75th OREGON LEGISLATIVE ASSEMBLY--2010 Special Session

                            Enrolled

                         House Bill 3664

Sponsored by COMMITTEE ON HEALTH CARE

                     CHAPTER ................

                             AN ACT

Relating to medical assistance for individuals under the age of
  21 who age out of foster care; creating new provisions;
  amending ORS 411.400, 411.402 and 414.025 and section 1,
  chapter 867, Oregon Laws 2009; and declaring an emergency.

Be It Enacted by the People of the State of Oregon:

  SECTION 1. ORS 414.025 is amended to read:
  414.025. As used in this chapter, unless the context or a
specially applicable statutory definition requires otherwise:
  (1) 'Category of aid' means assistance provided by the Oregon
Supplemental Income Program, aid granted under ORS 412.001 to
412.069 and 418.647 or federal Supplemental Security Income
payments.
  (2) 'Categorically needy' means, insofar as funds are available
for the category, a person who is a resident of this state and
who:
  (a) Is receiving a category of aid.
  (b) Would be eligible for a category of aid but is not
receiving a category of aid.
  (c) Is in a medical facility and, if the person left such
facility, would be eligible for a category of aid.
  (d) Is under the age of 21 years and would be a dependent child
as defined in ORS 412.001 except for age and regular attendance
in school or in a course of professional or technical training.
  (e)(A) Is a caretaker relative, as defined in ORS 412.001, who
cares for a child who would be a dependent child except for age
and regular attendance in school or in a course of professional
or technical training; or
  (B) Is the spouse of the caretaker relative.
  (f) Is under the age of 21 years  { - , - }  { +  and:
  (A) + } Is in a foster family home or licensed child-caring
agency or institution   { - under a purchase of care
agreement - }  and is one for whom a public agency of this state
is assuming financial responsibility, in whole or in part { + ;
or
  (B) Is 18 years of age or older, is one for whom federal
financial participation is available under Title XIX or XXI of
the federal Social Security Act and who met the criteria in
subparagraph (A) of this paragraph immediately prior to the
person's 18th birthday + }.
  (g) Is a spouse of an individual receiving a category of aid
and who is living with the recipient of a category of aid, whose
needs and income are taken into account in determining the cash

Enrolled House Bill 3664 (HB 3664-A)                       Page 1

needs of the recipient of a category of aid, and who is
determined by the Department of Human Services to be essential to
the well-being of the recipient of a category of aid.
  (h) Is a caretaker relative as defined in ORS 412.001 who cares
for a dependent child receiving aid granted under ORS 412.001 to
412.069 and 418.647 or is the spouse of the caretaker relative.
  (i) Is under the age of 21 years, is in a youth care center and
is one for whom a public agency of this state is assuming
financial responsibility, in whole or in part.
  (j) Is under the age of 21 years and is in an intermediate care
facility which includes institutions for persons with mental
retardation.
  (k) Is under the age of 22 years and is in a psychiatric
hospital.
  (L) Is under the age of 21 years and is in an independent
living situation with all or part of the maintenance cost paid by
the Department of Human Services.
  (m) Is a member of a family that received aid in the preceding
month under ORS 412.006 or 412.014 and became ineligible for aid
due to increased hours of or increased income from employment. As
long as the member of the family is employed, such families will
continue to be eligible for medical assistance for a period of at
least six calendar months beginning with the month in which such
family became ineligible for assistance due to increased hours of
employment or increased earnings.
  (n) Is an adopted person under 21 years of age for whom a
public agency is assuming financial responsibility in whole or in
part.
  (o) Is an individual or is a member of a group who is required
by federal law to be included in the state's medical assistance
program in order for that program to qualify for federal funds.
  (p) Is an individual or member of a group who, subject to the
rules of the department, may optionally be included in the
state's medical assistance program under federal law and
regulations concerning the availability of federal funds for the
expenses of that individual or group.
  (q) Is a pregnant woman who would be eligible for aid granted
under ORS 412.001 to 412.069 and 418.647, whether or not the
woman is eligible for cash assistance.
  (r) Except as otherwise provided in this section, is a pregnant
woman or child for whom federal financial participation is
available under Title XIX or XXI of the federal Social Security
Act.
  (s) Is not otherwise categorically needy and is not eligible
for care under Title XVIII of the federal Social Security Act or
is not a full-time student in a post-secondary education program
as defined by the Department of Human Services by rule, but whose
family income is less than the federal poverty level and whose
family investments and savings equal less than the investments
and savings limit established by the department by rule.
  (t) Would be eligible for a category of aid but for the receipt
of qualified long term care insurance benefits under a policy or
certificate issued on or after January 1, 2008. As used in this
paragraph, 'qualified long term care insurance' means a policy or
certificate of insurance as defined in ORS 743.652 (6).
  (u) Is eligible for the Health Care for All Oregon Children
program established in ORS 414.231.
  (3) 'Income' has the meaning given that term in ORS 411.704.
  (4) 'Investments and savings' means cash, securities as defined
in ORS 59.015, negotiable instruments as defined in ORS 73.0104

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and such similar investments or savings as the Department of
Human Services may establish by rule that are available to the
applicant or recipient to contribute toward meeting the needs of
the applicant or recipient.
  (5) 'Medical assistance' means so much of the following medical
and remedial care and services as may be prescribed by the Oregon
Health Authority according to the standards established pursuant
to ORS 413.032, including payments made for services provided
under an insurance or other contractual arrangement and money
paid directly to the recipient for the purchase of medical care:
  (a) Inpatient hospital services, other than services in an
institution for mental diseases;
  (b) Outpatient hospital services;
  (c) Other laboratory and X-ray services;
  (d) Skilled nursing facility services, other than services in
an institution for mental diseases;
  (e) Physicians' services, whether furnished in the office, the
patient's home, a hospital, a skilled nursing facility or
elsewhere;
  (f) Medical care, or any other type of remedial care recognized
under state law, furnished by licensed practitioners within the
scope of their practice as defined by state law;
  (g) Home health care services;
  (h) Private duty nursing services;
  (i) Clinic services;
  (j) Dental services;
  (k) Physical therapy and related services;
  (L) Prescribed drugs, including those dispensed and
administered as provided under ORS chapter 689;
  (m) Dentures and prosthetic devices; and eyeglasses prescribed
by a physician skilled in diseases of the eye or by an
optometrist, whichever the individual may select;
  (n) Other diagnostic, screening, preventive and rehabilitative
services;
  (o) Inpatient hospital services, skilled nursing facility
services and intermediate care facility services for individuals
65 years of age or over in an institution for mental diseases;
  (p) Any other medical care, and any other type of remedial care
recognized under state law;
  (q) Periodic screening and diagnosis of individuals under the
age of 21 years to ascertain their physical or mental
impairments, and such health care, treatment and other measures
to correct or ameliorate impairments and chronic conditions
discovered thereby;
  (r) Inpatient hospital services for individuals under 22 years
of age in an institution for mental diseases; and
  (s) Hospice services.
  (6) 'Medical assistance' includes any care or services for any
individual who is a patient in a medical institution or any care
or services for any individual who has attained 65 years of age
or is under 22 years of age, and who is a patient in a private or
public institution for mental diseases. 'Medical assistance '
includes 'health services' as defined in ORS 414.705. 'Medical
assistance' does not include care or services for an inmate in a
nonmedical public institution.
  (7) 'Medically needy' means a person who is a resident of this
state and who is considered eligible under federal law for
medically needy assistance.
  (8) 'Resources' has the meaning given that term in ORS 411.704.
For eligibility purposes, 'resources' does not include charitable

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contributions raised by a community to assist with medical
expenses.
  SECTION 2. Section 1, chapter 867, Oregon Laws 2009, as amended
by section 46, chapter 828, Oregon Laws 2009, is amended to read:
   { +  Sec. 1. + } (1) The Health System Fund is established in
the State Treasury, separate and distinct from the General Fund.
Interest earned by the Health System Fund shall be credited to
the fund.
  (2) Amounts in the Health System Fund are continuously
appropriated to the Oregon Health Authority for the purpose of
funding the Health Care for All Oregon Children program
established in   { - section 27, chapter 867, Oregon Laws
2009 - }   { + ORS 414.231 + }, health services described in ORS
414.705 (1)(a) to (j) and other health services. Moneys in the
fund may also be used by the authority to:
  (a) Provide grants to community health centers and safety net
clinics under   { - section 33, chapter 867, Oregon Laws 2009 - }
 { + ORS 413.225 + }.
  (b) Pay refunds due under section 41, chapter 736, Oregon Laws
2003, and under section 11, chapter 867, Oregon Laws 2009.
  (c) Pay administrative costs incurred by the authority to
administer the assessment in section 9, chapter 867, Oregon Laws
2009.
   { +  (d) Provide health services described in ORS 414.705 to
individuals described in ORS 414.025 (2)(f)(B). + }
  (3) The authority shall develop a system for reimbursement by
the authority to the Office of Private Health Partnerships out of
the Health System Fund for costs associated with administering
the private health option pursuant to   { - section 30, chapter
867, Oregon Laws 2009 - }  { +  ORS 414.826 + }.
  SECTION 3. ORS 411.400 is amended to read:
  411.400. (1) Application for any category of aid shall also
constitute application for medical assistance.
  (2) Except as otherwise provided in this section,   { - each
person requesting medical assistance shall make application
therefor to the Department of Human Services - }  { +  a person
shall request medical assistance by filing an application as
provided in ORS 411.081 + }.
   { +  (3) + } The Department  { + of Human Services + } shall
determine eligibility for and fix the date on which
 { - such - }   { + medical + } assistance may begin, and shall
obtain such other information required by the rules of the
department.
    { - (3) - }  { +  (4) + } If an applicant is unable to make
application for medical assistance, an application may be made by
someone acting responsibly for the applicant.
   { +  (5) The department may modify the application
requirements in ORS 411.081 for a person whose basis of
eligibility for medical assistance changes from one category of
aid to another category of aid under ORS 414.025 (2). + }
  SECTION 4. ORS 411.402 is amended to read:
  411.402. For each person applying for medical assistance, the
Department of Human Services shall fully document:
  (1) The category of aid as defined in ORS 414.025 that makes
the person eligible for medical assistance or the way in which
the person qualifies as categorically needy as defined in ORS
414.025;
  (2) The status of the person as a resident of this state; and
  (3) The   { - financial - }  income and resources of the
person { +  as necessary to establish financial eligibility + }.

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  SECTION 5.  { + No later than March 31, 2010, the Oregon Health
Authority shall submit an application to the Centers for Medicare
and Medicaid Services to obtain necessary approvals to implement
the amendments to ORS 411.400, 411.402 and 414.025 and section 1,
chapter 867, Oregon Laws 2009, by sections 1 to 4 of this 2010
Act. + }
  SECTION 6.  { + This 2010 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2010 Act takes effect on its
passage. + }
                         ----------

Passed by House February 23, 2010

      ...........................................................
                                             Chief Clerk of House

      ...........................................................
                                                 Speaker of House

Passed by Senate February 23, 2010

      ...........................................................
                                              President of Senate

Enrolled House Bill 3664 (HB 3664-A)                       Page 5

Received by Governor:

......M.,............., 2010

Approved:

......M.,............., 2010

      ...........................................................
                                                         Governor

Filed in Office of Secretary of State:

......M.,............., 2010

      ...........................................................
                                               Secretary of State

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