Legislature(2005 - 2006)CAPITOL 106
04/11/2006 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB467 | |
| SB177 | |
| HB426 | |
| HB482 | |
| HB467 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 467 | TELECONFERENCED | |
| += | HB 426 | TELECONFERENCED | |
| += | HB 482 | TELECONFERENCED | |
| += | HB 29 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 177 | TELECONFERENCED | |
| += | HB 468 | TELECONFERENCED | |
HB 426-MEDICAL ASSISTANCE FOR PERSONS UNDER 21 3:56:12 PM CHAIR WILSON announced that the next order of business would be HOUSE BILL NO. 426, "An Act relating to medical assistance eligibility and coverage for persons under 21 years of age." 3:56:34 PM REPRESENTATIVE ANDERSON moved to adopt CSHB 426, Version 24- LS1602\L, Mischel, 3/24/06, as the working document. There being no objection, CSHB 426, Version L was before the committee. CHAIR WILSON 3:57:02 PM RYNNIEVA MOSS, Staff to Representative John Coghill, Alaska State Legislature, introduced CSHB 426, Version L, on behalf of Representative Coghill, sponsor, and explained that the committee substitute (CS) eliminates Section 6, which considered the father's income for Medicaid qualification. Additionally, language was added to Section 8 in order to clarify the intent of the bill regarding the limits for applying to receive Medicaid. She went on to compare the amendments offered on the bill from Representatives Cissna and Coghill pointing out the additional language to subparagraph (C) in Version L.1: Amendment to CSHB426, Version 24-LS1602\L.1, Mischel, 4/11/06, offered by Representative Cissna, read: Page 1, line 4, following "eligibility;": Insert "relating to home and community-based services;" Page 7, following line 24: Insert a new bill section to read: "* Sec. 8. AS 47.07 is amended by adding a new section to read: Sec. 47.07.045. Home and community-based services. (a) A person who is eligible for medical assistance coverage may be paid for home and community-based services under a waiver approved by the federal government if the person is approved initially and at least once a year thereafter for the services by the department based on an assessment described in regulation that finds that the person meets a level of care necessary for admission to an intermediate care facility for the mentally retarded or to a nursing facility. (b) The department may not terminate payment for approved home and community-based services unless, at any time, (1) the recipient of the services scores below the eligibility standard on the assessment employed under (a) of this section; and (2) the score is reviewed by an independent qualified health care professional who certifies that the recipient's condition has materially improved from the previous assessment. (c) In this section, (1) "independent qualified health care professional" means a (A) registered nurse licensed under AS 08.68 who is qualified to assess children with complex medical conditions, older Alaskans, and adults with physical disabilities for medical assistance waivers; and (B) a person who is qualified under 42 CFR 483.430 as a mental retardation professional for the mental retardation and developmental disability waiver; (2) "materially improved" means that the recipient has previously qualified for a waiver for (A) children with complex medical conditions, no longer needs technical assistance for a life-threatening condition, and is expected to be placed in a skilled nursing facility for less than 30 days each year; (B) mental retardation or developmental disability, no longer needs the level of care provided by an intermediate care facility for the mentally retarded either because the qualifying diagnosis has changed or the recipient is able to demonstrate the ability to function in a home setting without the need for waiver services; or (C) older Alaskans or adults with physical disabilities, no longer has a functional limitation or cognitive impairment that would result in the need for nursing home placement, and is able to demonstrate the ability to function in a home setting without the need for waiver services." Renumber the following bill sections accordingly. Page 8, line 21: Delete "sec. 11" Insert "sec. 12" Amendment to CSHB, Version 24-LS1602\I.1, Mischel, 3/16/06, by Representative Coghill, read: Page 1, line 4, following "eligibility;": Insert "relating to home and community-based services;" Page 8, following line 12: Insert a new bill section to read: "* Sec. 9. AS 47.07 is amended by adding a new section to read: Sec. 47.07.045. Home and community-based services. (a) A person who is eligible for medical assistance coverage may be paid for home and community-based services under a waiver approved by the federal government if the person is approved initially and at least once a year thereafter for the services by the department based on an assessment described in regulation that finds that the person meets a level of care necessary for admission to an intermediate care facility for the mentally retarded or to a nursing facility. (b) The department may not terminate payment for approved home and community-based services unless, at any time, (1) the recipient of the services scores below the eligibility standard on the assessment employed under (a) of this section; and (2) the score is reviewed by an independent qualified health care professional who certifies that the recipient's condition has materially improved from the previous assessment. (c) In this section, (1) "independent qualified health care professional" means a (A) registered nurse licensed under AS 08.68 who is qualified to assess children with complex medical conditions, older Alaskans, and adults with physical disabilities for medical assistance waivers; and (B) a person who is qualified under 42 C.F.R. 483.430 as a mental retardation professional for the mental retardation and developmental disability waiver; (2) "materially improved" means that the recipient has previously qualified for a waiver for (A) children with complex medical conditions, no longer needs technical assistance for a life-threatening condition, and is expected to be placed in a skilled nursing facility for less than 30 days each year; (B) mental retardation or developmental disability, no longer needs the level of care provided by an intermediate care facility for the mentally retarded either because the qualifying diagnosis has changed or the recipient is able to demonstrate the ability to function in a home setting without the need for waiver services; or (C) older Alaskans or adults with physical disabilities, no longer has a functional limitation or cognitive impairment that would result in the need for nursing home placement." Renumber the following bill sections accordingly. Page 9, line 9: Delete "sec. 12" Insert "sec. 13" MS. MOSS stated that within the last nine months, clients have been removed from Medicaid waivers despite the fact that their physical conditions and needs have not changed. She expressed appreciation for the language which Representative Cissna has provided in Amendment, Version L.1, to ensure against this type of action continuing. STACIE KRALY, Chief Assistant Attorney General, Statewide Section Supervisor, Human Services Section; Civil Division, Department of Law (DOL), stated that Amendment, Version L.1, had been reviewed and no substantive issues were found. 4:00:15 PM REPRESENTATIVE CISSNA moved Amendment 1, labeled 24-LS1602\L.1, Mischel, 4/11/06, [text provided previously]. REPRESENTATIVE ANDERSON objected for discussion. MS. KRALY explained that the purpose of this amendment was to address a litigation issue which the Department of Health and Social Services is currently involved with, to wit: [The issue being] whether or not [Department of Health and Social Services] are required to demonstrate that an individual has materially improved prior to terminating them from a waiver services. Home and community based waiver services are provided to a number of individuals in ... Alaska, and in order to qualify for a waiver [the individual] must ... have a qualifying diagnosis ... [or] meet a level of care that would either be obtained in an intermediate care facility for the mentally retarded or a nursing facility. ... Upon assessment and eligibility [an individual] must be annually re-assessed, by federal and state law. ... Upon re-assessment there has been an allegation that [the department] must show material improvement. MS. KRALY provided the department's position to be that the assessment tool used by DHSS quantifies improvement, however, this amendment would further clarify the process and allow for an additional eligibility review; possibly bringing resolution to the current litigation. REPRESENTATIVE ANDERSON offered to remove his objection. REPRESENTATIVE CISSNA echoed Ms. Kraly's explanation of the amendment, and added that the outlook for a senior is different than the expectation held for a child's future. She stated that the amendment stipulates appropriate expectations for a senior; that they may aspire to a situation of requiring the least restrictive services. 4:03:41 PM MS. KRALY agreed and pointed out that goals for seniors and adults are also different. She stated that circumstances could, given the fluidity of life, allow for someone of any age to have a waiver terminated. What needs to be clearly articulated, she opined, is that a waiver is not necessarily for the rest of your life. She provided various reasons why individuals might be terminated from a waiver program: a general improvement of condition; non-waived services are made available; or other support services are made available which require waiver termination. The annual re-assessment for eligibility is conducted for this non-presumptive reason, she pointed out. CHAIR WILSON agreed with the need to continue the re-assessment program for continuation of services. 4:06:10 PM MS. MOSS stated: The term used in this amendment, ... "materially improved" helps in that direction, however, ... what we would like to see happen during the interim, ... [is legislation] to bring payment for services closer to an acuity based schedule. REPRESENTATIVE ANDERSON removed his objection to the amendment. There being no further objection, Amendment 1 was adopted. REPRESENTATIVE ANDERSON moved to report CSHB 426, Version 24- LS1602\L, Mischel, 3/24/06, as amended, out of committee with individual recommendations and the accompanying fiscal notes. REPRESENTATIVE GATTO objected and asked for clarity for voting purposes. Upon response he removed his objection. CHAIR WILSON announced that hearing no further objection, CSHB 426(HES) was reported out of the House Health, Education and Social Services Standing Committee. The committee took an at-ease from 4:08:28 PM to 4:09:13 PM. 4:09:13 PM
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