Substitute Bill No. 5358 proposes significant revisions to the reimbursement rates for residential facilities that provide care but are not certified under the Title XIX Medicaid program. The bill repeals subsections (a) and (b) of section 17b-244 of the general statutes and introduces new provisions that will take effect on July 1, 2026. Key changes include the annual determination of the room and board component of rates by the Commissioner of Social Services, and the ability for facilities to request actual debt service on loans instead of property costs, provided these terms are reasonable. The service component of the rates will also be determined annually by the Commissioner of Developmental Services. The bill establishes guidelines for rate adjustments based on capital improvements for resident health and safety, while ensuring that no facility receives a rate exceeding the charges for comparable services to the general public.

Additionally, the bill outlines a structured approach to rate adjustments, including a rebasing process every two years starting July 1, 2027, with no inflationary increases during rebasing years. It also introduces a minimum per diem rate of $501 for certain residential facilities and allows for pro rata fair rent increases for documented capital improvements. The bill deletes previous provisions that allowed the Commissioner to adjust rates based on available appropriations, streamlining the rate adjustment process. Furthermore, it emphasizes the importance of wage and benefit enhancements for facility employees, with potential rate decreases for facilities that do not implement salary increases by specified deadlines. Overall, the bill aims to create a more equitable and accountable framework for the reimbursement of residential care facilities while ensuring the health and safety of residents.