SB 183: "An Act relating to home and community-based services; and providing for an effective date."
00 SENATE BILL NO. 183 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, reduce
01 payment for services, or reduce the level of services provided under (a) of this 02 section, 03 (1) the department [RECIPIENT] must conduct [HAVE HAD] an 04 annual assessment to determine whether the recipient continues to meet the standards 05 under (a) of this section; 06 (2) an independent qualified health care professional under 07 contract with the department must review the annual assessment conducted 08 under (1) of this subsection; [THE ANNUAL ASSESSMENT MUST HAVE BEEN 09 REVIEWED BY AN INDEPENDENT QUALIFIED HEALTH CARE 10 PROFESSIONAL UNDER CONTRACT WITH THE DEPARTMENT; FOR 11 PURPOSES OF THIS PARAGRAPH, "INDEPENDENT QUALIFIED HEALTH 12 CARE PROFESSIONAL" MEANS, 13 (A) FOR A WAIVER BASED ON INTELLECTUAL OR 14 DEVELOPMENTAL DISABILITY, A PERSON WHO IS QUALIFIED 15 UNDER 42 C.F.R. 483.430 AS A QUALIFIED INTELLECTUAL 16 DISABILITY PROFESSIONAL; 17 (B) FOR OTHER ALLOWABLE WAIVERS, A 18 REGISTERED OR ADVANCED PRACTICE REGISTERED NURSE 19 LICENSED UNDER AS 08.68 WHO IS QUALIFIED TO ASSESS 20 CHILDREN WITH COMPLEX MEDICAL CONDITIONS, OLDER 21 ALASKANS, AND ADULTS WITH PHYSICAL DISABILITIES FOR 22 MEDICAL ASSISTANCE WAIVERS; AND] 23 (3) for purposes of a reduction in payment for services or a 24 reduction in the level of services under this subsection, the annual assessment must 25 find that a recipient who previously qualified for a waiver under this section is 26 able to demonstrate the ability to function and live independently in a home 27 setting under the reduced level of services [THE RECIPIENT'S CONDITION HAS 28 MATERIALLY IMPROVED SINCE THE PREVIOUS ASSESSMENT]; for 29 purposes of a termination of payment for services under this subsection, the 30 annual assessment must find [THIS PARAGRAPH, "MATERIALLY IMPROVED" 31 MEANS] that a recipient who [HAS] previously qualified for a waiver for
01 (A) a child with complex medical conditions, no longer needs 02 technical assistance for a life-threatening condition, and is expected to be 03 placed in a skilled nursing facility for less than 30 days each year; 04 (B) intellectual or developmental disability, no longer needs the 05 level of care provided by an intermediate care facility for persons with 06 intellectual and developmental disabilities either because the qualifying 07 diagnosis has changed or the recipient is able to demonstrate the ability to 08 function and live independently in a home setting without the need for waiver 09 services; or 10 (C) an older Alaskan or adult with a physical disability, no 11 longer has a functional limitation or cognitive impairment that would result in 12 the need for nursing home placement, and is able to demonstrate the ability to 13 function and live independently in a home setting without the need for waiver 14 services; and 15 (4) 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 person who is qualified to 26 provide personal care services under the 1915(k) state plan option under 27 42 U.S.C. 1396n or a registered or advanced practice registered nurse 28 licensed under AS 08.68 who is qualified to assess children with complex 29 medical conditions, older Alaskans, and adults with physical disabilities 30 for medical assistance waivers. 31 * Sec. 4. AS 47.07.045 is amended by adding new subsections to read:
01 (e) Not later than 10 days after the department receives the results of a 02 recipient's assessment or reassessment under this section, the department shall notify 03 the recipient, or a parent, guardian, or other individual with legal authority to act on 04 the recipient's behalf, in writing of the results. 05 (f) Not later than 10 days after the department makes a determination relating 06 to a recipient's eligibility, payment for services, or an assessment or reassessment 07 under this section, the department shall notify the recipient, or a parent, guardian, or 08 other individual with legal authority to act on the recipient's behalf, in writing of the 09 determination and that the recipient has a right to appeal the determination. The 10 department shall provide the notice at least 30 days before the date the determination 11 takes effect. 12 (g) Unless prohibited by federal law, the state shall allow a legally responsible 13 person to provide personal care services under this section to a recipient of medical 14 assistance under the home and community-based services waiver or 1915(k) state plan 15 option under 42 U.S.C. 1396n. 16 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 17 read: 18 TRANSITION: REASSESSMENT. If, between January 1, 2019, and January 1, 2022, 19 the Department of Health and Social Services reduced payment for services or the level of 20 services provided to a recipient under AS 47.07.045(a), the department shall notify the 21 recipient that the recipient may apply to the department for a reassessment. The reassessment 22 shall be conducted under the standards established in AS 47.07.045(b), as amended by sec. 2 23 of this Act, for a reduction in payment for services or a reduction in the level of services 24 provided to a recipient under AS 47.07.045(a). The department shall establish by regulation a 25 process that allows a recipient to apply for a reassessment. 26 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 27 read: 28 MEDICAID STATE PLAN FEDERAL APPROVAL. The Department of Health and 29 Social Services shall amend and submit for federal approval the state plan for medical 30 assistance coverage consistent with AS 47.07.045(a), (b), and (d), as amended by secs. 1 - 3 31 of this Act, and AS 47.07.045(e) - (g), enacted by sec. 4 of this Act.
01 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 02 read: 03 RETROACTIVITY. Section 5 of this Act is retroactive to January 1, 2019. 04 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 05 read: 06 CONDITIONAL EFFECT; NOTIFICATION. (a) Sections 1 - 4 of this Act take effect 07 only if, and only to the extent that, the United States Department of Health and Human 08 Services approves the amendments to the state plan for medical assistance under 09 AS 47.07.045(a), (b), and (d), as amended by secs. 1 - 3 of this Act, and AS 47.07.045(e) - 10 (g), enacted by sec. 4 of this Act. 11 (b) If the United States Department of Health and Human Services approves some or 12 all of the amendments to the state plan submitted under sec. 6 of this Act, the commissioner of 13 health and social services shall notify the revisor of statutes in writing not later than 30 days 14 after receiving notice of the approval. 15 * Sec. 9. If secs. 1 - 4 of this Act take effect, they take effect on the day after the date the 16 revisor of statutes receives notice from the commissioner of health and social services under 17 sec. 8 of this Act. 18 * Sec. 10. Sections 5 and 7 of this Act take effect immediately under AS 01.10.070(c).