Human Services Committee

JOINT FAVORABLE REPORT

Bill No.:

HB-5441

Title:

AN ACT CONCERNING DIRECT PAYMENT OF RESIDENTIAL CARE FACILITIES.

Vote Date:

3/18/2014

Vote Action:

Joint Favorable Substitute

PH Date:

3/6/2014

File No.:

SPONSORS OF BILL:

Human Services Committee

REASONS FOR BILL:

The original bill allows for the Department of Social Services to pay licensed residential care homes directly, instead of their residents, and automatically causes homes to lose retroactive rate hikes if they fail to report financial data to DSS in a timely fashion. Substitute language removes the mandatory automatic loss of rate hikes. It also allows the DSS commissioner to grant a rate hike, within available appropriations, for facility improvements made, with DSS approval, for the health and safety of residents.

RESPONSE FROM ADMINISTRATION/AGENCY:

RODERICK L. BREMBY, Commissioner, Department of Social Services, testified: “This bill is intended to improve the process by which DSS makes payments to licensed boarding homes. This improvement is accomplished by permitting the Department to make State Supplement benefit payments directly to boarding homes, instead of through residents. DSS uses a similar model to make payments to nursing facilities on behalf of Medicaid recipients. The current payment process for State Supplement benefits that are owed to a boarding home requires that the benefits pass through the resident and then be paid to the boarding home. This adds an unnecessary step in the payment process and frequently results in difficulties when the boarding home is unable to obtain the owed payments from the residents. Residential care homes have requested this operational change and the Department believes it will improve payment accuracy and efficiency.

“In addition to allowing the Department to make direct payments, the bill also seeks to address an area of operational inefficiency involving retroactive rate increases -- by requiring residential care homes to submit complete and accurate annual rate reports to the Department within 30 days of being notified that they failed to submit a complete and accurate report, or they will not receive retroactive rate increases.” This part of Section 3 of the bill was eliminated in Substitute language.

NATURE AND SOURCES OF SUPPORT:

MAG MORELLI, President, LeadingAge Connecticut, submitted testimony: “LeadingAge Connecticut supports this bill, which would allow the Department of Social Services to make direct payments, under the Aid to the Aged, Blind and Disabled (AABD)/State Supplement program to the residential care home (RCH). Presently, AABD payments to RACH services are issued to recipients, and homes regularly experience instances, particularly in the first month of stay, when residents do not apply their benefits to the cost of care. The proposed change assures that state funds are directed as intended under the AABD program. It also will save additional time and financial hardship for the RCH providers, who at times need to expend extensive resources in order to collect the required payment.”

She was opposed to the part of Section 3 regarding the loss of retroactive rate increases, which was eliminated in the Substitute language.

ELAINE COLE, Connecticut Association of Residential Care Homes (CARCH), testified that the Association “supports legislation that would enable the Department of Social Services to make direct payments, under the Aid to the Aged, Blind and Disabled (AABD)/ State Supplement program to the residential care home (RCH).

“The proposed change by DSS assures that state funds are directed as intended under the AABD program. It is unfair for RCH operators to provide services without payment. The majority of residents use the funds appropriately, but because RCHs service some of the most vulnerable in the state, including individuals with mental health and substance abuse issues, there are occasions when residents refuse to pay. This puts homes in a difficult and unnecessary position of having to try to recoup the funds, with little recourse.”

She was opposed to the part of Section 3 regarding the loss of retroactive rate increases, which was eliminated in the Substitute language.

Also submitting similar testimony were CARCH members:

DR. KULDIP BHOGAL, Administrator/ owner April Time RCH in Manchester,

who wrote: “A resident of April Time had over $10,000 paid into his EBT card. He was ready to go to the Mohegan Sun when he was overheard by a member of staff. We alerted the DSS and managed to get the funds diverted to April Time, albeit $1,100 short . . . and most times it has been impossible to fully retrieve these money from the residents.”

JANIS DAVIS, Vice President, Sheltering Arms in Norwich, who wrote: “We have experienced situations where the resident has received, cashed and spent the check and not provided the funds to us for payment.” In one case a resident had moved and a check in excess of $7,000, for several months' payment, was forwarded to the new address but had been cashed by the resident and their family member, without any funds being paid to the home.

PETER C. MacKAY, Adiministrator/owner, The Roseland in Brooklyn, who wrote: “The resident's rent checks HAVE to be made out and sent to the home. These funds are instrumental in the smooth operation of the facility. We are continuously chasing residents who have moved out to the community. The state pays their portion of the rent 30 days in arrears. Thus, when residents move out, the state sends our last rent check to residents who longer lives at the facility. We have to chase them person down and hope they give it to us. They can, and have, declined -- and we are told by DSS that it is between us and the residents and the state will not help.”

GARY FARACI, Maple Leaf Manor, who wrote that “a savvy resident will somehow manage to get the check and spend it without paying the facility. This happened to me for the sum of more than $2,800. . . . Our recourse to recover these funds is minimal. The best we can do is to get an arrest warrant against a client who will never have that amount of money to ever pay the facility.”

NATURE AND SOURCES OF OPPOSITION:

None submitted regarding the Substitute bill.

Reported by: Darya Pneva/Nancy Ahern

Date: April 1, 2014