May 21, 2010
STATE ELDERLY PROGRAMS
By: Saul Spigel, Chief Analyst
You asked for an update of OLR report 2009-R-0397, which describes state programs for the elderly.
The state's principal elderly services programs provide cash assistance, energy assistance, health care, housing, legal assistance, long-term care, nutrition, property tax relief, and transportation. We have included programs where (1) age is one criterion for eligibility or (2) a large proportion of the clients are elderly even though the programs are not only aimed at that group. Some of these programs are means tested. Some are funded, in part, with federal money.
State Supplement Program (SSP)
Under the SSP program, the Department of Social Services (DSS) provides state cash assistance to supplement federal Supplemental Security Income (SSI) payments. (An individual not receiving SSI may still qualify for SSP if his or her monthly Social Security, private pension, or veteran's benefits are low.) DSS bases the amount of a person's state aid on his or her total need. It then compares this amount to the individual's income, and the difference, after deductions are taken, is the SSP benefit. But the program's need standards are frozen at FY 09 levels for FY 10 and FY 11.
To qualify for benefits, an individual must be age 65 or older, blind, or disabled and have monthly gross income of $2,022 or less if living alone. Assets cannot exceed $1,600 for singles and $2,400 for married couples. In general, individuals who transfer assets within 24 months before applying for SSP assistance are presumed to have done so for the program. They are generally ineligible for SSP for a period of time based on the value of the asset, unless they can show the transfer was made for another reason or that it was made to a special needs trust and they (1) are living in a residential care home (RCH) or New Horizons, Inc. (a facility in Farmington for people with severe physical disabilities and (2) have available income above 300% of the maximum SSI benefit for an individual and below the private rate that the RCH or New Horizons charges.
Home Heating Assistance and Weatherization
The state runs two programs that help low-income households of all ages offset their winter heating bills:
1. The Connecticut Energy Assistance Program (CEAP) is available to households with incomes up to 150% of the federal poverty level (FPL). In addition, households with incomes between 150% and 200% of the FPL can receive CEAP assistance, provided at least one household member is age 60 or older or has a disability. Liquid assets cannot exceed $10,000 for homeowners and $7,000 for renters, unless the excess assets, when added to the household's annual income, still leave the family within the income limits. CEAP-eligible homeowners may also qualify for funding to provide emergency repair or replacement of unsafe or inoperable heating systems.
According to DSS, for the 2009-2010 heating season, basic CEAP benefits range from $605 to $880 for homeowners and renters whose heat is not included in the rent; renters whose heat is included may receive up to $410. Households using “deliverable fuels” including heating oil, kerosene, and propane may be eligible for a one-time $400 crisis assistance benefit. And depending on available funding, CEAP participants who use up their basic and crisis benefits may be eligible for a “safety net” assistance benefit of up to $400.
2. The Contingency Heating Assistance Program (CHAP) is available to households whose income is too high for CEAP but less than 60% of the state median income (SMI). Although this program is not restricted to the elderly, a household in which one or more members is age 60 or older may receive a higher benefit level. Currently, the basic benefit is $580; households with incomes up to 60% SMI may also receive a one-time crisis assistance benefit of $400.
These two programs are funded mainly by federal block grants and administered by DSS and local community action agencies.
CEAP-eligible households may also qualify for the Weatherization Assistance Program, administered by the community action agencies. Priority may be given to low-income families with elderly or disabled individuals and those with children under age six.
In addition, the Weatherization Residential Assistance Partnership (WRAP) helps low-income utility customers with high energy bills reduce their costs through several weatherization measures. WRAP is administered by DSS in partnership with community action agencies and utility companies.
Medicaid is a state and federally funded program administered by DSS that provides medical assistance to low-income families, seniors, and disabled individuals. For seniors, Medicaid expenditures primarily cover nursing home costs, but Medicaid also pays medical costs not covered under Medicare for qualified seniors living at home. The eligibility criteria vary depending on the type of care required, but in most cases applicants must pass both an income and asset test.
Qualified Medicare Beneficiary “Dually Eligible”
Low-income seniors on Medicare may also qualify for the Qualified Medicare Beneficiaries program, which uses Medicaid funds to pay Medicare premiums, deductibles, and some coinsurance for people with incomes at or below the poverty level. For those with slightly higher incomes, a related program, the Specified Low-Income Medicare Beneficiary program pays Medicare Part B premiums.
Prescription Coverage for Medicare-Medicaid Dually Eligible
Seniors and individuals with disabilities covered by both Medicare and Medicaid (“dually eligible”) receive the bulk of their prescription drug coverage through the approved private Medicare Part D prescription plans in which federal and state law require them to enroll. These individuals can get help paying for their premiums and co-payments from the federal Low-Income Subsidy (LIS) program. But, the annual federal premium payment only covers “benchmark” prescription plans ($31.74 per month in 2009). Thus, state law now requires these individuals to enroll in a Part D benchmark plan. (A benchmark plan is one that offers basic Part D coverage with premiums equal to or lower than the regional low-income premium subsidy amount calculated annually.)
In addition, these individuals must pay up to $15 per month in co-payments, with DSS paying anything above that. Co-payments range from $1.10 to $6 per prescription in 2009 and are subsidized by the LIS program.
Medicaid Administrative Services for the Elderly and Disabled
By law, DSS must contract with one or more entities, either on a risk or non-risk basis, to provide administrative services to elderly and disabled Medicaid recipients, including those (1) dually eligible for Medicare and (2) enrolled in dually eligible special needs plans. Administrative services may include care coordination; utilization, disease, provider network, and quality management; and customer service.
Medicare Advantage Special Needs Plan for the Dually Eligible
DSS offers voluntary Medicaid Special Needs Plans (SNPs), which provide coordinated care, to frail seniors who are eligible for both Medicaid and Medicare. SNPs integrate the full range of Medicaid and Medicare benefits including primary, acute, behavioral, and long-term health care services.
Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled (ConnPACE) Program
ConnPACE is a state program that pays for prescription drugs for seniors age 65 and older and disabled adults. State law requires Medicare-eligible ConnPACE participants to enroll in a Medicare Part D benchmark plan (see above). The law coordinates ConnPACE benefits with Part D so that participants do not pay more than ConnPACE's $45 annual registration fee and $16.25 per-prescription copayment for drugs on their plan's formulary. (They may pay less than the $16.25 copay if their federal copays are lower.)
A plan can choose which Part D covered drugs to put on its formulary and generally does not have to pay for Part D non-formulary drugs. ConnPACE participants can use the same federal appeals process as the Medicare-Medicaid dually eligible to obtain coverage for their non-formulary drugs.
An applicant's annual income currently cannot exceed $25,100 if single, and $33,800 if married. This limit is usually adjusted annually to reflect inflation adjustments in Social Security payments, but the current income limits are frozen until January 1, 2012. Participants must be state residents for at least six months and pay an annual $45 registration fee and a $16.25 co-payment for each prescription. Certain prescriptions are not covered, such as antihistamines and diet pills.
New applications for ConnPACE must be submitted between November 15 and December 31 of each year. This is the same enrollment period used by the Medicare Part D program. But, people can apply at other times of the year, provided it is within 31 days of either (1) turning age 65 or (2) becoming eligible for federal Social Security Disability Income (SSDI) or SSI benefits.
Medicare Savings Program (MSP)
Under this program DSS pays for MSP participants' Medicare Part A or Part B premiums, or both. And people who qualify for MSP also qualify for another federal program that pays part or all of their Medicare Part D drug benefit premium and any Part D “doughnut hole” charges. Participants also pay lower co-payments for each prescription. More low-income seniors and disabled adults are eligible to participate in the SP, since 2009, its income eligibility limits now equal those of ConnPACE.
Connecticut Medicare Assignment Program (ConnMAP)
The Connecticut Medicare Assignment Program (ConnMAP) prohibits medical providers from billing enrollees for charges beyond what the federal Medicare program determines is a “reasonable and necessary” rate, of which Medicare pays 80% (a practice called “balance billing.”) Thus, any provider accepting Medicare patients may not balance bill ConnMAP enrollees beyond the 20% co-payment for the service. (Patients are also responsible for Medicare Part B premiums and deductibles.) The annual income limits for the program are currently $41,415 for singles and $55,770 for married couples. ConnPACE recipients can use their ConnPACE cards in lieu of a ConnMAP card, and providers must accept both. Applicants must have resided in the state for at least 183 days before applying and be enrolled in Medicare Part B.
Medicaid for Employed Disabled (MED) Program
This DSS-administered program provides affordable health care coverage to employed individuals with severe disabilities earning up to $75,000 annually. Coverage under the program is free for individuals with income up to 200% FPL. Those whose income exceeds this amount must pay a monthly premium equal to 10% of the excess income.
Health Insurance Counseling – CHOICES Program
The CHOICES program is managed by DSS's Aging Services Division in partnership with the AAAs and the Center for Medicare Advocacy. 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. It also administers the MediSave project, which trains and encourages seniors to identify and report Medicare and other types of fraud. (CHOICES stands for Connecticut's programs for Health insurance assistance, Outreach, Information and referral, Counseling and Eligibility Screening). The CHOICES phone number is 1-800-994-9422.
Elderly Health Screening
DSS funds elderly health screening programs for seniors age 60 and older at various statewide locations. The programs provide health screenings that include tests for cancer, dental disease, and mental health conditions. Health care education, nutritional counseling and physical activity programs are also provided.
The Department of Economic and Community Development (DECD) and federal Housing and Urban Development (HUD) funds are used to develop various elderly housing complexes. Residents must meet certain
income limits to qualify for this housing. The income limits for state-assisted elderly housing, including congregate housing, are 80% of the area median income adjusted for family size.
DECD provides grants and loans to developers to construct or rehabilitate existing structures to create congregate housing for low-and moderate-income, frail elderly. DECD also provides an operating subsidy to offset the expense of congregate services for lower-income residents. A congregate housing complex contains separate living units for residents and provides some housekeeping, personal care, transportation, and at least one meal a day in a common dining room.
Currently, all 24 state-assisted congregate housing projects can offer more extensive “assisted living” services and receive payments from the Connecticut Homecare Program for Elders (CHCPE) program for those who qualify financially; 15 congregate projects currently offer these services. Assisted living services include more “hands on” personal care, assistance with activities of daily living, nursing, and medical services that enable the resident to stay in his or her congregate apartment instead of moving into a nursing home.
Congregate Housing Services Program (CHSP)
This HUD-funded program provides extra services to seniors living in federal housing who need help with activities of daily living. It is administered by DSS and the AAAs at five sites in Eastern Connecticut (Moosup Manor, Cedar View, Eastwind, Ga-Na-Den, and Little River) and four sites in Western Connecticut (Nunnawauk Meadows, Spruce Bank Farm, George B. Lewis, and Grace Meadows).
Assisted Living Demonstration Project
DSS, in collaboration with DECD, the Connecticut Housing Finance Authority (CHFA), and the Office of Policy and Management (OPM) operates an assisted living demonstration program for low- and moderate-income seniors living in government subsidized elderly housing. The Connecticut Homecare Program for Elders (CHCPE) pays for the services for those who qualify financially. The law permits a combination of subsidized and unsubsidized units in the same facility and gives DECD discretion to set the rental subsidy for the pilot at any percentage of the annual aggregate family income and define income and eligibility for these subsidies.
The program operates in four locations (for a total of up to 300 units): Herbert T. Clarke House in Glastonbury, The Retreat in Hartford, Luther Ridge in Middletown, and Smith Street Assisted Living in Seymour.
DECD also created state-funded assisted living demonstration programs in three federally funded elderly housing developments: Tower 1/Tower East in New Haven, Immanuel House in Hartford, and Juniper Hill in Mansfield. A 2009 law allows DECD to designate an additional federally funded elderly housing development to provide assisted living services to individuals otherwise eligible to receive these services under CHCPE. It has not yet done so.
Private Assisted Living Pilot Program
DSS operates a private assisted living pilot program that helps pay for assisted living services (but not room and board) for people in private assisted living facilities who have used up their own resources. The pilot has two parts; one is funded through a Medicaid waiver, the other is purely state-funded. They have a combined cap of 75 participants. Through this pilot, the state pays for assisted living services for seniors who meet all eligibility requirements for CHCPE.
Project Home Share
Project Home Share typically matches elderly homeowners having financial difficulty maintaining their homes with individuals seeking affordable housing. The program operates in the Hartford, New Haven, and New London areas. One person in each match must be at least 60 years old. The program is free for participants over 60; younger participants' costs are based on a sliding income-based scale. In exchange for opening their homes, elderly participants may receive monetary compensation, services, or companionship.
DECD Homeowner's Emergency Repair Assistance for Seniors Program
DECD's Homeowner's Emergency Repair Assistance for Seniors Program provides grants or low-interest loans to repair homes owned by low-income seniors at least 62 years old. The Community Renewal Team in Hartford has administered the program since 1999.
Rental Assistance Program (RAP)
Low-income seniors may be eligible for rental assistance under one of two programs. DECD's Elderly RAP provides project-based rental assistance to disabled adults and low-income seniors age 62 and older living in state-funded elderly housing projects. To qualify, seniors must spend more than 30% of their income on rent and utilities. The RAP amount is the difference between 30% of their adjusted gross income, less a utility allowance, and the base rent. Alternatively, seniors living in the community are eligible for certificates to help them pay for private housing under DSS's RAP program, which helps low-income families without age restriction.
Reverse Annuity Mortgages
CHFA's Reverse Annuity Mortgage (RAM) program provides loans to low-income elderly homeowners to help pay for medical or long-term care needs. Eligible costs include those associated with hospitals, nursing homes, residential care homes, in-home care, adult day care, durable medical equipment, medically needed home alterations, long-term care insurance premiums, and uninsured recurring or catastrophic medical and prescription drug expenses.
Unlike a regular mortgage, a RAM loan is not repaid until the owner dies or the house is sold. The borrower receives monthly payments for five or 10 years. After that, interest continues to accrue at 7% a year. To qualify, borrowers must be at least 70 years old and their annual household income cannot exceed $81,000. DSS also engages in outreach, provides the public with information on the program, and accepts applications.
A 2010 act requires DSS to amend the Medicaid state plan to assure that funds from RAMs, in certain circumstances, are not treated as income or assets for determining Medicaid eligibility.
LEGAL ASSISTANCE FOR SENIORS
The state's AAAs contract with three legal organizations to provide free legal help on elder law issues to people age 60 and older who cannot afford to hire a private attorney. Priority is given to people with problems regarding health care access, nursing home issues, patient's rights, and federal and state benefit programs. The following organizations provide assistance:
● Connecticut Legal Services, Inc. (http://connlegalservices.org ) serves Eastern, Western and Southwestern Connecticut;
● Greater Hartford Legal Aid (http://ghla.org/) serves North Central Connecticut; and
● New Haven Legal Assistance Association (http://nhlegal.org/) serves South Central Connecticut.
Consumer Law Project for Elders (CLPE) hotline
Connecticut Legal Services, Inc. offers free legal help for people age 60 and older who have consumer problems through its statewide CLPE telephone hotline. The hotline number is 1-800-296-1467.
Adult Day Care—Alzheimer's Disease
DSS provides funding through the state's AAAs to pay for adult day care program staff for people with Alzheimer's disease. Approximately 29 adult day centers participate. CHCPE also subsidizes the attendance fees for people who qualify financially.
Adult Family Living (formerly Adult Foster Care)
DSS funds a voluntary adult family living program for seniors who are inappropriately institutionalized or who might otherwise be placed in a nursing home. The program provides room, board, and personal care services in a host home or substantially equivalent environment. There are no income limits, but participants must contribute towards the program's costs according to a sliding fee scale. Currently, the program serves only two people and does not accept new applicants.
Alzheimer's Respite Program
The Statewide Respite Care Program provides respite for caregivers for people with Alzheimer's disease, or related disorders, regardless of age, who are not enrolled in CHCPE. DSS administers the program in partnership with the state's AAAs. The program has a waitlist and was closed to new applicants until May 1, 2010; people who apply for services after that date will be served once clients on the waitlist before that date receive services.
An individual is eligible to receive up to $3,500 of services annually if his or her annual income does not exceed $41,000 and assets do not exceed $109,000. Income and asset limits are annually increased to reflect Social Security cost of living adjustments. DSS may allow participants who demonstrate a need to receive up to $7,500 for additional services.
Respite services provided include homemaker services, adult day care, short-term medical facility care, home health care, and personal care assistant and companion services. There is no age requirement for eligibility, but these diseases primarily affect seniors.
Brain G.Y.M.M. Program
DSS contracts with the New England Cognitive Center's Brain G.Y.M.M. Program to provide services to certain participants in the Statewide Respite Care Program and 15 adult day centers. The program uses a two-tiered, non-pharmaceutical approach to address the needs of people with Alzheimer's disease. Its two primary interventions, computer exercises that target specific areas of cognition and hands-on cognitive training in a small group environment, are designed to maintain cognitive functioning levels in these individuals.
Connecticut Home Care Program for Elders (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, homemaker services, transportation, meals-on-wheels, minor home modifications, and certain PCA and assisted living services. An “access” agency determines the most appropriate service package for each participant.
Financial eligibility differs for the program's two portions. For the Medicaid-funded portion, the monthly income limit is currently $2,022 for the individual who receives the services. Assets are limited to $1,600 per individual, $3,200 per couple if both receive services, and $23,512 per couple, or higher if the couple undergoes a “community spousal assessment” (CSPA) if only one receives services. The state-funded portion currently has no income limit for people who would be Medicaid-eligible in a nursing home; asset limits are $32,868 for an individual and $43,824 for a couple, regardless of whether one or both are receiving services. These asset limits, respectively, represent 150% and 200% of the minimum CSPA amount of assets that a Medicaid-eligible nursing home resident's spouse living in the community can keep.
By law, state-funded participants must contribute to the cost of their care. Those with income up to 200% FPL must contribute 6% of the cost of care; those with income over 200% FPL must contribute 6% of the cost of care plus an applied income amount DSS determines. (Certain people living in affordable housing under the state's assisted living demonstration program are exempt.)
Elderly Personal Care Assistance Pilot
Under CHCPE, DSS offers a state-funded “consumer-directed” PCA pilot program that allows seniors to hire their own attendant instead of going through a home health care agency. To be eligible, individuals must be at least age 65 and meet all of CHCPE's functional and financial eligibility requirements. Because state law requires the program to operate within available appropriations, participation is currently limited to 250 individuals.
The program permits clients to choose their own assistants to help with personal care and activities of daily living. The client employs, trains, supervises, and may fire the attendant, but a financial intermediary takes care of the paperwork.
Homecare Option Program for the Elderly
The Home Care Option Program for the Elderly (HOPE) and a related trust fund help people (1) plan and save for the cost of services not covered by a long-term health insurance policy or (2) supplement services covered by such a policy or Medicare. This allows seniors to live in their homes or a non-institutional setting as they age.
Participants can establish individual savings accounts and designate a beneficiary to withdraw account funds to pay for qualified home care expenses. It exempts interest, dividends, and capital gains earned on a HOPE account from state income tax and makes any balance remaining when a beneficiary dies part of his or her estate. The program and trust fund are administered by the comptroller.
Money Follows the Person Demonstration Project
Money Follows the Person (MFP) is a federal demonstration program that permits states to move people out of nursing homes or other institutional settings into less-restrictive, community-based settings. The recent federal health care reform act extends the demonstration period to 2016.
To qualify, an individual must have lived in a nursing home or other institution for at least six months and, if not for the community-based services provided under the demonstration, would have to remain in the institution. For the first 12 months the participant lives in the community the program will pay an enhanced federal Medicaid match. (In Connecticut, the normal Medicaid match is 50%, and the enhanced demonstration match is up to 75%).
State law limits the maximum number of program slots to 5,000. By July 1, 2012 the DSS commissioner must implement a similar home- and community-based services program for adults who may not meet the MFP institutionalization requirement (often referred to as MFP II). Between December 2008 and January 2010, MFP has transitioned 176 individuals into the community who are eligible for the enhanced federal match.
National Family Caregiver Support Act Program
The National Family Caregiver Support Act, Title IIIe, of the federal Older Americans Act (OAA), gives grants to states to provide information, referral, training, counseling, respite care, and other supportive services to (1) people caring at home for chronically ill, frail, elderly relatives or relatives with mental retardation or other developmental disabilities and (2) grandparents and other relatives caring for children at home. Although the program's funding is entirely federal, it is distributed through the states. The states must provide the services through their AAAs.
States must give priority to services to seniors with the greatest social and economic need (with particular attention to low-income seniors) and to seniors caring for relatives with mental retardation or other related developmental disabilities.
DSS's Aging Services Division allocates the federal funds it receives to the state's AAAs through the OAA's distribution formulas. The AAAs or their contractors provide the services, which include caregiver counseling, information about available services, help in accessing services, respite services, and limited supplemental services not available through other programs. Each AAA must coordinate its activities with community agencies and voluntary organizations providing similar services.
Nursing Facilities Transition Grant Program
This small program helps transition elderly and disabled people from nursing homes into community living and helps them obtain needed support services to do so successfully. The program was initially funded by a three-year federal grant in 2001, but is now funded by the state. Since December of 2008, the program has helped 23 people transition to community living.
DSS Small House Nursing Home Pilot
By law, DSS must establish a pilot program, within existing resources, to help develop up to 10 small-house nursing homes. But, only one project with no more than 280 beds may be approved through June 30, 2011.
The pilot's goals are to improve the quality of life for nursing home residents and provide nursing home care in home-like, rather than institutional, settings. In selecting proposals, DSS must give priority to those that use energy efficient technology, including fuel cells. It may also give preference to proposals to develop a small-house nursing home in a distressed municipality with more than 100,000 people. Any small-house nursing home participating in the pilot must comply with certificate of need requirements and processes.
DSS Elderly Nutrition Program
Pursuant to federal law, DSS operates 13 elderly nutrition projects that provide nutritionally sound meals to people age 60 and older and their spouses. Programs must provide one meal per day, five days per week. These meals are offered either at congregate sites, known as “senior community cafes,” or delivered to the homes of people too frail to travel to the congregate locations or cook for themselves. Disabled people living in housing facilities that are congregate meal sites can also receive meals. There is no charge for the meals, although voluntary contributions are encouraged. Both federal and state funds are used to pay the program costs.
Senior Farmers' Market Nutrition Program
This Department of Agriculture-administered program provides low income seniors with $15 vouchers (five $3.00 checks) to purchase fresh fruits, vegetables, and herbs at authorized farmers' markets. In order to qualify for the program, seniors must participate in a subsidized rental housing or congregate meal program that has applied for and been accepted into the program.
PROPERTY TAX RELIEF
The Circuit Breaker program entitles seniors to a property tax reduction or rent rebate. An applicant must (1) be age 65 or older, have a spouse who is age 65 or older, or be at least 50 years old and a surviving spouse of someone who at the time of his or her death was eligible for the program; (2) occupy the property as his or her home; and (3) resided in Connecticut at least one year before applying for benefits. For applications filed in 2009, annual income in 2008 cannot exceed $37,300 for married couples and $30,500 for singles.
The Freeze Tax Relief Program fixes a participant's property tax payment at a reduced level. It started in 1967, but has not accepted new participants since 1979. Individuals participating in the program when it closed continue to receive benefits. It generally freezes property taxes for homeowners age 65 and over who have $6,000 or less in annual qualifying income. (Qualifying income includes federal adjusted gross income plus tax-exempt interest and excludes Social Security income, U.S. Postal pensions, and certain other types of income.) The tax payment was calculated by multiplying the property's assessed value, minus $1,000, times the mill rate of the year in which the person first received benefits. Thereafter, the property tax was frozen, even if the mill rate or the home's assessed value rose.
Municipal Option Property Tax Relief for Seniors
In addition to the circuit breaker and tax freeze programs, towns may provide additional “local option” tax relief to elderly homeowners who are at least age 65 and who have been taxpayers in the town for at least a year. Towns may, but are not required to, establish income criteria. The tax relief can take any form, including freezing tax payments at specified levels. But the overall amount of tax relief towns can provide is limited to no more than 10% of the total value of real property in the town in each given year. And the total value of tax relief a homeowner can receive under this and the tax freeze and circuit breaker programs cannot exceed his annual tax. But towns that choose to provide relief receive no state reimbursement for the tax revenue they forgo.
Towns may also freeze the property taxes on homes whose owner or spouse is at least 70 years old and a state resident of at least one year. The freeze continues for a surviving spouse who is at least age 62 when the homeowner dies. Homeowners must meet the circuit breaker income guidelines. Towns may also impose asset limits for eligibility and put a lien on the property.
PROTECTION FROM ABUSE AND NEGLECT
Long-Term Care Ombudsman
Under the Connecticut Long-Term Care Ombudsman program, an ombudsman's office in DSS represents the interests of residents in nursing and residential care homes and helps them resolve complaints about these facilities. One state and nine regional ombudsmen carry out these duties, assisted by over 60 volunteers.
The Ombudsman's Office also provides assistance and education to residents in assisted living facilities. People in state-subsidized assisted living programs have priority for these services, but the office will also help people in private assisted living facilities to the extent that funding is available.
Under the Protective Services for the Elderly Program, DSS staff investigate complaints of abuse, neglect, exploitation, or abandonment of seniors age 60 and older living in the community. And DSS provides any needed protective services. If the investigation confirms the abuse, the case is referred to the state's attorney for investigation and possible prosecution.
Division of Criminal Justice – Elder Abuse Unit
The elder abuse unit in the State's Attorney's Division of Criminal Justice investigates and prosecutes cases of abuse.
DSS Conservator of the Estate or Person Program
DSS runs a conservator of the estate or person program for elderly and disabled people with very low income and assets who cannot manage their own finances. The DSS commissioner is designated the client's conservator of the estate, and DSS employees perform financial functions for the client.
Elder Abuse Reporters
Doctors, nurses, nursing home administrators, other health care personnel, and other professionals must report suspected elder abuse to DSS within three days or face penalties. DSS must refer substantiated abuse cases involving long-term care residents to prosecutors. Legal remedies are available for anyone subjected to retaliation or discrimination for, in good faith, reporting elder abuse or complaining to DSS about care in a long-term care facility.
Automobile Insurance Discounts for Senior Drivers
By law, a driver age 60 or older is eligible for an automobile insurance premium discount for successfully completing a Department of Motor Vehicle (DMV) approved accident-prevention course. The premium discount, which is effective at the policy's next renewal, must be at least 5% and apply for at least two years. The driver must complete the course within the year before he or she applies for an initial discount. For any future discount, the driver must complete a course within the year before the current discount expires.
Handicapped Access Program/Dial-a-Ride/ADA Paratransit
The Handicapped Access Program provides transit districts with funds to meet Americans with Disabilities Act mandates. In order to receive federal capital and operating funds, transit districts must provide paratransit services to complement existing fixed route services, including lift-equipped vans and other vehicles that meet a disabled person's transportation needs. They often take the form of “dial-a-ride” services, where the person orders the transportation at least 24 hours in advance and pays a small fee. Some towns, senior centers, and other organizations also have dial-a-ride programs specifically for seniors.
Municipal Dial-A-Ride Grant Program
The municipal demand responsive (dial-a-ride) program for the disabled and seniors age 60 and older allocates matching grants to municipalities based on a formula with two equal factors: the municipality's relative share of the state's elderly population and its size compared to the state's total area. Municipalities must apply for the grants through a regional planning organization or transit district and
must collaborate on service design to determine how to use the funding most effectively. In 2008, there were 73 programs approved by the Department of Transportation (134 towns applied, but a number of them collaborated with other towns).
Community-Based Regional Transportation Systems for the Elderly
State law required DSS to provide grants to up to four towns with 25,000 or more people or to nonprofit organizations located in them to plan and develop financially self-sustaining, community-based regional transportation systems that, through a combination of private donations and user fees, provide rides in passenger cars for seniors who can no longer drive. (DSS actually funded five initial grant projects.) Before receiving the grant, the town or entity must secure at least $25,000 in matching private funds. Each recipient received $50,000 during the two-year period covering FY 06 and FY 07. The 2007 budget act provided additional funding for five new grants.
A grant recipient must, to the extent practicable, model its system on the “ITNAmerica” model. ITNAmerica is a national nonprofit organization engaged in planning to replicate in other locations a model first developed by the Independent Transportation Network (ITN) in the Portland, Maine, area. ITN obtains its operating funds through organization memberships; riders' fares; and support from individuals, community businesses, and private foundations. It uses passenger automobiles and operates with a combination of volunteers who drive their own vehicles and paid drivers for vehicles ITN owns.
VOLUNTEER AND EMPLOYMENT PROGRAMS
Retired Senior Volunteer Program (RSVP)
The RSVP program operates 12 projects across that state that provide volunteer opportunities to people age 55 and over. Most participants work in nonprofit agencies.
Breakthrough to the Aging
The Breakthrough to the Aging program recruits volunteers to provide services to the elderly, including telephone reassurance, shopping, banking, and friendly visits. The program also provides training, support, and supervision of volunteers to a cooperative network of agencies, home care personnel, and volunteer coordinators.
Senior Community Service Employment Program
This OAA program helps low-income seniors age 55 and older find employment opportunities. The program matches a person's skills and interests with a position in a community service agency. To be eligible, the person must have an income not more than 125% of the federal poverty level.
Seniors Helping Seniors
This program in the Norwich area enables senior volunteers to help other seniors remain in the community by providing transportation, shopping, chore services, and companionship. Volunteers earn credits toward the same kind of help if they themselves need it later.
Area Agencies on Aging (AAAs)
The state has five AAAs, which are private, nonprofit elderly planning and service agencies that receive state and federal funds to carry out the federal Older Americans Act requirements. The AAAs must (1) represent elderly people in their geographic areas, (2) develop and administer an area plan, (3) coordinate and assist local public and nonprofit private agencies in developing programs, (4) receive and distribute federal and state funds for these purposes, and (5) perform additional federally required functions.
The AAAs plan, coordinate, evaluate, and act as brokers for elderly services. They award funds to regional agencies, which in turn provide meals and related social services at local sites. Two of the AAAs also contract with DSS to administer the CHCPE in their regions. A total of about $14 million in federal OAA funds and $5 million in state matching funds is funneled through DSS to the AAAs for their various programs (including elderly nutrition), many of which are discussed elsewhere in this report.
Fall Prevention Program
By law DSS must, within available appropriations, establish a fall prevention program targeted at older adults. The program must promote and support fall prevention research; oversee research and
demonstration projects; and establish, in consultation with the public health commissioner, a professional education program on fall prevention for healthcare providers.
Long-Term Care Partnership Insurance Program
The Connecticut Partnership for Long-Term Care is a public-private initiative under which the state approves special long-term care insurance policies sold by private companies. (The policies must meet state standards.) People who buy them can later qualify for Medicaid and still keep assets equal to the amount the policy has paid for their care. Only Partnership-approved policies have this feature, called Medicaid asset protection.
Over 40,000 policies have been purchased since 1992 when the program began. The Office of Policy and Management (OPM) approves the policies, maintains statistics, and engages in program planning, administration, and outreach.
Municipal Agent for the Elderly
Each municipality must appoint a municipal agent for its elderly residents for a two-year renewable term. The agent is trained by DSS and is responsible for disseminating information to seniors and assisting them in (1) learning about available community resources and (2) applying for benefits to which they may be entitled.
Grandparents as Parents
This is a statewide network of local grandparents as parents support programs that provide advocacy and support and link grandparents and other relatives raising children to respite care and other services. DSS established the network in 1998 with a private foundation grant.
Kinship Fund and Grandparents and Relatives Respite Fund Grants
Grandparents or other relative caregivers who are court-appointed guardians of a child can apply for grants from the probate court-administered Kinship and Grandparents and Relatives Respite funds. Grants are subject to available appropriations.
Kinship Navigator Program
DCF, in consultation with other agencies, operates a kinship navigator program that provides information and referral services to relative caregivers. The program's information is available through the state's 2-1-1 Infoline.
Elderly Tuition Waivers
By law, regional community-technical colleges must waive tuition for any state resident age 62 or older, if at the end of the regular registration period enough other people are enrolled in the course for it to be offered and enough space is left to accommodate the senior citizens.