Senate File 434 - Introduced SENATE FILE 434 BY EDLER A BILL FOR An Act relating to community engagement activity requirements 1 under the Iowa health and wellness plan. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 1842XS (8) 88 pf/rh

S.F. 434 Section 1. MEDICAID DEMONSTRATION WAIVER REQUEST —— 1 COMMUNITY ENGAGEMENT REQUIREMENTS FOR IOWA HEALTH AND WELLNESS 2 PLAN MEMBERS. 3 1. The department of human services shall submit a request 4 by March 1, 2020, to receive federal approval from the centers 5 for Medicare and Medicaid services of the United States 6 department of health and human services (CMS) for a section 7 1115 demonstration waiver to require that as a condition of 8 eligibility, Iowa health and wellness plan members participate 9 in community engagement activities. 10 2. The waiver request submitted by the department shall 11 require that, unless an individual is exempt pursuant to 12 subsection 3, as a condition of eligibility for the Iowa health 13 and wellness plan, a recipient shall do one of the following: 14 a. Work twenty hours or more per week, averaged over a 15 six-month period. 16 b. Participate in and comply with the requirements of a 17 work program for twenty hours or more per week, averaged on a 18 monthly basis, as determined by the department. 19 c. Volunteer twenty hours or more per week, averaged on a 20 monthly basis, as determined by the department. 21 d. Meet a combination of work and work program participation 22 requirements for a total of twenty hours or more per week, as 23 determined by the department. 24 e. Participate in and comply with the PROMISE JOBS program 25 pursuant to chapter 239B. 26 f. Be enrolled in the future ready Iowa program. 27 g. Participate in other activities identified by the 28 department and approved by CMS. 29 3. The following individuals shall be exempt from the 30 requirements specified in subsection 2: 31 a. An individual medically certified as physically or 32 mentally unfit for employment. 33 b. An individual who is pregnant. 34 c. A parent or caretaker responsible for the care of a 35 -1- LSB 1842XS (8) 88 pf/rh 1/ 3

S.F. 434 dependent child under six years of age. 1 d. A parent or caretaker personally providing the care for a 2 dependent child with a serious medical condition or disability, 3 as determined by the department. 4 e. An individual receiving unemployment compensation and 5 complying with work requirements of the federal or state 6 unemployment compensation system. 7 f. An individual participating in a drug or alcohol 8 treatment and rehabilitation program. 9 g. An individual determined to be medically exempt. 10 h. An individual enrolled full-time in an educational 11 institution. 12 i. The parent of a child who provides private instruction 13 pursuant to chapter 299A to that child. 14 j. An individual who meets other criteria identified by the 15 department, and approved by CMS. 16 4. The waiver request submitted by the department shall 17 also provide that if an individual does not comply with the 18 community engagement activities during the individual’s initial 19 six-month period of eligibility, the individual shall be 20 placed on a limited benefit plan, and if an individual does 21 not comply with the community engagement activities during the 22 individual’s subsequent six-month period of eligibility, the 23 individual’s eligibility for the program shall be terminated. 24 The department shall include the parameters for the limited 25 benefit plan in the waiver request submitted. 26 5. a. The department shall implement the Medicaid waiver 27 as approved by CMS prospectively from the date of receipt of 28 federal approval. 29 b. The department shall adopt rules pursuant to chapter 17A 30 to administer the waiver provisions. 31 EXPLANATION 32 The inclusion of this explanation does not constitute agreement with 33 the explanation’s substance by the members of the general assembly. 34 This bill requires the department of human services (DHS) to 35 -2- LSB 1842XS (8) 88 pf/rh 2/ 3

S.F. 434 submit a request by March 1, 2020, to receive federal approval 1 from the centers for Medicare and Medicaid services of the 2 United States department of health and human services (CMS) 3 for a waiver to require that as a condition of eligibility, 4 Iowa health and wellness plan members participate in community 5 engagement activities. The bill specifies the types of 6 community engagement activities to be required under the waiver 7 submitted, provides exceptions to required participation in 8 community engagement activities, and provides for limitation 9 of benefits or termination of eligibility for noncompliance 10 with the community engagement activities. The bill directs DHS 11 to implement the waiver as approved by CMS prospectively from 12 the date of receipt of federal approval, and the department is 13 required to adopt administrative rules to administer the waiver 14 provisions. 15 -3- LSB 1842XS (8) 88 pf/rh 3/ 3