Rhode Island 2023 Regular Session

Rhode Island House Bill H5238 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3
4	4
5	5	2023 -- H 5238
6	6	========
7	7	LC000805
8	8	========
9	9	S TATE OF RHODE IS LAND
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2023
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO BEHAVIORAL HEALTHCARE, DEVELOPMENTAL DISABI LITIES AND
16	16	HOSPITALS -- COOPERATION WITH FED ERAL GOVERNMENT
17	17	Introduced By: Representatives Fellela, Carson, Donovan, Kazarian, Cortvriend,
18	18	Sanchez, and Nardone
19	19	Date Introduced: January 25, 2023
20	20	Referred To: House Finance
21	21
22	22
23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Chapter 40.1-1.1 of the General Laws entitled "Cooperation with Federal 1
25	25	Government" is hereby amended by adding thereto the following section: 2
26	26	40.1-1.1-5. Home and community based services to permit payments for family 3
27	27	caregivers and legally responsible individuals. 4
28	28	(a) Commencing July 1, 2023, and continuing thereafter, family caregivers and legally 5
29	29	responsible individuals, including guardians appointed for an adult by a court of competent 6
30	30	jurisdiction, and for children with special needs, shall be eligible to provide home and community 7
31	31	based services ("HCBS"), including personal care services, to developmentally disabled adults and 8
32	32	children with special needs, and be eligible to be paid for such services pursuant to the HCBS final 9
33	33	rules. As used in this section, the term "family caregivers" shall include a member of the individua l's 10
34	34	family and a legally responsible relative. Provided, the caregiver shall be required to meet the 11
35	35	provisions of subsection (b) of this section. 12
36	36	(b) The executive office of health and human services ("EOHHS") shall permit payment 13
37	37	for family caregivers and legally responsible individuals to provide HCBS, including personal care 14
38	38	services and all home-based services for children with special needs, and developmentally disabled 15
39	39	adults. To ensure that individuals receive necessary services as authorized in the plan of care, family 16
40	40	caregivers/legally responsible individuals will be required to document case notes reflecting the 17
41	41	services they provide, as well as an attestation that they have reviewed the plan of care and will 18
42	42
43	43
44	44	LC000805 - Page 2 of 4
45	45	provide the supports in the plan to the extent possible given the public health emergency and will 1
46	46	identify safe alternatives where necessary and possible. To ensure that payments are made for 2
47	47	services rendered, EOHHS will utilize the self-directed plan process. Under this process, 3
48	48	individuals who self-direct their services shall go through a fiscal intermediary agency, which 4
49	49	reviews employment paperwork and time sheets submitted by the parent/guardian. 5
50	50	(c) The EOHHS is directed to ensure that federal financial participation is used to the 6
51	51	maximum extent allowable to provide coverage pursuant to this section, and that state-only funds 7
52	52	will be used only if federal financial participation is not available. To the extent the EOHHS 8
53	53	determines it necessary to implement the provisions of this section, the EOHHS is authorized to 9
54	54	pursue a Medicaid section 1115 demonstration waiver request and renewal to seek a waiver of the 10
55	55	compliance provisions of 42 U.S.C. section 1396d(a) ("definitions"). 11
56	56	SECTION 2. Rhode Island Medicaid Reform Act of 2008 Joint Resolution. 12
57	57	WHEREAS, The General Assembly enacted Chapter 12.4 of Title 42 entitled "The Rhode 13
58	58	Island Medicaid Reform Act of 2008"; and 14
59	59	WHEREAS, A legislative enactment is required pursuant to Rhode Island General Laws § 15
60	60	42-12.4-1, et seq.; and 16
61	61	WHEREAS, Rhode Island General Laws § 42-7.2-5(3)(i) provides that the secretary of the 17
62	62	executive office of health and human services ("executive office") is responsible for the review and 18
63	63	coordination of any Medicaid section 1115 demonstration waiver requests and renewals as well as 19
64	64	any initiatives and proposals requiring amendments to the Medicaid state plan or category II or III 20
65	65	changes as described in the demonstration, "with potential to affect the scope, amount, or duration 21
66	66	of publicly-funded health care services, provider payments or reimbursements, or access to or the 22
67	67	availability of benefits and services provided by Rhode Island general and public laws"; and 23
68	68	WHEREAS, In pursuit of a more cost-effective consumer choice system of care that is 24
69	69	fiscally sound and sustainable, the secretary requests legislative approval of the following proposals 25
70	70	to amend the demonstration; and 26
71	71	WHEREAS, Implementation of adjustments may require amendments to the Rhode 27
72	72	Island's Medicaid state plan and/or section 1115 waiver under the terms and conditions of the 28
73	73	demonstration. Further, adoption of new or amended rules, regulations and procedures may also be 29
74	74	required: 30
75	75	(a) Section 1115 demonstration waiver – extension request. The executive office proposes 31
76	76	to seek approval from the federal centers for Medicare and Medicaid services ("CMS") to extend 32
77	77	the Medicaid section 1115 demonstration waiver as authorized in Rhode Island General Laws 33
78	78	chapter 12.4 of title 42. In the Medicaid section 1115 demonstration waiver extension request due 34
79	79
80	80
81	81	LC000805 - Page 3 of 4
82	82	to CMS by December 31, 2023, in addition to maintaining existing Medicaid section 1115 1
83	83	demonstration waiver authorities, the executive office proposes to seek a Medicaid section 1115 2
84	84	demonstration waiver request and renewal to a seek waiver of the compliance provisions of 42 3
85	85	U.S.C. section 1396d(a) ("definitions"), as set forth in subsection (b) of this resolution. 4
86	86	(b) Home and community based services ("HBCS"). The executive office proposes to 5
87	87	permit payment for family caregivers and legally responsible individuals, to provide HCBS, 6
88	88	including personal care services and all home-based services for children with special needs, and 7
89	89	developmentally disabled adults. To ensure that individuals receive necessary services as 8
90	90	authorized in the plan of care, family caregivers/legally responsible individuals will be required to 9
91	91	document case notes reflecting the services they provide, as well as an attestation that they have 10
92	92	reviewed the plan of care and will provide the supports in the plan to the extent possible given the 11
93	93	public health emergency and will identify safe alternatives where necessary and possible. To ensure 12
94	94	that payments are made for services rendered, EOHHS will utilize the self-directed plan process. 13
95	95	Under this process, individuals who self-direct their services go through a fiscal intermediary 14
96	96	agency, which reviews employment paperwork and time sheets submitted by the parent/guardian. 15
97	97	As used in this section, the term "family caregivers" may include a member of the individua l's 16
98	98	family and a legally responsible relative; now, therefore be it 17
99	99	RESOLVED, That the general assembly hereby approves the proposals stated above in the 18
100	100	recitals; and be it further; 19
101	101	RESOLVED, That the secretary of the executive office of health and human services is 20
102	102	authorized to pursue and implement any waiver amendments, state plan amendments, and/or 21
103	103	changes to the applicable department's rules, regulations and procedures approved herein and as 22
104	104	authorized by chapter 12.4 of title 42; and be it further; 23
105	105	RESOLVED, That this joint resolution shall take effect upon passage. 24
106	106	SECTION 3. This act shall take effect upon passage. 25
107	107	========
108	108	LC000805
109	109	========
110	110
111	111
112	112	LC000805 - Page 4 of 4
113	113	EXPLANATION
114	114	BY THE LEGISLATIVE COUNCIL
115	115	OF
116	116	A N A C T
117	117	RELATING TO BEHAVIORAL HEALTHCARE, DEVEL OPMENTAL DISABILITIES AND
118	118	HOSPITALS -- COOPERATION WITH FED ERAL GOVERNMENT
119	119	***
120	120	This act would codify in state law portions of an Attachment K Emergency and 1
121	121	Preparedness Response which included actions that state could take under existing section 1915(c) 2
122	122	of the Social Security Act relating to home and community-based waiver authority in order to 3
123	123	respond to the COVID-19 pandemic. More specifically, the act authorizes members of an 4
124	124	individual's family as well as a legally responsible adult to receive payment for delivering home 5
125	125	and community based services to a developmentally disabled adult and a child with special needs. 6
126	126	This act would also include a Medicaid Section 1115 Demonstration Waiver to permit this payment 7
127	127	to be made, notwithstanding the provisions of 42 U.S.C. section 1396d(a). 8
128	128	This act would take effect upon passage. 9
129	129	========
130	130	LC000805
131	131	========