Q: In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
SECTION 1. SHORT TITLE; AMENDMENTS TO SOCIAL SECURITY ACT; TABLE OF
CONTENTS.

(a) Short Title.--This Act may be cited as the ''Family Opportunity
Act of 2004'' or the ''Dylan Lee James Act''.
(b) Amendments to Social Security Act.--Except as otherwise
specifically provided, whenever in this Act an amendment is expressed
in terms of an amendment to or repeal of a section or other provision,
the reference shall be considered to be made to that section or other
provision of the Social Security Act.
(c) Table of Contents.--The table of contents of this Act is as
follows:

Sec. 1. Short title; amendments to Social Security Act; table of
contents.
Sec. 2. Opportunity for families of disabled children to purchase
medicaid coverage for such children.
Sec. 3. Treatment of inpatient psychiatric hospital services for
individuals under age 21 in home or
community-based services waivers.
Sec. 4. Development and support of family-to-family health information
centers.
Sec. 5. Restoration of medicaid eligibility for certain SSI
beneficiaries.

SEC. 2. OPPORTUNITY FOR FAMILIES OF DISABLED CHILDREN TO PURCHASE
MEDICAID COVERAGE FOR SUCH CHILDREN.

(a) State Option To Allow Families of Disabled Children To Purchase
Medicaid Coverage for Such Children.--
(1) In general.--Section 1902 (42 U.S.C. 1396a) is
amended--
(A) in subsection (a)(10)(A)(ii)--
(i) by striking ''or'' at the end of
subclause (XVII);
(ii) by adding ''or'' at the end of
subclause (XVIII); and
(iii) by adding at the end the following
new subclause:
''(XIX) who are disabled children
described in subsection (cc)(1);''; and
(B) by adding at the end the following new
subsection:
''(cc)(1) Individuals described in this paragraph are individuals--
''(A) who have not attained 18 years of age;
''(B) who would be considered disabled under section
1614(a)(3)(C) but for having earnings or deemed income or
resources (as determined under title XVI for children) that
exceed the requirements for receipt of supplemental security
income benefits; and
''(C) whose family income does not exceed such income level
as the State establishes and does not exceed--
''(i) 250 percent of the poverty line (as defined
in section 2110(c)(5)) applicable to a family of the
size involved; or
''(ii) such higher percent of such poverty line as
a State may establish, except that--
''(I) any medical assistance provided to an
individual whose family income exceeds 250
percent of such poverty line may only be
provided with State funds; and
''(II) no Federal financial participation
shall be provided under section 1903(a) for any
medical assistance provided to such an
individual.''.
(2) Interaction with employer-sponsored family coverage.--
Section 1902(cc) (42 U.S.C. 1396a(cc)), as added by paragraph
(1)(B), is amended by adding at the end the following new
paragraph:
''(2)(A) If an employer of a parent of an individual described in
paragraph (1) offers family coverage under a group health plan (as
defined in section 2791(a) of the Public Health Service Act), the State
shall--
''(i) require such parent to apply for, enroll in, and pay
premiums for, such coverage as a condition of such parent's
child being or remaining eligible for medical assistance under
subsection (a)(10)(A)(ii)(XIX) if the parent is determined
eligible for such coverage and the employer contributes at
least 50 percent of the total cost of annual premiums for such
coverage; and
''(ii) if such coverage is obtained--
''(I) subject to paragraph (2) of section 1916(h),
reduce the premium imposed by the State under that
section in an amount that reasonably reflects the
premium contribution made by the parent for private
coverage on behalf of a child with a disability; and
''(II) treat such coverage as a third party
liability under subsection (a)(25).
''(B) In the case of a parent to which subparagraph (A) applies, a
State, subject to paragraph (1)(C)(ii), may provide for payment of any
portion of the annual premium for such family coverage that the parent
is required to pay. Any payments made by the State under this
subparagraph shall be considered, for purposes of section 1903(a), to
be payments for medical assistance.''.
(b) State Option To Impose Income-Related Premiums.--Section 1916
(42 U.S.C. 1396o) is amended--
(1) in subsection (a), by striking ''subsection (g)'' and
inserting ''subsections (g) and (h)''; and
(2) by adding at the end the following new subsection:
''(h)(1) With respect to disabled children provided medical
assistance under section 1902(a)(10)(A)(ii)(XIX), subject to paragraph
(2), a State may (in a uniform manner for such children) require the
families of such children to pay monthly premiums set on a sliding
scale based on family income.
''(2) A premium requirement imposed under paragraph (1) may only
apply to the extent that--
''(A) in the case of a disabled child described in that
paragraph whose family income does not exceed 250 percent of
the poverty line, the aggregate amount of such premium and any
premium that the parent is required to pay for family coverage
under section 1902(cc)(2)(A)(i) does not exceed 7.5 percent of
the family's income; and
''(B) the requirement is imposed consistent with section
1902(cc)(2)(A)(ii)(I).
''(3) A State shall not require prepayment of a premium imposed
pursuant to paragraph (1) and shall not terminate eligibility of a
child under section 1902(a)(10)(A)(ii)(XIX) for medical assistance
under this title on the basis of failure to pay any such premium until
such failure continues for a period of not less than 60 days from the
date on which the premium became past due. The State may waive payment
of any such premium in any case where the State determines that
requiring such payment would create an undue hardship.''.
(c) Conforming Amendment.--Section 1903(f)(4) (42 U.S.C.
1396b(f)(4)) is amended in the matter preceding subparagraph (A), by
inserting ''1902(a)(10)(A)(ii)(XIX),'' after
''1902(a)(10)(A)(ii)(XVIII),''.
(d) Rule of Construction.--Notwithstanding any other provision of
law, nothing in the amendments made by this section shall be construed
as permitting the application of the enhanced FMAP (as defined in
section 2105(b) of the Social Security Act (42 U.S.C. 1397ee(b)) to
expenditures that are attributable to disabled children provided
medical assistance under section 1902(a)(10)(A)(ii)(XIX) of such Act
(42 U.S.C. 1396a(a)(10)(A)(ii)(XIX)) (as added by subsection (a) of
this section).
(e) Effective Date.--The amendments made by this section shall
apply to medical assistance for items and services furnished on or
after October 1, 2006.

SEC. 3. TREATMENT OF INPATIENT PSYCHIATRIC HOSPITAL SERVICES FOR
INDIVIDUALS UNDER AGE 21 IN HOME OR COMMUNITY-BASED
SERVICES WAIVERS.

(a) In General.--Section 1915(c) (42 U.S.C. 1396n(c)) is amended--
(1) in paragraph (1)--
(A) in the first sentence, by inserting '', or
would require inpatient psychiatric hospital services
for individuals under age 21,'' after ''intermediate
care facility for the mentally retarded''; and
(B) in the second sentence, by inserting '', or
would require inpatient psychiatric hospital services
for individuals under age 21'' before the period;
(2) in paragraph (2)(B), by striking ''or services in an
intermediate care facility for the mentally retarded'' each
place it appears and inserting ''services in an intermediate
care facility for the mentally retarded, or inpatient
psychiatric hospital services for individuals under age 21'';
(3) in paragraph (2)(C)--
(A) by inserting '', or who are determined to be
likely to require inpatient psychiatric hospital
services for individuals under age 21,'' after '', or
intermediate care facility for the mentally retarded'';
and
(B) by striking ''or services in an intermediate
care facility for the mentally retarded'' and inserting
''services in an intermediate care facility for the
mentally retarded, or inpatient psychiatric hospital
services for individuals under age 21''; and
(4) in paragraph (7)(A)--
(A) by inserting ''or would require inpatient
psychiatric hospital services for individuals under age
21,'' after ''intermediate care facility for the
mentally retarded,''; and
(B) by inserting ''or who would require inpatient
psychiatric hospital services for individuals under age
21'' before the period.
(b) Effective Date.--The amendments made by subsection (a) apply
with respect to medical assistance provided on or after October 1,
2006.

SEC. 4. DEVELOPMENT AND SUPPORT OF FAMILY-TO-FAMILY HEALTH INFORMATION
CENTERS.

Section 501 (42 U.S.C. 701) is amended by adding at the end the
following new subsection:
''(c)(1)(A) For the purpose of enabling the Secretary (through
grants, contracts, or otherwise) to provide for special projects of
regional and national significance for the development and support of
family-to-family health information centers described in paragraph
(2)--
''(i) there is appropriated to the Secretary, out of any
money in the Treasury not otherwise appropriated--
''(I) $3,000,000 for fiscal year 2006;
''(II) $4,000,000 for fiscal year 2007; and
''(III) $5,000,000 for fiscal year 2008; and
''(ii) there is authorized to be appropriated to the
Secretary, $5,000,000 for each of fiscal years 2009 and 2010.
''(B) Funds appropriated or authorized to be appropriated under
subparagraph (A) shall--
''(i) be in addition to amounts appropriated under
subsection (a) and retained under section 502(a)(1) for the
purpose of carrying out activities described in subsection
(a)(2); and
''(ii) remain available until expended.
''(2) The family-to-family health information centers described in
this paragraph are centers that--
''(A) assist families of children with disabilities or
special health care needs to make informed choices about health
care in order to promote good treatment decisions, cost-
effectiveness, and improved health outcomes for such children;
''(B) provide information regarding the health care needs
of, and resources available for, children with disabilities or
special health care needs;
''(C) identify successful health delivery models for such
children;
''(D) develop with representatives of health care
providers, managed care organizations, health care purchasers,
and appropriate State agencies a model for collaboration
between families of such children and health professionals;
''(E) provide training and guidance regarding caring for
such children;
''(F) conduct outreach activities to the families of such
children, health professionals, schools, and other appropriate
entities and individuals; and
''(G) are staffed by families of children with disabilities
or special health care needs who have expertise in Federal and
State public and private health care systems and health
professionals.
''(3) The Secretary shall develop family-to-family health
information centers described in paragraph (2) in accordance with the
following:
''(A) With respect to fiscal year 2006, such centers shall
be developed in not less than 25 States.
''(B) With respect to fiscal year 2007, such centers shall
be developed in not less than 40 States.
''(C) With respect to fiscal year 2008, such centers shall
be developed in all States.
''(4) The provisions of this title that are applicable to the funds
made available to the Secretary under section 502(a)(1) apply in the
same manner to funds made available to the Secretary under paragraph
(1)(A).
''(5) For purposes of this subsection, the term 'State' means each
of the 50 States and the District of Columbia.''.

SEC. 5. RESTORATION OF MEDICAID ELIGIBILITY FOR CERTAIN SSI
BENEFICIARIES.

(a) In General.--Section 1902(a)(10)(A)(i)(II) (42 U.S.C.
1396a(a)(10)(A)(i)(II)) is amended--
(1) by inserting ''(aa)'' after ''(II)'';
(2) by striking '') and'' and inserting ''and'';
(3) by striking ''section or who are'' and inserting
''section), (bb) who are''; and
(4) by inserting before the comma at the end the following:
'', or (cc) who are under 21 years of age and with respect to
whom supplemental security income benefits would be paid under
title XVI if subparagraphs (A) and (B) of section 1611(c)(7)
were applied without regard to the phrase 'the first day of the
month following'''.
(b) Effective Date.--The amendments made by subsection (a) shall
apply to medical assistance for items and services furnished on or
after January 1, 2006.

Passed the Senate May 6, 2004.

Attest:

EMILY J. REYNOLDS,

Secretary.
A:
Family Opportunity Act of 2004 or Dylan Lee James Act - Amends title XIX (Medicaid) of the Social Security Act (SSA) to: (1) give States the option of allowing families of disabled children to purchase Medicaid coverage for them; and (2) add to the list of persons eligible for Medicaid home and community-based service waiver programs individuals under 21 years of age requiring inpatient psychiatric hospital services.

Amends SSA title V (Maternal and Child Health Services) to: (1) make appropriations to the Secretary of Health and Human Services for FY 2005 through 2007; and (2) authorize appropriations to the Secretary for FY 2008 and 2009 for special projects of regional and national significance for development and support of family-to-family health information centers.

Amends SSA title XIX to confer Medicaid eligibility to persons who are under age 21 and who are eligible for SSI, effective on the later of: (1) the date the application was filed; or (2) the date the individual became eligible for SSI.