ENGROSSED
COMMITTEE SUBSTITUTE
FOR
Senate Bill No. 624
(Senators Schoonover and Love, original sponsors)
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[Passed March 14, 1998; in effect ninety days from passage.]
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AN ACT to amend and reenact section two, article one, chapter
nine of the code of West Virginia, one thousand nine hundred
thirty-one, as amended; and to amend and reenact section
three, article four of said chapter, all relating to the
division of human services; providing a definition of state
medicaid agency; continuing and defining the purpose and
composition of the advisory council for the medicaid
services fund; and providing for the appointment of its
members.
Be it enacted by the Legislature of West Virginia:
That section two, article one, chapter nine of the code of
West Virginia, one thousand nine hundred thirty-one, as amended,
be amended and reenacted; and that section three, article four of
said chapter be amended and reenacted, all to read as follows:
ARTICLE 1. LEGISLATIVE PURPOSE AND DEFINITIONS.
§9-1-2. Definitions.
The following words and terms when used in this chapter have
the meanings indicated unless the context clearly indicates a
different meaning, and any amendment of this section applies to
any verdict, settlement, compromise or judgment entered after the
effective date of the amendments to this section enacted during
the regular session of the Legislature, one thousand nine hundred
ninety-five.
(a) The term "department" means the state division of human
services.
(b) The term "commissioner" means the commissioner of human
services.
(c) The term "federal-state assistance" means and includes:
(1) All forms of aid, care, assistance and services to or on
behalf of persons, which are authorized by, and who are
authorized to receive the same under and by virtue of,
subchapters one, four, five, ten, fourteen, sixteen, eighteen and
nineteen, chapter seven, Title 42, United States Code, as those
subchapters have heretofore been and may hereafter be amended,
supplemented and revised by acts of Congress, and as those
subchapters so amended, supplemented and revised have heretofore
been and may hereafter be supplemented by valid rules and
regulations promulgated by authorized federal agents and agencies, and as those subchapters so amended, supplemented and
revised have heretofore been and may hereafter be supplemented by
rules promulgated by the state division of human services, which
division rules shall be consistent with federal laws, rules and
regulations, but not inconsistent with state law; and (2) all
forms of aid, care, assistance and services to persons, which are
authorized by, and who are authorized to receive the same under
and by virtue of, any act of Congress, other than the federal
social security act, as amended, for distribution through the
state division of human services to recipients of any form of
aid, care, assistance and services to persons designated or
referred to in (1) of this definition and to recipients of state
assistance, including by way of illustration, surplus food and
food stamps, which Congress has authorized the secretary of
agriculture of the United States to distribute to needy persons.
(d) The term "federal assistance" means and includes all
forms of aid, care, assistance and services to or on behalf of
persons, which are authorized by, and who are authorized to
receive the same under and by virtue of, any act of Congress for
distribution through the state division of human services, the
cost of which is paid entirely out of federal appropriations.
(e) The term "state assistance" means and includes all forms
of aid, care, assistance, services and general relief made
possible solely out of state, county and private appropriations to or on behalf of indigent persons, which are authorized by, and
who are authorized to receive the same under and by virtue of,
state division of human services' rules.
(f) The term "welfare assistance" means the three classes of
assistance administered by the state division of human services,
namely: Federal-state assistance, federal assistance and state
assistance.
(g) The term "indigent person" means any person who is
domiciled in this state and who is actually in need as defined by
department rules and has not sufficient income or other resources
to provide for such need as determined by the state division of
human services.
(h) The term "domiciled in this state" means being
physically present in West Virginia accompanied by an intention
to remain in West Virginia for an indefinite period of time, and
to make West Virginia his or her permanent home. The state
division of human services may by rules supplement the foregoing
definition of the term "domiciled in this state", but not in a
manner as would be inconsistent with federal laws, rules, and
regulations applicable to and governing federal-state assistance.
(i) The term "medical services" means medical, surgical,
dental and nursing services, and other remedial services
recognized by law, in the home, office, hospital, clinic and any
other suitable place, provided or prescribed by persons permitted or authorized by law to give such services; the services to
include drugs and medical supplies, appliances, laboratory,
diagnostic and therapeutic services, nursing home and
convalescent care and such other medical services and supplies as
may be prescribed by the persons.
(j) The term "general relief" means cash or its equivalent
in services or commodities expended for care and assistance to an
indigent person other than for care in a county infirmary, child
shelter or similar institution.
(k) The term "secretary" means the secretary of the
department of health and human resources.
(l) The term "estate" means all real and personal property
and other assets included within the individual's estate as
defined in the state's probate law.
(m) The term "services" means nursing facility services,
home and community-based services, and related hospital and
prescription drug services for which an individual received
medicaid medical assistance.
(n) The term "state medicaid agency" means the division of
the department of health and human resources that is the
federally designated single state agency charged with
administration and supervision of the state medicaid program.
ARTICLE 4. STATE ADVISORY BOARD; MEDICAL SERVICES FUND;
ADVISORY COUNCIL; GENERAL RELIEF FUND.
§9-4-3. Advisory council.
The advisory council, created by chapter one hundred forty-
three, acts of the Legislature, regular session, one thousand
nine hundred fifty-three, as an advisory body to the state
medicaid agency with respect to the medical services fund and
disbursements therefrom and to advise about health and medical
services, is continued so long as the medical services fund
remains in existence, and thereafter so long as the state
medicaid agency considers the advisory council to be necessary or
desirable, and it is organized as provided by this section and
applicable federal law and has those advisory powers and duties
as are granted and imposed by this section and elsewhere by law:
Provided, That the continuation of the advisory council is
subject to a preliminary performance review pursuant to the
provisions of article ten, chapter four of this code, evaluating
the effectiveness and efficiency of the advisory council, to be
conducted during the interim of the Legislature in the year two
thousand by the joint committee on government operations.
The term of office of those members serving on the advisory
council, on the effective date of the amendments made to this
section by the Legislature during its regular session in the year
one thousand nine hundred ninety-eight, shall continue until they
are reappointed or replaced in accordance with the provisions of
this section.
The advisory council shall consist of not less than nine
members, nor more than thirteen members, all but two of whom
shall be appointed by the state medicaid agency and serve until
replaced or reappointed on a rotating basis. The heads of the
public health and public welfare agencies are members ex officio.
The remaining members comprising the council consist of a person
of recognized ability in the field of medicine and surgery with
respect to whose appointment the state medical association shall
be afforded the opportunity of making nomination of three
qualified persons, one member shall be a person of recognized
ability in the field of dentistry with respect to whose
appointment the state dental association shall be afforded the
opportunity of nominating three qualified persons, and the
remaining members shall be chosen from persons of recognized
ability in the fields of hospital administration, nursing and
allied professions and from consumers groups, including medicaid
recipients, members of the West Virginia directors of senior and
community services, labor unions, cooperatives and consumer- sponsored prepaid group practices plans.
The council shall meet on call of the state medicaid agency.
Each member of the advisory council shall receive
reimbursement for reasonable and necessary travel expenses for
each day actually served in attendance at meetings of the council
in accordance with the state's travel regulations. Requisitions for the expenses shall be accompanied by an itemized statement,
which shall be filed with the auditor and preserved as a public
record.
The advisory council shall assist the state medicaid agency
in the establishment of rules, standards and bylaws necessary to
carry out the provisions of this section and shall serve as
consultants to the state medicaid agency in carrying out the
provisions of this section.