HB 595-FN-LOCAL - AS INTRODUCED
2009 SESSION
01/03
HOUSE BILL 595-FN-LOCAL
AN ACT relative to eligibility for long-term care.
SPONSORS: Rep. Butcher, Ches 3; Rep. P. McMahon, Merr 3
COMMITTEE: Health, Human Services and Elderly Affairs
This bill clarifies the conduct of the assessments used for eligibility for long-term care.
This bill is a request of the department of health and human services.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
09-0251
01/03
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Nine
AN ACT relative to eligibility for long-term care.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Long-Term Care; Eligibility. Amend RSA 151-E:3 to read as follows:
151-E:3 Eligibility.
I. A person is Medicaid eligible for nursing facility services or Medicaid home and community-based care waiver services if the person is:
(a) Clinically eligible for nursing facility care because the person requires 24-hour care for one or more of the following purposes[, as determined by registered nurses appropriately
trained to use an assessment tool and employed by the department, or a designee acting on behalf of the department]:
(1) Medical monitoring and nursing care when the skills of a licensed medical professional are needed to provide safe and effective services;
(2) Restorative nursing or rehabilitative care with patient-specific goals;
(3) Medication administration by oral, topical, intravenous, intramuscular, or subcutaneous injection, or intravenous feeding for treatment of recent or unstable conditions requiring medical or nursing intervention; or
(4) Assistance with 2 or more activities of daily living involving eating, toileting, transferring, bathing, dressing, and continence; and
(b) Financially eligible as either:
(1) Categorically needy, as calculated pursuant to rules adopted by the department under RSA 541-A; or
(2) Medically needy, as calculated pursuant to rules adopted by the department under RSA 541-A.
II. [A person is eligible for services under the medicaid waiver if the person has been determined eligible under RSA 151-E:3, I.] Skilled professional medical personnel employed by the department shall determine clinical eligibility in accordance with the criteria in subparagraph I(a). The clinical eligibility determination shall be based upon an assessment performed by skilled professional medical personnel employed by the department, or by an individual with equivalent training designated by the department. The department shall train all persons performing the assessment to use the assessment tool. For the purposes of this section, “skilled professional medical personnel” shall have the same meaning as in 42 C.F.R., sections 432:2 and 432.50.
III. The department shall not use a new assessment tool to determine clinical eligibility for nursing facility care until the tool has been reviewed by the county-state finance commission and has been approved by the oversight committee on health and human services established pursuant to RSA 126-A:13.
IV. If the [registered nurse is] skilled professional medical personnel employed by the department are unable to determine that an applicant is eligible following the clinical assessment pursuant to [subparagraph I(a)] paragraph II, the [registered nurse] skilled professional medical personnel shall obtain and give substantial weight to clinical information provided by the applicant’s physician or nurse practitioner, including, but not limited to diagnosis, prognosis, and plan of care recommendations, and consider information from other licensed practitioners, including occupational or physical therapists, if available. All clinical information obtained shall also be used in the preparation of the initial support plan.
2 Effective Date. This act shall take effect 60 days after its passage.
LBAO
09-0251
Revised 01/27/09
HB 595 FISCAL NOTE
AN ACT relative to eligibility for long-term care.
FISCAL IMPACT:
The Department of Health and Human Services states this bill will have no fiscal impact on state, county, and local revenue or expenditures.
METHODOLOGY:
The Department states the purpose of this bill was to clarify the conduct assessment used for eligibility for long-term care. The clinical eligibility for nursing facility services or Medicaid home and community base care (HCBC) waiver services shall be based upon an assessment performed by a “skilled professional medical personnel” employed by the department, or by an individual with equivalent training designated by the department. The Department states this bill will have no fiscal impact on state, county, and local revenue or expenditures.