TITLE 40
Human services

CHAPTER 40-8.9
Medical Assistance – Long-Term Care Service and Finance Reform

SECTION 40-8.9-4


§ 40-8.9-4 Unified long-term care budget.

Beginning on July 1, 2007, a unified long-term-care budget shall combine in a single, line-item appropriation within the executive office of health and human services (executive office), annual executive office Medicaid appropriations for nursing facility and community-based, long-term care services for elderly sixty-five (65) years and older and younger persons at risk of nursing home admissions (including adult day care, home health, PACE, and personal care in assisted living settings). Beginning on July 1, 2007, the total system savings attributable to the value of the reduction in nursing home days including hospice nursing home days paid for by Medicaid shall be allocated in the budget enacted by the general assembly for the ensuing fiscal year for the express purpose of promoting and strengthening community-based alternatives; provided, further, beginning July 1, 2009, said savings shall be allocated within the budgets of the executive office and, as appropriate, the department of human services, division of elderly affairs. The allocation shall include, but not be limited to, funds to support an on-going, statewide community education and outreach program to provide the public with information on home and community services and the establishment of presumptive eligibility criteria for the purposes of accessing home and community care. The home- and community-care service presumptive eligibility criteria shall be developed through rule or regulation on or before September 30, 2007. The allocation may also be used to fund home and community services provided by the division of elderly affairs for persons eligible for Medicaid long-term care, and the co-pay program administered pursuant to chapter 66.3 of title 42. Any monies in the allocation that remain unexpended in a fiscal year shall be carried forward to the next fiscal year for the express purpose of strengthening community-based alternatives.

The caseload estimating conference pursuant to § 35-17-1 shall determine the amount of general revenues to be added to the current service estimate of community-based, long-term care services for elderly sixty-five (65) and older and younger persons at risk of nursing home admissions for the ensuing budget year by multiplying the combined, cost per day of nursing home and hospice nursing home days estimated at the caseload conference for that year by the reduction in nursing home and hospice nursing home days from those in the second fiscal year prior to the current fiscal year to those in the first fiscal year prior to the current fiscal year.

History of Section.
(P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2007, ch. 73, art. 14, § 1; P.L. 2007, ch. 128, § 1; P.L. 2007, ch. 186, § 1; P.L. 2009, ch. 68, art. 5, § 8; P.L. 2009, ch. 223, § 1; P.L. 2016, ch. 142, art. 7, § 5.)