HF 1892

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; creating a program for
individuals with HIV; appropriating money; amending
Minnesota Statutes 2004, section 256.9365, by adding a
subdivision; proposing coding for new law in Minnesota
Statutes, chapter 256.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [256.9370] HIV PREVENTION AND HEALTH CARE
ACCESS PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Purpose. new text end

new text begin The commissioner of human
services shall establish an HIV prevention and health care
access program for low-income Minnesotans that:
new text end

new text begin (1) provides access to HIV treatment consistent with the
guidelines of the United States Public Health Service;
new text end

new text begin (2) promotes reduction of HIV transmission through
continuous and uninterrupted access to treatment consistent with
the United States Public Health Service guidelines;
new text end

new text begin (3) provides uniform benefits that are comprehensive as
defined by the most recent recommendations of the Institute of
Medicine and medically appropriate as established by the United
States Public Health Service to best meet HIV needs with a
minimum of administrative cost and efforts;
new text end

new text begin (4) ensures service delivery accountability to the people
it serves, including due notice; opportunities for community
input; and uniform, transparent procedures communicated to
current and eligible persons, their health care and social
service providers, community planning and advisory groups, and
agencies established under the Ryan White Care Act;
new text end

new text begin (5) provides access to HIV treatment inclusive of treatment
for substance abuse and mental health treatment as those
conditions interfere with HIV treatment adherence; and
new text end

new text begin (6) provides initial and continued access to HIV treatment
that is, to the maximum extent practicable, without regard to
the ability of the person to pay for the services and without
regard to the current or past health condition of the person
with HIV.
new text end

new text begin Subd. 2. new text end

new text begin Establishment. new text end

new text begin The commissioner of human
services shall establish a program to provide prescription drug
coverage and basic early intervention diagnostic services and to
pay private health plan premiums for persons who have contracted
human immunodeficiency virus (HIV) to enable them to secure or
continue coverage under a group or individual health plan and to
ensure continuous comprehensive treatment.
new text end

new text begin Subd. 3. new text end

new text begin Eligibility requirements. new text end

new text begin (a) To be eligible
for the program, an applicant must satisfy the following
requirements:
new text end

new text begin (1) the applicant must be HIV positive;
new text end

new text begin (2) the applicant must:
new text end

new text begin (i) have no health insurance coverage, or be undercovered
for medications;
new text end

new text begin (ii) have no health insurance coverage because of
ineligibility due to a preexisting condition;
new text end

new text begin (iii) face losing health insurance coverage due to a change
in employment status; or
new text end

new text begin (iv) have limited coverage not consistent with the
guidelines of the United States Public Health Service for best
practice HIV treatment;
new text end

new text begin (3) the applicant's monthly gross family income must not
exceed 300 percent of the federal poverty guidelines after
deducting medical expenses and insurance premiums; and
new text end

new text begin (4) the applicant must not own assets with a combined value
of more than $30,000, excluding:
new text end

new text begin (i) all assets excluded under section 256B.056;
new text end

new text begin (ii) retirement accounts, Keogh plans, and pension plans;
and
new text end

new text begin (iii) medical expense accounts set up through the
individual's employer.
new text end

new text begin (b) To be eligible for drug reimbursement, the applicant
may not be a recipient of medical assistance, medical assistance
for employed persons with disabilities, or general assistance
medical care.
new text end

new text begin (c) Individuals whose income and assets exceed the amounts
established in paragraph (a), but who meet all the other
eligibility requirements, shall be eligible for this program
upon payment of a premium. The premium shall be based on the
person's gross income using a sliding fee scale established by
the commissioner. The premium shall not exceed ten percent of
the person's annual gross income.
new text end

new text begin Subd. 4. new text end

new text begin Benefits. new text end

new text begin (a) If an individual is determined to
be eligible under subdivision 3, the commissioner shall pay that
portion of the group plan premium for which the individual is
responsible or shall pay the individual plan premium. The
commissioner shall not pay for that portion of a premium that is
attributable to other family members or dependents.
Requirements for the payment of individual plan premiums under
this section must be designed to ensure that the state cost of
paying an individual plan premium does not exceed the estimated
state cost that would otherwise be incurred in the medical
assistance and general assistance medical care program. The
commissioner shall purchase the most cost-effective coverage
available for eligible individuals.
new text end

new text begin (b) If an individual is determined to be eligible under
subdivision 3, the program benefits shall provide access to HIV
drugs and related drug treatments included in the HIV care drug
formulary established by the commissioner. The program benefits
shall include those services specified in subdivision 1 and
shall also provide access to early intervention treatment,
including initial diagnostics, hepatitis B and C, sexually
transmitted infections, and tuberculosis screening and tests,
and any treatment for HIV that is consistent with the guidelines
of the United States Public Health Service for HIV best practice
treatment.
new text end

new text begin (c) There shall be no co-payments or premiums or
cost-shares charged to any individual determined to be eligible
under subdivision 3, paragraph (a).
new text end

new text begin (d) The state may use nonfederal funds to supplement drug
assistance benefits available through the Medicare Part D
program.
new text end

new text begin (e) The priority use for all funds received through
prescription drug rebates through HIV drug purchases must be
used to purchase benefits for eligible persons.
new text end

new text begin Subd. 5. new text end

new text begin Public advisory process. new text end

new text begin The commissioner shall
establish a transparent, public advisory process for
establishing and revising an HIV care drug formulary. At a
minimum, the process shall include consultation with HIV health
care providers, HIV social service providers, persons living
with HIV, the Minnesota HIV Services Planning Council, and
entities directly contracted by the federal government to
administer funds from the Ryan White Care Act. Participants in
this process shall be appointed in equal numbers by the
commissioner and by the Minnesota HIV Services Planning Council.
new text end

Sec. 2.

Minnesota Statutes 2004, section 256.9365, is
amended by adding a subdivision to read:

new text begin Subd. 4. new text end

new text begin Expiration. new text end

new text begin This section expires upon
implementation of the HIV prevention and health care access
program.
new text end

Sec. 3. new text begin APPROPRIATION.
new text end

new text begin (a) $12,400,000 is appropriated for the biennium ending
June 30, 2007, from the general fund to the commissioner of
human services for the purposes of section 1.
new text end

new text begin (b) Funding sources include, but are not limited to, drug
rebate funds, the Ryan White Care Act, health care access funds,
and the general fund. The commissioner may use 100 percent of
the funds available for the AIDS drug assistance program, but no
more than 25 percent of the funds received through the Title II
formula allocation.
new text end

Sec. 4. new text begin EFFECTIVE DATE.
new text end

new text begin Sections 1 to 3 are effective July 1, 2005.
new text end