House File 2772 - Enrolled

PAG LIN



  1  1                                           HOUSE FILE 2772
  1  2
  1  3                             AN ACT
  1  4 CREATING A BRAIN INJURY SERVICES PROGRAM AND PROVIDING FOR
  1  5    ALLOCATION OF A PREVIOUSLY ENACTED APPROPRIATION.
  1  6
  1  7 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  1  8
  1  9    Section 1.  NEW SECTION.  135.22B  BRAIN INJURY SERVICES
  1 10 PROGRAM.
  1 11    1.  DEFINITIONS.  For the purposes of this section:
  1 12    a.  "Brain injury services waiver" means the state's
  1 13 medical assistance home and community=based services waiver
  1 14 for persons with brain injury implemented under chapter 249A.
  1 15    b.  "Program administrator" means the division of the
  1 16 department designated to administer the brain injury services
  1 17 program in accordance with subsection 2.
  1 18    2.  PROGRAM CREATED.
  1 19    a.  A brain injury services program is created and shall be
  1 20 administered by a division of the Iowa department of public
  1 21 health in cooperation with counties and the department of
  1 22 human services.
  1 23    b.  The division of the department assigned to administer
  1 24 the advisory council on brain injuries under section 135.22A
  1 25 shall be the program administrator.  The division duties shall
  1 26 include but are not limited to serving as the fiscal agent and
  1 27 contract administrator for the program and providing program
  1 28 oversight.
  1 29    c.  The division shall consult with the advisory council on
  1 30 brain injuries, established pursuant to section 135.22A,
  1 31 regarding the program and shall report to the council
  1 32 concerning the program at least quarterly.  The council shall
  1 33 make recommendations to the department concerning the
  1 34 program's operation.
  1 35    3.  PURPOSE.  The purpose of the brain injury services
  2  1 program is to provide services, service funding, or other
  2  2 support for persons with a brain injury under one of the
  2  3 program components established pursuant to this section.
  2  4    4.  GENERAL REQUIREMENTS == WAIVER ELIGIBLE COMPONENT.
  2  5    a.  The component of the brain injury services program for
  2  6 persons eligible for the brain injury services waiver is
  2  7 subject to the requirements provided in this subsection.
  2  8    b.  If a person is eligible for the brain injury services
  2  9 waiver and is on the waiting list for the waiver but the
  2 10 appropriation for the medical assistance program does not have
  2 11 sufficient funding designated to pay the nonfederal share of
  2 12 the costs to remove the person from the waiting list, the
  2 13 brain injury services program may provide the funding for the
  2 14 nonfederal share of the costs in order for the person to be
  2 15 removed from the waiting list and receive services under the
  2 16 waiver.
  2 17    c.  A person who receives support under the waiver eligible
  2 18 component is not eligible to receive support under the cost=
  2 19 share component of the program.
  2 20    d.  Provision of funding under the waiver eligible
  2 21 component is not an entitlement.  Subject to the department of
  2 22 human services requirements for the brain injury services
  2 23 waiver waiting list, the program administrator shall make the
  2 24 final determination whether funding will be authorized under
  2 25 this component.
  2 26    5.  GENERAL REQUIREMENTS == COST=SHARE COMPONENT.  The
  2 27 cost=share component of the brain injury services program
  2 28 shall be directed to persons who have been determined to be
  2 29 ineligible for the brain injury services waiver or persons who
  2 30 are eligible for the waiver but funding was not authorized or
  2 31 available to provide waiver eligibility for the persons under
  2 32 the waiver eligible component.  The cost=share component is
  2 33 subject to general requirements which shall include but are
  2 34 not limited to all of the following:
  2 35    a.  Services offered are consistent with the services
  3  1 offered through the brain injury services waiver.
  3  2    b.  Each service consumer has a service plan developed
  3  3 prior to service implementation and the service plan is
  3  4 reviewed and updated at least quarterly.
  3  5    c.  All other funding sources for which the service
  3  6 consumer is eligible are utilized to the greatest extent
  3  7 possible.  The funding sources potentially available include
  3  8 but are not limited to community resources and public and
  3  9 private benefit programs.
  3 10    d.  The maximum monthly cost of the services provided shall
  3 11 be based on the maximum monthly amount authorized for the
  3 12 brain injury services waiver.
  3 13    e.  Assistance under the cost=share component shall be made
  3 14 available to a designated number of service consumers who are
  3 15 eligible, as determined from the funding available for the
  3 16 cost=share component, on a first=come, first=served basis.
  3 17    f.  Nothing in this section shall be construed or is
  3 18 intended as, or shall imply, a grant of entitlement to
  3 19 services to persons who are eligible for participation in the
  3 20 cost=share component based upon the eligibility provisions
  3 21 adopted consistent with the requirements of this section.  Any
  3 22 obligation to provide services pursuant to this section is
  3 23 limited to the extent of the funds appropriated or provided
  3 24 for the cost=share component.
  3 25    6.  COST=SHARE COMPONENT ELIGIBILITY.  An individual must
  3 26 meet all of the following requirements in order to be eligible
  3 27 for the cost=share component of the brain injury services
  3 28 program:
  3 29    a.  The individual is age one month through sixty=four
  3 30 years.
  3 31    b.  The individual has a diagnosed brain injury as defined
  3 32 in section 135.22.
  3 33    c.  The individual is a resident of this state and either a
  3 34 United States citizen or a qualified alien as defined in 8
  3 35 U.S.C. } 1641.
  4  1    d.  The cost=share component's financial eligibility
  4  2 requirements shall be established in administrative rule.  In
  4  3 establishing the requirements, the department shall consider
  4  4 the eligibility and cost=share requirements used for the hawk=
  4  5 i program under chapter 514I.  The individual must meet the
  4  6 cost=share component's financial eligibility requirements and
  4  7 be willing to pay a cost=share for the cost=share component.
  4  8    e.  The individual does not receive services or funding
  4  9 under any type of medical assistance home and community=based
  4 10 services waiver.
  4 11    7.  COST=SHARE REQUIREMENTS.
  4 12    a.  An individual's cost=share responsibility for services
  4 13 under the cost=share component shall be determined on a
  4 14 sliding scale based upon the individual's family income.  An
  4 15 individual's cost=share shall be assessed as a copayment,
  4 16 which shall not exceed thirty percent of the cost payable for
  4 17 the service.
  4 18    b.  The service provider shall bill the department for the
  4 19 portion of the cost payable for the service that is not
  4 20 covered by the individual's copayment responsibility.
  4 21    8.  APPLICATION PROCESS.
  4 22    a.  The application materials for services under both the
  4 23 waiver eligible and cost=share components of the brain injury
  4 24 services program shall use the application form and other
  4 25 materials of the brain injury services waiver.  In order to
  4 26 apply for the brain injury services program, the applicant
  4 27 must authorize the department of human services to provide the
  4 28 applicant's waiver application materials to the brain injury
  4 29 services program.  The application materials provided shall
  4 30 include but are not limited to the waiver application, and any
  4 31 denial letter, financial assessment, and functional assessment
  4 32 regarding the person.
  4 33    b.  If a functional assessment for the waiver has not been
  4 34 completed due to a person's financial ineligibility for the
  4 35 waiver, the brain injury services program may provide for a
  5  1 functional assessment to determine the person's needs by
  5  2 reimbursing the department of human services for the
  5  3 assessment.
  5  4    c.  The program administrator shall file copies of the
  5  5 individual's application and needs assessment with the program
  5  6 resource facilitator assigned to the individual's geographic
  5  7 area.
  5  8    d.  The department's program administrator shall make a
  5  9 final determination as to whether program funding will be
  5 10 authorized under the cost=share component.
  5 11    9.  SERVICE PROVIDERS AND REIMBURSEMENT.  All of the
  5 12 following requirements apply to service providers and
  5 13 reimbursement rates payable for services under the cost=share
  5 14 component:
  5 15    a.  A service provider must either be certified to provide
  5 16 services under the brain injury services waiver or have a
  5 17 contract with a county to provide services and will become
  5 18 certified to provide services under such waiver within a
  5 19 reasonable period of time specified in rule.
  5 20    b.  The reimbursement rate payable for the cost of a
  5 21 service provided under the cost=share component is the rate
  5 22 payable under the medical assistance program.  However, if the
  5 23 service provided does not have a medical assistance program
  5 24 reimbursement rate, the rate shall be the amount payable under
  5 25 the county contract.
  5 26    10.  RESOURCE FACILITATION.  The program shall utilize
  5 27 resource facilitators to facilitate program services.  The
  5 28 resource facilitator shall be available to provide ongoing
  5 29 support for individuals with brain injury in coping with the
  5 30 issues of living with a brain injury and in assisting such
  5 31 individuals in transitioning back to employment and living in
  5 32 the community.  The resource facilitator is intended to
  5 33 provide a linkage to existing services and increase the
  5 34 capacity of the state's providers of services to persons with
  5 35 brain injury by doing all of the following:
  6  1    a.  Providing brain injury=specific information, support,
  6  2 and resources.
  6  3    b.  Enhancing the usage of support commonly available to an
  6  4 individual with brain injury from the community, family, and
  6  5 personal contacts and linking such individuals to appropriate
  6  6 services and community resources.
  6  7    c.  Training service providers to provide appropriate brain
  6  8 injury services.
  6  9    d.  Accessing, securing, and maximizing the private and
  6 10 public funding available to support an individual with a brain
  6 11 injury.
  6 12    Sec. 2.  2005 Iowa Acts, chapter 179, section 1, subsection
  6 13 2, paragraph d, is amended to read as follows:
  6 14    d.  For distribution to counties as cost=share for county
  6 15 coverage of services to adult persons with the Iowa department
  6 16 of public health for the brain injury in accordance with the
  6 17 law enacted as a result of the provisions of 2005 Iowa Acts,
  6 18 House File 876, or other law providing for such coverage to
  6 19 commence service program in the fiscal year beginning July 1,
  6 20 2006, as provided in accordance with section 135.22B, if
  6 21 enacted by the Eighty=first General Assembly, 2006 Session:
  6 22 .................................................. $  2,426,893
  6 23    The amount allocated in this paragraph "d" shall be
  6 24 allocated by the Iowa department of public health as follows:
  6 25    (1)  For state cost=share of services provided under
  6 26 section 135.22B:
  6 27 .................................................. $  2,092,665
  6 28    (2)  For contract resource facilitator services:
  6 29 .................................................. $    173,125
  6 30    (3)  For a sole source contract with a statewide
  6 31 association representing community providers of mental health,
  6 32 mental retardation, and brain injury services to provide, in
  6 33 collaboration with a statewide organization representing
  6 34 individuals with a brain injury and their families, brain
  6 35 injury training services and recruiting of service providers
  7  1 to increase the capacity within this state to address the
  7  2 needs of individuals with brain injuries and such individuals'
  7  3 families:
  7  4 .................................................. $     40,000
  7  5    (4)  For reimbursement for needs assessments performed
  7  6 under section 135.22B:
  7  7 .................................................. $     26,750
  7  8    (5)  For match of federal funding, administrative and
  7  9 personnel costs including salaries, support, maintenance, and
  7 10 miscellaneous purposes:
  7 11 .................................................. $     94,353
  7 12    Notwithstanding section 8.33, the appropriated moneys
  7 13 allocated in this paragraph "d" that remain unencumbered or
  7 14 unobligated at the close of the fiscal year shall not revert
  7 15 but shall remain available for expenditure for the purposes
  7 16 designated until the close of the succeeding fiscal year.
  7 17    Sec. 3.  EMERGENCY RULES.  The Iowa department of public
  7 18 health may adopt administrative rules under section 17A.4,
  7 19 subsection 2, and section 17A.5, subsection 2, paragraph "b",
  7 20 to implement the provisions of this Act, and the rules shall
  7 21 become effective immediately upon filing or on a later
  7 22 effective date specified in the rules, unless the effective
  7 23 date is delayed by the administrative rules review committee.
  7 24 Any rules adopted in accordance with this section shall not
  7 25 take effect before the rules are reviewed by the
  7 26 administrative rules review committee.  The delay authority
  7 27 provided to the administrative rules review committee under
  7 28 section 17A.4, subsection 5, and section 17A.8, subsection 9,
  7 29 shall be applicable to a delay imposed under this section,
  7 30 notwithstanding a provision in those sections making them
  7 31 inapplicable to section 17A.5, subsection 2, paragraph "b".
  7 32 Any rules adopted in accordance with the provisions of this
  7 33 section shall also be published as notice of intended action
  7 34 as provided in section 17A.4.
  7 35
  8  1
  8  2                                                             
  8  3                               CHRISTOPHER C. RANTS
  8  4                               Speaker of the House
  8  5
  8  6
  8  7                                                             
  8  8                               JEFFREY M. LAMBERTI
  8  9                               President of the Senate
  8 10
  8 11    I hereby certify that this bill originated in the House and
  8 12 is known as House File 2772, Eighty=first General Assembly.
  8 13
  8 14
  8 15                                                             
  8 16                               MARGARET THOMSON
  8 17                               Chief Clerk of the House
  8 18 Approved                , 2006
  8 19
  8 20
  8 21                            
  8 22 THOMAS J. VILSACK
  8 23 Governor