AN ACT CONCERNING MEDICAID REFORM TO PROMOTE AGING IN PLACE.

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

Section 1. (Effective from passage) (a) On and after July 1, 2015, the Commissioner of Social Services shall establish a one-year pilot program to fund services under the Connecticut home-care program for the elderly for a period of up to ninety days for not more than fifty applicants who require a skilled level of nursing care and who are determined to be presumptively eligible for Medicaid coverage. The pilot program shall be established in a county where the per capita rate of nursing home institutionalization exceeds such average for counties state-wide.

(b) The pilot program shall include, but not be limited to: (1) The development of a preliminary screening tool by the Department of Social Services to determine whether an applicant is functionally able to live at home or in a community setting and is likely to be financially eligible for Medicaid; (2) authorization by the commissioner for the access agency selected pursuant to section 17b-342 of the general statutes to screen such applicants and initiate home care services not later than five days after such screening; (3) a presumptive financial Medicaid eligibility determination for such applicants by the department not later than five days after such screening; and (4) a written agreement to be signed by such applicant attesting to the accuracy of financial and other information such applicant provides and acknowledging that (A) state-funded services shall be provided for not longer than ninety days from the date on which home care services are initiated under the program, and (B) such applicant shall complete a Medicaid application on the date such applicant is screened for functional ability to live at home or in a community setting or not later than five days after such screening. The department shall make a final determination as to Medicaid eligibility for presumptive eligibility applicants not later than ninety days after such applicant completes a Medicaid application.

(c) To the extent permissible under 42 CFR 435.915, the Commissioner of Social Services shall retroactively apply a final determination of Medicaid eligibility for presumptive Medicaid eligibility applicants.

(d) Not later than July 1, 2016, the commissioner shall submit a report on the program 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. The report shall include, but not be limited to: (1) The number of applicants who were determined presumptively eligible for Medicaid who later were determined not to be eligible for Medicaid; (2) the cost to the state to provide care for such applicants; (3) the savings to the state in institutionalization costs for applicants who were determined to be eligible for Medicaid after a presumptive Medicaid eligibility determination; and (4) recommendations on expanding the program state-wide to allow more persons to age in place, as described in section 17b-420a of the general statutes, and reduce state Medicaid expenditures on institutional care.