The bill amends Section 40-8.9-9 of the General Laws to establish a long-term-care rebalancing system reform goal. It mandates that at least 50% of Medicaid long-term-care funding be directed towards home- and community-based care for individuals aged 65 and over and adults with disabilities. The executive office of health and human services is tasked with applying for necessary waivers and amendments to implement this plan, which includes annual reporting on care distribution and waiting lists. The reform aims to promote person-centered care, individual choice, and access to supportive services in community settings, thereby reducing reliance on institutional care.

Additionally, the bill authorizes the executive office to develop tiered eligibility criteria for long-term-care services, consolidate existing home- and community-based services, and implement payment reforms to improve access and quality. It includes provisions for increasing wages for home-care workers, establishing a long-term-care-options counseling program, and creating a conflict-free case management network. Notably, starting January 1, 2026, the Medicaid reimbursement rate for Tier C services provided by assisted living residences licensed pursuant to the provisions of chapter 17.4 of title 23 will increase by thirteen percent (13%) over the rate in effect on December 31, 2025, enhancing financial support for these services. The act will take effect upon passage.

Statutes affected:
6289: 40-8.9-9