1Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
2act to consolidate, editorially revise, and codify the public
3welfare laws of the Commonwealth," <-changing the name of the 
4Department of Public Welfare to the Department of Human 
5Services and providing for a transition period; in general 
6powers and duties of the Department of Public Welfare, 
7further providing for county human services consolidated 
8planning and reporting; in public assistance,  further 
9providing for medical assistance payments for institutional 
10care and for medical assistance benefit packages, coverage, 
11copayments, premiums and rates; in children and youth, 
12further providing for payments to counties for services to 
13children and providing for provider submissions; in 
14intermediate care facilities assessments, further providing 
15for time periods and making editorial changes; in hospital 
16assessments, further providing for authorization and for time 
17period; in Statewide quality care assessment, further 
18defining "net inpatient revenue," providing for 
19implementation, for administration, for limitations and for 
20expiration; in Pennsylvania Trauma Systems Stabilization, 
21further providing for funding; in kinship care, further
22providing for scope and for definitions; <-and providing for
23family finding<-; and, in human services block grant pilot 
24program, further providing for establishment of human 
25services block grant pilot program, for powers and duties of 
26the department, for powers and duties of counties, for 
27allocation and for use of block grant funds.

<-28The General Assembly finds and declares as follows:

29(1) It is the purpose of this act to provide fiscal and

1administrative support that promotes the health, safety and
2welfare of the citizens of this Commonwealth.

3(2) Pennsylvania, through the Department of Public
4Welfare and the counties, provides a broad array of health
5care and other human services to low income families,
6children and youth, those with intellectual and physical
7disabilities and the elderly.

8(3) Section 24 of Article III of the Constitution of
9Pennsylvania requires the General Assembly to adopt all
10appropriations for the operation of government in this
11Commonwealth. The Supreme Court has repeatedly affirmed that,
12"It is fundamental within Pennsylvania's tripartite system
13that the General Assembly enacts the legislation establishing
14those programs which the State provides for its citizens and
15appropriates the funds necessary for their operation."

16(4) Section 11 of Article III of the Constitution of
17Pennsylvania requires the adoption of a general appropriation
18bill that embraces "nothing but appropriations." While actual
19appropriation can be contained in a general appropriations
20act, the achievement and implementation of a comprehensive
21budget involves much more than appropriations. Ultimately,
22the budget has to be balanced under Section 13 of Article
23VIII of the Constitution of Pennsylvania. This may
24necessitate changes to sources of funding and enactment of
25statutes to achieve full compliance with these constitutional

27(5) Therefore, it is the intent of the General Assembly
28through this act to provide further implementation of the
29General Appropriation Act of 2013, as it affects the
30operations and funding for the delivery of health care and

1human services that protect our most vulnerable and needy

3(6) This act shall accomplish all of the following:

4(i) Provide for the expansion of the Human Services
5Block Grant Pilot Program.

6(ii) Extend the authority for State and local
7assessments that support hospitals and intermediate care
8facilities for persons with an intellectual disability
9that serve persons in the medical assistance program.

10(iii) Provide for separate medical assistance fee-
11for-service payments for normal newborn care and for
12mothers' obstetrical delivery.

13(iv) Reauthorize the nursing facility revenue
14adjustment neutrality factor to provide continued
15payments for nursing facilities that serve persons in the
16medical assistance program.

17(v) Provide for quarterly medical assistance day one
18incentive payments to qualified nonpublic nursing

20(vi) Provide for publication of a premium schedule
21for families with children with special needs, who
22receive benefits under the medical assistance program.

23(vii) Establish a process to assure that the revenue
24of the Commonwealth is timely disbursed and expended
25properly for the delivery of public child welfare

27(viii) Reauthorize the reallocation of excess funds
28for payment to qualifying hospitals accredited or seeking
29accreditation as Level III trauma centers.

30(ix) Change the name of the Department of Public

1Welfare to the Department of Human Services.

2(x) Provide for the development and implementation
3of an enhanced medical services delivery system.

4The General Assembly of the Commonwealth of Pennsylvania
5hereby enacts as follows:

<-6Section 1. The heading of Article XIII of the act of June
713, 1967 (P.L.31, No.21), known as the Public Welfare Code,
8added September 30, 2003 (P.L.169, No.25), is amended to read:

<-9Section 1. Section 102 of the act of June 13, 1967 (P.L.31,
10No.21), known as the Public Welfare Code, is amended to read:

11Section 102. Definitions.--Subject to additional definitions
12contained in subsequent articles of this act, the following
13words when used in this act shall have, unless the context
14clearly indicates otherwise, the meanings given them in this

16"Department" means the Department of [Public Welfare] Human 
17Services of this Commonwealth.

18"Secretary" means the Secretary of [Public Welfare] Human 
19Services of this Commonwealth.

20Section 2. The act is amended by adding sections to read:

21Section 103. Redesignation.--(a) The Department of Public
22Welfare shall be known as the Department of Human Services.

23(b) A reference to the Department of Public Welfare in a
24statute or a regulation shall be deemed a reference to the
25Department of Human Services.

26(c) In order to provide an efficient and cost-minimizing
27transition, licenses, contracts, deeds and any other official
28actions of the Department of Public Welfare shall not be
29affected by the use of the designation of the department as the
30Department of Human Services. The department may continue to use

1the name Department of Public Welfare on badges, licenses,
2contracts, deeds, stationery and any other official documents
3until existing supplies are exhausted. The Department of Public
4Welfare may substitute the title "Department of Human Services"
5for "Department of Public Welfare" on its documents and
6materials on such schedule as it deems appropriate.

7(d) The Department of Human Services shall not replace
8existing signage at department locations with the redesignated
9name until the signs are worn and in need of replacement. This
10transition shall be coordinated with changes in administration.

11(e) The department shall continue to use the name Department
12of Public Welfare on its computer systems until the time of
13routine upgrades in each computer system in the department. The
14change in name shall be made at the time of the routine upgrade
15to the department computer systems.

16Section 441.10. Enhanced medical services delivery system.--
17(a) Any enhanced medical services delivery system developed
18collaboratively with the United States Department of Health and
19Human Services and approved for this Commonwealth shall consider
20and recognize all of the following design options or reforms:

21(1) Benefit design modifications that make the medical
22assistance program responsive and flexible to changing needs and
23demands, thereby allowing an expansion of coverage to additional
24citizens of this Commonwealth.

25(2) Improved accountability and personal responsibility
26through cost sharing that includes reasonable low-cost premiums
27or copay requirements, which encourage proper utilization and
28the delivery of services to those who need them most.

29(3) Plan design features that parallel the services and
30benefits available to citizens of this Commonwealth with

1commercial insurance coverage and meet the requirements of an
2essential health benefit plan as defined under the Patient
3Protection and Affordable Care Act (Public Law 111-148, 1124
4Stat. 119), including the delivery of behavioral health

6(4) Maximized use of commercial insurance that takes an
7integrated and market-based approach with new coverage
8opportunities, market competition and alternatives to the
9existing medical assistance program when determined to be more
10fiscally sound and appropriate, including movement to the health
11care exchange for those in the Medical Assistance for Workers
12with Disabilities program.

13(5) Implementation of an enhanced medical services delivery
14system that utilizes existing or supplemental plans for medical
15assistance programs as contracted by the department, using a
16risk-based approach for reimbursing Medicaid managed care

18(6) Continued operation of the Children's Health Insurance
19Program in a form that does not unnecessarily require a shift to
20medical assistance or an enhanced medical services delivery

22(7) Reasonable employment and job search requirements for
23those physically or mentally able, as well as appropriate limits
24on nonessential benefits, such as nonemergency transportation.

25(8) Improved access and continuity of care, with Federal and
26State support for the use of community-based health centers,
27medical homes, expanded scope of practice and targeted chronic
28care, including a managed long-term care pilot program and other
29long-term care measures, that provide coordination and delivery
30of preventive care and assure the wellness of the served


2(9) Use of competitive and value-based purchasing from
3medical providers and medical equipment suppliers that promotes
4efficiencies and delivers value to taxpayers.

5(10) Continued emphasis on the reduction of waste, fraud and
6abuse in all facets of the medical services delivery and
7provider system, with focused attention on credible allegations
8of fraud by providers and the use of predictive modeling.

9(11) Resolution on existing Federal deferrals and
10disallowances as they relate to the Pennsylvania Medicaid
11Program with minimal financial impact to the Commonwealth.

12(12) Maintained allowance of the Commonwealth's current
13gross receipts tax on Medicaid managed care organizations for
14the duration of any enhanced medical services delivery system in
15the Commonwealth.

16(13) Application of the Federal financial participation rate
17currently provided to the Commonwealth, based on existing
18Federal calculations, for medical assistance and all other
19eligible programs and services that receive a Federal match.

20(14) Affirmation that any expanded coverage under the
21enhanced medical services delivery system does not constitute an
22entitlement at the Federal or State level.

23(b) The adoption of an agreement to create an enhanced
24medical services delivery system in this Commonwealth for adults
25ranging from 19 to 65 years of age necessitates further
26discussions with the United States Department of Health and
27Human Services to ensure that it can be accomplished in an
28integrated, cost-effective and fiscally sustainable manner and
29that taxpayer dollars derived directly from citizens of this
30Commonwealth, which are going to the Federal Government under

1the Patient Protection and Affordable Care Act (Public Law 111-
2148, 124 Stat. 119), generate services to the citizens of this
3Commonwealth in proportion to that significant investment.

4(c) Recognition and furtherance of the objectives set forth
5under subsection (a) are essential as the Commonwealth
6vigorously pursues its discussions with the United States
7Department of Health and Human Services to develop and implement
8an agreement with the Secretary of the United States Department
9of Health and Human Services to expand eligibility to persons 
10described under section 1902(a)(10)(A)(i)(VIII) of the Social 
11Security Act (49 Stat. 620, 42 U.S.C. § 1396a(a)(10)(A)(i)
12(VIII)), no later than July 1, 2014. The department shall submit 
13an application for an enhanced medical services delivery system 
14to the United States Department of Health and Human Services for 
15review no later than October 1, 2013. The department shall 
16submit a revised State plan or waiver if required to implement 
17an expansion of eligibility under this subsection.

18(d) This section and the authority to expand eligibility
19under an enhanced medical services delivery system shall cease
20if the Federal medical assistance percentage under section
211905(y) of the Social Security Act (42 U.S.C. § 1396d(y)) is
22less than the following:

23(1) One hundred percent for calendar quarters in 2014, 2015
24and 2016.

25(2) Ninety-five percent for calendar quarters in 2017.

26(3) Ninety-four percent for calendar quarters in 2018.

27(4) Ninety-three percent for calendar quarters in 2019.

28(5) Ninety percent for calendar quarters in 2020 and each
29year thereafter.

30(e) Commencing in fiscal year 2019-2020, continued

1participation by recipients in an enhanced medical services
2delivery system shall be conditioned on the options of increased
3cost-sharing or the purchase of coverage with Federal subsidies
4through the exchange.

5(f) The General Assembly finds and declares as follows:

6(1) The Commonwealth has initiated transformative changes in
7the medical assistance health care delivery system through the
8expansive use of managed care; alignment of payment incentives;
9recognition of the need for rural, underserved and community-
10based health care access; support of community-based health care
11centers; multifaceted initiatives to reduce waste, fraud and
12abuse; targeted resources for the delivery of chronic care; and
13the establishment of medical homes. The Commonwealth is also
14known for its nationally recognized programs to promote patient
15safety and the use of electronic medical records, to reduce
16health care infections and to advance medical, technological and
17biological research, which collectively have contributed to
18advances in the care, treatment and cure of medical disease.

19(2) The Commonwealth established the PACE and PACENET
20programs to provide affordable pharmaceutical drugs for our
21seniors, which became model programs for the nation.

22(3) The Commonwealth created the innovative Children's
23Health Insurance Program, which also became a model for the
24nation by providing access to comprehensive health care services
25for children across this Commonwealth and is a vital program
26that should be preserved.

27(4) In 2001, the Commonwealth established a nonentitlement
28program known as AdultBasic for the purpose of providing health
29care insurance coverage to eligible adults not otherwise
30eligible for medical assistance, initially using funds available

1through the act of June 26, 2001 (P.L.755, No.77), known as the 
2Tobacco Settlement Act. Any agreement between the Commonwealth 
3and the United States Department of Health and Human Services on 
4the establishment of an enhanced medical assistance delivery 
5system will serve to advance these same interests.

6(5) Commonwealth taxpayers currently provide publicly 
7subsidized health care for nearly 2,400,000 thousand citizens of 
8this Commonwealth, or almost 19% of the total population of this 
9Commonwealth, which includes coverage for a broad array of 
10mandatory and optional health care benefits.

11Section 3. Section 443.1 (1.1)(i), (1.4) and (7)(iv) of the
12act, amended or added June 30, 2011 (P.L.89, No.22), are
13amended, paragraph (7) is amended by adding a subparagraph and
14the section is amended by adding a paragraph to read:

15Section 443.1.  Medical Assistance Payments for Institutional
16Care.--The following medical assistance payments shall be made
17on behalf of eligible persons whose institutional care is
18prescribed by physicians:

19* * *

20(1.1) Subject to section 813-G, for inpatient acute care
21hospital services provided during a fiscal year in which an
22assessment is imposed under Article VIII-G, payments under the
23medical assistance fee-for-service program shall be determined
24in accordance with the department's regulations, except as

26(i) If the Commonwealth's approved Title XIX State Plan for 
27inpatient hospital services in effect for the period of July 1, 
282010, through June 30, [2013] 2016, specifies a methodology for 
29calculating payments that is different from the department's 
30regulations or authorizes additional payments not specified in

1the department's regulations, such as inpatient disproportionate 
2share payments and direct medical education payments, the 
3department shall follow the methodology or make the additional 
4payments as specified in the approved Title XIX State Plan.

5* * *

6(1.4) Subject to section 813-G, for inpatient hospital
7services provided under the physical health medical assistance
8managed care program during State fiscal [year] years 2012-2013,
92013-2014, 2014-2015 and 2015-2016, the following shall apply:

10(A) The department may adjust its capitation payments to
11medical assistance managed care organizations to provide
12additional funds for inpatient hospital services.

13(B) For an out-of-network inpatient discharge of a recipient 
14enrolled in a medical assistance managed care organization that 
15occurs in State fiscal year 2012-2013, 2013-2014, 2014-2015 or 
162015-2016, the medical assistance managed care organization 
17shall pay, and the hospital shall accept as payment in full, the 
18amount that the department's fee-for-service program would have 
19paid for the discharge if the recipient [were] was enrolled in 
20the department's fee-for-service program.

21(C) Nothing in this paragraph shall prohibit an inpatient
22acute care hospital and a medical assistance managed care
23organization from executing a new participation agreement or
24amending an existing participation agreement on or after July 1,

26* * *

27(1.6) Notwithstanding any other provision of law or
28departmental regulation to the contrary, the department shall
29make separate fee-for-service APR-DRG payments for medically
30necessary inpatient acute care general hospital services

1provided for normal newborn care and for mothers' obstetrical

3* * *

4(7)  After June 30, 2007, payments to county and nonpublic
5nursing facilities enrolled in the medical assistance program as
6providers of nursing facility services shall be determined in
7accordance with the methodologies for establishing payment rates
8for county and nonpublic nursing facilities specified in the
9department's regulations and the Commonwealth's approved Title
10XIX State Plan for nursing facility services in effect after
11June 30, 2007. The following shall apply:

12* * *

13(iv)  Subject to Federal approval of such amendments as may
14be necessary to the Commonwealth's approved Title XIX State
15Plan, for each fiscal year beginning on or after July 1, 2011,
16the department shall apply a revenue adjustment neutrality
17factor to county and nonpublic nursing facility payment rates so
18that the estimated Statewide day-weighted average payment rate
19in effect for that fiscal year is limited to the amount
20permitted by the funds appropriated by the General Appropriation
21Act for the fiscal year. The revenue adjustment neutrality
22factor shall remain in effect until the sooner of June 30,
23[2013] 2016, or the date on which a new rate-setting methodology
24for medical assistance nursing facility services which replaces
25the rate-setting methodology codified in 55 Pa. Code Chs. 1187
26(relating to nursing facility services) and 1189 (relating to
27county nursing facility services) takes effect.

28(v) Subject to Federal approval of such amendments as may be
29necessary to the Commonwealth's approved Title XIX State Plan,
30for fiscal year 2013-2014, the department shall make quarterly

1medical assistance day one incentive payments to qualified
2nonpublic nursing facilities. The department shall determine the
3nonpublic nursing facilities that qualify for the quarterly
4medical assistance day one incentive payments and calculate the
5payments using the Total Pennsylvania medical assistance (PA MA)
6days and Total Resident Days as reported by nonpublic nursing
7facilities under Article VIII-A (relating to nursing facility
8assessments). The department's determination and calculations
9under this subparagraph shall be based on the nursing facility
10assessment quarterly resident day reporting forms available on
11October 31, January 31, April 30 and July 31. The department
12shall not retroactively revise a medical assistance day one
13incentive payment amount based on a nursing facility's late
14submission or revision of its report after these dates. The
15department, however, may recoup payments based on an audit of a
16nursing facility's report. The following shall apply:

17(A) A nonpublic nursing facility shall meet all of the
18following criteria to qualify for a medical assistance day one
19incentive payment:

20(I) The nursing facility shall have an overall occupancy
21rate of at least eighty-five percent during the resident day
22quarter. For purposes of determining a nursing facility's
23overall occupancy rate, a nursing facility's Total Resident
24Days, as reported by the facility under Article VIII-A, shall be
25divided by the product of the facility's licensed bed capacity,
26at the end of the quarter, multiplied by the number of calendar
27days in the quarter.

28(II) The nursing facility shall have a medical assistance
29occupancy rate of at least sixty-five percent during the
30resident day quarter. For purposes of determining a nursing

1facility's medical assistance occupancy rate, the nursing
2facility's Total PA MA days shall be divided by the nursing
3facility's Total Resident Days, as reported by the facility
4under Article VIII-A.

5(III) The nursing facility shall be a nonpublic nursing
6facility for a full resident day quarter prior to the applicable
7quarterly reporting due dates of October 31, January 31, April
830 and July 31.

9(B) The department shall calculate a qualified nonpublic
10nursing facility's medical assistance day one incentive
11quarterly payment as follows:

12(I) The total funds appropriated for payments under this
13subparagraph shall be divided by four.

14(II) To establish the quarterly per diem rate, the amount
15under subclause (I) shall be divided by the Total PA MA days, as
16reported by all qualifying nonpublic nursing facilities under
17Article VIII-A.

18(III) To determine a qualifying nonpublic nursing facility's
19quarterly medical assistance day one incentive payment, the
20quarterly per diem rate shall be multiplied by a nonpublic
21nursing facility's Total PA MA days, as reported by the facility
22under Article VIII-A.

23(C) For fiscal year 2013-2014, the State funds available for
24the nonpublic nursing facility medical assistance day one
25incentive payments shall equal seven million dollars

27* * *

28Section 4. Section 454(a) of the act, amended June 30, 2011
29(P.L.89, No.22), is amended to read:

30Section 454. Medical Assistance Benefit Packages; Coverage,

1Copayments, Premiums and Rates.--(a) Notwithstanding any other
2provision of law to the contrary, the department shall
3promulgate regulations as provided in subsection (b) to
4establish provider payment rates; the benefit packages and any
5copayments for adults eligible for medical assistance under
6Title XIX of the Social Security Act (49 Stat 620, 42 U.S.C. §
71396 et seq.) and adults eligible for medical assistance in
8general assistance-related categories; and the premium or 
9copayment requirements for disabled children whose family income
10is above two hundred percent of the Federal poverty income
11limit. Subject to such Federal approval as may be necessary, the
12regulations shall authorize and describe the available benefit
13packages and any copayments and premiums, except that the 
14department shall set forth the copayment and premium schedule 
15for disabled children whose family income is above two hundred 
16percent of the Federal poverty income limit by publishing a 
17notice in the Pennsylvania Bulletin. The department may adjust 
18such copayments and premiums for disabled children by notice 
19published in the Pennsylvania Bulletin. The regulations shall
20also specify the effective date for provider payment rates.

21* * *

22Section 5. Section 704.1(g) of the act, added July 9, 1976
23(P.L.846, No.148), is amended and the section is amended by
24adding subsections to read:

25Section 704.1. Payments to Counties for Services to
26Children.--* * *

27(g) The department shall[, within forty-five days of each
28calendar quarter, pay fifty percent of the department's share of
29the county institution district's or its successor's estimated
30expenditures for that quarter.] process payments to each county

1pursuant to this article from funds appropriated by the General 
2Assembly for each fiscal year, within 15 days of passage of the 
3general appropriation bill or by a date specified under 
4paragraphs (1), (2), (3), (4) or (5), whichever is later. The 
5department shall process the following applicable payments to 
6the county:

7(1) By July 15, twenty-five percent of the amount of State
8funds allocated to the county under section 709.3.

9(2) By August 31, or upon approval by the department of the
10county's final cumulative report for its expenditures for the
11prior fiscal year, whichever is later, twenty-five percent of
12the amount of State funds allocated to the county under section
13709.3, reduced by the amount of aggregate unspent State funds
14provided to the county during the previous fiscal year.

15(3) By November 30, or upon approval by the department of
16the county's report for its expenditures for the first quarter
17of the fiscal year, whichever is later, twenty-five percent of
18the amount of State funds allocated to the county under section
19709.3, reduced by the amount of unspent State funds already
20provided to the county for the first quarter of the fiscal year.

21(4) By February 28, or upon approval by the department of
22the county's report for its expenditures for the second quarter
23of the fiscal year, whichever is later, twelve and five-tenths
24percent of the amount of State funds allocated to the county
25under section 709.3, adjusted by the amount of overspending or
26underspending of State funds in the previous quarters, but not
27to exceed eighty-seven and five-tenths percent of the county's
28approved State allocation.

29(5) Upon approval by the department of the county's final
30cumulative report for its expenditures for the fiscal year,

1twelve and five-tenths percent of the amount of State funds
2allocated to the county under section 709.3, adjusted by the
3amount of overspending or underspending of State funds in the
4previous quarters.

5(g.1) After the final cumulative report for expenditures has
6been approved, if a county has adjustments to revenues or
7expenditures for the time period covered by the expenditure
8report in addition to the payments under subsection (g), the
9county shall submit to the department a revised expenditure
10report. After the report is approved, the department may adjust
11any payment under subsection (g) to account for any revision to
12a county's expenditure report.

13(g.2)  Service contracts or agreements shall include a timely
14payment provision that requires counties to make payment to
15service providers within thirty days of the county's receipt of
16an invoice under both of the following conditions:

17(1) The invoice satisfies the county's requirements for a
18complete and accurate invoice.

19(2) Funds have been appropriated to the department for
20payments to counties under subsection (g).

21* * *

22Section 6. The act is amended by adding a section to read:

23Section 704.3. Provider submissions.--(a) For fiscal year
242013-2014, a provider shall submit documentation of its costs of
25providing services and the department shall use such
26documentation, to the extent necessary, to support the
27department's claim for Federal funding and for State
28reimbursement for allowable direct and indirect costs incurred
29in the provision of out-of-home placement services.

30(b) The department shall convene a task force to include

1representatives from public and private children and youth
2social service agencies and other appropriate stakeholders as
3determined by the secretary or deputy secretary for the Office
4of Children, Youth and Families.

5(c) The task force established under subsection (b) shall
6develop recommendations for a methodology to determine
7reimbursement for actual and projected costs, which are
8reasonable and allowable, for the purchase of services from
9providers and for other purchased services. The task force shall
10provide written recommendations for the purchase of services
11from providers to the General Assembly no later than April 30,
122014. The task force shall provide written recommendations for
13other purchased services no later than December 31, 2014. The
14task force shall be convened within sixty days after the
15effective date of this section.

16(d) As used in this section, the term "provider" means an
17entity licensed or certified to provide twenty-four-hour out-of-
18home community-based or institutional care and supervision of a
19child, with the care and supervision being paid for or provided
20by a county using Federal or State funds disbursed under this

22Section 7. The heading of Article VIII-C of the act, added
23July 4, 2004 (P.L.528, No.69) is amended to read:




28Section 8. Sections 801-C, 802-C, 803-C, 804-C, 805-C, 806-
29C, 807-C, 808-C, 809-C and 810-C of the act, added July 4, 2004
30(P.L.528, No.69), are amended to read:

1Section 801-C.  Definitions.

2The following words and phrases when used in this article
3shall have the meanings given to them in this section unless the
4context clearly indicates otherwise:

5"Assessment."  The fee implemented pursuant to this article
6on every intermediate care facility for [mentally retarded]
7persons with an intellectual disability.

8"Department."  The Department of Public Welfare of the

10"Intermediate care facility for [mentally retarded] persons
11with an intellectual disability" or "[ICF/MR] ICF/ID."  A public
12or private facility defined in section 1905 of the Social
13Security Act (49 Stat. 620, 42 U.S.C. § 1905).

14"Medicaid."  The program established under Title XIX of the
15Social Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.).

16"Medical assistance program" or "program."  The medical
17assistance program as administered by the Department of Public

19"Secretary."  The Secretary of Public Welfare of the

21"Social Security Act."  49 Stat. 620, 42 U.S.C. § 301 et seq.

22Section 802-C.  Authorization.

23In order to generate additional revenues for medical
24assistance program recipients to have access to medically
25necessary [mental retardation] intellectual disability services,
26the department shall implement a monetary assessment on each
27[ICF/MR] ICF/ID subject to the conditions and requirements
28specified in this article.

29Section 803-C.  Implementation.

30The [ICF/MR] ICF/ID assessments shall be implemented on an

1annual basis as a health care-related tax as defined in section
21903(w)(3)(B) of the Social Security Act, or any amendments
3thereto, and may be imposed and is required to be paid only to
4the extent that the revenues generated from the assessment will
5qualify as the State share of program expenditures eligible for
6Federal financial participation.

7Section 804-C.  Amount.

8The assessment rate shall be determined in accordance with
9this article and implemented on an annual basis by the
10department, as approved by the Governor, upon notification to
11and in consultation with the [ICFs/MR] ICFs/ID. In each year in
12which the assessment is implemented, the assessment rate shall
13equal the amount established by the department subject to the
14maximum aggregate amount that may be assessed pursuant to the 6%
15indirect guarantee threshold set forth in 42 CFR 433.68(f)(3)(i)
16(relating to permissible health care-related taxes [after the
17transition period]) or any other maximum aggregate amount
18established by law.

19Section 805-C.  Administration.

20(a)  Notice of assessment.--The secretary, before
21implementing an assessment in any fiscal year, shall publish a
22notice in the Pennsylvania Bulletin that specifies the amount of
23the assessment being proposed and an explanation of the
24assessment methodology and amount determination that identifies
25the aggregate impact on [ICFs/MR] ICFs/ID subject to the
26assessment. Interested parties shall have 30 days in which to
27submit comments to the secretary. Upon expiration of the 30-day
28comment period, the secretary, after consideration of the
29comments, shall publish a second notice in the Pennsylvania
30Bulletin announcing the rate of the assessment.

1(b)  Review of assessment.--Except as permitted under section
2809-C, the secretary's determination of the aggregate amount and
3the rate of the assessment pursuant to subsection (a) shall not
4be subject to administrative or judicial review under 2 Pa.C.S.
5Chs. 5 Subch. A (relating to practice and procedure of
6Commonwealth agencies) and 7 Subch. A (relating to judicial
7review of Commonwealth agency action) or any other provision of
8law. No assessment implemented under this article nor forms or
9reports required to be completed by [ICFs/MR] ICFs/ID pursuant
10to this article shall be subject to the act of July 31, 1968
11(P.L.769, No.240), referred to as the Commonwealth Documents
12Law, the act of October 15, 1980 (P.L.950, No.164), known as the
13Commonwealth Attorneys Act, or the act of June 25, 1982
14(P.L.633, No.181), known as the Regulatory Review Act.

15Section 806-C.  Calculation.

16Using the assessment rate implemented by the secretary
17pursuant to section 804-C, each [ICF/MR] ICF/ID shall calculate
18the assessment amounts it owes for a calendar quarter on a form
19specified by the department and shall submit the form and the
20amount owed to the department no later than the last day of that
21calendar quarter or 30 days from the date of the department's
22second notice published pursuant to section 805-C(a), whichever
23is later.

24Section 807-C.  Purposes and uses.

25No [ICF/MR] ICF/ID shall be directly guaranteed a repayment
26of its assessment in derogation of 42 CFR 433.68 (relating to
27permissible health care-related taxes [after the transition
28period]), provided, however, in each fiscal year in which an
29assessment is implemented, the department shall use the State
30revenue collected from the assessment and any Federal funds

1received by the Commonwealth as a direct result of the
2assessment to fund services for persons with [mental
3retardation] an intellectual disability.

4Section 808-C.  Records.

5Upon request by the department, an [ICF/MR] ICF/ID shall
6furnish to the department such records as the department may
7specify in order to determine the assessment rate for a fiscal
8year or the amount of the assessment due from the [ICF/MR]
9ICF/ID or to verify that the [ICF/MR] ICF/ID has paid the
10correct amount due. In the event that the department determines
11that an [ICF/MR] ICF/ID has failed to pay an assessment or that
12it has underpaid an assessment, the department shall notify the
13[ICF/MR] ICF/ID in writing of the amount due, including
14interest, and the date on which the amount due must be paid,
15which shall not be less than 30 days from the date of the
16notice. In the event that the department determines that an
17[ICF/MR] ICF/ID has overpaid an assessment, the department shall
18notify the [ICF/MR] ICF/ID in writing of the overpayment and,
19within 30 days of the date of the notice of the overpayment,
20shall either authorize a refund of the amount of the overpayment
21or offset the amount of the overpayment against any amount that
22may be owed to the department by the [ICF/MR] ICF/ID.

23Section 809-C.  Appeal rights.

24An [ICF/MR] ICF/ID that is aggrieved by a determination of
25the department as to the amount of the assessment due from the
26[ICF/MR] ICF/ID or a remedy imposed pursuant to section 810-C
27may file a request for review of the decision of the department
28by the Bureau of Hearings and Appeals within the department,
29which shall have exclusive jurisdiction in such matters. The
30procedures and requirements of 67 Pa.C.S. Ch. 11 (relating to

1medical assistance hearings and appeals) shall apply to requests
2for review filed pursuant to this section except that, in any
3such request for review, an [ICF/MR] ICF/ID may not challenge
4the assessment rate determined by the secretary, but only
5whether the department correctly determined the assessment
6amount due from the [ICF/MR] ICF/ID using the assessment rate in
7effect for the fiscal year.

8Section 810-C.  Enforcement.

9In addition to any other remedy provided by law, the
10department may enforce this article by imposing one or more of
11the following remedies:

12(1)  When an [ICF/MR] ICF/ID fails to pay an assessment
13or penalty in the amount or on the date required by this
14article, the department may add interest at the rate provided
15in section 806 of the act of April 9, 1929 (P.L.343, No.176),
16known as The Fiscal Code, to the unpaid amount of the
17assessment or penalty from the date prescribed for its
18payment until the date it is paid.

19(2)  When an [ICF/MR] ICF/ID fails to file a report or to
20furnish records to the department as required by this
21article, the department may impose a penalty against the
22[ICF/MR] ICF/ID in the amount of $1,000 per day for each day
23the report or required records are not filed or furnished to
24the department.

25(3)  When an [ICF/MR] ICF/ID fails to pay all or part of
26an assessment or penalty within 60 days of the date that
27payment is due, the department may terminate the [ICF/MR]
28ICF/ID from participation in the medical assistance program
29and/or deduct the unpaid assessment or penalty and any
30interest owed thereon from any payments due to the [ICF/MR]

1ICF/ID until the full amount is recovered. Any such
2termination or payment deduction shall be made only after
3written notice to the [ICF/MR] ICF/ID.

4(4)  The secretary may waive all or part of the interest
5or penalties assessed against an [ICF/MR] ICF/ID pursuant to
6this article for good cause as shown by the [ICF/MR] ICF/ID.

7Section 9.  Section 811-C of the act, amended July 4, 2008
8(P.L.557, No.44), is amended to read:

9Section 811-C.  Time periods.

10(a)  Imposition.--The assessment authorized under this
11article shall not be imposed as follows:

12(1)  Prior to July 1, 2003, for private [ICFs/MR]

14(2)  Prior to July 1, 2004, for public [ICFs/MR] ICFs/ID.

15(3)  In the absence of Federal financial participation as
16described under section 803-C.

17(b)  Cessation.--The assessment authorized under this article
18shall cease June 30, [2013] 2016, or earlier, if required by

20Section 10.  Section 802-E of the act is amended by adding a
21subsection to read:

22Section 802-E.  Authorization.

23* * *

24(a.1)  Adjustments to assessment percentage.--

25(1)  For State fiscal years beginning after June 30, 
262013, and subject to the advance written approval of the 
27secretary as prescribed by the department, the municipality 
28may make a uniform adjustment to an assessment percentage 
29established by ordinance under subsection (a).

30(2)  After receiving written approval under paragraph (1)

1and before implementing an adjustment, the municipality shall 
2provide advance public notice. The notice shall specify the 
3proposed adjusted assessment percentage and identify the 
4aggregate impact on hospitals located in the municipality 
5subject to an assessment. An interested party shall have 30 
6days in which to submit comments to the municipality. Upon 
7expiration of the 30-day comment period, the municipality, 
8after consideration of the comments, shall publish a 
9subsequent notice announcing the adjusted assessment 

11* * *

12Section 11. Section 808-E of the act, reenacted October 22,
132010 (P.L.829, No.84), is amended to read:

14Section 808-E.  Time period.

15(a)  Cessation.--The assessment authorized under this article
16shall cease June 30, [2013] 2016.

17(b)  Assessment.--

18(1)  A municipality shall have the power to enact the
19assessment authorized in section 802-E(a)(2) either prior to
20or during its fiscal year ending June 30, 2010.

21(2)  A municipality may adjust an assessment percentage 
22as specified under section 802-E(a.1) either prior to or 
23during the fiscal year in which the adjusted assessment 
24percentage takes effect.

25Section 12. The definition of "net inpatient revenue" in
26section 801-G of the act, amended June 30, 2011 (P.L.89, No.22),
27is amended to read:

28Section 801-G. Definitions.

29The following words and phrases when used in this article
30shall have the meanings given to them in this section unless the

1context clearly indicates otherwise:

2* * *

3"Net inpatient revenue." Gross charges for facilities for
4inpatient services less any deducted amounts for bad debt
5expense, charity care expense and contractual allowances as
6reported on forms specified by the department and:

7(1) as identified in the hospital's records for the
8State fiscal year commencing July 1, [2007] 2010; or

9(2) as identified in the hospital's records for the most
10recent State fiscal year, or part thereof, if amounts are not
11available under paragraph (1).

12* * *

13Section 13. Section 803-G(b) of the act, amended June 30,
142011 (P.L.89, No.22), is amended to read:

15Section 803-G. Implementation.

16* * *

17(b) Assessment percentage.--Subject to subsection (c), each
18covered hospital shall be assessed as follows:

19(1) for fiscal year 2010-2011, each covered hospital
20shall be assessed an amount equal to 2.69% of the net
21inpatient revenue of the covered hospital; and

22(2) for fiscal years 2011-2012 [and] , 2012-2013, 2013-
232014, 2014-2015 and 2015-2016, an amount equal to 3.22% of
24the net inpatient revenue of the covered hospital.

25* * *

26Section 14. Section 804-G(a.1) of the act, amended June 30,
272011 (P.L.89, No.22), is amended and the section is amended by
28adding a subsection to read:

29Section 804-G. Administration.

30* * *

1(a.1) Calculation of assessment with changes of ownership.--

2(1) If a single covered hospital changes ownership or
3control, the department will continue to calculate the
4assessment amount using the hospital's net inpatient revenue
5for State fiscal year [2008-2009] 2010-2011 or for the most
6recent State fiscal year, or part thereof, if the State
7fiscal year [2008-2009] 2010-2011 amounts are not available.
8The covered hospital is liable for any outstanding assessment
9amounts, including outstanding amounts related to periods
10prior to the change of ownership or control.

11(2) If two or more hospitals merge or consolidate into a
12single covered hospital as a result of a change in ownership
13or control, the department will calculate the covered
14hospital assessment amount using the combined net inpatient
15revenue for State fiscal year [2008-2009] 2010-2011 or for
16the most recent State fiscal year, or part thereof, if the
17State fiscal year [2008-2009] 2010-2011 amounts are not
18available, of any covered hospitals that were merged or
19consolidated into the single covered hospital. The single
20covered hospital is liable for any outstanding assessment
21amounts, including outstanding amounts related to periods
22prior to the change of ownership or control, of any covered
23hospital that was merged or consolidated.

24* * *

25(a.3) Calculation of assessment for new hospitals.--A
26hospital that begins operation as a covered hospital during a
27fiscal year in which an assessment is in effect shall be
28assessed as follows:

29(1) During the State fiscal year in which a covered
30hospital begins operation or in which a hospital becomes a

1covered hospital, the covered hospital is not subject to the

3(2) For the State fiscal year following the State fiscal
4year under paragraph (1), the department shall calculate the
5hospital's assessment amount using the net inpatient revenue
6from the State fiscal year in which the covered hospital
7began operation or became a covered hospital.

8(3) For the State fiscal years following the first full
9State fiscal year under paragraph (2), the department shall
10calculate the hospital's assessment amount using the net
11inpatient revenue from the prior State fiscal year.

12* * *

13Section 15. Section 805-G(a)(3) and (b)(5) of the act,
14amended June 30, 2011 (P.L.89, No.22), is amended and subsection
15(b) is amended by adding paragraphs to read:

16Section 805-G. Restricted account.

17(a) Establishment.--There is established a restricted
18account, known as the Quality Care Assessment Account, in the
19General Fund for the receipt and deposit of revenues collected
20under this article. Funds in the account are appropriated to the
21department for the following:

22* * *

23(3) Any other purpose approved by the secretary for 
24inpatient hospital, outpatient hospital and hospital-related 

26(b) Limitations.--

27* * *

28(4.1) For State fiscal years 2013-2014 and 2014-2015,
29the amount used for the medical assistance payment for
30hospitals and medical assistance managed care organizations

1may not exceed the aggregate amount of the assessment funds
2collected for the year less $150,000,000.

3(4.2) For State fiscal year 2015-2016, the amount used
4for the medical assistance payment for hospitals and medical
5assistance managed care organizations may not exceed the
6aggregate amount of the assessment funds collected for the
7year less $140,000,000.

8(5) The amounts retained by the department pursuant to 
9paragraphs (1), (2) [and], (4), (4.1) and (4.2) and any 
10additional amounts remaining in the restricted accounts after 
11the payments described in subsection (a)(1) and (2) are made 
12shall be used for purposes approved by the secretary under 
13subsection (a)(3).

14* * *

15Section 16. Section 815-G of the act, added July 9, 2010 
16(P.L.336, No.49), is amended to read:

17Section 815-G. Expiration.

18This article shall expire June 30, [2013] 2016.

19Section 17. Section 805-H(c) of the act is amended by adding
20a paragraph to read:

21Section 805-H. Funding.

22* * *

23(c) Payment calculation.--

24* * *

25(5) Funds not used to make payments to qualifying
26hospitals accredited or seeking accreditation as Level III
27trauma centers shall be used to make payments to qualifying
28hospitals accredited as Level I and Level II trauma centers.

29* * *

30Section 18. The heading of Article XIII of the act, added

1September 30, 2003 (P.L.169, No.25), is amended to read:



4Section <-2 19. Section 1301 of the act, added September 30,
52003 (P.L.169, No.25), is amended to read:

6Section 1301. [Scope] Legislative intent.

7[This article relates to the Kinship Care Program.] This 
8article is intended to ensure that family finding occurs on an 
9ongoing basis for all children entering the child welfare 
10system. This article is also intended to promote the use of 
11kinship care when it is necessary to remove a child from the 
12child's home in an effort to:

13(1) Identify and build positive connections between the
14child and the child's relatives and kin.

15(2) Support the engagement of relatives and kin in
16children and youth social service planning and delivery.

17(3) Create a network of extended family support to
18assist in remedying the concerns that led the child to be
19involved with the county agency.

20Section <-3 20. Section 1302 of the act is amended by adding
21definitions to read:

22Section 1302. Definitions.

23The following words and phrases when used in this article
24shall have the meanings given to them in this section unless the
25context clearly indicates otherwise:

26"Accept for service." Decide on the basis of the needs and
27problems of an individual to admit or receive the individual as
28a client of the county agency or as required by a court order
29entered under 42 Pa.C.S. Ch. 63 (relating to juvenile matters).

30* * *

1"Family finding." Ongoing diligent efforts between a county
2agency, or its contracted providers, and relatives and kin to:

3(1) Search for and identify adult <-maternal and paternal
4relatives and kin and engage them in children and youth
5social service planning and delivery.

6(2) Gain commitment from relatives and kin to support a
7child or parent receiving children and youth social services.

8* * *

9Section <-4 21. The act is amended by adding sections to read:

10Section 1302.1. Family finding required.

11Family finding shall be conducted for a child when the child
12is accepted for services and at least annually thereafter, until
13the child's involvement with the county agency is terminated or
14the family finding is discontinued in accordance with section

16Section 1302.2. Discontinuance of family finding.

17(a) General rule.--A county agency may discontinue family
18finding for a child under the following circumstances:

19(1) The child has been adjudicated dependent pursuant to
2042 Pa.C.S. Ch. 63 (relating to juvenile matters) and a court
21has made a specific determination that continued family
22finding no longer serves the best interests of the child or
23is a threat to the child's safety.

24(2) The child is not under the jurisdiction of a court
25and the county agency has determined that continued family
26finding is a threat to the child's safety. A determination
27that continued family finding is a threat to the child's
28safety must be based on credible information about a specific
29safety threat, and the county agency shall document the
30reasons for its determination.

1(3) The child is in a preadoptive placement, and court
2proceedings to adopt the child have been commenced pursuant
3to 23 Pa.C.S. Part III (relating to adoption).

4(b) Resuming family finding.--Notwithstanding the provisions
5of subsection (a), a county agency shall resume family finding
6for a child if:

7(1) the child is under the jurisdiction of a court, and
8the court determines that resuming family finding is best
9suited to the safety, protection and physical, mental and
10moral welfare of the child and does not pose a threat to the
11child's safety; or

12(2) the child is not under the jurisdiction of a court,
13and <-the county agency determines that resuming family finding
14serves the best interest of the child and does not pose a
15threat to the child's safety.

<-16Section 5. Within one year of the effective date of the
17amendment or addition of sections 1301, 1302, 1302.1 and 1302.2
18of the act, the Department of Public Welfare shall promulgate
19regulations providing for the requirements of county agencies.

20Section 6. This act shall take effect in 60 days.

<-21Section 22.  Sections 1402-B, 1404-B, 1405-B and 1406-B of
22the act, added June 30, 2012 (P.L.668, No.80), are amended to

24Section 1402-B. Establishment of Human Services Block Grant
25Pilot Program.

26The following shall apply to the Human Services Block Grant
27Pilot Program.

28(1) The Human Services Block Grant Pilot Program is
29established for the purpose of allocating block grant funds to
30county governments to provide locally identified county-based

1human services that will meet the service needs of county
2residents. A county's request to participate in the block grant
3shall be on a form and contain such information as the
4department may prescribe.

5(2) The department[, in its discretion,] may approve a
6county's request based on [criteria determined by the
7department.] the county's plan to provide human services and 
8integrate its human service programs. A county with a history of 
9participation or application to participate in the block grant 
10shall have priority over a county which has not previously 
11applied for the block grant. The department shall also consider 
12diversity in representation of counties, regarding such factors 

14(i) Geographic location.

15(ii) Total population.

16(iii) Urban, rural and suburban population.

17(iv) Proximity to a large urban area.

18(v) County class.

19(vi) Form of county government.

20(vii) Whether the county is part of a local collaborative

22(viii) The county's human services administrative structure.

23(3) No more than [20] 30 counties may participate in the
24block grant in any fiscal year. A county's participation in the 
25block grant is voluntary.

26Section 1404-B.  Powers and duties of counties.

27The local county officials of each county government
28participating in the block grant shall have the power and duty

30(1)  Administer and disburse block grant funds for the

1provision of county-based human services in accordance with
2this article and regulations promulgated under section 1403-
3B(10) and Federal requirements.

4(2)  Establish or maintain, in agreement with another
5county or counties, local collaborative arrangements for the
6delivery of any county-based human service. Counties may
7establish new local collaborative arrangements under this
8paragraph for the provision of a specific county-based human
9service or county-based human services, subject to approval
10by the secretary.

11(3)  Determine and redetermine, when necessary, whether a
12person is eligible to participate in a county-based human
13service, subject to appeal under 2 Pa.C.S. Ch. 5 Subch. B
14(relating to practice and procedures of local agencies).

15(4)  Submit required reports under section 1403-B(b)(4).

16(5)  Submit to the department an annual Human Services
17Block Grant Pilot Plan to include the intended delivery of
18county-based human services by client population to be
19served, including a detailed description of how the county
20intends to serve its residents in the least restrictive
21setting appropriate to their needs and the distribution and
22the projected expenditure level of block grant funds by
23county-based human services allocated under this article in
24such form and containing such information as the department
25may require. Prior to submitting the annual Human Services
26Block Grant Pilot Plan to the department, the county shall
27hold at least two public hearings on the plan under 65
28Pa.C.S. Ch. 7 (relating to open meetings), which shall
29include an opportunity for individuals and families who
30receive services to testify about the plan.

1(6)  Submit to the department a written notice if a
2county intends to opt out of the block grant. Such opt out
3shall take effect at the beginning of the next State fiscal

5Section 1405-B.  Allocation.

6(a)  Allocation.--The department shall allocate State block
7grant funds to counties as follows:

8(1)  The department shall allocate State block grant
9funds according to each county's proportional share of the
10aggregate amount of the following State funds allocated for
11fiscal year 2011-2012:

12(i)  Funds allocated to counties under the act of
13October 5, 1994 (P.L.531, No.78), known as the Human
14Services Development Fund Act.

15(ii)  Funds allocated to counties for mental health
16and intellectual disability services under the act of
17October 20, 1966 (3rd Sp.Sess., P.L.96, No.6), known as
18the Mental Health and Intellectual Disability Act of

20(iii)  Funds allocated to counties for behavioral
21health services.

22(iv)  Funds allocated to counties for drug and
23alcohol services under section 2334 of the act of April
249, 1929 (P.L.177, No.175), known as The Administrative
25Code of 1929.

26(v)  Funds allocated to counties for the provision of
27services to the homeless.

28(vi)  Funds allocated to county child welfare
29agencies as certain additional grants under section

1(2)  The department shall allocate Federal block grant
2funds to counties according to each county's fiscal year
32011-2012 proportional share of each Federal appropriation
4associated with the funds identified in paragraph (1).

5(3)  Funds identified in paragraphs (1) and (2) that were
6allocated to county local collaborative arrangements shall be
7allocated to individual counties based on the individual
8county population.

9(4)  The department may revise the allocation of Federal
10funds identified in paragraph (2) as necessary to comply with
11applicable Federal requirements.

12(a.1)  Adjustment of allocation.--The department may adjust 
13grants under this article to a county participating in the block 
14grant based on the county's demonstrated need for funds to meet 
15the specific human services needs of its residents for a fiscal 
16year. Such adjustment shall not be considered in the county's 
17allocation under subsection (a) for any subsequent fiscal year.

18(b)  Expenditure.--Each county participating in the block
19grant shall expend its allocated block grant funds as follows:

20(1)  For State fiscal year 2012-2013, each county shall
21expend on each of the following county-based human services
22at least 80% of the amount the county is allocated under the
23funds identified in subsection (a)(1) for that county-based
24human service:

25(i)  Community-based mental health services.

26(ii)  Intellectual disability services.

27(iii) Child welfare services.

28(iv)  Drug and alcohol treatment and prevention

30(v)  Homeless assistance services.

1(vi)  Behavioral health services.

2(2)  For State fiscal year 2013-2014, each county shall
3expend on each of the following county-based human services
4at least 75% of the amount the county was allocated under the
5funds identified in subsection (a)(1) for that county-based
6human service:

7(i)  Community-based mental health services.

8(ii)  Intellectual disability services.

9(iii)  Child welfare services.

10(iv)  Drug and alcohol treatment and prevention

12(v)  Homeless assistance services.

13(vi)  Behavioral health services.

14(3)  For State fiscal year 2014-2015, each county shall
15expend on each of the following county-based human services
16at least 50% of the amount the county is allocated under the
17funds identified in subsection (a)(1) for that county-based
18human service:

19(i)  Community-based mental health services.

20(ii)  Intellectual disability services.

21(iii)  Child welfare services.

22(iv)  Drug and alcohol treatment and prevention

24(v)  Homeless assistance services.

25(vi)  Behavioral health services.

26(4)  For State fiscal year 2015-2016, each county shall
27expend on each of the following county-based human services
28at least 25% of the amount the county is allocated under the
29funds identified in subsection (a)(1), for that county-based
30human service:

1(i)  Community-based mental health services.

2(ii)  Intellectual disability services.

3(iii)  Child welfare services.

4(iv)  Drug and alcohol treatment and prevention

6(v)  Homeless assistance services.

7(vi)  Behavioral health services.

8(5)  For State fiscal year 2016-2017 and thereafter,
9counties may expend block grant funds on county-based human
10services as determined by local need.

11(c)  Waiver.--A county may request in writing that the
12department waive the requirements of subsection (b). [The
13department may, in its discretion, grant the request upon good
14cause shown by the county.] The department may grant the request 
15upon a showing by the county that specific circumstances create 
16a local need for funds to provide a human service that cannot be 
17met without a waiver, and that adequate and appropriate access 
18to other human services will remain available in the county. A 
19request for a waiver under this subsection shall specify the 
20amount of funds and the human services on which those funds will 
21be transferred and expended.

22(d)  Use of remaining funds.--Except as provided in
23subsection (b), counties may expend the remaining block grant
24funds on county-based human services needs as determined by
25county officials.

26(e)  Contribution to local collaborative arrangement.--Each
27county that is part of a local collaborative arrangement in
28accordance with section 1404-B(2) shall contribute at a minimum
29the percentage of funds specified in subsection (b) to the local
30collaborative arrangement for the provision of the county-based

1human services delivered by the local collaborative arrangement.

2Section 1406-B.  Use of block grant funds.

3(a)  General rule.--Block grant funds received by counties
4under this article shall be used solely for the provision of
5county-based human services.

6(b)  Reinvestment.--A county participating in the block grant 
7may submit to the department a written plan to reinvest up to 3% 
8of its block grant allocation for any State fiscal year to be 
9expended on county-based human services in the next State fiscal 
10year. The 3% limitation may be waived by the department upon 
11[good cause shown by the county.] a showing by the county that 
12it has a specific and detailed plan to reinvest the funds to 
13expand access to human services based on local need and that 
14adequate and available human services will remain available in 
15the county. A request for a waiver under this subsection shall 
16include all of the following:

17(1) The specific amount of funds the county seeks to

19(2) An explanation why the funds were not expended for
20human services during the fiscal year.

21(3) An explanation how the reinvestment will support the
22plan submitted under section 1404-B(5).

23(4) The projected time period for expenditure of the

25(c)  Eligibility.--No county shall be required to expend
26block grant funds under this article on behalf of an individual
27until the individual has exhausted eligibility and receipt of
28benefits under all other existing Federal, State, local or
29private programs.

30(d)  Allocation.--For State fiscal year 2012-2013, each

1county in expending block grant funds shall provide local
2matching funds for block grant funds allocated to it in the same
3percentage as that county's aggregate local match percentage for
4the State funds identified in section 1405-B(a)(1) in State
5fiscal year 2010-2011. For each State fiscal year thereafter,
6each county in expending block grant funds shall provide local
7matching funds for State block grant funds allocated to it in
8the same percentage as that county's aggregate local match
9percentage for the State funds identified in section 1405-B(a)
10(1) in State fiscal year 2011-2012.

11(e)  County obligation.--Except as provided in subsection
12(d), counties shall have no financial obligation to provide
13human services under this article in excess of their allocation
14of block grant funds for any fiscal year.

15Section 23. This act shall take effect as follows:

16(1) The amendment or addition of sections 102 and 103 of
17the act shall take effect December 31, 2013.

18(2) The following provisions shall take effect

20(i) The addition of section 441.10 of the act.

21(ii) The amendment of section 443.1(1.1)(i), (1.4)
22and (7)(iv) and (v) of the act.

23(iii) The amendment or addition of sections
24704.1(g), (g.1) and (g.2) and 704.3 of the act.

25(iv) The amendment of the heading of Article VIII-C
26and sections 801-C, 802-C, 803-C, 804-C, 805-C, 806-C,
27807-C, 808-C, 809-C, 810-C and 811-C of the act.

28(v) The amendment of sections 802-E and 808-E of the

30(vi) The amendment or addition of the definition of

1"net inpatient revenue" in section 801-G and sections
2803-G(b), 804-G(a.1) and (a.3), 805-G(a)(3), (b)(4.1),
3(4.2) and (5) and 815-G of the act.

4(vii) The amendment of the heading of Article XIV-B,
5and sections 1402-B, 1403-B, 1404-B, 1405-B and 1406-B of
6the act.

7(viii) This section.

8(3) The remainder of this act shall take effect in 60