Connecticut 2021 Regular Session Status: In Committee Bipartisan · 2 D · 1 R cosponsors

SB 418 — AN ACT INCREASING THE PERSONAL NEEDS ALLOWANCE FOR CERTAIN LONG-TERM CARE FACILITY RESIDENTS AND AUTHORIZING A DEDUCTION FOR CONSERVATOR EXPENSES FROM THE AMOUNT OF INCOME A MEDICAID RECIPIENT APPLIES TO THE COST OF CARE.

Last action — REF. BY SEN. TO COMM. ON Appropriations

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

This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there are no live odds of enactment. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

266 added · 58 removed

266 line(s) added, 58 removed.

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General Assembly Committee Bill No.
Senate General Assembly File No.
418 January Session, 2021 LCO No.
60 January Session, 2021 Substitute Senate Bill No.
3512 Referred to Committee on AGING Introduced by:
418 Senate, March 16, 2021 The Committee on Aging reported through SEN.
(AGE) AN ACT INCREASING THE PERSONAL NEEDS ALLOWANCE FOR CERTAIN LONG-TERM CARE FACILITY RESIDENTS AND AUTHORIZING A DEDUCTION FOR CONSERVATOR EXPENSES FROM THE AMOUNT OF INCOME A MEDICAID RECIPIENT APPLIES TO THE COST OF CARE.
SLAP of the 5th Dist., Chairperson of the Committee on the part of the Senate, that the substitute bill ought to pass.
AN ACT INCREASING THE PERSONAL NEEDS ALLOWANCE FOR CERTAIN LONG-TERM CARE FACILITY RESIDENTS AND AUTHORIZING A DEDUCTION FOR CONSERVATOR EXPENSES FROM THE AMOUNT OF INCOME A MEDICAID RECIPIENT APPLIES TO THE COST OF CARE.
(b) Effective July 1, 2011, the commissioner shall provide a state supplement payment for recipients of Medicaid and the federal Supplemental Security Income Program who reside in long-term care facilities sufficient to increase their personal needs allowance to [sixty dollars] seventy-two dollars and seventy-five cents per month.
(b) [Effective July 1, 2011, the] The commissioner shall provide a state supplement payment for recipients of Medicaid and the federal Supplemental Security Income Program who reside in long-term care facilities sufficient to increase their personal needs allowance to [sixty dollars] seventy-two dollars and seventy-five cents per month.
For the purposes of this subsection, "long-term care facility" means a licensed chronic and convalescent nursing home, a chronic disease hospital, a rest home with nursing supervision, an intermediate care facility for individuals with intellectual disabilities or a state humane LCO No.
For the purposes of this subsection, "long-term care facility" means a licensed chronic and convalescent nursing home, a chronic disease sSB418 / File No.
3512 1 of 4 Committee Bill No.418 institution.
60 1 sSB418 File No.
60 hospital, a rest home with nursing supervision, an intermediate care facility for individuals with intellectual disabilities or a state humane institution.
Effective July 1, 2011, the Commissioner of Social Services shall permitpatientsresidinginnursinghomes,chronicdisease hospitalsand state humane institutions who are medical assistance recipients under sections 17b-260 to 17b-262, inclusive, 17b-264 to 17b-285, inclusive, and 17b-357 to 17b-361, inclusive, to have a monthly personal fund allowance of [sixty dollars] seventy-two dollars and seventy-five cents.
[Effective July 1, 2011, the] The Commissioner of Social Services shall permitpatientsresidinginnursinghomes,chronicdisease hospitalsand state humane institutions who are medical assistance recipients under sections 17b-260 to 17b-262, inclusive, 17b-264 to 17b-285, inclusive, and 17b-357 to 17b-361, inclusive, to have a monthly personal fund allowance of [sixty dollars] seventy-two dollars and seventy-five cents.
and (4) any other fiduciary expenses approved by the Probate Court, provided such deductions are permissible under federal law.
and (4) any other fiduciary expenses approved by the Probate Court, provided such deductions are permissible underfederallaw.Wheneversuchqualifieddeductionfrom the applied income is permitted, the Commissioner of Social Services shall increase the Medicaid payment in the amount of such deduction to the nursing home where the applicant or recipient resides or intends to reside.
(c) On or before December 31, 2022, and annually thereafter, the Commissioner of Social Services shall calculate the total amount deducted from applied income under subsection (a) of this section during the preceding fiscal year and inform the Probate Court LCO No.
sSB418 / File No.
3512 2 of 4 Committee Bill No.
60 2 sSB418 File No.
418 Administrator, in writing, ofthe amount.
60 (c) On or before December 31, 2022, and annually thereafter, the Commissioner of Social Services shall calculate the total amount deducted from applied income under subsection (a) of this section during the preceding fiscal year and inform the Probate Court Administrator, in writing, ofthe amount.
The Commissioner of Social Services shall not treat any Probate Court-approved conservator or fiduciary fee paid for services rendered as an improper transfer of assets for the purpose of obtaining Medicaid eligibility.
The Commissioner of Social Services shall not treat any conservator or fiduciary fee paid for services rendered that has been approved by the Probate Court as an improper transfer of assets for the purpose of obtaining Medicaid eligibility.
3 from passage New section Sec.
3 from passage New section sSB418 / File No.
60 3 sSB418 File No.
60 Sec.
5 July 1, 2021 17b-261(d) LCO No.
5 July 1, 2021 17b-261(d) Statement of Legislative Commissioners:
3512 3 of 4 Committee Bill No.
In Section 1(b) and Section 2, "Effective July 1, 2011, the" was changed to [Effective July 1, 2011, the] The" for clarity and consistency with the effective dates of the sections;
418 Statement of Purpose:
in Section 3(a), the last sentence was redrafted for clarity;
To increase the amount of personal income a long-term care facility resident who receives medical assistance may keep and authorize a deduction for conservator expenses from the amount of income a Medicaid recipient must apply toward the cost of his or her care.
and in Section 5(d), "Probate Court-approved conservator or fiduciary fee paid for services rendered" was changed to "conservator or fiduciary fee paid for services rendered that has been approved by the Probate Court" for clarity.
that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.] Co-Sponsors:
AGE Joint Favorable Subst.
SEN.
sSB418 / File No.
KELLY, 21st Dist.;
60 4 sSB418 File No.
SEN.
60 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.
SLAP, 5th Dist.
In general, fiscal impacts are based upon a variety of informational sources, including the analyst’s professional knowledge.
REP.
Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
PHIPPS, 100th Dist.;
OFA Fiscal Note State Impact:
REP.
Agency Affected Fund-Effect FY 22 $ FY 23 $ Social Services, Dept.
WILSON, 66th Dist.
GF - Cost 2,650,000 2,150,000 Social Services, Dept.
SEN.
GF - Revenue Gain 375,000 - Probate Court PCAF - Savings 950,000 950,000 Note:
FORMICA, 20th Dist.;
GF=General Fund;
SEN.
PCAF=Probate Court Administration Fund Municipal Impact:
OSTEN, 19th Dist.
None Explanation The bill results in the impact described below due to (1) increasing the Personal Needs Allowance, and (2) requiring the state to deduct certain conservatorship expenses when calculating the amount of income an institutionalized Medicaid enrollee must contribute towards his or her care, to the extent allowed under federal law.
S.B.
Sections 1 and 2 result in a state Medicaid cost of approximately $1.2 million annually ($2.4 million gross after considering both the state and federal share) by increasing the personal needs allowance (PNA) by $12.75 from $60 to $72.75.
418 LCO No.
Sections 3 and 4 result in increased state Medicaid costs of approximately $950,000 in FY 22 and $1.9 million in FY 23 ($950,000 in FY 23 after a transfer from the Probate Court Administration Fund) by requiring the Department of Social Services (DSS) to deduct certain conservator expenses when calculating a Medicaid-eligible nursing home resident’s applied income.
3512 4 of 4
This assumes a start date of January 1, 2022.
In addition, DSS will incur one-time Other Expenses costs of approximately $500,000 in FY 22 to enhance the state's eligibility system sSB418 / File No.
60 5 sSB418 File No.
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60 in order to implement the applied income deductions specified in the bill.
The system enhancement costs are anticipated to result in a federal grants revenue gain of $375,000, which reflects federal reimbursement for such costs under Medicaid.
These provisions also result in a net savings to the Probate Court Administration Fund (PCAF) of $950,000 in FY 22 and FY 23 associated with requiring the Probate Court to transfer funds to DSS equal to one- half the amount deducted for conservator expenses in the prior fiscal year, beginning in FY 23.
In FY 20, the Probate Court supported conservator expenses for approximately 2,500 Medicaid individuals in long-term care.
The estimated impact to the PCAF and DSS is detailed in the tables below.
Probate Court PCAF $ FY 22 FY 23 FY 24 Reduction in Conservator Reimbursement/Fee Waivers 950,000 1,900,000 1,900,000 Transfer to DSS - (950,000) (1,900,000) Net Impact to PCAF 950,000 950,000 - DSS Medicaid $ FY 22 FY 23 FY 24 Gross cost 1,900,000 3,800,000 3,800,000 State Share 950,000 1,900,000 1,900,000 Transfer from Probate - (950,000) (1,900,00) Net Impact to DSS 950,000 950,000 - DSS Other Expense/Federal Grants $ FY 22 FY 23 FY 24 Impact System Enhancements 500,000 - - Federal Grants Rev 375,000 - - Net Impact to State 125,000 - - The actual cost to DSS will depend on (1) the amount of the conservator expenses (including conservator compensation), Probate Court filing fees/expenses, and premiums for any Probate Court bonds counted as a deduction from a beneficiary’s income, and (2) the sSB418 / File No.
60 6 sSB418 File No.
60 commensurate shift to the state for Medicaid costs which would have been paid by the beneficiary.
Section 5 will result in a cost to the state Medicaid program to the extent the penalty period that would have been imposed on an individual, making them temporarily ineligible for Medicaid long term care services, is either reduced or eliminated.
The cost to the state Medicaid program will depend on the reduction or elimination of the penalty period which would have been imposed on the individual and the scope of services that otherwise would not be eligible for Medicaid coverage.
The Out Years The annualized ongoing fiscal impact for increasing the PNA is subject to the number of Medicaid residents in long-term care facilities.
The annualized ongoing fiscal impact related to sections 3 and 4 is described in the tables above.
sSB418 / File No.
60 7 sSB418 File No.
60 OLR Bill Analysis sSB 418 AN ACT INCREASING THE PERSONAL NEEDS ALLOWANCE FOR CERTAIN LONG-TERM CARE FACILITY RESIDENTS AND AUTHORIZING A DEDUCTION FOR CONSERVATOR EXPENSES FROM THE AMOUNT OF INCOME A MEDICAID RECIPIENT APPLIES TO THE COST OF CARE.
SUMMARY This bill requires the Department of Social Services (DSS) commissioner to increase, from $60 to $72.75 per month, the personal needs allowance (PNA) provided to long-term care facility residents who receive Medicaid or certain other federal or state assistance (see BACKGROUND).
The bill also requires the commissioner to amend the Medicaid state planbyDecember31,2021,toallowthedeductionofcertainconservator expenses when calculating a Medicaid-eligible nursing home resident’s applied income.
In general, these residents must spend any income they have on their care, except for certain allowances (i.e., applied income).
The bill also:
1.
requires DSS to increase a nursing home’s Medicaid payment by the amount of the reduced applied income;
2.
requires the DSS commissioner to annually notify the probate court administrator of the total conservatorship expenses deducted from the applied income in the preceding fiscal year;
3.
requires the probate court administrator to annually transfer from the Probate Court Administration Fund to DSS an amount equal to half of such conservatorship expenses for Medicaid- eligible nursing home residents for that year;
sSB418 / File No.
60 8 sSB418 File No.
60 4.
requires the DSS commissioner to deduct a baseline of $125 in conservatorship expenses from a nursing home resident’s applied income and approve deductions that exceed this amount under certain conditions;
and 5.
prohibits DSS from treating any probate court-approved conservator or fiduciary fees as an improper asset transfer for purposes of imposing a penalty period.
EFFECTIVE DATE:
July 1, 2021, except the provisions on Medicaid applied income take effect upon passage.
APPLIED INCOME Medicaid State Plan Amendment The bill requires the DSS commissioner to amend the Medicaid state plan by December 31, 2021, to allow the deduction of the following conservatorship expenses:
1.
compensation for the individual’s conservator, in amounts approved by the probate court;
2.
probate court filing fees and expenses, including conservatorship fees, fiduciary accounting fees, and miscellaneous fees (see BACKGROUND);
3.
premiums for any bond the probate court requires;
and 4.
any other fiduciary expenses the probate court approved that are permissible under federal law.
Under the bill, whenever these conservator fees and expenses are deducted from the applied income, DSS must increase the nursing home’s Medicaid payment by the amount of the reduced applied income.
The DSS commissioner must seek approval from the federal Centers for Medicare and Medicaid Services (CMS) for the state plan amendment.
The bill applies to conservator expenses incurred on or sSB418 / File No.
60 9 sSB418 File No.
60 after October 1, 2021, or the date CMS approves the state plan amendment, whichever is later.
Notification and Transfer of Funds The bill requires the DSS commissioner, by December 31, 2022, and annually thereafter, to calculate the total conservatorship expenses deducted from a nursing home resident’s applied income in the preceding fiscal year and inform the probate court administrator in writing of the amount.
Within 30 days after receiving the commissioner’s calculation, the probate court administrator must transfer from the Probate Court Administration Fund to DSS funds equal to half of the conservatorship expenses for that year.
Deduction Amount Under the bill, DSS must deduct from a conserved nursing home resident’s applied income a baseline of $125 per month in conservatorship expenses.
The DSS commissioner must approve deductions above this amount if they are approved by the probate court (1) when the conserved nursing home resident is initially granted Medicaid benefits and (2) upon eligibility redeterminations.
PENALTY PERIOD Under federal law, DSS must impose a penalty period when individuals transfer assets for less than fair market value in the 60 months before applying for Medicaid coverage (i.e., improper asset transfer).
The bill prohibits DSS from treating any probate court- approved conservator or fiduciary fees as an improper asset transfer.
By law, the penalty period (in months) is generally calculated by dividing the value of all assets transferred during the 60 months before application by the average monthly cost to a private patient of nursing facility services in the state or community.
Medicaid does not pay for long-term care services and supports during the penalty period.
BACKGROUND sSB418 / File No.
60 10 sSB418 File No.
60 Medicaid Personal Needs Allowance Covered facilities include nursing homes, chronic disease hospitals, intermediate care facilities for individuals with intellectual disabilities, and state humane institutions.
Residents of these facilities who receive Medicaid apply their monthly income (e.g., Social Security) towards the cost of their care.
But federal law allows them to keep a portion of this income (the PNA) to pay for incidental items, such as haircuts, telephone expenses, newspapers, or hobbies.
Facilities deposit the PNA into residents’ personal fund accounts.
Probate Court Fees By law, the general fee for most probate court matters related to conservatorship is $250 (CGS § 45a-106a).
This includes filing motions to (1)appoint aconservator,(2)change residence or placement inalong- term care facility, and (3) terminate a conservatorship.
The basic fee for a fiduciary to file an account in the probate court in any matter other than estate settlement is at least $50 and up to $500 per year, based on a formula (CGS § 45a-108a).
The lawalso allowstheprobate court to charge feesfor miscellaneous expenses (i.e., filing or copying certain documents) (CGS § 45a-109).
The law allows an indigent petitioner or applicant to the probate court to apply for a fee waiver (CGS § 45a-111).
COMMITTEE ACTION Aging Committee Joint Favorable Substitute Yea 15 Nay 0 (03/02/2021) sSB418 / File No.
60 11
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Action History

  1. REF. BY SEN. TO COMM. ON Appropriations

  2. FILE NO. 60

  3. SENATE CALENDAR NUMBER 72

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

  5. RPTD. OUT OF LCO

  6. REFERRED TO Office of Legislative Research AND Office of Fiscal Analysis 03/15/21

  7. FILED WITH LCO

  8. Joint Favorable Substitute

  9. PUBLIC HEARING 0223

  10. REF. TO JOINT COMM. ON Aging

  11. DRAFTED BY COMMITTEE

  12. Vote to Draft

  13. REF. TO JOINT COMM. ON Aging

Sponsors

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7 sponsors · 0 co-sponsors · 180 not signed on

Sponsors (7)

Co-sponsors (0)

None.

Not signed on (180)

180 members have not signed on to this bill.

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Frequently asked questions

Who sponsors SB 418?
SB 418 is sponsored by Derek Slap (Democratic), Wilson, David T., Tony Hwang (Republican), Phipps, Quentin W., Formica, Paul M., Catherine A. Osten (Democratic), and Kevin C. Kelly.
What is the current status of SB 418?
This bill died with 2021 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 418?
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