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