SECTION 1. Title 40 of the General Laws entitled "Human Services" is hereby amended by adding thereto the following chapter:

{ADD 40-8.4-1. Title. -- ADD} {ADD This chapter is hereby entitled "The Health Care for Families Act". ADD}

{ADD 40-8.4-2. Purpose. -- ADD} {ADD It is the intent of the general assembly to continue to meet the goal established in 1993 pursuant to 42-12.3-1 to assure access to comprehensive health care by providing or creating access to health insurance to all Rhode Islanders who are uninsured. Over the course of several years, health insurance through the RIte Care program has been extended to pregnant women and children living in families whose income is less than two hundred fifty percent (250%) of the federal poverty level. Many of the parents of these children are uninsured and without the means to purchase health insurance. Federal funds are available to help pay for health insurance for low-income families through the medical assistance program under section 1931 of title XIX of the social security act which delinks medical assistance from cash assistance and allows for expanded income and resource methodologies. It is the intent of the general assembly, therefore, to implement section 1931 of title XIX of the social security act and in addition to provide expanded access to health insurance for eligible families. Federal funds for some children and their parents may also be available under title XXI of the social security act and it is further the intent of the general assembly to access these funds as appropriate. ADD}

{ADD 40-8.4-3. Definitions . -- ADD} {ADD "Family" means a minor child or children and the parent(s) or relative as defined in section 40-5.1-3, with whom they reside including two parent families in which one parent is working more than 100 hours per month. ADD}

{ADD "Minor child" means a child under the age of eighteen (18) or who is eighteen (18) and a full-time student in a secondary school or in the equivalent level of vocational or technical training. ADD}

{ADD 40-8.4-4. Eligibility. -- ADD} {ADD (a) Medical assistance for families. There is hereby established a category of medical assistance eligibility pursuant to section 1931 of title XIX of the social security act for families whose income and resources are no greater than the standards in effect in the aid to families with dependent children program on July 16, 1996 or such increased standards as the department may determine. The department of human services is directed to amend the medical assistance title XIX state plan and to submit to the U.S. Department of Health and Human Services an amendment to the RIte Care waiver project to provide for medical assistance coverage to families under this chapter in the same amount, scope and duration as coverage provided to comparable groups under the waiver. The department is further authorized and directed to submit such amendments and or requests for waivers to the title XXI state plan as may be necessary to maximize federal contribution for provision of medical assistance coverage under this chapter. However, implementation of expanded coverage under this chapter shall not be delayed pending federal review of any title XXI amendment or waiver. ADD}

{ADD (b) Income. The director of the department of human services is authorized and directed to amend the medical assistance title XIX state plan or RIte Care waiver to provide medical assistance coverage through expanded income disregards or other methodology for families whose income levels are below one hundred eighty-five percent (185%) of the federal poverty level. ADD}

{ADD (c) Resources. Resources shall be disregarded in determining eligibility under this chapter. ADD}

{ADD 40-8.4-5. Managed care. -- ADD} {ADD The delivery and financing of the health care services provided under this chapter shall be provided through a system of managed care. A managed care system integrates an efficient financing mechanism with quality service delivery, provides a "medical home" to assure appropriate care and deter unnecessary and inappropriate care, and places emphasis on preventive and primary health care. ADD}

{ADD 40-8.4-6. Administration. -- ADD} {ADD The department of human services shall assure that eligibility and enrollment is determined and provided in a timely, efficient and user friendly manner, including mail-in applications. The department may enter into any necessary cooperative agreements with the department of health and/or other state agencies to achieve the purposes of this section. Children and families applying for cash assistance through the family independence program, 40-5.1-1 et seq. shall not be required to complete a separate application for medical assistance under this chapter. ADD}

{ADD 40-8.4-7. Buy-In. -- ADD} {ADDThe Department of Human Services shall investigate and develop opportunities for individuals and/or employers to buy into, at the individual's and/or employer's expense, one or more programs the department may establish under this chapter or chapter 42-12.3 to address uninsurance among Rhode Islanders. ADD}

{ADD 40-8.4-8. Appropriations. -- ADD} {ADDAuthorization to pay for health care. The general assembly shall annually appropriate to this department of human services such sums as it may deem necessary to carry out the purposes of this chapter. Authorization to pay for health care services specified in this chapter shall be made by representatives of the department of human services, and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of such sum or sums or so much thereof as may be required from time to time, upon the receipt by him or her of properly authenticated vouchers, provided, however, that the department of human services may enter into cooperative agreements for the transfer of funds to effectuate the purposes set forth in this chapter. ADD}

{ADD 40-8.4-9. Assignment of medical support rights. --ADD} {ADD Any person who is determined eligible for health care assistance under this chapter is hereby deemed to have made an assignment of rights to medical support in accordance with 40-6-9(b), and the provisions of 40-6-9(b) and (d) are incorporated by reference and shall apply to such person. ADD}

{ADD 40-8.4-10. Regulations. --ADD} {ADD The department of human services is authorized to promulgate any regulations necessary to implement this chapter. ADD}

{ADD 40-8.4-11. Severability. -- ADD} {ADDIf any provision in any section of this chapter or the application thereof to any person or circumstances is held invalid, its invalidity does not affect other provisions or applications of this chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable. ADD}

SECTION 2. Section 40-6-29 of the General Laws in Chapter 40-6 entitled "Public Assistance Act" is hereby amended to read as follows:

40-6-29. Health care benefits -- Employers -- Discrimination against public assistance recipients. -- (a) No employer in the state who shall hire, contract with, or employ an individual (hereinafter "recipient") who has been determined eligible to receive public assistance or medical assistance under chapters 6 and 5.1 {ADD and 8.4 ADD} of this title, or chapter 12.3 of title 42 and/or title XIX of the Social Security Act, 42 U.S.C. section 1396 et seq., shall discriminate against the recipient(s) on the basis that the recipient(s) receive health care coverage as an element of their eligibility under those chapters and act.

(b) The department of human services is hereby authorized and directed to amend its regulations and any appropriate state plan(s) pursuant to the federal Social Security Act, 42 U.S.C. section 301 et seq., to provide for imposition of a fine on the failure of any employer to comply with the requirements of this section.

(c) The amount of the fine imposed by subsection (b) of this section shall be equal to one hundred dollars ($100) for each day for each individual for which the failure occurs.

(d) No fine shall be imposed by subsection (b) if:

(1) the failure was due to reasonable cause and not willful neglect, and

(2) the failure is corrected during the thirty (30) day period (or such period as the director of the department of human services may determine appropriate) beginning on the first day any of the individuals whom the fine is imposed know, or exercising reasonable diligence would have known, that the failure existed. In the case of a failure which is due to reasonable cause and not to willful neglect, the director may waive part or all of the fine imposed by subsection (a) to the extent that the payment of the fine would be excessive relative to the failure involved.

(e) No employer may refuse to provide employee data information lawfully requested by the department of human services about specific employees whom the department had determined eligible or is in the process of determining eligibility to receive public health care benefits.

(f) As used in this section, the term "group health plan" has the meaning given the term in section 5000(b)(1) of the Internal Revenue Code of 1986, 26 U.S.C. section 5000(b)(1).

(g) A group health plan offered by an employer:

(1) May not take into account, for any item or services to be furnished to a recipient at the time the recipient is covered under the plan by reason of the current employment of that recipient (or the recipient's spouse), that the recipient is entitled to health care coverage as an element of their eligibility, and

(2) Shall provide that any recipient, and any recipient's spouse and minor dependents, shall be entitled to the same benefits under the plan under the same conditions as any employee, and the spouse and dependents of the employee.

(h) It is unlawful for an employer to offer any financial or other incentive for a recipient not to enroll (or to terminate enrollment) under a group health plan, unless the incentive is also offered to all individuals who are eligible for coverage under the plan. Any entity that violates the previous sentence is subject to a civil money penalty not to exceed five thousand dollars ($5,000) for each violation which may be imposed by the department of human services.

SECTION 3. This article shall take effect on July 1, 1998, and provided further that expansion of eligibility pursuant to 40-8.4-4(b) shall be provided beginning on the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of federal approval of amendment of the RIte Care waiver project from the Secretary of the U.S. Department of Health and Human Services, provided however, that the Rhode Island Department of Human Services is authorized and directed to seek federal approvals upon passage of this act.