Bill Text: FL S1544 | 2020 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Long-term Care

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2020-03-09 - Laid on Table, refer to CS/HB 1373 [S1544 Detail]

Download: Florida-2020-S1544-Introduced.html

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       Florida Senate - 2020                                    SB 1544
       
       
        
       By Senator Albritton
       
       
       
       
       
       26-01529A-20                                          20201544__
    1                        A bill to be entitled                      
    2         An act relating to elderly care; creating s. 409.9022,
    3         F.S.; providing applicability; prohibiting the
    4         Department of Children and Families, in determining
    5         Medicaid eligibility, from considering the cash
    6         surrender value of certain life insurance policies as
    7         assets if certain conditions are met; specifying
    8         requirements for a collateral assignment by a Medicaid
    9         applicant; requiring Medicaid recipients, or their
   10         guardians or legal representatives, to continue to pay
   11         premiums on such policies; requiring the deduction of
   12         the cost of premiums from a recipient’s income for
   13         certain purposes; requiring the Agency for Health Care
   14         Administration to file a claim for the death benefit
   15         upon the recipient’s death; specifying requirements
   16         for the payment of a certain funeral expense benefit
   17         by the state and the distribution of remaining
   18         balances by the issuer of the policy; providing that
   19         certain transfers constitute improper asset transfers
   20         unless certain conditions are met; requiring the
   21         Department of Children and Families and the agency, in
   22         collaboration with the Office of Insurance Regulation,
   23         to adopt rules; authorizing the agency to seek a
   24         federal waiver; amending s. 409.979, F.S.; revising
   25         the individuals who must be rescreened annually by
   26         aging resource centers under the Medicaid long-term
   27         care managed care program; revising the individuals
   28         who must be placed on the wait list for potential
   29         enrollment for certain services; requiring that
   30         certain other individuals be placed on a registry of
   31         interest maintained by the Department of Elderly
   32         Affairs; requiring personnel of the aging resource
   33         center to provide certain information to individuals
   34         on the registry of interest; providing construction;
   35         requiring the Department of Elderly Affairs to notify
   36         individuals or their authorized representatives of
   37         placement on the registry of interest; amending s.
   38         430.04, F.S.; requiring the Department of Elderly
   39         Affairs to develop, and adopt by rule, a tool for
   40         comprehensive assessment of long-term-care supports
   41         and services needed by family and friend caregivers
   42         for elderly and disabled adults; providing the purpose
   43         of the tool; amending s. 430.205, F.S.; authorizing a
   44         community-care-for-the-elderly services provider to
   45         dispute certain referrals and request certain
   46         negotiations by the adult protective services program;
   47         providing construction; providing an effective date.
   48          
   49  Be It Enacted by the Legislature of the State of Florida:
   50  
   51         Section 1. Section 409.9022, Florida Statutes, is created
   52  to read:
   53         409.9022 Exemption for certain life insurance policies as
   54  assets; requirements.—
   55         (1) This section applies to an applicant:
   56         (a) Who is in need of the services of a licensed nursing
   57  facility;
   58         (b) Who meets the nursing facility level of care;
   59         (c) Whose income does not exceed 300 percent of the
   60  Supplemental Security Income standard;
   61         (d) Who owns one or more whole or universal life insurance
   62  policies; and
   63         (e) Who would meet the assets standards for Medicaid
   64  eligibility except for the cash surrender value of the whole or
   65  universal life insurance policy or policies he or she owns.
   66         (2) Notwithstanding any law to the contrary, in determining
   67  an applicant’s eligibility for Medicaid, the department may not
   68  consider the cash surrender value of a whole or universal life
   69  insurance policy owned by the applicant as an asset if the
   70  applicant collaterally assigns the face value of the life
   71  insurance policy to the state for an amount that is not greater
   72  than the amount of Medicaid benefits to be provided to the
   73  applicant.
   74         (3) The collateral assignment:
   75         (a) Must be a written agreement submitted to and recorded
   76  by the issuing company of the life insurance.
   77         (b) Must provide for the issuer to notify the department
   78  before a potential lapse in the policy.
   79         (c) Must be completed and accepted by the department as
   80  part of the application process before Medicaid benefits may be
   81  authorized or provided.
   82         (d) Is void if the application for Medicaid benefits is not
   83  approved.
   84         (4) The Medicaid recipient, or his or her guardian or legal
   85  representative, shall continue to pay premiums on a life
   86  insurance policy that is subject to the collateral assignment.
   87  The cost of premiums must be deducted from the recipient’s
   88  income for purposes of calculating his or her assets.
   89         (5) Upon the recipient’s death:
   90         (a) The agency shall file a claim for the death benefit
   91  under the policy, up to the costs expended to provide Medicaid
   92  services to the recipient, to be remitted to the state.
   93         (b) The state shall pay to the recipient’s estate a funeral
   94  expense benefit of $7,500 or 5 percent of the policy’s face
   95  value, whichever is less.
   96         (c) Any remaining balance of the death benefit must be paid
   97  by the issuer of each policy to other beneficiaries under the
   98  policy.
   99         (6) A transfer of ownership of a whole or universal life
  100  insurance policy within the 60-month period preceding the
  101  Medicaid application by the applicant to a person or entity
  102  related to the applicant for less than the net present value of
  103  the death benefit, as determined by a standard actuarial
  104  discount factor, constitutes an improper asset transfer by the
  105  applicant unless the transferee collaterally assigns the face
  106  value of the policy pursuant to this section.
  107         (7) The department and the agency shall, in collaboration
  108  with the Office of Insurance Regulation, adopt rules to
  109  administer this section.
  110         (8) The agency may seek any federal waiver to implement
  111  this section.
  112         Section 2. Subsection (3) of section 409.979, Florida
  113  Statutes, is amended to read:
  114         409.979 Eligibility.—
  115         (3) REGISTRY OF INTEREST, WAIT LIST, RELEASE, AND OFFER
  116  PROCESS.—The Department of Elderly Affairs shall maintain a
  117  statewide wait list for enrollment for home and community-based
  118  services through the long-term care managed care program.
  119         (a) The Department of Elderly Affairs shall prioritize
  120  individuals for potential enrollment for home and community
  121  based services through the long-term care managed care program
  122  using a frailty-based screening tool that results in a priority
  123  score. The priority score is used to set an order for releasing
  124  individuals from the wait list for potential enrollment in the
  125  long-term care managed care program. If capacity is limited for
  126  individuals with identical priority scores, the individual with
  127  the oldest date of placement on the wait list shall receive
  128  priority for release.
  129         1. Pursuant to s. 430.2053, aging resource center personnel
  130  certified by the Department of Elderly Affairs shall perform the
  131  screening for each individual requesting enrollment for home and
  132  community-based services through the long-term care managed care
  133  program. The Department of Elderly Affairs shall request that
  134  the individual or the individual’s authorized representative
  135  provide alternate contact names and contact information.
  136         2. The individual requesting the long-term care services,
  137  or the individual’s authorized representative, must participate
  138  in an initial screening or rescreening for placement on the wait
  139  list. The screening or rescreening must be completed in its
  140  entirety before placement on the wait list.
  141         3. Pursuant to s. 430.2053, aging resource center personnel
  142  shall administer rescreening annually for individuals with a
  143  priority score of 3, 4, or 5; or upon notification of a
  144  significant change in an individual’s circumstances.
  145         4. The Department of Elderly Affairs shall adopt by rule a
  146  screening tool that generates the priority score, and shall make
  147  publicly available on its website the specific methodology used
  148  to calculate an individual’s priority score.
  149         (b) Upon completion of the screening or rescreening
  150  process, the Department of Elderly Affairs shall place all
  151  individuals with a priority score of 3, 4, or 5 on the wait
  152  list. Individuals with a priority score of 1 or 2 must be placed
  153  on a registry of interest established and maintained by the
  154  Department of Elderly Affairs. Aging resource center personnel
  155  shall inform individuals who are placed on the registry of
  156  interest of other community resources that may be available to
  157  assist them and shall inform them that they may contact the
  158  agency resource center for a new assessment if they experience a
  159  significant change in circumstances. Placement on the registry
  160  of interest does not prohibit an individual from receiving
  161  services, if available. The Department of Elderly Affairs shall
  162  notify the individual or the individual’s authorized
  163  representative that the individual has been placed on the wait
  164  list or on the registry of interest.
  165         (c) If the Department of Elderly Affairs is unable to
  166  contact the individual or the individual’s authorized
  167  representative to schedule an initial screening or rescreening,
  168  and documents the actions taken to make such contact, it shall
  169  send a letter to the last documented address of the individual
  170  or the individual’s authorized representative. The letter must
  171  advise the individual or his or her authorized representative
  172  that he or she must contact the Department of Elderly Affairs
  173  within 30 calendar days after the date of the notice to schedule
  174  a screening or rescreening and must notify the individual that
  175  failure to complete the screening or rescreening will result in
  176  his or her termination from the screening process and the wait
  177  list.
  178         (d) After notification by the agency of available capacity,
  179  the CARES program shall conduct a prerelease assessment. The
  180  Department of Elderly Affairs shall release individuals from the
  181  wait list based on the priority scoring process and prerelease
  182  assessment results. Upon release, individuals who meet all
  183  eligibility criteria may enroll in the long-term care managed
  184  care program.
  185         (e) The Department of Elderly Affairs may terminate an
  186  individual’s inclusion on the wait list if the individual:
  187         1. Does not have a current priority score due to the
  188  individual’s action or inaction;
  189         2. Requests to be removed from the wait list;
  190         3. Does not keep an appointment to complete the rescreening
  191  without scheduling another appointment and has not responded to
  192  three documented attempts by the Department of Elderly Affairs
  193  to contact the individual;
  194         4. Receives an offer to begin the eligibility determination
  195  process for the long-term care managed care program; or
  196         5. Begins receiving services through the long-term care
  197  managed care program.
  198  
  199  An individual whose inclusion on the wait list is terminated
  200  must initiate a new request for placement on the wait list, and
  201  any previous priority considerations must be disregarded.
  202         (f) Notwithstanding this subsection, the following
  203  individuals are afforded priority enrollment for home and
  204  community-based services through the long-term care managed care
  205  program and do not have to complete the screening or wait-list
  206  process if all other long-term care managed care program
  207  eligibility requirements are met:
  208         1. An individual who is 18, 19, or 20 years of age who has
  209  a chronic debilitating disease or condition of one or more
  210  physiological or organ systems which generally make the
  211  individual dependent upon 24-hour-per-day medical, nursing, or
  212  health supervision or intervention.
  213         2. A nursing facility resident who requests to transition
  214  into the community and who has resided in a Florida-licensed
  215  skilled nursing facility for at least 60 consecutive days.
  216         3. An individual who is referred by the Department of
  217  Children and Families pursuant to the Adult Protective Services
  218  Act, ss. 415.101-415.113, as high risk and who is placed in an
  219  assisted living facility temporarily funded by the Department of
  220  Children and Families.
  221         (g) The Department of Elderly Affairs and the agency may
  222  adopt rules to implement this subsection.
  223         Section 3. Subsection (15) is added to section 430.04,
  224  Florida Statutes, to read:
  225         430.04 Duties and responsibilities of the Department of
  226  Elderly Affairs.—The Department of Elderly Affairs shall:
  227         (15) Develop, and adopt by rule, a tool for comprehensive
  228  assessment of long-term-care supports and services needed by
  229  family and friend caregivers for elderly and disabled adults.
  230  The tool is to be used by persons administering state funds for
  231  such supports and services in determining eligibility and which
  232  supports and services are appropriate for service recipients and
  233  their caregivers.
  234         Section 4. Paragraph (a) of subsection (5) of section
  235  430.205, Florida Statutes, is amended to read:
  236         430.205 Community care service system.—
  237         (5) Any person who has been classified as a functionally
  238  impaired elderly person is eligible to receive community-care
  239  for-the-elderly core services.
  240         (a) Those elderly persons who are determined by protective
  241  investigations to be vulnerable adults in need of services,
  242  pursuant to s. 415.104(3)(b), or to be victims of abuse,
  243  neglect, or exploitation who are in need of immediate services
  244  to prevent further harm and are referred by the adult protective
  245  services program, shall be given primary consideration for
  246  receiving community-care-for-the-elderly services. As used in
  247  this paragraph, “primary consideration” means that an assessment
  248  and services must commence within 72 hours after referral to the
  249  department or as established in accordance with department
  250  contracts by local protocols developed between department
  251  service providers and the adult protective services program.
  252  However, a community-care-for-the-elderly services provider may
  253  dispute the referral by requesting that the adult protective
  254  services program negotiate the referral placement of, and the
  255  services to be provided to, a vulnerable adult or victim of
  256  abuse, neglect, or exploitation. If an agreement cannot be
  257  reached with the adult protective services program for
  258  modification of the referral decision, the adult protective
  259  services program’s determination shall control.
  260         Section 5. This act shall take effect July 1, 2020.