Bill Text: IA SF395 | 2013-2014 | 85th General Assembly | Introduced

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

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Bill Title: A bill for an act relating to child, adult, and family services under the purview of the department of human services, making penalties applicable, and including effective date provisions. (Formerly SSB 1227.)

Spectrum: Committee Bill

Status: (Engrossed - Dead) 2013-12-31 - END OF 2013 ACTIONS [SF395 Detail]

Download: Iowa-2013-SF395-Introduced.html

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Senate File 395 - Introduced
SENATE FILE 395
BY COMMITTEE ON HUMAN
RESOURCES
(SUCCESSOR TO SSB 1227)
(COMPANION TO LSB 1151HV BY
COMMITTEE ON HUMAN RESOURCES)
A BILL FOR
An Act relating to child, adult, and family services under
the purview of the department of human services, making
penalties applicable, and including effective date
provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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Section 1. Section 225C.38, subsection 1, paragraph c, Code
2013, is amended to read as follows:
c. Except as provided in section 225C.41 , a family support
subsidy for a fiscal year shall be in an amount determined by
the department in consultation with the comprehensive family
support council created in section 225C.48 . The parent or
legal guardian receiving a family support subsidy may elect
to receive a payment amount which is less than the amount
determined in accordance with this paragraph.
Sec. 2. Section 225C.42, subsection 1, Code 2013, is amended
to read as follows:
1. The department shall conduct an annual evaluation of
the family support subsidy program in conjunction with the
comprehensive family support council and shall submit the
evaluation report with recommendations to the governor and
general assembly. The report shall be submitted on or before
October 30 and provide an evaluation of the latest completed
fiscal year.
Sec. 3. Section 225C.47, subsection 5, unnumbered paragraph
1, Code 2013, is amended to read as follows:
The department shall design the program in consultation with
the comprehensive family support council created in section
225C.48 . The department shall adopt rules to implement the
program which provide for all of the following:
Sec. 4. Section 225C.49, subsection 4, Code 2013, is amended
to read as follows:
4. The department shall designate one individual whose sole
duties are to provide central coordination of the programs
under sections 225C.36 and 225C.47 and to work with the
comprehensive family support council to oversee development and
implementation of the programs.
Sec. 5. Section 239B.5, Code 2013, is amended by adding the
following new subsection:
NEW SUBSECTION . 4. a. The department shall implement
policies and procedures as necessary to comply with provisions
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of the federal Middle Class Tax Relief and Job Creation Act
of 2012, Pub. L. No. 112-96, to prevent assistance provided
under this chapter from being used in any electronic benefit
transfer transaction in any liquor store; any casino, gambling
casino, or gaming establishment; or any retail establishment
which provides adult-oriented entertainment in which performers
disrobe or perform in an unclothed state for entertainment.
For purposes of this paragraph, the definitions found in the
federal Middle Class Tax Relief and Job Creation Act and
related rules and statutes apply.
b. Unless otherwise precluded by federal law or regulation,
policies and procedures implemented under this subsection shall
at a minimum impose the prohibition described in paragraph “a”
as a condition for continued eligibility for assistance under
this chapter.
c. The department may implement additional measures as may
be necessary to comply with federal regulations in implementing
paragraph “a” .
d. The department shall adopt rules as necessary to
implement this subsection.
Sec. 6. Section 239B.14, subsection 1, Code 2013, is amended
to read as follows:
1. a. An individual who obtains, or attempts to obtain,
or aids or abets an individual to obtain, by means of a
willfully false statement or representation, by knowingly
failing to disclose a material fact, or by impersonation, or
any fraudulent device, any assistance or other benefits under
this chapter to which the individual is not entitled, commits
a fraudulent practice.
b. An individual who accesses benefits provided under
this chapter in violation of any prohibition imposed by the
department pursuant to section 239B.5, subsection 4, commits
a fraudulent practice.
Sec. 7. Section 249A.3, subsection 1, Code 2013, is amended
by adding the following new paragraph:
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NEW PARAGRAPH . v. Beginning January 1, 2014, is an
individual who meets all of the following requirements:
(1) Is under twenty-six years of age.
(2) Was in foster care under the responsibility of the state
on the date of attaining eighteen years of age or such higher
age to which foster care is provided.
(3) Was enrolled in the medical assistance program under
this chapter while in such foster care.
Sec. 8. Section 249A.3, subsection 2, paragraph a,
subparagraph (9), Code 2013, is amended by striking the
subparagraph.
Sec. 9. Section 249J.26, subsection 2, Code 2013, is amended
to read as follows:
2. This chapter is repealed October December 31, 2013.
Sec. 10. Section 514I.4, subsection 5, paragraph a, Code
2013, is amended by striking the paragraph.
Sec. 11. Section 514I.5, subsection 7, paragraph f, Code
2013, is amended to read as follows:
f. Review, in consultation with the department, and take
necessary steps to improve interaction between the program and
other public and private programs which provide services to the
population of eligible children. The board, in consultation
with the department, shall also develop and implement a plan
to improve the medical assistance program in coordination with
the hawk-i program, including but not limited to a provision to
coordinate eligibility between the medical assistance program
and the hawk-i program, and to provide for common processes
and procedures under both programs to reduce duplication and
bureaucracy.
Sec. 12. Section 514I.5, subsection 8, paragraphs b and f,
Code 2013, are amended by striking the paragraphs.
Sec. 13. Section 514I.7, subsection 2, paragraphs a and g,
Code 2013, are amended to read as follows:
a. Determine individual eligibility for program enrollment
based upon review of completed applications and supporting
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documentation as prescribed by federal law and regulation,
using policies and procedures adopted by rule of the department
pursuant to chapter 17A . The administrative contractor shall
not enroll a child who has group health coverage , unless
expressly authorized by such rules .
g. Create and Utilize the department’s eligibility system
to maintain eligibility files that are compatible with the
data system of the department with pertinent eligibility
determination and ongoing enrollment information including , but
not limited to , data regarding beneficiaries, enrollment dates,
disenrollments, and annual financial redeterminations.
Sec. 14. Section 514I.7, subsection 2, paragraphs c, d, e,
f, and k, Code 2013, are amended by striking the paragraphs.
Sec. 15. Section 514I.8, subsection 1, Code 2013, is amended
to read as follows:
1. a. Effective July 1, 1998, and notwithstanding any
medical assistance program eligibility criteria to the
contrary, medical assistance shall be provided to, or on behalf
of, an eligible child under the age of nineteen whose family
income does not exceed one hundred thirty-three percent of the
federal poverty level, as defined by the most recently revised
poverty income guidelines published by the United States
department of health and human services.
b. Additionally, effective Effective July 1, 2000, and
notwithstanding any medical assistance program eligibility
criteria to the contrary, medical assistance shall be provided
to, or on behalf of, an eligible infant whose family income
does not exceed two hundred percent of the federal poverty
level, as defined by the most recently revised poverty income
guidelines published by the United States department of health
and human services.
c. Effective July 1, 2009, and notwithstanding any medical
assistance program eligibility criteria to the contrary,
medical assistance shall be provided to, or on behalf of, a
pregnant woman or an eligible child who is an infant and whose
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family income is at or below three hundred percent of the
federal poverty level, as defined by the most recently revised
poverty income guidelines published by the United States
department of health and human services.
Sec. 16. Section 514I.8, subsection 2, paragraph c, Code
2013, is amended to read as follows:
c. Is a member of a family whose income does not exceed
three hundred percent of the federal poverty level, as defined
in 42 U.S.C. § 9902(2), including any revision required by
such section, and in accordance with the federal Children’s
Health Insurance Program Reauthorization Act of 2009, Pub. L.
No. 111-3. The modified adjusted gross income methodology
prescribed in section 2101 of the federal Patient Protection
and Affordable Care Act, Pub. L. No. 111-148, to determine
family income under this paragraph.
Sec. 17. Section 514I.8, subsections 3 and 4, Code 2013, are
amended to read as follows:
3. In accordance with the rules adopted by the board,
a child may be determined to be presumptively eligible for
the program pending a final eligibility determination.
Following final determination of eligibility by the
administrative contractor , a child shall be eligible for a
twelve-month period. At the end of the twelve-month period,
the administrative contractor shall conduct a review of the
circumstances of the eligible child’s family shall be conducted
to establish eligibility and cost sharing for the subsequent
twelve-month period.
4. Once an eligible child is enrolled in a plan, the
eligible child shall remain enrolled in the plan unless a
determination is made, according to criteria established by the
board, that the eligible child should be allowed to enroll in
another qualified child health plan or should be disenrolled.
An enrollee may request to change plans within ninety days of
initial enrollment for any reason and at any time for cause, as
defined in 42 C.F.R. § 438.56(d)(2). Otherwise, an enrollee
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may change plan enrollment once a year on the enrollee’s
anniversary date.
Sec. 18. Section 514I.8, subsections 5 and 6, Code 2013, are
amended by striking the subsections.
Sec. 19. Section 514I.9, Code 2013, is amended to read as
follows:
514I.9 Program benefits.
1. Until June 30, 1999, the benefits provided under the
program shall be those benefits established by rule of the
board and in compliance with Tit. XXI of the federal Social
Security Act.
2. On or before June 30, 1999, the hawk-i board shall adopt
rules to amend the benefits package based upon review of the
results of the initial benefits package used.
3. Subsequent to June 30, 1999, the The hawk-i board shall
review the benefits package annually and shall determine
additions to or deletions from the benefits package offered.
The hawk-i board shall submit the recommendations to the
general assembly for any amendment to the benefits package.
4. 2. Benefits, in addition to those required by rule, may
be provided to eligible children by a participating insurer if
the benefits are provided at no additional cost to the state.
Sec. 20. REPEAL. Section 225C.48, Code 2013, is repealed.
Sec. 21. EFFECTIVE DATE. The following provision or
provisions of this Act take effect December 31, 2013:
1. The section of this Act amending section 249A.3,
subsection 2, paragraph “a”, subparagraph (9).
EXPLANATION
This bill relates to child, adult, and family services under
the purview of the department of human services.
The bill eliminates the comprehensive family support council
and strikes references to the council.
The bill directs the department of human services (DHS) to
implement policies and procedures necessary to comply with the
federal Middle Class Tax Relief and Job Creation Act of 2012,
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to prevent family investment program assistance from being used
in any electronic benefit transfer transaction in a liquor
store; a casino, gambling casino, or gaming establishment;
or a retail establishment that provides adult-oriented
entertainment. The bill also provides that an individual
accessing benefits through the family investment program in a
way prohibited under the policies and procedures implemented by
the department commits a fraudulent practice.
The bill extends the repeal date of the IowaCare program from
October 31, 2013, to December 31, 2013.
The bill amends provisions relating to the medical
assistance (Medicaid) and hawk-i programs to comply with
provisions of the federal Patient Protection and Affordable
Care Act (ACA).
The bill provides, as required under the ACA, that beginning
January 1, 2014, individuals who were in foster care and
enrolled in the Medicaid program while they were in foster
care, are eligible for Medicaid up to 26 years of age. As a
conforming measure, the bill eliminates Medicaid eligibility
for an individual who is under the age of 21 who aged out of the
foster care system and has an income of less than 200 percent
of the federal poverty level. This provision takes effect
December 31, 2013.
The bill amends provisions relating to the hawk-i program.
Because the ACA changes requirements relating to determination
of eligibility and the application process, the bill eliminates
various provisions relating to application development and
the application process under the hawk-i program. The bill
eliminates the requirement that DHS develop a joint application
form for the hawk-i and Medicaid programs; eliminates the
requirement that the hawk-i board and DHS develop and implement
a plan to improve coordination between the hawk-i program and
the Medicaid program; and eliminates the requirement that
the hawk-i board and DHS adopt rules addressing the hawk-i
application form and standards for program eligibility.
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Because of changes in the application process, the bill
provides that the administrative contractor shall determine
eligibility as prescribed by federal law and regulation, using
policies and procedures established by rule rather than based
on a review of individual applications. The administrative
contractor must also utilize the department’s eligibility
system to maintain eligibility files with pertinent eligibility
determination and ongoing enrollment information. The bill
also eliminates the following duties of the administrative
contractor: forward names of children that may be eligible
for Medicaid to DHS and retain their identifying data; monitor
and assess the medical and dental care provided as well as
complaints and grievances; verify and forward participating
insurers’ payment requests to DHS; develop and issue approval,
denial, and cancellation notifications to applicants and
enrollees, and process applications; and receive completed
applications and verifications at a central location. The bill
also eliminates the duty of the administrative contractor to
conduct a review of the circumstances of the child’s family
to establish eligibility and cost-sharing in the subsequent
eligibility period following the initial determination and
period of eligibility.
The bill requires the use of the modified adjusted gross
income methodology as required under the ACA to establish
family income in determining eligibility for hawk-i.
The bill modifies the ability of an enrollee to request a
change in health plans by providing that an enrollee of the
program may request to change plans within the initial 90-day
period of enrollment for any reason and at any time for cause,
as identified in federal regulations, and otherwise may change
once a year on the enrollee’s anniversary date.
The bill eliminates the requirement that the hawk-i board
study and make recommendations regarding the level of family
income appropriate for application to the program; and the
requirement that the board and the council on human services
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cooperate to coordinate the administration of hawk-i and the
medical assistance program and develop a plan for a unified
medical assistance and hawk-i program system through use of a
single health insurance card.
The bill makes other technical changes to eliminate outdated
provisions under the hawk-i program.
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