This document includes Senate Committee Amendments incorporated into the bill on Wed, Feb 17, 2021 at 2:11 PM by lpoole.
This document includes Senate 2nd Reading Floor Amendments incorporated into the bill on Fri, Feb 26, 2021 at 11:08 AM by lpoole.
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7 LONG TITLE
8 General Description:
9 This bill creates a program to increase health insurance coverage for children and
10 directs the Department of Health to expand eligibility for children's Medicaid and
11 CHIP.
12 Highlighted Provisions:
13 This bill:
14 ▸ creates the Children's Coverage Outreach Pilot Program;
15 ▸ describes the Children's Coverage Outreach Pilot Program, which includes:
16 • a grant program to deliver targeted outreach and direct application assistance;
17 • a media outreach campaign to raise awareness of options for health insurance
18 coverage that are available to Utah children; and
19 • direct enrollment assistance to certain populations; Ŝ→ and ←Ŝ
20 Ŝ→ [
21 ▸ directs the Department of Health to expand eligibility for the Medicaid and
22 Children's Health Insurance Program to include children who do not currently
23 qualify.
24 Money Appropriated in this Bill:
25 None
26 Other Special Clauses:
27 None
28 Utah Code Sections Affected:
29 ENACTS:
30 26-18-27, Utah Code Annotated 1953
31 26-18-28, Utah Code Annotated 1953
32 26-40-117, Utah Code Annotated 1953
33
34 Be it enacted by the Legislature of the state of Utah:
35 Section 1. Section 26-18-27 is enacted to read:
36 26-18-27. Children's Coverage Outreach Pilot Program.
37 (1) As used in this section:
38 Ŝ→ [
39 Account created in Subsection (7).
40 (b)
41 Subsection (2)(a).
42 Ŝ→ [
42a a
43 positive result or outcome for improving the quality of life of individuals or communities in a
44 county by:
45 (i) promoting economic opportunity and innovation;
46 (ii) facilitating collaboration between public and private entities;
47 (iii) improving human health and well-being;
48 (iv) providing low-income or undeserved individuals or communities with beneficial
49 products or services;
50 (v) promoting child and youth development;
51 (vi) targeting specialized populations with social innovation, including populations
52 impacted by:
53 (A) homelessness; or
54 (B) intergenerational poverty; or
55 (vii) conferring any other particular benefit on the community to create a positive
56 impact.
57 (2) (a) There is created the Children's Coverage Outreach Pilot Program within the
58 Department of Health.
59 (b) The purpose of the program is to:
60 (i) make affordable, accessible health care available to all children in Utah;
61 (ii) maximize the enrollment and retention of eligible children in the Medicaid program
62 and the Utah Children's Health Insurance Program created in Title 26, Chapter 40, Utah
63 Children's Health Insurance Act;
64 (iii) perform outreach through Ŝ→ partners, including ←Ŝ schools, churches, and other
64a community organizations
65 that deliver social impact services to increase the number of children in the state who are
66 covered by health insurance;
67 (iv) increase coverage of children in Utah whose family income is at or below 200% of
68 the federal poverty level as defined in Section 26-18-411;
69 (v) create a model that ensures outreach to, enrollment of, and participation of diverse
70 communities with established partnerships and grantees with specific attention to the effect of
71 social determinants of health;
72 (vi) address the impact of social determinants of health through social impact services
73 in outreach and delivery of health care services to Ŝ→ [
73a Section 26-18-27 or 26-40-117 ←Ŝ ;
74 (vii) administer the grant program described in Subsection (4);
75 (viii) conduct the media outreach campaign described in Subsection (5); and
76 (ix) provide enrollment assistance as described in Subsection (6).
77 (3) The department shall convene a working group that consists of individuals with
78 experience in delivering social impact services and conducting outreach to the individuals
79 described in Subsection (2) to create and carry out the program.
80 (4) To maximize the enrollment and retention of eligible children in the Medicaid
81 program and the Utah Children's Health Insurance Program created in Title 26, Chapter 40,
82 Utah Children's Health Insurance Act, the department shall collaborate with the working group
83 described in Subsection (3) to develop Ŝ→ [
83a to
84 organizations and community based groups to deliver culturally specific and targeted outreach
85 and direct application assistance to:
86 (a) members of racial, ethnic, and language minority communities;
87 (b) children living in Ŝ→ [
88 (c) children and family members with additional barriers to accessing health care,
89 including:
90 (i) cognitive, mental health, or sensory disorders;
91 (ii) physical disabilities;
92 (iii) chemical dependency; and
93 (iv) children experiencing homelessness.
94 (5) The department shall develop a media outreach campaign in collaboration with:
95 (a) the working group created in Subsection (3); and
96 (b) the recipients of grant funds under Subsection (4).
97 (6) The department Ŝ→ [
97a through:
98 (a) school based settings;
99 (b) safety net clinics; and
100 (c) community health workers.
101 Ŝ→ [
102 "Children's Coverage Outreach Pilot Program Restricted Account."
103 (b) The restricted account consists of:
104 (i) money appropriated to the restricted account by the Legislature;
105 (ii) private donations; and
106 (iii) all income and interest derived from the deposit and investment of money in the
107 account.
108 (c) Subject to legislative appropriations, money in the restricted account may be used
109 to fund activities related to the program created in this chapter.
110 (d) (i) Except as provided in Subsection (7)(d)(ii), the program shall be funded solely
111 with money from the account.
112 (ii)
112a services
113 for children Ŝ→ [
113a1 under any
113a available Medicaid or CHIP program, including the emergency only program under Section
113b 1902 of the Social Security Act, before enrolling a child in the program Ŝ→ [
113c Subsection (7)(a)
114 Section 2. Section 26-18-28 is enacted to read:
115 26-18-28. Presumptive eligibility for children -- Expansion of coverage to all Utah
116 children.
117 (1) Notwithstanding any other provision of this title, the department shall permit an
118 enrollee who is 18 years old or younger to remain in the Medicaid program for a 12-month
119 certification period, as that certification period is defined by the department.
120 (2) The department shall, in accordance with this section, expand eligibility for the
121 Medicaid program to individuals who:
122 (a) are 18 years old or younger;
123 (b) are otherwise ineligible for federal financial participation; and
124 (c) meet the income requirement for coverage under the Medicaid program.
125 (3) The department shall expand eligibility for Medicaid under Subsection (2) on the
126 earlier of:
127 (a) when the director determines that systems have been programmed for
128 implementation of this section; and
129 (b) July 1, Ŝ→ [
130 (4) (a) An individual who is eligible for coverage under the Medicaid program under
131 Subsection (2) shall be eligible for the full scope of Medicaid benefits that the individual would
132 otherwise receive if the individual was otherwise eligible for federal financial participation.
133 (b) Ŝ→ [
134 Subsection (2) shall be required to enroll in a Medicaid Ŝ→ [
134a managed care ←Ŝ delivery
135 system, where implemented.
136 (c) (i) The department shall:
137 (A) seek any necessary federal approvals to obtain federal financial participation in
138 implementing this section; and
139 (B) maximize federal financial participation in implementing this section.
140 (ii) If federal financial participation is not available to pay a portion of the cost of
141 providing coverage under this section, the cost shall be paid solely with state funds.
142 (5) Section 26-18-18 does not apply to an expansion of Medicaid under this section.
143 Section 3. Section 26-40-117 is enacted to read:
144 26-40-117. Expansion of coverage to all Utah children.
145 (1) Notwithstanding Subsection 26-40-105(1), the department shall, in accordance with
146 this section, expand eligibility for the program to individuals who:
147 (a) are 18 years old or younger;
148 (b) are otherwise ineligible for federal financial participation; and
149 (c) meet the income requirement for coverage under the program.
150 (2) The department shall expand eligibility for the program under Subsection (1) on the
151 earlier of:
152 (a) when the Ŝ→ [
152a programmed for
153 implementation of this section; and
154 (b) July 1, Ŝ→ [
155 (3) (a) An individual who is eligible for coverage under the program under Subsection
156 (1) shall be eligible for the full scope of benefits that the individual would otherwise receive if
157 the individual was otherwise eligible for federal financial participation.
158 (b) (i) The department shall:
159 (A) seek any necessary federal approvals to obtain federal financial participation in
160 implementing this section; and
161 (B) maximize federal financial participation in implementing this section.
162 (ii) If federal financial participation is not available to pay a portion of the cost of
163 providing coverage under this section, the cost shall be paid solely with state funds.