CSHB 292(HSS): "An Act relating to home and community-based services; and providing for an effective date."
00 CS FOR HOUSE BILL NO. 292(HSS) 01 "An Act relating to home and community-based services; and providing for an effective 02 date." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 47.07.045(a) is amended to read: 05 (a) The department may provide home and community-based services under a 06 waiver or 1915(k) state plan option and Medicaid personal care services under 07 [IN ACCORDANCE WITH] 42 U.S.C. 1396 - 1396p (Title XIX, Social Security 08 Act), this chapter, and regulations adopted under this chapter, if the department has 09 received approval from the federal government and the department has appropriations 10 allocated for the purpose. To supplement the standards in (b) and (c) of this section, 11 the department shall establish in regulation additional standards for eligibility and 12 payment for the services. 13 * Sec. 2. AS 47.07.045(b) is amended to read: 14 (b) Before the department may terminate payment for services or reduce the
01 level of services provided under (a) of this section, 02 (1) the department [RECIPIENT] must conduct [HAVE HAD] an 03 annual assessment to determine whether the recipient continues to meet the standards 04 under (a) of this section; 05 (2) an independent qualified health care professional under 06 contract with the department must review the annual assessment conducted 07 under (1) of this subsection; [THE ANNUAL ASSESSMENT MUST HAVE BEEN 08 REVIEWED BY AN INDEPENDENT QUALIFIED HEALTH CARE 09 PROFESSIONAL UNDER CONTRACT WITH THE DEPARTMENT; FOR 10 PURPOSES OF THIS PARAGRAPH, "INDEPENDENT QUALIFIED HEALTH 11 CARE PROFESSIONAL" MEANS, 12 (A) FOR A WAIVER BASED ON INTELLECTUAL OR 13 DEVELOPMENTAL DISABILITY, A PERSON WHO IS QUALIFIED 14 UNDER 42 C.F.R. 483.430 AS A QUALIFIED INTELLECTUAL 15 DISABILITY PROFESSIONAL; 16 (B) FOR OTHER ALLOWABLE WAIVERS, A 17 REGISTERED OR ADVANCED PRACTICE REGISTERED NURSE 18 LICENSED UNDER AS 08.68 WHO IS QUALIFIED TO ASSESS 19 CHILDREN WITH COMPLEX MEDICAL CONDITIONS, OLDER 20 ALASKANS, AND ADULTS WITH PHYSICAL DISABILITIES FOR 21 MEDICAL ASSISTANCE WAIVERS; AND] 22 (3) for purposes of a reduction in the level of personal care and 23 chore services under 42 U.S.C. 1396n(k) or Medicaid personal care services 24 under 42 U.S.C. 1396 - 1396p (Title XIX, Social Security Act), the annual 25 assessment must find that the recipient's condition has materially improved since the 26 previous assessment; in [FOR PURPOSES OF] this paragraph, "materially improved" 27 means that a recipient who has previously qualified for services is able to function in 28 a home setting with the reduced level of services; 29 (4) for purposes of a termination of payment for services, the 30 annual assessment must find that the recipient's condition has materially 31 improved since the previous assessment; in this paragraph, "materially
01 improved" means that a recipient who has previously qualified for a service [A 02 WAIVER] for 03 (A) a child with complex medical conditions, no longer needs 04 technical assistance for a life-threatening condition, and is expected to be 05 placed in a skilled nursing facility for less than 30 days each year; 06 (B) intellectual or developmental disability, no longer needs the 07 level of care provided by an intermediate care facility for persons with 08 intellectual and developmental disabilities either because the qualifying 09 diagnosis has changed or the recipient is able to demonstrate the ability to 10 function in a home setting without the need for [WAIVER] services; or 11 (C) an older Alaskan or adult with a physical disability, no 12 longer has a functional limitation or cognitive impairment that would result in 13 the need for nursing home placement, and is able to demonstrate the ability to 14 function in a home setting without the need for [WAIVER] services; and 15 (5) the department must provide the notices required by (e) and (f) 16 of this section. 17 * Sec. 3. AS 47.07.045(d) is amended to read: 18 (d) In [(c) OF] this section, 19 (1) "military" means the armed forces of the United States, the United 20 States Coast Guard, or the Alaska National Guard; 21 (2) "independent qualified health care professional" means 22 (A) for a waiver based on intellectual or developmental 23 disability, a person who is qualified under 42 C.F.R. 483.430 as a qualified 24 intellectual disability professional; 25 (B) for other allowable waivers, a registered or advanced 26 practice registered nurse licensed under AS 08.68 who is qualified to 27 assess children with complex medical conditions, older Alaskans, and 28 adults with physical disabilities for medical assistance waivers. 29 * Sec. 4. AS 47.07.045 is amended by adding new subsections to read: 30 (e) Not later than 10 days after the department receives the results of a 31 recipient's assessment or reassessment under this section, the department shall notify
01 the recipient, or a parent, guardian, or other individual with legal authority to act on 02 the recipient's behalf, in writing of the results. 03 (f) Not later than 10 days after the department makes a determination relating 04 to a recipient's eligibility, payment for services, or an assessment or reassessment 05 under this section, the department shall notify the recipient, or a parent, guardian, or 06 other individual with legal authority to act on the recipient's behalf, in writing of the 07 determination and that the recipient has a right to appeal the determination. The 08 department shall provide the notice at least 30 days before the date the determination 09 takes effect. 10 (g) Unless prohibited by federal law, the state shall allow a legally responsible 11 person to provide personal care services under this section to a recipient of medical 12 assistance under the home and community-based services waiver or 1915(k) state plan 13 option under 42 U.S.C. 1396n. 14 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 15 read: 16 REPORT TO THE LEGISLATURE. Not later than one year after the effective date of 17 secs. 1 - 4 this Act, the Department of Health shall submit a report to the senate secretary and 18 chief clerk of the house of representatives and notify the legislature that the report is 19 available. The report must 20 (1) include an assessment of the payment rates for home and community- 21 based services in the state under a waiver or 1915(k) state plan option under 42 U.S.C. 22 1396n(k); the assessment must address the adequacy of those rates to ensure sufficient 23 workforce needs for independent qualified health care professionals; and 24 (2) assess and identify the adequacy of services under AS 47.07.045(a); this 25 analysis shall include the number of individuals eligible for services, the number of 26 individuals receiving services, the average length of time for which an individual is placed on 27 a waitlist for services, and the average hours of service each recipient receives annually, 28 monthly, and weekly; and 29 (3) assess and recommend additional changes to state statute, regulations, and 30 payment for services to enhance the delivery of services under AS 47.07.045(a) to individuals 31 eligible to receive care, particularly changes involving decreasing waitlists, reducing services,
01 and addressing workforce shortages. 02 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 03 read: 04 TRANSITION: REASSESSMENT. If, between January 1, 2019, and January 1, 2022, 05 the Department of Health and Social Services reduced the level of services provided to a 06 recipient under AS 47.07.045(a), the department shall notify the recipient that the recipient 07 may apply to the department for a reassessment. The reassessment shall be conducted under 08 the standards established in AS 47.07.045(b), as amended by sec. 2 of this Act, for a reduction 09 in the level of services provided to a recipient under AS 47.07.045(a). The department shall 10 establish by regulation a process that allows a recipient to apply for a reassessment. 11 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 12 read: 13 MEDICAID STATE PLAN FEDERAL APPROVAL. The Department of Health shall 14 amend and submit for federal approval the state plan for medical assistance coverage 15 consistent with AS 47.07.045(a), (b), and (d), as amended by secs. 1 - 3 of this Act, and 16 AS 47.07.045(e) - (g), enacted by sec. 4 of this Act. 17 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 18 read: 19 RETROACTIVITY. Section 6 of this Act is retroactive to January 1, 2019. 20 * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to 21 read: 22 CONDITIONAL EFFECT; NOTIFICATION. (a) Sections 1 - 4 of this Act take effect 23 only if, and only to the extent that, the United States Department of Health and Human 24 Services approves the amendments to the state plan for medical assistance under 25 AS 47.07.045(a), (b), and (d), as amended by secs. 1 - 3 of this Act, and AS 47.07.045(e) - 26 (g), enacted by sec. 4 of this Act. 27 (b) If the United States Department of Health and Human Services approves some or 28 all of the amendments to the state plan submitted under sec. 7 of this Act, the commissioner of 29 health shall notify the revisor of statutes in writing not later than 30 days after receiving 30 notice of the approval. 31 * Sec. 10. If secs. 1 - 4 of this Act take effect, they take effect on the day after the date the
01 revisor of statutes receives notice from the commissioner of health under sec. 9 of this Act. 02 * Sec. 11. Sections 6 and 8 of this Act take effect immediately under AS 01.10.070(c).