H.R.3454 - Medicaid Home and Community Quality Services Act of 1987100th Congress (1987-1988)
|Sponsor:||Rep. Florio, James J. [D-NJ-1] (Introduced 10/08/1987)|
|Committees:||House - Energy and Commerce|
|Latest Action:||House - 09/30/1988 Subcommittee Hearings Held. (All Actions)|
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Summary: H.R.3454 — 100th Congress (1987-1988)All Information (Except Text)
Introduced in House (10/08/1987)
Medicaid Home and Community Quality Services Act of 1987 - Amends title XIX (Medicaid) of the Social Security Act to require States to provide Medicaid coverage of community and family support services for severely disabled individuals who became disabled before age 22 and are living in a family home, foster family home, or community living facility. Requires that such services be provided in accordance with a written habilitation plan developed by an interdisciplinary team on the basis of a comprehensive assessment of the individual's strengths and the services and support necessary to: (1) enable such individual to attain or retain capabilities for independence or self-care; (2) promote interaction between disabled and nondisabled individuals within the community; and (3) enable disabled individuals who are over age 18 to engage in paid employment.
Increases the age at which newly disabled individuals will be eligible for this Act's coverage so that eventually individuals who become disabled between age 22 and 50 will be covered.
Lists the services which may comprise community and family support services, requiring that such services include at a minimum: (1) case management services; (2) individual and family support services; (3) specialized vocational services; and (4) protective intervention services. Excludes from such services: (1) room and board, other than room and board provided for less than six consecutive weeks and less than 12 weeks per year; (2) cash payments as a service; (3) aversive behavior intervention, management, or therapies; (4) services provided to a disabled individual living in a hospital, or skilled nursing or intermediate care facility; (5) educational services which the State makes generally available to its residents without cost and without regard to their income; and (6) services for which payment is made under title XVIII (Medicare), or part A (Aid to Families with Dependent Children) or B (Child Welfare Services) of title IV of the Act.
Requires each State to make certain assurances regarding their provision of community and family support services and submit an implementation strategy to the Secretary of Health and Human Services. Requires that such implementation strategies: (1) describe the extent and scope of community and family support services provided to the severely disabled and the extent and scope of services provided to the severely disabled who are institutionalized; (2) set forth the objectives and a five-year strategy for expanding community and family support services for the severely disabled; (3) include certain procedures for transferring severely disabled, institutionalized individuals to family homes, foster family homes, or community living facilities; (4) set forth standards for the provision of community and family support services and a program for licensing and certifying all facilities and programs providing such services; (5) provide for assessments of the provision and affect of community and family support services and the correction of service deficiencies; (6) provide the public with an adequate opportunity to comment on the strategies; (7) set forth methods ensuring that the personnel providing community and family support services receive adequate training and are competent to provide such services; (8) provide that the State has in effect a management information system capable of collecting, storing, and retrieving data on the severely disabled who receive community and family support services; (9) provide an opportunity for an appeal and hearing before a hearing officer to individuals who believe themselves to be inappropriately served or denied an appropriate service, or who are being scheduled for an involuntary transfer from one living arrangement to another; (10) describe the methods to be used in administering community and family support services; and (11) set forth procedures to protect the interests of public employees who will be affected by the transfer of the severely disabled from public institutions.
Allows States to provide any new community and family support service for up to three years without meeting the Medicaid requirements that they provide a service on a statewide basis and that the service be comparable in all parts of the State.
Requires that intermediate care facility services for the mentally retarded include the ascertainment of the individual needs of each newly admitted individual by an interdisciplinary team within 30 days and the development of a written habilitation plan for each individual.
Limits Medicaid payments to States for skilled nursing and intermediate care facility services furnished to individuals under age 65 who became disabled before age 22 to the amount payable for such services in the fiscal year ending after the enactment of this Act, increased if and by the extent to which the percentage increase in the consumer price index exceeds six percent. Makes such limitation inapplicable to facilities which have less than 16 beds or meet the size and location requirements for a community living facility.
Requires States to have in effect a system to protect and advocate those rights of the severely disabled who are eligible for medical assistance which relate to the provision of such assistance. Provides Federal Medicaid matching funds for such system.
Gives individuals who are adversely affected by a violation of this Act's requirements the right to bring an action to enjoin such violation.
Allows States to set payment rates for community and family support services for the severely disabled.
Authorizes States to treat severely disabled individuals under age 19 who are not in a medical institution as receiving benefits under title XVI (Supplemental Security Income) (SSI) of the Act for Medicaid eligibility purposes if they would be eligible for SSI benefits if institutionalized. Requires States to establish a uniform income standard for the severely disabled regardless of whether or not they are in a medical institution. Authorizes States to provide Medicaid coverage of disabled spouses and children who, except for the resources deemed to them, would be eligible for SSI benefits.
Removes certain limitations on the Secretary's approval of reduction and correction plans for deficient intermediate care facilities for the mentally retarded.
Makes individuals who are severely disabled and receiving or deemed to be receiving SSI benefits eligible for Medicaid as long as such qualifications continue to be satisfied.
Directs the Secretary to establish, within the Health Care Financing Administration, a Bureau of Developmental Disabilities Services responsible for administering Medicaid programs for the severely disabled.
Requires the Secretary to: (1) develop standards and a program for training Federal and State personnel who perform surveys of skilled nursing and intermediate care facilities to determine whether such facilities meet Medicaid participation requirements; and (2) periodically conduct studies of the reliability of such surveys and make the changes necessary to improve such reliability. Directs the Secretary to support the development of: (1) instruments to assess outcomes in the provision of this Act's services; and (2) competency-based personnel standards for agencies and organizations providing services to the severely disabled pursuant to this Act. Requires the Secretary to: (1) conduct an annual assessment of each State's compliance with this Act's requirements; and (2) issue final regulations regarding this Act's amendments prior to the first fiscal year beginning after this Act's enactment. Sets forth reporting requirements.