The bill proposes amendments to Section 40-8.9-9 of the General Laws, focusing on the reform of the state's long-term care system, particularly for Medicaid funding. It sets a goal for at least 50% of Medicaid long-term care funds for seniors and adults with disabilities to be allocated to home- and community-based care. The executive office of health and human services is tasked with applying for waivers and state-plan amendments to achieve this goal and is required to report annually on the funding distribution between institutional care and home- and community-based care. The bill emphasizes maintaining the financial viability of all current long-term care services while pursuing this goal and outlines that the reformed system should be person-centered, promoting self-determination and individual choice. It also allows for the continuation of current level-of-care criteria for those already receiving services as of June 30, 2015, and includes provisions for failed community placements.

The bill also seeks to enhance home- and community-based service capacity by reforming Medicaid payment methodologies, introducing revised certification standards, and increasing access to specialized services. It establishes Medicaid certification standards for providers of various adult services and introduces an acuity-based, tiered service and payment methodology. To address the demand for home-care workers, the bill includes a one-time increase in base-payment rates for FY 2019 to raise wages for personal care attendants and home health aides, with a 10% increase for home-care providers and a 20% increase for providers delivering skilled nursing and therapeutic services. It also mandates an annual inflation increase to the base rate for home-care providers starting July 1, 2019, and introduces a payment methodology change for FY 2022 to address wage gaps and high turnover rates. The bill establishes a long-term-care-options counseling program and authorizes the executive office to pay for services to transition beneficiaries from institutional settings to home or community care. Additionally, the bill requires the executive office to develop higher resource eligibility limits and implement service and payment reforms, including setting rates for chiropractic services for federal fiscal year 2024. The bill would take effect upon passage.

Statutes affected:
512: 40-8.9-9