Bill Summary – FastDemocracy

ENROLLED ORIGINAL

                                               AN ACT

                                       ___________________

                    IN THE COUNCIL OF THE DISTRICT OF COLUMBIA

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To amend title I of the Birth-to-Three for All DC Amendment Act of 2018 to extend health

      insurance coverage for eligible home visiting services through Medicaid, DC HealthCare

      Alliance, and the Immigrant Children’s Program.

       BE IT ENACTED BY THE COUNCIL OF THE DISTRICT OF COLUMBIA, That this

act may be cited as the “Home Visiting Services Reimbursement Amendment Act of 2024”.

         Sec. 2. Title I of the Birth-to-Three for All DC Amendment Act of 2018, effective

October 30, 2018 (D.C. Law 22-179; D.C. Official Code § 4-651.01 et seq.), is amended by

adding a new section 111 to read as follows:

         “Sec. 111. Reimbursement for home visiting services.

         “(a) By January 1, 2025, health insurance coverage through Medicaid or the DC

HealthCare Alliance and the Immigrant Children’s Program shall cover and reimburse eligible

home visiting services provided by an eligible home visiting program; except, that no Medicaid

payment shall be made until such time that CMS approves the Medicaid state plan amendment

described in subsection (b) of this section.

         “(b)(1) By December 31, 2024, DHCF shall submit for approval from CMS an

amendment to the Medicaid state plan to authorize the Medicaid payments described in this

section.

                 “(2) While preparing the Medicaid state plan amendment application, DHCF

shall:

                          “(A) In consultation with organizations providing home visiting services

and other relevant entities, establish criteria and processes for billing and reimbursement of

eligible home visiting services, including:

                                 “(i) Establishing coverage and eligibility criteria to include at least

the covered population;

                                 “(ii) Establishing a payment methodology based on monthly

payments per individual or family receiving eligible home visiting services so that the payment

results in adequate reimbursement;

                                 “(iii) Developing program support and training for home visitors to

facilitate billing; and

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                                “(iv) Assessing the viability of incentive payments to home visitors

whose clients attend postpartum appointments with a medical provider; and

                        “(B) In consultation with DOH and other relevant entities, issue rules to

determine eligibility for reimbursement by Medicaid, the DC HealthCare Alliance, and the

Immigrant Children’s Program.

        “(c) For purposes of this section, the term:

                “(1) “CMS” means the Centers for Medicare & Medicaid Services.

                “(2) “Covered population” means:

                        “(A) First-time expectant parents; and

                        “(B) Families, and expectant parents, who have children under the age of 5

and meet 3 or more medical, behavioral, or social risk factors, as determined by DHCF.

               “(3) “Eligible home visiting program” means a home visiting program that

conforms to a home visitation model that has been in existence for at least 3 years and:

                        “(A) Is research-based and grounded in relevant empirically based

knowledge;

                        “(B) Has demonstrated program-determined outcomes;

                        “(C) Is associated with a national organization, institution of higher

education, or other organization that has comprehensive home visitation program standards to

ensure high quality service delivery and continuous program quality improvement; and

                        “(D) Meets the U.S. Department of Health and Human Services’ criteria

for evidence of effectiveness as determined by a Home Visiting Evidence of Effectiveness

review or meets substantially equivalent criteria for evidence of effectiveness as determined by a

credible, independent academic or research organization.”.

        Sec. 3. Applicability.

        (a) This act shall apply upon the date of inclusion of its fiscal effect in an approved

budget and financial plan.

        (b) The Chief Financial Officer shall certify the date of the inclusion of the fiscal effect in

an approved budget and financial plan, and provide notice to the Budget Director of the Council

of the certification.

        (c)(1) The Budget Director shall cause the notice of the certification to be published in

the District of Columbia Register.

                 (2) The date of publication of the notice of the certification shall not affect the

applicability of this act.

       Sec. 4. Fiscal impact statement.

       The Council adopts the fiscal impact statement in the committee report as the fiscal

impact statement required by section 4a of the General Legislative Procedures Act of 1975,

approved October 16, 2006 (120 Stat. 2038; D.C. Official Code § 1-301.47a).

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       Sec. 5. Effective date.

       This act shall take effect after approval by the Mayor (or in the event of veto by the

Mayor, action by the Council to override the veto), a 30-day period of congressional review as

provided in section 602(c)(1) of the District of Columbia Home Rule Act, approved December

24, 1973 (87 Stat. 813; D.C. Official Code § 1-206.02(c)(1)), and publication in the District of

Columbia Register.

               ______________________________

               Chairman

               Council of the District of Columbia

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Mayor

District of Columbia

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