Senate Study Bill 1158 - Introduced SENATE FILE _____ BY (PROPOSED COMMITTEE ON HUMAN RESOURCES BILL BY CHAIRPERSON SEGEBART) A BILL FOR An Act relating to the provision of supported community living 1 services under Medicaid home and community-based services 2 waivers, and including effective date and retroactive 3 applicability provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 5 TLSB 2626XC (6) 87 pf/nh

S.F. _____ Section 1. MEDICAID HOME AND COMMUNITY-BASED SERVICES 1 WAIVERS —— SUPPORTED COMMUNITY LIVING SERVICES IN HOME OF 2 FAMILY MEMBER OR PERSON LEGALLY RESPONSIBLE FOR THE MEMBER —— 3 REIMBURSEMENT. 4 1. Beginning March 1, 2017, the department of human services 5 shall make supported community living services available at a 6 daily rate to members living in the home of a family member 7 or of a person legally responsible for the member, who is the 8 provider of the community living services. 9 2. The department shall ensure that the provider meets the 10 provider qualifications specified for the service provided, 11 that there is a properly executed provider agreement, and that 12 the family member or person legally responsible for the member 13 has a unique ability to meet the needs of the member. 14 3. The department shall ensure that the services provided 15 by a person who is legally responsible for the member are 16 deemed extraordinary care and that the provision of care by 17 the legally responsible person is in the best interest of the 18 member. 19 4. For the purposes of this section, “family member” 20 includes a person related to the member by consanguinity or 21 affinity, including but not limited to a sibling of the member 22 or a parent of an adult member; “a person legally responsible 23 for the member” includes a parent of a member who is a minor 24 or the spouse of a member; and “extraordinary care” means care 25 exceeding the range of activities that a legally responsible 26 individual would ordinarily perform in the household on behalf 27 of a person without a disability or chronic illness of the 28 same age, and which care is necessary to ensure the health and 29 welfare of the member and to avoid institutionalization. 30 5. A family member or person legally responsible for the 31 member in whose home the member lives and who is providing 32 supported community living services under an exception to 33 policy on or before the effective date of this Act, shall 34 be allowed to continue to provide the services and to be 35 -1- LSB 2626XC (6) 87 pf/nh 1/ 3

S.F. _____ reimbursed at the daily rate in effect on the effective date of 1 this Act until such time as the family member or person legally 2 responsible for the member transitions to being a supported 3 community living services provider in accordance with this Act. 4 6. The department shall amend any Medicaid managed care 5 contract, shall amend or adopt administrative rules pursuant to 6 chapter 17A as necessary, and shall seek any federal approval 7 necessary to amend home and community-based services waivers to 8 comply with this section, effective March 1, 2017. 9 Sec. 2. EFFECTIVE UPON ENACTMENT. This Act, being deemed of 10 immediate importance, takes effect upon enactment. 11 Sec. 3. RETROACTIVE APPLICABILITY. This Act applies 12 retroactively to March 1, 2017. 13 EXPLANATION 14 The inclusion of this explanation does not constitute agreement with 15 the explanation’s substance by the members of the general assembly. 16 This bill directs the department of human services, 17 beginning March 1, 2017, to make available under Medicaid 18 home and community-based services waivers the provision 19 of and a daily rate reimbursement for supported community 20 living services in the home of a family member or of a person 21 legally responsible for the member, who is the provider of the 22 community living services. 23 The department of human services shall ensure that the 24 provider meets the provider qualifications specified for the 25 service provided, that there is a properly executed provider 26 agreement, and that the family member or person legally 27 responsible for the member has a unique ability to meet the 28 needs of the member. The department of human services shall 29 also ensure that the services provided by a person who is 30 legally responsible for the member are deemed extraordinary 31 care and that the provision of care by the legally responsible 32 person is in the best interest of the member. 33 The bill defines “family member”, “a person legally 34 responsible for the member”, and “extraordinary care”. 35 -2- LSB 2626XC (6) 87 pf/nh 2/ 3

S.F. _____ The bill also provides that a family member or person legally 1 responsible for the member in whose home the member lives and 2 who is providing supported community living services under an 3 exception to policy on or before the effective date of the 4 bill, shall be allowed to continue to provide the services and 5 to be reimbursed at the daily rate in effect on the effective 6 date of the bill until such time as the family member or person 7 legally responsible for the member transitions to being a 8 supported community living services provider in accordance with 9 the bill. 10 The department of human services shall amend any Medicaid 11 managed care contract, shall amend or adopt any administrative 12 rules as necessary, and shall seek any federal approval 13 necessary to amend existing Medicaid home and community-based 14 services waivers to comply with the bill effective March 1, 15 2017. 16 The bill takes effect upon enactment and is retroactively 17 applicable to March 1, 2017. 18 -3- LSB 2626XC (6) 87 pf/nh 3/ 3