The bill amends Section 40-8.9-9 of the General Laws to establish a long-term-care rebalancing system reform goal. It requires 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 responsible for applying for necessary waivers and amendments to implement this plan, which includes annual reporting on care distribution and waiting lists. The reform emphasizes a person-centered approach, promoting individual choice and access to various community-based services while ensuring the financial viability of existing long-term-care services.

Additionally, the bill authorizes the executive office to adopt tiered eligibility criteria for long-term-care services, consolidate 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. The bill mandates the implementation of these reforms by January 1, 2026, and introduces a provision to increase the Medicaid reimbursement rate for Tier C services provided by assisted living residences by thirteen percent (13%) over the rate in effect on December 31, 2025, starting January 1, 2026. This increase aims to enhance financial support for assisted living facilities and improve care quality for beneficiaries.

Statutes affected:
6289: 40-8.9-9