Nursing Home Transition Laws 2001-2005
In 1998 the Centers for Medicare & Medicaid Services (CMS) began providing grants to states to aid in the development of programs related to nursing home transition. The purpose of the grants was to implement innovative approaches to assist residents of nursing homes who want to return to their own homes and communities and receive services. In 2001, as part of the federal government’s New Freedom Initiative, additional grants were awarded to states. This Initiative included grants to 33 states and centers for independent living. The grants initiated a variety of partnerships among the federal government, states, providers, and consumers to identify and invest in promising strategies supporting the transition of nursing home residents into community living.
As interest in nursing facility transition grows, several state legislatures have assumed a policy making role on the topic. This web page identifies state legislation focused on supporting transition of persons with long term care needs from nursing homes into the community. It includes laws enacted between 2001 and 2005 related to various aspects of nursing home transition.
The compilation of laws sorts legislative activities into four policy areas associated with nursing facility transition: support for community based care options, individual assessment of needs, policy related to Medicaid waiver applications, and policy related to consumer information. Several laws fit into more than one category.
Most of the laws in this section express the legislature’s intent that persons now in nursing facilities have an option of receiving care in a community setting. Some of them focus on specific groups of residents such as persons with mental illnesses or traumatic brain injury and support service delivery in the community.
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CT
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HB 6786 Public Act no. 05-14 (2005) Requires that the state's long term care plan provide individuals with long term care needs the option to chose and receive support in the least restrictive appropriate setting. |
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CO |
SB 197 Chapter 272 (2002) Removes the requirement that home and community-based services shall only be offered to a person for whom the cost of services necessary to prevent nursing facility placement would not exceed the average cost of nursing home care. Requires the home and community-based services for persons with major mental illnesses to meet aggregate federal waiver budget neutrality requirements. Similar language from HB1127 is in Chapter 71 (2002). |
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IL |
HB 5057 Public Act No. 93-902 (2003) Requires that the Department on Aging assist eligible nursing home residents and their families to select long-term care options that meet their needs and reflect their preferences. requires that the Department on Aging develop a program of transition services. Requires that the Department of Public Aid apply for necessary waivers. |
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MA |
HB 4922 Chapter No. 261-2004 (2004) Requires the Department of Health and Human Services to apply for an expansion of the home and community-based waiver. Members shall be offered under the waiver a choice of receiving benefits in their home, community-based setting or nursing home, whichever is the least restrictive once said waiver is granted and implemented. |
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MD |
HB 478 Chapter No. 303 (2003) Prohibits the Department of Health and Mental Hygiene from denying an individual access to a home and community-based services waiver due to a lack of funding under certain circumstances; requires the department to notify certain nursing home residents about the opportunity to apply for participation in a waiver. |
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MD |
SB 620 Chapter No. 426 (2004) Requires a nursing facility to refer a resident to the Department of Health and Mental Hygiene or its designee for assistance in obtaining home and community-based services. Requires the Department or its designee to review quarterly assessments to identify individuals indicating a preference to live in the community. Requires the Department or its designee to provide specified residents with information and assistance, including assistance in moving from a nursing facility to a community-based setting. An identical bill HB946 is Chapter No. 427 (2004). |
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NY |
SB 7073 Chapter No. 615 (2004) Authorizes the Commissioner of Health to apply for a nursing facility transition and diversion Medicaid waiver in order to test the feasibility of providing home and community based services to individuals who otherwise would be cared for in a nursing facility and provides for reimbursement for several home and community based services not presently included in the medical assistance program. |
| TX |
HB 1867 Chapter No. 985 (2005) Provides for redirection of funds to provide care for certain persons in nursing facilities who are leaving the facility before the end of the biennium to live in the community with the assistance of community-based services. |
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WA |
HB 1341 Chapter 269 (2001) Provides for home and community based services waiver for individuals whose incomes exceed a certain criteria. |
The legislation in this section includes policy related to individual assessment for persons who are seeking long term care services or seeking to move into community settings or recognized the importance of assessing nursing home residents and helping them to select appropriate long term care options.
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ND |
SB 2085 Chapter No. 427 (2003) Removes the effective date related to a law that requires targeted case management and assessment services. |
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MD |
SB 620 Chapter No. 426 (2004) Requires a nursing facility to refer a resident to the Department of Health and Mental Hygiene or its designee for assistance in obtaining home and community-based services. Requires the Department or its designee to review quarterly assessments to identify individuals indicating a preference to live in the community. Requires the Department or its designee to provide specified residents with information and assistance, including assistance in moving from a nursing facility to a community-based setting. An identical law, HB946, is chaptered as No 427 (2004). |
To further facilitate transition activities, several state legislatures directed the state administrative agencies to go beyond the options available in Medicaid state plans and apply for federal waivers. Waivers can pay for specific services that nursing home residents need to move to the community, including targeted case management to support them as they make their transition to home and community based settings.
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HB 1282 Chapter 79 (2002) Requires the department of health care policy and financing to seek any necessary amendments to the current federal waiver for the home- and community-based services program for persons with brain injury to allow services to be provided to eligible persons on a supportive care campus. Modifies the definition of "eligible person" under the program to include a person who is in need of specialized care provided in a nursing facility in lieu of a hospital. Specifies that the implementation of provisions relating to supported living provided on a supportive care campus are conditioned upon the approval of necessary waiver amendments by the federal government. |
| IL |
HB 5057 Public Act No. 93-902 (2003) Requires that the Department on Aging assist eligible nursing home residents and their families to select long-term care options that meet their needs and reflect their preferences. requires that the Department on Aging develop a program of transition services. Requires that the Department of Public Aid apply for necessary waivers. |
| MA |
HB 4922 Chapter No. 261-2004 (2004) Requires the Department of Health and Human Services to apply for an expansion of the home and community-based waiver. Members shall be offered under the waiver a choice of receiving benefits in their home, community-based setting or nursing home, whichever is the least restrictive once said waiver is granted and implemented. |
| NY |
SB 7073 Chapter No. 615 (2004) Authorizes the Commissioner of Health to apply for a nursing facility transition and diversion Medicaid waiver in order to test the feasibility of providing home and community based services to individuals who otherwise would be cared for in a nursing facility and provides for reimbursement for several home and community based services not presently included in the medical assistance program. |
State policies recognize that consumers who want to exercise their choice of care settings need information about what is available to them. These laws emphasize the importance of informing nursing home residents about opportunities to receive services in home and community based settings.
| IL |
HB 5057 Public Act No. 93-902 (2003) Requires that the Department on Aging assist eligible nursing home residents and their families to select long-term care options that meet their needs and reflect their preferences. requires that the Department on Aging develop a program of transition services. Requires that the Department of Public Aid apply for necessary waivers. |
| MD |
HB 752 Chapter No. 84 (2002) Requires a social worker at a nursing facility to provide information annually to residents about home or community-based waiver programs. The bill also requires a long-term care case manager in the local department of social services to provide assistance and referrals to residents that may help them access home or community-based services. |
| MD |
HB 478 Chapter No. 303 (2003) Prohibits the Department of Health and Mental Hygiene from denying an individual access to a home- and community-based services waiver due to a lack of funding under certain circumstances; requires the department to notify certain nursing home residents about the opportunity to apply for participation in a waiver. |
| MD |
SB 620 Chapter No. 426 (2004) Requires a nursing facility to refer a resident to the Department of Health and Mental Hygiene or its designee for assistance in obtaining home and community-based services. Requires the Department or its designee to review quarterly assessments to identify individuals indicating a preference to live in the community. Requires the Department or its designee to provide specified residents with information and assistance, including assistance in moving from a nursing facility to a community-based setting. An identical law, HB946, is chaptered as No. 427(2004). |
This page was developed under contract from the Rutgers Center for State Health Policy, funded by Grant No. 11-P-92015/2-0 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal government. Please include this disclaimer whenever copying or using all or any part of this page in dissemination activities.
For questions contact:
National Conference of State Legislatures
Forum for State Health Policy Leadership
444 North Capitol Street, NW
Washington, D.C. 20001
202.624.8171
health-info@ncsl.org
