May 29, 2008
STATE ELDERLY PROGRAMS
By: Nicole Dube, Legislative Analyst II
You asked for an update of OLR Report 2008-R-0021 which describes state programs for the elderly.
The state's principal elderly services programs provide cash assistance, energy assistance, health care, housing, legal assistance, nutrition, property tax relief, and transportation. We have included programs where (1) age is one criterion for eligibility or (2) a large proportion of the clients are elderly even though the programs are not only aimed at that group. Some of these programs are means tested. Some are funded, in part, with federal money.
State Supplement Program (SSP) — Old Age Assistance
Under the SSP program, DSS provides state cash assistance to supplement federal Supplemental Security Income (SSI) payments. The amount of state aid is based on DSS's determination of a recipient's total needs. This amount is then compared to the individual's income, and the difference (after deductions are taken) is the SSP benefit.
To be eligible for benefits, an individual must be age 65 or over, blind, or disabled and have monthly gross income of not more than $1,809 if living alone. Assets can be no greater than $1,600 for singles, and $2,400 for married couples.
SSP aid can help elderly, blind, or disabled people live independently in the community or pay for room and board in a licensed boarding facility, such as a residential care home (RCH). RCHs (formerly known as “homes for the aged”) provide room and board, housekeeping, laundry, medication management, some personal care, and other services to seniors and younger people with disabilities who cannot live alone but who do not need nursing home care. DSS partially bases the rates it pays an RCH on the facility's costs.
Home Heating Assistance and Weatherization
The state runs two programs, funded mainly by federal block grants and administered by DSS and local community action agencies, that help low-income households of all ages, offset their winter heating bills:
1. The Connecticut Energy Assistance Program (CEAP) is available to households with incomes up to 150% of the federal poverty level (FPL). In addition, households with incomes between 150% and 200% of the FPL can receive assistance under the program, provided at least one household member is age 60 or older or has a disability. Liquid assets cannot exceed $10,000 for homeowners and $7,000 for renters, unless the excess assets, when added to the household's annual income, still leave the family within the income limits. CEAP-eligible homeowners may also be eligible for funding to provide emergency repair or replacement of unsafe or inoperable heating systems.
2. If it receives enough federal funding, the state can also run a Contingency Heating Assistance Program for households whose income is too high for CEAP but less than 60% of state median income. It had not done so since the 2003-2004 heating season. But 2005 state legislation required DSS to reinstate the program for the 2005-2006 heating season and DSS has continued the program since that time.
Although this program is not restricted to the elderly, a household in which one or more members is 60 years or older may receive a higher benefit level.
CEAP-eligible households may also qualify for the Weatherization Assistance Program, run through the community action agencies. Priority may be given to low-income families with an elderly individual or one with a disability and those with a young child.
In addition, the Weatherization Residential Assistance Partnership (WRAP) helps low-income utility customers with high energy bills reduce their costs through several weatherization measures. WRAP is a partnership of DSS, community action agencies, and utility companies.
Medicaid is a state-federal program that provides medical assistance to low-income families and elderly and disabled individuals. For the elderly, the lion's share of Medicaid expenditures covers nursing home costs, but it also pays medical costs for qualified elderly people who live at home that Medicare does not cover. The Department of Social Services (DSS) administers Medicaid in Connecticut. The eligibility criteria vary, depending on the type of care required, but in most cases applicants must pass both an income and asset test.
Qualified Medicare Beneficiary “Dual Eligible's”
Low-income seniors on Medicare may also be eligible for the Qualified Medicare Beneficiaries (QMB) program, which uses Medicaid funds to pay Medicare premiums, deductibles, and some coinsurance for people with incomes at or below the poverty level and minimal liquid assets. For those with slightly higher incomes, a related program, the Specified Low-Income Medicare Beneficiary program pays the Medicare Part B premium.
Prescription Coverage for Medicare-Medicaid Dually Eligible
Consistent with the federal Medicare Part D prescription plan program that began January 1, 2006, seniors and people with disabilities covered by both Medicare and Medicaid (the “dually eligible”) now receive the bulk of their prescription drug coverage through the approved private Part D plans in which federal and state law requires them to enroll. For this group, Medicaid no longer covers drugs for which the new Part D program could pay (Part D covered drugs), but it continues to cover prescriptions it previously paid for that are not covered by Part D.
A plan can choose which Part D covered drugs to put on its formulary (called “formulary drugs”) and does not generally have to pay for Part D drugs that are not on its formulary (“non-formulary” drugs). The federal government provides extra help for dually eligible people to pay for formulary drugs, and the state pays the $1 to $5 federally required prescription co-pay for them. Patients can request coverage for nonformulary drugs from their plan through a federal appeals process.
2005 state legislation created a state-funded Medicare Part D Supplemental Needs Fund. If a Part D plan denies coverage for a drug because it is not on its formulary, DSS is required to pay for an initial 30-day supply of the nonformulary drug for the dually eligible. Pending an appeals process outcome, DSS must continue to pay claims for the denied drug until the earlier of when the plan approves it or, in some situations, the end of the calendar year.
Medicare Advantage Special Needs Plan for Dual Eligible's
The 2007 budget act allowed DSS to implement voluntary Medicaid Special Needs Plans (SNPs), which offer coordinated care to frail elderly individuals who are eligible for both Medicaid and Medicare. SNPs integrate the full range of Medicaid and Medicare benefits (e.g. primary, acute, behavioral, and long-term services) for dual eligibles.
Nursing Facilities Transition Grant Program
This small program, begun in 2001 with federal grants and now funded by state money since the federal grants expired, helps move elderly and disabled people from nursing homes to more independent living in the community and helps them obtain needed support services to do so successfully. So far, the program has helped 130 people make the transition to community living.
Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled (ConnPACE) Program
ConnPACE is a state program that pays for prescription drugs for people age 65 and over and younger people with disabilities. Applicants' annual income currently must be not more than $23,700 if single, and $31,900 if part of a married couple. This limit is adjusted annually to reflect inflation adjustments in Social Security payments. Participants must be state residents for at least six months and pay an annual $30 registration fee and a $16.25 co-payment for each prescription. Certain
prescriptions are not covered, such as antihistamines and diet pills. ConnPACE had over 39,429 enrollees as of June 30, 2007. Over 34,154 were seniors.
State law requires Medicare-eligible ConnPACE participants to enroll in a Medicare Part D private plan. The law coordinates ConnPACE benefits with Part D so that participants do not pay more than ConnPACE's $30 annual registration fee and $16.25 per-prescription copayment for drugs on their plan's formulary. (They may pay less than the $16.25 copay if their federal copays are lower.)
A plan can choose which Part D covered drugs to put on its formulary (“formulary drugs”) and does not generally have to pay for Part D drugs that are not on its formulary (“non-formulary” drugs). ConnPACE participants can use the same federal appeals process as the Medicare-Medicaid dually eligible to obtain coverage for their non-formulary drugs.
And, if a Part D plan denies the ConnPACE participant coverage for a nonformulary drug, 2006 state legislation requires DSS to pay for an initial 30-day supply of the drug, subject to the applicable copay, also using the Medicare Part D Supplemental Needs Fund (see above). Pending an appeals process outcome, DSS must continue to pay claims for the denied drug until the earlier of when the plan approves it or, in some situations, the end of the calendar year. (PA 06-188, § 13)
Connecticut Medicare Assignment Program (ConnMAP)
The Connecticut Medicare Assignment Program (ConnMAP) prohibits medical providers from billing enrollees for charges beyond what the federal Medicare program determines is a “reasonable and necessary” rate, of which Medicare pays 80% (a practice called “balance billing.”) Thus, any provider accepting Medicare patients may not balance bill ConnMAP enrollees beyond the 20% co-payment for the service. (Patients are also responsible for the Part B premiums and deductibles.) The income limits for the ConnMAP program are tied to those for ConnPACE. The current maximum is 165% of the ConnPACE limits. ConnPACE recipients can use their ConnPACE cards in lieu of a ConnMAP card, and providers must accept both. Applicants must have resided in the state for at least 183 days before applying and be enrolled in Medicare Part B.
Connecticut Home Care Program for Elders (CHCPE)
The CHCPE has both Medicaid- and state-funded components that pay for home- and community-based services for infirm elderly individuals who might otherwise require nursing home care. Services include care management, adult day care, adult foster care, homemaker services, transportation, meals-on-wheels, minor home modifications, and certain assisted living services. An “access” agency determines the most appropriate service package for each participant. Qualifying people in the higher income ranges must contribute to the cost of their care.
Financial eligibility differs for the program's two portions. For the Medicaid-funded portion, the income limit is currently $1,869 a month for the individual who receives the services. Assets are limited to $1,600 per individual, $3,200 per couple if both receive services, and $22,480 per couple, or higher if the couple undergoes a “community spousal assessment” (CSPA) if only one receives services. For the state-funded portion, there is currently no specific income limit for people who would be Medicaid-eligible in a nursing home; asset limits are $31,320 for an individual and $41,760 for a couple, regardless of whether one or both are receiving services. These asset limits, respectively, represent 150% and 200% of the minimum CSPA amount of assets that a Medicaid-eligible nursing home resident's spouse living in the community can keep.
Elderly Personal Care Assistance Pilot
DSS administers a state-funded “consumer-directed” personal care assistance (PCA) pilot program that allows seniors to hire their own attendant instead of going through a home health care agency. To be eligible, people must be age 65 or over and meet CHCPE's functional and financial qualifications (see above). 2007 legislation eliminated the 250-person limit on the number of participants, effective July 1, 2007 (PA 07-130, § 9).
The Elderly PCA Pilot Program permits clients to choose their own assistants to help with personal care and activities of daily living. The client employs, trains, supervises, and may fire the attendant, but a financial intermediary takes care of the paperwork.
Expansion of Medicaid PCA Waiver for the Disabled to People Age 65 and Over
2006 legislation removed the upper age limit in the state's Medicaid PCA waiver program for disabled people aged 18 to 64, effective July 1, 2006. This change allows (1) participants to continue in the program after turning age 65 and (2) new applicants age 65 or over to enter the program if they qualify. Previously, people who “aged out” of this program could continue their PCA services only by applying for the purely state-funded pilot PCA program for people age 65 and older.
Removing the age cap also applies to working disabled people currently receiving PCA services because they are participating in the Medicaid for Employed Disabled “buy in” program (see below).
Medicaid for Employed Disabled (MED) Program Age Change
2006 legislation (PA 06-188, § 27) also lets DSS allow older, working individuals to participate in the MED “buy-in” program, effective July 1, 2006. Previously, the law limited eligibility to adults under age 65. The MED program provides affordable health care coverage to working people (including those working part-time) with severe disabilities. (Medicare pays for most of these individuals' health care; Medicaid generally covers everything else.)
Alzheimer's Respite Program
The Connecticut Statewide Respite Care Program gives families who care for relatives with Alzheimer's or related disorders an occasional break by paying for up to $3,500 of respite services per year. DSS runs the program in partnership with the Area Agencies on Aging (AAAs). Patients are eligible for this program if they have annual incomes of no more than $30,000 and assets of no more than $80,000. They cannot be enrolled in the Connecticut Home Care Program for Elders (CHCPE). 2007 legislation changed the program requirements to allow Medicaid recipients under age 65 to participate (PA 07-86).
Participants can receive the respite care in their home, at an adult day care center, or other out-of-home service (out-of-home services other than adult day care are limited to 30 days annually). There is no age requirement for eligibility, but these diseases affect more seniors than younger people.
Day Care—Alzheimer's Disease
DSS provides funding through the state's AAAs to pay for staff for adult day care programs for people with Alzheimer's disease. Approximately 29 adult day care centers participate. The department's CHCPE program also subsidizes the attendance fees for people who qualify financially.
Brain G.Y.M.M. Program
The New England Cognitive Center's Brain G.Y.M.M. Program uses a two-tiered, non-pharmaceutical approach to address the needs of people with Alzheimer's disease. It evaluated two primary interventions--computer exercises that target specific areas of cognition and hands-on cognitive training in a small group or workshop environment-- to determine whether the program could maintain cognitive functioning levels in these individuals. In FY 06, 1,046 individuals participated in one-on-one cognitive workout sessions, and 144 group training sessions were held. The state first funded the program in FY 06 with funds from a 2005 settlement with drug companies.
National Family Caregiver Support Act Program
The National Family Caregiver Support Act, Title IIIe, of the federal Older Americans Act (OAA), gives grants to states to provide information and referral, training, counseling, respite care, and other supportive services to (1) people caring at home for chronically ill, frail, elderly relatives or relatives with mental retardation or other developmental disabilities and (2) grandparents and other relatives caring for children at home. Although the program's funding is entirely federal, it is distributed through the states. The states must provide the services through their AAAs.
States must give priority to services to older people with the greatest social and economic need (with particular attention to low-income seniors) and to older people who are taking care of relatives with mental retardation or other related developmental disabilities.
The state Department of Social Services' (DSS) Aging Services Division allocates the money it receives from the federal government to the state's five AAAs through the OAA's distribution formulas. The AAAs or their contractors provide the services, which include caregiver counseling, information about available services, help in accessing services, respite services, and limited supplemental services not available through other programs. Each AAA must coordinate its activities with community agencies and voluntary organizations providing similar services.
Adult Family Living (formerly Adult Foster Care)
DSS funds a voluntary adult family living program for elderly people who are inappropriately institutionalized or who might otherwise be placed in a nursing home. The program provides room, board, and personal care services in a host home or substantially equivalent environment. There are no income limits, but participants must contribute towards the program's costs according to a sliding fee scale. Currently, the program serves only two people and does not accept new applicants.
Health Insurance Counseling – CHOICES Program
The CHOICES program is managed by DSS's Aging Services Division in partnership with the AAAs and the nonprofit Center for Medicare Advocacy. The program provides seniors with health insurance information and counseling; information on Medicare plans, including Medicare Part D plans; and available long-term care options. It also administers the MediSave project, which trains and encourages seniors to identify and report Medicare and other types of fraud. (CHOICES stands for Connecticut's programs for Health insurance assistance, Outreach, Information and referral, Counseling and Eligibility Screening). The CHOICES phone number is 1-800-994-9422.
Elderly Health Screening
DSS funds elderly health screening programs for people age 60 and older in five locations: Hartford, New Haven, Norwich, Bloomfield and Bridgeport. The programs provide health screenings that include tests for cancer, dental disease, and mental health conditions. Health care education, nutritional counseling and physical activity programs are also provided.
DSS Small House Nursing Home Pilot
2008 legislation requires DSS to establish a pilot program, within existing resources, to help develop up to 10 small-house nursing homes. The pilot's goals are to improve the quality of life for nursing home residents and provide nursing home care in home-like, rather than institutional, settings. DSS must develop design specification guidelines and other requirements for the homes and submit them to the legislature's Human Services Committee by October 1, 2008 for approval.
In selecting proposals, DSS must give priority to proposals that use energy efficient technology, including fuel cells. And two of the proposals selected must be to develop a small-house nursing home in a distressed municipality with more than 100,000 people. Any small-house nursing home participating in the pilot must comply with certificate of need requirements and processes.
Department of Economic and Community Development (DECD) and federal Housing and Urban Development (HUD) funds can both be used to develop various elderly housing complexes. Residents must meet certain income limits to qualify for this housing. The income limits for state-assisted elderly housing, including congregate housing, are 80% of the area median income adjusted for family size.
Rental Assistance Program (RAP)
Low-income seniors could be eligible for rental assistance under one of two programs. DECD's Elderly RAP provides “project-based” rental assistance to low-income seniors over age 62 and younger disabled people living in state-funded elderly housing projects. To qualify, seniors must spend more than 30% of their income on rent and utilities. The RAP amount is the difference between 30% of their adjusted gross income, less a utility allowance, and the base rent. Alternatively, elderly people living in the community are eligible for certificates (vouchers) to help them pay for private housing under DSS's RAP program, which helps low-income families without age restriction.
DECD makes grants and loans to developers to construct or rehabilitate existing structures to create congregate housing for low-and moderate-income, frail elderly. DECD also provides an operating subsidy to offset the expense of congregate services for lower-income residents. A congregate housing complex contains separate living units for residents and provides some housekeeping, personal care, transportation, and at least one meal a day in a common dining room.
Currently, all 24 state-assisted congregate housing projects can offer more extensive “assisted living” services and receive payments from the CHCPE program for those who qualify financially. Fifteen congregate projects currently offer the services. Assisted living services include more “hands on” personal care, assistance with activities of daily living, nursing, and medical services that enable the resident to stay in his congregate apartment and “age in place” rather than having to move to a nursing home.
Assisted Living Pilot Programs
A pilot assisted living demonstration program for low- and moderate-income seniors living in government subsidized elderly housing is operating in four locations in the state (for a total of up to 300 units). The CHCPE program pays for the services for those who qualify financially. The law permits a combination of subsidized and unsubsidized units in the same facility, and gives DECD discretion to set the rental subsidy for the pilot at any percentage of the annual aggregate family income and define income and eligibility for these subsidies. DSS, DECD, and the Connecticut Housing Finance Authority (CHFA) are cooperating on the project. Four locations are currently open: Herbert T. Clarke House in Glastonbury, The Retreat in Hartford, Luther Ridge in Middletown, and Smith Street Assisted Living in Seymour.
DECD has also created assisted living demonstration programs with state money in three existing federally funded elderly housing developments: Tower 1/Tower East in New Haven, Immanuel House in Hartford, and Juniper Hill in Mansfield.
In addition, the state has operated two pilot programs since January 2003 that help pay for assisted living services (but not room and board) for people in private assisted living facilities who have used up their own resources. One pilot is funded through a Medicaid waiver, the other solely with state money. They have a combined cap of 75 participants. Through these programs, the state pays for assisted living services for seniors whose assets and income otherwise qualify them for the CHCPE if the facility where they live decides to participate in the pilots.
Congregate Housing Services Program (CHSP)
This program is administered through the AAAs and DSS. It provides extra services to seniors living in federal housing who need help with activities of daily living. It uses federal Department of Housing and Urban Development funds.
Project Home Share
Project Home Share typically matches elderly homeowners having financial difficulty maintaining their homes with individuals seeking affordable housing. The program is active in the Hartford, New Haven, and New London areas. One person in each match must be at least 60 years old. The program is free for participants over 60 and younger participants' costs are based on a sliding income-based scale. In exchange for opening their homes, the elderly participants may receive monetary compensation, services, or companionship. DSS funding provides partial support of program staff.
DECD Homeowners' Emergency Repair Assistance for Seniors Program
DECD's Homeowner's Emergency Repair Assistance for Seniors Program, begun in 1987, gives grants or low-interest loans to repair homes owned by low-income people who are at least 62 years old. The Community Renewal Team in Hartford has administered the program since 1999.
Reverse Annuity Mortgages
CHFA's Reverse Annuity Mortgage (RAM) program, makes loans to lower-income elderly homeowners to help pay for medical or long-term care needs. Eligible costs include those associated with hospitals, nursing homes, residential care homes, in-home care, adult day care, durable medical equipment, medically needed home alterations, long-term care insurance premiums, and uninsured recurring or catastrophic medical and prescription drug expenses.
Unlike a regular mortgage, a RAM loan is not repaid until the owner dies or the house is sold. The borrower receives monthly payments for five or 10 years. After that, interest continues to accrue at 7% a year. To be eligible, borrowers must be at least 70 years old, and their annual household income cannot exceed $81,000. DSS also engages in outreach, provides the public with information on the program, and accepts applications.
Homecare Option Program for the Elderly
The Home Care Option Program for the Elderly (HOPE) and a related trust fund helps people plan and save for the costs of services that are not covered by a long-term health insurance policy or supplement services that such a policy or Medicare covers. This allows seniors to live in their homes or a non-institutional setting as they age.
Participants can establish individual savings accounts and designate a beneficiary to withdraw account funds to pay for qualified home care expenses. It exempts interest the accounts earn from state income tax and makes any balance remaining when a beneficiary dies part of his or her estate. The program and trust fund are administered by the comptroller.
2008 legislation (PA 08-140) exempts dividends and capital gains earned on contributions to a HOPE account from the designated account beneficiary's state income tax. It expands the people who can benefit from a HOPE account to include any designated beneficiary. Under prior law, only a person who enters the HOPE participation agreement or who is later designated as that person's spouse or civil union partner could benefit.
New Money Follows the Person Demonstration Project
In January 2007, the federal government approved Connecticut's application to participate in the new Money Follows the Person Rebalancing Demonstration Grant Program (MFP). MFP is a five-year program that permits states to move people out of nursing homes or other institutional settings into less-restrictive, community-based settings.
To be eligible, individuals must have lived in a nursing home or other institution for at least six months and, if not for the community-based services provided under the demonstration, would have to remain in the institution. For the first 12 months the participant lives in the community, the program will pay an enhanced federal match compared to the usual Medicaid match. (In Connecticut, the Medicaid match is 50%, and the state's demonstration match is up to 75%).
2008 legislation (PA 08-180) requires DSS to increase the maximum number of participants from 700 to 5000. It also requires the commissioner to develop a plan to establish and administer a similar home- and community-based services project for adults who may not meet the MFP institutionalization requirement.
DSS has developed a protocol for the demonstration program and is seeking federal approval, which is required before it can be implemented.
LEGAL ASSISTANCE FOR SENIORS
The state's AAAs contract with three legal organizations to provide free legal help on elder law issues to people age 60 and older who cannot afford to hire a private attorney. Priority is given to people with problems regarding health care access, nursing home issues, patient's rights, and federal and state benefit programs. The following organizations provide assistance:
● Connecticut Legal Services, Inc. (http://connlegalservices.org ) serves Eastern, Western and Southwestern Connecticut;
● Greater Hartford Legal Aid (http://ghla.org/) serves North Central Connecticut; and
● New Haven Legal Assistance Association (http://nhlegal.org/) serves South Central Connecticut.
Consumer Law Project for Elders (CLPE) hotline
Connecticut Legal Services, Inc. offers free legal help for people age 60 and over who have consumer problems through its statewide CLPE telephone hotline. The hotline number is 1-800-296-1469.
DSS Elderly Nutrition Program
Pursuant to federal law DSS operates 13 elderly nutrition projects that provide nutritionally sound meals to people age 60 and older and their spouses. Programs must provide one meal per day, five days a week. These meals are either offered at congregate sites, known as “senior community cafes,” or delivered to the homes of people too frail to come to the congregate locations or cook for themselves. Disabled people living in housing facilities that are congregate meal sites can also receive meals. There is no charge for the meals, although voluntary contributions are encouraged. Both federal and state funds are used to pay the program costs.
Senior Farmers' Market Nutrition Program
The Department of Agriculture administers and funds this program. It provides low income seniors with $15 vouchers (five $3.00 checks) to purchase fresh fruits, vegetables, and herbs at authorized farmers' markets. In order to be eligible for the program, seniors must participate in a subsidized rental housing or congregate meal program that has applied for and been accepted into the program.
PROPERTY TAX RELIEF
The “Circuit Breaker” Program entitles elderly people to a property tax reduction or a rent rebate. An applicant must (1) be 65 years of age or older, have a spouse who is 65 or older, or be at least 50 and a surviving spouse of someone who at the time of his death was eligible for the program; (2) occupy the property as his home; and (3) have lived in Connecticut at least one year before applying for benefits. For applications filed in 2008, yearly income in 2007 cannot exceed $29,800 for married couples and $36,500 for singles.
The Freeze Tax Relief Program fixes a participant's property tax payment at a reduced level. It started in 1967, but has not accepted new participants since 1979. The people who were in the program when it closed continue to receive benefits. It generally freezes property taxes for homeowners age 65 and over who have $6,000 or less in annual qualifying income (Qualifying income includes federal adjusted gross income plus tax-exempt interest and excludes Social Security income, U.S. Postal pensions, and certain other types of income.) The tax payment was calculated by multiplying the property's assessed value, minus $1,000, times the mill rate of the year in which the person first received benefits. Thereafter, the property tax was frozen, even if the mill rate or the home's assessed value rose.
Municipal Option Property Tax Relief for Seniors
In addition to the circuit breaker and tax freeze programs, towns may provide additional “local option” tax relief to elderly homeowners who are at least age 65 and who have been taxpayers in the town for at least a year. Towns may, but are not required, to establish income criteria. The tax relief can take any form, including freezing tax payments at specified levels. But the overall amount of tax relief towns can provide is limited to no more than 10% of the total value of real property in the town in each given year. And the total value of tax relief a homeowner can receive under this and the tax freeze and circuit breaker programs cannot exceed his annual tax. But towns that choose to provide relief receive no state reimbursement for the tax revenue they forgo.
In addition, a 2006 law also allows towns to freeze the property taxes on homes owned by certain elderly people. To be eligible, the homeowner or his spouse must be age 70 or older and have lived in the state at least one year. The freeze continues for a surviving spouse who is at least age 62 when the homeowner dies. Homeowners must meet the circuit breaker income guidelines. Towns may also impose asset limits for eligibility and put a lien on the property. (PA 06-176).
PROTECTION FROM ABUSE AND NEGLECT
Long-Term Care Ombudsman
Under the Connecticut Long-Term Care Ombudsman program, an ombudsman's office in DSS represents the interests of residents in
nursing and residential care homes and helps them resolve complaints about these facilities. One state and nine regional ombudsmen carry out these duties, assisted by over 60 volunteers.
As a result of 2004 legislation (PA-04-158), the Ombudsman's Office implemented a pilot program to expand its services to provide assistance and education to residents in assisted living facilities. People in state-subsidized assisted living programs have priority for these services, but the Ombudsman's Office will also help people in private assisted living facilities to the extent that funding is available.
Under the Protective Services for the Elderly Program, DSS staff investigates complaints of abuse, neglect, exploitation, or abandonment of elderly people age 60 and over living in the community. If an individual needs protective services, DSS provides them. If the investigation confirms the abuse, the case is referred to the state's attorney for investigation and possible prosecution.
Division of Criminal Justice – Elder Abuse Unit
The elder abuse unit in the State's Attorney's Division of Criminal Justice investigates and prosecutes cases of abuse referred to it.
DSS Conservator of the Estate or Person Program
DSS runs a conservator of the estate or person program for very poor elderly and disabled people with very low assets who cannot handle their own finances. The DSS commissioner is designated the clients' conservator of the estate, and DSS employees perform financial functions for the clients.
Elder Abuse Reporters
Doctors, nurses, nursing home administrators, other health care personnel, and other professionals must report suspected elder abuse to DSS. They have to report it within three days or face penalties. DSS must refer substantiated abuse cases involving long-term care residents to prosecutors. Legal remedies are available for anyone subjected to retaliation or discrimination for, in good faith, reporting elder abuse or complaining to DSS about care in a long-term care facility.
Automobile Insurance Discounts for Senior Drivers
By law, a driver age 60 or older is eligible for an automobile insurance premium discount for successfully completing a Department of Motor Vehicle (DMV) approved accident-prevention course. The premium discount, which is effective at the policy's next renewal, must be at least 5% and apply for at least two years. The driver must complete the course within the year before he or she applies for an initial discount. For any future discount, the driver must complete a course within the year before the current discount expires.
2008 legislation requires DMV regulations governing these accident-prevention courses also to address approval of Internet courses, including methods to verify a person's (1) identity when he or she registers for, and throughout, the course, (2) participation throughout the course's duration, (3) course completion within any time requirements the course or commissioner requires, and (4) successful course completion.
Handicapped Access Program/Dial-a-Ride/ADA Paratransit
The Handicapped Access Program provides transit districts the funds to meet the mandates of the Americans with Disabilities Act, which requires them to provide paratransit services to complement existing fixed route services as a condition for receiving federal capital and operating funds. Paratransit services include lift-equipped vans and other vehicles that can meet a disabled person's transportation needs. They often take the form of “dial-a-ride” services, where the person orders the transportation at least 24 hours ahead and often pays a small fee such as $2 per one-way ride.
Some towns, senior centers, and other organizations also have dial-a-ride programs specifically for seniors.
Municipal Dial-A-Ride Grant Program
2005 legislation provided $5 million in both FY 06 and FY 07 for the municipal demand responsive (dial-a-ride) matching grant program for the disabled and those age 60 and older, which the legislature established in 1999 but never funded. The program allocates matching grants to municipalities based on a formula with two equal factors: the municipality's relative share of the state's elderly population and its size compared to the state's total area. Municipalities must apply for the grants through a regional planning organization or transit district and must collaborate on service design to determine how to use the funding most effectively. There are currently 73 programs approved by the Department of Transportation (134 towns applied, but a number of them collaborated with other towns).
Community Based Regional Transportation Systems for the Elderly
Legislation in 2005 and 2006 required DSS to provide grants to up to four towns with 25,000 or more people or to nonprofit organizations located in them to plan and develop financially self-sustaining, community-based regional transportation systems that, through a combination of private donations and user fees, provide rides in passenger cars for seniors who can no longer drive. (DSS actually funded five initial grant projects.) Before receiving the grant, the town or entity must secure at least $25,000 in matching private funds. Each recipient received $50,000 during the two-year period covering FY 06 and FY 07. The 2007 budget act provided additional funding for five new grants.
A grant recipient must, to the extent practicable, model its system on the “ITNAmerica” model. ITNAmerica is a national nonprofit organization engaged in planning to replicate in other locations a model first developed by the Independent Transportation Network (ITN) in the Portland, Maine, area. ITN obtains its operating funds through organization memberships; riders' fares; and support from individuals, community businesses, and private foundations. It uses passenger automobiles and operates with a combination of volunteers who drive their own vehicles and paid drivers for vehicles ITN owns.
VOLUNTEER AND EMPLOYMENT PROGRAMS
Retired Senior Volunteer Program (RSVP)
The RSVP program provides opportunities to people age 55 and over to volunteer in their communities. It operates 12 projects, which cover most towns in the state. Most participants work in nonprofit agencies.
Breakthrough to the Aging
The Breakthrough to the Aging program recruits volunteers to provide services to elderly people. These services include telephone reassurance, shopping, banking, and friendly visits. The program also provides training, support, and supervision of volunteers to a cooperative network of agencies, home care personnel, and volunteer coordinators.
Senior Community Service Employment Program
This OAA program helps low-income seniors age 55 and older find employment opportunities. The program matches a person's skills and interests with a position in a community service agency. To be eligible, the person must have an income not more than 125% of the federal poverty level.
Seniors Helping Seniors
This program in the Norwich area enables volunteer seniors to help other seniors remain in the community by providing transportation, shopping, chore services, and companionship. Volunteers earn credits toward the same kind of help if they themselves need it later.
Area Agencies on Aging (AAAs)
The state has five AAAs, which are private, nonprofit elderly planning and service agencies that receive state and federal funds to carry out the federal Older Americans Act requirements. The AAAs must (1) represent elderly people in their geographic areas, (2) develop and administer an area plan, (3) coordinate and assist local public and nonprofit private agencies in developing programs, (4) receive and distribute federal and state funds for these purposes, and (5) perform additional federally required functions.
The AAAs plan, coordinate, evaluate, and act as brokers for elderly services. They award funds to regional agencies, which in turn provide meals and related social services at local sites. Two of the AAAs also contract with DSS to administer the CHCPE in their regions. A total of about $14 million in federal OAA funds and $5 million in state matching funds is funneled through DSS to the AAAs for their various programs (including elderly nutrition), many of which are discussed elsewhere in this report.
Long-Term Care Partnership Insurance Program
The Connecticut Partnership for Long-Term Care is a public-private initiative under which the state approves special long-term care insurance policies sold by private companies. The policies must meet state standards. People who buy them can later qualify for Medicaid and still keep assets equal to the amount the policy has paid for their care. Only Partnership-approved policies have this feature, called Medicaid asset protection.
Around 40,000 policies have been purchased since 1992 when the program began. The Office of Policy and Management (OPM) approves the policies, keeps related statistics, and engages in some planning, administrative, and outreach work for the program. DSS also does some outreach.
Municipal Agent for the Elderly
Each municipality must appoint a municipal agent for its elderly residents for a two-year renewable term. The agent is responsible for disseminating information to seniors and assisting them in (1) learning about available community resources and (2) applying for benefits to which they may be entitled. DSS trains the agents.
Grandparents as Parents
This is a statewide network of local grandparents as parents support programs that provides advocacy and support and links grandparents and other relatives raising children to respite care and other services. DSS started it in 1998 with a private foundation grant.
Kinship Fund and Grandparents and Relatives Respite Fund Grants
2008 legislation (PA 08-97) allows grandparents or other relative caregivers appointed guardian of a child through Superior Court who are not receiving subsidized guardianship or foster care payments from the Department of Children and Families (DCF) to apply for grants from the probate court-administered Kinship and Grandparents and Relatives Respite funds. Previously, only grandparents or relative caregivers appointed guardian of a child through probate court could get these grants, which are subject to available appropriations.
Kinship Navigator Program
2006 legislation required DCF, in consultation with other agencies, to establish, within available appropriations, a kinship navigator program to help people caring for their relatives' children find services. The program must ensure that grandparents and other relative caregivers get information on the array of state services and benefits for which they may qualify, including DCF's subsidized guardianship program. It also assumes DCF's role to tell relative caregivers how they can become foster parents. The new program's information must be available through 2-1-1 Infoline.
Elderly Tuition Waivers
By law, regional community-technical colleges must waive tuition for any state resident age 62 or older, if at the end of the regular registration period enough other people are enrolled in the course for it to be offered and enough space is left to accommodate the senior citizens.