Sec. 17b-28a. Waiver Application Development Council. Medicaid waiver
unit. (a) There is established a Waiver Application Development Council that shall be
composed of the following members: The chairpersons and ranking members of the
joint standing committee of the General Assembly having cognizance of matters relating
to appropriations, or their designees; the chairpersons and ranking members of the joint
standing committee of the General Assembly having cognizance of matters relating to
human services, or their designees; the chairpersons and ranking members of the joint
standing committee of the General Assembly having cognizance of matters relating to
public health, or their designees; the Commissioner of Social Services, or his designee;
the Commissioner of Public Health, or his designee; the Commissioner of Mental Health
and Addiction Services, or his designee; the Commissioner of Mental Retardation, or
his designee; the Secretary of the Office of Policy and Management, or his designee; the
State Comptroller, or his designee; a representative of advocacy for mental retardation to
be appointed by the president pro tempore of the Senate; a representative of advocacy
for the elderly to be appointed by the majority leader of the Senate; a representative
of the nursing home industry to be appointed by the minority leader of the Senate; a
representative of the home health care industry, independent of the nursing home industry, to be appointed by the speaker of the House of Representatives; a representative of
the mental health profession to be appointed by the majority leader of the House of
Representatives; a representative of the substance abuse profession to be appointed by
the minority leader of the House of Representatives; a health care provider to be appointed by the president pro tempore of the Senate; two elderly consumers of Medicaid
services who are also eligible for Medicare, to be appointed by the speaker of the House
of Representatives; a representative of the managed care industry, to be appointed by
the president pro tempore of the Senate; a social services care provider, to be appointed
by the majority leader of the House of Representatives; a family support care provider,
to be appointed by the majority leader of the Senate; two persons with disabilities who
are consumers of Medicaid services, one to be appointed by the president pro tempore
of the Senate and one to be appointed by the minority leader of the House of Representatives; a representative of legal advocacy for Medicaid clients, to be appointed by the
minority leader of the Senate; and six members of the General Assembly, one member
appointed by the president pro tempore of the Senate; one member appointed by the
majority leader of the Senate; one member appointed by the minority leader of the
Senate; one member appointed by the speaker of the House of Representatives; one
member appointed by the majority leader of the House of Representatives; and one
member appointed by the minority leader of the House of Representatives. The council
shall be responsible for advising the Department of Social Services, which shall be the
lead agency in the development of a Medicaid Research and Demonstration Waiver
under Section 1115 of the Social Security Act for application to the Office of State
Health Reform of the United States Department of Health and Human Services by May
1, 1996. The council shall advise the department with respect to specific provisions
within the waiver application, including but not limited to, the identification of populations to be included in a managed care program, a timetable for inclusion of distinct
populations, expansion of access to care, quality assurance and grievance procedures
for consumers and providers. The council shall also advise the department with respect
to the goals of the waiver, including but not limited to, the expansion of access and
coverage, making state health spending more efficient and to the reduction of uncompensated care.
(b) There is established a Medicaid waiver unit within the Department of Social
Services for the purposes of developing the waiver under subsection (a) of this section.
The Medicaid waiver unit's responsibilities shall include but not be limited to the following: (1) Administrating the Medicaid managed care program, established pursuant to
section 17b-28; (2) contracting with and evaluating prepaid health plans providing Medicaid services, including negotiation and establishment of capitated rates; (3) assessing
quality assurance information compiled by the federally required independent quality
assurance contractor; (4) monitoring contractual compliance; (5) evaluating enrollment
broker performance; (6) providing assistance to the Insurance Department for the regulation of Medicaid managed care health plans; and (7) developing a system to compare
performance levels among prepaid health plans providing Medicaid services.
(P.A. 95-257, S. 7, 58; P.A. 96-268, S. 30, 34; June 18 Sp. Sess. P.A. 97-2, S. 114, 165; June 18 Sp. Sess. P.A. 97-8,
S. 29, 88.)
History: P.A. 95-257, S. 7 effective July 1, 1995 (Revisor's note: A reference in Subsec. (b)(7) to "Department of
Insurance" was changed editorially by the Revisors to "Insurance Department" for consistency with customary statutory
usage); P.A. 96-268 added the chairpersons and ranking members of the committee having cognizance of matters relating
to human services, or their designees, to the Waiver Application Development Council, effective July 1, 1996; June 18
Sp. Sess. P.A. 97-2 amended Subsec. (a) by adding the chairpersons and ranking members of the joint standing committee
of the General Assembly having cognizance of matters relating to public health, or their designees, the Commissioner of
Social Services, or his designee, the Commissioner of Public Health, or his designee, the Commissioner of Mental Health
and Addiction Services, or his designee, the Commissioner of Mental Retardation, or his designee, the Secretary of the
Office of Policy and Management, or his designee, the State Comptroller, or his designee, a representative of advocacy
for mental retardation to be appointed by the president pro tempore of the Senate, a representative of advocacy for the
elderly to be appointed by the majority leader of the Senate, a representative of the nursing home industry to be appointed
by the minority leader of the Senate, a representative of the home health care industry, independent of the nursing home
industry, to be appointed by the speaker of the House of Representatives, a representative of the mental health profession
to be appointed by the majority leader of the House of Representatives, a representative of the substance abuse profession
to be appointed by the minority leader of the House of Representatives, a health care provider to be appointed by the
president pro tempore of the Senate, two elderly consumers of Medicaid services who are also eligible for Medicare, to
be appointed by the speaker of the House of Representatives, a representative of the managed care industry, to be appointed
by the president pro tempore of the Senate, a social services care provider, to be appointed by the majority leader of the
House of Representatives, a family support care provider to be appointed by the majority leader of the Senate, two person
with disabilities who are consumers of Medicaid services, one to be appointed by the president pro tempore of the Senate
and one to be appointed by the minority leader of the House of Representatives, and a representative of legal advocacy for
Medicaid clients, to be appointed by the minority leader of the Senate to the Waiver Application Development Council
and made conforming changes, effective July 1, 1997; June 18 Sp. Sess. P.A. 97-8 deleted Subdiv. (6) in Subsec. (b) re
provision of data to Connecticut Health Care Data Institute, renumbering remaining Subdivs. accordingly, effective July
1, 1997.
Sec. 17b-28b. Competitive bidding for Medicaid managed care plans. On and
after January 1, 1997, the Department of Social Services may award, on the basis of a
competitive bidding procedure, contracts for Medicaid managed care health plans.
(P.A. 96-268, S. 29, 34.)
History: P.A. 96-268 effective July 1, 1996.
Sec. 17b-28c. Application for a federal waiver for pilot program based on
principles of national Program of All-Inclusive Care for the Elderly (PACE). The
Commissioner of Social Services may submit an application for a federal waiver for
the purpose of conducting a pilot program based on the principles of the national Program
of All-Inclusive Care for the Elderly (PACE): (1) To provide comprehensive health care
and care management services for elderly and disabled Medicaid recipients who may
also be eligible for Medicare; and (2) to simplify eligibility for Medicaid. The program
shall be designed to reduce costs and increase efficiency in the operation of the Medicaid
program and to improve the coordination of health care benefits with the Medicare
program. Under said program, the Commissioner of Social Services, in consultation
with the Insurance Commissioner, may initially enter into contracts with integrated
service networks which have successfully completed a feasibility study, in conjunction
with a PACE technical assistance center, for the provision of comprehensive long-term
health care and care management for participating Medicaid recipients on a prepayment
or per capita basis. The Commissioner of Social Services may make payments on such
basis to designated PACE sites from funds appropriated to the Medicaid account. The
Commissioner of Social Services, in such contracts, may establish conditions necessary
to operate such pilot program within available appropriations, including, but not limited
to, requiring a nursing facility to reduce its number of beds in a certificate of networks
shall emphasize the utilization of primary and community-based services to avoid utilization of institutional care. Eligible Medicaid recipients shall have a choice of enrolling
in an integrated service network or receiving Medicaid covered services in a fee-for-service program, and no copays or a lower level of optional Medicaid state plan services
than currently covered under fee-for-service Medicaid, shall be used to induce individuals to transfer into the networks.
(June 18 Sp. Sess. P.A. 97-2, S. 113, 165; P.A. 98-198, S. 2, 4.)
History: June 18 Sp. Sess. P.A. 97-2 effective July 1, 1997; P.A. 98-198 amended Subsec. (a) to (1) allow the commissioner to submit an application for a federal waiver for purpose of conducting a pilot program based on the principles of
the national Program of All-Inclusive Care for the Elderly (PACE), in lieu of requiring commissioner to submit an application for a federal waiver for an 1115 research and demonstration program; (2) authorize commissioner to "initially" enter
into contracts with integrated service networks which have successfully completed a feasibility study, in conjunction with
a PACE technical assistance center, for provision of health care for Medicaid recipients; (3) authorize commissioner to
make payments to designated PACE sites from funds appropriated to Medicaid account; (4) allow commissioner to establish
conditions in such contracts necessary to operate such pilot program within available appropriations; and (5) eliminate
provisions which specify what the program may include; and eliminated Subsecs. (b) and (c) in their entirety, effective
June 8, 1998.
Sec. 17b-28d. Amendment to state Medicaid plan to increase federal matching
funds for Medicaid services provided to children requiring special education. The
Commissioner of Social Services, in consultation with the Commissioner of Education,
shall submit to the Centers for Medicare and Medicaid Services an amendment to the
state Medicaid plan required by Title XIX of the Social Security Act to enhance federal
financial participation for Medicaid services provided to Medicaid enrolled children
requiring special education pursuant to an individualized education plan. The amendment shall propose (1) the establishment of either a simplified cost-based or fixed fee
method of determining state expenditures for eligible Medicaid services provided to
such children, and (2) the replacement of the annual activity cost reports for all school-based child health services provided to such children. Any fixed fee established by the
Department of Social Services shall be a per diem or monthly rate per child and shall
reflect reimbursable administrative expenses.
(P.A. 98-239, S. 8, 35; P.A. 03-19, S. 37.)
History: P.A. 98-239 effective July 1, 1998; P.A. 03-19 made technical changes, including replacing "Health Care
Financing Administration" with "Centers for Medicare and Medicaid Services", effective May 12, 2003.
Sec. 17b-28e. Amendment to Medicaid state plan re optional services. Not later
than September 30, 2002, the Commissioner of Social Services shall submit an amendment to the Medicaid state plan to implement the provisions of public act 02-1 of the
May 9 special session* concerning optional services under the Medicaid program. Said
state plan amendment shall supersede any regulations of Connecticut state agencies
concerning such optional services.
(May 9 Sp. Sess. P.A. 02-7, S. 104; P.A. 04-257, S. 31.)
*Public act 02-1 of the May 9 special session is entitled "An Act Concerning Adjustments to the State Budget for the
Biennium ending June 30, 2003, State Revenues and Operating a Motor Vehicle while under the Influence of Intoxicating
Liquor". (See Reference Table captioned "Public Acts of May 9, 2002" in Volume 16 which lists the sections amended,
created or repealed by the act.)
History: May 9 Sp. Sess. P.A. 02-7 effective August 15, 2002; P.A. 04-257 made a technical change, effective June
14, 2004.
Sec. 17b-28f. Managed care subcontractors. Report on costs and profit. On
and after July 1, 2002, each managed care subcontractor paying claims for mental health
or dental care paid by a Medicaid managed care plan shall submit a report on a quarterly
basis to the Commissioner of Social Services on the proportion and amount of its monthly
payment received from the plan which has been (1) paid directly to providers of health
services, and (2) used by the subcontractor for its own administrative costs and profit.
(P.A. 02-3, S. 6.)
History: P.A. 02-3 effective April 1, 2002.
Sec. 17b-29. Council to monitor implementation of temporary family assistance program and the employment services program. Appointments. Reports. (a)
There is established a council to monitor the implementation of the temporary family
assistance program and the employment services program. The council shall be composed of the chairmen and ranking members of the joint standing committee of the
General Assembly having cognizance of matters relating to human services, or their
designees, the chairmen and ranking members of the joint standing committee of the
General Assembly having cognizance of matters relating to labor, or their designees,
one child care provider and one expert on child support enforcement, to be appointed
by the president pro tempore of the Senate; one representative of advocacy groups, to
be appointed by the majority leader of the Senate; two education and training specialists,
one experienced in job training and one experienced in basic adult education, one to be
appointed by the minority leader of the Senate and one to be appointed by the minority
leader of the House of Representatives; one member of the public who is a current
recipient of benefits under the temporary family assistance program, to be appointed
by speaker of the House of Representatives; and two members, one experienced in higher
education programs and one experienced in teenage pregnancy issues, to be appointed by
the majority leader of the House of Representatives. The council shall elect a chairperson
from among its members. The council shall convene its first meeting not later than
September 1, 1997.
(b) Beginning September 1, 1997, at meetings scheduled by the council, the Commissioner of Social Services and the Labor Commissioner shall update the council on
the implementation of the temporary family assistance program and the employment
services program. The council shall submit recommendations to the department regarding, but not limited to, the availability of quality child care and the provision of seamless
child care services, procedures for informing parents and teenagers about family planning and pregnancy prevention, client education regarding their rights and responsibilities, the effectiveness of child support enforcement, the effect of reduced exemptions,
time limits and increased sanctions, the coordination with Medicaid managed care and
health care reform measures and the fiscal impact of these program changes.
(c) On January 1, 1998, and quarterly thereafter, the council shall submit a report
to the General Assembly on the implementation of the temporary family assistance
program and the employment services program.
(May Sp. Sess. P.A. 94-5, S. 23, 30; P.A. 95-194, S. 6, 33; June 18 Sp. Sess. P.A. 97-2, S. 22, 165; P.A. 03-268, S. 3.)
History: May Sp. Sess. P.A. 94-5 effective June 16, 1994; P.A. 95-194 amended Subsec. (a) by requiring the council
to monitor the federal waiver for the AFDC program in Sec. 17b-112, effective June 29, 1995; June 18 Sp. Sess. P.A. 97-2 amended Subsec. (a) by requiring the council to monitor the TFA program and the employment services program instead
of the federal waiver for the aid to families with dependent children program and the operation of the job opportunities
and basic skills program, by adding the chairman and ranking members, or their designees, of the Labor Department to
the council, replacing a member of the public who is a current recipient of benefits under the aid to families with dependent
children program with a member of the public who is a current recipient of benefits under the TFA program, extended the
convening date of the council from July 1, 1994, to September 1, 1997, amended Subsec. (b) by requiring the Labor
Commissioner, in addition to the Commissioner of Social Services to update the council monthly, beginning on September
1, 1997, on the implementation of the TFA program and the employment services program, eliminated obsolete recommendation requirements, amended Subsec. (c) by changing the date the council shall submit quarterly reports to the General
Assembly on the implementation of the TFA program and the employment services program from October 1, 1994, to
January 1, 1998, effective July 1, 1997; P.A. 03-268 amended Subsec. (b) by replacing "and monthly thereafter" with "at
meetings scheduled by the council" re updates to council on implementation of temporary family assistance program and
employment services program.
Sec. 17b-30. Biometric identifier system. (a) For purposes of this section, "biometric identifier system" means a system which allows for the recognition of an individual through retinal scanning, finger-imaging, hand geometry or facial recognition. The
Commissioner of Social Services and the Commissioner of Motor Vehicles shall examine available biometric identifier systems and to the greatest extent possible, select a
system which is compatible with the systems of surrounding states. The Commissioner
of Social Services may enter into a memorandum of understanding with the Commissioner of Motor Vehicles for the Department of Motor Vehicles to provide the hardware,
software, equipment maintenance, technical training and other resources deemed necessary by the commissioner to establish said system.
(b) At the conclusion or cancellation of the contract entered into pursuant to the
memorandum of understanding in subsection (a) of this section, the Commissioner of
Social Services may extend the contract for not more than one year, provided, no later
than one year after such conclusion or cancellation, the commissioner shall issue a
request for proposals for providing the hardware, software, equipment maintenance,
technical training and other resources deemed necessary by the commissioner to maintain or improve said system. The subsequent contract for providing the resources for
said system shall be awarded pursuant to section 4a-59 and shall begin no later than one
year after such conclusion or cancellation.
(c) Said system shall be utilized for office use only in the following programs: (1)
Temporary family assistance; and (2) any other program to be determined at the discretion of the Commissioner of Social Services.
(d) A recipient of a program utilizing said system pursuant to subsection (b) of
this section shall participate in said system or be subject to disqualification from such
program. The commissioner shall have the authority to exempt a recipient from participation in said system.
(e) The implementation of said system shall begin on or before January 1, 1996.
The schedule of such implementation shall be determined by the Commissioner of Social
Services.
(f) Biometric identifier information obtained pursuant to subsection (d) of this section shall be the proprietary information of the Department of Social Services and shall
not be released or made available to any agency or organization and shall not be used
for any purpose other than identification or fraud prevention in this or any other state,
except that such information may be made available to the office of the Chief State's
Attorney if necessary for the prosecution of fraud discovered pursuant to the biometric
identifier system established in subsection (a) of this section or in accordance with
section 17b-90. The penalty for a violation of this subsection shall be up to a five-thousand-dollar fine or five years' imprisonment or both and the cost of prosecution.
(g) The Commissioner of Social Services shall report to the joint standing committee of the General Assembly having cognizance of matters relating to human services,
in accordance with the provisions of section 11-4a, on or before January 1, 1997, and
annually thereafter, through January 1, 2004, the following information: (1) The number
of recipients participating in said system; (2) the number of recipients whose benefits
have been discontinued due to their failure to participate in said system; (3) the cost of
implementation and operation of said system; (4) the amount of savings attributed to
the establishment and operation of said system; and (5) the compatibility of said system
with biometric systems being utilized in surrounding states. The commissioner shall
issue a final report on the implementation of a biometric identifier system not later than
January 1, 2004.
(P.A. 95-194, S. 28, 33; 95-351, S. 27, 30; P.A. 96-176, S. 4; June 18 Sp. Sess. P.A. 97-2, S. 23, 165; P.A. 03-268, S.
4; P.A. 04-76, S. 8.)
History: P.A. 95-194, S. 28 effective July 1, 1995; P.A. 95-351 amended Subsec. (b) by providing that the biometric
identifier system shall be utilized for office use only, effective July 1, 1995; P.A. 96-176 inserted new Subsec. (b) authorizing
one-year contract extension and requiring commissioner thereafter to issue request for proposals for maintenance or improvement of biometric identifier system, relettered former Subsecs. (b) to (e), inclusive, as Subsecs. (c) to (f), inclusive,
respectively, and added Subsec. (g) re annual report by Commissioner of Social Services; June 18 Sp. Sess. P.A. 97-2
amended Subsec. (c) to replace a reference to aid to families with dependent children with temporary family assistance,
effective July 1, 1997; P.A. 03-268 amended Subsec. (g) to provide that final report on implementation of biometric
identifier system shall be issued not later than January 1, 2004; P.A. 04-76 deleted Subsec. (c)(1) re "general assistance"
and redesignated former Subsecs. (c)(2) and (c)(3) as new Subsecs. (c)(1) and (c)(2).
Sec. 17b-31. Parent's Fair Share Program. (a) The Commissioner of Social Services shall seek a waiver from federal law to participate in the federal Parent's Fair
Share Program, Section 482(d)(3) of the Social Security Act. Such program shall assist
noncustodial parents in becoming current in delinquent child support payments.
(b) The Commissioner of Social Services may accept private foundation grants and
may use such grants to carry out the purposes of this section.
(P.A. 95-266, S. 1.)
Secs. 17b-32 to 17b-54. Reserved for future use.
Sec. 17b-55. Regulations re welfare reform. Section 17b-55 is repealed, effective
October 1, 2003.
(P.A. 95-194, S. 31, 33; P.A. 03-28, S. 4.)
PART II
INTERSTATE COMPACT ON WELFARE SERVICES
Sec. 17b-56. (Formerly Sec. 17-21a). Compact. The Interstate Compact on Welfare Services is hereby enacted into law and entered into by this state with any other
jurisdiction or jurisdictions legally joining therein in the form substantially as follows:
INTERSTATE COMPACT ON WELFARE SERVICES
ARTICLE I
The policy of the states party to this compact is to make welfare services available
on a reciprocal basis under this compact and to eliminate barriers caused by restrictive
residence or settlement requirements of the several states. However, it is recognized
that law and policy relating generally to the provision of welfare services by a particular
state should not be determined by interstate compact and will remain a matter for determination by that party state and its subdivisions. This compact shall be open for joinder
by any state of the United States and the District of Columbia.
ARTICLE II
As used in this compact, the phrase "welfare service" shall mean and include: (1)
Old age assistance; (2) aid to the blind; (3) temporary family assistance; (4) aid to the
permanently and totally disabled; (5) general assistance or home relief, by whatever
name known, for persons not eligible under other assistance categories; (6) child welfare
services; (7) care of unwed mothers; (8) welfare medical services for those in need;
provided that no party state shall be obligated to provide a welfare service which is not
made available generally by its laws.
ARTICLE III
(a) No person who has removed himself from one party state to another party state
shall be ineligible for a welfare service in such other party state because of failure to meet
that state's residence or settlement requirements for eligibility. The cost of providing a
welfare service to any person made eligible therefor by reason of this compact shall be
charged within the state in accordance with the laws of such state.
(b) The appropriate official, department or agency of the state where application
for a welfare service is made pursuant to this compact shall be entitled to request and
receive any pertinent information available from any other party state with respect to
such applicant.
ARTICLE IV
(a) The duly constituted administrative authorities of any two or more party states
may enter into supplementary agreements for the provision of any service or facility in
the field of social welfare which may be in addition to those denominated as welfare
services in this compact whenever the states concerned shall find that such agreements
will improve social welfare, its services or facilities. No such supplementary agreement
shall be construed so as to relieve any party state of any obligation which it otherwise
would have under other provisions of this compact; nor shall it authorize or require any
party state to assume any obligation not otherwise authorized by law.
(b) Nothing in this compact shall be construed to invalidate any reciprocal
agreement between a party state and a nonparty state relating to the reciprocal provision
of welfare services nor to invalidate any statutory authority for such agreements.
ARTICLE V
Each party state shall appoint a compact administrator who shall act as general coordinator of activities under the compact in his state, and whose duty it shall be to cooperate
with the compact administrators of other party states. The compact administrators of
the respective party states shall have power to promulgate reasonable regulations to
carry out the terms and provisions of this compact.
ARTICLE VI
(a) This compact shall enter into full force and effect as to any state when enacted
by it into law and such state shall thereafter be a party thereto with any and all states
legally joining therein.
(b) A state party to this compact may withdraw therefrom by enacting a statute
repealing the same. Such withdrawal shall take effect six months after notice thereof
has been communicated officially and in writing to the governors and compact administrators of all other party states. However, the withdrawal of any state shall not affect
the rights of any person who is receiving a welfare service pursuant to the provisions
of this compact.
(c) Withdrawal from any supplementary agreement made pursuant to Article IV
shall be in accordance with the terms of such agreement.
ARTICLE VII
This compact shall be liberally construed so as to effectuate the purposes thereof. The
provisions of this compact shall be severable and if any phrase, clause, sentence or
provision of this compact is declared to be contrary to the constitution of any party state
or of the United States or the applicability thereof to any government, agency, person
or circumstance is held invalid, the validity of the remainder of this compact and the
applicability thereof to any government, agency, person or circumstance shall not be
affected thereby. If this compact shall be held contrary to the constitution of any state
party thereto, the compact shall remain in full force and effect as to the remaining states
and in full force and effect as to the state affected as to all severable matters.
(1961, P.A. 372, S. 1; June 18 Sp. Sess. P.A. 97-2, S. 24, 165.)
History: Sec. 17-21a transferred to Sec. 17b-56 in 1995; June 18 Sp. Sess. P.A. 97-2 amended Article II to replace a
reference to aid to families with dependent children with temporary family assistance, effective July 1, 1997.
Annotation to former section 17-21a:
Cited. 149 C. 223.