00 SENATE CS FOR HOUSE BILL NO. 178(HES) 01 "An Act adding children under the age of 21 who are eligible for adoption 02 assistance because of special needs to the optional Medicaid coverage list and 03 revising the order of priority in which groups eligible for optional Medicaid 04 coverage are eliminated; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. AS 47.07.020(b) is amended to read: 07  (b) In addition to the persons specified in (a) of this section, the following 08 optional groups of persons for whom the state may claim federal financial participation 09 are eligible for medical assistance: 10  (1) persons eligible for but not receiving assistance under any plan of 11 the state approved under 42 U.S.C. 601 - 615 (Title IV-A, Social Security Act, Aid to 12 Families with Dependent Children) or 42 U.S.C. 1381 - 1383c (Title XVI, Social 13 Security Act, Supplemental Security Income); 14  (2) persons in a general hospital, skilled nursing facility, or intermediate 01 care facility, who, if they left the facility, would be eligible for assistance under one 02 of the federal programs specified in (1) of this subsection; 03  (3) persons under age 21 who are under supervision of the department, 04 for whom maintenance is being paid in whole or in part from public funds, and who 05 are in foster homes or private child-care institutions; 06  (4) aged, blind, or disabled persons, who, because they do not meet 07 income and resources requirements, do not receive supplemental security income under 08 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not receive a 09 mandatory state supplement, but who are eligible, or would be eligible if they were not 10 in a skilled nursing facility or intermediate care facility to receive an optional state 11 supplementary payment; 12  (5) persons under age 21 who are in an institution designated as an 13 intermediate care facility for the mentally retarded and who are financially eligible as 14 determined by the standards of the federal aid to families with dependent children 15 program; 16  (6) persons in a medical or intermediate care facility whose income 17 while in the facility does not exceed 300 percent of the supplemental security income 18 benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) but who 19 would not be eligible for an optional state supplementary payment if they left the 20 hospital or other facility; 21  (7) persons under age 21 who are receiving active treatment in a 22 psychiatric hospital and who are financially eligible as determined by the standards of 23 42 U.S.C. 601 - 615 (Title IV-A, Social Security Act, Aid to Families with Dependent 24 Children); 25  (8) persons under age 21 and not covered under (a) of this section, who 26 would be eligible for benefits under the federal aid to families with dependent children 27 program, except that they have the care and support of both their natural and adoptive 28 parents; 29  (9) pregnant women not covered under (a) of this section and who meet 30 the income and resource requirements of the federal aid to families with dependent 31 children program; 01  (10) persons under age 21 not covered under (a) of this section who 02 the department has determined cannot be placed for adoption without medical 03 assistance because of a special need for medical or rehabilitative care and who the 04 department has determined are hard-to-place children eligible for subsidy under 05 AS 25.23.190 - 25.23.220; 06  (11) persons who can be considered under 42 U.S.C. 1396a(e)(3) 07 (Title XIX, Social Security Act, Medical Assistance) to be individuals with respect 08 to whom a supplemental security income is being paid under 42 U.S.C. 1381 - 09 1383c (Title XVI, Social Security Act) because they meet all of the following 10 criteria: 11  (A) they are 18 years of age or younger and qualify as 12 disabled individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security 13 Act); 14  (B) the department has determined that 15  (i) they require a level of care provided in a hospital, 16 nursing facility, or intermediate care facility for the mentally 17 retarded; 18  (ii) it is appropriate to provide their care outside of 19 an institution; and 20  (iii) the estimated amount that would be spent for 21 medical assistance for their individual care outside an institution is 22 not greater than the estimated amount that would otherwise be 23 expended individually for medical assistance within an appropriate 24 institution; 25  (C) if they were in a medical institution, they would be 26 eligible for medical assistance under other provisions of this chapter; and 27  (D) home and community-based services under a waiver 28 approved by the federal government are either not available to them under 29 this chapter or would be inappropriate for them [REPEALED]. 30 * Sec. 2. AS 47.07.030 is amended by adding a new subsection to read: 31  (c) Notwithstanding (b) of this section, the department may offer a service for 01 which the department has received a waiver from the federal government if the 02 department was authorized, directed, or requested to apply for the waiver by law or by 03 a concurrent or joint resolution of the legislature. The department shall annually 04 submit to the legislature its recommendations about where a service offered under this 05 subsection should be placed on the priority list in AS 47.07.035. 06 * Sec. 3. AS 47.07.035 is amended to read: 07  Sec. 47.07.035. PRIORITY OF MEDICAL ASSISTANCE. If the department 08 finds that the cost of medical assistance for all persons eligible under this chapter will 09 exceed the amount allocated in the state budget for that assistance for the fiscal year, 10 the department shall eliminate coverage for optional medical services and optionally 11 eligible groups of individuals in the following order: 12  (1) clinical social workers' services; 13  (2) psychologists' services; 14  (3) chiropractic services; 15  (4) advanced nurse practitioner services; 16  (5) adult dental services; 17  (6) emergency hospital services; 18  (7) treatment of speech, hearing, and language disorders; 19  (8) optometrists' services and eyeglasses; 20  (9) occupational therapy; 21  (10) mammography screening; 22  (11) prosthetic devices; 23  (12) medical supplies and equipment; 24  (13) targeted case management services; 25  (14) rehabilitative services for substance abusers and emotionally 26 disturbed or chronically mentally ill adults; 27  (15) clinic services; 28  (16) physical therapy; 29  (17) personal care services in a recipient's home; 30  (18) prescribed drugs; 31  (19) long-term care noninstitutional services; 01  (20) inpatient psychiatric facility services; 02  (21) intermediate care facility services for the mentally retarded; 03  (22) intermediate care facility services; 04  (23) individuals described in AS 47.07.020(b)(11); 05  (24) individuals under age 21 who are not eligible for benefits under 06 the federal aid to families with dependent children program because they are not 07 deprived of one or more of their natural or adoptive parents; 08  (25) [(24)] skilled nursing facility services for persons under age 21; 09  (26) [(25)] aged, blind, and disabled individuals who, because they do 10 not meet the income requirements, do not receive supplemental security income under 11 Title XVI of the Social Security Act, but who are eligible, or would be eligible if they 12 were not in a skilled nursing facility or intermediate care facility, to receive an 13 optional state supplementary payment; 14  (27) [(26)] individuals in a hospital, skilled nursing facility, or 15 intermediate care facility whose income while in the facility does not exceed 300 16 percent of the supplemental security income benefit rate under Title XVI of the Social 17 Security Act, but who, because of income, are not eligible for the optional state 18 supplementary payment; 19  (28) [(27)] individuals under age 21 under supervision of the 20 department, for whom maintenance is being paid in whole or in part from public 21 money and who are in foster homes or private child-care institutions; 22  (29) individuals under age 21 who the department has determined 23 cannot be placed for adoption without medical assistance because of a special 24 need for medical or rehabilitative care and who the department has determined 25 are hard-to-place children eligible for subsidy under AS 25.23.190 - 25.23.220. 26 * Sec. 4. (a) AS 47.07.020(b)(11), added by sec. 1 of this Act, and AS 47.07.035(23), 27 amended by sec. 3 of this Act, take effect on the 180th day after the effective date of 28 Medicaid plan amendments approved by the federal government under which the state would 29 implement a waiver for home and community-based services under 42 U.S.C. 1396n for 30 persons who are Medicaid eligible and who would otherwise require a level of care provided 31 in a hospital, nursing facility, or intermediate care facility for the mentally retarded in the 01 absence of home and community-based services. 02 (b) The Department of Health and Social Services shall notify the revisor of statutes 03 as to the effective date of the plan amendments referred to in (a) of this section. 04 * Sec. 5. Section 2 of this Act takes effect immediately under AS 01.10.070(c). 05 * Sec. 6. Except as provided in secs. 4 and 5 of this Act, this Act takes effect July 1, 1993.