June 2, 2003
LEGISLATION AFFECTING SENIORS: PAST FIVE YEARS
By: Helga Niesz, Principal Analyst
You asked what significant legislation passed in the last five years that affects seniors. We have arranged the legislation according to major subject areas and by year.
In the past five years, the legislature made significant progress in expanding services for seniors, but recent budgetary problems have led to a number of retrenchment measures to save the state money.
Major legislation included:
• expansions of the Connecticut Pharmaceutical Assistance Contract to the Elderly and the Disabled (ConnPACE) program, followed most recently by increases in copays and annual fees;
• a prescription prior authorization plan which has been in the works for several years under ConnPACE, Medicaid and other state medical assistance programs, a preferred drug list, and other cost-saving measures for prescriptions;
• creation of an inter-agency Long-Term Care Planning Committee and a Long-term Care Advisory Council;
• increased personal needs allowances for nursing home Medicaid patients, more funding for nursing home wages and staffing in 1999, and various measures guarding patients’ health and rights;
• expansions of the state’s home care program, a new personal care assistance pilot for the elderly, and an Alzheimer’s respite program;
• development of state-subsidized assisted living opportunities and assistance for people who run out of money while living in private assisted living facilities;
• tightening of Medicaid asset transfer rules, including a waiver request to federal authorities to change (1) how the penalty period for inappropriate transfers is calculated and (2) the look back period for real estate transfers from three years to five (which the federal government has not yet approved);
• recent reductions in Medicaid and other state medical assistance services; and
• various measures concerning insurance, senior housing, continuing care retirement communities, funding for elderly transportation, the “circuit breaker” program, elder abuse, and tax exemptions and rebates.
ConnPACE, first established in 1985, helps low-income seniors and people with disabilities who do not qualify for Medicaid pay for prescription drugs. It pays for most prescription drugs, insulin, and insulin syringes and needles. Applicants' annual income cannot currently be more than $ 20,300, if single, and $ 27,500 if part of a married couple; the cap is adjusted annually for inflation. Participants must currently pay a per-prescription copayment of $ 16. 25 and an annual fee of $ 30 as a result of recent legislation.
Expedited Eligibility. This new law authorized eligible seniors who expect to exhaust their insurance coverage for prescription medication to apply for ConnPACE before their coverage ends. It required the applicant to notify the Department of Social Services (DSS) when coverage is exhausted and, if asked, prove it and DSS to include the applicant in the program within 10 days after receiving the notification. The act required the program to (1) cover prescriptions not covered by other providers and (2) retroactively cover prescriptions filled after insurance coverage ends (PA 98-194).
ConnPACE B (Not Implemented). While it did not make any significant changes to the existing ConnPACE program in 2000, the legislature did address the issue of seniors’ prescription drug needs. A new law directed DSS to come up with a plan to establish a ConnPACE “B” program for people who don’t qualify for regular ConnPACE. The legislation allowed the plan to provide for drugs at a reduced price to seniors, income limits, and an income exclusion for people with catastrophic prescription costs. The act allowed the program to begin operation only if the costs associated with running it were less than the revenues that accrued from such things as manufacturer rebates and participant fees. The law specified that if the requirement was met, the program had to start by July 1, 2001 (PA 00-2, JSS). DSS created the plan and submitted it to legislative committees, but the committees took no action, apparently because the plan was not cost neutral. ConnPACE B was never implemented.
ConnPACE Income Cap Expansion. A new law increased ConnPACE income limits from $ 15,100 and $ 18,100 for single and married applicants, respectively, to $ 20,000 and $ 27,100, beginning April 1, 2002. But if DSS receives a federal waiver for Medicaid funding, the law required the limits to rise to $ 25,800 and $ 34,800, respectively, effective July 1, 2002. As of May 2003, the federal government has not yet approved the waiver, so the second expansion has never taken place. Existing law still requires the commissioner to adjust the income limits each year based on the Social Security inflation adjustment (PA 01-2, JSS, § 22).
ConnPACE Copayment Increase. A new law increased the $ 12 per-prescription copayment to $ 15 for some people who enter the ConnPACE program on or after September 1, 2002, based on their annual incomes, marital status, and the date they first become eligible. Generally, it retained the $ 12 copayment for existing and future participants with low incomes (PA 02-7, May 9 Special Session, §§ 15 and 16).
ConnPACE Copayment and Annual Fee Increase. The budget bill passed early in the current legislative session increased the copays to $ 16. 25 per prescription for everyone regardless of income or enrollment date, starting March 15, and increased the annual fee from $ 25 to $ 30 (PA 03-2, §§ 14 and 15).
OTHER PRESCRIPTION-RELATED COST SAVING INITIATIVES
Prescription Drug Prior Authorization Plan. A new law allowed DSS to require “prior authorizations” for prescription drugs in the ConnPACE, Medicaid, and other state medical assistance programs under certain conditions and required DSS to prepare a prior authorization plan (PA 00-2, JSS). Prior authorization was required for (1) initial prescriptions for brand-name drugs for which a chemically-equivalent generic is available and drugs costing more than $ 500 per month and (2) early refills.
Prescription Drug Prior Authorization. As required by law, DSS submitted its prior authorization plan to the three legislative committees of cognizance in early 2002. Although one committee rejected the plan, it was considered approved and is currently scheduled to go into effect in two phases starting in the summer of 2003.
New laws, passed in the 2002 May 9 Special Session, specifically required the DSS commissioner to implement the prior authorization plan, made some exceptions for mental health drugs, established an 11-member Medicaid Pharmaceutical and Therapeutics Committee in DSS, and required DSS to adopt a preferred drug list when this committee recommends one. The act required the committee to review all drugs on the list at least every 12 months, to the extent possible and allowed it to recommend that drugs be added or taken off the list. Any drug not on the preferred drug list will require prior authorization, with some exceptions (PA 02-7, § 50, May 9 Special Session, PA 02-1, § 121, May 9 Special Session).
Voluntary Mail Order Option. A new law allowed the DSS commissioner to establish a voluntary mail order option for maintenance prescription drugs covered under DSS drug assistance programs. Maintenance drugs are those that the patient must take for long periods of time (PA 02-1, § 120).
Pharmaceutical Purchasing Initiative. The legislature gave the DSS commissioner authority to implement a “pharmaceutical purchasing initiative” by contracting with an established entity for the lowest pricing available for these assistance programs. Any entity with which the commissioner contracts must have an established pharmaceutical network and demonstrate its ability to process the anticipated prescription volume. (PA 02-1, § 123, May 9 Special Session) DSS must report annually on the initiative’s status to the Appropriations Committee (PA 02-7 § 56, May 9 Special Session).
Preferred Drug List Change. The budget bill passed early in the 2003 session required DSS (1) to adopt a preferred drug list by July 1, 2003 without reference to the previously established Medicaid Pharmaceutical and Therapeutics Committee and (2) only to consult with the committee without having to wait for its recommendation (PA 03-2, § 19).
LONG-TERM CARE PLANNING
Long-Term Care Planning Committee. A new law created an inter-agency Long-Term Care Planning Committee, consisting of legislators and officials from relevant state agencies, to exchange information on long-term care issues, coordinate policy development, and create a state long-term care plan for the elderly. It required that the plan integrate the three components of a long-term care system (home and community-based services, supportive housing arrangements, and nursing facilities) and address how changes in one component affect the others. It also required the committee to submit the plan to certain legislative committees every two years beginning January 1, 1999 (later changed to every three years). The next plan is due in January 2004 (PA 98-175, PA 98-239).
Long-Term Care Advisory Council. The same new law created a Long-Term Care Advisory Council to advise and make recommendations to the long-term care planning committee. At that point, the council consisted of the Commission on Aging director, the state nursing home ombudsman, and representatives of various long-term care industry, labor, and elderly interest groups (PA 98-239).
Members Added To Long-Term Care Planning Committee. New legislation added three new members to the Planning Committee, one each from the departments of Mental Retardation, Mental Health and Addiction Services, and Transportation (PA 99-28).
Advisory Council Added Members. Legislation added 10 members to the nine-member Advisory Council (PA 00-135, § 20).
Long-Term Care Planning Committee Change of Mission. New legislation broadened the Long-Term Care Planning Committee’s scope to include all people in need of long-term care instead of only the elderly. The act further required the committee to evaluate long-term care issues in light of the U. S. Supreme Court decision in Olmstead v. L. C. , which required states to place people with disabilities in community settings rather than in institutions when it is appropriate, the individual does not oppose the transfer, and the community placement can be reasonably accommodated.
In addition, the act required:
1. the committee's long-term care plan to serve as a guide for state agencies’ programs that serve people in need of long-term care and
2. any state agency, when developing or modifying any program that, wholly or partially, assists or supports people with long-term care needs to include, to the extent feasible, features that (a) support care-giving by family members and other informal caregivers and (b) promote consumer-directed care.
The act added two new members to the committee. And it required the committee to issue its long-term care plan every three years instead of every two (PA 01-119).
New Duties for Advisory Council. A new law required the Advisory Council to seek recommendations from people with disabilities or people receiving long-term care services who reflect the state’s socioeconomic diversity. It also added eight new members to the 19-member council, for a total of 27 (PA 02-100).
Long-Term Care Website. The legislature required the Office of Policy and Management (OPM), within existing budgetary resources, to develop a single, consumer-oriented Internet website to provide comprehensive information on long-term care options in Connecticut. It required that the website include direct links and referral information on long-term care resources, including private and nonprofit organizations offering advice, counseling, and legal services. And it required OPM to consult with the Select Committee on Aging, the Commission on Aging, and the Long-Term Care Advisory Council when developing the site (PA 02-7, § 51, May 9 Special Session).
Comprehensive Needs Assessment. The legislature required OPM to conduct a comprehensive needs assessment of unmet long-term care needs in the state, project future demand for such services, and review the Department of Mental Retardation’s waiting list (SA 02-7).
Personal Needs Allowance Increase. A new law increased the monthly personal needs allowance from $ 30 to $ 50 for nursing home residents who receive Medicaid and required the new allowance to be adjusted annually for inflation. The personal needs allowance is the monthly amount Medicaid recipients in nursing homes are allowed to retain from their incomes to pay for clothing and miscellaneous personal needs (PA 98-239).
Nursing Home Financial Advisory Committee. Another act established a Nursing Home Financial Advisory Committee to examine nursing homes’ financial solvency, support DSS and the Department of Public Health (DPH) oversight mission, and recommend appropriate action for improving the financial condition of any home in financial distress. The committee consists of five state officials and two nursing home representatives appointed by the governor (PA 98-239).
Increased Funding for Nursing Home Staffing. The 1999 budget and DSS implementing legislation contained a Nursing Home Wage, Benefit, and Staffing Enhancement Initiative, which appropriated $ 198 million in additional funds over FYs 1999-00 and 2000-01 to nursing homes to increase the wages and benefits paid to non-administrative staff (SA 99-10).
State Nursing Home Ombudsman. 1999 legislation made the state nursing home ombudsman office more independent. She kept her office (officially renamed the "Office of the Long-Term Care Ombudsman”) in the DSS Division of Elderly Services (the "division"). But the new legislation strengthened her authority over the ombudsman program and emphasized her role as advocate for long-term care facility residents. The act still required the DSS commissioner to appoint the state ombudsman, but it allowed the ombudsman to appoint the regional ombudsmen. It required the ombudsman to more broadly monitor and comment on laws, regulations, and government policies than before and gave her greater latitude in identifying problems affecting residents. It required the division to make sure long-term care residents and the ombudsman receive adequate legal counsel. It gave the ombudsman expanded access to facilities, people, and records and made more types of willful interference with the ombudsman unlawful and subject to penalties. And it incorporated federal standards concerning records confidentiality and conflicts of interest into state law (PA 99-176).
Designees and Nursing Home Patients’ Bill Of Rights. A new law required people to honor documents executed by one adult designating another adult to make certain decisions on the maker’s behalf in nursing homes, residential care homes, chronic disease hospitals, psychiatric hospitals, other health care settings, and certain other situations. The act included these designees in certain portions of the nursing home patients’ bill of rights and authorized them to (1) receive between 30 and 60 days advance notice of involuntary, non-emergency room transfers, including moving Medicaid patients from private to non-private rooms; (2) be included in the pre-transfer consultative process (the law requires notice to, and consultation with, certain relatives, conservators and guardians, or other representatives); (3) visit them in private (prior law applied to spouses only); and (4) meet with other patients’ families at the facility (PA 02-105).
Flu and Pneumonia Vaccinations. New legislation required the public health commissioner to adopt regulations to prevent influenza and pneumococcal disease in nursing homes. It required the regulations to assure that each nursing home patient is immunized annually against influenza, and against pneumonia according to recommendations of the National Advisory Committee on Immunization. And it required the regulations to also provide appropriate exemptions for patients (1) for whom immunization is medically contraindicated or (2) who object on religious grounds (PA 02-10).
The Connecticut Home Care Program for Elders (CHCPE) enables frail seniors age 65 and over who meet certain functional and financial conditions to avoid premature entry into a nursing home. Services covered include such assistance as home health aides, homemaker aides, visiting nurses, adult daycare, personal assistance, and Meals-on-Wheels.
Increased Funding to Reduce Waiting Lists. The 1998 budget added $ 29. 4 million to expand client services for the homecare program, a 20% increase which enabled DSS to eliminate waiting lists (SA 98-6).
Home Care Program Funding. Funding for CHCPE was increased by nearly $ 5. 5 million in FY 1999-2000, and an additional $ 12. 2 million in the following year to continue to prevent waiting lists for the program (SA 99-10).
Pilot Home Care Program. A new law required the DSS commissioner to establish a state-funded, one-year pilot program to allow up to 10 people to receive services under CHCPE who, except for excess income of up to $ 100 per month, were eligible to participate in the Medicaid-funded portion of the program and who had formerly received Medicaid-funded services under it (PA 99-279).
Elimination of Gross Income Test. The legislature made more seniors eligible for the CHCPE as a result of a new law which eliminated the program’s gross income limit; now, someone can qualify for state-funded home care benefits if he would otherwise qualify for Medicaid in a nursing home. (People still have to contribute toward their care costs and asset limits did not change. ) The changes currently apply only to the program’s state-funded portion because federal approval is still needed for the Medicaid waiver portion (PA 00-2, JSS).
Pilot Extension. In the meantime, the legislature extended 10-person pilot program for people with incomes up to $ 100 over the limits. The extension was to last until the earlier of when these services would be covered by Medicaid or July 1, 2001 (PA 00-2, JSS).
New Services. The legislature added assisted living services and minor home modifications to the CHCPE program offerings. The assisted living services must be offered in (1) state-funded congregate housing and (2) other assisted living pilot or demonstration programs established under state law (PA 00-2, JSS).
CHCPE Pilot for People With Excess Income Continuation. The legislature continued the pilot for people with excess income beyond the prior July 1, 2001 cutoff date until the state receives federal approval for Medicaid coverage for the participants. As of may 2003, no approval has been granted (PA 01-2, JSS, § 31).
PERSONAL CARE ASSISTANTS
PCA Pilot for Seniors. A new law required the DSS commissioner to establish a pilot Personal Care Assistance (PCA) program to allow up to 50 seniors (up to 100 if the program is cost-effective) to hire their own attendant as an alternative to going through a home health care agency for services. The act made the program available to individuals who (1) were receiving PCA Medicaid waiver services any time during the year before they turned 65 or (2) were eligible for the CHCPE but unable to access adequate services (PA 00-2, JSS).
Pilot Program. A new law (1) established a pilot program to provide respite care services for caretakers of individuals with Alzheimer’s disease or related disorders, (2) capped the patients’ annual income at $ 30,000 and their liquid assets at $ 80,000, and (3) excluded people who are covered by Medicaid. It capped the dollar amount of services at $ 3,500 per fiscal year and limited the duration of out-of-home respite services to 21 days per fiscal year. It also allowed DSS to require a copayment from the patient (which was later set at 20% by regulation) or waive it due to financial hardship. The program is administered by DSS in conjunction with the area agencies on aging (PA 98-239, SA 98-6).
Program Changes. The legislature increased the maximum number of annual out-of-home services days from 21 to 30 . And it removed the limit on the number of days a participant can use adult day care services (PA 99-162).
Another new law allowed the DSS commissioner to allocate any funds over $ 500,000 appropriated for the Alzheimer’s respite program among the state’s five area agencies on aging based on need. The first $ 500,000 must still be divided equally among the area agencies on aging, as it was in FY 1998-99 (PA 99-279).
Assisted Living Demonstration Project. A new law authorized a subsidized assisted living demonstration program in housing projects in three cities selected by DSS. It allowed the project to provide services to up to 300 units and accept applications for up to three years. The act required applicants to meet the same financial and functional eligibility requirements as for the CHCPE program. It also required DSS to (1) work together on the project with the Department of Economic and Community Development (DECD) and the Connecticut Housing Finance Authority (CHFA), (2) apply for an assisted living Medicaid waiver so the state can receive federal Medicaid matching funds, (3) establish a process to choose assisted living providers, and (4) determine how many housing units the project will cover. It required DECD to provide rental assistance (RAP) or rental subsidy certificates to participants and CHFA to issue requests for proposals by July 1, 1999 and provide mortgage loans for the projects. As of 2003, the Medicaid waivers have been obtained and projects have received state approval, but construction on the first of the projects has not yet begun (PA 98-239).
Additional Locations. A new law allowed the program to be located in more than three municipalities, permitted a combination of subsidized and unsubsidized units in the same facility, and gave DECD discretion to set the rental subsidy for the pilot at any percentage of the annual aggregate family income and to define income and eligibility for these subsidies consistent with the demonstration project (PA 99-279).
Assisted Living Services under CHCPE. The legislature allowed the CHCPE program to pay for assisted living services in (1) state-funded congregate housing and (2) other assisted living pilot or demonstration programs established under state law. It also authorized state-funded congregate senior housing facilities to provide residents with assisted living services (paid for by the CHCPE program for those who qualify) through assisted living service agencies. It allowed a waiver of some existing regulations to facilitate this authorization. It also required the state to establish assisted living demonstration programs in two federally assisted elderly housing projects (PA 00-2, JSS).
Expansion in Federal Senior Housing. A new law doubled, from two to four, the number of federally funded elderly housing developments where the DECD commissioner could establish assisted living demonstration programs. It required that multiple properties with overlapping board membership or ownership be considered as a single applicant (PA 01-2, JSS, § 36).
Deadline Change for Demonstration in State-funded Affordable Housing. The legislature removed a June 8, 2001 deadline for accepting applications under the 300-unit assisted living demonstration program in state-funded affordable elderly housing (PA 01-2, JSS, § 37).
Private Assisted Living Pilot Program. Under a new law, some seniors living in private assisted living facilities who are in danger of running out of money may not have to move to a nursing home. The legislature authorized DSS, on or after January 1, 2003 and within available appropriations, to start two new pilot programs: a Medicaid waiver pilot for up to 50 people and a purely state-funded pilot for another 25 people. It required the pilots to pay for assisted living services for these seniors if their assets and income otherwise qualify them for CHCPE. DSS must use Medicaid asset transfer rules in determining eligibility for both pilots.
The act required applicants for either pilot to (1) reside in a managed residential community (MRC) where the assisted living services are provided by a licensed assisted living services agency and (2) be ineligible to receive these services under any other assisted living services pilot program established by the General Assembly (PA 02-7, §§ 27-28, May 9 Special Session).
Medicaid Asset Transfers. A 2001 law made it harder for people to transfer their assets to someone else or put assets in a trust so that Medicaid will cover their nursing home, home care, or other long-term care services. The act tightened the asset transfer rules by:
1. defining what is an "available asset" that must go to pay for the person's care and specifying that a trustee's refusal to distribute funds from a trust does not automatically make them unavailable;
2. limiting allowable asset transfers for "other valuable consideration" just to those where that consideration (such as services rendered to keep the person out of a nursing home) has a value equal to or greater than the transferred assets;
3. requiring DSS to seek a waiver of federal Medicaid law to start the penalty period for inappropriate asset transfers (during which the person is ineligible for Medicaid) on the date a nursing home resident applies for Medicaid rather than on the transfer date (currently, some people can avoid the penalty by delaying their Medicaid applications until the penalty period has expired; this will not be possible for transfers made after the waiver is approved, which as of May 2003 has not yet happened);
4. limiting the probate court’s powers, in conservatorship hearings, to make exceptions to the Medicaid asset transfer rules and to exceed limits on the assets a nursing home resident's spouse can keep in cases of financial duress or when higher amounts are needed to generate income for the spouse still living at home;
5. making DSS the sole agency to determine eligibility for assistance and services under any DSS-administered programs;
6. requiring the probate courts, as well as the people applying for spousal support orders in conservatorship cases, to provide certain notices and information to DSS, and giving DSS the right to appear at such hearings to present the department's position; and
7. prohibiting the probate court from approving any spousal support applications unless the required notices have been made and the decision is consistent with state and federal law.
Under federal and state Medicaid law, there is already a “look back” period of 36 months for most asset transfers, and five years for transfers to most trusts. When a nursing home resident applies for Medicaid, DSS looks back from that date and, if the person has made an inappropriate transfer of assets, delays coverage using a formula that takes into account the asset’s uncompensated value and the average cost of nursing home care. There are exceptions that allow certain kinds of transfers within the look back period (PA 01-2, JSS, §§ 3-6).
Medicaid Optional Services. A new law required DSS to amend the Medicaid state plan in order to implement elimination of the Medicaid optional services (PA 02-7, § 104, May 9 Special Session). As a consequence, on January 1, 2003, Medicaid stopped paying for certain services provided by "independently enrolled" practitioners to people age 21 and older. The program continues to pay them for services that they offer to patients under age 21. Independent practitioners are those who work on their own in private practice as physical therapists, podiatrists, chiropractors, naturopaths, psychologists, audiologists, and speech pathologists, according to DSS Policy Transmittal 2002-12 (PB 2002-45, December 2002). Medicaid patients of any age can apparently still receive these services from therapists working under the supervision of a physician or physicians' group or through a hospital outpatient department or other freestanding clinic (a "non-independent practice").
SAGA and GA. 2002 legislation also eliminated state-funded coverage for these same services, as well as vision services provided by optometrists and opticians (including all optical hardware), and home health care under the State-administered General Assistance and town General Assistance (SAGA and GA) programs (PA 02-7, §§ 19, 20 & 62, May 9 Special Session).
Reorganization of Non-Emergency Medical Transportation. A new law allowed DSS, by June 30, 2003, in consultation with OPM, to submit an amendment to the Medicaid state plan to implement changes needed to reduce Medicaid nonemergency medical transportation expenditures. But it prohibited eliminating any “category of eligible need” (e. g. , livery, wheelchair vans, ambulances) other than reimbursement for personal vehicle use. It also made DSS the sole state agency that sets both emergency and nonemergency medical transportation fees or fee schedules for any transportation services the department reimburses under Medicaid, SAGA, and other medical assistance programs it runs (PA 02-7, § 60-61, May 9 Special Session).
Medicaid and SAGA $ 1 copayment. The budget bill passed early in the current legislative session requires Medicaid and SAGA recipients to make a $ 1 co-payment for outpatient medical services and for each prescription filled (PA 032, § 9, 18).
Long-term Care Insurance Reciprocity. A new law allowed DSS to enter into reciprocal agreements with other states to extend the asset exclusions for Medicaid eligibility under the Connecticut Partnership for Long-Term Care program to people who buy qualified long-term care insurance in other states. These approved long-term care insurance policies let people shelter an amount of their own assets equal to what the insurance has paid out for long-term care if they later have to apply for Medicaid (PA 98-239).
Medicare Consumers Guide. A new law required DSS, through its CHOICES program, to develop, distribute, and update a Connecticut Medicare consumers guide to anyone requesting it. (CHOICES provides free information, counseling, and assistance to older people and other Medicare beneficiaries. ) It required DSS to cooperate with the insurance commissioner and other organizations in this effort (PA 99-177).
CHOICES Health Insurance Assistance Program. The legislature updated the laws concerning the CHOICES health insurance assistance program. The act (1) specified that the program must be a comprehensive Medicare advocacy program that not only provides information and advice for Medicare beneficiaries, but also legal representation where appropriate in the appeals process; (2) allowed non-attorneys to give advice on Medicare benefits and other health insurance matters on the program’s toll-free phone number; and (3) specified that the program must include any functions DSS deems necessary to conform to federal grant requirements. These changes reflected then- current practice and the cooperative roles in the program of the Center for Medicare Advocacy and the area agencies on aging (PA 01-39).
Designation of Third Party to Receive Certain Cancellation Notices. A new law required automobile and homeowner insurers to include a conspicuous statement with each policy informing policyholders age 55 and older that they may designate a third party to receive cancellation or nonrenewal notices (PA 02-60).
Drug Convictions as Bar to Entry and Cause for Eviction from Elderly Housing. This new law allowed housing authorities and developers who run state-assisted elderly housing projects to evict occupants convicted of selling or possessing illegal drugs. It also barred anyone from moving into state-assisted elderly housing who has been convicted of selling or possessing illegal drugs in the past two years. People were already barred from entry if they (1) used illegal drugs, (2) abused alcohol and had a recent history of behavior that threatens others or potentially damages property, or (3) had a recent history of such threatening or damaging behavior (PA 98-114).
Resident Services Coordinators and Disabled Housing Registry. A new law required DECD to give grants to housing authorities, municipal developers, and nonprofit corporations operating elderly housing to hire resident services coordinators to assist residents in maintaining independent living. It allowed the grants to be used to assess residents’ individual needs, maintain regular contact with the residents, monitor support services delivery, advocate changes in services, and provide mediation and conflict resolution. The grants are based on need and availability of matching funds. The law also required creation of a statewide electronic database on availability of housing accessible to, or adaptable for use by, people with disabilities (PA 98-263, SA 98-6).
Pets In Elderly Housing. A new law allowed a senior moving into a state-subsidized elderly housing project to keep a pet he already owns if pets were allowed on the date he applied for admission, even if a later vote prohibited them. Prior lawhad already allowed seniors living in such housing to keep one pet if the project's residents have, by majority vote, decided to allow pets (PA 99-50).
CONTINUING CARE RETIREMENT COMMUNITIES
Disclosures. Continuing care retirement communities (CCRCs) provide senior citizens with a continuum of care for the rest of their lives (ranging from an independent apartment and one or more meals a day through assisted living services to nursing home care) in exchange for a sizeable entrance fee and a continuing monthly payment. CCRCs must make certain disclosures before entering into a contract with prospective residents in a document known as a disclosure statement.
A new law required the CCRC to give the prospective resident a conspicuous statement informing him that a continuing care contract is a financial investment and his money may be at risk. It required the statement to (1) disclose that the CCRC’s ability to meet its contractual obligations depends on its financial performance, (2) advise the prospective resident to consult an attorney or other experienced professional before he signs the contract, and (3) state that DSS does not guarantee his investment. It also required the CCRC to disclose whether it is associated with a for-profit organization.
The new law also required the CCRC to deliver an updated disclosure statement to the prospective resident between 60 and 10 days before final payment of the entrance fee. It required the disclosure statement and the new financial risk notification statement to be signed and dated by the resident before the contract goes into effect and before money changes hands. Each statement must contain an acknowledgement that
the resident has reviewed it and the contract. The CCRC must keep these signed statements on file for as long as the contract is in effect (PA 98-250).
Additional CCRC Protections. A new law gave some added protections to seniors living in CCRCs. It required the CCRCs to give the prospective resident an updated disclosure statement between 60 and 10 days before the person actually moves in. If there have been no changes, they only need to deliver a statement to that effect. It also required CCRCs to notify the Department of Social Services (DSS) in writing before refinancing their existing indebtedness or making material business or corporate structure changes. It also allowed the DSS commissioner to require additional information from existing CCRCs in financial distress and from those new CCRCs being built if they are at risk of being in financial distress. It required the CCRCs to make information filed with the state (except refinancing and "financial distress" information) available to their residents and to give them at least annual notice of their right to see this information and request a copy. The new law allowed the commissioner, through the attorney general, to seek restitution or damages and other appropriate relief for anyone injured by violations of the CCRC laws (PA 99-282).
Dial-a-Ride. The 1998 budget contained $ 2. 5 million for Dial-a-Ride services to make up for federal cuts in operating funds to larger urbanized areas (New Haven, Meriden, Bridgeport, and Hartford). Dial-a-ride is a service provided by paratransit districts, towns, or nonprofit entities that allows an elderly or disabled person to call ahead for a ride to a doctor appointment, shopping, or other purposes for a nominal fee (SA 98-6). This funding has remained at this same level every year since then.
Municipal Elderly Transportation Grants. A new law required the Department of Transportation (DOT) commissioner to make state matching grants, within available General Fund appropriations, for municipalities to provide elderly and disabled dial-a-ride programs, starting January 1, 2000, again by October 1, 2000, and annually after that. (But SA 99-10, the appropriations act, did
not appropriate any money for this program and it has never been funded since then. ) The act specified a formula for distributing the funds and requires a 50% match from the municipality (PA 99-265).
Municipal Transportation Grant Procedural Change. The legislature made a procedural change for the still unfunded municipal transportation grants. It required municipalities to apply for the grants through the designated regional planning organizations or transit districts to the DOT (as they do for the Federal Transit Administration Section 5310 program, which currently provides capital equipment grants to agencies serving the elderly and disabled) rather than directly to DOT (PA 00-148).
Minimum Tax Credit and Local Options. A new law increased the minimum property tax credit that low-income seniors participating in the homeowners’ “circuit breaker” program can receive by $ 50 in each income bracket except the highest. It also updated the income brackets in the statutes to reflect then-current levels, which OPM already adjusted for inflation every year (PA 99-01, June Special Session). Another new law made it clear that local option homeowner’s circuit breaker programs can include residents of co-operatives (PA 99-189).
Elder Abuse Reporters. A new law added psychologists to the list of professionals who must report to the DSS commissioner (1) elderly persons (age 60 and older) who need protective services and (2) suspected cases of elder abuse, neglect, exploitation, and abandonment. Most other health care professionals, nursing home administrators and staff, police officers, and the clergy were already required to make these reports (PA 99-101).
DSS Powers Regarding Elder Abuse. A new law strengthened the DSS commissioner’s powers in elderly protective services cases. It required her to investigate, rather than evaluate, allegations of elder abuse, neglect, exploitation, and abandonment. The act gave DSS elderly protective services staff more authority to interview the potential elderly victim alone. It let the commissioner seek a court order to stop a caretaker from interfering with the interview. It also allowed her to subpoena witnesses, take testimony under oath, and compel the production of documents necessary and relevant to investigations. It let her subpoena confidential records needed for investigations if she reasonably believes the elderly person is not capable of giving consent or if the person’s caretaker has refused consent and the commissioner reasonably believes the caretaker has abused, neglected, exploited, or abandoned the person. The act authorized the commissioner to ask the attorney general to seek a court order as appropriate to enforce the new law and made several other changes (PA 01-209).
Elderly Property Tax Abatement Supplemental Payments. The 1998 budget included an additional $ 8 million to provide one-time supplemental payments to seniors participating in the property tax freeze program, the circuit breaker tax abatement program for elderly homeowners, and the renters’ rebate program (SA 98-6).
Social Security Income Exemption and Rebates. Tax legislation exempted the remaining taxable 25% of Social Security income from the state personal income tax for joint filers with adjusted gross income under $ 60,000 and single filers under $ 50,000. Changes in prior years had already exempted the rest of Social Security income for this group (PA 99-173).
The same new law also provided a one-time sales tax rebate to Connecticut residents who (1) filed a 1998 resident Connecticut income tax return or an extension, (2) filed a 1998 federal income tax return, or (3) received social security benefits under Title II of the federal Social Security Act (which includes old age, survivors and disability benefits). The rebate was $ 50 per person ($ 100 for a couple filing jointly).
Protecting Hearing Aid Buyers. This new law gave a hearing aid buyer a right to a refund of the deposit, minus examination costs if leaves a deposit of $ 100 or more with a hearing aid dealer or audiologist, but then cannot inspect the hearing aid at the seller’s place of business within 45 days. It required clear and conspicuous notice of this right to be in every sales contract, receipt, and order (PA 99-111).
Anthem Demutualization Payments. A new law exempted recent one-time cash payments and the value of stock distributed to individuals in connection with Anthem, Inc. ’s conversion to a stockholder-owned company from being counted as income in determining eligibility for the following programs:
2. state-reimbursed additional property tax exemption for veterans,
3. elderly property tax freeze,
4. rental rebates for elderly and totally disabled people,
5. property tax credits for elderly and totally disabled homeowners (circuit breaker),
6. local-option additional property tax exemptions for veterans and totally disabled and blind people, and
7. local-option property tax relief for elderly and disabled people.
For stock distributions to be excluded, the recipient had to sell these in the tax year in which they were distributed or the two following tax years. The exclusion was limited to the stock’s value on the distribution date and did not cover any gains accrued between the distribution date and the sale date (SA 02-1).