Medical Assistance -- Long-term Care Service And Finance Reform
Impact
The impact of HB 5314 on state laws is substantial as it amends various sections of the existing General Laws regarding medical assistance and long-term care. By prioritizing home- and community-based services, the bill not only aims to reduce the financial burden on Medicaid but also seeks to address the high turnover rates and low wages experienced by home-care workers. Additionally, the bill mandates annual reporting of percentage distributions in care types and waiting lists, which holds the executive office accountable for the transition to this new service model. The intent is to increase the stability and viability of long-term care services while ensuring that diverse needs of individuals are met.
Summary
House Bill 5314 introduces significant reforms to the long-term care services and financing in Rhode Island, primarily aimed at enhancing home- and community-based care for the elderly and adults with disabilities. The bill requires the Executive Office of Health and Human Services to allocate a minimum of 50% of Medicaid long-term care funding towards these alternative care settings. This shift underscores a growing recognition that individuals can often receive better care and maintain a higher quality of life outside of institutional environments. The legislative framework proposed by this bill reflects a broader trend toward person-centered care and emphasizes individual choice, involvement of families, and interagency collaboration.
Contention
Despite its potential benefits, HB 5314 has sparked some debate among stakeholders. Advocates for the bill highlight its ability to promote independence for those with long-term care needs, while critics express concerns regarding the adequacy of funding and resources for home-based care. There are also fears that an emphasis on reducing institutional care could neglect the essential support systems needed for those who require intensive professional supervision. Proponents argue that with proper implementation, these reforms can lead to improved care outcomes, while critics urge caution and call for comprehensive assessments to ensure that quality is not compromised.
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.
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.
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.
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.
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.
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.