HB 353-FN – AS AMENDED BY THE HOUSE
23Feb2011… 0160h
2011 SESSION
05/04
HOUSE BILL 353-FN
AN ACT establishing a Medicaid waiver program to provide in-home support services for children who are medically fragile or children with chronic illness.
SPONSORS: Rep. Elliott, Rock 4; Rep. C. McMahon, Rock 4
COMMITTEE: Health, Human Services and Elderly Affairs
This bill directs the department of health and human services to submit a Medicaid waiver to provide in-home support services for children who are medically fragile or children with chronic illness. The program shall be structured as a 3-year pilot program.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
23Feb2011… 0160h
11-0225
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eleven
AN ACT establishing a Medicaid waiver program to provide in-home support services for children who are medically fragile or children with chronic illness.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Purpose. The general court resolves and finds that a pilot in-home support waiver program for children who are medically fragile or children with chronic illness is necessary to explore and determine potential cost savings to the state of New Hampshire in a way that ensures necessary supports for these children and their dedicated families. Henceforth, this act shall be known as “Sean’s Law” named after Sean William Corey who inspired this legislation.
2 New Section; Health and Human Services; In-Home Supports Waiver for Children who are Medically Fragile or Children with Chronic Illness. Amend RSA 126-A by inserting after section 4-g the following new section:
126-A:4-h In-Home Supports Waiver for Children who are Medically Fragile or Children with Chronic Illness.
I. The department of health and human services shall apply to the Centers for Medicare and Medicaid Services for a Medicaid home and community-based care waiver under section 1915(c) of the Social Security Act for children who are medically fragile or children with chronic illness. Such waiver is to be known as the in-home supports waiver for children with chronic illnesses (IHS-CI).
(a) The IHS-CI waiver shall be operated as a pilot program for a 3-year period, at the end of which time the department shall either renew or conclude the program based upon meaningful review and analysis of the pilot and subject to approval by the health and human services oversight committee.
(b) Up to 20 children may participate in the IHS-CI waiver at any given time during the pilot period and additional waiver slots may be made available if such slots would not exceed the allowable aggregate financial cap under the waiver.
(c) The IHS-CI waiver eligibility criteria shall include the following:
(1) Participation for eligible children from birth to age nineteen.
(2) Medical eligibility shall include a medical diagnosis of an acute onset medical condition or a chronic medical condition.
(3) Medical eligibility shall be determined using a standardized rating tool developed by the department and approved by the health and human services oversight committee.
(4) Periodic re-evaluation shall be required for continued eligibility.
(5) Eligible services shall be furnished by providers chosen by the family.
(6) Participants in the IHS-CI waiver shall have the right to choose an independent case manager, known as a “service coordinator.”
(7) The bureau of developmental services shall be responsible for informing participants in the IHS-CI waiver, in writing, of their right to choose an independent case manager.
(8) Eligibility determinations shall be administered by the special medical services unit of the department’s bureau of developmental services.
(9) Waiver coordination shall be administered by the participant’s independent case manager in conjunction with the participant’s physician.
(d) Subject to approval by the Center for Medicare and Medicaid Services, the IHS-CI waiver may include such services as are medically necessary to assist the child to remain at home with his or her family.
II. The commissioner of health and human services shall submit the request for an IHS-CI waiver to the Center for Medicare and Medicaid Services on or before June 30, 2011.
III. The commissioner of health and human services shall adopt rules, pursuant to RSA 541-A, relative to eligibility, covered services, and the operation of the IHS-CI waiver program.
3 Funding Source. In each year of the biennium ending June 30, 2013, the department of health and human services shall use existing appropriations to the department to fund the pilot program established in section 2 of this act. Notwithstanding any provision of law to the contrary, the department may transfer funds between and among PAU’s within the department as may be necessary to fully implement the program with state funds pending the availability of federal matching funds.
4 Effective Date. This act shall take effect upon its passage.
LBAO
11-0225
Amended 03/09/11
HB 353 FISCAL NOTE
AN ACT establishing a Medicaid waiver program to provide in-home support services for children who are medically fragile or children with chronic illness.
FISCAL IMPACT:
The Department of Health and Human Services states this bill, as amended by the House (Amendment #2011-0160h), may increase state revenue and expenditures by an indeterminable amount in FY 2012 and each year thereafter. There will be no fiscal impact on county or local revenue and expenditures.
METHODOLOGY:
The Department states this bill directs the Department it to submit a Medicaid waiver request to the Center for Medicare and Medicaid Services (CMS), on or before June 30, 2011, for a three year pilot program for up to 20 children who are medically fragile or who have a chronic illness. The bill, as amended, does not appropriate funds, but directs the department to fund the pilot program with existing appropriations.
The Department assumes the following concerning the fiscal impact of this bill:
• The Department will absorb the cost of preparing the waiver from its exiting budget. There is no fiscal impact for preparing the request.
• The proposed waiver will serve up to 20 children from birth to age 19. Additional children may be served if services do not exceed the aggregate financial cap under the waiver and result in no additional fiscal impact.
• The proposal is assumed to have a $30,000 annual cap per child with and assumed average allocation of $20,000 per child. The annual cost to provide services would be up to $400,000 of which $200,000 would be state general funds and $200,000 would be federal Medicaid funds.
• If the waiver is approved by CMS, the Department may realize some savings from other programs, however these savings are not known at this time.
• It this bill passes and is effective in June 2011, the Department will work with CMS during FY 2012 and enrollment in the program may begin in FY 2012.