Senate File 538 - Reprinted SENATE FILE 538 BY COMMITTEE ON LABOR AND BUSINESS RELATIONS (SUCCESSOR TO SSB 1134) (As Amended and Passed by the Senate March 19, 2019 ) 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 SF 538 (2) 88 pf/rh

S.F. 538 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 unable to fulfill the requirements of subsection 2. 33 b. An individual who is pregnant. 34 c. A parent or caretaker responsible for the care of a 35 -1- SF 538 (2) 88 pf/rh 1/ 2

S.F. 538 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 enrolled full-time in an educational 10 institution. 11 h. The parent of a child who provides private instruction 12 pursuant to chapter 299A to that child. 13 i. An individual who is a caregiver for an elderly person or 14 an adult with a chronic, disabling, or serious health condition 15 as determined by the department. 16 j. An individual who meets other criteria identified by the 17 department, and approved by CMS. 18 4. The waiver request submitted by the department shall 19 also provide that if an individual does not comply with the 20 community engagement activities during the individual’s initial 21 six-month period of eligibility, the individual’s eligibility 22 for the program shall be terminated for the remainder of the 23 individual’s benefit year. The department shall only terminate 24 an individual’s eligibility thirty days after the individual 25 receives notice of the termination of benefits. 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 -2- SF 538 (2) 88 pf/rh 2/ 2