2005 Connecticut Code - Sec. 4-66d. Standardized form for notification of possible reimbursement liability.
Sec. 4-66d. Standardized form for notification of possible reimbursement liability. (a) The Secretary of the Office of Policy and Management shall develop a standardized form of notice for the Departments of Social Services, Children and Families,
Mental Retardation and Mental Health and Addiction Services for the purpose of disclosing to an applicant or recipient of care or support, or the legally liable relative, as defined
in subsection (c) of section 4a-12, of a person receiving care or support, the possibility
of liability for reimbursement of any amount paid by the state on behalf of the care or
support of an applicant, recipient or child. Said form shall include the following: (1)
Whether payments required are full or partial payment of moneys owed to the department; (2) that the applicant or recipient of care or support, or the legally liable relative
may be liable for the entire cost of care or support; and (3) that upon request, at the end
of care or support, itemization of costs and list of services provided. Said form may be
included in an application for care or support.
(P.A. 97-312, S. 1.)
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