This bill proposes to increase the cap on personal care assistant (PCA) services for Medicaid beneficiaries who are clinically eligible for nursing facility level of care from the current limit of 40 hours to 91 hours per week. The Department of Human Services is mandated to approve these additional hours as medically necessary and to modify the existing assessment tool for PCA services accordingly. Furthermore, before implementing this increase, the Commissioner of Human Services must provide a separate rate certification for the additional PCA service hours within the state's managed long-term services and supports program, ensuring compliance with federal standards. A mid-year rate adjustment will be required for the managed long-term services and supports program to accommodate this increase during a State Fiscal Year.

The bill also defines personal care assistant services as health-related tasks that assist beneficiaries with activities of daily living, performed by qualified individuals under the supervision of a registered professional nurse. This change aims to better support vulnerable Medicaid beneficiaries, allowing them to remain in their communities for longer periods. Currently, the Medicaid program allows for PCA services up to 40 hours per week, with additional hours granted only in exceptional circumstances. By raising the cap to 91 hours, the bill seeks to enhance the quality of care and support available to those in need.