LCO No. 2221 1 of 20 General Assembly Raised Bill No. 5373 February Session, 2024 LCO No. 2221 Referred to Committee on HUMAN SERVICES Introduced by: (HS) AN ACT CONCERNING VARIOUS REVISIONS TO HUMAN SERVICES STATUTES. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 17b-606 of the general statutes is repealed and the 1 following is substituted in lieu thereof (Effective from passage): 2 [(a) The Department of Social Services shall be the lead agency for 3 services to persons with physical or mental disabilities and shall 4 coordinate the delivery of such services by all state agencies servicing 5 persons with disabilities. 6 (b) Not later than September 30, 1988, the Commissioner of Social 7 Services shall appoint a Connecticut Council for Persons with 8 Disabilities to advise the Department of Social Services in carrying out 9 its duties pursuant to the provisions of subsection (a) of this section. The 10 council shall be composed of seventeen members, a majority of whom 11 shall be persons with disabilities. The council shall establish its own 12 rules and shall meet at least quarterly.] 13 [(c)] (a) There shall be established an interagency management 14 Raised Bill No. 5373 LCO No. 2221 2 of 20 committee for services to persons with disabilities. The committee shall 15 be composed of the commissioners, or their designees, of each state 16 agency that provides services to persons with disabilities. The 17 committee shall monthly review and evaluate services to persons with 18 disabilities and shall develop a policy under which state agencies may 19 enter into contracts with other state agencies for the delivery of services 20 to persons with disabilities. The first meeting of the committee shall be 21 convened by the Commissioner of Social Services. 22 [(d)] (b) The Department of Social Services shall maintain on the 23 department's Internet web site information on services provided to 24 persons with disabilities. The department's Internet web site shall 25 include a link to the Internet web page maintained by the Department 26 of Aging and Disability Services pursuant to section 17a-838 containing 27 information about services for deaf, deafblind and hard of hearing 28 individuals. 29 Sec. 2. Subdivision (1) of subsection (h) of section 17b-340 of the 2024 30 supplement to the general statutes is repealed and the following is 31 substituted in lieu thereof (Effective from passage): 32 (h) (1) For the fiscal year ending June 30, 1993, any intermediate care 33 facility for individuals with intellectual disabilities with an operating 34 cost component of its rate in excess of one hundred forty per cent of the 35 median of operating cost components of rates in effect January 1, 1992, 36 shall not receive an operating cost component increase. For the fiscal 37 year ending June 30, 1993, any intermediate care facility for individuals 38 with intellectual disabilities with an operating cost component of its rate 39 that is less than one hundred forty per cent of the median of operating 40 cost components of rates in effect January 1, 1992, shall have an 41 allowance for real wage growth equal to thirty per cent of the increase 42 determined in accordance with subsection (q) of section 17-311-52 of the 43 regulations of Connecticut state agencies, provided such operating cost 44 component shall not exceed one hundred forty per cent of the median 45 of operating cost components in effect January 1, 1992. Any facility with 46 real property other than land placed in service prior to October 1, 1991, 47 Raised Bill No. 5373 LCO No. 2221 3 of 20 shall, for the fiscal year ending June 30, 1995, receive a rate of return on 48 real property equal to the average of the rates of return applied to real 49 property other than land placed in service for the five years preceding 50 October 1, 1993. For the fiscal year ending June 30, 1996, and any 51 succeeding fiscal year, the rate of return on real property for property 52 items shall be revised every five years. The commissioner shall, upon 53 submission of a request, allow actual debt service, comprised of 54 principal and interest, in excess of property costs allowed pursuant to 55 section 17-311-52 of the regulations of Connecticut state agencies, 56 provided such debt service terms and amounts are reasonable in 57 relation to the useful life and the base value of the property. For the fiscal 58 year ending June 30, 1995, and any succeeding fiscal year, the inflation 59 adjustment made in accordance with subsection (p) of section 17-311-52 60 of the regulations of Connecticut state agencies shall not be applied to 61 real property costs. For the fiscal year ending June 30, 1996, and any 62 succeeding fiscal year, the allowance for real wage growth, as 63 determined in accordance with subsection (q) of section 17-311-52 of the 64 regulations of Connecticut state agencies, shall not be applied. For the 65 fiscal year ending June 30, 1996, and any succeeding fiscal year, no rate 66 shall exceed three hundred seventy-five dollars per day unless the 67 commissioner, in consultation with the Commissio ner of 68 Developmental Services, determines after a review of program and 69 management costs, that a rate in excess of this amount is necessary for 70 care and treatment of facility residents. For the fiscal year ending June 71 30, 2002, rate period, the Commissioner of Social Services shall increase 72 the inflation adjustment for rates made in accordance with subsection 73 (p) of section 17-311-52 of the regulations of Connecticut state agencies 74 to update allowable fiscal year 2000 costs to include a three and one-half 75 per cent inflation factor. For the fiscal year ending June 30, 2003, rate 76 period, the commissioner shall increase the inflation adjustment for 77 rates made in accordance with subsection (p) of section 17-311-52 of the 78 regulations of Connecticut state agencies to update allowable fiscal year 79 2001 costs to include a one and one-half per cent inflation factor, except 80 that such increase shall be effective November 1, 2002, and such facility 81 rate in effect for the fiscal year ending June 30, 2002, shall be paid for 82 Raised Bill No. 5373 LCO No. 2221 4 of 20 services provided until October 31, 2002, except any facility that would 83 have been issued a lower rate effective July 1, 2002, than for the fiscal 84 year ending June 30, 2002, due to interim rate status or agreement with 85 the department shall be issued such lower rate effective July 1, 2002, and 86 have such rate updated effective November 1, 2002, in accordance with 87 applicable statutes and regulations. For the fiscal year ending June 30, 88 2004, rates in effect for the period ending June 30, 2003, shall remain in 89 effect, except any facility that would have been issued a lower rate 90 effective July 1, 2003, than for the fiscal year ending June 30, 2003, due 91 to interim rate status or agreement with the department shall be issued 92 such lower rate effective July 1, 2003. For the fiscal year ending June 30, 93 2005, rates in effect for the period ending June 30, 2004, shall remain in 94 effect until September 30, 2004. Effective October 1, 2004, each facility 95 shall receive a rate that is five per cent greater than the rate in effect 96 September 30, 2004. Effective upon receipt of all the necessary federal 97 approvals to secure federal financial participation matching funds 98 associated with the rate increase provided in subdivision (4) of 99 subsection (f) of this section, but in no event earlier than October 1, 2005, 100 and provided the user fee imposed under section 17b-320 is required to 101 be collected, each facility shall receive a rate that is four per cent more 102 than the rate the facility received in the prior fiscal year, except any 103 facility that would have been issued a lower rate effective October 1, 104 2005, than for the fiscal year ending June 30, 2005, due to interim rate 105 status or agreement with the department, shall be issued such lower rate 106 effective October 1, 2005. Such rate increase shall remain in effect unless: 107 (A) The federal financial participation matching funds associated with 108 the rate increase are no longer available; or (B) the user fee created 109 pursuant to section 17b-320 is not in effect. For the fiscal year ending 110 June 30, 2007, rates in effect for the period ending June 30, 2006, shall 111 remain in effect until September 30, 2006, except any facility that would 112 have been issued a lower rate effective July 1, 2006, than for the fiscal 113 year ending June 30, 2006, due to interim rate status or agreement with 114 the department, shall be issued such lower rate effective July 1, 2006. 115 Effective October 1, 2006, no facility shall receive a rate that is more than 116 three per cent greater than the rate in effect for the facility on September 117 Raised Bill No. 5373 LCO No. 2221 5 of 20 30, 2006, except any facility that would have been issued a lower rate 118 effective October 1, 2006, due to interim rate status or agreement with 119 the department, shall be issued such lower rate effective October 1, 2006. 120 For the fiscal year ending June 30, 2008, each facility shall receive a rate 121 that is two and nine-tenths per cent greater than the rate in effect for the 122 period ending June 30, 2007, except any facility that would have been 123 issued a lower rate effective July 1, 2007, than for the rate period ending 124 June 30, 2007, due to interim rate status, or agreement with the 125 department, shall be issued such lower rate effective July 1, 2007. For the 126 fiscal year ending June 30, 2009, rates in effect for the period ending June 127 30, 2008, shall remain in effect until June 30, 2009, except any facility that 128 would have been issued a lower rate for the fiscal year ending June 30, 129 2009, due to interim rate status or agreement with the department, shall 130 be issued such lower rate. For the fiscal years ending June 30, 2010, and 131 June 30, 2011, rates in effect for the period ending June 30, 2009, shall 132 remain in effect until June 30, 2011, except any facility that would have 133 been issued a lower rate for the fiscal year ending June 30, 2010, or the 134 fiscal year ending June 30, 2011, due to interim rate status or agreement 135 with the department, shall be issued such lower rate. For the fiscal year 136 ending June 30, 2012, rates in effect for the period ending June 30, 2011, 137 shall remain in effect until June 30, 2012, except any facility that would 138 have been issued a lower rate for the fiscal year ending June 30, 2012, 139 due to interim rate status or agreement with the department, shall be 140 issued such lower rate. For the fiscal years ending June 30, 2014, and 141 June 30, 2015, rates shall not exceed those in effect for the period ending 142 June 30, 2013, except the rate paid to a facility may be higher than the 143 rate paid to the facility for the period ending June 30, 2013, if a capital 144 improvement approved by the Department of Developmental Services, 145 in consultation with the Department of Social Services, for the health or 146 safety of the residents was made to the facility during the fiscal year 147 ending June 30, 2014, or June 30, 2015, to the extent such rate increases 148 are within available appropriations. Any facility that would have been 149 issued a lower rate for the fiscal year ending June 30, 2014, or the fiscal 150 year ending June 30, 2015, due to interim rate status or agreement with 151 the department, shall be issued such lower rate. For the fiscal years 152 Raised Bill No. 5373 LCO No. 2221 6 of 20 ending June 30, 2016, and June 30, 2017, rates shall not exceed those in 153 effect for the period ending June 30, 2015, except the rate paid to a 154 facility may be higher than the rate paid to the facility for the period 155 ending June 30, 2015, if a capital improvement approved by the 156 Department of Developmental Services, in consultation with the 157 Department of Social Services, for the health or safety of the residents 158 was made to the facility during the fiscal year ending June 30, 2016, or 159 June 30, 2017, to the extent such rate increases are within available 160 appropriations. For the fiscal years ending June 30, 2016, and June 30, 161 2017, and each succeeding fiscal year, any facility that would have been 162 issued a lower rate, due to interim rate status, a change in allowable fair 163 rent or agreement with the department, shall be issued such lower rate. 164 For the fiscal years ending June 30, 2018, and June 30, 2019, rates shall 165 not exceed those in effect for the period ending June 30, 2017, except the 166 rate paid to a facility may be higher than the rate paid to the facility for 167 the period ending June 30, 2017, if a capital improvement approved by 168 the Department of Developmental Services, in consultation with the 169 Department of Social Services, for the health or safety of the residents 170 was made to the facility during the fiscal year ending June 30, 2018, or 171 June 30, 2019, only to the extent such rate increases are within available 172 appropriations. For the fiscal years ending June 30, 2020, and June 30, 173 2021, rates shall not exceed those in effect for the fiscal year ending June 174 30, 2019, except the rate paid to a facility may be higher than the rate 175 paid to the facility for the fiscal year ending June 30, 2019, if a capital 176 improvement approved by the Department of Developmental Services, 177 in consultation with the Department of Social Services, for the health or 178 safety of the residents was made to the facility during the fiscal year 179 ending June 30, 2020, or June 30, 2021, only to the extent such rate 180 increases are within available appropriations. For the fiscal year ending 181 June 30, 2022, rates shall not exceed those in effect for the fiscal year 182 ending June 30, 2021, except the commissioner may, in the 183 commissioner's discretion and within available appropriations, provide 184 pro rata fair rent increases to facilities that have documented fair rent 185 additions placed in service in the cost report year ending September 30, 186 2020, that are not otherwise included in rates issued. For the fiscal year 187 Raised Bill No. 5373 LCO No. 2221 7 of 20 ending June 30, 2023, rates shall not exceed those in effect for the fiscal 188 year ending June 30, 2022, except the commissioner may, in the 189 commissioner's discretion and within available appropriations, provide 190 pro rata fair rent increases to facilities which have documented fair rent 191 additions placed in service in the cost report year ending September 30, 192 2021, that are not otherwise included in rates issued. For the fiscal years 193 ending June 30, 2022, and June 30, 2023, a facility may receive a rate 194 increase for a capital improvement approved by the Department of 195 Developmental Services, in consultation with the Department of Social 196 Services, for the health or safety of the residents during the fiscal year 197 ending June 30, 2022, or June 30, 2023, only to the extent such rate 198 increases are within available appropriations. There shall be no increase 199 to rates based on inflation or any inflationary factor for the fiscal years 200 ending June 30, 2022, and June 30, 2023. Notwithstanding any other 201 provisions of this chapter, any subsequent increase to allowable 202 operating costs, excluding fair rent, shall be inflated by the gross 203 domestic product deflator when funding is specifically appropriated for 204 such purposes in the enacted budget. The rate of inflation shall be 205 computed by comparing the most recent rate year to the average of the 206 gross domestic product deflator for the previous four fiscal quarters 207 ending [April thirtieth] March thirty-first. Any increase to rates based 208 on inflation shall be applied prior to the application of any other budget 209 adjustment factors that may impact such rates. For the fiscal year ending 210 June 30, 2024, the department shall determine facility rates based upon 211 2022 cost report filings subject to the provisions of this section, adjusted 212 to reflect any rate increases provided after the cost report year ending 213 June 30, 2022, and with the addition of a two per cent adjustment factor. 214 No facility shall receive a rate less than the rate in effect for the fiscal 215 year ending June 30, 2023. For the fiscal year ending June 30, 2024, the 216 minimum per diem, per bed rate shall remain at five hundred one 217 dollars for a residential facility licensed pursuant to section 17a-227 and 218 certified to participate in the Title XIX Medicaid program as an 219 intermediate care facility for individuals with intellectual disability. 220 There shall be no increase to rates based on any inflationary factor for 221 the fiscal year ending June 30, 2024. For the fiscal year ending June 30, 222 Raised Bill No. 5373 LCO No. 2221 8 of 20 2024, and each subsequent fiscal year, the commissioner may, in the 223 commissioner's discretion and within available appropriations, provide 224 pro rata fair rent increases to facilities that have documented fair rent 225 additions placed in service in the cost report years that are not otherwise 226 included in rates issued. For the fiscal year ending June 30, 2025, the 227 department shall determine facility rates based upon 2023 cost report 228 filings subject to the provisions of this section, adjusted to reflect any 229 rate increases provided after the cost report ending June 30, 2023. A 230 facility may receive a rate that is less than the rate in effect for the fiscal 231 year ending June 30, 2024, but shall not receive a rate less than the 232 minimum per diem, per bed rate. For the fiscal year ending June 30, 233 2025, the minimum per diem, per bed rate shall remain at five hundred 234 one dollars for a residential facility licensed pursuant to section 17a-227 235 and certified to participate in the Title XIX Medicaid program as an 236 intermediate care facility for individuals with intellectual disability. 237 There shall be no increase to rates based on any inflationary factor for 238 the fiscal year ending June 30, 2025. For the fiscal year ending June 30, 239 2026, the department shall determine facility rates based upon 2024 cost 240 report filings subject to the provisions of this section, adjusted to reflect 241 any rate increases provided after the cost report ending June 30, 2024. 242 For the fiscal year ending June 30, 2026, there shall be no minimum per 243 diem, per bed rate for a residential facility licensed pursuant to section 244 17a-227 and certified to participate in the Title XIX Medicaid program 245 as an intermediate care facility for individuals with intellectual 246 disability. There shall be no increase to rates based on any inflationary 247 factor for the fiscal year ending June 30, 2026. For the fiscal years ending 248 June 30, 2024, and June 30, 2025, a facility may receive a rate increase for 249 a capital improvement approved by the Department of Developmental 250 Services, in consultation with the Department of Social Services, for the 251 health or safety of the residents during the fiscal year ending June 30, 252 2024, or June 30, 2025, only to the extent such rate increases are within 253 available appropriations. Any facility that has a significant decrease in 254 land and building costs shall receive a reduced rate to reflect such 255 decrease in land and building costs. For the fiscal years ending June 30, 256 2012, June 30, 2013, June 30, 2014, June 30, 2015, June 30, 2016, June 30, 257 Raised Bill No. 5373 LCO No. 2221 9 of 20 2017, June 30, 2018, June 30, 2019, June 30, 2020, June 30, 2021, June 30, 258 2022, June 30, 2023, June 30, 2024, and June 30, 2025, the Commissioner 259 of Social Services may provide fair rent increases to any facility that has 260 undergone a material change in circumstances related to fair rent and 261 has an approved certificate of need pursuant to section 17b-352, 17b-353, 262 17b-354 or 17b-355. Notwithstanding the provisions of this section, the 263 Commissioner of Social Services may, within available appropriations, 264 increase or decrease rates issued to intermediate care facilities for 265 individuals with intellectual disabilities to reflect a reduction in 266 available appropriations as provided in subsection (a) of this section. 267 For the fiscal years ending June 30, 2014, and June 30, 2015, the 268 commissioner shall not consider rebasing in determining rates. 269 Notwithstanding the provisions of this subsection, effective July 1, 2021, 270 and July 1, 2022, the commissioner shall, within available 271 appropriations, increase rates for the purpose of wage and benefit 272 enhancements for employees of intermediate care facilities. Facilities 273 that receive a rate adjustment for the purpose of wage and benefit 274 enhancements but do not provide increases in employee salaries as 275 described in this subsection on or before July 31, 2021, and July 31, 2022, 276 respectively, may be subject to a rate decrease in the same amount as the 277 adjustment by the commissioner. 278 Sec. 3. Subsection (i) of section 17b-340 of the 2024 supplement to the 279 general statutes is repealed and the following is substituted in lieu 280 thereof (Effective from passage): 281 (i) For the fiscal year ending June 30, 1993, any residential care home 282 with an operating cost component of its rate in excess of one hundred 283 thirty per cent of the median of operating cost components of rates in 284 effect January 1, 1992, shall not receive an operating cost component 285 increase. For the fiscal year ending June 30, 1993, any residential care 286 home with an operating cost component of its rate that is less than one 287 hundred thirty per cent of the median of operating cost components of 288 rates in effect January 1, 1992, shall have an allowance for real wage 289 growth equal to sixty-five per cent of the increase determined in 290 accordance with subsection (q) of section 17-311-52 of the regulations of 291 Raised Bill No. 5373 LCO No. 2221 10 of 20 Connecticut state agencies, provided such operating cost component 292 shall not exceed one hundred thirty per cent of the median of operating 293 cost components in effect January 1, 1992. Beginning with the fiscal year 294 ending June 30, 1993, for the purpose of determining allowable fair rent, 295 a residential care home with allowable fair rent less than the twenty-296 fifth percentile of the state-wide allowable fair rent shall be reimbursed 297 as having allowable fair rent equal to the twenty-fifth percentile of the 298 state-wide allowable fair rent. Beginning with the fiscal year ending 299 June 30, 1997, a residential care home with allowable fair rent less than 300 three dollars and ten cents per day shall be reimbursed as having 301 allowable fair rent equal to three dollars and ten cents per day. Property 302 additions placed in service during the cost year ending September 30, 303 1996, or any succeeding cost year shall receive a fair rent allowance for 304 such additions as an addition to three dollars and ten cents per day if 305 the fair rent for the facility for property placed in service prior to 306 September 30, 1995, is less than or equal to three dollars and ten cents 307 per day. Beginning with the fiscal year ending June 30, 2016, a 308 residential care home shall be reimbursed the greater of the allowable 309 accumulated fair rent reimbursement associated with real property 310 additions and land as calculated on a per day basis or three dollars and 311 ten cents per day if the allowable reimbursement associated with real 312 property additions and land is less than three dollars and ten cents per 313 day. For the fiscal year ending June 30, 1996, and any succeeding fiscal 314 year, the allowance for real wage growth, as determined in accordance 315 with subsection (q) of section 17-311-52 of the regulations of Connecticut 316 state agencies, shall not be applied. For the fiscal year ending June 30, 317 1996, and any succeeding fiscal year, the inflation adjustment made in 318 accordance with subsection (p) of section 17-311-52 of the regulations of 319 Connecticut state agencies shall not be applied to real property costs. 320 Beginning with the fiscal year ending June 30, 1997, minimum allowable 321 patient days for rate computation purposes for a residential care home 322 with twenty-five beds or less shall be eighty-five per cent of licensed 323 capacity. Beginning with the fiscal year ending June 30, 2002, for the 324 purposes of determining the allowable salary of an administrator of a 325 residential care home with sixty beds or less the department shall revise 326 Raised Bill No. 5373 LCO No. 2221 11 of 20 the allowable base salary to thirty-seven thousand dollars to be annually 327 inflated thereafter in accordance with section 17-311-52 of the 328 regulations of Connecticut state agencies. The rates for the fiscal year 329 ending June 30, 2002, shall be based upon the increased allowable salary 330 of an administrator, regardless of whether such amount was expended 331 in the 2000 cost report period upon which the rates are based. Beginning 332 with the fiscal year ending June 30, 2000, and until the fiscal year ending 333 June 30, 2009, inclusive, the inflation adjustment for rates made in 334 accordance with subsection (p) of section 17-311-52 of the regulations of 335 Connecticut state agencies shall be increased by two per cent, and 336 beginning with the fiscal year ending June 30, 2002, the inflation 337 adjustment for rates made in accordance with subsection (c) of said 338 section shall be increased by one per cent. Beginning with the fiscal year 339 ending June 30, 1999, for the purpose of determining the allowable 340 salary of a related party, the department shall revise the maximum 341 salary to twenty-seven thousand eight hundred fifty-six dollars to be 342 annually inflated thereafter in accordance with section 17-311-52 of the 343 regulations of Connecticut state agencies and beginning with the fiscal 344 year ending June 30, 2001, such allowable salary shall be computed on 345 an hourly basis and the maximum number of hours allowed for a related 346 party other than the proprietor shall be increased from forty hours to 347 forty-eight hours per work week. For the fiscal year ending June 30, 348 2005, each facility shall receive a rate that is two and one-quarter per 349 cent more than the rate the facility received in the prior fiscal year, 350 except any facility that would have been issued a lower rate effective 351 July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim 352 rate status or agreement with the department shall be issued such lower 353 rate effective July 1, 2004. Effective upon receipt of all the necessary 354 federal approvals to secure federal financial participation matching 355 funds associated with the rate increase provided in subdivision (4) of 356 subsection (f) of this section, but in no event earlier than October 1, 2005, 357 and provided the user fee imposed under section 17b-320 is required to 358 be collected, each facility shall receive a rate that is determined in 359 accordance with applicable law and subject to appropriations, except 360 any facility that would have been issued a lower rate effective October 361 Raised Bill No. 5373 LCO No. 2221 12 of 20 1, 2005, than for the fiscal year ending June 30, 2005, due to interim rate 362 status or agreement with the department, shall be issued such lower rate 363 effective October 1, 2005. Such rate increase shall remain in effect unless: 364 (1) The federal financial participation matching funds associated with 365 the rate increase are no longer available; or (2) the user fee created 366 pursuant to section 17b-320 is not in effect. For the fiscal year ending 367 June 30, 2007, rates in effect for the period ending June 30, 2006, shall 368 remain in effect until September 30, 2006, except any facility that would 369 have been issued a lower rate effective July 1, 2006, than for the fiscal 370 year ending June 30, 2006, due to interim rate status or agreement with 371 the department, shall be issued such lower rate effective July 1, 2006. 372 Effective October 1, 2006, no facility shall receive a rate that is more than 373 four per cent greater than the rate in effect for the facility on September 374 30, 2006, except for any facility that would have been issued a lower rate 375 effective October 1, 2006, due to interim rate status or agreement with 376 the department, shall be issued such lower rate effective October 1, 2006. 377 For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect 378 for the period ending June 30, 2009, shall remain in effect until June 30, 379 2011, except any facility that would have been issued a lower rate for 380 the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 381 2011, due to interim rate status or agreement with the department, shall 382 be issued such lower rate, except (A) any facility that would have been 383 issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal 384 year ending June 30, 2011, due to interim rate status or agreement with 385 the Commissioner of Social Services shall be issued such lower rate; and 386 (B) the commissioner may increase a facility's rate for reasonable costs 387 associated with such facility's compliance with the provisions of section 388 19a-495a concerning the administration of medication by unlicensed 389 personnel. For the fiscal year ending June 30, 2012, rates in effect for the 390 period ending June 30, 2011, shall remain in effect until June 30, 2012, 391 except that (i) any facility that would have been issued a lower rate for 392 the fiscal year ending June 30, 2012, due to interim rate status or 393 agreement with the Commissioner of Social Services shall be issued 394 such lower rate; and (ii) the commissioner may increase a facility's rate 395 for reasonable costs associated with such facility's compliance with the 396 Raised Bill No. 5373 LCO No. 2221 13 of 20 provisions of section 19a-495a concerning the administration of 397 medication by unlicensed personnel. For the fiscal year ending June 30, 398 2013, the Commissioner of Social Services may, within available 399 appropriations, provide a rate increase to a residential care home. Any 400 facility that would have been issued a lower rate for the fiscal year 401 ending June 30, 2013, due to interim rate status or agreement with the 402 Commissioner of Social Services shall be issued such lower rate. For the 403 fiscal years ending June 30, 2012, and June 30, 2013, the Commissioner 404 of Social Services may provide fair rent increases to any facility that has 405 undergone a material change in circumstances related to fair rent and 406 has an approved certificate of need pursuant to section 17b-352, 17b-353, 407 17b-354 or 17b-355. For the fiscal years ending June 30, 2014, and June 408 30, 2015, for those facilities that have a calculated rate greater than the 409 rate in effect for the fiscal year ending June 30, 2013, the commissioner 410 may increase facility rates based upon available appropriations up to a 411 stop gain as determined by the commissioner. No facility shall be issued 412 a rate that is lower than the rate in effect on June 30, 2013, except that 413 any facility that would have been issued a lower rate for the fiscal year 414 ending June 30, 2014, or the fiscal year ending June 30, 2015, due to 415 interim rate status or agreement with the commissioner, shall be issued 416 such lower rate. For the fiscal year ending June 30, 2014, and each fiscal 417 year thereafter, a residential care home shall receive a rate increase for 418 any capital improvement made during the fiscal year for the health and 419 safety of residents and approved by the Department of Social Services, 420 provided such rate increase is within available appropriations. For the 421 fiscal year ending June 30, 2015, and each succeeding fiscal year 422 thereafter, costs of less than ten thousand dollars that are incurred by a 423 facility and are associated with any land, building or nonmovable 424 equipment repair or improvement that are reported in the cost year used 425 to establish the facility's rate shall not be capitalized for a period of more 426 than five years for rate-setting purposes. For the fiscal year ending June 427 30, 2015, subject to available appropriations, the commissioner may, at 428 the commissioner's discretion: Increase the inflation cost limitation 429 under subsection (c) of section 17-311-52 of the regulations of 430 Connecticut state agencies, provided such inflation allowance factor 431 Raised Bill No. 5373 LCO No. 2221 14 of 20 does not exceed a maximum of five per cent; establish a minimum rate 432 of return applied to real property of five per cent inclusive of assets 433 placed in service during cost year 2013; waive the standard rate of return 434 under subsection (f) of section 17-311-52 of the regulations of 435 Connecticut state agencies for ownership changes or health and safety 436 improvements that exceed one hundred thousand dollars and that are 437 required under a consent order from the Department of Public Health; 438 and waive the rate of return adjustment under subsection (f) of section 439 17-311-52 of the regulations of Connecticut state agencies to avoid 440 financial hardship. For the fiscal years ending June 30, 2016, and June 441 30, 2017, rates shall not exceed those in effect for the period ending June 442 30, 2015, except the commissioner may, in the commissioner's discretion 443 and within available appropriations, provide pro rata fair rent increases 444 to facilities which have documented fair rent additions placed in service 445 in cost report years ending September 30, 2014, and September 30, 2015, 446 that are not otherwise included in rates issued. For the fiscal years 447 ending June 30, 2016, and June 30, 2017, and each succeeding fiscal year, 448 any facility that would have been issued a lower rate, due to interim rate 449 status, a change in allowable fair rent or agreement with the department, 450 shall be issued such lower rate. For the fiscal year ending June 30, 2018, 451 rates shall not exceed those in effect for the period ending June 30, 2017, 452 except the commissioner may, in the commissioner's discretion and 453 within available appropriations, provide pro rata fair rent increases to 454 facilities which have documented fair rent additions placed in service in 455 the cost report year ending September 30, 2016, that are not otherwise 456 included in rates issued. For the fiscal year ending June 30, 2019, rates 457 shall not exceed those in effect for the period ending June 30, 2018, 458 except the commissioner may, in the commissioner's discretion and 459 within available appropriations, provide pro rata fair rent increases to 460 facilities which have documented fair rent additions placed in service in 461 the cost report year ending September 30, 2017, that are not otherwise 462 included in rates issued. For the fiscal year ending June 30, 2020, rates 463 shall not exceed those in effect for the fiscal year ending June 30, 2019, 464 except the commissioner may, in the commissioner's discretion and 465 within available appropriations, provide pro rata fair rent increases to 466 Raised Bill No. 5373 LCO No. 2221 15 of 20 facilities which have documented fair rent additions placed in service in 467 the cost report year ending September 30, 2018, that are not otherwise 468 included in rates issued. For the fiscal year ending June 30, 2021, rates 469 shall not exceed those in effect for the fiscal year ending June 30, 2020, 470 except the commissioner may, in the commissioner's discretion and 471 within available appropriations, provide pro rata fair rent increases to 472 facilities which have documented fair rent additions placed in service in 473 the cost report year ending September 30, 2019, that are not otherwise 474 included in rates issued. For the fiscal year ending June 30, 2022, the 475 commissioner may, in the commissioner's discretion and within 476 available appropriations, provide pro rata fair rent increases to facilities 477 that have documented fair rent additions placed in service in the cost 478 report year ending September 30, 2020, that are not otherwise included 479 in rates issued. For the fiscal year ending June 30, 2023, the 480 commissioner may, in the commissioner's discretion and within 481 available appropriations, provide pro rata fair rent increases to facilities 482 which have documented fair rent additions placed in service in the cost 483 report year ending September 30, 2021, that are not otherwise included 484 in rates issued. For the fiscal years ending June 30, 2022, and June 30, 485 2023, a facility may receive a rate increase for a capital improvement 486 approved by the Department of Social Services, for the health or safety 487 of the residents during the fiscal year ending June 30, 2022, or June 30, 488 2023, only to the extent such rate increases are within available 489 appropriations. For the fiscal year ending June 30, 2022, and June 30, 490 2023, rates shall be based upon rates in effect for the fiscal year ending 491 June 30, 2021, inflated by the gross domestic product deflator applicable 492 to each rate year, except the commissioner may, in the commissioner's 493 discretion and within available appropriations, provide pro rata fair 494 rent increases to facilities which have documented fair rent additions 495 placed in service in the cost report years ending September 30, 2020, and 496 September 30, 2021, that are not otherwise included in rates issued. For 497 the fiscal years ending June 30, 2024, and June 30, 2025, a facility may 498 receive a rate increase for a capital improvement approved by the 499 Department of Social Services, for the health or safety of the residents 500 during the fiscal year ending June 30, 2024, or June 30, 2025, only to the 501 Raised Bill No. 5373 LCO No. 2221 16 of 20 extent such rate increases are within available appropriations. For the 502 fiscal year ending June 30, 2024, the department shall determine facility 503 rates based upon 2022 cost report filings subject to the provisions of this 504 section, adjusted to reflect any rate increases provided after the cost 505 report year ending September 30, 2022. There shall be no increase to 506 rates based on any inflationary factor for the fiscal year ending June 30, 507 2024. Notwithstanding any other provisions of this chapter, any 508 subsequent increase to allowable operating costs, excluding fair rent, 509 shall be inflated by the gross domestic product deflator when funding 510 is specifically appropriated for such purposes in the enacted budget. 511 The rate of inflation shall be computed by comparing the most recent 512 rate year to the average of the gross domestic product deflator for the 513 previous four fiscal quarters ending [April thirtieth] March thirty-first. 514 Any increase to rates based on inflation shall be applied prior to the 515 application of any other budget adjustment factors that may impact 516 such rates. The commissioner shall determine whether and to what 517 extent a change in ownership of a facility shall occasion the rebasing of 518 the facility's costs. There shall be no inflation adjustment during a year 519 in which a facility's rates are rebased. For the fiscal year ending June 30, 520 2024, the commissioner may, in the commissioner's discretion and 521 within available appropriations, provide pro rata fair rent increases to 522 facilities that have documented fair rent additions placed in service in 523 the cost report year ending September 30, 2022, that are not otherwise 524 included in rates issued. For the fiscal year ending June 30, 2025, the 525 commissioner may, in the commissioner's discretion and within 526 available appropriations, provide pro rata fair rent increases to facilities 527 that have documented fair rent additions placed in service in the cost 528 report year ending September 30, 2023, that are not otherwise included 529 in rates issued. 530 Sec. 4. Subdivision (11) of subsection (a) of section 17b-340d of the 531 2024 supplement to the general statutes is repealed and the following is 532 substituted in lieu thereof (Effective from passage): 533 (11) There shall be no increase to rates based on inflation or any 534 inflationary factor for the fiscal years ending June 30, 2022, and June 30, 535 Raised Bill No. 5373 LCO No. 2221 17 of 20 2023, unless otherwise authorized under subdivision (1) of this 536 subsection. Notwithstanding section 17-311-52 of the regulations of 537 Connecticut state agencies, for the fiscal years ending June 30, 2024, and 538 June 30, 2025, there shall be no inflationary increases to rates beyond 539 those already factored into the model for the transition to an acuity-540 based reimbursement system. Notwithstanding any other provisions of 541 this chapter, any subsequent increase to allowable operating costs, 542 excluding fair rent, shall be inflated by the gross domestic product 543 deflator when funding is specifically appropriated for such purposes in 544 the enacted budget. The rate of inflation shall be computed by 545 comparing the most recent rate year to the average of the gross domestic 546 product deflator for the previous four fiscal quarters ending [April 547 thirtieth] March thirty-first. Any increase to rates based on inflation 548 shall be applied prior to the application of any other budget adjustment 549 factors that may impact such rates. 550 Sec. 5. Subsection (b) of section 17b-238 of the general statutes is 551 repealed and the following is substituted in lieu thereof (Effective from 552 passage): 553 (b) Any institution or agency to which payments are to be made 554 under sections 17b-239 to 17b-246, inclusive, and sections 17b-340, as 555 amended by this act, and 17b-343 which is aggrieved by any decision of 556 said commissioner may, within ten days after written notice thereof 557 from the commissioner, obtain, by written request to the commissioner, 558 a rehearing on all items of aggrievement. On and after July 1, 1996, a 559 rehearing shall be held by the commissioner or his designee, provided a 560 detailed written description of all such items is filed within ninety days 561 of written notice of the commissioner's decision. The rehearing shall be 562 held within thirty days of the filing of the detailed written description 563 of each specific item of aggrievement. The commissioner shall issue a 564 final decision within sixty days of the close of evidence or the date on 565 which final briefs are filed, whichever occurs later. Any designee of the 566 commissioner who presides over such rehearing shall be impartial and 567 shall not be employed within the Department of Social Services office of 568 certificate of need and rate setting. Any such items not resolved at such 569 Raised Bill No. 5373 LCO No. 2221 18 of 20 rehearing to the satisfaction of either such institution or agency or said 570 commissioner [shall be submitted to binding arbitration to an 571 arbitration board consisting of one member appointed by the institution 572 or agency, one member appointed by the commissioner and one 573 member appointed by the Chief Court Administrator from among the 574 retired judges of the Superior Court, which retired judge shall be 575 compensated for his services on such board in the same manner as a 576 state referee is compensated for his services under section 52-434. The 577 proceedings of the arbitration board and any decisions rendered by such 578 board shall be conducted in accordance with the provisions of the Social 579 Security Act, 49 Stat. 620 (1935), 42 USC 1396, as amended from time to 580 time, and chapter 54] may be appealed in accordance with section 4-183. 581 Such appeals shall be privileged cases to be heard by the court as soon 582 after the return day as shall be practicable. 583 Sec. 6. Subsection (i) of section 17b-99a of the general statutes is 584 repealed and the following is substituted in lieu thereof (Effective from 585 passage): 586 (i) Any facility aggrieved by a final report issued pursuant to 587 subsection (h) of this section may request a rehearing. A rehearing shall 588 be held by the commissioner or the commissioner's designee, provided 589 a detailed written description of all items of aggrievement in the final 590 report is filed by the facility not later than ninety days following the date 591 of written notice of the commissioner's decision. The rehearing shall be 592 held not later than thirty days following the date of filing of the detailed 593 written description of each specific item of aggrievement. The 594 commissioner shall issue a final decision not later than sixty days 595 following the close of evidence or the date on which final briefs are filed, 596 whichever occurs later. Any items not resolved at such rehearing to the 597 satisfaction of the facility or the commissioner [shall be submitted to 598 binding arbitration by an arbitration board consisting of one member 599 appointed by the facility, one member appointed by the commissioner 600 and one member appointed by the Chief Court Administrator from 601 among the retired judges of the Superior Court, which retired judge 602 shall be compensated for his services on such board in the same manner 603 Raised Bill No. 5373 LCO No. 2221 19 of 20 as a state referee is compensated for his services under section 52-434. 604 The proceedings of the arbitration board and any decisions rendered by 605 such board shall be conducted in accordance with the provisions of the 606 Social Security Act, 42 USC 1396, as amended from time to time, and 607 chapter 54] may be appealed in accordance with section 4-183. Such 608 appeals shall be privileged cases to be heard by the court as soon after 609 the return day as shall be practicable. 610 Sec. 7. Subsection (c) of section 17a-784 of the general statutes is 611 repealed and the following is substituted in lieu thereof (Effective from 612 passage): 613 (c) The Commissioner of Aging and Disability Services shall develop 614 and maintain a program of public education and information. The 615 program shall include, but need not be limited to, education of the 616 public concerning services available from the Department of Aging and 617 Disability Services, its policies and goals, an outreach effort to discover 618 persons with disabilities, including such persons who are minorities as 619 defined in subsection (a) of section 32-9n, who may benefit from the 620 services it offers and the dissemination of printed materials to persons 621 at their initial meeting with staff of the department, including a 622 statement of such person's rights. [Each state agency providing services 623 to persons with disabilities shall furnish to each person applying for 624 such services, at the time of initial application, a written summary of all 625 state programs for persons with disabilities. Such summary shall be 626 developed by the Department of Social Services as the lead agency for 627 services to persons with disabilities pursuant to section 17b-606. The 628 Department of Social Services shall distribute sufficient copies of the 629 summary to all state agencies providing services to persons with 630 disabilities in order that such copies may be furnished in accordance 631 with this subsection.] 632 Sec. 8. Sections 17b-608 and 17b-609 of the general statutes are 633 repealed. (Effective from passage)634 Raised Bill No. 5373 LCO No. 2221 20 of 20 This act shall take effect as follows and shall amend the following sections: Section 1 from passage 17b-606 Sec. 2 from passage 17b-340(h)(1) Sec. 3 from passage 17b-340(i) Sec. 4 from passage 17b-340d(a)(11) Sec. 5 from passage 17b-238(b) Sec. 6 from passage 17b-99a(i) Sec. 7 from passage 17a-784(c) Sec. 8 from passage Repealer section Statement of Purpose: To repeal obsolete statutory provisions, make technical statutory changes and replace an arbitration process with the right to appeal to a Superior Court. [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]