Read the full stored bill text
House
File
2641
-
Introduced
HOUSE
FILE
2641
BY
COMMITTEE
ON
HEALTH
AND
HUMAN
SERVICES
(SUCCESSOR
TO
HSB
739)
A
BILL
FOR
An
Act
relating
to
the
Medicaid
home
and
community-based
1
services
elderly
waiver
program,
including
transition
2
planning
and
assisted
living
services.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
TLSB
6062HV
(1)
91
ak/ko
H.F.
2641
Section
1.
NEW
SECTION
.
249A.32C
Medicaid
home
and
1
community-based
services
elderly
waiver
program
——
transition
2
planning,
case
management,
and
assisted
living
services.
3
The
department
of
health
and
human
services
shall
adopt
4
rules
pursuant
to
chapter
17A
that
do
all
of
the
following:
5
1.
Allow
case
managers
and
care
coordination
team
members
6
to
work
with
a
resident
of
a
skilled
nursing
facility,
family
7
members
of
the
resident,
and
other
skilled
nursing
facility
8
staff
to
initiate
transition
planning
from
the
skilled
9
nursing
facility
to
the
Medicaid
home
and
community-based
10
services
elderly
waiver
program
prior
to
the
discharge
of
11
the
resident.
Transition
planning
may
include
but
is
not
12
limited
to
needs
assessments,
care
coordination,
and
service
13
planning.
Transition
planning
may
be
initiated
for
any
14
resident
of
a
skilled
nursing
facility
who
is
determined
by
the
15
skilled
nursing
facility’s
discharge
planner
to
be
capable
of
16
successfully
transitioning
to
a
lower
level
of
care,
and
who
is
17
otherwise
eligible
for
the
Medicaid
home
and
community-based
18
services
elderly
waiver
program.
Provision
of
Medicaid
home
19
and
community-based
elderly
waiver
services
shall
commence
20
after
the
resident
is
discharged
to
a
lower
level
of
care.
21
2.
a.
Define
“targeted
population”
,
for
purposes
of
22
case
management
services
furnished
to
Medicaid
home
and
23
community-based
services
elderly
waiver
program
participants,
24
as
an
individual
who
meets
one
of
the
following
criteria:
25
(1)
An
adult
who
is
identified
with
a
primary
diagnosis
26
of
intellectual
disability,
chronic
mental
illness,
or
27
developmental
disability.
28
(2)
A
child
who
is
eligible
to
receive
home
and
29
community-based
intellectual
disability
waiver
services
or
home
30
and
community-based
children’s
mental
health
waiver
services.
31
(3)
An
adult
aged
sixty-five
or
older
who
is
a
resident
of
32
a
nursing
facility,
as
that
term
is
defined
in
section
135C.1,
33
approved
by
Medicaid
to
provide
services
under
the
Medicaid
34
home
and
community-based
services
elderly
waiver
program.
35
-1-
LSB
6062HV
(1)
91
ak/ko
1/
3
H.F.
2641
b.
A
member
enrolled
with
a
managed
care
organization
or
1
integrated
health
home
shall
not
be
included
in
the
definition
2
of
targeted
population.
3
Sec.
2.
MEDICAID
ELDERLY
WAIVER
——
ASSISTED
LIVING
4
SERVICES.
The
department
of
health
and
human
services
shall
5
adopt
rules
pursuant
to
chapter
17A
that
do
all
of
the
6
following:
7
1.
Define
“assisted
living
service”
to
mean
personal
care
8
and
supportive
services
that
are
furnished
to
Medicaid
home
and
9
community-based
services
elderly
waiver
program
participants
10
who
reside
in
a
homelike,
noninstitutional
setting.
The
11
assisted
living
service
must
include
twenty-four-hour
on-site
12
response
capability
to
meet
participant
needs,
as
well
as
13
member
safety
and
security,
through
incidental
supervision.
14
Assisted
living
service
is
not
reimbursable
if
performed
15
at
the
same
time
as
any
service
included
in
an
approved
16
consumer-directed
attendant
care
agreement.
17
2.
Specify
that
a
unit
of
assisted
living
service
is
one
18
day.
19
3.
Specify
that
a
unit
of
assisted
living
service
is
20
billable
only
if
both
of
the
following
requirements
are
met:
21
a.
The
member
was
present
in
the
facility
during
that
day’s
22
bed
census.
23
b.
The
assisted
living
provider
has
documented
at
least
24
one
assisted
living
service
encounter
for
that
day.
The
25
documentation
must
include
the
participant’s
response
to
26
the
assisted
living
service
encounter.
The
documented
27
assisted
living
service
encounter
cannot
also
be
an
authorized
28
consumer-directed
attendant
care
service.
29
EXPLANATION
30
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
31
the
explanation’s
substance
by
the
members
of
the
general
assembly.
32
This
bill
relates
to
the
Medicaid
home
and
community-based
33
services
elderly
waiver
program
(elderly
waiver),
including
34
transition
planning
and
assisted
living
services.
35
-2-
LSB
6062HV
(1)
91
ak/ko
2/
3
H.F.
2641
The
bill
directs
the
department
of
health
and
human
1
services
(HHS)
to
adopt
rules
to
allow
case
managers
and
care
2
coordination
team
members
to
work
with
a
resident
of
a
skilled
3
nursing
facility,
family
members
of
the
resident,
and
other
4
skilled
nursing
facility
staff
to
initiate
transition
planning
5
from
the
skilled
nursing
facility
to
the
elderly
waiver
program
6
prior
to
the
discharge
of
the
resident.
7
HHS
must
also
adopt
rules
to
include
adults
aged
65
or
older
8
who
are
residents
of
a
nursing
facility
in
the
definition
of
9
targeted
population
for
purposes
of
case
management
services
10
furnished
to
elderly
waiver
participants.
11
The
bill
directs
HHS
to
adopt
rules
to
define
“assisted
12
living
service”
to
mean
personal
care
and
supportive
services
13
that
are
furnished
to
waiver
participants
who
reside
in
a
14
homelike,
noninstitutional
setting.
The
service
must
include
15
24-hour
on-site
response
capability
to
meet
member
needs
16
as
well
as
member
safety
and
security
through
incidental
17
supervision.
Assisted
living
service
is
not
reimbursable
18
if
performed
at
the
same
time
as
any
service
included
in
an
19
approved
consumer-directed
attendant
care
agreement.
The
rules
20
must
also
specify
certain
billing
requirements.
21
-3-
LSB
6062HV
(1)
91
ak/ko
3/
3