1     
CAREGIVER COMPENSATION AMENDMENTS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Wayne A. Harper

5     
House Sponsor: Jennifer Dailey-Provost

6     

7     LONG TITLE
8     General Description:
9          This bill addresses reimbursement for certain personal care services under Medicaid.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms;
13          ▸     directs the Department of Health and Human Services to:
14               •     apply for an amendment to an existing waiver to the state Medicaid plan to
15     implement a program to reimburse a parent or guardian who provides
16     extraordinary personal care services to a waiver enrollee; and
17               •     make administrative rules defining personal care services that are extraordinary;
18     and
19          ▸     makes technical and conforming changes.
20     Money Appropriated in this Bill:
21          This bill appropriates in fiscal year 2023:
22          ▸     to the Department of Health and Human Services -- Long-term Services & Support
23     -- Community Supports Waiver Services:
24               •     from Closing Nonlapsing, ($1,734,500).
25          This bill appropriates in fiscal year 2024:
26          ▸     to the Department of Health and Human Services -- Long-term Services & Support
27     -- Community Supports Waiver Services:
28               •     from Beginning Nonlapsing $1,734,500.

29     Other Special Clauses:
30          None
31     Utah Code Sections Affected:
32     AMENDS:
33          26-18-426, as enacted by Laws of Utah 2021, Chapter 212
34     

35     Be it enacted by the Legislature of the state of Utah:
36          Section 1. Section 26-18-426 is amended to read:
37          26-18-426. Medicaid waiver expansion for extraordinary care reimbursement.
38          (1) As used in this section:
39          (a) "Existing home and community-based services waiver" means an existing home
40     and community-based services waiver in the state that serves an individual:
41          (i) with an acquired brain injury;
42          (ii) with an intellectual or physical disability; or
43          (iii) who is 65 years old or older.
44          (b) "Guardian" means a person appointed by a court to manage the affairs of a living
45     individual.
46          (c) "Parent" means a biological or adoptive parent of an individual.
47          (d) "Personal care services" means a service that:
48          (i) is furnished to an individual who is not an inpatient nor a resident of a hospital,
49     nursing facility, intermediate care facility, or institution for mental diseases;
50          (ii) is authorized for an individual described in Subsection [(1)(b)(i)] (1)(d)(i) in
51     accordance with a plan of treatment;
52          (iii) is provided by an individual who is qualified to provide the services; and
53          (iv) is furnished in a home or another community-based setting.
54          [(c)] (e) "Waiver enrollee" means an individual who is enrolled in an existing home
55     and community-based services waiver.

56          (2) Before July 1, 2021, the department shall apply with CMS for an amendment to an
57     existing home and community-based services waiver to implement a program to offer
58     reimbursement to an individual who provides personal care services that constitute
59     extraordinary care to a waiver enrollee who is the individual's spouse.
60          (3) If CMS approves the amendment described in Subsection (2), the department shall
61     implement the program described in Subsection (2).
62          (4) The department shall by rule, made in accordance with Title 63G, Chapter 3, Utah
63     Administrative Rulemaking Act, define "extraordinary care" for purposes of Subsection (2).
64          (5) Before July 1, 2023, the department shall apply with CMS for an amendment to an
65     existing home and community-based services waiver to implement a program to offer
66     reimbursement to an individual who provides personal care services that constitute
67     extraordinary care to a waiver enrollee to whom the individual is a parent or guardian.
68          (6) If CMS approves the amendment described in Subsection (5), the department shall
69     implement the program described in Subsection (5).
70          (7) The department shall by rule, made in accordance with Title 63G, Chapter 3, Utah
71     Administrative Rulemaking Act, define "extraordinary care" for purposes of Subsection (5).
72          Section 2. Appropriation.
73          The following sums of money are appropriated for the fiscal year beginning July 1,
74     2022, and ending June 30, 2023. These are additions to amounts previously appropriated for
75     fiscal year 2023. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
76     Act, the Legislature appropriates the following sums of money from the funds or accounts
77     indicated for the use and support of the government of the state of Utah.
78     To Department of Health and Human Services -- Long-term Services & Support
79          From Closing Nonlapsing
(1,734,500)

80          Schedule of Programs:
81               Community Supports Waiver Services               (1,734,500)
82          Section 3. Appropriation.

83          The following sums of money are appropriated for the fiscal year beginning July 1,
84     2023, and ending June 30, 2024. These are additions to amounts previously appropriated for
85     fiscal year 2024. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
86     Act, the Legislature appropriates the following sums of money from the funds or accounts
87     indicated for the use and support of the government of the state of Utah.
88     To Department of Health and Human Services -- Long-term Services & Support
89          From Beginning Nonlapsing
1,734,500

90          Schedule of Programs:
91               Community Supports Waiver Services               1,734,500
92          The Legislature intends that the Department of Health and Human Services use up to
93     $1,734,500 beginning nonlapsing balance from the Long-term Services & Support line item in
94     FY 2024 to help fund the state costs of S.B. 106 Caregiver Compensation Amendments.