LCO No. 4290 1 of 38 General Assembly Governor's Bill No. 1251 January Session, 2025 LCO No. 4290 Referred to Committee on HUMAN SERVICES Introduced by: Request of the Governor Pursuant to Joint Rule 9 AN ACT IMPLEMENTING THE GOVERNOR’S RECOMMENDATIONS FOR HEALTH AND HUMAN SERVICES. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section 14-11b of the general statutes is repealed and the 1 following is substituted in lieu thereof (Effective July 1, 2025): 2 (a) There shall be within the Department of [Aging and Disability 3 Services] Motor Vehicles a unit for the purpose of evaluating and 4 training persons with disabilities in the operation of motor vehicles. 5 There shall be assigned to the driver training unit for persons with 6 disabilities such staff as is necessary for the orderly administration of 7 the driver training program for persons with disabilities. The personnel 8 assigned to the driver training unit for persons with disabilities shall, 9 while engaged in the evaluation, [or] instruction or examination of a 10 person with disabilities, have the authority and immunities with respect 11 to such activities as are granted under the general statutes to motor 12 vehicle inspectors. The Commissioner of Motor Vehicles may permit a 13 person whose license has been withdrawn as a result of a condition that 14 Governor's Bill No. 1251 LCO No. 4290 2 of 38 makes such person eligible for evaluation and training under this 15 section to operate a motor vehicle while accompanied by personnel 16 assigned to the driver training unit for persons with disabilities. [When 17 a person with disabilities has successfully completed the driver training 18 program for persons with disabilities, the Department of Aging and 19 Disability Services shall certify such completion in writing to the 20 Commissioner of Motor Vehicles and shall recommend any license 21 restrictions or limitations to be placed on the license of such person. The 22 Commissioner of Motor Vehicles may accept such certification in lieu of 23 the driving skills portion of the examination prescribed under 24 subsection (e) of section 14-36. If such person with disabilities has met 25 all other requirements for obtaining a license, the Commissioner of 26 Motor Vehicles shall issue a license with such restrictions recommended 27 by the Department of Aging and Disability Services.] 28 (b) Any resident of this state who has a serious physical or mental 29 disability which does not render the resident incapable of operating a 30 motor vehicle and who must utilize special equipment in order to 31 operate a motor vehicle and who cannot obtain instruction in the 32 operation of a motor vehicle through any alternate program, including, 33 but not limited to, other state, federal or privately operated drivers' 34 schools shall be eligible for instruction under the Department of [Aging 35 and Disability Services] Motor Vehicles driver training program for 36 persons with disabilities. 37 Sec. 2. Subsection (b) of section 17b-104 of the general statutes is 38 repealed and the following is substituted in lieu thereof (Effective July 1, 39 2025): 40 (b) On July 1, 2007, and annually thereafter, the commissioner shall 41 increase the payment standards over those of the previous fiscal year 42 under the state-administered general assistance program by the 43 percentage increase, if any, in the most recent calendar year average in 44 the consumer price index for urban consumers over the average for the 45 previous calendar year, provided the annual increase, if any, shall not 46 Governor's Bill No. 1251 LCO No. 4290 3 of 38 exceed five per cent, except that the payment standards for the fiscal 47 years ending June 30, 2010, June 30, 2011, June 30, 2012, June 30, 2013, 48 June 30, 2016, June 30, 2017, June 30, 2018, June 30, 2019, June 30, 2020, 49 [and] June 30, 2021, June 30, 2026, and June 30, 2027, shall not be 50 increased. 51 Sec. 3. Subsection (a) of section 17b-106 of the general statutes is 52 repealed and the following is substituted in lieu thereof (Effective July 1, 53 2025): 54 (a) On July 1, 1989, and annually thereafter, the commissioner shall 55 increase the adult payment standards over those of the previous fiscal 56 year for the state supplement to the federal Supplemental Security 57 Income Program by the percentage increase, if any, in the most recent 58 calendar year average in the consumer price index for urban consumers 59 over the average for the previous calendar year, provided the annual 60 increase, if any, shall not exceed five per cent, except that the adult 61 payment standards for the fiscal years ending June 30, 1993, June 30, 62 1994, June 30, 1995, June 30, 1996, June 30, 1997, June 30, 1998, June 30, 63 1999, June 30, 2000, June 30, 2001, June 30, 2002, June 30, 2003, June 30, 64 2004, June 30, 2005, June 30, 2006, June 30, 2007, June 30, 2008, June 30, 65 2009, June 30, 2010, June 30, 2011, June 30, 2012, June 30, 2013, June 30, 66 2016, June 30, 2017, June 30, 2018, June 30, 2019, June 30, 2020, [and] June 67 30, 2021, June 30, 2026, and June 30, 2027, shall not be increased. 68 Effective October 1, 1991, the coverage of excess utility costs for 69 recipients of the state supplement to the federal Supplemental Security 70 Income Program is eliminated. Notwithstanding the provisions of this 71 section, the commissioner may increase the personal needs allowance 72 component of the adult payment standard as necessary to meet federal 73 maintenance of effort requirements. 74 Sec. 4. Subsection (a) of section 17b-112g of the general statutes is 75 repealed and the following is substituted in lieu thereof (Effective July 1, 76 2025): 77 Governor's Bill No. 1251 LCO No. 4290 4 of 38 (a) The Commissioner of Social Services shall offer immediate 78 diversion assistance designed to prevent certain families who are 79 applying for monthly temporary family assistance from needing such 80 assistance. Diversion assistance shall be offered to families that (1) upon 81 initial assessment are determined eligible for temporary family 82 assistance, (2) demonstrate a short-term need that cannot be met with 83 current or anticipated family resources, and (3) with the provision of a 84 service or short-term benefit, would be prevented from needing 85 monthly temporary family assistance. [Within resources available to the 86 Department of Social Services, a person who requests diversion 87 assistance on the basis of being a victim of domestic violence, as defined 88 in section 17b-112a, shall be deemed to satisfy subdivision (2) of this 89 subsection and shall not be subject to the requirements of subdivision 90 (3) of this subsection. In determining whether the family of such a victim 91 of domestic violence satisfies the requirements of subdivision (1) of this 92 subsection and the appropriate amount of diversion assistance to 93 provide, the commissioner shall not include as a member of the family 94 the spouse, domestic partner or other household member credibly 95 accused of domestic violence by such victim, nor shall the commissioner 96 count the income or assets of such a spouse, domestic partner or other 97 household member. For purposes of this subsection, allegations of 98 domestic violence may be substantiated by the commissioner pursuant 99 to the provisions of subsection (b) of section 17b-112a.] 100 Sec. 5. Section 17b-191 of the general statutes is repealed and the 101 following is substituted in lieu thereof (Effective July 1, 2025): 102 (a) Notwithstanding the provisions of sections 17b-190, 17b-195 and 103 17b-196, the Commissioner of Social Services shall operate a state-104 administered general assistance program in accordance with this section 105 and sections 17b-131, 17b-193, 17b-194, 17b-197 and 17b-198. 106 Notwithstanding any provision of the general statutes, on and after 107 October 1, 2003, no town shall be reimbursed by the state for any general 108 assistance medical benefits incurred after September 30, 2003, and on 109 and after March 1, 2004, no town shall be reimbursed by the state for 110 Governor's Bill No. 1251 LCO No. 4290 5 of 38 any general assistance cash benefits or general assistance program 111 administrative costs incurred after February 29, 2004. 112 (b) The state-administered general assistance program shall provide 113 cash assistance of (1) two hundred dollars per month for an 114 unemployable person upon determination of such person's 115 unemployability; (2) two hundred dollars per month for a transitional 116 person who is required to pay for shelter; and (3) fifty dollars per month 117 for a transitional person who is not required to pay for shelter. The 118 standard of assistance paid for individuals residing in rated boarding 119 facilities shall remain at the level in effect on August 31, 2003. No person 120 shall be eligible for cash assistance under the program if eligible for cash 121 assistance under any other state or federal cash assistance program. The 122 standards of assistance set forth in this subsection shall be subject to 123 annual increases, as described in subsection (b) of section 17b-104, as 124 amended by this act. 125 (c) To be eligible for cash assistance under the program, a person shall 126 (1) be (A) eighteen years of age or older; (B) a minor found by a court to 127 be emancipated pursuant to section 46b-150; or (C) under eighteen years 128 of age and the commissioner determines good cause for such person's 129 eligibility, and (2) not have assets exceeding five hundred dollars or, if 130 such person is married, such person and his or her spouse shall not have 131 assets exceeding one thousand dollars. In determining eligibility, the 132 commissioner shall not consider as income (A) Aid and Attendance 133 pension benefits granted to a veteran, as defined in section 27-103, or the 134 surviving spouse of such veteran; and (B) any tax refund or advance 135 payment with respect to a refundable credit to the same extent such 136 refund or advance payment would be disregarded under 26 USC 6409 137 in any federal program or state or local program financed in whole or in 138 part with federal funds. No person who is a substance abuser and 139 refuses or fails to enter available, appropriate treatment shall be eligible 140 for cash assistance under the program until such person enters 141 treatment. No person whose benefits from the temporary family 142 assistance program have terminated as a result of time-limited benefits 143 Governor's Bill No. 1251 LCO No. 4290 6 of 38 or for failure to comply with a program requirement shall be eligible for 144 cash assistance under the program. 145 (d) Prior to or upon discontinuance of assistance, a person previously 146 determined to be a transitional person may petition the commissioner 147 to review the determination of his or her status. In such review, the 148 commissioner shall consider factors, including, but not limited to: (1) 149 Age; (2) education; (3) vocational training; (4) mental and physical 150 health; and (5) employment history and shall make a determination of 151 such person's ability to obtain gainful employment. 152 [(e) Notwithstanding any other provision of this section or section 153 17b-194, a victim of domestic violence, as defined in section 17b-112a, 154 who is not eligible for diversion assistance under the provisions of 155 section 17b-112g, shall be eligible for a one-time assistance payment 156 under the state-administered general assistance program within 157 resources available to the Department of Social Services. Such payment 158 shall be equivalent to that which such victim would be entitled to 159 receive as diversion assistance if such victim and his or her family, if 160 any, were eligible for diversion assistance. In determining whether and 161 in what amount a victim of domestic violence and his or her family are 162 eligible for a one-time assistance payment pursuant to this subsection, 163 the commissioner shall not include as a member of such victim's family 164 the spouse, domestic partner or other household member credibly 165 accused of domestic violence by such victim, nor shall the commissioner 166 count the income or assets of such a spouse, domestic partner or other 167 household member. For purposes of this subsection, allegations of 168 domestic violence may be substantiated by the commissioner pursuant 169 to the provisions of subsection (b) of section 17b-112a, and "family" has 170 the same meaning as used in section 17b-112, except as otherwise 171 provided in this subsection.] 172 Sec. 6. Section 17b-278l of the general statutes is repealed and the 173 following is substituted in lieu thereof (Effective July 1, 2025): 174 Governor's Bill No. 1251 LCO No. 4290 7 of 38 (a) (1) As used in this section, "bariatric surgery" means surgical 175 changes to the digestive system to help a patient with obesity to lose 176 weight; 177 (2) "Body mass index" means the number calculated by dividing an 178 individual's weight in kilograms by the individual's height in meters 179 squared; 180 (3) "Medical services" means (A) prescription drugs approved by the 181 federal Food and Drug Administration for the treatment of obesity on 182 an outpatient basis for individuals with type 2 diabetes and prescription 183 drugs approved by the federal Food and Drug Administration on an 184 outpatient basis for the treatment of a comorbid condition for 185 individuals with obesity, subject to prior authorization and only after 186 step therapy when clinically appropriate, and (B) nutritional counseling 187 provided by a registered dietitian-nutritionist certified pursuant to 188 section 20-206n; 189 (4) "Severe obesity" means a body mass index that is: 190 (A) Greater than forty; or 191 (B) Thirty-five or more if an individual has been diagnosed with a 192 comorbid disease or condition, including, but not limited to, a 193 cardiopulmonary condition, diabetes, hypertension or sleep apnea; and 194 (5) "Obesity" means a body mass index of thirty or higher. 195 (b) The Commissioner of Social Services shall [provide medical 196 assistance] amend the Medicaid state plan and the state plan for the 197 Children's Health Insurance Program to implement the provisions of 198 this section and provide coverage under the Medicaid program, in 199 accordance with federal law, for (1) bariatric surgery and related 200 medical services for Medicaid and HUSKY B beneficiaries with severe 201 obesity, and (2) medical services for Medicaid and HUSKY B 202 beneficiaries with a body mass index greater than thirty-five, provided 203 Governor's Bill No. 1251 LCO No. 4290 8 of 38 such beneficiaries otherwise meet conditions set by the Centers for 204 Medicare and Medicaid Services for such surgery and medical services. 205 If necessary, the commissioner may amend the Medicaid state plan and 206 the state plan for the Children's Health Insurance Program to implement 207 the provisions of this section. 208 (c) Notwithstanding the provisions of subsection (b) of section 17b-209 274f, any step therapy that may be required by the Commissioner of 210 Social Services pursuant to the provisions of this section may be for a 211 period of time not longer than one hundred eighty days. 212 Sec. 7. Subsection (a) of section 17b-244 of the general statutes is 213 repealed and the following is substituted in lieu thereof (Effective July 1, 214 2025): 215 (a) The room and board component of the rates to be paid by the state 216 to private facilities and facilities operated by regional education service 217 centers which are licensed to provide residential care pursuant to 218 section 17a-227, but not certified to participate in the Title XIX Medicaid 219 program as intermediate care facilities for individuals with intellectual 220 disabilities, shall be determined annually by the Commissioner of Social 221 Services, except that rates effective April 30, 1989, shall remain in effect 222 through October 31, 1989. Any facility with real property other than 223 land placed in service prior to July 1, 1991, shall, for the fiscal year 224 ending June 30, 1995, receive a rate of return on real property equal to 225 the average of the rates of return applied to real property other than land 226 placed in service for the five years preceding July 1, 1993. For the fiscal 227 year ending June 30, 1996, and any succeeding fiscal year, the rate of 228 return on real property for property items shall be revised every five 229 years. The commissioner shall, upon submission of a request by such 230 facility, allow actual debt service, comprised of principal and interest, 231 on the loan or loans in lieu of property costs allowed pursuant to section 232 17-313b-5 of the regulations of Connecticut state agencies, whether 233 actual debt service is higher or lower than such allowed property costs, 234 provided such debt service terms and amounts are reasonable in 235 Governor's Bill No. 1251 LCO No. 4290 9 of 38 relation to the useful life and the base value of the property. In the case 236 of facilities financed through the Connecticut Housing Finance 237 Authority, the commissioner shall allow actual debt service, comprised 238 of principal, interest and a reasonable repair and replacement reserve 239 on the loan or loans in lieu of property costs allowed pursuant to section 240 17-313b-5 of the regulations of Connecticut state agencies, whether 241 actual debt service is higher or lower than such allowed property costs, 242 provided such debt service terms and amounts are determined by the 243 commissioner at the time the loan is entered into to be reasonable in 244 relation to the useful life and base value of the property. The 245 commissioner may allow fees associated with mortgage refinancing 246 provided such refinancing will result in state reimbursement savings, 247 after comparing costs over the terms of the existing proposed loans. For 248 the fiscal year ending June 30, 1992, the inflation factor used to 249 determine rates shall be one-half of the gross national product 250 percentage increase for the period between the midpoint of the cost year 251 through the midpoint of the rate year. For fiscal year ending June 30, 252 1993, the inflation factor used to determine rates shall be two-thirds of 253 the gross national product percentage increase from the midpoint of the 254 cost year to the midpoint of the rate year. For the fiscal years ending 255 June 30, 1996, and June 30, 1997, no inflation factor shall be applied in 256 determining rates. The Commissioner of Social Services shall prescribe 257 uniform forms on which such facilities shall report their costs. Such rates 258 shall be determined on the basis of a reasonable payment for necessary 259 services. Any increase in grants, gifts, fund-raising or endowment 260 income used for the payment of operating costs by a private facility in 261 the fiscal year ending June 30, 1992, shall be excluded by the 262 commissioner from the income of the facility in determining the rates to 263 be paid to the facility for the fiscal year ending June 30, 1993, provided 264 any operating costs funded by such increase shall not obligate the state 265 to increase expenditures in subsequent fiscal years. Nothing contained 266 in this section shall authorize a payment by the state to any such facility 267 in excess of the charges made by the facility for comparable services to 268 the general public. The service component of the rates to be paid by the 269 Governor's Bill No. 1251 LCO No. 4290 10 of 38 state to private facilities and facilities operated by regional education 270 service centers which are licensed to provide residential care pursuant 271 to section 17a-227, but not certified to participate in the Title XIX 272 Medicaid programs as intermediate care facilities for individuals with 273 intellectual disabilities, shall be determined annually by the 274 Commissioner of Developmental Services in accordance with section 275 17b-244a. For the fiscal year ending June 30, 2008, no facility shall receive 276 a rate that is more than two per cent greater than the rate in effect for 277 the facility on June 30, 2007, except any facility that would have been 278 issued a lower rate effective July 1, 2007, due to interim rate status or 279 agreement with the department, shall be issued such lower rate effective 280 July 1, 2007. For the fiscal year ending June 30, 2009, no facility shall 281 receive a rate that is more than two per cent greater than the rate in effect 282 for the facility on June 30, 2008, except any facility that would have been 283 issued a lower rate effective July 1, 2008, due to interim rate status or 284 agreement with the department, shall be issued such lower rate effective 285 July 1, 2008. For the fiscal years ending June 30, 2010, and June 30, 2011, 286 rates in effect for the period ending June 30, 2009, shall remain in effect 287 until June 30, 2011, except that (1) the rate paid to a facility may be higher 288 than the rate paid to the facility for the period ending June 30, 2009, if a 289 capital improvement required by the Commissioner of Developmental 290 Services for the health or safety of the residents was made to the facility 291 during the fiscal years ending June 30, 2010, or June 30, 2011, and (2) any 292 facility that would have been issued a lower rate for the fiscal year 293 ending June 30, 2010, or June 30, 2011, due to interim rate status or 294 agreement with the department, shall be issued such lower rate. For the 295 fiscal year ending June 30, 2012, rates in effect for the period ending June 296 30, 2011, shall remain in effect until June 30, 2012, except that (A) the 297 rate paid to a facility may be higher than the rate paid to the facility for 298 the period ending June 30, 2011, if a capital improvement required by 299 the Commissioner of Developmental Services for the health or safety of 300 the residents was made to the facility during the fiscal year ending June 301 30, 2012, and (B) any facility that would have been issued a lower rate 302 for the fiscal year ending June 30, 2012, due to interim rate status or 303 Governor's Bill No. 1251 LCO No. 4290 11 of 38 agreement with the department, shall be issued such lower rate. Any 304 facility that has a significant decrease in land and building costs shall 305 receive a reduced rate to reflect such decrease in land and building costs. 306 The rate paid to a facility may be increased if a capital improvement 307 approved by the Department of Developmental Services, in consultation 308 with the Department of Social Services, for the health or safety of the 309 residents was made to the facility during the fiscal year ending June 30, 310 2014, or June 30, 2015, only to the extent such increases are within 311 available appropriations. For the fiscal years ending June 30, 2016, and 312 June 30, 2017, rates shall not exceed those in effect for the period ending 313 June 30, 2015, except the rate paid to a facility may be higher than the 314 rate paid to the facility for the period ending June 30, 2015, if a capital 315 improvement approved by the Department of Developmental Services, 316 in consultation with the Department of Social Services, for the health or 317 safety of the residents was made to the facility during the fiscal year 318 ending June 30, 2016, or June 30, 2017, to the extent such rate increases 319 are within available appropriations. For the fiscal years ending June 30, 320 2016, and June 30, 2017, and each succeeding fiscal year, any facility that 321 would have been issued a lower rate, due to interim rate status, a change 322 in allowable fair rent or agreement with the department, shall be issued 323 such lower rate. For the fiscal years ending June 30, 2018, and June 30, 324 2019, rates shall not exceed those in effect for the period ending June 30, 325 2017, except the rate paid to a facility may be higher than the rate paid 326 to the facility for the period ending June 30, 2017, if a capital 327 improvement approved by the Department of Developmental Services, 328 in consultation with the Department of Social Services, for the health or 329 safety of the residents was made to the facility during the fiscal year 330 ending June 30, 2018, or June 30, 2019, to the extent such rate increases 331 are within available appropriations. For the fiscal years ending June 30, 332 2020, and June 30, 2021, rates shall not exceed those in effect for the fiscal 333 year ending June 30, 2019, except the rate paid to a facility may be higher 334 than the rate paid to the facility for the fiscal year ending June 30, 2019, 335 if a capital improvement approved by the Department of 336 Developmental Services, in consultation with the Department of Social 337 Governor's Bill No. 1251 LCO No. 4290 12 of 38 Services, for the health or safety of the residents was made to the facility 338 during the fiscal year ending June 30, 2020, or June 30, 2021, to the extent 339 such rate increases are within available appropriations. For the fiscal 340 years ending June 30, 2022, and June 30, 2023, rates shall be based upon 341 rates in effect for the fiscal year ending June 30, 2021, inflated by the 342 gross domestic product deflator applicable to each rate year, except the 343 commissioner may, in the commissioner's discretion and within 344 available appropriations, provide pro rata fair rent increases to facilities 345 which have documented fair rent additions placed in service in the cost 346 report years ending September 30, 2020, and September 30, 2021, that 347 are not otherwise included in rates issued, or if a rate adjustment for a 348 capital improvement approved by the Department of Developmental 349 Services, in consultation with the Department of Social Services, for the 350 health or safety of the residents was made to the facility during the fiscal 351 year ending June 30, 2022, or June 30, 2023. For the fiscal year ending 352 June 30, 2024, rates shall not exceed those in effect for the fiscal year 353 ending June 30, 2023, except the rate paid to a facility may be higher 354 than the rate paid to the facility for the fiscal year ending June 30, 2023, 355 if a capital improvement approved by the Department of 356 Developmental Services, in consultation with the Department of Social 357 Services, for the health or safety of the residents was made to the facility 358 during the fiscal year ending June 30, 2024, to the extent such rate 359 increases are within available appropriations. For the fiscal years ending 360 June 30, 2026, and June 30, 2027, rates shall not exceed those in effect for 361 the fiscal year ending June 30, 2025, except the rate paid to a facility may 362 be higher than the rate paid to the facility for the fiscal year ending June 363 30, 2025, if a capital improvement approved by the Department of 364 Developmental Services, in consultation with the Department of Social 365 Services, for the health or safety of the residents was made to the facility 366 during the fiscal year ending June 30, 2026, or June 30, 2027, to the extent 367 such rate increases are within available appropriations. 368 Sec. 8. (Effective July 1, 2025) For the fiscal years ending June 30, 2026, 369 and June 30, 2027, notwithstanding the provisions of subsection (a) of 370 Governor's Bill No. 1251 LCO No. 4290 13 of 38 section 17b-244 of the general statutes, as amended by this act, and 371 subsections (a) to (i), inclusive, of section 17b-340 of the general statutes, 372 as amended by this act, or any other provision of title 17 or 17b of the 373 general statutes, or regulations adopted thereunder, the state rates of 374 payment in effect for the fiscal year ending June 30, 2025, for residential 375 care homes, community living arrangements and community 376 companion homes that receive the flat rate for residential services under 377 section 17-311-54 of the regulations of Connecticut state agencies shall 378 remain in effect. 379 Sec. 9. Subdivision (1) of subsection (h) of section 17b-340 of the 380 general statutes is repealed and the following is substituted in lieu 381 thereof (Effective July 1, 2025): 382 (h) (1) For the fiscal year ending June 30, 1993, any intermediate care 383 facility for individuals with intellectual disabilities with an operating 384 cost component of its rate in excess of one hundred forty per cent of the 385 median of operating cost components of rates in effect January 1, 1992, 386 shall not receive an operating cost component increase. For the fiscal 387 year ending June 30, 1993, any intermediate care facility for individuals 388 with intellectual disabilities with an operating cost component of its rate 389 that is less than one hundred forty per cent of the median of operating 390 cost components of rates in effect January 1, 1992, shall have an 391 allowance for real wage growth equal to thirty per cent of the increase 392 determined in accordance with subsection (q) of section 17-311-52 of the 393 regulations of Connecticut state agencies, provided such operating cost 394 component shall not exceed one hundred forty per cent of the median 395 of operating cost components in effect January 1, 1992. Any facility with 396 real property other than land placed in service prior to October 1, 1991, 397 shall, for the fiscal year ending June 30, 1995, receive a rate of return on 398 real property equal to the average of the rates of return applied to real 399 property other than land placed in service for the five years preceding 400 October 1, 1993. For the fiscal year ending June 30, 1996, and any 401 succeeding fiscal year, the rate of return on real property for property 402 items shall be revised every five years. The commissioner shall, upon 403 Governor's Bill No. 1251 LCO No. 4290 14 of 38 submission of a request, allow actual debt service, comprised of 404 principal and interest, in excess of property costs allowed pursuant to 405 section 17-311-52 of the regulations of Connecticut state agencies, 406 provided such debt service terms and amounts are reasonable in 407 relation to the useful life and the base value of the property. For the fiscal 408 year ending June 30, 1995, and any succeeding fiscal year, the inflation 409 adjustment made in accordance with subsection (p) of section 17-311-52 410 of the regulations of Connecticut state agencies shall not be applied to 411 real property costs. For the fiscal year ending June 30, 1996, and any 412 succeeding fiscal year, the allowance for real wage growth, as 413 determined in accordance with subsection (q) of section 17-311-52 of the 414 regulations of Connecticut state agencies, shall not be applied. For the 415 fiscal year ending June 30, 1996, and any succeeding fiscal year, no rate 416 shall exceed three hundred seventy-five dollars per day unless the 417 commissioner, in consultation with the Commissioner of 418 Developmental Services, determines after a review of program and 419 management costs, that a rate in excess of this amount is necessary for 420 care and treatment of facility residents. For the fiscal year ending June 421 30, 2002, rate period, the Commissioner of Social Services shall increase 422 the inflation adjustment for rates made in accordance with subsection 423 (p) of section 17-311-52 of the regulations of Connecticut state agencies 424 to update allowable fiscal year 2000 costs to include a three and one-half 425 per cent inflation factor. For the fiscal year ending June 30, 2003, rate 426 period, the commissioner shall increase the inflation adjustment for 427 rates made in accordance with subsection (p) of section 17-311-52 of the 428 regulations of Connecticut state agencies to update allowable fiscal year 429 2001 costs to include a one and one-half per cent inflation factor, except 430 that such increase shall be effective November 1, 2002, and such facility 431 rate in effect for the fiscal year ending June 30, 2002, shall be paid for 432 services provided until October 31, 2002, except any facility that would 433 have been issued a lower rate effective July 1, 2002, than for the fiscal 434 year ending June 30, 2002, due to interim rate status or agreement with 435 the department shall be issued such lower rate effective July 1, 2002, and 436 have such rate updated effective November 1, 2002, in accordance with 437 Governor's Bill No. 1251 LCO No. 4290 15 of 38 applicable statutes and regulations. For the fiscal year ending June 30, 438 2004, rates in effect for the period ending June 30, 2003, shall remain in 439 effect, except any facility that would have been issued a lower rate 440 effective July 1, 2003, than for the fiscal year ending June 30, 2003, due 441 to interim rate status or agreement with the department shall be issued 442 such lower rate effective July 1, 2003. For the fiscal year ending June 30, 443 2005, rates in effect for the period ending June 30, 2004, shall remain in 444 effect until September 30, 2004. Effective October 1, 2004, each facility 445 shall receive a rate that is five per cent greater than the rate in effect 446 September 30, 2004. Effective upon receipt of all the necessary federal 447 approvals to secure federal financial participation matching funds 448 associated with the rate increase provided in subdivision (4) of 449 subsection (f) of this section, but in no event earlier than October 1, 2005, 450 and provided the user fee imposed under section 17b-320 is required to 451 be collected, each facility shall receive a rate that is four per cent more 452 than the rate the facility received in the prior fiscal year, except any 453 facility that would have been issued a lower rate effective October 1, 454 2005, than for the fiscal year ending June 30, 2005, due to interim rate 455 status or agreement with the department, shall be issued such lower rate 456 effective October 1, 2005. Such rate increase shall remain in effect unless: 457 (A) The federal financial participation matching funds associated with 458 the rate increase are no longer available; or (B) the user fee created 459 pursuant to section 17b-320 is not in effect. For the fiscal year ending 460 June 30, 2007, rates in effect for the period ending June 30, 2006, shall 461 remain in effect until September 30, 2006, except any facility that would 462 have been issued a lower rate effective July 1, 2006, than for the fiscal 463 year ending June 30, 2006, due to interim rate status or agreement with 464 the department, shall be issued such lower rate effective July 1, 2006. 465 Effective October 1, 2006, no facility shall receive a rate that is more than 466 three per cent greater than the rate in effect for the facility on September 467 30, 2006, except any facility that would have been issued a lower rate 468 effective October 1, 2006, due to interim rate status or agreement with 469 the department, shall be issued such lower rate effective October 1, 2006. 470 For the fiscal year ending June 30, 2008, each facility shall receive a rate 471 Governor's Bill No. 1251 LCO No. 4290 16 of 38 that is two and nine-tenths per cent greater than the rate in effect for the 472 period ending June 30, 2007, except any facility that would have been 473 issued a lower rate effective July 1, 2007, than for the rate period ending 474 June 30, 2007, due to interim rate status, or agreement with the 475 department, shall be issued such lower rate effective July 1, 2007. For the 476 fiscal year ending June 30, 2009, rates in effect for the period ending June 477 30, 2008, shall remain in effect until June 30, 2009, except any facility that 478 would have been issued a lower rate for the fiscal year ending June 30, 479 2009, due to interim rate status or agreement with the department, shall 480 be issued such lower rate. For the fiscal years ending June 30, 2010, and 481 June 30, 2011, rates in effect for the period ending June 30, 2009, shall 482 remain in effect until June 30, 2011, except any facility that would have 483 been issued a lower rate for the fiscal year ending June 30, 2010, or the 484 fiscal year ending June 30, 2011, due to interim rate status or agreement 485 with the department, shall be issued such lower rate. For the fiscal year 486 ending June 30, 2012, rates in effect for the period ending June 30, 2011, 487 shall remain in effect until June 30, 2012, except any facility that would 488 have been issued a lower rate for the fiscal year ending June 30, 2012, 489 due to interim rate status or agreement with the department, shall be 490 issued such lower rate. For the fiscal years ending June 30, 2014, and 491 June 30, 2015, rates shall not exceed those in effect for the period ending 492 June 30, 2013, except the rate paid to a facility may be higher than the 493 rate paid to the facility for the period ending June 30, 2013, if a capital 494 improvement approved by the Department of Developmental Services, 495 in consultation with the Department of Social Services, for the health or 496 safety of the residents was made to the facility during the fiscal year 497 ending June 30, 2014, or June 30, 2015, to the extent such rate increases 498 are within available appropriations. Any facility that would have been 499 issued a lower rate for the fiscal year ending June 30, 2014, or the fiscal 500 year ending June 30, 2015, due to interim rate status or agreement with 501 the department, shall be issued such lower rate. For the fiscal years 502 ending June 30, 2016, and June 30, 2017, rates shall not exceed those in 503 effect for the period ending June 30, 2015, except the rate paid to a 504 facility may be higher than the rate paid to the facility for the period 505 Governor's Bill No. 1251 LCO No. 4290 17 of 38 ending June 30, 2015, if a capital improvement approved by the 506 Department of Developmental Services, in consultation with the 507 Department of Social Services, for the health or safety of the residents 508 was made to the facility during the fiscal year ending June 30, 2016, or 509 June 30, 2017, to the extent such rate increases are within available 510 appropriations. For the fiscal years ending June 30, 2016, and June 30, 511 2017, and each succeeding fiscal year, any facility that would have been 512 issued a lower rate, due to interim rate status, a change in allowable fair 513 rent or agreement with the department, shall be issued such lower rate. 514 For the fiscal years ending June 30, 2018, and June 30, 2019, rates shall 515 not exceed those in effect for the period ending June 30, 2017, except the 516 rate paid to a facility may be higher than the rate paid to the facility for 517 the period ending June 30, 2017, if a capital improvement approved by 518 the Department of Developmental Services, in consultation with the 519 Department of Social Services, for the health or safety of the residents 520 was made to the facility during the fiscal year ending June 30, 2018, or 521 June 30, 2019, only to the extent such rate increases are within available 522 appropriations. For the fiscal years ending June 30, 2020, and June 30, 523 2021, rates shall not exceed those in effect for the fiscal year ending June 524 30, 2019, except the rate paid to a facility may be higher than the rate 525 paid to the facility for the fiscal year ending June 30, 2019, if a capital 526 improvement approved by the Department of Developmental Services, 527 in consultation with the Department of Social Services, for the health or 528 safety of the residents was made to the facility during the fiscal year 529 ending June 30, 2020, or June 30, 2021, only to the extent such rate 530 increases are within available appropriations. For the fiscal year ending 531 June 30, 2022, rates shall not exceed those in effect for the fiscal year 532 ending June 30, 2021, except the commissioner may, in the 533 commissioner's discretion and within available appropriations, provide 534 pro rata fair rent increases to facilities that have documented fair rent 535 additions placed in service in the cost report year ending September 30, 536 2020, that are not otherwise included in rates issued. For the fiscal year 537 ending June 30, 2023, rates shall not exceed those in effect for the fiscal 538 year ending June 30, 2022, except the commissioner may, in the 539 Governor's Bill No. 1251 LCO No. 4290 18 of 38 commissioner's discretion and within available appropriations, provide 540 pro rata fair rent increases to facilities which have documented fair rent 541 additions placed in service in the cost report year ending September 30, 542 2021, that are not otherwise included in rates issued. For the fiscal years 543 ending June 30, 2022, and June 30, 2023, a facility may receive a rate 544 increase for a capital improvement approved by the Department of 545 Developmental Services, in consultation with the Department of Social 546 Services, for the health or safety of the residents during the fiscal year 547 ending June 30, 2022, or June 30, 2023, only to the extent such rate 548 increases are within available appropriations. There shall be no increase 549 to rates based on inflation or any inflationary factor for the fiscal years 550 ending June 30, 2022, and June 30, 2023. Notwithstanding any other 551 provisions of this chapter, any subsequent increase to allowable 552 operating costs, excluding fair rent, shall be inflated by the gross 553 domestic product deflator when funding is specifically appropriated for 554 such purposes in the enacted budget. The rate of inflation shall be 555 computed by comparing the most recent rate year to the average of the 556 gross domestic product deflator for the previous four fiscal quarters 557 ending March thirty-first. Any increase to rates based on inflation shall 558 be applied prior to the application of any other budget adjustment 559 factors that may impact such rates. For the fiscal year ending June 30, 560 2024, the department shall determine facility rates based upon 2022 cost 561 report filings subject to the provisions of this section, adjusted to reflect 562 any rate increases provided after the cost report year ending June 30, 563 2022, and with the addition of a two per cent adjustment factor. No 564 facility shall receive a rate less than the rate in effect for the fiscal year 565 ending June 30, 2023. For the fiscal year ending June 30, 2024, the 566 minimum per diem, per bed rate shall remain at five hundred one 567 dollars for a residential facility licensed pursuant to section 17a-227 and 568 certified to participate in the Title XIX Medicaid program as an 569 intermediate care facility for individuals with intellectual disability. 570 There shall be no increase to rates based on any inflationary factor for 571 the fiscal year ending June 30, 2024. For the fiscal year ending June 30, 572 2024, and each subsequent fiscal year, the commissioner may, in the 573 Governor's Bill No. 1251 LCO No. 4290 19 of 38 commissioner's discretion and within available appropriations, provide 574 pro rata fair rent increases to facilities that have documented fair rent 575 additions placed in service in the cost report years that are not otherwise 576 included in rates issued. For the fiscal year ending June 30, 2025, the 577 department shall determine facility rates based upon 2023 cost report 578 filings subject to the provisions of this section, adjusted to reflect any 579 rate increases provided after the cost report ending June 30, 2023. A 580 facility may receive a rate that is less than the rate in effect for the fiscal 581 year ending June 30, 2024, but shall not receive a rate less than the 582 minimum per diem, per bed rate. For the fiscal year ending June 30, 583 2025, the minimum per diem, per bed rate shall remain at five hundred 584 one dollars for a residential facility licensed pursuant to section 17a-227 585 and certified to participate in the Title XIX Medicaid program as an 586 intermediate care facility for individuals with intellectual disability. 587 There shall be no increase to rates based on any inflationary factor for 588 the fiscal year ending June 30, 2025. For the fiscal year ending June 30, 589 2026, the department shall determine facility rates based upon 2024 cost 590 report filings subject to the provisions of this section, adjusted to reflect 591 any rate increases provided after the cost report ending June 30, 2024. 592 For the fiscal year ending June 30, 2026, there shall be no minimum per 593 diem, per bed rate for a residential facility licensed pursuant to section 594 17a-227 and certified to participate in the Title XIX Medicaid program 595 as an intermediate care facility for individuals with intellectual 596 disability. There shall be no increase to rates based on any inflationary 597 factor for the fiscal year ending June 30, 2026. For the fiscal year ending 598 June 30, 2027, rates shall not exceed those in effect for the fiscal year 599 ending June 30, 2026, except the commissioner may, in the 600 commissioner's discretion and within available appropriations, provide 601 pro rata fair rent increases to facilities that have documented fair rent 602 additions placed in service in the cost report year ending September 30, 603 2025, that are not otherwise included in rates issued. For the fiscal years 604 ending June 30, 2024, and June 30, 2025, a facility may receive a rate 605 increase for a capital improvement approved by the Department of 606 Developmental Services, in consultation with the Department of Social 607 Governor's Bill No. 1251 LCO No. 4290 20 of 38 Services, for the health or safety of the residents during the fiscal year 608 ending June 30, 2024, or June 30, 2025, only to the extent such rate 609 increases are within available appropriations. For the fiscal years ending 610 June 30, 2026, and June 30, 2027, a facility may receive a rate increase for 611 a capital improvement approved by the Department of Developmental 612 Services, in consultation with the Department of Social Services, for the 613 health or safety of the residents during the fiscal year ending June 30, 614 2026, or June 30, 2027, only to the extent such rate increases are within 615 available appropriations. Any facility that has a significant decrease in 616 land and building costs shall receive a reduced rate to reflect such 617 decrease in land and building costs. For the fiscal years ending June 30, 618 2012, June 30, 2013, June 30, 2014, June 30, 2015, June 30, 2016, June 30, 619 2017, June 30, 2018, June 30, 2019, June 30, 2020, June 30, 2021, June 30, 620 2022, June 30, 2023, June 30, 2024, [and] June 30, 2025, June 30, 2026, and 621 June 30, 2027, the Commissioner of Social Services may provide fair rent 622 increases to any facility that has undergone a material change in 623 circumstances related to fair rent and has an approved certificate of need 624 pursuant to section 17b-352, 17b-353, 17b-354 or 17b-355. 625 Notwithstanding the provisions of this section, the Commissioner of 626 Social Services may, within available appropriations, increase or 627 decrease rates issued to intermediate care facilities for individuals with 628 intellectual disabilities to reflect a reduction in available appropriations 629 as provided in subsection (a) of this section. For the fiscal years ending 630 June 30, 2014, and June 30, 2015, the commissioner shall not consider 631 rebasing in determining rates. Notwithstanding the provisions of this 632 subsection, effective July 1, 2021, and July 1, 2022, the commissioner 633 shall, within available appropriations, increase rates for the purpose of 634 wage and benefit enhancements for employees of intermediate care 635 facilities. Facilities that receive a rate adjustment for the purpose of wage 636 and benefit enhancements but do not provide increases in employee 637 salaries as described in this subsection on or before July 31, 2021, and 638 July 31, 2022, respectively, may be subject to a rate decrease in the same 639 amount as the adjustment by the commissioner. 640 Governor's Bill No. 1251 LCO No. 4290 21 of 38 Sec. 10. Subsection (i) of section 17b-340 of the general statutes is 641 repealed and the following is substituted in lieu thereof (Effective July 1, 642 2025): 643 (i) For the fiscal year ending June 30, 1993, any residential care home 644 with an operating cost component of its rate in excess of one hundred 645 thirty per cent of the median of operating cost components of rates in 646 effect January 1, 1992, shall not receive an operating cost component 647 increase. For the fiscal year ending June 30, 1993, any residential care 648 home with an operating cost component of its rate that is less than one 649 hundred thirty per cent of the median of operating cost components of 650 rates in effect January 1, 1992, shall have an allowance for real wage 651 growth equal to sixty-five per cent of the increase determined in 652 accordance with subsection (q) of section 17-311-52 of the regulations of 653 Connecticut state agencies, provided such operating cost component 654 shall not exceed one hundred thirty per cent of the median of operating 655 cost components in effect January 1, 1992. Beginning with the fiscal year 656 ending June 30, 1993, for the purpose of determining allowable fair rent, 657 a residential care home with allowable fair rent less than the twenty-658 fifth percentile of the state-wide allowable fair rent shall be reimbursed 659 as having allowable fair rent equal to the twenty-fifth percentile of the 660 state-wide allowable fair rent. Beginning with the fiscal year ending 661 June 30, 1997, a residential care home with allowable fair rent less than 662 three dollars and ten cents per day shall be reimbursed as having 663 allowable fair rent equal to three dollars and ten cents per day. Property 664 additions placed in service during the cost year ending September 30, 665 1996, or any succeeding cost year shall receive a fair rent allowance for 666 such additions as an addition to three dollars and ten cents per day if 667 the fair rent for the facility for property placed in service prior to 668 September 30, 1995, is less than or equal to three dollars and ten cents 669 per day. Beginning with the fiscal year ending June 30, 2016, a 670 residential care home shall be reimbursed the greater of the allowable 671 accumulated fair rent reimbursement associated with real property 672 additions and land as calculated on a per day basis or three dollars and 673 Governor's Bill No. 1251 LCO No. 4290 22 of 38 ten cents per day if the allowable reimbursement associated with real 674 property additions and land is less than three dollars and ten cents per 675 day. For the fiscal year ending June 30, 1996, and any succeeding fiscal 676 year, the allowance for real wage growth, as determined in accordance 677 with subsection (q) of section 17-311-52 of the regulations of Connecticut 678 state agencies, shall not be applied. For the fiscal year ending June 30, 679 1996, and any succeeding fiscal year, the inflation adjustment made in 680 accordance with subsection (p) of section 17-311-52 of the regulations of 681 Connecticut state agencies shall not be applied to real property costs. 682 Beginning with the fiscal year ending June 30, 1997, minimum allowable 683 patient days for rate computation purposes for a residential care home 684 with twenty-five beds or less shall be eighty-five per cent of licensed 685 capacity. Beginning with the fiscal year ending June 30, 2002, for the 686 purposes of determining the allowable salary of an administrator of a 687 residential care home with sixty beds or less the department shall revise 688 the allowable base salary to thirty-seven thousand dollars to be annually 689 inflated thereafter in accordance with section 17-311-52 of the 690 regulations of Connecticut state agencies. The rates for the fiscal year 691 ending June 30, 2002, shall be based upon the increased allowable salary 692 of an administrator, regardless of whether such amount was expended 693 in the 2000 cost report period upon which the rates are based. Beginning 694 with the fiscal year ending June 30, 2000, and until the fiscal year ending 695 June 30, 2009, inclusive, the inflation adjustment for rates made in 696 accordance with subsection (p) of section 17-311-52 of the regulations of 697 Connecticut state agencies shall be increased by two per cent, and 698 beginning with the fiscal year ending June 30, 2002, the inflation 699 adjustment for rates made in accordance with subsection (c) of said 700 section shall be increased by one per cent. Beginning with the fiscal year 701 ending June 30, 1999, for the purpose of determining the allowable 702 salary of a related party, the department shall revise the maximum 703 salary to twenty-seven thousand eight hundred fifty-six dollars to be 704 annually inflated thereafter in accordance with section 17-311-52 of the 705 regulations of Connecticut state agencies and beginning with the fiscal 706 year ending June 30, 2001, such allowable salary shall be computed on 707 Governor's Bill No. 1251 LCO No. 4290 23 of 38 an hourly basis and the maximum number of hours allowed for a related 708 party other than the proprietor shall be increased from forty hours to 709 forty-eight hours per work week. For the fiscal year ending June 30, 710 2005, each facility shall receive a rate that is two and one-quarter per 711 cent more than the rate the facility received in the prior fiscal year, 712 except any facility that would have been issued a lower rate effective 713 July 1, 2004, than for the fiscal year ending June 30, 2004, due to interim 714 rate status or agreement with the department shall be issued such lower 715 rate effective July 1, 2004. Effective upon receipt of all the necessary 716 federal approvals to secure federal financial participation matching 717 funds associated with the rate increase provided in subdivision (4) of 718 subsection (f) of this section, but in no event earlier than October 1, 2005, 719 and provided the user fee imposed under section 17b-320 is required to 720 be collected, each facility shall receive a rate that is determined in 721 accordance with applicable law and subject to appropriations, except 722 any facility that would have been issued a lower rate effective October 723 1, 2005, than for the fiscal year ending June 30, 2005, due to interim rate 724 status or agreement with the department, shall be issued such lower rate 725 effective October 1, 2005. Such rate increase shall remain in effect unless: 726 (1) The federal financial participation matching funds associated with 727 the rate increase are no longer available; or (2) the user fee created 728 pursuant to section 17b-320 is not in effect. For the fiscal year ending 729 June 30, 2007, rates in effect for the period ending June 30, 2006, shall 730 remain in effect until September 30, 2006, except any facility that would 731 have been issued a lower rate effective July 1, 2006, than for the fiscal 732 year ending June 30, 2006, due to interim rate status or agreement with 733 the department, shall be issued such lower rate effective July 1, 2006. 734 Effective October 1, 2006, no facility shall receive a rate that is more than 735 four per cent greater than the rate in effect for the facility on September 736 30, 2006, except for any facility that would have been issued a lower rate 737 effective October 1, 2006, due to interim rate status or agreement with 738 the department, shall be issued such lower rate effective October 1, 2006. 739 For the fiscal years ending June 30, 2010, and June 30, 2011, rates in effect 740 for the period ending June 30, 2009, shall remain in effect until June 30, 741 Governor's Bill No. 1251 LCO No. 4290 24 of 38 2011, except any facility that would have been issued a lower rate for 742 the fiscal year ending June 30, 2010, or the fiscal year ending June 30, 743 2011, due to interim rate status or agreement with the department, shall 744 be issued such lower rate, except (A) any facility that would have been 745 issued a lower rate for the fiscal year ending June 30, 2010, or the fiscal 746 year ending June 30, 2011, due to interim rate status or agreement with 747 the Commissioner of Social Services shall be issued such lower rate; and 748 (B) the commissioner may increase a facility's rate for reasonable costs 749 associated with such facility's compliance with the provisions of section 750 19a-495a concerning the administration of medication by unlicensed 751 personnel. For the fiscal year ending June 30, 2012, rates in effect for the 752 period ending June 30, 2011, shall remain in effect until June 30, 2012, 753 except that (i) any facility that would have been issued a lower rate for 754 the fiscal year ending June 30, 2012, due to interim rate status or 755 agreement with the Commissioner of Social Services shall be issued 756 such lower rate; and (ii) the commissioner may increase a facility's rate 757 for reasonable costs associated with such facility's compliance with the 758 provisions of section 19a-495a concerning the administration of 759 medication by unlicensed personnel. For the fiscal year ending June 30, 760 2013, the Commissioner of Social Services may, within available 761 appropriations, provide a rate increase to a residential care home. Any 762 facility that would have been issued a lower rate for the fiscal year 763 ending June 30, 2013, due to interim rate status or agreement with the 764 Commissioner of Social Services shall be issued such lower rate. For the 765 fiscal years ending June 30, 2012, and June 30, 2013, the Commissioner 766 of Social Services may provide fair rent increases to any facility that has 767 undergone a material change in circumstances related to fair rent and 768 has an approved certificate of need pursuant to section 17b-352, 17b-353, 769 17b-354 or 17b-355. For the fiscal years ending June 30, 2014, and June 770 30, 2015, for those facilities that have a calculated rate greater than the 771 rate in effect for the fiscal year ending June 30, 2013, the commissioner 772 may increase facility rates based upon available appropriations up to a 773 stop gain as determined by the commissioner. No facility shall be issued 774 a rate that is lower than the rate in effect on June 30, 2013, except that 775 Governor's Bill No. 1251 LCO No. 4290 25 of 38 any facility that would have been issued a lower rate for the fiscal year 776 ending June 30, 2014, or the fiscal year ending June 30, 2015, due to 777 interim rate status or agreement with the commissioner, shall be issued 778 such lower rate. For the fiscal year ending June 30, 2014, and each fiscal 779 year thereafter, a residential care home shall receive a rate increase for 780 any capital improvement made during the fiscal year for the health and 781 safety of residents and approved by the Department of Social Services, 782 provided such rate increase is within available appropriations. For the 783 fiscal year ending June 30, 2015, and each succeeding fiscal year 784 thereafter, costs of less than ten thousand dollars that are incurred by a 785 facility and are associated with any land, building or nonmovable 786 equipment repair or improvement that are reported in the cost year used 787 to establish the facility's rate shall not be capitalized for a period of more 788 than five years for rate-setting purposes. For the fiscal year ending June 789 30, 2015, subject to available appropriations, the commissioner may, at 790 the commissioner's discretion: Increase the inflation cost limitation 791 under subsection (c) of section 17-311-52 of the regulations of 792 Connecticut state agencies, provided such inflation allowance factor 793 does not exceed a maximum of five per cent; establish a minimum rate 794 of return applied to real property of five per cent inclusive of assets 795 placed in service during cost year 2013; waive the standard rate of return 796 under subsection (f) of section 17-311-52 of the regulations of 797 Connecticut state agencies for ownership changes or health and safety 798 improvements that exceed one hundred thousand dollars and that are 799 required under a consent order from the Department of Public Health; 800 and waive the rate of return adjustment under subsection (f) of section 801 17-311-52 of the regulations of Connecticut state agencies to avoid 802 financial hardship. For the fiscal years ending June 30, 2016, and June 803 30, 2017, rates shall not exceed those in effect for the period ending June 804 30, 2015, except the commissioner may, in the commissioner's discretion 805 and within available appropriations, provide pro rata fair rent increases 806 to facilities which have documented fair rent additions placed in service 807 in cost report years ending September 30, 2014, and September 30, 2015, 808 that are not otherwise included in rates issued. For the fiscal years 809 Governor's Bill No. 1251 LCO No. 4290 26 of 38 ending June 30, 2016, and June 30, 2017, and each succeeding fiscal year, 810 any facility that would have been issued a lower rate, due to interim rate 811 status, a change in allowable fair rent or agreement with the department, 812 shall be issued such lower rate. For the fiscal year ending June 30, 2018, 813 rates shall not exceed those in effect for the period ending June 30, 2017, 814 except the commissioner may, in the commissioner's discretion and 815 within available appropriations, provide pro rata fair rent increases to 816 facilities which have documented fair rent additions placed in service in 817 the cost report year ending September 30, 2016, that are not otherwise 818 included in rates issued. For the fiscal year ending June 30, 2019, rates 819 shall not exceed those in effect for the period ending June 30, 2018, 820 except the commissioner may, in the commissioner's discretion and 821 within available appropriations, provide pro rata fair rent increases to 822 facilities which have documented fair rent additions placed in service in 823 the cost report year ending September 30, 2017, that are not otherwise 824 included in rates issued. For the fiscal year ending June 30, 2020, rates 825 shall not exceed those in effect for the fiscal year ending June 30, 2019, 826 except the commissioner may, in the commissioner's discretion and 827 within available appropriations, provide pro rata fair rent increases to 828 facilities which have documented fair rent additions placed in service in 829 the cost report year ending September 30, 2018, that are not otherwise 830 included in rates issued. For the fiscal year ending June 30, 2021, rates 831 shall not exceed those in effect for the fiscal year ending June 30, 2020, 832 except the commissioner may, in the commissioner's discretion and 833 within available appropriations, provide pro rata fair rent increases to 834 facilities which have documented fair rent additions placed in service in 835 the cost report year ending September 30, 2019, that are not otherwise 836 included in rates issued. For the fiscal year ending June 30, 2022, the 837 commissioner may, in the commissioner's discretion and within 838 available appropriations, provide pro rata fair rent increases to facilities 839 that have documented fair rent additions placed in service in the cost 840 report year ending September 30, 2020, that are not otherwise included 841 in rates issued. For the fiscal year ending June 30, 2023, the 842 commissioner may, in the commissioner's discretion and within 843 Governor's Bill No. 1251 LCO No. 4290 27 of 38 available appropriations, provide pro rata fair rent increases to facilities 844 which have documented fair rent additions placed in service in the cost 845 report year ending September 30, 2021, that are not otherwise included 846 in rates issued. For the fiscal years ending June 30, 2022, and June 30, 847 2023, a facility may receive a rate increase for a capital improvement 848 approved by the Department of Social Services, for the health or safety 849 of the residents during the fiscal year ending June 30, 2022, or June 30, 850 2023, only to the extent such rate increases are within available 851 appropriations. For the fiscal year ending June 30, 2022, and June 30, 852 2023, rates shall be based upon rates in effect for the fiscal year ending 853 June 30, 2021, inflated by the gross domestic product deflator applicable 854 to each rate year, except the commissioner may, in the commissioner's 855 discretion and within available appropriations, provide pro rata fair 856 rent increases to facilities which have documented fair rent additions 857 placed in service in the cost report years ending September 30, 2020, and 858 September 30, 2021, that are not otherwise included in rates issued. For 859 the fiscal years ending June 30, 2024, and June 30, 2025, a facility may 860 receive a rate increase for a capital improvement approved by the 861 Department of Social Services, for the health or safety of the residents 862 during the fiscal year ending June 30, 2024, or June 30, 2025, only to the 863 extent such rate increases are within available appropriations. For the 864 fiscal year ending June 30, 2024, the department shall determine facility 865 rates based upon 2022 cost report filings subject to the provisions of this 866 section, adjusted to reflect any rate increases provided after the cost 867 report year ending September 30, 2022. There shall be no increase to 868 rates based on any inflationary factor for the fiscal year ending June 30, 869 2024. For the fiscal years ending June 30, 2026, and June 30, 2027, a 870 facility may receive a rate increase for a capital improvement approved 871 by the Department of Social Services, for the health or safety of the 872 residents during the fiscal year ending June 30, 2026, or June 30, 2027, 873 only to the extent such rate increases are within available 874 appropriations. For the fiscal year ending June 30, 2026, the department 875 shall determine facility rates based upon 2024 cost report filings subject 876 to the provisions of this section, adjusted to reflect any rate increases 877 Governor's Bill No. 1251 LCO No. 4290 28 of 38 provided after the cost report year ending September 30, 2024. For the 878 fiscal year ending June 30, 2027, the department shall determine facility 879 rates based upon 2025 cost report filings subject to the provisions of this 880 section, adjusted to reflect any rate increases provided after the cost 881 report year ending September 30, 2025. There shall be no increase to 882 rates based on any inflationary factor for the fiscal years ending June 30, 883 2026, and June 30, 2027. Notwithstanding any other provisions of this 884 chapter, any subsequent increase to allowable operating costs, 885 excluding fair rent, shall be inflated by the gross domestic product 886 deflator when funding is specifically appropriated for such purposes in 887 the enacted budget. The rate of inflation shall be computed by 888 comparing the most recent rate year to the average of the gross domestic 889 product deflator for the previous four fiscal quarters ending March 890 thirty-first. Any increase to rates based on inflation shall be applied 891 prior to the application of any other budget adjustment factors that may 892 impact such rates. The commissioner shall determine whether and to 893 what extent a change in ownership of a facility shall occasion the 894 rebasing of the facility's costs. There shall be no inflation adjustment 895 during a year in which a facility's rates are rebased. For the fiscal year 896 ending June 30, 2024, the commissioner may, in the commissioner's 897 discretion and within available appropriations, provide pro rata fair 898 rent increases to facilities that have documented fair rent additions 899 placed in service in the cost report year ending September 30, 2022, that 900 are not otherwise included in rates issued. For the fiscal year ending 901 June 30, 2025, the commissioner may, in the commissioner's discretion 902 and within available appropriations, provide pro rata fair rent increases 903 to facilities that have documented fair rent additions placed in service 904 in the cost report year ending September 30, 2023, that are not otherwise 905 included in rates issued. For the fiscal year ending June 30, 2026, the 906 commissioner may, in the commissioner's discretion and within 907 available appropriations, provide pro rata fair rent increases to facilities 908 that have documented fair rent additions placed in service in the cost 909 report year ending September 30, 2024, that are not otherwise included 910 in rates issued. For the fiscal year ending June 30, 2027, the 911 Governor's Bill No. 1251 LCO No. 4290 29 of 38 commissioner may, in the commissioner's discretion and within 912 available appropriations, provide pro rata fair rent increases to facilities 913 that have documented fair rent additions placed in service in the cost 914 report year ending September 30, 2025, that are not otherwise included 915 in rates issued. 916 Sec. 11. Subdivision (9) of subsection (a) of section 17b-340d of the 917 general statutes is repealed and the following is substituted in lieu 918 thereof (Effective July 1, 2025): 919 (9) On and after July 1, 2025, costs shall be rebased no more frequently 920 than every two years and no less frequently than every four years, as 921 determined by the commissioner. There shall be no inflation adjustment 922 during a year in which a facility's rates are rebased. The commissioner 923 shall determine whether and to what extent a change in ownership of a 924 facility shall occasion the rebasing of the facility's costs. There shall be 925 no rebasing for the fiscal years ending June 30, 2026, and June 30, 2027. 926 Sec. 12. Subdivision (11) of subsection (a) of section 17b-340d of the 927 general statutes is repealed and the following is substituted in lieu 928 thereof (Effective July 1, 2025): 929 (11) There shall be no increase to rates based on inflation or any 930 inflationary factor for the fiscal years ending June 30, 2022, and June 30, 931 2023, unless otherwise authorized under subdivision (1) of this 932 subsection. Notwithstanding section 17-311-52 of the regulations of 933 Connecticut state agencies, for the fiscal years ending June 30, 2024, 934 [and] June 30, 2025, June 30, 2026, and June 30, 2027, there shall be no 935 inflationary increases to rates beyond those already factored into the 936 model for the transition to an acuity-based reimbursement system. 937 Notwithstanding any other provisions of this chapter, any subsequent 938 increase to allowable operating costs, excluding fair rent, shall be 939 inflated by the gross domestic product deflator when funding is 940 specifically appropriated for such purposes in the enacted budget. The 941 rate of inflation shall be computed by comparing the most recent rate 942 Governor's Bill No. 1251 LCO No. 4290 30 of 38 year to the average of the gross domestic product deflator for the 943 previous four fiscal quarters ending March thirty-first. Any increase to 944 rates based on inflation shall be applied prior to the application of any 945 other budget adjustment factors that may impact such rates. 946 Sec. 13. Subsection (i) of section 17b-342 of the general statutes is 947 repealed and the following is substituted in lieu thereof (Effective July 1, 948 2025): 949 (i) (1) The Commissioner of Social Services shall, within available 950 appropriations, administer a state-funded portion of the Connecticut 951 home-care program for the elderly for persons (A) who are sixty-five 952 years of age and older and are not eligible for Medicaid; (B) who are 953 inappropriately institutionalized or at risk of inappropriate 954 institutionalization; (C) whose income is less than or equal to the 955 amount allowed for a person who would be eligible for medical 956 assistance if residing in a nursing facility; and (D) whose assets, if single, 957 do not exceed one hundred fifty per cent of the federal minimum 958 community spouse protected amount pursuant to 42 USC 1396r-5(f)(2) 959 or, if married, the couple's assets do not exceed two hundred per cent of 960 said community spouse protected amount. For program applications 961 received by the Department of Social Services for the fiscal years ending 962 June 30, 2016, and June 30, 2017, only persons who require the level of 963 care provided in a nursing home shall be eligible for the state-funded 964 portion of the program, except for persons residing in affordable 965 housing under the assisted living demonstration project established 966 pursuant to section 17b-347e who are otherwise eligible in accordance 967 with this section. 968 (2) Except for persons residing in affordable housing under the 969 assisted living demonstration project established pursuant to section 970 17b-347e, as provided in subdivision (3) of this subsection, any person 971 whose income is at or below two hundred per cent of the federal poverty 972 level and who is ineligible for Medicaid shall contribute [three] five per 973 cent of the cost of his or her care not to exceed a cap of one hundred 974 Governor's Bill No. 1251 LCO No. 4290 31 of 38 seventy-five dollars per month for the fiscal year ending June 30, 2026. 975 On July 1, 2026, and annually thereafter, said cap shall be indexed 976 annually based on the percentage increase in the most recent calendar 977 year average in the consumer price index for urban consumers over the 978 average for the previous calendar year. Any person whose income 979 exceeds two hundred per cent of the federal poverty level shall 980 contribute [three] five per cent of the cost of his or her care not to exceed 981 said cap in addition to the amount of applied income determined in 982 accordance with the methodology established by the Department of 983 Social Services for recipients of medical assistance. Any person who 984 does not contribute to the cost of care in accordance with this 985 subdivision shall be ineligible to receive services under this subsection. 986 Notwithstanding any provision of sections 17b-60 and 17b-61, the 987 department shall not be required to provide an administrative hearing 988 to a person found ineligible for services under this subsection because 989 of a failure to contribute to the cost of care. 990 (3) Any person who resides in affordable housing under the assisted 991 living demonstration project established pursuant to section 17b-347e 992 and whose income is at or below two hundred per cent of the federal 993 poverty level, shall not be required to contribute to the cost of care. Any 994 person who resides in affordable housing under the assisted living 995 demonstration project established pursuant to section 17b-347e and 996 whose income exceeds two hundred per cent of the federal poverty 997 level, shall contribute to the applied income amount determined in 998 accordance with the methodology established by the Department of 999 Social Services for recipients of medical assistance. Any person whose 1000 income exceeds two hundred per cent of the federal poverty level and 1001 who does not contribute to the cost of care in accordance with this 1002 subdivision shall be ineligible to receive services under this subsection. 1003 Notwithstanding any provision of sections 17b-60 and 17b-61, the 1004 department shall not be required to provide an administrative hearing 1005 to a person found ineligible for services under this subsection because 1006 of a failure to contribute to the cost of care. 1007 Governor's Bill No. 1251 LCO No. 4290 32 of 38 (4) The annualized cost of services provided to an individual under 1008 the state-funded portion of the program shall not exceed fifty per cent 1009 of the weighted average cost of care in nursing homes in the state, except 1010 an individual who received services costing in excess of such amount 1011 under the Department of Social Services in the fiscal year ending June 1012 30, 1992, may continue to receive such services, provided the annualized 1013 cost of such services does not exceed eighty per cent of the weighted 1014 average cost of such nursing home care. The commissioner may allow 1015 the cost of services provided to an individual to exceed the maximum 1016 cost established pursuant to this subdivision in a case of extreme 1017 hardship, as determined by the commissioner, provided in no case shall 1018 such cost exceed that of the weighted cost of such nursing home care. 1019 Sec. 14. Section 17b-597 of the general statutes, as amended by section 1020 64 of public act 24-81, is repealed and the following is substituted in lieu 1021 thereof (Effective July 1, 2025): 1022 (a) The Department of Social Services shall establish and implement 1023 a working persons with disabilities program to provide medical 1024 assistance as authorized under 42 USC 1396a(a)(10)(A)(ii), as amended 1025 from time to time, to persons who are disabled and regularly employed. 1026 (b) The Commissioner of Social Services shall amend the Medicaid 1027 state plan to allow persons specified in subsection (a) of this section to 1028 qualify for medical assistance. The amendment shall include the 1029 following requirements: (1) That the person be engaged in a substantial 1030 and reasonable work effort as determined by the commissioner and as 1031 permitted by federal law and have an annual adjusted gross income, as 1032 defined in Section 62 of the Internal Revenue Code of 1986, or any 1033 subsequent corresponding internal revenue code of the United States, 1034 as amended from time to time, of not more than eighty-five thousand 1035 dollars per year; (2) a disregard of all countable income up to two 1036 hundred per cent of the federal poverty level; (3) for an unmarried 1037 person, an asset limit of twenty thousand dollars, and for a married 1038 couple, an asset limit of thirty thousand dollars; (4) a disregard of any 1039 Governor's Bill No. 1251 LCO No. 4290 33 of 38 retirement and medical savings accounts established pursuant to 26 1040 USC 220 and held by either the person or the person's spouse; (5) a 1041 disregard of any moneys in accounts designated by the person or the 1042 person's spouse for the purpose of purchasing goods or services that 1043 will increase the employability of such person, subject to approval by 1044 the commissioner; (6) a disregard of spousal income solely for purposes 1045 of determination of eligibility; and (7) a contribution of any countable 1046 income of the person or the person's spouse which exceeds two hundred 1047 per cent of the federal poverty level, as adjusted for the appropriate 1048 family size, equal to ten per cent of the excess minus any premiums paid 1049 from income for health insurance by any family member, but which 1050 does not exceed the maximum contribution allowable under Section 1051 201(a)(3) of Public Law 106-170, as amended from time to time. 1052 [(c) Notwithstanding the provisions of subsection (b) of this section, 1053 on and after July 1, 2026, the commissioner shall phase in the elimination 1054 of income and asset limits for a participant in the program over four 1055 fiscal years by annually increasing (1) the income limit prescribed in 1056 subdivision (1) of subsection (b) of this section by ten thousand dollars, 1057 and (2) the asset limit prescribed in subdivision (3) of subsection (b) of 1058 this section by ten thousand dollars for an unmarried person and fifteen 1059 thousand dollars for a married couple. On and after July 1, 2029, there 1060 shall be no income or asset limit for eligibility for the program.] 1061 [(d)] (c) The Commissioner of Social Services shall implement the 1062 policies and procedures necessary to carry out the provisions of this 1063 section while in the process of adopting such policies and procedures in 1064 regulation form, provided notice of intent to adopt the regulations is 1065 posted on the eRegulations System in accordance with section 17b-10. 1066 The commissioner shall define "countable income" for purposes of 1067 subsection (b) of this section which shall take into account impairment-1068 related work expenses as defined in the Social Security Act. Such 1069 policies and procedures shall be valid until the time final regulations are 1070 effective. 1071 Governor's Bill No. 1251 LCO No. 4290 34 of 38 Sec. 15. Section 19a-634 of the general statutes is repealed and the 1072 following is substituted in lieu thereof (Effective July 1, 2025): 1073 (a) [The] On or before June 30, 2029, and every five years thereafter, 1074 the Health Systems Planning Unit shall conduct, [on a biennial basis] 1075 within available appropriations, a state-wide health care facility 1076 utilization study. Such study may include an assessment of: (1) Current 1077 availability and utilization of acute hospital care, hospital emergency 1078 care, specialty hospital care, outpatient surgical care, primary care and 1079 clinic care; (2) geographic areas and subpopulations that may be 1080 underserved or have reduced access to specific types of health care 1081 services; and (3) other factors that the unit deems pertinent to health care 1082 facility utilization. Not later than June thirtieth of the year in which the 1083 [biennial] quinquennial study is conducted, the Commissioner of 1084 Health Strategy shall report, in accordance with section 11-4a, to the 1085 Governor and the joint standing committees of the General Assembly 1086 having cognizance of matters relating to public health and human 1087 services on the findings of the study. Such report may also include the 1088 unit's recommendations for addressing identified gaps in the provision 1089 of health care services and recommendations concerning a lack of access 1090 to health care services. 1091 (b) The unit, in consultation with such other state agencies as the 1092 commissioner deems appropriate, shall establish and maintain a state-1093 wide health care facilities and services plan. Such plan may include, but 1094 not be limited to: (1) An assessment of the availability of acute hospital 1095 care, hospital emergency care, specialty hospital care, outpatient 1096 surgical care, primary care and clinic care; (2) an evaluation of the unmet 1097 needs of persons at risk and vulnerable populations as determined by 1098 the commissioner; (3) a projection of future demand for health care 1099 services and the impact that technology may have on the demand, 1100 capacity or need for such services; and (4) recommendations for the 1101 expansion, reduction or modification of health care facilities or services. 1102 In the development of the plan, the unit shall consider the 1103 recommendations of any advisory bodies which may be established by 1104 Governor's Bill No. 1251 LCO No. 4290 35 of 38 the commissioner. The commissioner may also incorporate the 1105 recommendations of authoritative organizations whose mission is to 1106 promote policies based on best practices or evidence-based research. 1107 The commissioner, in consultation with hospital representatives, shall 1108 develop a process that encourages hospitals to incorporate the state-1109 wide health care facilities and services plan into hospital long-range 1110 planning and shall facilitate communication between appropriate state 1111 agencies concerning innovations or changes that may affect future 1112 health planning. The unit shall update the state-wide health care 1113 facilities and services plan not less than once every [two] five years. 1114 (c) For purposes of conducting the state-wide health care facility 1115 utilization study and preparing the state-wide health care facilities and 1116 services plan, the unit shall establish and maintain an inventory of all 1117 health care facilities, the equipment identified in subdivisions (9) and 1118 (10) of subsection (a) of section 19a-638, and services in the state, 1119 including health care facilities that are exempt from certificate of need 1120 requirements under subsection (b) of section 19a-638. The unit shall 1121 develop an inventory questionnaire to obtain the following information: 1122 (1) The name and location of the facility; (2) the type of facility; (3) the 1123 hours of operation; (4) the type of services provided at that location; and 1124 (5) the total number of clients, treatments, patient visits, procedures 1125 performed or scans performed in a calendar year. The inventory shall 1126 be completed [biennially] every five years by health care facilities and 1127 providers and such health care facilities and providers shall not be 1128 required to provide patient specific or financial data. 1129 Sec. 16. Subsection (a) of section 38a-1060 of the general statutes is 1130 repealed and the following is substituted in lieu thereof (Effective July 1, 1131 2025): 1132 (a) There is established an Office of the Behavioral Health Advocate 1133 which shall be within the [Insurance Department for administrative 1134 purposes only] Office of the Healthcare Advocate. 1135 Governor's Bill No. 1251 LCO No. 4290 36 of 38 Sec. 17. Section 38a-1061 of the general statutes is repealed and the 1136 following is substituted in lieu thereof (Effective July 1, 2025): 1137 (a) [The Office of the Behavioral Health Advocate shall be under the 1138 direction of the Behavioral Health Advocate who shall be appointed by 1139 the Governor, with the approval of the General Assembly.] The 1140 Behavioral Health Advocate shall be an elector of the state with 1141 expertise and experience in the fields of mental or behavioral health 1142 care, health insurance and advocacy for parity in mental and behavioral 1143 health access and outcomes. [In addition to the Behavioral Health 1144 Advocate, the Office of the Behavioral Health Advocate shall consist of 1145 sufficient staff as the requirements and resources of the office permit, of 1146 whom at least one shall be an attorney and at least one shall be a patient 1147 care navigator.] 1148 (b) The Governor shall make the initial appointment of the Behavioral 1149 Health Advocate from a list of candidates prepared and submitted, not 1150 later than February 1, 2024, to the Governor by the advisory committee 1151 established pursuant to section 38a-1062. The Governor shall notify the 1152 advisory committee of the pending expiration of the term of an 1153 incumbent Behavioral Health Advocate not less than ninety days prior 1154 to the final day of the Behavioral Health Advocate's term in office. If a 1155 vacancy occurs in the position of Behavioral Health Advocate, the 1156 Governor shall notify the advisory committee immediately of the 1157 vacancy. The advisory committee shall meet to consider qualified 1158 candidates for the position of Behavioral Health Advocate and shall 1159 submit a list of not more than five candidates to the Governor ranked in 1160 order of preference, not more than sixty days after receiving notice from 1161 the Governor of the pending expiration of the Behavioral Health 1162 Advocate's term or the occurrence of a vacancy. The Governor shall 1163 designate, not more than sixty days after receipt of the list of candidates 1164 from the advisory committee, one candidate from the list for the position 1165 of Behavioral Health Advocate. If, after the list is submitted to the 1166 Governor by the advisory committee, any candidate withdraws from 1167 consideration, the Governor shall designate a candidate from those 1168 Governor's Bill No. 1251 LCO No. 4290 37 of 38 remaining on the list. If the Governor fails to designate a candidate 1169 within sixty days of receipt of the list from the advisory committee, the 1170 advisory committee shall refer the candidate with the highest ranking 1171 on the list to the General Assembly for confirmation. If the General 1172 Assembly is not in session at the time of the [Governor's or] advisory 1173 committee's designation of a candidate, the candidate shall serve as the 1174 acting Behavioral Health Advocate until the General Assembly meets 1175 and confirms the candidate as Behavioral Health Advocate. A candidate 1176 serving as acting Behavioral Health Advocate is entitled to 1177 compensation and has all the powers, duties and privileges of the 1178 Behavioral Health Advocate. A Behavioral Health Advocate shall serve 1179 a term of four years, not including any time served as acting Behavioral 1180 Health Advocate, and may be reappointed by the Governor or shall 1181 remain in the position until a successor is confirmed. Although an 1182 incumbent Behavioral Health Advocate may be reappointed, the 1183 Governor shall also consider additional candidates from a list submitted 1184 by the advisory committee as provided in this section. 1185 [(c) Upon a vacancy in the position of the Behavioral Health 1186 Advocate, the most senior attorney in the Office of the Behavioral 1187 Health Advocate shall serve as the acting Behavioral Health Advocate 1188 until the vacancy is filled pursuant to subsection (a) or (b) of this section. 1189 The acting Behavioral Health Advocate has all the powers, duties and 1190 privileges of the Behavioral Health Advocate.] 1191 Sec. 18. Subdivision (3) of subsection (d) of section 4-28f of the general 1192 statutes is repealed and the following is substituted in lieu thereof 1193 (Effective July 1, 2025): 1194 (3) After such recommendations for the authorization of 1195 disbursement have been approved or modified pursuant to subdivision 1196 (2) of this subsection, any modification in the amount of an authorized 1197 disbursement in excess of [fifty] one hundred seventy-five thousand 1198 dollars [or ten per cent of the authorized amount, whichever is less,] 1199 shall be submitted to said joint standing committees and approved, 1200 Governor's Bill No. 1251 LCO No. 4290 38 of 38 modified or rejected in accordance with the procedure set forth in 1201 subdivision (2) of this subsection. Notification of all disbursements from 1202 the trust fund made pursuant to this section shall be sent to the joint 1203 standing committees of the General Assembly having cognizance of 1204 matters relating to public health and appropriations and the budgets of 1205 state agencies, through the Office of Fiscal Analysis. 1206 This act shall take effect as follows and shall amend the following sections: Section 1 July 1, 2025 14-11b Sec. 2 July 1, 2025 17b-104(b) Sec. 3 July 1, 2025 17b-106(a) Sec. 4 July 1, 2025 17b-112g(a) Sec. 5 July 1, 2025 17b-191 Sec. 6 July 1, 2025 17b-278l Sec. 7 July 1, 2025 17b-244(a) Sec. 8 July 1, 2025 New section Sec. 9 July 1, 2025 17b-340(h)(1) Sec. 10 July 1, 2025 17b-340(i) Sec. 11 July 1, 2025 17b-340d(a)(9) Sec. 12 July 1, 2025 17b-340d(a)(11) Sec. 13 July 1, 2025 17b-342(i) Sec. 14 July 1, 2025 17b-597 Sec. 15 July 1, 2025 19a-634 Sec. 16 July 1, 2025 38a-1060(a) Sec. 17 July 1, 2025 38a-1061 Sec. 18 July 1, 2025 4-28f(d)(3) Statement of Purpose: To implement the Governor's budget recommendations regarding health and human services. [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.]