House File 503 - Introduced HOUSE FILE BY HEDDENS, FOEGE, JOCHUM, ABDUL=SAMAD, FREVERT, HEATON, GRASSLEY, UPMEYER, and DEYOE Passed House, Date Passed Senate, Date Vote: Ayes Nays Vote: Ayes Nays Approved A BILL FOR 1 An Act relating to providing opportunities to individuals with 2 disabilities. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 TLSB 2122YH 82 5 pf/je/5 PAG LIN 1 1 Section 1. Section 249A.3, subsection 1, Code 2007, is 1 2 amended by adding the following new paragraph: 1 3 NEW PARAGRAPH. u. As allowed under the federal Deficit 1 4 Reduction Act of 2005, Pub. L. No. 109=171, section 6062, is 1 5 an individual who is less than nineteen years of age who meets 1 6 the federal supplemental security income program rules for 1 7 disability but whose income or resources exceed such program 1 8 rules, who is a member of a family whose income is at or below 1 9 three hundred percent of the most recently revised official 1 10 poverty guidelines published by the United States department 1 11 of health and human services for the family, and whose parent 1 12 complies with the requirements relating to family coverage 1 13 offered by the parent's employer and any premium requirements 1 14 adopted by rule of the department. Such assistance shall be 1 15 provided on a phased=in basis, based upon the age of the 1 16 individual. The rules adopted by the department shall provide 1 17 that premiums charged shall not exceed the sum of five percent 1 18 of family income for families with incomes between one hundred 1 19 and two hundred percent of the most recently revised official 1 20 poverty guidelines and shall not exceed seven and one=half 1 21 percent of family income for families with incomes from two 1 22 hundred through three hundred percent of the most recently 1 23 revised official poverty guidelines. As used in this 1 24 paragraph, in determining the amount of premiums charged, the 1 25 amount shall include both premiums charged under the medical 1 26 assistance program and any premiums charged for family 1 27 coverage under any other health insurance coverage for the 1 28 family. The rules shall also provide that the premium may be 1 29 waived if payment would create an undue hardship. 1 30 Sec. 2. HOME AND COMMUNITY=BASED ALTERNATIVES TO 1 31 PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES FOR CHILDREN. As 1 32 provided under the federal Deficit Reduction Act of 2005, Pub. 1 33 L. No. 109=171, section 6063, the department of human services 1 34 shall seek a waiver to participate in a demonstration project 1 35 to test the effectiveness in improving or maintaining a 2 1 child's functional level and the cost effectiveness of 2 2 providing coverage of home and community=based alternatives to 2 3 psychiatric residential treatment for children for individuals 2 4 under twenty=one years of age who are enrolled in the medical 2 5 assistance program. The department shall collaborate with 2 6 directors of psychiatric medical institutions for children as 2 7 defined in section 135H.1, community=based services providers, 2 8 and other interested parties in developing and implementing 2 9 the demonstration project. 2 10 Sec. 3. DEVELOPMENT AND SUPPORT OF FAMILY=TO=FAMILY HEALTH 2 11 INFORMATION CENTER. 2 12 1. As provided under the federal Deficit Reduction Act of 2 13 2005, Pub. L. No. 109=171, section 6064, the department of 2 14 human services shall aggressively pursue the establishment of 2 15 a family=to=family health information center in Iowa. The 2 16 center shall provide for all of the following: 2 17 a. Assistance to families of children with disabilities or 2 18 special health care needs to make informed choices about 2 19 health care in order to promote good treatment decisions, 2 20 cost=effectiveness, and improved health outcomes for such 2 21 children. 2 22 b. Information regarding health care needs of and 2 23 resources available for such children. 2 24 c. Identification of successful health delivery models for 2 25 such children. 2 26 d. Development, with representatives of health care 2 27 providers, managed care organizations, health care purchasers, 2 28 and appropriate state agencies, of a model for collaboration 2 29 between families of such children and health professionals. 2 30 e. Training and guidance regarding caring for such 2 31 children. 2 32 f. Conducting of outreach activities to the families of 2 33 such children, health professionals, schools, and other 2 34 appropriate entities and individuals. 2 35 2. The center shall be staffed by families of children 3 1 with disabilities or special health care needs who have 3 2 expertise in federal and state public and private health care 3 3 systems and by health professionals. 3 4 Sec. 4. PRESUMPTIVE ELIGIBILITY FOR CERTAIN SUPPLEMENTAL 3 5 SECURITY INCOME BENEFICIARIES. Pursuant to the federal 3 6 Deficit Reduction Act of 2005, Pub. L. No. 109=171, section 3 7 6065, the department of human services shall adopt rules, 3 8 pursuant to chapter 17A, to provide presumptive eligibility, 3 9 on the latter of the date of application or the date federal 3 10 supplemental security income is granted, under the medical 3 11 assistance program for individuals under twenty=one years of 3 12 age who meet the presumptive eligibility requirements under 3 13 the federal supplemental security income program. 3 14 EXPLANATION 3 15 This bill directs the department of human services to 3 16 implement certain provisions specified in the federal Deficit 3 17 Reduction Act of 2005 for individuals with disabilities. 3 18 The bill directs the department to implement the Medicaid 3 19 buy=in provision for individuals under 19 years of age with 3 20 disabilities whose family income or resources are at or below 3 21 300 percent of the federal poverty level. In order to be 3 22 eligible for the program the parent of the individual would be 3 23 required to comply with provisions relating to family coverage 3 24 offered by the parent's employer and any premium requirements 3 25 adopted by rule of the department. Premium amounts would be 3 26 limited to not more than 5 percent of family income for 3 27 families with incomes between 100 and 200 percent of the 3 28 federal poverty level and not more than 7.5 percent of family 3 29 income for families with incomes from 200 through 300 percent 3 30 of the federal poverty level. In determining the amount of 3 31 premium costs, both premium costs charged under the Medicaid 3 32 program and under any other family health insurance coverage 3 33 are to be included. Additionally, the rules regarding 3 34 premiums would provide that the premium may be waived if 3 35 payment would create an undue hardship. 4 1 The bill directs the department of human services to seek a 4 2 waiver to participate in a demonstration project to test the 4 3 effectiveness in improving or maintaining a child's functional 4 4 level and the cost effectiveness of providing coverage of home 4 5 and community=based alternatives to psychiatric residential 4 6 treatment for children for individuals under 21 years of age 4 7 who are enrolled in the medical assistance program. The bill 4 8 requires the department to collaborate with directors of 4 9 psychiatric medical institutions for children, community=based 4 10 services providers, and other interested parties in developing 4 11 and implementing the demonstration project. 4 12 The bill requires the department of human services to 4 13 aggressively pursue the establishment of a family=to=family 4 14 health information center in Iowa to provide assistance to 4 15 families of children with disabilities or special health care 4 16 needs to make informed choices about health care in order to 4 17 promote good treatment decisions, cost=effectiveness, and 4 18 improved health outcomes for such children. The center would 4 19 be staffed by families of children with disabilities or 4 20 special health care needs who have expertise in federal and 4 21 state public and private health care systems and by health 4 22 professionals. 4 23 The bill directs the department of human services to adopt 4 24 rules to provide presumptive eligibility under the medical 4 25 assistance program for individuals under 21 years of age who 4 26 meet the presumptive eligibility requirements under the 4 27 federal supplemental security income program. 4 28 LSB 2122YH 82 4 29 pf:nh/je/5.1