Connecticut 2024 Regular Session

Connecticut Senate Bill SB00310 Compare Versions

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Version 2 (New)

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7	5		General Assembly Raised Bill No. 310
8	6		February Session, 2024
9	7		LCO No. 2106
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12	10		Referred to Committee on HUMAN SERVICES
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14	12
15	13		Introduced by:
16	14		(HS)
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20	19		AN ACT CONCERNING COMPENSATION FOR FAMILY CAREGIVERS,
21	20		RETROACTIVE ELIGIBILITY FOR MEDICAID AND TREATMENT OF
22	21		ASSETS DISCOVERED AFTER AN APPLICATION FOR MEDICAL
23	22		ASSISTANCE.
24	23		Be it enacted by the Senate and House of Representatives in General
25	24		Assembly convened:
26	25
27	26		Section 1. (NEW) (Effective July 1, 2024) To the extent permissible 1
28	27		under federal law, payment rates for family caregivers authorized to 2
29	28		receive compensation in programs administered by the Department of 3
30	29		Social Services shall be equal to the rates set for nonfamily professional 4
31	30		caregivers providing the same types of services to participants in such 5
32	31		programs. The Commissioner of Social Services shall use the fair market 6
33	32		value of services provided by a family caregiver in determining whether 7
34	33		a Medicaid applicant who transferred assets to such caregiver as part of 8
35	34		a legally enforceable compensation agreement for such services violated 9
36	35		any provision of federal law regarding the transfer of assets. 10
37	36		Sec. 2. Subsection (h) of section 17b-342 of the general statutes is 11
38	37		repealed and the following is substituted in lieu thereof (Effective July 1, 12
39		-	2024): 13 Bill No. 310
	38	+	2024): 13 Raised Bill No. 310
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46	44		(h) An individual who is otherwise eligible for services pursuant to 14
47	45		this section shall, as a condition of participation in the program, apply 15
48	46		for medical assistance benefits pursuant to section 17b-260 when 16
49	47		requested to do so by the department and shall accept such benefits if 17
50	48		determined eligible. To the extent permissible under 42 CFR 435.915, as 18
51	49		amended from time to time, the Commissioner of Social Services shall 19
52	50		provide medical assistance for Medicaid-eligible home care services 20
53	51		retroactive to not more than three months before the date an eligible 21
54	52		individual applied for medical assistance benefits, provided such 22
55	53		individual was otherwise eligible for such benefits in the three-month 23
56	54		period prior to the date of application. 24
57	55		Sec. 3. Section 17b-261 of the 2024 supplement to the general statutes 25
58	56		is repealed and the following is substituted in lieu thereof (Effective July 26
59	57		1, 2024): 27
60	58		(a) Medical assistance shall be provided for any otherwise eligible 28
61	59		person (1) whose income, including any available support from legally 29
62	60		liable relatives and the income of the person's spouse or dependent 30
63	61		child, is not more than one hundred forty-three per cent, pending 31
64	62		approval of a federal waiver applied for pursuant to subsection (e) of 32
65	63		this section, of the benefit amount paid to a person with no income 33
66	64		under the temporary family assistance program, and (2) if such person 34
67	65		is an institutionalized individual as defined in Section 1917 of the Social 35
68	66		Security Act, 42 USC 1396p(h)(3), and has not made an assignment or 36
69	67		transfer or other disposition of property for less than fair market value 37
70	68		for the purpose of establishing eligibility for benefits or assistance under 38
71	69		this section. Any such disposition shall be treated in accordance with 39
72	70		Section 1917(c) of the Social Security Act, 42 USC 1396p(c). Any 40
73	71		disposition of property made on behalf of an applicant or recipient or 41
74	72		the spouse of an applicant or recipient by a guardian, conservator, 42
75	73		person authorized to make such disposition pursuant to a power of 43
76	74		attorney or other person so authorized by law shall be attributed to such 44
77	75		applicant, recipient or spouse. A disposition of property ordered by a 45
78		-	court shall be evaluated in accordance with the standards applied to any 46 Bill No. 310
	76	+	court shall be evaluated in accordance with the standards applied to any 46
	77	+	other such disposition for the purpose of determining eligibility. The 47 Raised Bill No. 310
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85		-	other such disposition for the purpose of determining eligibility. The 47
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86	83		commissioner shall establish the standards for eligibility for medical 48
87	84		assistance at one hundred forty-three per cent of the benefit amount 49
88	85		paid to a household of equal size with no income under the temporary 50
89	86		family assistance program. In determining eligibility, the commissioner 51
90	87		shall not consider as income Aid and Attendance pension benefits 52
91	88		granted to a veteran, as defined in section 27-103, or the surviving 53
92	89		spouse of such veteran. Except as provided in section 17b-277 and 54
93	90		section 17b-292, the medical assistance program shall provide coverage 55
94	91		to persons under the age of nineteen with household income up to one 56
95	92		hundred ninety-six per cent of the federal poverty level without an asset 57
96	93		limit and to persons under the age of nineteen, who qualify for coverage 58
97	94		under Section 1931 of the Social Security Act, with household income 59
98	95		not exceeding one hundred ninety-six per cent of the federal poverty 60
99	96		level without an asset limit, and their parents and needy caretaker 61
100	97		relatives, who qualify for coverage under Section 1931 of the Social 62
101	98		Security Act, with household income not exceeding one hundred fifty-63
102	99		five per cent of the federal poverty level without an asset limit. Such 64
103	100		levels shall be based on the regional differences in such benefit amount, 65
104	101		if applicable, unless such levels based on regional differences are not in 66
105	102		conformance with federal law. Any income in excess of the applicable 67
106	103		amounts shall be applied as may be required by said federal law, and 68
107	104		assistance shall be granted for the balance of the cost of authorized 69
108	105		medical assistance. The Commissioner of Social Services shall provide 70
109	106		applicants for assistance under this section, at the time of application, 71
110	107		with a written statement advising them of (A) the effect of an 72
111	108		assignment or transfer or other disposition of property on eligibility for 73
112	109		benefits or assistance, (B) the effect that having income that exceeds the 74
113	110		limits prescribed in this subsection will have with respect to program 75
114	111		eligibility, and (C) the availability of, and eligibility for, services 76
115	112		provided by the Connecticut Home Visiting System, established 77
116	113		pursuant to section 17b-751b. For coverage dates on or after January 1, 78
117	114		2014, the department shall use the modified adjusted gross income 79
118	115		financial eligibility rules set forth in Section 1902(e)(14) of the Social 80
119		-	Security Act and the implementing regulations to determine eligibility 81 Bill No. 310
	116	+	Security Act and the implementing regulations to determine eligibility 81
	117	+	for HUSKY A, HUSKY B and HUSKY D applicants, as defined in section 82 Raised Bill No. 310
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126		-	for HUSKY A, HUSKY B and HUSKY D applicants, as defined in section 82
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127	123		17b-290. Persons who are determined ineligible for assistance pursuant 83
128	124		to this section shall be provided a written statement notifying such 84
129	125		persons of their ineligibility and advising such persons of their potential 85
130	126		eligibility for one of the other insurance affordability programs as 86
131	127		defined in 42 CFR 435.4. 87
132	128		(b) For the purposes of the Medicaid program, the Commissioner of 88
133	129		Social Services shall consider parental income and resources as available 89
134	130		to a child under eighteen years of age who is living with his or her 90
135	131		parents and is blind or disabled for purposes of the Medicaid program, 91
136	132		or to any other child under twenty-one years of age who is living with 92
137	133		his or her parents. 93
138	134		(c) For the purposes of determining eligibility for the Medicaid 94
139	135		program, an available asset is one that is actually available to the 95
140	136		applicant or one that the applicant has the legal right, authority or 96
141	137		power to obtain or to have applied for the applicant's general or medical 97
142	138		support. If the terms of a trust provide for the support of an applicant, 98
143	139		the refusal of a trustee to make a distribution from the trust does not 99
144	140		render the trust an unavailable asset. Notwithstanding the provisions of 100
145	141		this subsection, the availability of funds in a trust or similar instrument 101
146	142		funded in whole or in part by the applicant or the applicant's spouse 102
147	143		shall be determined pursuant to the Omnibus Budget Reconciliation Act 103
148	144		of 1993, 42 USC 1396p. The provisions of this subsection shall not apply 104
149	145		to a special needs trust, as defined in 42 USC 1396p(d)(4)(A), as 105
150	146		amended from time to time. For purposes of determining whether a 106
151	147		beneficiary under a special needs trust, who has not received a disability 107
152	148		determination from the Social Security Administration, is disabled, as 108
153	149		defined in 42 USC 1382c(a)(3), the Commissioner of Social Services, or 109
154	150		the commissioner's designee, shall independently make such 110
155	151		determination. The commissioner shall not require such beneficiary to 111
156	152		apply for Social Security disability benefits or obtain a disability 112
157	153		determination from the Social Security Administration for purposes of 113
158		-	determining whether the beneficiary is disabled. 114 Bill No. 310
	154	+	determining whether the beneficiary is disabled. 114
	155	+	(d) The transfer of an asset in exchange for other valuable 115 Raised Bill No. 310
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165		-	(d) The transfer of an asset in exchange for other valuable 115
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166	161		consideration shall be allowable to the extent the value of the other 116
167	162		valuable consideration is equal to or greater than the value of the asset 117
168	163		transferred. 118
169	164		(e) The Commissioner of Social Services shall seek a waiver from 119
170	165		federal law to permit federal financial participation for Medicaid 120
171	166		expenditures for families with incomes of one hundred forty-three per 121
172	167		cent of the temporary family assistance program payment standard. 122
173	168		(f) To the extent [permitted by] permissible under federal law, 123
174	169		Medicaid eligibility shall be extended for one year to a family that 124
175	170		becomes ineligible for medical assistance under Section 1931 of the 125
176	171		Social Security Act due to income from employment by one of its 126
177	172		members who is a caretaker relative or due to receipt of child support 127
178	173		income. A family receiving extended benefits on July 1, 2005, shall 128
179	174		receive the balance of such extended benefits, provided no such family 129
180	175		shall receive more than twelve additional months of such benefits. 130
181	176		(g) An institutionalized spouse applying for Medicaid and having a 131
182	177		spouse living in the community shall be required, to the maximum 132
183	178		extent permitted by law, to divert income to such community spouse in 133
184	179		order to raise the community spouse's income to the level of the 134
185	180		minimum monthly needs allowance, as described in Section 1924 of the 135
186	181		Social Security Act. Such diversion of income shall occur before the 136
187	182		community spouse is allowed to retain assets in excess of the 137
188	183		community spouse protected amount described in Section 1924 of the 138
189	184		Social Security Act. The Commissioner of Social Services, pursuant to 139
190	185		section 17b-10, may implement the provisions of this subsection while 140
191	186		in the process of adopting regulations, provided the commissioner 141
192	187		[prints] posts notice of intent to adopt the regulations [in the 142
193	188		Connecticut Law Journal within] on the Internet web site of the 143
194	189		Department of Social Services and the eRegulations System not later 144
195	190		than twenty days of adopting such policy. Such policy shall be valid 145
196		-	until the time final regulations are effective. 146 Bill No. 310
	191	+	until the time final regulations are effective. 146
	192	+	(h) To the extent permissible under federal law, an institutionalized 147 Raised Bill No. 310
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203		-	(h) To the extent permissible under federal law, an institutionalized 147
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204	198		individual, as defined in Section 1917 of the Social Security Act, 42 USC 148
205	199		1396p(h)(3), shall not be determined ineligible for Medicaid solely on 149
206	200		the basis of the cash value of a life insurance policy worth less than ten 150
207	201		thousand dollars provided the individual is pursuing the surrender of 151
208	202		the policy. 152
209	203		(i) To the extent permissible under federal law, an individual who has 153
210	204		applied for medical assistance shall not be determined ineligible solely 154
211	205		on the basis of an asset discovered by such individual after the date of 155
212	206		application, provided (1) the individual reports the discovery of the 156
213	207		asset to the Commissioner of Social Services not later than ten days after 157
214	208		the discovery, (2) the individual takes steps to liquidate such 158
215	209		individual's interest in the asset and spend down the proceeds in 159
216	210		accordance with applicable income and asset limits, and (3) in the event 160
217	211		the individual is unable to gain access to the asset, the Department of 161
218	212		Social Services provides assistance to the individual to gain access to the 162
219	213		asset. 163
220	214		[(i)] (j) Medical assistance shall be provided, in accordance with the 164
221	215		provisions of subsection (e) of section 17a-6, to any child under the 165
222	216		supervision of the Commissioner of Children and Families who is not 166
223	217		receiving Medicaid benefits, has not yet qualified for Medicaid benefits 167
224	218		or is otherwise ineligible for such benefits. Medical assistance shall also 168
225	219		be provided to any child in the behavioral services program operated 169
226	220		by the Department of Developmental Services who is not receiving 170
227	221		Medicaid benefits, has not yet qualified for Medicaid benefits or is 171
228	222		otherwise ineligible for benefits. To the extent practicable, the 172
229	223		Commissioner of Children and Families and the Commissioner of 173
230	224		Developmental Services shall apply for, or assist such child in qualifying 174
231	225		for, the Medicaid program. 175
232	226		[(j)] (k) The Commissioner of Social Services shall provide Early and 176
233	227		Periodic Screening, Diagnostic and Treatment program services, as 177
234	228		required and defined as of December 31, 2005, by 42 USC 1396a(a)(43), 178
235		-	42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal 179 Bill No. 310
	229	+	42 USC 1396d(r) and 42 USC 1396d(a)(4)(B) and applicable federal 179
	230	+	regulations, to all persons who are under the age of twenty-one and 180 Raised Bill No. 310
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242		-	regulations, to all persons who are under the age of twenty-one and 180
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243	236		otherwise eligible for medical assistance under this section. 181
244	237		[(k)] (l) A veteran, as defined in section 27-103, and any member of 182
245	238		his or her family, who applies for or receives assistance under the 183
246	239		Medicaid program, shall apply for all benefits for which he or she may 184
247	240		be eligible through the United States Department of Veterans Affairs or 185
248	241		the United States Department of Defense. 186
249	242		[(l)] (m) On and after January 1, 2023, and until June 30, 2024, the 187
250	243		Commissioner of Social Services shall, within available appropriations, 188
251	244		provide state-funded medical assistance to any child twelve years of age 189
252	245		and younger, regardless of immigration status, (1) whose household 190
253	246		income does not exceed two hundred one per cent of the federal poverty 191
254	247		level without an asset limit, and (2) who does not otherwise qualify for 192
255	248		Medicaid, the Children's Health Insurance Program, or an offer of 193
256	249		affordable, employer-sponsored insurance, as defined in the Affordable 194
257	250		Care Act, as an employee or a dependent of an employee. On and after 195
258	251		July 1, 2024, the commissioner shall, within available appropriations, 196
259	252		provide state-funded medical assistance to any child fifteen years of age 197
260	253		and younger, regardless of immigration status, who qualifies pursuant 198
261	254		to subdivisions (1) and (2) of this subsection. A child eligible for such 199
262	255		assistance under this subsection shall continue to receive such assistance 200
263	256		until such child is nineteen years of age, provided the child continues to 201
264	257		meet the eligibility requirements prescribed in subdivisions (1) and (2) 202
265	258		of this subsection. The provisions of section 17b-265 shall apply with 203
266	259		respect to any medical assistance provided pursuant to this subsection. 204
267	260		This act shall take effect as follows and shall amend the following
268	261		sections:
269	262
270	263		Section 1 July 1, 2024 New section
271	264		Sec. 2 July 1, 2024 17b-342(h)
272	265		Sec. 3 July 1, 2024 17b-261
273	266
274		-	HS Joint Favorable C/R APP Bill No. 310
	267	+	Statement of Purpose:
	268	+	To pay family caregivers authorized to receive compensation in
	269	+	Medicaid-funded programs at the rate of professional caregivers, grant Raised Bill No. 310
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	275	+	retroactive Medicaid eligibility to eligible home care clients and remove
	276	+	penalties for assets discovered after Medicaid applications.
	277	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	278	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	279	+	underlined.]
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