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S.F. No. 3611 - Medical Assistance Work and Community Engagement Requirement (with A-1 Amendment)
 
Author: Senator Mark Johnson
 
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
 
Date: March 28, 2018



 

SF 3611 requires the commissioner of human services to submit a waiver to the federal government permitting the state to implement a medical assistance work and community engagement requirement for certain individuals enrolled in medical assistance.

Section 1 Medical assistance work and community engagement requirement for able-bodied individuals.

Subdivision 1 requires the Commissioner of Human Services to apply to the Centers of Medicare and Medicaid Services (CMS) for a section 1115 waiver to allow the state to implement a medical assistance (MA) work and community engagement requirement for able-bodied adults who meet the definition of  "qualified individuals."  Requires the waiver proposal to meet the requirements in this section and be consistent with the work requirements of the Supplemental Nutrition Assistance Program (SNAP) and the guidance issued by CMS.  This subdivision also requires the commissioner to report to the legislature on the specific strategies, criteria, requirements, and procedures that are to be proposed in the waiver at least 60 days before submitting the waiver application.  The commissioner must also make the report and the waiver application available to the public on the department’s Web site.  Upon waiver approval, the commissioner is required to submit to the legislature draft legislation on any statutory changes necessary to implement the waiver.

Subd. 2 paragraph (a) defines the individuals who would be considered qualified and subject to the work and community engagement requirement as the following:  parents and caretakers; adults without dependent children; and children ages 19 and 20.

Paragraph (b) specifies that if an individual is not identified in paragraph (a), they are not subject to the work and community engagement requirement.

Paragraph (c) defines the individuals who are exempt from the requirement:  (1) pregnant; (2) age 18 or younger or age 60 or older; (3) working a minimum of 30 hours per week or earning weekly wages at least equal to the federal minimum wage multiplied by 30 hours; (4) a student enrolled at least half time in school, training program, or a higher education institution; (5) the sole or primary caregiver of a family member who is under the age of 18 or is incapacitated; (6) receiving temporary or permanent disability benefits from a private insurer or state or federal program; (7) medically frail; (8) determined to be physically or mentally unfit for employment by a health care professional; (9) subject to and complying with the work requirements of MFIP; and (10) receiving treatment for a substance abuse disorder in a residential or inpatient setting or receiving treatment for a substance use disorder for at least ten hours per week in an outpatient setting.

Paragraph (d) requires the commissioner to develop a standard exemption form for a health care professional to complete in order for an individual to apply for an exemption on the basis of being medically frail or physically or mentally unfit for employment.  This form must be submitted to the county human services agency.

Paragraph (e) requires qualified individuals who have been exempt for the work and community engagement requirement to report to the county human services agency any changes related to their exempt status within ten days of the change.  The agency is required to redetermine eligibility for the exemption when a change in status is reported and at the time of the qualified individual’s annual renewal.

Subd. 3 paragraph (a) requires qualified individuals to meet the work and community engagement requirement beginning three months from when MA eligibility is approved.  The commissioner may provide one or more extensions if the commissioner determines the individual is making a good faith effort to establish an exemption.  A qualified individual shall have met the requirement if the individual is engaged in one of more of the following activities for at least 80 hours per month: (1) is employed, engaged in community or public service or a combination; (2) is actively seeking employment or engaged in career planning, job training, referral, or job support services or a combination; and (3) participates in a workfare program if assigned by a state agency.

Paragraph (b) requires a qualified individual to accept any bona fide offer of suitable employment in order to satisfy the work and community engagement requirement.

Paragraph (c) requires the commissioner to establish criteria to determine whether a qualified individual is in compliance with the requirements and requires the individual to verify to the commissioner on a monthly basis that they are in compliance.

Subd. 4 paragraph (a) requires the commissioner through county human services agencies to implement strategies to assist individuals in meeting the work and community engagement requirement and link individuals to additional resources to help individuals prepare for work, maintain employment, or increase earnings.

Paragraph (b) requires the commissioner to ensure that due process rights are protected. The commissioner is required to assess each individual’s barriers to employment and self-sufficiency and based on the assessment identify appropriate work and community engagement activities and services, determine the need of any exemptions from the requirement and identify any reasonable modifications and supports necessary for the individual to participate in work and community engagement activities and attain long-term employment and self-sufficiency.

Paragraph (c) requires the commissioner to modify and permits the commissioner to temporarily suspend the work and community engagement requirement in order to respond to local employment market and other circumstances that prevent an individual from complying with the requirement.

Paragraph (d) requires the commissioner to administer the work and community engagement requirement in a manner that complies with state and federal civil rights laws, and gives the commissioner the authority to exempt from the requirement individuals considered to have disabilities under the ADA or the ACA, or provide these individuals with reasonable modifications to the requirement.

Paragraph (e) requires the commissioner to develop a good cause exemption process for qualified individuals who do not satisfy the work and community engagement requirements.

Subd. 5 requires the commissioner to suspend MA benefits for qualified individuals who do not satisfy the work and community engagement requirement and to reinstate benefits once the individual satisfies the requirement for a calendar month.  Reinstatement of benefits would begin the first day of the month following the month that the individual satisfies the requirement.

Section 2 requires the Commissioner of Management and Budget to determine if the Commissioner of Human Services has submitted the waiver by October 1, 2018, and if not, to transfer for each business day of noncompliance, $5,000 from the central office operations account of the Department of Human Services to the general fund.

 

 

 
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