Substitute House Bill No. 5358 seeks to amend 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 for determining room and board rates by the Commissioner of Social Services. These rates will be assessed annually, with guidelines for calculating the rate of return on real property and provisions for actual debt service on loans. The bill also ensures that increases in operating costs funded by grants or gifts do not obligate the state to increase future expenditures. Additionally, it establishes a framework for service component reimbursement rates, limiting increases to no more than two percent unless specific conditions, such as capital improvements for health or safety, are met.

The bill further mandates that reimbursement rates for community living arrangements, community companion homes, and intermediate care facilities for individuals with intellectual disabilities be rebased every two years, starting July 1, 2026, for the former two and July 1, 2027, for the latter. It prohibits inflationary increases during rebasing years and requires adjustments to allowable operating costs based on the gross domestic product deflator. The bill also removes the authority of the Department of Social Services commissioner to adjust rates based on reductions in appropriations, while still allowing for adjustments under other circumstances. Overall, the bill aims to create a more structured and equitable reimbursement system for residential care facilities while ensuring fiscal responsibility.