New Law Accelerates Access to Home Health Services for Connecticut Seniors

Connecticut seniors will be able to quickly access Medicaid-funded home health care services due to a new presumptive eligibility system included in a wide-ranging law on elder care that took effect this week.

The provision requires the Department of Social Services to implement a system under which applicants to the Connecticut Home Care Program for Elders will be deemed immediately eligible for services — bypassing a Medicaid approval process that can sometimes take up to 90 days.

By passing the policy, lawmakers hoped to spare senior citizens the choice between residing in a nursing home or forgoing care while awaiting approval.

The state Senate sent the bill to the governor’s desk on a unanimous vote back in May. At the time, Senator Jan Hochadel, co-chair of the legislature’s Aging Committee, said the many changes included in the legislation would protect the well-being of seniors who prefer home-based care.

“As more and more of our seniors choose to age in their homes, we must adopt policies that preserve their safety and dignity,” Hochadel said. “This bill takes steps to ensure our elders can spend their later years at home, surrounded by their families and loved ones.”

Costs related to the first year of the bill’s presumptive Medicaid eligibility program are estimated at around $500,000 and will be covered by remaining federal funds under the American Rescue Plan Act.

However, the policy is not expected to result in additional costs to the state because nearly all of the impacted services are covered by Medicaid and will be reimbursed under the program. If the Department of Social Services concludes after two years the eligibility presumption has not been cost-effective, the bill includes a provision allowing the agency’s commissioner to discontinue the policy.

At a June ceremony to mark Gov. Ned Lamont’s approval of two bills designed to improve elder care in Connecticut, Social Services Commissioner Andrea Barton Reeves said the provision would remove some of the uncertainty that comes with trying to pay for quality care.

“Medicaid is extremely complex and often it takes far longer than it should to determine eligibility and that creates uncertainty for residents and their families,” Barton Reeves said. “With this bill — with these bills — that will change.”

Another provision of the bill that went into effect this week requires the state Department of Public Health to establish a nursing home consumer dashboard to connect seniors and their families to information on the quality of care at facilities and industry leading practices.

Posted by Hugh McQuaid