Chapter 247

2004 -- H 8191

Enacted 07/01/04

A N A C T

RELATING TO STATE AFFAIRS AND GOVERNMENT -- MEDICAID EXPENDITURES -- ANNUAL REPORT

Introduced By: Representatives Naughton, Slater, Giannini, Handy, and Dennigan

Date Introduced: February 26, 2004

It is enacted by the General Assembly as follows:

SECTION 1. Section 35-17-1 of the General Laws in Chapter 35-17 entitled "Medical

Assistance and Public Assistance Caseload Estimating Conferences" is hereby amended to read

as follows:

35-17-1. Purpose and membership. -- (a) In order to provide for a more stable and

accurate method of financial planning and budgeting, it is hereby declared the intention of the

legislature that there be a procedure for the determination of official estimates of anticipated

medical assistance expenditures and public assistance caseloads, upon which the executive budget

shall be based and for which appropriations by the general assembly shall be made.

(b) The state budget officer, the house fiscal advisor, and the senate fiscal advisor shall

meet in regularly scheduled caseload estimating conferences (C.E.C.). These conferences shall be

open public meetings.

budget officer, the house fiscal advisor, and the senate fiscal advisor, hereinafter referred to as

principals. The schedule shall be arranged so that no chairperson shall preside over two (2)

successive regularly scheduled conferences on the same subject.

(d) Representatives of all state agencies are to participate in all conferences for which

their input is germane.

(e) The department of human services shall provide monthly data to the members of the

caseload estimating conference by the fifteenth day of the following month. Monthly data shall

include, but is not limited to, actual caseloads and expenditures for the following case assistance

programs: temporary assistance to needy families, SSI federal program and SSI state program,

general public assistance, child care, state food stamp program, and weatherization. The report

shall include relevant caseload information and expenditures for the following medical assistance

categories: hospitals, nursing homes, managed care, special education, and all other. In the

category of managed care, caseload information and expenditures for the following populations

shall be separately identified and reported: children with disabilities, children in foster care, and

children receiving adoption assistance.

SECTION 2. Section 42-12-17 of the General Laws in Chapter 42-12 entitled

"Department of Human Services" is hereby amended to read as follows:

42-12-27. Annual report of statewide Medicaid expenditures -- Health and social

outcomes. -- (a) The governor and the general assembly hereby find and declare that statewide

Medicaid program expenditures were approximately $1.037 billion dollars during state fiscal year

1998, and accounted for nearly twenty-eight percent (28%) of state's total annual expenditures of

$3.725 billion in fiscal year 1998, and are projected to continue to be a significant percentage of

the total annual state budget; that those expenditures have a significant impact on the health,

educational and social fabric of the state; that although the department of human services has

been designated as the single state agency responsible to the federal government and the state for

the effective and efficient administration and supervision of the state's Medicaid program, as well

as to provide assurances of statewide accessibility to a comprehensive system of high-quality

health care services, only two-thirds (2/3) of total Medicaid expenditures is appropriated to and

directly administered by the department of human services, while the remaining one-third (1/3) is

appropriated to other departments within state government. The governor and the general

assembly further recognize that policy makers may not have the benefit of a comprehensive and

consolidated depiction of the total impact of the Medicaid program on Rhode Island children and

families, adults with disabilities and the elderly; and, that policy makers should require a higher

level of assurance that the funds are used to enhance health service accessibility, delivery and

outcomes, as well as to improve the fiscal integrity and accountability for Medicaid expenditures.

(b) The governor and the general assembly further find and declare that a well-

coordinated comprehensive financing and service delivery system that specifically addresses the

interfaces between other health, social, and educational programs, including those administered at

the municipal and community level, is essential.

of human services, as the administrator of the single state agency for the Medicaid program in

Rhode Island, to issue a report to the governor, to the general assembly and to the caseload

estimating conference established under section 15-17-1, no later than March 31, 2000, and by

March 31st of each year thereafter, of expenditures and outcomes over time for the Medicaid

program as a whole, including but not limited to the following information:

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

(2) expenditures and outcomes 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);

(3) expenditures and outcomes by each state department or other municipal or public

entity receiving federal reimbursement under Titles XIX and XXI, and

(4) expenditures and outcomes by type of service and/or service provider.

(d) In order to assist the department of human services to prepare the annual report

referred to in (c), all departments of state government as well as local governments and school

departments shall timely provide such information and analysis relating to Medicaid expenditures

and outcomes as may from time to time be requested by the director of the department of human

services.

SECTION 3. This act shall take effect upon passage.

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LC01676

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