EXECUTIVE AND LEGISLATIVE NOMINATIONS COMMITTEE;

CURRENT ISSUES

1. What will be your highest priorities in light of the current budget situation? What effects have the budget cuts had on programs and initatives? If programs or services must be cut, where do you think the cuts should be made?

2. Medicaid and prescription drug costs have increased over the years. Describe what has already been done to control these costs and what could still be done?

3. There have been complaints that Medicaid reimbursement to providers is inadequate and is affecting patients’ access to services. What can the state do to address this situation?

4. Explain the progress the Department of Social Services (DSS) has made in implementing the prior authorization plan for brand name prescription drugs and generic substitutions under Medicaid, ConnPACE, and other state medical programs. When do you expect to have the program up and running? What are some of the difficulties you are having in implementing the plan?

5. DSS has applied for a federal Medicaid waiver that would increase ConnPACE income caps and turn it into a Medicaid program to give the state federal financial help with its costs. So far, the request has not been approved. Could you discuss what has happened and what the barriers to approval are? Do you foresee the request being approved in the near future? If it is approved, do you think the expansion is still feasible, given the budget situation?

6. Another request for a federal Medicaid waiver consists of controversial changes to the penalty period for inappropriate transfers of assets made by people applying for Medicaid help with their nursing home care and an increase in the lookback period for real estate transfers from three to five years. This waiver has not been approved. Could you discuss what has happened and the chances of approval or disapproval?

7. As of January 1, 2003, Medicaid, State-administered General Assistance (SAGA), and town General Assistance (GA) no longer pay for services to clients over age 21 by “independently enrolled” podiatrists, chiropractors, naturopaths, psychologists, physical therapists, audiologists, and speech pathologists. SAGA and GA also no longer pay for home health care or vision services provided by optometrists and opticians (including all optical hardware). How will these changes affect the quality of patient care? How can people still obtain these services?

8. The HUSKY program allows low-income parents and caretakers of participating children to enroll in HUSKY A. What are your views on proposals to eliminate HUSKY A adult coverage and make other cost-cutting changes in the program? What are your views on the new Health Insurance Flexibility and Accountability Initiative (HIFA) waivers that allow states to use Medicaid and federal State Children’s Health Insurance Program (SCHIP) funds to cover childless adults?

9. The federal Temporary Assistance to Needy Families (TANF) law, which provides funding for the state’s Temporary Family Assistance (TFA), Safety Net, and related programs, is up for reauthorization. What are your views on proposals to increase required hours of work from 30 to 40 hours? How would that affect our programs?

10. What are you views on proposals to include more education (particularly higher education) and training as an allowable activity to satisfy TANF work requirements?

11. Since the mid-‘90s, welfare reform has succeeded in reducing the number of people on welfare in a high employment economy. In light of the current economic and unemployment problems, more people may be in need of help from the state. Do you think the TANF program needs any adjustments to address the changed economic circumstances?

12. Over the last decade, the state has taken a number of gradual steps to help elderly and disabled people receive long-term care at home or in the community rather than in more expensive nursing homes. Could you describe some of these initiatives and comment on their level of success? What are your views on shifting state resources in this way?

13. What type of planning is the department doing to meet the long-term care needs of aging Baby Boomers? What are your views on creating a cost-effective, consumer-oriented continuum of long-term care?

14. There is a recent trend for disabled and elderly people to choose their own personal care assistants (PCAs) and act as their employers (known as the “consumer-directed option”), instead of receiving services through a home health agency. What do you think is the potential for such initiatives to make long-term care more consumer-oriented or to save the state money?

ISSUES RELATING TO AGENCY OPERATIONS AND PROCEDURES

1. Describe the department’s organizational structure. How do the various divisions interact with one another? What has been the effect of the recent layoffs? What can your department do to fulfill people’s needs for help while still controlling costs?

2. What is the department doing to help clients of the four local DSS offices that recently closed obtain the services they need?

3. Can you achieve any internal efficiencies by reorganizing your department or changing how it functions?

4. How could DSS be more efficient in reaching people who need services and in providing those services? What are you currently doing along these lines?

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