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 long-term-care rebalancing system reform goal. It requires the executive office of health and human services to allocate at least 50% of Medicaid long-term-care funding for individuals aged 65 and over, as well as adults with disabilities, towards home- and community-based care. The office must also provide an annual report on funding distribution between institutional and community care, along with current and projected waiting lists for these services. The legislation emphasizes a person-centered approach that promotes individual choice and self-determination, ensuring access to a variety of supportive services in community settings.

Furthermore, the bill authorizes the executive office to develop a tiered set of eligibility criteria for long-term-care services in collaboration with relevant departments and consumer groups. It includes provisions for consolidating home- and community-based services, implementing a long-term-care-options counseling program, and establishing a statewide network for conflict-free case management. The bill mandates the implementation of these reforms by January 1, 2016. Additionally, it specifies that, notwithstanding any law or regulation to the contrary, on and after January 1, 2027, 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 shall be increased by thirteen percent (13%) over the rate in effect on December 31, 2026. This increase aims to enhance financial support for assisted living facilities and improve the quality of care for beneficiaries.

Statutes affected:
8314: 40-8.9-9