S.B. 61

1

PORTABILITY OF MEDICAL ASSISTANCE
2 FUNDS
3 2007 GENERAL SESSION
4 STATE OF UTAH
5 Chief Sponsor: Ed Mayne
6 House Sponsor: ____________
7
8 LONG TITLE
9 General Description:
10 This bill amends the Medical Assistance Act to require portability of funds, if
11 necessary, to allow an eligible person to receive home or community-based services
12 instead of being placed in, or remaining in, a long-term care facility.
13 Highlighted Provisions:
14 This bill:
15 . defines terms;
16 . requires the Department of Health to provide home or community-based services to
17 a person who qualifies to be placed in, or remain in, a long-term care facility if the
18 person desires to receive the services and the services can be provided at a cost to
19 the state that is equal to, or less than, the cost to the state of maintaining the person
20 in a long-term care facility;
21 . provides for case management in determining the home or community-based
22 services necessary to care for a person outside of a long-term care facility;
23 . provides that the Department of Health may contract with the Department of Human
24 Services or other agencies to make the determinations or provide the services
25 described in this bill; and
26 . provides for the portability of funds, that would have been used to place or maintain
27 a person in a long-term care facility, to fund home or community-based services for

28 that person if the waiver funds designated for that purpose are inadequate.
29 Monies Appropriated in this Bill:
30 None
31 Other Special Clauses:
32 None
33 Utah Code Sections Affected:
34 ENACTS:
35 26-18-601, Utah Code Annotated 1953
36 26-18-602, Utah Code Annotated 1953
37 26-18-603, Utah Code Annotated 1953
38 26-18-604, Utah Code Annotated 1953
39
40 Be it enacted by the Legislature of the state of Utah:
41 Section 1. Section 26-18-601 is enacted to read:
42 Part 6. Portability of Medical Assistance Funds
43 26-18-601. Title.
44 This part is known as "Portability of Medical Assistance Funds."
45 Section 2. Section 26-18-602 is enacted to read:
46 26-18-602. Definitions.
47 As used in this part:
48 (1) "Medical assistance" means financial assistance or other services paid for under the
49 state plan for Medicaid under Title XIX of the Social Security Act.
50 (2) "Long-term care facility" is as defined in Section 62A-3-202 .
51 Section 3. Section 26-18-603 is enacted to read:
52 26-18-603. Requirement to provide home or community-based services --
53 Authority to contract.
54 (1) The department shall provide home or community-based services to a person
55 instead of placing or maintaining the person in a long-term care facility if:
56 (a) the person:
57 (i) is a resident of this state;
58 (ii) qualifies for medical assistance to fund the person's placement in a long-term care

59 facility;
60 (iii) applies for:
61 (A) placement in a long-term care facility; or
62 (B) home or community-based services in order to avoid being placed in, or remaining
63 in, a long-term care facility;
64 (iv) desires to receive home or community-based services instead of being placed in, or
65 remaining in, a long-term care facility; and
66 (v) may be safely and adequately cared for outside of a long-term care facility; and
67 (b) the cost to the state of providing the home or community-based services described
68 in this Subsection (1) is less than, or equal to, the cost to the state of providing care to the
69 resident in a long-term care facility.
70 (2) If a person qualifies under Subsection (1) for, and chooses to receive, home or
71 community-based services, the department shall, on an ongoing basis:
72 (a) determine the extent of the resources already available to the person;
73 (b) determine the home and community-based services needed to safely and adequately
74 care for the person outside of a long-term care facility; and
75 (c) arrange for or provide the services described in Subsection (2)(b).
76 (3) The department may contract with the Department of Human Services or other
77 qualified agencies to make the determinations, or provide the services, described in this
78 section.
79 Section 4. Section 26-18-604 is enacted to read:
80 26-18-604. Funding for home or community-based services.
81 (1) Except as provided in Subsection (2), the costs of the home or community-based
82 services described in Section 26-18-603 shall be paid for with the applicable Medicaid waiver
83 funds designated for that purpose.
84 (2) If the funds described in Subsection (1) are not adequate to pay the costs of the
85 home and community-based services described in Section 26-18-603 :
86 (a) the costs shall be paid from the funds that would have been used to pay the costs of
87 placing the person in a long-term care facility; and
88 (b) if the services are provided by, or through a contract with, the Department of
89 Human Services or another agency, the department shall execute a revenue transfer to the

90 Department of Human Services or the other agency in order to comply with Subsection (2)(a).
91 (3) A revenue transfer described in Subsection (2)(b) is exempt from the requirements
92 of Title 63, Chapter 38, Budgetary Procedures Act.




Legislative Review Note
as of 1-19-07 5:58 PM

Office of Legislative Research and General Counsel