SF 534 (LSB 1475XS (3) 91)

SENATE FILE 534

BY  CELSI

A BILL FOR

An Act relating to options for long-term care, and making appropriations.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICAID —— REIMBURSEMENT OF TRANSPORTATION COSTS —— HOME HEALTH CARE PROVIDERS.  The department of health and human services shall establish a rate structure for reimbursement of the transportation costs of home health care providers by incorporating an increased reimbursement amount into the existing home health care provider reimbursement rate that reflects the total time expended by a home health care provider, including the provider’s travel time, in the per visit reimbursement. The department shall submit a report on the reimbursement rate structure and the projected cost of application of the reimbursement rate structure to the governor and the general assembly by December 1, 2025.
    Sec. 2.  OPTIONS FOR LONG-TERM LIVING —— STUDY —— REPORT.
   1.  Pursuant to section 231.58, and considering the intent of the general assembly for the long-term living system in Iowa pursuant to section 231F.1, including maximizing independence, choice, and dignity for consumers, the director of health and human services shall convene a study group to facilitate the coordination of long-term living system policy, service delivery, and long-range planning by performing a focused review of the alternatives for the long-term living system in the state.
   2.  The study group shall include all of the following members:
   a.  The director of health and human services.
   b.  The director of the division of aging and disability services of the department of health and human services.
   c.  The director of the department of inspections, appeals, and licensing.
   d.  The state director of AARP Iowa, or the state director’s designee.
   e.  The chief executive officer of each area agency on aging, or the chief executive officer’s designee.
   f.  The chairperson of the older Iowans legislature.
   g.  The executive director of the Iowa caregivers association, or the executive director’s designee.
   h.  The executive director of the Alzheimer’s association, Iowa chapter, or the executive director’s designee.
   i.  The executive director of disability rights Iowa, or the executive director’s designee.
   j.  The director of the Barbara and Richard Csomay center for gerontological excellence, at the state university of Iowa college of nursing, or the director’s designee.
   k.  The director of the gerontology program at Iowa state university of science and technology, or the director’s designee.
   l.  The director of the university of northern Iowa school of applied human sciences, or the director’s designee.
   m.  The president and vice president of the Hale group.
   3.  The review shall include a survey of existing long-term living approaches utilized in other states and innovative approaches such as the greenhouse system, adult family homes, and elder group homes, with the goal of providing Iowans with access to an extensive range of high-quality, affordable, and cost-effective long-term living options. The review shall also consider how the state may assist nursing facilities which are not at full occupancy by incorporating other sectors including but not limited to child care, adult day care, and home health services.
   4.  The study group shall submit a report of its findings and recommendations including a summary of existing and innovative approaches, how other states have successfully implemented existing approaches, and how the state of Iowa can encourage development of the identified existing and innovative approaches in this state, to the governor and the general assembly by December 15, 2025.
    Sec. 3.  ADULT DAY CARE PROVIDERS —— MEDICAID REIMBURSEMENT.  For the fiscal year beginning July 1, 2025, reimbursement rates under the Medicaid program for adult day care providers who provide services to Medicaid home and community-based services waiver recipients shall be increased by five percent over the reimbursement rates in effect on June 30, 2025.
    Sec. 4.  IOWA RETURN TO COMMUNITY PROGRAM —— APPROPRIATION.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount, or so much thereof as is necessary, to be used in collaboration with affected stakeholders to continue to expand the Iowa return to community program to assist non-Medicaid-eligible consumers who indicate a preference to return to the community and are deemed appropriate for discharge, to return to their community following a nursing facility or hospital stay:
   ...................................................................... $  2,000,000
   The department of health and human services shall submit to the governor and the general assembly by December 15, 2025, an estimate of the cost to fully fund an expansion of the Iowa return to community program to provide access to all interested consumers.
    Sec. 5.  STATEWIDE DEMENTIA CARE COORDINATOR —— DEMENTIA SERVICE SPECIALISTS —— APPROPRIATION.  There is appropriated from the general fund of the state to the department of health and human services for the fiscal year beginning July 1, 2025, and ending June 30, 2026, the following amount or so much thereof as is necessary, for the department of health and human services to employ a statewide dementia care coordinator within the department to provide statewide coordination of dementia-friendly initiatives including efforts pursuant to section 231.62; to coordinate dementia service specialists in each area agency on aging; to provide grants to each area agency on aging to employ a dementia service specialist to increase access and connections to local supports and services for persons living with dementia, their families, and caregivers; to evaluate the availability of respite care for family caregivers of persons with dementia and to provide recommendations to the department and the general assembly on how to meet the demand; and to increase awareness about dementia within the network of area agency on aging providers as well as in communities, businesses, health care facilities, and assisted living programs throughout the state:
   ...................................................................... $    750,000
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to options for long-term living and funding of long-term care services.
   The bill requires the department of health and human services (HHS) to establish a rate structure for reimbursement of the transportation costs of home health care providers by incorporating an increased reimbursement amount for travel time into the per visit reimbursement. The department shall submit a report of the rate structure and the projected cost of application of the reimbursement rate structure to the governor and the general assembly by December 1, 2025.
   The bill requires that pursuant to Code section 231.58 (long-term living coordination) and considering the intent of the general assembly for the long-term living system in Iowa pursuant to Code section 231F.1 (intent for Iowa’s long-term living system), including maximizing independence, choice, and dignity for consumers, the director of HHS shall convene a study group that includes members specified in the bill to perform a focused review of the alternatives for long-term living options in the state. The review shall include a survey of existing approaches utilized in other states and innovative approaches to provide Iowans with access to an extensive range of high-quality, affordable, and cost-effective long-term living options. The review shall also consider how the state may assist nursing facilities not at full occupancy by incorporating other sectors. The study group shall submit a report of its findings and recommendations to the governor and the general assembly by December 15, 2025.
   The bill provides that for FY 2025-2026, Medicaid reimbursement rates for adult day care providers who provide services to Medicaid home and community-based services waiver recipients shall be increased by 5 percent over the rates in effect on June 30, 2025.
   The bill makes an appropriation to HHS for FY 2025-2026 from the general fund of the state to be used in collaboration with affected stakeholders to continue to expand the Iowa return to community program. The bill requires HHS to submit to the governor and the general assembly by December 15, 2025, an estimate of the cost to fund an expansion of the Iowa return to community program to provide access to all interested consumers.
   The bill makes an appropriation to HHS for FY 2025-2026 from the general fund of the state to be used by HHS to employ a statewide dementia care coordinator within HHS to provide coordination services related to statewide dementia care as described in the bill.