CSSB 105(HES): "An Act relating to eligibility requirements for medical assistance for certain children, pregnant women, and persons in a medical or intermediate care facility; and providing for an effective date."
00 CS FOR SENATE BILL NO. 105(HES) 01 "An Act relating to eligibility requirements for medical assistance for certain children, 02 pregnant women, and persons in a medical or intermediate care facility; and providing 03 for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 47.07.020(b) is amended to read: 06 (b) In addition to the persons specified in (a) of this section, the following 07 optional groups of persons for whom the state may claim federal financial 08 participation are eligible for medical assistance: 09 (1) persons eligible for but not receiving assistance under any plan of 10 the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act, 11 Supplemental Security Income) or a federal program designated as the successor to the 12 aid to families with dependent children program; 13 (2) persons in a general hospital, skilled nursing facility, or 14 intermediate care facility, who, if they left the facility, would be eligible for assistance
01 under one of the federal programs specified in (1) of this subsection; 02 (3) persons under age 21 who are under supervision of the department, 03 for whom maintenance is being paid in whole or in part from public funds, and who 04 are in foster homes or private child-care institutions; 05 (4) aged, blind, or disabled persons, who, because they do not meet 06 income and resources requirements, do not receive supplemental security income 07 under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not 08 receive a mandatory state supplement, but who are eligible, or would be eligible if 09 they were not in a skilled nursing facility or intermediate care facility to receive an 10 optional state supplementary payment; 11 (5) persons under age 21 who are in an institution designated as an 12 intermediate care facility for the mentally retarded and who are financially eligible as 13 determined by the standards of the federal program designated as the successor to the 14 aid to families with dependent children program; 15 (6) persons in a medical or intermediate care facility whose income 16 while in the facility does not exceed $1,656 a month [300 PERCENT OF THE 17 SUPPLEMENTAL SECURITY INCOME BENEFIT RATE UNDER 42 U.S.C. 1381 18 - 1383C (TITLE XVI, SOCIAL SECURITY ACT)] but who would not be eligible for 19 an optional state supplementary payment if they left the hospital or other facility; 20 (7) persons under age 21 who are receiving active treatment in a 21 psychiatric hospital and who are financially eligible as determined by the standards of 22 the federal program designated as the successor to the Aid to Families with Dependent 23 Children program; 24 (8) persons under age 21 and not covered under (a) of this section, who 25 would be eligible for benefits under the federal program designated as the successor to 26 the aid to families with dependent children program, except that they have the care and 27 support of both their natural and adoptive parents; 28 (9) pregnant women not covered under (a) of this section and who 29 meet the income and resource requirements of the federal program designated as the 30 successor to the aid to families with dependent children program; 31 (10) persons under age 21 not covered under (a) of this section who the
01 department has determined cannot be placed for adoption without medical assistance 02 because of a special need for medical or rehabilitative care and who the department 03 has determined are hard-to-place children eligible for subsidy under AS 25.23.190 - 04 25.23.220; 05 (11) persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title 06 XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom 07 a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title 08 XVI, Social Security Act) because they meet all of the following criteria: 09 (A) they are 18 years of age or younger and qualify as disabled 10 individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); 11 (B) the department has determined that 12 (i) they require a level of care provided in a hospital, 13 nursing facility, or intermediate care facility for the mentally retarded; 14 (ii) it is appropriate to provide their care outside of an 15 institution; and 16 (iii) the estimated amount that would be spent for 17 medical assistance for their individual care outside an institution is not 18 greater than the estimated amount that would otherwise be expended 19 individually for medical assistance within an appropriate institution; 20 (C) if they were in a medical institution, they would be eligible 21 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 either not available to them under this 24 chapter or would be inappropriate for them; 25 (12) disabled persons, as described in 42 U.S.C. 26 1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under 27 applicable federal regulations or guidelines, is less than 250 percent of the official 28 poverty line applicable to a family of that size according to the federal Office of 29 Management and Budget, and who, but for earnings in excess of the limit established 30 under 42 U.S.C. 1396d(q)(2)(B), would be considered to be individuals with respect to 31 whom a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c; a
01 person eligible for assistance under this paragraph who is not eligible under another 02 provision of this section shall pay a premium or other cost-sharing charges according 03 to a sliding fee scale that is based on income as established by the department in 04 regulations; 05 (13) persons under age 19 who are not covered under (a) of this section 06 and whose household income does not exceed 07 (A) $1,635 a month if the household consists of one person; 08 (B) $2,208 a month if the household consists of two persons; 09 (C) $2,782 a month if the household consists of three 10 persons; 11 (D) $3,355 a month if the household consists of four 12 persons; 13 (E) $3,928 a month if the household consists of five persons; 14 (F) $4,501 a month if the household consists of six persons; 15 (G) $5,074 a month if the household consists of seven 16 persons; 17 (H) $5,647 a month if the household consists of eight 18 persons; 19 (I) $5,647 a month, plus an additional $574 a month for 20 each extra person above eight persons who is in the household if the 21 household consists of nine persons or more [200 PERCENT OF THE 22 FEDERAL POVERTY GUIDELINE AS DEFINED BY THE FEDERAL 23 OFFICE OF MANAGEMENT AND BUDGET AND REVISED UNDER 42 24 U.S.C. 9902(2)]; 25 (14) pregnant women who are not covered under (a) of this section and 26 whose household income does not exceed 27 (A) $2,489 a month if the household consists of two persons; 28 (B) $3,130 a month if the household consists of three 29 persons; 30 (C) $3,772 a month if the household consists of four 31 persons;
01 (D) $4,414 a month if the household consists of five persons; 02 (E) $5,055 a month if the household consists of six persons; 03 (F) $5,697 a month if the household consists of seven 04 persons; 05 (G) $6,339 a month if the household consists of eight 06 persons; 07 (H) $6,339 a month, plus an additional $642 a month for 08 each extra person above eight persons who is in the household if the 09 household consists of nine persons or more [200 PERCENT OF THE 10 FEDERAL POVERTY LINE AS DEFINED BY THE FEDERAL OFFICE OF 11 MANAGEMENT AND BUDGET AND REVISED UNDER 42 U.S.C. 12 9902(2)]. 13 * Sec. 2. AS 47.07.042(d) is amended to read: 14 (d) In addition to the requirements established under (a) and (b) of this section, 15 the department may require premiums or cost-sharing contributions from recipients 16 who are eligible for benefits under AS 47.07.020(b)(13) and whose household income 17 is greater than the applicable amount set out in (e) of this section [BETWEEN 150 18 AND 200 PERCENT OF THE FEDERAL POVERTY GUIDELINE]. If the 19 department requires premiums or cost-sharing contributions under this subsection, the 20 department 21 (1) shall adopt in regulation a sliding scale for those premiums or 22 contributions based on household income; 23 (2) may not exceed the maximums allowed under federal law; and 24 (3) shall implement a system by which the department or its designee 25 collects those premiums or contributions. 26 * Sec. 3. AS 47.07.042 is amended by adding a new subsection to read: 27 (e) In (d) of this section, the term "applicable amount" means 28 (1) $1,385 a month if the household consists of one person; 29 (2) $1,867 a month if the household consists of two persons; 30 (3) $2,348 a month if the household consists of three persons; 31 (4) $2,829 a month if the household consists of four persons;
01 (5) $3,310 a month if the household consists of five persons; 02 (6) $3,792 a month if the household consists of six persons; 03 (7) $4,273 a month if the household consists of seven persons; 04 (8) $4,754 a month if the household consists of eight persons; 05 (9) $4,754 a month, plus an additional $482 a month for each extra 06 person above eight persons who is in the household if the household consists of nine 07 persons or more. 08 * Sec. 4. This Act takes effect July 1, 2003.