AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET RECOMMENDATIONS WITH RESPECT TO SOCIAL SERVICES PROGRAMS.

AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET RECOMMENDATIONS WITH RESPECT TO SOCIAL SERVICES PROGRAMS.

This bill makes several unrelated changes in the law governing the Department of Social Services' (DSS) programs.

It requires DSS, in consultation with the Office of Policy and Management (OPM), to determine whether it would be cost effective to offer hospice services as a benefit under the Medicaid state plan. If it is, DSS must amend the plan to include the benefit by February 1, 2009.

It allows individuals (1) living in residential care homes (RCH) or New Horizons, Inc. (a residential facility for individuals with severe physical disabilities) and (2) applying for State Supplement benefits to transfer to a trust any excess income without jeopardizing their eligibility for benefits.

And it increases the amount of child support income that DSS disregards when determining a family's eligibility for Temporary Family Assistance (TFA) benefits.

The bill also allows the Behavioral Health Partnership (BHP) to serve families served by the Judicial Department's Court Support Services Division, and adds a representative of the division to the BHP oversight council.

The bill requires DSS to consult with OPM to determine the cost effectiveness of amending the Medicaid State Plan to include hospice services. The DSS commissioner must amend the state plan to include the services by February 1, 2009, if it is determined to be cost effective to do so.

Currently, Medicaid pays for certain home health care services but not the full panoply of hospice benefits, such as bereavement counseling.

TRUSTS FOR STATE SUPPLEMENT APPLICANTS RESIDING IN RESIDENTIAL CARE HOMES AND NEW HORIZONS, INC.

In general, State Supplement applicants who transfer assets within 24 months before applying for assistance are presumed to have done so to qualify. Such transfers generally render the transferor ineligible for State Supplement for a period of time based on the value of the asset. But if the applicant can provide convincing evidence that the transfer was made for another reason, eligibility is not affected.

The bill adds a second exception by allowing transfers to “special needs trusts” by individuals who (1) are living in residential care homes or New Horizons, Inc. (a facility for people with severe physical disabilities, located in Farmington) and (2) have available income that is more than 300% of the maximum federal Supplemental Security Income (SSI) program benefit for an individual ($ 1,911 per month in 2008) and below the private rate that the RCH or New Horizons charges. Currently, an individual cannot qualify for State Supplement benefits if his or her income exceeds 300% of the SSI benefit.

The bill does not explicitly provide that individuals with such trusts can have the excess income they deposit into them disregarded for purposes of State Supplement eligibility. So it appears that individuals who create these trusts could lose their eligibility on that basis.

The bill requires the trust to be funded solely with the individual's excess income. The trust must provide that once the individual dies, the state will receive all amounts remaining in it after the Medicaid program is reimbursed for Medicaid-funded services the individual received, up to an amount equaling the amount of State Supplement provided. The type of trust someone may establish is the same that federal law allows for purposes of Medicaid eligibility (42 USC § 1396p(d)(4)).

The bill increases, from $ 50 to $ 100, the amount of monthly child support that DSS must disregard when determining income eligibility and benefit levels in the TFA program. Raising this limit allows families to keep more child support income without affecting their TFA benefits. If DSS collects more than the disregard limit, the excess counts towards eligibility but not the benefit amount and is considered reimbursement for TFA benefits. But when the current support collected exceeds the family's monthly TFA benefit plus the limit, the child support is paid directly to the family and is counted for purposes of determining the TFA benefit.

The current monthly TFA benefit for a family of three living in most parts of the state is $ 560. To initially qualify for TFA, a family's income can be no higher than the TFA benefit for that family's size, plus $ 90 (from earnings). Once receiving TFA, families can have income up to the federal poverty level without losing eligibility.

The bill allows the Behavioral Health Partnership to provide integrated behavioral health services to children, adolescents, and families served by the Court Support Services Division (CSSD) of the Judicial Department. By law, these services must be offered to HUSKY A and B enrollees and children enrolled in the Department of Children and Families' (DCF) voluntary services program. At DSS' and DCF's discretion, the program can also serve other children, adolescents, and families.

As a corollary, the bill also adds a nonvoting, ex-officio member representing the CSSD to the partnership's oversight council. The chief court administrator appoints this member.

State Supplement is a state-funded program offering cash assistance to aged, blind, and disabled residents, most of whom receive SSI. To qualify, an individual may not have income above 300% of the maximum SSI benefit and assets cannot exceed $ 1,600 for a single person. The amount of the State Supplement benefit is based on the individual's living arrangement, with individuals living in institutional settings receiving higher amounts than individuals residing in the community.

HB 5447 (File 394), reported by Public Health and Human Services, changes who appoints the BHP council. sHB 5910 (File 412) requires DSS, when adopting regulations pertaining to the BHP, to submit them to the BHP oversight council for its approval.

sSB 558, reported by Human Services and Appropriations, requires DSS to amend the Medicaid state plan to include hospice services, effective July 1, 2008.

sSB 666 (File 606), reported by Human Services and Appropriations, contains the same child support disregard provision.

Yea

Nay

(03/13/2008)

Yea

Nay

(03/28/2008)