The legislature’s Aging Committee is considering a bill to protect the state’s elderly residents from a rising tide of scam attempts, another to require nursing homes to spend at least 80% of the Medicaid funds they receive on direct care, and a third addressing quality of life issues at nursing homes.
House Bill 5210 would instruct the Chief State’s Attorney to establish an elder justice unit within the Division of Criminal Justice to investigate and prosecute criminal activity against the elderly.
Rep. Anne Hughes, an Easton Democrat and committee member who co-chaired the working group that researched the bill, said the legislation will request $2 million – $1 million each from the Appropriations Committee and the Opioid Settlement Fund. She said the unit will need $1.5 million in seed money, after which the committee will try to access federal funding like neighboring states Massachusetts and New Hampshire have done for similar elder justice units.
The U.S. Attorney’s Office has lately been busy investigating scams of older adults. In one case, perpetrators are charged with stealing $479,569.08 from a victim’s bank account with one individual facing 30 years in prison.
Hughes said she would expect state prosecutors to advocate for harsher penalties than were seen in previous Connecticut cases.
The unit would revive a previous similar effort and operate under the Chief State’s Attorney’s Office. The previous disbanded when federal funding lapsed.
However, in written testimony on HB 5210, Chief State’s Attorney Patrick Griffin said that while the Criminal Justice Division agrees that crimes against the elderly should be investigated, it has concerns about the bill in its current form.
“The Division of Criminal Justice is, and remains, strongly committed to prosecuting persons who commit crimes against our elderly citizens to the fullest extent of the law,” Griffin’s statement read. “This agency is not, however, equipped at this time to do what Raised Bill No. 5210 requires of it.”
Griffin said he anticipates that the elder justice unit would require, at a minimum, two prosecutors, five inspectors, and one forensic accountant.
“At this time, the Division does not have the appropriated funds necessary to sustain this increase in personnel or to provide the specialized training and expertise such personnel would need in order to properly carry out the functions of an elder justice unit,” Griffin wrote.
Other advocates in the state think the bill is a good idea.
“Connecticut’s older adult population is going to continue to grow in the coming years, and creating an elder justice unit at DCJ is a positive step to acknowledging the unique dynamics of crimes committed against older adults in Connecticut,” said Anna Doroghazi, AARP Connecticut’s associate state director for advocacy and outreach.
Redirecting Medicaid Reimbursements To Direct Care
The committee also heard testimony on a number of other bills, including one that would reallocate Medicaid funds in nursing homes across the state.
Senate Bill 156, one of several bills on which the committee heard testimony Thursday, would require nursing homes to use 80% of state-funded Medicaid reimbursements to pay for resident care.
Senate President Martin Looney testified in favor of the bill, and said he would even support expanding it. In fact, he said, the bill should be expanded so that nursing homes are required to allocate 80% of all revenue to the direct care of patients.
“I would urge the committee to support this bill, and to include additional transparency requirements on nursing home facilities, so that our state and our residents can have confidence in how nursing homes spend their revenue,” Looney said.
Looney referenced both federal statutes and new laws in neighboring states, which placed limits on how much of a nursing home’s revenue could be spent on administrative costs.
While the bill would increase state support for resident care costs, which is defined as services directly provided by staff to a patient for activities like bathing, dressing, feeding, etc. – it would leave 20% of state-funded Medicaid reimbursements for other allowable costs like facility maintenance and administrative salaries.
Matthew Barrett, president of the Connecticut Association of Healthcare Facilities, said in a written statement that the organization opposes the bill because of the financial strain it will place on nursing homes with respect to other allowable costs.
“No facility in the state could sustain a shortfall of that magnitude without a considerable increase in its Medicaid rate,” Barrett said.
Department of Social Services Commissioner Andrea Barton Reeves testified that the bill could have “unintended, adverse consequences.”
In her written testimony, Barton Reeves said both she and the department support the intent of the bill, but the state’s 200 nursing homes are currently spending 51% of their total funds on direct care, and 49% on other allowable costs – so an 80% mandate on direct-care spending could lead to other costs going underfunded.
Sen. Saud Anwar, a South Windsor Democrat who is also a medical doctor and co-chairs the Public Health Committee, said in a phone interview that more of the budget should be going toward the people who are providing direct care.
“What we have learned during the pandemic was that workers have to do a heroic job, but with limited resources,” Anwar said. “And any time there is an increase in payment, workers’ lives have not improved.”
A bill similar to HB 5210 that would have required 90% of Medicaid funds to be allocated for resident care failed in a previous legislative session.
Quality of Life for Nursing Home Residents
House Bill 5046, An Act Promoting Nursing Home Resident Quality Of Life, would address some of the issues that have come out regarding the quality and availability of care being provided for patients in nursing homes.
Manisha Juthani, commissioner of the Department of Public Health, said an important aspect of the bill is the $500,000 in ARPA funds that would be used to create a dashboard for streamlining and improving patient services.
Committee co-chair Sen. Jan Hochadel, D-Meriden, said in a written statement that she was looking forward to exploring the issue over the coming weeks.
“It is critical that Medicaid dollars are focused on supporting direct care for nursing home residents, one of our most vulnerable populations,” Hochadel said.
With 18,000 older adults receiving care in licensed homes across the state, Juthani said she believes the bill is important for maintaining services for both temporary and permanent residents at nursing homes.
