ARTICLE 14 SUBSTITUTE A AS AMENDED

Relating To Medical Assistance -- Long-Term Care Service and Finance Reform

SECTION 1. Sections 40-8.9-3, 40-8.9-4 and 40-8.9-5 of the General Laws in Chapter 40-8.9 entitled "Medical Assistance - Long-Term Care Service and Finance Reform" are hereby amended to read as follows:

40-8.9-3. Least restrictive setting requirement. -- Beginning on July 1, 2006 2007, the department of human services is directed and authorized to recommend the allocate allocation of existing Medicaid resources as needed to ensure that those in need of long-term care and support services receive them in the least restrictive setting appropriate to their needs and preferences. The department is hereby authorized to utilize screening criteria, to avoid unnecessary institutionalization of persons during the full eligibility determination process for Medicaid community based care.

40-8.9-4. Unified long-term care budget. -- Beginning on July 1, 2007, a unified long-term care budget shall combine in a single line-item appropriation within the department of human services budget, annual department of human services Medicaid appropriations for nursing facility and community-based long-term care services for elderly sixty-five (65) and older (including adult day care, home health, and personal care in assisted living settings). Beginning on July 1, 2007, the total system savings attributable to the value of the reduction in nursing home days including hospice care paid for by Medicaid shall be allocated in the budget enacted by the general assembly for the ensuing fiscal year for the express purpose of promoting and strengthening community-based alternatives.

The caseload estimating conference pursuant to section 35-17-1 shall determine the amount of general revenues to be added to the current service estimate of community based long-term care services for elderly sixty-five (65) and older for the ensuing budget year by multiplying the combined cost per day of nursing home and hospice days estimated at the caseload conference for that year by the reduction in nursing home and hospice days from those in the second fiscal year prior to the current fiscal year to those in the first fiscal year prior to the current fiscal year.

40-8.9-5. Administration and regulations. -- As the The single state agency designated to administer the Rhode Island Medicaid program, the department is hereby directed and authorized to develop and submit any requests for waivers, demonstration projects, grants and state plan amendments or regulations that may be considered necessary and appropriate to support the general purposes of this statute. Such requests shall be made in consultation with any affected departments and, to the extent feasible, any consumer group, advisory body, or other entity designated for such purposes.

SECTION 2. This article shall take effect upon passage.