2015 -- S 0652

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LC001858

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2015

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A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - OFFICE OF HEALTH AND

HUMAN SERVICES

     Introduced By: Senators Miller, Sosnowski, Metts, Archambault, and Conley

     Date Introduced: March 11, 2015

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 42-7.2-5 of the General Laws in Chapter 42-7.2 entitled "Office of

Health and Human Services" is hereby amended to read as follows:

     42-7.2-5. Duties of the secretary. -- The secretary shall be subject to the direction and

supervision of the governor for the oversight, coordination and cohesive direction of state

administered health and human services and in ensuring the laws are faithfully executed, not

withstanding any law to the contrary. In this capacity, the Secretary of Health and Human

Services shall be authorized to:

      (1) Coordinate the administration and financing of health care benefits, human services

and programs including those authorized by the Global Consumer Choice Compact Waiver and,

as applicable, the Medicaid State Plan under Title XIX of the US Social Security Act. However,

nothing in this section shall be construed as transferring to the secretary the powers, duties or

functions conferred upon the departments by Rhode Island public and general laws for the

administration of federal/state programs financed in whole or in part with Medicaid funds or the

administrative responsibility for the preparation and submission of any state plans, state plan

amendments, or authorized federal waiver applications, once approved by the secretary.

      (2) Serve as the governor's chief advisor and liaison to federal policymakers on Medicaid

reform issues as well as the principal point of contact in the state on any such related matters.

      (3) Review and ensure the coordination of any Global Consumer Choice Compact

Waiver requests and renewals as well as any initiatives and proposals requiring amendments to

the Medicaid state plan or category two (II) or three (III) changes, as described in the special

terms and conditions of the Global Consumer Choice Compact Waiver with the potential to affect

the scope, amount or duration of publicly-funded health care services, provider payments or

reimbursements, or access to or the availability of benefits and services as provided by Rhode

Island general and public laws. The secretary shall consider whether any such changes are legally

and fiscally sound and consistent with the state's policy and budget priorities. The secretary shall

also assess whether a proposed change is capable of obtaining the necessary approvals from

federal officials and achieving the expected positive consumer outcomes. Department directors

shall, within the timelines specified, provide any information and resources the secretary deems

necessary in order to perform the reviews authorized in this section;

      (4) Beginning in 2006, prepare and submit to the governor, the chairpersons of the house

and senate finance committees, the caseload estimating conference, and to the joint legislative

committee for health care oversight, by no later than March 15 of each year, a comprehensive

overview of all Medicaid expenditures outcomes, and utilization rates. The overview shall

include, but not be limited to, the following information:

      (i) Expenditures under Titles XIX and XXI of the Social Security Act, as amended;

      (ii) Expenditures, outcomes and utilization rates by population and sub-population

served (e.g. families with children, children with disabilities, children in foster care, children

receiving adoption assistance, adults with disabilities, and the elderly);

      (iii) Expenditures, outcomes and utilization rates by each state department or other

municipal or public entity receiving federal reimbursement under Titles XIX and XXI of the

Social Security Act, as amended; and

      (iv) Expenditures, outcomes and utilization rates by type of service and/or service

provider.

      The directors of the departments, as well as local governments and school departments,

shall assist and cooperate with the secretary in fulfilling this responsibility by providing whatever

resources, information and support shall be necessary.

      (5) Resolve administrative, jurisdictional, operational, program, or policy conflicts

among departments and their executive staffs and make necessary recommendations to the

governor.

      (6) Assure continued progress toward improving the quality, the economy, the

accountability and the efficiency of state-administered health and human services. In this

capacity, the secretary shall:

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      (i) Direct implementation of reforms in the human resources practices of the departments

that streamline and upgrade services, achieve greater economies of scale and establish the

coordinated system of the staff education, cross-training, and career development services

necessary to recruit and retain a highly-skilled, responsive, and engaged health and human

services workforce;

      (ii) Encourage the departments to utilize consumer-centered approaches to service design

and delivery that expand their capacity to respond efficiently and responsibly to the diverse and

changing needs of the people and communities they serve;

      (iii) Develop all opportunities to maximize resources by leveraging the state's purchasing

power, centralizing fiscal service functions related to budget, finance, and procurement,

centralizing communication, policy analysis and planning, and information systems and data

management, pursuing alternative funding sources through grants, awards and partnerships and

securing all available federal financial participation for programs and services provided through

the departments;

      (iv) Improve the coordination and efficiency of health and human services legal

functions by centralizing adjudicative and legal services and overseeing their timely and judicious

administration;

      (v) Facilitate the rebalancing of the long term system by creating an assessment and

coordination organization or unit for the expressed purpose of developing and implementing

procedures across departments that ensure that the appropriate publicly-funded health services are

provided at the right time and in the most appropriate and least restrictive setting; and

      (vi) Strengthen health and human services program integrity, quality control and

collections, and recovery activities by consolidating functions within the office in a single unit

that ensures all affected parties pay their fair share of the cost of services and are aware of

alternative financing.

      (vii) Broaden access to publicly funded food and nutrition services by consolidating

agency programs and initiatives to eliminate duplication and overlap and improve the availability

and quality of services; and

      (viii) Assure protective services are available to vulnerable elders and adults with

developmental and other disabilities by reorganizing existing services, establishing new services

where gaps exist and centralizing administrative responsibility for oversight of all related

initiatives and programs.

     (ix) Create and evaluate an evidence-based behavioral health care program for

incarcerated adults with co-occurring substance use and mental disorders, that includes clinically

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appropriate assessment and treatment of individuals during their incarceration, and the provision

of treatment to facilitate the successful reintegration of individuals returning from incarceration to

their communities.

      (7) Prepare and integrate comprehensive budgets for the health and human services

departments and any other functions and duties assigned to the office. The budgets shall be

submitted to the state budget office by the secretary, for consideration by the governor, on behalf

of the state's health and human services in accordance with the provisions set forth in § 35-3-4 of

the Rhode Island general laws.

      (8) Utilize objective data to evaluate health and human services policy goals, resource

use and outcome evaluation and to perform short and long-term policy planning and

development.

      (9) Establishment of an integrated approach to interdepartmental information and data

management that complements and furthers the goals of the CHOICES initiative and that will

facilitate the transition to consumer-centered system of state administered health and human

services.

      (10) At the direction of the governor or the general assembly, conduct independent

reviews of state-administered health and human services programs, policies and related agency

actions and activities and assist the department directors in identifying strategies to address any

issues or areas of concern that may emerge thereof. The department directors shall provide any

information and assistance deemed necessary by the secretary when undertaking such

independent reviews.

      (11) Provide regular and timely reports to the governor and make recommendations with

respect to the state's health and human services agenda.

      (12) Employ such personnel and contract for such consulting services as may be required

to perform the powers and duties lawfully conferred upon the secretary.

      (13) Implement the provisions of any general or public law or regulation related to the

disclosure, confidentiality and privacy of any information or records, in the possession or under

the control of the executive office or the departments assigned to the executive office, that may be

developed or acquired for purposes directly connected with the secretary's duties set forth herein.

      (14) Hold the director of each health and human services department accountable for

their administrative, fiscal and program actions in the conduct of the respective powers and duties

of their agencies.

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     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT - OFFICE OF HEALTH AND

HUMAN SERVICES

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     This act would require the secretary of the office of health and human services to create

an evidence-based behavioral health care program for incarcerated adults with co-occurring

substance use and mental disorders.

     This act would take effect upon passage.

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