AN ACT CONCERNING THE REBASING OF RATES OF REIMBURSEMENT FOR CERTAIN RESIDENTIAL FACILITIES.

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General Assembly Substitute Bill No. 5358
February Session, 2026

AN ACT CONCERNING THE REBASING OF RATES OF
REIMBURSEMENT FOR CERTAIN RESIDENTIAL FACILITIES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:

Section 1. Subsections (a) and (b) of section 17b -244 of the general 1
statutes are repealed and the following is substituted in lieu thereof 2
(Effective July 1, 2026): 3
(a) The room and board component of the rates to be paid by the state 4
to private facilities and facilities operated by regional education service 5
centers which are licensed to provide residential care pursuant to 6
section 17a-227, but not certified to participate in the Title XIX Medicaid 7
program as intermediate care facilities for individuals with intellectual 8
disabilities, shall be determined annually by the Commissioner of Social 9
Services, except that rates effective April 30, 1989, shall remain in effect 10
through October 31, 1989. Any facility with real property other than 11
land placed in service prior to July 1, 1991, shall, for the fiscal year 12
ending June 30, 1995, receive a rate of return on real property equal to 13
the average of the rates of return applied to real property other than land 14
placed in service for the five years preceding July 1, 1993. For the fiscal 15
year ending June 30, 1996, and any succeeding fiscal year, the rate of 16
return on real property for property items shall be revised every five 17
years. The commissioner shall, upon submission of a request by such 18
facility, allow actual debt service, comprised of principal and interest, 19
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on the loan or loans in lieu of property costs allowed pursuant to section 20
17-313b-5 of the regulations of Connecticut state agencies, whether 21
actual debt service is higher or lower than such allowed property costs, 22
provided such debt service terms and amounts are reasonable in 23
relation to the useful life and the base value of the property. In the case 24
of facilities financed through the Connecticut Housing Finance 25
Authority, the commissioner shall allow actual debt service, comprised 26
of principal, interest and a reasonable repair and replacement reserve 27
on the loan or loans in lieu of property costs allowed pursuant to section 28
17-313b-5 of the regulations of Connecticut state agencies, whether 29
actual debt service is higher or lower than such allowed property costs, 30
provided such debt service terms and amounts are determined by the 31
commissioner at the time the loan is entered into to be reasonable in 32
relation to the useful life and base value of the property. The 33
commissioner may allow fees associated with mortgage refinancing 34
provided such refinancing will result in state reimbursement savings, 35
after comparing costs over the terms of the existing proposed loans. For 36
the fiscal year ending June 30, 1992, the inflation factor used to 37
determine rates shall be one -half of the gross national product 38
percentage increase for the period between the midpoint of the cost year 39
through the midpoint of the rate year. For fiscal year ending June 30, 40
1993, the inflation factor used to determine rates shall be two -thirds of 41
the gross national product percentage increase from the midpoint of the 42
cost year to the midpoint of the rate year. For the fiscal years ending 43
June 30, 1996, and June 30, 1997, no inflation factor shall be applied in 44
determining rates. The Commissioner of Social Services shall prescribe 45
uniform forms on which such facilities shall report their costs. Such rates 46
shall be determined on the basis of a reasonable payment for necessary 47
services. Any increase in grants, gifts, fund -raising or endowment 48
income used for the payment of operating costs by a private facility in 49
the fiscal year ending June 30, 1992, shall be excluded by the 50
commissioner from the income of the facility in determining the rates to 51
be paid to the facility for the fiscal year ending June 30, 1993, provided 52
any operating costs funded by such increase shall not obligate the state 53
to increase expenditures in subsequent fiscal years. Nothing contained 54
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in this section shall authorize a payment by the state to any such facility 55
in excess of the charges made by the facility for comparable services to 56
the general public. The service component of the rates to be paid by the 57
state to private facilities and facilities operated by regional education 58
service centers which are licensed to provide residential care pursuant 59
to section 17a -227, but not certified to participate in the Title XIX 60
Medicaid programs as intermediate care facilities for individuals with 61
intellectual disabilities, shall be determined annually by the 62
Commissioner of Developmental Services in accordance with section 63
17b-244a. For the fiscal year ending June 30, 2008, no facility shall receive 64
a rate that is more than two per cent greater than the rate in effect for 65
the facility on June 30, 2007, except any facility that would have been 66
issued a lower rate effective July 1, 2007, due to interim rate status or 67
agreement with the department, shall be issued such lower rate effective 68
July 1, 2007. For the fiscal year ending June 30, 2009, no facility shall 69
receive a rate that is more than two per cent greater than the rate in effect 70
for the facility on June 30, 2008, except any facility that would have been 71
issued a lower rate effective July 1, 2008, due to interim rate status or 72
agreement with the department, shall be issued such lower rate effective 73
July 1, 2008. For the fiscal years ending June 30, 2010, and June 30, 2011, 74
rates in effect for the period ending June 30, 2009, shall remain in effect 75
until June 30, 2011, except that (1) the rate paid to a facility may be higher 76
than the rate paid to the facility for the period ending June 30, 2009, if a 77
capital improvement required by the Commissioner of Developmental 78
Services for the health or safety of the residents was made to the facility 79
during the fiscal years ending June 30, 2010, or June 30, 2011, and (2) any 80
facility that would have been issued a lower rate for the fiscal year 81
ending June 30, 2010, or June 30, 2011, due to interim rate status or 82
agreement with the department, shall be issued such lower rate. For the 83
fiscal year ending June 30, 2012, rates in effect for the period ending June 84
30, 2011, shall remain in effect until June 30, 2012, except that (A) the 85
rate paid to a facility may be higher than the rate paid to the facility for 86
the period ending June 30, 2011, if a capital improvement required by 87
the Commissioner of Developmental Services for the health or safety of 88
the residents was made to the facility during the fiscal year ending June 89
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30, 2012, and (B) any facility that would have been issued a lower rate 90
for the fiscal year ending June 30, 2012, due to interim rate status or 91
agreement with the department, shall be issued such lower rate. Any 92
facility that has a significant decrease in land and building costs shall 93
receive a reduced rate to reflect such decrease in land and building costs. 94
The rate paid to a facility may be increased if a capital improvement 95
approved by the Department of Developmental Services, in consultation 96
with the Department of Social Services, for the health or safety of the 97
residents was made to the facility during the fiscal year ending June 30, 98
2014, or June 30, 2015, only to the extent such increases are within 99
available appropriations. For the fiscal years ending June 30, 2016, and 100
June 30, 2017, rates shall not exceed those in effect for the period ending 101
June 30, 2015, except the rate paid to a facility may be higher than the 102
rate paid to the facility for the period ending June 30, 2015, if a capital 103
improvement approved by the Department of Developmental Services, 104
in consultation with the Department of Social Services, for the health or 105
safety of the residents was made to the facility during the fiscal year 106
ending June 30, 2016, or June 30, 2017, to the extent such rate increases 107
are within available appropriations. For the fiscal years ending June 30, 108
2016, and June 30, 2017, and each succeeding fiscal year, any facility that 109
would have been issued a lower rate, due to interim rate status, a change 110
in allowable fair rent or agreement with the department, shall be issued 111
such lower rate. For the fiscal years ending June 30, 2018, and June 30, 112
2019, rates shall not exceed those in effect for the period ending June 30, 113
2017, except the rate paid to a facility may be higher than the rate paid 114
to the facility for the period ending June 30, 2017, if a capital 115
improvement approved by the Department of Developmental Services, 116
in consultation with the Department of Social Services, for the health or 117
safety of the residents was made to the facility during the fiscal year 118
ending June 30, 2018, or June 30, 2019, to the extent such rate increases 119
are within available appropriations. For the fiscal years ending June 30, 120
2020, and June 30, 2021, rates shall not exceed those in effect for the fiscal 121
year ending June 30, 2019, except the rate paid to a facility may be higher 122
than the rate paid to the facility for the fiscal year ending June 30, 2019, 123
if a capital improvement approved by the Department of 124
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Developmental Services, in consultation with the Department of Social 125
Services, for the health or safety of the residents was made to the facility 126
during the fiscal year ending June 30, 2020, or June 30, 2021, to the extent 127
such rate increases are within available appropriations. For the fiscal 128
years ending June 30, 2022, and June 30, 2023, rates shall be based upon 129
rates in effect for the fiscal year ending June 30, 2021, inflated by the 130
gross domestic product deflator applicable to each rate year, except the 131
commissioner may, in the commissioner's discretion and within 132
available appropriations, provide pro rata fair rent increases to facilities 133
which have documented fair rent additions placed in service in the cost 134
report years ending September 30, 2020, and September 30, 2021, that 135
are not otherwise included in rates issued, or if a rate adjustment for a 136
capital improvement approved by the Department of Developmental 137
Services, in consultation with the Department of Social Services, for the 138
health or safety of the residents was made to the facility during the fiscal 139
year ending June 30, 2022, or June 30, 2023. For the fiscal year ending 140
June 30, 2024, rates shall not exceed those in effect for the fiscal year 141
ending June 30, 2023, except the rate paid to a facility may be higher 142
than the rate paid to the facility for the fiscal year ending June 30, 2023, 143
if a capital improvement approved by the Department of 144
Developmental Services, in consultation with the Department of Social 145
Services, for the health or safety of the residents was made to the facility 146
during the fiscal year ending June 30, 2024, to the extent such rate 147
increases are within available appropriations. On or after July 1, 2026, 148
costs shall be rebased every two years. For the fiscal year ending June 149
30, 2027, rates shall not be rebased. Rebasing shall be based on the cost 150
report period ending June thirtieth, as filed with the department, from 151
the two years prior to the year in which the rebasing occurs. There shall 152
be no inflationary increase to rates during a year in which rebasing 153
occurs. Any increase to rates based on inflation shall be applied prior to 154
the application of any other budget adjustment factors that may impact 155
such rates. Notwithstanding any other provisions of this chapter or 156
section 17-313b-5 of the regulations of Connecticut state agencies, any 157
subsequent increase to allowable operating costs, excluding fair rent, 158
shall be inflated by the gross domestic product deflator. The rate of 159
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inflation shall be computed by comparing the most recent rate year to 160
the average of the gross domestic product deflator for the previous four 161
fiscal quarters ending March thirty-first. 162
(b) Notwithstanding the provisions of subsection (a) of this section, 163
state rates of payment for the fiscal years ending June 30, 2018, June 30, 164
2019, June 30, 2020, and June 30, 2021, for residential care homes and 165
community living arrangements that receive the flat rate for residential 166
services under section 17-311-54 of the regulations of Connecticut state 167
agencies shall be set in accordance with section 298 of public act 19-117. 168
For the fiscal years ending June 30, 2022, and June 30, 2023, rates shall 169
be based upon rates in effect for the fiscal year ending June 30, 2021, 170
inflated by the gross domestic product deflator applicable to each rate 171
year. Notwithstanding any other provisions of this chapter, any 172
subsequent increase to allowable operating costs, excluding fair rent, 173
shall be inflated by the gross domestic product deflator. The rate of 174
inflation shall be computed by comparing the most recent rate year to 175
the average of the gross domestic product deflator for the previous four 176
fiscal quarters ending March thirty-first. Any increase to rates based on 177
inflation shall be applied prior to the application of any other budget 178
adjustment factors that may impact such rates. 179
Sec. 2. Subdivision (1) of subsection (h) of section 17b-340 of the 2026 180
supplement to the general statutes, as amended by section 64 of public 181
act 26 -1, is repealed and the following is substituted in lieu thereof 182
(Effective July 1, 2026): 183
(h) (1) For the fiscal year ending June 30, 1993, any intermediate care 184
facility for individuals with intellectual disabilities with an operating 185
cost component of its rate in excess of one hundred forty per cent of the 186
median of operating cost components of rates in effect January 1, 1992, 187
shall not receive an operating cost component increase. For the fiscal 188
year ending June 30, 1993, any intermediate care facility for individuals 189
with intellectual disabilities with an operating cost component of its rate 190
that is less than one hundred forty per cent of the median of operating 191
cost components of rates in effect January 1, 1992, shall have an 192
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allowance for real wage growth equal to thirty per cent of the increase 193
determined in accordance with subsection (q) of section 17-311-52 of the 194
regulations of Connecticut state agencies, provided such operating cost 195
component shall not exceed one hundred forty per cent of the median 196
of operating cost components in effect January 1, 1992. Any facility with 197
real property other than land placed in service prior to October 1, 1991, 198
shall, for the fiscal year ending June 30, 1995, receive a rate of return on 199
real property equal to the average of the rates of return applied to real 200
property other than land placed in service for the five years preceding 201
October 1, 1993. For the fiscal year ending June 30, 1996, and any 202
succeeding fiscal year, the rate of return on real property for property 203
items shall be revised every five years. The commissioner shall, upon 204
submission of a request, allow actual debt service, comprised of 205
principal and interest, in excess of property costs allowed pursuant to 206
section 17 -311-52 of the regulations of Connecticut state agencies, 207
provided such debt service terms and amounts are reasonable in 208
relation to the useful life and the base value of the property. For the fiscal 209
year ending June 30, 1995, and any succeeding fiscal year, the inflation 210
adjustment made in accordance with subsection (p) of section 17-311-52 211
of the regulations of Connecticut state agencies shall not be applied to 212
real property costs. For the fiscal year ending June 30, 1996, and any 213
succeeding fiscal year, the allowance for real wage growth, as 214
determined in accordance with subsection (q) of section 17-311-52 of the 215
regulations of Connecticut state agencies, shall not be applied. For the 216
fiscal year ending June 30, 1996, and any succeeding fiscal year, no rate 217
shall exceed three hundred seventy -five dollars per day unless the 218
commissioner, in consultation with the Commissioner of 219
Developmental Services, determines after a review of program and 220
management costs, that a rate in excess of this amount is necessary for 221
care and treatment of facility residents. For the fiscal year ending June 222
30, 2002, rate period, the Commissioner of Social Services shall increase 223
the inflation adjustment for rates made in accordance with subsection 224
(p) of section 17-311-52 of the regulations of Connecticut state agencies 225
to update allowable fiscal year 2000 costs to include a three and one-half 226
per cent inflation factor. For the fiscal year ending June 30, 2003, rate 227
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period, the commissioner shall increase the inflation adjustment for 228
rates made in accordance with subsection (p) of section 17-311-52 of the 229
regulations of Connecticut state agencies to update allowable fiscal year 230
2001 costs to include a one and one-half per cent inflation factor, except 231
that such increase shall be effective November 1, 2002, and such facility 232
rate in effect for the fiscal year ending June 30, 2002, shall be paid for 233
services provided until October 31, 2002, except any facility that would 234
have been issued a lower rate effective July 1, 2002, than for the fiscal 235
year ending June 30, 2002, due to interim rate status or agreement with 236
the department shall be issued such lower rate effective July 1, 2002, and 237
have such rate updated effective November 1, 2002, in accordance with 238
applicable statutes and regulations. For the fiscal year ending June 30, 239
2004, rates in effect for the period ending June 30, 2003, shall remain in 240
effect, except any facility that would have been issued a lower rate 241
effective July 1, 2003, than for the fiscal year ending June 30, 2003, due 242
to interim rate status or agreement with the department shall be issued 243
such lower rate effective July 1, 2003. For the fiscal year ending June 30, 244
2005, rates in effect for the period ending June 30, 2004, shall remain in 245
effect until September 30, 2004. Effective October 1, 2004, each facility 246
shall receive a rate that is five per cent greater than the rate in effect 247
September 30, 2004. Effective upon receipt of all the necessary federal 248
approvals to secure federal financial participation matching funds 249
associated with the rate increase provided in subdivision (4) of 250
subsection (f) of this section, but in no event earlier than October 1, 2005, 251
and provided the user fee imposed under section 17b-320 is required to 252
be collected, each facility shall receive a rate that is four per cent more 253
than the rate the facility received in the prior fiscal year, except any 254
facility that would have been issued a lower rate effective October 1, 255
2005, than for the fiscal year ending June 30, 2005, due to interim rate 256
status or agreement with the department, shall be issued such lower rate 257
effective October 1, 2005. Such rate increase shall remain in effect unless: 258
(A) The federal financial participation matching funds associated with 259
the rate increase are no longer available; or (B) the user fee created 260
pursuant to section 17b -320 is not in effect. For the fiscal year ending 261
June 30, 2007, rates in effect for the period ending June 30, 2006, shall 262
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remain in effect until September 30, 2006, except any facility that would 263
have been issued a lower rate effective July 1, 2006, than for the fiscal 264
year ending June 30, 2006, due to interim rate status or agreement with 265
the department, shall be issued such lower rate effective July 1, 2006. 266
Effective October 1, 2006, no facility shall receive a rate that is more than 267
three per cent greater than the rate in effect for the facility on September 268
30, 2006, except any facility that would have been issued a lower rate 269
effective October 1, 2006, due to interim rate status or agreement with 270
the department, shall be issued such lower rate effective October 1, 2006. 271
For the fiscal year ending June 30, 2008, each facility shall receive a rate 272
that is two and nine-tenths per cent greater than the rate in effect for the 273
period ending June 30, 2007, except any facility that would have been 274
issued a lower rate effective July 1, 2007, than for the rate period ending 275
June 30, 2007, due to interim rate status, or agreement with the 276
department, shall be issued such lower rate effective July 1, 2007. For the 277
fiscal year ending June 30, 2009, rates in effect for the period ending June 278
30, 2008, shall remain in effect until June 30, 2009, except any facility that 279
would have been issued a lower rate for the fiscal year ending June 30, 280
2009, due to interim rate status or agreement with the department, shall 281
be issued such lower rate. For the fiscal years ending June 30, 2010, and 282
June 30, 2011, rates in effect for the period ending June 30, 2009, shall 283
remain in effect until June 30, 2011, except any facility that would have 284
been issued a lower rate for the fiscal year ending June 30, 2010, or the 285
fiscal year ending June 30, 2011, due to interim rate status or agreement 286
with the department, shall be issued such lower rate. For the fiscal year 287
ending June 30, 2012, rates in effect for the period ending June 30, 2011, 288
shall remain in effect until June 30, 2012, except any facility that would 289
have been issued a lower rate for the fiscal year ending June 30, 2012, 290
due to interim rate status or agreement with the department, shall be 291
issued such lower rate. For the fiscal years ending June 30, 2014, and 292
June 30, 2015, rates shall not exceed those in effect for the period ending 293
June 30, 2013, except the rate paid to a facility may be higher than the 294
rate paid to the facility for the period ending June 30, 2013, if a capital 295
improvement approved by the Department of Developmental Services, 296
in consultation with the Department of Social Services, for the health or 297
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safety of the residents was made to the facility during the fiscal year 298
ending June 30, 2014, or June 30, 2015, to the extent such rate increases 299
are within available appropriations. Any facility that would have been 300
issued a lower rate for the fiscal year ending June 30, 2014, or the fiscal 301
year ending June 30, 2015, due to interim rate status or agreement with 302
the department, shall be issued such lower rate. For the fiscal years 303
ending June 30, 2016, and June 30, 2017, rates shall not exceed those in 304
effect for the period ending June 30, 2015, except the rate paid to a 305
facility may be higher than the rate paid to the facility for the period 306
ending June 30, 2015, if a capital improvement approved by the 307
Department of Developmental Services, in consultation with the 308
Department of Social Services, for the health or safety of the residents 309
was made to the facility during the fiscal year ending June 30, 2016, or 310
June 30, 2017, to the extent such rate increases are within available 311
appropriations. For the fiscal years ending June 30, 2016, and June 30, 312
2017, and each succeeding fiscal year, any facility that would have been 313
issued a lower rate, due to interim rate status, a change in allowable fair 314
rent or agreement with the department, shall be issued such lower rate. 315
For the fiscal years ending June 30, 2018, and June 30, 2019, rates shall 316
not exceed those in effect for the period ending June 30, 2017, except the 317
rate paid to a facility may be higher than the rate paid to the facility for 318
the period ending June 30, 2017, if a capital improvement approved by 319
the Department of Developmental Services, in consultation with the 320
Department of Social Services, for the health or safety of the residents 321
was made to the facility during the fiscal year ending June 30, 2018, or 322
June 30, 2019, only to the extent such rate increases are within available 323
appropriations. For the fiscal years ending June 30, 2020, and June 30, 324
2021, rates shall not exceed those in effect for the fiscal year ending June 325
30, 2019, except the rate paid to a facility may be higher than the rate 326
paid to the facility for the fiscal year ending June 30, 2019, if a capital 327
improvement approved by the Department of Developmental Services, 328
in consultation with the Department of Social Services, for the health or 329
safety of the residents was made to the facility during the fiscal year 330
ending June 30, 2020, or June 30, 2021, only to the extent such rate 331
increases are within available appropriations. For the fiscal year ending 332
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June 30, 2022, rates shall not exceed those in effect for the fiscal year 333
ending June 30, 2021, except the commissioner may, in the 334
commissioner's discretion and within available appropriations, provide 335
pro rata fair rent increases to facilities that have documented fair rent 336
additions placed in service in the cost report year ending September 30, 337
2020, that are not otherwise included in rates issued. For the fiscal year 338
ending June 30, 2023, rates shall not exceed those in effect for the fiscal 339
year ending June 30, 2022, except the commissioner may, in the 340
commissioner's discretion and within available appropriations, provide 341
pro rata fair rent increases to facilities which have documented fair rent 342
additions placed in service in the cost report year ending September 30, 343
2021, that are not otherwise included in rates issued. For the fiscal years 344
ending June 30, 2022, and June 30, 2023, a facility may receive a rate 345
increase for a capital improvement approved by the Department of 346
Developmental Services, in consultation with the Department of Social 347
Services, for the health or safety of the residents during the fiscal year 348
ending June 30, 2022, or June 30, 2023, only to the extent such rate 349
increases are within available appropriations. There shall be no increase 350
to rates based on inflation or any inflationary factor for the fiscal years 351
ending June 30, 2022, and June 30, 2023. Notwithstanding any other 352
provisions of this chapter, any subsequent increase to allowable 353
operating costs, excluding fair rent, shall be inflated by the gross 354
domestic product deflator when funding is specifically appropriated for 355
such purposes in the enacted budget. The rate of inflation shall be 356
computed by comparing the most recent rate year to the average of the 357
gross domestic product deflator for the previous four fiscal quarters 358
ending March thirty-first. Any increase to rates based on inflation shall 359
be applied prior to the application of any other budget adjustment 360
factors that may impact such rates. For the fiscal year ending June 30, 361
2024, the department shall determine facility rates based upon 2022 cost 362
report filings subject to the provisions of this section, adjusted to reflect 363
any rate increases provided after the cost report year ending June 30, 364
2022, and with the addition of a two per cent adjustment factor. No 365
facility shall receive a rate less than the rate in effect for the fiscal year 366
ending June 30, 2023. For the fiscal year ending June 30, 2024, the 367
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minimum per diem, per bed rate shall remain at five hundred one 368
dollars for a residential facility licensed pursuant to section 17a-227 and 369
certified to participate in the Title XIX Medicaid program as an 370
intermediate care facility for individuals with intellectual disability. 371
There shall be no increase to rates based on any inflationary factor for 372
the fiscal year ending June 30, 2024. For the fiscal year ending June 30, 373
2024, and each subsequent fiscal year, the commissioner may, in the 374
commissioner's discretion and within available appropriations, provide 375
pro rata fair rent increases to facilities that have documented fair rent 376
additions placed in service in the cost report years that are not otherwise 377
included in rates issued. For the fiscal year ending June 30, 2025, the 378
department shall determine facility rates based upon 2023 cost report 379
filings subject to the provisions of this section, adjusted to reflect any 380
rate increases provided after the cost report ending June 30, 2023. A 381
facility may receive a rate that is less than the rate in effect for the fiscal 382
year ending June 30, 2024, but shall not receive a rate less than the 383
minimum per diem, per bed rate. For the fiscal year ending June 30, 384
2025, the minimum per diem, per bed rate shall remain at five hundred 385
one dollars for a residential facility licensed pursuant to section 17a-227 386
and certified to participate in the Title XIX Medicaid program as an 387
intermediate care facility for individuals with intellectual disability. 388
There shall be no increase to rates based on any inflationary factor for 389
the fiscal year ending June 30, 2025. For the fiscal year ending June 30, 390
2026, the department shall determine facility rates based upon 2024 cost 391
report filings subject to the provisions of this section, adjusted to reflect 392
any rate increases provided after the cost report ending June 30, 2024. 393
Additionally, the facility shall receive a rate that is three and four-tenths 394
per cent greater than the calculated rate, except that any facility that 395
would have been issued a lower rate effective July 1, 2025, due to interim 396
rate status, or agreement with the department, shall be issued such 397
lower rate effective July 1, 2025. For the fiscal year ending June 30, 2026, 398
there shall be no minimum per diem, per bed rate for a residential 399
facility licensed pursuant to section 17a -227 and certified to participate 400
in the Title XIX Medicaid program as an intermediate care facility for 401
individuals with intellectual disability. There shall be no increase to 402
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rates based on any inflationary factor for the fiscal year ending June 30, 403
2026. For the fiscal year ending June 30, 2027, each facility shall receive 404
a rate that is five and eight-tenths per cent greater than the rate in effect 405
for the period ending June 30, 2026, except that any facility that would 406
have been issued a lower rate effective July 1, 2026, than the rate for the 407
period ending June 30, 2027, due to interim rate status, or agreement 408
with the department, shall be issued such lower rate effective July 1, 409
2026. On or after July 1, 2027, costs shall be rebased every two years. 410
Rebasing will be based on the cost report period ending September 411
thirtieth, as filed with the department, from the two years prior to the 412
year in which the rebasing occurs. There shall be no inflationary increase 413
to rates during a year in which rebasing occurs. Any increase to rates 414
based on inflation shall be applied prior to the application of any other 415
budget adjustment factors that may impact such rates. For the fiscal year 416
ending June 30, 2028, the issued rate shall be adjusted to reflect any rate 417
increases provided after the cost report period ending June 30, 2026, and 418
each facility shall receive a rate that is six and three -tenths per cent 419
greater than the calculated rate, [in effect for the period ending June 30, 420
2027,] except that any facility that would have been issued a lower rate 421
effective July 1, 2027, than the rate for the period ending June 30, 2027, 422
due to interim rate status, or agreement with the department, shall be 423
issued such lower rate effective July 1, 2027. Effective January 1, 2028, 424
each facility shall receive a rate that is six and three -tenths per cent 425
greater than the rate in effect for the period ending December 31, 2027, 426
except that any facility that would have been issued a lower rate 427
effective January 1, 2028, than the rate for the period ending December 428
31, 2027, due to interim rate status, or agreement with the department, 429
shall be issued such lower rate effective January 1, 2028. For the fiscal 430
years ending June 30, 2024, and June 30, 2025, a facility may receive a 431
rate increase for a capital improvement approved by the Department of 432
Developmental Services, in consultation with the Department of Social 433
Services, for the health or safety of the residents during the fiscal year 434
ending June 30, 2024, or June 30, 2025, only to the extent such rate 435
increases are within available appropriations. For the fiscal years ending 436
June 30, 2026, and June 30, 2027, a facility may receive a rate increase for 437
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a capital improvement approved by the Department of Developmental 438
Services, in consultation with the Department of Social Services, for the 439
health or safety of the residents during the fiscal year ending June 30, 440
2026, or June 30, 2027, only to the extent such rate increases are within 441
available appropriations. Any facility that has a significant decrease in 442
land and building costs shall receive a reduced rate to reflect such 443
decrease in land and building costs. For the fiscal years ending June 30, 444
2012, June 30, 2013, June 30, 2014, June 30, 2015, June 30, 2016, June 30, 445
2017, June 30, 2018, June 30, 2019, June 30, 2020, June 30, 2021, June 30, 446
2022, June 30, 2023, June 30, 2024, June 30, 2025, June 30, 2026, and June 447
30, 2027, the Commissioner of Social Services may provide fair rent 448
increases to any facility that has undergone a material change in 449
circumstances related to fair rent and has an approved certificate of need 450
pursuant to section 17b -352, 17b -353, 17b -354 or 17b -355. The 451
Department of Social Services shall amend the regulations of 452
Connecticut state agencies to allow for the waiver of the separate 453
inflation cost limitation on direct care costs when rebasing rates for 454
intermediate care facilities for individuals with intellectual disabilities 455
after the fiscal year ending June 30, 2027. [Notwithstanding the 456
provisions of this section, the Commissioner of Social Services may, 457
within available appropriations, increase or decrease rates issued to 458
intermediate care facilities for individuals with intellectual disabilities 459
to reflect a reduction in available appropriations as provided in 460
subsection (a) of this section. ] For the fiscal years ending June 30, 2014, 461
and June 30, 2015, the commissioner shall not consider rebasing in 462
determining rates. Notwithstanding the provisions of this subsection, 463
effective July 1, 2021, and July 1, 2022, the commissioner shall, within 464
available appropriations, increase rates for the purpose of wage and 465
benefit enhancements for employees of intermediate care facilities. 466
Facilities that receive a rate adjustment for the purpose of wage and 467
benefit enhancements but do not provide increases in employee salaries 468
as described in this subsection on or before July 31, 2021, and July 31, 469
2022, respectively, may be subject to a rate decrease in the same amount 470
as the adjustment by the commissioner. 471
Substitute Bill No. 5358

LCO 15 of 15

This act shall take effect as follows and shall amend the following
sections:

Section 1 July 1, 2026 17b-244(a) and (b)
Sec. 2 July 1, 2026 17b-340(h)(1)

HS Joint Favorable Subst.
APP Joint Favorable