Chapter 114

2005 -- H 5827

Enacted 06/29/05

A N A C T

RELATING TO HUMAN SERVICES -- CARE FOR THE ELDERLY

Introduced By: Representatives Costantino, Sullivan, Pacheco, Jackson, and Church

Date Introduced: March 01, 2005

It is enacted by the General Assembly as follows:

     SECTION 1. Title 40 of the General Laws entitled "Human Services" is hereby amended

by adding thereto the following chapter:

CHAPTER 8.8

PROGRAM FOR THE ALL-INCLUSIVE CARE FOR THE ELDERLY

40-8.8-1. Short title. – This chapter shall be known and may be cited as the "Program of

All-Inclusive Care for the Elderly."

40-8.8-2. Program for all-inclusive care for the elderly. – The department of human

services is hereby authorized to elect a program for all-inclusive care for the elderly program as

an optional Medicaid benefit, pursuant to section 1905(a)(26) of the social security act, as added

by section 4802(a)(1) of the balanced budget act of 1997.

40-8.8-3. Purpose. – The purpose of the program for all-inclusive care for the elderly is

to offer an alternative to nursing home care for frail elders. The program for all-inclusive care for

the elderly is a pre-paid, capitated program of managed care service delivery for beneficiaries

who meet special eligibility requirements, including being eligible for nursing home placement,

and who elect to enroll. The model of care includes as core services the provision of adult day

health care and multidisciplinary team case management, through which access to and allocation

of all health services are coordinated.

40-8.8-4. Definitions. – As used in this chapter, the term "Program for all-inclusive care

for the elderly" shall mean a program of services coordinated for the eligible population by an

organization approved by the United States department of health and human services for these

purposes. The program of services include at minimum the following benefit package:

multidisciplinary assessment and treatment planning; primary care services including physician

and nursing services; social work services; restorative therapies; personal care and supportive

services; nutritional counseling; recreational therapy; transportation; meals; medical specialty

services; laboratory tests; drugs and biologicals; prosthetics and durable medical equipment;

acute inpatient care, ambulance and emergency care; and nursing facility care.

40-8.8-5. Authorization for the program of all-inclusive care for the elderly. – The

department of human services is hereby authorized and directed to amend its title XIX state plan

to initiate a program of all-inclusive care for the elderly.

40-8.8-6. Eligibility. – To be eligible for benefits under the program of all-inclusive care

for the elderly:

(a) The person shall meet the eligibility criteria for both the Rhode Island Medical

Assistance Program and for the federal Medicare Program; and

(b) The person shall meet the eligibility criteria for the program of all-inclusive care for

the elderly as established by the United States department of health and human services and the

state department of human services, including, but not limited to:

(1) being at least fifty-five (55) years old;

(2) residing in the program for all-inclusive care for the elderly service area; and

(3) being certified as eligible for nursing home care by the state department of human

services.

40-8.8-7. Regulations and commencement of program. – (a) The department of human

services shall submit the Medicaid state plan amendment and promulgate any rules or regulations

necessary to implement the provisions of this act, contingent upon, and immediately following,

federal approval of any program for all-inclusive care for the elderly.

(b) Contingent upon completion of the Medicaid state plan amendment process, and the

appropriation of necessary funding to implement the program, the program for all-inclusive care

for the elderly shall commence on July 1, 2005.

     SECTION 2. This act shall take effect upon passage.     

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LC02454

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