Rhode Island 2023 Regular Session

Rhode Island House Bill H5633 Compare Versions

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55 2023 -- H 5633
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99 S TATE OF RHODE IS LAND
1010 IN GENERAL ASSEMBLY
1111 JANUARY SESSION, A.D. 2023
1212 ____________
1313
1414 A N A C T
1515 RELATING TO HUMAN SE RVICES -- PUBLIC ASSISTANCE ACT
1616 Introduced By: Representatives Spears, Cotter, Donovan, Dawson, O'Brien, Caldwell,
1717 Azzinaro, Knight, Tanzi, and Speakman
1818 Date Introduced: February 15, 2023
1919 Referred To: House Finance
2020
2121
2222 It is enacted by the General Assembly as follows:
2323 SECTION 1. Section 40-6-27 of the General Laws in Chapter 40-6 entitled "Public 1
2424 Assistance Act" is hereby amended to read as follows: 2
2525 40-6-27. Supplemental Security Income. 3
2626 (a)(1) The director of the department is hereby authorized to enter into agreements on 4
2727 behalf of the state with the Secretary of the Department of Health and Human Services or other 5
2828 appropriate federal officials, under the Supplemental Security Income (SSI) program established 6
2929 by Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., concerning the administration 7
3030 and determination of eligibility for SSI benefits for residents of this state, except as otherwise 8
3131 provided in this section. The state’s monthly share of supplementary assistance to the Supplemental 9
3232 Security Income program shall be as follows: 10
3333 (i) Individual living alone: $39.92 11
3434 (ii) Individual living with others: $51.92 12
3535 (iii) Couple living alone: $79.38 13
3636 (iv) Couple living with others: $97.30 14
3737 (v) Individual living in state-licensed assisted-living residence: $332.00 15
3838 (vi) [Deleted by P.L. 2021, ch. 162, art. 12, § 1.] 16
3939 (vii) Individual living in state-licensed supportive residential-care settings that, depending 17
4040 on the population served, meet the standards set by the department of human services in conjunction 18
4141 with the department of children, youth and families, the office of healthy aging, and/or the 19
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4545 department of behavioral healthcare, developmental disabilities and hospitals: $300.00. 1
4646 Provided, however, that the department of human services shall, by regulation, reduce, 2
4747 effective January 1, 2009, the state’s monthly share of supplementary assistance to the 3
4848 Supplemental Security Income (SSI) program for each of the above-listed payment levels, by the 4
4949 same value as the annual federal cost of living adjustment to be published by the federal Social 5
5050 Security Administration in October 2008 and becoming effective on January 1, 2009, as determined 6
5151 under the provisions of Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq.; and 7
5252 provided further, that it is the intent of the general assembly that the January 1, 2009, reduction in 8
5353 the state’s monthly share shall not cause a reduction in the combined federal and state payment 9
5454 level for each category of recipients in effect in the month of December 2008; provided further, 10
5555 that the department of human services is authorized and directed to provide for payments to 11
5656 recipients in accordance with the above directives. Provided, however, that the state's monthly share 12
5757 of supplementary assistance to the Supplemental Security Income (SSI) program for individua ls 13
5858 living in the community shall be increased each July by the same cost-of-living adjustment applied 14
5959 by the federal Social Security Administration for the federal SSI benefit in January of that calendar 15
6060 year. 16
6161 (2) As of July 1, 2010, state supplement payments shall not be federally administered and 17
6262 shall be paid directly by the department of human services to the recipient. 18
6363 (3) Individuals living in institutions shall receive a twenty-dollar ($20.00) forty-five dollar 19
6464 ($45.00) per-month personal needs allowance from the state that shall be in addition to the personal 20
6565 needs allowance allowed by the Social Security Act, 42 U.S.C. § 301 et seq. Beginning July 1, 21
6666 2024, and every other year thereafter, the monthly personal needs allowance shall be adjusted by 22
6767 the percentage of increase in the Consumer Price Index for all Urban Consumers (CPI-U) as 23
6868 published by the United States Bureau of Labor Statistics determined as of September 30 of the 24
6969 prior calendar year; said adjustment shall be rounded to the nearest one dollar ($1.00) increment; 25
7070 provided that, the total allowance shall not be less than provided for in the previous year. 26
7171 (4) Individuals living in state-licensed supportive residential-care settings and assisted-27
7272 living residences who are receiving SSI supplemental payments under this section shall be allowed 28
7373 to retain a minimum personal needs allowance of fifty-five dollars ($55.00) per month from their 29
7474 SSI monthly benefit prior to payment of any monthly fees in addition to any amounts established 30
7575 in an administrative rule promulgated by the secretary of the executive office of health and human 31
7676 services for persons eligible to receive Medicaid-funded long-term services and supports in the 32
7777 settings identified in subsection (a)(1)(v). 33
7878 (5) The department is authorized and directed to make a determination of the medical need 34
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8282 and whether a setting provides the appropriate services for those persons who: 1
8383 (i) Have applied for or are receiving SSI, and who apply for admission to supportive 2
8484 residential-care settings and assisted-living residences on or after October 1, 1998; or 3
8585 (ii) Who are residing in supportive residential-care settings and assisted-living residences, 4
8686 and who apply for or begin to receive SSI on or after October 1, 1998. 5
8787 (6) The process for determining medical need required by subsection (a)(5) of this section 6
8888 shall be developed by the executive office of health and human services in collaboration with the 7
8989 departments of that office and shall be implemented in a manner that furthers the goals of 8
9090 establishing a statewide coordinated long-term-care entry system as required pursuant to the 9
9191 Medicaid section 1115 waiver demonstration. 10
9292 (7) To assure access to high-quality, coordinated services, the executive office of health 11
9393 and human services is further authorized and directed to establish certification or contract standards 12
9494 that must be met by those state-licensed supportive residential-care settings, including adult 13
9595 supportive-care homes and assisted-living residences admitting or serving any persons eligible for 14
9696 state-funded supplementary assistance under this section. The certification or contract standards 15
9797 shall define: 16
9898 (i) The scope and frequency of resident assessments, the development and implementation 17
9999 of individualized service plans, staffing levels and qualifications, resident monitoring, service 18
100100 coordination, safety risk management and disclosure, and any other related areas; 19
101101 (ii) The procedures for determining whether the certifications or contract standards have 20
102102 been met; and 21
103103 (iii) The criteria and process for granting a one-time, short-term good-cause exemption 22
104104 from the certification or contract standards to a licensed supportive residential-care setting or 23
105105 assisted-living residence that provides documented evidence indicating that meeting, or failing to 24
106106 meet, the standards poses an undue hardship on any person eligible under this section who is a 25
107107 prospective or current resident. 26
108108 (8) The certification or contract standards required by this section shall be developed in 27
109109 collaboration by the departments, under the direction of the executive office of health and human 28
110110 services, so as to ensure that they comply with applicable licensure regulations either in effect or 29
111111 in development. 30
112112 (b) The department is authorized and directed to provide additional assistance to 31
113113 individuals eligible for SSI benefits for: 32
114114 (1) Moving costs or other expenses as a result of an emergency of a catastrophic nature, 33
115115 which is defined as a fire or natural disaster; and 34
116116
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119119 (2) Lost or stolen SSI benefit checks or proceeds of them; and 1
120120 (3) Assistance payments to SSI-eligible individuals in need because of the application of 2
121121 federal SSI regulations regarding estranged spouses; and the department shall provide the 3
122122 assistance in a form and amount that the department shall by regulation determine. 4
123123 SECTION 2. Section 40-8-2 of the General Laws in Chapter 40-8 entitled "Medical 5
124124 Assistance" is hereby amended to read as follows: 6
125125 40-8-2. Definitions. 7
126126 As used in this chapter, unless the context shall otherwise require: 8
127127 (1) “Dental service” means and includes emergency care, X-rays for diagnoses, extractions, 9
128128 palliative treatment, and the refitting and relining of existing dentures and prosthesis. 10
129129 (2) “Department” means the department of human services. 11
130130 (3) “Director” means the director of human services. 12
131131 (4) “Drug” means and includes only drugs and biologicals prescribed by a licensed dentist 13
132132 or physician as are either included in the United States pharmacopoeia, national formulary, or are 14
133133 new and nonofficial drugs and remedies. 15
134134 (5) “Inpatient” means a person admitted to and under treatment or care of a physician or 16
135135 surgeon in a hospital or nursing facility that meets standards of and complies with rules and 17
136136 regulations promulgated by the director. 18
137137 (6) “Inpatient hospital services” means the following items and services furnished to an 19
138138 inpatient in a hospital other than a hospital, institution, or facility for tuberculosis or mental 20
139139 diseases: 21
140140 (i) Bed and board; 22
141141 (ii) Nursing services and other related services as are customarily furnished by the hospital 23
142142 for the care and treatment of inpatients and drugs, biologicals, supplies, appliances, and equipment 24
143143 for use in the hospital, as are customarily furnished by the hospital for the care and treatment of 25
144144 patients; 26
145145 (iii)(A) Other diagnostic or therapeutic items or services, including, but not limited to, 27
146146 pathology, radiology, and anesthesiology furnished by the hospital or by others under arrangements 28
147147 made by the hospital, as are customarily furnished to inpatients either by the hospital or by others 29
148148 under such arrangements, and services as are customarily provided to inpatients in the hospital by 30
149149 an intern or resident-in-training under a teaching program having the approval of the Council on 31
150150 Medical Education and Hospitals of the American Medical Association or of any other recognized 32
151151 medical society approved by the director. 33
152152 (B) The term “inpatient hospital services” shall be taken to include medical and surgical 34
153153
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156156 services provided by the inpatient’s physician, but shall not include the services of a private-duty 1
157157 nurse or services in a hospital, institution, or facility maintained primarily for the treatment and 2
158158 care of patients with tuberculosis or mental diseases. Provided, further, it shall be taken to include 3
159159 only the following organ transplant operations: kidney, liver, cornea, pancreas, bone marrow, lung, 4
160160 heart, and heart/lung, and other organ transplant operations as may be designated by the director 5
161161 after consultation with medical advisory staff or medical consultants; and provided that any such 6
162162 transplant operation is determined by the director or his or her designee to be medically necessary. 7
163163 Prior written approval of the director, or his or her designee, shall be required for all covered organ 8
164164 transplant operations. 9
165165 (C) In determining medical necessity for organ transplant procedures, the state plan shall 10
166166 adopt a case-by-case approach and shall focus on the medical indications and contra-indications in 11
167167 each instance; the progressive nature of the disease; the existence of any alternative therapies; the 12
168168 life-threatening nature of the disease; the general state of health of the patient apart from the 13
169169 particular organ disease; and any other relevant facts and circumstances related to the applicant and 14
170170 the particular transplant procedure. 15
171171 (7) “Nursing services” means the following items and services furnished to an inpatient in 16
172172 a nursing facility: 17
173173 (i) Bed and board; 18
174174 (ii) Nursing care and other related services as are customarily furnished to inpatients 19
175175 admitted to the nursing facility, and drugs, biologicals, supplies, appliances, and equipment for use 20
176176 in the facility, as are customarily furnished in the facility for the care and treatment of patients; 21
177177 (iii) Other diagnostic or therapeutic items or services, legally furnished by the facility or 22
178178 by others under arrangements made by the facility, as are customarily furnished to inpatients either 23
179179 by the facility or by others under such arrangement; 24
180180 (iv) Medical services provided in the facility by the inpatient’s physician, or by an intern 25
181181 or resident-in-training of a hospital with which the facility is affiliated or that is under the same 26
182182 control, under a teaching program of the hospital approved as provided in subsection (6); and 27
183183 (v) A personal-needs allowance of fifty dollars ($50.00) per month as provided pursuant to 28
184184 § 40-6-27(3). 29
185185 (8) “Relative with whom the dependent child is living” means and includes the father, 30
186186 mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, 31
187187 uncle, aunt, first cousin, nephew, or niece of any dependent child who maintains a home for the 32
188188 dependent child. 33
189189 (9) “Visiting nurse service” means part-time or intermittent nursing care provided by or 34
190190
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193193 under the supervision of a registered professional nurse other than in a hospital or nursing home. 1
194194 SECTION 3. This act shall take effect upon passage. 2
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201201 EXPLANATION
202202 BY THE LEGISLATIVE COUNCIL
203203 OF
204204 A N A C T
205205 RELATING TO HUMAN SE RVICES -- PUBLIC ASSISTANCE ACT
206206 ***
207207 This act would adjust the state's monthly share of Supplemental Security Income to equal 1
208208 the federal Supplemental Security Income benefit in January of that calendar year. 2
209209 This act would take effect upon passage. 3
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