House File 568 - Introduced HOUSE FILE 568 BY COMMITTEE ON HUMAN RESOURCES (SUCCESSOR TO HSB 197) (COMPANION TO LSB 1151SV BY COMMITTEE ON HUMAN RESOURCES) A BILL FOR An Act relating to child, adult, and family services under 1 the purview of the department of human services, making 2 penalties applicable, and including effective date 3 provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 1151HV (3) 85 pf/nh

H.F. 568 Section 1. Section 225C.38, subsection 1, paragraph c, Code 1 2013, is amended to read as follows: 2 c. Except as provided in section 225C.41 , a family support 3 subsidy for a fiscal year shall be in an amount determined by 4 the department in consultation with the comprehensive family 5 support council created in section 225C.48 . The parent or 6 legal guardian receiving a family support subsidy may elect 7 to receive a payment amount which is less than the amount 8 determined in accordance with this paragraph. 9 Sec. 2. Section 225C.42, subsection 1, Code 2013, is amended 10 to read as follows: 11 1. The department shall conduct an annual evaluation of 12 the family support subsidy program in conjunction with the 13 comprehensive family support council and shall submit the 14 evaluation report with recommendations to the governor and 15 general assembly. The report shall be submitted on or before 16 October 30 and provide an evaluation of the latest completed 17 fiscal year. 18 Sec. 3. Section 225C.47, subsection 5, unnumbered paragraph 19 1, Code 2013, is amended to read as follows: 20 The department shall design the program in consultation with 21 the comprehensive family support council created in section 22 225C.48 . The department shall adopt rules to implement the 23 program which provide for all of the following: 24 Sec. 4. Section 225C.49, subsection 4, Code 2013, is amended 25 to read as follows: 26 4. The department shall designate one individual whose sole 27 duties are to provide central coordination of the programs 28 under sections 225C.36 and 225C.47 and to work with the 29 comprehensive family support council to oversee development and 30 implementation of the programs. 31 Sec. 5. Section 239B.5, Code 2013, is amended by adding the 32 following new subsection: 33 NEW SUBSECTION . 4. a. The department shall implement 34 policies and procedures as necessary to comply with provisions 35 -1- LSB 1151HV (3) 85 pf/nh 1/ 9

H.F. 568 of the federal Middle Class Tax Relief and Job Creation Act 1 of 2012, Pub. L. No. 112-96, to prevent assistance provided 2 under this chapter from being used in any electronic benefit 3 transfer transaction in any liquor store; any casino, gambling 4 casino, or gaming establishment; or any retail establishment 5 which provides adult-oriented entertainment in which performers 6 disrobe or perform in an unclothed state for entertainment. 7 For purposes of this paragraph, the definitions found in the 8 federal Middle Class Tax Relief and Job Creation Act and 9 related rules and statutes apply. 10 b. Unless otherwise precluded by federal law or regulation, 11 policies and procedures implemented under this subsection shall 12 at a minimum impose the prohibition described in paragraph “a” 13 as a condition for continued eligibility for assistance under 14 this chapter. 15 c. The department may implement additional measures as may 16 be necessary to comply with federal regulations in implementing 17 paragraph “a” . 18 d. The department shall adopt rules as necessary to 19 implement this subsection. 20 Sec. 6. Section 239B.14, subsection 1, Code 2013, is amended 21 to read as follows: 22 1. a. An individual who obtains, or attempts to obtain, 23 or aids or abets an individual to obtain, by means of a 24 willfully false statement or representation, by knowingly 25 failing to disclose a material fact, or by impersonation, or 26 any fraudulent device, any assistance or other benefits under 27 this chapter to which the individual is not entitled, commits 28 a fraudulent practice. 29 b. An individual who accesses benefits provided under 30 this chapter in violation of any prohibition imposed by the 31 department pursuant to section 239B.5, subsection 4, commits 32 a fraudulent practice. 33 Sec. 7. Section 249A.3, subsection 1, Code 2013, is amended 34 by adding the following new paragraph: 35 -2- LSB 1151HV (3) 85 pf/nh 2/ 9

H.F. 568 NEW PARAGRAPH . v. Beginning January 1, 2014, is an 1 individual who meets all of the following requirements: 2 (1) Is under twenty-six years of age. 3 (2) Was in foster care under the responsibility of the state 4 on the date of attaining eighteen years of age or such higher 5 age to which foster care is provided. 6 (3) Was enrolled in the medical assistance program under 7 this chapter while in such foster care. 8 Sec. 8. Section 249A.3, subsection 2, paragraph a, 9 subparagraph (9), Code 2013, is amended by striking the 10 subparagraph. 11 Sec. 9. Section 249J.26, subsection 2, Code 2013, is amended 12 to read as follows: 13 2. This chapter is repealed October December 31, 2013. 14 Sec. 10. Section 514I.4, subsection 5, paragraph a, Code 15 2013, is amended by striking the paragraph. 16 Sec. 11. Section 514I.5, subsection 7, paragraph f, Code 17 2013, is amended to read as follows: 18 f. Review, in consultation with the department, and take 19 necessary steps to improve interaction between the program and 20 other public and private programs which provide services to the 21 population of eligible children. The board, in consultation 22 with the department, shall also develop and implement a plan 23 to improve the medical assistance program in coordination with 24 the hawk-i program, including but not limited to a provision to 25 coordinate eligibility between the medical assistance program 26 and the hawk-i program, and to provide for common processes 27 and procedures under both programs to reduce duplication and 28 bureaucracy. 29 Sec. 12. Section 514I.5, subsection 8, paragraphs b and f, 30 Code 2013, are amended by striking the paragraphs. 31 Sec. 13. Section 514I.7, subsection 2, paragraphs a and g, 32 Code 2013, are amended to read as follows: 33 a. Determine individual eligibility for program enrollment 34 based upon review of completed applications and supporting 35 -3- LSB 1151HV (3) 85 pf/nh 3/ 9

H.F. 568 documentation as prescribed by federal law and regulation, 1 using policies and procedures adopted by rule of the department 2 pursuant to chapter 17A . The administrative contractor shall 3 not enroll a child who has group health coverage , unless 4 expressly authorized by such rules . 5 g. Create and Utilize the department’s eligibility system 6 to maintain eligibility files that are compatible with the 7 data system of the department with pertinent eligibility 8 determination and ongoing enrollment information including , but 9 not limited to , data regarding beneficiaries, enrollment dates, 10 disenrollments, and annual financial redeterminations. 11 Sec. 14. Section 514I.7, subsection 2, paragraphs c, d, e, 12 f, and k, Code 2013, are amended by striking the paragraphs. 13 Sec. 15. Section 514I.8, subsection 1, Code 2013, is amended 14 to read as follows: 15 1. a. Effective July 1, 1998, and notwithstanding any 16 medical assistance program eligibility criteria to the 17 contrary, medical assistance shall be provided to, or on behalf 18 of, an eligible child under the age of nineteen whose family 19 income does not exceed one hundred thirty-three percent of the 20 federal poverty level, as defined by the most recently revised 21 poverty income guidelines published by the United States 22 department of health and human services. 23 b. Additionally, effective Effective July 1, 2000, and 24 notwithstanding any medical assistance program eligibility 25 criteria to the contrary, medical assistance shall be provided 26 to, or on behalf of, an eligible infant whose family income 27 does not exceed two hundred percent of the federal poverty 28 level, as defined by the most recently revised poverty income 29 guidelines published by the United States department of health 30 and human services. 31 c. Effective July 1, 2009, and notwithstanding any medical 32 assistance program eligibility criteria to the contrary, 33 medical assistance shall be provided to, or on behalf of, a 34 pregnant woman or an eligible child who is an infant and whose 35 -4- LSB 1151HV (3) 85 pf/nh 4/ 9

H.F. 568 family income is at or below three hundred percent of the 1 federal poverty level, as defined by the most recently revised 2 poverty income guidelines published by the United States 3 department of health and human services. 4 Sec. 16. Section 514I.8, subsection 2, paragraph c, Code 5 2013, is amended to read as follows: 6 c. Is a member of a family whose income does not exceed 7 three hundred percent of the federal poverty level, as defined 8 in 42 U.S.C. § 9902(2), including any revision required by 9 such section, and in accordance with the federal Children’s 10 Health Insurance Program Reauthorization Act of 2009, Pub. L. 11 No. 111-3. The modified adjusted gross income methodology 12 prescribed in section 2101 of the federal Patient Protection 13 and Affordable Care Act, Pub. L. No. 111-148, to determine 14 family income under this paragraph. 15 Sec. 17. Section 514I.8, subsections 3 and 4, Code 2013, are 16 amended to read as follows: 17 3. In accordance with the rules adopted by the board, 18 a child may be determined to be presumptively eligible for 19 the program pending a final eligibility determination. 20 Following final determination of eligibility by the 21 administrative contractor , a child shall be eligible for a 22 twelve-month period. At the end of the twelve-month period, 23 the administrative contractor shall conduct a review of the 24 circumstances of the eligible child’s family shall be conducted 25 to establish eligibility and cost sharing for the subsequent 26 twelve-month period. 27 4. Once an eligible child is enrolled in a plan, the 28 eligible child shall remain enrolled in the plan unless a 29 determination is made, according to criteria established by the 30 board, that the eligible child should be allowed to enroll in 31 another qualified child health plan or should be disenrolled. 32 An enrollee may request to change plans within ninety days of 33 initial enrollment for any reason and at any time for cause, as 34 defined in 42 C.F.R. § 438.56(d)(2). Otherwise, an enrollee 35 -5- LSB 1151HV (3) 85 pf/nh 5/ 9

H.F. 568 may change plan enrollment once a year on the enrollee’s 1 anniversary date. 2 Sec. 18. Section 514I.8, subsections 5 and 6, Code 2013, are 3 amended by striking the subsections. 4 Sec. 19. Section 514I.9, Code 2013, is amended to read as 5 follows: 6 514I.9 Program benefits. 7 1. Until June 30, 1999, the benefits provided under the 8 program shall be those benefits established by rule of the 9 board and in compliance with Tit. XXI of the federal Social 10 Security Act. 11 2. On or before June 30, 1999, the hawk-i board shall adopt 12 rules to amend the benefits package based upon review of the 13 results of the initial benefits package used. 14 3. Subsequent to June 30, 1999, the The hawk-i board shall 15 review the benefits package annually and shall determine 16 additions to or deletions from the benefits package offered. 17 The hawk-i board shall submit the recommendations to the 18 general assembly for any amendment to the benefits package. 19 4. 2. Benefits, in addition to those required by rule, may 20 be provided to eligible children by a participating insurer if 21 the benefits are provided at no additional cost to the state. 22 Sec. 20. REPEAL. Section 225C.48, Code 2013, is repealed. 23 Sec. 21. EFFECTIVE DATE. The following provision or 24 provisions of this Act take effect December 31, 2013: 25 1. The section of this Act amending section 249A.3, 26 subsection 2, paragraph “a”, subparagraph (9). 27 EXPLANATION 28 This bill relates to child, adult, and family services under 29 the purview of the department of human services. 30 The bill eliminates the comprehensive family support council 31 and strikes references to the council. 32 The bill directs the department of human services (DHS) to 33 implement policies and procedures necessary to comply with the 34 federal Middle Class Tax Relief and Job Creation Act of 2012, 35 -6- LSB 1151HV (3) 85 pf/nh 6/ 9

H.F. 568 to prevent family investment program assistance from being used 1 in any electronic benefit transfer transaction in a liquor 2 store; a casino, gambling casino, or gaming establishment; 3 or a retail establishment that provides adult-oriented 4 entertainment. The bill also provides that an individual 5 accessing benefits through the family investment program in a 6 way prohibited under the policies and procedures implemented by 7 the department commits a fraudulent practice. 8 The bill extends the repeal date of the IowaCare program from 9 October 31, 2013, to December 31, 2013. 10 The bill amends provisions relating to the medical 11 assistance (Medicaid) and hawk-i programs to comply with 12 provisions of the federal Patient Protection and Affordable 13 Care Act (ACA). 14 The bill provides, as required under the ACA, that beginning 15 January 1, 2014, individuals who were in foster care and 16 enrolled in the Medicaid program while they were in foster 17 care, are eligible for Medicaid up to 26 years of age. As a 18 conforming measure, the bill eliminates Medicaid eligibility 19 for an individual who is under the age of 21 who aged out of the 20 foster care system and has an income of less than 200 percent 21 of the federal poverty level. This provision takes effect 22 December 31, 2013. 23 The bill amends provisions relating to the hawk-i program. 24 Because the ACA changes requirements relating to determination 25 of eligibility and the application process, the bill eliminates 26 various provisions relating to application development and 27 the application process under the hawk-i program. The bill 28 eliminates the requirement that DHS develop a joint application 29 form for the hawk-i and Medicaid programs; eliminates the 30 requirement that the hawk-i board and DHS develop and implement 31 a plan to improve coordination between the hawk-i program and 32 the Medicaid program; and eliminates the requirement that 33 the hawk-i board and DHS adopt rules addressing the hawk-i 34 application form and standards for program eligibility. 35 -7- LSB 1151HV (3) 85 pf/nh 7/ 9

H.F. 568 Because of changes in the application process, the bill 1 provides that the administrative contractor shall determine 2 eligibility as prescribed by federal law and regulation, using 3 policies and procedures established by rule rather than based 4 on a review of individual applications. The administrative 5 contractor must also utilize the department’s eligibility 6 system to maintain eligibility files with pertinent eligibility 7 determination and ongoing enrollment information. The bill 8 also eliminates the following duties of the administrative 9 contractor: forward names of children that may be eligible 10 for Medicaid to DHS and retain their identifying data; monitor 11 and assess the medical and dental care provided as well as 12 complaints and grievances; verify and forward participating 13 insurers’ payment requests to DHS; develop and issue approval, 14 denial, and cancellation notifications to applicants and 15 enrollees, and process applications; and receive completed 16 applications and verifications at a central location. The bill 17 also eliminates the duty of the administrative contractor to 18 conduct a review of the circumstances of the child’s family 19 to establish eligibility and cost-sharing in the subsequent 20 eligibility period following the initial determination and 21 period of eligibility. 22 The bill requires the use of the modified adjusted gross 23 income methodology as required under the ACA to establish 24 family income in determining eligibility for hawk-i. 25 The bill modifies the ability of an enrollee to request a 26 change in health plans by providing that an enrollee of the 27 program may request to change plans within the initial 90-day 28 period of enrollment for any reason and at any time for cause, 29 as identified in federal regulations, and otherwise may change 30 once a year on the enrollee’s anniversary date. 31 The bill eliminates the requirement that the hawk-i board 32 study and make recommendations regarding the level of family 33 income appropriate for application to the program; and the 34 requirement that the board and the council on human services 35 -8- LSB 1151HV (3) 85 pf/nh 8/ 9