SB 96

Under current law, the Department of Health Services (DHS) provides home or

community-based care, under a waiver of federal Medicaid laws, to Medical

Assistance (MA) recipients who are relocated from nursing homes or who meet MA

level of care requirements for nursing home care. The community integration

program under which this care is provided is commonly known as "CIP II." Under

part of CIP II, DHS is authorized to pay an enhanced rate for MA services for persons

who, on or after July 27, 2005, either are relocated from a nursing home or meet MA

level of care requirements and are diverted from imminent entry into a nursing

home, if the total number of persons served does not exceed the number of delicensed

nursing home beds. Payment of the enhanced rate for persons who are diverted from

imminent entry into a nursing home is limited to 150 persons, but, if it is likely that

the number of persons so diverted will exceed 150, DHS may submit a request to the

Joint Committee on Finance (JCF) of the legislature, under a passive review process,

for approval to expand the number of that category of persons served.

This bill eliminates the limitation on the number of persons who meet MA level

of care requirements and are diverted from imminent entry into a nursing home and

for whom an enhanced rate of payment for MA services may be made under CIP II.

The bill also eliminates authority for DHS to submit a request to JCF for approval

to expand the number of that category of persons served.