Chapter 469

2013 -- H 5155 SUBSTITUTE A

Enacted 07/16/13

 

A N A C T

RELATING TO HUMAN SERVICES - FAMILY CAREGIVERS SUPPORT ACT OF 2013

 

     Introduced By: Representatives Naughton, and E Coderre

     Date Introduced: January 24, 2013

 

   It is enacted by the General Assembly as follows:

 

     SECTION 1. Section 40-8.10-4 of the General Laws in Chapter 40-8.10 entitled "Long-

Term Care Service Reform for Medicaid Eligible Individuals" is hereby amended to read as

follows:

 

     40-8.10-4. Assessment and Coordination Unit (ACU). -- (a) The department of human

services, in collaboration with the executive office of health and human services, shall implement

a long-term care options counseling program to provide individuals or their representative, or

both, with long-term care consultations that shall include, at a minimum, information about long-

term care options, sources and methods of both public and private payment for long term care

services, information on caregiver support services, including respite care, and an assessment of

an individual's functional capabilities and opportunities for maximizing independence. Each

individual admitted to or seeking admission to a long-term care facility, regardless of the payment

source, shall be informed by the facility of the availability of the long-term care options

counseling program and shall be provided with a long-term care options consultation, if he or she

so requests. Each individual who applies for Medicaid long-term care services shall be provided

with a long-term care consultation.

      (b) Core and preventative home and community based services defined and delineated in

section 40-8.10-2 shall be provided only to those individuals who meet one of the levels of care

provided for in this chapter. Other long term care services authorized by the federal government,

such as medication management, may also be provided to Medicaid eligible recipients who have

established the requisite need as determined by the Assessment and Coordination Unit (ACU).

Access to institutional and community based supports and services shall be through the

Assessment and Coordination Unit (ACU). The provision of Medicaid-funded long-term care

services and supports shall be based upon a comprehensive assessment that shall include, but not

be limited to, an evaluation of the medical, social and environmental needs of each applicant for

these services or programs. The assessment shall serve as the basis for the development and

provision of an appropriate plan of care for the applicant.

      (c) The ACU shall assess the financial eligibility of beneficiaries to receive long-term

care services and supports in accordance with the applicable provisions of section 40-8.9-9.

      (d) The ACU shall be responsible for conducting assessments; determining a level of

care for applicants for medical assistance; developing service plans; pricing a service budget and

developing a voucher when appropriate; making referrals to appropriate settings; maintaining a

component of the unit that will provide training to and will educate consumers, discharge

planners and providers; tracking utilization; monitoring outcomes; and reviewing service/care

plan changes. The ACU shall provide interdisciplinary high cost case reviews and choice

counseling for eligible recipients.

      (e) The assessments for individuals conducted in accordance with this section shall serve

as the basis for individual budgets for those medical assistance recipients eligible to receive

services utilizing a self-directed delivery system.

      (f) Nothing in this section shall prohibit the secretary of the executive office of health

and human services, or the directors of that office's departments from utilizing community

agencies or contractors when appropriate to perform assessment functions outlined in this

chapter.

 

     SECTION 2. Title 40 of the General Laws entitled "HUMAN SERVICES" is hereby

amended by adding thereto the following chapter:

 

CHAPTER 8.11

FAMILY CAREGIVERS SUPPORT ACT OF 2013

 

     40-8.11-1. Findings. -- (a) Family members, partners and close friends provide the vast

majority of long-term services and supports.

     (b) An estimated one hundred and forty-eight thousand (148,000) persons in Rhode

Island are providing care at any one time to persons living in the community. The estimated value

of their unpaid contributions in 2009 was one billion eight hundred eighty million dollars

($1,880,000,000).

     (c) Family or other caregivers who provide the majority of care in the home are

frequently under substantial physical, psychological, and financial stress. The stress, if unrelieved

by support for the caregiver, may lead to premature or unnecessary nursing home and institutional

placement and health and financial burdens for the caregiver.

     (d) Respite care and other community-based supportive services for the family caregiver

can relive some of the stresses faced by caregivers, maintain and strengthen the family structure,

postpone or prevent institutionalization and lead to better outcomes for both the caregiver and

care recipient.

     (e) The percent of Rhode Islanders age sixty-five (65) years of age and older is projected

to grow from fourteen percent (14%) of the state population in 2010 to twenty-one percent (21%)

by 2030. As persons age, they have greater dependency needs and an increased need for long-

term care services and support. Younger people with disabilities also require continued

supportive long-term care services as they age.

     (f) As informal caregivers and families are a vital part of the long-term care services and

support system, it is an important public purpose to recognize and respect their contributions and

to assess and support their needs.

 

     40-8.11-2. Definitions. -- (a) "Caregiver assessment" is defined and refers to a systematic

process of gathering information about a caregiving situation to identify the specific problems,

needs, strengths, and resources of the family caregiver, as well as the caregiver's ability to

contribute to the needs of the care recipient.

     (b) The term "family caregiver" is defined and refers to any relative, partner, friend, or

neighbor who has a significant relationship with, and who provides a broad range of assistance

for, an older adult or an adult or child with chronic or disabling conditions.

 

     40-8.11-3. Caregiver assessment requirement. -- The comprehensive assessment

required in subsection 40-8.10-4(b) as part of Medicaid long-term service reform shall also

include a caregiver assessment whenever the plan of care depends on a family caregiver for

providing assistance with activities of daily living needs. The assessment shall be used to develop

a plan of care that recognizes both needs of the care recipient and the caregiver. The assessment

shall also serve as the basis for development and provision of an appropriate plan for caregiver

information, referral and support services. Information about available respite programs,

caregiver training and education programs, support groups and community support services shall

be included as part of the caregiver support plan. To implement the caregiver assessment, the

executive office of health and human services shall adopt evidenced-based caregiver assessments

and referral tools appropriate to the departments within the office that provide long-term care

services and support.

 

     SECTION 3. This act shall take effect upon passage.

     

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LC00665/SUB A

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