SCS/HCS/HB 466 - This act modifies several positions relating to medical public assistance, including: (1) the Ticket to Work Health Assurance Program; (2) MO HealthNet benefits for former foster youth; (3) MO HealthNet per diem reimbursement rates; (4) the Missouri RX Plan; (5) structured family caregiving; (6) personal care assistance services; and (7) suspension of MO HealthNet benefits of offenders in correctional facilities and jails.
TICKET TO WORK HEALTH ASSURANCE PROGRAM (Section 208.146)
This act changes the Ticket to Work Health Assurance Program's expiration date from August 28, 2019, to August 28, 2025.
This provision is identical to SB 232 (2019).
MO HEALTHNET BENEFITS FOR FORMER FOSTER YOUTH (Section 208.151)
Under this act, persons who reside in Missouri, are at least 18 years of age and under 26, and who have received foster care for at least six months in another state shall be eligible for MO HealthNet benefits.
This provision is identical to SB 514 (2019) and provisions in the perfected SS/SCS/SBs 70 & 128 (2019).
MO HEALTHNET PER DIEM REIMBURSEMENT RATES (Section 208.225)
Under this act, any intermediate care facility or skilled nursing facility participating in MO HealthNet that incurs total capital expenditures in excess of $2,000 per bed shall be entitled to obtain a recalculation of its Medicaid per diem reimbursement rate based on its additional capital costs or all costs incurred during the facility fiscal year during which such capital expenditures were made.
This provision is identical to the perfected SB 11 (2019), SB 863 (2018), and a provision in SB 906 (2018) and similar to SB 818 (2018) and HB 2068 (2018).
MO RX PLAN (Section 208.790)
Under current law, only Medicaid dual eligible individuals meeting certain income limitations are eligible to participate in the Missouri RX Plan. This act removes the Medicaid dual eligible requirement, while retaining the income limitations.
This provision is identical to SB 78 (2019), SB 563 (2018), HB 1276 (2018), and HB 2278 (2018).
STRUCTURED FAMILY CAREGIVING (Section 208.896)
This act requires the Department of Social Services to seek a waiver from the U.S. Secretary of Health and Human Services to add structured family caregiving as a covered home and community based service for certain MO HealthNet participants. Structured family caregiving shall include: (1) a choice for participants of qualified and credentialed caregivers; (2) a choice for participants of the community settings in which they receive care; (3) a requirement that caregivers be added to the Family Care Safety Registry; (4) a requirement that caregivers be required to carry liability insurance; (5) a cap of 300 participants to receive services; (6) a requirement that structured family caregiving agencies are accountable for quality care; (7) a requirement that caregivers provide for participants' personal needs; (8) a daily, adequate payment rate; and (9) that such payment rate be capped at 60% of the daily nursing home cost cap established by the state each year.
These provisions are substantially similar to provisions in SB 362 (2019) and HB 466 (2019) and similar to SB 922 (2016) and HB 1753 (2016).
PERSONAL CARE ASSISTANCE SERVICES (Sections 208.909, 208.918, and 208.924)
Under current law, vendors of consumer-directed services shall monitor the performance of personal care assistance service plans. This act requires the consumer to permit the vendor to comply with its quality assurance and supervision process, including bi-annual face-to-face home visits and monthly case management activities. During the home visits, the vendor shall document if the attendant was present and providing services as set forth in the plan of care and report the Department if the attendant is not present or providing services, which may result in a suspension of services to the consumer.
This act repeals language permitting the Department of Health and Senior Services to establish certain pilot projects for telephone tracking systems.
This act also requires vendors to notify consumers during orientation that falsification of personal care attendant time sheets shall be considered and reported to the Department as fraud.
Under this act, a vendor shall submit an annual financial statement audit or annual financial statement review performed by a certified public accountant to the Department upon request. The Department shall require the vendor to maintain a business location in compliance with any and all city, county, state, and federal requirements. Additionally, this act requires the Department to create a consumer-directed services division provider certification manager course. No state or federal funds shall be authorized or expended if the owner, primary operator, certified manager, or any direct employee of the consumer-directed services vendor is also the personal care attendant, unless such person provides services solely on a temporary basis for no more than three days in a thirty-day period.
Currently, a consumer's services may be discontinued if the consumer has falsified records. This act adds language to include providing false information of his or her condition, functional capacity, or level of care needs.
These provisions are identical to the perfected SS/SCS/SBs 70 & 128 (2019), substantially similar to HCS/HB 1885 (2018) and HB 2500 (2018), and similar to SB 969 (2018) and provisions of SB 526 (2017).
SUSPENSION OF MO HEALTHNET BENEFITS OF OFFENDERS IN CORRECTIONAL FACILITIES AND JAILS (Sections 217.930 and 221.125)
Under this act, MO HealthNet benefits shall be suspended, rather than cancelled or terminated, for offenders entering into a correctional facility or jail if the Department of Social Services is notified of the person's entry into the correctional center or jail, the person was currently enrolled in MO HealthNet, and the person is otherwise eligible for MO HealthNet benefits but for his or her incarcerated status. Upon release from incarceration, the suspension shall end and the person shall continue to be eligible for MO HealthNet benefits until such time as he or she is otherwise ineligible.
The Department of Corrections shall notify the Department of Social Services within 20 days of receiving information that person receiving MO HealthNet benefits is or will become an offender in a correctional center or jail and within 45 days prior to the release of such person whose benefits have been suspended under this act. City, county, and private jails shall notify the Department of Social Services within 10 days of receiving information that person receiving MO HealthNet benefits is or will become an offender in the jail.
These provisions are identical to SB 393 (2019) and provisions in the perfected SS/SCS/SBs 70 & 128 (2019).