1     
LIMITED SUPPORT SERVICES WAIVER AMENDMENTS

2     
2020 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Daniel Hemmert

5     
House Sponsor: Norman K. Thurston

6     

7     LONG TITLE
8     General Description:
9          This bill relates to the provision of services for individuals with disabilities.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms;
13          ▸     amends provisions relating to the allocation of appropriations to the Division of
14     Services for People with Disabilities; and
15          ▸     makes technical changes.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          None
20     Utah Code Sections Affected:
21     AMENDS:
22          62A-5-101, as last amended by Laws of Utah 2018, Chapter 404
23          62A-5-102, as last amended by Laws of Utah 2019, Chapter 104
24     

25     Be it enacted by the Legislature of the state of Utah:
26          Section 1. Section 62A-5-101 is amended to read:
27          62A-5-101. Definitions.
28          As used in this chapter:
29          (1) "Approved provider" means a person approved by the division to provide
30     home-based services.
31          (2) "Board" means the Utah State Developmental Center Board created under Section
32     62A-5-202.5.
33          (3) (a) "Brain injury" means an acquired injury to the brain that is neurological in
34     nature, including a cerebral vascular accident.
35          (b) "Brain injury" does not include a deteriorating disease.
36          (4) "Designated intellectual disability professional" means:
37          (a) a psychologist licensed under Title 58, Chapter 61, Psychologist Licensing Act,
38     who:
39          (i) (A) has at least one year of specialized training in working with persons with an
40     intellectual disability; or
41          (B) has at least one year of clinical experience with persons with an intellectual
42     disability; and
43          (ii) is designated by the division as specially qualified, by training and experience, in
44     the treatment of an intellectual disability; or
45          (b) a clinical social worker, certified social worker, marriage and family therapist, or
46     professional counselor, licensed under Title 58, Chapter 60, Mental Health Professional
47     Practice Act, who:
48          (i) has at least two years of clinical experience with persons with an intellectual
49     disability; and
50          (ii) is designated by the division as specially qualified, by training and experience, in
51     the treatment of an intellectual disability.
52          (5) "Deteriorating disease" includes:
53          (a) multiple sclerosis;
54          (b) muscular dystrophy;
55          (c) Huntington's chorea;
56          (d) Alzheimer's disease;
57          (e) ataxia; or
58          (f) cancer.
59          (6) "Developmental center" means the Utah State Developmental Center, established in
60     accordance with Part 2, Utah State Developmental Center.
61          (7) "Director" means the director of the Division of Services for People with
62     Disabilities.
63          (8) "Direct service worker" means a person who provides services to a person with a
64     disability:
65          (a) when the services are rendered in:
66          (i) the physical presence of the person with a disability; or
67          (ii) a location where the person rendering the services has access to the physical
68     presence of the person with a disability; and
69          (b) (i) under a contract with the division;
70          (ii) under a grant agreement with the division; or
71          (iii) as an employee of the division.
72          (9) (a) "Disability" means a severe, chronic disability that:
73          (i) is attributable to:
74          (A) an intellectual disability;
75          (B) a condition that qualifies a person as a person with a related condition, as defined
76     in 42 C.F.R. 435.[1009]1010;
77          (C) a physical disability; or
78          (D) a brain injury;
79          (ii) is likely to continue indefinitely;
80          (iii) (A) for a condition described in Subsection (9)(a)(i)(A), (B), or (C), results in a
81     substantial functional limitation in three or more of the following areas of major life activity:
82          (I) self-care;
83          (II) receptive and expressive language;
84          (III) learning;
85          (IV) mobility;
86          (V) self-direction;
87          (VI) capacity for independent living; or
88          (VII) economic self-sufficiency; or
89          (B) for a condition described in Subsection (9)(a)(i)(D), results in a substantial
90     limitation in three or more of the following areas:
91          (I) memory or cognition;
92          (II) activities of daily life;
93          (III) judgment and self-protection;
94          (IV) control of emotions;
95          (V) communication;
96          (VI) physical health; or
97          (VII) employment; and
98          (iv) requires a combination or sequence of special interdisciplinary or generic care,
99     treatment, or other services that:
100          (A) may continue throughout life; and
101          (B) must be individually planned and coordinated.
102          (b) "Disability" does not include a condition due solely to:
103          (i) mental illness;
104          (ii) personality disorder;
105          (iii) deafness or being hard of hearing;
106          (iv) visual impairment;
107          (v) learning disability;
108          (vi) behavior disorder;
109          (vii) substance abuse; or
110          (viii) the aging process.
111          (10) "Division" means the Division of Services for People with Disabilities.
112          (11) "Eligible to receive division services" or "eligibility" means qualification, based
113     on criteria established by the division [in accordance with Subsection 62A-5-102(4)], to receive
114     services that are administered by the division.
115          (12) "Endorsed program" means a facility or program that:
116          (a) is operated:
117          (i) by the division; or
118          (ii) under contract with the division; or
119          (b) provides services to a person committed to the division under Part 3, Admission to
120     an Intermediate Care Facility for People with an Intellectual Disability.
121          (13) "Licensed physician" means:
122          (a) an individual licensed to practice medicine under:
123          (i) Title 58, Chapter 67, Utah Medical Practice Act; or
124          (ii) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
125          (b) a medical officer of the United States Government while in this state in the
126     performance of official duties.
127          (14) "Limited support services" means services that are administered by the division to
128     individuals with a disability:
129          (a) under a waiver authorized under 42 U.S.C. Sec. 1396n(c) by the Centers for
130     Medicare and Medicaid Services that permits the division to limit services to an individual who
131     is eligible to receive division services; and
132          (b) through a program that:
133          (i) was not operated by the division on or before January 1, 2020; and
134          (ii) (A) limits the kinds of services that an individual may receive; or
135          (B) sets a maximum total dollar amount for program services provided to each
136     individual.
137          [(14)] (15) "Physical disability" means a medically determinable physical impairment
138     that has resulted in the functional loss of two or more of a person's limbs.
139          [(15)] (16) "Public funds" means state or federal funds that are disbursed by the
140     division.
141          [(16)] (17) "Resident" means an individual under observation, care, or treatment in an
142     intermediate care facility for people with an intellectual disability.
143          [(17)] (18) "Sustainability fund" means the Utah State Developmental Center
144     Long-Term Sustainability Fund created in Section 62A-5-206.7.
145          Section 2. Section 62A-5-102 is amended to read:
146          62A-5-102. Division of Services for People with Disabilities -- Creation --
147     Authority -- Direction -- Provision of services.
148          (1) There is created within the department the Division of Services for People with
149     Disabilities, under the administrative direction of the executive director of the department.
150          (2) In accordance with this chapter, the division has the responsibility to plan and
151     deliver an appropriate array of services and supports to persons with disabilities and their
152     families in this state.
153          (3) Within appropriations from the Legislature, the division shall provide services to
154     any [person] individual with a disability who is eligible to receive division services.
155          (4) (a) [Starting on July 1, 2013,] Except as provided in Subsection (4)(c), any new
156     appropriations designated to serve eligible [persons] individuals waiting for services from the
157     division shall be [allocated as set forth in this section. (b) Eighty-five percent of the money
158     appropriated in Subsection (4)(a) shall be] allocated, as determined by the division by rule
159     based on the:
160          (i) severity of the disability;
161          (ii) urgency of the need for services;
162          (iii) ability of a parent or guardian to provide the [person] individual with appropriate
163     care and supervision; and
164          (iv) length of time during which the [person] individual has not received services from
165     the division.
166          [(c) Fifteen percent of the money appropriated in Subsection (4)(a) shall be allocated
167     for respite services, and the division shall:]
168          [(i) establish rules to identify a person whose only need is respite services;]
169          [(ii) allocate money under this Subsection (4)(c) to the people described in Subsection
170     (4)(c)(i) based on random selection; and]
171          [(iii) if all persons described in Subsection (4)(c)(i) have been served and there is
172     money remaining for respite care under this Subsection (4)(c), the division shall use the
173     remaining money as described in Subsection (4)(b).]
174          [(d)] (b) Funds from Subsection (4)[(b)](a) that are not spent by the division at the end
175     of the fiscal year may be used as set forth in Subsection (7).
176          (c) Subsections (4)(a) and (b) do not apply to any new appropriations designated to
177     provide limited support services.
178          (5) The division:
179          (a) has the functions, powers, duties, rights, and responsibilities described in Section
180     62A-5-103; and
181          (b) is authorized to work in cooperation with other state, governmental, and private
182     agencies to carry out the responsibilities described in Subsection (5)(a).
183          (6) Within appropriations authorized by the Legislature, and to the extent allowed
184     under Title XIX of the Social Security Act, the division shall ensure that the services and
185     support that the division provides to [any person] an individual with a disability:
186          (a) are provided in the least restrictive and most enabling environment;
187          (b) ensure opportunities to access employment; and
188          (c) enable reasonable personal choice in selecting services and support that:
189          (i) best meet individual needs; and
190          (ii) promote:
191          (A) independence;
192          (B) productivity; and
193          (C) integration in community life.
194          (7) (a) Appropriations to the division are nonlapsing.
195          (b) After an individual stops receiving services under this section, the division shall use
196     the funds that paid for the individual's services to provide services under this section to another
197     eligible individual in an intermediate care facility transitioning to division services, if the funds
198     were allocated under a program established under Section 26-18-3 to transition individuals
199     with intellectual disabilities from an intermediate care facility.
200          (c) Except as provided in Subsection (7)(b), if an individual receiving services under
201     Subsection (4)[(b) or (c)](a) ceases to receive those services, the division shall use the funds
202     that were allocated to that individual to provide services to another eligible individual waiting
203     for services as described in Subsection (4)[(b)](a).
204          (d) Funds unexpended by the division at the end of the fiscal year may be used only for
205     one-time expenditures unless otherwise authorized by the Legislature.
206          (e) A one-time expenditure under this section:
207          (i) is not an entitlement;
208          (ii) may be withdrawn at any time; and
209          (iii) may provide short-term, limited services, including:
210          (A) respite care;
211          (B) service brokering;
212          (C) family skill building and preservation classes;
213          (D) after school group services; and
214          (E) other professional services.