This bill aims to reform the long-term care system by prioritizing home- and community-based care for individuals aged 65 and over, adults with disabilities, and individuals with developmental disabilities. It authorizes the executive office of health and human services to apply for necessary waivers and amendments to implement this plan. The bill also establishes a person-centered and individual choice-focused long-term care system that provides specialized and tailored home-based services. It directs the executive office to adopt eligibility criteria for services and allows for the consolidation of all home- and community-based services into a single system. The bill also includes provisions for payment methodology reforms, revised Medicaid certification standards for providers, and an increase in base-payment rates for home-care service providers.

This bill seeks to amend reimbursement rates for home care providers, home nursing care providers, and hospice providers to ensure they are paid at least the free-for-service rates. It also authorizes the secretary to develop higher resource eligibility limits for persons with long-term care needs who remain living at home. The bill requires the implementation of home- and community-based service and payment reforms, such as adult day services level of need criteria and acuity-based, tiered-payment methodology. The secretary is authorized to seek necessary waivers or amendments for timely adoption of new rules, regulations, policies, or procedures.

Statutes affected:
5314: 40-8.9-9