(1) Subject to the
provisions of this part 3, home- and community-based services for the elderly, blind,
and disabled include only the following services:
(a) Adult day care;
(b) Alternative care services;
(c) (Deleted by amendment, L. 2023.)
(d) Home modification services;
(e) (Deleted by amendment, L. 2023.)
(f) Nonmedical transportation services;
(g) (Deleted by amendment, L. 2023.)
(h) Respite care services;
(i) Repealed.
(j) (Deleted by amendment, L. 2023.)
(k) (Deleted by amendment, L. 2023.)
(2) All providers of home- and community-based services for the elderly,
blind, and disabled may be separately certified to provide other services, if
otherwise qualified.
(3) A case management agency may be certified to provide the services
described in subsection (1) of this section, if otherwise qualified as a provider under
the state medical assistance program.
(4) (a) The case management agency, in coordination with the eligible
person, the person's family or guardian, and the person's physician, shall include in
each case plan a process by which the eligible person may receive necessary care,
which may include respite care, if the eligible person's family or service provider is
unavailable due to an emergency situation or to unforeseen circumstances. The
eligible person and the person's family or guardian shall be duly informed by the
case management agency of these alternative care provisions at the time the case
plan is initiated.
(b) The requirements of this subsection (4) shall not apply if the eligible
person is residing in an alternative care facility.
(5) (a) No later than January 2024, the state department shall submit a
report to the senate health and human services committee, the house of
representatives public and behavioral health and human services committee, and
the house of representatives health and insurance committee, or any successor
committees, as part of its State Measurement for Accountable, Responsive, and
Transparent (SMART) Government Act presentation required by section 2-7-203.
At a minimum, the report must identify:
(I) A reimbursement system with a goal to incentivize and increase
transportation provider participation;
(II) How the state department will ensure compliance with applicable federal
laws and waiver requirements;
(III) A system of common reporting to ensure a member does not exceed the
medicaid benefit in a multi-provider scenario; and
(IV) Best practices based on what other states have done to allow
transportation network companies to provide nonmedical transportation services
for individuals receiving services, including but not limited to, reimbursement rates;
driver compensation; and integration with programs that provide nonmedical
transportation services.
(b) In developing the report, the state department shall engage in a
stakeholder process that includes individuals with intellectual and developmental
disabilities and their families, individuals with disabilities, and transportation
network companies. The report may be developed in conjunction with the reporting
requirement in sections 25.5-6-409 (6), 25.5-6-606 (9), 25.5-6-704 (8), and 25.5-6-1303 (9).
(c) (I) Upon completion of the report described in subsection (5)(a) of this
section, the state department shall analyze and review each operational
transportation network company, as defined in section 40-10.1-602 (3). The state
department shall verify each transportation network company's viability to ensure
the health, safety, welfare, cost effectiveness, and capability in expanding
nonmedical transportation services for individuals receiving services pursuant to
this section and comply with all rules promulgated pursuant to subsection (5)(e)(I)
of this section.
(II) No later than July 1, 2024, the state department shall authorize verified
transportation network companies to provide nonmedical transportation services if
the state department finds the transportation network company viable under
federal requirements and within budgetary constraints.
(III) For the purposes of this subsection (5)(c), verify means a transportation
network company meets all requirements resulting from the report described in
subsection (5)(a) of this section.
(d) The state department may seek any necessary federal authorization for
the implementation of this subsection (5).
(e) (I) The state department shall promulgate any necessary rules to ensure
transportation network companies comply with federal and state oversight
requirements and shall include all relevant stakeholders, including medicaid
members, transportation network companies, current providers and drivers for
nonmedical transportation services, and other parties interested in developing the
requirements.
(II) Pursuant to section 40-10.1-105 (1)(l), transportation network companies
are not subject to regulation by the public utilities commission when providing
nonmedical transportation services pursuant to this section and are instead subject
to rules promulgated by the state department pursuant to this subsection (5)(e).
(f) This subsection (5) does not apply to a provider authorized to provide
transportation services pursuant to part 8 of article 1 of title 25.5 prior to August
10, 2022.