00 HOUSE BILL NO. 303 01 "An Act expanding reimbursable waiver services under Medicaid waivers for older 02 Alaskans and adults with physical disabilities to include adult companion services; and 03 relating to legislative intent concerning eligibility and coverage for personal care 04 attendant services." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 07 to read: 08 LEGISLATIVE INTENT. (a) It is the intent of the legislature that the Department of 09 Health and Social Services implement regulation changes to 7 AAC 43.750 - 795 to control 10 and reduce costs of the personal care attendant program by: 11 (1) clearly defining recipient eligibility in the "purpose and scope" section 12 where, absent personal care attendant assistance, an individual would require hospitalization 13 or nursing home care; 14 (2) clearly defining recipient eligibility in the "purpose and scope" section 01 where, absence of personal attendant care assistance would result in the individual's loss of 02 employment; 03 (3) deleting "stand-by" assistance as an allowable personal care attendant task; 04 (4) clearly stating that instrumental activities of daily living are not allowable 05 unless specifically related to an approved task for an activity of daily living need; 06 (5) adopting an objective client assessment tool that results in a reliable and 07 consistent care plan to be used by personal care attendant providers, personal care attendant 08 agencies, and the department; 09 (6) requiring physical certification of an individual's condition as stated in the 10 personal care attendant assessment to confirm need for services; 11 (7) requiring that if more than one personal care attendant services recipient 12 resides in the same home, only one personal care attendant is allowed for both recipients; 13 (8) tightening enrollment criteria for all providers to require specific training 14 and experience; 15 (9) requiring Medicaid certification for personal care attendant provider 16 agencies; 17 (10) requiring that the owner or manager of a personal care attendant agency 18 meet a specified minimum level of education and administrative or business experience in a 19 related field; 20 (11) clearly stating that an individual's assessment function will be conducted 21 by department staff or the department's designee; 22 (12) requiring prior authorization by department staff or the department's 23 designee for all personal care attendant services; 24 (13) including a new regulation that prevents the individual solicitation of 25 clients by personal care attendant agencies and provides consequences for those actions; 26 (14) reviewing consumer-directed services to determine processes or 27 procedures to improve program effectiveness. 28 (b) It is the intent of the legislature to restore nonmedical care, supervision, and 29 socialization provided through companion services to functionally impaired adults who are 30 eligible for home and community based waivers for older Alaskans and for adults with 31 physical disabilities. Companion services were formerly provided as part of respite services 01 before the amendments to 7 AAC 43.1040. Effective May 15, 2004, the Department of 02 Health and Social Services was prohibited from paying for respite services that allow a 03 primary caregiver of an eligible recipient to work under 7 AAC 43.049(d)(4)(A) or that are 04 provided during sleeping or nighttime hours. Adult companion services should be made 05 available, subject to other federal and state limits, as part of the recipient's approved plan of 06 care to allow a primary caregiver to work, to allow a primary caregiver to sleep during normal 07 nighttime hours when the recipient of care cannot be safely left unsupervised during the 08 caregiver's sleep hours, and to allow supervision or monitoring of a recipient who is not 09 otherwise safe while sleeping. 10 * Sec. 2. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 MEDICAL ASSISTANCE WAIVER APPROVAL. (a) The Department of Health 13 and Social Services shall proceed immediately to seek federal approval to amend the home 14 and community based waiver program under AS 47.07.030(c) to add adult companion 15 services for older Alaskans and for adults with physical disabilities as a reimbursable service 16 either as a separate service or as a service that may be combined with other waivers, including 17 respite or chore services or personal attendant services. The adult companion services may be 18 offered only if the services result in greater efficiency in administering the program and are 19 more beneficial to the recipient of waiver services. 20 (b) If federal approval to implement (a) of this section is obtained, the department 21 shall adopt regulations that are necessary to implement this section. 22 (c) In this section, "adult companion services" means nonmedical care, supervision, or 23 socialization provided to a functionally impaired adult in accordance with a therapeutic goal 24 in the recipient's plan of care under the home and community based waiver program; for 25 purposes of this subsection, "therapeutic goal" means a goal that has the effect of delaying or 26 avoiding placement of the recipient in a more restrictive environment, including an assisted 27 living home or a nursing home, and that supports the vital needs for the primary caregiver of 28 the recipient.