OLR Bill Analysis

sSB 814

AN ACT CONCERNING PERSONAL CARE ASSISTANCE SERVICES UNDER THE CONNECTICUT HOME CARE PROGRAM FOR THE ELDERLY.

SUMMARY:

This bill requires the Department of Social Services (DSS) to provide personal care assistance (PCA) services under the Connecticut Homecare Program for Elders (CHCPE) if these services (1) are not available under the Medicaid state plan and (2) are more cost effective than existing Medicaid state plan services.

Currently, DSS provides PCA services only through (1) a state-funded PCA pilot program for certain qualifying seniors, (2) the PCA Medicaid waiver program for disabled adults, and (3) the acquired brain injury (ABI) Medicaid waiver program.

EFFECTIVE DATE: July 1, 2009

BACKGROUND

PCA Services

Personal care assistants provide non-medical care, such as assistance with bathing, dressing, eating, walking, toileting, or transfer from a bed to a chair. Consumer-directed PCA services provide an alternative to nursing homes or agency-provided home care. Under these programs, participants hire their own assistants to help with personal care and activities of daily living instead of going through a home health care agency. The participant hires and manages the assistant, but a financial intermediary handles the paperwork.

State-Funded PCA Pilot Program

Under CHCPE, DSS offers consumer-directed PCA services only through a state-funded pilot program. To be eligible, individuals must be at least age 65 and meet all of CHCPE's functional and financial eligibility requirements. Participation is limited to 250 individuals. (Although 2007 legislation removed the 250 person limit, because the law requires the program to operate within available appropriations, DSS has retained the cap. )

PCA Medicaid Waiver Programs

DSS also provides consumer-directed PCA services under the Medicaid PCA waiver for disabled adults and acquired brain injury waiver. Both programs serve adults ages 18 to 64 and have only a limited number of program slots available. (2006 legislation eliminated the upper age limit for the PCA waiver program so that people who turn 65 can remain in the program if they choose. )

CHCPE

CHCPE is a Medicaid waiver and state-funded program that provides home and community-based services for qualifying individuals age 65 and older who are institutionalized or at risk of institutionalization. Services include care management, adult day care, adult foster care, homemaker services, transportation, meals-on-wheels, minor home modifications, and certain assisted living services. An “access” agency determines the most appropriate service package for each participant.

COMMITTEE ACTION

Select Committee on Aging

Joint Favorable Substitute Change of Reference

Human Services Committee

Joint Favorable