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art.010/8/010/7/010/6/010/5/010/4/010/3/010/2/010/1

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     ARTICLE 10 AS AMENDED

RELATING TO HEALTH AND HUMAN SERVICES

     SECTION 1. Section 23-13-22 of the General Laws in Chapter 23-13 entitled "Maternal

and Child Health Services for Children with Special Health Care Needs" is hereby amended to read

as follows:

     23-13-22. Early intervention program for developmentally disabled infants.

     (a) The director secretary of the department of human services executive office of health

and human services (EOHHS) shall ensure that all developmentally disabled infants from birth to

three (3) years of age shall be enrolled in the early intervention program. Beginning July 1, 2026,

EOHHS and the department of elementary and secondary education shall create a plan to allow

children to remain in early intervention until September 1 after their third birthday, as allowed by

federal law 20 U.S.C. § 1435(c). Further, such plan shall include, but not be limited to, seeking any

federal approvals necessary or desirable to implement the aforesaid policy. By January 1, 2028,

EOHHS shall allow children who turn three (3) years old between May 1 and August 31 to remain

in early intervention until September 1 after the child’s third birthday. Regulations governing the

delivery of services under this program, including eligibility criteria, shall be promulgated by the

department of human services EOHHS, with the advice of the interagency coordinating council;

provided, however, that all regulations promulgated by the department of health shall remain in full

force and effect until the time they are replaced by regulations promulgated by the department of

human services EOHHS. The regulations shall stipulate, at a minimum, the following provisions

that are consistent with the intent of this chapter:

     (1) The director secretary shall develop and maintain a procedure for the earliest possible

identification and efficient referral of all developmentally disabled infants;

     (2) The director secretary shall ensure that every infant identified and referred to this

program is enrolled as soon as possible after birth; and further, that for infants placed on a waiting

list for facility based group programming, an early intervention program shall be made available

within a thirty (30) day period from the time a need is identified in the individual program plan;

     (3) Unless parents refuse the service, the home visiting component of the program shall

commence as soon as the infant has been identified as having a possible developmental disability;

     (4) Any parent(s) who is/are dissatisfied with decisions or termination of service or with

practices and procedures of a particular agency or the department of human services EOHHS shall

notify the director secretary of the department of human services EOHHS in writing within thirty

(30) calendar days and the complaint shall be reviewed in accordance with department of health

EOHHS policy and procedures, as amended, and the Administrative Procedures Act, chapter 35 of

title 42.

     (5) An early intervention program for purposes of this section shall mean a comprehensive

array of educational, developmental, health, and social services provided on a calendar year basis

to eligible infants, children, and their families as specified in program regulations.

     (b) Within ninety (90) days after October 1, 2004, an evaluation plan describing outcome

measures that document the program’s successes and shortcomings from the previous fiscal year

shall be submitted to the speaker of the house of representatives, the president of the senate and the

house oversight committee and the governor and the interagency coordinating council.

Development of the plan shall be made in consultation with the entities with expertise in this area

and the interagency coordinating council. The plan shall include a memorandum of understanding

between the department of health, department of human services and the department of elementary

and secondary education that demonstrates coordination and continuity of early intervention

services among these departments.

     (c) Within six (6) months after January 1, 2005 where prescribed outcomes documented in

the evaluation plan have not been accomplished the responsible agencies shall submit written

explanations for the shortfalls, together with their proposed remedies. The report shall also include

evaluation of the progress of the coordination efforts between the department of health and the

department of human services and the department of elementary and secondary education and the

interagency coordinating council and shall include any recommendations regarding modifications

of the reimbursement mechanisms of this chapter.

     (d) Within twelve (12) months after August 1, 2005 a final report shall include the progress

of the coordination efforts between the department of health and the department of human services

and department of elementary and secondary education, interagency coordinating council and shall

include any recommendations regarding modifications to the comprehensive array of educational,

developmental, health and social services provided on a calendar year basis to eligible infants,

children and their families as specified in an early intervention system.

     (e) All reports or documents required to be produced pursuant to 20 U.S.C. § 1471 et seq.,

shall be submitted to the speaker of the house, president of the senate and the chairpersons of the

appropriate house of representatives and senate oversight committees and the governor and the

interagency coordinating council. Adherence to such plans and reporting requirements, and budgets

and the timely achievement of goals contained therein shall be considered by the oversight

committees of the house of representatives and senate, among other relevant factors, in determining

appropriations or other systemic changes.

     (f) In developing and implementing the plan to extend early intervention services beyond

age three (3) as provided in subsection (a) of this section, the secretary shall:

     (1) Appoint and convene an implementation advisory committee to advise on the

implementation of the plan. The committee shall include:

     (i) The individual designated by the state to serve as the coordinator for Part C in EOHHS;

     (ii) The individual designated by the state to serve as the coordinator for Section 619 of the

Individuals with Disabilities Education Act (IDEA) in the department of elementary and secondary

education;

     (iii) Not fewer than three (3) representatives of early intervention provider agencies;

     (iv) Not fewer than two (2) representatives of local education agencies (“LEA”);

     (v) Not fewer than two (2) advocates or experts with demonstrated expertise in early

intervention or early childhood special education; and

     (vi) Not fewer than two (2) parents of children who have received early intervention

services and have transitioned to early childhood special education within the preceding three (3)

years.

     (2) The implementation advisory committee shall:

     (i) Meet for a period of at least one year following the official effective date of the extension

policy;

     (ii) Identify strategies to reduce administrative burdens on families, early intervention

providers, LEA, and the state including, but not limited to, the use of federal funds earmarked for

early intervention extension to the extent allowable;

     (iii) Earmark appropriate federal early intervention funding and develop shared resources

to support training and development for early intervention providers and LEA regarding the

extension option; and

     (iv) Develop strategies to maximize providers’ ability to support the new over-three (3)

population during spring and summer months, including through the appropriate use of group-based

therapies while maintaining services necessary to meet individualized developmental needs.

     (3) All meetings of the implementation advisory committee shall be open to the public and

conducted in accordance with chapter 46 of title 42.

     (4) Not later than September 30, 2031, the secretary shall prepare and submit to the speaker

of the house of representatives and the president of the senate a report evaluating the

implementation of the extension plan provided for in subsection (a) of this section. The report shall

include, but not be limited to: data regarding the number of families who elected to extend early

intervention services and the number of families who declined to extend early intervention services;

and an assessment of the impact of the extension provided for in subsection (a) of this section on

children, families, early intervention providers, LEA, and the state.

     SECTION 2. Section 27-18-64 of the General Laws in Chapter 27-18 entitled "Accident

and Sickness Insurance Policies" is hereby amended to read as follows:

     27-18-64. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. Such coverage shall not be subject to deductibles and coinsurance factors.

Any amount paid by an insurer under this section for a dependent child shall not be applied to any

annual or lifetime maximum benefit contained in the policy or contract. For the purpose of this

section, “early intervention services” means, but is not limited to, speech and language therapy,

occupational therapy, physical therapy, evaluation, case management, nutrition, service plan

development and review, nursing services, and assistive technology services and devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the executive

office of health and human services ("EOHHS") as eligible for services under part Part C of the

Individuals with Disabilities Education Act (20 U.S.C. § 1471 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Insurers shall reimburse certified, early intervention providers, who are designated as

such by the executive office of health and human services (EOHHS), for early intervention services

as defined in this section at rates of reimbursement equal to, or greater than, the prevailing

integrated state Medicaid rate for early intervention services as established by the executive office

of health and human services (EOHHS).

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident or both; and (9) Other limited benefit policies.

     SECTION 3. Section 27-19-55 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

     27-19-55. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)

per dependent child per policy or calendar year and shall not be subject to deductibles and

coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall

not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For

the purpose of this section, “early intervention services” means, but is not limited to: speech and

language therapy, occupational therapy, physical therapy, evaluation, case management, nutrition,

service plan development and review, nursing services, and assistive technology services and

devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the department

of executive office of health and human services (“EOHHS”) as eligible for services under part

Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Subject to the annual limits provided in this section, insurers shall reimburse certified

early intervention providers, who are designated as such by the department of human services

EOHHS, for early intervention services as defined in this section at rates of reimbursement equal

to or greater than the prevailing integrated state/Medicaid rate for early intervention services as

established by the department of human services EOHHS.

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident, or both; and (9) Other limited benefit policies.

     SECTION 4. Section 27-20-50 of the General Laws in Chapter 27-20 entitled "Nonprofit

Medical Service Corporations" is hereby amended to read as follows:

     27-20-50. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)

per dependent child per policy or calendar year and shall not be subject to deductibles and

coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall

not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For

the purpose of this section, “early intervention services” means, but is not limited to: speech and

language therapy; occupational therapy; physical therapy; evaluation; case management; nutrition;

service plan development and review; nursing services; and assistive technology services and

devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the department

of executive office of health and human services (“EOHHS”) as eligible for services under part

Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Subject to the annual limits provided in this section, insurers shall reimburse certified

early intervention providers, who are designated as such by the department of human services

EOHHS, for early intervention services as defined in this section at rates of reimbursement equal

to or greater than the prevailing integrated state/Medicaid rate for early intervention services as

established by the department of human services EOHHS.

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident or both; and (9) Other limited benefit policies.

     SECTION 5. Section 27-41-68 of the General Laws in Chapter 27-41 entitled "Health

Maintenance Organizations" is hereby amended to read as follows:

     27-41-68. Coverage for early intervention services.

     (a) Every individual or group hospital or medical expense insurance policy or contract

providing coverage for dependent children, delivered or renewed in this state on or after July 1,

2004, shall include coverage of early intervention services which coverage shall take effect no later

than January 1, 2005. The coverage shall be limited to a benefit of five thousand dollars ($5,000)

per dependent child per policy or calendar year and shall not be subject to deductibles and

coinsurance factors. Any amount paid by an insurer under this section for a dependent child shall

not be applied to any annual or lifetime maximum benefit contained in the policy or contract. For

the purpose of this section, “early intervention services” means, but is not limited to: speech and

language therapy, occupational therapy, physical therapy, evaluation, case management, nutrition,

service plan development and review, nursing services, and assistive technology services and

devices for:

     (1) dependents Dependents from birth to age three (3) who are certified by the department

of executive office of health and human services (“EOHHS”) as eligible for services under part

Part C of the Individuals with Disabilities Education Act (20 U.S.C. § 1431 et seq.); or

     (2) Dependents who are older than age three (3) and are eligible for services pursuant to §

23-13-22 and are certified by the EOHHS as eligible for services under Part C of the Individuals

with Disabilities Education Act (20 U.S.C. § 1431 et seq.).

     (b) Subject to the annual limits provided in this section, insurers shall reimburse certified

early intervention providers, who are designated as such by the department of human services

EOHHS, for early intervention services as defined in this section at rates of reimbursement equal

to or greater than the prevailing integrated state/Medicaid rate for early intervention services as

established by the department of human services EOHHS.

     (c) This section shall not apply to insurance coverage providing benefits for: (1) Hospital

confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare

supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily

injury or death by accident or both; and (9) Other limited benefit policies.

     SECTION 6. Sections 40-5.2-10, 40-5.2-20 and 40-5.2-35 of the General Laws in Chapter

40-5.2 entitled "The Rhode Island Works Program" are hereby amended to read as follows:

     40-5.2-10. Necessary requirements and conditions.

     The following requirements and conditions shall be necessary to establish eligibility for

the program.

     (a) Citizenship, alienage, and residency requirements.

     (1) A person shall be a resident of the state of Rhode Island.

     (2) Effective October 1, 2008, a person shall be a United States citizen, or shall meet the

alienage requirements established in § 402(b) of the Personal Responsibility and Work Opportunity

Reconciliation Act of 1996, PRWORA, Pub. L. No. 104-193 and as that section may hereafter be

amended [8 U.S.C. § 1612]; a person who is not a United States citizen and does not meet the

alienage requirements established in PRWORA, as amended, is not eligible for cash assistance in

accordance with this chapter.

     (b) The family/assistance unit must meet any other requirements established by the

department of human services by rules and regulations adopted pursuant to the Administrative

Procedures Act, as necessary to promote the purpose and goals of this chapter.

     (c) Receipt of cash assistance is conditional upon compliance with all program

requirements.

     (d) All individuals domiciled in this state shall be exempt from the application of

subdivision 115(d)(1)(A) of Pub. L. No. 104-193, the Personal Responsibility and Work

Opportunity Reconciliation Act of 1996, PRWORA [21 U.S.C. § 862a], which makes any

individual ineligible for certain state and federal assistance if that individual has been convicted

under federal or state law of any offense that is classified as a felony by the law of the jurisdiction

and that has as an element the possession, use, or distribution of a controlled substance as defined

in § 102(6) of the Controlled Substances Act (21 U.S.C. § 802(6)).

     (e) Individual employment plan as a condition of eligibility.

     (1) Following receipt of an application, the department of human services shall assess the

financial conditions of the family, including the non-parent caretaker relative who is applying for

cash assistance for themself as well as for the minor child(ren), in the context of an eligibility

determination. If a parent or non-parent caretaker relative is unemployed or under-employed, the

department shall conduct an initial assessment, taking into account:

     (A) The physical capacity, skills, education, work experience, health, safety, family

responsibilities, and place of residence of the individual; and

     (B) The child care and supportive services required by the applicant to avail themself of

employment opportunities and/or work readiness programs.

     (2) On the basis of this assessment, the department of human services and the department

of labor and training, as appropriate, in consultation with the applicant, shall develop an individual

employment plan for the family that requires the individual to participate in the intensive

employment services. Intensive employment services shall be defined as the work requirement

activities in § 40-5.2-12(g) and (i).

     (3) The director, or the director’s designee, may assign a case manager to an

applicant/participant, as appropriate.

     (4) The department of labor and training and the department of human services in

conjunction with the participant shall develop a revised individual employment plan that shall

identify employment objectives, taking into consideration factors above, and shall include a

strategy for immediate employment and for preparing for, finding, and retaining employment

consistent, to the extent practicable, with the individual’s career objectives.

     (5) The individual employment plan must include the provision for the participant to

engage in work requirements as outlined in § 40-5.2-12.

     (6)(i) The participant shall attend and participate immediately in intensive assessment and

employment services as the first step in the individual employment plan, unless temporarily exempt

from this requirement in accordance with this chapter. Intensive assessment and employment

services shall be defined as the work requirement activities in § 40-5.2-12(g) and (i).

     (ii) Parents under age twenty (20) without a high school diploma or general equivalency

diploma (GED) shall be referred to special teen-parent programs that will provide intensive services

designed to assist teen parents to complete high school education or GED, and to continue approved

work plan activities in accord with Rhode Island works program requirements.

     (7) The applicant shall become a participant in accordance with this chapter at the time the

individual employment plan is signed and entered into.

     (8) Applicants and participants of the Rhode Island works program shall agree to comply

with the terms of the individual employment plan, and shall cooperate fully with the steps

established in the individual employment plan, including the work requirements.

     (9) The department of human services has the authority under the chapter to require

attendance by the applicant/participant, either at the department of human services or at the

department of labor and training, at appointments deemed necessary for the purpose of having the

applicant enter into and become eligible for assistance through the Rhode Island works program.

The appointments include, but are not limited to: the initial interview, orientation and assessment;

job readiness; and job search. Attendance is required as a condition of eligibility for cash assistance

in accordance with rules and regulations established by the department.

     (10) As a condition of eligibility for assistance pursuant to this chapter, the

applicant/participant shall be obligated to keep appointments; attend orientation meetings at the

department of human services and/or the Rhode Island department of labor and training; participate

in any initial assessments or appraisals; and comply with all the terms of the individual employment

plan in accordance with department of human services rules and regulations.

     (11) A participant, including a parent or non-parent caretaker relative included in the cash

assistance payment, shall not voluntarily quit a job or refuse a job unless there is good cause as

defined in this chapter or the department’s rules and regulations.

     (12) A participant who voluntarily quits or refuses a job without good cause, as defined in

§ 40-5.2-12(l), while receiving cash assistance in accordance with this chapter, shall be sanctioned

in accordance with rules and regulations promulgated by the department.

     (f) Resources.

     (1) The family or assistance unit’s countable resources shall be less than the allowable

resource limit established by the department in accordance with this chapter.

     (2) No family or assistance unit shall be eligible for assistance payments if the combined

value of its available resources (reduced by any obligations or debts with respect to such resources)

exceeds five thousand dollars ($5,000).

     (3) For purposes of this subsection, the following shall not be counted as resources of the

family/assistance unit in the determination of eligibility for the works program:

     (i) The home owned and occupied by a child, parent, relative, or other individual;

     (ii) Real property owned by a husband and wife as tenants by the entirety, if the property

is not the home of the family and if the spouse of the applicant refuses to sell his or her interest in

the property;

     (iii) Real property that the family is making a good faith effort to dispose of, however, any

cash assistance payable to the family for any such period shall be conditioned upon such disposal

of the real property within six (6) months of the date of application and any payments of assistance

for that period shall (at the time of disposal) be considered overpayments to the extent that they

would not have occurred at the beginning of the period for which the payments were made. All

overpayments are debts subject to recovery in accordance with the provisions of the chapter;

     (iv) Income-producing property other than real estate including, but not limited to,

equipment such as farm tools, carpenter’s tools, and vehicles used in the production of goods or

services that the department determines are necessary for the family to earn a living;

     (v) One vehicle for each adult household member, but not to exceed two (2) vehicles per

household, and in addition, a vehicle used primarily for income-producing purposes such as, but

not limited to, a taxi, truck, or fishing boat; a vehicle used as a family’s home; a vehicle that

annually produces income consistent with its fair market value, even if only used on a seasonal

basis; a vehicle necessary to transport a family member with a disability where the vehicle is

specially equipped to meet the specific needs of the person with a disability or if the vehicle is a

special type of vehicle that makes it possible to transport the person with a disability;

     (vi) Household furnishings and appliances, clothing, personal effects, and keepsakes of

limited value;

     (vii) Burial plots (one for each child, relative, and other individual in the assistance unit)

and funeral arrangements;

     (viii) For the month of receipt and the following month, any refund of federal income taxes

made to the family by reason of § 32 of the Internal Revenue Code of 1986, 26 U.S.C. § 32 (relating

to earned income tax credit), and any payment made to the family by an employer under § 3507 of

the Internal Revenue Code of 1986, 26 U.S.C. § 3507 [repealed] (relating to advance payment of

such earned income credit);

     (ix) The resources of any family member receiving supplementary security income

assistance under the Social Security Act, 42 U.S.C. § 301 et seq.;

     (x) Any veteran’s disability pension benefits received as a result of any disability sustained

by the veteran while in the military service.

     (g) Income.

     (1) Except as otherwise provided for herein, in determining eligibility for and the amount

of cash assistance to which a family is entitled under this chapter, the income of a family includes

all of the money, goods, and services received or actually available to any member of the family.

     (2) In determining the eligibility for and the amount of cash assistance to which a

family/assistance unit is entitled under this chapter, income in any month shall not include the first

five hundred and twenty-five dollars ($525) of gross earnings plus fifty percent (50%) of the gross

earnings of the family in excess of five hundred and twenty-five dollars ($525) earned during the

month.

     (3) The income of a family shall not include:

     (i) The first fifty dollars ($50.00) one hundred dollars ($100) in child support received for

one child, or two hundred dollars ($200) for households with two (2) or more children, in any month

from each noncustodial parent of a child plus any arrearages in child support (to the extent of the

first fifty dollars ($50.00) child support pass-through dollars per month multiplied by the number

of months in which the support has been in arrears) that are paid in any month by a noncustodial

parent of a child;

     (ii) Earned income of any child;

     (iii) Income received by a family member who is receiving Supplemental Security Income

(SSI) assistance under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq.;

     (iv) The value of assistance provided by state or federal government or private agencies to

meet nutritional needs, including: value of USDA-donated foods; value of supplemental food

assistance received under the Child Nutrition Act of 1966, as amended, and the special food service

program for children under Title VII, nutrition program for the elderly, of the Older Americans Act

of 1965 as amended, and the value of food stamps;

     (v) Value of certain assistance provided to undergraduate students, including any grant or

loan for an undergraduate student for educational purposes made or insured under any loan program

administered by the United States Commissioner of Education (or the Rhode Island council on

postsecondary education or the Rhode Island division of higher education assistance);

     (vi) Foster care payments;

     (vii) Home energy assistance funded by state or federal government or by a nonprofit

organization;

     (viii) Payments for supportive services or reimbursement of out-of-pocket expenses made

to foster grandparents, senior health aides, or senior companions and to persons serving in SCORE

and ACE and any other program under Title II and Title III of the Domestic Volunteer Service Act

of 1973, 42 U.S.C. § 5000 et seq.;

     (ix) Payments to volunteers under AmeriCorps VISTA as defined in the department’s rules

and regulations;

     (x) Certain payments to native Americans; payments distributed per capita to, or held in

trust for, members of any Indian Tribe under P.L. 92-254, 25 U.S.C. § 1261 et seq., P.L. 93-134,

25 U.S.C. § 1401 et seq., or P.L. 94-540; receipts distributed to members of certain Indian tribes

which are referred to in § 5 of P.L. 94-114, 25 U.S.C. § 459d, that became effective October 17,

1975;

     (xi) Refund from the federal and state earned income tax credit and any federal or state

child tax credits or rebates;

     (xii) The value of any state, local, or federal government rent or housing subsidy, provided

that this exclusion shall not limit the reduction in benefits provided for in the payment standard

section of this chapter;

     (xiii) The earned income of any adult family member who gains employment while an

active RI Works household member. This income is excluded for the first six (6) months of

employment in which the income is earned, or until the household’s total gross income exceeds

one hundred eighty-five percent (185%) of the federal poverty level, unless the household reaches

its sixty-month (60) time limit first;

     (xiv) Any veteran’s disability pension benefits received as a result of any disability

sustained by the veteran while in the military service.

     (4) The receipt of a lump sum of income shall affect participants for cash assistance in

accordance with rules and regulations promulgated by the department.

     (h) Time limit on the receipt of cash assistance.

     (1) On or after January 1, 2020, no cash assistance shall be provided, pursuant to this

chapter, to a family or assistance unit that includes an adult member who has received cash

assistance for a total of sixty (60) months (whether or not consecutive), to include any time

receiving any type of cash assistance in any other state or territory of the United States of America

as defined herein. Provided further, in no circumstances other than provided for in subsection (h)(3)

with respect to certain minor children, shall cash assistance be provided pursuant to this chapter to

a family or assistance unit that includes an adult member who has received cash assistance for a

total of a lifetime limit of sixty (60) months.

     (2) Cash benefits received by a minor dependent child shall not be counted toward their

lifetime time limit for receiving benefits under this chapter should that minor child apply for cash

benefits as an adult.

     (3) Certain minor children not subject to time limit. This section regarding the lifetime time

limit for the receipt of cash assistance, shall not apply only in the instances of a minor child(ren)

living with a parent who receives SSI benefits and a minor child(ren) living with a responsible adult

non-parent caretaker relative who is not in the cash assistance payment.

     (4) Receipt of family cash assistance in any other state or territory of the United States of

America shall be determined by the department of human services and shall include family cash

assistance funded in whole or in part by Temporary Assistance for Needy Families (TANF) funds

[Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.] and/or family cash assistance

provided under a program similar to the Rhode Island families work and opportunity program or

the federal TANF program.

     (5)(i) The department of human services shall mail a notice to each assistance unit when

the assistance unit has six (6) months of cash assistance remaining and each month thereafter until

the time limit has expired. The notice must be developed by the department of human services and

must contain information about the lifetime time limit, the number of months the participant has

remaining, the hardship extension policy, the availability of a post-employment-and-closure bonus;

and any other information pertinent to a family or an assistance unit nearing the sixty-month (60)

lifetime time limit.

     (ii) For applicants who have less than six (6) months remaining in the sixty-month (60)

lifetime time limit because the family or assistance unit previously received cash assistance in

Rhode Island or in another state, the department shall notify the applicant of the number of months

remaining when the application is approved and begin the process required in subsection (h)(5)(i).

     (6) If a cash assistance recipient family was closed pursuant to Rhode Island’s Temporary

Assistance for Needy Families Program (federal TANF described in Title IV-A of the Federal

Social Security Act, 42 U.S.C. § 601 et seq.), formerly entitled the Rhode Island family

independence program, more specifically under § 40-5.1-9(2)(c) [repealed], due to sanction

because of failure to comply with the cash assistance program requirements; and that recipient

family received sixty (60) months of cash benefits in accordance with the family independence

program, then that recipient family is not able to receive further cash assistance for his/her family,

under this chapter, except under hardship exceptions.

     (7) The months of state or federally funded cash assistance received by a recipient family

since May 1, 1997, under Rhode Island’s Temporary Assistance for Needy Families Program

(federal TANF described in Title IV-A of the Federal Social Security Act, 42 U.S.C. § 601 et seq.),

formerly entitled the Rhode Island family independence program, shall be countable toward the

time-limited cash assistance described in this chapter.

     (i) Time limit on the receipt of cash assistance.

     (1) No cash assistance shall be provided, pursuant to this chapter, to a family assistance

unit in which an adult member has received cash assistance for a total of sixty (60) months (whether

or not consecutive) to include any time receiving any type of cash assistance in any other state or

territory of the United States as defined herein effective August 1, 2008. Provided further, that no

cash assistance shall be provided to a family in which an adult member has received assistance for

twenty-four (24) consecutive months unless the adult member has a rehabilitation employment plan

as provided in § 40-5.2-12(g)(5).

     (2) Effective August 1, 2008, no cash assistance shall be provided pursuant to this chapter

to a family in which a child has received cash assistance for a total of sixty (60) months (whether

or not consecutive) if the parent is ineligible for assistance under this chapter pursuant to subsection

(a)(2) to include any time they received any type of cash assistance in any other state or territory

of the United States as defined herein.

     (j) Hardship exceptions.

     (1) The department may extend an assistance unit’s or family’s cash assistance beyond the

time limit, by reason of hardship; provided, however, that the number of families to be exempted

by the department with respect to their time limit under this subsection shall not exceed twenty

percent (20%) of the average monthly number of families to which assistance is provided for under

this chapter in a fiscal year; provided, however, that to the extent now or hereafter permitted by

federal law, any waiver granted under § 40-5.2-34, for domestic violence, shall not be counted in

determining the twenty percent (20%) maximum under this section.

     (2) Parents who receive extensions to the time limit due to hardship must have and comply

with employment plans designed to remove or ameliorate the conditions that warranted the

extension.

     (k) Parents under eighteen (18) years of age.

     (1) A family consisting of a parent who is under the age of eighteen (18), and who has

never been married, and who has a child; or a family consisting of a person under the age of eighteen

(18) from onset of pregnancy shall be eligible for cash assistance only if the family resides in the

home of an adult parent, legal guardian, or other adult relative. The assistance shall be provided to

the adult parent, legal guardian, or other adult relative on behalf of the individual and child unless

otherwise authorized by the department.

     (2) This subsection shall not apply if the minor parent or pregnant minor has no parent,

legal guardian, or other adult relative who is living and/or whose whereabouts are unknown; or the

department determines that the physical or emotional health or safety of the minor parent, or his or

her child, or the pregnant minor, would be jeopardized if he or she was required to live in the same

residence as his or her parent, legal guardian, or other adult relative (refusal of a parent, legal

guardian, or other adult relative to allow the minor parent or his or her child, or a pregnant minor,

to live in his or her home shall constitute a presumption that the health or safety would be so

jeopardized); or the minor parent or pregnant minor has lived apart from his or her own parent or

legal guardian for a period of at least one year before either the birth of any child to a minor parent

or the onset of the pregnant minor’s pregnancy; or there is good cause, under departmental

regulations, for waiving the subsection; and the individual resides in a supervised supportive-living

arrangement to the extent available.

     (3) For purposes of this section, “supervised supportive-living arrangement” means an

arrangement that requires minor parents to enroll and make satisfactory progress in a program

leading to a high school diploma or a general education development certificate, and requires minor

parents to participate in the adolescent parenting program designated by the department, to the

extent the program is available; and provides rules and regulations that ensure regular adult

supervision.

     (l) Assignment and cooperation. As a condition of eligibility for cash and medical

assistance under this chapter, each adult member, parent, or caretaker relative of the

family/assistance unit must:

     (1) Assign to the state any rights to support for children within the family from any person

that the family member has at the time the assignment is executed or may have while receiving

assistance under this chapter;

     (2) Consent to and cooperate with the state in establishing the paternity and in establishing

and/or enforcing child support and medical support orders for all children in the family or assistance

unit in accordance with title 15 of the general laws, as amended, unless the parent or caretaker

relative is found to have good cause for refusing to comply with the requirements of this subsection.

     (3) Absent good cause, as defined by the department of human services through the

rulemaking process, for refusing to comply with the requirements of subsections (l)(1) and (l)(2),

cash assistance to the family shall be reduced by twenty-five percent (25%) until the adult member

of the family who has refused to comply with the requirements of this subsection consents to and

cooperates with the state in accordance with the requirements of this subsection.

     (4) As a condition of eligibility for cash and medical assistance under this chapter, each

adult member, parent, or caretaker relative of the family/assistance unit must consent to and

cooperate with the state in identifying and providing information to assist the state in pursuing any

third party who may be liable to pay for care and services under Title XIX of the Social Security

Act, 42 U.S.C. § 1396 et seq.

     40-5.2-20. Childcare assistance — Families or assistance units eligible.

     (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%) two hundred eighty-five

percent (285%) 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%) two hundred eighty-five percent (285%) 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 from January 1, 2025 through December 31, 2026, 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.

Effective on January 1, 2027, the department shall also provide childcare assistance to families

with incomes below two hundred eighty-five percent (285%) 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) The department shall also provide childcare assistance to families who meet the

requirements of the protective services group. For the purposes of this section, "protective services

group” means foster or kinship children served through the department of children, youth and

families as well as the children of childcare educators as defined in subsection (l) of this section.

     (c)(d) 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)(e) 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)(f) 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)(g)(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%)

two hundred eighty-five percent (285%) of the applicable federal poverty guidelines shall continue

to be eligible for childcare assistance until their incomes exceed three hundred percent (300%) three

hundred twenty-five percent (325%) 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)(h) 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)(i) 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)(j) 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)(k) 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)(l) Effective from August 1, 2023, through July 31, 20282030, 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. This protective service group

shall continue to be eligible for childcare assistance until their incomes exceed three hundred

twenty-five percent (325%) of the applicable federal poverty guidelines. 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.

     40-5.2-35. Child support pass-through.

     For any month in which a noncustodial parent makes a child support payment in the month

when due and the support is collected by the department of human services, for a child or children

receiving cash assistance pursuant to this chapter, in a household of one child the first fifty dollars

($50.00) one hundred dollars ($100) of the child support payment, or the actual amount of the child

support payment if the payment is less than fifty dollars ($50.00) one hundred dollars ($100), shall

be paid to the family in which the child resides; in a household of two (2) or more children the first

two hundred dollars ($200) of the child support payment, or the actual amount of the child support

payment if the payment is less than two hundred dollars ($200), shall be paid to the family in which

the child resides. If more than one noncustodial parent makes a child support payment to children

living in the same family, there shall only be one payment of fifty ($50.00) one hundred dollars

($100) for a household of one child, or two hundred dollars ($200) for a household with two (2) or

more children paid to the family from the child support collected. This payment is known as the

“pass through” payment and shall be sent to the family within two (2) business days of the

determination that the amount is due and owing and no later than within two (2) business days of

the end of the month in which the support was collected.

     SECTION 7. 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

     (m) Effective July 1, 2026, 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 $351 $358 $373 $382 $397

Toddlers $278 $284 $296 $303 $315

Preschoolers $236 $247 $255 $263 $273

School Age $210 $215 $231 $250 $263

     SECTION 8. Section 40.1-1-13 of the General Laws in Chapter 40.1-1 entitled

“Department of Behavioral Healthcare, Developmental Disabilities and Hospitals” is hereby

amended to read as follows:

     40.1-1-13. Powers and duties of the office.

     Notwithstanding any provision of the Rhode Island general laws to the contrary, the

department of behavioral healthcare, developmental disabilities and hospitals shall have the

following powers and duties:

     (1) To establish and promulgate the overall plans, policies, objectives, and priorities for

state substance abuse education, prevention, and treatment; provided, however, that the director

shall obtain and consider input from all interested state departments and agencies prior to the

promulgation of any such plans or policies;

     (2) Evaluate and monitor all state grants and contracts to local substance abuse service

providers;

     (3) Develop, provide for, and coordinate the implementation of a comprehensive state plan

for substance abuse education, prevention, and treatment;

     (4) Ensure the collection, analysis, and dissemination of information for planning and

evaluation of substance abuse services;

      (5) Provide support, guidance, and technical assistance to individuals, local governments,

community service providers, public and private organizations in their substance abuse education,

prevention, and treatment activities;

     (6) Confer with all interested department directors to coordinate the administration of state

programs and policies that directly affect substance abuse treatment and prevention;

     (7) Seek and receive funds from the federal government and private sources in order to

further the purposes of this chapter;

     (8) To act in conjunction with the executive office of health and human services as the

state’s co-designated agency (42 U.S.C. § 300x-30(a)) for administering federal aid and for the

purposes of the calculation of the expenditures relative to the substance abuse block grant and

federal funding maintenance of effort. The department of behavioral healthcare, developmental

disabilities and hospitals, as the state’s substance abuse authority, will have the sole responsibility

for the planning, policy and implementation efforts as it relates to the requirements set forth in

pertinent substance abuse laws and regulations including 42 U.S.C. § 300x-21 et seq.;

     (9) Propose, review, and/or approve, as appropriate, proposals, policies, or plans involving

insurance and managed care systems for substance abuse services in Rhode Island;

     (10) To enter into, in compliance with the provisions of chapter 2 of title 37, contractual

relationships and memoranda of agreement as necessary for the purposes of this chapter;

     (11) To license facilities and programs for the care and treatment of substance abusers and

for the prevention of substance abuse, and provide the list of licensed chemical dependency

professionals (LCDP) and licensed chemical dependency clinical supervisors (LCDCS) (licensed

by the department of health pursuant to chapter 69 of title 5) for use by state agencies including,

but not limited to, the adjudication office of the department of transportation, the district court and

superior court and the division of probation and parole for referral of individuals requiring

substance use disorder treatment;

     (12) To promulgate rules and regulations necessary to carry out the requirements of this

chapter;

     (13) Perform other acts and exercise any other powers necessary or convenient to carry out

the intent and purposes of this chapter;

     (14) To exercise the authority and responsibilities relating to education, prevention, and

treatment of substance abuse, as contained in, but not limited to, the following chapters: chapters

1.10, 10.1, and 28.2 of title 23; chapters 21.2 and 21.3 of title 16; chapter 50.1 of title 42 [repealed];

chapter 109 of title 42; chapter 69 of title 5; and § 35-4-18;

     (15) To establish a Medicare Part D restricted-receipt account in the hospitals and

community rehabilitation services program and the Rhode Island state psychiatric hospital program

to receive and expend Medicare Part D reimbursements from pharmacy benefit providers consistent

with the purposes of this chapter;

     (16) To establish a RICLAS group home operations restricted-receipt account in the

services for the developmentally disabled program to receive and expend rental income from

RICLAS group clients for group home-related expenditures, including food, utilities, community

activities, and the maintenance of group homes;

     (17) To establish a non-Medicaid, third-party payor restricted-receipt account in the

hospitals and community rehabilitation services program to receive and expend reimbursement

from non-Medicaid, third-party payors to fund hospital patient services that are not Medicaid

eligible; and

     (18) To certify any and all recovery housing facilities directly, or through a contracted

entity, as defined by department guidelines, which includes adherence to using National Alliance

for Recovery Residences (NARR) standards. In accordance with a schedule to be determined by

the department, all referrals from state agencies or state-funded facilities shall be to certified

houses, and only certified recovery housing facilities shall be eligible to receive state funding to

deliver recovery housing services. As of January 1, 2027, all recovery housing facilities shall be

registered with the department and shall adhere to the NARR certification process.

     (19) To establish, operate, and/or designate a RI 9-8-8 Suicide & Crisis Lifeline center or

centers to provide telephone, text and chat crisis intervention services and crisis care coordination

to individuals accessing the RI 9-8-8 Suicide & Crisis Lifeline.

     SECTION 9. Title 40.1 of the General Laws entitled “Behavioral Healthcare, Development

Disabilities and Hospitals” is hereby amended by adding thereto the following chapter:

CHAPTER 8.6

RHODE ISLAND 9-8-8 SUICIDE & CRISIS LIFELINE

     40.1-8.6-1. Definitions.

     As used in this chapter:

     (1) "9-8-8 Suicide & Crisis Lifeline" or "lifeline" means the national network system

operated by the National Suicide Prevention Lifeline ("NSPL") or its successor entity, within which

the department-approved or department-operated RI 9-8-8 Suicide & Crisis Lifeline Center

participates.

     (2) "Department" means the department of behavioral healthcare, developmental

disabilities and hospitals.

     (3) "Director" means the director of the department of behavioral healthcare,

developmental disabilities and hospitals.

     (4) "National Suicide Prevention Lifeline" ("NSPL") means the national network of local

crisis centers providing free and confidential emotional support to people in suicidal crisis or

emotional distress twenty-four (24) hours a day, seven (7) days a week. Membership as an NSPL

center requires nationally recognized certification which includes evidence-based training for all

staff and volunteers in the management of NSPL calls.

     (5) "Rhode Island (RI) 9-8-8 state administrator" means the administrator designated by

the director of the department to manage the locally operated and funded center within the national

network of the 9-8-8 Suicide & Crisis Lifeline within Rhode Island.

     (6) "Rhode Island (RI) 9-8-8 Suicide & Crisis Lifeline Center" or "lifeline center" means a

department-approved or department-operated center that participates in the National Suicide

Prevention Lifeline Network and responds to statewide or regional 9-8-8 contacts that is operated

by or under contract with the department.

     40.1-8.6-2. 9-8-8 Suicide and Crisis Lifeline.

     (a) The director is hereby authorized to establish, operate, promulgate regulations with

regard to, and/or designate a RI 9-8-8 Suicide & Crisis Lifeline center or centers to provide

telephone, text and chat crisis intervention services and crisis care coordination to individuals

accessing the RI 9-8-8 Suicide & Crisis Lifeline twenty-four (24) hours a day, seven (7) days a

week.

     (b) The director shall have the authority to provide general oversight of the RI 9-8-8 Suicide

& Crisis Lifeline Center(s) established by this chapter.

     (c) The RI 9-8-8 Suicide & Crisis Lifeline center(s) shall have an active agreement with

the administrator of the National Suicide Prevention Lifeline ("NSPL") maintained by SAMHSA,

or any successor entity, for participation within the network.

     (d) The designated RI 9-8-8 Suicide & Crisis Lifeline center(s) shall meet SAMHSA and

NSPL or any successor entity’s requirements and best practices guidelines for operational and

clinical standards for adults and children.

     (e) The designated RI 9-8-8 Suicide & Crisis Lifeline center(s) shall provide and report

data and participate in evaluations and related quality improvement activities as required by the 9-

8-8 state administrator. The department shall provide the department of children, youth, and

families with data regarding utilization of RI 9-8-8 services by children, youth and their families,

consistent with NSPL requirements and state and federal confidentiality and privacy laws and

regulations.

     (f) The designated RI 9-8-8 Suicide & Crisis Lifeline center(s) shall make referrals,

consistent with guidance and policies established by the NSPL or any successor entity, to follow-

up services for individuals who access the RI 9-8-8 Suicide & Crisis Lifeline.

     (g) The director shall consult with the director of the department of children, youth, and

families prior to promulgating rules and regulations specific to RI 9-8-8 services for children,

youth, and their families and may require appropriate training regarding children services into a

contract with the 9-8-8 service center provider.

     (h) Nothing in §§ 40.1-8.6-2, 40.1-8.6-3, or 40.1-8.6-4 shall be construed to restrict the

authority of the department of children, youth and family (DCYF) pursuant to chapters 72 and 72.1

of title 42.

     40.1-8.6-3. Funding of the 988 Suicide & Crisis Lifeline.

     (a) The director shall have the authority to expend any and all funds allocated to support

the operations of the RI 9-8-8 Suicide & Crisis Lifeline.

     40.1-8.6-4. Implementation.

     (a) The director shall designate the RI 9-8-8 state administrator. The RI 9-8-8 state

administrator shall be an employee of the department and shall serve at the pleasure of the director,

or shall be a contractor who has a contract with the department and shall serve for the period

designated in the contract and in accordance with the terms of such contract.

     (b) All state agencies and/or departments shall provide to the department any and all data

and other information necessary for the department to comply with federal and/or state reporting

requirements with respect to the establishment and/or operation of the RI 9-8-8 Suicide & Crisis

Lifeline.

     SECTION 10. Chapter 42-72 of the General Laws entitled "Department of Children, Youth

and Families" is hereby amended by adding thereto the following section:

     42-72-37. Application for social security benefits, supplemental security income, and

veterans benefits.

     (a) Definitions. For the purposes of this section:

     (1) "Benefits" means social security benefits, supplemental security income, veterans

benefits, and railroad retirement benefits; and

     (2) "Youth's attorney" and "guardian ad litem" means the person appointed as the youth's

attorney or guardian ad litem in the proceeding in which the department is appointed as the youth's

guardian or custodian.

     (b) Application for benefits.

     (1) Upon receiving temporary custody or guardianship of a youth in care, the department

shall assess the youth to determine whether the youth may be eligible for benefits. If, after the

assessment, the department determines that the youth may be eligible for benefits, the department

shall ensure that an application is filed on behalf of the youth. The department shall conserve the

youth’s benefits, including SSDI, inheritance, pensions, life insurance, or other benefits. If the

department determines the youth is eligible for an ABLE account as authorized by Section 529A

of the Internal Revenue Code of 1986, it shall conserve the benefits in that account in a manner that

appropriately avoids any federal asset or resource limits, absent a compelling reason to conserve

benefits in another manner. The department shall prescribe by rules and regulations how it will

review cases of youth in care at regular intervals to determine whether the youth may have become

eligible for benefits after the initial assessment. The department shall make reasonable efforts to

encourage youth in care over the age of eighteen (18) who are likely eligible for benefits to

cooperate with the application process and to assist youth with the application process.

     (2) When applying for benefits under this section for a youth in care the department shall

identify a representative payee in accordance with the requirements of 20 CFR 404.2021 and

416.621. If the department is seeking to be appointed as the youth's representative payee, the

department shall consider input, if provided, from the youth's attorney and guardian ad litem

regarding whether another representative payee, consistent with the requirements of 20 CFR

404.2021 and 416.621, is available. If the department serves as the representative payee for a youth

over the age of eighteen (18), the department shall request a court order.

     (c) Notifications. The department shall immediately notify a youth over the age of sixteen

(16), the youth's attorney and guardian ad litem, and the youth's parent or legal guardian or another

responsible adult of:

     (1) Any application for or any application to become representative payee for benefits on

behalf of a youth in care;

     (2) Any communications from the Social Security Administration, the U.S. Department of

Veterans Affairs, or the Railroad Retirement Board pertaining to the acceptance or denial of

benefits or the selection of a representative payee; and

     (3) Any appeal or other action requested by the department regarding an application for

benefits.

     (d) Use of benefits. Consistent with federal law, when the department serves as the

representative payee for a youth receiving benefits and receives benefits on the youth's behalf, the

department shall:

     (1) Beginning January 1, 2027, except as provided in a request for the disbursement of

funds, ensure that youth of any age in the care and custody of the department and until the

department no longer serves as the representative payee, the entirety of the youth's benefits are

conserved.

     (2) Exercise discretion and seek advisement from the Office of the General Treasurer in

accordance with federal law and in the best interests of the youth when making decisions to use or

conserve the youth's benefits that are less than or not subject to asset or resource limits under federal

law, including using the benefits to address the youth's special needs and conserving the benefits

for the youth's reasonably foreseeable future needs.

     (3) Appropriately monitor any federal asset or resource limits for the benefits and ensure

that the youth's best interest is served by using or conserving the benefits, including SSDI,

inheritance, pensions, life insurance, or other benefits in a way that avoids violating any federal

asset or resource limits that would affect the youth's eligibility to receive the benefits.

     (e)(1) Annual accounting. The department shall provide an annual accounting to the youth's

attorney and guardian ad litem of how the youth's benefits have been used and conserved. In

addition, within ten (10) business days of a request from a youth or the youth's attorney and

guardian ad litem, the department shall provide an accounting to the youth of how the youth's

benefits have been used and conserved.

     (2) Final accounting. When the department's guardianship of the youth is being terminated,

the department shall provide:

     (i) A final accounting to the Social Security Administration, to the youth's attorney and

guardian ad litem, and to either the person or persons who will assume guardianship of the youth

or who is in the process of adopting the youth, if the youth is under eighteen (18), or to the youth,

if the youth is over eighteen (18); and

     (ii) Information to the parent, guardian, or youth regarding how to apply to become the

representative payee. The department shall adopt rules and regulations to ensure that the

representative payee transitions occur in a timely and appropriate manner.

     (f) Financial literacy. The department shall provide the youth with financial literacy

training and support, including specific information regarding the existence, availability, and use

of funds conserved for the youth in accordance with this subsection, beginning by age fourteen

(14). The literacy program and support services shall be developed in consultation with input from

the department's statewide speak advisory board and the office of the general treasurer.

     (g) Adoption of rules and regulations. The department shall adopt rules and regulations to

implement the provisions of this section by October 1, 2026.

     (h) Reporting. No later than January 1, 2029, the department shall file a report with the

general assembly providing the following information for state fiscal years 2027 and 2028 and

annually beginning January 1, 2030, for the preceding fiscal year:

     (1) The number of youth entering care.

     (2) The number of youth entering care receiving each of the following types of benefits:

social security benefits, supplemental security income, veterans benefits, and/or railroad retirement

benefits.

     (3) The number of youth entering care for whom the department filed an application for

each of the following types of benefits: social security benefits, supplemental security income,

veterans benefits, and/or railroad retirement benefits.

     (4) The number of youth entering care who were awarded each of the following types of

benefits based on an application filed by the department: social security benefits, supplemental

security income, veterans benefits, and/or railroad retirement benefits.

     (i) Annually beginning January 1, 2029, the department shall file a report with the general

assembly with the following information regarding the preceding fiscal year:

     (1) The number of conserved accounts established and maintained for youth in care;

     (2) The average amount conserved by age group; and

     (3) The total amount conserved by age group.

     SECTION 11. Sections 42-160-3 and 42-160-5 of the General Laws in Chapter 42-160

entitled "Rhode Island Pay for Success Act" are hereby amended to read as follows:

     42-160-3. Annual reporting.

     The executive office, in collaboration with the Rhode Island Coalition to End

Homelessness or other qualified organization as determined by the executive office, shall provide

yearly progress reports to the general assembly beginning no later than January 30, 2022, and

annually thereafter until January 30, 2027 2028. These reports will include recommendations on a

proposed structure for entering into pay for success contracts, for administering the program, and

for any and all matters related thereto that the executive office deems necessary to administer future

pay for success projects at the conclusion of the pilot program in 2026 2027. As a condition of this

project, HUD requires that a third party conduct a transparent and rigorous evaluation of the

intervention to determine whether the outcomes have indeed achieved success. The evaluation

results will be reported yearly to the governor and general assembly.

     42-160-5. Pilot program established.

     There is established a five-year (5) six-year (6) pay-for-success pilot program to be

administered by the Rhode Island executive office of health and human services. The pilot will

follow the proposal outlined in the 2016 pay-for-success grant proposal to HUD and 2017

feasibility study. The pay-for-success project will provide a person-centered housing and

supportive services intervention (PSH) for one hundred twenty-five (125) persons in Rhode Island

experiencing homelessness who are high utilizers of the healthcare and justice systems. The pilot

program will leverage eight hundred seventy-five thousand dollars ($875,000) of HUD/DOJ grant

funds. Contract agreements with the executive office of health and human services pursuant to this

chapter shall not exceed one million five hundred thousand dollars ($1,500,000) per fiscal year or

six million dollars ($6,000,000) in the aggregate over the five (5) six (6) years of the pilot program,

as determined by the department; provided, no agreements shall be entered by the department after

July 1, 2026 2027, without further authorization by the general assembly.

     SECTION 12. Section 6 of this article shall take effect January 1, 2027, except for the

provisions of § 42-5.2-20(c) which shall take effect July 1, 2026. The remainder of this article shall

take effect July 1, 2026.