COMMITTEE SUBSTITUTE
FOR
H. B. 4473
(By Mr. Speaker, (Mr. Kiss), and Delegates Leach, Perdue and
Michael)
[Originating in theCommittee on Government Organization.]
[February 23, 2006]
A BILL to amend the Code of West Virginia, 1931, as amended, by
adding thereto a new article, designated §9-4E-1, §9-4E-2,
§9-4E-3, §9-4E-4, §9-4E-5 and §9-4E-6, all relating to funding
for community-based services and supports for individuals with
disabilities; establishing the "Money Follows the Person Act";
providing definitions for certain terms; requiring the
Department of Health and Human Resources to modify certain
policies to improve community-based long-term services;
providing for individual support services; legislative
oversight; and requiring legislative rules.
Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended
by adding thereto a new article, designated §9-4E-1, §9-4E-2,
§9-4E-3, §9-4E-4, §9-4E-5 and §9-4E-6, all to read as follows:
ARTICLE 4E. MONEY FOLLOWS THE PERSON ACT.
§9-4E-1. Title.
This act shall be known as and may be cited as the "Money
Follows the Person Act."
§9-4E-2. Definitions.
As used in this article:
(1) "Community-based services and supports" means services and
supports designed to assist the consumer in accomplishing
activities of daily living and health-related tasks in order to
function in the most integrated setting. These services and
supports are furnished to an individual:
(A) Under a plan of services that is based on an assessment of
functional need and that is agreed to by the individual or the
individual's representative; and
(B) Under existing models or new models developed as part of
enduring improvements in community-based services and supports.
(2) "Consumer" means an eligible individual who is currently
receiving services and supports in an institutional setting.
(3) "Department" means the Department of Health and Human
Resources.
(4) "Eligible individual" means an individual who has a severe
chronic or permanent disability that precludes or significantly
impairs the individual's independent performance of essential
activities of daily living, self-care, or mobility. This includes
an individual with a cognitive, sensory, mental health, or physical
disability who:
(A) Has a functional need that limits the individual's ability
to perform one or more activities of daily living;
(B) Requires substantial supervision or episodic or short-term
crisis assistance; or
(C) Needs assistance with the performance of health-related
tasks.
(6) "Functional need" means the need for services and supports based on abilities and limitations of the consumer, regardless of
medical diagnosis or other category of disability.
(7) "Other service options" means methods other than an
agency-provider model including vouchers, direct cash payments, or
use of a fiscal agent to assist in obtaining services.
(8) "Representative" means a parent, family member, guardian,
advocate, or authorized representative of an eligible individual.
§9-4E-3. Program components, standards and requirements; planning
and oversight committee.
(a) The department shall modify policies and procedures to
allow the administrative transfer or integration of funds from
state budget accounts that are obligated for expenditures for
long-term care facilities to other accounts for the obligation for
the provision of community-based services and supports when an
eligible individual transitions from residing in such a facility to
residing in the community.
(b) The department shall design and implement enduring
improvements in community-based long-term services and support
systems to enable eligible individuals with disabilities to live
and participate in community life, particularly with respect to
those practices that will ensure the successful transition of
eligible individuals who:
(1) Reside in a nursing home, intermediate care facility for
the mentally retarded or other institutional setting; and
(2) Would prefer to live in the community and could do so,
provided that they have the appropriate community-based services
and supports that would enable them to live and function in the
community setting.
(c) The department will engage in system reform activities to
re-balance expenditures for long-term services through
administrative actions that reduce reliance on institutional forms
of service and build up more community capacity.
(d) The department shall utilize the Olmstead Advisory Council
as the planning and oversight committee to assist in the
development and implementation of all aspects of a comprehensive
program of community-based services and supports, including program
standards, eligibility determination instrument and protocol, and
a quality assurance program.
(e) To the extent possible, an eligible individual may select,
manage, and control his or her own community-based services and
supports in order to move into the community.
(f) Community-based services and supports shall be provided in
the most integrated community setting but may not be provided in a
nursing facility, intermediate care facility for the mentally
retarded, or other congregate setting.
(g) The department shall identify and educate eligible
individuals residing in long-term care facilities about the
opportunity to receive community-based services and supports.
(h) The department shall ensure that each eligible individual
identified has the opportunity and information to make an informed
choice regarding whether to transition to the community with
community-based services.
(i) The department shall maintain an adequate quality
improvement system so that eligible individuals receive adequate
services and supports.
(j) A consumer receiving services and supports under this article may receive assistance if the consumer needs home- and
community-based services and supports in order to move into the
community.
§9-4E-4. Individual support plans; appeal.
(a) A mutually-agreed-upon, individualized services plan shall
be jointly developed by the consumer and the department or its
designee for each consumer of community-based services and supports
as prescribed by the community-based program for which they are
eligible.
(b) A consumer who is dissatisfied with the administration or
provision of his or her community-based services and supports shall
have a right of appeal to the department.
§9-4E-5. Legislative oversight; required reports.
The department shall report to the Legislative Oversight
Commission on Health and Human Resources accountability every three
months concerning the progress of policy changes to eliminate the
institutional bias and the status of those eligible individuals who
choose to move to community-based settings. The first report is
due on or before the first day of September, two thousand six.
§9-4E-6. Legislative rules.
On or before the twenty-eighth day of June, two thousand six,
the Secretary of the Department of Health and Human Resources, in
consultation with the Olmstead Advisory Council, shall propose
rules for legislative approval in accordance with the provisions of
article three, chapter twenty-nine-a of this code
, to implement the
provisions of this article, including but not limited to program
components, standards and requirements as set forth in section
three of this article, and an appeal process as set forth in section four of this article.
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