State Affairs and Government

CHAPTER 42-12.3
Health Care for Children and Pregnant Women

SECTION 42-12.3-8

§ 42-12.3-8. Enhanced services for children.

(a) The department of human services shall develop a panel of enhanced services to be available as appropriate to RIte Track and medical assistance recipients under the age of eighteen (18), who are considered at risk, as defined by department of human services regulations. These services shall include, but not be limited to: care coordination, home visitation, nutrition counseling, parenting skills education. These services may be performed through a fee for service, contractual arrangement, or capitated rate as determined by the department of human services. The provision of enhanced services is subject to available appropriations; in the event that appropriations are not adequate for the provision of these services, the department has the authority to limit the amount, scope, and duration of these enhanced services, and to limit eligibility for enhanced services to children under the age of eight (8). Nothing in this section shall prohibit the department of human services from providing enhanced services to a medical assistance recipient, within existing appropriations.

(b) Except as provided in subsection (c) below, the department of human services shall also provide pediatric palliative care services to eligible children under the age of nineteen (19) years who have a terminal illness, provided that such services qualify for federal financial participation. These services shall be designed to achieve an improved quality of life and to meet the physical and emotional needs experienced by the patient during the course of the terminal illness and death. The services offered shall be determined by the department and may include, but are not limited to, consultations for pain and symptom management, case management and assessment, social services, counseling, volunteer support services, and respite services. The services shall be provided by licensed health care facilities that meet the criteria established by regulations promulgated by the department. The department is further authorized to establish limits on the services provided under this section.

(c) The department shall be the payor of last resort with respect to services provided under subsection (b) above. With respect to children under the age of nineteen (19) years who are covered by an individual or family health insurance plan or program that provides payment in whole or in part for the type of pediatric palliative health care services listed in subsection (b) above, the department shall coordinate benefits with these primary payors, and provided further that payments by the department shall be in accordance with the department's fee schedules.

History of Section.
(P.L. 1993, ch. 398, § 1; P.L. 1995, ch. 370, art. 22, § 1; P.L. 1996, ch. 129, § 15; P.L. 1996, ch. 131, § 15; P.L. 1996, ch. 132, § 15; P.L. 1996, ch. 133, § 15; P.L. 2003, ch. 182, § 1; P.L. 2003, ch. 192, § 1.)