Legitalk:

[Unidentified public testifier (home care provider)]: The VA and Medicare are paying. It's really becoming difficult for me to attract staff, to retain staff, and, you know, we want to provide these services. It's just a question of whether we can afford to and it it the squeeze is is really getting difficult. And you know this. I'm just here to testify the same thing that other people are saying. We want to we want people to have access to care, and we want to provide care. Please help. Absolutely. Thank you for listening and have a good night.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: Yes. Thank you. Thank you very much. Okay. Representative Gilchrist.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Alright.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: Let me pass this back to you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you. Is Heather George with us? How about Giselle Nino? Oh, did that. Tom oh, we did those. I'm sorry. That was okay. That was Jill. Okay. So 111. Carol Rios. Daneli Santos. Monica Nugent. Cameron English. Jean Mills. Go right ahead.

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: Sorry. Forgot how to unmute. Good evening. I'm glad I'm not saying good morning. I'm Jean Mills, I'm an elder law attorney with Connecticut Legal Services. I've submitted written testimony. So I'll try to go quickly and just hit the highlights and hopefully you'll read my testimony. I'm submitting this testimony on behalf of all three of Connecticut's legal aid programs and our low income and elderly and disabled clients who include former and current SNAP recipients and residents of nursing homes. First, I'd like to, testify in favor of Senate Bill four ninety seven, an act protecting food security for veterans and others and mitigating federal cuts to nutritional assistance. Last year, 12% of Connecticut households, 450,110 of our neighbors use SNAP benefits. Also last year, President Trump signed HR1, which enacted extreme changes and cuts to SNAP. Eligibility was tightened and work requirements were expanded, affecting millions of Americans and according to DSS, approximately 36,000 residents of Connecticut who could lose SNAP benefits. Some of them already have. It's absolutely clear that a lot of Connecticut residents and all parts of the States are going to be hungrier and less healthy as a result of these federal reductions in SNAP. SB four ninety seven offers a way to protect food security for veterans and others and to mitigate federal cuts to SNAP assistance. This is the kind of help Connecticut's food insecure residents need. Veterans are specifically exempted from work requirements under this bill. Many of the other impacted groups of people under the federal snap cuts called vulnerable persons in the bill will be eligible to receive assistance to include benefits of at least 194 per month for up to a year, access to drive job training. And the case management to help document compliance with work requirements or eligibility for federal exemptions to work requirements. We suggest that an adult who is a caretaker for a child between the ages of fourteen and eighteen be added to Section four d of Senate Bill four ninety seven, as these individuals were fully exempted from work requirements prior to HR one, and should continue to be. We also believe that the time limit, the twelve month time limit for assistance, especially for caretakers and the refugee population should be removed as those groups may have barriers to working that may not be addressed by access to job training and case management services.

[Committee staff/host (technical or brief interjections)]: Also in this bill, there is section seven, which is a plan to initiate a food as medicine program under Medicaid for Connecticut,

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: which would be another source of nutritious food for individuals and families in need. And we also support Section eight, which adds an annual cost of living adjustment to Meals on Wheels providers, serving participants in the Connecticut Home Care Program for the Elderly. Senate Bill four ninety seven is a good bill and we support its passage. I also like to speak briefly on Senate Bill four eighty one and act establishing financial safeguards for private equity ownership of nursing homes and prohibited required arbitration agreements. We strongly support Senate Bill four eighty one. I've testified the past few years on similar bills with respect to private equity in nursing homes. It's well known that private equity companies exist to earn money for their investors. They're increasingly investing in nursing homes and their investment strategies often incompatible with the nursing homes responsibility to provide good staffing and quality care to nursing home residency, residents. There's a trans the section one of the bill requires every nursing home to provide the file extensive information to the commissioner of DSS annually. And this transparency requirement is well backed up by a provision which allows the commissioner to impose a penalty of $1,000 per day on any nursing home which fails to provide such information. This protects residents against sudden closure or lack of funding for staff.

[Committee timekeeper]: Please summarize.

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: Sure. The proposed statute also provides that no one can sell a property within five years of acquisition of it, which is to prevent the usual flipping of property that we know private equity firms do. Other states have done this New York, Massachusetts and New Jersey and I've cited those laws, in my testimony. And lastly, section two, prohibits nursing homes from requiring that a resident or prospective resident sign an arbitration agreement as a condition of admission or continued care. And this is a strong protection for nursing home residents who may have a complaint against the facility, for example, for poor poor care. So we strongly support the passage of Senate Bill four eighty one as well. Thank you so much for your time and answer any questions.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. I don't see any questions. We so appreciate your testimony. Have a great evening.

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: Thank you.

[Committee staff/host (technical or brief interjections)]: Thank

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: you. Next is Caleb Rosmi.

[Caleb Rosemey (Assured Quality Home Care; CT Association for Healthcare at Home)]: Hello. I wanna thank you all for this opportunity to talk. Distinguished members of the appropriation committee, my name is Caleb Rosemey, and I serve as the chair for the home care committee, you know, and I am a board member as well of the Connecticut Association for Healthcare at Home. And I am also the CEO of Assured Quality Home Care, and I'm here today in strong support of HB 5,561. Exactly one year ago, and actually a month ago as well, I submitted testimony, describing the industry being at its breaking point. Today, you know, the pressure has only intensified When you adjust for inflation, our Medicaid reimbursement rates are currently underfunded by over 50% compared to our 2007 levels. Agencies are not just passed through, wait for wages. We manage the essential infrastructure for that the state relies on. We, have to carry payroll taxes, workers' comp, provide training, and 20 fourseven backup coverage for our care for our caregivers who provide care for the vulnerable elderly and vulnerable in the community. And, you know, we are required to operate legally and responsible, and yet the currently, the state's reimbursements do not reflect these fully burdened costs, especially compared to our neighbors. Our agency as well operates in Rhode Island, and, the reimbursement rates for, home care services in Rhode Island is well over $42 an hour compared to Connecticut, which is closer to $28 So, there is, you know, no longer any projection. This is the reality. You know, agencies are now forced to turn away Medicaid referrals or limit the service areas just to survive. When we cannot provide home care services, these individuals don't disappear. They move into a far more expensive institutional settings and this shift doesn't save money. It increases the state's Medicaid expenses. So in closing, we're not asking for expansion. We're just asking for alignment, and that we get a meaningful rate increase. We're glad and thankful for what you've already put in the bill, and we're just asking that you continue through and implement that for the good of home care and for the good of the industry.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Yes. Representative Vail.

[Rep. Kurt Vail]: Yes. Good evening. I just wanted thank you for being patient and sticking with us throughout the night, and appreciate your testimony. Thank you.

[Unidentified testifier (brief responses)]: My pleasure. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Have a great evening. Next up is Cheryl and Kemye Fortson. Cheryl, if you're there, you just have to unmute, please.

[Committee staff/host (technical or brief interjections)]: Hello?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yep. Now we can hear you.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: Okay. Hello. I'm sorry. My apologies. My mom took her night med. She has to go to bed. So I'm gonna read her testimony if that's okay with y'all. I appreciate y'all listening and taking the time out to hear us.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Appreciate you. Go right ahead.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: Okay. Good morning, senator Lesser, representative Gilchrist, and distinguished members of the Human Services Committee. Her name is Cheryl Forson, and she is my consumer who has used me as a personal care attendant. Sitting here with her, with me. We both are here to urge you to put full support behind senate bill four ninety eight, an act protecting paychecks for personal care attendants and expanding public access to state programs. A bill that is beyond important and personal to both of us. Me, which is my name is Kimmy Fortune senior, has been my mom's PCA for eleven years. It's a different routine for a parent initially to have their child being their caretaker. We watch them grow, and we know we're always want to care and protect them. But when the day comes that changes our roles, I know there is no one in the world I'd rather care for me than my son, which is me. Our set up was great. Me, Kimmy, knew my needs was there when I needed care and knew when to give my space to take care of myself. Unfortunately, this past June, I made a mistake, a mistake that proved to be detrimental for my son more than anyone. I missed a notification to file my redetermination. A simple notification that brought a lifetime of change for me, her son, and herself. It led to the suspension of her Medicaid waiver program, the very program that provides me with my paycheck. Meanwhile, me, Kimi, kept working my normal hours. Neither of us knew anything was wrong until the next week when he didn't get his paycheck, which is me. Kimi called GT Independence who told him they didn't know why or couldn't provide me with information, and they would often point the blame to DDS. So me, called DDS, expected to get some answers. Instead, they directed me to the department again of aging. And then it was finger pointing back and forth. The whole time, I still provided my care and still provided my care with no pay for a single hour. It wasn't until November that DDS finally shared the payment issue was all tied to the need to file redetermination. Six months of payment issues, aggravation, humiliation, and moreover, the simple redetermination that DDS could have informed me of during the first phone call instead,

[Committee staff/host (technical or brief interjections)]: they left

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: hello?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yep. Can you just please summarize? The three minutes have run out.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: Okay. Basically, there's finger pointing, like, when I was there earlier. There's a two pronged problem. DDS and GTI. They're both pointing fingers at each other. There's no reason that we should have to work and not get paid because they don't work and get paid. That's not fair to us as individuals and as family members. Because when I don't get paid, my whole family loses out because I take care of my family as I'm supposed to, as a person, as a leader, as a parent. And when they reject us and just throw us to the side, that's not fair to us because we all suffer. But they get

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: paid. Agree.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: At GT Independent, when we first when they were first hired, their value was 35,000,000. Now after one year of taking our contract, they're up to 75,000,000.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much for your testimony. We really appreciate it. And thanks for being here tonight and taking care of your mom.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: Oh, I appreciate you. And I thank you all for listening to us and taking your time to wait here for us. And I appreciate it. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you. Have a great evening.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: You too.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Next is Linden Pitter.

[Lindon Pitter (Personal Care Attendant)]: Good evening. Representative Gilchrist and honorable members of the Human Services committee. Thank you for allowing me to testify. My name is Lindon Peter. I live in West Hartford, and I have been a personal care attendant for over ten years caring for my brother-in-law. I am here to ask you to support senate bill four nine eight and act protecting pay paycheck for personal care attendant. I want you to picture this. A young man with autism, his family is new to this country. Immigrants facing their own struggles and unable to provide twenty four hour care he needs. As your son-in-law, I made a life changing decision. I gave up my career, my benefits, and my financial security to care for him. Today, he is thriving. But that has come with a cost. I earn a near poverty wage and I have no retirement saving. And it is often feels like the system is punishing those of us who choose to care for our loved ones. And I am one of the lucky ones because I have not experienced the payroll issues that so many of my fellow PCAs have faced. Since November, there has been over 3,000 grievances filed due to late or incorrect paid by GTI. This means that thousands of moments where caregivers already live in paycheck to paycheck are pushed into crisis. A missed paycheck can mean not paying rent, utilities, or even putting food on the table. Two thirds of PCAs are people of color and about one third are immigrants. This is not just all about payroll issue. This is an issue of racial justice, economic justice, and disability rights. Senate bill four nine eight offer real solutions. It would increase transparency and accountability, evaluate more reliable system of options, expand access to health care coverage and ensure compensation when workers are armed by late pay. Caregivers deserve stability still. Every day I ask myself, where is the value placed on those of us who care for the most vulnerable? When caregivers are unstable, the entire care system becomes unstable. We should not have to choose between caring for our loved ones and securing our own dignity. I urge you to pass senate bill four nine eight. Thank you for taking the time to listen.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you for the work you do and for being here this evening.

[Lindon Pitter (Personal Care Attendant)]: Thank you very much.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Is Kylie Kelsey with us? Okay. Moving to Cecilia Livingston.

[Cecilia Livingston (Senior Director of Operations, A&B Home Care Solutions)]: Good evening. I apologize. A late evening ER visit interrupted my my evening, so I'm glad that you're still here. So good evening, Terrace Lesser and Gilchrist and ranking members, Kaye Simprillo. My name is Cecilia Livingston, and I'm the senior director of operations at a and b home care solutions. I'd like to thank you and all the members of the committee for taking the time to hear testimony regarding the critical need for sustainable funding in Connecticut's home care programs. Home care, which is often referred to as personal care services, plays a vital role in the health care continuum. It allows individuals who need help with daily activities to live safely and independently at home while preventing avoidable hospital and nursing facility admissions. Our a and b caregivers work with your constituents every day to ensure that they're able to live, successfully, independently, helping their families to observe changes that may identify potential health issues before they become acute, and it really improves the quality of their lives and helps to avoid costly facility based care. Over the past years, I've worked, with many of you, I've had the opportunity to speak with several of you and your colleagues about the importance of this particular service in the Husky Health Program. And as the state navigates the immense ongoing funding challenges, I wanted to reiterate the message that I have shared in the past. Nonmedical personal care services represent a patient centered cost effective approach to help people healthfully and be supported at home. It avoids unnecessary use of emergency departments, and it prevents the need for more costly facility based care settings such as long term acute care facilities and nursing homes. Public data shows that homemaker services in an individual's home averages less than $6,500 a month compared to more than $15,000 a month for nursing home care. That equates to a difference of over a $100,000 per year per individual. The demand for personal care services has clearly outpaced our ability to meet the need. Despite recent rate increases tied to minimum wage, adjustments, reimbursement has not kept pace. As a result, we're losing caregivers to private industry for less grueling work, other health care settings, and as has been mentioned, neighboring states are reimbursed at higher rates. When a caregiver of ours commuted from New New Haven to New York City to work at a higher wage, even covering her own transportation costs. All of Connecticut's neighboring states are reimbursing these services at higher rates, and we're losing caregivers, not just AMB Home Care, but as you have heard, all personal care providers in the state. We urge passage of house bill five five six one increasing all homemaker companion rates 13% annually for the next two years and then 10% annually for the following three. Without increased reimbursement, we will see continued workforce loss, reduced access to cost effective home care, and increased institutional care costs for the state. Thank you very much for your time and attention this evening.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much for your work you do and for your testimony. Have a great evening.

[Committee/staff interjection]: Thank

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: one twenty one. Ernie Davis.

[Ernie Davis (Senior Director, State Government Affairs, Blood Cancer United)]: Good evening, members of the committee. My name is Ernie Davis. I'm the senior director of state government affairs for Blood Cancer United, formerly Leukemia Lymphoma, and I'm here to provide, testimony in support of Senate Bill three. I've submitted written testimony, in lieu of, that and certainly the time of the evening, I'm just going to go over the highlights. First and foremost, wanted to highlight our support for the creation and expansion of access to high quality affordable health care in the bill, obviously through the Connecticut Health Care Trust and the Connecticut option. We would we do wanna bring attention though that these initiatives as laid out in Senate Bill three are far superior, to some other legislative efforts to expand access to substandard plans such as association health plans. And certainly, the initiatives laid out in Senate Bill three are far superior because those other substandard plans take into account preexisting conditions and would remove enrollees from the very risk pool that this legislation seeks to cover and would directly undermine SB3's efforts to provide high quality insurance and patient subsidies. Another issue of support for us is the financial assistance policies to make healthcare accessible and affordable for patients. Financial assistance or charity care at a hospital is supposed to ease financial burdens but patients continue to face barriers in receiving the aid that may they may be eligible for. As a result, the hospital that should be covering existing financial assistance can end up costing thousands of dollars more in medical bills for our patients. Medical frailty. It's just an issue that we wanted to bring to the committee's attention. We would welcome clarification in the bill that the commissioner of social services who's tasked within the definition of medical frailty for the purposes of HR one implementation, should prioritize a definition that allows, self attestation and also accounts for individuals undergoing cancer treatment and survivorship. And one other issue we wanted to bring to the committee's attention was the transfer of transfer of risk portfolios concerns that we had. Our patients, tend to be some of the highest risk and we would urge the legislature explicitly to define, what this section means to avoid fracturing or fragmenting overall risk by segregating higher cost, higher risk individuals. If the intent of the language is to provide a mechanism for reinsurance or other risk mitigation approaches, that do not fracture the segment risk pool other than separate a separate high risk pool, we would encourage that clarification and specification to be made. And again, we we would really highlight, certainly the financial assistance policies. We in collaboration with a lot of coalition partners have done a lot of work on medical debt in Connecticut, and we believe that the financial assistance policies as laid out certainly strengthen, abilities of our patients and their families and others to afford their medical coverage, moving forward. We support the bill and, certainly happy to answer any questions you may have.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for your testimony and for being here in this late hour. We'll take a look at it. Have a great evening.

[Ernie Davis (Senior Director, State Government Affairs, Blood Cancer United)]: Appreciate it. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you. Leticia counsel. Oh, those were in persons. I got them. So sorry. Jennifer Meister Mag Morelli.

[Mag Morelli (President, LeadingAge Connecticut Rhode Island)]: Thank you, representative Gilchrist, senator Lesser, and members of the Human Services Committee. My name is Mag Morelli, and I'm the president of LeadingAge Connecticut and Rhode Island. LeadingAge is a membership association representing not for profit and mission driven providers serving older adults across the full continuum of aging services and senior housing. I wanna thank you for the opportunity to offer testimony on several of the bills before you tonight, and I'll provide just a brief overview of my submitted testimony. First, I'd like to address house bill five five six two and thank the committee for including sections five, six, and seven, which updates statutory references to reflect the recent consolidation of LeadingAge Connecticut and LeadingAge Rhode Island into one organization now known as LeadingAge Connecticut Rhode Island. So thank you. We also support the provision requiring managed residential communities to post Department of Social Services contact information for reporting abuse, neglect, exploitation, or abandonment. However, we have do we do have concerns regarding section nine of this bill. It appears to incorporate two federal nursing home regulations into state law, but the language is unclear as to which specific portions are intended. The cited regulations cover a very broad range of requirements far beyond the antipsychotic medications and informed consent that we believe is what is trying to be targeted. We respectfully ask that the bill be clarified to specify exactly which subsections are intended in order to avoid unintentionally incorporating in the entire federal regulatory frameworks into state statute. In senate bill four eighty one, which addresses private equity ownership of nursing homes, we understand the strong interest in this issue. We support the concepts of disclosure and transparency contained in the bill, but recommend that the definitions and reporting requirements be carefully structured. In particular, we suggest replacing the term ownership entity with investment entity and aligning any new financial reporting requirements with existing reporting already submitted to the Department of Public Health in order to avoid duplication. In addition, since the intent of the bill is to add additional reporting to DSS, we ask that the requirement be placed on those providers with DSS Medicaid agreements. I also wanna note that the federal regulations do already prohibit mandatory arbitration agreements. With respect to Senate Bill four ninety five, which expands the charge of the Long Term Care Planning Committee, We respectfully request that if new stakeholders are added to the committee's membership, that representative representation from long term care providers also be included to ensure balanced discussion and informed recommendations. And we would be pleased to serve in that role. And finally, we support senate bill four nine nine and sections nine and ten of house bill five five six one, which address Medicaid reimbursement for long term services and supports. Adequate reimbursement is essential to maintaining a strong network of providers, particularly in home and community based services where workforce shortages are already limiting access to care. Increasing Medicaid rates and ensuring that they are updated on a predictable schedule will help sustain these services and allow older adults to receive care in the settings they prefer, including their own homes. Thank you for the opportunity to testify tonight, and we look forward to continuing to work with the committee on these important issues.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much, Mag, for your continued work and for always showing up. Appreciate it. Have a great evening.

[Unidentified testifier (brief responses)]: You too. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Oh, wait. Wait. Unless his hand raised.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Sorry to throw our wrench into it. Just a quick question about the anti psychotic provision that you were concerned about. If we were to make that change and and clarify the, the specific section of the federal regs that we're we're referring, would you you would not oppose that section?

[Mag Morelli (President, LeadingAge Connecticut Rhode Island)]: No. We would not oppose it. And and we in our testimony, we point out specifically which sections those address are addressed.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Yeah. I do. I I I saw the testimony, but I just wanna make sure that you thank you for that clarification. Thank you. I appreciate it.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you, senator. Thank you, Meg.

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Next up is Tracy Hunter with us? Alright. Going to Linda Sprague Martinez.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: Good evening, sir.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: We'll bring her back on. There she is.

[Linda Sprague Martinez, PhD (Director, UConn Health Disparities Institute)]: Sorry, I think I got bumped out just there. Good evening. My name is Linda Sprague Martinez. I direct the health, the Yukon Health Disparities Institute, and I'm a professor of medicine at the Yukon School of Medicine and the Department of Medicine. Thank you for the opportunity to submit testimony in support of SB3 and act concerning healthcare affordability on behalf of the Health Disparities Institute. HDI was established in 2011 as part of a legislative mandate to enhance research and the delivery of care to minoritized and medically underserved populations in the state. HDI was born out of Connecticut's commitment to addressing health disparities and promoting economic mobility. We are in strong support of SB3 and stand with Health Justice Now, with the Health Justice Now campaign advocating for quality, affordable health care for everyone in Connecticut. Connecticut residents need real solutions to health care affordability to the health care affordability crisis, which SB3 offers. We specifically support stronger hospital finance, financial assistance programs, a basic health program, a state run health insurance option, and participatory planning process for these programs to ensure equitable outcomes. Recently, we've been working with the Commission on Racial Equity and Public Health. We have a contract with them to conduct a data driven participatory planning process to inform their strategic plan. As part of this contract, we've convened a team of community research, a community research team that's comprised of residents from across the state of Connecticut who have been involved in designing and implementing a statewide assessment. This allowed us to speak directly with community residents, across Connecticut to identify priorities, that would that they felt would promote health equity. We consistently heard about the cost of health care in Connecticut and the fact that it's unaffordable. In fact, making health care more affordable and reducing medical debt emerged as one of four central goals of Connecticut, the Connecticut Commission on Racial Equity and Public Health strategic plan. Through the process, we heard from community members who frequently spoke about the fear of unexpected medical bills, accumulating medical debt, which we've heard all day today, which is compounded oftentimes by confusion over what insurance covers and what it doesn't. Many residents have also shared with us about receiving medical bills for thousands of dollars, but not understanding why and what they're covering. Community members emphasize high cost. The high cost of care can lead to fear of being driven into medical debt, and the lack of transparency around what coverage, what's covered leads to delaying and oftentimes avoiding care. One resident in New Haven told us about, for example, $4,000 that she a $4,000 bill that she received after already being in medical debt for $8,000 So this isn't hundreds of dollars, it's thousands of dollars. Another resident told us that even when you have insurance, you worry about what the copay is gonna be because it's not just the insurance, but it's what comes after that as well. And imagine if you are worried when you they've said that imagine if you're worried when when you already have insurance, what about people who don't have insurance? The data we've collected, across projects, not just the commission project, It's consistently illustrated the high cost of health care and the lack of insurance. Yep, I can sum up. Believe people forced to make impossible choices to live in worry. And I would like to also emphasize that the worry and anxiety that we've heard about all day, that chronic, that chronic stress accumulates over time. And so we see health care access disparities also contributing to overall health disparities.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Great point. Thank you so much. Thank you for your testimony and for being here this evening.

[Unidentified testifier (brief acknowledgments)]: Thank you.

[Susan Halpin (Connecticut Association of Health Plans)]: Kaveh Kashnood?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Alright. Jennifer Laduke.

[Jennifer Leduc (Executive Director, Day Kimball Health at Home & Hospice)]: Hi. Good evening. Chairpersons and members of the Human Services Committee, thank you for the opportunity to testify today. My name is Jennifer Leduc. I am the executive director of Day Kimbell Health at Home and Hospice, board chair of the Connecticut Association for Health Care at Home, a registered nurse of twenty six years, and a proud lifelong resident of the Quiet Corner. I strongly support HB 5,561, an act concerning Medicaid rates rate increases for certain providers. Day Kimbell Health at Home provides skilled home health and hospice services to a population across rural Northeastern Connecticut that is rapidly aging in place. In our region, poverty, extremely limited transportation options, and difficulty accessing essential services place significant strain on our patients' ability to remain healthy and safe in their homes. In my agency, three quarters of our patients are over the 70. More than half of those are dually eligible for both Medicare and Medicaid. They are some of the most medically complex and vulnerable individuals in our region. Our services are what they depend on to recover at home after hospitalizations and safely manage their chronic conditions. We are deeply committed to serving these patients. In fact, it is truly our mission. But it is increasingly difficult to sustain the level of care they need when Medicaid reimbursement does not come close to covering the cost of providing those services. When that gap is combined with health care workforce shortages and access challenges that come with living in a rural community, our options become limited. Families are forced to make very tough decisions. I often find myself thinking about what our patients would do without us. I wish I didn't have to think about that, but it is our reality. I know without us, many of our patients will end up back in the hospital or in nursing facilities, outcomes that are far more costly for both families and the state. That is why I strongly support Medicaid rate adjustments for home health services proposed in HB 5,561. These increases are long overdue and will help begin to close the gap between the care being delivered in the home and the reimbursement that providers receive. Home health care is often the only realistic way patients can receive the care they need. I urge the committees to support these rate increases and help ensure that older adults and individuals with disabilities can continue to receive safe care at home. Your support will also help us preserve and grow our dwindling nursing workforce. Home health care is not a convenience or a luxury. It is basic human care. It is a bridge that keeps our residents connected to our health care systems, and we cannot afford to watch that bridge crumble. Thank you for your time and consideration.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. My first job was out in the quiet corner, so special place in my heart. Thanks for for doing. Thanks for your testimony tonight.

[Jennifer Leduc (Executive Director, Day Kimball Health at Home & Hospice)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: John Antunas. Oops. Sorry about that. Paula Mosho Gianna. Kevin Funnell, Amy Martin.

[Amy Martin (Community Mentor/Life Skills Coach)]: Yes. I'm here.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Great. Go right ahead.

[Amy Martin (Community Mentor/Life Skills Coach)]: Let me unmute. Sorry.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: Okay.

[Amy Martin (Community Mentor/Life Skills Coach)]: Good evening, Senator Lesser, Representative Gilchrist, and distinguished members of the Human Services Committee. My name is Amy Martin, and I am a community mentor and life skills coach. While I'm semi retired, I work with two individuals on the autism spectrum. I am here today to speak in support of senate bill four ninety eight, an act protecting paychecks for personal care attendants and expanding public access to state programs. My job includes helping my clients find motivation and building the skills they need to live more independently. Things like cleaning their homes, cooking meals, decluttering, and managing their household budgets. I also support their social development, taking them on outings like summer concerts or out to eat. For these individuals, I help make a level of independence possible that may not have been achievable before. I have worked with both of my clients for several years. One of them I first connected with through key human services and later continued with them when they transitioned to GT Independence. However, in late twenty twenty four, I was unable to serve that client for several weeks because of delays in transferring paperwork. Even after I was approved to resume working with them in December 2024, GTI told me I would not be paid for weeks. How is that acceptable? Still, I chose to work because my client needed my support. What I did not expect was to go for more than two months without a paycheck. That is simply outrageous. I cannot pay my bill. I have asked my stepfather for financial help, and that was humiliating. I was asking my 87 year old stepfather who was already caring for my mother and her health issues to support me. The fact that GTI believed these clients could go without services for that long or that I could go without pay for the same period is unbelievable. Taking that long to process paperwork and reconnect a client with a provider they already had simply because of an agency transfer is completely unacceptable. Going months without being able to pay my bills was horrific. It created deep emotional and financial stress that still affects me today. That is something you cannot easily recover from. I know some of our unpaid members have finally been paid, but the damage is already done. It is time for someone to address the ongoing problems with GTI. And if EDS won't do it, we need you, our elected officials, to do so. And the first step is to pass s b four nine eight because no caregiver should ever go unpaid, not for a day, not for a week, and never for months. Thank you for your time and for listening to my testimony.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much, Amy, for your testimony and for being here tonight.

[Amy Martin (Community Mentor/Life Skills Coach)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Nylex Gray Husey, Terrence Brown, Betsy Torres, Elizabeth Bausch, Douglas Smith.

[Dr. Douglas Smith (President, CT Chapter, American College of Emergency Physicians)]: Hello. Can you hear me?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yes. We can. Go right ahead.

[Dr. Douglas Smith (President, CT Chapter, American College of Emergency Physicians)]: Thank you very much. Good evening, senator Lesser, senator Perillo, representative Gilchrist, representative Case, and members of the committee. Thank you for the opportunity to testify today. My name is doctor Douglas Smith. I'm a board certified emergency physician practicing in Danbury, Connecticut, and I serve as the president of the Connecticut chapter of the American College of Emergency Physicians. I speak today in support of h b five five six one, specifically section eight. Connecticut is rightly proud of its health care institutions and its commitment to caring for vulnerable populations. Yet despite these strengths, access to care remains a growing challenge across our state. One important and correctable reason is that physician Medicaid reimbursement rates have remained effectively stagnant for more than nineteen years now, even as the cost of practicing medicine has risen dramatically. Connecticut physicians faced a high cost of living, demanding a medical liability environment, and reimbursement rates that have not kept pace with inflation. For many physicians, particularly those early in their careers, this makes Connecticut a difficult place to practice and to stay. As a result, we increasingly lose our medical school graduates and trained physicians to neighboring states with more sustainable practice environments. Emergency departments feel this pressure acutely. By law and by mission, we care for every patient regardless of insurance status or ability to pay. We are the health care safety net when access else elsewhere breaks down. When Medicaid rates fall too far behind, it does not reduce demand. It simply concentrates it in already stretched emergency departments and hospitals, worsening crowding, wait times, and staffing challenges. This is not about physician income in isolation. It is about whether Medicaid patients can find physicians willing and able to care for them, whether hospitals can staff their emergency departments, and whether communities, urban and rural alike, retain access to timely high quality care. Adjusting Medicaid physician reimbursement to reflect inflation and the cost real cost of care is a necessary step to stabilize our workforce and to protect the access for patients who rely on this program the most. Without action, we risk continued erosion of physician participation, greater reliance on emergency care, and higher long term system costs. You'll hear additional data today from my colleagues, doctors Shango and Moore, further detailing the scope and urgency of this issue. I urge you to support this long overdue Medicaid rate adjustment and to refer reaffirm Connecticut's commitment, not just to coverage, but to meaningful access to care. Thanks very much for your time and commitment.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for your testimony this evening.

[Dr. Douglas Smith (President, CT Chapter, American College of Emergency Physicians)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Leticia counsel.

[Unidentified testifier (brief responses)]: Oh, well, good evening, senator, representative. Thank you guys for coming back to me even though I was here, but I didn't have it correct. Thank you guys for being here so late. My name is Leticia Council, and I have been a personal care attendant for two decades. I am here in front of you today to testify in support of Senate bill four ninety eight as at protecting paychecks for personal care attendants and representing and expanding public access to state programs.

[Leticia Council (Personal Care Attendant)]: In all my years of providing care, I have never felt forgotten as I do today. The first time I didn't get paid, I was broke down. I started crying. I panic because I figured how am I gonna pay my bills? How am I gonna feed myself? I don't get food stamps. I have to borrow money. The last thing I wanted to do was borrow money from someone. That's the least the worst thing to do, especially when you got not don't get paid because how you gonna pay it back? My options were quickly limited because it didn't happen just once. It happened multiple times, and it affect many of us. We already live paycheck to paycheck. Our hours are limited to what Medicaid approves, which sometimes mean losing expect expected hours while little with little notice. On top of that, not getting paid is devastating. You're left constantly wondering what will happen next. And yet every single day, I still show up for work. One of my clients is blind. The other one is bug bound. I take my job very serious. I love my job. I've been doing it for a very long time.

[Kemye “Kimi” Fortson Sr. (PCA, reading for Cheryl Fortson)]: I just

[Leticia Council (Personal Care Attendant)]: We have filed thousands of grievance. We had to show up at their headquarters twice, and still hundreds of members have not been paid. It's not an old issue. It's still going on today as we speak. PCAs are still not being paid, and the issue is a back and forth between DSS and GT because nobody knows where the problem lies at. It is time for the state of Connecticut to start validating health care workers. Every single one of us PCAs are critical part of health care systems in the state, yet we are frequently overlooked. We are treated as if we do not matter. The constant feeling of being undervalued is deeply painful. So today, I don't just urge you. I strongly call on you to pass the bill four ninety eight because it will start to address the ongoing payroll failures affected thousands of people across the state. And I just wanna point out, my client, once again, is blind. So in order for me to go into his portal is a violation of Hippo, but he can't see to do it himself. So I don't have no other choice sometimes to go in here and check his information. But is that can I get in trouble for that? Like, I just don't understand. Like, nobody comes here and check on him. Nobody calls and comes by. So how is that how is the state allowing that to happen?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much.

[Mag Morelli (President, LeadingAge Connecticut Rhode Island)]: And thank

[Leticia Council (Personal Care Attendant)]: you. And thank you guys for your time.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yeah. Truly appreciate it. Have a good evening.

[Unidentified testifier (brief responses)]: You too.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Tanisha Joyner, Phoenix Lightbringer, Rosa Rodriguez, Ferete G, Thomas Burr, Kenneth Kohlmeier, Jacqueline McGrath Curtis, Cynthia Johnson.

[Cynthia Johnson (PCA and parent)]: I'm here.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Alright. Go right ahead.

[Cynthia Johnson (PCA and parent)]: Good evening. Senator Lester, representative Gilchrist, and distinguished members of the human services committee. My name is Cynthia Johnson, and I'm a personal care attendant for my daughter. So I so I see here before you today, not just as a health care worker, but also as a parent who is constantly worried about caring for and providing for her daughter. Passing Senate bill four ninety eight, an act protecting paychecks for personal care attendants and expanding public access to state programs is not just a necessity. It's the importance of survival for all of us. My daughter, she started having grandma's seizure at the age of six. Since then, she has been having different types of major seizures. They it's gotten complicated because she also now has vertigo and suffered PTSD from drop seizures, the traumatic falls that accompanied them. As you know, that is very scary and is very serious. As a mom, it breaks my heart every time I see her having these seizures because I can't stop her suffering. However, my daughter is determined to go on and become a productive American. She wants to go to college and becoming a veterinarian. I wanna make sure that she does not do it alone, and she gets and she makes that goal. Unfortunately, we now have additional added stress in our household because of the nonpayments that my me me and others have suffered through GTI and Ally. Luckily for me, it's it hasn't occurred as many times as others, but it is something that we are worrying about again, worrying about whether or not we get paid or worrying about whether we're gonna get the right amount, whether it's this, that, and the other. And it's just not fair. It should not be happening. When did this become acceptable? In the past, we've we've experienced a pay loss. I've experienced it. Others have experienced it, and it's just not acceptable. We should be getting paid on time every time. This issue causes severe financial stress for the family for all our families. We already working paycheck to paycheck. Please do the right thing. Make sure and pass the bill s b four ninety eight. Not just for me, not for some of the others that you heard, but thousands of the PCAs that are giving love, giving care to others that are unable to care for themselves. Thank you for your time, and thank you for hearing my testimony. If you have any questions, feel free to ask.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you, Cynthia. Thank you so much for your testimony and for being here tonight.

[Cynthia Johnson (PCA and parent)]: You're welcome. And thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Is Dale Elliott with us? Alright. Bridget Prince came earlier. Tamara oh, came earlier. Jean Paul Gamez. Miriam Hakim Zargar. Doctor.

[Rep. Susan Johnson]: Good evening or good morning, I

[Dr. Maryam Hakim Zargar (President, Connecticut State Medical Society)]: should say. Representative Gilchrist, senator Lesser, distinguished members of the Human Services Committee, thank you again for this opportunity to testify. And thank you for being here and listening to all this testimony. For me personally, it's been very educational listening to everyone else's, testimonies. But my name is Maryam Hakim Zargar. I'm a, orthopedic surgeon and president of the Connecticut State Medical Society. I'm a solo practice in Torrington, Connecticut. I'm here in support of increasing Medicaid physician payment rates and, to comment on bills four ninety nine and five thousand five hundred and sixty one. In my practice, about twenty to twenty five percent of my patients, particularly after I take call for the emergency room, have Medicaid. Even running a very lean office, each Medicaid visit reimburses roughly half of my overhead costs. I'm in a unique position as I didn't incur much debt as a medic and for my medical education. But most of my colleagues simply can't afford to see Medicaid patients at these rates. Medicaid patients have real access and outcome issues. Here's a story for you. Father in his thirties working as a manual laborer, injures his foot while playing with his kids. And then he goes to urgent care. They take some x rays. They say he has a metatarsal fracture. That's a type of foot fracture. And they place him in a boot and tell him to follow-up with Orthopedics. He calls multiple offices, can't get an appointment because they don't accept his insurance or the next available appointments too far out. He can't work and he's losing income. Eventually goes to the emergency room because really that's his only option to get access to care. By the time he's seen by a specialist, what was initially treated as a simple fracture is now recognized as a more complex mid foot sprain injury that now has displaced and needs surgery. And this is going to put him now months out of work. And this could have been avoided by timely care into something that would have healed in two to four weeks to now something that's going to take this man out of work for three to four months. And that affects the entire livelihood of this family. So this is an isolated story. My office, I have these kinds of injuries at least meet at least once a month. And I'm just one doctor. And across the state, you can imagine how many people and how many lives are affected by this. Low Medicaid rates are workforce issue. Connecticut struggles to retain physicians and young doctors choose to practice in states where reimbursement support and sustainable practice. Low Medicaid rates are also a health equity issue and a cost issue. When patients cannot access care, conditions worsen, leading to more expensive emergency visits, hospitalizations and long term complications. We are also concerned that proposed increases may apply to some physicians, but not others. A piecemeal approach is how we got here in Connecticut. If Connecticut wants better access, better outcomes in a stable health care system, it must invest in Medicaid physician rates across all specialties. Thank you again for the opportunity to testify, and I'm happy to answer any questions.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for the work you do and for your testimony. My my pleasure. Thank you. Have a good evening.

[Committee timekeeper]: You too.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Sherlyn Healy. Nashley Rose.

[Ashley Rose (public testifier)]: Good morning. How are you guys? Good. Good morning.

[Committee/staff interjection]: Good

[Ashley Rose (public testifier)]: morning. Alrighty. So, in regards again, senator Lester, representative Gil Gilchrist, and members of the human services committee. My name is Ashley Rose, and I live in Manchester, Connecticut. I am testifying in support of s B four nine seven and s b three. Snap is about keeping people fed with respect and dignity. Right now, federal cuts are putting thousands of Connecticut residents at risk of going hungry, including babies, children, senior veterans, and people with disabilities, and thousands more at risk of losing their husky health coverage. There are many reasons why people need Husky and SNAP. Here are my top three reasons why we need Husky and SNAP. Reason number one. Cuts to Husky and SNAP limits access to healthy foods for low income families. Without Husky and SNAP for families, especially low and working class families, it will negatively affect individuals creating such difficulties for families to be productive members of society. Reason number two. Loss of free school meals worsen students in schools. Loss of free school meals affects an individual's fluid insecurities at home. The individual may function poorly in school. The less food I call it, the less education. Lastly, reason number three. Increased hospital visits can't happen due to loss of coverage of Husky. Without Husky, hospital visits will soon become a higher burden than it already is. This is a a problem for all families that prevent them from ensuring a safe life. State's, abundant SNAP, transitional benefits give people a bridges of work so no one loses food while they are getting their SNAP eligibility approved. This is the state doing its job, protecting residents from having to choose between seeing a doctor or putting food on the table. I support these bills because Connecticut should put money behind protecting our access to food and healthcare. So no one falls to the cracks. The number tells the story. Right now, the state is not sharing how many people lose Husky and SNAP due to federal cuts. Our communities deserve to know how many of our people with families are losing their food and health care. And this bill makes that information public. People who qualify for Husky and SNAP should not lose health care and food because of paperwork. This bill directs the state to automatically identify who qualifies for an exemption from work requirements and protects them. Lastly, SNAP and Husky are about respecting our families and protecting our health. I'm asking this committee to pass SB four ninety seven and SB three. Nobody should have to choose between feeding their kids and keeping them healthy. Please keep us protected from federal benefit cuts with state investments that bridge the gap. Lastly, for me, I have the second oldest out of eight siblings, and I have two hardworking parents that work their behinds off to put foot on the table. Most of my other siblings are in high school currently. I used to do track and field and basketball, and and they would have to go to the nurses to, you know, to make sure that, they have insurance and husky. But the absence of husky, that's going to affect my younger siblings as well. I contribute most of my time working to provide for my family as a as a second on the side of eight. And just even with the absence of SNAP, that also affects us as well as low class sorry. With 14 class families as we're trying to be productive members of society. So passing this will will not mean so much for me, but for thousands of Americans that are also struggling as well. Any questions or concerns?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for your testimony.

[Committee staff/host (technical or brief interjections)]: Of course.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Have a great day.

[Ashley Rose (public testifier)]: Thank you. God bless you guys. Have a good one. Bye bye.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Bye. Next, Gretchen Rafa.

[Gretchen Rafa (Chief Policy & Advocacy Officer, Planned Parenthood of Southern New England)]: Good morning, representative Gilchrist, senator Lesser, and honorable members of the Human Services Committee. My name is Gretchen Rafa, chief policy and advocacy officer at Planned Parenthood of Southern New England, testifying in support of Race House Bill 5,561, an act concerning Medicaid rate increases for certain providers. As one of the largest providers of sexual and reproductive healthcare to over 52,000 patients at 14 health centers across the state in telehealth last year, we believe all people should have access to quality, affordable healthcare as a basic human right, regardless of who you are, where you live, your income, if you have health insurance, or your immigration status. We're very grateful to Governor Lamont, this committee, and the General Assembly for your commitment and strategic investments in women's healthcare and family planning, including supporting a one time allocation to backfill block to federal Medicaid funding due to the harmful actions by the Trump Administration and Congress in H. R. One. Yet, greater state investments in our public health infrastructure are urgently needed to ensure reproductive health care providers like Planned Parenthood of Southern New England can continue providing essential care to the people who need us most. HB 5,561 is a necessary step the state must take this session and why we're here before you tonight, just as we were last year, asking for an increase in Medicaid reimbursement rates for family planning providers on the family planning fee schedule. Planned Parenthood health centers have an irreplaceable role in our healthcare system in Connecticut, and for many communities, we're the sole provider of sexual and reproductive healthcare. In the last fiscal year, forty six percent of PPS and E patients were insured by Husky Health to cover their services, and twenty four percent were self pay. Eighty seven percent of the care delivered is preventive or gynecological care. PPS and E is a safety net provider that reduces burden to the healthcare system, but without the buffers that other safety net providers have. Unlike private practices, PPS and E has little ability to offset low Medicaid reimbursement rates with higher private insurance rates because of our service mix and without high margin services to offset losses. We're facing serious operational pressures, including not being adequately compensated for care provided while the cost of delivering that care continues to rise, threatening our ability to continue meeting the needs of patients and communities. One in three women have been to a Planned Parenthood health center for care. No other provider can easily fill the gap if Planned Parenthood is forced to shut down. That's according to research done by the Guttmacher Institute. In nine states, including Connecticut, FQHCs and other publicly supported clinics would need to increase their caseloads by more than a 100% to provide care for patients currently served by Planned Parenthood of Southern New England. We urge the legislature and governor Lamont to prioritize increases to Medicaid reimbursement rates for family planning clinics now to ensure continued care for our patients and communities in the future. Based on patient volumes across the state for previous years, we estimate a rate increase for preventive services at family planning clinics would require a state investment of approximately $500,000 An investment of this amount is based on Maine's family planning rates, which is a benchmark state from the Medicaid rate study. Access to reproductive healthcare remains vulnerable here in Connecticut. We're concerned about the continued inequity in access to health care for residents of our state and barriers they face to health care coverage, which has only worsened due to HR1 and other federal actions or inactions. We look forward to continuing to work with our elected leaders to find long term solutions to this very real financial challenge that continues to threaten access to essential reproductive health care in our region, and we need greater investment in family planning providers and clinics now. Planned Parenthood patients are counting on you. Thank you for your time and consideration, and we'll also be submitting testimony in support of s v three as well.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Great. Thank you so much, Gretchen. Thank you for all your advocacy and for being here.

[Gretchen Rafa (Chief Policy & Advocacy Officer, Planned Parenthood of Southern New England)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: I see. Joseph Avni Singer, Kathleen Garrity, Gregory Schangold, Heather Gates, Joseph Downer, Nancy Jones, Lindsey Russo, Henry John, Susan Beck, Quinn Meehan, James Lehman, Pearl Barnett?

[Gretchen Rafa (Chief Policy & Advocacy Officer, Planned Parenthood of Southern New England)]: She already went.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Right. Thank you. Melinda

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: I'm I'm getting notified that there are folks who are trying to get promoted and are in the queue, but they haven't been promoted.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Okay. We they're not. And if people do hear their name, then they should. Right? Like, that's kind of the point.

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: They should accept

[Committee timekeeper]: the promotion.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yes. If you hear your name, accept the promotion. Fiona Crowley.

[Fiona Crowley (UConn MSW student)]: Hello. Good evening, senator Lasser, representative Gilchrist, and esteemed members of the human services committee. My name is Fiona Crowley. I'm a resident of Tong, Connecticut, and tonight, I'm speaking as a student in the University of Connecticut's master of social work program. I stand in support of SB four ninety six, an act concerning hospital uncompensated care, and section 10 of SB three, an act concerning health care affordability. In my education, I've had the honor and privilege of working with organizations led by folks that know firsthand the impact of not being able to access their basic human right to affordable care. When families face unaffordable care costs, they are at risk of acquiring medical debt, making sacrifices to basic needs, and avoiding preventative and life saving care. Community members have shared stories of stress over costs, worsening their health when they're sick. When they do seek care, high out of pocket costs cause financial setbacks. When they are made aware of financial assistance options, the application process can be lengthy and complex. Folks without insurance often describe affordable care as a far off dream, and this is a population we know will increase by over 200,000 in Connecticut by 2034 because of cuts and policy changes under HR run that will disproportionately burden Latina, AOX, and non Hispanic black residents. Today, I am urging Connecticut's leaders to turn the right to preventative and life saving care that does not hinder overall well-being into a reality. Community members are exhausted. Year after year, they voice the barriers they face to affordable care, and year after year, they are burdened by the emotional and financial stress of simply trying to stay healthy. When all of Connecticut's communities cannot be healthy, Connecticut cannot be healthy. Nonprofit Connecticut hospital spending in the twenty twenty four fiscal year remained less than revenue. While spending grew by 6% from 2023 to 2024, charity care accounted for about only 3% of total expenses. A large portion of hospital costs went to salaries and wages. Unfortunately, national disparities in salary increases for nonprofit hospital CEOs and healthcare workers indicate a pattern of hospital systems not equally investing in their community members who provide preventative and life saving care. SB four ninety six takes a critical step towards affordable, accessible care for all by standardizing hospital systems financial assistance policies. According to the Connecticut Hospital Association, hospital financial assistance requirements can change from year to year, making a complex process more complex with changes that require administrative costs. Community members should not have to choose between seeking potentially life saving care at a hospital closer to them and finding one where they are eligible for financial assistance. Thank you for the opportunity to testify in support of SB four ninety six and SB three, and I urge the committee to favorably pass this bill. In my written testimony, I've included recommendations on presumptive eligibility for SNAP and WIC recipients and the incorporation of race, ethnicity, and language data into reporting on hospital financial assistance to the Office of Health Strategy. Thank you for your time.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for your time and for your testimony this evening. Alright. Have a good night's sleep. Kevin Alexander. Marlene Ciccarella. Okay. Lynn Afori Afori. Oops. Sorry. I messed that up.

[Unidentified testifier (brief acknowledgments)]: Hi. I'm I'm 177, but I'm Diana Martinez, not Lynn.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Got it. Thank you. Go right ahead.

[Diana Martinez (Founder/Executive Director, Chicahtowy Farm)]: Thank you. Good morning, human service committee members. Thank you for the opportunity to speak. I'm the founder. I'm Diana Martinez. I'm the founder and executive director of Chickahawy Farm. Our organization works at the intersection of food justice and the criminal justice system with the dual goals of increasing access to farming for underrepresented and directly impacted people and organizing to address the gaps in our social safety net that land people in the criminal justice system in the first place. Our members and leaders support people in all matters of small scale farming. We often encourage people with SNAP benefits to purchase organic produce at farmers markets and harvest their seeds to start their own seedlings. Over the course of the past year, we learned that some of our community members are denied or thought they were unable to access SNAP benefits even if they earn well under the income limits simply because they have a violation of probation or parole. Today, over three times as many people as are in prison are under supervision. Many thousands of others in our communities have completed supervision at least once. And over half of people on probation earn under 20 ks a year, which is a reality exacerbated by race and gender as evidenced by seventy percent of all women and eighty one percent of black women on probation earning under 20 k. Violations of supervision are also very commonplace and can be triggered by new crimes or by technical noncriminal violations like missing a probation appointment or failing a drug test. At least twenty percent of formerly incarcerated people report experiencing food insecurity. And in Connecticut, where the vast majority of people incarcerated come from our major urban hubs, that insecurity is bolstered by food deserts and the lack of farms in urban and suburban spaces. Members of our organization launched the free CT campaign to address the failures of our supervision system in enabling successful reentry and to ban the box on food access. We queried the prison policy initiative and learned Connecticut goes well beyond the federal mandate in restricting SNAP benefits. Federal regulations deny SNAP access to people with underlying felony drug charges who are probation violators, which is a term they've used to specifically refer to people with active warrants for their arrest as opposed to any person with any violation of supervision. In addition to the state law, the SNAP application further deters people from applying for benefits by very broadly asking, do you or any member of your household have a violation of probation or parole? Today, we're urging you to vote, yes in support of s b four nine seven and not concerning protecting food security for veterans and others because it would both align our policies with the federal government and eliminate or amend the violation question on SNAP applications. Community supervision is meant to help people establish themselves, reestablish themselves, and reengage with their families, and contribute successfully to our communities. Restricting access to food runs directly counter to those goals because we know people are far less likely to recidivate if their basic needs are met and food is as basic as it gets. Please help us keep people home and keep people fed by voting, in support of s B497. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Senator Lesser, go right ahead.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Yes. Thank you, madam chair, and, good to see you, Diane. I I believe I saw you, fourteen hours ago at a a Yeah. Very long day.

[Diana Martinez (Founder/Executive Director, Chicahtowy Farm)]: Long day. Thank you.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Just wanted to thank you for raising this issue. I do note that the department, which had a lot of concerns with that bill, actually seemed to understand and support. I don't support maybe a little bit much, but they seem to be very much open to the suggestion that you're making. And I thought that was a very positive statement in their testimony. So I just wanna I'm grateful for you to advancing the issue, and I hope that we can move that forward.

[Diana Martinez (Founder/Executive Director, Chicahtowy Farm)]: Thank you. Thank you for your support.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thanks for your testimony and your work on this, and have a great evening.

[Diana Martinez (Founder/Executive Director, Chicahtowy Farm)]: Good night. Okay.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Next, we'll go back to number one sixty, Kathleen Garrity, followed by one sixty one Gregory Schenold.

[Kathleen Garrity (Executive Director, Connecticut State Dental Association)]: Thank you very much, representative Gilchrist, Senator Lesser, and the rest of the committee members, and thank you for hanging in there for a very long day. I've been here here the whole day, and I feel like I could just say ditto to a lot of my other colleagues, but I will persevere. My name is Kathleen Garrity. I'm the executive director of the Connecticut State Dental Association representing licensed dentists and the patients that we serve across the state. We have provided written statements on SB3, SB499, HB5041, and HB5561, one, with recommendations on all those bills, including specific, language recommendation for the last bill, 5,561. We started today on ground on, Saint Patrick's Day, but it feels like Groundhog Day because we find ourselves before you once again discussing a decaying provider network, reimbursement levels that do not reflect the cost of care, and the growing consequences for patient access. But it's important to remember we have seen this before, and we have also seen what works here in Connecticut. In 2007, Connecticut was considered the gold standard in Medicaid dental care. We had a stable and robust network of providers, and the reimbursement rates, while not perfect, were sufficient to support participation. Patients not only had access to care, but convenience of care. This led to what has become known as the Connecticut effect. Studies demonstrated that when the dental network was stable and functioning, Medicaid patients experienced measurable improvements not just to oral health, but overall health. Improved dental access was associated with better management of chronic diseases, fewer complications, healthier populations, and less ED appointments. That is the standard we should strive towards again. Today, however, we are moving the opposite direction. We are already spending the money that should have been invested in the system all along, just in the most expensive and least effective ways possible. Redirecting it into preventative and timely dental care doesn't create a new cost. It replaces avoidable medical spending, ED visits, chronic diseases, hospitalizations. We can replace all those with appropriate care. I also wanna represent many of our young dentists who are moving into Connecticut. Most enter this profession with a genuine commitment to public health, many of whom have their MPHs. They simply cannot afford to participate in the Medicaid program. They find that the economics of the system make participation unsustainable. And we have many experienced providers who have carried this program for years that are either reducing their participation, leaving altogether, or retiring. This is not a question of willingness. It's a question of viability. That's why SB four ninety nine is so important. It is critical that dental services are explicitly included in the rate setting process and that benchmarks are based on objective real world data. I'm just gonna skip over this and go right to the fact that there already is data that we've pointed out several times to you before called Fair Health database, which compiles actual claim data and establishes the EOCRs that are already in place by procedure and geographic region. This is what we need in the dental world because Medicare rates do not always translate to Medicaid for dental. They simply don't exist. So please look at the Fairhaven databank. Similarly, you consider broad health care affordability efforts under SB3 and coverage expansion under 5,041. Oral health must be included explicitly in these. They're not right now. It says health care, but very often we find that dental care does not get included when it comes down to the fine tuning of these bills. And with respect to five five six one, we encourage careful attention to clinical language. The term periodontal therapy for healthy adults does not address the intent. Our written statement, I can go into that more, but basically, Periodontal Therapy, is when there's already disease in the mouth. So a healthy adult, by definition in this bill, cannot have Periodontal Therapy. In conclusion, the lesson from 2007 is clear. Maintaining a strong provider network requires consistent investment that reflects the real cost of care. Standing back and allowing that network to erode leads us exactly to where we are today. History cannot repeat itself. We respectfully request CSDA be included as a stakeholder in all discussions regarding the Medicaid policy and next steps for the programs within OPM, DSS, and other spaces. Our involvement will ensure that the policy decisions translate into meaningful access to care for our patients. Thank you for your time, your consideration, and for sitting through yet another human service, marathon hearing. You guys are the champions.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for being here, and thank you for your testimony. Gregory Schenggold, go right ahead. Decision's translated to me.

[Dr. Gregory Shangold (Emergency Physician; past President CSMS and CCEMP)]: Good evening, representative Gilchrist, Senator Lesser, and

[Committee timekeeper]: Good evening.

[Dr. Gregory Shangold (Emergency Physician; past President CSMS and CCEMP)]: Remaining members of the committee. Congratulations for staying awake. Feels like one of the my night shifts. My name is Gregory Shangel. I'm a board certified emergency physician and practice in Connecticut for twenty four years. I'm the past president of both the Connecticut State Medical Society and the Connecticut College of Emergency Physicians. I currently lead a group of 90 emergency physicians and advanced practice providers staffing seven of Connecticut's emergency departments that collectively care for approximately 600 patients a day. This is the fourth year consecutively we've debated Medicaid reimbursement rates that were last set in 2007. Over those nineteen years, health care costs have risen dramatically while physician reimbursement has remained frozen. At this point, there is broad consensus that the current rates are unsustainable. In my written testimony, you can evaluate the evidence and detail providing that need. Connecticut now ranks forty sixth in the nation for Medicaid reimbursement for most physician services. At the same time, the Medicaid population has grown to more than 1,000,000 residents, including nearly thirty percent of Connecticut's children. When reimbursement is this low, physician limit physicians limit their participation in Medicaid and access to care declines. In the emergency department, we see the consequences every day. A recent example is a patient with poorly controlled diabetes who repeatedly comes to the emergency department with dangerously high blood sugar and complications. She has Medicaid, but cannot find an endocrinologist willing to take new Medicaid patients. Without consistent specialty care condition worsens until she ends up back in the emergency department. This is not good care for the patient and it is far more expensive for the health care system. Physicians appreciate that HB 5,561 recognizes the unique role of emergency medicine, but the broader issue remains that most physicians, Medicaid rates have not increased in nearly two decades. SB four ninety nine moves in the right direction by benchmarking rates to the Medicare economic index. However, the proposed increase to 75% of Medicare by 2029 is not sufficient to address nineteen years of underpayment. To make a meaningful difference in the access to care, physician Medicaid reimbursements should be increased immediately to Medicare should be increased immediately to Medicare rates and then adjusted annually using the Medicare economic index. Connecticut's emergence departments are already stretched in and emergency physician burnout now affects nearly 70% of the workforce. The deboarding task force, created, by this legislature recognized this problem and recommended increasing Medicaid reimbursement as part of the solution. This is the fourth year we have discussed this issue. The need is clear. The data are clear. What is needed now is action. Strengthening Medicaid reimbursement strengthens the entire health care system and improves access to care for all of Connecticut's residents. Thank you for your time and consideration.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Representative Johnson?

[Rep. Susan Johnson]: I just wanna thank, doctor Shengold for, his staying up and, testifying in all of his work that he's done, here in Wyndham and, throughout the state. So thank you so much.

[Dr. Gregory Shangold (Emergency Physician; past President CSMS and CCEMP)]: Thank thank you, representative.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Have a great evening.

[Dr. Gregory Shangold (Emergency Physician; past President CSMS and CCEMP)]: Have a good night.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: 178 Michael Lung.

[Michael Lung (VP Operations, Companions & Homemakers / Companions Forever)]: Good morning. Thank you. I'm Michael Lung out of Southbury, and I'm the vice president of operations for both Companions and Homemakers out of Farmington and Companions Forever out of Newington. I have been an employee of Companions and Homemakers for over fifteen years. I'm speaking in support of HB5561 concerning Medicaid rate increases for certain providers. My two companies currently provide nonmedical home care for a total of 840 older adults throughout all of Connecticut. The care provided to ninety nine percent of these individuals is paid for by Medicaid waiver programs. Our business focuses on those who are most in need of assistance with daily living and who depend on these programs. While many of our competitors have been forced to limit assisting federal and state funded programs due to inadequate reimbursement rates, we have taken the opposite approach up until this point. The truth is that we are now forced to consider cutting back on Medicaid funded services due to increased operating costs and the ever increasing difficulties in recruiting quality caregivers. Connecticut's inadequate reimbursement rates have affected us all. Our clients deserve to be cared for by qualified caregivers, but many of those caregivers seek employment in neighboring states. The caregivers that choose to work in Connecticut are paid minimum wage or slightly more and struggle to support their families. Our approach to client care has had to shift from finding the perfect match to finding an able body. Most recently, I've been forced to make difficult business decisions and reduce my office staff, something all businesses strive to avoid. We have asked for several years to be heard. We have asked for a systematic approach to adjusting Medicaid reimbursement rates. Too many years of inaction have led us to this point, but HP HB five five six one can fix that. Our elderly population have put in their time, and now it is up to us to ensure they receive the care they need and deserve. It's time for the state's Medicaid rates to accurately reflect the importance of this service and match the quality of care we are expected to provide. Thank you for your time and support.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you for staying up with us and testifying tonight.

[Michael Lung (VP Operations, Companions & Homemakers / Companions Forever)]: My pleasure.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Have a great evening or morning. I'll stop saying whatever. 179, Michael Biondi, doctor Biondi. Alright. Sandra Ferreira Molina.

[Sandra Ferreira Molina (Connecticut Oral Health Initiative)]: Hi, everyone. Thank you for allowing me to testify. I represent the Connecticut Oral Health Initiative, and I'm here to testify in strong support of Ray's bill five five six one. As I've sat here through these hours, I would like to point out something that often goes unnoticed in these halls or in these Zoom meetings is that every person who has testified tonight has had the teeth and the oral health necessary to be able to testify. For many of the Husky members we serve, chronic dental pain or tooth loss is a literal barrier for having a voice in this process. Right now, a Husky dental system is reactive. We wait for a crisis instead of preventing one. We are essentially asking our neighbors to get sick enough to qualify for the care that would have kept them healthy in the first place. HB5561 changes that. I would like to draw your attention to line 23 through 24. Currently, husky adults live under a $1,000 annual cap. If they get a routine cleaning, the cost is deducted from their cap. If they then have a dental emergency, they are often forced to choose between fixing a broken tooth or staying within their budget. By exempting preventive and medically necessary services like dentures from the cap, you are ensuring that baseline health is no longer a financial penalty. Look at line 47. This is also a game changer for health equity. COHAI is in agreement with CSDA as Kathleen mentioned earlier. In correcting the language, it should be periodontal treatment to reflect deep cleanings for all adults. Right now, our system is of wait and see. We often deny deep cleanings until a patient is already diagnosed with a comorbidity like diabetes or heart disease. But gum disease is not just about teeth. It is about a systemic inflammatory crisis. In Connecticut, nearly forty seven percent of adults 30 have some form of gum disease, and that number jumps to over sixty percent for Hispanic and black adults. Treating this early reduces a cardiovascular events and can lower medical costs for diabetic patients. However, we cannot talk about these services without talking about the people who provide them. It is critical for dental providers to be fairly reimbursed in order for them to actually support these patients. Without sustainable rates, these benefits are just words on paper because no one will be able to afford to provide the care. Finally, I would like to suggest a technical correction. And, instead of the Connecticut Dental Health Partnership, which is a contractor vendor to the Department of Social Services, the seats that are being added to be part of MAPOC to be asked from the Dental Policy Advisory Coalition, DPAC, This would avoid conflict of interest to ensure that there's independent advocacy driven voices at at the Mapoc table. And last, I just urge you to pass HB five five six and move Connecticut towards a prevention first system. Thank you for listening, and hope everybody has a good night.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Thank you. We will look at your testimony. Have a nice night.

[Committee staff/host (technical or brief interjections)]: You too.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Next is Daniel Frass.

[Ernie Davis (Senior Director, State Government Affairs, Blood Cancer United)]: I believe I'm speaking on behalf of him. My name is can you hear me? Sorry. Chris Moore. So Senator Lester represent Gilchrist, represent Comey, represent Hughes, representative Johnson, representative San Santiago, and anyone else who's still listening.

[Dr. Chris Moore (Emergency Physician; CT College of Emergency Physicians)]: Thank you for the opportunity to present my testimony in support of SB nine four ninety nine and s HB 5,561, which addressed the need for increased Medicaid report reimbursement. Like Doctor. Schanghold, I'm happy to see you guys here so late. It feels like a night shift. I'm a board certified emergency physician, and I've practiced at an urban level one trauma center emergency department in Connecticut for the last twenty five years. I currently serve on the board of the Connecticut College of Emergency Physicians. I also served as the prior co chair on the emergency department boarding and crowding task force and recently on the discharge challenges working group, which tries to address many issues regarding capacity for care in Connecticut. We recently submitted our report this week and many of our recommendations are directly relevant to these bills. I first started working in the ED in Connecticut in early two thousand and two. In my time here, I recall one overnight shift where we actually had taken care of all the patients. They'd either been admitted or discharged. The grief board, as they called it in those days, where we actually physically wrote patient names was clear. We had, quote, won the game, unquote. Of course, that only lasted a few minutes until the next patient checked in. Fast forward to 2026, winning the game is now impossible. At the main emergency department where I work, we routinely care for more than 300 patients a day. We sometimes have as many as 100 patients boarding in the emergency department. These are patients who have been admitted that remain in the department, often in hallways and on uncomfortable stretchers awaiting an inpatient bed. Data from hospitals in 2024 showed that more than thirty eight percent of admitted patients born for more than four hours in Connecticut, and 2025 data showed little change. The changes we see in EDs have happened slowly. Like the proverbial frog being boiled, we get used to it, but make no mistake, our healthcare system is straining. EDs in Connecticut are the place where a healthcare system under stress becomes apparent. This is not just an issue for patients on Medicaid. It affects anyone who may have an emergency. The last broad based major adjustment to Medicaid payments to physicians was in 2007. Underfunding Medicaid has broad effects on the health care system. In particular, it makes it harder for patients to get care early when they need it as an outpatient. The ability of patients on Medicaid to see a primary care physician or specialist becomes more limited when reimbursement is low. Where do these patients go when they can't get care? You guessed it. The emergency department, the only place in America that is legally required to provide care regardless of the ability to pay or how much the state decides to reimburse. EMTALA, the Emergency Treatment and Labor Act, was enacted in 1987 to assure that no one requiring emergency care could be refused treatment. I am proud to work in an environment where that is the case. However, it is an unfunded or at least underfunded mandate. Our ability to care for people without appropriate reimbursement is not unlimited. We have debated Medicaid payment adjustments for years. It is time to stop kicking the can down the road. Please do the right thing and fund this the way it needs to be funded to help ensure all Connecticut residents get the medical care they need when they need it. And thank you again.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Appreciate you being here and for your continued Good luck. Help. Just wanna remind folks that they need to accept the promotion. Next up is Kevin Johnson.

[Kevin Johnson (Gaylord Specialty Healthcare)]: Good morning, members of the Human Services Committee. My name is Kevin Johnson, and I'm honored to speak on behalf of Gaylord Specialty Health Care in support of section 11 of House Bill five five six one, which provides Medicaid rate increases for certain providers. The biennium budget, includes $45,000,000 in fiscal year twenty twenty seven to help providers cover the cost of care and treat more medic Medicaid patients. Gaylord is one of only two long term acute care hospitals or LTACs in Connecticut. We provide highly specialized hospital level care to patients recovering from catastrophic illness or injury. Our patients are medically complex, clinically fragile, and often can cannot safely transition to a lower level of care. They typically need weeks of intensive medical management, interdisciplinary rehab, and specialized services just to stabilize and regain function. While we provide the same level of complex care as our peer LTAC in Connecticut, Medicaid reimbursement does not reflect that. Today, Gaylord is reimbursed roughly $950 per Medicaid patient per day, which is only about 58% of our annual of our average Medicaid Medicare rate and far less, than what comparable providers receive. This gap has grown over the past twenty years, even as staffing, technology, pharmaceuticals, and regulatory costs have increased dramatically. Gaylord absorbs that difference every day to make sure that our patients get the care that they need. This, inequity also affects Connecticut's health care system more broadly. When Medicaid rates don't match the care provided, it strains specialized post acute providers and limits access for patients who could really benefit from Gaylord services. Fair, equitable reimbursement would help support appropriate patient placement, improve hospital throughput, and reduce costly prolonged stays in acute care hospitals. The proposed increase in section 11, $206 per patient per day, would finally bring parity for LTACs in Connecticut. This is an important step towards making sure reimbursement reflects the complexity and cost of care we deliver and preserving access for state's most medically complex and vulnerable patients. Thank you for your time, your consideration, and your commitment to strengthening Connecticut's health care system.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you, Kevin. Good to see you again. Thank you for your test Yeah. Tonight, and have a great rest of your evening.

[Kevin Johnson (Gaylord Specialty Healthcare)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: 184 Miles Bradley. 185 Jacqueline Baez.

[Jacqueline Baez (Domestic worker and community organizer, Naugatuck Valley Project)]: Good night, everyone. Thank you for the opportunity. My name is Jacqueline Baez. I am a domestic worker and also a community organizer with Naga two Valley Project in Guadalupe. I am part of common wisdom circle and chief leader, Justice. I am here to testify in support of the senate bill three to protect and strengthen access to health insurance, especially for our children and the families who need it most. Today, I stand before, like, you I'm a grandmother. I have an eight year old grandson named Javier. He used Husky Health. He is currently facing a health issues and requiring him visit various specialists. However, in our city, we often lack access to this medical service. Do the assure of a specialist in our local hospital, we frequently need to travel to other cities so that can be received the care he need. We we had a travel as far as well in Fort and even to the children hospital in Hartford. For many families, this might seem like just a simple trip. But for us, for many other working families, every medical appointments means organizing transportation, time, and resources. That we simple does not have. Javier mother, my daughter, she's not have a car. Thank god my door my other daughter and I, we have a car. So we can take him to the medical appointment. By I constantly think about the families who do not have the kind to support. What happens with the parent who don't own a car? What happens to the mother who have to choose between go to work or take their child to the doctors? What more health insurance cover often places, or essential service, such as transportation. This create another barrier for families who are already struggling. Let's reflect on something very important. The kids who need medical care today represent our future in our country. When the child does not have received a care they need, it's not just one family that suffer. Our entire community suffers. That is why I want to say something with accelerated clear clarity. A text to health insurance is not a luxury, not a gift. It's a human right. Every human being deserve the opportunity to live a life of health and dignity. Today, I ask to you and the legislators to listen to the stories of working families. I ask to you to recognize that this is not just matter to the public policies. It's a daily reality for thousands of families across the Connecticut. We ask you to support legislation that protect and strengthen access to health insurance, especially for our children and for the families who need it most. Because when you protect the health of our children, we are protecting the future of Connecticut. Thank you, and God bless you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Beautiful testimony. Thanks for being

[Jacqueline Baez (Domestic worker and community organizer, Naugatuck Valley Project)]: Thank you. Good night.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Night. Paul Kidwell? Christina Diaz, Chris Butler, Jennifer Wheeler, Lisa Allen, Sandy Pope, Rodriguez, Shakira Rivas, Natalie Shurtleff, Ashley Makar, Nicholas Glaum, Susan Halpin.

[Susan Halpin (Connecticut Association of Health Plans)]: Good morning, everyone. It's a pleasure to be before the human services committee. Thank you all for, sticking with us, for the, duration of this hearing. For the record, my name is Susan Halpin, and I'm here tonight or this morning on behalf of the Connecticut Association of Health Plans, which is inclusive of Aetna, Anthem, Cigna, Connecticut, and United. And I'm testifying on two bills, of note on your agenda, both senate bill three and, HB 5,041. We share the legislature's and the administration's goal of improving access to and affordability of coverage of care. Senate bill three, respectfully, we have to oppose as it's currently written because we read it to fundamentally restructure the coverage marketplace in Connecticut by creating what we view as a pathway to a public option, a change from the covered Connecticut program to a basic health plan. And, also, there are some pretty significant prior authorization timelines that are changed that we believe will result in an increase in denials, which is contrary to the intent of the legislation. I think it's really important for the committee and for the legislature to note that there are only three insurance carriers in Connecticut currently in both the individual and small group fully insured market. It puts the state and consumers in a pretty precarious situation that argues against measures, whether well intentioned or not or laudable or not, that could have the unintentional consequence of driving the remaining insurers out of the market. Of particular concern in senate bill three is the work group that calls for the design and more importantly, the implementation of undefined affordable health care programs as well as a new subsidy structure that goes along with that, that deviates from the subsidy structure that the legislature and the administration, just passed and implemented. That is something that the association did support in its development. I'm also would like to talk a little bit about the some of the definitions in Senate Bill three one, which speaks to other persons, which while I could read the bill in one way to be targeted to specific populations and specific poverty levels not otherwise currently covered, by the exchange or covered Connecticut. I could also read it as kind of taking over covered Connecticut and expanding it by virtue of the term other persons to a a much broader category of of people. So that is a significant concern for us as well. And the prior authorization provisions, as I said in my initial statement, by reducing the time frame from seven days, summarize already? Okay. Wow. That was really quick. Okay. I'm happy to answer any questions. How's that for summary?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: That's great. Thank you. I don't see oh, yep. Senator Lesser. Go right ahead.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Yeah. Thank you, Susan. I appreciate your testimony and and your concerns, and I just would ask that you, continue to work with us on some of those elements. I'm assuming with your your, comments, though, about the basic health plan, unless you don't necessarily oppose a basic health plan, but you have questions about, you know, the transition and making sure that we're working with your members on a transition that we're not just jettisoning, cover Connecticut, but we're having a, you know, a a thoughtful transition plan if one is appropriate. Is that is am I putting words in your mouth that are accurate, or I just wanna make sure I understand your your your position your position?

[Susan Halpin (Connecticut Association of Health Plans)]: No. I think I think your, comments are accurate. I think what we're what we think the state should pursue is flexibility of whether or not to pursue a basic health plan, because I I think some of the testimony earlier in the in the day confirmed what I was thinking might be the intent of this legislation. And I think it was an answer to a question that you posed, senator Lesser, to somebody that was testifying is that they would they would like to see covered Connecticut go away, and that the basic health plan would run on the framework of the current Medicaid program. That's a concern for us for a couple of reasons. Obviously, first, we have carriers

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: I'm sorry. I I I sorry. The hour is late. I just wanna make sure. You're not saying that that's something I said. That you're saying that some somebody else said that?

[Susan Halpin (Connecticut Association of Health Plans)]: Yes. Somebody else said that. And answer

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: to one of your questions.

[Susan Halpin (Connecticut Association of Health Plans)]: I'm sorry. You you asked a question of, you know, should we kinda go with the thirteen thirty two waiver or go with or thirteen thirty one or continue with the eleven fifteen waiver. And the the I think the answer from one of the previous folks testifying was that they would like to go with just the thirteen thirty one waiver and run it on the framework of the Medicaid program, if I understood the answer correctly. And that was one of our concerns going forward for two reasons. One is that currently our members, service the covered Connecticut program under the, umbrella of the exchange. And second, we have a concern about any reduced fee schedule that would be associated with the Medicaid, program exacerbating the current cost shift that the commercial carriers pick up as a result of the lower Medicaid patient payments to those providers. Did that make sense?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: It's so late. It's late.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Yes. But I think it's you know, we'll we'll have to just see the rules of the BHP and have some sort of thoughtful conversations about how to how to best decide that. But I understand.

[Susan Halpin (Connecticut Association of Health Plans)]: And we would we would welcome the opportunity to continue to work in with all of you.

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: Okay. And appreciate your testimony, and we'll continue to chat.

[Susan Halpin (Connecticut Association of Health Plans)]: Thank you. Thank you all. Good luck. Much.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thanks. Doctor Thomas Farquhar? Deirdre Murch?

[Deirdre Murch (Vice President, SEIU 1199NE; Home Care Director)]: Alright. Good morning. I'm Deirdre. I'm the home care director and one of the vice presidents here at eleven ninety nine. We now represent 14,000 personal care attendants who provide services for individuals with disabilities, either physical or intellectual. And, you know, to be honest, this is, I think, my twelfth year testifying on the issue of PCA payroll, so I'm not just tired because it's one in the morning. I'm tired because we have discussed this issue with you guys year after year. And we're, I'm sure you're just as tired as we are about hearing about people working and not getting paid for hours worked. In November, there were 5,000 non payments. Those are DSS's numbers. 5,000 non payments alone. So about 40% of the workforce was impacted in November. And, you know, today we finally have a settlement that's going to make whole some of those workers, but there are still hundreds that are unpaid, unresolved, including about a 150 unresolved grievances from 2025. So going on three, three and a half months old grievances. And the unfortunate truth is is that there's new grievances filed every single day. You know, you've heard many of the stories tonight. You'll hear some more tonight for the intrepid who are still on. I have never, in my fifteen years with the union, heard so many stories of PCAs who have become homeless as I have in the past three months. I've never heard so many stories of repossessed cars, of mental health crises. It has been just devastating to watch how many lives have been thrown into chaos because of both the decisions of DSS and also because of the errors of GTI. And I've listened to them for the past, you know, thirteen hours or whatever it is now, kind of talking about who is at fault here. And the reality from our perspective is that there is responsibility for both parties. Like Allied, we believe GTI can't do the job or at least has not yet been able to do the job, but they're making a much greater profit to not do that job. The year before they took the contract in Connecticut, they had a net profit of about $34,000,000. And in 2024, the year they took the contract, they had a net profit of $75,000,000. So doing PCA payroll certainly hasn't hurt their bottom line. And, of course, the unfortunate thing is that the problems are also closer to home with DSS. DSS, as you've heard several people testify, have been are not yet willing to notify PCAs if consumers face eligibility issues that are gonna interrupt their paychecks. You know, I heard miss Barnett and mister Carmichael saying that, that's really standard practice not to notify workers. That's just not true. In Illinois, in Oregon, in Washington, in Massachusetts, many of the provisions that we're seeking to pass in this bill, those are already standard practice there, including notifying workers when there are reductions to a consumer's care plan that are going to impact their ability to get paid.

[Committee timekeeper]: Can you please sum up?

[Deirdre Murch (Vice President, SEIU 1199NE; Home Care Director)]: We saw to the commissioner's credit, she did work with us. She paused the shift from annual sorry. From initially, it was a shift from annual to monthly budgets, and she paused that shift. And she worked with us on a settlement to get money and back pay to 877 individuals who received it today, coincidentally. But as I said, hundreds remain unresolved, and we still haven't received any of the data we've requested from DSS and GTI, routinely for ten years. So we're asking for you to support senate bill four ninety eight. Please end this payroll nightmare, not just for the 14,000 caregivers, but for the, nearly 10,000 consumers who rely on the services of their PCAs to live independently. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much, and thank you for keeping us updated and for your continued advocacy. Appreciate it. Kate Kasia Flynn? Okay. Melissa Wilder? Bright Johnson?

[Bryte Johnson (ACS CAN, Connecticut Government Relations Director)]: Good morning. I'm Bryte Johnson, Connecticut government relations director for the American Cancer Society Cancer Action Network. In 2026, it is estimated that approximately twenty four thousand Connecticut residents will be diagnosed with cancer, while six thousand seven hundred will die from the disease. Nationwide, more than two million Americans will be diagnosed with cancer this year, and more than eighteen point five million Americans living today have a history of cancer. At every education level, individuals with health insurance are more likely than those without it to have access to critical early detection cancer procedures. Having health insurance coverage makes an individual more likely to survive cancer, and the effects of insurance coverage on cancer survival are even more pronounced in dis in disadvantaged communities. In Connecticut, Medicaid provides health insurance for over 900,000 children and adults who don't make enough money to afford health care coverage on their own and around and are not offered coverage through their job. Having access to health coverage is one of the great greatest predictors of whether or not someone survives their cancer. Medicaid is a lifeline for cancer patients because it ensures affordable health care for people who become too sick to work. The ACA allowed for significant progress in the fight against cancer and enabled tens of millions of people to access affordable comprehensive health insurance, many for the first time. Research shows having health insurance is one of the most significant factors in surviving cancer. Access to health coverage results in earlier cancer diagnosis when the disease is more treatable and less costly and cancer outcomes are improved. Many provisions in HR one and subsequent rulemaking work against the spirit of the patient protections in the ACA and would roll back years of progress as well as tie the hands of state legislatures to improve health insurance coverage in their state. The consequences of that bill will be devastating. Americans will live sicker and die sooner. However, states, including Connecticut, have an important role to play in shaping the implementation of H R one and certain decisions made in the states will significantly affect the ability of patients to prevent, detect, treat, and survive cancer. SB three provides sensible choices and solutions to many of the issues leading to higher health care costs and fewer future viable options as a result. ACS CAN's mission to end cancer as we know it is for every as we know it for everyone. Access to affordable quality health care is crucial to achieving that reality. It is vital to comprehensive affordable access to health care coverage remain a lifeline for people with cancer, survivors, and people in need of preventive and screening services. Access to care should not be expand should be expanded, not limited. Research consistently shows that expanding access to care increases insurance coverage rates among cancer patients and survivors, early stage cancer diagnosis, access to timely cancer treatment, receipt of cancer screenings and preventative services, and survival rates. Thank you for your consideration.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much, and thank you for your continued advocacy and for staying here so late with us tonight.

[Bryte Johnson (ACS CAN, Connecticut Government Relations Director)]: I admire your stamina.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Lots of coffee. Alright. Have a good one. Beatrice Moncada. John Stakely.

[Jonathan Stakely (PCA for his brother)]: Good morning, representative Gilchrist, Senator Lesser, and distinguished members of the committee. My name is Jonathan Stakely, and I'm a personal care assistant for my brother, Jesse, who has Down syndrome. I'm here today to support Senate Bill four ninety eight, an act protecting paychecks for personal care attendants and expanding public access to state employ state programs. Like thousands of individuals across Connecticut and physical across Connecticut with physical and intellectual disabilities, My brother depends on caregivers every single day. On sunny days, he needs care. On rainy days, he needs care. No matter the season or the temperature, his needs just, they don't change. His safety, health, and dignity rely on consistent, dependable support. And without that care, I I worry deeply about what his his future will look like. You know, I love my job. I love being able to ensure that my brother's health and well-being are protected. But with the responsibility comes come some real challenges. One of the most pressing challenges we face is a payroll system through GT independence that serves caregivers. And as a delegate in our home care union, I regularly receive calls from workers who have not been paid on time for the hours that they've worked. Some have gone weeks waiting for corrected paychecks, and the added financial stress makes it incredibly difficult for caregivers to pay rent, buy groceries, and maintain stability in their households. We we're already facing a a workforce shortage and, you know, recruiting and retention retaining qualified caregivers, especially for individuals like my brother who is nonverbal, requires trust and reliability. It's nearly impossible to ask someone to take on this important work if we cannot guarantee that they'll be paid accurately and and on time every time. That includes proper payment when they use their earned paid time off. Unfortunately, caregivers are still not consistently receiving their correct compensation when they use their paid time off. When caregivers are not paid correctly, it does not just impact the workers. It directly impacts the people who depend on them. And my request today is simple. Please pass senate bill four ninety eight to ensure that caregivers across our state are paid in full, accurately, and on time every time. A stable fiscal intermediary means stability for caregivers, and stability for caregivers means safety and dignity for people like my brother. So thank you for your time and your consideration.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much for the work you do and for being here and to advocate tonight.

[Pastor Sam Sailor (Faith and Power Assembly; Hartford cohort)]: Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Okay. We're gonna rattle off some names. John Brady, Guina Perez, Terry Henning, Michelle Jonas, Nikki Scholes, Arlene Angel, Drew Michael McQueeney, Meg Gorman, Lauren Gardner. Joshua Amoroso, Leah Palagashvili, Harold Kritzman, Brian Donahue, John Kissell is not here, Barbara Lehman, Paul Boudreaux, John Satterfield

[Pastor Sam Sailor (Faith and Power Assembly; Hartford cohort)]: Okay.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Ellen Andrews, Esteban Calderon, Gabriel Gambardella, Mally Callahan, Latia Maldonado, Tiffany Glasser, Philip Schenkman, Juan Govidia, Sarah Egan, Pearl Granet, Jaquelle Johnson, Chris Moore, Nick Karapazes. Go right ahead.

[Unidentified testifier (brief responses)]: Well, good morning, distinguished members of the committee. My name is doctor Nikharapasas. I'm a chiropractor practicing in Manchester, and I serve as president of the Connecticut Chiropractic Physicians Association. I'm here to speak in support of SB499. First, I wanna say thank you.

[Dr. Nick Karapazes (President, CT Chiropractic Physicians Association)]: This committee played a key role in restoring chiropractic medicine to the fully to the Medicaid program. Without your work, that wouldn't have happened. Before that, we were only covered to treat children who were referred to us through the EPSDT program. Your actions made a real difference for patients. In in my private practice and at at a FQHC in Enfield, I do my best to care for patients who are part of underserved populations, and that includes those of us who are on Medicaid. You know better than anyone, and you've heard it over and over again, that reimbursements that we're receiving for services in Medicaid are terribly low and cover a fraction of office overhead per patient. For chiropractic, I wanna give you some concrete examples. Out of all the codes for treatment within our scope, Medicaid currently only covers manipulation of the spine and pelvis. Chiropractic billing requires us to report each body region addressed during treatment for spinal manipulation. So for a one to two region spinal manipulation, let's say treating the neck and low back, Husky Medicaid reimburses $15.12. For a three to four region spinal manipulation, so somebody who has a $20.72. So Medicaid is paying roughly half of Medicare for the exact same medically necessary service and a small fraction of average allowable rates for mediator major medical. If Medicaid rates were brought up to the 75% of Medicare, we'd increase to about $20.98 for the one to two region and $30 and 8 for the three to four. That's far more realistic than what we're getting paid today and would make a meaningful difference to whether or not providers can keep seeing these patients. We should close that gap, as you know, under s b four ninety nine within three years. Right now, it's virtually impossible to operate a practice that's dominated by title 19 patients with fees at these levels. As you well know, inadequate reimbursement inevitably hurts patient access through multiple compounding mechanisms. Chiropractic care is noninvasive, it's evidence based, and opioid free. We consistently achieve excellent results for our patients with high patient satisfaction scores. We also reduce the risk of addiction in patients who are experiencing serious pain and might otherwise be steered towards opioid use. Our treatments are conservative in nature, and for that reason, we also support section 13 of house bill fifty five sixty one, which encourages the use of non narcotic pain treatments in Medicaid. Your committee has always supported Medicaid patients and the providers who care for them. We know that, and we know you'll continue to do your best this year. We're honored to serve these patients. Senate bill four ninety nine is a solid step in that direction. We strongly support it. Thanks for the opportunity to testify. Thanks for everything you guys do in hanging in there, and I'm happy to take any questions you guys have.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Representative Comey, go right ahead.

[Caleb Rosemey (Assured Quality Home Care; CT Association for Healthcare at Home)]: Please.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: Thank you, madam chair. Hello, doctor.

[Pastor Sam Sailor (Faith and Power Assembly; Hartford cohort)]: Hi.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: I was wondering, if you would be able to, explain the cost effectiveness of the, opioid I mean, the narcotics, the no narcotic treatment of pain?

[Dr. Nick Karapazes (President, CT Chiropractic Physicians Association)]: Okay. So there's there's lots of layers to it. The first door that patients walk through determines how much it's gonna cost us, and it's gonna cost the state. The data we have shows that when patients start with seeing a chiropractic physician, the total bill goes down. So we're seeing fewer unnecessary advanced imaging like MRIs or CT scans, fewer ER visits, and fewer surgeries. On top of that, the most practical tool we have to avoid opioid prescriptions is preventing that first prescription from happening. We know that patients who see a chiropractor for spine pain are significantly less likely to end up on opioids in the first place or to suffer from long term dependency. They're also less likely to end up on an operating table because they're getting care before the problem spirals. We have a 24 systematic review that goes over all of that. I can get that to you if you're interested. There are layers of it in terms of data and studies. We I'm looking at something that we had that we're reducing overall creep treatment cost for low back pain by up to forty percent and reducing opioid prescriptions by 56%. I I can go on and on, but it's late at this hour, and I I don't wanna hold you guys up. It's my world and passion, and it's how I'm engaged. So happy to help any way I can to get that message across.

[Unidentified committee member (“Representative Comey” as called by the Chair)]: Thank you very much. I appreciate you coming out

[Committee staff/host (technical or brief interjections)]: Thank you.

[Jean Mills, Connecticut Legal Services (Elder Law Attorney)]: With us.

[Dr. Nick Karapazes (President, CT Chiropractic Physicians Association)]: I appreciate you guys hanging in there too.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much.

[Committee staff/host (technical or brief interjections)]: Have a great

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: rest of your night.

[Dr. Nick Karapazes (President, CT Chiropractic Physicians Association)]: Good night.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Alright. Christy Covell? Dominic Cotton? Dominic, if you're there, just unmute, please. Alright, Dominic.

[Dr. Maryam Hakim Zargar (President, Connecticut State Medical Society)]: He might have fallen asleep.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: He's been texting, but I'm gonna keep going, and then we'll come back to you. Sarah Mervine, Sally Grossman, Georgina Fuentes, Anne Olsen, Joelle Fishman.

[Joelle Fishman (Connecticut Communist Party)]: I appreciate you, members of the human services committee, very, very much. My name is Joelle Fishman. I live in New Haven. I'm speaking on behalf of the Connecticut Communist Party in support of SB three, SB four nine seven, SB four eight nine as part of the stand up Connecticut agenda of Connecticut for all and the Health Justice Now Coalition. And what I'd like to do is, focus on payment for home care workers from my personal experience. My mother, Edie Fishman, passed away in 2024 at age 103. And in her last years, she required full time assistance due to macular degeneration. And, we were so fortunate to have the care of a group of wonderful PCAs from Ghana who became extended family, and I shared this testimony with them. So they're part of it. If one or another could not make it to their regular shift, they covered for each other, and Edie was never left alone. At that time, the fiscal intermediary was Allied Community Resources, and it was a nightmare. The caregivers were constantly shorted in their pay and had to take time, sometimes hours, right on the job to try and get through on the phone to inform the agency. And the union tried to help. In the end, EDSPCA's were never fully compensated for the labor they put in. And shortly before my mother passed away, Allied was dropped by the state, and the current fiscal intermediary, GTI, took over. And at that time, we celebrated. So I was horrified to learn that the same thing is happening all over again with GTI. Workers not being paid while GTI doubles their profits. It's it's just completely unacceptable. In the end, the state of Connecticut is ultimately responsible to make sure if workers put in hours, they're fully compensated. Otherwise, we're talking about slavery. How can it be that hardworking caregivers are losing their housing because the paycheck didn't come in, but that is the reality. I support s p four ninety eight that establishes important safeguards, and I especially support transferring fiscal intermediary duties for our private for profit contractor to the public sector. Home care workers and patients will be much better served if the state of Connecticut handles the pay and instead of a for profit private intermediary. It would mean more jobs for state workers and more accountability. Passing s b four ninety eight is a necessary response to an emergency situation that just can't continue to exist. And I also wanna speak in support of SB three. Establishing the Connecticut option affordable health care program is a concrete step that goes in the direction of making health care as a human right into a reality. Federal cuts to health care are cruel and unconscionable. It's up to our state to stand up and take action to protect our families and communities. If I'm running out of time, I'll go to the end. Yes. The Connecticut option is also a concrete step toward addressing the widening wealth and racial gap in our state. This is the moment for us to step forward in Connecticut and enact measures like SB three that benefit the health and welfare of all of us and our communities, and I thank you very much.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you very much. Thank you for your testimony and for being here this evening. Dominic, may I please

[Dominic Cotton (PCA; 1199NE)]: I think I'm I'm on your name. Whoops. My apologies.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Alright. We got you. Go right ahead. Recording of progress.

[Dominic Cotton (PCA; 1199NE)]: Alright. Sorry. My name is Dominic Cotton. I'm here as a representative working with eleven ninety nine as my union. I've been working on a a waiver programs for the past twenty six years as a private provider. Dominic, it's here on twice. Alright. How do I do this? Am I alright? Am

[Sen. Matt Lesser, Senate Chair (Human Services Committee)]: I alright? Am I alright? Alright.

[Committee staff/host (technical or brief interjections)]: You're not going to go to the doctor.

[Dominic Cotton (PCA; 1199NE)]: Alright. Alright. I'm not sure which one I'm on. I'll start.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: What is what is

[Committee staff/host (technical or brief interjections)]: what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what is what

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: is what is what is what is what is what is what is what is what is what is what is what is what is what is what

[Committee staff/host (technical or brief interjections)]: is what is what is what is what is what is what is what is what is what is what is what is what is what

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: is what is what

[Committee staff/host (technical or brief interjections)]: is what is what

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Alright. Let's see if this works. Try again.

[Dominic Cotton (PCA; 1199NE)]: Am I still here?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yep. And there's no echo. Go right ahead. Dominic?

[Susan Halpin (Connecticut Association of Health Plans)]: Uh-oh. We lost him

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: again. Oh, there you are.

[Dominic Cotton (PCA; 1199NE)]: Alright. Am I here?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yes. Go for it.

[Dominic Cotton (PCA; 1199NE)]: I'm hoping I'm here. If I'm not, then it's I guess it's a different problem. So I'm here with, eleven ninety nine tonight. Obviously, I've worked on this program for the past twenty six years as a private provider, as an agency provider, as also working as I used to run all of Goodwill's programs a multitude of years ago. I guess my issue tonight, is, s p four ninety eight. I've taken the opportunity to have, conversations with, Christine Weston as well as, with the commissioner over, this issue, I kinda brought them to light, that there was a problem when they switched over from, a an annual contract, where you might go over on certain months and you would be under hours on the next month. Whereas due to, the federal government, they switched over to a monthly limitation. Unfortunately, because of this, back in October, with the way that the days fell in the month, the majority of the extra days beyond the 28 happened on a Wednesday, Thursday, and Friday when a large majority of people received their services. And because of the situation and a multitude of other problems that they had, People went over hours without knowing that DSS had actually changed over to a different way of calculating their hours. So I brought this to their attention back at the November when I could see that this was gonna be a problem, for myself and, one of the clients that I work with, as we went over hours for the month. I think I left in my testimony, a long explanation of what some of the issues are that are ongoing, with, the Department of Social Services. I appreciate, that the commissioner has worked very closely to try to fix a lot of these things. The difficulty that I have specifically is it's usually after the fact that we find out that there's a problem, that they tend to jump in instead of telling us beforehand that they're making changes within the system. Obviously there's been issues with GTI, much as there was issues with Allied prior to that. The whole program is set up as a retrospective payment system instead of a prospective payment system, which I brought to their attention. I know I use the Sandata system because I also own an agency, which I provide a service for people under the brain injury waiver, which, doesn't allow you to be able to go over hours in a particular month, because it asks you to enter in that information ahead of time. Whereas the system that you have with GTI is retrospective. I know they've made some corrections to their budgeting system, but I feel like the system itself is far too complicated, for a a general person to be able to understand how to utilize. And it leads to a lot of complications. And because of this, and because they don't really tell you, when somebody's services have like, either due to them not doing their renewals, might have ended. It ends up where people don't get paid for their services. So I let the commissioner know on opening day that I was perfectly willing to work with her to help test their systems to try to figure out a better way to work with us. I would be in favor of more oversight of them because Dominic, can you wrap it up? It's it's usually afterwards that they come to understand that there's a problem rather than prior to.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Great. Thank you.

[Dominic Cotton (PCA; 1199NE)]: If that's helpful.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yeah. Okay.

[Committee staff/host (technical or brief interjections)]: Alright.

[Dr. Gregory Shangold (Emergency Physician; past President CSMS and CCEMP)]: Did we

[Dominic Cotton (PCA; 1199NE)]: catch all that?

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Yeah. Let me mute him at this point. Thank you. Thank you so much. Sarah Mervine. Oh, I already did all those. Nope. Going to Maria Cochran Skinner, Diana Martinez. Gary Turco is not here. Frank Vichy, John Kearney, Terrell Williams, Kara O'Dwyer.

[Committee/staff interjection]: Good morning. Good

[Michael Lung (VP Operations, Companions & Homemakers / Companions Forever)]: morning. Good morning.

[Committee/staff interjection]: Senator Wilson, representative Gilchrist, and honorable honorable members of the human services committee. My name is Kara Ouzwyer. I'm a personal care attendant, and I'm here to ask you to pass senate bill four ninety eight, an act protecting paychecks for personal care attendants and expanding public ask access to state programs. At this point, it is up to you to address the crisis happening with GT independence, especially when it comes to PCAs being paid properly and on time. I have been a PCA for over eleven years, and for almost nine years with Allied Community Resources and the last over two years with GT independence has been a nightmare. In October, I became homeless for the second time. The first time was with Allied when my parents' home got foreclosed on partly due to unpredictable payments from the fiscal intermediaries that make it so that we get paid for the services we provide to the most vulnerable people in our state. For the past over four months, hundreds of PCAs have been fighting to be paid for hours we worked. In some cases, it was just a few hours. Other others are completely missing entire weeks of pay. This is unacceptable. That's slavery when you work and you're not paid. We're already working for poverty wages, struggling to piece together hours of work. And when we're paid partially late or not at all, it puts us into desperate spaces. It makes us hungry, lacking medical care, homeless. How are we supposed to provide the care that our clients deserve when we can't even take care of our own selves? This is a failure on behalf of the state of Connecticut, and I was so hopeful that JT independence would be different. And in a lot of ways, they were. I used to get paid on Thursdays a day early, and that was great. But issues with PTO being paid at a lesser rate, paychecks not showing up. Bills are late. You get late fees, overdraft fees, fees, fees, fees. It's expensive to be in poverty, and we don't deserve it. Neither do the people we serve, and this needs to be fixed long ago. We don't deserve this. Thank you for your time.

[Susan Halpin (Connecticut Association of Health Plans)]: Thank you for your time,

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: and thank you for sticking up with us. Truly appreciate you being here.

[Committee/staff interjection]: Of course.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Tysiana O'Connor, Howard Selinger, junior warden, Denise Welsh.

[Denise Walsh (Junior Warden, St. Martin’s Episcopal Church, Hartford)]: Good morning, Senator Lesser, Representative Gilchrist, and distinguished members of the Human Services Committee. My name is Denise Walsh. I'm a junior warden at Saint Martin's Episcopal Church here in Hartford. Today and always, I will stand by and in support of our personal care attendants, PCAs. And so I'm happy to put my support behind Senate Bill four ninety eight, an act protecting paychecks for personal care attendants and expanding public access to state programs. And I urge you, each and every one of you to do the same. As a member of the increasing numbers of seniors and retirees in our state that will not only need, but depend on the service that PCA offers us. I know the value of what they provide. It's dignity, it's comfort, it's never feeling alone. Their services are nothing new. We have had home care in one form or another for decades. Yet here we are in nine in 2026, they're still fighting for respect, recognition, and livable wages to be paid on time. How is this even possible? It is time for Connecticut to acknowledge the importance of PCs in our society. It is time to compensate them for the job that they do that allows those in their care to live dignified and supportive, support in their own homes. The PCA brings them compassion, safety, keep them healthy, and fill a void of loneliness at times. Yet, at the same time, the PCA the PCAs are often unseen, forgotten, or undervalued. A family member of my own church, a woman in her eighties, is committed to caring for her brother at an age when she should be getting ready to retire, slow down. She has no plans of doing that. Instead, she shows up for him every single day. These caregivers need you, the elected officials of our state, to stand by them too. Show them the respect they deserve. It is as simple as making sure all communications for and two, the PCAs are improved. So they know when there is an issue in a timely manner instead of waiting for a missed paycheck. I'm I'm begging you. I'm beseeching you. It's time

[Amy Martin (Community Mentor/Life Skills Coach)]: for you

[Denise Walsh (Junior Warden, St. Martin’s Episcopal Church, Hartford)]: to support and make sure that caregivers are being paid accurately and on time every single time. That change starts today with your support of SB four ninety eight and showing the pieces they do matter and you do care. Again, on behalf of the members of my church and everyone in hair shot, please let us show them the love. Let us give them the respect. Let us give them that livable wage that is always paid on time and is always accurate. Again, thank you for all that you do, and may God continue to bless and give you the strength to do the work, but it is time and they do need you. They need you to support them very much. Their families need you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you for your time.

[Denise Walsh (Junior Warden, St. Martin’s Episcopal Church, Hartford)]: Thanks again. And Of that bill.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Have a great evening. Thank you for being here.

[Committee/staff interjection]: You too.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: James Norquish, Steven Owen, Lillard Lewis, Cynthia Jennings, Ed Hawthorne, Joseph Pandolfo, Sue Prihar, Tom Swan.

[Tom Swan (Executive Director, Connecticut Citizen Action Group)]: Good morning, all. My name is Tom Swan. I'm the executive director of the Connecticut Citizen Action Group. On behalf of our member families, I wanna really thank you all for the time you put in and the dedication. All of you have shown to listening peep to people with some really powerful stories and some really big needs. It's really important, but I know it's not easy. I've been on this listening for hours, and you guys do this all the time. So thank you. CCG is also a founding member of Health Justice Now. That's a coalition that came together this year to really push us to go to additional levels in terms of health care reform. And I think during a short legislative session, I wanna commend you for as a committee, for stepping up to meet the moment and also set the table for some of the stuff that we all know are coming down coming down the pike. The legislature and the governor in special session created the emergency fund that helped to blunt some of the worst aspects of Trump's HR one, but that bill is gonna continue to be with us. Many of the worst parts of that bill are gonna kick in after the elections because the authors of that knew how unpopular it was. So many of the worst changes to Medicaid, in Connecticut, what's gonna happen to the people who we got subsidies for this year. But at the end of the year, coming down the pike, there's a bunch of things that are gonna happen. I mean, the Rand Corporation announced in a study recently that they expect a 100 of over a 114,000 people will lose Medicaid. On top of that, we're gonna see tens of thousands of people lose and another tens of thousands of people having food assistance get cut at a time when food is the cost of food is gonna be going through the roof because of this foolish war that we've been engaged in in Iran. And I think we're we might need to push through some additional revenue or funds from the emergency funds to meet them in the long term. My coworkers, I think, mentioned testifying in member bills. I just wanna voice our strong support for senate bill three and senate bill four nine seven today. And also I gotta give a shout out to the paying of the PCAs after the last couple of testimonies are resonating with me. In Connecticut, no one should lose their health care, and nobody should go to bed hungry. We're the richest state in the country and the richest country in the world. The top 25% of taxpayers in Connecticut, we're gonna be getting a tax cut of $3,400,000,000 every year over the next five years from the Trump redistribution of wealth upwards bill that was passed by congress. This is real numbers. This real what you're talking about with your bills here are a small fraction of that 3,400,000,000.0. I'm happy to do it. The crisis is escalating. We know that what's coming down the place can be really bad. Thank you for doing what you're doing. I say it up just to express my appreciation, not to keep you up later. Thank you.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you for all you do, and thanks for being here with us. Alright. Allison Weir, Maribel Rodriguez, Jennifer Chadukhut. I'm not gonna even try. Anthony Pearson Delizia, Jill Ricard, Jenny Cornejo, Caprice Saunders, Jennifer Fiorillo, Samuel Sailor. Hello. Hello. Wow.

[Pastor Sam Sailor (Faith and Power Assembly; Hartford cohort)]: I've been listening all day. I was at the Capitol when the commissioner spoke very eloquently and anyway, let me get here because I need to go to bed. I got a funeral to do in the morning. My name is pastor Sam Sailor. I'm with the Faith and Power Assembly in, Africa, Connecticut, cohort of, pastors, representing the social justice and working on health care disparities and issues. I'm here to speak on senate bill four nine eight, which you've heard a lot about today, protecting the paychecks of personal care attendants and expanding public access to state programs. And I'm I'm a I'm a skip the salutation to take my two minutes. You know who you are, Gilchrist and Senator Lester listen to you all day. Your your passion and commitment seems as realistic commissioners. You've heard the passion of people beg you for you to do the right thing. I'm here. My name is Sam Sailor, and my relevant reason for speaking before you today is predicated on the belief that I hold regarding the value of citizenship, my humanity, and the theology of being my brother's and sister's keeper. Because of that, I stand or I sit here today at this late hour in

[Committee staff/host (technical or brief interjections)]: the

[Pastor Sam Sailor (Faith and Power Assembly; Hartford cohort)]: morning, say saying, please put your support behind senate bill four nine eight. I'm saying it is your absolute responsibility to do so and act protecting the personal paychecks. As a witness to testimony of these individuals, there are individuals, they're real human beings, they're living, breathing human beings that do a job that we really don't wanna do. While we sleep at night and have our parties and have our celebrations, they are putting in the time and the work to keep the dignity of a living individual alive and the hope alive in their life. And they deserve our attention, our dudious attention. Time is so precious, and I value our time at this very moment to gather for the reason together, gather to gather together and reason together for a better Connecticut. A hope for a better Connecticut is a song worth singing, but I cannot sing that song based on the current realities of the grievous burdensome burdensome and dangerous survival conditions within the segment of our society, state, and homes, namely those personal care assistants. I'm asking I'm speaking on on on the working conditions of the personal care attendants that you've heard so diligently expressed to you, Dave, so sincerely expressed to you, Dave. And being on these nights at this time of night, I know you have a compassion to hear. This is more than a duty for you. This is your lifestyle to listen to the people and respond to them. And so I'm speaking on that issue today because we have a more a moral responsibility to do something seriously about it. We heard from the third party contractor all the issues that were going on. All that stuff from what I understand all kept ringing in my head was everything is fixable. Everything is fixable if we really wanna fix it. I pride we pride ourselves in in in our state model with our state model called the constitution state. When speaking of the model, it should mean that we are more than a piece of paper. It's more than just a quick comment or rehearsal of what could be, but rather what should be. It should be it should speak to the character of our values. And I dare say our values must speak to the worth of our citizens, those that we send to work do the jobs that we don't wanna do. Sadly, we are not standing on the value constitution regarding on our value constitution regarding the conditions of personal care attendants. Please let me elaborate. I value I value PCAs, our people too. They are parents, taxpayers, consumers, voters, patients, drivers, church members, sponsors, nonprofit, organizations, and respective of their respective communities. They have heavenly and seemingly invisible lifting, and lifting the standard of dignity requisite to engagement of their consumers, for their consumers to live on despite the struggles presented in their lives. Our PCAs deserve us to deal with this issue as diligently and as as fast as we can to bring dignity back to the life that they're doing. And I'll close with this, concern, this this this song that you probably heard from the wonderful Tina Tarek, we need a little bit more respect. We need a little bit more respect for those people who are doing such a delicate and wonderful job and not getting paid or not getting paid on time because the bills don't end and the light companies doesn't wait and the gas companies doesn't wait and the full bill doesn't wait. And so we need to have a little bit more respect, a little bit understanding of this delicate role that we're asking people to play while we go on and live the life that we wanna live. Please spend some more concern and do some due diligence. We thank you for spending the night with us tonight and hearing us all tonight. Amen. Have a great night.

[Rep. Jillian Gilchrest, House Chair (Human Services Committee)]: Thank you so much. Kristen Ferguson? Alright. That concludes the human services public hearing. Thank you everyone for being here, and thank you to the staff. Especially.

[Committee staff/host (technical or brief interjections)]: Amen.