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repealed and the following is substituted in lieu thereof (Effective July 1, 12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is repealed and the following is substituted in lieu thereof (Effective July 26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