HSB 197 (LSB 1151XD (8) 85)

SENATE/HOUSE FILE _____

BY  (PROPOSED DEPARTMENT OF HUMAN SERVICES BILL)

A BILL FOR

An Act relating to child, adult, and family services under the purview of the department of human services, making penalties applicable, and including effective date provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 225C.38, subsection 1, paragraph c, Code 2013, is amended to read as follows:
   c.  Except as provided in section 225C.41, a family support subsidy for a fiscal year shall be in an amount determined by the department in consultation with the comprehensive family support council created in section 225C.48. The parent or legal guardian receiving a family support subsidy may elect to receive a payment amount which is less than the amount determined in accordance with this paragraph.
    Sec. 2.  Section 225C.42, subsection 1, Code 2013, is amended to read as follows:
   1.  The department shall conduct an annual evaluation of the family support subsidy program in conjunction with the comprehensive family support council and shall submit the evaluation report with recommendations to the governor and general assembly. The report shall be submitted on or before October 30 and provide an evaluation of the latest completed fiscal year.
    Sec. 3.  Section 225C.47, subsection 5, unnumbered paragraph 1, Code 2013, is amended to read as follows:
   The department shall design the program in consultation with the comprehensive family support council created in section 225C.48. The department shall adopt rules to implement the program which provide for all of the following:
    Sec. 4.  Section 225C.49, subsection 4, Code 2013, is amended to read as follows:
   4.  The department shall designate one individual whose sole duties are to provide central coordination of the programs under sections 225C.36 and 225C.47 and to work with the comprehensive family support council to oversee development and implementation of the programs.
    Sec. 5.  Section 239B.5, Code 2013, is amended by adding the following new subsection:
   NEW SUBSECTION.  4.
  a.  The department shall implement policies and procedures as necessary to comply with provisions of the federal Middle Class Tax Relief and Job Creation Act of 2012, Pub. L. No. 112-96, to prevent assistance provided under this chapter from being used in any electronic benefit transfer transaction in any liquor store; any casino, gambling casino, or gaming establishment; or any retail establishment which provides adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment. For purposes of this paragraph, the definitions found in the federal Middle Class Tax Relief and Job Creation Act and related rules and statutes apply.
   b.  Unless otherwise precluded by federal law or regulation, policies and procedures implemented under this subsection shall at a minimum impose the prohibition described in paragraph “a” as a condition for continued eligibility for assistance under this chapter.
   c.  The department may implement additional measures as may be necessary to comply with federal regulations in implementing paragraph “a”.
   d.  The department shall adopt rules as necessary to implement this subsection.
    Sec. 6.  Section 239B.14, subsection 1, Code 2013, is amended to read as follows:
   1.
  a.  An individual who obtains, or attempts to obtain, or aids or abets an individual to obtain, by means of a willfully false statement or representation, by knowingly failing to disclose a material fact, or by impersonation, or any fraudulent device, any assistance or other benefits under this chapter to which the individual is not entitled, commits a fraudulent practice.
   b.  An individual who accesses benefits provided under this chapter in violation of any prohibition imposed by the department pursuant to section 239B.5, subsection 4, commits a fraudulent practice.
    Sec. 7.  Section 249A.3, subsection 1, Code 2013, is amended by adding the following new paragraph:
   NEW PARAGRAPH.  v.  Is an individual under twenty-six years of age who was in foster care under the responsibility of the state on the date of attaining eighteen years of age or such higher age to which foster care is provided and was enrolled in medical assistance under this chapter while in such foster care.
    Sec. 8.  Section 249A.3, subsection 2, paragraph a, subparagraph (9), Code 2013, is amended by striking the subparagraph.
    Sec. 9.  Section 249J.26, subsection 2, Code 2013, is amended to read as follows:
   2.  This chapter is repealed October
 
December 31, 2013.
    Sec. 10.  Section 514I.4, subsection 5, paragraph a, Code 2013, is amended by striking the paragraph.
    Sec. 11.  Section 514I.5, subsection 7, paragraph f, Code 2013, is amended to read as follows:
   f.  Review, in consultation with the department, and take necessary steps to improve interaction between the program and other public and private programs which provide services to the population of eligible children. The board, in consultation with the department, shall also develop and implement a plan to improve the medical assistance program in coordination with the hawk-i program, including but not limited to a provision to coordinate eligibility between the medical assistance program and the hawk-i program, and to provide for common processes and procedures under both programs to reduce duplication and bureaucracy.
    Sec. 12.  Section 514I.5, subsection 8, paragraphs b and f, Code 2013, are amended by striking the paragraphs.
    Sec. 13.  Section 514I.7, subsection 2, paragraphs a and g, Code 2013, are amended to read as follows:
   a.  Determine individual eligibility for program enrollment based upon review of completed applications and supporting documentation
 
using policies and procedures established by the department by rule. The administrative contractor shall not enroll a child who has group health coverage
 
unless expressly authorized to do so by a department rule.
   g.  Create and
 
Utilize the department’s eligibility system to maintain eligibility files that are compatible with the data system of the department
 
with pertinent eligibility determination and ongoing enrollment information including, but not limited to, data regarding beneficiaries, enrollment dates, disenrollments, and annual financial redeterminations.
    Sec. 14.  Section 514I.7, subsection 2, paragraphs c, d, e, f, and k, Code 2013, are amended by striking the paragraphs.
    Sec. 15.  Section 514I.8, subsection 2, paragraph c, Code 2013, is amended to read as follows:
   c.  Is a member of a family whose income does not exceed three hundred percent of the federal poverty level, as defined in 42 U.S.C. § 9902(2), including any revision required by such section, and in accordance with the federal Children’s Health Insurance Program Reauthorization Act of 2009, Pub. L. No. 111-3.

The modified adjusted gross income methodology prescribed in the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148, shall be used to establish the family income for program eligibility purposes.
    Sec. 16.  Section 514I.8, subsections 3 and 4, Code 2013, are amended to read as follows:
   3.  In accordance with the rules adopted by the board, a child may be determined to be presumptively eligible for the program pending a final eligibility determination. Following final determination of eligibility by the administrative contractor, a child shall be eligible for a twelve-month period. At the end of the twelve-month period, the administrative contractor shall conduct a review of the circumstances of the eligible child’s family
 
shall be conducted to establish eligibility and cost sharing for the subsequent twelve-month period.
   4.  Once an eligible child is enrolled in a plan, the eligible child shall remain enrolled in the plan unless a determination is made, according to criteria established by the board, that the eligible child should be allowed to enroll in another qualified child health plan or should be disenrolled. An
 
an enrollee may
 
request to change plans within ninety days of initial enrollment for any reason and at any time for cause, as defined in 42 C.F.R. § 438.56(d)(2). Otherwise, an enrollee may change plan enrollment once a year on the enrollee’s anniversary date.
    Sec. 17.  Section 514I.8, subsections 5 and 6, Code 2013, are amended by striking the subsections.
    Sec. 18.  Section 514I.9, subsections 1 and 2, Code 2013, are amended by striking the subsections.
    Sec. 19.  REPEAL.  Section 225C.48, Code 2013, is repealed.
    Sec. 20.  EFFECTIVE DATE.  The following provision or provisions of this Act take effect January 1, 2014:
   1.  The sections of this Act amending section 249A.3.
EXPLANATION
   This bill relates to child, adult, and family services under the purview of the department of human services by eliminating the comprehensive family support council, amending provisions related to the family investment program by prohibiting the use of assistance in an electronic benefit transfer transaction in certain locations, amending provisions related to medical assistance eligibility, IowaCare, and the healthy and well kids in Iowa program (hawk-i), and ensuring compliance with the federal Patient Protection and Affordable Care Act.
   The bill eliminates the comprehensive family support council and strikes references to the council.
   The bill directs the department of human services (DHS) to implement policies and procedures necessary to comply with the federal Middle Class Tax Relief and Job Creation Act of 2012, to prevent family investment program assistance from being used in any electronic benefit transfer transaction in a liquor store; a casino, gambling casino, or gaming establishment; or a retail establishment that provides adult-oriented entertainment. The bill also provides that an individual accessing benefits through the family investment program in a way prohibited under the policies and procedures implemented by the department commits a fraudulent practice.
   The bill extends the repeal date of the IowaCare program from October 31, 2013, to December 31, 2013.
   The bill amends provisions relating to the medical assistance program and hawk-i to comply with provisions of the federal Patient Protection and Affordable Care Act.
   The bill adds an additional eligibility category for medical assistance for an individual under the age of 26 who aged out of the foster care system and was enrolled in the medical assistance program while in foster care. The bill also eliminates language regarding eligibility for medical assistance for an individual who is under the age of 21 who aged out of the foster care system and has an income of less than 200 percent of the poverty guidelines. These provisions are effective January 1, 2014.
   The bill amends provisions of hawk-i. The bill eliminates the requirement that DHS develop a joint application form for hawk-i and the medical assistance program. The bill deletes the requirement that the hawk-i board and DHS adopt rules addressing the hawk-i application form and standards for program eligibility. The bill also eliminates the requirement that the hawk-i board and DHS develop and implement a plan to improve coordination between the hawk-i program and the medical assistance program.
   The bill amends the role of the administrative contractor for hawk-i. The bill provides that the administrative contractor shall determine eligibility using policies and procedures established by rule rather than based on a review of the applications. The administrative contractor must also maintain eligibility files with relevant eligibility determination and ongoing enrollment information. The bill also eliminates the following duties of the administrative contractor: to forward names of children that may be eligible for medical assistance to DHS; monitor and assess medical and dental care provided and monitor complaints and grievances; verify and forward participating insurers’ payment requests to DHS; develop and issue approval, denial, and cancellation notifications to applicants and enrollees; and receive completed applications and verifications at a central location. The bill also eliminates the administrative contractor as the person responsible for conducting a review of the circumstances of the child’s family to establish eligibility and cost-sharing in subsequent eligibility periods.
   The bill requires the use of the modified adjusted gross income methodology in the federal Patient Protection and Affordable Care Act to establish the family income in determining eligibility for hawk-i.
   The bill adds that an enrollee of the program may request to change plans within the initial 90-day period of enrollment for any reason and at any time for cause, as identified in federal regulations.
   The bill eliminates the requirement that the hawk-i board study and make recommendations regarding the level of family income appropriate for application to the program. The bill also eliminates the requirement that the board and the council on human services try to coordinate the administration of hawk-i and the medical assistance program.
   The bill eliminates provisions relating to benefits provided prior to July 1, 1999.