Chapter 469
2013 -- H 5155 SUBSTITUTE A
Enacted 07/16/13
A N A C T
RELATING TO
HUMAN SERVICES - FAMILY CAREGIVERS SUPPORT ACT OF 2013
Introduced
By: Representatives Naughton, and
Date Introduced: January 24, 2013
It is enacted by the General Assembly
as follows:
SECTION 1. Section 40-8.10-4 of the General Laws in Chapter
40-8.10 entitled "Long-
Term Care Service Reform
for Medicaid Eligible Individuals" is hereby amended to read as
follows:
40-8.10-4.
Assessment and Coordination Unit (ACU). -- (a) The department of human
services, in collaboration with the executive office of health
and human services, shall implement
a long-term care options counseling program to provide
individuals or their representative, or
both, with long-term care consultations that shall
include, at a minimum, information about long-
term care options, sources and methods of both public and
private payment for long term care
services, information on caregiver support services,
including respite care, and an assessment of
an individual's functional capabilities and
opportunities for maximizing independence. Each
individual admitted to or seeking admission to a long-term care
facility, regardless of the payment
source, shall be informed by the facility of the
availability of the long-term care options
counseling program and shall be provided with a long-term care
options consultation, if he or she
so requests. Each individual who applies for Medicaid
long-term care services shall be provided
with a long-term care consultation.
(b) Core and
preventative home and community based services defined and delineated in
section 40-8.10-2 shall be provided only to those individuals
who meet one of the levels of care
provided for in this chapter. Other long term care services
authorized by the federal government,
such as medication management, may also be provided to
Medicaid eligible recipients who have
established the requisite need as determined by the Assessment
and Coordination Unit (ACU).
Access to institutional and community based supports
and services shall be through the
Assessment and Coordination Unit
(ACU). The provision of
Medicaid-funded long-term care
services and supports shall be based upon a comprehensive
assessment that shall include, but not
be limited to, an evaluation of the medical, social and
environmental needs of each applicant for
these services or programs. The assessment shall serve as
the basis for the development and
provision of an appropriate plan of care for the applicant.
(c) The ACU shall
assess the financial eligibility of beneficiaries to receive long-term
care services and supports in accordance with the
applicable provisions of section 40-8.9-9.
(d) The ACU shall be
responsible for conducting assessments; determining a level of
care for applicants for medical assistance; developing
service plans; pricing a service budget and
developing a voucher when appropriate; making referrals to
appropriate settings; maintaining a
component of the unit that will provide training to and will
educate consumers, discharge
planners and providers; tracking utilization; monitoring
outcomes; and reviewing service/care
plan changes. The ACU shall provide interdisciplinary high
cost case reviews and choice
counseling for eligible recipients.
(e) The assessments for
individuals conducted in accordance with this section shall serve
as the basis for individual budgets for those medical
assistance recipients eligible to receive
services utilizing a self-directed delivery system.
(f) Nothing in this
section shall prohibit the secretary of the executive office of health
and human services, or the directors of that office's
departments from utilizing community
agencies or contractors when appropriate to perform assessment
functions outlined in this
chapter.
SECTION 2. Title 40 of the General Laws entitled "HUMAN
SERVICES" is hereby
amended by adding thereto the following chapter:
CHAPTER
8.11
FAMILY
CAREGIVERS SUPPORT ACT OF 2013
40-8.11-1.
Findings. -- (a) Family members, partners and
close friends provide the vast
majority of long-term services and supports.
(b) An estimated one
hundred and forty-eight thousand (148,000) persons in Rhode
Island are providing care at any one time to persons living in
the community. The estimated value
of their unpaid contributions in 2009 was one billion
eight hundred eighty million dollars
($1,880,000,000).
(c) Family or other
caregivers who provide the majority of care in the home are
frequently under substantial physical, psychological, and
financial stress. The stress, if unrelieved
by support for the caregiver, may lead to premature or
unnecessary nursing home and institutional
placement and health and financial burdens for the caregiver.
(d) Respite care and
other community-based supportive services for the family caregiver
can relive some of the stresses faced by caregivers,
maintain and strengthen the family structure,
postpone or prevent institutionalization and lead to better
outcomes for both the caregiver and
care recipient.
(e) The percent of
Rhode Islanders age sixty-five (65) years of age and older is projected
to grow from fourteen percent (14%) of the state
population in 2010 to twenty-one percent (21%)
by 2030. As persons age, they have greater dependency
needs and an increased need for long-
term care services and support. Younger people with
disabilities also require continued
supportive long-term care services as they age.
(f) As informal
caregivers and families are a vital part of the long-term care services and
support system, it is an important public purpose to
recognize and respect their contributions and
to assess and support their needs.
40-8.11-2.
Definitions. -- (a) "Caregiver
assessment" is defined and refers to a systematic
process of gathering information about a caregiving
situation to identify the specific problems,
needs, strengths, and resources of the family caregiver, as
well as the caregiver's ability to
contribute to the needs of the care recipient.
(b) The term
"family caregiver" is defined and refers to any relative, partner,
friend, or
neighbor who has a significant relationship with, and who
provides a broad range of assistance
for, an older adult or an adult or child with chronic or
disabling conditions.
40-8.11-3.
Caregiver assessment requirement. -- The
comprehensive assessment
required in subsection 40-8.10-4(b) as part of Medicaid
long-term service reform shall also
include a caregiver assessment whenever the plan of care
depends on a family caregiver for
providing assistance with activities of daily living needs. The
assessment shall be used to develop
a plan of care that recognizes both needs of the care
recipient and the caregiver. The assessment
shall also serve as the basis for development and provision
of an appropriate plan for caregiver
information, referral and support services. Information about
available respite programs,
caregiver training and education programs, support groups and
community support services shall
be included as part of the caregiver support plan. To
implement the caregiver assessment, the
executive office of health and human services shall adopt
evidenced-based caregiver assessments
and referral tools appropriate to the departments within
the office that provide long-term care
services and support.
SECTION 3. This act shall take effect upon passage.
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LC00665/SUB A
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