PA 12-91—sHB 5476
Human Services Committee
AN ACT EXPANDING CONSUMER CHOICE FOR LIFE SUPPORT CARE AT HOME
SUMMARY: This act requires the Department of Social Services (DSS) commissioner, within available appropriations, to establish and operate a two-year, state-funded pilot program for up to 10 ventilator-dependent Medicaid recipients who live in Fairfield County and receive medical care at home. Under the pilot, the participants can hire their own licensed registered nurses (RN) and respiratory therapists directly. (Medicaid rules generally require home health care agencies to hire these professionals and send them to Medicaid recipients' homes. ) DSS must annually screen the participants to determine whether they can continue to manage their care.
The act requires DSS to set a maximum amount it reimburses the nurses and therapists for pilot services, which must be at least 80% of the prevailing rate DSS pays home health agencies to provide comparable care. Currently, DSS pays home health care agencies the following amounts for RN services: $94. 26 for any part of the first hour, $23. 56 for each 15-minute increment of the second hour, and $43. 07 for any part of an hour after the first hour for visits lasting more than two hours. DSS does not pay for services a respiratory therapist provides in the home. However, it will pay for respiratory care services that a nurse provides.
The act requires nurses and therapists participating in the pilot to (1) submit to criminal history background checks and (2) certify, in writing, that they will not terminate a patient's care unless they provide at least two weeks written notice, except in an emergency.
The act requires the commissioner to report by January 1, 2015 to the Appropriations and Human Services committees on the pilot program, including its cost-effectiveness and care continuity.
The act also requires the DSS commissioner, by July 1, 2013, to survey Medicaid recipients who are receiving continuous skilled care at home and report the survey results to the Human Services Committee by January 1, 2014.
EFFECTIVE DATE: October 1, 2012
PILOT PROGRAM FOR VENTILATOR-DEPENDENT MEDICAID RECIPIENTS
Under the act, DSS must, at least annually, screen each Medicaid recipient participating in the pilot to determine whether he or she can manage his or her care.
Participants must certify in writing that they, or their authorized representatives, assume responsibility for their plan of care. These plans must (1) be directed by a physician, (2) be approved by DSS, and (3) include a protocol for ensuring that care is provided when the caregiver the recipient has hired is unavailable.
SURVEY OF MEDICAID RECIPIENTS RECEIVING CONTINUOUS SKILLED NURSING CARE AT HOME
Under the act, the survey DSS conducts must determine:
1. the number of recipients receiving continuous skilled care at home,
2. the number of times each recipient's care has been terminated by a licensed home health care agency in the two years preceding the survey and the reasons, and
3. consumer satisfaction with the quality of care the agencies provided.
OLR Tracking: RC: KM: PF: DY/ro: eh