State Legislative Session Ends
The Connecticut General Assembly's 2019 regular legislative session ended at the stroke of midnight on June 5. While the regular session adjourned at midnight, a special session will be held for the purpose of adopting a bond package.
It was a very busy session this year and LeadingAge Connecticut was very active; providing testimony at thirty public hearings on fifty different bills, providing extensive testimony on the Governor's budget proposals, working on the details of many proposals, and tracking hundreds of bills throughout the session.
We want to thank our members who participated in our advocacy efforts this session
. Your calls, visits, consultation and testimony were invaluable contributions to our efforts and to the outcomes we saw this session. The strength of our advocacy efforts helped us to achieve several good outcomes including a nursing home rate increase for all nursing homes and full funding for the assisted living demonstration sites.
In addition, much of our advocacy this session was conducted in collaboration with other health care associations, including CHA, CAHCF, CALA, CSMS, and the CT Association for Healthcare at Home. We want to acknowledge the strong, collaborative relationship we have with these associations which truly benefits all of our members.
And finally, we want to thank our consultants, Maureen Weaver, JD of Wiggin and Dana, George Thomas of BlumShapiro, and our lobbyist Hilary Felton-Reid of Robinson & Cole for their vital role in our advocacy efforts!
There will be a LeadingAge Connecticut Board and Membership Meeting on Tuesday, June 11 at 9 a.m. at our Wallingford offices and we will be presenting a Legislative Update during the meeting. All LeadingAge Connecticut members, subscribers, and business affiliate members are invited to attend. Please RSVP to Nurka at ncarrero@leadingagect.org.
Session Overview
The following is an overview of the regular session outcomes that are related to aging services and senior housing. As we have done in previous years, a more detailed review of the legislative outcomes will be developed by Wiggin and Dana for distribution to the membership later this summer. To access information or to view any of the bills mentioned in this report, go to the Connecticut General Assembly website at www.cga.ct.gov.
Biennial Budget Bill
The budget agreement that was reached between the Governor and Democratic leadership was passed in the last week of the session and awaits the Governor's signature. It is a comprehensive document that is almost 500 pages long and the accompanying summary document is over 200 pages: Budget Document; OLR Summary; Fiscal Note. We are waiting for confirmation on a few issues, but the following is a brief summary of the relevant sections of the document.
Nursing Homes
: The budget agreement includes rate increases for all nursing homes. The increases will be 2% on July 1, 2019, 1% on October 1, 2020, and 1% on January 1, 2021 and are to be used toward increases in wages and benefits. There will be flexibility as to the mandated timing of the wage and benefit increases and we will be working closely with state officials to deliver additional detail regarding the implementation process.
Other items affecting nursing homes include a rebasing of the rates that will be done prior to the July 1, 2019 scheduled increase. The rebasing itself will not provide a rate increase, but will cause homes with an issued rate higher than their calculated rate to incur a 2% stop loss in their rate, or, if they are less than 70% occupied or have achieved a one star overall rating for the last three quarters, they will incur a zero stop loss and their rate will drop down to their calculated rate.
The budget language also allows for a nursing home to petition to close without a public hearing as long as they are no longer financially viable, less than 70% occupied, the closing is consistent with the state's strategic rebalancing plan and the facility does not provide a special service that would go unmet if it was closed. The bill also makes some procedural changes in the receivership statute that are an effort to shorten the length of a receivership.
Assisted Living Demonstration Sites:
The four assisted living demonstration sites will receive the full funding that was requested by the administration and that is needed to make up for the cuts made in the previous budget.
Residential Care Homes
: Residential care home rates will remain frozen, other than fair rent increases.
HCBS:
It does not appear that CT Home Care Program for Elders providers will receive a rate increase, although the Meals on Wheels services provided through this program will receive a 10% rate increase.
Rate Appeals:
Good news for Medicaid providers in general, the Governor's effort to remove the ability of providers to appeal a rate or to appeal a decision made by the Commissioner were rejected and therefore provider appeal rights remain intact. There was a strong healthcare association collaborative effort to maintain these appeal rights.
Non-Compete Prohibition:
Homemaker, companion and home health services will be prohibited from having non-compete provisions in their employee contracts.
Legislative Commissions:
Consolidates the Commission on Equity and Opportunity and the Commission on Women, Children and Seniors into a single entity.
Professional Licensure
: A licensure program for art therapists is created as well as an associate licensure category for professional counselors.
LGBTQ Health and Human Services Network
: A LGBTQ Health and Human Services Network is established and charged with building a safer and healthier environment for LGBTQ persons.
Bills of Interest That Passed and Are Awaiting the Governor's Signature:
Senate Bill 375, (as amended by Senate A), AN ACT AN ACT CONCERNING NURSING HOME STAFFING LEVELS
This bill strives to promote transparency in the reporting of daily nursing home staffing and is written to coordinate with the current state and federal posting and reporting requirements. The bill does not increase the minimum required staffing ratios contained in the public health code and the Department of Public Health will continue to regulate based on the standard that a nursing home must maintain staffing levels to meet the needs of their residents. More detail on this bill will be distributed prior to the effective date of October 1, 2019.
Senate Bill 827, (as amended by Senate A) AN ACT CONCERNING ALZHEIMER'S DISEASE AND DEMENTIA TRAINING AND BEST PRACTICES
The Alzheimer's Association promoted this bill which modifies the current continuing education statutes for physicians and APRNs and establishes a working group inclusive of a person living with dementia, family representatives, and a health care professional with expertise in diagnosing and treating Alzheimer's disease and dementia, to review the recommendations of the task force established in 2013, determine gaps in implementation of the task force's recommendations and make recommendations concerning best practices for Alzheimer's disease and dementia care.
Senate Bill 832, (as amended by Senate A), AN ACT CONCERNING REGISTRIES OF PERSONS FOUND RESPONSIBLE FOR ASSAULTS OR OTHER ABUSE, NEGLECT, EXPLOITATION OR ABANDONMENT OF ELDERLY PERSONS OR PERSONS WITH DISABILITIES
This bill requires the state to (1) provide a website portal that includes links to publicly available background databases and (2) convene a working group to develop strategies to raise public awareness of these databases to people hiring providers to care for adults aged 60 and older, children, or individuals with disabilities.
House Bill 7163, (as amended by Senate A) AN ACT CONCERNING THE DEPARTMENT ON AGING AND DISABILITY SERVICES AND MEALS ON WHEELS
This bill makes technical changes throughout statute in reference to the Department of Rehabilitative Services (DORS) being renamed the "Department of Aging and Disability Services." This bill also allows the Department of Social Services (DSS) commissioner, beginning July 1, 2020, to annually increase the reimbursement rate for meals-on-wheels providers under the Connecticut Home Care Program for Elders by at least the consumer price index's cost of living adjustment.
Senate Bill 804, (as amended by Senate A), AN ACT CONCERNING A COMMUNITY OMBUDSMAN
To develop an expansion of the investigatory oversight of the State LTC Ombudsman to include home and community-based services.
Senate Bill 920, (as amended by Senate B), AN ACT CONCERNING THE DEPARTMENT OF PUBLIC HEALTH'S RECOMMENDATIONS REGARDING VARIOUS REVISIONS TO THE PUBLIC HEALTH STATUTES
This large bill implements the Department of Public Health's recommendations regarding various technical revisions to the public health statutes. Of note, this bill made some technical corrections to various nursing home statutes.
Senate Bill 1088, AN ACT CONCERNING PARTICIPATION BY A RESIDENT OF A NURSING HOME FACILITY OR RESIDENTIAL CARE HOME IN A RECEIVERSHIP PROCEEDING
This bill seeks to address the well-being of a nursing home resident who is at risk of being involuntarily transferred from one facility to another as the result of a receivership proceeding by requiring a court to allow (1) a resident of a nursing home or residential care home that is the subject of a receivership application or (2) the resident's legally liable relative, conservator, or guardian, to be heard at the hearing on the application without having to file as a party.
Senate Bill 1052, (as amended by Senate A), AN ACT EXPANDING MEDICAID COVERAGE OF TELEHEALTH SERVICES
This bill will permit the Commissioner of Social Services to expand Medicaid coverage of telehealth services and requires a report back to the legislature by August 1, 2020.
This bill generally prohibits anyone from using the title "social worker," or any associated initials, or advertising services as a social worker unless he or she (1) has a bachelor's or master's degree in social work from a program accredited by the Council on Social Work Education (CSWE); (2) a doctorate in social work; or (3) if educated outside of the U.S. or its territories, completed an education program CSWE deems equivalent.
PAID FAMILY MEDICAL LEAVE
The House and Senate adopted a bill to establish an employee funded Paid Family Medical Leave insurance program, but only after a compromise was reached with the Governor's office on changes needed to the bill. The agreed upon changes were subsequently included in sections 232-235 of the budget bill that was adopted. Summary of the bill; Summary of the changes (see sections 232-235) More details on this legislation will be forthcoming.
$15 MINIMUM WAGE
The Governor has signed the minimum wage bill that is now Public Act 19-4 and which establishes a four-year phase in of a $15 minimum wage. Specifically, the law will increase the state's minimum hourly wage from its current $10.10 to (1) $11.00 on October 1, 2019; (2) $12.00 on September 1, 2020; (3) $13.00 on August 1, 2021; (4) $14.00 on July 1, 2022; and (5) $15.00 on June 1, 2023. Beginning January 1, 2024, it indexes future annual minimum wage changes to the federal employment cost index (ECI). Starting October 1, 2019, the bill also changes the "training wage" that employers may pay to learners, beginners, and people under age 18.
Bills of Interested That Failed this Session:
There are several ways a bill can fail during the legislative session, including the fact that if a bill is not voted on favorably by both the House and the Senate by midnight on the last day of session, it dies. The following is a listing of several of the bills of interest to our members that did not succeed this year:
- House Bill 7232, An Act Enhancing the Safety of Nursing Home Residents with Video Cameras
- Senate Bill 819, An Act Prohibiting Assisted Living Services Agencies and Continuing Care Providers Offering Assisted Living Services from Requiring a Third-party Contract Guarantor
- Senate Bill 1059, An Act Concerning the Unauthorized Practice of Law and the Prevention of False Long-Term Care Legal Planning and Advisement
- Senate Bill 764 and House Bill 6924, An Act Limiting "On-Call" Shift Scheduling
- House Bill 7100, An Act Concerning Non-Emergency Transportation for Nursing Home Residents
- Senate Bill 1051, An Act Strengthening Home Care Services
- House Bill 5276, An Act Concerning the Safety of Nursing Home Patients at Risk of Falling, and House Bill 7103, An Act Concerning Nursing Home Falls, although in response to the concern raised this session regarding this issue, LeadingAge Connecticut and CAHCF are working with DPH to produce a statewide Falls Prevention Conference this fall.
