2012 Special Session I

Budget Amendments - HB1301 (Committee Approved)

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Restore Medicaid Eligibility for Long-term Care Services

Item 307 #5s

Item 307 #5s

First Year - FY2013 Second Year - FY2014
Health And Human Resources
Medical Assistance Services, Department of FY2013 $0 FY2014 $5,965,424 GF
FY2013 $0 FY2014 $5,965,424 NGF

Page 225, line 49, strike "$9,042,320,948" and insert "$9,054,251,796".
Page 238, line 45, before "The", insert:
"1.  Prior to the implementation of the reduction in paragraph 4, the Director of the Department of Medical Assistance Services shall provide a detailed report and analysis of the impact of the reduction of income eligibility from 300 percent to 250 percent of Supplemental Security Income (SSI).  The report shall include a comprehensive review and analysis of the estimated savings, costs and effects of the eligibility change.  The report shall be based on current enrollment in nursing homes, other institutions, and community-based waivers including the income level of those enrollees.  The report shall include a projection of future needs for nursing homes and community-based waivers, the estimated impact on admission to a nursing home or other institution, and the cost of care in each waiver compared to institutional care.  Further, the report shall include the impact of patient-pay requirements on the Medicaid cost of institutional and community-based care for those with income at or above 250 percent of the SSI payment level, and the availability and expected use of the medically needy eligibility process by those with income at or above 250 percent of the SSI payment level to obtain Medicaid coverage for institutional and community-based care.  Finally, the report shall evaluate the impact of this eligibility change on compliance with the terms of the Commonwealth's settlement agreement with the U.S. Department of Justice, and available options for long-term care services for those who would no longer qualify for Medicaid services because of this income eligibility change.  The final report shall be provided to the Chairmen of the Senate Finance and House Appropriations Committees as well as the Joint Commission on Health Care no later than October 1, 2012.
2.  The Director of Medical Assistance Services shall restore Medicaid eligibility up to 300 percent of Supplemental Security Income on January 1, 2014, contingent upon additional general fund resources from the combination of actual general fund revenue collections for FY 2012 exceeding the official FY 2012 revenue estimate contained in the first enactment of the 2010-12 appropriations act, as amended by the 2012 session of the General Assembly, and by any discretionary unspent general fund appropriations recommended by the Governor for reversion at the end of FY 2012 after first satisfying the requirement for a one-time bonus payment to state employees as set out in Item 468 of this Act.  In the event that the funds provided for in this paragraph are insufficient to fully fund the general fund cost of restoring Medicaid eligibility to 300 percent of SSI, the income eligibility level shall be prorated to a percent of income eligibility equivalent to the amount of total general fund resources provided.
3. For purposes of restoring Medicaid eligibility up to 300 percent of SSI, the State Comptroller shall reserve $12,252,334 on the balance sheet for the general fund attributable to FY 2012 general fund revenue collections in excess of the official revenue estimate and the cost of providing a three percent salary increase as set out in Item 468 of this Act and discretionary general fund balances recommended for reversion by the Governor.
Page 239, line 1, strike "250" and insert "267".

(This amendment provides $6.0 million from the general fund and $6.0 million in federal matching funds to restore Medicaid long-term care services for 1,494 elderly and disabled individuals. The introduced budget reduced the income eligibility limit for long-term care services from 300 percent of the federal Supplemental Security Income (SSI) payment level ($2,094 per month) to 250 percent of the SSI payment level ($1,745 per month) effective January 1, 2014, resulting in 4,562 fewer individuals qualifying for Medicaid funded nursing home care or long-term care waiver services. This amendment restores Medicaid eligibility for long-term care services to 200 percent of federal poverty guides (or 267 percent of SSI). Language is also included to restore eligibility up to 300 percent of SSI if revenues exceed the 2012 general fund forecast and the amount of funding needed to provide a three percent salary increase for state employees. This amendment also requires a report on the implications of reducing the income eligibility limit for Medicaid long-term care services effective January 1, 2014 prior to implementation of this policy change.)