2023 -- H 5394

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LC001301

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2023

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A N   A C T

RELATING TO HUMAN SERVICES -- RHODE ISLAND PATHWAYS PROJECT

     

     Introduced By: Representatives Bennett, Kislak, J. Lombardi, Casimiro, McNamara,
Cruz, Shallcross Smith, Donovan, Ajello, and Handy

     Date Introduced: February 03, 2023

     Referred To: House Finance

     It is enacted by the General Assembly as follows:

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     SECTION 1. Title 40 of the General Laws entitled "HUMAN SERVICES" is hereby

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amended by adding thereto the following chapter:

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CHAPTER 23

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RHODE ISLAND PATHWAYS PROJECT

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     40-23-1. Short title.

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     This chapter shall be known and may be cited as the "Rhode Island pathways project."

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     40-23-2. Definitions.

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     (a) For the purposes of this chapter, and consistent with 42 U.S.C. § 11360(2) et seq.,

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"chronically homeless" means, with respect to an individual or family, that the individual or family:

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     (1) Is homeless and lives or resides in a place not meant for human habitation, a safe haven,

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or in an emergency shelter;

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     (2) Has been homeless and living or residing in a place not meant for human habitation, a

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safe haven, or in an emergency shelter continuously for at least one year or on at least four (4)

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separate occasions in the last three (3) years; and

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     (3) Has an adult head of household (or a minor head of household if no adult is present in

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the household) with a diagnosable substance use disorder, serious mental illness, developmental

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disability, post-traumatic stress disorder, cognitive impairments resulting from a brain injury, or

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chronic physical illness or disability, including the co-occurrence of two (2) or more of those

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conditions.

 

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     (b) A person who currently lives or resides in an institutional care facility, including a jail,

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substance abuse or mental health treatment facility, hospital or other similar facility, and has resided

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there for fewer than ninety (90) days shall be considered chronically homeless if such person met

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all of the requirements described in subsections (a)(1) through (a)(3) of this section prior to entering

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that facility.

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     (c) For purposes of this chapter, "Medicaid-expansion population" means any individual

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who became newly eligible to receive Medicaid-funded health coverage as of January 1, 2014 as

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defined under the federal Social Security Act, 1902(a)(10)(A)(i)(VIII), and enrolled in such

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Medicaid-funded health coverage.

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     40-23-3. Purpose.

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     The purpose of this chapter is to require the executive office of health and human services

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(EOHHS) to conduct a study to assess the impact of using Medicaid funds to provide coverage for

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the treatment of underlying conditions that contribute to homelessness.

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     40-23-4. Establishment of the Rhode Island pathways project pilot study.

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     (a) EOHHS shall conduct a study to assess the impact of using Medicaid funds to provide

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coverage for the treatment of underlying conditions that contribute to homelessness, including the

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costs to provide coverage for the chronically homeless population in the state; provided, that for

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the purposes of this chapter, "treatment" or "treatment of underlying conditions that contribute to

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homelessness" includes:

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     (1) Behavioral health services, including mental health and substance abuse services;

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     (2) Case management;

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     (3) Personal care and personal assistance services;

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     (4) Home and community-based services; and

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     (5) Housing support services, including rental payment assistance.

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     (b) EOHHS shall submit findings and recommendations, including any proposed

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legislation, to the general assembly no later than January 1, 2024, and annually on or before January

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1 thereafter.

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     40-23-5. Duties and responsibilities.

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     (a) The executive office of health and human services (EOHHS) will have the authority to

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utilize Medicaid waiver funds to provide coverage for supportive housing for the chronically

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homeless population in the state.

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     (b) In planning for the expansion of supportive housing services provided through

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Medicaid managed care plans, EOHHS shall consider the following:

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     (1) Benefit eligibility, including criteria related to:

 

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     (i) Health conditions;

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     (ii) Housing status; and

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     (iii) Current or potential system costs;

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     (2) Supportive housing services including, but not limited to:

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     (i) Outreach and engagement;

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     (ii) Housing search assistance;

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     (iii) Tenancy rights and responsibilities education;

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     (iv) Eviction prevention;

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     (v) Rental payment assistance;

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     (vi) Service plan development;

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     (vii) Coordination with primary care and health homes;

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     (viii) Coordination with substance use treatment providers;

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     (ix) Coordination with mental health providers;

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     (x) Coordination of vision and dental providers;

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     (xi) Coordination with hospitals and emergency departments;

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     (xii) Crisis intervention and critical time intervention;

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     (xiii) Independent living skills coaching; and

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     (xiv) Linkages to education, job skills training, and employment;

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     (3) Pursuant to § 40-8-17, EOHHS is directed and authorized to apply for and obtain any

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necessary waiver(s), waiver amendment(s) and/or state plan amendment(s) from the Secretary of

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the United States Department of Health and Human Services, that will ensure that individuals who

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are chronically homeless have access to housing and supportive housing services;

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     (4) Financing and reinvestment strategies, including:

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     (i) Health care costs and housing status of current Medicaid-funded populations;

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     (ii) The degree to which accurate and up-to-date information on housing status is available

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for current Medicaid-funded populations;

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     (iii) Health care costs of current residents of supportive housing;

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     (iv) Health care costs of the Medicaid-expansion population;

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     (v) Potential impact on costs to other systems, such as jails, long-term care, and treatment

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facilities;

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     (vi) Affordable housing investments that can be leveraged to create new units of supportive

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housing; and

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     (vii) Amount of flexible service dollars available to cover the costs that Medicaid cannot;

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and

 

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     (5) Administration of the benefit, including:

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     (i) The role of managed care;

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     (ii) The role of supportive housing service providers; and

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     (iii) Coordination with existing and emerging systems.

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     (c) EOHHS shall submit a report to the legislature regarding the status of its efforts,

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including any proposed legislation, no later than January 1, 2024, and annually on or before January

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1 thereafter. The report shall include:

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     (1) The status of proposed amendment(s) to expand Medicaid waivers pursuant to § 40-8-

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17;

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     (2) A description of housing and/or supportive housing services currently being provided

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to the chronically homeless population in the state;

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     (3) An analysis of the effectiveness of providing housing and/or supportive housing

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services at current levels in the state;

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     (4) Estimates of the cost and potential savings of expanding the program(s) to meet the

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needs of the chronically homeless in the state; and

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     (5) Proposed eligibility criteria to qualify for supportive housing services.

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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 HUMAN SERVICES -- RHODE ISLAND PATHWAYS PROJECT

***

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     This act would require the executive office of health and human services (EOHHS) to

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conduct a study to assess the impact of using Medicaid funds to provide coverage for the treatment

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of the chronically homeless.

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     This act would take effect upon passage.

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