Cooperation With Federal Government
The bill's enactment will broaden the scope of who can provide HCBS under the Rhode Island Medicaid program, allowing family members to be reimbursed for personal care services. This change is seen as a necessary response to the unique challenges posed by the COVID-19 pandemic which heightened the need for flexible care options and delivery mechanisms. By facilitating payments for family caregivers, the legislation aims to alleviate the financial burden on families caring for special needs individuals and to ensure continuity of care in home settings.
House Bill 5238 seeks to amend the cooperation with the federal government in relation to behavioral healthcare and developmental disabilities by allowing family caregivers and legally responsible individuals to provide home and community-based services (HCBS) to developmentally disabled adults and children with special needs, and to be compensated for these services. This legislative measure, set to take effect on July 1, 2023, indicates a significant shift towards recognition and formalization of the role of family caregivers in the healthcare system, particularly for vulnerable populations requiring specialized care.
Notably, the bill includes provisions for the executive office of health and human services to pursue a Medicaid Section 1115 demonstration waiver to enable these changes, which raises some concerns regarding the implications for federal compliance. As the bill shifts certain responsibilities and financial burdens from state agencies to family members, it has sparked discussions regarding the sustainability of supporting family caregivers as a viable component of the state's healthcare system. Critics may argue this could lead to inequities in access and quality of care based on family circumstances and resources.