Bill Text: CT SB00017 | 2016 | General Assembly | Comm Sub


Bill Title: An Act Implementing The Governor's Budget Recommendations For Human Services.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2016-05-03 - Senate Recommitted to Human Services [SB00017 Detail]

Download: Connecticut-2016-SB00017-Comm_Sub.html

General Assembly

 

Substitute Bill No. 17

    February Session, 2016

 

*_____SB00017HS____031816____*

AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HUMAN SERVICES.

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

Section 1. (NEW) (Effective from passage) The Commissioners of Developmental Services and Social Services and the Secretary of the Office of Policy and Management shall develop and implement, within available appropriations, a continuum of services for persons with intellectual disabilities. The partnership shall be known as the Intellectual Disabilities Partnership. The Intellectual Disabilities Partnership shall seek to increase access to quality services for persons with intellectual disabilities by: (1) Expanding individualized and community-based services; (2) maximizing federal revenue to fund services for persons with intellectual disabilities; (3) converting grant-funded services to rate-based, fee-for-service payment systems where possible; (4) exploring the feasibility of services management by an administrative services or managed care organization; (5) exploring opportunities for private and other third-party payments; (6) developing models to support persons with intellectual disabilities in supportive housing; (7) reducing unnecessary use of institutional and residential services; (8) improving administrative oversight and efficiencies; (9) monitoring individual outcomes, provider performance and overall program performance; and (10) identifying strategies to make resources available to address the waiting list for residential services in the Department of Developmental Services.

Sec. 2. Section 17a-227 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) No person, firm or corporation shall operate within this state a community living arrangement or community companion home which it owns, leases or rents for the lodging, care or treatment of persons with intellectual disability, Prader-Willi syndrome or autism spectrum disorder unless such person, firm or corporation, upon written application, verified by oath, has obtained a license issued by the Department of Developmental Services.

(b) The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to insure the comfort, safety, adequate medical care and treatment of such persons at the residential facilities described in subsection (a) of this section. Such regulations shall include requirements that: (1) All residential facility staff be certified in cardiopulmonary resuscitation in a manner and time frame prescribed by the commissioner; (2) records of staffing schedules and actual staff hours worked, by residential facility, be available for inspection by the department upon advance notice; (3) each residential facility develop and implement emergency plans and staff training to address emergencies that may pose a threat to the health and safety of the residents of the facility; (4) department staff verify during quality service reviews and licensing inspections, that (A) staff is adequately trained to respond in an emergency, and (B) a summary of information on each resident is available to emergency medical personnel for use in an emergency; (5) all residential facilities serving persons with Down syndrome fifty years of age or older have at least one staff member trained in Alzheimer's disease and dementia symptoms and care; and (6) not less than one-half of the quality service reviews, licensing inspections or facility visits conducted by the department after initial licensure are unannounced.

(c) After receiving an application and making such investigation as is deemed necessary and after finding the specified requirements to have been fulfilled, the department shall grant a license to such applicant to operate a facility of the character described in such application, which license shall specify the name of the person to have charge and the location of each facility operated under the license. Any person, firm or corporation aggrieved by any requirement of the regulations or by the refusal to grant any license may request an administrative hearing in accordance with the provisions of chapter 54. If the licensee of any such facility desires to place in charge thereof a person other than the one specified in the license, application shall be made to the Department of Developmental Services, in the same manner as provided for the original application, for permission to make such change. Such application shall be acted upon not later than ten calendar days from the date of the filing of the application. Each such license shall be renewed annually upon such terms as may be established by regulations and may be revoked by the department upon proof that the facility for which such license was issued is being improperly operated, or for the violation of any of the provisions of this section or of the regulations adopted pursuant to this section, provided the licensee shall first be given a reasonable opportunity to be heard in reference to such proposed revocation. Any person, firm or corporation aggrieved by such revocation may request an administrative hearing in accordance with the provisions of chapter 54. Each person, firm or corporation, upon filing an application under the provisions of this section for a license for a community living arrangement, shall pay to the State Treasurer the sum of fifty dollars.

(d) The Department of Developmental Services may contract, within available appropriations, with any qualified provider for the operation of a community-based residential facility, provided the qualified provider is licensed by the department to operate such facilities. The department shall include in all contracts with such licensed qualified providers, provisions requiring the department to (1) conduct periodic reviews of contract performance, and (2) take progressive enforcement actions if the department finds poor performance or noncompliance with the contract, as follows: (A) The licensed qualified provider may be placed on a strict schedule of monitoring and oversight by the department; (B) the licensed qualified provider may be placed on a partial-year contract; and (C) payments due under the contract may be reduced by specific amounts on a monthly basis until the licensed qualified provider complies with the contract. If compliance cannot be achieved, the department shall terminate the contract.

(e) The Commissioner of Developmental Services and the Commissioner of Social Services shall approve any change in ownership of any licensed community living arrangement operated by a private provider of services under the Department of Developmental Services before such change in ownership takes place. Change in ownership includes, but is not limited to, a sale to a new provider, a transfer of ownership or any other manner in which a licensed community living arrangement is divested from one provider to another. The value of the property upon the change in ownership shall equal the fair rental value at the date of such transfer for the remaining years of useful life.

(f) If a property licensed as a community living arrangement operated by a private provider of services under the Department of Developmental Services is sold and the residents are transitioned to another provider in a different property, the original provider shall have an adjustment on a future development of a community living arrangement for the amount that represents the residual value of the original property at the date of the sale.

[(e)] (g) The department may contract with any person, firm or corporation to provide residential support services for persons with intellectual disability, Prader-Willi syndrome or autism spectrum disorder who reside in settings which are not licensed by the department. The commissioner shall adopt regulations, in accordance with the provisions of chapter 54, to ensure the safety, adequate supervision and support of persons receiving such residential support services.

[(f)] (h) Any person, firm or corporation who operates any facility contrary to the provisions of this section shall be fined not more than one thousand dollars or imprisoned not more than six months or both. Any person, firm or corporation who operates any facility contrary to the regulations adopted pursuant to subsection (b) of this section shall be fined not more than one thousand dollars.

Sec. 3. Section 17a-215 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

The Department of [Developmental] Social Services shall serve as the lead agency to coordinate, where possible, the functions of the several state agencies which have responsibility for providing services to persons diagnosed with autism spectrum disorder.

Sec. 4. Section 17a-215c of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) There is established a Division of Autism Spectrum Disorder Services within the Department of [Developmental] Social Services.

(b) The Department of [Developmental] Social Services [shall] may adopt regulations, in accordance with chapter 54, to define the term "autism spectrum disorder", establish eligibility standards and criteria for the receipt of services by any resident of the state diagnosed with autism spectrum disorder, regardless of age, and data collection, maintenance and reporting processes. The [commissioner] Commissioner of Social Services may implement policies and procedures necessary to administer the provisions of this section prior to adoption of such regulations, provided the commissioner shall publish notice of intent to adopt such regulations not later than twenty days after implementation of such policies and procedures. Any such policies and procedures shall be valid until such regulations are adopted.

(c) The Division of Autism Spectrum Disorder Services may, within available appropriations, research, design and implement the delivery of appropriate and necessary services and programs for all residents of the state with autism spectrum disorder. Such services and programs may include the creation of: (1) Autism-specific early intervention services for any child under the age of three diagnosed with autism spectrum disorder; (2) education, recreation, habilitation, vocational and transition services for individuals age three to twenty-one, inclusive, diagnosed with autism spectrum disorder; (3) services for adults over the age of twenty-one diagnosed with autism spectrum disorder; and (4) related autism spectrum disorder services deemed necessary by the Commissioner of [Developmental] Social Services.

(d) The Department of [Developmental] Social Services shall serve as the lead state agency for the purpose of the federal Combating Autism Act, P.L. 109-416, as amended from time to time, and for applying for and receiving funds and performing any related responsibilities concerning autism spectrum disorder which are authorized pursuant to any state or federal law.

(e) [On or before February 1, 2009, and annually thereafter, the] The Department of [Developmental] Social Services may make recommendations to the Governor and the joint standing committee of the General Assembly having cognizance of matters relating to [public health] human services concerning legislation and funding required to provide necessary services to persons diagnosed with autism spectrum disorder.

(f) The Division of Autism Spectrum Disorder Services shall research and locate possible funding streams for the continued development and implementation of services for persons diagnosed with autism spectrum disorder but not with intellectual disability. The division shall take all necessary action [, in coordination with the Department of Social Services,] to secure Medicaid reimbursement for home and community-based individualized support services for adults diagnosed with autism spectrum disorder but not with intellectual disability. Such action may include applying for a Medicaid waiver pursuant to Section 1915(c) of the Social Security Act, as amended from time to time, in order to secure the funding for such services.

(g) The Division of Autism Spectrum Disorder Services shall, within available appropriations: (1) Design and implement a training initiative that shall include training to develop a workforce; and (2) develop a curriculum specific to autism spectrum disorder in coordination with the Board of Regents for Higher Education.

(h) The case records of the Division of Autism Spectrum Disorder Services maintained by the division for any purpose authorized pursuant to subsections (b) to (g), inclusive, of this section shall be subject to the same confidentiality requirements, under state and federal law, that govern all client records maintained by the Department of [Developmental] Social Services.

(i) The Commissioner of Social Services [, in consultation with the Commissioner of Developmental Services,] may seek approval of an amendment to the state Medicaid plan or a waiver from federal law, whichever is sufficient and most expeditious, to establish and implement a Medicaid-financed home and community-based program to provide community-based services and, if necessary, housing assistance, to adults diagnosed with autism spectrum disorder but not with intellectual disability.

(j) On or before January 1, 2008, and annually thereafter, the Commissioner of Social Services, [in consultation with the Commissioner of Developmental Services, and] in accordance with the provisions of section 11-4a, shall submit a report to the joint standing committee of the General Assembly having cognizance of matters relating to [public health] human services, on the status of any amendment to the state Medicaid plan or waiver from federal law as described in subsection (i) of this section and on the establishment and implementation of the program authorized pursuant to subsection (i) of this section.

(k) The Autism Spectrum Disorder Advisory Council, established pursuant to section 17a-215d, as amended by this act, shall advise the Commissioner of [Developmental] Social Services on all matters relating to autism.

(l) The Commissioner of [Developmental] Social Services, in consultation with the Autism Spectrum Disorder Advisory Council, shall designate services and interventions that demonstrate, in accordance with medically established and research-based best practices, empirical effectiveness for the treatment of autism spectrum disorder. The commissioner shall update such designations periodically and whenever the commissioner deems it necessary to conform to changes generally recognized by the relevant medical community in evidence-based practices or research.

Sec. 5. Section 17a-215d of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) There is established the Autism Spectrum Disorder Advisory Council. The council shall consist of the following members: (1) The Commissioner of [Developmental] Social Services, or the commissioner's designee; (2) the Commissioner of Children and Families, or the commissioner's designee; (3) the Commissioner of Education, or the commissioner's designee; (4) the Commissioner of Mental Health and Addiction Services, or the commissioner's designee; (5) the Commissioner of Public Health, or the commissioner's designee; (6) the Commissioner of Rehabilitation Services, or the commissioner's designee; (7) the Commissioner of [Social] Developmental Services, or the commissioner's designee; (8) the Commissioner of the Office of Early Childhood, or the commissioner's designee; (9) the Secretary of the Office of Policy and Management, or the secretary's designee; [(9)] (10) the executive director of the Office of Protection and Advocacy for Persons with Disabilities, or the executive director's designee; [(10)] (11) two persons with autism spectrum disorder, one each appointed by the Governor and the speaker of the House of Representatives; [(11)] (12) two persons who are parents or guardians of a child with autism spectrum disorder, one each appointed by the Governor and the minority leader of the Senate; [(12)] (13) two persons who are parents or guardians of an adult with autism spectrum disorder, one each appointed by the president pro tempore of the Senate and the majority leader of the House of Representatives; [(13)] (14) two persons who are advocates for persons with autism spectrum disorder, one each appointed by the Governor and the speaker of the House of Representatives; [(14)] (15) two persons who are licensed professionals working in the field of autism spectrum disorder, one each appointed by the Governor and the majority leader of the Senate; [(15)] (16) two persons who provide services for persons with autism spectrum disorder, one each appointed by the Governor and the minority leader of the House of Representatives; [(16)] (17) two persons who shall be representatives of an institution of higher education in the state with experience in the field of autism spectrum disorder, one each appointed by the Governor and the president pro tempore of the Senate; and [(17)] (18) one person who is a physician who treats or diagnoses persons with autism spectrum disorder, appointed by the Governor.

(b) The council shall have two chairpersons, one of whom shall be the Commissioner of [Developmental] Social Services, or the commissioner's designee, and one of whom shall be elected by the members of the council. The council shall make rules for the conduct of its affairs. The council shall meet not less than four times per year and at such other times as requested by the chairpersons. Council members shall serve without compensation.

(c) The council shall advise the Commissioner of [Developmental] Social Services concerning: (1) Policies and programs for persons with autism spectrum disorder; (2) services provided by the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services; and (3) implementation of the recommendations resulting from the autism feasibility study. The council may make recommendations to the commissioner for policy and program changes to improve support services for persons with autism spectrum disorder.

(d) The Autism Spectrum Disorder Advisory Council shall terminate on June 30, 2018.

Sec. 6. Subdivision (2) of section 17a-247a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(2) "Authorized agency" means any agency authorized in accordance with the general statutes to conduct abuse and neglect investigations and responsible for issuing or carrying out protective services for persons with intellectual disability or individuals receiving services or funding from the [department's] Department of Social Services' Division of Autism Spectrum Disorder Services.

Sec. 7. Section 17a-247f of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) For purposes of this section "individual who receives services from the [department's] Department of Social Services' Division of Autism Spectrum Disorder Services" means an individual eighteen years of age to sixty years of age, inclusive, who receives funding or services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services.

(b) (1) The [commissioner] Commissioner of Social Services may investigate any reports alleging abuse or neglect of an individual who receives services from the [department's] Department of Social Services' Division of Autism Spectrum Disorder Services. Such investigation shall include a visit to the residence of the individual reported to have been abused or neglected and consultation with persons having knowledge of the facts surrounding such allegation. All state, local and private agencies shall have a duty to cooperate with any such investigation, including the release of complete records of such individual for review, inspection and copying, except where such individual refuses to permit his or her record to be released. All such records shall be kept confidential by the [department] Department of Social Services.

(2) Upon completion of the investigation of each case, the [commissioner] Commissioner of Social Services shall prepare written findings that shall include a determination as to whether abuse or neglect has occurred and recommendations as to whether protective services are needed. The [commissioner] Commissioner of Social Services, except in cases where the parent or guardian of the individual reported to be abused or neglected is the alleged perpetrator of abuse or neglect or is residing with the alleged perpetrator, shall notify the parents or guardian, if any, of such individual if a report of abuse or neglect is made that the department determines warrants investigation. The [commissioner] Commissioner of Social Services shall provide the parents or guardians who the [commissioner] Commissioner of Social Services determines are entitled to such information with further information upon request. The person making the allegation of abuse or neglect and the Director of the Office of Protection and Advocacy for Persons with Disabilities shall be notified of the findings resulting from the investigation, upon such person's request.

(3) Neither the original allegation of abuse or neglect nor the investigation report of the investigator that includes findings and recommendations shall be deemed a public record for purposes of section 1-210. The name of the person making the original allegation shall not be disclosed to any person unless the person making the original allegation consents to such disclosure or unless a judicial proceeding results therefrom.

Sec. 8. Subsection (a) of section 17a-270 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) There is established a Council on Developmental Services which shall consist of fifteen members appointed as follows: Eight shall be appointed by the Governor, for two-year terms, one of whom shall be a doctor of medicine, one of whom shall be a person with intellectual disability who is receiving services from the Department of Developmental Services and at least two of whom shall be a relative or a guardian of a person with intellectual disability; six shall be appointed by members of the General Assembly for two-year terms, one of whom shall be a relative or guardian of a person with intellectual disability, appointed by the speaker of the House, one of whom shall be appointed by the minority leader of the House, one of whom shall be appointed by the president pro tempore of the Senate, one of whom shall be a person with intellectual disability and autism spectrum disorder who is receiving, or has received, services from the [department's Division of Autism Spectrum Disorder Services] department appointed by the majority leader of the House, one of whom shall be appointed by the majority leader of the Senate, and one of whom shall be a relative or guardian of a person with intellectual disability, appointed by the minority leader of the Senate; and one of whom shall be a member of the board of trustees of the Southbury Training School, appointed by said board for a term of one year. No member of the council may serve more than three consecutive terms, except that a member may continue to serve until a successor is appointed. The members of the council shall serve without compensation except for necessary expenses incurred in performing their duties. The Commissioner of Developmental Services or the commissioner's designee shall be an ex-officio member of the Council on Developmental Services without vote and shall attend its meetings. No employee of any state agency engaged in the care or training of persons with intellectual disability shall be eligible for appointment to the council. The council shall appoint annually, from among its members, a chairperson, vice chairperson and secretary. The council may make rules for the conduct of its affairs. The council shall meet at least six times per year and at other times upon the call of the chair or the written request of any two members.

Sec. 9. Section 17b-2 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

The Department of Social Services is designated as the state agency for the administration of (1) the Connecticut energy assistance program pursuant to the Low Income Home Energy Assistance Act of 1981; (2) the state plan for vocational rehabilitation services for the fiscal year ending June 30, 1994; (3) the refugee assistance program pursuant to the Refugee Act of 1980; (4) the legalization impact assistance grant program pursuant to the Immigration Reform and Control Act of 1986; (5) the temporary assistance for needy families program pursuant to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996; (6) the Medicaid program pursuant to Title XIX of the Social Security Act; (7) the supplemental nutrition assistance program pursuant to the Food and Nutrition Act of 2008; (8) the state supplement to the Supplemental Security Income Program pursuant to the Social Security Act; (9) the state child support enforcement plan pursuant to Title IV-D of the Social Security Act; [and] (10) the state social services plan for the implementation of the social services block grants and community services block grants pursuant to the Social Security Act; and (11) services for persons with autism spectrum disorder in accordance with sections 17a-215, as amended by this act, and 17a-215c, as amended by this act.

Sec. 10. Subsection (h) of section 26-30 of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(h) The Commissioner of Energy and Environmental Protection may issue a group fishing license to any tax-exempt organization qualified under Section 501(c)(3) of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, for the purpose of conducting a group fishing event or events for persons: (1) With a service-related or other disability who receive services at a facility of the United States Department of Veterans Affairs Connecticut Healthcare System, (2) who receive mental health or addiction services from: (A) The Department of Mental Health and Addiction Services, (B) state-operated facilities, as defined in section 17a-458, or (C) programs or facilities funded by the Department of Mental Health and Addiction Services, as provided for in sections 17a-468b, 17a-469, 17a-673 and 17a-676, (3) with intellectual disability [or diagnosed with autism spectrum disorder] who receive services from the Department of Developmental Services, as provided for in section 17a-217, or from facilities licensed by the Department of Developmental Services, as provided for in section 17a-227, as amended by this act, [or] (4) diagnosed with autism spectrum disorder who receive services from the Department of Social Services, or (5) receiving care from the Department of Children and Families, as provided for in section 17a-94, or from programs or child-care facilities licensed pursuant to section 17a-145 or 17a-147. Any such organization shall conduct not more than fifty such events, including marine and inland water events, in any calendar year and each such event shall be limited to not more than fifty persons. Application for such a group fishing license shall be submitted once per calendar year on a form prescribed by the commissioner and with the necessary fee and shall provide such information as required by the commissioner. All fishing activities conducted pursuant to such group license shall be supervised by staff or volunteers of the organization conducting the event or events. Such staff or volunteers shall possess such group fishing license at the site of any such event or events. Each such staff member or volunteer shall have a license to fish. Such organization shall, not later than ten days after such group fishing event, report to the commissioner, on forms provided by the commissioner, information on the results of such event. Such information shall include, but not be limited to, the total: [(i)] (A) Number of participants, [(ii)] (B) hours fished, [(iii)] (C) number of each species caught, and [(iv)] (D) number of each species not released. Such organization shall not charge a fee to any person that participates in any such group fishing event conducted pursuant to such group fishing license and any such group fishing event shall not be used by such organization as a fund raising event.

Sec. 11. Subdivision (4) of subsection (a) of section 38a-514b of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(4) "Behavioral therapy" means any interactive behavioral therapies derived from evidence-based research and consistent with the services and interventions designated by the Commissioner of [Developmental] Social Services pursuant to subsection (l) of section 17a-215c, as amended by this act, including, but not limited to, applied behavior analysis, cognitive behavioral therapy, or other therapies supported by empirical evidence of the effective treatment of individuals diagnosed with autism spectrum disorder, that are: (A) Provided to children less than twenty-one years of age; and (B) provided or supervised by (i) a behavior analyst who is certified by the Behavior Analyst Certification Board, (ii) a licensed physician, or (iii) a licensed psychologist. For the purposes of this subdivision, behavioral therapy is "supervised by" such behavior analyst, licensed physician or licensed psychologist when such supervision entails at least one hour of face-to-face supervision of the autism spectrum disorder services provider by such behavior analyst, licensed physician or licensed psychologist for each ten hours of behavioral therapy provided by the supervised provider.

Sec. 12. Subdivision (4) of subsection (a) of section 38a-488b of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(4) "Behavioral therapy" means any interactive behavioral therapies derived from evidence-based research and consistent with the services and interventions designated by the Commissioner of [Developmental] Social Services pursuant to subsection (l) of section 17a-215c, as amended by this act, including, but not limited to, applied behavior analysis, cognitive behavioral therapy, or other therapies supported by empirical evidence of the effective treatment of individuals diagnosed with autism spectrum disorder, that are: (A) Provided to children less than twenty-one years of age; and (B) provided or supervised by (i) a behavior analyst who is certified by the Behavior Analyst Certification Board, (ii) a licensed physician, or (iii) a licensed psychologist. For the purposes of this subdivision, behavioral therapy is "supervised by" such behavior analyst, licensed physician or licensed psychologist when such supervision entails at least one hour of face-to-face supervision of the autism spectrum disorder services provider by such behavior analyst, licensed physician or licensed psychologist for each ten hours of behavioral therapy provided by the supervised provider.

Sec. 13. Subdivision (11) of section 46a-11a of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(11) "Individual who receives services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services" means an individual eighteen years of age to sixty years of age, inclusive, who receives funding or services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services.

Sec. 14. Section 46a-11b of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(a) Any physician or surgeon licensed under the provisions of chapter 370, any resident physician or intern in any hospital in this state, whether or not so licensed, any registered nurse, any person paid for caring for persons in any facility and any licensed practical nurse, medical examiner, dental hygienist, dentist, occupational therapist, optometrist, chiropractor, psychologist, podiatrist, social worker, school teacher, school principal, school guidance counselor, school paraprofessional, mental health professional, physician assistant, licensed or certified substance abuse counselor, licensed marital and family therapist, speech and language pathologist, clergyman, police officer, pharmacist, physical therapist, licensed professional counselor or sexual assault counselor or domestic violence counselor, as defined in section 52-146k, who has reasonable cause to suspect or believe that any person with intellectual disability or any individual who receives services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services has been abused or neglected shall, as soon as practicable but not later than seventy-two hours after such person has reasonable cause to suspect or believe that a person with intellectual disability or any individual who receives services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services has been abused or neglected, report such information or cause a report to be made in any reasonable manner to the director or persons the director designates to receive such reports. Such initial report shall be followed up by a written report not later than five calendar days after the initial report was made. Any person required to report under this subsection who fails to make such report shall be fined not more than five hundred dollars.

(b) Such report shall contain the name and address of the allegedly abused or neglected person, a statement from the person making the report indicating his or her belief that such person has intellectual disability or receives funding or services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services, information supporting the supposition that such person is substantially unable to protect himself or herself from abuse or neglect, information regarding the nature and extent of the abuse or neglect and any other information that the person making such report believes might be helpful in an investigation of the case and the protection of such person with intellectual disability or who receives funding or services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services.

(c) Each facility, as defined in section 46a-11a, as amended by this act, shall inform residents of their rights and the staff of their responsibility to report abuse or neglect and shall establish appropriate policies and procedures to facilitate such reporting.

(d) Any other person having reasonable cause to believe that a person with intellectual disability or an individual who receives services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services is being or has been abused or neglected may report such information, in any reasonable manner, to the director or to the director's designee.

(e) Any person who makes any report pursuant to sections 46a-11a to 46a-11g, inclusive, as amended by this act, or who testifies in any administrative or judicial proceeding arising from such report shall be immune from any civil or criminal liability on account of such report or testimony, except for liability for perjury, unless such person acted in bad faith or with malicious purpose. Any person who obstructs, hinders or endangers any person reporting or investigating abuse or neglect or providing protective services or who makes a report in bad faith or with malicious purpose and who is not subject to any other penalty shall be fined not more than five hundred dollars. No resident or employee of a facility, as defined in section 46a-11a, as amended by this act, shall be subject to reprisal or discharge because of his actions in reporting pursuant to sections 46a-11a to 46a-11g, inclusive, as amended by this act.

(f) For purposes of said sections, the treatment of any person with intellectual disability or any individual who receives services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services by a Christian Science practitioner, in lieu of treatment by a licensed practitioner of the healing arts, shall not of itself constitute grounds for the implementation of protective services.

(g) When the director of the Office of Protection and Advocacy for Persons with Disabilities or persons designated by said director are required to investigate or monitor abuse or neglect reports that are referred to the Office of Protection and Advocacy for Persons with Disabilities from another agency, all provisions of this section shall apply to any investigation or monitoring of such case or report.

Sec. 15. Subsection (b) of section 46a-11c of the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(b) The director, upon receiving a report that an individual who receives services from the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services, allegedly is being or has been abused or neglected, shall make an initial determination whether such individual receives funding or services from said division, shall determine if the report warrants investigation and shall cause, in cases that so warrant, a prompt, thorough evaluation, as described in subsection (b) of section 17a-247f, as amended by this act, to be made by the Department of [Developmental] Social Services to determine whether the individual has been abused or neglected.

Sec. 16. Section 17a-215e of the 2016 supplement to the general statutes is repealed and the following is inserted in lieu thereof (Effective July 1, 2016):

Not later than February 1, [2016] 2017, and annually thereafter, the Commissioner of [Developmental] Social Services shall report, in accordance with the provisions of section 11-4a, to the joint standing committee of the General Assembly having cognizance of matters relating to [public health] human services concerning the activities of the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services, established pursuant to section 17a-215c, as amended by this act, and the Autism Spectrum Disorder Advisory Council, established pursuant to section 17a-215d, as amended by this act. Such report shall include, but not be limited to: (1) The number and ages of persons with autism spectrum disorder who are served by the Department of [Developmental] Social Services' Division of Autism Spectrum Disorder Services and, when practicable to report, the number and ages of such persons who are served by other state agencies; (2) the number and ages of persons with autism spectrum disorder on said division's waiting list for Medicaid waiver services; (3) the type of Medicaid waiver services currently provided by the department to persons with autism spectrum disorder; (4) a description of the unmet needs of persons with autism spectrum disorder on said division's waiting list; (5) the projected estimates for a five-year period of the costs to the state due to such unmet needs; (6) measurable outcome data for persons with autism spectrum disorder who are eligible to receive services from said division, including, but not limited to, (A) the number of such persons who are enrolled in postsecondary education, (B) the employment status of such persons, and (C) a description of such persons' living arrangements; and (7) a description of new initiatives and proposals for new initiatives that are under consideration.

Sec. 17. (NEW) (Effective from passage) Except as otherwise provided in the general statutes, "autism spectrum disorder" has the same meaning as is set forth in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders".

Sec. 18. Subsection (e) of section 5-259 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

(e) Notwithstanding the provisions of subsection (a) of this section, [(1)] vending stand operators eligible for membership in the state employees' retirement system pursuant to section 5-175a shall be eligible for coverage under the group hospitalization and medical and surgical insurance plans procured under this section, provided the cost for such operators' insurance coverage shall be paid by the Department of Rehabilitation Services from vending machine income pursuant to section 10-303. [, and (2) blind persons employed in workshops, established pursuant to section 10-298a, on December 31, 2002, shall be eligible for coverage under the group hospitalization and medical and surgical insurance plans procured under this section, provided the cost for such persons' insurance coverage shall be paid by the Department of Rehabilitation Services.]

Sec. 19. Section 17b-131 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

When a person in any town, or sent from such town to any licensed institution or state humane institution, dies or is found dead therein and does not leave sufficient estate or has no legally liable relative able to pay the cost of a proper funeral and burial, or upon the death of any beneficiary under the state-administered general assistance program, the Commissioner of Social Services shall give to such person a proper funeral and burial, and shall pay a sum not exceeding one thousand [four] two hundred dollars as an allowance toward the funeral expenses of such deceased, said sum to be paid, upon submission of a proper bill, to the funeral director, cemetery or crematory, as the case may be. Such payment for funeral and burial expenses shall be reduced by (1) the amount in any revocable or irrevocable funeral fund, (2) any prepaid funeral contract, (3) the face value of any life insurance policy owned by the decedent, and (4) contributions in excess of three thousand two hundred dollars toward such funeral and burial expenses from all other sources including friends, relatives and all other persons, organizations, veterans' and other benefit programs and other agencies.

Sec. 20. Section 17b-84 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective July 1, 2016):

Upon the death of any beneficiary under the state supplement or the temporary family assistance program, the Commissioner of Social Services shall order the payment of a sum not to exceed one thousand [four] two hundred dollars as an allowance toward the funeral and burial expenses of such deceased. The payment for funeral and burial expenses shall be reduced by the amount in any revocable or irrevocable funeral fund, prepaid funeral contract or the face value of any life insurance policy owned by the recipient. Contributions may be made by any person for the cost of the funeral and burial expenses of the deceased over and above the sum established under this section without thereby diminishing the state's obligation.

Sec. 21. (Effective July 1, 2016) Notwithstanding the rate-setting provisions set forth in chapters 319v and 319y of the general statutes, or regulations adopted thereunder, the state rates of payments in effect for the fiscal year ending June 30, 2016, for residential care homes, community living arrangements and community companion homes that receive the flat rate for residential services, as provided pursuant to section 17-311-54 of the regulations of Connecticut state agencies, shall remain in effect until June 30, 2017.

Sec. 22. Section 17b-239 of the 2016 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

[(a) (1) Until the time subdivision (2) of this subsection is effective, the rate to be paid by the state to hospitals receiving appropriations granted by the General Assembly and to freestanding chronic disease hospitals providing services to persons aided or cared for by the state for routine services furnished to state patients, shall be based upon reasonable cost to such hospital, or the charge to the general public for ward services or the lowest charge for semiprivate services if the hospital has no ward facilities, imposed by such hospital, whichever is lowest, except to the extent, if any, that the commissioner determines that a greater amount is appropriate in the case of hospitals serving a disproportionate share of indigent patients. Such rate shall be promulgated annually by the Commissioner of Social Services within available appropriations.]

[(2) On or after July 1, 2013,] (a) Medicaid rates paid to acute care hospitals, including children's hospitals, shall be based on diagnosis-related groups established and periodically rebased by the Commissioner of Social Services in accordance with 42 USC 1396a(a)(30)(A), provided the Department of Social Services completes a fiscal analysis of the impact of such rate payment system on each hospital. The commissioner shall, in accordance with the provisions of section 11-4a, file a report on the results of the fiscal analysis not later than six months after implementing the rate payment system with the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies. Within available appropriations, the commissioner shall annually determine in-patient payments for each hospital by multiplying diagnosis-related group relative weights by a base rate. Over a period of up to four years beginning on or after January 1, 2016, within available appropriations and at the discretion of the commissioner, the Department of Social Services shall transition hospital-specific, diagnosis-related group base rates to state-wide diagnosis-related group base rates by peer groups determined by the commissioner. For the purposes of this subsection, "peer group" means a group comprised of one of the following categories of acute care hospitals: Privately operated acute care hospitals, publicly operated acute care hospitals, or acute care children's hospitals licensed by the Department of Public Health. At the discretion of the Commissioner of Social Services, the peer group for privately operated acute care hospitals may be further subdivided into peer groups for privately operated acute care hospitals. For inpatient hospital services that the Commissioner of Social Services determines are not appropriate for reimbursement based on diagnosis-related groups, the commissioner shall reimburse for such services using any other methodology that complies with 42 USC 1396a(a)(30)(A). Within available appropriations, the commissioner may, in his or her discretion, make additional payments to hospitals based on criteria to be determined by the commissioner. Upon the conversion to a hospital payment methodology based on diagnosis-related groups, the commissioner shall evaluate payments for all hospital services, including, but not limited to, a review of pediatric psychiatric inpatient units within hospitals. The commissioner may, within available appropriations, implement a pay-for-performance program for pediatric psychiatric inpatient care. Nothing contained in this section shall authorize Medicaid payment by the state to any such hospital in excess of the charges made by such hospital for comparable services to the general public.

(b) Effective October 1, 1991, the rate to be paid by the state for the cost of special services rendered by such hospitals shall be established annually by the commissioner for each such hospital [based on the reasonable cost to each hospital of such services furnished to state patients] pursuant to 42 USC 1396a(a)(30)(A) and within available appropriations. Nothing contained in this subsection shall authorize a payment by the state for such services to any such hospital in excess of the charges made by such hospital for comparable services to the general public.

[(c) The term "reasonable cost" as used in this section means the cost of care furnished such patients by an efficient and economically operated facility, computed in accordance with accepted principles of hospital cost reimbursement. The commissioner may adjust the rate of payment established under the provisions of this section for the year during which services are furnished to reflect fluctuations in hospital costs within available appropriations. Such adjustment may be made prospectively to cover anticipated fluctuations or may be made retroactive to any date subsequent to the date of the initial rate determination for such year or in such other manner as may be determined by the commissioner. In determining "reasonable cost" the commissioner may give due consideration to allowances for fully or partially unpaid bills, 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, requirements for working capital and cost of development of new services, including additions to and replacement of facilities and equipment. The commissioner shall not give consideration to 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 the commissioner from considering amounts paid for legal counsel related to the negotiation of collective bargaining agreements, the settlement of grievances or normal administration of labor relations.]

[(d)] (c) (1) Until such time as subdivision (2) of this subsection is effective, the state shall also pay to such hospitals for each outpatient clinic and emergency room visit a [reasonable] rate [to be] established [annually] by the commissioner for each hospital [, such rate to be determined by the reasonable cost of such services] pursuant to 42 USC 1396a(a)(30)(A) and within available appropriations.

(2) On or after July 1, 2013, with the exception of publicly operated psychiatric hospitals, hospitals shall be paid for outpatient and emergency room episodes of care based on prospective rates established by the commissioner within available appropriations and in accordance with the Medicare Ambulatory Payment Classification system in conjunction with a state conversion factor, provided the Department of Social Services completes a fiscal analysis of the impact of such rate payment system on each hospital. The Commissioner of Social Services shall, in accordance with the provisions of section 11-4a, file a report on the results of the fiscal analysis not later than six months after implementing the rate payment system with the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies. The Medicare Ambulatory Payment Classification system shall be augmented to provide payment for services not generally covered under the Medicare Ambulatory Payment Classification system, including, but not limited to, mammograms, durable medical equipment, physical, occupational and speech therapy. Nothing contained in this subsection shall authorize a payment by the state for such episodes of care to any hospital in excess of the charges made by such hospital for comparable services to the general public. Effective upon implementation of the Ambulatory Payment Classification system, a covered outpatient hospital service that does not have an established Medicare Ambulatory Payment Classification code shall be paid in accordance with a fee schedule or an alternative payment methodology, as determined by the commissioner. Prior to the implementation of the Ambulatory Payment Classification system, each hospital's charges shall be based on the charge master in effect as of June 1, 2015. After implementation of such system, annual increases in each hospital's charge master shall not exceed, in the aggregate, the annual increase in the Medicare economic index. The Commissioner of Social Services shall establish a fee schedule for outpatient hospital services to be effective on and after January 1, 1995, and 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 hospitals in the aggregate and ensures patient access. Utilization may be a factor in determining cost neutrality.

[(e)] (d) On and after January 1, 2015, and concurrent with the implementation of the diagnosis-related group methodology of payment to hospitals, an emergency department physician may enroll separately as a Medicaid provider and qualify for direct reimbursement for professional services provided in the emergency department of a hospital to a Medicaid recipient, including services provided on the same day the Medicaid recipient is admitted to the hospital. The commissioner shall pay to any such emergency department physician the Medicaid rate for physicians in accordance with the physician fee schedule in effect at that time. If the commissioner determines that payment to an emergency department physician pursuant to this subsection results in an additional cost to the state, the commissioner shall adjust such rate in consultation with the Connecticut Hospital Association and the Connecticut College of Emergency Physicians to ensure budget neutrality.

[(f)] (e) The commissioner [shall] may adopt regulations, in accordance with the provisions of chapter 54, establishing criteria for defining emergency and nonemergency visits to hospital emergency rooms. All nonemergency visits to hospital emergency rooms shall be paid [at the hospital's outpatient clinic services rate] in accordance with subsection (c) of this section. Nothing contained in this subsection or the regulations adopted under this section shall authorize a payment by the state for such services to any hospital in excess of the charges made by such hospital for comparable services to the general public. To the extent permitted by federal law, the Commissioner of Social Services [shall] may impose cost-sharing requirements under the medical assistance program for nonemergency use of hospital emergency room services.

[(g)] (f) The commissioner shall establish rates to be paid to freestanding chronic disease hospitals within available appropriations.

[(h)] (g) The Commissioner of Social Services may implement policies and procedures as necessary to carry out the provisions of this section while in the process of adopting the policies and procedures as regulations, provided notice of intent to adopt the regulations is published in accordance with the provisions of section 17b-10 not later than twenty days after the date of implementation.

[(i)] (h) In the event the commissioner is unable to implement the provisions of subsection [(e)] (d) of this section by January 1, 2015, the commissioner shall submit written notice, not later than thirty-five days prior to January 1, 2015, to the joint standing committees of the General Assembly having cognizance of matters relating to human services and appropriations and the budgets of state agencies indicating that the department will not be able to implement such provisions on or before such date. The commissioner shall include in such notice (1) the reasons why the department will not be able to implement such provisions by such date, and (2) the date by which the department will be able to implement such provisions.

[(j) The] (i) Notwithstanding the provisions of this chapter, or regulations adopted thereunder, the Department of Social Services is not required to increase rates paid, or to set any rates to be paid to, any hospital based on inflation, including, but not limited to, any current payments or adjustments that are being made based on dates of service in previous years.

Sec. 23. Subsection (b) of section 17b-263 of the general statutes is repealed and the following is substituted in lieu thereof (Effective from passage):

(b) Notwithstanding the provisions of subsection [(d)] (c) of section 17b-239, as amended by this act, the commissioner shall establish a service-specific fee schedule for hospital outpatient mental health therapy services, except for partial hospitalization and other comprehensive services as defined by the commissioner. Payment for partial hospitalization services shall be considered payment in full for all outpatient mental health services.

Sec. 24. Section 17a-484e of the 2016 supplement to the general statutes is repealed. (Effective July 1, 2016)

Sec. 25. Section 17b-277b of the general statutes is repealed. (Effective July 1, 2016)

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

Section 1

from passage

New section

Sec. 2

July 1, 2016

17a-227

Sec. 3

July 1, 2016

17a-215

Sec. 4

July 1, 2016

17a-215c

Sec. 5

July 1, 2016

17a-215d

Sec. 6

July 1, 2016

17a-247a(2)

Sec. 7

July 1, 2016

17a-247f

Sec. 8

July 1, 2016

17a-270(a)

Sec. 9

July 1, 2016

17b-2

Sec. 10

July 1, 2016

26-30(h)

Sec. 11

July 1, 2016

38a-514b(a)(4)

Sec. 12

July 1, 2016

38a-488b(a)(4)

Sec. 13

July 1, 2016

46a-11a(11)

Sec. 14

July 1, 2016

46a-11b

Sec. 15

July 1, 2016

46a-11c(b)

Sec. 16

July 1, 2016

17a-215e

Sec. 17

from passage

New section

Sec. 18

July 1, 2016

5-259(e)

Sec. 19

July 1, 2016

17b-131

Sec. 20

July 1, 2016

17b-84

Sec. 21

July 1, 2016

New section

Sec. 22

from passage

17b-239

Sec. 23

from passage

17b-263(b)

Sec. 24

July 1, 2016

Repealer section

Sec. 25

July 1, 2016

Repealer section

HS

Joint Favorable Subst.

 
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