HB 292 — An Act relating to home and community-based services; and providing for an effective date.

32-LS1344\I32-LS1344\B CS FOR HOUSE BILL NO.

292(HSS)292 IN THE LEGISLATURE OF THE STATE OF ALASKA THIRTY-SECOND LEGISLATURE - SECOND SESSION BY THEREPRESENTATIVES HOUSESNYDER, HEALTHStory, ANDFields, SOCIALTarr SERVICESIntroduced: COMMITTEE Referred:

Finance1/27/22 Sponsor(s):Referred:

REPRESENTATIVESHealth SNYDER,and Story,Social Fields,Services, TarrFinance A BILL FOR AN ACT ENTITLED "An Act relating to home and community-based services;

(b) Before the department may terminate payment for servicesservices, or reduce theHB0292a HB0292b -1- CSHBHB 292(HSS)292 New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\I32-LS1344\B payment for services, or reduce the level of services provided under (a) of this section, (1) the department [RECIPIENT] must conduct [HAVE HAD] an annual assessment to determine whether the recipient continues to meet the standards under (a) of this section;

AND] (3) for purposes of a reduction in payment for services or a reduction in the level of personalservices careunder this subsection, the annual assessment must find that a recipient who previously qualified for a waiver under this section is able to demonstrate the ability to function and chorelive servicesindependently in a home setting under 42the U.S.C.reduced level of services [THE RECIPIENT'S CONDITION HAS MATERIALLY IMPROVED SINCE THE PREVIOUS ASSESSMENT];

1396n(k)for orpurposes Medicaidof personala caretermination of payment for services under 42this U.S.C.subsection, the annual assessment must find [THIS PARAGRAPH, "MATERIALLY IMPROVED" MEANS] that a recipient who [HAS] previously qualified for a waiver for HB 292 -2- HB0292a New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\B (A) a child with complex medical conditions, no longer needs technical assistance for a life-threatening condition, and is expected to be placed in a skilled nursing facility for less than 30 days each year;

1396(B) -intellectual 1396por (Titledevelopmental XIX,disability, Socialno Securitylonger Act),needs the annuallevel assessmentof mustcare findprovided thatby an intermediate care facility for persons with intellectual and developmental disabilities either because the recipient'squalifying conditiondiagnosis has materiallychanged improvedor sincethe recipient is able to demonstrate the previousability assessment;to function and live independently in a home setting without the need for waiver services;

inor [FOR(C) PURPOSESan OF]older thisAlaskan paragraph,or "materiallyadult improved"with meansa thatphysical adisability, recipientno wholonger has previouslya qualifiedfunctional limitation or cognitive impairment that would result in the need for servicesnursing home placement, and is able to demonstrate the ability to function and live independently in a home setting withwithout the reducedneed levelfor ofwaiver services;

and (4) for purposes of a termination of payment for services, the annualdepartment assessment must findprovide that the recipient'snotices conditionrequired hasby materially(e) improvedand since(f) theof previousthis assessment;section.

in this paragraph, "materially CSHB 292(HSS) -2- HB0292b New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\I improved" means that a recipient who has previously qualified for a service [A WAIVER] for (A) a child with complex medical conditions, no longer needs technical assistance for a life-threatening condition, and is expected to be placed in a skilled nursing facility for less than 30 days each year;

(B) intellectual or developmental disability, no longer needs the level of care provided by an intermediate care facility for persons with intellectual and developmental disabilities either because the qualifying diagnosis has changed or the recipient is able to demonstrate the ability to function in a home setting without the need for [WAIVER] services;

or (C) an older Alaskan or adult with a physical disability, no longer has a functional limitation or cognitive impairment that would result in the need for nursing home placement, and is able to demonstrate the ability to function in a home setting without the need for [WAIVER] services;

and (5) the department must provide the notices required by (e) and (f) of this section.

(B) for other allowable waivers, a registeredperson or advanced practice registered nurse licensed under AS 08.68 who is qualified to assessprovide childrenpersonal withcare complexservices medicalunder conditions,the older1915(k) Alaskans,state andplan adultsoption withunder physical42 disabilitiesU.S.C. for medical assistance waivers.

1396n or a registered or advanced practice registered nurse licensed under AS 08.68 who is qualified to assess children with complex medical conditions, older Alaskans, and adults with physical disabilities for medical assistance waivers.

HB0292a -3- HB 292 New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\B (e) Not later than 10 days after the department receives the results of a recipient's assessment or reassessment under this section, the department shall notify HB0292b -3- CSHB 292(HSS) New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\I the recipient, or a parent, guardian, or other individual with legal authority to act on the recipient's behalf, in writing of the results.

REPORT TO THE LEGISLATURE.

Not later than one year after the effective date of secs.

1 - 4 this Act, the Department of Health shall submit a report to the senate secretary and chief clerk of the house of representatives and notify the legislature that the report is available.

The report must (1) include an assessment of thepayment rates for home and community- based services in the state under a waiver or 1915(k) state plan option under 42 U.S.C.

1396n(k);

the assessment must address the adequacy of those rates to ensure sufficient workforce needs for independent qualified health care professionals;

and (2) assess and identify the adequacy of services under AS 47.07.045(a);

this analysis shall include the number of individuals eligible for services, the number of individuals receiving services, the average length of time for which an individual is placed on a waitlist for services, and the average hours of service each recipient receives annually, monthly, and weekly;

and (3) assess and recommend additional changes to state statute, regulations, and payment for services to enhance the delivery of services under AS 47.07.045(a) to individuals eligible to receive care, particularly changes involving decreasing waitlists, reducing services, CSHB 292(HSS) -4- HB0292b New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\I and addressing workforce shortages.

* Sec.

6.

The uncodified law of the State of Alaska is amended by adding a new section to read:

If, between January 1, 2019, and January 1, 2022, the Department of Health and Social Services reduced payment for services or the level of services provided to a recipient under AS 47.07.045(a), the department shall notify the recipient that the recipient may apply to the department for a reassessment.

2 of this Act, for a reduction in payment for services or a reduction in the level of services provided to a recipient under AS 47.07.045(a).

7.6.

The Department of Health and Social Services shall amend and submit for federal approval the state plan for medical assistance coverage consistent with AS 47.07.045(a), (b), and (d), as amended by secs.

HB 292 -4- HB0292a New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\B * Sec.

8.7.

Section 65 of this Act is retroactive to January 1, 2019.

9.8.

76 of this Act, the commissioner of health and social services shall notify the revisor of statutes in writing not later than 30 days after receiving notice of the approval.

10.9.

1 - 4 of this Act take effect, they take effect on the day after the date the HB0292b -5- CSHB 292(HSS) New Text Underlined [DELETED TEXT BRACKETED] 32-LS1344\I revisor of statutes receives notice from the commissioner of health and social services under sec.