HB 1 — AN ACT relating to public welfare.

2020(x).

SECTION 6.

A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO READ AS FOLLOWS:

(1) If at any time after the effective date of this Act, seventy-five percent (75%) of the General Fund budget request for the provision of Medicaid services is needed to provide the state match required to support the expanded Medicaid population, Page 4 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 the cabinet shall implement a community engagement program that requires individuals in the expanded Medicaid population, who have been in the expanded Medicaid population for one year or more, to participate in at least eighty (80) hours qualifying activities each month.

SECTION 7.5.

(1) TheWithin cabinetone shall,hundred withintwenty ninety(120) (90) days of the effective date of this Act, preparethe cabinet shall design and pursuedevelop federala approvalhealth ofinsurance theoption following:for individuals who become ineligible to participate in Medicaid due to an increase in income.

(a)(2) AAn waiverindividual fromshall be eligible to participate in the Unitedhealth Statesinsurance Departmentoption designed and developed pursuant to this section for not more than twelve (12) Page 4 of Agriculture21 FoodHB000110.100 and- Nutrition1154 Service- relatingXXXX toGA 7UNOFFICIAL C.F.R.COPY 20 RS HB 1/GA months from the date of original eligibility if he or she:

(a) Was eligible for Medicaid at any time on or after July 1, 2019;

(b) Earns between one hundred thirty-eight percent (138%) and two hundred percent (200%) of the federal poverty level;

and (c) Meets all other Medicaid eligibility guidelines.

(3) (a) To the extent permitted under 42 U.S.C.

273.24(c)(4);18051, the health insurance option designed and developed by the cabinet pursuant to this section shall include monthly premiums and cost-sharing, as defined in KRS 304.17A- 164.

The premiums and (b)cost Asharing Sectionrequirements 1115shall waiverbe underestablished 42on U.S.C.a sliding scale and shall increase by twenty-five percent (25%) with each fifteen percent (15%) increase in income above one hundred thirty-eight percent (138%) of the federal poverty level.

sec.(b) The cabinet shall verify the income of an individual participating in the health insurance option designed and developed pursuant to this section on a quarterly basis and adjust premiums and cost sharing accordingly.

1315(4) to(a) permitNotwithstanding the twelve (12) month eligibility limit established in subsection (2) of this section, the cabinet to:may, on a case-by-case basis, extend an individual's eligibility to participate in the health insurance option for a period of not more than twelve (12) additional months.

1.(b) The cabinet shall, through the promulgation of administrative regulations, establish the criteria for the extension of an individual's eligibility.

Implement(5) The cabinet shall consult with the provisionsDepartment of SectionInsurance 6to ofdesign and develop the health insurance option required by this Act;section.

2.SECTION 6.

a.

Require that a Medicaid-eligible individual who is employed, is earning not more than one hundred thirty-eight percent (138%) of the federal poverty level, and whose employer offers health insurance benefits to enroll in their employer-sponsored health insurance plan if the cabinet determines that enrollment in such a plan would be cost-effective for the state;

and b.

Pay the individual's share of the employer-sponsored health insurance premium through the Kentucky Integrated Health Insurance Premium Payment Program;

and 3.

a.

Expand Medicaid eligibility to include individuals who earn Page 5 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 more than one hundred thirty-eight percent (138%) but not more than two hundred percent (200%) of the federal poverty level, who are employed, and whose employer offers health insurance;

b.

Require that an individual who is eligible for Medicaid under this subparagraph and whose employer offers health insurance benefits to enroll in their employer-sponsored health insurance plan;

and c.

i.

Pay the individual's share of any employer-sponsored health insurance premium through the Kentucky Integrated Health Insurance Premium Payment Program for not more than twelve (12) months;

or ii.

If the employer of an individual who is eligible for Medicaid under this subparagraph does not offer health insurance benefits, pay the individual's health insurance premium for a health plan purchased from the federal Health Insurance Marketplace for not more than twelve (12) months.

(2) If a waiver request required by subsection (1) of this section is approved, the cabinet shall, within one hundred twenty (120) days after receiving notification of approval, fully implement the provisions of the waiver.

(3) If the cabinet determines that a waiver or authorization from a federal agency is necessary prior to the implementation of any provision of Sections 1 to 4, Section 6, or Sections 11 to 13 of this Act, the cabinet shall, within ninety (90) days of the effective date of this Act, request the waiver or authorization and may delay implementation of those provisions only until the waiver or authorization is granted.

(4) As used in this section, "cost-effective" means that the expense associated with Page 6 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 paying an individual's share of an employer-sponsored health insurance plan premium is less than the capitation rate that would otherwise be paid to a managed care organization for an individual's coverage under Medicaid.

SECTION 8.

The(1) cabinetWithin shallninety report(90) todays theof Public Assistance Oversight and Advisory Committee on efforts to implement the provisionseffective ofdate Sections 1 to 7 and 11 to 13 of this Act withinand ninetyin (90)each daysbiennium afterthereafter, the effectivecabinet dateshall ofconduct thisan Act,analysis oneof (1)state yearexpenditures afterto theprovide effectivePage date5 of this21 Act,HB000110.100 and- at1154 any- timeXXXX thereafterGA uponUNOFFICIAL requestCOPY from20 theRS PublicHB Assistance1/GA Oversightservices, support, and Advisoryassistance Committee.under 42 U.S.C.

SECTIONsecs. 9.

601 et seq.

The analysis conducted pursuant to this section shall include identification of unobligated funds and any actions necessary to access those funds.

(2) If the cabinet, through the analysis required by this section, identifies any unobligated funds, allocation of those funds shall prioritize:

(a) The provision of prevention services for families at risk of entering the child welfare system;

and (b) Additional work supports and supportive services as permitted under 42 U.S.C.

secs.

601 et seq.

SECTION 7.

The Attorneycabinet Generalshall shall,report to the Public Assistance Oversight and Advisory Committee on behalfefforts ofto theimplement CommonwealthSections 1, 2, 3, 4, 5, 6, 10, 11, 12, 13, 14, and 15 of Kentucky,this haveAct jurisdictionno tolater enforcethan December 1, 2020, within one (1) year after the provisionseffective date of this Act.Act, and at any time thereafter upon request from the Public Assistance Oversight and Advisory Committee.

TheSECTION Attorney8. General shall bring an action against the cabinet if all of the provisions of Sections 1 to 8 and 11 to 13 of this Act are not fully implemented as required.

SectionA 10.NEW SECTION OF KRS CHAPTER 205 IS CREATED TO READ AS FOLLOWS:

The Attorney General may, on behalf of the Commonwealth of Kentucky, have jurisdiction to enforce this chapter.

The Attorney General shall bring an action against the cabinet if all of the provisions of Sections 1, 2, 3, 4, 5, 6, 7, 10, 11, 12, 13, and 15 of this Act are not fully implemented as required.

Section 9.

Page 6 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA four (4) members of the House of Representatives appointed by the Speaker of the House of Representatives;

The co-chairs shall have joint responsibilities for Page 7 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 committee meeting agendas and presiding at committee meetings.

(3) The committee shall meet at least four (4) times annually[annually. and shall provide oversight on the implementation of Medicaid within the Commonwealth including access to services, utilization of services, quality of services, and cost containment].

(4) The purposecommittee[and] of the committee shall be to provide oversight on the implementation and administration of all public assistance programsprograms[Medicaid] andwithin the Commonwealth, including access to adviseservices theand Generalbenefits, Assemblyutilization of anyservices, recommendedquality reformsof orservices revisionsand tobenefits, theand provisioncost ofcontainment, publicand assistanceexamine strategies to promote participation in the Commonwealth.workforce by public assistance beneficiaries.

Section 11.10.

The Page 7 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA secretary shall also promulgate administrative regulations to allow for between a forty percent (40%) and a forty-five percent (45%) ratable reduction in the method of calculating eligibility and benefits for public assistance under Title IV-A of the Federalfederal Social Security Act.

In no instance shall grants to families with no income be less than the appropriate grant maximum used for public assistance under Title Page 8 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 IV-A of the Federalfederal Social Security Act.

(4) The secretary may by administrative regulation prescribe conditions for bringing paternity proceedings or actions for support in cases of out of wedlock birth or nonsupport by a parent in the public assistance under Title IV-A of the Federalfederal Social Security Act program.

(6) The cabinet shall promptly notify the appropriate law enforcement officials of the furnishing of public assistance under Title IV-A of the Federalfederal Social Security Act in respect to a child who has been deserted or abandoned by a parent.

(a) To register for employment with the state employment service, (b) To accept suitable training, or Page 8 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA (c) To accept suitable employment.

(8) To the extent permitted by federal law, scholarships, grants, or other types of financial assistance for education shall not be considered as income for the purpose Page 9 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 of determining eligibility for public assistance.

(10) WhenFor determiningthe ifpurpose anof applicantdetermining eligibility for servicespublic or assistance providedthrough underthe thisKentucky chapterTransition meetsAssistance theProgram applicableunder incomeTitle eligibilityIV guidelines,of the cabinetfederal shallSocial onlySecurity considerAct, the mostasset recentlimit incomeshall verificationbe datatwo thatthousand isfive available.hundred dollars ($2,500).

(11)[(10)](11) (a)When Notwithstandingdetermining anywhether otheran provisionapplicant offor Kentuckyservices law,or theassistance followingprovided shallunder bethis disregardedchapter formeets the purposesapplicable ofincome determining an individual's eligibility forguidelines, a means-tested public assistance program, and the amountcabinet ofshall assistanceonly oruse benefits the individualmost isrecent eligibleincome toverification receivedata underavailable. the program:

(12) If an individual traffics, sells, distributes, gives, or otherwise transfers an electronic benefit transfer card issued by the department for money, service, or other valuable consideration, the individual may be deemed ineligible for all public assistance programs administered by the cabinet for a period of not more than six (6) months for a first offense and may be deemed permanently ineligible for all public assistance programs administered by the cabinet for subsequent offenses.

Page 9 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA (13)[(10)] (a) Notwithstanding any other provision of Kentucky law, the following shall be disregarded for the purposes of determining an individual's eligibility for a means-tested public assistance program, and the amount of assistance or benefits the individual is eligible to receive under the program:

Any contract to provide Medicaid managed care established Page 10 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 pursuant to this chapter;

Section 12.11.

(1) AnyPursuant publicto assistance21 recipientU.S.C. under Title IV of the Federal Social Security Act and any federal food stamp program recipient who is[has been] convicted of a felony offense under KRS Chapter 218A[drug felony] after August 22, 1996, may remain eligible for the program benefits if the recipient is[has been] assessed as having a substance use disorder[chemically dependent] and is participating in or has successfully completed a substance use disorder[chemical dependency] treatment program or is pregnant, and the recipient is otherwise eligible.

(2)sec. Any public assistance recipient under Title XIX of the Federal Social Security Act who is convicted of a felony offense under KRS 218A after the effective date of this Act and whose sentence did not include mandatory treatment for a substance use disorder, may remain eligible for the program benefits if within ninety (90) days of release from incarceration the recipient begins treatment, including but not limited to inpatient treatment, outpatient treatment, group counseling, or individual counseling, for a substance use disorder or is pregnant, and the recipient is otherwise eligible.

862a(d)(1), all individuals residing in Kentucky shall be exempt from the application of 21 U.S.C.

sec.

862a(a)[Any public assistance recipient under Title IV of the Federal Social Security Act and any federal food stamp program recipient who has been convicted of a drug felony after August 22, Page 10 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA 1996, may remain eligible for the program benefits if the recipient has been assessed as chemically dependent and is participating in or has successfully completed a chemical dependency treatment program or is pregnant, and the recipient is otherwise eligible].

(2) If a federal waiver or authorization from the federal government is obtained, the cost of treatment for substance abuse or patient navigation by a social worker shall be a covered Medicaid benefit for incarcerated individuals.

Section 12.

KRS 205.231 is amended to read as follows:

(1) The secretary shall appoint one (1) or more impartial hearing officers to hear and decide upon appealed decisions.

(2) Any applicant or recipient who is dissatisfied with the decision or delay in action on his or her application for public assistance or the amount granted to him or her, or who is deemed ineligible for public assistance benefits under Section 2, 4, 11, or 13 of this Act may appeal to a hearing officer, except that an appeal and a hearing need not be granted if the sole issue is a federal or state law requiring an automatic change adversely affecting some or all recipients of the Kentucky medical assistance program so long as advance notice of the change, with an explanation of appeal rights, is provided to all affected recipients.

However, a recipient may appeal whether the cabinet is accurately interpreting a change in federal or state law which may adversely affect the recipient.

On receipt of an appeal, an administrative hearing shall be conducted in accordance with KRS Chapter 13B.

(3) The secretary may appoint an Appeal Board for Public Assistance composed of the secretary and two (2) other members.

The secretary shall be chairman, and he and one (1) other member constitute a quorum.

(4) Any applicant or recipient who is dissatisfied with the decision of a hearing officer may appeal to the appeal board in the manner and form prescribed by administrative regulation.

The board may on its own motion affirm, modify, or set aside any Page 11 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA decision of a hearing officer on the basis of the evidence previously submitted in the case, or direct the taking of additional evidence, or may permit any of the parties to the decision to initiate further appeals before it.

The board may remove itself or transfer to another hearing officer the proceedings on any appeal pending before a hearing officer.

The board shall promptly notify the parties to any proceedings of its findings and decisions.

(5) The manner in which appeals are presented and hearings and appeals conducted under subsection (4) of this section shall be in accordance with administrative regulations promulgated by the secretary.

(6) After a decision by the appeal board, any party aggrieved by the decision may seek judicial review of the decision by filing a petition in the Circuit Court of the county in which the petitioner resides, in accordance with KRS 13B.140, 13B.150, and 13B.160.

(1) Whenever the cabinet receives an application for public assistance on behalf of a needy dependent child or reviews the records of those currently receiving public assistance on behalf of a needy dependent child and it appears to the satisfaction of Page 11 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 the cabinet that either or both parents have failed to provide support to the child, the cabinet shall[may] take appropriate action under this chapter, or any other appropriate state and federal laws and regulations, to assure that the responsible parent or parents provide support to the child.

(3) TheSubsections provisions of subsections (1) and (2) of this section shall not apply if:

Page 12 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA (a) The cabinet has reason to believe allegations of child abuse or domestic violence and that the disclosure of information required by subsection (2) of this section could be harmful to the custodial parent or the child;

SectionSECTION 14.

A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO READ AS FOLLOWS:

If a custodial parent of a dependent child is disqualified from receiving public assistance benefits pursuant to this Section 2, 3, 4, 10, or 11 of this Act, the dependent child's or other adult family member's eligibility for public assistance shall not be affected, and the custodial parent may choose to designate another person as a protective payee to receive benefits for the minor child.

The designated person shall be an adult immediate family member of the dependent child, if such a person is available.

The designated person shall be approved by the cabinet.

SECTION 15.

A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO READ AS FOLLOWS:

For the purposes of Sections 1 to 8, 9, 10, 11, 12, 13, and 14 of this Act, public assistance shall not be interpreted or construed to include foster care payments, kinship care payments, fictive kin care payments, or relative placement payments made by the cabinet.

Section 16.

Page 13 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA (1) The county governing body shall prescribe rules for the government, security, safety, and cleanliness of the jail and the comfort and treatment of prisoners, provided such rules are consistent with state law.

(2) Willful violation of the rules promulgated pursuant to subsection (1) of this section Page 12 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 shall be deemed a violation.

Page 14 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA (7) (a) When the cost of necessary medical, dental, or psychological care for a prisoner exceeds one thousand dollars ($1,000), as calculated by using the maximum allowable costs to similar persons or facilities for the same or similar services under the Kentucky Medical Assistance Program, the state shall reimburse the county for that portion of the costs that exceeds one Page 13 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 thousand dollars ($1,000).

The county shall retain ultimate payment responsibility as established under subsection (3) of this section, and the provider may bill the county for payment after the Page 15 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA expiration of ninety (90) days from the date the provider submitted the claim to the state for payment if the claim remains unpaid at that time.

The Page 14 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 prisoner shall not be considered indigent, in the case of prisoner medical care, if:

(11) Any money appropriated for a given fiscal year to fund the state's obligation under subsection (7) of this section which remains unspent at the end of the year shall not lapse but shall be made available to satisfy, to the maximum extent possible, that Page 16 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA portion of each catastrophic claim made during said year above the threshold amount for which the county did not receive state assistance pursuant to subsection (7) of this section.

In the event there is an insufficient surplus to satisfy said balance of all such catastrophic claims which are made during that year, the state shall pay to those qualified counties, on a per claim basis, an amount equal to each claim's Page 15 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 percentage of the total surplus.

(e) This subsection does not authorize recovery of funds from a prisoner for medical care which has been paid or reimbursed by the state pursuant to this Page 17 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA section.

(14) Except as provided in subsection (4) of this section, all payments for necessary medical, dental, or psychological care for jail, regional jail, or holdover prisoners shall be made at a rate not to exceed the Medicaid rate for the same or similar services, which shall be paid within thirty (30) days under the provisions of KRS Page 16 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 65.140 of receiving a claim from the health facility or provider for the item or service.

(d) When a county, urban-county, consolidated local government, charter county, unified local government, jail, regional jail, holdover, local detention center, Page 18 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA or other local correctional facility is responsible for paying for medical or other health care costs under paragraph (c) of this subsection, payment shall be made only at the Medicaid rate for same or similar services.

Page 17 of 18 XXXX Jacketed UNOFFICIAL COPY 20 RS BR 1154 2.

(16) (a) The jailer shall notify the Cabinet for Health and Family ServicesServices, Department offor Community Based Services:

At least forty-eight (48) hours prior to a county prisoner's release from incarceration.incarceration unless the county prisoner is ordered to be released in fewer than forty-eight (48) hours, in which case the county jailer shall immediately notify the Department for Community Based Services.

PageSection 1817. of 18 XXXX Jacketed

If the cabinet determines that a waiver or any other authorization from a federal agency is necessary prior to the implementation of any provision of Section 1, 2, 3, 4, 5, 6, 11, 12, or 15 of this Act, the cabinet shall, within 90 days after the effective date of this Act, request the waiver or authorization and shall only delay full implementation of those provisions for which a waiver or authorization was deemed necessary until the waiver or authorization is granted.

Section 18.

The Program Review and Investigations Committee shall conduct Page 19 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA an in-depth analysis of Temporary Assistance for Needy Families (TANF) and Kentucky Transition Assistance Program (K-TAP) spending by the Cabinet for Health and Family Services and seek to identify alternative sources of funding for child welfare programs and services currently funded by the federal TANF block grant and state maintenance-of- effort dollars, including possible strategies for securing additional Title IV-E funds, so that future K-TAP expenditures may be allocated in a manner that prioritizes assisting recipients of public assistance in transitioning off of public assistance by finding and maintaining stable employment.

Section 19.

Within 90 days of the effective date of this Act, the Cabinet for Health and Family Services shall provide the following information to the Public Assistance Oversight and Advisory Committee:

(1) An estimate of what the cost to the state would be to increase eligibility for the Child Care Assistance Program to 200% of the federal poverty level;

and (2) An assessment of what the fiscal impact of discontinuing multiple copayments for families with more than one child in the Child Care Assistance Program would be.

Section 20.

The Legislative Research Commission shall establish the Substance Use Recovery Task Force to review all substance use recovery grants and efforts underway in the Commonwealth.

Section 21.

The duties of the Substance Use Recovery Task Force shall include but are not limited to:

(1) Examining the University of Kentucky HEALing grant, the Kentucky Opioid Response Efforts, and any other substance use recovery grants or efforts in the Commonwealth;

and (2) Making recommendations to the Legislative Research Commission, the Cabinet for Health and Family Services, the Justice and Public Safety Cabinet, and the Education Workforce Development Cabinet to establish pathways for reentry of substance-involved individuals that may include engagement by social workers, Page 20 of 21 HB000110.100 - 1154 - XXXX GA UNOFFICIAL COPY 20 RS HB 1/GA peer support, health care connections, and workforce development supports.

Section 22.

The Substance Use Recovery Task Force shall be composed of the following members with final membership of the task force being subject to the consideration and approval of the Legislative Research Commission:

(1) Four members of the House of Representatives appointed by the Speaker of the House of Representatives, one of whom shall be designated by the Speaker of the House of Representatives as a co-chair of the task force;

and (2) Four members of the Senate appointed by the President of the Senate, one of whom shall be designated by the President of the Senate as a co-chair of the task force.

Section 23.

The Substance Use Recovery Task Force shall meet monthly during the 2020 Interim of the General Assembly.

The task force shall submit findings and recommendations to the Legislative Research Commission for referral to the appropriate committee or committees by December 1, 2020.

Section 24.

Provisions of Sections 16, 18, 19, 20, and 21 of this Act to the contrary notwithstanding, the Legislative Research Commission shall have the authority to alternatively assign the issues identified herein to an interim joint committee or a subcommittee thereof, and to designate a study completion date.

Section 25.

Sections 16 to 22 of this Act shall have the same legal status as a House Concurrent Resolution.

Section 26.

If any section, any subsection, or any provision of this Act is found by a court of competent jurisdiction in a final, unappealable order to be invalid or unconstitutional, the decision of the court shall not affect or impair any of the remaining sections, subsections, or provisions of this Act.

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