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SUBSTITUTE HOUSE BILL 1341
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AS AMENDED BY THE SENATE
Passed Legislature - 2001 Regular Session
State of Washington 57th Legislature 2001
Regular Session
By
Read first time 03/08/2001. Referred to
Committee on .
Developing a home and
community-based waiver for persons in community residential settings.
AN ACT Relating to
increasing community residential options for nursing facility eligible clients;
amending RCW 74.09.700; and adding a new section to chapter 74.39 RCW.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF
WASHINGTON:
Sec. 1. RCW 74.09.700 and 1993 c
57 s 2 are each amended to read as follows:
(1) To the extent of
available funds and subject to any conditions placed on appropriations made for
this purpose, medical care may be provided under the limited casualty program
to persons not otherwise eligible for medical assistance or medical care
services who are medically needy as defined in the social security Title XIX
state plan and medical indigents in accordance with eligibility requirements
established by the department. The eligibility requirements may include
minimum levels of incurred medical expenses. This includes residents of
nursing facilities ((and)), residents of intermediate care
facilities for the mentally retarded, and individuals who are otherwise
eligible for section 1915(c) of the federal social security act home and
community-based waiver services, administered by the department of social and
health services aging and adult services administration, who are aged,
blind, or disabled as defined in Title XVI of the federal social security act
and whose income exceeds three hundred percent of the federal supplement
security income benefit level.
(2) Determination of
the amount, scope, and duration of medical coverage under the limited casualty
program shall be the responsibility of the department, subject to the
following:
(a) Only the following
services may be covered:
(i) For persons who are
medically needy as defined in the social security Title XIX state plan:
Inpatient and outpatient hospital services, and home and community-based
waiver services;
(ii) For persons who
are medically needy as defined in the social security Title XIX state plan, and
for persons who are medical indigents under the eligibility requirements
established by the department: Rural health clinic services; physicians' and
clinic services; prescribed drugs, dentures, prosthetic devices, and
eyeglasses; nursing facility services; and intermediate care facility services
for the mentally retarded; home health services; hospice services; other
laboratory and x-ray services; rehabilitative services, including occupational
therapy; medically necessary transportation; and other services for which funds
are specifically provided in the omnibus appropriations act;
(b) Medical care
services provided to the medically indigent and received no more than seven
days prior to the date of application shall be retroactively certified and
approved for payment on behalf of a person who was otherwise eligible at the
time the medical services were furnished: PROVIDED, That eligible persons who
fail to apply within the seven-day time period for medical reasons or other
good cause may be retroactively certified and approved for payment.
(3) The department
shall establish standards of assistance and resource and income exemptions.
All nonexempt income and resources of limited casualty program recipients shall
be applied against the cost of their medical care services.
NEW SECTION. Sec.
2. A new section is added
to chapter 74.39 RCW to read as follows:
(1) To the extent of
available funds and subject to any conditions placed on appropriations for this
purpose, the department may provide one or more home and community-based waiver
programs in accordance with section 1915(c) of the federal social security act
for Washington residents who have a gross income in excess of three hundred
percent of the federal supplemental security income benefit level. The waiver
services provided in accordance with this section may differ from, and shall
operate with a separate limit or limits on total enrollment than, those
provided for persons who are categorically needy as defined in Title XIX of the
federal social security act. The department shall adopt rules to establish
eligibility criteria, applicable income standards, and the specific waiver
services to be provided. Total annual enrollment levels and the services to be
provided shall be as specified in the waiver agreement or agreements with the
federal government, subject to any conditions on appropriations for this
purpose.
(2) If a nursing
facility resident becomes eligible for home and community-based waiver service
alternatives to nursing facility care, but chooses to continue to reside in a
nursing facility, the department must allow that choice. However, if the
resident is a medicaid recipient, the resident must require a nursing facility
level of care.
(3) If a recipient of
home and community-based waiver services may continue to receive home and
community-based waiver services, despite an otherwise disqualifying level of
income, but chooses to seek admission to a nursing facility, the department
must allow that choice. However, if the resident is a medicaid recipient, the
resident must require a nursing facility level of care.
(4) The
department will fully disclose to all individuals eligible for waiver services
under this section the services available in different long-term care settings.
