Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 137 (2024GS)

Sponsor

Rep. Dailey-Provost, J.

Final action

House/ filed 3/1/2024

Outcome

Failed / filed without passage

Summary

What it does

• This bill:
• defines terms;
• requires the Department of Health and Human Services (department) to apply for a Medicaid waiver or state plan amendment to provide wraparound services to qualified individuals with a disability;
• requires qualified individuals who receive services under the waiver or state plan amendment to make cost-sharing payments according to a sliding scale established by the department;
• specifies certain percentages and maximum payment amounts for the sliding scale established by the department; and
• requires the department to make rules.

Every vote on this bill

Bill text

DISABILITY COVERAGE AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Jennifer Dailey-Provost
Senate Sponsor: 
____________
LONG TITLE
General Description:
This bill addresses wraparound services for certain individuals with a disability.
Highlighted Provisions:
This bill:
▸ defines terms;
▸ requires the Department of Health and Human Services (department) to apply for a
Medicaid waiver or state plan amendment to provide wraparound services to
qualified individuals with a disability;
▸ requires qualified individuals who receive services under the waiver or state plan
amendment to make cost-sharing payments according to a sliding scale established
by the department;
▸ specifies certain percentages and maximum payment amounts for the sliding scale
established by the department; and
▸ requires the department to make rules.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
ENACTS:
26B-3-229
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26B-3-229
 is enacted to read:
 26B-3-229.
Wraparound services for qualified individuals with a disability.
(1) As used in this section:
(a) "Federal poverty level" means the same as that term is defined in Section
26B-3-207
.
(b) "Minimum essential coverage" means the same as that term is defined in 26 U.S.C.
Sec. 5000A.
(c) "Qualified individual" means an individual who:
(i) is a disabled individual as described in 42 U.S.C. Sec. 1382c;
(ii) within the past 12 months has been enrolled in the state Medicaid program;
(iii) is enrolled in minimum essential coverage other than the Medicaid program;
(iv) except as provided in Subsections (1)(c)(v) and (vi), does not meet the income or
asset requirements for enrollment in the state Medicaid program;
(v) has a household income that is between 250% and 500% of the federal poverty
level; and
(vi) has assets, excluding one home and one automobile, that are valued at less than
$125,000.
(d) "Wraparound services" means services and benefits that:
(i) are covered by the Medicaid program; and
(ii) are not covered by the minimum essential coverage described in Subsection
(1)(c)(iii).
(2) Before July 1, 2024, the department shall apply for a Medicaid waiver with CMS to
provide wraparound services to qualified individuals:
(a) as state funding permits; and
(b) in a manner that requires qualified individuals to make cost sharing payments
according to the sliding scale described in Subsection (3).
(3) (a) The department shall establish a sliding scale for services received under this
section that:
(i) is based on household income; and
(ii) is used to determine the percentage of the cost of a wraparound service that a
qualified individual is required to pay.
(b) The percentage of the cost of wraparound services that a qualified individual is
required to pay:
(i) may not be less than 100% for a qualified individual with a household income
greater than $125,000; and
(ii) for a qualified individual with a household income less than or equal to $125,000,
shall be determined according to income categories established by the department as provided
in Subsection (4).
(c) Notwithstanding Subsection (3)(b), the amount paid by a qualified individual under
Subsection (3)(b) may not exceed:
(i) $2,900 per month for a qualified individual with a household income greater than
$125,000; and
(ii) for a qualified individual with a household income less than or equal to $125,000,
an amount determined according to income categories established by the department as
provided in Subsection (4).
(d) The department shall credit the amount of premium payments that a qualified
individual makes for minimum essential coverage other than Medicaid toward the amount that
a qualified individual is required to pay for wraparound services under this section.
(4) The department shall make rules in accordance with Title 63G, Chapter 3, Utah
Administrative Rulemaking Act, to:
(a) establish the income categories, percentages, and maximum payment amounts
described in Subsection (3); and
(b) provide continuous enrollment for 12 months for a qualified individual who
receives wraparound services in accordance with this section.
(5) If a waiver or state plan amendment described in Subsection (2) is approved, the
department shall provide wraparound services in accordance with this section.
Section 2. 
Effective date.
This bill takes effect on May 1, 2024.