Senior and Long Term Care Bills
- LC 0339 – Require 30-day notice before termination of participation in HCBS waiver program. This measure would require DPHHS to provide written notice to Medicaid waiver service recipients 30 days before they send a letter terminating those services. This is to allow time for recipients to provide information or clarification to avoid termination of services.
Why do we need this? Currently, the Department sends a letter to a recipient when they have decided to terminate services. They announce in the letter that the person will lose services in 10 days. For those who have been receiving these services, this notice is often a surprise and causes tremendous anxiety and stress. Our office has represented multiple people who have received these notices. We have appealed these decisions and often had the services restored after months of going without. These are often critical services. In all but a few of these cases, we have not produced any more information on appeal than what was available to the Department when it decided to terminate services in the first place. This bill would give a recipient notice that the Department was considering terminating services, so they would have some time to try to clarify the issue before that decision is made. This would help people who qualify to preserve their services, while not placing an obstacle in cases where the DPHHS is appropriately terminating services for those who do not qualify.
2. LC 0340 – Require administrative rulemaking for substantive changes to HCBS programs. This bill requires DPHHS to engage in administrative rule making when placing caps, soft caps or prior authorizations on categories of services. It clarifies that substantive limitations or changes to services cannot be enacted in policy, but have to be enacted in rule.
Why is this bill necessary? Unfortunately, over the last five years, the senior and long term care division of DPHHS has established substantive limitations to all recipients’ benefits by merely changing that benefit in policy. They made no attempt to make those changes in rule, which would have alerted the public to the changes and allowed them to comment upon them. Even though the changes were only in policy and not made enforceable by putting them in rule, the division still enforced them against individual members in the programs and took away important services. This bill clarifies that when they make these important substantive changes to people’s benefits, it must be done via rulemaking to ensure that the public knows that these changes have been proposed and can comment upon the proposed changes.
- LC 0341 – Establish legislative intent for home and community-based services waivers. This bill would (a) establish that it is the intent of the legislature that the Department shall review whether the services and equipment recommended by medical professionals will collectively, not individually, prevent an individual from requiring an institutional level of care; and (b) approve each waiver service or item of medical equipment that will contribute to allowing a person to remain in a home or community setting even if the service or item on its own would not prevent an institutional level of care.
Why is this necessary? The senior and long term care division began to require that services and equipment provided to people on the waiver individually keep people out of institutional settings.
This was a substantial change and contrary to the spirit of the waiver program. Prior, the Department had looked at the services and equipment as a whole. This bill would return the Department to using that interpretation of the need for waiver services and equipment.
- LC 0338 – Clarify requirements for the Medicaid medically needy program. This bill would require DPHHS to allow people to satisfy spend down requirements with medical and other related expenses.
Why do we need this? Before the current administrators at Senior and Long Term Care took their positions, people could deduct their medical expenses not covered by Medicaid to account for how much they need to “spend down” each month to remain qualified for services. This new administration doesn’t allow that and so people have to pay twice – they have to give money to the State for the spend down, but then still have the medical expenses to pay as well. This affects very low income people with disabilities of all ages – children to seniors.
- LC 0336 – Require consideration of less restrictive options in guardianship proceedings. This bill requires findings of the other, less restrictive options that have been considered prior to granting a guardianship.
- LC 0337 – Revise monitoring requirements for guardians of adults. This bill requires a proposed guardian to submit a plan regarding various aspects of the life of the ward. This includes where they will live, how often the guardian will visit, what social and educational activities are expected, etc. It also prohibits the waiver of annual accounting by the guardian.
- SB 15 – Revise election laws related to accessibility for disabled electors. This bill makes multiple changes to the election law that address accessibility of voting. Perhaps the most notable requirement is the provision of accessible voting machines in school and other elections in addition to the current process where they are available in county/federal elections.