Senate File 251 - Introduced
SENATE FILE
BY COMMITTEE ON HUMAN RESOURCES
(SUCCESSOR TO SSB 1135)
Passed Senate, Date Passed House, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the expenditures allowable from medical
2 assistance income trusts.
3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
4 TLSB 1238SV 82
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PAG LIN
1 1 Section 1. Section 633C.3, subsection 1, Code 2007, is
1 2 amended to read as follows:
1 3 1. Regardless of the terms of a medical assistance income
1 4 trust, if the beneficiary's total monthly income is less than
1 5 the average statewide charge for nursing facility services to
1 6 a private pay resident of a nursing facility, then, during the
1 7 life of the beneficiary, any property received or held by the
1 8 trust shall be expended only as follows, as applicable, and in
1 9 the following order of priority:
1 10 a. A reasonable amount may be paid or set aside each month
1 11 for necessary expenses of the trust, not to exceed ten dollars
1 12 per month without court approval.
1 13 b. From the remaining principal or income of the trust, an
1 14 amount sufficient to bring the beneficiary's available income
1 15 up to three hundred percent of the benefit for an individual
1 16 under the federal supplemental security income program shall
1 17 be paid to or otherwise made available to the beneficiary on a
1 18 monthly basis, to be counted as income or a resource in
1 19 determining eligibility for medical assistance under chapter
1 20 249A amounts may be paid for expenses that qualify as required
1 21 deductions from income pursuant to 42 C.F.R. } 435.725(c) or
1 22 435.726(c) for purposes of determining the amount by which
1 23 medical assistance payments under chapter 249A for
1 24 institutional services or for home and community=based
1 25 services provided under a federal waiver will be reduced based
1 26 on the beneficiary's income.
1 27 c. If the beneficiary is an institutionalized individual
1 28 or receiving home and community=based services provided under
1 29 a federal waiver, the remaining principal or income of the
1 30 trust shall be paid directly to the provider of institutional
1 31 care or home and community=based services, on a monthly basis,
1 32 for any cost not paid by the beneficiary from the
1 33 beneficiary's available income under paragraph "b", to reduce
1 34 any amount paid as medical assistance under chapter 249A.
1 35 d. Any remaining principal or income of the trust may, at
2 1 the trustee's discretion or as directed by the terms of the
2 2 trust, be paid directly to providers of other medical care or
2 3 services that would otherwise be covered by medical
2 4 assistance, paid to the state as reimbursement for medical
2 5 assistance paid on behalf of the beneficiary, or retained by
2 6 the trust.
2 7 EXPLANATION
2 8 This bill relates to the allowable expenditures from
2 9 medical assistance income trusts. The bill eliminates the
2 10 limit on the amount of income that is available to individuals
2 11 under medical assistance income trusts and special needs
2 12 trusts while retaining their eligibility for medical
2 13 assistance, if the individual's total monthly income is less
2 14 than the average statewide charge for the type of care the
2 15 individual requires. The levels of care to which the bill
2 16 applies, including home and community=based services, are
2 17 nursing facility care including specialized services, care
2 18 provided through an intermediate care facility for persons
2 19 with mental retardation, care provided through a psychiatric
2 20 medical institution for children, and care provided in a state
2 21 mental health institute.
2 22 Current law limits the disbursement to the individual as
2 23 income to an amount sufficient to bring the individual's
2 24 available income up to three hundred percent of the benefit
2 25 for an individual under the federal supplemental security
2 26 income program. Under the bill, the individual would have
2 27 access to all of the individual's income for the purpose of
2 28 allowable expenses, which are expenses that are allowed as
2 29 deductions in determining client participation such as the
2 30 personal needs allowance, spousal and dependent allowances,
2 31 and unmet medical expenses. Any excess income above the
2 32 allowable expenses would then be applied toward payment of
2 33 providers of facility or home and community=based services,
2 34 toward payment of other providers of medical care or services
2 35 that would otherwise be covered by medical assistance, toward
3 1 payment to the state for reimbursement for medical assistance
3 2 paid on behalf of the individual, or would be retained by the
3 3 trust.
3 4 LSB 1238SV 82
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