Personal Independence Commission

Legislative Workgroup

The Legislative Work Group made the following legislative recommendations.  The PIC supported these three recommendations, and research is being done to determine any legal or other barriers.

1.  Establish an exemption for children with disabilities to the requirement that children be uninsured six months before qualifying for the Children's Health Insurance Program.  Children with special health care needs cannot afford to go without health care coverage for six months.

Status: Senator Dougherty has pre-filed a bill to do this.

2.  Change the Medicaid income eligibility rules to apply an income disregard for housing costs that are over $163.50, with a maximum disregard of $300.  [$163.50 (30% of SSI) is the amount that an individual receiving SSI pays for public housing through HUD].  For example, if an individual's rent is $350, their income disregard would be $350 minus $163.50, or $186.50.  This would reduce the individual's spenddown and allow them to keep enough money to pay for housing, which is one of the highest expenses people have.

Status: The workgroup has put the discussion on income disregards on hold because there is no money in the budget.

3.  Change the definition of the "homebound" requirement for Medicaid home health so that an individual can sometimes leave his or her home and still qualify for home health.  The Center for Medicare and Medicaid Services issued a policy clarification that states should change the definition to allow people to leave their homes.  US. Dept. of Health and Human Services said that "State policies that impose the requirement that one must be homebound to receive Medicaid home health services can create barriers to community participation. Specifically, HCFA indicates that such a State-imposed limit violates Medicaid's requirement that home health services be made available on a comparable basis to anyone on Medicaid who would qualify based on their needs."  Currently, individuals who are using Medicaid home health cannot participate in any activity in the community without being disqualified.   There are many people who need home health care who need to and want to get out of their homes into the community for things such as attending a grandchild's high school graduation or participating in support groups.

Status: The workgroup will ask Division of Medical Services whether this requires rule change or legislation. If it takes legislation, Senator Dougherty and the workgroup will draft legislation.