House File 2134

                                       HOUSE FILE       
                                       BY  COMMITTEE ON
                                           HUMAN RESOURCES

                                       (SUCCESSOR TO HF 2035)


    Passed House, Date               Passed Senate,  Date             
    Vote:  Ayes        Nays           Vote:  Ayes        Nays         
                 Approved                            

                                      A BILL FOR

  1 An Act relating to the medical assistance and state supplementary
  2    assistance programs, providing an effective date, and
  3    providing for retroactive applicability.
  4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
  5 TLSB 5555HV 80
  6 pf/sh/8

PAG LIN

  1  1    Section 1.  Section 135C.1, subsection 17, Code Supplement
  1  2 2003, is amended to read as follows:
  1  3    17.  "Residential care facility" means any institution,
  1  4 place, building, or agency providing for a period exceeding
  1  5 twenty=four consecutive hours accommodation, board, personal
  1  6 assistance and other essential daily living activities to
  1  7 three or more individuals, not related to the administrator or
  1  8 owner thereof within the third degree of consanguinity, who by
  1  9 reason of illness, disease, or physical or mental infirmity
  1 10 are unable to sufficiently or properly care for themselves but
  1 11 who do not require the services of a registered or licensed
  1 12 practical nurse except on an emergency basis or who by reason
  1 13 of illness, disease, or physical or mental infirmity are
  1 14 unable to sufficiently or properly care for themselves but who
  1 15 do not require the services of a registered or licensed
  1 16 practical nurse except on an emergency basis if home and
  1 17 community=based services, other than nursing care, as defined
  1 18 by this chapter and departmental rule, are provided.  For the
  1 19 purposes of this definition, the home and community=based
  1 20 services to be provided are limited to the type included under
  1 21 the medical assistance program provided pursuant to chapter
  1 22 249A, are subject to cost limitations established by the
  1 23 department of human services under the medical assistance
  1 24 program, and except as otherwise provided by the department of
  1 25 inspections and appeals with the concurrence of the department
  1 26 of human services are limited in capacity to the number of
  1 27 licensed residential care facilities and the number of
  1 28 licensed residential care facility beds in the state as of
  1 29 December 1, 2003.
  1 30    Sec. 2.  Section 135C.4, Code 2003, is amended to read as
  1 31 follows:
  1 32    135C.4  RESIDENTIAL CARE FACILITIES.
  1 33    Each facility licensed as a residential care facility shall
  1 34 provide an organized continuous twenty=four=hour program of
  1 35 care commensurate with the needs of the residents of the home
  2  1 and under the immediate direction of a person approved and
  2  2 certified by the department whose combined training and
  2  3 supervised experience is such as to ensure adequate and
  2  4 competent care.  All admissions to residential care facilities
  2  5 shall be based on an order written by a physician certifying
  2  6 that the individual being admitted does not require nursing
  2  7 services or that the individual's need for nursing services
  2  8 can be avoided if home and community=based services, other
  2  9 than nursing care, as defined by this chapter and departmental
  2 10 rule, are provided.  For the purposes of this section, the
  2 11 home and community=based services to be provided shall be
  2 12 limited to the type included under the medical assistance
  2 13 program provided pursuant to chapter 249A, shall be subject to
  2 14 cost limitations established by the department of human
  2 15 services under the medical assistance program, and except as
  2 16 otherwise provided by the department of inspections and
  2 17 appeals with the concurrence of the department of human
  2 18 services shall be limited in capacity to the number of
  2 19 licensed residential care facilities and the number of
  2 20 licensed residential care facility beds in the state as of
  2 21 December 1, 2003.
  2 22    Sec. 3.  NEW SECTION.  222.60A  COST OF ASSESSMENT.
  2 23    Notwithstanding any provision of this chapter to the
  2 24 contrary, any amount attributable to any fee assessed pursuant
  2 25 to section 249A.21 that would otherwise be the liability of
  2 26 any county shall be paid by the state.  The department may
  2 27 transfer funds from the appropriation for medical assistance
  2 28 to pay any amount attributable to any fee assessed pursuant to
  2 29 section 249A.21 that is a liability of the state.
  2 30    Sec. 4.  Section 249.3, Code 2003, is amended by adding the
  2 31 following new subsection:
  2 32    NEW SUBSECTION.  4.  At the discretion of the department,
  2 33 persons who meet the criteria listed in all of the following
  2 34 paragraphs:
  2 35    a.  Are either of the following:
  3  1    (1)  Sixty=five years of age or older.
  3  2    (2)  Disabled as defined by 42 U.S.C. } 1382c(a)(3), except
  3  3 that being engaged in substantial gainful activity shall not
  3  4 preclude a determination of disability for the purpose of this
  3  5 subparagraph.
  3  6    b.  Live in one of the following:
  3  7    (1)  The individual's own home.
  3  8    (2)  The home of another individual.
  3  9    (3)  A group living arrangement.
  3 10    (4)  A medical facility.
  3 11    c.  Would be eligible for supplemental security income
  3 12 benefits but for having excess income or but for being engaged
  3 13 in substantial gainful activity and having excess income.
  3 14    d.  Are not eligible for another state supplementary
  3 15 assistance group.
  3 16    e.  Receive medical assistance under chapter 249A and are
  3 17 not required to meet a spend=down or pay a premium to be
  3 18 eligible for such benefits.
  3 19    f.  Is currently eligible for Medicare part B.
  3 20    g.  Have income exceeding one hundred thirty=five percent
  3 21 of the federal poverty level but not exceeding the medical
  3 22 assistance income limit for the eligibility group for the
  3 23 individual person's living arrangement.
  3 24    Sec. 5.  Section 249.4, Code 2003, is amended to read as
  3 25 follows:
  3 26    249.4  APPLICATION == AMOUNT OF GRANT.
  3 27    1.  Applications for state supplementary assistance shall
  3 28 be made in the form and manner prescribed by the director or
  3 29 the director's designee, with the approval of the council on
  3 30 human services, pursuant to chapter 17A.  Each person who so
  3 31 applies and is found eligible under section 249.3 shall, so
  3 32 long as the person's eligibility continues, receive state
  3 33 supplementary assistance on a monthly basis, from funds
  3 34 appropriated to the department for the purpose.
  3 35    2.  Any person who applies within fifteen months from the
  4  1 date of implementation of eligibility pursuant to section
  4  2 249.3, subsection 4, and who would have been eligible under
  4  3 that subsection for any period on or after October 1, 2003,
  4  4 may be granted benefits retroactive to October 1, 2003.
  4  5    Sec. 6.  Section 249A.21, subsection 1, Code 2003, is
  4  6 amended to read as follows:
  4  7    1.  The department may assess intermediate care facilities
  4  8 for persons with mental retardation, as defined in section
  4  9 135C.1, that are not operated by the state, a fee in an amount
  4 10 not to exceed six percent of the total annual revenue of the
  4 11 facility for the preceding fiscal year.
  4 12    Sec. 7.  Section 249A.21, Code 2003, is amended by adding
  4 13 the following new subsection:
  4 14    NEW SUBSECTION.  6.  The department may adopt
  4 15 administrative rules under section 17A.4, subsection 2, and
  4 16 section 17A.5, subsection 2, paragraph "b", to implement this
  4 17 section, and any fee assessed pursuant to this section against
  4 18 an intermediate care facility for persons with mental
  4 19 retardation that is operated by the state may be made
  4 20 retroactive to October 1, 2003.
  4 21    Sec. 8.  2003 Iowa Acts, chapter 112, section 4, subsection
  4 22 9, is amended to read as follows:
  4 23    9.  The department may adopt administrative rules under
  4 24 section 17A.4, subsection 2, and section 17A.5, subsection 2,
  4 25 paragraph "b", to implement this section, and any assessment
  4 26 made pursuant to this section may be made retroactive to
  4 27 October 1, 2003.
  4 28    Sec. 9.  WAIVER PAYMENT SLOTS.  The department of human
  4 29 services shall provide an opportunity for counties to request
  4 30 an expansion of the county's home and community=based waiver
  4 31 payment slots under the medical assistance program in order to
  4 32 add slots to address the changes in the definition of
  4 33 "residential care facility" under chapter 135C made by this
  4 34 Act.  Any expansion in the number of waiver payment slots as
  4 35 described in this section shall be implemented on July 1,
  5  1 2004, or the date authorized in the federal approval of the
  5  2 expansion of the waiver slots, whichever is later.
  5  3    Sec. 10.  RETROACTIVE APPLICABILITY.  The following
  5  4 provisions of this Act are retroactively applicable to October
  5  5 1, 2003:
  5  6    1.  The provision creating section 222.60A, relating to the
  5  7 costs of the assessment for intermediate care facilities for
  5  8 persons with mental retardation.
  5  9    2.  The provision creating section 249.3, subsection 4,
  5 10 relating to state supplementary assistance eligibility.
  5 11    3.  The provision amending section 249.4, relating to
  5 12 applications and amounts of grants for state supplementary
  5 13 assistance.
  5 14    4.  The provision amending section 249A.21, subsection 1,
  5 15 and the provision creating section 249A.21, subsection 6,
  5 16 relating to the nursing facility quality assurance assessment.
  5 17    5.  The provision amending 2003 Iowa Acts, chapter 112,
  5 18 section 4, subsection 9, relating to the adoption of
  5 19 administrative rules relating to the nursing facility quality
  5 20 assurance assessment.
  5 21    Sec. 11.  EFFECTIVE DATE.  This Act, being deemed of
  5 22 immediate importance, takes effect upon enactment.
  5 23 HF 2134
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