Changes to intermediate care facility reimbursement funds advance
Senators gave first-round approval April 18 to a bill intended to improve utilization of a reimbursement fund for intermediate care facilities for individuals with developmental disabilities, known as ICF/MR.
LB23, introduced by Kearney Sen. Galen Hadley, would change allocations of the state’s ICF/MR Reimbursement Protection Fund.
Hadley said the fund is a way for Nebraska to leverage federal participation funds that are provided to the state based on a voluntary tax that ICF/MR pay. In Nebraska, the ICF/MR comprise the Beatrice State Developmental Center and MOSAIC, a private company.
“They can tax themselves a dollar,” he said, “then the state sends that dollar to Washington … [and] they send $1.60 back to the state. We get a 60 cent addition for every dollar.”
A Health and Human Services Committee amendment, adopted 39-0, replaced the bill.
As amended, LB23 would require the state Department of Health and Human Serviced (DHHS), beginning July 1, 2014, to use the ICF/MR Reimbursement Protection Fund – including the matching federal participation funds – to enhance rates paid under Medicaid to ICF/MR and for annual contributions to community-based programs for persons with developmental disabilities.
The amendment also would require, beginning in fiscal year 2014-15, that funds be remitted from the fund as follows:
• the first $55,000 for administration of the fund;
• the amount needed to reimburse the cost of the tax to ICF/MR;
• $312,000 for community-based services for persons with developmental disabilities; and
• the remaining proceeds of the tax amount available in the fund to enhance rates in non-state-operated ICF/MR by increasing the annual inflation factor to the extent allowed by such proceeds and any funds appropriated by the Legislature.
The amendment also would remove a provision that any remaining proceeds be remitted to the state’s general fund.
Additionally, beginning July 1, 2014, the amendment allows for the tax to end if federal participation funds become unavailable or if money in the ICF/MR Reimbursement Protection Fund is appropriated, transferred or otherwise expended for any use other than permitted by law.
Hadley said the bill would provide specific guidelines to DHHS for maximizing utilization of the fund.
“It’s a way to leverage money not only to help the ICF/MR,” he said, “but also the developmentally disabled in the state.”
Fullerton Sen. Annette Dubas supported the bill, saying it would help MOSAIC provide a broader range of community-based services to individuals with developmental disabilities.
“If we want to have community based care,” Dubas said, “then we have to make sure that those people who provide community based care have the resources needed to be able to help to provide the needed services.”
Lincoln Sen. Colby Coash offered an amendment, which he originally introduced as LB343, that would replace the term “mental retardation” in state law with the term “intellectual disability.”
Coash said the bill would continue the work done in the 1980s that removed similarly out-dated and disparaging terms for people with developmental disabilities.
“We will be showing the citizens of Nebraska who have developmental disabilities that we value them, we honor them and we treat them with dignity and respect,” he said.
Dubas also supported the Coash amendment, saying it would help remove barriers between those with disabilities and those without.
Lawmakers adopted the amendment on a 40-0 vote, and advanced the bill to select file 38-0.
