Adopted

AMENDMENT NO 2 PROPOSED TO

Cmte Sub for House Bill No.  528

BY: Representative Holland

     AMEND by inserting the following new section after line 1037:

     "SECTION 4.  The following shall be codified as Section 43-13-121.1, Mississippi Code of 1972:

      43-13-121.1.  (1)  It is the intent of the Legislature to implement a "money follows the person" process by which a portion of the money used to cover the cost of nursing facility services for Medicaid-eligible beneficiaries may be transferred to fund home- and community-based waiver services through the Elderly and Disabled Waiver, administered by the Division of Medicaid, and the Independent Living Waiver and the Traumatic Brain Injury/Spinal Cord Injury Waiver, administered by the Department of Rehabilitation Services.

      (2)  Notwithstanding any other state law, the Executive Director of the Division of Medicaid is authorized to transfer funds allocated for nursing facility services for Medicaid-eligible nursing facility residents to cover the cost of home- and community-based waiver services if the nursing facility resident meets the eligibility criteria for either the Elderly and Disabled Waiver, the Independent Living Waiver, or the Traumatic Brain Injury/Spinal Cord Injury Waiver program and the resident chooses to receive those services.

     (3)  The authority of the executive director of the division to transfer funds from nursing facility services shall apply to home- and community-based waiver programs administered by the division, the Department of Rehabilitation Services and the Department of Mental Health.

     (4)  Under the "money follows the person" process, the executive director of the division shall transfer funds to the appropriate home- and community-based waiver program administering agency to cover the cost of services provided through the Elderly and Disabled Waiver, the Independent Living Waiver, and the Traumatic Brain Injury/Spinal Cord Injury Waiver programs for  Medicaid-eligible nursing facility residents who choose to leave the nursing facility and receive home- and community-based waiver services.  The executive director of the division shall ensure that the amount transferred under this section is redirected to the appropriate home- and community-based waiver program in an amount sufficient to provide waiver services to each nursing facility resident upon his or her discharge from the nursing facility.

     (5)  The number of nursing facility residents who receive home- and community-based waiver services through the "money follows the person" process will not count against the total number of individuals previously approved by the Centers for Medicare and Medicaid Services (CMS) to receive home- and community-based services through the Elderly and Disabled Waiver, the Independent Living Waiver, or the Traumatic Brain Injury/Spinal Cord Injury Waiver programs.  In addition, the number of nursing facility residents who receive services as a result of the "money follows the person" process shall not count against any additional slots approved by CMS and authorized by the state as a result of prior litigation settlements reached by the state.  Instead, the division shall request CMS to amend the Elderly and Disabled Waiver, the Independent Living Waiver, and the Traumatic Brain Injury/Spinal Cord Injury Waiver, as necessary, to obtain authorization from CMS to specifically serve this group of former nursing facility residents through the "money follows the person" process.

     (6)  Rules and regulations pertaining to the implementation of the process shall be written and promulgated by the division no later than September 1, 2007.  Two months before implementation of the "money follows the person" process, the executive director of the division shall send a letter to all Medicaid-eligible nursing facility residents informing them of the option to obtain home- and community-based waiver services through this process and providing them with contact information for applying for home- and community-based waiver services.

     (7)  Consistent with federal requirements, the division shall assure that necessary safeguards are taken to protect the health and safety of nursing facility residents who choose to receive home- and community-based waiver services through the "money follows the person" process.  This assurance must include a formal system by which: 

          (a)  The division or its designee monitors that all provider standards and health and welfare protections are continuously met; and

          (b)  Plans of care for waiver participants are  periodically reviewed to ensure that the services furnished are consistent with the identified needs of waiver participants; and

          (c)  All deficiencies identified through this quality monitoring system are addressed in an appropriate and timely manner, consistent with the severity and nature of the deficiencies.

     (8)  There shall be a Money Follows the Person (MFP) Advisory Committee to make recommendations and advise the division with regard to the process mandated in this act, by which funding for nursing facility services for Medicaid-eligible beneficiaries may be used to pay for home- and community-based waiver services for those nursing facility residents who choose to receive those services.  The committee shall be composed of the following individuals:

          (a)  The respective chairmen of the House Public Health and Human Services Committee and the Senate Public Health and Welfare Committee;

          (b)  One (1) member of the House of Representatives appointed by the Speaker of the House, and one (1) member of the Senate appointed by the Lieutenant Governor;

          (c)  The executive directors of the State Department of Mental Health and of the State Department of Rehabilitation

Services;

          (d)  One (1) member each appointed by the Speaker of the House and the Lieutenant Governor, from among the membership of any recognized statewide association representing the concerns of the nursing facility owners and managers; and

          (e)  One (1) member each appointed by the Chairman of the House Public Health and Human Services Committee and the Chairman of the Senate Public Health and Welfare Committee, from among members of the community representing the concerns of individuals with disabilities. 

     (9)  The executive director of the division shall report to the Attorney General the name and location of individuals who have transitioned from nursing facilities to the Elderly and Disabled Waiver, the Independent Living Waiver, and the Traumatic Brain Injury/Spinal Cord Injury Waiver programs.  The director shall furnish, to each individual making such a transition and to the person who will be responsible for providing home- and community-based waiver services to the individual, the telephone number of the Attorney General's Office and a copy of the Mississippi Vulnerable Adults Act contained in Sections 43-47-1 through 43-47-37, with particular emphasis on the penalties imposed under that act.  The Attorney General is authorized to designate members of his office to initiate follow-up visits with those individuals who have made such a transition.

     (10)  The executive director of the division shall submit an annual report by January 1 of each year to the Legislature and to the MFP Advisory Committee concerning: 

          (a)  The number of individuals who have transitioned from nursing facilities to the Elderly and Disabled Waiver, the Independent Living Waiver, and the Traumatic Brain Injury/Spinal Cord Injury Waiver programs;

          (b)  The number of individuals in nursing facilities who have indicated that they want to return to the community; and

          (c)  The number of individuals on referral lists for the Elderly and Disabled Waiver, the Independent Living Waiver, and the Traumatic Brain Injury/Spinal Cord Injury Waiver programs."

     AMEND FURTHER by renumbering the section that begins on line 1038.

     AMEND FURTHER the title by inserting the following after the semicolon on line 15:

"TO CODIFY NEW SECTION 43-13-121.1, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE DIVISION OF MEDICAID SHALL IMPLEMENT A "MONEY FOLLOWS THE PERSON" PROCESS BY WHICH FUNDING FOR NURSING FACILITY SERVICES FOR MEDICAID-ELIGIBLE BENEFICIARIES MAY BE USED TO PAY FOR HOME- AND COMMUNITY-BASED WAIVER SERVICES FOR THOSE NURSING FACILITY RESIDENTS WHO CHOOSE THOSE SERVICES;"