OFFICE OF FISCAL ANALYSIS

Legislative Office Building, Room 5200

Hartford, CT 06106 (860) 240-0200

http: //www. cga. ct. gov/ofa

sHB-5476

AN ACT EXPANDING CONSUMER CHOICE FOR LIFE SUPPORT CARE AT HOME.

OFA Fiscal Note

State Impact:

Agency Affected

Fund-Effect

FY 13 $

FY 14 $

Social Services, Dept.

GF - Cost/Revenue Loss

See Below

See Below

Note: GF=General Fund

Municipal Impact: None

Explanation

The bill results in a cost to the Department of Social Services (DSS) associated with establishing and operating a two-year, state-funded pilot program for certain Medicaid recipients. To the extent that this replaces services that are currently federally reimbursable, the state will experience a revenue loss associated with reduced Medicaid payments.

The table below outlines the minimum rate DSS can establish for pilot services provided under the bill. 1

Time Period

Current RN Rate $

Proposed Minimum Rate $ under Pilot

First Hour

94. 26

75. 41

15 Minute Increments of Second Hour

23. 56

18. 85

Second Hour+ for Visits More than Two Hours

43. 07

34. 46

The bill specifies that DSS implement the bill's provisions within available appropriations. The total costs to DSS are dependent on the number of individuals participating in the pilot (a maximum of ten individuals), the number of service hours for which DSS must pay nurses and therapists, and the rate for such services.

The Out Years

The bill requires DSS to report on the two-year pilot, including its cost-effectiveness and continuity of care, by January 1, 2015.

1 Under the pilot program, DSS is required to pay registered nurses (RNs) a rate of at least 80% of the prevailing rate DSS pays home health agencies to provide comparable care. Current RN rates reflect those in the DSS Medical Assistance Fee Schedule for Home Health Services as of January 1, 2012.