DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of the
legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law
or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 3 Engrossed 2018 First Extraordinary Session Hoffmann
Abstract: Establishes a planning process for a work and community engagement initiative within
the Medicaid program.
Proposed law provides that it shall be known as the "Promotion of Work and Community
Engagement in Medicaid Law".
Proposed law provides legislative findings and a declaration concerning health effects associated
with productive work and community engagement.
Proposed law requires the secretary of the La. Department of Health (LDH) to submit to the
legislative committees on health and welfare a plan for a work and community engagement initiative
in the Medicaid program, and to commence to implement the plan upon approval by the committees.
Provides that the plan may include submission of an application to the federal Medicaid agency for
a program in which certain working-age, non-pregnant, non-exempt adults who qualify for Medicaid
on a basis other than a disability will be required to participate in certain work or community
engagement activities.
Proposed law provides that the plan may incorporate a workforce development component and
identify alignment opportunities with current work promotion programs of the Supplemental
Nutrition Assistance Program, if practicable.
Proposed law requires the secretary of LDH to ensure that the work and community engagement
initiative proposed in the plan can be implemented in a cost effective manner and with maximum
administrative efficiency, and authorizes the secretary to model the initiative proposed in the plan
on a similar initiative of any other state.
Proposed law provides that work activities required by the initiative may include any of the
following:
(1)Full-time or part-time employment.
(2)Career planning, job training, or referral and job support services.
Proposed law provides that community engagement activities required by the initiative may include
any of the following: (1)Volunteer work.
(2)Community service.
(3)Education.
Proposed law requires the secretary of LDH to establish minimum participation standards, in terms
of average number of hours per week or per month, for participants in the initiative.
Proposed law specifies that Medicaid beneficiaries to be exempt from work and community
engagement requirements may include any of the following:
(1)Any individual who is a primary caregiver of a dependent.
(2)Any parent or caretaker of a dependent child who is under the age of public school eligibility.
(3)Individuals with health-related barriers to employment.
(4)Other persons or populations with extenuating circumstances as determined by the secretary.
Proposed law stipulates that the work and community engagement initiative shall include procedures
that allow for an assessment of beneficiaries' abilities and barriers to employment in order to identify
appropriate services, supports, and any modifications necessary for them to meet requirements of the
initiative and attain long-term employment and self-sufficiency; and that the initiative shall ensure
all of the following:
(1)That individuals with substance use disorders, who may not be defined as disabled for
Medicaid purposes but may be protected by certain disability laws, have access to appropriate
Medicaid coverage and treatment services.
(2)That individuals with a serious medical condition or terminal illness have access to
appropriate Medicaid coverage and treatment services.
(3)That beneficiaries have support in meeting work and community engagement requirements
through linkages to resources for job training or other employment services, child care
assistance, transportation, or other work supports necessary to help them prepare for work
or increase earnings.
(4)That the project adheres to all requirements set forth by the federal Medicaid agency,
including but not limited to due process for recipients, transparency, budget neutrality,
monitoring, and evaluation.
Proposed law requires that the work and community engagement initiative include all of the
following: (1)Supports for beneficiaries in regions with limited employment opportunities or localities
facing particular economic stress or lack of viable transportation.
(2)Measures to address social determinants of health.
Proposed law provides that prior to submitting the plan for the work and community engagement
initiative for legislative approval as required by proposed law, LDH shall conduct a public input
process that provides an opportunity for consideration of the views of Medicaid beneficiaries,
applicants, and other stakeholders, and for gathering input that may support continuous improvement
of the initiative.
Proposed law stipulates that its implementation is subject to the appropriation of funds for this
purpose, and that nothing in proposed law shall cause access to health care to become temporarily
or permanently prohibitive or excluded to the citizenry of La.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 46:460.101-460.107)
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to the
original bill:
1. Delete proposed law stipulating that no able-bodied adult without a dependent shall be
eligible for Medicaid benefits unless he meets certain work or community engagement
requirements.
2. Delete proposed law associated with a program of mandatory work or community
engagement for certain able-bodied Medicaid enrollees.
3. Require the secretary of the La. Department of Health (LDH) to submit to the legislative
committees on health and welfare a plan for a work and community engagement
initiative in the Medicaid program, and to commence to implement the plan upon
approval by the committees. Provide that the plan may include submission of an
application to the federal Medicaid agency for a program in which certain working-age,
non-pregnant, non-exempt adults who qualify for Medicaid on a basis other than a
disability will be required to participate in certain work or community engagement
activities.
4. Provide that the plan may incorporate a workforce development component and identify
alignment opportunities with current work promotion programs of the Supplemental
Nutrition Assistance Program, if practicable.
5. Require the secretary of LDH to ensure that the work and community engagement initiative proposed in the plan can be implemented in a cost effective manner and with
maximum administrative efficiency, and authorize the secretary to model the initiative
proposed in the plan on a similar initiative of any other state.
6. Provide that work activities required by the initiative may include any of the following:
(a)Full-time or part-time employment.
(b)Career planning, job training, or referral and job support services.
7. Provide that community engagement activities required by the initiative may include any
of the following:
(a)Volunteer work.
(b)Community service.
(c)Education.
8. Require the secretary of LDH to establish minimum participation standards, in terms of
average number of hours per week or per month, for participants in the initiative.
9. Specify that Medicaid beneficiaries to be exempt from work and community engagement
requirements may include any of the following:
(a)Any individual who is a primary caregiver of a dependent.
(b)Any parent or caretaker of a dependent child who is under the age of public
school eligibility.
(c)Individuals with health-related barriers to employment.
(d)Other persons or populations with extenuating circumstances as determined by
the secretary.
10.Stipulate that the work and community engagement initiative shall include procedures
that allow for an assessment of beneficiaries' abilities and barriers to employment in
order to identify appropriate services, supports, and any modifications necessary for them
to meet requirements of the initiative and attain long-term employment and
self-sufficiency; and that the initiative shall ensure all of the following:
(a)That individuals with substance use disorders, who may not be defined as
disabled for Medicaid purposes but may be protected by certain disability laws,
have access to appropriate Medicaid coverage and treatment services. (b)That individuals with a serious medical condition or terminal illness have access
to appropriate Medicaid coverage and treatment services.
(c)That beneficiaries have support in meeting work and community engagement
requirements through linkages to resources for job training or other employment
services, child care assistance, transportation, or other work supports necessary
to help them prepare for work or increase earnings.
(d)That the project adheres to all requirements set forth by the federal Medicaid
agency, including but not limited to due process for recipients, transparency,
budget neutrality, monitoring, and evaluation.
11.Require that the work and community engagement initiative include all of the following:
(a)Supports for beneficiaries in regions with limited employment opportunities or
localities facing particular economic stress or lack of viable transportation.
(b)Measures to address social determinants of health.
12.Require LDH to conduct a public input process that provides an opportunity for
consideration of the views of Medicaid beneficiaries, applicants, and other stakeholders,
and for gathering input that may support continuous improvement of the work and
community engagement initiative.
13.Stipulate that implementation of proposed law is subject to the appropriation of funds for
this purpose.
14.Stipulate that nothing in proposed law shall cause access to health care to become
temporarily or permanently prohibitive or excluded to the citizenry of La.
15.Change effective date of proposed law from effective upon signature of the governor to
effective upon the default effective date for Acts of the 2018 1
st
Extraordinary Session
(60
th
day after final adjournment of the session).