Rhode Island 2023 Regular Session

Rhode Island House Bill H5998 Compare Versions

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

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5	5	2023 -- H 5998
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7	7	LC002211
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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 STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND
16	16	HUMAN SERVICES
17	17	Introduced By: Representatives Spears, Tanzi, Casimiro, Fenton-Fung, Morales, Henries,
18	18	Cortvriend, and Kislak
19	19	Date Introduced: March 01, 2023
20	20	Referred To: House Finance
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23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Section 42-7.2-5 of the General Laws in Chapter 42-7.2 entitled "Office of 1
25	25	Health and Human Services" is hereby amended to read as follows: 2
26	26	42-7.2-5. Duties of the secretary. 3
27	27	The secretary shall be subject to the direction and supervision of the governor for the 4
28	28	oversight, coordination, and cohesive direction of state-administered health and human services 5
29	29	and in ensuring the laws are faithfully executed, notwithstanding any law to the contrary. In this 6
30	30	capacity, the secretary of the executive office of health and human services (EOHHS) shall be 7
31	31	authorized to: 8
32	32	(1) Coordinate the administration and financing of healthcare benefits, human services, and 9
33	33	programs including those authorized by the state’s Medicaid section 1115 demonstration waiver 10
34	34	and, as applicable, the Medicaid state plan under Title XIX of the U.S. Social Security Act. 11
35	35	However, nothing in this section shall be construed as transferring to the secretary the powers, 12
36	36	duties, or functions conferred upon the departments by Rhode Island public and general laws for 13
37	37	the administration of federal/state programs financed in whole or in part with Medicaid funds or 14
38	38	the administrative responsibility for the preparation and submission of any state plans, state plan 15
39	39	amendments, or authorized federal waiver applications, once approved by the secretary. 16
40	40	(2) Serve as the governor’s chief advisor and liaison to federal policymakers on Medicaid 17
41	41	reform issues as well as the principal point of contact in the state on any such related matters. 18
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45	45	(3)(i) Review and ensure the coordination of the state’s Medicaid section 1115 1
46	46	demonstration waiver requests and renewals as well as any initiatives and proposals requiring 2
47	47	amendments to the Medicaid state plan or formal amendment changes, as described in the special 3
48	48	terms and conditions of the state’s Medicaid section 1115 demonstration waiver with the potential 4
49	49	to affect the scope, amount or duration of publicly funded healthcare services, provider payments 5
50	50	or reimbursements, or access to or the availability of benefits and services as provided by Rhode 6
51	51	Island general and public laws. The secretary shall consider whether any such changes are legally 7
52	52	and fiscally sound and consistent with the state’s policy and budget priorities. The secretary shall 8
53	53	also assess whether a proposed change is capable of obtaining the necessary approvals from federal 9
54	54	officials and achieving the expected positive consumer outcomes. Department directors shall, 10
55	55	within the timelines specified, provide any information and resources the secretary deems necessary 11
56	56	in order to perform the reviews authorized in this section. 12
57	57	(ii) Direct the development and implementation of any Medicaid policies, procedures, or 13
58	58	systems that may be required to assure successful operation of the state’s health and human services 14
59	59	integrated eligibility system and coordination with HealthSource RI, the state’s health insurance 15
60	60	marketplace. 16
61	61	(iii) Beginning in 2015, conduct on a biennial basis a comprehensive review of the 17
62	62	Medicaid eligibility criteria for one or more of the populations covered under the state plan or a 18
63	63	waiver to ensure consistency with federal and state laws and policies, coordinate and align systems, 19
64	64	and identify areas for improving quality assurance, fair and equitable access to services, and 20
65	65	opportunities for additional financial participation. 21
66	66	(iv) Implement service organization and delivery reforms that facilitate service integration, 22
67	67	increase value, and improve quality and health outcomes. 23
68	68	(4) Beginning in 2020, prepare and submit to the governor, the chairpersons of the house 24
69	69	and senate finance committees, the caseload estimating conference, and to the joint legislative 25
70	70	committee for health-care oversight, by no later than September 15 of each year, a comprehensive 26
71	71	overview of all Medicaid expenditures outcomes, administrative costs, and utilization rates. The 27
72	72	overview shall include, but not be limited to, the following information: 28
73	73	(i) Expenditures under Titles XIX and XXI of the Social Security Act, as amended; 29
74	74	(ii) Expenditures, outcomes and utilization rates by population and sub-population served 30
75	75	(e.g., families with children, persons with disabilities, children in foster care, children receiving 31
76	76	adoption assistance, adults ages nineteen (19) to sixty-four (64), and elders); 32
77	77	(iii) Expenditures, outcomes and utilization rates by each state department or other 33
78	78	municipal or public entity receiving federal reimbursement under Titles XIX and XXI of the Social 34
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82	82	Security Act, as amended; 1
83	83	(iv) Expenditures, outcomes and utilization rates by type of service and/or service provider; 2
84	84	and 3
85	85	(v) Expenditures by mandatory population receiving mandatory services and, reported 4
86	86	separately, optional services, as well as optional populations receiving mandatory services and, 5
87	87	reported separately, optional services for each state agency receiving Title XIX and XXI funds. 6
88	88	The directors of the departments, as well as local governments and school departments, 7
89	89	shall assist and cooperate with the secretary in fulfilling this responsibility by providing whatever 8
90	90	resources, information and support shall be necessary. 9
91	91	(5) Resolve administrative, jurisdictional, operational, program, or policy conflicts among 10
92	92	departments and their executive staffs and make necessary recommendations to the governor. 11
93	93	(6) Ensure continued progress toward improving the quality, the economy, the 12
94	94	accountability and the efficiency of state-administered health and human services. In this capacity, 13
95	95	the secretary shall: 14
96	96	(i) Direct implementation of reforms in the human resources practices of the executive 15
97	97	office and the departments that streamline and upgrade services, achieve greater economies of scale 16
98	98	and establish the coordinated system of the staff education, cross-training, and career development 17
99	99	services necessary to recruit and retain a highly-skilled, responsive, and engaged health and human 18
100	100	services workforce; 19
101	101	(ii) Encourage EOHHS-wide consumer-centered approaches to service design and delivery 20
102	102	that expand their capacity to respond efficiently and responsibly to the diverse and changing needs 21
103	103	of the people and communities they serve; 22
104	104	(iii) Develop all opportunities to maximize resources by leveraging the state’s purchasing 23
105	105	power, centralizing fiscal service functions related to budget, finance, and procurement, 24
106	106	centralizing communication, policy analysis and planning, and information systems and data 25
107	107	management, pursuing alternative funding sources through grants, awards and partnerships and 26
108	108	securing all available federal financial participation for programs and services provided EOHHS-27
109	109	wide; 28
110	110	(iv) Improve the coordination and efficiency of health and human services legal functions 29
111	111	by centralizing adjudicative and legal services and overseeing their timely and judicious 30
112	112	administration; 31
113	113	(v) Facilitate the rebalancing of the long term system by creating an assessment and 32
114	114	coordination organization or unit for the expressed purpose of developing and implementing 33
115	115	procedures EOHHS-wide that ensure that the appropriate publicly funded health services are 34
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119	119	provided at the right time and in the most appropriate and least restrictive setting; 1
120	120	(vi) Strengthen health and human services program integrity, quality control and 2
121	121	collections, and recovery activities by consolidating functions within the office in a single unit that 3
122	122	ensures all affected parties pay their fair share of the cost of services and are aware of alternative 4
123	123	financing; 5
124	124	(vii) Assure protective services are available to vulnerable elders and adults with 6
125	125	developmental and other disabilities by reorganizing existing services, establishing new services 7
126	126	where gaps exist and centralizing administrative responsibility for oversight of all related initiatives 8
127	127	and programs. 9
128	128	(7) Prepare and integrate comprehensive budgets for the health and human services 10
129	129	departments and any other functions and duties assigned to the office. The budgets shall be 11
130	130	submitted to the state budget office by the secretary, for consideration by the governor, on behalf 12
131	131	of the state’s health and human services agencies in accordance with the provisions set forth in § 13
132	132	35-3-4. 14
133	133	(8) Utilize objective data to evaluate health and human services policy goals, resource use 15
134	134	and outcome evaluation and to perform short and long-term policy planning and development. 16
135	135	(9) Establishment of an integrated approach to interdepartmental information and data 17
136	136	management that complements and furthers the goals of the unified health infrastructure project 18
137	137	initiative and that will facilitate the transition to a consumer-centered integrated system of state 19
138	138	administered health and human services. 20
139	139	(10) At the direction of the governor or the general assembly, conduct independent reviews 21
140	140	of state-administered health and human services programs, policies and related agency actions and 22
141	141	activities and assist the department directors in identifying strategies to address any issues or areas 23
142	142	of concern that may emerge thereof. The department directors shall provide any information and 24
143	143	assistance deemed necessary by the secretary when undertaking such independent reviews. 25
144	144	(11) Provide regular and timely reports to the governor and make recommendations with 26
145	145	respect to the state’s health and human services agenda. 27
146	146	(12) Employ such personnel and contract for such consulting services as may be required 28
147	147	to perform the powers and duties lawfully conferred upon the secretary. 29
148	148	(13) Assume responsibility for complying with the provisions of any general or public law 30
149	149	or regulation related to the disclosure, confidentiality and privacy of any information or records, in 31
150	150	the possession or under the control of the executive office or the departments assigned to the 32
151	151	executive office, that may be developed or acquired or transferred at the direction of the governor 33
152	152	or the secretary for purposes directly connected with the secretary’s duties set forth herein. 34
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156	156	(14) Hold the director of each health and human services department accountable for their 1
157	157	administrative, fiscal and program actions in the conduct of the respective powers and duties of 2
158	158	their agencies. 3
159	159	(15) For all health and human services programs, develop a sliding scale decrease in 4
160	160	benefits as a beneficiary’s income increases up to two hundred fifty percent (250%) of the federal 5
161	161	poverty level. 6
162	162	SECTION 2. This act shall take effect upon passage. 7
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169	169	EXPLANATION
170	170	BY THE LEGISLATIVE COUNCIL
171	171	OF
172	172	A N A C T
173	173	RELATING TO STATE AFFAIRS AND GOVERNMENT -- OFFICE OF HEALTH AND
174	174	HUMAN SERVICES
175	175	***
176	176	This act would authorize the secretary of the executive office of health and human services 1
177	177	(EOHHS) to develop a sliding scale decrease in benefits as a beneficiary’s income increases up to 2
178	178	two hundred fifty percent (250%) of the federal poverty level. 3
179	179	This act would take effect upon passage. 4
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181	181	LC002211
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