The bill mandates that the State Medicaid program provide coverage for assisted living services specifically 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 introduces a functional assessment process, to be established by the Commissioner of Human Services, allowing licensed mental health professionals to determine eligibility based on an individual's medical records, psychiatric history, and functional evaluations. The bill also defines ADLs and IADLs to clarify the types of assistance covered, ensuring that individuals can receive support for more complex tasks necessary for independent living.

Furthermore, the legislation requires the Commissioner of Human Services to apply for any necessary State plan amendments or waivers to implement these provisions and secure federal financial participation for Medicaid expenditures. It includes a timeline for the adoption of rules and regulations to facilitate implementation, which must occur within 180 days of enactment. The provisions of the bill will take effect on the first day of the sixth month following its enactment, aiming to enhance the quality of life for individuals with serious mental illnesses by providing essential assisted living services.

Statutes affected:
Introduced: 30:4D-6