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2011 -- H 5618 | |
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LC01572 | |
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STATE OF RHODE ISLAND | |
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IN GENERAL ASSEMBLY | |
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JANUARY SESSION, A.D. 2011 | |
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A N A C T | |
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RELATING TO HUMAN SERVICES - HEALTH CARE ASSISTANCE FOR WORKING | |
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PEOPLE WITH DISABILITIES | |
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Introduced By: Representatives Naughton, E Coderre, Ferri, and Kennedy | |
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Date Introduced: March 03, 2011 | |
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Referred To: House Finance | |
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It is enacted by the General Assembly as follows: | |
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SECTION 1. Sections 40-8.7-6 and 40-8.7-9 of the General Laws in Chapter 40-8.7 |
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entitled "Health Care Assistance for Working People with Disabilities" are hereby amended to |
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read as follows: |
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40-8.7-6. Eligibility. -- To be eligible for benefits under the Medicaid buy-in program: |
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(1) The person shall be an individual with disabilities as defined in section 40-8.7-4, but |
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without regard to his or her ability to engage in substantial gainful activity, as specified in the |
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Social Security Act, 42 U.S.C. section 423(d)(4); |
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(2) The person shall be employed as defined in section 40-8.7-4; |
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(3) The |
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hundred fifty percent (250%) of the federal poverty level, taking into account the SSI program |
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disregards and impairment-related work expenses as defined in 42 U.S.C. section 1396a(r)(2); |
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(4) A maximum of ten thousand dollars ($10,000) of available resources for an |
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individual and twenty thousand dollars ($20,000) for a couple shall be disregarded as shall any |
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additional resources held in a retirement account, in a medical savings account, or any other |
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account, related to enhancing the independence of the individual and approved under rules to be |
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adopted by the department; and |
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(5) The person shall be a current medical assistance recipient under section 40-8.5-1 |
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[CNIL]or section 40-8-3(v)[MNIL] or shall meet income, assets, (except as modified by |
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subdivision (4) above) and eligibility requirements for the medical assistance program under |
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section 40-8.5-1 [CNIL]or section 40-8-3(v) [MNIL] as such requirements are modified and |
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extended by this chapter. |
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40-8.7-9. Regulations and commencement of program. – (a) The department of human |
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services shall promulgate the rules or regulations necessary to implement the provisions of this |
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act by |
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Medicaid buy-in program shall commence on |
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(b) All participants in the Sherlock plan shall annually report wages earned and average |
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hours worked to the department. |
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(c) The department shall report to the governor and the general assembly on or before |
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January 31, 2011 and annually thereafter, with regard to the effectiveness of this act in achieving |
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its purpose, which report shall include, but not be limited to: |
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(1) The number of applications for the Sherlock plan, the number of beneficiaries |
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approved who are new to Medicaid and the number of beneficiaries who were in another |
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Medicaid eligibility category just prior to the Sherlock plan; |
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(2) Demographics including: age, sex, employment supports provided and primary |
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disabling conditions; |
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(3) Prior and current participation in other public programs including Medicare, Social |
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Security Disability Insurance (SSDI), Supplemental Security Income (SSI), including the 1619(b) |
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provision; |
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(4) Statistics regarding the number of beneficiaries employed and the average wage of |
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those beneficiaries prior to and post Sherlock plan eligibility and the hours worked prior to and |
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post Sherlock plan eligibility; |
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(5) Statistics regarding the amounts of premiums and co-payments collected; and |
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(6) Findings and recommendations with regard to any improvements, amendments, or |
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changes that should be considered to make the act more effective in achieving its purposes or |
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which may be necessary in order to encourage more Medicaid beneficiaries to seek and retain |
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employment. |
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SECTION 2. This act shall serve as a Joint Resolution required pursuant to Rhode Island |
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General Laws section 42-12.4-1, et seq. |
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WHEREAS, The General Assembly enacted Chapter 12.4 of Title 42 entitled "The |
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Rhode Island Medicaid Reform Act of 2008"; and |
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WHEREAS, Rhode Island General Law section 42-12.4-7 provides that any change that |
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requires implementation of a rule or regulation or modification of a rule or regulation in existence |
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prior to the implementation of the global consumer choice section 1115 demonstration ("the |
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demonstration") shall require prior approval of the general assembly; and further provides that |
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any category II change or category III change as defined in the demonstration shall also require |
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prior approval to the general assembly; and |
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WHEREAS, Rhode Island General Law section 42-7.2-5 states that the secretary of the |
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office of health and human services is responsible for the "review and coordination of any Global |
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Consumer Choice Compact Waiver requests and renewals as well as any initiatives and proposals |
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requiring amendments to the Medicaid state plan or category I or II changes" as described in the |
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demonstration with "the potential to affect the scope, amount, or duration of publicly-funded |
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health care services, provider payments or reimbursements, or access to or the availability of |
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benefits and services provided by Rhode Island general and public laws"; and |
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WHEREAS, In pursuit of a more cost-effective consumer choice system of care that is |
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fiscally sound and sustainable, the Secretary requests that the following proposal to amend the |
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demonstration be approved by the general assembly: |
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Modify the Sherlock Act. The department of human services proposes refining the |
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determination of eligibility, premiums and co-sharing of workers with disabilities enrolled in the |
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Medicaid Buy-In program; Now, therefore be it |
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RESOLVED, That the general assembly hereby approves the changes set forth in the |
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proposal listed above to amend the demonstration; and be it further |
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RESOLVED, That the secretary of the office of health and human services is authorized |
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to pursue and implement any such necessary waiver amendments, category II or category III |
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changes, state plan amendments and/or changes to the applicable department's rules, regulations |
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and procedures approved herein and as authorized by section 42-12.4-7. |
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SECTION 3. This act shall take effect on July 1, 2011. |
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LC01572 | |
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EXPLANATION | |
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BY THE LEGISLATIVE COUNCIL | |
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OF | |
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A N A C T | |
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RELATING TO HUMAN SERVICES - HEALTH CARE ASSISTANCE FOR WORKING | |
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PEOPLE WITH DISABILITIES | |
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This act would change the determination of eligibility, premiums and co-sharing of |
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workers with disabilities enrolled into the Sherlock Medicaid Buy-In program. This act would |
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also establish the legal authority for the department of human services to undertake a series of |
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programmatic reforms geared toward the restructuring of its Medicaid programs in FY 2012. |
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This act would take effect on July 1, 2011. |
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LC01572 | |
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