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Home & Community-Based Services: State-Only Funded Programs in Connecticut

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: CT Home Care Program for Elders (category 1&2)⁴,⁹

Administrative Agency: Dept of Social Services

Population Served: Elderly 65+, physically disabled adults

Annual Expenditure: $23,000,000 FY02 Appropriation (may include federal funds)

Funding Source: General Revenue + Federal funds (SSBG)

Number of People Served: 3,439 (FY02) (may include federally funded clients)

Eligibility Criteria: Program split in 3 categories, category 1&2 services are state-funded with less restrictive financial & functional eligibility criteria than category 3 waiver services. No income limit, asset limit FY02 $18,132 (individual). Functional eligibility criteria: (category 1) 1/2 critical needs & at risk of institutionalization, (category 2) 3/more critical needs but ineligible for Medicaid.

Further Information: Cost control: Cost cap - Max. $1033/mth, 25% av. Medicaid cost in nursing facility (category 1) $2067 50% av. Medicaid nursing care cost (category 2). Co-pay may be required. No service limits applied. Quality control: annual client satisfaction surveys. Consumer direction Can be consumer directed.

Program Name: Statewide Respite Care Program³,⁹

Administrative Agency: Dept of Social Services

Population Served: N/A

Annual Expenditure: $1,064,181

Funding Source: General revenue, Clients contribute

Number of People Served: N/A

Eligibility Criteria: Income limit $30,000/yr, liquid assets less than $80,000. Diagnosis of dementia or related disorder, The individual receiving care cannot be covered by Medicaid.

Further Information: Cost control Respite cap of $3500/year.

Program Name: Personal Care State-Funded Pilot Program³,⁹

Administrative Agency: Dept of Social Services

Population Served: Elderly 65+

Annual Expenditure: N/A

Funding Source: General revenue

Number of People Served: Up to 100 04-06

Eligibility Criteria: Must meet eligibility requirement of Home Care Program to qualify.

Further Information: Cost control Respite cap of $4067/month. Other information To provide personal care as an alternative to HH aide, families can be paid to provide personal care, homemaker/chore

Program Name: Alzheimer's Respite⁹

Administrative Agency: Dept of Social Services

Population Served: Adults with dementia or related disorders

Annual Expenditure: $1,120,200 FY02 Appropriation

Funding Source: General revenue, clients contribute

Number of People Served: 491 FY02

Eligibility Criteria: Income limit $2,500/mth, asset limit $80,000/yr (individual).

Further Information: Cost control: Co-pay 20% of service cost. Cost cap max. $3,500/family/yr Other information: There may be a 'Day Care for Alzheimer's victims' program, for which $180,000 was appropriated in FY02 & served approx 100 individuals.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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