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2013 -- S 0615 | |
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LC00773 | |
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STATE OF RHODE ISLAND | |
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IN GENERAL ASSEMBLY | |
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JANUARY SESSION, A.D. 2013 | |
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A N A C T | |
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RELATING TO HUMAN SERVICES -- LONG-TERM CARE SERVICE REFORM FOR | |
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MEDICAID ELIGIBLE INDIVIDUALS | |
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Introduced By: Senator Maryellen Goodwin | |
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Date Introduced: March 06, 2013 | |
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Referred To: Senate Health & Human Services | |
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It is enacted by the General Assembly as follows: | |
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SECTION 1. Section 40-8.10-4 of the General Laws in Chapter 40-8.10 entitled "Long |
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Term Care Service Reform for Medicaid Eligible Individuals" is hereby amended to read as |
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follows: |
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40-8.10-4. Assessment and Coordination Unit (ACU). -- (a) The department of human |
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services, in collaboration with the executive office of health and human services, shall implement |
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a long-term care options counseling program to provide individuals or their representative, or |
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both, with long-term care consultations that shall include, at a minimum, information about long- |
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term care options, sources and methods of both public and private payment for |
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term care services, information on caregiver support services, including respite care, and an |
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assessment of an individual's functional capabilities and opportunities for maximizing |
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independence. Each individual admitted to or seeking admission to a long-term care facility, |
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regardless of the payment source, shall be informed by the facility of the availability of the long- |
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term care options counseling program and shall be provided with a long-term care options |
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consultation, if he or she so requests. Each individual who applies for Medicaid long-term care |
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services shall be provided with a long-term care consultation. |
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(b) Core and preventative home and community based services defined and delineated in |
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section 40-8.10-2 shall be provided only to those individuals who meet one of the levels of care |
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provided for in this chapter. Other long term care services authorized by the federal government, |
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such as medication management, may also be provided to Medicaid eligible recipients who have |
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established the requisite need as determined by the Assessment and Coordination Unit (ACU). |
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Access to institutional and community based supports and services shall be through the |
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Assessment and Coordination Unit (ACU). The provision of Medicaid-funded long-term care |
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services and supports shall be based upon a comprehensive assessment that shall include, but not |
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be limited to, an evaluation of the medical, social and environmental needs of each applicant for |
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these services or programs. The assessment shall serve as the basis for the development and |
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provision of an appropriate plan of care for the applicant. |
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(c) The ACU shall assess the financial eligibility of beneficiaries to receive long-term |
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care services and supports in accordance with the applicable provisions of section 40-8.9-9. |
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(d) The ACU shall be responsible for conducting assessments; determining a level of |
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care for applicants for medical assistance; developing service plans; pricing a service budget and |
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developing a voucher when appropriate; making referrals to appropriate settings; maintaining a |
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component of the unit that will provide training to and will educate consumers, discharge |
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planners and providers; tracking utilization; monitoring outcomes; and reviewing service/care |
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plan changes. The ACU shall provide interdisciplinary high cost case reviews and choice |
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counseling for eligible recipients. |
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(e) The assessments for individuals conducted in accordance with this section shall serve |
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as the basis for individual budgets for those medical assistance recipients eligible to receive |
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services utilizing a self-directed delivery system. |
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(f) Nothing in this section shall prohibit the secretary of the executive office of health |
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and human services, or the directors of that office's departments from utilizing community |
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agencies or contractors when appropriate to perform assessment functions outlined in this |
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chapter. |
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SECTION 2. Title 40 of the General Laws entitled "HUMAN SERVICES" is hereby |
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amended by adding thereto the following chapter: |
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CHAPTER 8.11 |
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CAREGIVER ASSESSMENT |
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40-8.11-1. Findings. -- (a) Family members, partners and close friends provide the vast |
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majority of long-term services and supports. |
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(b) An estimated one hundred forty-eight thousand (148,000) people in Rhode Island are |
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providing care at any one time to persons living in the community. The estimated value of their |
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unpaid contributions in 2009 was one billion eight hundred eighty million dollars ($1.88 billion). |
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(c) Family or other caregivers who provide the majority of care in the home are |
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frequently under substantial stress, physical, psychological, and financial. The stress, if |
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unrelieved by support for the caregiver, may lead to premature or unnecessary nursing home and |
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institutional placement and health and financial burdens for the caregiver. |
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(d) Respite care and other community-based supportive services for the family caregiver |
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can relieve some of the stresses faced by caregivers, maintain and strengthen the family structure, |
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postpone or prevent institutionalization and lead to better outcomes for both the caregiver and |
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care recipient. |
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(e) The percentage of Rhode Islanders sixty-five (65) years of age and older is projected |
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to grow from fourteen percent (14%) of the state population in 2010 to twenty-one percent (21%) |
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by 2030. As people age, they have greater dependency needs and an increased need for continued |
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supportive long-term care services and supports. Younger people with disabilities also require |
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continued supportive long-term care services as they age. |
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(f) As informal caregivers and families are a vital part of the long-term care services and |
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supports system, it is an important public purpose to recognize and respect their contributions and |
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to assess and support their needs. |
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40-8.11-2. Definitions. -- (a) "Caregiver assessment" means a systematic process of |
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gathering information about a caregiving situation to identify the specific problems, needs, |
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strengths, and resources of the family caregiver, as well as the caregiver's ability contribute to the |
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needs of the care recipient. |
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(b) The term "family caregiver" means any relative, partner, friend, or neighbor who has |
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a significant relationship with, and who provides a broad range of assistance for, an older adult or |
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an adult or child with chronic or disabling conditions. |
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40-8.11-3. Caregiver assessment requirement. -- The comprehensive assessment |
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required in subsection 40-8.10-4(b) as part of Medicaid long-term service reform shall also |
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include a caregiver assessment whenever the plan of care depends on a family caregiver for |
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providing assistance with activities of daily living needs. The assessment shall be used to develop |
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a plan of care that recognizes both the needs of the care recipient and the caregiver. The |
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assessment shall also serve as the basis for development and provision of an appropriate plan for |
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caregiver information, referral and support services. Information about available respite |
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programs, caregiver training and education programs, support groups and community support |
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services shall be included as part of the caregiver support plan. To implement the caregiver |
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assessment, the executive office of health and human services shall adopt evidenced-based |
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caregiver assessment and referral tools appropriate to the departments within the office that |
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provide that provides long-term care services and supports. |
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SECTION 3. This act shall take effect upon passage. |
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LC00773 | |
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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 -- LONG-TERM CARE SERVICE REFORM FOR | |
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MEDICAID ELIGIBLE INDIVIDUALS | |
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*** | |
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This act would require that the department of human services provide information on |
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caregiver support services, including respite care in its long-term care counseling program. This |
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act would also require that caregiver assessment be used to develop an appropriate plan of care. |
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This act would take effect upon passage. |
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LC00773 | |
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