On March 12th, AARP provided testimony to the Human Services Committee of the Connecticut General Assembly, showing strong support for bills on the docket concerning Medicaid services, long term care, and social service.
AARP offered testimony in support of S.B. 1084, An Act Concerning Delays in Medicaid Application Processing, S.B. 1086, An Act Concerning Long Term Care, and H.B. 6610, An Act Concerning Federal Medicaid Waivers. These proposals complement the Governor’s call for “a more efficient and effective long-term services and supports (LTSS) system aligned with the principles of choice, autonomy and dignity”. AARP also supported S.B. 1083, An Act Concerning the Department of Social Services.
S.B. 1084, AN ACT CONCERNING DELAYS IN MEDICAID APPLICATION PROCESSING
AARP strongly supports efforts to ensure prompt access to safety-net health and long-term care programs through technology upgrades and a streamlined determination process as required under S.B. 1084, An Act Concerning Delays in Medicaid Application Processing. Specifically, S.B. 1084 requires DSS to comply with Medicaid timelines for processing Medicaid applications and provides “presumptive eligibility” for applicants receiving or requesting home and community-based services (HCBS) after 90 days. Determining financial eligibility for Medicaid applicants for community based services in 2011 took an average of 134 days—far exceeding the Standard of Promptness set by the Centers for Medicare and Medicaid Services. Without timely decisions these applicants’ health and well-being could be at risk and the long delay may determine whether they remain in a community setting or enter a nursing facility.
States that lead the way in consumer choice share common characteristics, including timely eligibility determinations for home care services. When decisions must be made quickly at a time of crisis, state Medicaid programs must be able to arrange for HCBS in a timely manner. Failure to determine timely eligibility for Medicaid HCBS often results in unnecessary nursing home placement and the financial consequences for the state are steep. On average, the cost of serving a Medicaid client in the community is approximately one third the average cost of serving that individual in an institution.
S.B. 1084 recognizes the need to improve access to Medicaid services through timely eligibility determinations and improved screening processes. While AARP prefers the more expansive approach for presumptive eligibility outlined in H.B. 5919, we support S.B. 1084 as a significant improvement on the current system. Expedited eligibility determinations will improve access to services in the setting the consumer chooses. Additionally, the proposal would stretch limited public resources by serving individuals in cost-effective community based settings, when institutional care is neither desired nor needed.
S.B. 1086, An Act Concerning Long Term Care &
H.B. 6610, An Act Concerning Federal Medicaid
AARP supports the state reviewing options and identifying service gaps in the Medicaid waiver system to expand consumer options and meet future needs. In addition, AARP urges the Committee to expand the scope of S.B. 1086, An Act Concerning Long Term Care, and H.B. 6610, An Act Concerning Federal Medicaid Waivers, to also evaluate implementation of Community First Choice in Connecticut. Community First Choice (CFC) is an option established in the Affordable Care Act (ACA) to help states with rebalancing efforts. CFC creates a new Medicaid State Plan option to provide home and community-based personal care attendant services. States exercising this option will receive a six percentage point (6%) increase in their state’s federal Medicaid matching rate for those services. In January, Governor Malloy called for an analysis of CFC implementation in Connecticut. It makes sense for the state to undertake that analysis while it considers other waiver and service gap issues.
AARP would strongly support Connecticut’s decision to pursue CFC. We have hired an independent consulting firm to provide an initial review and cost analysis of CFC option in Connecticut. Preliminary results suggest that Connecticut has the potential to save an estimated $4.6 million annually and serve over 1,100 additional individuals currently on HCBS waiting lists.
S.B. 1083, An Act Concerning The Department of Social Services
AARP supports the objective outlined in S.B. 1083 to review existing energy assistance programs and plan for power outages in facilities that serve DSS clients. The proposal will help identify gaps in energy assistance programs, inform policy to make energy assistance programs more responsive to client needs, and improve safety for DSS clients during potential power outages