2005-2006 Bill 4722: Spartanburg Assisted Living Medicaid Waiver Program - South Carolina

1 South Carolina General Assembly 2 116th Session, 2005-2006 3 4 H. 4722 5 6 STATUS INFORMATION 7 8 General Bill 9 Sponsors: Reps. Mitchell, Bannister, Anthony, J. Brown, Davenport, Littlejohn, Mahaffey, W.D. Smith, 10 Talley and Walker 11 Document Path: l:\council\bills\nbd\12180ac06.doc 12 13 Introduced in the House on February 23, 2006 14 Currently residing in the House Committee on Ways and Means 15 16 Summary: Spartanburg Assisted Living Medicaid Waiver Program 17 18 19 HISTORY OF LEGISLATIVE ACTIONS 20 21 Date Body Action Description with journal page number 22 2/23/2006 House Introduced and read first time HJ-43 23 2/23/2006 House Referred to Committee on Ways and Means HJ-44 24 25 26 VERSIONS OF THIS BILL 27 28 2/23/2006 29 1 2 3 4 5 6 7 8 9 A BILL 10 11 TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 12 1976, BY ADDING SECTION 44-6-85 SO AS TO ENACT THE 13 SPARTANBURG ASSISTED LIVING MEDICAID WAIVER 14 PROGRAM, PROVIDING THAT THE DEPARTMENT OF 15 HEALTH AND HUMAN SERVICES SHALL SEEK FEDERAL 16 APPROVAL TO AMEND THE EXISTING HOME AND 17 COMMUNITY BASED WAIVER TO INCLUDE FEDERAL 18 MATCHING FUNDING FOR THIS PROGRAM; TO REQUIRE 19 THE DEPARTMENT TO DEVELOP MEDICAID ELIGIBILITY 20 DETERMINATION CRITERIA; TO REQUIRE THE GENERAL 21 ASSEMBLY TO APPROPRIATE MATCHING FUNDS FROM 22 GENERAL REVENUES ANNUALLY TO FUND THIS 23 PROGRAM AND TO PROVIDE THE REIMBURSEMENT 24 RATE AND METHODS TO ADJUST THIS RATE 25 ANNUALLY; AND TO REQUIRE THE DEPARTMENT TO 26 EVALUATE, MONITOR, AND REPORT ON THIS PROGRAM 27 TO THE GENERAL ASSEMBLY FIVE YEARS AFTER ITS 28 IMPLEMENTATION. 29 30 Be it enacted by the General Assembly of the State of South 31 Carolina: 32 33 SECTION 1. Article 1, Chapter 6, Title 44 of the 1976 Code is 34 amended by adding: 35 36 “Section 44-6-85. (A) The Director of the Department of 37 Health and Human Services shall seek approval from the Centers 38 of Medicare and Medicaid Services to amend the existing Home 39 and Community Based Waiver to include federal matching funding 40 for the Spartanburg Assisted Living Medicaid Waiver Program for 41 seventy-five individuals in the first year of the program and up to 42 one hundred fifty individuals for the remaining five years in a

1 [4722] 1 1 licensed community residential care facility, owned by, under 2 contract with, or administered by the Spartanburg Housing 3 Authority. The amended waiver must be project based. The 4 federal and state funds appropriated for the program described in 5 this section remain with this program and do not follow the 6 individual if he or she leaves the program or becomes ineligible for 7 the program. 8 (B) The director shall formulate the waiver amendment 9 application and shall submit the waiver request not later than 10 September 15, 2006. The waiver obtained under this section must 11 be reviewed and expanded periodically in consultation with the 12 director. 13 (C) The director shall develop Medicaid eligibility 14 determination criteria. Supportive services paid for with state and 15 federal funds in an eligible community residential care facility 16 owned by, under contract with, or administered by the Spartanburg 17 Housing Authority must be provided to individuals who are 18 eligible for or at risk for placement in a nursing facility and whose 19 comprehensive assessment indicates that the individual is eligible 20 for these services. 21 (D) The General Assembly shall appropriate from state general 22 funds the required matching funds beginning with fiscal year 23 2006-2007 and continuing for a period of four years thereafter. 24 Reimbursement to eligible community residential care facilities is 25 thirty-two dollars a day for each eligible recipient. The 26 reimbursement rate may be adjusted on October 1 each year based 27 on the average percentage increase or decrease of the consumer 28 price index for the twelve-month state fiscal year ending the 29 preceding September 30. 30 (E) Upon implementation of the program established in this 31 section, the Department of Health and Human Services and the 32 Spartanburg Housing Authority shall monitor, evaluate, and report, 33 at the end of the first five years of inception, on the qualitative 34 benefits and cost-effectiveness of the program. The department 35 shall submit this report to the General Assembly. 36 (F) As used in this section: 37 (1) ‘Comprehensive assessment’ means a tool approved by 38 the Department of Health and Human Services to determine the 39 level of supportive services required by an individual. 40 (2) ‘Eligible community residential care facility’ means a 41 facility as defined in Section 44-7-260 and Regulation 61-84 that 42 provides services to Medicaid eligible recipients under a written 43 contract with the Department of Health and Human Services.

1 [4722] 2 1 (3) ‘Low income and moderate low income’ means the 2 definition as published annually by the United States Department 3 of Housing and Urban Development for federally subsidized 4 housing developments. 5 (4) ‘Personal care services’ means the provision by the staff 6 of a facility of one or more of the following services, as required 7 by the individual care plan or orders by the physician or other 8 authorized health care provider or as reasonably requested by the 9 resident, including, assisting with activities of daily living, being 10 aware of the resident’s general whereabouts, and monitoring the 11 activities of the resident to ensure his or her health, safety and 12 well-being.” 13 14 SECTION 2. This act takes effect upon approval by the 15 Governor. 16 ----XX---- 17

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