1999 Montana Legislature

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SENATE BILL NO. 93

INTRODUCED BY HARGROVE D

BY REQUEST OF THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES

Montana State Seal

AN ACT REVISING THE LAWS RELATING TO SUBSIDIZED ADOPTIONS; AMENDING SECTIONS 42-10-102, 42-10-103, 42-10-106, 42-10-107, 42-10-108, 42-10-109, AND 53-6-131, MCA; AND REPEALING SECTION 42-10-110, MCA.



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



     Section 1.  Section 42-10-102, MCA, is amended to read:

     "42-10-102.  Purpose. The purpose of this part is to encourage and promote the adoption of children who are hard to place with special needs by providing information and assistance in completing the adoption process and financial assistance when necessary to ensure the health and welfare of the hard-to-place child with special needs."



     Section 2.  Section 42-10-103, MCA, is amended to read:

     "42-10-103.  Definitions. As used in this part, the following definitions apply:

     (1)  "Child with special needs" means a child who is a dependent of a public or voluntary licensed child placement agency and meets at least one of the following criteria as a child who is:

     (a) diagnosed as having a physical, mental, or emotional disability;

     (b) recognized to be at high risk of developing a physical, mental, or emotional disability;

     (c) a member of a minority group;

     (d) six years of age or older; or

     (e) a member of a sibling group to be placed together for adoption.

     (2) "Department" means the department of public health and human services provided for in 2-15-2201.

     (2)  "Hard-to-place child" means a minor, as defined by 41-1-101, who is a dependent of a public or voluntary licensed child-placing agency, legally free for adoption, and is not likely to be adopted because of:

     (a)  physical or mental disease or disability;

     (b)  recognized high risk of physical or mental disease or disability; or

     (c)  sibling relationship to another child who is eligible for adoption."



     Section 3.  Section 42-10-106, MCA, is amended to read:

     "42-10-106.  Certification as hard to place child with special needs. (1) Whenever the conditions of 42-10-103 are found to exist and the foster parents seek to adopt the child, the child shall must be certified as hard to place a child with special needs.

     (2)  In all other cases in which the conditions of 42-10-103 are found to exist and after reasonable efforts have been made and without the use of subsidy no appropriate adoptive family has been found for a child, the department shall certify the child as hard to place a child with special needs.

     (3)  If the child is the dependent of a voluntary licensed child-placing agency, that agency shall present to the department evidence of inability to place the child for adoption due to any of the conditions specified in 42-10-103. The agency shall present evidence that reasonable efforts have been made to place the child without subsidy, such as recruitment of potential parents, use of adoption resource exchanges, and referral to appropriate specialized adoption agencies. Upon such a showing, the department shall certify the child as hard to place a child with special needs."



     Section 4.  Section 42-10-107, MCA, is amended to read:

     "42-10-107.  Eligibility for subsidy. Any family which that applies for an adoption subsidy, is approved by the department or a licensed child placement agency as a suitable adoptive family, is or may be financially unable to meet the special needs of a hard-to-place child as determined by the department, and adopts a hard-to-place child with special needs is eligible for subsidy regardless of the domicile or residence of the family at the time of application for adoption, placement, legal decree of adoption, or thereafter."



     Section 5.  Section 42-10-108, MCA, is amended to read:

     "42-10-108.  Subsidy agreement. (1) When parents are approved for adoption of a child certified as hard to place a child with special needs and before the final decree of adoption is issued, there shall must be a written agreement between the family entering into the subsidized adoption and the department. The terms of the adoption subsidy agreement may commence with the adoption placement or at an appropriate time after the adoption decree.

     (2)  The subsidy agreement shall must continue in accordance with its terms until the child reaches majority or for as long as the adopted child is the legal dependent of the adoptive parents and the child's condition continues, in the case of a child with a mental or physical handicap, until 21 years of age. Termination or modification of the subsidy agreement may be requested by the adoptive parents or the department at any time."



     Section 6.  Section 42-10-109, MCA, is amended to read:

     "42-10-109.  Amount, duration, and scope of subsidy. The amount, duration, and scope of the subsidy may vary with the special needs of the child as well as the availability of other resources, including those of the adoptive parents, to meet these needs. The subsidy may be for services only or for the money payments, but in no case may the amount of the subsidy exceed:

     (1)  in the case of a sibling relationship, that which would be allowable for such maintenance costs such as payments to cover the cost of food, clothing, shelter, daily supervision, school supplies, and a child's personal incidentals, not to exceed the foster care rate established by the department for a child under foster family care; or

     (2)  in the case of a state medical subsidy, the reasonable fee for the services rendered, not to exceed the amount of $2,600 annually."



     Section 7.  Section 53-6-131, MCA, is amended to read:

     "53-6-131.  Eligibility requirements. (1) Medical assistance under the Montana medicaid program may be granted to a person who is determined by the department of public health and human services, in its discretion, to be eligible as follows:

     (a)  The person receives or is considered to be receiving supplemental security income benefits under Title XVI of the Social Security Act, 42 U.S.C. 1381, et seq., and does not have income or resources in excess of the applicable medical assistance limits or receive from FAIM financial assistance, as defined in 53-4-702, benefits under Title IV of the federal Social Security Act, 42 U.S.C. 601, et seq.

     (b)  The person would be eligible for assistance under a program described in subsection (1)(a) if that person were to apply for that assistance.

     (c)  The person is in a medical facility that is a medicaid provider and, but for residence in the facility, the person would be receiving assistance under one of the programs in subsection (1)(a).

     (d)  The person is under 19 years of age and meets the conditions of eligibility in the state plan, as defined in 53-4-201, other than with respect to age and school attendance.

     (e)  The person is under 21 years of age and in foster care under the supervision of the state or was in foster care under the supervision of the state and has been adopted as a hard-to-place child with special needs.

     (f)  The person meets the nonfinancial criteria of the categories in subsections (1)(a) through (1)(e) and:

     (i)  the person's income does not exceed the income level specified for federally aided categories of assistance and the person's resources are within the resource standards of the federal supplemental security income program; or

     (ii) the person, while having income greater than the medically needy income level specified for federally aided categories of assistance:

     (A)  has an adjusted income level, after incurring medical expenses, that does not exceed the medically needy income level specified for federally aided categories of assistance or, alternatively, has paid in cash to the department the amount by which the person's income exceeds the medically needy income level specified for federally aided categories of assistance; and

     (B)  has resources that are within the resource standards of the federal supplemental security income program.

     (g)  The person is a qualified pregnant woman or child as defined in 42 U.S.C. 1396d(n).

     (2)  The department may establish income and resource limitations. Limitations of income and resources must be within the amounts permitted by federal law for the medicaid program.

     (3)  The Montana medicaid program shall pay, as required by federal law, the premiums necessary for medicaid-eligible persons participating in the medicare program and may, within the discretion of the department, pay all or a portion of the medicare premiums, deductibles, and coinsurance for a qualified medicare-eligible person or for a qualified disabled and working individual, as defined in section 6408(d)(2) of the federal Omnibus Budget Reconciliation Act of 1989, Public Law 101-239, who:

     (a)  has income that does not exceed income standards as may be required by the Social Security Act; and

     (b)  has resources that do not exceed standards that the department determines reasonable for purposes of the program.

     (4)  The department may pay a medicaid-eligible person's expenses for premiums, coinsurance, and similar costs for health insurance or other available health coverage, as provided in 42 U.S.C. 1396b(a)(1).

     (5)  In accordance with waivers of federal law that are granted by the secretary of the U.S. department of health and human services, the department of public health and human services may grant eligibility for basic medicaid benefits as described in 53-6-101 to an individual receiving FAIM financial assistance, as defined in 53-4-702, as the specified caretaker relative of a dependent child under the FAIM project and to all adult recipients of medical assistance only who are covered under a group related to the program of FAIM financial assistance. A recipient who is pregnant, meets the criteria for disability provided in Title II of the Social Security Act, 42 U.S.C. 416, et seq., or is less than 21 years of age is entitled to full medicaid coverage as provided in 53-6-101.

     (6)  The department, under the Montana medicaid program, may provide, if a waiver is not available from the federal government, medicaid and other assistance mandated by Title XIX of the Social Security Act, 42 U.S.C. 1396, et seq., as may be amended, and not specifically listed in this part to categories of persons that may be designated by the act for receipt of assistance.

     (7)  Notwithstanding any other provision of this chapter, medical assistance must be provided to infants and pregnant women whose family income does not exceed 133% of the federal poverty threshold, as provided in 42 U.S.C. 1396a(a)(10)(A)(ii)(IX) and 42 U.S.C. 1396a(l)(2)(A)(i), and whose family resources do not exceed standards that the department determines reasonable for purposes of the program.

     (8)  Subject to appropriations, the department may cooperate with and make grants to a nonprofit corporation that uses donated funds to provide basic preventive and primary health care medical benefits to children whose families are ineligible for the Montana medicaid program and who are ineligible for any other health care coverage, are under 19 years of age, and are enrolled in school if of school age.

     (9)  A person described in subsection (7) must be provided continuous eligibility for medical assistance, as authorized in 42 U.S.C. 1396a(e)(5) through a(e)(7).

     (10) The department may establish resource and income standards of eligibility for mental health services that are more liberal than the resource and income standards of eligibility for physical health services. The standards for eligibility for mental health services may provide for eligibility for households with family income that does not exceed 200% of the federal poverty threshold or that does not exceed a lesser amount determined in the discretion of the department. The department may by rule specify under what circumstances deductions for medical expenses should be used to reduce countable family income in determining eligibility. The department may also adopt rules establishing fees to be charged recipients for services. The fees may vary according to family income."



     Section 8.  Repealer. Section 42-10-110, MCA, is repealed.

- END -




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