S.B. 819

VETOES

(2) ASSIST MEDICALLY AND FUNCTIONALLY IMPAIRED INDIVIDUALS IN
THE COMMUNITY, OR WHEN DISCHARGED FROM A HOSPITAL, RECEIVE HOME AND
COMMUNITY-BASED WAIVER SERVICES; AND

(3) MAKE ADJUSTMENTS IN MEDICAID REIMBURSEMENTS AS PROVIDED
IN SUBSECTION (C)(2)(III) OF THIS SECTION.

[(b)] (F) On or before [August 1, 1999] SEPTEMBER 1, 2004, the Department
shall apply to the [Health Care Financing Administration] CENTERS FOR MEDICARE
AND MEDICAID SERVICES of the United States Department of Health and Human
Services for an amendment to the existing home and community based services
waiver (Control Number 0265.90) under § 1915(c) of the federal Social Security Act to
receive federal matching funds for waiver services received by eligible medically and
functionally impaired individuals participating in the waiver AND TO RECEIVE
FEDERAL MATCHING FUNDS FOR WAIVER SERVICES TO ASSIST DUALLY ELIGIBLE
NURSING FACILITY RESIDENTS IN OBTAINING LONG TERM CARE SERVICES IN THE
COMMUNITY.

(C) (1) IF PERMITTED BY THE CENTERS FOR MEDICARE AND MEDICAID
SERVICES, AN INDIVIDUAL SHALL BE DETERMINED MEDICALLY ELIGIBLE TO
RECEIVE SERVICES UNDER THE WAIVER UNDER SUBSECTION (B) OF THIS SECTION IF
THE INDIVIDUAL REQUIRES:

(I)      SKILLED NURSING FACILITY CARE OR OTHER RELATED
SERVICES;

(II)     REHABILITATION SERVICES; OR

(III)   HEALTH-RELATED SERVICES ABOVE THE LEVEL OF ROOM AND
BOARD THAT ARE AVAILABLE ONLY THROUGH NURSING FACILITIES, INCLUDING
INDIVIDUALS WHO BECAUSE OF SEVERE COGNITIVE IMPAIRMENTS OR OTHER
CONDITIONS:

1. A. ARE CURRENTLY UNABLE TO PERFORM AT LEAST
TWO ACTIVITIES OF DAILY LIVING WITHOUT HANDS-ON ASSISTANCE OR STANDBY
ASSISTANCE FROM ANOTHER INDIVIDUAL; AND

B. HAVE BEEN OR WILL BE UNABLE TO PERFORM AT LEAST
TWO ACTIVITIES OF DAILY LIVING FOR A PERIOD OF AT LEAST 90 DAYS DUE TO A
LOSS OF FUNCTIONAL CAPACITY; OR

2. NEED SUBSTANTIAL SUPERVISION FOR PROTECTION
AGAINST THREATS TO HEALTH AND SAFETY DUE TO SEVERE COGNITIVE
IMPAIRMENT.

(2) THE DEPARTMENT SHALL ADOPT REGULATIONS TO CARRY OUT THE
PROVISIONS OF THIS SUBSECTION.

[(c)] (G)(D) The Department's waiver application shall include the
following GOALS AND OBJECTIVES:

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