House of Representatives
File No. 660
February Session, 2010
(Reprint of File No. 318)
As Amended by House Amendment
Approved by the Legislative Commissioner
April 28, 2010
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 17b-307 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(a) Notwithstanding any provision of the general statutes, [not later than November 1, 2007,] the Department of Social Services shall develop [a plan to] and implement a pilot program for the delivery of health care services through a system of primary care case management to not less than one thousand individuals who are otherwise eligible to receive HUSKY Plan, Part A benefits. [Such plan shall be submitted to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies. Not later than thirty days after the date of receipt of such plan, said joint standing committees of the General Assembly shall hold a joint public hearing to review such plan. Said joint standing committees of the General Assembly may advise the commissioner of their approval or denial or modifications, if any, of the plan.] Primary care providers participating in the primary care case management [system] pilot program shall provide program beneficiaries with primary care medical services and arrange for specialty care as needed. For purposes of this section, "primary care case management" means a system of care in which the health care services for program beneficiaries are coordinated by a primary care provider chosen by or assigned to the beneficiary. The Commissioner of Social Services shall begin enrollment for the primary care case management system not later than April 1, 2008.
(b) The Department of Social Services shall expand the pilot program for the delivery of health care services through the primary care case management system, as described in subsection (a) of this section, to include primary care providers in the towns of Torrington and Putnam. Not later than July 1, 2010, the department shall expand the pilot program to include the town of Putnam. Not later than October 1, 2010, the department shall expand the pilot program to include the town of Torrington. The Commissioner of Social Services may seek a waiver from federal law for the purpose of expanding the primary care case management system pursuant to this subsection.
(c) Not later than July 1, 2011, the commissioner shall report, in accordance with section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies on the expansion of the pilot program.
This act shall take effect as follows and shall amend the following sections:
The following Fiscal Impact Statement and Bill Analysis are prepared for the benefit of the members of the General Assembly, solely for purposes of information, summarization and explanation and do not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
OFA Fiscal Note
Department of Social Services
GF - Uncertain
Note: GF=General Fund
The bill requires the Department of Social Services (DSS) to expand the current primary care case management (PCCM) pilot program to Torrington and Putnam.
Comparative per member, per month costs between the PCCM pilot and the standard HUSKY managed care program are not available as the anticipated external evaluation has not yet been completed. As such, the fiscal impact of expanding the alternative PCCM model is not known.
House “A” adjusted the schedule for rolling out new PCCM sites. It did not alter the fiscal impact of the underlying bill.
The Out Years
OLR Bill Analysis
This bill requires the Department of Social Services (DSS) to expand the HUSKY Primary Care pilot program to include primary care providers in Putnam (by July 1, 2010) and Torrington (by October 1, 2010). The bill permits the DSS commissioner to seek a federal waiver to make these expansions. HUSKY Primary Care is the state's primary care case management program, which is an alternative care model available to HUSKY A enrollees.
The commissioner must report on the program's expansion to the Human Services and Appropriations committees by July 1, 2011.
The bill also removes obsolete language and makes technical changes.
*House Amendment A” (1) eliminates the requirement that DSS continue to add two municipalities until the program is operating in every county in the state and (2) delays until October 1, 2010 the date by which the Torrington expansion must occur.
EFFECTIVE DATE: Upon passage
HUSKY Primary Care
Since early 2009, certain HUSKY A families have had the option of enrolling in HUSKY Primary Care. The family is matched with a primary care provider (PCP) or providers who provide primary care services and also manage the family's care, including making referrals to specialists. The PCPs are paid a monthly fee for managing the HUSKY recipient's care in addition to any reimbursement they receive for providing medical services. The pilot serves as an alternative to the managed care organizations, which also serve the HUSKY A population.
The pilot program serves four cities—Hartford, New Haven, Waterbury, and Windham (geographic areas) and the towns contiguous to them. Currently, the program is not operating in Fairfield, Litchfield, and Middlesex counties. Torrington is part of Litchfield County and Putnam is in Windham County.
DSS operates its HUSKY A program under a federal Medicaid waiver. A 2009 amendment to the waiver calls for extending the program after July 15, 2010 to additional areas that the DSS commissioner approves provided (1) an independent evaluation finds that primary care case management contains costs and improves quality and access to health care and (2) an adequate number of PCPs for both children and adults have applied to participate in the program.
As of April 2010, there were 359 HUSKY A recipients enrolled in the program and 237 providers participating.
Human Services Committee
Joint Favorable Substitute