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5 | 5 | | 2023 -- H 5633 |
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6 | 6 | | ======== |
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7 | 7 | | LC001333 |
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8 | 8 | | ======== |
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9 | 9 | | S TATE OF RHODE IS LAND |
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10 | 10 | | IN GENERAL ASSEMBLY |
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11 | 11 | | JANUARY SESSION, A.D. 2023 |
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12 | 12 | | ____________ |
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13 | 13 | | |
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14 | 14 | | A N A C T |
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15 | 15 | | RELATING TO HUMAN SE RVICES -- PUBLIC ASSISTANCE ACT |
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16 | 16 | | Introduced By: Representatives Spears, Cotter, Donovan, Dawson, O'Brien, Caldwell, |
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17 | 17 | | Azzinaro, Knight, Tanzi, and Speakman |
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18 | 18 | | Date Introduced: February 15, 2023 |
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19 | 19 | | Referred To: House Finance |
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20 | 20 | | |
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21 | 21 | | |
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22 | 22 | | It is enacted by the General Assembly as follows: |
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23 | 23 | | SECTION 1. Section 40-6-27 of the General Laws in Chapter 40-6 entitled "Public 1 |
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24 | 24 | | Assistance Act" is hereby amended to read as follows: 2 |
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25 | 25 | | 40-6-27. Supplemental Security Income. 3 |
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26 | 26 | | (a)(1) The director of the department is hereby authorized to enter into agreements on 4 |
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27 | 27 | | behalf of the state with the Secretary of the Department of Health and Human Services or other 5 |
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28 | 28 | | appropriate federal officials, under the Supplemental Security Income (SSI) program established 6 |
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29 | 29 | | by Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., concerning the administration 7 |
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30 | 30 | | and determination of eligibility for SSI benefits for residents of this state, except as otherwise 8 |
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31 | 31 | | provided in this section. The state’s monthly share of supplementary assistance to the Supplemental 9 |
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32 | 32 | | Security Income program shall be as follows: 10 |
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33 | 33 | | (i) Individual living alone: $39.92 11 |
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34 | 34 | | (ii) Individual living with others: $51.92 12 |
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35 | 35 | | (iii) Couple living alone: $79.38 13 |
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36 | 36 | | (iv) Couple living with others: $97.30 14 |
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37 | 37 | | (v) Individual living in state-licensed assisted-living residence: $332.00 15 |
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38 | 38 | | (vi) [Deleted by P.L. 2021, ch. 162, art. 12, § 1.] 16 |
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39 | 39 | | (vii) Individual living in state-licensed supportive residential-care settings that, depending 17 |
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40 | 40 | | on the population served, meet the standards set by the department of human services in conjunction 18 |
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41 | 41 | | with the department of children, youth and families, the office of healthy aging, and/or the 19 |
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42 | 42 | | |
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43 | 43 | | |
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44 | 44 | | LC001333 - Page 2 of 7 |
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45 | 45 | | department of behavioral healthcare, developmental disabilities and hospitals: $300.00. 1 |
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46 | 46 | | Provided, however, that the department of human services shall, by regulation, reduce, 2 |
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47 | 47 | | effective January 1, 2009, the state’s monthly share of supplementary assistance to the 3 |
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48 | 48 | | Supplemental Security Income (SSI) program for each of the above-listed payment levels, by the 4 |
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49 | 49 | | same value as the annual federal cost of living adjustment to be published by the federal Social 5 |
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50 | 50 | | Security Administration in October 2008 and becoming effective on January 1, 2009, as determined 6 |
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51 | 51 | | under the provisions of Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq.; and 7 |
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52 | 52 | | provided further, that it is the intent of the general assembly that the January 1, 2009, reduction in 8 |
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53 | 53 | | the state’s monthly share shall not cause a reduction in the combined federal and state payment 9 |
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54 | 54 | | level for each category of recipients in effect in the month of December 2008; provided further, 10 |
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55 | 55 | | that the department of human services is authorized and directed to provide for payments to 11 |
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56 | 56 | | recipients in accordance with the above directives. Provided, however, that the state's monthly share 12 |
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57 | 57 | | of supplementary assistance to the Supplemental Security Income (SSI) program for individua ls 13 |
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58 | 58 | | living in the community shall be increased each July by the same cost-of-living adjustment applied 14 |
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59 | 59 | | by the federal Social Security Administration for the federal SSI benefit in January of that calendar 15 |
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60 | 60 | | year. 16 |
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61 | 61 | | (2) As of July 1, 2010, state supplement payments shall not be federally administered and 17 |
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62 | 62 | | shall be paid directly by the department of human services to the recipient. 18 |
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63 | 63 | | (3) Individuals living in institutions shall receive a twenty-dollar ($20.00) forty-five dollar 19 |
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64 | 64 | | ($45.00) per-month personal needs allowance from the state that shall be in addition to the personal 20 |
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65 | 65 | | needs allowance allowed by the Social Security Act, 42 U.S.C. § 301 et seq. Beginning July 1, 21 |
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66 | 66 | | 2024, and every other year thereafter, the monthly personal needs allowance shall be adjusted by 22 |
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67 | 67 | | the percentage of increase in the Consumer Price Index for all Urban Consumers (CPI-U) as 23 |
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68 | 68 | | published by the United States Bureau of Labor Statistics determined as of September 30 of the 24 |
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69 | 69 | | prior calendar year; said adjustment shall be rounded to the nearest one dollar ($1.00) increment; 25 |
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70 | 70 | | provided that, the total allowance shall not be less than provided for in the previous year. 26 |
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71 | 71 | | (4) Individuals living in state-licensed supportive residential-care settings and assisted-27 |
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72 | 72 | | living residences who are receiving SSI supplemental payments under this section shall be allowed 28 |
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73 | 73 | | to retain a minimum personal needs allowance of fifty-five dollars ($55.00) per month from their 29 |
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74 | 74 | | SSI monthly benefit prior to payment of any monthly fees in addition to any amounts established 30 |
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75 | 75 | | in an administrative rule promulgated by the secretary of the executive office of health and human 31 |
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76 | 76 | | services for persons eligible to receive Medicaid-funded long-term services and supports in the 32 |
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77 | 77 | | settings identified in subsection (a)(1)(v). 33 |
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78 | 78 | | (5) The department is authorized and directed to make a determination of the medical need 34 |
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79 | 79 | | |
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80 | 80 | | |
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81 | 81 | | LC001333 - Page 3 of 7 |
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82 | 82 | | and whether a setting provides the appropriate services for those persons who: 1 |
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83 | 83 | | (i) Have applied for or are receiving SSI, and who apply for admission to supportive 2 |
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84 | 84 | | residential-care settings and assisted-living residences on or after October 1, 1998; or 3 |
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85 | 85 | | (ii) Who are residing in supportive residential-care settings and assisted-living residences, 4 |
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86 | 86 | | and who apply for or begin to receive SSI on or after October 1, 1998. 5 |
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87 | 87 | | (6) The process for determining medical need required by subsection (a)(5) of this section 6 |
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88 | 88 | | shall be developed by the executive office of health and human services in collaboration with the 7 |
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89 | 89 | | departments of that office and shall be implemented in a manner that furthers the goals of 8 |
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90 | 90 | | establishing a statewide coordinated long-term-care entry system as required pursuant to the 9 |
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91 | 91 | | Medicaid section 1115 waiver demonstration. 10 |
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92 | 92 | | (7) To assure access to high-quality, coordinated services, the executive office of health 11 |
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93 | 93 | | and human services is further authorized and directed to establish certification or contract standards 12 |
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94 | 94 | | that must be met by those state-licensed supportive residential-care settings, including adult 13 |
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95 | 95 | | supportive-care homes and assisted-living residences admitting or serving any persons eligible for 14 |
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96 | 96 | | state-funded supplementary assistance under this section. The certification or contract standards 15 |
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97 | 97 | | shall define: 16 |
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98 | 98 | | (i) The scope and frequency of resident assessments, the development and implementation 17 |
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99 | 99 | | of individualized service plans, staffing levels and qualifications, resident monitoring, service 18 |
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100 | 100 | | coordination, safety risk management and disclosure, and any other related areas; 19 |
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101 | 101 | | (ii) The procedures for determining whether the certifications or contract standards have 20 |
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102 | 102 | | been met; and 21 |
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103 | 103 | | (iii) The criteria and process for granting a one-time, short-term good-cause exemption 22 |
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104 | 104 | | from the certification or contract standards to a licensed supportive residential-care setting or 23 |
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105 | 105 | | assisted-living residence that provides documented evidence indicating that meeting, or failing to 24 |
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106 | 106 | | meet, the standards poses an undue hardship on any person eligible under this section who is a 25 |
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107 | 107 | | prospective or current resident. 26 |
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108 | 108 | | (8) The certification or contract standards required by this section shall be developed in 27 |
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109 | 109 | | collaboration by the departments, under the direction of the executive office of health and human 28 |
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110 | 110 | | services, so as to ensure that they comply with applicable licensure regulations either in effect or 29 |
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111 | 111 | | in development. 30 |
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112 | 112 | | (b) The department is authorized and directed to provide additional assistance to 31 |
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113 | 113 | | individuals eligible for SSI benefits for: 32 |
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114 | 114 | | (1) Moving costs or other expenses as a result of an emergency of a catastrophic nature, 33 |
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115 | 115 | | which is defined as a fire or natural disaster; and 34 |
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116 | 116 | | |
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117 | 117 | | |
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118 | 118 | | LC001333 - Page 4 of 7 |
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119 | 119 | | (2) Lost or stolen SSI benefit checks or proceeds of them; and 1 |
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120 | 120 | | (3) Assistance payments to SSI-eligible individuals in need because of the application of 2 |
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121 | 121 | | federal SSI regulations regarding estranged spouses; and the department shall provide the 3 |
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122 | 122 | | assistance in a form and amount that the department shall by regulation determine. 4 |
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123 | 123 | | SECTION 2. Section 40-8-2 of the General Laws in Chapter 40-8 entitled "Medical 5 |
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124 | 124 | | Assistance" is hereby amended to read as follows: 6 |
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125 | 125 | | 40-8-2. Definitions. 7 |
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126 | 126 | | As used in this chapter, unless the context shall otherwise require: 8 |
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127 | 127 | | (1) “Dental service” means and includes emergency care, X-rays for diagnoses, extractions, 9 |
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128 | 128 | | palliative treatment, and the refitting and relining of existing dentures and prosthesis. 10 |
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129 | 129 | | (2) “Department” means the department of human services. 11 |
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130 | 130 | | (3) “Director” means the director of human services. 12 |
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131 | 131 | | (4) “Drug” means and includes only drugs and biologicals prescribed by a licensed dentist 13 |
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132 | 132 | | or physician as are either included in the United States pharmacopoeia, national formulary, or are 14 |
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133 | 133 | | new and nonofficial drugs and remedies. 15 |
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134 | 134 | | (5) “Inpatient” means a person admitted to and under treatment or care of a physician or 16 |
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135 | 135 | | surgeon in a hospital or nursing facility that meets standards of and complies with rules and 17 |
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136 | 136 | | regulations promulgated by the director. 18 |
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137 | 137 | | (6) “Inpatient hospital services” means the following items and services furnished to an 19 |
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138 | 138 | | inpatient in a hospital other than a hospital, institution, or facility for tuberculosis or mental 20 |
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139 | 139 | | diseases: 21 |
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140 | 140 | | (i) Bed and board; 22 |
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141 | 141 | | (ii) Nursing services and other related services as are customarily furnished by the hospital 23 |
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142 | 142 | | for the care and treatment of inpatients and drugs, biologicals, supplies, appliances, and equipment 24 |
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143 | 143 | | for use in the hospital, as are customarily furnished by the hospital for the care and treatment of 25 |
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144 | 144 | | patients; 26 |
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145 | 145 | | (iii)(A) Other diagnostic or therapeutic items or services, including, but not limited to, 27 |
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146 | 146 | | pathology, radiology, and anesthesiology furnished by the hospital or by others under arrangements 28 |
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147 | 147 | | made by the hospital, as are customarily furnished to inpatients either by the hospital or by others 29 |
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148 | 148 | | under such arrangements, and services as are customarily provided to inpatients in the hospital by 30 |
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149 | 149 | | an intern or resident-in-training under a teaching program having the approval of the Council on 31 |
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150 | 150 | | Medical Education and Hospitals of the American Medical Association or of any other recognized 32 |
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151 | 151 | | medical society approved by the director. 33 |
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152 | 152 | | (B) The term “inpatient hospital services” shall be taken to include medical and surgical 34 |
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153 | 153 | | |
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154 | 154 | | |
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155 | 155 | | LC001333 - Page 5 of 7 |
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156 | 156 | | services provided by the inpatient’s physician, but shall not include the services of a private-duty 1 |
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157 | 157 | | nurse or services in a hospital, institution, or facility maintained primarily for the treatment and 2 |
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158 | 158 | | care of patients with tuberculosis or mental diseases. Provided, further, it shall be taken to include 3 |
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159 | 159 | | only the following organ transplant operations: kidney, liver, cornea, pancreas, bone marrow, lung, 4 |
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160 | 160 | | heart, and heart/lung, and other organ transplant operations as may be designated by the director 5 |
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161 | 161 | | after consultation with medical advisory staff or medical consultants; and provided that any such 6 |
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162 | 162 | | transplant operation is determined by the director or his or her designee to be medically necessary. 7 |
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163 | 163 | | Prior written approval of the director, or his or her designee, shall be required for all covered organ 8 |
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164 | 164 | | transplant operations. 9 |
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165 | 165 | | (C) In determining medical necessity for organ transplant procedures, the state plan shall 10 |
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166 | 166 | | adopt a case-by-case approach and shall focus on the medical indications and contra-indications in 11 |
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167 | 167 | | each instance; the progressive nature of the disease; the existence of any alternative therapies; the 12 |
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168 | 168 | | life-threatening nature of the disease; the general state of health of the patient apart from the 13 |
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169 | 169 | | particular organ disease; and any other relevant facts and circumstances related to the applicant and 14 |
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170 | 170 | | the particular transplant procedure. 15 |
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171 | 171 | | (7) “Nursing services” means the following items and services furnished to an inpatient in 16 |
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172 | 172 | | a nursing facility: 17 |
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173 | 173 | | (i) Bed and board; 18 |
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174 | 174 | | (ii) Nursing care and other related services as are customarily furnished to inpatients 19 |
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175 | 175 | | admitted to the nursing facility, and drugs, biologicals, supplies, appliances, and equipment for use 20 |
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176 | 176 | | in the facility, as are customarily furnished in the facility for the care and treatment of patients; 21 |
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177 | 177 | | (iii) Other diagnostic or therapeutic items or services, legally furnished by the facility or 22 |
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178 | 178 | | by others under arrangements made by the facility, as are customarily furnished to inpatients either 23 |
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179 | 179 | | by the facility or by others under such arrangement; 24 |
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180 | 180 | | (iv) Medical services provided in the facility by the inpatient’s physician, or by an intern 25 |
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181 | 181 | | or resident-in-training of a hospital with which the facility is affiliated or that is under the same 26 |
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182 | 182 | | control, under a teaching program of the hospital approved as provided in subsection (6); and 27 |
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183 | 183 | | (v) A personal-needs allowance of fifty dollars ($50.00) per month as provided pursuant to 28 |
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184 | 184 | | § 40-6-27(3). 29 |
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185 | 185 | | (8) “Relative with whom the dependent child is living” means and includes the father, 30 |
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186 | 186 | | mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, 31 |
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187 | 187 | | uncle, aunt, first cousin, nephew, or niece of any dependent child who maintains a home for the 32 |
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188 | 188 | | dependent child. 33 |
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189 | 189 | | (9) “Visiting nurse service” means part-time or intermittent nursing care provided by or 34 |
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190 | 190 | | |
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191 | 191 | | |
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192 | 192 | | LC001333 - Page 6 of 7 |
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193 | 193 | | under the supervision of a registered professional nurse other than in a hospital or nursing home. 1 |
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194 | 194 | | SECTION 3. This act shall take effect upon passage. 2 |
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195 | 195 | | ======== |
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196 | 196 | | LC001333 |
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197 | 197 | | ======== |
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198 | 198 | | |
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199 | 199 | | |
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200 | 200 | | LC001333 - Page 7 of 7 |
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201 | 201 | | EXPLANATION |
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202 | 202 | | BY THE LEGISLATIVE COUNCIL |
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203 | 203 | | OF |
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204 | 204 | | A N A C T |
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205 | 205 | | RELATING TO HUMAN SE RVICES -- PUBLIC ASSISTANCE ACT |
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206 | 206 | | *** |
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207 | 207 | | This act would adjust the state's monthly share of Supplemental Security Income to equal 1 |
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208 | 208 | | the federal Supplemental Security Income benefit in January of that calendar year. 2 |
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209 | 209 | | This act would take effect upon passage. 3 |
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210 | 210 | | ======== |
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211 | 211 | | LC001333 |
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212 | 212 | | ======== |
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