2009SB-00841-R000528-BA

This bill postpones the reestablishment of a state Department on Aging by two years, from July 1, 2008 to July 1, 2010. It delays the transfer to the new department the functions, powers, duties, and personnel of the Department of Social Services' (DSS) Division of Elderly Services or any successor division or portion of a division.

The bill transfers additional programs on July 1, 2010. These include the Long-Term Care Ombudsman Office, the federal Older Americans Act funding for the area agencies on aging, the Statewide Alzheimer's Respite Program, the state-funded portion of the Connecticut Homecare Program for Elders (CHCPE), two private assisted living pilot programs, the state-funded personal care assistance (PCA) pilot program, health insurance counseling, administration of state grants for elderly community services and programs, elderly nutrition, and adult foster care.

The bill postpones the reestablishment of the Department on Aging until July 1, 2010. It requires DSS to continue to administer programs under the Aging Department's jurisdiction until the governor appoints a commissioner and administrative staff are hired. It specifies that any DSS order in effect on July 1, 2009 will remain effective until amended, repealed, or superseded by law.

The bill allows the governor, with approval of the Finance Advisory Committee, to transfer funds between DSS and the Aging Department during FY 11 and FY 12 to implement this re-establishment.

It adds the Aging Department commissioner to the statutory list of executive department heads. It also expands the commissioner's powers and duties, requiring that he establish and maintain a toll-free telephone number and Internet website to provide a single access point for individuals to access information on elderly services and resources.

The bill transfers from DSS to the Aging Department the requirement that it continuously study the conditions and needs of the elderly for nutrition, transportation, home-care, housing, income, employment, health, recreation, and other matters. It also makes the Aging Department responsible for overall planning, development, and administration of a comprehensive and integrated social service delivery system for the elderly. The department must do this in cooperation with federal, state, local, and area planning agencies on aging. Specifically, it must:

1. measure the need for services;

2. survey ways to administer service delivery programs;

3. periodically evaluate social services;

4. maintain technical, information, consultation, and referral services, in cooperation with other state agencies, for local and area public and private agencies to the fullest extent possible;

5. develop and coordinate educational outreach programs that inform the public about available programs;

6. cooperate with appropriate state agencies in developing performance standards for licensing residential and medical care facilities;

7. supervise the establishment of pilot programs for the elderly in selected communities;

8. coordinate with the Department of Transportation to provide adequate elderly transportation services; and

9. cooperate with other state agencies to provide adequate alternate elderly housing, including congregate housing (CGS § 17b-4 (b)).

The bill substitutes the Aging commissioner and the Aging Department for the DSS commissioner and DSS in a number of statutes in order to transfer certain functions and responsibilities. Specifically, it:

1. transfers to the Aging Department the administration of (a) the state-funded PCA pilot program and (b) the state's two private assisted living pilot programs (one Medicaid and one purely state-funded);

2. requires (a) the state's five area agencies on aging (AAAs) to submit their area plans to the Aging Department and (b) the department to allocate federal Older Americans Act (OAA) funds to the AAAs;

3. requires the Aging Department commissioner to consult with the five AAAs, review the method for allocating OAA funds, and report any findings and recommendations to the Appropriations and Human Services committees;

4. requires the Aging Department to prepare and routinely update a community services policy manual;

5. gives the Aging Department commissioner authority over the adult foster care program;

6. transfers responsibility for elderly nutrition programs;

7. transfers administration of the state's Alzheimer's respite program and eliminates the DSS commissioner's current authority to allocate funds over $ 500,000 for the program to the five AAAs; and

8. transfers authority to award state grants for community services and programs for the elderly and allows use of up to 5% of these grant funds toward related administrative expenses.

The bill also removes obsolete reporting requirements pertaining to the PCA pilot program and the private assisted living pilot programs.

The bill requires the Aging Department commissioner, instead of the DSS commissioner, to appoint the Long-term Care Ombudsman, and moves the ombudsman's office from DSS to the Aging Department (see BACKGROUND). It also makes other technical and conforming changes related to this transfer.

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 at risk of institutionalization. The bill transfers administration of the program's state-funded portion from DSS to the Aging Department. Currently, the DSS Division of Medical Care Administration's Alternate Care Unit administers both portions of the program. (Federal law requires Medicaid waiver programs to be administered by the state's Medicaid agency, DSS; thus the bill only transfers the program's state-funded portion to the Aging Department. )

It also makes technical and conforming changes to specify that the state-funded program's asset and cost-sharing requirements are still based on the established methodology in DSS's uniform policy manual.

The bill requires mandated reporters of elder abuse, neglect, exploitation, and abandonment in long-term care facilities to report within 72 hours to the Aging Department commissioner instead of the DSS commissioner. It requires non-mandated reporters and other individuals wishing to file any other complaint about a long-term care facility to also report to the Aging Department commissioner instead of the DSS commissioner. The Aging Department commissioner must then inform the resident of the services provided by the Office of the Long-Term Care Ombudsman. This is currently required of the DSS commissioner.

The bill also transfers to the Aging Department commissioner, the DSS commissioner's authority to disclose certain information derived from these reports. Current law allows the DSS commissioner to disclose the name of the long-term care facility and the number and types of substantiated complaints. But, he cannot reveal the identity of the resident or complainant unless the individual authorizes it or a court proceeding results from the report. If an investigation is conducted, the bill requires the Aging Department commissioner, instead of the DSS commissioner, to notify the complainant of the investigation results.

The bill also transfers, from the DSS commissioner to the Aging Department commissioner, the requirement that he keep a statewide registry of the reports, evaluations, and actions taken.

The bill gives the Aging Department authority over DSS's health insurance counseling and assistance program, CHOICES. (CHOICES stands for Connecticut's programs for Health insurance assistance, Outreach, Information and referral, Counseling and Eligibility Screening. ) The program provides seniors with health insurance information and counseling; information on Medicare plans, including Medicare Part D plans; and available long-term care options.

The bill also allows the Insurance commissioner to require Medicare organizations to submit certain information to him on behalf of or in cooperation with the Aging Department commissioner instead of the DSS commissioner. Current law allows the Insurance commissioner to require Medicare organizations to submit data, reports, or information relevant to plan beneficiaries. These reports must be submitted annually or whenever there is a change in benefits, services, or costs to beneficiaries.

Current law requires the DSS commissioner to disseminate information to elderly and disabled individuals about any pharmaceutical company's drug program for low-income people. Information must be disseminated through the ConnPACE and CHOICES programs and the Connecticut Infoline. The bill requires the DSS commissioner to do this in consultation with the Aging Department commissioner.

§§ 5 & 6 — LONG-TERM CARE PLANNING COMMITTEE AND ADVISORY COUNCIL CHANGE IN MEMBERSHIP

The bill adds the Aging Department commissioner, or his or her designee, to the Long-term Care Planning Committee and the Long-Term Care Advisory Council.

By law, the Long-term Care Planning Committee is composed of representatives from executive agencies and legislators. It is responsible for (1) exchanging information on long-term care issues, coordinating long-term care policy development, (2) establishing a statewide long-term care plan and revising it every three years, and (3) studying related issues.

By law, the Long-term Care Advisory Council advises the Long-term Care Planning Committee and is composed of long-term care providers and consumer advocates.

The bill authorizes the Aging Department commissioner instead of the DSS commissioner, to adopt regulations concerning (1) the Long-Term Care Ombudsman program, (2) elder abuse reports, (3) violations of advance notice prohibitions for nursing home inspections, and (4) discrimination against nursing home residents who lodge complaints.

1. collect and analyze data relating to complaints and conditions in long-term care facilities and to residents to identify and resolve significant problems, and

2. submit the data, on a regular basis, to DPH, other appropriate state and federal entities determined by the state ombudsman, the National Ombudsman Resource Center, and DSS.

The bill transfers this responsibility to the Aging Department commissioner. It also requires the statewide uniform system to document reports received, investigations made, and actions recommended and taken. (It is unclear to which reports, investigations, and actions the bill is referring. ) The bill requires the commissioner only to analyze, not collect data, as DSS must currently do, on complaints, conditions, and residents in long-term facilities.

Connecticut disbanded its Department on Aging in 1993 and merged most of its functions and personnel into DSS as the Division of Elderly Services. (This DSS division was renamed the Aging Services Division several years ago. ) In 2005, the legislature reestablished the department as of January 1, 2007, but PA 07-2, JSS postponed the reestablishment date from July 1, 2007 to July 1, 2008.

The state's Long-Term Care Ombudsman's Office provides services to protect the health, safety, welfare, and rights of individuals age 60 or older who reside or are patients in a long-term care facility. It offers information to consumers and providers, monitors state and federal laws and regulations, and make recommendations for improvement. Specifically, it:

1. receives and investigates complaints and assists residents in resolving problems;

2. represents residents' interests before government agencies and seeks administrative, legal, and other remedies;

3. identifies and seeks to remedy gaps in facility, government, or community services;

4. establishes and operates ombudsman programs in Connecticut under the federal 1965 Older Americans Act (P. L. 89-73 §§ 711 to 713);

5. trains regional ombudsmen and residents' advocates; and

6. coordinates ombudsman services with the protection and advocacy systems for individuals with developmental disabilities and mental illnesses.

One state and nine regional ombudsmen carry out these duties, assisted by over 60 volunteers.