The bill amends Section 40-8.9-9 of the General Laws in Chapter 40-8.9, titled "Medical Assistance — Long-Term Care Service and Finance Reform," to establish a goal for the state's Medicaid long-term care funding. It mandates that a minimum of 50% of this funding be allocated to home- and community-based care for individuals aged 65 and over and adults with disabilities. The executive office of health and human services (EOHHS) is authorized to apply for necessary waivers and state-plan amendments to facilitate this allocation. Additionally, the EOHHS is required to report annually on the distribution of funding between institutional and home- and community-based care, including current and projected waiting lists for services. The bill emphasizes prioritizing investments in home- and community-based care while ensuring the financial viability of existing long-term care services.

Furthermore, the bill introduces a person-centered approach to long-term care, promoting individual choice and family involvement. It establishes a tiered eligibility criteria for services, potentially imposing stricter criteria for institutional care compared to home- and community-based services. The bill also allows for the consolidation of home- and community-based services into a single system and authorizes the EOHHS to pursue reforms in payment methodologies to enhance service access. Key provisions include a one-time increase in base payment rates for home-care service providers, adjustments to payment methodologies for direct-care workers, and the establishment of a statewide conflict-free case management network by January 1, 2024. The bill aims to improve the quality and accessibility of long-term care services while ensuring adequate compensation for direct-care workers.

Statutes affected:
696: 40-8.9-9