S.F. 2370 Section 1. NEW SECTION . 217.41C Public assistance programs 1 —— verification of applicant eligibility —— residency. 2 1. The department of human services shall implement an 3 eligibility verification system for public assistance programs 4 to verify the eligibility of an individual who is an applicant 5 for any such program. The information to be verified and 6 sources to be examined for each individual shall include but 7 are not limited to all of the following: 8 a. Earned and unearned income. 9 b. Employment status and changes in employment. 10 c. Immigration status. 11 d. Residency status, including a nationwide best-address 12 source to verify that individuals are residents of the state. 13 e. Enrollment status in other state-administered public 14 assistance programs. 15 f. Incarceration status. 16 g. Death records. 17 h. Enrollment status in public assistance programs outside 18 of this state. 19 i. Records of any potential identity fraud or identity 20 theft. 21 2. The department of human services shall enter into a 22 memorandum of understanding with any department, division, 23 bureau, section, unit, or any other subunit of a department, as 24 necessary, to obtain the information specified in subsection 1. 25 3. The department of human services may contract with a 26 third-party vendor to provide the information specified in 27 subsection 1. Any such contract shall include a provision 28 that ensures that annualized savings to the state exceed the 29 contract’s total annual cost to the state. 30 4. Nothing in this section shall preclude the department 31 of human services from receiving, reviewing, or verifying 32 additional information related to the eligibility of an 33 individual not specified in this section or from contracting 34 with a third-party vendor to provide additional information not 35 -1- LSB 5181SV (1) 87 pf/rh 1/ 17

S.F. 2370 specified in this section. 1 5. The department of human services shall require that an 2 applicant for a public assistance program demonstrate residency 3 in the state for at least one year prior to submission of the 4 application. The department shall require that the applicant 5 specify the county in which the applicant has resided, 6 the length of residence in the state, and state that the 7 maintenance of the residence has been in good faith and not for 8 the purposes of obtaining public assistance benefits only. An 9 individual who fails to demonstrate residency in the state for 10 at least one year prior to submission of an application for 11 public assistance benefits shall be ineligible to receive such 12 benefits. 13 6. For the purposes of this section, “public assistance 14 program” shall include but is not limited to the Medicaid 15 program, the family investment program (FIP), and the 16 supplemental nutrition assistance program (SNAP). 17 Sec. 2. NEW SECTION . 217.41D Public assistance programs —— 18 real-time eligibility monitoring. 19 1. At least quarterly, the department of human services 20 shall obtain and review all of the following information and 21 sources to determine ongoing eligibility of an enrollee in a 22 public assistance program: 23 a. Earned and unearned income. 24 b. Employment status and changes in employment. 25 c. Residency status. 26 d. Enrollment status in other state-administered public 27 assistance programs. 28 e. Financial resources. 29 f. Incarceration status. 30 g. Death records. 31 h. Lottery winnings. 32 i. Enrollment status in public assistance programs outside 33 of the state. 34 2. The department of human services shall enter into a 35 -2- LSB 5181SV (1) 87 pf/rh 2/ 17

S.F. 2370 memorandum of understanding with any department, division, 1 bureau, section, unit, or any other subunit of a department to 2 obtain the information specified in subsection 1. 3 3. The department of human services may contract with a 4 third-party vendor to provide the information specified in 5 subsection 1. Any such contract shall include a provision that 6 ensures that any annualized savings to the state exceed the 7 contract’s total annual cost to the state. 8 4. The department of human services shall explore 9 opportunities to join existing multistate collaborations to 10 identify individuals who are also enrolled in public assistance 11 programs outside of the state, including the national accuracy 12 clearinghouse. 13 5. Nothing in this section shall preclude the department 14 of human services from receiving or reviewing additional 15 information related to the eligibility of an individual 16 not specified in this section or from contracting with a 17 third-party vendor to provide additional information not 18 specified in this section. 19 6. If the department of human services receives information 20 about an enrollee in a public assistance program that indicates 21 a potential change or discrepancy in circumstances that may 22 affect the individual’s eligibility for that public assistance 23 program, the department shall review the individual’s 24 circumstances and respond appropriately, as follows: 25 a. If the review does not result in the department 26 confirming any discrepancy or change in an individual’s 27 circumstances that may affect eligibility, the department shall 28 take no further action. 29 b. If the review results in the department finding 30 a potential discrepancy or change in the individual’s 31 circumstances that may affect eligibility, the department shall 32 promptly notify the individual. 33 (1) The department shall provide written notice to the 34 enrollee, which shall describe in sufficient detail the 35 -3- LSB 5181SV (1) 87 pf/rh 3/ 17

S.F. 2370 circumstances of the potential discrepancy or change, the 1 manner in which the enrollee may respond, and the consequences 2 of failing to take action. However, a self-declaration of an 3 enrollee alone shall not be accepted as verification to refute 4 the information. 5 (2) The enrollee shall have ten business days, or the 6 minimum required by federal or state law, to respond to the 7 department in writing, to provide information to refute and 8 resolve the potential discrepancy or change. After receiving 9 the enrollee’s written response, the department may request 10 additional documentation if the department determines that 11 the documentation is inadequate or that a risk of fraud or 12 misrepresentation exists. A self-declaration of an enrollee 13 refuting the information shall not, alone, constitute a 14 refutation of the potential discrepancy or change. 15 (3) If the enrollee does not respond to the written 16 notice in a timely manner, the department shall provide 17 notice to terminate the individual’s enrollment, based upon 18 the individual’s failure to cooperate, and shall terminate 19 the individual’s enrollment in any applicable public 20 assistance program. The individual’s eligibility shall not be 21 reestablished until the discrepancy or change is resolved. 22 (4) If the enrollee responds to the written notice in a 23 timely manner and disagrees with the findings, the department 24 shall reevaluate the enrollee’s situation. If the department 25 determines through the reevaluation that the information upon 26 which the discrepancy or change was based is in error, the 27 department shall take immediate action to correct the error and 28 no further action on the enrollee’s eligibility status shall be 29 taken. If the department affirms through the reevaluation that 30 a discrepancy or change exists, the department shall determine 31 the effect on the enrollee’s eligibility and take appropriate 32 action. Written notice of the results of the department’s 33 reevaluation and the actions to be taken shall be provided to 34 the individual. 35 -4- LSB 5181SV (1) 87 pf/rh 4/ 17

S.F. 2370 (5) If the enrollee responds to the written notice in a 1 timely manner and agrees with the findings, the department 2 shall determine the effect on the enrollee’s circumstances and 3 take appropriate action. Written notice of the actions to be 4 taken by the department shall be provided to the individual. 5 7. For the purposes of this section, “public assistance 6 program” shall include but is not limited to the Medicaid 7 program, the family investment program (FIP), and the 8 supplemental nutrition assistance program (SNAP). 9 Sec. 3. NEW SECTION . 217.41E Supplemental nutrition 10 assistance program —— resource limitations —— child support 11 cooperation as a condition of eligibility —— work requirements. 12 1. The department of human services shall not establish 13 resource limits for the supplemental nutrition assistance 14 program (SNAP) that exceed the resource limitations specified 15 in 7 U.S.C. §2014(g)(1), unless specifically required under 16 federal law. Additionally, categorical eligibility shall not 17 exempt households from these resource limits for any noncash, 18 in-kind, or other benefit, unless expressly required by federal 19 law. 20 2. The department of human services shall require, as a 21 condition of eligibility for SNAP, that an individual cooperate 22 with the child support recovery unit in establishing and 23 enforcing a child support order pursuant to 7 C.F.R. §273.11(o) 24 and (p). 25 3. a. The department of human services shall not seek, 26 apply for, accept, or renew any waiver of the work requirements 27 applicable to an individual to be eligible for SNAP pursuant to 28 7 U.S.C. §2015(o). 29 b. The department of human services shall assign an 30 individual who is subject to the work requirements specified 31 in 7 U.S.C. §2015(d)(1), but who is exempt from the work 32 requirements pursuant to 7 U.S.C. §2015(o), to participate in 33 an employment and training program established pursuant to 7 34 U.S.C. §2015(d)(4). 35 -5- LSB 5181SV (1) 87 pf/rh 5/ 17

S.F. 2370 Sec. 4. NEW SECTION . 217.41F Work requirements —— Medicaid 1 program. 2 1. The department of human services shall require that, 3 unless an individual is exempt pursuant to subsection 2, as a 4 condition of eligibility for Medicaid, a recipient shall do one 5 of the following: 6 a. Work twenty hours or more per week, averaged on a monthly 7 basis. 8 b. Participate in and comply with the requirements of a work 9 program for twenty hours or more per week, as determined by the 10 department. 11 c. Volunteer twenty hours or more per week, as determined 12 by the department. 13 d. Meet a combination of work and work program participation 14 requirements for a total of twenty hours or more per week, as 15 determined by the department. 16 e. Participate in and comply with the PROMISE JOBS program 17 pursuant to chapter 239B. 18 2. The following individuals shall be exempt from the 19 requirements specified in subsection 1: 20 a. An individual under the age of nineteen. 21 b. An individual over the age of sixty-four. 22 c. An individual medically certified as physically or 23 mentally unfit for employment. 24 d. An individual who is pregnant. 25 e. A parent or caretaker responsible for the care of a 26 dependent child under one year of age. 27 f. A parent or caretaker personally providing the care for a 28 dependent child with a serious medical condition or disability, 29 as determined by the department. 30 g. An individual receiving unemployment compensation 31 and complying with work requirements of the federal or state 32 unemployment compensation system. 33 h. An individual participating in a drug or alcohol 34 treatment and rehabilitation program. 35 -6- LSB 5181SV (1) 87 pf/rh 6/ 17

S.F. 2370 Sec. 5. NEW SECTION . 217.41G Drug testing for applicants. 1 1. For the purposes of this section, unless the context 2 otherwise requires: 3 a. “Confirmed positive test result” means the results of a 4 urine, hair, or sweat test in which the level of drugs or their 5 metabolites in the sample analyzed meets or exceeds nationally 6 accepted standards for determining the detectable levels of 7 drugs as adopted by the federal substance abuse and mental 8 health services administration. 9 b. “Drug” means the same as defined in section 730.5. 10 c. “Licensed substance abuse treatment program” means an 11 inpatient or outpatient substance abuse treatment program 12 licensed by the department of public health under chapter 125. 13 d. “Sample” means a sample from the human body capable of 14 revealing the presence of drugs, or their metabolites, which 15 shall include urine, hair, or sweat. 16 2. a. As a condition of eligibility for an applicant 17 to receive benefits under a public assistance program, the 18 applicant shall agree to participate in drug testing in 19 accordance with this section. 20 b. Dependent children under the age of eighteen years are 21 exempt from the drug testing requirements of this section. 22 c. The department shall require a drug test that is similar 23 to a drug test as a condition of employment under section 730.5 24 to screen the individuals subject to this section for the 25 presence of drugs. The individual is responsible for the cost 26 of the individual’s drug test. 27 3. a. An individual who is subject to this section is 28 ineligible to receive benefits under a public assistance 29 program if the individual does not participate in the required 30 drug testing. 31 b. An individual who is subject to this section is 32 ineligible to receive benefits under a public assistance 33 program under this section if the individual has a confirmed 34 positive test result for the presence of either of the 35 -7- LSB 5181SV (1) 87 pf/rh 7/ 17

S.F. 2370 following: 1 (1) A substance listed in schedule I under section 124.204. 2 (2) A substance listed in schedule II, III, or IV under 3 chapter 124 that was not prescribed for the individual. 4 4. The department shall do all of the following in 5 implementing this section: 6 a. (1) Provide notice of drug testing to each individual 7 who is subject to this section at the time of application. The 8 notice must advise the individual that drug testing will be 9 conducted as a condition for receiving benefits under a public 10 assistance program and that the individual must bear the cost 11 of the drug testing. If the individual’s drug test results in 12 a confirmed positive test result, the cost of the drug test 13 shall not be reimbursed. If the individual’s drug test does 14 not result in a confirmed positive test result, the cost of the 15 drug test shall be reimbursed by being added to the benefits 16 disbursed pursuant to rules adopted by the department. The 17 applicant shall be advised that the required drug testing may 18 be avoided if the applicant does not complete or withdraws the 19 application for assistance. 20 (2) Advise each individual to be tested, before the test 21 is conducted, that the individual may, but is not required to, 22 advise the agent administering the test of any prescription or 23 over-the-counter medication the individual is taking. 24 (3) Require each individual to be tested to sign a written 25 acknowledgment that the individual has received and understood 26 the notice and advice provided under this paragraph “a” . 27 b. Ensure that each individual being tested has a reasonable 28 degree of dignity while producing and submitting a sample for 29 drug testing, consistent with the department’s need to ensure 30 the reliability of the sample. 31 c. Adopt rules specifying circumstances under which an 32 individual with a confirmed positive test result has the right 33 to retake the drug test. 34 d. Inform an individual who has a confirmed positive 35 -8- LSB 5181SV (1) 87 pf/rh 8/ 17

S.F. 2370 test result and is deemed ineligible for assistance that the 1 individual may not reapply for assistance for one year after 2 the date of the confirmed positive test result unless the 3 individual meets the requirements of paragraph “f” . If the 4 individual has a subsequent confirmed positive test result, 5 the individual shall be ineligible to receive assistance for 6 three years after the date of the subsequent result unless the 7 individual meets the requirements of paragraph “f” . 8 e. Provide any individual with a confirmed positive test 9 result with a list of licensed substance abuse treatment 10 programs available in the area in which the individual resides. 11 Neither the department nor the state is responsible for 12 providing or paying for substance abuse treatment as part of 13 the drug testing conducted under this section. 14 f. An individual with a confirmed positive test result 15 who is denied benefits under this section may reapply for 16 assistance after six months if the individual can document the 17 successful completion of a licensed substance abuse treatment 18 program. An individual who has met the requirements of this 19 paragraph and reapplies for assistance must also pass the 20 initial drug test required under subsection 2. Any drug test 21 conducted while the individual is undergoing substance abuse 22 treatment must meet the requirements for a drug test under 23 subsection 2. The cost of any drug testing or substance 24 abuse treatment provided under this subsection shall be the 25 responsibility of the individual being tested or receiving 26 treatment. An individual with a confirmed positive test result 27 from the drug test required under subsection 2 may reapply for 28 assistance under this paragraph only once. 29 5. a. If an applicant is deemed ineligible for assistance 30 as a result of having a confirmed positive test result from a 31 drug test conducted under this section, the eligibility of the 32 applicant’s dependent child for assistance is not affected. 33 b. An appropriate protective payee shall be designated 34 to receive assistance on behalf of the dependent child. 35 -9- LSB 5181SV (1) 87 pf/rh 9/ 17

S.F. 2370 The parent may choose to designate an individual as the 1 protective payee. The individual designated by the parent as 2 the protective payee must be a specified relative or other 3 immediate family member unless such family member is not 4 available or the family member declines the designation. In 5 such a case, another individual, approved by the department, 6 shall be designated as the protective payee. The individual 7 must also undergo drug testing before being approved to be 8 the protective payee. If the designated individual has a 9 confirmed positive test result, the designated individual shall 10 be ineligible to be the protective payee. 11 6. For the purposes of this section, “public assistance 12 program” shall include but not be limited to the Medicaid 13 program, the family investment program (FIP), and the 14 supplemental nutrition assistance program (SNAP). 15 Sec. 6. NEW SECTION . 217.41H Reporting of fraud. 16 If, through the activities of the department of human 17 services under this subchapter, the department discovers 18 potential fraudulent activity, the department shall report its 19 findings and any supportive information to the office of the 20 attorney general for review. 21 Sec. 7. NEW SECTION . 217.41I Reporting. 22 The department of human services shall submit a report to 23 the governor and the general assembly by January 15, 2019, and 24 by January 15 annually thereafter, detailing the impact of 25 verification of applicant eligibility for public assistance 26 programs and real-time eligibility monitoring of recipients 27 of public assistance programs as provided in this subchapter. 28 The initial report shall provide information for the period 29 beginning July 1, 2018, and ending December 31, 2018. The 30 reports shall include the number of cases reviewed, the number 31 of cases closed, the number of fraud investigation referrals 32 made, and the amount of savings and cost avoidance realized 33 from the provisions of the subchapter. 34 Sec. 8. NEW SECTION . 234.13A Eligible food items. 35 -10- LSB 5181SV (1) 87 pf/rh 10/ 17

S.F. 2370 1. The department of human services shall maintain a list of 1 eligible food and food items for the food assistance program 2 utilizing a numeric-based code assigned to the food item 3 wherever the food item is sold throughout the state. 4 2. A retailer shall not allow a food assistance program 5 recipient to use a benefit transfer instrument to purchase food 6 and food items that are not included on the eligible food item 7 list. 8 3. The department of human services shall assess a civil 9 penalty against a retailer who violates this section of not 10 more than one thousand dollars for a first violation, two 11 thousand dollars for a second violation occurring within five 12 years from the date of the first violation, or five thousand 13 dollars for any subsequent violations. 14 4. For purposes of this section, “retailer” means the same 15 as defined in section 234.12A. 16 Sec. 9. FOOD ASSISTANCE PROGRAM —— AUTHORITY TO RESTRICT 17 USE OF BENEFITS. The department of human services shall submit 18 a request to the United States department of agriculture 19 for authorization for a five-year waiver, pilot project, or 20 other approach for restricting the use of food assistance 21 benefits, as administered by the state under the federal 22 supplemental nutrition assistance program for food and food 23 items with a low nutritional value that cost more than eight 24 dollars per pound or that purport to provide an additional 25 potential health benefit or reduce a potential adverse health 26 effect to consumers when compared to less expensive food 27 items. The request shall include a proposal for a thorough 28 process evaluation to document how the restrictions will be 29 implemented by both the state and retailers, with a study 30 design that includes counterfactual data indicating the 31 effects of the absence of such restrictions on food assistance 32 program recipients, and a full cost estimate that addresses 33 both federal and state costs and savings associated with 34 such restrictions. The request shall be submitted within 35 -11- LSB 5181SV (1) 87 pf/rh 11/ 17

S.F. 2370 ninety days of the effective date of this section of this Act. 1 The department shall regularly report on the status of the 2 request to the chairpersons and ranking members of the general 3 assembly’s standing committees on commerce and the legislative 4 services agency. 5 Sec. 10. ADMINISTRATION AND IMPLEMENTATION. 6 1. The department of human services shall adopt rules 7 pursuant to chapter 17A to administer this Act. 8 2. The department of human services shall submit, to the 9 centers for Medicare and Medicaid services (CMS) of the United 10 States department of health and human services any Medicaid 11 state plan amendment or waiver request necessary to administer 12 this Act. 13 3. The provisions of this Act requiring approval of a 14 Medicaid state plan amendment or waiver shall be implemented 15 upon receipt of such federal approval. 16 4. The section of this Act enacting section 234.13A is 17 contingent upon receipt of approval from the United States 18 department of agriculture for a five-year waiver, pilot 19 project, or other approach for restricting the use of certain 20 food assistance benefits. The department of human services 21 shall notify the Code editor upon the receipt of such approval. 22 5. The provisions of this Act not requiring approval of a 23 Medicaid state plan amendment or waiver or approval from the 24 United States department of agriculture shall be implemented 25 on January 1, 2019. 26 Sec. 11. DIRECTIVE TO CODE EDITOR. The Code editor shall 27 codify the provisions of this Act enacting sections 217.41C, 28 217.41D, 217.41E, 217.41F, 217.41G, 217.41H, and 217.41I as 29 chapter 217, subchapter III. 30 Sec. 12. EFFECTIVE DATE. The section of this Act directing 31 the department of human services to submit a request for a 32 five-year waiver, pilot project, or other approach to the 33 United States department of agriculture, being deemed of 34 immediate importance, takes effect upon enactment. 35 -12- LSB 5181SV (1) 87 pf/rh 12/ 17

S.F. 2370 EXPLANATION 1 The inclusion of this explanation does not constitute agreement with 2 the explanation’s substance by the members of the general assembly. 3 This bill relates to public assistance program oversight. 4 For purposes of the bill, “public assistance program” includes 5 but is not limited to the Medicaid program, the family 6 investment program (FIP), and the supplemental nutrition 7 assistance program (SNAP). 8 The bill provides for verification of a public assistance 9 program applicant’s eligibility. The department of human 10 services (DHS) is required to implement an eligibility 11 verification system for public assistance programs to verify 12 the eligibility of an individual who is an applicant for 13 any such program. The bill specifies the information to 14 be verified; requires DHS to enter into a memorandum of 15 understanding with any department or subunit of a department, 16 as necessary, to obtain the information specified; and 17 authorizes DHS to contract with a third-party vendor to 18 provide the information specified, subject to a provision 19 in the contract that ensures that annualized savings to the 20 state exceed the contract’s total annual cost to the state. 21 The bill does not preclude DHS from receiving, reviewing, or 22 verifying additional information related to the eligibility of 23 an individual not specified in the bill or from contracting 24 with a third-party vendor to provide additional information not 25 specified in the bill. 26 The bill requires DHS to require that an applicant for a 27 public assistance program demonstrate residency in the state 28 for at least one year prior to submission of the application. 29 The department shall require that the applicant specify the 30 county in which the applicant has resided, the length of 31 residence in the state, and state that the maintenance of the 32 residence has been in good faith and not for the purposes 33 of obtaining public assistance benefits only. An individual 34 who fails to demonstrate residency in the state for at least 35 -13- LSB 5181SV (1) 87 pf/rh 13/ 17

S.F. 2370 one year prior to submission of an application for public 1 assistance benefits shall be ineligible to receive such 2 benefits. 3 The bill provides for real-time monitoring of the 4 eligibility of public assistance program enrollees. The 5 bill requires DHS, as least quarterly, to obtain and review 6 specified information to determine ongoing eligibility of 7 an individual enrolled in a public assistance program. The 8 bill requires DHS to enter into memoranda of understanding 9 with any department or subunit of a department, as necessary, 10 to obtain the information specified; authorizes DHS to 11 contract with a third-party vendor to provide the information 12 specified, subject to a provision in the contract that ensures 13 that annualized savings to the state exceed the contract’s 14 total annual cost to the state; and requires DHS to explore 15 opportunities to join existing multistate collaborations to 16 identify individuals who are also enrolled in public assistance 17 programs outside of the state, including the national accuracy 18 clearinghouse. The bill does not preclude DHS from receiving 19 or reviewing additional information related to the eligibility 20 of an individual not specified in the bill or from contracting 21 with a third-party vendor to provide additional information not 22 specified in the bill. 23 The bill provides that if DHS receives information about 24 an individual enrolled in a public assistance program that 25 indicates a potential change or discrepancy in circumstances 26 that may affect the enrollee’s eligibility for that 27 public assistance program, DHS shall review the enrollee’s 28 circumstances and respond appropriately. The bill delineates 29 the appropriate response based upon the response of the 30 enrollee following notice. 31 The bill prohibits DHS from establishing resource limits 32 for the supplemental nutrition assistance program (SNAP) that 33 exceed the resource limitations specified in federal law, 34 unless specifically required under federal law. Additionally, 35 -14- LSB 5181SV (1) 87 pf/rh 14/ 17

S.F. 2370 the bill provides that categorical eligibility shall not exempt 1 households from these resource limits for any noncash, in-kind, 2 or other benefit, unless expressly required by federal law. 3 The bill requires DHS to require, as a condition of 4 eligibility for SNAP, that an individual cooperate with the 5 child support recovery unit in establishing and enforcing a 6 child support order pursuant to federal law. 7 The bill also prohibits DHS from seeking, applying for, 8 accepting, or renewing any waiver of the work requirements 9 applicable to an individual to be eligible for SNAP, unless 10 the individual is exempt under federal law and requires DHS 11 to assign an individual who would otherwise be subject to the 12 work requirements under federal law, but meets the criteria for 13 one of the exemptions under federal law, to participate in an 14 employment and training program established as prescribed in 15 federal law. 16 The bill also requires DHS to require that, unless an 17 individual is exempt as specified in the bill, as a condition 18 of eligibility for Medicaid, a recipient shall work or 19 participate in a work program or a combination of both for 20 a certain number of hours, volunteer, or participate in the 21 PROMISE JOBS program. 22 The bill provides that if, through the department’s 23 activities under the bill, the department discovers potential 24 fraudulent activity, the department shall report its 25 findings and any supportive information to the office of the 26 attorney general for review. The bill requires DHS to adopt 27 administrative rules to administer the bill. 28 The bill requires DHS to submit a report to the governor and 29 the general assembly by January 15, 2019, and by January 15 30 annually thereafter, detailing the impact of the provisions of 31 the bill relating to verification of applicant eligibility for 32 public assistance programs and real-time eligibility monitoring 33 of recipients of public assistance programs. The initial 34 report must include information for the period beginning July 35 -15- LSB 5181SV (1) 87 pf/rh 15/ 17

S.F. 2370 1, 2018, and ending December 31, 2018. The reports shall 1 include the number of cases reviewed, the number of cases 2 closed, the number of fraud investigation referrals made, and 3 the amount of savings and cost avoidance resulting from the 4 provisions of the bill. 5 The bill requires DHS to submit, to the centers for Medicare 6 and Medicaid services (CMS) of the United States department of 7 health and human services, any Medicaid state plan amendment or 8 waiver request necessary to administer the bill. 9 A provision of the bill requiring approval of a Medicaid 10 state plan amendment or waiver is to be implemented upon 11 receipt of such federal approval. A provision of the bill not 12 requiring approval of a Medicaid state plan amendment or waiver 13 is to be implemented on January 1, 2019. 14 The bill requires drug testing of applicants for public 15 assistance programs. 16 With the exception of dependent children under the age of 17 18 years, DHS is directed to require a drug test for each 18 individual who is an applicant for a public assistance program. 19 The individual is responsible for the cost of the drug test. 20 An applicant who does not participate in the required drug 21 testing is ineligible for public assistance. An individual who 22 has a confirmed positive test result shall be ineligible to 23 reapply for assistance for one year. 24 The bill specifies requirements for administering the drug 25 testing requirement. If a parent is deemed ineligible for 26 assistance as a result of having a confirmed positive test 27 result, the dependent child remains eligible for assistance and 28 a protective payee is to be designated by the parent to receive 29 the assistance on behalf of the child. If a specified relative 30 or other immediate family member declines to be designated, the 31 department must designate the protective payee. The protective 32 payee is then subject to drug testing before being approved to 33 receive benefits on behalf of the child. A protective payee 34 with a confirmed positive test result is ineligible to receive 35 -16- LSB 5181SV (1) 87 pf/rh 16/ 17

S.F. 2370 assistance on behalf of the child. 1 The bill requires DHS to maintain a list of eligible 2 food and food items for the food assistance program using a 3 numeric-based code assignment (new Code section 234.13A). A 4 retailer shall not allow a food assistance program recipient 5 to use a benefit transfer instrument to purchase food and food 6 items that are not on the eligible food item list. The bill 7 provides civil penalties for a retailer who violates this 8 provision of the bill. 9 The bill requires DHS to submit a request to the United 10 States department of agriculture for a five-year waiver, pilot 11 project, or other approach for restricting the use of food 12 assistance benefits for food items with a low nutritional value 13 or that cost more than $8 per pound. The bill requires the 14 request to include a proposal for a thorough process evaluation 15 to document how the restrictions will be implemented by both 16 the state and retailers, with a study design that includes 17 counterfactual data indicating the effects of the absence of 18 such restrictions on food assistance program recipients, and a 19 full cost estimate that addresses both federal and state costs 20 and savings associated with such restrictions. The department 21 is to submit the request within 90 days of the effective 22 date of the bill. The bill directs the department to submit 23 regular reports to the chairpersons and ranking members of 24 the general assembly’s standing committees on commerce and to 25 the legislative services agency on the status of the request. 26 Implementation of the pilot program is contingent upon receipt 27 of approval from the United States department of agriculture. 28 The department of human services is required to notify the Code 29 editor upon receipt of the approval. 30 The directive to the department to submit a request for a 31 waiver, pilot project, or other approach restricting the use of 32 certain food assistance benefits takes effect upon enactment. 33 -17- LSB 5181SV (1) 87 pf/rh 17/ 17