Connecticut Seal

General Assembly

File No. 108

    February Session, 2016

House Bill No. 5284

House of Representatives, March 22, 2016

The Committee on Aging reported through REP. SERRA of the 33rd Dist., Chairperson of the Committee on the part of the House, that the bill ought to pass.

AN ACT INCREASING FUNDING FOR ELDERLY NUTRITION.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (a) of section 17b-242 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(a) The Department of Social Services shall determine the rates to be paid to home health care agencies and homemaker-home health aide agencies by the state or any town in the state for persons aided or cared for by the state or any such town. [For the period from February 1, 1991, to January 31, 1992, inclusive, payment for each service to the state shall be based upon the rate for such service as determined by the Office of Health Care Access, except that for those providers whose Medicaid rates for the year ending January 31, 1991, exceed the median rate, no increase shall be allowed. For those providers whose rates for the year ending January 31, 1991, are below the median rate, increases shall not exceed the lower of the prior rate increased by the most recent annual increase in the consumer price index for urban consumers or the median rate. In no case shall any such rate exceed the eightieth percentile of rates in effect January 31, 1991, nor shall any rate exceed the charge to the general public for similar services. Rates effective February 1, 1992, shall be based upon rates as determined by the Office of Health Care Access, except that increases shall not exceed the prior year's rate increased by the most recent annual increase in the consumer price index for urban consumers and rates effective February 1, 1992, shall remain in effect through June 30, 1993. Rates effective July 1, 1993, shall be based upon rates as determined by the Office of Health Care Access except if the Medicaid rates for any service for the period ending June 30, 1993, exceed the median rate for such service, the increase effective July 1, 1993, shall not exceed one per cent. If the Medicaid rate for any service for the period ending June 30, 1993, is below the median rate, the increase effective July 1, 1993, shall not exceed the lower of the prior rate increased by one and one-half times the most recent annual increase in the consumer price index for urban consumers or the median rate plus one per cent.] The Commissioner of Social Services shall establish a fee schedule for home health services to be effective on and after July 1, 1994. The commissioner may annually modify such fee schedule if such modification is needed to ensure that the conversion to an administrative services organization is cost neutral to home health care agencies and homemaker-home health aide agencies in the aggregate and ensures patient access. Utilization may be a factor in determining cost neutrality. The commissioner shall increase the fee schedule for home health services provided under the Connecticut home-care program for the elderly established under section 17b-342, effective July 1, 2000, by two per cent over the fee schedule for home health services for the previous year. On and after July 1, 2016, the commissioner shall increase the fee schedule for meals on wheels provided under the Connecticut home-care program for the elderly to reflect reasonable costs of providers and minimize any copayments incurred by participants in the program. Reasonable costs shall be based on the cost of food, food preparation and packaging, transportation, delivery and associated labor and administration costs. The commissioner may increase any fee payable to a home health care agency or homemaker-home health aide agency upon the application of such an agency evidencing extraordinary costs related to (1) serving persons with AIDS; (2) high-risk maternal and child health care; (3) escort services; or (4) extended hour services. In no case shall any rate or fee exceed the charge to the general public for similar services. A home health care agency or homemaker-home health aide agency which, due to any material change in circumstances, is aggrieved by a rate determined pursuant to this subsection may, within ten days of receipt of written notice of such rate from the Commissioner of Social Services, request in writing a hearing on all items of aggrievement. The commissioner shall, upon the receipt of all documentation necessary to evaluate the request, determine whether there has been such a change in circumstances and shall conduct a hearing if appropriate. The Commissioner of Social Services shall adopt regulations, in accordance with chapter 54, to implement the provisions of this subsection. The commissioner may implement policies and procedures to carry out the provisions of this subsection while in the process of adopting regulations, provided notice of intent to adopt the regulations is published [in the Connecticut Law Journal] on the Internet web site of the Department of Social Services and the eRegulations System not later than twenty days after the date of implementing the policies and procedures. Such policies and procedures shall be valid for not longer than nine months.

Sec. 2. Section 17b-343 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

The Commissioner of Social Services shall establish annually the maximum allowable rate to be paid by agencies for homemaker services, chore person services, companion services, respite care, meals on wheels, adult day care services, case management and assessment services, transportation, mental health counseling and elderly foster care. [, except that the maximum allowable rates in effect July 1, 1990, shall remain in effect during the fiscal years ending June 30, 1992, and June 30, 1993.] The Commissioner of Social Services shall prescribe uniform forms on which agencies providing such services shall report their costs for such services. Such rates shall be determined on the basis of a reasonable payment for necessary services rendered. The maximum allowable rates established by the Commissioner of Social Services for the Connecticut home-care program for the elderly established under section 17b-342 shall constitute the rates required under this section until revised in accordance with this section. The Commissioner of Social Services shall establish a fee schedule, to be effective on and after July 1, 1994, for homemaker services, chore person services, companion services, respite care, meals on wheels, adult day care services, case management and assessment services, transportation, mental health counseling and elderly foster care. The commissioner [may] shall annually increase [any fee in] the fee schedule based on an increase in the cost of services. The commissioner shall increase the fee schedule effective July 1, 2000, by not less than five per cent, for adult day care services. The commissioner shall increase the fee schedule effective July 1, 2011, by four dollars per person, per day for adult day care services. On and after July 1, 2016, the commissioner shall increase the fee schedule for meals on wheels provided under the Connecticut home-care program for the elderly to reflect reasonable costs of providers and minimize any copayments incurred by participants in the program. Reasonable costs shall be based on the cost of food, food preparation and packaging, transportation, delivery and associated labor and administration costs. Nothing contained in this section shall authorize a payment by the state to any agency for such services in excess of the amount charged by such agency for such services to the general public.

This act shall take effect as follows and shall amend the following sections:

Section 1

from passage

17b-242(a)

Sec. 2

from passage

17b-343

AGE

Joint Favorable

 

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

State Impact:

Agency Affected

Fund-Effect

FY 17 $

FY 18 $

Social Services, Dept.

GF - Cost

Indeterminate

Indeterminate

Note: GF=General Fund

Municipal Impact: None

Explanation

The bill will result in an indeterminate cost to the Department of Social Services (DSS) as the bill does not specify the value of the fee increase for services provided by the Connecticut Home Care Program for Elders (CHCPE), and the definition for “reasonable cost” is subject to interpretation. The bill requires the Commissioner of DSS to annually increase rates for home-delivered meals for clients of the CHCPE. In addition, the bill requires the Commissioner to annually increase fees for various services outlined in the bill based on the increased cost of those services. There is an average of 16,242 clients per month served by programs who utilize these services. For reference, a 1% increase in the total annual net CHCPE expenditures is approximately $2.1 million annually.

The current Medicaid daily rate for a single meal is $4.79 and $8.76 for two meals. Not all clients served by these programs receive meals.

The Out Years

The annualized ongoing fiscal impact identified above would continue into the future subject to inflation.

OLR Bill Analysis

HB 5284

AN ACT INCREASING FUNDING FOR ELDERLY NUTRITION.

SUMMARY:

This bill requires, rather than allows, the social services commissioner to annually increase the fees paid to providers for specified services based on cost increases. It applies to fees for homemaker, chore, companionship, respite care, meals on wheels, adult day care, case management and assessment, transportation, mental health counseling, and elderly foster care services.

It also requires the commissioner, on and after July 1, 2016, to increase the fees for meals on wheels provided through the Connecticut Home Care Program for Elders (CHCPE) to reflect reasonable provider costs and minimize participant copayments. Under the bill, reasonable costs must be based on the cost of food, food preparation and packaging, transportation, delivery, and associated labor and administration costs. CHCPE is a Medicaid waiver and state-funded program that provides home- and community-based services for eligible individuals age 65 and older who are at risk for institutionalization.

By law, the commissioner may implement policies and procedures while in the process of adopting regulations about payments to home health care and homemaker-health aide agencies, provided he provides a notice of intent to adopt regulations within 20 days of the policy implementation date. The bill requires the commissioner to publish the notice on the department's website and the Secretary of State's online eRegulations system, instead of the Connecticut Law Journal. By law, such policies and procedures are valid for a maximum of nine months.

The bill also removes obsolete provisions regarding rates for home-based services.

EFFECTIVE DATE: Upon passage

COMMITTEE ACTION

Aging Committee

Joint Favorable

Yea

13

Nay

0

(03/08/2016)

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