This bill mandates that the State Medicaid program 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 encompass more complex tasks like managing medications and personal finances. A functional assessment, conducted by a licensed mental health professional, will determine eligibility based on the individual's medical records, psychiatric history, and input from relevant parties.

Furthermore, the bill includes provisions to ensure that providers cannot charge recipients for services deemed medically unnecessary, establishing that payments made under this act will constitute full payment to the provider. The Commissioner of Human Services is tasked with applying for any necessary State plan amendments or waivers to implement these provisions and secure federal financial participation for Medicaid expenditures. The Commissioner must also adopt rules and regulations within 180 days of the bill's enactment, with the provisions taking effect on the first day of the sixth month following enactment.

Statutes affected:
Introduced: 30:4D-6