Senate File 538 S-3017 Amend Senate File 538 as follows: 1 1. By striking everything after the enacting clause and 2 inserting: 3 < Section 1. MEDICAID DEMONSTRATION WAIVER REQUEST —— 4 COMMUNITY ENGAGEMENT REQUIREMENTS FOR IOWA HEALTH AND WELLNESS 5 PLAN MEMBERS. 6 1. The department of human services shall submit a request 7 by March 1, 2020, to receive federal approval from the centers 8 for Medicare and Medicaid services of the United States 9 department of health and human services (CMS) for a section 10 1115 demonstration waiver to require that as a condition of 11 eligibility, Iowa health and wellness plan members participate 12 in community engagement activities. 13 2. The waiver request submitted by the department shall 14 require that, unless an individual is exempt pursuant to 15 subsection 3, as a condition of eligibility for the Iowa health 16 and wellness plan, a recipient shall do one of the following: 17 a. Work twenty hours or more per week, averaged over a 18 six-month period. 19 b. Participate in and comply with the requirements of a 20 work program for twenty hours or more per week, averaged on a 21 monthly basis, as determined by the department. 22 c. Volunteer twenty hours or more per week, averaged on a 23 monthly basis, as determined by the department. 24 d. Meet a combination of work and work program participation 25 requirements for a total of twenty hours or more per week, as 26 determined by the department. 27 e. Participate in and comply with the PROMISE JOBS program 28 pursuant to chapter 239B. 29 f. Be enrolled in the future ready Iowa program. 30 g. Participate in other activities identified by the 31 department and approved by CMS. 32 3. The following individuals shall be exempt from the 33 requirements specified in subsection 2: 34 a. An individual medically certified as physically or 35 -1- SF538.775 (2) 88 pf/rh 1/ 3 #1.

mentally unfit for employment. 1 b. An individual who is pregnant. 2 c. A parent or caretaker responsible for the care of a 3 dependent child under six years of age. 4 d. A parent or caretaker personally providing the care for a 5 dependent child with a serious medical condition or disability, 6 as determined by the department. 7 e. An individual receiving unemployment compensation and 8 complying with work requirements of the federal or state 9 unemployment compensation system. 10 f. An individual participating in a drug or alcohol 11 treatment and rehabilitation program. 12 g. An individual determined to be medically exempt. 13 h. An individual enrolled full-time in an educational 14 institution. 15 i. The parent of a child who provides private instruction 16 pursuant to chapter 299A to that child. 17 j. An individual who is a caregiver for an elderly person or 18 an adult with a chronic, disabling, or serious health condition 19 as determined by the department. 20 k. An individual who meets other criteria identified by the 21 department, and approved by CMS. 22 4. The waiver request submitted by the department shall 23 also provide that if an individual does not comply with the 24 community engagement activities during the individual’s initial 25 six-month period of eligibility, the individual shall be 26 placed on a limited benefit plan, and if an individual does 27 not comply with the community engagement activities during the 28 individual’s subsequent six-month period of eligibility, the 29 individual’s eligibility for the program shall be terminated. 30 The department shall include the parameters for the limited 31 benefit plan in the waiver request submitted. 32 5. a. The department shall implement the Medicaid waiver 33 as approved by CMS prospectively from the date of receipt of 34 federal approval. 35 -2- SF538.775 (2) 88 pf/rh 2/ 3