reglab/statecodes huggingface dataset:
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 7 - ANNUAL COVERAGE ASSESSMENT ACT OF 2013 (§§ 71-5-701 — 71-5-708) › Section 71-5-706 - Individual eligibility requirements

The director shall ensure that the buy-in program:
(1)
Requires that, for a person to qualify for the program, the person must:
(A)
Meet the following general requirements as established for the medical assistance program:
(i)
Residence in this state;
(ii)
Citizenship or immigration status in the United States;
(iii)
Possession of a valid social security account number; and
(iv)
Assignment of medical support rights to this state;
(B)
Be at least eighteen (18) years of age;
(C)
Meet federal disability requirements; and
(D)
Be employed full- or part-time, including self-employment;
(2)
Does not require a resource test;
(3)
Requires that an enrollee comply with cost-sharing provisions; and
(4)
Allows a person who, once approved for the program, experiences a job loss to choose to continue program coverage through the original six (6) months of eligibility, if:
(A)
The job loss results from an involuntary dismissal or health crisis; and
(B)
The person continues to pay the monthly premium based on the person's income.
Added by 2024 Tenn. Acts, ch. 1002,s 1, eff. 5/21/2024.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 7 - ANNUAL COVERAGE ASSESSMENT ACT OF 2013 (§§ 71-5-701 — 71-5-708) › Section 71-5-707 - Employment requirements

The director shall ensure that, for the purpose of the buy-in program, a person is considered to be employed if the person:
(1)
Gets paid for working;
(2)
Has earnings that are subject to federal income tax; and
(3)
Unless the person is self-employed, has payroll taxes deducted from earnings received.
Added by 2024 Tenn. Acts, ch. 1002,s 1, eff. 5/21/2024.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 7 - ANNUAL COVERAGE ASSESSMENT ACT OF 2013 (§§ 71-5-701 — 71-5-708) › Section 71-5-708 - Premium payments - Billing and payment of premiums

(a)
The director shall ensure, when determining the premium amount a person must pay for participation in the buy-in program, that:
(1)
The bureau counts only the income of the person approved for the program, and does not count the income of another household member;
(2)
For purposes of determining countable income to be used in the premium calculation, the bureau applies the following rules:
(A)
Income is considered available and owned when it is:
(i)
Received; and
(ii)
Can be used to meet the person's needs for food, clothing, and shelter; and
(B)
Certain receipts are not income as described in
20 C.F.R. § 416.1103
;
(3)
The buy-in program premium amount equals, rounded down to the nearest whole dollar, five percent (5%) of countable income described in subdivision (a)(2), including both earned and unearned income;
(4)
When determining the premium amount, the bureau uses the verified income amount until a change in income is reported and processed, unless good cause for delay in verifying changes exists; and
(5)
A change in the premium amount is effective the month after the change in income is reported to and processed by the bureau.
(b)
The director shall ensure, when billing for and processing payments of buy-in program premiums, that:
(1)
For current and ongoing coverage, the bureau bills for program premiums during the month following the benefit month;
(2)
The first monthly premium begins the first full month of coverage;
(3)
Pursuant to § 71-5-706(3), the bureau may terminate program coverage if premiums are not paid in full for four (4) consecutive months;
(4)
The person must pay the monthly premium in full to avoid losing program coverage and, if a person makes a partial payment, the payment does not count as a full payment toward the premium;
(5)
Payments received are applied to premiums owed in the following order:
(A)
Past due months, beginning with the most delinquent month; and
(B)
The current coverage month that has been invoiced; and
(6)
A person must pay a premium for any month that program coverage is provided, including months when a redetermination of coverage is made, months when continued coverage is requested, and during the period of an aid-pending eligibility appeal.
Added by 2024 Tenn. Acts, ch. 1002,s 1, eff. 5/21/2024.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 8 - POVERTY REDUCTION PLAN (§§ 71-5-801 — 71-5-806) › Section 71-5-801 - [Repealed]

Acts 2014, ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 8 - POVERTY REDUCTION PLAN (§§ 71-5-801 — 71-5-806) › Section 71-5-802 - [Repealed]

Acts 2014, ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 8 - POVERTY REDUCTION PLAN (§§ 71-5-801 — 71-5-806) › Section 71-5-803 - [Repealed]

Acts 2014, ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 8 - POVERTY REDUCTION PLAN (§§ 71-5-801 — 71-5-806) › Section 71-5-804 - [Repealed]

Acts 2014, ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 8 - POVERTY REDUCTION PLAN (§§ 71-5-801 — 71-5-806) › Section 71-5-805 - [Repealed]

Acts 2014, ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 8 - POVERTY REDUCTION PLAN (§§ 71-5-801 — 71-5-806) › Section 71-5-806 - [Repealed]

Acts 2014, ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 9 - POVERTY REDUCTION PLAN (§§ 71-5-901 — 71-5-903) › Section 71-5-901 - Commissioner of human services to conduct study of poverty

The commissioner of human services shall complete a study of poverty in Tennessee, including its implications and potential solution strategies with feedback from departments, agencies, and selected non-governmental organizations serving the affected populations. Such departments, agencies and organizations shall include, but not be limited to the following:
(1)
Department of children's services;
(2)
Department of health;
(3)
The bureau of TennCare;
(4)
Department of economic and community development;
(5)
The Tennessee commission on children and youth;
(6)
Department of disability and aging;
(7)
The Room in the Inn program of Middle Tennessee;
(8)
The Catholic Charities in Tennessee;
(9)
The Area Relief Ministries of Jackson, Tennessee;
(10)
The Second Harvest Food Bank of Tennessee;
(11)
The Neighborhood Christian Center of Memphis, Tennessee; and
(12)
The Regional Interfaith Alliance of Jackson, Tennessee.
Amended by 2024 Tenn. Acts, ch. 688,s 184, eff. 7/1/2024.
Acts 2014, ch. 934, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 9 - POVERTY REDUCTION PLAN (§§ 71-5-901 — 71-5-903) › Section 71-5-902 - Poverty reduction plan

(a)
The poverty reduction plan shall:
(1)
Assess the current and future impact of poverty on the residents of Tennessee;
(2)
Examine the existing barriers, services and resources addressing the needs of persons living in poverty and their families; and
(3)
Develop a proposed strategy to mobilize the state response to the poverty crisis;
(b)
The poverty reduction plan shall include an examination of the following in its assessment and recommendations:
(1)
A determination of the economic and human impact of poverty in this state;
(2)
A review of the remedies to reduce the number of individuals and families living in poverty in this state;
(3)
Information to be utilized as potential legislative remedies for consideration in the one hundred ninth general assembly; and
(4)
Needed state policies or responses, including directions for the provision of clear and coordinated services and support to persons living in poverty and strategies to address any identified gaps in services.
Acts 2014, ch. 934, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 9 - POVERTY REDUCTION PLAN (§§ 71-5-901 — 71-5-903) › Section 71-5-903 - Deadline for submission of findings and recommendations

(a)
The commissioner and other departments, agencies and selected non-governmental organizations conducting the study shall hold a public meeting and utilize technological means to gather feedback on the recommendations from the general public and from persons and families affected by poverty.
(b)
The department shall submit its findings and recommendations to the governor and the general assembly in the form of a state anti-poverty plan by January 15, 2015.
Acts 2014, ch. 934, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 10 - NURSING HOME ASSESSMENT TRUST FUND (§§ 71-5-1001 — 71-5-1011) › Section 71-5-1005 - Bureau to seek federal approvals if necessary - Bureau authorized to adopt rules and regulations to implement part

(a)
The bureau shall seek necessary federal approval in the form of state plan amendments in order to implement this part, if it determined such approvals are necessary.
(b)
The bureau is authorized to adopt rules and regulations necessary to implement this part or obtain approval of the state plan amendments. However, §
71-5-1413
shall be the exclusive authority for rulemaking by the bureau of TennCare regarding the initial rules regarding the acuity-based nursing home reimbursement system and any subsequent modifications to the nursing home reimbursement system.
Amended by 2018 Tenn. Acts, ch. 836,s 7, eff. 7/1/2018.
Amended by 2017 Tenn. Acts, ch. 377,s 4, eff. 7/1/2017.
Acts 2014, ch. 859, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 10 - NURSING HOME ASSESSMENT TRUST FUND (§§ 71-5-1001 — 71-5-1011) › Section 71-5-1007 - Requirements for nursing homes participating in medicaid program - Penalties for noncompliance - Waiver of penalties

For the purposes of this part, any nursing home participating in the medicaid program shall file cost reports in accordance with the rules adopted by the bureau. Any nursing home participating in the medicaid program that does not adopt the uniform classification of accounts, or other acceptable accounting methods as shall be established by the rules of the bureau, in consultation with the comptroller of the treasury and the Tennessee Health Care Association, or does not submit cost data as required by the bureau, shall be assessed a penalty of one hundred dollars ($100) for each day such provider is not in compliance with this section. The bureau may waive, in whole or in part, any penalty upon a determination that there is good cause for such a waiver. The penalty imposed by this section shall supersede any penalty imposed under §
12-4-304
.
Acts 2014, ch. 859, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 10 - NURSING HOME ASSESSMENT TRUST FUND (§§ 71-5-1001 — 71-5-1011) › Section 71-5-1008 - Oversight authority of fiscal review committee

The fiscal review committee shall review and have oversight of the implementation of this part and the nursing home assessment trust fund.
Acts 2014, ch. 859, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 10 - NURSING HOME ASSESSMENT TRUST FUND (§§ 71-5-1001 — 71-5-1011) › Section 71-5-1009 - Enactment of part does not excuse payment of assessment fee

Enactment of this part and any amendments to this part shall not operate to excuse the monthly installment payment of any nursing home assessment fee due during any current or prior fiscal year.
Amended by 2019 Tenn. Acts, ch. 423,s 10, eff. 7/1/2019.
Amended by 2016 Tenn. Acts, ch. 883,s 9, eff. 7/1/2016.
Amended by 2015 Tenn. Acts, ch. 360,s 7, eff. 7/1/2015.
Acts 2014, ch. 859, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 10 - NURSING HOME ASSESSMENT TRUST FUND (§§ 71-5-1001 — 71-5-1011) › Section 71-5-1010 - Termination of fee - Suspension of assessment

(a)
The nursing home annual assessment fee established by this part shall terminate on June 30, 2025.
(b)
The assessment imposed by this part shall be suspended if the bureau attempts to utilize the money in the account for any use other than permitted by this part.
(c)
Any assessment fee obligation imposed by §
71-5-1003
shall be suspended to the extent that, and for the period that receipt of the assessment fee by the state results in, a corresponding reduction in federal financial participation under Title XIX of the federal Social Security Act (
42 U.S.C. § 1396
et seq.).
Amended by 2024 Tenn. Acts, ch. 1037,s 8, eff. 7/1/2024.
Amended by 2023 Tenn. Acts, ch. 384, s 3, eff. 7/1/2023.
Amended by 2022 Tenn. Acts, ch. 1059, s 8, eff. 7/1/2022.
Amended by 2021 Tenn. Acts, ch. 530, s 9, eff. 7/1/2021.
Amended by 2020 Tenn. Acts, ch. 644, s 8, eff. 7/1/2020.
Amended by 2019 Tenn. Acts, ch. 423, s 11, eff. 7/1/2019.
Amended by 2018 Tenn. Acts, ch. 836, s 9, eff. 7/1/2018.
Amended by 2016 Tenn. Acts, ch. 883, s 10, eff. 7/1/2016.
Amended by 2015 Tenn. Acts, ch. 360, s 8, eff. 7/1/2015.
Acts 2014 , ch. 859, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 10 - NURSING HOME ASSESSMENT TRUST FUND (§§ 71-5-1001 — 71-5-1011) › Section 71-5-1011 - [Repealed]

Repealed by 2019 Tenn. Acts, ch. 423,s 12, eff. 7/1/2019.
Amended by 2015 Tenn. Acts, ch. 360,s 10, eff. 7/1/2015.
Amended by 2015 Tenn. Acts, ch. 360,s 9, eff. 7/1/2015.
Acts 2014, ch. 859, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 11 - ANNUAL COVERAGE ASSESSMENT ACT OF 2016 [Expired] (§§ 71-5-1101 — 71-5-1106) › Section 71-5-1101 - [Repealed] Expired

Added by 2016 Tenn. Acts, ch. 854, s 2, eff. 7/1/2016.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 11 - ANNUAL COVERAGE ASSESSMENT ACT OF 2016 [Expired] (§§ 71-5-1101 — 71-5-1106) › Section 71-5-1106 - [Expired] Expired

Added by 2016 Tenn. Acts, ch. 854, s 2, eff. 7/1/2016.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 12 - FAMILIES FIRST COUNCILS (§§ 71-5-1201 — 71-5-1204) › Section 71-5-1202 - Families first community grants program

(a)
The department shall begin accepting grant applications from eligible nonprofit organizations and other qualified entities, distributed proportionally across the three (3) grand divisions of the state to the extent possible, for programs to provide services to families and individuals eligible for the TANF program and in furtherance of the four (4) purposes of the TANF program.
(b)
The department must award community grants in amounts not to exceed fifty million dollars ($50,000,000), subject to appropriations in the general appropriations act, using funds from the department's existing surplus reserve of TANF funds.
(c)
The department is authorized to select community intermediaries and external compliance partners to assist in outreach and marketing, evaluation of grant proposals, administration of the grant program funding, and monitoring to ensure compliance with applicable state and federal requirements; provided, that the costs of these activities do not exceed the amount of federal TANF funds available for those purposes.
Amended by 2021 Tenn. Acts, ch. 515, s 4, eff. 7/1/2021.
Acts 1996, ch. 950, § 27; 1999, ch. 388, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1301 - Creation of grant assistance program

There is hereby created a grant assistance program to provide financial support for eligible individuals residing in nursing homes licensed by the state, which individuals do not have their nursing home care paid for, in whole or in part, by a federal, state or combined federal-state medical care program.
Acts 1992, ch. 954, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1302 - Eligibility

To be eligible to apply for a grant assistance payment under this part, an individual must meet the following qualifications:
(1)
The individual must have resided or be residing, after June 30, 1992, in a facility licensed by the state as a nursing home. Residents in facilities certified as intermediate care facilities for the mentally retarded are not eligible; and
(2)
For each day for which grant assistance is sought, the individual's nursing home care must not have been paid for, in whole or in part, by a federal, state or combined federal-state medical care program.
Acts 1992, ch. 954, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1303 - Application for payment - Nursing home certification to department

(a)
An application for grant assistance program payments must be made by the individual or such individual's legally authorized representative on forms prescribed by regulations of the department of health. Such forms shall include a certification of the individual's annual income for the calendar year immediately preceding the beginning of the state fiscal year during which grant assistance will be requested, and such certification shall be made by the individual or individual's legally authorized representative.
(b)
Following the application, the nursing home shall provide, following the provision of service, but not less than monthly, on forms prescribed by the department, a certification to the department indicating the number of days the individual resided in the nursing home during the preceding month, the per day expense for care at the facility during that period and the source or sources of payment to defray the expense. Application information and monthly certification information is subject to verification by the department.
Acts 1992, ch. 954, § 1; 1993, ch. 425, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1304 - Processing of applications - Funding - Determination of grant

Applications shall be processed by the department on a first come, first served basis and are subject to the amount annually appropriated for this program in the general appropriations act. Based on the application, the department shall calculate a projected annual nursing home expense for the individual, which shall be the average per diem nursing home expense for the days claimed times three hundred sixty-five (365) days. The projected annual nursing home expense shall be deducted from the prior year's annual income certified by the patient. The remainder shall be the adjusted annual income for purposes of this grant. The amount of the daily grant shall be determined as follows:
(1)
The amount of the payments made pursuant to this part shall be based upon adjusted annual income;
(2)
Adjusted annual income for the purposes of determining eligibility must not exceed three hundred fifty percent (350%) of the federal poverty guidelines for an individual as published annually by the United States department of health and human services for determining medicaid eligibility;
(3)
Individual payments under this part for adjusted annual incomes ranging from zero dollars ($0.00) to an amount calculated to be one hundred eighty-five percent (185%) of the individual poverty guidelines is six dollars and fifty cents ($6.50) per day;
(4)
Maximum individual payments under this part for adjusted annual incomes ranging from one hundred eighty-six percent (186%) to three hundred fifty percent (350%) of the individual poverty guidelines are not to exceed six dollars ($6.00) per day, as determined by rules and regulations promulgated by the commissioner of health in order to meet the sums annually appropriated for this program.
Acts 1992, ch. 954, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1305 - Grant payments

Grant payments under this part shall be made to the individual monthly and forwarded to such person at the place of such individual's residence. Grant payments are non-assignable and payable only to the individual or such individual's legally authorized representative, which shall not be the nursing home.
Acts 1992, ch. 954, § 1; 1993, ch. 425, § 2.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1306 - Rules and regulations

The department of health is authorized to promulgate regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as necessary to implement this part. Notwithstanding any other law, the commissioner of health is authorized to promulgate such initial rules as emergency rules pursuant to §
4-5-208
.
Acts 1992, ch. 954, § 1; 2009, ch. 566, § 12.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1307 - Reserved

Acts 1992, ch. 954, § 1; repealed by Acts 2012, ch. 673, § 5, effective 7/1/2012.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1308 - Administration of part

The department of health is authorized to administer this part, including, but not limited to, the ability to contract with other state agencies or entities to make payments or verify income as required by this part.
Acts 1992, ch. 954, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1309 - Funding

This part shall have no application unless funding is specifically provided for and included in the general appropriations act. During any fiscal year, payments under this part shall not exceed the level of funding specifically provided for such purposes within the general appropriations act.
Acts 1992, ch. 954, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1310 - Total annual income - Certification of income

The amount of total annual income certified by an individual in order to qualify for a grant pursuant to this part shall include income from all sources. The certification of income by the resident shall be subject to verification by the department in its discretion.
Acts 1992, ch. 954, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 13 - GRANT ASSISTANCE PROGRAM FOR NURSING HOME CARE (§§ 71-5-1301 — 71-5-1311) › Section 71-5-1311 - Veterans education benefits

Notwithstanding any other provision of this chapter, to the extent permitted by federal law, the value of federal veterans education benefits received by an applicant shall not be included as any form of income when making eligibility determinations for assistance under this part.
Acts 2003, ch. 239, § 9.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1401 - Short title

This part shall be known and may be cited as the "Long-Term Care Community Choices Act of 2008."
Acts 2008, ch. 1190, § 2.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1405 - Single entry point into the long-term care system

The commissioner shall ensure that there is a single entry point into the long-term care system that is responsible for ensuring that persons seeking care and their families have access to readily available, easy-to-understand information about long-term care options. Functions performed by the single entry point may include counseling and assistance in evaluating long-term care options, screening and intake for long-term care programs, facilitated enrollment for medicaid financial eligibility and assistance with evaluation of level of care in order to facilitate determination of medical eligibility for medicaid long-term care services. Activities performed by the single entry point shall be conducted based on clear and consistent policies, processes and timelines in order to expedite access to available long-term care programs and services. To ensure the most seamless and efficient system possible, medicaid-eligible persons shall not be required to go back through the single entry point in order to access long-term care services, but rather shall have a single entity that is responsible for coordinating all of the medicaid benefits the member may need, including medical, behavioral, nursing facility and home and community-based services.
Acts 2008 , ch. 1190, § 6.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1406 - Implementation of policies and processes by commissioner

The commissioner shall implement policies and processes that expedite the determination of medicaid categorical and financial eligibility and medical eligibility for home and community-based programs and services, either through contracted functions of the department of human services or within the bureau of TennCare. The policies and processes may include, but are not limited to, presumptive or immediate medicaid eligibility determination, fast-track eligibility determination, development of specialized units or teams for determination of medicaid eligibility for HCBS, implementation of facilitated enrollment processes and the implementation of an online medical eligibility application process.
Acts 2008, ch. 1190, § 7.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1407 - Level of care and continued stay criteria - Preadmission evaluation (PAE)

(a)
The commissioner shall develop level of care criteria for new nursing facility admissions that ensure that the most intensive level of long-term care services is provided to persons with the highest level of need. The bureau of TennCare shall define the state's medical eligibility criteria for all long-term care services, including nursing facility and home- and community-based waiver services and adopt such standards by rule pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. In circumstances under which such standards are initially adopted as emergency rules, the bureau of TennCare shall make the proposed emergency rules available through public notice or a posting on the TennCare website, and shall provide for a public hearing prior to the emergency rule's adoption and implementation. Any changes made to the emergency rules after the public hearing shall be posted on the TennCare website. The bureau of TennCare shall develop the preadmission evaluation (PAE) assessment tool, and shall make the determination of medical eligibility for long-term care services.
(b)
Nursing facility residents who meet continued stay criteria and who remain financially eligible for medicaid shall continue to be eligible to receive nursing facility services or cost-effective home and community-based waiver services, and shall not be required to meet new nursing facility level-of-care criteria.
(c)
Current enrollees in the statewide home and community-based services waiver program for persons who are elderly or adults with physical disabilities, or both, who meet continued stay criteria and remain financially eligible for medicaid shall continue to be eligible to receive cost-effective home and community-based waiver services and shall not be required to meet new nursing facility level-of-care criteria except for admission to a nursing facility.
(d)
The commissioner shall develop and seek approval of a waiver application or amendment to a waiver application that allows persons who meet a lesser level of care, i.e., who do not meet new nursing facility level-of-care criteria, but are at risk of institutional care, to qualify for a more moderate package of medicaid-reimbursed home and community-based waiver services up to a specified enrollment cap.
Acts 2008, ch. 1190, § 8; 2012, ch. 971, § 2.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1408 - Strategies to encourage utilization of cost - effective home and community-based services - Requirements related to nursing facility diversion

(a)
The commissioner shall develop and implement strategies to encourage the utilization of cost-effective home and community-based services in lieu of institutional placement.
(b)
The commissioner shall specify in contractor risk agreements with integrated long-term care contractors requirements related to nursing facility diversion. The requirements may include, but are not limited to, the following:
(1)
Documentation prior to approval of nursing facility admission that an individual and the individual's family or other caregivers have been advised of home and community-based alternatives and that the alternatives are not appropriate, cost-effective or desired; and
(2)
A requirement for care coordinators to work with hospital discharge planners and to provide face-to-face visits in nursing facilities within a minimum number of days following admission to develop a plan, as appropriate, for transition back to a home or community-based setting.
Acts 2008 , ch. 1190, § 9.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1409 - Nursing facility transition initiative

(a)
The commissioner shall develop and implement a nursing facility transition initiative.
(b)
The commissioner shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to nursing facility-to-community transitions.
(c)
Contractor requirements shall include identification of nursing facility residents who may be appropriate for transition to home and community-based settings, as well as assessment and care plan development by a qualified entity. The contractor shall plan and facilitate those transitions in a timely manner. Contractors shall be permitted to coordinate or subcontract with local community-based organizations to assist in the identification, planning and facilitation processes, and may offer, as a cost-effective alternative to continued institutional care, a per-person transition cost allowance not to exceed two thousand dollars ($2,000) for items such as, but not limited to, first month's rent, rent deposits, utility deposits, kitchen appliances, furniture and basic household items.
(d)
It is the legislative intent of this section to provide more opportunities for home and community-based services for the at-risk population, subject to the availability of funding in each year's appropriations bill.
Acts 2008, ch. 1190, § 10.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1410 - Strategies to assist nursing facilities in diversifying their lines of business

(a)
The commissioner shall develop and implement strategies to assist nursing facilities in diversifying their lines of business, including provision of home and community-based services and specialized nursing facility care to meet the targeted needs of chronic care populations.
(b)
The strategies may include, but are not limited to, provision of training and technical assistance, streamlined provider enrollment processes for home and community-based services and development of special acuity-based rates to meet the more intensive caregiving demands of certain chronic care populations, subject to the availability of funding in each year's appropriations bill.
Acts 2008, ch. 1190, § 11.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1411 - Plan to expand cost-effective community-based residential alternatives to institutional care

(a)
The commissioner shall develop and implement a plan to expand cost-effective community-based residential alternatives to institutional care for persons who are elderly or adults with physical disabilities, or both, which may include, but not limited to, the development of multiple levels of assisted-care living facility services, adult family care homes, adult foster care homes, companion care models and other cost-effective residential alternatives to nursing facility care.
(b)
The commissioner and the board for licensing health care facilities shall work to develop or modify, or both, licensure requirements for such facilities to support a nursing facility substitute framework for members who want to age in place in residences that offer increasing levels of cost-effective home and community-based care as an alternative to institutionalization as members' needs change.
Acts 2008 , ch. 1190, § 12.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1412 - Transition period following implementation of managed long-term care service delivery system

(a)
A managed care organization (MCO) shall contract with any nursing facility licensed under title 68, chapter 11, part 2, and certified by the centers for medicare and medicaid services, that provides medicaid nursing facility services pursuant to an approved preadmission evaluation (PAE) and is willing to contract with the MCO to provide that service under the same terms and conditions as are offered to any other participating facility contracted with that MCO to provide that service under any policy, contract, or plan that is part of the TennCare managed long-term care service delivery system. Terms and conditions shall not include the rate of reimbursement.
(b)
Nothing in this section shall be interpreted as preventing the bureau of TennCare or an MCO from enforcing a contract between an MCO and a nursing facility or as preventing the bureau of TennCare from adopting reasonable and necessary requirements for the participation of a nursing facility in the TennCare program. All requirements for participation adopted after July 1, 2016, shall be promulgated by the bureau of TennCare as a rule under title 4, chapter 5, part 2, and shall include a hearing under §
4-5-203
, prior to the enforcement of such requirement as part of any provider contract, unless otherwise required by federal law.
Amended by 2016 Tenn. Acts, ch. 883, s 11, eff. 7/1/2016.
Amended by 2014 Tenn. Acts, ch. 859, s 2, eff. 7/1/2014.
Acts 2008 , ch. 1190, § 13; 2012 , ch. 971, § 3.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1415 - Quality assurance and quality improvement strategies

The commissioner shall develop and implement quality assurance and quality improvement strategies to ensure the quality of long-term care services provided pursuant to this part and shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to the quality of long-term care services provided. The strategies may include the use of electronic visit verification for data collection and reporting, HEDIS measures pertaining to long-term care services, and shall include mechanisms to ensure direct feedback from members and family or other caregivers regarding the quality of services received. The commissioner shall ensure that recipients of long-term care services are notified how to contact the bureau of TennCare if they have concerns about the long-term care services they are or are not receiving and the process for resolving such issues.
Acts 2008, ch. 1190, § 16.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1416 - Funding to increase access to home and community-based services in the state-funded options program

Subject to the availability of funding, the commissioner shall designate in each year's appropriations bill an amount of money that can be used to increase access to home and community-based services in the state-funded options program for persons who do not qualify for medicaid long-term care services. This funding may be used to provide services such as home-delivered meals, homemaker services and personal care, and to reduce the waiting list for these services under the options program, or to offer transportation services or assistance to non-medicaid-eligible individuals.
Acts 2008 , ch. 1190, § 17.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1417 - Funding for medicaid long-term care services

The commissioner shall provide medicaid long-term care services subject to the availability of funding in each year's appropriations bill.
Acts 2008 , ch. 1190, § 18.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1420 - Veterans education benefits

Notwithstanding any other provision of this chapter, to the extent permitted by federal law, the value of federal veterans education benefits received by an applicant shall not be included as any form of income when making eligibility determinations for assistance under this part.
Acts 2003, ch. 239, § 10; T.C.A. §
71-5-1410
; Acts 2008, ch. 1190, §§ 1, 11.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1421 - Prompt payment of claims and liability for bad faith failure to pay claims promptly

Any managed care organization shall comply with §
56-32-126
and any prompt pay provisions within the MCO contractor risk agreements with TennCare. In addition, the MCO shall ensure that ninety percent (90%) of clean claims for nursing facility services shall be processed and paid within fourteen (14) calendar days and ninety-nine and one half percent (99.5%) paid within twenty-one (21) days.
Acts 2008, ch. 1190, § 25; 2012, ch. 971, § 5.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1422 - Pilot project for disabled individuals and family members to self-direct supports and services

(a)
The department of disability and aging shall develop a pilot project proposal in accordance with this section. The long-term care services planning council shall be responsible for evaluating the implementation of the project. If funded in the general appropriations act, the pilot project shall be implemented and shall continue for three (3) years. The department shall annually report on the pilot project to the council, the health and welfare committee of the senate and the health committee of the house of representatives. At the end of the project the department shall report on the project to the council and to the standing committees of the senate and the house of representatives. The council shall also make reports of any evaluations that it might undertake of the project to the standing committees of the senate and the house of representatives.
(b)
The department of disability and aging shall develop a pilot project in a county or counties of one (1) of the area agencies on aging and disability (AAAD) and shall enter into a contract with the selected AAAD in order to implement the project. The project shall utilize the services of an aging and disability resource center located in the AAAD. Subject to any approvals required from the department by the contract, a working group from the selected AAAD shall design the project and determine whether to use a program manager in the project. In selecting the AAAD, the department shall consider any administrative and oversight efficiencies that locating the project in any particular AAAD might afford the project.
(c)
The project shall offer families with a member with a disability who requires long-term supports and services and individuals with a disability who require long-term supports and services opportunities to direct their own services. The families and individuals shall exercise choice, control and responsibility for their services within a cost neutral framework.
(d)
The project may involve the following:
(1)
Personal control and choice;
(2)
Encouragement of cost-effective decision-making in the purchase of supports and services;
(3)
Allowing eligible families and individuals to receive a cash allowance or an individual budget to obtain personal assistant services and related supports; and
(4)
Providing fiscal agent and supportive broker services to sustain individuals and families in directing their own services.
Amended by 2024 Tenn. Acts, ch. 688,s 187, eff. 7/1/2024.
Amended by 2013 Tenn. Acts, ch. 236, s 50, eff. 4/19/2013.
Acts 2008 , ch. 1168, § 1.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 14 - LONG-TERM CARE COMMUNITY CHOICES ACT OF 2008 (§§ 71-5-1401 — 71-5-1425) › Section 71-5-1423 - Hearing on resident's appeal of involuntary discharge from facility - Timeframe for hearing and final order

If a resident appeals the facility's notice of involuntary discharge to that resident and a hearing is requested pursuant to
42 C.F.R. § 431.220(a)(3)
before the bureau of TennCare:
(1)
The hearing shall be conducted and a final order rendered within ninety (90) days from the date of the resident's appeal of the facility's involuntary discharge notice;
(2)
The timeframe specified in subdivision (1) may be extended or continued with the consent of both the facility and the resident; and
(3)
The timeframe specified in subdivision (1) may be extended by the presiding administrative law judge without the consent of the facility, but only after a showing by the resident, or the resident's representative, that the resident faces a substantial threat of irreparable damage or injury if a continuance is not granted.
Added by 2014 Tenn. Acts, ch. 911,s 1, eff. 5/13/2014.