Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
Impact
The legislation mandates that a minimum of 50% of Medicaid's long-term care funding be allocated towards home and community-based services. This shift not only aims to reduce reliance on institutional care but also seeks to expand investment in community options. By implementing these reforms, S0696 attempts to balance the long-term care system while ensuring that individuals have more choice and control over their care, which could ultimately lead to better health outcomes and quality of life for seniors and individuals with disabilities.
Summary
S0696, introduced in January 2025, aims to reform long-term care services in Rhode Island by increasing resource eligibility limits for individuals with long-term care needs who remain living at home. Specifically, the bill proposes to raise the financial eligibility threshold to $12,000 for single individuals and $18,000 for couples, thereby enhancing access to essential support services. Such adjustments are intended to empower more residents to remain in their homes, which aligns with broader efforts to reform long-term care systems to prioritize community-based and home care solutions over institutional placements.
Contention
While the bill is designed to improve access to long-term care services, there are points of contention that could arise. Critics may argue about the sufficiency of the increased eligibility limits, questioning whether they adequately address the needs of all disabled and elderly individuals. There may also be concerns regarding the transition from institutional to community-based care, especially about the adequacy of funding and support systems to manage this shift effectively. The requirement for semi-annual reporting by assisted living and adult day service providers could face resistance from those who view it as an added bureaucratic burden.
All Medicaid programs operated by EOHHS would not reimburse home care providers less than fee-for-service rates adopted by rate review recommendations of the office of health insurance commissioners.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
Increases the state’s share of supplementary assistance to individuals living in a state-licensed assisted-living residence from $332.00 to $352.00, of which $140.00 would be allocated to the personal needs allowance.
Increases the state's share of supplementary assistance to individuals living in a state-licensed assisted-living residence from $332.00 to $352.00, of which $140.00 would be allocated to the personal needs allowance.
Prohibits contractors and subcontractors from paying employees the cash equivalent of any applicable healthcare benefit in lieu of actually purchasing the healthcare benefit unless the employee is covered under a different healthcare plan.
Amends works program to provide eligibility for benefits to pregnant persons from onset of pregnancy including lawful permanent residents, increases monthly cash benefits, disallows termination of benefits for failure to work, limits monetary sanctions.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Establishes Medicaid fee-for-service reimbursement rates set by the general assembly as the rate floor for Medicaid managed care by home care, home nursing care and hospice providers licensed by the DOH and continue the EEOHH.
Authorizes an increase in resource eligibility limits for persons with long-term-care needs who reside at home and requires semi-annual reports from Medicaid certified assisted living facilities and adult day service providers to the EOHHS.
Raises the per diem rate by thirteen percent (13%) for Medicaid reimbursement for Tier C services provide by assisted living residence beginning January 1, 2026.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
Provides the executive office of health and human services would submit to the US Department of Health and Human Services a state plan to set rates for chiropractic services.
All Medicaid programs operated by EOHHS would not reimburse home care providers less than fee-for-service rates adopted by rate review recommendations of the office of health insurance commissioners.
Prohibits contractors and subcontractors from paying employees the cash equivalent of any applicable healthcare benefit in lieu of actually purchasing the healthcare benefit unless the employee is covered under a different healthcare plan.