10-R303
2010 -- S 2976
Enacted 06/08/10
S E N A T E R E
S O L U T I O N
RESPECTFULLY
REQUESTING THE EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES TO REPORT
DESIGNATED MEDICAID INFORMATION TO THE RHODE ISLAND SENATE COMMITTEE ON HEALTH
AND HUMAN SERVICES
Introduced By: Senators Perry, Miller, Pichardo, Sheehan, and C Levesque
Date Introduced: June 04, 2010
WHEREAS, It is essential that Medicaid remain a sustainable,
cost-effective, person-
centered program offering comprehensive health care for the
diverse populations that the program
serves; and
WHEREAS, Since January
of 2009, the State of
fundamental redesign of the Medicaid Program, hereby referred to
as the “Global Waiver” in
order to achieve savings and efficiencies in the program;
and
WHEREAS, Given the unprecedented nature of the “Global Waiver,” the
General
Assembly has a responsibility to ensure that Medicaid
remains an accessible and comprehensive
system of coordinated care that focuses on independence and
choice; maximizes available service
options, promotes accountability and transparency; encourages
and rewards healthy outcomes;
and promotes efficiencies through interdepartmental
cooperation; and
WHEREAS, The state Executive Office of Health and Human Services, in
collaboration
with the directors of the Health and Human Services
agencies, is responsible for implementation
and oversight of the "Global Waiver"; and
WHEREAS The Senate
Committee on Health and Human Services, along with the
Senate Finance Subcommittee on Health and Human
Services, has convened a series of oversight
hearings during which they learned of continuing fiscal and programmatic
concerns with the
implementation of the Global Waiver; now, therefore be it
RESOLVED, That this Senate of the State of
hereby respectfully requests the Executive Office of Health
and Human Services to report to the
Rhode Island Senate Committee on Health and Human
Services on a quarterly basis beginning
September 15, 2010, on the following information:
(a)
The number of new applicants found eligible for Medicaid funded long-term care
services, as well as the basis for the eligibility
determination, including level of clinical need and
any HIPAA compliant demographic data about such
applicants;
(b)
The number of new applicants found ineligible for Medicaid funded long-term
care
services, as well as the basis for the determination of ineligibility,
including whether ineligibility
resulted from failure to meet financial or clinical criteria,
and any HIPAA compliant demographic
data about such applicants;
(c)
The number of Medicaid beneficiaries, by age, over and under 65 years, served
in
institutional and home and community-based long-term care settings,
by provider and service
type and/or delivery system as applicable, including:
nursing facilities, home care, adult day
services for elders and persons with disabilities, assisted
living, personal attendant and
homemaker services, PACE, public and private group homes for
persons with developmental
disabilities, in-home support services for persons with
developmental disabilities, shared living,
behavioral health group home, residential facility and
institution, and the number of persons in
supported employment;
(d)
Data on the cost and utilization of service units for Medicaid long-term care
beneficiaries;
(e)
Percent distribution of expenditures for Medicaid long-term care institutional
services
and home and community services by population, including:
elders aged 65 and over, persons
with disabilities, and children with special health care
needs;
(f)
The number of persons on waiting lists for any long-term care services;
(g)
The number of persons in a non-Medicaid funded long-term care co-pay program,
by
type and units of service utilized and expenditures;
(h)
The average and median length of time between submission
of a completed long term
care application and Medicaid approval/denial;
(i) Number of applicants for Medicaid funded long-term care
meeting the clinical
eligibility criteria for each level of : (1) Nursing facility
care; (2) Intermediate care facility for
persons with developmental disabilities or mental
retardation; and (3) Hospital care;
(j)
The average and median turnaround time for such clinical eligibility
determinations
across populations;
(k)
Number of appeals of clinical eligibility determinations across populations;
(l)
Average and median length of time after an applicant is approved for Medicaid
long-
term care until placement in the community or an
institutional setting;
(m)
For persons transitioned from nursing homes, the average length of stay prior
to
transfer and type of living arrangement or setting and
services upon transfer;
(n)
Data on diversions and transitions from nursing homes to community care,
including
information of unsuccessful transitions and their cause;
(o)
Data on the number of RIte Care and RIte Share applications per month and the
outcome of the eligibility determination by income level
(acceptance or denial, including the
basis for denial);
(p)
For new RIte Care and RIte
Share applicants, the number of applications pending
more than 30 days;
(q)
Data on the number of RIte Care and RIte Share beneficiaries losing coverage per
month including the basis for the loss of coverage and
whether the coverage was terminated at
recertification or at another time;
(r) Number of families enrolled in RIte Care and RIte Share required to pay
premiums by
income level (150-184% FPL, 185-199% FPL, and 200-250% FPL);
(s)
Information on sanctions due to nonpayment of premiums by income level
(150-184%
FPL, 185-199% FPL, and
200-250% FPL);
(t)
On an annual basis, State and Federal Expenditures under the "Cost Not
Otherwise
Matchable" provision of Section 1115(a)(2)
of the Social Security Act; and
(u)
On an annual basis, data on Medicaid spending recoveries, including estate
recoveries
as provided for in section 40-8-15; and be it further
RESOLVED,
That this Senate hereby requests the Executive Office
of Health and
Human Services to provide a
copy of the comprehensive Medicaid overview as provided for in
section 42-7.2-5(4), to the Senate committee on Health and
Human Services; and be it further
RESOLVED,
That the Secretary of State be and he hereby is
authorized and directed to
transmit a duly certified copy of this resolution to the
Secretary of the Rhode Island Office of
Health
and Human Services.
=======
LC02819
=======