Connecticut 2023 Regular Session Status: Enacted Bipartisan · 8 D · 6 R cosponsors

SB 989 — AN ACT CONCERNING NONPROFIT PROVIDER RETENTION OF CONTRACT SAVINGS, COMMUNITY HEALTH WORKER MEDICAID REIMBURSEMENT AND STUDIES OF MEDICAID RATES OF REIMBURSEMENT, NURSING HOME TRANSPORTATION AND NURSING HOME WAITING LISTS.

Last action — SIGNED BY GOVERNOR

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed House
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced February 09, 2023. Enacted.

Signed by Governor Ned Lamont (Democratic) on June 28, 2023.

Odds of enactment

High chance

Based on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.

Upgrade to see the exact probability and what's driving it.

A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Likely to advance 78% · moderate confidence

  • Enacted

    Current position in the legislative process.

  • 18 sponsors

    18 primary, 0 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (8 D · 6 R) — cross-party backing.

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Bill Text

What changed in the latest version

242 added · 592 removed

242 line(s) added, 592 removed.

→
Previous
Latest
General Assembly Substitute Bill No.
Substitute Senate Bill No.
989 January Session, 2023 AN ACT CONCERNING NURSING HOME AIR CONDITIONING, COST REPORTING TRANSPARENCY, WAITING LIST REQUIREMENTS, INVOLUNTARY PATIENT TRANSFER NOTICES AND TRANSPORTATION FOR RESIDENT SOCIAL VISITS.
989 Public Act No.
23-186 AN ACT CONCERNING NONPROFIT PROVIDER RETENTION OF CONTRACT SAVINGS, COMMUNITY HEALTH WORKER MEDICAID REIMBURSEMENT AND STUDIES OF MEDICAID RATES OF REIMBURSEMENT, NURSING HOME TRANSPORTATION AND NURSING HOME WAITING LISTS.
Section 19a-522a of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(Effective from passage) (a) Within available appropriations, the Commissioner of Social Services shall conduct a two-part study of Medicaid rates of reimbursement beginning with (1) an examination of such rates for physician specialists, dentists and behavioral health providers followed by (2) a review of the reimbursement system for all other aspects of the Medicaid program, including, but not limited to, ambulance services, the encounter-based reimbursement model for federally qualified health centers and reimbursement rates for specialty hospitals, complex nursing care and methadone maintenance.
(a) On and after July 1, 2024, the Department of Public Health shall conduct a review of each nursing home facility, as defined in section 19a-490, to determine which such facilities have air conditioning in all resident rooms.
(b) The rate reimbursement study shall include, but need not be limited to:
For those facilities that do not have air conditioning in all resident rooms, each such facility shall report to the Department of Public Health in a time and manner prescribed by the Commissioner of Public Health:
(1) A comparison of the state's Medicaid rates with Medicaid rates provided by neighboring states;
(1) Whether and how such facility is able to adequately control the climate in resident rooms during hot weather;
and (2) a comparison of the state's Medicaid rates with Medicare rates and cost-of-living increases provided under Medicare compared to the state Medicaid program.
(2) What air conditioning system options are feasible for installation at such facility;
(c)The commissionershallfile interimreports,inaccordance withthe Substitute Senate Bill No.
(3) The cost and physical plant needs involved in providing air conditioning in each resident room;
989 provisions of section 11-4a of the general statutes, (1) not later than February 1, 2024, on the aspects of the study conducted pursuant to subdivision (1) of subsection (a) of this section;
and LCO \\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-00989-R1 of 17 SB.docx Substitute Bill No.
and (2) not later than January 1, 2025, on the aspects of the study conducted pursuant to subdivision (2) of subsection (a) of this section with the joint standing committees of the General Assembly having cognizance of matters relating to appropriations and the budgets of state agencies and human services.
989 (4) Other impediments to providing air conditioning in each resident room.
Nothing in this section shall be construed to impact Medicaid rates of reimbursement for the fiscal years ending June 30, 2024, and June 30, 2025.
(b) Not later than January 1, 2025, the Department of Public Health shall submit a report, in accordance with the provisions of section 11-4a, to the joint standing committees of the General Assembly having cognizance of matters relating to aging, human services and public health on (1) the number of such facilities without air conditioning in all resident rooms, (2) how many such facilities are able to adequately control the temperature and humidity levels in resident rooms, (3) the overall costs for nursing home facilities without air conditioning in every resident room to provide air conditioning in such rooms, and (4) any impediments to providing air conditioning in all resident rooms at specific nursing homes.
(c) On or before January 1, 2026, each nursing home facility shall provide air conditioning in every resident room.
(d) A chronic and convalescent nursing home or a rest home with nursing supervision may maintain temperatures in resident rooms and other areas used by residents at such facilities at levels that are lower than minimum temperature standards prescribed in the Public Health Code provided temperature levels at such facilities comply with the comfortable and safe temperature standards prescribed under federal law pursuant to 42 CFR 483.15(h)(6).
In accordance with section 19a-36, the Commissioner of Public Health shall amend the Public Health Code in conformity with the provisions of this section.
(e) The provisions of this section shall not apply to residential care homes, as defined in section 19a-490.
(NEW) (Effective from passage) (a) There is established, within the Connecticut Health and Educational Facilities Authority, a revolving loan account for the purpose of providing financial assistance to an owner of a nursing home facility, as defined in section 19a-490 of the general statutes, for costs incurred to install an air conditioning LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0092 of 17 R02-SB.docx } Substitute Bill No.
(NEW) (Effective July 1, 2023) (a) As used in this section, (1) "private provider organization" and "purchase of service contract" each have the same meanings as provided in section 4-70b of the general statutes;(2)"healthandhumanservices"meansservicesprovidedunder contract with a state agency that directly support the health, safety and welfare of residents, including, but not limited to, those residents who may have conditions that include, but are not limited to, behavioral health disorders, intellectual disabilities, developmental disabilities, physical disabilities and autism spectrum disorder;
989 system in each resident room.
(3) "attempt to recover or otherwise offset" means efforts to recoup savings at the end of each fiscal year;
(b) The revolving loan account shall contain any moneys provided or required by law to be deposited in the account.
and (4) "state agency" means the Departments of Developmental Services, Mental Health and Addiction Services, Social Services and Children and Families.
The authority may accept contributions from any source, public or private, for deposit in the account for purposes of the loan program.
(b)Subject to theprovisionsofsubsection(c) ofthissection,eachstate agency that contracts with a nonprofit private provider organization for health and human services shall allow such nonprofit organization that otherwise meets contractual requirements, including, but not limited to, its contractual obligations regarding services provided and clients served, to retain any savings from a purchase of service contract at the end of each fiscal year.
(c) Loans made pursuant to this section shall have such terms and conditions and shall be subject to such eligibility, loan approval, credit and other underwriting requirements and criteria as are determined by the authority to be reasonable in light of the purpose of the loan program.
No state agency shall attempt to recover or otherwise offset funds retained by such nonprofit organization from the Public Act No.
(d)OnorbeforeJanuary 1,2026,theauthorityshallsubmit tothejoint standing committees of the General Assembly having cognizance of matters relating to aging, human services and public health a report, in accordance with section 11-4a of the general statutes, setting forth the following information:
23-186 2 of 8 Substitute Senate Bill No.
(1) A list of the loans made under the program, a general description of the terms and conditions of such loans and the repayment history;
989 contracted cost for services.
(2) an assessment of the impact of such loans on compliance with any requirements for nursing home facilities to provide an air conditioning system in each resident room;
(c) Any nonprofit private provider organization allowed to retain savings under this section shall submit an application to the contracting state agency on how savings are planned to be reinvested and report to the contracting state agency on how savings will be reinvested to strengthen quality, invest in deferred maintenance and make asset improvements.
(3) the need for additional funding for the loan program authorized by this section;
The commissioner of each state agency shall prescribe theformandmannerofsuchapplicationformandthefrequencyofsuch reports.
and (4) such other information as the authority deems relevant to evaluating the success of the loan program in meeting its objectives.
The commissioner of each state agency shall review an application submitted pursuant to this subsection and respond to a nonprofit private provider organization not later than ninety days after receiving such application from such provider organization.
(e) In connection with the making and administration of loans pursuant to this section, the authority shall have and may exercise such powers as are necessary or appropriate to carry out the purposes of this section, including the same powers expressly granted to the authority in section 10a-180 of the general statutes with respect to other loans.
Retained funds may only be used for the purposes of strengthening quality, investingindeferredmaintenanceandmakingassetimprovements.The commissioner of each state agency shall approve, disapprove or modify any application for funds in accordance with the allowable uses in this subsection.
(f) No new loan may be made pursuant to this section after January 1, 2026, and any moneys then remaining in, or thereafter received to the credit of, the account established in subsection (b) of this section may be withdrawn by the authority from such account and used for other LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0093 of 17 R02-SB.docx } Substitute Bill No.
Nonprofit private provider organizations providing health and human services shall be permitted to expend retained funds on programs that are funded by the same state agency.
989 purposes of the authority, subject to specific restrictions governing any contribution to such account pursuant to subsection (b) of this section.
(d) Notwithstanding any provisions to the contrary in this section, a state agency shall not allow a nonprofit private provider organization to retain surplus funds from the contracted cost of services under a contract funded in whole, or in part, with federal funds when allowing such organization to retain such funds would jeopardize federal funding or reimbursement for such contract or when such allowance is prohibited by federal law or regulations.
(g) The authority shall adopt written procedures, in accordance with section 1-121 of the general statutes, to carry out the provisions of this section.
(e) The Commissioner of Social Services, in consultation with the Secretary of the Office of Policy and Management and the Commissioners of Children and Families, Mental Health and Addiction Services and Developmental Services, may undertake a study of the contracting and billing practices of such nonprofit private provider Public Act No.
23-186 3 of 8 Substitute Senate Bill No.
989 organizations to ensure compliance with all Medicaid waivers and Medicaid state plan amendments.
Any study started under this subsection shall be completed not later than December 31, 2024.
(f) Notwithstanding the provisions of subsections (a) to (e), inclusive, of this section, the Commissioner of Developmental Services, in consultation with the Secretary of the Office of Policy and Management, may extend the provisions of this section to other private provider organizations with which the Department of Developmental Services contracts, provided they meet all of the requirements set forth in this section, including, but not limited to, meeting all terms and conditions of their contracts for services with the Department of Developmental Services.
Subsection (c) of section 19a-535 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
Section 4-216 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2023):
(c) (1) Before effecting any transfer or discharge of a resident from the facility, thefacility shallnotify,inwriting,theresident andtheresident's guardian or conservator, if any, or legally liable relative or other responsible party if known, of the proposed transfer or discharge, the reasonstherefor,theeffective dateoftheproposedtransferordischarge, the location to which the resident is to be transferred or discharged, the right to appeal the proposed transfer or discharge and the procedures for initiating such an appeal as determined by the Department of Social Services, the date by which an appeal must be initiated in order to preserve the resident's right to an appeal hearing and the date by which an appeal must be initiated in order to stay the proposed transfer or discharge and the possibility of an exception to the date by which an appeal must be initiated in order to stay the proposed transfer or discharge for good cause, that the resident may represent himself or herself or be represented by legal counsel, a relative, a friend or other spokesperson, and information as to bed hold and nursing home readmission policy when required in accordance with section 19a-537.
(a) No state agency may execute a personal service agreement having a cost of more than fifty thousand dollars or a term of more than one year, without the approval of the secretary.
The notice shall also include the name, mailing address and telephone number of the State [Long-Term Care] Ombudsman.
A state agency may apply for an approval by submitting the following information to the secretary:
If the resident is, or the facility alleges a resident is, mentally ill or developmentally disabled, the notice shall include the name, mailing address and telephone number of the nonprofit entity designated by the Governor in accordance with section 46a-10b to serve as the Connecticut protection and advocacy system.
(1) A description of the services to be purchased and the need for such services;
The notice shall be given at least thirty days and no more than sixty days prior to the resident's proposed transfer or LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-00984 of 17 R02-SB.docx } Substitute Bill No.
(2) an estimate of the cost of the services and the term of the agreement;
989 discharge, except where the health or safety of individuals in the facility are endangered, or where the resident's health improves sufficiently to allow a more immediate transfer or discharge, or where immediate transfer or discharge is necessitated by urgent medical needs or where a resident has not resided in the facility for thirty days, in which cases notice shall be given as many days before the transfer or discharge as practicable.
(3) whether the services are to be on-going;
Show all 195 changed rows (155 more)
Previous
Latest
(2) The resident may initiate an appeal pursuant to this section by submitting a written request to the Commissioner of Social Services not later than sixty calendar days after the facility issues the notice of the proposed transfer or discharge, except as provided in subsection (h) of this section.
(4) whether the state agency has contracted out for such services during the preceding two years and, if so, the name of the contractor, term of the agreement with such contractor and the amount paid to the contractor;
In order to stay a proposed transfer or discharge, the resident must initiate an appeal not later than twenty days after the date the resident receives the notice of the proposed transfer or discharge from the facility unless the resident demonstrates good cause for failing to initiate such appeal within the twenty-day period.
(5) whether any other state agency has the resources to provide the services;
(3) On the date that the facility provides notice of a proposed involuntary transfer or discharge of a resident pursuant to the provisions of subdivision (1) of this subsection, the facility shall notify the State Ombudsman, appointed pursuant to section 17a-870, in a manner prescribed by the State Ombudsman, of such proposed involuntary transfer or discharge.
(6) whether the agency intends to purchase the services by competitive negotiation and, if not, why;
Failure to provide notice to the State Ombudsman pursuant to the provisions of this subdivision shall invalidate any notice of the proposed involuntary transfer or discharge of a resident submitted pursuant to the provisions of subdivision (1) of this subsection.
and (7) whether it is possible to purchase the services on a cooperative basis with other state agencies.
Sec.
The secretary shall approve or disapprove an application within fifteen business days after receiving it and any necessary supporting information, provided if the secretary does not act within such Public Act No.
23-186 4 of 8 Substitute Senate Bill No.
989 fifteen-day period the application shall be deemed to have been approved.
The secretary shall immediately notify the Auditors of Public Accounts of any application which the secretary receives for approval of a personal services agreement for audit services and give said auditors an opportunity to review the application during such fifteen- day period and advise the secretary as to whether such audit services are necessary and, if so, could be provided by said auditors.
(b) Each personal service agreement having a cost of more than fifty thousand dollars or a term of more than one year shall be based on competitive negotiation or competitive quotations, unless the state agency purchasing the personal services applies to the secretary for a waiver from such requirement and the secretary grants the waiver in accordance with the guidelines adopted under section 4-215.
[(c) The secretary shall establish an incentive program for nonprofit providers of human services that shall (1) allow providers who otherwise meet contractual requirements to retain any savings realized by the providers from the contracted cost for services, and (2) provide that future contracted amounts from the state for the same types of services are not reduced solely to reflect savings achieved in previous contracts by such providers.
For purposes of this subsection, "nonprofit providers of human services" includes, but is not limited to, nonprofit providers of services to persons with intellectual, physical or mental disabilities or autism spectrum disorder.
Any nonprofit provider of human services allowed to retain savings under the incentive program shall submit a report to the secretary on how excess funds were reinvested to strengthen quality, invest in deferred maintenance and make asset improvements.] Sec.
Subsection (k) of section 19a-535 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):
(NEW) (Effective from passage) (a) For purposes of this section, "certified community health worker" has the same meaning as provided in section 20-195ttt of the general statutes.
(k) [A] Except as otherwise provided in subdivision (3) of subsection (c) of this section, a facility shall electronically report each involuntary transfer or discharge to the State Ombudsman, appointed pursuant to LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0095 of 17 R02-SB.docx } Substitute Bill No.
The Commissioner of Social Services shall design and implement a program to provide Medicaid Public Act No.
989 section [17a-405] 17a-870, (1) in a manner prescribed by the State Ombudsman, and (2) on an Internet web site portal maintained by the State Ombudsman in accordance with patient privacy provisions of the Health Insurance Portability and Accountability Act of 1996, P.L.
23-186 5 of 8 Substitute Senate Bill No.
104- 191, as amended from time to time.
989 reimbursement to certified community health workers for services provided to HUSKY Health program members, including, but not limited to:
(1) Coordination of medical, oral and behavioral health care services and social supports;
(2) connection to and navigation of health systems and services;
(3) prenatal, birth, lactation and postpartum supports;
and (4) health promotion, coaching and self-management education.
(b) The Commissioner of Social Services and the commissioner's designees shall consult with certified community health workers, Medicaid beneficiaries and advocates, including, but not limited to, advocates for persons with physical, mental and developmental disabilities, and others throughout the design and implementation of the certified community health worker reimbursement program in a manner that (1) is inclusive of community-based and clinic-based certified community health workers;
(2) is representative of medical assistance program member demographics;
and (3) helps shape the reimbursement program's design and implementation.
The commissioner, in consultation with community health workers, Medicaid beneficiaries and such advocates, shall explore options for the reimbursement program's design that ensures access to such community health workers, encourages workforce growth to support such access and averts the risk of creating financial incentives for other providers to limit access to such community health workers.
(c) Not later than January 1, 2024, and annually thereafter until the reimbursement program is fully implemented, the Commissioner of Social Services shall submit a report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committee of the General Assembly having cognizance of matters relating to human services and the Council on Medical Assistance Program Oversight.
The initial report shall be submitted not less than six months prior to the implementation of the reimbursement program.
The reports Public Act No.
23-186 6 of 8 Substitute Senate Bill No.
989 shall contain an update on the certified community health worker reimbursement program design, including, but not limited to (1) an analysis regarding the program elements designed to ensure access to such services, promote workforce growth and avert the risk of creating financial incentives for other providers to limit access to such community health workers, and (2) an evaluation of any impact of the program on health outcomes and health equity.
(NEW) (Effective July 1, 2023) (a) Any nursing home facility, as defined in section 19a-490 of thegeneral statutes, with availablevehicles equipped to transport nonambulatory residents, may provide nonemergency transportation of such residents to the homes of such residents' family members, provided:
(Effective July 1, 2023) (a) Any nursing home facility, as defined in section 19a-490 of the general statutes, with available vehicles equipped to transport nonambulatory residents, may provide nonemergency transportation of such residents to the homes of such residents' family members, provided:
(b) The Commissioner of Social Services, within available appropriations, may establish a grant program to fund such nonemergency transportation.
Nothing in this section shall be construed to authorize or require any payment or reimbursement to a nursing home facility for such nonemergency transportation services.
The commissioner shall prescribe forms and procedures for a nursing home facility to apply for a grant through any such grant program.
(b) The Commissioner of Social Services shall evaluate whether the need for such transportation would qualify as a health-related social need and file a report not later than October 1, 2023, with the Council on Medical Assistance Program Oversight on such evaluation and potential federal funding that may be available for such transportation.
The commissioner shall evaluate whether the need for such transportation would qualify as a health-related social need and file a report not later than October 1, 2023, with the Council on Medical Assistance Program Oversight on such evaluation and potential federal funding that may be available for such transportation.
(Effective from passage) (a) The State Ombudsman, appointed pursuant to section 17a-870 of the general statutes, shall convene a working group concerning any revisions necessary to nursing home waiting list requirements as described in section 19a-533 of the general statutes.
(Effective from passage) (a) The State Ombudsman, appointed pursuant to section 17a-870 of the general statutes, and the Public Act No.
The working group shall include, but need not be limited to, LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0096 of 17 R02-SB.docx } Substitute Bill No.
23-186 7 of 8 Substitute Senate Bill No.
989 the State Ombudsman, or the State Ombudsman's designee;
989 Commissioners of Public Health and Social Services shall convene a working group concerning any revisions necessary to nursing home waiting list requirements as described in section 19a-533 of the general statutes.
not less than two representatives of the nursing home industry, appointed by the State Ombudsman;
The working group shall include, but need not be limited to, the State Ombudsman, or the State Ombudsman's designee;
and any other member the State Ombudsman may appoint.
and not fewer than two representatives of the nursing home industry, appointed by the Commissioner of Social Services.
(b) The State Ombudsman, or the State Ombudsman's designee, shall serve as chairperson of the working group, which shall meet not less than once monthly.
(b) The State Ombudsman, or the State Ombudsman's designee, and the Commissioner of Social Services, or the commissioner's designee, shall serve as chairpersons of the working group, which shall meet not less than once monthly.
Not later than January 1, 2024, the State Ombudsman shall file a report, in accordance with section 11-4a of the general statutes, with the joint standing committees of the General Assembly having cognizance of matters relating to human services and public health with recommendations concerning any changes to the waiting list requirements, including, but not limited to, authorizing nursing homes to maintain waiting lists in electronic form.
Not later than January 1, 2024, the State Ombudsman and the Commissioners of Public Health and Social Services shall file a report, in accordance with section 11-4a of the general statutes, with the joint standing committees of the General Assembly having cognizance of matters relating to human services and public health with recommendations concerning any changes to the waiting list requirements, including, but not limited to, authorizing nursing homes to maintain waiting lists in electronic form.
Sec.
Approved June 28, 2023 Public Act No.
7.
23-186 8 of 8
(NEW) (Effective July 1, 2023) (a) As used in this section, "allowable costs" has the same meaning as provided in section 17b-340d of the general statutes.
Beginning with the cost report year ending on September 30, 2024, and annually thereafter, each nursing home facility, as defined in section 19a-490 of the general statutes, shall submit to the Commissioner of Social Services narrative summaries of expenditures in addition to the cost reports required pursuant to section 17b-340 of the general statutes, as amended by this act.
The summaries shall be in plain language and include the percentage of Medicaid funding allocated to (1) the five cost components of allowable costs, broken down to include individual expenditure categories of each cost component described in subdivision (4) of subsection (a) of section 17b- 340d of the general statutes, and (2) any related party, as defined in section 17b-340 of the general statutes, as amended by this act.
(b) Not later than January 1, 2025, and annually thereafter, the Commissioner of Social Services shall post in a conspicuous area on the department's Internet web site a link to (1) the annual cost reports and the plain language summaries provided by each nursing home facility, (2) comparisons between individual nursing homes by expenditures, LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0097 of 17 R02-SB.docx } Substitute Bill No.
989 and (3) a summary of the average reported expenditures of all reporting nursing homes for each category.
Any cost report forms utilized by the department shall include a glossary and explanation of the terms used and a description of the categories being reported on, including, but not limited to, plain language explanations of formulas and formula terms used to determine maximum costs for direct costs, indirect costs, fair rent, capital-related costs and administrative and general costs, as described in subdivision (4) of subsection (a) of section 17b-340d of the general statutes.
(c) Any nursing home facility that violates or fails to comply with the provisions of this section shall be fined not more than ten thousand dollars for each incident of noncompliance.
The Commissioner of Social Services may offset payments due a facility to collect the penalty.
Prior to imposing any penalty pursuant to this subsection, the commissioner shall notify the nursing home facility of the alleged violation and the accompanying penalty and shall permit such facility to request that the department review its findings.
A facility shall request such review not later than fifteen days after receipt of the notice of violation from the department.
The department shall stay the imposition of any penalty pending the outcome of the review.
The commissioner may impose a penalty upona facility pursuant to thissubsectionregardlessofwhether a change in ownership of the facility has taken place since the time of the violation, provided the department issued notice of the alleged violationand the accompanying penalty prior to the effective date of the change in ownership and record of such notice is readily available in a central registry maintained by the department.
Payments of fines received pursuant to this subsection shall be deposited in the General Fund and credited to the Medicaid account.
Sec.
8.
Section 19a-491a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2023):
(a) A person seeking a license to establish, conduct, operate or maintain a nursing home shall provide the Department of Public Health with the following information:
LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-00988 of 17 R02-SB.docx } Substitute Bill No.
989 (1) (A) The name and business address of the owner and a statement of whether the owner is an individual, partnership, corporation or other legal entity;
(B) the names of the officers, directors, trustees, or managing and general partners of the owner, the names of persons having a ten per cent or greater ownership interest in the owner, and a description of each such person's occupation with the owner;
[and] (C) if the owner is a corporation which is incorporated in another state, a certificate of good standing from the secretary of state of the state of incorporation;
and (D) if a private equity firm owns any portion of the business, the name of the private equity fund's investment advisor and a copy of the most recent quarterly statement provided to the private equity fund's investors, including information regarding fees, expenses and performance of the fund;
(2)A descriptionoftherelevantbusinessexperience oftheowner and of the administrator of the nursing home and evidence that the administrator has a license issued pursuant to section 19a-514;
(3) Affidavits signed by the owner, any of the persons described in subdivision (1) of this subsection, the administrator, assistant administrator, the medical director, the director of nursing and assistant director of nursing disclosing any matter in which such person has been convicted of a felony, as defined in section 53a-25, or has pleaded nolo contendere to a felony charge, or has been held liable or enjoined in a civilactionby finaljudgment,ifthefelonyorcivilactioninvolvedfraud, embezzlement, fraudulent conversion or misappropriation of property;
or is subject to an injunction or restrictive or remedial order of a court of record at the time of application, within the past five years has had any state or federal license or permit suspended or revoked as a result of an action brought by a governmental agency or department, arising out of or relating to health care business activity, including, but not limited to, actions affecting the operation of a nursing home, retirement home, residential care home or any facility subject to sections 17b-520 to 17b- 535, inclusive, or a similar statute in another state or country;
(4) (A) A statement as to whether or not the owner is, or is affiliated LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-00989 of 17 R02-SB.docx } Substitute Bill No.
989 with, a religious, charitable or other nonprofit organization;
(B) the extent of the affiliation, if any;
(C) the extent to which the affiliate organization will be responsible for the financial obligations of the owner;
and (D) the provision of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as from time to time amended, if any, under which the owner or affiliate is exempt from the payment of income tax;
(5) The location and a description of other health care facilities of the owner, existing or proposed,and,ifproposed,theestimatedcompletion date or dates and whether or not construction has begun;
[and] (6) Audited and certified financial statements of the owner, including (A) a balance sheet as of the end of the most recent fiscal year, and (B) income statements for the most recent fiscal year of the owner or such shorter period of time as the owner shall have been in existence;
and [(6)] (7) If the operation of the nursing home has not yet commenced, a statement of the anticipated source and application of the funds used or to be used in the purchase or construction of the home, including:
(A) An estimate of such costs as financing expense, legal expense, land costs, marketing costs and other similar costs which the owner expects to incur or become obligated for prior to the commencement of operations;
and (B) A description of any mortgage loan or any other financing intended to be used for the financing of the nursing home, including the anticipated terms and costs of such financing.
[(b) In addition to the information provided pursuant to subsection (a) of this section, the commissioner may reasonably require an applicant for a nursing home license or renewal of a nursing home license to submit additional information.
Such information may include audited and certified financial statements of the owner, including, (1) a balance sheet as of the end of the most recent fiscal year, and (2) income statements for the most recent fiscal year of the owner or such shorter LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0010 of 17 R02-SB.docx } Substitute Bill No.
989 period of time as the owner shall have been in existence.] [(c)] (b) No person acting individually or jointly with any other person shall establish, conduct, operate or maintain a nursing home without maintaining professional liability insurance or other indemnity against liability for professional malpractice.
The amount of insurance which such person shall maintain as insurance or indemnity against claims for injury or death for professional malpractice shall be not less than one million dollars for one person, per occurrence, with an aggregate of not less than three million dollars.
The requirements of this subsection shall not apply to any person who establishes, conducts, operates or maintains a residential care home.
[(d)] (c) A person seeking to renew a nursing home license shall furnish the department with any information required under this section that was not previously submitted and with satisfactory written proof that the owner of the nursing home consents to such renewal, if the owner is different from the person seeking renewal, and shall provide data on any change in the information submitted.
The commissioner shall refuse to issue or renew a nursing home license if the person seeking renewal fails to provide the information required under thissection.Uponsuchrefusal,thecommissioner shallgrant such license to the holder of the certificate of need, provided such holder meets all requirements for such licensure.
If such holder does not meet such requirements, the commissioner shall proceed in accordance with sections19a-541 to 19a-549,inclusive.
Ifthecommissioner isconsidering a license renewal application pursuant to an order of the commissioner, the procedures in this subsection shall apply to such consideration.
Sec.
9.
Subsection (a) of section 17b-340 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2023):
(a) For purposes of this subsection, (1) a "related party" includes, but is not limited to, any company related to a chronic and convalescent nursing home through family association, common ownership, control LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0011 of 17 R02-SB.docx } Substitute Bill No.
989 or business association with any of the owners, operators or officials of such nursing home;
(2) "company" means any person, partnership, association, holding company, limited liability company or corporation;
(3) "family association" means a relationship by birth, marriage or domestic partnership;
and (4) "profit and loss statement" means the most recent annual statement on profits and losses finalized by a related party before the annual report mandated under this subsection.
The rates to be paid by or for persons aided or cared for by the state or any town in this state to licensed chronic and convalescent nursing homes, to chronic disease hospitals associated with chronic and convalescent nursing homes, to rest homes with nursing supervision, to licensed residential care homes, as defined by section 19a-490, and to residential facilities for persons with intellectual disability that are licensed pursuant to section 17a-227 and certified to participate in the Title XIX Medicaid program as intermediate care facilities for individuals with intellectual disabilities, for room, board and services specified in licensing regulations issued by the licensing agency shall be determined annually, except as otherwise provided in this subsection by the Commissioner of Social Services, to be effective July first of each year except as otherwise provided in this subsection.
Such rates shall be determined on a basis of a reasonable payment for such necessary services, which basis shall take into account as a factor the costs of such services.
Cost of such services shall include reasonable costs mandated by collective bargaining agreements with certified collective bargaining agents or other agreements between the employer and employees, provided "employees" shall not include persons employed as managers or chief administrators or required to be licensed as nursing home administrators, and compensation for services rendered by proprietors at prevailing wage rates, as determined by application of principles of accounting as prescribed by said commissioner.
Cost of such services shall not include amounts paid by the facilities to employees as salary, or to attorneys or consultants as fees, where the responsibility of the employees, attorneys, or consultants is to persuade or seek to persuade the other employees of the facility to support or oppose unionization.
Nothing in this subsection shall prohibit inclusion of amounts paid for LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0012 of 17 R02-SB.docx } Substitute Bill No.
989 legal counsel related to the negotiation of collective bargaining agreements, the settlement of grievances or normal administration of labor relations.
The commissioner may, in the commissioner's discretion, allow the inclusion of extraordinary and unanticipated costs ofproviding services that were incurredto avoidanimmediate negative impact on the health and safety of patients.
The commissioner may, in the commissioner's discretion, based upon review of a facility's costs, direct care staff to patient ratio and any other related information,revise a facility's rate for any increases or decreases to total licensed capacity of more than ten beds or changes to its number of licensed rest home with nursing supervision beds and chronic and convalescent nursing home beds.
The commissioner may, in the commissioner's discretion, revise the rate of a facility that is closing.
An interim rate issued for the period during which a facility is closing shall be based on a review of facility costs, the expected duration of the close-down period, the anticipated impact on Medicaid costs, available appropriations and the relationship of the rate requested by the facility to the average Medicaid rate for a close-downperiod.The commissioner may so revise afacility's rate established for the fiscal year ending June 30, 1993, and thereafter for any bed increases, decreases or changes in licensure effective after October 1, 1989.
Effective July 1, 1991, in facilities that have both a chronic and convalescent nursing home and a rest home with nursing supervision, the rate for the rest home with nursing supervision shall not exceed such facility's rate for its chronic and convalescent nursing home.
All such facilities for which rates are determined under this subsection shall report on a fiscal year basis ending on September thirtieth.
Such report shall be submitted to the commissioner by February fifteenth.
Each for-profit chronic and convalescent nursing home that receives state funding pursuant to this section shall include insuch annual report a profit andloss statement fromeachrelatedparty that receives from such chronic and convalescent nursing home [fifty thousand dollars or more per year] any amount of income for goods, fees and services.
No cause of action or liability shall arise against the state, the Department of Social Services, any state official or agent for failure to take action based on the information required to be reported LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-00913 of 17 R02-SB.docx } Substitute Bill No.
989 under this subsection.
The commissioner may reduce the rate in effect for a facility that fails to submit a complete and accurate report on or before February fifteenth by an amount not to exceed ten per cent of such rate.
If a licensed residential care home fails to submit a complete andaccuratereport,thedepartmentshallnotifysuchhomeofthefailure and the home shall have thirty days from the date the notice was issued to submit a complete and accurate report.
If a licensed residential care home fails to submit a complete and accurate report not later than thirty days after the date of notice, such home may not receive a retroactive rate increase, in the commissioner's discretion.
The commissioner shall, annually,onorbeforeAprilfirst,reportthedatacontainedinthe reports of such facilities on the department's Internet web site.
For the cost reporting year commencing October 1, 1985, and for subsequent cost reportingyears, facilitiesshallreportthecostofusing theservicesofany nursing personnel supplied by a temporary nursing services agency by separating said cost into two categories, the portion of the cost equal to the salary of the employee for whom the nursing personnel supplied by a temporary nursing services agency is substituting shall be considered a nursing cost and any cost in excess of such salary shall be further divided so that seventy-five per cent of the excess cost shall be considered an administrative or general cost and twenty-five per cent of the excess cost shall be considered a nursing cost, provided if the total costsofa facility for nursing personnelsuppliedby atemporary nursing services agency in any cost year are equal to or exceed fifteen per cent of the total nursing expenditures of the facility for such cost year, no portion of such costs in excess of fifteen per cent shall be classified as administrative or general costs.
The commissioner, in determining such rates, shall also take into account the classification of patients or boarders according to special care requirements or classification of the facility according to such factors as facilities and services and such other factors as the commissioner deems reasonable, including anticipated fluctuations in the cost of providing such services.
The commissioner may establish a separate rate for a facility or a portion of a facility for traumatic brain injury patients who require extensive care but not acute general hospital care.
Such separate rate shall reflect the special care LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-009814 of 17 R02-SB.docx } Substitute Bill No.
989 requirements of such patients.
If changes in federal or state laws, regulations or standards adopted subsequent to June 30, 1985, result in increased costs or expenditures in an amount exceeding one-half of one per cent of allowable costs for the most recent cost reporting year, the commissioner shall adjust rates and provide payment for any such increased reasonable costs or expenditures within a reasonable period of time retroactive to the date of enforcement.
Nothing in this section shall be construed to require the Department of Social Services to adjust rates and provide payment for any increases in costs resulting from an inspection of a facility by the Department of Public Health.
Such assistance as the commissioner requires from other state agencies or departments in determining rates shall be made available to the commissioner at the commissioner's request.
Payment of the rates established pursuant to this section shall be conditioned on the establishment by such facilities of admissions procedures that conform with this section, section 19a-533 and all other applicable provisions of the law and the provision of equality of treatment to all persons in such facilities.
The established rates shall be the maximum amount chargeable by such facilities for care of such beneficiaries, and the acceptance by or on behalf of any such facility of any additional compensation for care of any such beneficiary from any other person or source shall constitute the offense of aiding a beneficiary to obtain aid to which the beneficiary is not entitled and shall be punishable in the same manner as is provided in subsection (b) of section 17b-97.
Notwithstanding any provision of this section, the Commissioner of SocialServicesmay, withinavailableappropriations,provideaninterim rate increase for a licensed chronic and convalescent nursing home or a resthomewithnursingsupervisionforrateperiodsnoearlierthanApril 1, 2004, only if the commissioner determines that the increase is necessary to avoid the filing of a petition for relief under Title 11 of the United States Code;
imposition of receivership pursuant to sections 19a- 542 and 19a-543;
or substantial deterioration of the facility's financial condition that may be expected to adversely affect resident care and the continued operation of the facility, and the commissioner determines that the continued operation of the facility is in the best interest of the LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0015 of 17 R02-SB.docx } Substitute Bill No.
989 state.
The commissioner shall consider any requests for interim rate increases on file with the department from March 30, 2004, and those submitted subsequently for rate periods no earlier than April 1, 2004.
When reviewing an interim rate increase request the commissioner shall, at a minimum, consider:
(A) Existing chronic and convalescent nursing home or rest home with nursing supervision utilization in the area and projected bed need;
(B) physical plant long-term viability and the ability of the owner or purchaser to implement any necessary property improvements;
(C) licensure and certification compliance history;
(D) reasonableness of actual and projected expenses;
and (E) the ability of the facility to meet wage and benefit costs.
No interim rate shall be increased pursuant to this subsection in excess of one hundred fifteen per cent of the median rate for the facility's peer grouping, established pursuant to subdivision (2) of subsection (f) of this section, unless recommended by the commissioner and approved by the Secretary of the Office of Policy and Management after consultation with the commissioner.
Such median rates shall be published by the Department of Social Services not later than April first of each year.
In the event that a facility granted an interim rate increase pursuant to this section is sold or otherwise conveyed for value to an unrelated entity less than five years after the effective date of such rate increase, the rate increase shall be deemed rescinded and the department shall recover an amount equal to the difference between payments made for all affected rate periods and payments that would have been made if the interim rate increase was not granted.
The commissioner may seek recovery of such payments from any facility with common ownership.
With the approval of the Secretary of the Office of Policy and Management, the commissioner may waive recovery and rescission of the interim rate for good cause shown that is not inconsistent with this section, including, but not limited to, transfers to family members that were made for no value.
The commissioner shall provide written quarterly reports to the joint standing committees of the General Assembly having cognizance of matters relating to aging, human services and appropriations and the budgets of state agencies, that identify each facility requesting an interim rate increase, the amount of the requested rate increase for each LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-0016 of 17 R02-SB.docx } Substitute Bill No.
989 facility,theactiontakenbythecommissioner andthesecretarypursuant to this subsection, and estimates of the additional cost to the state for each approved interim rate increase.
Nothing in this subsection shall prohibit the commissioner from increasing the rate of a licensed chronic andconvalescent nursing homeor arest homewithnursing supervision for allowable costs associated with facility capital improvements or increasingtherateincaseofasaleofalicensedchronicandconvalescent nursing home or a rest home with nursing supervision if receivership has been imposed on such home.
For purposes of this section, "temporary nursing services agency" and "nursing personnel" have the same meaning as provided in section 19a-118.
This act shall take effect as follows and shall amend the following sections:
Section 1 from passage 19a-522a Sec.
2 from passage New section Sec.
3 from passage 19a-535(c) Sec.
4 from passage 19a-535(k) Sec.
5 July 1, 2023 New section Sec.
6 from passage New section Sec.
7 July 1, 2023 New section Sec.
8 July 1, 2023 19a-491a Sec.
9 July 1, 2023 17b-340(a) HS Joint Favorable Subst.
JUD Joint Favorable LCO {\\PRDFS1\SCOUSERS\FORZANOF\WS\2023SB-00989-17 of 17 R02-SB.docx }
⬇ Download PDF
View plain text versions (5)

Action History

  1. SIGNED BY GOVERNOR

  2. TRANSMITTED BY SECRETARY OF THE STATE TO GOVERNOR

  3. TRANSMITTED TO SECRETARY OF THE STATE

  4. PUBLIC ACT 23-186

  5. ON CONSENT CALENDAR /IN CONCURRENCE

  6. SEN. PASSED, HO. AMEND. SCH. A

  7. SEN. PASSED, SEN. AMEND. SCH. A

  8. SEN. ADOPTED HO. AMEND. SCH. A

  9. DISAGREEING ACTION,TABLED FOR CAL., SEN.

  10. TRANSMITTED PURSUANT TO JOINT RULE 17

  11. HOUSE PASSED, HOUSE AMEND. SCH. A

  12. HOUSE PASSED, SEN. AMEND. SCH. A

  13. HOUSE ADOPTED HOUSE AMEND. SCH. A

  14. HOUSE ADOPTED SEN. AMEND. SCH. A

  15. HOUSE CALENDAR NUMBER 604

  16. FAV. RPT., TABLED FOR HOUSE CALENDAR

  17. RULES SUSPENDED,TRANS.TO HOUSE

  18. SEN. PASSED, SEN. AMEND. SCH. A

  19. SEN. ADOPTED SEN. AMEND. SCH. A

  20. FAV. RPT., TAB. FOR CAL., SEN.

  21. NO NEW FILE BY COMM. ON Judiciary

  22. RPTD. OUT OF LCO

  23. FILED WITH LCO

  24. Joint Favorable

  25. REF. BY SEN. TO COMM. ON Judiciary

  26. FILE NO. 554

  27. SENATE CALENDAR NUMBER 326

  28. FAV. RPT., TAB. FOR CAL., SEN.

  29. RPTD. OUT OF LCO

  30. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 04/12/23

  31. FILED WITH LCO

  32. Joint Favorable Substitute

  33. PUBLIC HEARING 0216

  34. REF. TO JOINT COMM. ON Human Services

Sponsors

Sponsorship breakdown

Export CSV (upgrade) →

18 sponsors · 0 co-sponsors · 169 not signed on

Sponsors (18)

Co-sponsors (0)

None.

Not signed on (169)

169 members have not signed on to this bill.

Show all 169 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

public-safety healthcare labor transportation health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 989?
SB 989 is sponsored by Jason Doucette (Democratic), Mccarty, K., Kevin C. Kelly, Eleni Kavros DeGraw (Democratic), Michel, David, Patricia A. Dillon (Democratic), Patricia Billie Miller (Democratic), Lisa Seminara, Mitch Bolinsky (Republican), Aimee Berger-Girvalo (Democratic), Eric C. Berthel (Republican), Kate Farrar (Democratic), William Pizzuto (Republican), John A. Kissel (Republican), Matthew L. Lesser (Democratic), Rob Sampson (Republican), Jeff Gordon (Republican), and Herron Gaston (Democratic).
What is the current status of SB 989?
This bill has been enacted into law. Introduced February 09, 2023. Enacted.
Where can I track SB 989?
Track SB 989 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on SB 989

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of SB 989

Last checked for changes 2 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →