SB 5: "An Act relating to Medicaid eligibility of persons who are eligible to be institutionalized but who are not in institutions; relating to Medicaid waivers; reordering the priorities assigned to groups of persons served under the Medicaid program; and providing for an effective date."
00SENATE BILL NO. 5 01 "An Act relating to Medicaid eligibility of persons who are eligible to be 02 institutionalized but who are not in institutions; relating to Medicaid waivers; 03 reordering the priorities assigned to groups of persons served under the Medicaid 04 program; 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 who can be considered under 42 U.S.C. 1396a(e)(3) 02 (Title XIX, Social Security Act, Medical Assistance) to be individuals with respect 03 to whom a supplemental security income is being paid under 42 U.S.C. 1381 - 04 1383c (Title XVI, Social Security Act) because they meet all of the following 05 criteria: 06 (A) they are 18 years of age or younger and qualify as 07 disabled individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security 08 Act); 09 (B) the department has determined that 10 (i) they require a level of care provided in a hospital, 11 nursing facility, or intermediate care facility for the mentally 12 retarded; 13 (ii) it is appropriate to provide their care outside of 14 an institution; and 15 (iii) the estimated amount that would be spent for 16 medical assistance for their individual care outside an institution is 17 not greater than the estimated amount that would otherwise be 18 expended individually for medical assistance within an appropriate 19 institution; 20 (C) if they were in a medical institution, they would be 21 eligible for medical assistance under other provisions of this chapter; and 22 (D) home and community-based services under a waiver 23 approved by the federal government are not available to them under this 24 chapter [REPEALED]. 25 * Sec. 2. AS 47.07.030 is amended by adding a new subsection to read: 26 (c) Notwithstanding (b) of this section, the department may offer a service for 27 which the department has received a waiver from the federal government if the 28 department was authorized, directed, or requested to apply for the waiver by law or by 29 a concurrent or joint resolution of the legislature. 30 * Sec. 3. AS 47.07.035 is amended to read: 31 Sec. 47.07.035. PRIORITY OF MEDICAL ASSISTANCE. If the department
01 finds that the cost of medical assistance for all persons eligible under this chapter will 02 exceed the amount allocated in the state budget for that assistance for the fiscal year, 03 the department shall eliminate coverage for optional medical services and optionally 04 eligible groups of individuals in the following order: 05 (1) clinical social workers' services; 06 (2) psychologists' services; 07 (3) chiropractic services; 08 (4) advanced nurse practitioner services; 09 (5) adult dental services; 10 (6) emergency hospital services; 11 (7) treatment of speech, hearing, and language disorders; 12 (8) optometrists' services and eyeglasses; 13 (9) occupational therapy; 14 (10) mammography screening; 15 (11) prosthetic devices; 16 (12) medical supplies and equipment; 17 (13) targeted case management services; 18 (14) rehabilitative services for substance abusers and emotionally 19 disturbed or chronically mentally ill adults; 20 (15) clinic services; 21 (16) physical therapy; 22 (17) personal care services in a recipient's home; 23 (18) prescribed drugs; 24 (19) long-term care noninstitutional services; 25 (20) inpatient psychiatric facility services; 26 (21) intermediate care facility services for the mentally retarded; 27 (22) intermediate care facility services; 28 (23) individuals described in AS 47.07.020(b)(10); 29 (24) individuals under age 21 who are not eligible for benefits under 30 the federal aid to families with dependent children program because they are not 31 deprived of one or more of their natural or adoptive parents;
01 (25) [(24)] skilled nursing facility services for persons under age 21; 02 (26) [(25)] aged, blind, and disabled individuals who, because they do 03 not meet the income requirements, do not receive supplemental security income under 04 Title XVI of the Social Security Act, but who are eligible, or would be eligible if they 05 were not in a skilled nursing facility or intermediate care facility, to receive an 06 optional state supplementary payment; 07 (27) [(26)] individuals in a hospital, skilled nursing facility, or 08 intermediate care facility whose income while in the facility does not exceed 300 09 percent of the supplemental security income benefit rate under Title XVI of the Social 10 Security Act, but who, because of income, are not eligible for the optional state 11 supplementary payment; 12 (28) [(27)] individuals under age 21 under supervision of the 13 department, for whom maintenance is being paid in whole or in part from public 14 money and who are in foster homes or private child-care institutions. 15 * Sec. 4. DEPARTMENT TO SEEK WAIVER. The Department of Health and Social 16 Services shall seek approval of a waiver for home and community-based services under 42 17 U.S.C. 1396n for persons who are Medicaid eligible and who would otherwise require a level 18 of care provided in a hospital, nursing facility, or intermediate care facility for the mentally 19 retarded, in the absence of home and community-based services. 20 * Sec. 5. Sections 1 and 3 of this Act take effect July 1, 1993. 21 * Sec. 6. Sections 2 and 4 of this Act take effect immediately under AS 01.10.070(c).