CSHB 459(FIN) AM: "An Act establishing new eligibility for medical assistance for certain disabled persons and giving their eligibility for services the highest priority among optional services and groups under the medical assistance program; amending the definition of 'personal care services in a recipient's home' as used in the medical assistance program; moving midwife services from being the first to being the 14th service eliminated under the medical assistance program when there is insufficient funding; and adjusting the priority of optional services and optional eligible groups under the medical assistance program in order to reflect the new priorities given to the newly-eligible disabled persons and to midwife services but without otherwise changing the relative order of the other optional services and optional groups."
00CS FOR HOUSE BILL NO. 459(FIN) am 01 "An Act establishing new eligibility for medical assistance for certain disabled 02 persons and giving their eligibility for services the highest priority among optional 03 services and groups under the medical assistance program; amending the definition 04 of 'personal care services in a recipient's home' as used in the medical 05 assistance program; moving midwife services from being the first to being the 06 14th service eliminated under the medical assistance program when there is 07 insufficient funding; and adjusting the priority of optional services and optional 08 eligible groups under the medical assistance program in order to reflect the new 09 priorities given to the newly-eligible disabled persons and to midwife services but 10 without otherwise changing the relative order of the other optional services and 11 optional groups." 12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 13 * Section 1. AS 47.07.020(b) is amended by adding a new paragraph to read: 14 (12) disabled persons, as described in 42 U.S.C.
01 1396a(a)(10)(A)(ii)(XIII), who are in families whose income is less than 250 percent 02 of the official poverty line applicable to a family of that size according to the federal 03 Office of Management and Budget, and who, but for earnings in excess of the limit 04 established under 42 U.S.C. 1396d(q)(2)(B), would be considered to be individuals 05 with respect to whom a supplemental security income is being paid under 42 U.S.C. 06 1381 - 1383c; a person eligible for assistance under this paragraph who is not eligible 07 under another provision of this section shall pay a premium or other cost-sharing 08 charges according to a sliding fee scale that is based on income as established by the 09 department in regulations. 10 * Sec. 2. AS 47.07.035 is amended to read: 11 Sec. 47.07.035. Priority of medical assistance. If the department finds that 12 the cost of medical assistance for all persons eligible under this chapter will exceed 13 the amount allocated in the state budget for that assistance for the fiscal year, the 14 department shall eliminate coverage for optional medical services and optionally 15 eligible groups of individuals in the following order: 16 (1) [MIDWIFE SERVICES; 17 (2)] clinical social workers' services; 18 (2) [(3)] psychologists' services; 19 (3) [(4)] chiropractic services; 20 (4) [(5)] advanced nurse practitioner services; 21 (5) [(6)] adult dental services; 22 (6) [(7)] emergency hospital services; 23 (7) [(8)] treatment of speech, hearing, and language disorders; 24 (8) [(9)] optometrists' services and eyeglasses; 25 (9) [(10)] occupational therapy; 26 (10) [(11)] mammography screening; 27 (11) [(12)] prosthetic devices; 28 (12) [(13)] medical supplies and equipment; 29 (13) [(14)] targeted case management services; 30 (14) midwife services; 31 (15) rehabilitative services for substance abusers and emotionally
01 disturbed or chronically mentally ill adults; 02 (16) clinic services; 03 (17) physical therapy; 04 (18) personal care services in a recipient's home; 05 (19) prescribed drugs; 06 (20) hospice care; 07 (21) long-term care noninstitutional services; 08 (22) inpatient psychiatric facility services; 09 (23) intermediate care facility services for the mentally retarded; 10 (24) intermediate care facility services; 11 (25) individuals described in AS 47.07.020(b)(11); 12 (26) individuals under age 21 who are not eligible for benefits under 13 the federal program designated as the successor to the aid to families with dependent 14 children program because they are not deprived of one or more of their natural or 15 adoptive parents; 16 (27) skilled nursing facility services for persons under age 21; 17 (28) aged, blind, and disabled individuals who, because they do not 18 meet the income requirements, do not receive supplemental security income under Title 19 XVI of the Social Security Act, but who are eligible, or would be eligible if they were 20 not in a skilled nursing facility or intermediate care facility, to receive an optional state 21 supplementary payment; 22 (29) individuals in a hospital, skilled nursing facility, or intermediate 23 care facility whose income while in the facility does not exceed 300 percent of the 24 supplemental security income benefit rate under Title XVI of the Social Security Act, 25 but who, because of income, are not eligible for the optional state supplementary 26 payment; 27 (30) individuals under age 21 under supervision of the department for 28 whom maintenance is being paid in whole or in part from public money and who are 29 in foster homes or private child-care institutions; 30 (31) individuals under age 21 who the department has determined 31 cannot be placed for adoption without medical assistance because of a special need for
01 medical or rehabilitative care and who the department has determined are hard-to-place 02 children eligible for subsidy under AS 25.23.190 - 25.23.220 ; 03 (32) individuals who are eligible under AS 47.07.020(b)(12) . 04 * Sec. 3. AS 47.07.900(15) is amended to read: 05 (15) "personal care services in a recipient's home" means services 06 authorized under a service plan [PRESCRIBED BY A PHYSICIAN] in accordance 07 with applicable federal and state law [THE RECIPIENT'S PLAN OF TREATMENT 08 AND PROVIDED BY AN INDIVIDUAL WHO IS 09 (A) QUALIFIED TO PROVIDE THE SERVICES; 10 (B) SUPERVISED BY A REGISTERED NURSE; AND 11 (C) NOT A MEMBER OF THE RECIPIENT'S FAMILY]; 12 * Sec. 4. TRANSITIONAL PROVISION. Notwithstanding AS 47.07.020(b)(12), added 13 by sec. 1 of this Act, an individual described in that provision is eligible for medical 14 assistance under AS 47.07 without the payment of a premium or other cost-sharing charges 15 until the effective date of regulations adopted by the Department of Health and Social Services 16 that set the premium or other cost-sharing charges. 17 * Sec. 5. REGULATIONS. The Department of Health and Social Services shall adopt 18 regulations establishing the sliding fee scale for premiums or other cost-sharing charges 19 described in this Act by July 1, 1999.