Sec. 17b-221a. Revenue from Riverview Hospital to be used to pay Medicaid
claims. For the fiscal year ending June 30, 2002, and each fiscal year thereafter, revenue
received by the Department of Administrative Services-Financial Services Center/Collections from Medicaid managed care plans for services performed at Riverview Hospital shall be deposited in the General Fund and credited to a nonlapsing account in the
Department of Social Services and shall be available for expenditure by the Department
of Social Services for the payment of Medicaid claims.
(June Sp. Sess. P.A. 01-6, S. 12, 85.)
History: June Sp. Sess. P.A. 01-6 effective July 1, 2001.
Sec. 17b-221b. Federal matching funds for special education-related services.
Portion to be used for Medicaid claims. For the fiscal year ending June 30, 2002, and
each fiscal year thereafter, all federal matching funds received by the Department of
Social Services for special education-related services rendered in schools pursuant to
section 10-76d shall be deposited in the General Fund and credited to a nonlapsing
account in the Department of Social Services. Sixty per cent of such funds shall be
expended by the Department of Social Services for payment of grants to towns pursuant
to subdivision (3) of subsection (a) of section 10-76d and the remaining funds shall
be available for expenditure by the Department of Social Services for the payment of
Medicaid claims.
(June Sp. Sess. P.A. 01-6, S. 13, 85.)
History: June Sp. Sess. P.A. 01-6 effective July 1, 2001.
As used in sections 17b-223, 17b-228, 17b-229 and 17b-748, "state humane institution" or "humane institution" means and includes state mental hospitals, community
mental health centers, treatment facilities for children and adolescents, or any other
facility or program administered by the Departments of Mental Health and Addiction
Services, Mental Retardation, or Children and Families. The person in charge of each
state humane institution shall furnish the Commissioner of Administrative Services with
a daily report of changes in the patient roster and the date of formal commitment of each
patient.
(1955, S. 1488d; 1957, P.A. 586, S. 7; 1959, P.A. 201; 1967, P.A. 314, S. 16; 839, S. 1; 1971, P.A. 530, S. 1; P.A. 75-
603, S. 12, 15; P.A. 77-614, S. 70, 610; P.A. 87-421, S. 6, 13; P.A. 93-91, S. 1, 2; 93-381, S. 9, 39; P.A. 95-257, S. 30, 58.)
History: 1959 act required that welfare commissioner be supplied with daily report of changes in patient roster and
dates of formal commitment of patients; 1967 acts deleted "tuberculosis facilities in chronic disease hospitals" from the
definition and provided that the commissioner of finance and control rather than the welfare commissioner receive the
reports of patient rosters; 1971 act included community mental health centers, treatment facilities for children and adolescents and other facilities and programs administered by mental health department in definition of "humane institution";
P.A. 75-603 included reference to programs and facilities administered by children and youth services department; P.A.
77-614 replaced commissioner of finance and control with commissioner of administrative services; P.A. 87-421 included
facilities or programs administered by the Connecticut state alcohol and drug abuse commission and by the department of
mental retardation in the definition of state human institution and excluded state training schools for mentally retarded
persons from the definition; P.A. 93-91 substituted commissioner and department of children and families for commissioner
and department of children and youth services, effective July 1, 1993; P.A. 93-381 replaced Connecticut alcohol and drug
abuse commission with department of public health and addiction services, effective July 1, 1993; Sec. 17-294 transferred
to Sec. 17b-222 in 1995; P.A. 95-257 replaced Department of Mental Health with Department of Mental Health and
Addiction Services and deleted reference to the Department of Public Health and Addiction Services, effective July 1, 1995.
Annotations to former section 17-294:
Cited. 183 C. 330, 332—334, 336.
Cited. 30 CS 118.
(a) The
Comptroller shall at least annually determine the cost per capita per diem for the support
of persons in state humane institutions and furnish such itemized per capita cost to the
Commissioner of Administrative Services. Such cost for the care of persons in facilities
operated by the Department of Mental Health and Addiction Services shall be determined by the Comptroller, in consultation with the Commissioner of Mental Health and
Addiction Services, on a facility-wide, ward-wide or unit-wide basis. The provisions
of this section shall not apply to cases eligible for medical assistance or public assistance
under Title XVIII or Title XIX of the Social Security Act, and such cases shall be
administered as medical or public assistance cases and shall be subject to federal and
state law, rules and procedures governing the same.
(b) The maximum rate to be charged for the support of each patient for the ensuing
year shall be the per capita cost. The commissioner shall, upon the admission of each
patient to a humane institution, and may, upon any subsequent readmission of such
patient, cause an investigation to be made of the financial circumstances of each liable
person and the estate of each patient and, if any such person or estate is found unable
to pay the per capita cost, shall bill such liable person or estate from the date of admission
at a rate which he finds such person or estate able to pay, provided the total billing to
all persons responsible for the support of any patient, including the patient or patient's
estate, shall be based on actual days of attendance at the facility involved and shall not
exceed the per capita cost. A complete disclosure for the amount and terms of such
monthly billing and continuing liability for costs associated with services provided by
the state shall be provided to such liable person or patient prior to admission or if the
immediate need or admission precludes such notification, at the earliest possibility thereafter.
(c) Each patient, the husband or wife of such patient and the father and mother of
a patient under the age of eighteen years each shall be legally liable from the date of
admission for the support of such patient in such institution in accordance with his ability
to pay; except that the maximum liability of legally liable relatives as such for a patient
in a state humane institution shall be determined by the commissioner in accordance
with section 4a-12 and subsection (b) of this section. The guardian, conservator and
payee of Social Security or other benefits on behalf of any such patient shall be similarly
responsible for the support of such patient, but shall be liable in such capacity only in
accordance with the amount of the patient's estate or the benefits received, or both, as
the case may be. Said commissioner may bill and accept payment from any other person
or agency willing to assume any portion of the cost of support of a person in a state
humane institution at such rate as such person or agency is willing to pay. The relatives
of any such patient who is a veteran shall not be liable as such for any part of the cost
of his care in such institution.
(d) Wherever a rate of billing has been established as the result of a fraud of the
patient or a liable person, or where assets of the patient or relative have been concealed
so as not to be available to civil process, such patient or liable person, as the case may
be, shall be liable for the difference between the amounts actually billed and paid and
the amount which would have been billed against such patient or liable person except
for such fraud or concealment, which difference may be recovered in a civil action in
the same manner as is provided in section 17b-228, together with interest at the rate of
twelve per cent from the date of such billing, and no statute of limitations shall apply
to such right of action.
(1949 Rev., S. 2661; 1953, 1955, S. 1489d; November, 1955, S. N169; 1959, P.A. 470; 671, S. 1; 1961, P.A. 590;
February, 1965, P.A. 539, S. 1; 594, S. 1, 2; 1967, P.A. 314, S. 16; 364, S. 1, 3; 746, S. 3; 759, S. 2, 3; 825; 1969, P.A.
730, S. 12; 1972, P.A. 127, S. 27; P.A. 74-243, S. 1—3; P.A. 76-435, S. 19, 82; P.A. 77-614, S. 70, 610; P.A. 78-302, S.
9, 11; 78-343, S. 1, 2; P.A. 79-376, S. 20; 79-443, S. 1, 2; P.A. 80-389, S. 1, 3; P.A. 84-246, S. 1, 2; P.A. 86-169; P.A. 87-
421, S. 7, 13; P.A. 88-285, S. 30, 35; P.A. 95-257, S. 11, 58; P.A. 96-135; P.A. 97-312, S. 3.)
History: 1959 acts added, in Subsec. (b), proviso re maximum rate and exception for patients eligible for medical and
hospital benefits; added, in Subsec. (c), provision re cessation of liability and limitation on responsibility of guardian,
conservator and payee of social security and requirement for investigating each patient's estate; added Subsec. (d); limited
application of Subsec. (e) to liable relatives or the patient and substituted, in Subsec. (f), "liable persons" for "legally liable
relatives"; 1961 act placed limitation, in Subsec. (b), on maximum rate, provided for payment by more than one relative
in the same period in Subsec. (c) and eliminated, in Subsec. (d), deferral of finding re financial responsibility pending
commission's finding, referring determination directly to commissioner; 1965 acts added a Subsec. (h) establishing maximum rates predicated on taxable income where patient was mentally retarded, and allowed exclusion of four hundred
dollars from available assets of mentally retarded patients returning from outside training in determination of ability to
pay in Subsec. (e); 1967 acts removed items of cost provisions from Subsec. (a) and added sentence re social security act,
changed basis of rate in Subsec. (b) to per capita cost, specified the maximum rate "per week" and deleted exceptions,
changed relatives liable in Subsec. (c) to parents of children under twenty-one and children of parents under sixty-five,
repealed Subsec. (h), substituting Sec. 17-295a, and substituted commissioner of finance and control for welfare commissioner; 1969 act deleted from exception regarding liability statement that children be only equally liable and that liability
waived if child's gross income is $15,000 or less in Subsec. (c); 1972 act changed reference to patients under twenty-one
to refer to those under eighteen in Subsec. (c), reflecting changed age of majority; P.A. 74-243 made maximum rate charged
relatives applicable after first one hundred twenty days of treatment and added provisions re investigation and adjustments
in charge if liable person or estate cannot bear the charge in Subsec. (b), deleted from liability in Subsec. (c) children of
patient under sixty-five and deleted provisions re investigation and adjustment to charges now in Subsec. (b) and rephrased
use of measurement standard in Subsec. (e) for clarification; P.A. 76-435 deleted Subsec. (g) which had allowed commissioner to recover balance of charges billed despite receipt of lesser rate; P.A. 77-614 replaced commissioner of finance
and control with commissioner of administrative services; P.A. 78-302 required annual determinations of cost under Subsec.
(a); P.A. 78-343 extended exception to allow charge of maximum rate for patients committed to High Meadows from
date of admission or commitment under Subsec. (b); P.A. 79-376 substituted "workers' compensation" for "workmen's
compensation" in Subsec. (e); P.A. 79-443 made cost determination on per diem rather than per week basis and added
provision re determination of costs in facilities operated by mental health department in Subsec. (a); P.A. 80-389 increased
maximum rate for legally liable relatives from $26.95 to $53.90 per week and increased interest rate in Subsec. (f) from
six to twelve per cent; P.A. 84-246 eliminated mandatory investigation upon readmission of patients, deleted requirement
that investigation be made prior to rendering of bill and provided a monetary limit on liability of legally liable relatives;
P.A. 86-169 deleted provision setting maximum rate charged to legally liable relatives of patients at High Meadows; P.A.
87-421 (1) amended Subsec. (b) to delete a maximum dollar amount per week which could be charged liable relatives after
the first one hundred twenty days of care, (2) amended Subsec. (c) to remove a cap on liability based on sixteen years of
care and to substitute a cap determined in accordance with Sec. 4-68a and Subsec. (b) of this section and (3) removed
Subsec. (e) on the considerations for determining ability of liable relatives to contribute to the cost of care and relettered
the remaining subsection; P.A. 88-285 amended Subsec. (d) to replace veterans' home and hospital commission with
commissioner of veterans' affairs; Sec. 17-295 transferred to Sec. 17b-223 in 1995; P.A. 95-257 replaced Commissioner
and Department of Mental Health with Commissioner and Department of Mental Health and Addiction Services, effective
July 1, 1995; P.A. 96-135 repealed provisions of former Subsec. (d) re review by Commissioner of Veterans Affairs of
determination of financial responsibility for certain veterans admitted to state humane institutions, consolidated remaining
provisions of former Subsec. (d) into Subsec. (c) and relettered former Subsec. (e) as Subsec. (d); P.A. 97-312 amended
Subsec. (b) by requiring full disclosure of monthly billing and continuing liability to the liable person, prior to admission
or at the earliest possibility thereafter.
See Sec. 17a-278 re recall of residents placed in private boarding home for examination.
See Sec. 17a-461 re charges for care in Connecticut Mental Health Center.
See Sec. 19a-257 re support of patients with chronic illness excluding tuberculosis.
Annotations to former statute:
Cited. 139 C. 472; 142 C. 329.
Cited. 14 CS 33.
Social security payments made to parent as "representative payee" for dependent child are property of child and may
be billed against for child's hospitalization. 4 Conn. Cir. Ct. 63, 66. Estate of veteran with service- connected disability
liable for maximum rate under subsection (b). Id., 75. Commissioner may make a retroactive change in patient's billing upon
discovery of new circumstances. Id., 81. Burden of proof commissioner acted illegally or so arbitrarily and unreasonably as
to abuse his discretion is on plaintiff. Id., 138. Cited. Id., 402. During confinement of social security recipient for mental
illness under order of criminal court, defendant, representative payee of recipient, must apply such funds for support of
beneficiary at institution of commitment. 5 Conn. Cir. Ct. 542.
Annotations to former section 17-295:
Cited. 152 C. 55. Cited. 183 C. 330, 332—336. Cited. 192 C. 520, 522. State not precluded by federal supremacy clause
from using legal process to compel payment of institutional support charges. 205 C. 104—108, 115.
Cited. 30 CS 118. Cited. 34 CS 518, 520, 521.
Subsec. (b):
Cited. 183 C. 330, 333, 336.
Subsec. (c):
Cited. 183 C. 330, 333.
Sec. 17b-224. (Formerly Sec. 17-295b). Liability of patient for per capita cost
of care. A patient who is receiving or has received care in a state humane institution,
his estate or both shall be liable to reimburse the state for any unpaid portion of per
capita cost to the same extent as the liability of a public assistance beneficiary under
sections 17b-93 and 17b-95, subject to the same protection of a surviving spouse or
dependent child as is therein provided.
(1969, P.A. 730, S. 13.)
History: Sec. 17-295b transferred to Sec. 17b-224 in 1995.
Annotations to former section 17-295b:
Cited. 192 C. 520, 522, 525.
State's claim against estate of deceased recipient or patient depends upon amount due at time of death of such recipient
or patient. Upon date of death, estate's liability to reimburse state is fixed and cannot be expanded or contracted by
subsequent enactments. 34 CS 518—520, 522, 523.
Sec. 17b-225. (Formerly Sec. 17-295c). Availability of patient information to
certain agencies. (a) The Department of Public Safety, the Department of Social Services and the United States Department of Health and Human Services shall be entitled
to receive only such information concerning patients in institutions, hospitals and facilities of the Departments of Public Health, Mental Retardation and Mental Health and
Addiction Services as is required to obtain support and payments for the care of such
patients, including submissions of such information to probate courts, agencies and
corporations dispensing benefits, or only such information concerning such patients as
is required for the purpose of claiming federal reimbursement, or only such information
concerning such patients as is required for the review and audit of federally funded
programs. Any such information received by said Department of Public Safety, Department of Social Services and United States Department of Health and Human Services
shall be confidential and shall be used for the purposes of obtaining support and payments
for the care of said patients or for the purpose of claiming federal reimbursement or for
the review and audit of federally funded programs.
(b) The Department of Administrative Services shall be entitled to receive only
such information concerning patients in institutions, hospitals and facilities of the Departments of Public Health, Mental Health and Addiction Services and Mental Retardation, and state humane institutions, as defined in section 17b-222, as is required to obtain
support and payments for the care of such patients, including submissions of such information to probate courts, agencies and corporations dispensing benefits. Any such information received by said Department of Administrative Services shall be confidential
and shall be used only for the purposes specified in this subsection.
(1971, P.A. 263; P.A. 73-248, S. 1, 2; P.A. 74-215, S. 1, 3; P.A. 75-420, S. 4, 6; 75-638, S. 21, 23; P.A. 77-614, S. 71,
323, 587, 608, 610; P.A. 78-303, S. 85, 127, 136; P.A. 79-383; P.A. 93-262, S. 1, 87; 93-381, S. 9, 39; P.A. 95-257, S. 11,
12, 21, 58.)
History: P.A. 73-248 entitled welfare department and U.S. Department of Health, Education and Welfare to receive
information and included information relevant to claims for federal reimbursement or to review or audit of federally-
funded programs; P.A. 74-215 added word "only" with reference to information re federal reimbursement and federal
reviews and audits; P.A. 75-420 replaced welfare department with department of social services; P.A. 75-638 included
information on patients in facilities of mental retardation department; P.A. 77-614 replaced central collections division of
department of finance and control with department of administrative services and, effective January 1, 1979, replaced
department of health with department of health services and department of social services with department of income
maintenance; P.A. 78-303 entitled department of public safety to information; P.A. 79-383 added Subsec. (b) containing
special provisions re information to which administrative services department entitled and removed references to said
department in previous provisions, now Subsec. (a); P.A. 93-262 authorized substitution of commissioner and department
of social services for commissioner and department of income maintenance, effective July 1, 1993; P.A. 93-381 replaced
department of health services with department of public health and addiction services, effective July 1, 1993; Sec. 17-295c
transferred to Sec. 17b-225 in 1995; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction
Services with Commissioner and Department of Public Health and replaced Commissioner and Department of Mental
Health with Commissioner and Department of Mental Health and Addiction Services, effective July 1, 1995.
Sec. 17b-226. (Formerly Sec. 17-295d). Consideration of the costs mandated
by collective bargaining agreements. The state shall take into consideration the costs
mandated by collective bargaining agreements with certified collective bargaining
agents or other agreements between employers and employees when making grants to
or entering into contracts for services with the following: (1) Nonprofit organizations
for mental health services pursuant to section 17a-476; (2) nonprofit organizations concerning services for drug-dependent and alcohol-dependent persons pursuant to section
17a-676; (3) residential and educational services pursuant to subsections (a) and (b) of
section 17a-17; (4) psychiatric clinics and community mental health facilities pursuant
to section 17a-20; (5) day treatment centers pursuant to section 17a-22; (6) youth service
bureaus pursuant to subsection (a) of section 10-19n; (7) programs for the treatment
and prevention of child abuse and neglect and for juvenile diversion pursuant to section
17a-49; (8) community-based service programs pursuant to sections 18-101i and 18-
101k; (9) programs for mentally retarded children and adults pursuant to section 17a-
217; (10) community-based residential facilities for mentally retarded persons pursuant
to section 17a-218; and (11) vocational training programs for mentally retarded adults
pursuant to section 17a-226.
(P.A. 87-497, S. 2, 3; P.A. 90-209, S. 22; P.A. 91-406, S. 3, 29; P.A. 93-381, S. 13, 39.)
History: P.A. 90-209 in Subdiv. (2) substituted "alcohol-dependent" for "alcoholic" and Sec. 17-155gg for repealed
Sec. 17-226d and made a technical change; P.A. 91-406 deleted former Subdiv. (11) re diagnostic clinics for mentally
retarded persons, renumbering former Subsec. (12) accordingly; P.A. 93-381 made technical changes, effective July 1,
1993; Sec. 17-295d transferred to Sec. 17b-226 in 1995.
All bills for support of inmates in state hospitals for mental illness shall be paid to the
Commissioner of Administrative Services, who shall keep an account of the same and
turn over the amount received in payment thereof to the State Treasurer.
(1949 Rev., S. 2662; 1951, S. 1497d; 1967, P.A. 314, S. 16; P.A. 77-614, S. 70, 610.)
History: 1967 act substituted commissioner of finance and control for welfare commissioner; P.A. 77-614 replaced
commissioner of finance and control with commissioner of administrative services; Sec. 17-297 transferred to Sec. 17b-
227 in 1995.
Sec. 17b-228. (Formerly Sec. 17-298). Court action by state to recover unpaid
portion of charges. When any person has been supported, wholly or in part, by the state
in a humane institution, whether such person was admitted thereto as a pauper or indigent
or otherwise, and any portion of the charges for which such person or his liable relatives
were liable under the provisions of section 17b-223 remains unpaid, such person or such
relatives, as the case may be, or the estate of any such person or such relatives, shall be
liable to the state therefor, and the Commissioner of Administrative Services may, in
the name of the state, bring a complaint therefor, against any liable person or persons,
in any court having jurisdiction thereof in the county in which such liable person or the
conservator or guardian of such patient resides, or, if several are liable, in the county
in which any of them resides, and any other person who might, under the provisions
hereof, have been made a defendant in such action may be cited in as a party defendant
on motion of either party thereto. Said court may render judgment against the defendant,
or each or any of the several defendants, in favor of the state for the balance of the
charges remaining unpaid for which such defendants are liable, and payment of such
judgment may be secured by attachment and execution issued thereon. The limitation
of action provided in section 52-576 shall apply only to any such claim against a relative
as such, and any claim by the state for reimbursement of the balance of the billed charges
remaining unpaid from the estate of any deceased person shall be presented to the executor or administrator thereof within the time limited for the presentation of other claims
against such estate.
(1949 Rev., S. 2663; 1953, 1955, S. 1498d; 1959, P.A. 404; 1961, P.A. 62; 1967, P.A. 314, S. 16; 653, S. 1; 1969, P.A.
453, S. 4; P.A. 77-614, S. 70, 610.)
History: 1959 act specified Sec. 52-276 apply only to claims against a relative as such, raised amount of personal estate
limit from one to two thousand dollars, and reduced waiting time from ninety to thirty days; 1961 act deleted provision
for municipality to take estate proceedings, added expenses for last illness and burial and authorized banks, etc., having
control to pay sums to commissioner and deleted alternatives for paying same; 1967 acts substituted commissioner of
finance and control for welfare commissioner and raised personal estate limit from two thousand to thirty-five hundred
dollars; 1969 act deleted provisions re taking of estates not exceeding thirty-five thousand dollars by state; P.A. 77-614
replaced commissioner of finance and control with commissioner of administrative services; Sec. 17-298 transferred to
Sec. 17b-228 in 1995.
See Sec. 17b-222 for definition of "humane institution".
See Sec. 17b-745 re issuance of court order for support of persons supported by state and wage executions.
Annotations to former section 17-298:
Applies to a past expenditure. 93 C. 573. By bringing action, state subjects itself to the procedure established for its
final disposition. 119 C. 220. Trustee's agreement to pay for support furnished prior to death of testator held invalid. 119
C. 508. In action by city against same trustee, held no duty on trustee of discretionary trust to use fund for support of
inmate. 133 C. 31. Essential for recovery against an estate that decedent was able to reimburse the state during his lifetime.
140 C. 21, 26. Cited. 127 C. 58; 137 C. 319; 139 C. 472; 140 C. 214; 142 C. 329; 152 C. 55. Cited. 189 C. 726, 727.
Finding by probate court that a person was a pauper not conclusive because fact is a jurisdictional one. 4 CS 286. Statute
retrospective in operation because it does not originate a new cause of action but extends one which previously existed in
the state to the towns and cities. 11 CS 295. Not applicable to a person, certified insane after having been committed to
jail on a binding over process, and then transferred to a state hospital until the time of his trial. 14 CS 33. Cited. 15 CS
177. An action under this provision should not be entered on the jury docket. Id., 369. Claim for reimbursement for care
of tubercular patient allowed. 16 CS 118. Creates absolute liability on recipient of town aid for support and care in a humane
institution. 18 CS 337.
Commissioner may proceed under this section or section 17-324 to obtain support for a patient in a state humane
institution. 4 Conn. Cir. Ct. 81. Cited. 4 Conn. Cir. Ct. 548.
(a) No relative of a patient in a state humane institution, nor the estate of such relative, shall be
liable for any portion of the cost of support of any such patient in such institution for any
period prior to July 1, 1955, except unpaid charges billed by the Welfare Commissioner.
(b) The provisions of sections 17a-278, 17a-502, 17b-222, 17b-223, 17b-228, 17b-
232, 17b-748, 46b-215 and 53-304 shall not affect or impair the responsibility of any
patient or patient's estate for his care in a state humane institution prior to July 1, 1955,
and the same may be enforced by any action by which such responsibility would have
been enforceable prior to July 1, 1955, but only to the extent of that portion of such
estate as is not needed for the support of the spouse, parents and dependent children of
such patient.
(1955, S. 1499d; 1957, P.A. 330, S. 1, 2; February, 1965, P.A. 574, S. 25; P.A. 76-139, S. 11; P.A. 77-614, S. 587, 608,
610; P.A. 78-303, S. 85, 136; P.A. 91-406, S. 4, 29.)
History: 1965 act deleted references to Secs. 17-159, 17-168 and 17-323 and added reference to Sec. 17-174a; P.A.
76-139 deleted reference to Secs. 19-122, 19-123 and 19-124 repealed by same act; P.A. 77-614 and P.A. 78-303 would
have replaced welfare commissioner with commissioner of income maintenance but for qualifying date reference; P.A. 91-
406 made technical changes in Subsec. (b), deleting references to Secs. 17-174a, 17-296 and 17-320 and adding references to
Secs. 17a-278 and 46b-215; Sec. 17-299 transferred to Sec. 17b-229 in 1995.
Sec. 17b-230. (Formerly Sec. 17-300). Claim of state on death of institution
patient. Upon the death of a patient or of a person who has, at any time, been a patient
in a state humane institution, the state shall have a claim against his estate for reimbursement for institutional support according to the provisions of sections 17b-223, 17b-
224 and 17b-229 to the extent that the amount which the surviving spouse, parent or
dependent children of the decedent would otherwise take from such estate is not needed
for their support. Such claims shall have priority over all unsecured claims against such
estate, except (1) expenses of last sickness not to exceed three hundred seventy-five
dollars, (2) funeral and burial expenses in accordance with section 17b-84, (3) such
unpaid fees and expenses of the conservator of such patient, if any, as are authorized
by law and (4) administrative expenses, including probate fees and taxes, and including
fiduciary fees not exceeding the following commissions on the value of the whole estates
accounted for by such fiduciaries: On the first two thousand dollars or portion thereof,
five per cent; on the next eight thousand dollars or portion thereof, four per cent; on the
excess over ten thousand dollars, three per cent. Upon petition by any fiduciary, the
Probate Court, after hearing thereon, may authorize compensation in excess of the above
schedule for extraordinary services. Notice of any such petition and hearing shall be
given to the Commissioner of Administrative Services in Hartford at least ten days in
advance of such hearing. The allowable funeral and burial payment herein shall be
reduced by the amount of any prepaid funeral arrangement. Any amount paid from the
estate under this section to any person which exceeds the limits provided herein shall
be repaid to the estate by such person, and such amount may be recovered in a civil
action with interest at six per cent from the date of demand.
(1957, P.A. 500; 1959, P.A. 395, S. 3; 1961, P.A. 426, S. 3; 1963, P.A. 438, S. 9; February, 1965, P.A. 625, S. 8; 1967,
P.A. 151, S. 8; 314, S. 16; 1969, P.A. 730, S. 39; 1972, P.A. 294, S. 16; P.A. 77-614, S. 70, 610; P.A. 78-337, S. 10, 11;
P.A. 88-364, S. 27, 123.)
History: 1959 act amended Subdiv. (2) to raise total funeral and burial expenses from three hundred to six hundred
dollars and added Subdiv. (3) and provisions re reductions for prepaid funeral arrangements and recovery or repayment
of amounts paid in excess of limits; 1961 act clarified language re restrictions placed on application of Secs. 17-295 and
17-299; 1963 act reduced funeral and burial expense priority amount from six hundred to four hundred dollars; 1965 act
increased funeral and burial expense priority amount to four hundred fifty dollars; 1967 acts raised funeral and burial
expense ceiling to five hundred dollars and substituted commissioner of finance and control for welfare commissioner;
1969 act increased limit on funeral and burial expenses to six hundred dollars; 1972 act added reference to Sec. 17-295b;
P.A. 77-614 replaced commissioner of finance and control with commissioner of administrative services; P.A. 78-337
replaced specific dollar limit on funeral and burial expenses with reference to amounts allowed under Sec. 17-82q; P.A.
88-364 made technical change in section; Sec. 17-300 transferred to Sec. 17b-230 in 1995.
Annotations to former section 17-300:
Cited. 34 CS 518, 522, 523.
Sec. 17b-231. (Formerly Sec. 17-301). Refund for support of persons in state
institutions. Claim for any sum due from the state as a refund for the support of any
person in a state institution may be made by the person entitled thereto to the Commissioner of Administrative Services, in writing, on forms furnished by said commissioner,
who shall decide as to the amount due and, if satisfied that the claimant is entitled to
any refund, shall certify the amount due to the comptroller, who shall pay the same.
(1949 Rev., S. 2619; 1967, P.A. 314, S. 16; P.A. 77-614, S. 70, 610.)
History: 1967 act substituted commissioner of finance and control for welfare commissioner; P.A. 77-614 replaced
commissioner of finance and control with commissioner of administrative services; Sec. 17-301 transferred to Sec. 17b-
231 in 1995.
Annotations to former section 17-301:
Cited. 30 CS 118.
Sec. 17b-232. (Formerly Sec. 17-306). Payment for board and care in boarding
home, group home, convalescent hospital or other residential facility. The state,
through the agency of the state-operated facility, as defined in subsection (b) of section
17a-458, authorizing the transfer of a resident to a private boarding home for mental
patients, group home, chronic and convalescent hospital or other residential facility as
provided by section 17a-509, shall pay the cost of the board and care of such mentally
ill person, provided such cost shall not be in excess of the rates established under section
17b-340 for such facilities.
(1949 Rev., S. 2685; 1953, 1955, S. 1513d; 1957, P.A. 19; 1959, P.A. 543; P.A. 80-3; June Sp. Sess. P.A. 83-39, S. 3, 18.)
History: 1959 act deleted provision that state pay costs in addition to those paid in accordance with Sec. 17-295, added
that payment is not to exceed rates under Sec. 17-314 and substituted term "mentally retarded" for "mentally deficient";
P.A. 80-3 deleted state hospital reference, included state- operated facilities, regional centers or other facilities for care
and training of the mentally retarded and group homes or other residential facilities and updated section reference to reflect
transfer of Sec. 17-174 to Sec. 19-569h; June Sp. Sess. P.A. 83-39 deleted reference to state training schools, regional
centers or other facilities for the care and training of the mentally retarded and reference to Sec. 19a-451; Sec. 17-306
transferred to Sec. 17b-232 in 1995.
Sec. 17b-233. (Formerly Sec. 17-307). Care of handicapped and other children
at Newington Children's Hospital. Children with drug-related conditions not to
be admitted. Newington Children's Hospital may admit any child who is handicapped
or afflicted with any pediatric illness upon application of the selectmen of any town, or
the guardian or any relative of such child, or any public health agency or physician,
provided, no person shall be admitted primarily for the treatment of any drug-related
condition. Said hospital shall admit such child to said hospital if such child is pronounced
by the physicians on the staff of said hospital, after examination, to be suitable for
admission, and said hospital shall keep and support such child for such length of time
as it deems proper. Said hospital shall not be required to admit any such child unless it
can conveniently receive and care for such child at the time application is made and
said hospital may return to the town in which such child resides any child so taken who
is pronounced by the physicians on the staff of said hospital, after examination, to be
unsuitable for retention or who, by reason of improvement in his condition or completion
of his treatment or training, ought not to be further retained. The hospital may refuse
to admit any child pronounced by the physicians on the staff of said hospital, after
examination, to be unsuitable for admission and may refuse to admit any such child
when the facilities at the hospital will not, in the judgment of said physicians, permit
the hospital to care for such child adequately and properly.
(1949 Rev., S. 2609; June, 1949, 1955, S. 1440d; 1959, P.A. 610, S. 1; P.A. 80-293, S. 1, 2.)
History: 1959 act changed name of hospital, substituted affliction with "noncontagious pediatric illness or handicapping
physical condition" for "poliomyelitis or cerebral palsy or any uncontagious crippling disease," deleted statement that
child or relatives must be unable to pay and required that child be "suitable" rather than "fit" for admission; P.A. 80-293
changed admission requirement, substituting "handicapped" child for one "of sound mind who is a cripple", allowing
admission for any pediatric illness rather than for "noncontagious" illnesses alone and deleting reference to "handicapping
physical condition", and added proviso prohibiting admission "primarily for the treatment of any drug-related condition";
Sec. 17-307 transferred to Sec. 17b-233 in 1995.
Annotations to former section 17-307:
In tort action no recovery allowed for value of services rendered gratuitously by state-supported or other public charity.
129 C. 207.
The Department of Social Services shall
notify the Newington Children's Hospital of each referral for whom said department
can apply for federal matching grants. Newington Children's Hospital shall charge the
Department of Social Services for said eligible referrals only and shall retain all such
payments received from the department. Such payments by the state shall be in lieu of
all other payments to said hospital by the state or any town in this state except payments
by the Department of Social Services as provided in this section, the State Board of
Education or the Department of Public Health. Such payments shall not prevent payments to said hospital from private sources for the care and support of any child in said
hospital or for the balance of such operating expense. The Office of Health Care Access,
in establishing rates to be charged by the Newington Children's Hospital, shall not
include the grant made to said hospital pursuant to this section. In order to be eligible
for the grant authorized by this section, the Newington Children's Hospital shall cooperate with The University of Connecticut Health Center in order to provide consolidated
and coordinated pediatric services.
(June, 1949, 1951, 1953, S. 1441d; November, 1955, S. N167, N168; 1957, P.A. 550, S. 1; 1959, P.A. 610, S. 2; 1961,
P.A. 460, S. 1; P.A. 73-117, S. 20; 73-273, S. 1, 3; P.A. 74-182, S. 2, 3; P.A. 75-420, S. 4, 6; P.A. 77-614, S. 323, 608,
610; P.A. 79-560, S. 24, 39; P.A. 81-430, S. 1, 3; P.A. 82-91, S. 31, 38; June Sp. Sess. P.A. 83-32, S. 5, 8; P.A. 84-442,
S. 1, 2; P.A. 88-281, S. 1, 4; P.A. 93-262, S. 1, 87; 93-381, S. 9, 39; P.A. 95-257, S. 12, 21, 39, 58; June 18 Sp. Sess. P.A.
97-8, S. 20, 88.)
History: 1959 act changed name of hospital, increased per cent of operating expenses paid from twenty-five to twenty-
six per cent and added provision re per capita operating expense for preceding year; 1961 act increased portion of operating
expense paid to twenty-eight per cent and deleted exclusion, when calculating operating expense, for expense of operation
of farm; P.A. 73-117 replaced hospital cost commission with committee established under Sec. 17-311; P.A. 73-273
reduced state payment by amount paid by welfare department for services to children for whom said department receives
federal matching grants and added provisions re notice to hospital of eligible referrals and charges pertaining in such cases;
P.A. 74-182 changed payments' basis from year ending June thirtieth to year ending September thirtieth as of July 1, 1974,
and required determination of payment amount on or before July 1, 1974, adding provisions for making determination and
adjustments; P.A. 75-420 replaced welfare department with department of social services; P.A. 77-614 replaced department
of health with department of health services and replaced department of social services with department of income maintenance, effective January 1, 1979; P.A. 79-560 replaced references to committee established under Sec. 17-311 with references to commissioner of income maintenance; P.A. 81-430 lowered state's payment for support of children admitted to
the hospital from twenty-eight to twenty-four per cent of the hospital's operating cost; P.A. 82-91 added Subsec. (a) which
provided that (1) for fiscal years 82-83 and 83-84, the state grant to Newington Children's Hospital shall be the lesser of
$1,000,000 or the amount by which 24% of the hospital's operating expense exceeds payments to it by the department of
income maintenance, (2) the hospital shall retain all payments from said department, (3) the state grant shall be in lieu of
all other payments by the state or any town, except payments by said department or the state board of education and (4)
commission on hospitals and health care shall not include grant in establishing rates and specified that, in order to be
eligible for state grant the hospital shall cooperate with The University of Connecticut health center in order to provide
consolidated, coordinated pediatric services; June Sp. Sess. P.A. 83-32 amended Subsec. (a) which reduced the grant to
the Newington Children's Hospital from one million dollars to seven hundred fifty thousand dollars and excepted payments
by the department of health services from the provision that the state grant shall be in lieu of all other payments; P.A. 84-
442 deleted Subsec. (b) which would, effective July 1, 1984, establish the state's payment to the hospital at twenty-four
per cent of the hospital's operating expenses, and applied provisions formerly designated as Subsec. (a) to fiscal year
commencing July 1, 1984, and each year thereafter; P.A. 88-281 changed the amount of the annual grant, on behalf of the
department of health services, to the hospital from "the lesser of (1) seven hundred fifty thousand dollars or (2) the amount
by which twenty-four per cent of the operating expense of said hospital exceeds payments to said hospital by the department
of income maintenance for services to children for whom said department receives federal matching grants" to "the amount
appropriated to the department for the purposes of such grant" and repealed method for determination of "operating
expense"; P.A. 93-262 authorized substitution of commissioner and department of social services for commissioner and
department of income maintenance, effective July 1, 1993; P.A. 93-381 replaced department of health services with department of public health and addiction services, effective July 1, 1993; Sec. 17-308 transferred to Sec. 17b-234 in 1995;
P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and
Department of Public Health and replaced Commission on Hospitals and Health Care with Office of Health Care Access,
effective July 1, 1995; June 18 Sp. Sess. P.A. 97-8 deleted obsolete provision re grants to Newington Children's Hospital,
effective July 1, 1997.
Annotation to former section 17-308:
Cited. 33 CA 673, 693.
Nothing
in section 17b-234 shall preclude the state from paying retroactive claims to Newington
Children's Hospital for the purpose of claiming federal reimbursement.
(P.A. 73-273, S. 2, 3.)
History: Sec. 17-308a transferred to Sec. 17b-235 in 1995.
When there is found in any town in this state any
child of sound mind who is physically disabled or who is afflicted with poliomyelitis
or rheumatic fever, or any uncontagious disabling disease, and who is unable to pay and
whose relatives who are legally liable for his support are unable to pay the full cost of
treating such disease, if such child and one of such relatives reside in this state, the
selectmen of such town, or the guardian or any relative of such child, or any public
health agency or physician in this state, may make application to The Children's Center,
located at Hamden, for the admission of such child to said center. Said center shall admit
such child if such child is pronounced by the physicians on the staff of said center, after
examination, to be fit for admission, and said center shall keep and support such child
for such length of time as it deems proper. Said center shall not be required to admit
any such child unless it can conveniently receive and care for him at the time such
application is made, and said center may return to the town in which such child resides
any child so taken who is pronounced by the physicians on the staff of said center, after
examination, to be unfit for retention, or who, by reason of improvement in his condition
or completion of his treatment or training, ought not to be further retained. The center
may refuse to admit any child who is pronounced by the physicians on the staff of said
center, after examination, to be unfit for admission, and may refuse to admit any such
child when the facilities at the center will not, in the judgment of said physicians, permit
the center to care for such child adequately and properly.
(1955, S. 1442d; 1969, P.A. 571, S. 7, 9.)
History: 1969 act changed name of New Haven Orphan Asylum to the Children's Center; Sec. 17-309 transferred to
Sec. 17b-236 in 1995.
Sec. 17b-237. (Formerly Sec. 17-310). State aid toward support of children at
center. The state shall pay annually toward the support of children who have been
admitted to the center in accordance with the provisions of section 17b-236 twenty-five
per cent of the operating expense of the convalescent hospital for the preceding year
ended June thirtieth. Such amount shall be determined annually by the Commissioner
of Social Services. Upon the determination by said commissioner of such amount, said
commissioner shall notify the Comptroller thereof, and the Comptroller shall pay
monthly during the ensuing fiscal year one-twelfth of the amount so determined. Such
payments by the state shall not abrogate any responsibility for payments by the state or
any town or any person for care in said center, except that for care in said convalescent
hospital of any child directly supported by the state the charge for such care to the state
shall not exceed seventy-five per cent of the daily average cost rate for the preceding
year ended June thirtieth as such rate shall be determined by said commissioner.
(1955, S. 1443d; 1957, P.A. 541, S. 1; P.A. 73-117, S. 21, 31; P.A. 79-560, S. 25, 39; P.A. 93-262, S. 1, 87.)
History: P.A. 73-117 replaced hospital cost commission with "the committee established under ... section 17-311";
P.A. 79-560 replaced references to committee and incorrect references to its predecessor, the commission, with references
to commissioner of income maintenance; P.A. 93-262 authorized substitution of commissioner and department of social
services for commissioner and department of income maintenance, effective July 1, 1993; Sec. 17-310 transferred to Sec.
17b-237 in 1995.
(a) The
Commissioner of Social Services shall establish annually the cost of services for which
payment is to be made under the provisions of section 17b-239. All hospitals receiving
state aid shall submit their cost data under oath on forms approved by the commissioner.
The commissioner may adopt, in accordance with the provisions of chapter 54, regulations concerning the submission of data by institutions and agencies to which payments
are to be made under sections 17b-239, 17b-243, 17b-244, 17b-340, 17b-341 and section
17b-343, and the defining of policies utilized by the commissioner in establishing rates
under said sections, which data and policies are necessary for the efficient administration
of said sections. The commissioner shall provide, upon request, a statement of interpretation of the Medicaid cost-related reimbursement system regulations for long-term care
facilities reimbursed under section 17b-340 concerning allowable and unallowable costs
or expenditures. Such statement of interpretation shall not be construed to constitute a
regulation violative of chapter 54. Failure of such statement of interpretation to address
a specific unallowable cost or expenditure fact pattern shall in no way prevent the commissioner from enforcing all applicable laws and regulations.
(b) Any institution or agency to which payments are to be made under sections 17b-
239 to 17b-246, inclusive, and sections 17b-340 and 17b-343 which is aggrieved by
any decision of said commissioner may, within ten days after written notice thereof
from the commissioner, obtain, by written request to the commissioner, a rehearing on
all items of aggrievement. On and after July 1, 1996, a rehearing shall be held by the
commissioner or his designee, provided a detailed written description of all such items
is filed within ninety days of written notice of the commissioner's decision. The rehearing shall be held within thirty days of the filing of the detailed written description of
each specific item of aggrievement. The commissioner shall issue a final decision within
sixty days of the close of evidence or the date on which final briefs are filed, whichever
occurs later. Any designee of the commissioner who presides over such rehearing shall
be impartial and shall not be employed within the Department of Social Services office
of certificate of need and rate setting. Any such items not resolved at such rehearing to
the satisfaction of either such institution or agency or said commissioner shall be submitted to binding arbitration to an arbitration board consisting of one member appointed by
the institution or agency, one member appointed by the commissioner and one member
appointed by the Chief Court Administrator from among the retired judges of the Superior Court, which retired judge shall be compensated for his services on such board in
the same manner as a state referee is compensated for his services under section 52-
434. The proceedings of the arbitration board and any decisions rendered by such board
shall be conducted in accordance with the provisions of the Social Security Act, 49 Stat.
620 (1935), 42 USC 1396, as amended from time to time, and chapter 54.
(c) The submission of any false or misleading fiscal information or data to said
commissioner shall be grounds for suspension of payments by the state under sections
17b-239 to 17b-246, inclusive, and sections 17b-340 and 17b-343 in accordance with
regulations adopted by said commissioner. In addition, any person, including any corporation, who knowingly makes or causes to be made any false or misleading statement
or who knowingly submits false or misleading fiscal information or data on the forms
approved by the commissioner shall be guilty of a class D felony.
(d) Said commissioner, or any agent authorized by the commissioner to conduct
any inquiry, investigation or hearing under the provisions of this section, shall have
power to administer oaths and take testimony under oath relative to the matter of inquiry
or investigation. At any hearing ordered by the commissioner, the commissioner or such
agent having authority by law to issue such process may subpoena witnesses and require
the production of records, papers and documents pertinent to such inquiry. If any person
disobeys such process or, having appeared in obedience thereto, refuses to answer any
pertinent question put to him by the commissioner or his authorized agent or to produce
any records and papers pursuant thereto, the commissioner or his agent may apply to
the superior court for the judicial district of Hartford or for the judicial district wherein
the person resides or wherein the business has been conducted, or to any judge of said
court if the same is not in session, setting forth such disobedience to process or refusal
to answer, and said court or such judge shall cite such person to appear before said court
or such judge to answer such question or to produce such records and papers.
(1949, 1953, S. 1585d; 1961, P.A. 474, S. 1; February, 1965, P.A. 146; 1969, P.A. 506; 642, S. 1; 1971, P.A. 300; P.A.
73-117, S. 22, 31; P.A. 75-420, S. 4, 6; 75-562, S. 5, 8; P.A. 76-244; 76-436, S. 10a, 592, 681; P.A. 77-574, S. 3, 6; 77-
593, S. 3, 4; 77-614, S. 19, 344, 587, 610; P.A. 78-264, S. 1, 4; 78-280, S. 1, 5, 127; 78-303, S. 85, 136; P.A. 79-182, S.
2, 4; P.A. 80-196, S. 1, 2; P.A. 81-249; P.A. 83-73; P.A. 86-319, S. 2; P.A. 88-156, S. 18; 88-230, S. 1, 12; 88-317, S. 74,
107; P.A. 90-98, S. 1, 2; P.A. 93-142, S. 4, 7, 8; 93-262, S. 1, 87; P.A. 95-220, S. 4—6; 95-351, S. 24, 30.)
History: 1961 act added commissioners of finance and control and mental health, deleted requirement that commission
prescribe and provide uniform forms and provided that commission approve cost data forms; 1965 act added Subsec. (b);
1969 acts replaced hospital cost analyst with executive director of commission in Subsec. (a) and replaced appeal provisions
in Subsec. (b) with provisions for rehearing and required aggrieved hospital to file within ten days after receiving notice
rather than within thirty days; 1971 act replaced state budget director with commissioner of finance and control in Subsec.
(a) and added commission's power to make regulations and define policies used in establishing rates; P.A. 73-117 replaced
commission with committee, removed commissioner of health as member and added chairman and vice chairman of
commission on hospitals and health care and replaced provision concerning executive director with statement that necessary
staff will be made available by commission on hospitals and health care; P.A. 75-420 replaced welfare commissioner with
commissioner of social services; P.A. 75-562 made department of health responsible for supplying necessary staff; P.A.
76-244 added Subsec. (c) re power to administer oaths, take testimony, issue subpoenas, etc.; P.A. 76-436 replaced chief
judge with chief court administrator in Subsec. (b), effective July 1, 1978; P.A. 77-574 replaced "hospital" with "institution
or agency ..." in Subsec. (b); P.A. 77-593 inserted new Subsec. (c) re submission of false or misleading fiscal information
and relettered former Subsec. (c) as Subsec. (d); P.A. 77-614 and P.A. 78-303 replaced commissioner of finance and control
with secretary of the office of policy and management as committee member but later provision replaced committee with
commissioner of income maintenance and removed reference to staff supplied by health department, effective January 1,
1979; P.A. 78-264 repealed amendments to Subsec. (a) made by P.A. 77-614; P.A. 78-280 replaced "county" with "judicial
district" and "Hartford courts", with "judicial district of Hartford-New Britain"; P.A. 79-182 added reference to Sec. 17-
314a in Subsec. (a); P.A. 80-196 required that proceedings of arbitration board be conducted in accordance with Social
Security and Uniform Administrative Procedure Act; P.A. 81-249 amended Subsec. (c) to provide that any person, including
any corporation, who knowingly makes or causes to be made any false or misleading statement or who knowingly submits
false or misleading fiscal information shall be guilty of a class D felony; P.A. 83-73 amended Subsec. (a) to provide for a
statement of interpretation of the medicaid cost related reimbursement system regulations; P.A. 86-319 added references
to Sec. 17-314c; P.A. 88-156 made a technical correction in Subsec. (b); P.A. 88-230 replaced "judicial district of Hartford-
New Britain" with "judicial district of Hartford", effective September 1, 1991; P.A. 88-317 amended Subsec. (b) by
substituting "chapter 54" for "the Uniform Administrative Procedure Act, sections 4-166 to 4-189", effective July 1, 1989,
and applicable to all agency proceedings commencing on or after that date; P.A. 90-98 changed the effective date of P.A.
88-230 from September 1, 1991, to September 1, 1993; P.A. 93-142 changed the effective date of P.A. 88-230 from
September 1, 1993, to September 1, 1996, effective June 14, 1993; P.A. 93-262 authorized substitution of commissioner
and department of social services for commissioner and department of income maintenance, effective July 1, 1993; Sec.
17-311 transferred to Sec. 17b-238 in 1995; P.A. 95-220 changed the effective date of P.A. 88-230 from September 1,
1996, to September 1, 1998, effective July 1, 1995; P.A. 95-351 amended Subsec. (b) by adding provisions for a rehearing,
effective July 1, 1995.
See Sec. 19a-630 for applicable definitions.
Annotations to former section 17-311:
Subsec. (b):
Cited. 42 CS 348, 349, 351, 352, 354. Cited. Id., 558—561.
Subsec. (c):
Cited. 242 C. 345.
Annotations to present section:
Subsec. (a):
Cited. 242 C. 345.
Subsec. (c):
Cited. 242 C. 345.
(a)
The rate to be paid by the state to hospitals receiving appropriations granted by the
General Assembly and to freestanding chronic disease hospitals, providing services to
persons aided or cared for by the state for routine services furnished to state patients,
shall be based upon reasonable cost to such hospital, or the charge to the general public
for ward services or the lowest charge for semiprivate services if the hospital has no
ward facilities, imposed by such hospital, whichever is lowest, except to the extent, if
any, that the commissioner determines that a greater amount is appropriate in the case
of hospitals serving a disproportionate share of indigent patients. Such rate shall be
promulgated annually by the Commissioner of Social Services. Nothing contained
herein shall authorize a payment by the state for such services to any such hospital in
excess of the charges made by such hospital for comparable services to the general
public. Notwithstanding the provisions of this section, for the rate period beginning July
1, 2000, rates paid to freestanding chronic disease hospitals and freestanding psychiatric
hospitals shall be increased by three per cent. For the rate period beginning July 1, 2001,
a freestanding chronic disease hospital or freestanding psychiatric hospital shall receive
a rate that is two and one-half per cent more than the rate it received in the prior fiscal
year and such rate shall remain effective until December 31, 2002. Effective January
1, 2003, a freestanding chronic disease hospital or freestanding psychiatric hospital shall
receive a rate that is two per cent more than the rate it received in the prior fiscal year.
Notwithstanding the provisions of this subsection, for the period commencing July 1,
2001, and ending June 30, 2003, the commissioner may pay an additional total of no
more than three hundred thousand dollars annually for services provided to long-term
ventilator patients. For purposes of this subsection, "long-term ventilator patient" means
any patient at a freestanding chronic disease hospital on a ventilator for a total of sixty
days or more in any consecutive twelve-month period.
(b) Effective October 1, 1991, the rate to be paid by the state for the cost of special
services rendered by such hospitals shall be established annually by the commissioner
for each such hospital based on the reasonable cost to each hospital of such services
furnished to state patients. Nothing contained herein shall authorize a payment by the
state for such services to any such hospital in excess of the charges made by such hospital
for comparable services to the general public.
(c) The term "reasonable cost" as used in this section means the cost of care furnished such patients by an efficient and economically operated facility, computed in
accordance with accepted principles of hospital cost reimbursement. The commissioner
may adjust the rate of payment established under the provisions of this section for the
year during which services are furnished to reflect fluctuations in hospital costs. Such
adjustment may be made prospectively to cover anticipated fluctuations or may be made
retroactive to any date subsequent to the date of the initial rate determination for such
year or in such other manner as may be determined by the commissioner. In determining
"reasonable cost" the commissioner may give due consideration to allowances for fully
or partially unpaid bills, reasonable costs mandated by collective bargaining agreements
with certified collective bargaining agents or other agreements between the employer
and employees, provided "employees" shall not include persons employed as managers
or chief administrators, requirements for working capital and cost of development of
new services, including additions to and replacement of facilities and equipment. The
commissioner shall not give consideration to amounts paid by the facilities to employees
as salary, or to attorneys or consultants as fees, where the responsibility of the employees,
attorneys or consultants is to persuade or seek to persuade the other employees of the
facility to support or oppose unionization. Nothing in this subsection shall prohibit the
commissioner from considering amounts paid for legal counsel related to the negotiation
of collective bargaining agreements, the settlement of grievances or normal administration of labor relations.
(d) The state shall also pay to such hospitals for each outpatient clinic and emergency
room visit a reasonable rate to be established annually by the commissioner for each
hospital, such rate to be determined by the reasonable cost of such services. The emergency room visit rates in effect June 30, 1991, shall remain in effect through June 30,
1993, except those which would have been decreased effective July 1, 1991, or July 1,
1992, shall be decreased. Nothing contained herein shall authorize a payment by the
state for such services to any hospital in excess of the charges made by such hospital
for comparable services to the general public. For those outpatient hospital services paid
on the basis of a ratio of cost to charges, the ratios in effect June 30, 1991, shall be
reduced effective July 1, 1991, by the most recent annual increase in the consumer price
index for medical care. For those outpatient hospital services paid on the basis of a ratio
of cost to charges, the ratios computed to be effective July 1, 1994, shall be reduced
by the most recent annual increase in the consumer price index for medical care. The
emergency room visit rates in effect June 30, 1994, shall remain in effect through December 31, 1994. The Commissioner of Social Services shall establish a fee schedule for
outpatient hospital services to be effective on and after January 1, 1995. Except with
respect to the rate periods beginning July 1, 1999, and July 1, 2000, such fee schedule
shall be adjusted annually beginning July 1, 1996, to reflect necessary increases in the
cost of services. Notwithstanding the provisions of this subsection, the fee schedule for
the rate period beginning July 1, 2000, shall be increased by ten and one-half per cent,
effective June 1, 2001.
(e) The commissioner shall adopt regulations, in accordance with the provisions of
chapter 54, establishing criteria for defining emergency and nonemergency visits to
hospital emergency rooms. All nonemergency visits to hospital emergency rooms shall
be paid at the hospital's outpatient clinic services rate. Nothing contained in this subsection or the regulations adopted hereunder shall authorize a payment by the state for such
services to any hospital in excess of the charges made by such hospital for comparable
services to the general public.
(f) On and after October 1, 1984, the state shall pay to an acute care general hospital
for the inpatient care of a patient who no longer requires acute care a rate determined
by the following schedule: For the first seven days following certification that the patient
no longer requires acute care the state shall pay the hospital at a rate of fifty per cent of
the hospital's actual cost; for the second seven-day period following certification that
the patient no longer requires acute care the state shall pay seventy-five per cent of the
hospital's actual cost; for the third seven-day period following certification that the
patient no longer requires acute care and for any period of time thereafter, the state shall
pay the hospital at a rate of one hundred per cent of the hospital's actual cost. On and
after July 1, 1995, no payment shall be made by the state to an acute care general hospital
for the inpatient care of a patient who no longer requires acute care and is eligible for
Medicare unless the hospital does not obtain reimbursement from Medicare for that stay.
(g) Effective June 1, 2001, the commissioner shall establish inpatient hospital rates
in accordance with the method specified in regulations adopted pursuant to this section
and applied for the rate period beginning October 1, 2000, except that the commissioner
shall update each hospital's target amount per discharge to the actual allowable cost per
discharge based upon the 1999 cost report filing multiplied by sixty-two and one-half
per cent if such amount is higher than the target amount per discharge for the rate period
beginning October 1, 2000, as adjusted for the ten per cent incentive identified in Section
4005 of Public Law 101-508. If a hospital's rate is increased pursuant to this subsection,
the hospital shall not receive the ten per cent incentive identified in Section 4005 of
Public Law 101-508. For rate periods beginning October 1, 2001, and October 1, 2002,
the commissioner shall not apply an annual adjustment factor to the target amount per
discharge.
(1949, 1953, S. 1586d; 1961, P.A. 474, S. 2; 1967, P.A. 726, S. 1; 1969, P.A. 339, S. 1; P.A. 73-117, S. 23, 31; P.A.
77-574, S. 4, 6; P.A. 79-560, S. 26, 39; P.A. 81-472, S. 111, 159; P.A. 84-367, S. 1, 3; P.A. 85-482, S. 1, 2; P.A. 87-27,
S. 1; 87-516, S. 1, 5; P.A. 88-156, S. 19; P.A. 89-296, S. 6, 9; June Sp. Sess. P.A. 91-8, S. 13, 43, 63; May Sp. Sess. P.A.
92-16, S. 25, 89; P.A. 93-262, S. 1, 87; May Sp. Sess. P.A. 94-5, S. 2, 30; P.A. 95-160, S. 25, 69; 95-306, S. 1, 7; 95-351,
S. 28, 30; P.A. 96-139, S. 12, 13; P.A. 98-131, S. 1, 2; P.A. 99-279, S. 13, 14, 45; June Sp. Sess. P.A. 00-2, S. 15, 53; June
Sp. Sess. P.A. 01-2, S. 11, 66, 69; June Sp. Sess. P.A. 01-3, S. 1, 2, 6; June Sp. Sess. P.A. 01-9, S. 119, 120, 121, 129, 131;
May 9 Sp. Sess. P.A. 02-7, S. 57.)
History: 1961 act changed technical language, added standard of comparable charges to Subsec. (a), deleted requirement
of Subsec. (b) that special services be professional and added Subsec. (c); 1967 act changed term "welfare" to "state"
patients, restricted standard of comparable charges in Subsec. (a), made allowances for unpaid bills, working capital
requirements and services development costs in determination of "actual cost" in Subsec. (c) and added Subsec. (d); 1969
act allowed alternative rates in Subsec. (a) based on charges for ward or semiprivate facilities and placed limit on rate for
outpatient clinic visit in Subsec. (d); P.A. 73-117 replaced hospital cost commission with committee established in accordance with Sec. 17-311; P.A. 77-574 included allowances for costs associated with collective bargaining agreements in
Subsec. (c); P.A. 79-560 replaced committee with commissioner of income maintenance; P.A. 81-472 made technical
changes; P.A. 84-367 changed the basis of the rate from "actual" to "reasonable" cost and added Subsec. (e) setting rates
for the inpatient care of patients who no longer require acute care; P.A. 85-482 amended Subsec. (d) by substituting "one
hundred sixteen" per cent for "one hundred fifty" per cent of combined average fee of general practitioner and specialist
for office visit as maximum rate for an outpatient clinic visit; P.A. 87-27 amended Subsec. (c) to exclude from "reasonable
cost" amounts paid to employees, attorneys or consultants due to unionization disputes; P.A. 87-516 allowed the commissioner to establish a rate cap if he receives approval for a disproportionate share exemption pursuant to federal regulations;
P.A. 88-156 added freestanding chronic disease hospitals providing services to persons aided or cared for by the state for
routine services furnished to state patients and gave the commissioner the discretion to set a higher rate for hospitals serving
a disproportionate share of indigent patients; P.A. 89-296 amended Subsec. (d) to prohibit the state from paying a hospital
for services in excess of the charges made by the hospital for comparable services to the public, added a new Subsec. (e)
requiring the commissioner to adopt regulations establishing criteria for defining emergency and nonemergency visits to
hospital emergency rooms and relettered former Subsec. (e) as Subsec. (f); June Sp. Sess. P.A. 91-8 amended Subsec. (b)
to add a provision re payment by the state of charges in excess of charges made when comparable service is rendered to
the general public and amended Subsec. (d) re rates paid by the state for outpatient clinic, services, emergency room visits
and outpatient hospital services paid on the basis of a ratio of cost to charges; May Sp. Sess. P.A. 92-16 amended Subsec.
(d) by providing that emergency room visit rates in effect on June 30, 1991, shall remain in effect through June 30, 1993,
except that those which would decrease on July 1, 1992, shall decrease; P.A. 93-262 authorized substitution of commissioner
and department of social services for commissioner and department of income maintenance, effective July 1, 1993; May
Sp. Sess. P.A. 94-5 amended Subsec. (d) to add a formula concerning outpatient hospital services paid on the basis of a
ratio of cost to charges and required the commissioner to establish a fee schedule for outpatient hospital services, effective
July 1, 1994; Sec. 17-312 transferred to Sec. 17b-239 in 1995; P.A. 95-160 amended Subsec. (a) by adding a provision
for rates to be paid to freestanding chronic disease hospitals, effective July 1, 1995; P.A. 95-306 amended Subsec. (f) by
prohibiting payment to an acute care general hospital for inpatient care of a patient if such patient is no longer in need of
such care and is eligible for Medicare, unless Medicare reimbursement is not received for such care, effective July 1, 1995;
P.A. 95-351 amended Subsec. (a) by providing that the commissioner use the "actual charge based on utilized service"
instead of the "cost of service" when determining rates paid to freestanding chronic disease hospitals, effective July 1,
1995; P.A. 96-139 changed effective date of P.A. 95-160 but without affecting this section; P.A. 98-131 added new Subsec.
(g) requiring commissioner to establish hospital inpatient rates, effective July 1, 1998; P.A. 99-279 amended Subsec. (d)
to eliminate annual increases in the fee schedule for outpatient hospital services for the rate periods beginning July 1, 1999,
and July 1, 2000, and amended Subsec. (g) to provide an exception for the rate period beginning October 1, 1998, from
the application of the three per cent annual adjustment factor to the target amount per discharge, to prohibit the commissioner
from applying an annual adjustment factor for succeeding rate periods, and to make a technical change, effective July 1,
1999; June Sp. Sess. P.A. 00-2 amended Subsec. (a) by deleting provisions re rates paid to freestanding chronic disease
hospitals on and after July 1, 1995, and inserting provisions re rates paid to freestanding chronic disease hospitals and
freestanding psychiatric hospitals, beginning July 1, 2000, and thereafter, effective July 1, 2000; June Sp. Sess. P.A. 01-
2 amended Subsec. (a) to make a technical change for the purpose of gender neutrality, to require commissioner to use the
rate of the highest-paid freestanding chronic disease hospital for any freestanding chronic disease hospital having more
than an average of fifteen per cent of its inpatient days utilized as long-term ventilator patient days beginning for the rate
period ending in 2001, in lieu of rate paid for period when determining rates paid on and after July 1, 2001, notwithstanding
provisions of subsection, and to define term "long-term ventilator patient", effective July 1, 2001, and further amended
Subsec. (a) to remove discretion of commissioner re determination of appropriate amount in the case of hospitals serving
a disproportionate number share of indigent patients and to replace provisions re rates paid to freestanding chronic disease
hospitals and freestanding psychiatric hospitals for rate period beginning July 1, 2001, effective July 2, 2001; June Sp.
Sess. P.A. 01-3 amended Subsec. (d) by deleting provisions re rate for outpatient clinic visit and rate cap for outpatient
clinics upon approval of disproportionate share exemption and adding provision re increase of fee schedule for rate period
beginning July 1, 2001, and amended Subsec. (g) by deleting former provisions and adding provisions re establishment
of inpatient hospital rates, effective July 1, 2001; June Sp. Sess. P.A. 01-9 amended Subsec. (d) to make ten and one-half
per cent increase applicable to rate period beginning July 1, 2000, and effective June 1, 2001, and amended Subsec. (g) to
make June 1, 2001, the date by which the commissioner is to establish inpatient hospital rates, effective July 1, 2001, and
revised effective date of June Sp. Sess. P.A. 01-2 but without affecting this section; May 9 Sp. Sess. P.A. 02-7 amended
Subsec. (a) by delaying from July 1, 2002, to January 1, 2003, a two per cent rate increase to a free standing chronic disease
hospital and a free standing psychiatric hospital and maintaining effectiveness of existing rate until December 31, 2002,
effective August 15, 2002.
Annotations to former section 17-312:
Cited. 175 C. 49, 60, 65. Cited. 181 C. 130—132, 135.
Subsec. (a):
Cited. 175 C. 49, 60. Cited. 181 C. 130, 133, 135.
For the fiscal year ending June 30, 2002, and the fiscal year
ending June 30, 2003, the Department of Social Services may, within available funds,
make payments to all short-term general hospitals located in distressed municipalities, as
defined in section 32-9p, with a population greater than seventy thousand. The payment
amount for each hospital shall be determined by the Commissioner of Social Services
based upon the ratio that the number of inpatient discharges paid by Medicaid on a fee-
for-service basis to the hospital for the most recently filed cost report period bears to
the total hospital discharges paid by Medicaid on a fee-for-service basis for all qualifying
hospitals. Notwithstanding the provisions of this section, no payment shall be made to
a facility licensed as a children's hospital.
(June Sp. Sess. P.A. 01-3, S. 4, 6.)
History: June Sp. Sess. P.A. 01-3 effective July 1, 2001.
Sec. 17b-240. (Formerly Sec. 17-312a). Payments to hospitals by the Office of
Health Care Access. Notwithstanding the provisions of section 17b-239, the rate to be
paid by the state to a hospital receiving appropriations granted by the General Assembly
shall be established annually by the Office of Health Care Access pursuant to the provisions of chapter 368z, provided said office receives a waiver of Medicare principles of
reimbursement from the Department of Health and Human Services pursuant to Section
222 of Public Law 92-603. This section shall be effective only for such period as said
waiver remains in effect.
(P.A. 78-250, S. 1, 2; P.A. 95-257, S. 39, 58.)
History: Sec. 17-312a transferred to Sec. 17b-240 in 1995; P.A. 95-257 replaced Commission on Hospitals and Health
Care with Office of Health Care Access, effective July 1, 1995.
Annotations to former section 17-312a:
Cited. 181 C. 130, 135.
(a) Any
rates established by the Commissioner of Social Services in effect February 1, 1991,
for mental health and substance abuse residential facilities shall remain in effect through
June 30, 1992, except those which would have been decreased effective July 1, 1991,
shall be decreased. Any rate increases made during the fiscal year ending June 30, 1993,
shall not exceed the most recent annual increase in the consumer price index for urban
consumers.
(b) Any rates established by the Commissioner of Social Services in effect February
1, 1991, for free-standing detoxification centers shall remain in effect through June 30,
1992, except those which would have been decreased effective July 1, 1991, shall be
decreased. Any rate increases made during the fiscal years ending June 30, 1993, June
30, 1994, and June 30, 1995, shall not exceed the most recent annual increase in the
consumer price index for urban consumers. Any free-standing detoxification center
which has an established rate below the average and, due to a material change in circumstances resulting in financial hardship, is aggrieved by a rate determined pursuant to
this subsection may, within ten days of receipt of written notice of such rate from the
commissioner, request in writing a hearing on such rate. The commissioner shall, upon
the receipt of all documentation necessary to evaluate the request, determine whether
there has been such a change in circumstances and shall conduct a hearing if appropriate.
(June Sp. Sess. P.A. 91-8, S. 16, 63; May Sp. Sess. P.A. 92-16, S. 33, 89; P.A. 93-262, S. 1, 87; 93-418, S. 23, 41.)
History: May Sp. Sess. P.A. 92-16 amended Subsecs. (a) and (b) by adding provision to each requiring that any rate
increases made during the fiscal year ending June 30, 1993, shall not exceed the most recent annual increase in the consumer
price index for urban consumers; P.A. 93-262 authorized substitution of commissioner and department of social services
for commissioner and department of income maintenance, effective July 1, 1993; P.A. 93-418 amended Subsec. (b) to
make provisions applicable to the fiscal years ending June 30, 1994, and June 30, 1995 and added provision regarding
free-standing detoxification centers' request for hearing on a rate established by the commissioner, effective July 1, 1993;
Sec. 17-312b transferred to Sec. 17b-241 in 1995.
Sec. 17b-242. (Formerly Sec. 17-313). Payments to home health care agencies
and homemaker-home health aide agencies. Appeals. Hearings. Regulations. (a)
The Department of Social Services shall determine the rates to be paid to home health
care agencies and homemaker-home health aide agencies by the state or any town in
the state for persons aided or cared for by the state or any such town. For the period
from February 1, 1991, to January 31, 1992, inclusive, payment for each service to the
state shall be based upon the rate for such service as determined by the Office of Health
Care Access, except that for those providers whose Medicaid rates for the year ending
January 31, 1991, exceed the median rate, no increase shall be allowed. For those providers whose rates for the year ending January 31, 1991, are below the median rate, increases
shall not exceed the lower of the prior rate increased by the most recent annual increase
in the consumer price index for urban consumers or the median rate. In no case shall
any such rate exceed the eightieth percentile of rates in effect January 31, 1991, nor
shall any rate exceed the charge to the general public for similar services. Rates effective
February 1, 1992, shall be based upon rates as determined by the Office of Health Care
Access, except that increases shall not exceed the prior year's rate increased by the
most recent annual increase in the consumer price index for urban consumers and rates
effective February 1, 1992, s
