The bill mandates that Medicaid will cover assisted living services for individuals diagnosed with serious mental illnesses who do not require assistance with activities of daily living (ADLs) but struggle with instrumental activities of daily living (IADLs). It defines ADLs as basic self-care tasks, such as bathing and dressing, while IADLs include more complex tasks necessary for independent living, like managing medications and finances. A licensed mental health professional will conduct a functional assessment to determine eligibility for these services, considering the individual's medical records, psychiatric history, and input from relevant parties. The bill also stipulates that payments for these services will be made in full to providers, ensuring no additional charges to recipients for authorized services.

Furthermore, the bill tasks the Commissioner of Human Services with applying for necessary State plan amendments or waivers to implement these changes and secure federal financial participation for Medicaid expenditures. The Commissioner is required to adopt rules and regulations within 180 days of the bill's enactment to facilitate its implementation. The provisions of the bill will take effect on the first day of the sixth month following its enactment.

Statutes affected:
Introduced: 30:4D-6