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ARTICLE 10 |
RELATING TO HEALTH AND HUMAN SERVICES
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SECTION 1. Sections 23-14.1-2, 23-14.1-3, 23-14.1-4, 23-14.1-5, 23-14.1-6, 23-14.1-8 |
and 23-14.1-9 of the General Laws in Chapter 23-14.1 entitled "Health Professional Loan |
Repayment Program" are hereby amended to read as follows: |
23-14.1-2. Definitions. |
For the purpose of this chapter, the following words and terms have the following meanings |
unless the context clearly requires otherwise: |
(1) “Board” means the health professional loan repayment board. |
(2) “Commissioner” means the commissioner of postsecondary education. |
(3)(2) “Community health center” means a healthcare facility as defined and licensed under |
chapter 17 of this title. |
(4)(3) “Division” "Department" means the Rhode Island division of higher education |
assistance department of health. |
(5)(4) "Director" means the director of the Rhode Island department of health. |
(5) “Eligible health professional” means a physician, dentist, dental hygienist, nurse |
practitioner, certified nurse midwife, physician assistant, or any other eligible healthcare |
professional under § 338A of the Public Health Service Act, 42 U.S.C. § 254l, licensed in the state |
who has entered into a contract with the board to serve medically underserved populations. |
(6) “Loan repayment” means an amount of money to be repaid to satisfy loan obligations |
incurred to obtain a degree or certification in an eligible health profession as defined in subdivision |
(5). |
23-14.1-3. Health professional loan repayment program established. |
There is established within the division department, to be administered by the |
commissioner director, the health professional loan repayment program whose purpose shall be to |
provide support the recruitment and retention of high-quality health professionals working with |
underserved populations in identified health professional shortage areas (HPSAs) by providing loan |
repayment to eligible health professionals to defray the cost of their professional education. |
23-14.1-4. Health professional loan repayment board. |
(a) There is created the health professional loan repayment board, which shall consist of |
the director of the department of health and eight (8) nine (9) members appointed by the governor |
with the advice and consent of the senate. The governor shall give due consideration to any |
recommendations for nominations submitted to him or herthe governor by the department, the |
Rhode Island Medical Society; the Rhode Island Dental Association; the Rhode Island Health |
Center Association; the dean of the Brown University Medical School; the dean of the College of |
Nursing at the University of Rhode Island; the Rhode Island State Nurses’ Association; the Hospital |
Association of Rhode Island; the Rhode Island division of higher education assistance office of the |
postsecondary commissioner. All appointed members shall serve for terms of three (3) years and |
shall receive no compensation for their services. Board members shall be eligible to succeed |
themselves. |
(b) The director of the department of health shall serve as chairperson. The board shall |
elect such other officers as it deems necessary from among its members. All meetings shall be |
called by the chairperson. |
(c) Members of the board shall be removable by the governor pursuant to the provisions of |
§ 36-1-7 and for cause only, and removal solely for partisan or personal reasons unrelated to |
capacity or fitness for the office shall be unlawful. |
23-14.1-5. Duties of the board. |
The board shall: |
(1) Determine which areas of the state shall be eligible to participate in the loan repayment |
program each year, based on health professional shortage area designations.; |
(2) Receive and consider all applications for loan repayment made by eligible health |
professionals.; |
(3) Conduct a careful and full investigation of the ability, character, financial needs, and |
qualifications of each applicant.; |
(4) Consider the intent of the applicant to practice in a health professional shortage area |
and to adhere to all the requirements for participation in the loan repayment program.; |
(5) Submit to the commissioner director a list of those individuals eligible for loan |
repayment and amount of loan repayment to be granted.; |
(6) Promulgate rules and regulations to ensure an effective implementation and |
administration of the program.; |
(7) Within ninety (90) days after the end of each fiscal year, the board shall approve and |
submit an annual report to the governor, the speaker of the house of representatives, the president |
of the senate, and the secretary of state, of its activities during that fiscal year. The report shall |
provide: an operating statement summarizing meetings or hearings held, including meeting |
minutes, subjects addressed, decisions rendered, applications considered and their disposition, rules |
or regulations promulgated, studies conducted, polices and plans developed, approved, or modified, |
and programs administered or initiated; a consolidated financial statement of all funds received and |
expended including the source of the funds, a listing of any staff supported by these funds, and a |
summary of any clerical, administrative or technical support received; a summary of performance |
during the previous fiscal year including accomplishments, shortcomings and remedies; a synopsis |
of hearings, complaints, suspensions, or other legal matters related to the committee; a summary of |
any training courses held pursuant to this chapter; a briefing on anticipated activities in the |
upcoming fiscal year, and findings and recommendations for improvements. The report shall be |
posted electronically on the websites of the general assembly and the secretary of state pursuant to |
the provisions of § 42-20-8.2. The director of the department of administration shall be responsible |
for the enforcement of the provisions of this subsection.; and |
(8) Conduct a training course for newly appointed and qualified members within six (6) |
months of their qualification or designation. The course shall be developed by the chair of the |
board, be approved by the board, and be conducted by the chair of the board. The board may |
approve the use of any board and/or staff members and/or individuals to assist with training. The |
training course shall include instruction in the following areas: the provisions of chapter 46 of title |
42, chapter 14 of title 36, chapter 2 of title 38; and the board’s rules and regulations. The director |
of the department of administration shall, within ninety (90) days of June 16, 2006, prepare and |
disseminate training materials relating to the provisions of chapter 46 of title 42, chapter 14 of title |
36, chapter 2 of title 38. |
23-14.1-6. Duties of the commissioner Duties of the director. |
The commissioner director shall: |
(1) Grant loan repayments to successful applicants as determined by the board. |
(2) Enter into contracts, on behalf of the division department with each successful |
applicant, reflecting the purpose and intent of this chapter. |
(3) Be authorized to implement legal proceedings against eligible health professionals |
participating in the Rhode Island health professional loan repayment program determined by the |
director to be in default or breach of contract. |
23-14.1-8. Contracts required. |
Prior to being granted loan repayment, each eligible health professional shall enter into a |
contract with the division department agreeing to the terms and conditions upon which the loan |
repayment is granted. The contract shall include any provisions that are required to fulfill the |
purposes of this chapter and those deemed advisable by the commissioner director. |
23-14.1-9. Penalty for failure to complete contract. |
(a) If the recipient of a loan repayment fails, without justifiable cause, to practice pursuant |
to the terms and conditions of his or her contract with the division, a penalty for the failure to |
complete the contract will be imposed. If the recipient fails to complete the period of obligated |
service, he or she shall be liable to the state of Rhode Island for If the eligible health professional |
fails to begin or fails to complete service, they will incur a debt to the Statestate in an amount not |
less than the damages that would be owed under the National Health Service Corps Loan |
Repayment Program default provisions pursuant to 42 U.S.C. 6(A), Subchapter II, Part D, Subpart |
iii, § 254o. Upon determination by the director, if that the eligible health professional has failed to |
fulfill the terms and conditions of the contract, and no exception has been determined under |
subsection (c), the eligible health professional shall pay an amount equal to the sum of the |
following: |
(1) An amount equal to the total paid on behalf of the recipient The total of the amounts |
paid by the director on behalf of the eligible health professional for any period of obligated service |
not served; and |
(2) An unserved obligation penalty equal to the number of months of obligated service not |
completed by the recipient multiplied by one thousand dollars ($1,000) An amount equal to the |
number of months of obligated service not served, multiplied by seven thousand five hundred |
dollars ($7,500); and |
(3) Interest on the above amounts at the maximum legal prevailing rate, as determined by |
the Treasurer of the United States, from the date of breach; except that the amount to recover will |
not be less than thirty one thousand dollars ($31,000). |
(b) If the recipient fails to complete one year of service, he or she shall be liable to the state |
of Rhode Island for: |
(1) An amount equal to the total paid on behalf of the recipient; and |
(2) An unserved obligation penalty equal to the number of months in the full period |
multiplied by one thousand dollars ($1,000). All payments pursuant to § 23-14.1-9 (a)(1), (a)(2), |
and (a)(3) hereof shall be made to the Statestate of Rhode Island, for the benefit of the Rhode Island |
health professional loan repayment program, within one year after being notified by the director in |
writing that the eligible health professional has failed to abide by the terms and conditions of their |
contract. The director is authorized to recover payments and/or penalties and return the funds to the |
Rhode Island health professional loan repayment program to avoid having the amounts deducted |
from the department’s federal grant by the federal grant funding authority. Eligible health |
professionals are considered to be in default or breach if they do not complete the period of |
obligated service at an eligible site in accordance with their contract, or otherwise fail to comply |
with the terms of their contract, even if no monies have yet been disbursed to or on behalf of the |
participant. |
(c) Any amount owed shall be paid to the state of Rhode Island within one year of the date |
that the recipient is in breach of contract. |
(d)(c) Where the commissioner director, subject to the approval of the board and/or as |
defined in regulation, determines that there exists justifiable cause for the failure of a recipient to |
practice pursuant to the terms and conditions of the contract, he or shethe director may relieve the |
recipient of the obligation to fulfill any or all of the terms of the contract. |
SECTION 2. Sections 23-17.5-32, 23-17.5-33 and 23-17.5-34 of the General Laws in |
Chapter 23-17.5 entitled "Rights of Nursing Home Patients" are hereby amended to read as follows: |
23-17.5-32. Minimum staffing levels. |
(a) Each facility shall have the necessary nursing service personnel (licensed and non- |
licensed) in sufficient numbers on a twenty-four (24) hour basis, to assess the needs of residents, |
to develop and implement resident care plans, to provide direct resident care services, and to |
perform other related activities to maintain the health, safety, and welfare of residents. The facility |
shall have a registered nurse on the premises twenty-four (24) hours a day. |
(b) For purposes of this section, the following definitions shall apply: |
(1) “Direct caregiver” means a person who receives monetary compensation as an |
employee of the nursing facility or a subcontractor as a registered nurse, a licensed practical nurse, |
a medication technician, a certified nurse assistant, a licensed physical therapist, a licensed |
occupational therapist, a licensed speech-language pathologist, a mental health worker who is also |
a certified nurse assistant, or a physical therapist assistant, social worker, or any nurse aide with a |
valid license, even if it is probationary. |
(2) “Hours of direct nursing care” means the actual hours of work performed per patient |
day by a direct caregiver. |
(c)(i) Commencing on January 1, 2022 2026, nursing facilities shall provide a quarterly |
minimum average of three and fifty-eight hundredths (3.58) hours of direct nursing care per |
resident, per day, of which at least two and forty-four hundredths (2.44) hours shall be provided by |
certified nurse assistants. |
(ii) Commencing on January 1, 2023, nursing facilities shall provide a quarterly minimum |
of three and eighty-one hundredths (3.81) hours of direct nursing care per resident, per day, of |
which at least two and six-tenths (2.6) hours shall be provided by certified nurse assistants. |
(d) Director of nursing hours and nursing staff hours spent on administrative duties or non- |
direct caregiving tasks are excluded and may not be counted toward compliance with the minimum |
staffing hours requirement in this section. |
(e) The minimum hours of direct nursing care requirements shall be minimum standards |
only. Nursing facilities shall employ and schedule additional staff as needed to ensure quality |
resident care based on the needs of individual residents and to ensure compliance with all relevant |
state and federal staffing requirements. |
(f) The department shall promulgate rules and regulations to amend the Rhode Island code |
of regulations in consultation with stakeholders to implement these minimum staffing requirements |
on or before October 15, 2021. |
(g) On or before January 1, 2024, and every five (5) years thereafter, the department shall |
consult with consumers, consumer advocates, recognized collective bargaining agents, and |
providers to determine the sufficiency of the staffing standards provided in this section and may |
promulgate rules and regulations to increase the minimum staffing ratios to adequate levels. |
23-17.5-33. Minimum staffing level compliance and enforcement program. |
(a) Compliance determination. |
(1) The department shall submit proposed rules and regulations for adoption by October |
15, 2021, establishing a system for determining compliance with minimum staffing requirements |
set forth in § 23-17.5-32. |
(2) Compliance shall be determined quarterly by comparing the number of hours provided |
per resident, per day using the Centers for Medicare and Medicaid Services’ payroll-based journal |
and the facility’s daily census, as self-reported by the facility to the department on a quarterly basis. |
(3) The department shall use the quarterly payroll-based journal and the self-reported |
census to calculate the number of hours provided per resident, per day and compare this ratio to the |
minimum staffing standards required under § 23-17.5-32. Discrepancies between job titles |
contained in § 23-17.5-32 and the payroll-based journal shall be addressed by rules and regulations. |
(b) Monetary penalties. |
(1) The department shall submit proposed rules and regulations for adoption on or before |
October 15, 2021, implementing monetary penalty provisions for facilities not in compliance with |
minimum staffing requirements set forth in § 23-17.5-32. |
(2) Monetary penalties shall be imposed quarterly and shall be based on the latest quarter |
for which the department has data. |
(3) No monetary penalty may be issued for noncompliance with the increase in the standard |
set forth in § 23-17.5-32(c)(ii) from January 1, 2023, to March 31, 2023. If a facility is found to be |
noncompliant with the increase in the standard during the period that extends from January 1, 2023, |
to March 31, 2023, the department shall provide a written notice identifying the staffing |
deficiencies and require the facility to provide a sufficiently detailed correction plan to meet the |
statutory minimum staffing levels. |
(4) Monetary penalties shall be established based on a formula that calculates on a daily |
basis the cost of wages and benefits for the missing staffing hours. |
(5) All notices of noncompliance shall include the computations used to determine |
noncompliance and establishing the variance between minimum staffing ratios and the |
department’s computations. |
(6) The penalty for the first offense shall be two hundred percent (200%) of the cost of |
wages and benefits for the missing staffing hours. The penalty shall increase to two hundred fifty |
percent (250%) of the cost of wages and benefits for the missing staffing hours for the second |
offense and three hundred percent (300%) of the cost of wages and benefits for the missing staffing |
hours for the third and all subsequent offenses. |
(7) For facilities that have an offense in three (3) consecutive quarters, EOHHS shall deny |
any further Medicaid Assistance payments with respect to all individuals entitled to benefits who |
are admitted to the facility on or after January 1, 2022, or shall freeze admissions of new residents. |
(c)(1) The penalty shall be imposed regardless of whether the facility has committed other |
violations of this chapter during the same period that the staffing offense occurred. |
(2) The penalty may not be waived except as provided in subsection (c)(3) of this section, |
but the department shall have the discretion to determine the gravity of the violation in situations |
where there is no more than a ten percent (10%) deviation from the staffing requirements and make |
appropriate adjustments to the penalty. |
(3) The department is granted discretion to waive the penalty when unforeseen |
circumstances have occurred that resulted in call-offs of scheduled staff. This provision shall be |
applied no more than two (2) times per calendar year. |
(4) Nothing in this section diminishes a facility’s right to appeal pursuant to the provisions |
of chapter 35 of title 42 (“administrative procedures”). |
(d)(1) Pursuant to rules and regulations established by the department, funds that are |
received from financial penalties shall be used for technical assistance or specialized direct care |
staff training. |
(2) The assessment of a penalty does not supplant the state’s investigation process or |
issuance of deficiencies or citations under this title. |
(3) A notice of noncompliance, whether or not the penalty is waived, and the penalty |
assessment shall be prominently posted in the nursing facility and included on the department’s |
website. |
(a) Retroactive application: |
(1) All fines or penalties incurred prior to January 1, 2026, are hereby forgiven, and any |
enforcement actions, including fines and penalties, shall commence only for violations occurring |
on or after January 1, 2026. |
(b) Compliance determination: |
(1) Compliance shall be determined quarterly by comparing staffing data from the Centers |
for Medicare and Medicaid Services’ (CMS) payroll-based journal and the facility’s daily census, |
as self-reported to the department. |
(2) Discrepancies between job titles and payroll-based journal entries shall be addressed |
by departmental regulations. |
(c) Staffing level compliance payment adjustments: |
(1) Facilities failing to meet minimum staffing requirements shall face a fine in the |
following quarter valued at three percent (3%) of the total of Medicaid reimbursements, calculated |
based on the most recent financial period. |
(d) Corrective action plan: |
(1) Facilities found non-compliant will receive a thirty-(30)day (30) corrective notice. |
(2) If compliance is not achieved within thirty (30) days, payment reductions shall be |
enforced. |
(e) Waiver provision: |
(1) The department shall waive fines for facilities that demonstrate high quality care. To |
qualify for a waiver, a facility must meet at least one of the following criteria: |
(i) Substantial compliance: During the last three (3) consecutive survey cycles, the facility |
received no substandard quality of care/immediate jeopardy deficiencies and was not placed under |
compliance orders, temporary management, or quality monitoring; or |
(ii) Acuity criterion: A facility is considered to serve a lower-acuity resident population if |
its Nursing Case-Mix Index ranks in the lowest twenty-five percent (25%) of all Medicaid- |
participating nursing homes. The lowest twenty-five percent (25%) is determined by multiplying |
the current total number of Medicaid-participating nursing homes by twenty-five hundredths (0.25) |
and rounding up to the nearest whole number; or |
(iii) If the facility achieved compliance for at least seventy-five percent (75%) of operating |
days in the quarter. |
(f) Recovered funds: |
(1) Funds recovered through payment adjustments shall be allocated to: |
(i) Workforce development programs aimed at enhancing the recruitment, training, and |
retention of direct care staff.; and |
(ii) Compliance assistance programs designed to provide technical support to |
underperforming facilities. |
(g) Implementation and oversight: |
(1) The department shall issue regulations to implement these provisions, with a transition |
period of six (6) months provided to allow facilities to meet the new requirements. |
(2) The department shall provide public reports on facility compliance, staffing levels, and |
payment adjustments on a quarterly basis. |
(3) Nursing home facilities shall provide a list of all licensed staff, including name, license, |
and home addresses, to the department upon renewal of the nursing home operator license or when |
there is a change in effective control of the nursing home facility. Failure to provide the required |
list within thirty (30) days of the renewal or change in effective control shall result in a direct |
monetary fine of up to one thousand dollars ($1,000) per day. |
(h) Audit requirements |
(1) EOHHS shall conduct a financial and billing audit of any Medicaid‐participating |
nursing home that, for four (4) consecutive quarters, has both: |
(i) Failed to meet the state safe-staffing standard; and |
(ii) Not qualified for a waiver under § 23-17.5-33(e).; and |
(2) EOHHS shall initiate such audit within twelve (12) months following the end of the |
fourth consecutive quarter of non-compliance. |
(i) Public reporting. |
(1) Within thirty (30) days after completing any audit under subsection (f)(1), EOHHS |
shall publish on its website a report that includes, for each audited facility: |
(i) The quarter(s) audited; |
(ii) Key audit findings and any identified overpayments; and |
(iii) Amounts recovered and corrective actions taken. |
23-17.5-34. Nursing staff posting requirements. |
(a) Each nursing facility shall post its daily direct care nurse staff levels by shift in a public |
place within the nursing facility that is readily accessible to and visible by residents, employees, |
and visitors. The posting shall be accurate to the actual number of direct care nursing staff on duty |
for each shift per day. The posting shall be in a format prescribed by the director, to include: |
(1) The number of registered nurses, licensed practical nurses, certified nursing assistants, |
medication technicians, licensed physical therapists, licensed occupational therapists, licensed |
speech-language pathologists, mental health workers who are also certified nurse assistants, and |
physical therapist assistants, social workers, or any nurse aide with a valid license, even if it is |
probationary; |
(2) The number of temporary, outside agency nursing staff; |
(3) The resident census as of twelve o’clock (12:00) a.m.; and |
(4) Documentation of the use of unpaid eating assistants (if utilized by the nursing facility |
on that date). |
(b) The posting information shall be maintained on file by the nursing facility for no less |
than three (3) years and shall be made available to the public upon request. |
(c) Each nursing facility shall report the information compiled pursuant to section (a) of |
this section and in accordance with department of health regulations to the department of health on |
a quarterly basis in an electronic format prescribed by the director. The director shall make this |
information available to the public on a quarterly basis on the department of health website, |
accompanied by a written explanation to assist members of the public in interpreting the |
information reported pursuant to this section. |
(d) In addition to the daily direct nurse staffing level reports, each nursing facility shall |
post the following information in a legible format and in a conspicuous place readily accessible to |
and visible by residents, employees, and visitors of the nursing facility: |
(1) The minimum number of nursing facility direct care staff per shift that is required to |
comply with the minimum staffing level requirements in § 23-17.5-32; and |
(2) The telephone number or internet website that a resident, employee, or visitor of the |
nursing facility may use to report a suspected violation by the nursing facility of a regulatory |
requirement concerning staffing levels and direct patient care. |
(e) No nursing facility shall discharge or in any manner discriminate or retaliate against |
any resident of any nursing facility, or any relative, guardian, conservator, or sponsoring agency |
thereof or against any employee of any nursing facility or against any other person because the |
resident, relative, guardian, conservator, sponsoring agency, employee, or other person has filed |
any complaint or instituted or caused to be instituted any proceeding under this chapter, or has |
testified or is about to testify in any such proceeding or because of the exercise by the resident, |
relative, guardian, conservator, sponsoring agency, employee, or other person on behalf of himself, |
herselfthemself, or others of any right afforded by §§ 23-17.5-32, 23-17.5-33, and 23-17.5-34. |
Notwithstanding any other provision of law to the contrary, any nursing facility that violates any |
provision of this section shall: |
(1) Be liable to the injured party for treble damages; and |
(2)(i) Reinstate the employee, if the employee was terminated from employment in |
violation of any provision of this section; or |
(ii) Restore the resident to the resident’s living situation prior to such discrimination or |
retaliation, including the resident’s housing arrangement or other living conditions within the |
nursing facility, as appropriate, if the resident’s living situation was changed in violation of any |
provision of this section. For purposes of this section, “discriminate or retaliate” includes, but is |
not limited to, the discharge, demotion, suspension, or any other detrimental change in terms or |
conditions of employment or residency, or the threat of any such action. |
(f)(1) The nursing facility shall prepare an annual report showing the average daily direct |
care nurse staffing level for the nursing facility by shift and by category of nurse to include: |
(i) Registered nurses; |
(ii) Licensed practical nurses; |
(iii) Certified nursing assistants; |
(iv) Medication technicians; |
(v) Licensed physical therapists; |
(vi) Licensed occupational therapists; |
(vii) Licensed speech-language pathologists; |
(viii) Mental health workers who are also certified nurse assistants; |
(ix) Physical therapist assistants; |
(x) Social workers; or |
(xi) Any nurse aide with a valid license, even if it is probationary. |
(x)(xii) The use of registered and licensed practical nurses and certified nursing assistant |
staff from temporary placement agencies; and |
(xi)(xiii) The nurse and certified nurse assistant turnover rates. |
(2) The annual report shall be submitted with the nursing facility’s renewal application and |
provide data for the previous twelve (12) months and ending on or after September 30, for the year |
preceding the license renewal year. Annual reports shall be submitted in a format prescribed by the |
director. |
(g) The information on nurse staffing shall be reviewed as part of the nursing facility’s |
annual licensing survey and shall be available to the public, both in printed form and on the |
department’s website, by nursing facility. |
(h) The director of nurses may act as a charge nurse only when the nursing facility is |
licensed for thirty (30) beds or less. |
(i) Whenever the licensing agency determines, in the course of inspecting a nursing facility, |
that additional staffing is necessary on any residential area to provide adequate nursing care and |
treatment or to ensure the safety of residents, the licensing agency may require the nursing facility |
to provide such additional staffing and any or all of the following actions shall be taken to enforce |
compliance with the determination of the licensing agency: |
(1) The nursing facility shall be cited for a deficiency and shall be required to augment its |
staff within ten (10) days in accordance with the determination of the licensing agency; |
(2) If failure to augment staffing is cited, the nursing facility shall be required to curtail |
admission to the nursing facility; |
(3) If a continued failure to augment staffing is cited, the nursing facility shall be subjected |
to an immediate compliance order to increase the staffing, in accordance with § 23-1-21; or |
(4) The sequence and inclusion or non-inclusion of the specific sanctions may be modified |
in accordance with the severity of the deficiency in terms of its impact on the quality of resident |
care. |
(j) No nursing staff of any nursing facility shall be regularly scheduled for double shifts. |
(k) A nursing facility that fails to comply with the provisions of this chapter, or any rules |
or regulations adopted pursuant thereto, shall be subject to a penalty as determined by the |
department. |
SECTION 3. Section 30-25-14 of the General Laws in Chapter 30-25 entitled "Burial of |
Veterans" is hereby amended to read as follows: |
30-25-14. Rhode Island veterans’ memorial cemetery. |
(a) The Rhode Island veterans’ memorial cemetery, located on the grounds of the Joseph |
H. Ladd school in the town of Exeter, shall be under the management and control of the director of |
the department of human services. The director of the department of human services shall appoint |
an administrator for the Rhode Island veterans’ memorial cemetery who shall be an honorably |
discharged veteran of the United States Armed Forces and shall have the general supervision over, |
and shall prescribe rules for, the government and management of the cemetery. The administrator |
shall make all needful rules and regulations governing the operation of the cemetery and generally |
may do all things necessary to ensure the successful operation thereof. The director shall |
promulgate rules and regulations, not inconsistent with the provisions of 38 U.S.C. § 2402, to |
govern the eligibility for burial in the Rhode Island veterans’ memorial cemetery. In addition to all |
persons eligible for burial pursuant to rules and regulations established by the director, any person |
who served in the armyArmy, navyNavy, airAir forceForce, or marineMarine corpsCorps of the |
United States for a period of not less than two (2) years and whose service was terminated |
honorably, shall be eligible for burial in the Rhode Island veterans’ memorial cemetery. The |
director shall appoint and employ all subordinate officials and persons needed for the proper |
management of the cemetery. National guardGuard members who are killed in the line of duty or |
who are honorably discharged after completion of at least six (6) years of service in the Rhode |
Island nationalNational guardGuard and/or reserveReserve and their spouse shall be eligible for |
interment in the Rhode Island veterans’ memorial cemetery. National guardGuard members and/or |
reservistsReservists who are honorably discharged after completion of at least six (6) years of |
service with another state, and who are a Rhode Island resident for at least two (2) consecutive |
years immediately prior to death, shall be eligible, along with their spouse, for interment in the |
Rhode Island veterans’ memorial cemetery. For the purpose of computing service under this |
section, honorable service in the active forces or reserves shall be considered toward the six (6) |
years of nationalNational guardGuard service. The general assembly shall make an annual |
appropriation to the department of human services to provide for the operation and maintenance |
for the cemetery. The director shall may charge and collect a grave liner fee per interment of the |
eligible spouse and/or eligible dependents of the qualified veteran, nationalNational guardGuard |
member, and/or reservistReservist equal to the department’s cost for the grave liner. The director |
may promulgate rules and regulations necessary to fulfill the intent of this chapter. |
(b) No domestic animal shall be allowed on the grounds of the Rhode Island veterans’ |
memorial cemetery, whether at large or under restraint, except for seeing eye guide dogs, hearing |
ear signal dogs or any other service animal, as required by federal law or any personal assistance |
animal, as required by chapter 9.1 of title 40. Any person who violates the provisions of this section |
shall be subject to a fine of not less than five hundred dollars ($500). |
(c) The state of Rhode Island office of veterans services shall bear the cost of all tolls |
incurred by any motor vehicles that are part of a veteran’s funeral procession, originating from |
Aquidneck Island ending at the veterans’ memorial cemetery, for burial or internment. The |
executive director of the turnpike and bridge authority shall assist in the administration and |
coordination of this toll reimbursement program. |
SECTION 4. Section 40-5.2-20 of the General Laws in Chapter 40-5.2 entitled "The Rhode |
Island Works Program" is hereby amended to read as follows: |
40-5.2-20. Childcare assistance — Families or assistance units eligible. [Effective |
January 1, 2025.] |
(a) The department shall provide appropriate child care to every participant who is eligible |
for cash assistance and who requires child care in order to meet the work requirements in |
accordance with this chapter. |
(b) Low-income child care. The department shall provide child care to all other working |
families with incomes at or below two hundred sixty-one percent (261%) of the federal poverty |
level if, and to the extent, these other families require child care in order to work at paid |
employment as defined in the department’s rules and regulations. The department shall also provide |
child care to families with incomes below two hundred sixty-one percent (261%) of the federal |
poverty level if, and to the extent, these families require child care to participate on a short-term |
basis, as defined in the department’s rules and regulations, in training, apprenticeship, internship, |
on-the-job training, work experience, work immersion, or other job-readiness/job-attachment |
program sponsored or funded by the human resource investment council (governor’s workforce |
board) or state agencies that are part of the coordinated program system pursuant to § 42-102-11. |
Effective from January 1, 2021, through June 30, 2022, the department shall also provide childcare |
assistance to families with incomes below one hundred eighty percent (180%) of the federal poverty |
level when such assistance is necessary for a member of these families to enroll or maintain |
enrollment in a Rhode Island public institution of higher education provided that eligibility to |
receive funding is capped when expenditures reach $200,000 for this provision. Effective July 1, |
2022 through December 31, 2024, the department shall also provide childcare assistance to families |
with incomes below two hundred percent (200%) of the federal poverty level when such assistance |
is necessary for a member of these families to enroll or maintain enrollment in a Rhode Island |
public institution of higher education. Effective January 1, 2025, the department shall also provide |
childcare assistance to families with incomes below two hundred sixty-one percent (261%) of the |
federal poverty level when such assistance is necessary for a member of these families to enroll or |
maintain enrollment in a Rhode Island public institution of higher education. |
(c) No family/assistance unit shall be eligible for childcare assistance under this chapter if |
the combined value of its liquid resources exceeds one million dollars ($1,000,000), which |
corresponds to the amount permitted by the federal government under the state plan and set forth |
in the administrative rulemaking process by the department. Liquid resources are defined as any |
interest(s) in property in the form of cash or other financial instruments or accounts that are readily |
convertible to cash or cash equivalents. These include, but are not limited to: cash, bank, credit |
union, or other financial institution savings, checking, and money market accounts; certificates of |
deposit or other time deposits; stocks; bonds; mutual funds; and other similar financial instruments |
or accounts. These do not include educational savings accounts, plans, or programs; retirement |
accounts, plans, or programs; or accounts held jointly with another adult, not including a spouse. |
The department is authorized to promulgate rules and regulations to determine the ownership and |
source of the funds in the joint account. |
(d) As a condition of eligibility for childcare assistance under this chapter, the parent or |
caretaker relative of the family must consent to, and must cooperate with, the department in |
establishing paternity, and in establishing and/or enforcing child support and medical support |
orders for any children in the family receiving appropriate child care under this section in |
accordance with the applicable sections of title 15, as amended, unless the parent or caretaker |
relative is found to have good cause for refusing to comply with the requirements of this subsection. |
(e) For purposes of this section, “appropriate child care” means child care, including infant, |
toddler, preschool, nursery school, and school-age, that is provided by a person or organization |
qualified, approved, and authorized to provide the care by the state agency or agencies designated |
to make the determinations in accordance with the provisions set forth herein. |
(f)(1) Families with incomes below one hundred percent (100%) of the applicable federal |
poverty level guidelines shall be provided with free child care. Families with incomes greater than |
one hundred percent (100%) and less than two hundred percent (200%) of the applicable federal |
poverty guideline shall be required to pay for some portion of the child care they receive, according |
to a sliding-fee scale adopted by the department in the department’s rules, not to exceed seven |
percent (7%) of income as defined in subsection (h) of this section. |
(2) Families who are receiving childcare assistance and who become ineligible for |
childcare assistance as a result of their incomes exceeding two hundred sixty-one percent (261%) |
of the applicable federal poverty guidelines shall continue to be eligible for childcare assistance |
until their incomes exceed three hundred percent (300%) of the applicable federal poverty |
guidelines. To be eligible, the families must continue to pay for some portion of the child care they |
receive, as indicated in a sliding-fee scale adopted in the department’s rules, not to exceed seven |
percent (7%) of income as defined in subsection (h) of this section, and in accordance with all other |
eligibility standards. |
(g) In determining the type of child care to be provided to a family, the department shall |
take into account the cost of available childcare options; the suitability of the type of care available |
for the child; and the parent’s preference as to the type of child care. |
(h) For purposes of this section, “income” for families receiving cash assistance under § |
40-5.2-11 means gross, earned income and unearned income, subject to the income exclusions in |
§§ 40-5.2-10(g)(2) and 40-5.2-10(g)(3), and income for other families shall mean gross, earned and |
unearned income as determined by departmental regulations. |
(i) The caseload estimating conference established by chapter 17 of title 35 shall forecast |
the expenditures for child care in accordance with the provisions of § 35-17-1. |
(j) In determining eligibility for childcare assistance for children of members of reserve |
components called to active duty during a time of conflict, the department shall freeze the family |
composition and the family income of the reserve component member as it was in the month prior |
to the month of leaving for active duty. This shall continue until the individual is officially |
discharged from active duty. |
(k) Effective from August 1, 2023, through July 31, 2025 2028, the department shall |
provide funding for child care for eligible childcare educators, and childcare staff, who work at |
least twenty (20) hours a week in licensed childcare centers and licensed family childcare homes |
as defined in the department’s rules and regulations. Eligibility is limited to qualifying childcare |
educators and childcare staff with family incomes up to three hundred percent (300%) of the |
applicable federal poverty guidelines and will have no copayments. Qualifying participants may |
select the childcare center or family childcare home for their children. The department shall |
promulgate regulations necessary to implement this section, and will collect applicant and |
participant data to report estimated demand for state-funded child care for eligible childcare |
educators and childcare staff. The report shall be due annually to the governor and the general |
assembly by November 1, 2024. |
SECTION 5. Section 40-6-8 of the General Laws in Chapter 40-6 entitled "Public |
Assistance Act" is hereby amended to read as follows: |
40-6-8. Supplemental nutrition assistance program (SNAP). |
(a) The department shall have the responsibility to administer the food stamp program for |
the state in compliance with the provisions of the federal Food Stamp Act of 1964, as amended, 7 |
U.S.C. § 2011 et seq. The supplemental nutrition assistance program (SNAP) is and shall be the |
new title of the program formerly known as the food stamp program. All references in the Rhode |
Island general laws to food stamps shall be deemed to mean, apply to, refer to, and be interpreted |
in accordance with the supplemental nutrition assistance program (SNAP). |
(b) The department is empowered and authorized to submit its plan for food stamps to the |
federal government, or any agency or department of it, as follows: |
(1) The department shall act for the state in any negotiations relative to the submission and |
approval of a plan, and may make any arrangement or changes in its plan not inconsistent with this |
chapter that may be required by the Food Stamp Act or the rules and regulations promulgated |
pursuant to it to obtain and retain such approval and to secure for this state the benefits of the |
provisions of the federal act relating to food stamps; |
(2) The department shall make reports to the federal government, or any agency or |
department of it, in the form and nature required by it, and in all respects comply with any request |
or direction of the federal government, or any agency or department of it, that may be necessary to |
assure the correctness and verification of the reports; and |
(3) The department shall develop a plan to streamline the application, certification, and |
recertification process for SNAP beneficiaries aged sixty (60) years and over. |
(c) The department is authorized and directed to pay one hundred percent (100%) of the |
state’s share of the administrative cost involved in the operation of the food stamp program. |
(d) No person shall be ineligible for food stamp benefits due solely to the restricted |
eligibility rules otherwise imposed by § 115(a)(2) of the Personal Responsibility and Work |
Opportunity Reconciliation Act of 1996 (Pub. L. No. 104-193), 21 U.S.C. § 862a(a)(2), and as this |
section may hereafter be amended. |
(e) To support a fiscally responsible and high-integrity Supplemental Nutritional |
Assistance Program (SNAP), the Rhode Island department of human services (DHS), in |
consultation with the department of administration, shall submit a plan with initial |
recommendations to reduce the state's SNAP Payment Error Rate (PER) to below six percent (6%), |
due on or before October 1, 2025, as part of the department's annual budget submission. |
Starting January 18, 2026, DHS shall report monthly on implementation progress and |
performance metrics as part of its existing legislative reporting framework. These updates shall be |
incorporated into DHS's monthly House Oversight RIBridges Report to ensure transparency, |
minimize administrative burden, and align progress tracking with the state's fiscal and policy |
planning cycles. Updates will include: timeliness and accuracy indicators; status of technology |
modernization efforts; staff training and readiness metrics; and the status of customer service |
enhancements and any correspondence with the federal government related to Supplemental |
Nutrition Assistance Program payment error rates and/or penalties. |
SECTION 6. Section 40-6.2-1.1 of the General Laws in Chapter 40-6.2 entitled "Child |
Care — State Subsidies" is hereby amended to read as follows: |
40-6.2-1.1. Rates established. |
(a) Through June 30, 2015, subject to the payment limitations in subsection (c), the |
maximum reimbursement rates to be paid by the departments of human services and children, youth |
and families for licensed childcare centers and licensed family childcare providers shall be based |
on the following schedule of the 75th percentile of the 2002 weekly market rates adjusted for the |
average of the 75th percentile of the 2002 and the 2004 weekly market rates: |
Licensed Childcare Centers 75th Percentile of Weekly Market Rate |
Infant $182.00 |
Preschool $150.00 |
School-Age $135.00 |
Licensed Family Childcare Providers 75th Percentile of Weekly Market Rate |
Infant $150.00 |
Preschool $150.00 |
School-Age $135.00 |
Effective July 1, 2015, subject to the payment limitations in subsection (c), the maximum |
reimbursement rates to be paid by the departments of human services and children, youth and |
families for licensed childcare centers and licensed family childcare providers shall be based on the |
above schedule of the 75th percentile of the 2002 weekly market rates adjusted for the average of |
the 75th percentile of the 2002 and the 2004 weekly market rates. These rates shall be increased by |
ten dollars ($10.00) per week for infant/toddler care provided by licensed family childcare |
providers and license-exempt providers and then the rates for all providers for all age groups shall |
be increased by three percent (3%). For the fiscal year ending June 30, 2018, licensed childcare |
centers shall be reimbursed a maximum weekly rate of one hundred ninety-three dollars and sixty- |
four cents ($193.64) for infant/toddler care and one hundred sixty-one dollars and seventy-one |
cents ($161.71) for preschool-age children. |
(b) Effective July l, 2018, subject to the payment limitations in subsection (c), the |
maximum infant/toddler and preschool-age reimbursement rates to be paid by the departments of |
human services and children, youth and families for licensed childcare centers shall be |
implemented in a tiered manner, reflective of the quality rating the provider has achieved within |
the state’s quality rating system outlined in § 42-12-23.1. |
(1) For infant/toddler child care, tier one shall be reimbursed two and one-half percent |
(2.5%) above the FY 2018 weekly amount, tier two shall be reimbursed five percent (5%) above |
the FY 2018 weekly amount, tier three shall be reimbursed thirteen percent (13%) above the FY |
2018 weekly amount, tier four shall be reimbursed twenty percent (20%) above the FY 2018 weekly |
amount, and tier five shall be reimbursed thirty-three percent (33%) above the FY 2018 weekly |
amount. |
(2) For preschool reimbursement rates, tier one shall be reimbursed two and one-half |
percent (2.5%) above the FY 2018 weekly amount, tier two shall be reimbursed five percent (5%) |
above the FY 2018 weekly amount, tier three shall be reimbursed ten percent (10%) above the FY |
2018 weekly amount, tier four shall be reimbursed thirteen percent (13%) above the FY 2018 |
weekly amount, and tier five shall be reimbursed twenty-one percent (21%) above the FY 2018 |
weekly amount. |
(c) [Deleted by P.L. 2019, ch. 88, art. 13, § 4.] |
(d) By June 30, 2004, and biennially through June 30, 2014, the department of labor and |
training shall conduct an independent survey or certify an independent survey of the then-current |
weekly market rates for child care in Rhode Island and shall forward the weekly market rate survey |
to the department of human services. The next survey shall be conducted by June 30, 2016, and |
triennially thereafter. The departments of human services and labor and training will jointly |
determine the survey criteria including, but not limited to, rate categories and sub-categories. |
(e) In order to expand the accessibility and availability of quality child care, the department |
of human services is authorized to establish, by regulation, alternative or incentive rates of |
reimbursement for quality enhancements, innovative or specialized child care, and alternative |
methodologies of childcare delivery, including nontraditional delivery systems and collaborations. |
(f) Effective January 1, 2007, all childcare providers have the option to be paid every two |
(2) weeks and have the option of automatic direct deposit and/or electronic funds transfer of |
reimbursement payments. |
(g) Effective July 1, 2019, the maximum infant/toddler reimbursement rates to be paid by |
the departments of human services and children, youth and families for licensed family childcare |
providers shall be implemented in a tiered manner, reflective of the quality rating the provider has |
achieved within the state’s quality rating system outlined in § 42-12-23.1. Tier one shall be |
reimbursed two percent (2%) above the prevailing base rate for step 1 and step 2 providers, three |
percent (3%) above prevailing base rate for step 3 providers, and four percent (4%) above the |
prevailing base rate for step 4 providers; tier two shall be reimbursed five percent (5%) above the |
prevailing base rate; tier three shall be reimbursed eleven percent (11%) above the prevailing base |
rate; tier four shall be reimbursed fourteen percent (14%) above the prevailing base rate; and tier |
five shall be reimbursed twenty-three percent (23%) above the prevailing base rate. |
(h) Through December 31, 2021, the maximum reimbursement rates paid by the |
departments of human services, and children, youth and families to licensed childcare centers shall |
be consistent with the enhanced emergency rates provided as of June 1, 2021, as follows: |
Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 |
Infant/Toddler $257.54 $257.54 $257.54 $257.54 $273.00 |
Preschool Age $195.67 $195.67 $195.67 $195.67 $260.00 |
School Age $200.00 $200.00 $200.00 $200.00 $245.00 |
The maximum reimbursement rates paid by the departments of human services, and |
children, youth and families to licensed family childcare providers shall be consistent with the |
enhanced emergency rates provided as of June 1, 2021, as follows: |
Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 |
Infant/Toddler $224.43 $224.43 $224.43 $224.43 $224.43 |
Preschool Age $171.45 $171.45 $171.45 $171.45 $171.45 |
School Age $162.30 $162.30 $162.30 $162.30 $162.30 |
(i) Effective January 1, 2022, the maximum reimbursement rates to be paid by the |
departments of human services and children, youth and families for licensed childcare centers shall |
be implemented in a tiered manner, reflective of the quality rating the provider has achieved within |
the state’s quality rating system outlined in § 42-12-23.1. Maximum weekly rates shall be |
reimbursed as follows: |
Licensed Childcare Centers |
Tier One Tier Two Tier Three Tier Four Tier Five |
Infant/Toddler $236.36 $244.88 $257.15 $268.74 $284.39 |
Preschool $207.51 $212.27 $218.45 $223.50 $231.39 |
School-Age $180.38 $182.77 $185.17 $187.57 $189.97 |
The maximum reimbursement rates for licensed family childcare providers paid by the |
departments of human services, and children, youth and families is determined through collective |
bargaining. The maximum reimbursement rates for infant/toddler and preschool age children paid |
to licensed family childcare providers by both departments is implemented in a tiered manner that |
reflects the quality rating the provider has achieved in accordance with § 42-12-23.1. |
(j) Effective July 1, 2022, the maximum reimbursement rates to be paid by the departments |
of human services and children, youth and families for licensed childcare centers shall be |
implemented in a tiered manner, reflective of the quality rating the provider has achieved within |
the state’s quality rating system outlined in § 42-12-23.1. Maximum weekly rates shall be |
reimbursed as follows: |
Licensed Childcare Centers |
Tier One Tier Two Tier Three Tier Four Tier Five |
Infant/Toddler $265 $270 $282 $289 $300 |
Preschool $225 $235 $243 $250 $260 |
School-Age $200 $205 $220 $238 $250 |
(k) Effective July 1, 2024, the maximum reimbursement rates to be paid by the departments |
of human services and children, youth and families for licensed childcare centers shall be |
implemented in a tiered manner, reflective of the quality rating the provider has achieved within |
the state’s quality rating system outlined in § 42-12-23.1. Maximum weekly rates shall be |
reimbursed as follows: |
Licensed Childcare Centers |
Tier One Tier Two Tier Three Tier Four Tier Five |
Infant/Toddler $278 $284 $296 $303 $315 |
Preschool $236 $247 $255 $263 $273 |
School-Age $210 $215 $231 $250 $263 |
(l) Effective July 1, 2025, the maximum reimbursement rates to be paid by the departments |
of human services and children, youth and families for licensed childcare centers shall be |
implemented in a tiered manner, reflective of the quality rating the provider has achieved within |
the state’s quality rating system outlined in § 42-12-23.1. Maximum weekly rates shall be |
reimbursed as follows: |
Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 |
Infant $334 $341 $355 $364 $378 |
Toddlers $278 $284 $296 $303 $315 |
Preschoolers $236 $247 $255 $263 $273 |
School Age $210 $215 $231 $250 $263 |
SECTION 7. Section 42-7.2-10 of the General Laws in Chapter 42-7.2 entitled "Office of |
Health and Human Services" is hereby amended to read as follows: |
42-7.2-10. Appropriations and disbursements. |
(a) The general assembly shall annually appropriate such sums as it may deem necessary |
for the purpose of carrying out the provisions of this chapter. The state controller is hereby |
authorized and directed to draw his or her orders upon the general treasurer for the payment of such |
sum or sums, or so much thereof as may from time to time be required, upon receipt by him or her |
of proper vouchers approved by the secretary of the executive office of health and human services, |
or his or her designee. |
(b) For the purpose of recording federal financial participation associated with qualifying |
healthcare workforce development activities at the state’s public institutions of higher education, |
and pursuant to the Rhode Island designated state health programs (DSHP), as approved by the |
Centers for Medicare & Medicaid Services (CMC) October 20, 2016, in the 11-W-00242/1 |
amendment to Rhode Island’s section 1115 Demonstration Waiver, there is hereby established a |
restricted-receipt account entitled “Health System Transformation Project” in the general fund of |
the state and included in the budget of the office of health and human services. |
(c) There are hereby created within the general fund of the state and housed within the |
budget of the office of health and human services two restricted receipt accounts, respectively |
entitled “HCBS Support-ARPA” and “HCBS Admin Support-ARPA”. Amounts deposited into |
these accounts are equivalent to the general revenue savings generated by the enhanced federal |
match received on eligible home and community-based services between April 1, 2021, and March |
31, 2022, allowable under Section 9817 of the American Rescue Plan Act of 2021, Pub. L. No. |
117-2. Funds deposited into the “HCBS Support-ARPA” account will be used to finance the state |
share of newly eligible Medicaid expenditures by the office of health and human services and its |
sister agencies, including the department of children, youth and families, the department of health, |
and the department of behavioral healthcare, developmental disabilities and hospitals. Funds |
deposited into the “HCBS Admin Support-ARPA” account will be used to finance the state share |
of allowable administrative expenditures attendant to the implementation of these newly eligible |
Medicaid expenditures. The accounts created under this subsection shall be exempt from the |
indirect cost recovery provisions of § 35-4-27. |
(d) There is hereby created within the general fund of the state and housed within the budget |
of the office of health and human services a restricted receipt account entitled “Rhode Island |
Statewide Opioid Abatement Account” for the purpose of receiving and expending monies from |
settlement agreements with opioid manufacturers, pharmaceutical distributors, pharmacies, or their |
affiliates, as well as monies resulting from bankruptcy proceedings of the same entities. The |
executive office of health and human services shall deposit any revenues from such sources that |
are designated for opioid abatement purposes into the restricted receipt account. Funds from this |
account shall only be used for forward-looking opioid abatement efforts as defined and limited by |
any settlement agreements, state-city and town agreements, or court orders pertaining to the use of |
such funds. By January 1 of each calendar year, the secretary of health and human services shall |
report to the governor, the speaker of the house of representatives, the president of the senate, and |
the attorney general on the expenditures that were funded using monies from the Rhode Island |
statewide opioid abatement account and the amount of funds spent. The account created under this |
subsection shall be exempt from the indirect cost recovery provisions of § 35-4-27. No |
governmental entity has the authority to assert a claim against the entities with which the attorney |
general has entered into settlement agreements concerning the manufacturing, marketing, |
distributing, or selling of opioids that are the subject of the Rhode Island Memorandum of |
Understanding Between the State and Cities and Towns Receiving Opioid Settlement Funds |
executed by every city and town and the attorney general and wherein every city and town agreed |
to release all such claims against these settling entities, and any amendment thereto. Governmental |
entity means any state or local governmental entity or sub-entity and includes, but is not limited to, |
school districts, fire districts, and any other such districts. The claims that shall not be asserted are |
the released claims, as that term is defined in the settlement agreements executed by the attorney |
general, or, if not defined therein, the claims sought to be released in such settlement agreements. |
(e) There is hereby created within the general fund of the state and housed within the budget |
of the executive office of health and human services a restricted receipt account, respectively |
entitled "Minimum Staffing Level Compliance and Enforcement". Funds deposited into the account |
will be used for workforce development and compliance assistance programs as included in § 23- |
17.5-33. |
SECTION 8. Section 42-7.4-3 of the General Laws in Chapter 42-7.4 entitled "The |
Healthcare Services Funding Plan Act" is hereby amended to read as follows: |
42-7.4-3. Imposition of healthcare services funding contribution. [As enacted in 2014.] |
(a) Each insurer is required to pay the healthcare services funding contribution for each |
contribution enrollee of the insurer at the time the contribution is calculated and paid, at the rate set |
forth in this section. |
(1) Beginning January 1, 2016, the secretary shall set the healthcare services funding |
contribution each fiscal year in an amount equal to: (i) The child immunization funding requirement |
described in § 23-1-46; plus (ii) The adult immunization funding requirement described in § 23-1- |
46; plus (iii) The children’s health services funding requirement described in § 42-12-29; and all |
as divided by (iv) The number of contribution enrollees of all insurers. |
(2) The contribution set forth herein shall be in addition to any other fees or assessments |
upon the insurer allowable by law. |
(b) The contribution shall be paid by the insurer; provided, however, a person providing |
health benefits coverage on a self-insurance basis that uses the services of a third-party |
administrator shall not be required to make a contribution for a contribution enrollee where the |
contribution on that enrollee has been or will be made by the third-party administrator. |
(c) Beginning calendar year 2026, in addition to the assessment collection pursuant to |
subsection (a), there shall be an additional amount assessed pursuant to (i) and (ii), to support |
primary care and other critical healthcare programs totaling thirty million dollars ($30,000,000), |
which shall be deposited as general revenues. |
(c) The secretary shall create a process to facilitate the transition to the healthcare services |
funding contribution method that: (i) assures adequate funding beginning July 1, 2016, (ii) reflects |
that funding via the healthcare services funding contribution method initially will be for only a |
portion of the state’s fiscal year, and (iii) avoids duplicate liability for any insurer that made a |
payment under the premium assessment method in effect prior to January 1, 2016, for a period for |
which it would also be liable for a contribution under the healthcare services funding contribution |
method as described in this chapter. |
42-7.4-3. Imposition of healthcare services funding contribution. [As amended by P.L. |
2024, ch. 423, § 1; See Compiler’s Note.] |
(a) Each insurer is required to pay the healthcare services funding contribution for each |
contribution enrollee of the insurer at the time the contribution is calculated and paid, at the rate set |
forth in this section. |
(1) Beginning July 1, 2024, the secretary shall set the healthcare services funding |
contribution each fiscal year in an amount equal to: (i) The child immunization funding requirement |
described in § 23-1-46; plus (ii) The adult immunization funding requirement described in § 23-1- |
46; plus (iii) The children’s health services funding requirement described in § 42-12-29; plus (iv) |
The psychiatry resource network funding requirement described in § 23-1-46.1 and all as divided |
by; (v) The number of contribution enrollees of all insurers. |
(2) The contribution set forth herein shall be in addition to any other fees or assessments |
upon the insurer allowable by law. |
(b) The contribution shall be paid by the insurer; provided, however, a person providing |
health benefits coverage on a self-insurance basis that uses the services of a third-party |
administrator shall not be required to make a contribution for a contribution enrollee where the |
contribution on that enrollee has been or will be made by the third-party administrator. |
(c) The secretary shall create a process to facilitate the transition to the healthcare services |
funding contribution method that: (i) assures adequate funding beginning July 1, 2016, (ii) reflects |
that funding via the healthcare services funding contribution method initially will be for only a |
portion of the state’s fiscal year, and (iii) avoids duplicate liability for any insurer that made a |
payment under the premium assessment method in effect prior to January 1, 2016, for a period for |
which it would also be liable for a contribution under the healthcare services funding contribution |
method as described in this chapter. |
SECTION 9. This article shall take effect upon passage. |