Senate File 2009
SENATE FILE
BY TINSMAN
Passed Senate, Date Passed House, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the medical assistance and state supplementary
2 assistance programs, providing an effective date, and
3 providing for retroactive applicability.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN
1 1 Section 1. Section 135C.1, subsection 17, Code Supplement
1 2 2003, is amended to read as follows:
1 3 17. "Residential care facility" means any institution,
1 4 place, building, or agency providing for a period exceeding
1 5 twenty=four consecutive hours accommodation, board, personal
1 6 assistance and other essential daily living activities to
1 7 three or more individuals, not related to the administrator or
1 8 owner thereof within the third degree of consanguinity, who by
1 9 reason of illness, disease, or physical or mental infirmity
1 10 are unable to sufficiently or properly care for themselves but
1 11 who do not require the services of a registered or licensed
1 12 practical nurse except on an emergency basis or who by reason
1 13 of illness, disease, or physical or mental infirmity are
1 14 unable to sufficiently or properly care for themselves but who
1 15 do not require the services of a registered or licensed
1 16 practical nurse except on an emergency basis if home and
1 17 community=based services, other than nursing services, of the
1 18 type and within the cost limits included under the medical
1 19 assistance program pursuant to chapter 249A are provided.
1 20 Sec. 2. Section 135C.4, Code 2003, is amended to read as
1 21 follows:
1 22 135C.4 RESIDENTIAL CARE FACILITIES.
1 23 Each facility licensed as a residential care facility shall
1 24 provide an organized continuous twenty=four=hour program of
1 25 care commensurate with the needs of the residents of the home
1 26 and under the immediate direction of a person approved and
1 27 certified by the department whose combined training and
1 28 supervised experience is such as to ensure adequate and
1 29 competent care. All admissions to residential care facilities
1 30 shall be based on an order written by a physician certifying
1 31 that the individual being admitted does not require nursing
1 32 services or that the individual's need for nursing services
1 33 can be avoided if home and community=based services, other
1 34 than nursing services, of the type and within the cost limits
1 35 included under the medical assistance program pursuant to
2 1 chapter 249A are provided to the individual.
2 2 Sec. 3. NEW SECTION. 222.60A COST OF ASSESSMENT.
2 3 Notwithstanding any provision of this chapter to the
2 4 contrary, any amount attributable to any fee assessed pursuant
2 5 to section 249A.21 that would otherwise be the liability of
2 6 any county shall be paid by the state. The department may
2 7 transfer funds from the appropriation for medical assistance
2 8 to pay any amount attributable to any fee assessed pursuant to
2 9 section 249A.21 that is a liability of the state.
2 10 Sec. 4. Section 249.3, Code 2003, is amended by adding the
2 11 following new subsection:
2 12 NEW SUBSECTION. 4. At the discretion of the department,
2 13 persons who meet the criteria listed in all of the following
2 14 paragraphs:
2 15 a. Are either of the following:
2 16 (1) Sixty=five years of age or older.
2 17 (2) Disabled as defined by 42 U.S.C. } 1382c(a)(3), except
2 18 that being engaged in substantial gainful activity shall not
2 19 preclude a determination of disability for the purpose of this
2 20 subparagraph.
2 21 b. Live in one of the following:
2 22 (1) The individual's own home.
2 23 (2) The home of another individual.
2 24 (3) A group living arrangement.
2 25 (4) A medical facility.
2 26 c. Would be eligible for supplemental security income
2 27 benefits but for having excess income or but for being engaged
2 28 in substantial gainful activity and having excess income.
2 29 d. Are not eligible for another state supplementary
2 30 assistance group.
2 31 e. Receive medical assistance under chapter 249A and are
2 32 not required to meet a spend=down or pay a premium to be
2 33 eligible for such benefits.
2 34 f. Is currently eligible for Medicare part B.
2 35 g. Have income exceeding one hundred thirty=five percent
3 1 of the federal poverty level but not exceeding the medical
3 2 assistance income limit for the eligibility group for the
3 3 individual person's living arrangement.
3 4 Sec. 5. Section 249.4, Code 2003, is amended to read as
3 5 follows:
3 6 249.4 APPLICATION == AMOUNT OF GRANT.
3 7 1. Applications for state supplementary assistance shall
3 8 be made in the form and manner prescribed by the director or
3 9 the director's designee, with the approval of the council on
3 10 human services, pursuant to chapter 17A. Each person who so
3 11 applies and is found eligible under section 249.3 shall, so
3 12 long as the person's eligibility continues, receive state
3 13 supplementary assistance on a monthly basis, from funds
3 14 appropriated to the department for the purpose.
3 15 2. Any person who applies within fifteen months from the
3 16 date of implementation of eligibility pursuant to section
3 17 249.3, subsection 4, and who would have been eligible under
3 18 that subsection for any period on or after October 1, 2003,
3 19 may be granted benefits retroactive to October 1, 2003.
3 20 Sec. 6. Section 249A.21, subsection 1, Code 2003, is
3 21 amended to read as follows:
3 22 1. The department may assess intermediate care facilities
3 23 for persons with mental retardation, as defined in section
3 24 135C.1, that are not operated by the state, a fee in an amount
3 25 not to exceed six percent of the total annual revenue of the
3 26 facility for the preceding fiscal year.
3 27 Sec. 7. Section 249A.21, Code 2003, is amended by adding
3 28 the following new subsection:
3 29 NEW SUBSECTION. 6. The department may adopt
3 30 administrative rules under section 17A.4, subsection 2, and
3 31 section 17A.5, subsection 2, paragraph "b", to implement this
3 32 section, and any fee assessed pursuant to this section against
3 33 an intermediate care facility for persons with mental
3 34 retardation that is operated by the state may be made
3 35 retroactive to October 1, 2003.
4 1 Sec. 8. 2003 Iowa Acts, chapter 112, section 4, subsection
4 2 9, is amended to read as follows:
4 3 9. The department may adopt administrative rules under
4 4 section 17A.4, subsection 2, and section 17A.5, subsection 2,
4 5 paragraph "b", to implement this section, and any assessment
4 6 made pursuant to this section may be made retroactive to
4 7 October 1, 2003.
4 8 Sec. 9. RETROACTIVE APPLICABILITY. The following
4 9 provisions of this Act are retroactively applicable to October
4 10 1, 2003:
4 11 1. The provision creating section 222.60A, relating to the
4 12 costs of the assessment for intermediate care facilities for
4 13 persons with mental retardation.
4 14 2. The provision creating section 249.3, subsection 4,
4 15 relating to state supplementary assistance eligibility.
4 16 3. The provision amending section 249.4, relating to
4 17 applications and amounts of grants for state supplementary
4 18 assistance.
4 19 4. The provision amending section 249A.21, subsection 1,
4 20 and the provision creating section 249A.21, subsection 6,
4 21 relating to the nursing facility quality assurance assessment.
4 22 5. The provision amending 2003 Iowa Acts, chapter 112,
4 23 section 4, subsection 9, relating to the adoption of
4 24 administrative rules relating to the nursing facility quality
4 25 assurance assessment.
4 26 Sec. 10. EFFECTIVE DATE. This Act, being deemed of
4 27 immediate importance, takes effect upon enactment.
4 28 EXPLANATION
4 29 This bill makes changes relative to the medical assistance
4 30 and state supplementary assistance (SSA) programs.
4 31 The bill changes the definition of residential care
4 32 facility for the purposes of providing Medicaid waiver
4 33 services in these facilities.
4 34 The bill expands the assessment on intermediate care
4 35 facilities for persons with mental retardation to include
5 1 those operated by the state and provides for the transfer of
5 2 funds from the medical assistance appropriation to cover
5 3 payment of the amounts attributable to the assessment. These
5 4 provisions are retroactively applicable to October 1, 2003.
5 5 The bill amends the eligibility provisions for state
5 6 supplementary assistance to cover additional persons. This
5 7 provision is retroactively applicable to October 1, 2003.
5 8 The bill also provides that the nursing facility quality
5 9 assurance assessment is retroactively applicable to October 1,
5 10 2003.
5 11 The bill takes effect upon enactment.
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