CCS#2 HS HCS SCS SB 236 -- TEMPORARY AND MEDICAL ASSISTANCE;
INDEPENDENCE GRANTS; ADOPTION

This bill makes various changes to provisions relating to
children and families.

TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)

Under the provisions of the bill, education beyond secondary
education qualifies as a work activity for purposes of TANF
eligibility for up to 60 months.  The Department of Social
Services is required to make a detailed presentation and report
on the TANF program to certain committees of the General
Assembly every 2 years beginning January 1, 2002.

MEDICAL ASSISTANCE FOR EMPLOYED INDIVIDUALS

The bill establishes eligibility requirements for needy persons
to receive medical assistance.  These requirements are derived
from the federal Ticket to Work and Work Incentives Improvement
Act of 1999 (TWWIIA).  The bill authorizes medical assistance to
be paid for a person who is employed and who:

(1)  Meets the definition of the term "disabled" under the
Supplemental Security Income Program or meets the definition of
employed individual with a medically improved disability under
TWWIIA;

(2)  Meets the asset limits specified in the bill; and

(3)  Has an annual income of 250% or less of the federal poverty
guidelines.  Income does not include any income of the person's
spouse or children.  Individuals with incomes greater than 150%
of the federal poverty guidelines will pay a premium for
participation.

A person otherwise eligible for medical assistance under the
bill will not lose eligibility if he or she maintains an
independent living development account, as defined in the bill.
These accounts will not be considered an asset for determining
eligibility until the person reaches 65 years of age.

If an eligible individual's employer offers employer-sponsored
health insurance and the Department of Social Services
determines that it is more cost-effective than medical
assistance, the individual will participate in the
employer-sponsored insurance.  The department will pay the
individual's portion of the premiums, copayments, and other
associated costs.

Medical assistance will be provided to an eligible person as a
secondary or supplemental policy to any employer-sponsored
benefits available to that person.  The department will submit
appropriate documentation to the federal government for approval
and will apply for all grants available to offset the costs
associated with the bill's provisions.

TRANSITION TO INDEPENDENCE GRANTS

The bill provides one-time, transition-to-independence grants of
up to $1,500 to individuals who are institutionalized and want
to move from a nursing home to the community.  The Division of
Medical Services, the Department of Health and Senior Services,
and the Division of Vocational Rehabilitation are required to
develop information and training on community-based service
options for those making the transition into the community.
Representatives of disability-related community organizations
are required to complete training before initiating contact with
institutionalized individuals

ADOPTION

The bill adds adult first cousins of a child to the list of
relatives who are qualified to receive adoption subsidies.

Missouri is allowed to recognize an adoption that has occurred
in another country when the adopted child migrates to the United
States with the permission of the Department of Justice and the
Immigration and Naturalization Service.  A child's cultural,
racial, and ethnic background is removed from the factors
considered when placing a child for adoption.

GRANDPARENTS AS FOSTER PARENTS PROGRAM

The bill revises the grandparents as foster parents program.
The program is subject to appropriation and, to be eligible,
grandparents must be 50 or older, be the legal guardian of a
grandchild placed in their custody, have an annual household
income of less than 200% of the federal poverty level, and
participate in the division's training.  The Division of Family
Services is required to annually review eligibility of
grandparents in the program.  The division can include other
close relatives of the child who obtain legal guardianship or
custody if grandparents are not willing to participate in the
program, but the other relatives must meet all other
requirements of the program.  Subject to appropriation, the
program provides reimbursement up to 75% of the current foster
care payment schedule.  The program also provides for training,
counseling, support services, Medicaid services for the child,
and ancillary services.  Grandparents who are under 50 or who do
not participate in foster parent training may apply for foster
care reimbursement and assistance, which is paid out of TANF
funds and subject to TANF time limits.

Missouri House of Representatives
Last Updated November 26, 2001 at 11:47 am