Committees approve 5-year renewal of Connecticut Home Care Program for Elders waiver

The Human Services Committee and the Appropriations Committee approved the five-year renewal of the Connecticut Home Care Program for Elders (CHCPE) 1915(c) waiver on Sept. 11, 2025, allowing the state to submit the waiver renewal to the federal Centers for Medicare & Medicaid Services (CMS).

The Connecticut Department of Social Services (DSS) told the committees the renewal does not make substantive changes to the waiver, which currently serves more than 15,000 older adults who are at risk of institutionalization. William Halsey, Medicaid director at the Department of Social Services, introduced the application and said DSS was seeking committee support to submit the renewal to CMS.

The waiver renewal was approved in a roll call vote in Human Services and again in Appropriations. Human Services recorded a tally of 17 yea, 6 absent; the Appropriations recorded 41 yea, 0 nay, 12 absent. The motion in Human Services was moved by Representative Nathan and seconded by Senator Anwar; the Appropriations motion was moved by Senator Lesser and seconded by Representative Dathan.

Why it matters: CHCPE supports a package of home- and community-based services for Connecticut residents age 65 and older, including adult day health, personal care assistance, Meals on Wheels, case management, homemaker services, respite for family caregivers, assisted living supports and environmental accessibility adaptations. DSS said the waiver helps prevent or delay nursing-home placement for people who can remain safely in the community.

Department officials told the committees the renewal is primarily administrative. “This renewal does not make substantive changes to the existing program,” Halsey said. Christine Weston, director of community options at DSS, told members the department received one public comment during the required 30-day public comment period — from a provider identified as Careforth — requesting revisions to the adult family living service. “We received 1 comment, from, a home and community based service provider named Careforth,” Weston said.

DSS said it did not adopt Careforth’s recommendations as part of the renewal because the department intends to do a more comprehensive review of the adult family living service, which DSS described as the waiver’s fastest-growing service. Weston said roughly 4,500 members currently use adult family living and that DSS will convene focus groups with providers, members and families and consult with other states before proposing any substantive amendment. "We owe a really deep dive to reimagine the service," she said.

DSS also told legislators that the state is operating the waiver under a temporary CMS extension after the prior five-year authorization technically expired on June 30. The department said the temporary extension preserves coverage for participants while the renewal proceeds.

Policy and implementation details discussed during the hearing included: - CMS renewal timing: Committee members were reminded that CMS requires 1915(c) waivers to be renewed every five years; DSS submitted a ‘‘no substantive change’’ five-year renewal to meet that requirement. - Service trends and outreach: Several legislators asked DSS to provide outreach materials and application guidance for constituents and to review utilization trends for certain services such as environmental accessibility adaptations (ramps, grab bars, door widening). DSS said it will provide a one-page summary of the program and application routes and that members should contact assigned case managers to request environmental adaptations. - Rate adjustments outside the renewal: DSS reported a scheduled rate increase effective Jan. 1, 2026 intended to address low-wage worker pay on waiver programs. The department said a 4.9% increase will be applied to affected procedure codes to reduce the risk of a Medicaid reimbursement gap and to support provider wage increases.

Voting and next steps: After the committee approvals, DSS will submit the five-year renewal application to CMS. DSS officials said they expect to return to the committees later with a proposed waiver amendment that would follow the department’s planned focus groups and program review for adult family living. DSS also said it is evaluating IT and staffing needs connected to broader federal changes discussed in HR 1 and will provide the committees with further information as it becomes available.

The committee hearings included multiple members’ questions and clarifications; DSS said the CHCPE program does not currently maintain a wait list although applicants may face processing delays while completing functional and financial eligibility assessments. The department said there are phone, online and paper application routes and that it will provide materials for legislative offices to distribute.

The committees’ approvals do not change waiver-covered services immediately; changes to service definitions, rates or covered items would require subsequent formal amendments filed with CMS and committee review.