reglab/housing_qa huggingface dataset:
RI Gen L § 40-8.11-2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.11 - Family Caregivers Support Act of 2013|Section 40-8.11-2 - Definitions.

§ 40-8.11-2. Definitions.(a) "Caregiver assessment" is defined and refers to a systematic process of gathering information about a caregiving situation to identify the specific problems, needs, strengths, and resources of the family caregiver, as well as the caregiver's ability to contribute to the needs of the care recipient.(b) The term "family caregiver" is defined and refers to any relative, partner, friend, or neighbor who has a significant relationship with, and who provides a broad range of assistance for, an older adult or an adult or child with chronic or disabling conditions.History of Section.P.L. 2013, ch. 457, § 2; P.L. 2013, ch. 469, § 2.
RI Gen L § 40-8.11-3 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.11 - Family Caregivers Support Act of 2013|Section 40-8.11-3 - Caregiver assessment requirement.

§ 40-8.11-3. Caregiver assessment requirement.(a) The comprehensive assessment required in § 40-8.10-4(b) as part of Medicaid long-term service reform shall also include a caregiver assessment whenever the plan of care depends on a family caregiver for providing assistance with activities of daily-living or instrumental activities of daily-living needs. The assessment shall be used to develop a plan of care that recognizes both needs of the care recipient and the caregiver. The assessment shall also serve as the basis for development and provision of an appropriate plan for caregiver information, education and training, referral, and support services. Information about available respite programs, caregiver training, and education programs, support groups, and community support services shall be included as part of the caregiver support plan. To implement the caregiver assessment, the executive office of health and human services shall adopt evidenced-based caregiver assessments and referral tools appropriate to the departments within the office that provide long-term-care services and support.(b) The executive office of health and human services shall develop annual reports to track data on the number of caregiver assessments conducted; the identified needs of caregivers to include both met and unmet needs; and referrals made for education, respite, and other support services. The reports shall be provided to the chairs of the house and senate finance committees as part of annual budget hearings and the chair of the long-term care coordinating council and posted on the executive office of health and human services website.History of Section.P.L. 2013, ch. 457, § 2; P.L. 2013, ch. 469, § 2; P.L. 2019, ch. 110, § 1; P.L. 2019, ch. 130, § 1.
RI Gen L § 40-8.12-1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.12 - Health Care for Adults|Section 40-8.12-1 - Purpose.

§ 40-8.12-1. Purpose.Pursuant to § 42-12.3-2, it is the intent of the general assembly to create access to comprehensive health care for uninsured Rhode Islanders. The Rhode Island Medicaid program has become an important source of insurance coverage for low-income pregnant women, families with children, elders, and persons with disabilities who might not be able otherwise to obtain or afford health care. Under the U.S. Patient Protection and Affordable Care Act (ACA) of 2010, all Americans will be required to have health insurance, with some exceptions, beginning in 2014. Federal funding is available with ACA implementation to help pay for health insurance for low-income adults, ages nineteen (19) to sixty-four (64), who do not qualify for Medicaid eligibility under Rhode Island general and public laws. It is the intent of the general assembly, therefore, to implement the Medicaid expansion for adults without dependent children authorized by the ACA, to extend health insurance coverage to these Rhode Islanders and further the goal established in § 42-12.3-2 in 1993.History of Section.P.L. 2013, ch. 144, art. 19, § 2.
RI Gen L § 40-8.12-2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.12 - Health Care for Adults|Section 40-8.12-2 - Eligibility.

§ 40-8.12-2. Eligibility.(a) Medicaid coverage for nonpregnant adults without children. There is hereby established, effective January 1, 2014, a category of Medicaid eligibility pursuant to Title XIX of the Social Security Act, as amended by the U.S. Patient Protection and Affordable Care Act (ACA) of 2010, 42 U.S.C. § 1396u-1, for adults ages nineteen (19) to sixty-four (64) who do not have dependent children and do not qualify for Medicaid under Rhode Island general laws applying to families with children and adults who are blind, aged, or living with a disability. The executive office of health and human services is directed to make any amendments to the Medicaid state plan and waiver authorities established under Title XIX necessary to implement this expansion in eligibility and ensure the maximum federal contribution for health insurance coverage provided pursuant to this chapter.(b) Income. The secretary of the executive office of health and human services is authorized and directed to amend the Medicaid Title XIX state plan and, as deemed necessary, any waiver authority to effectuate this expansion of coverage to any Rhode Islander who qualifies for Medicaid eligibility under this chapter with income at or below one hundred and thirty-three percent (133%) of the federal poverty level, based on modified adjusted-gross income.(c) Delivery system. The executive office of health and human services is authorized and directed to apply for and obtain any waiver authorities necessary to provide persons eligible under this chapter with managed, coordinated healthcare coverage consistent with the principles set forth in chapter 12.4 of title 42, pertaining to a healthcare home.History of Section.P.L. 2013, ch. 144, art. 19, § 2; P.L. 2020, ch. 79, art. 1, § 32.
RI Gen L § 40-8.12-3 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.12 - Health Care for Adults|Section 40-8.12-3 - Premium assistance program.

§ 40-8.12-3. Premium assistance program.(a) The executive office of health and human services is directed to amend its rules and regulations to implement a premium assistance program for adults with dependent children, enrolled in the state's health-benefits exchange, whose annual income and resources meet the guidelines established in § 40-8.4-4 in effect on December 1, 2013. The premium assistance will pay one-half of the cost of a commercial plan that a parent may incur after subtracting the cost-sharing requirement under § 40-8.4-4 as of December 31, 2013, and any applicable federal tax credits available. The office is also directed to amend the 1115 waiver demonstration extension and the medical assistance Title XIX state plan for this program if it is determined that it is eligible for funding pursuant to Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.(b) The executive office of health and human services shall require any individual receiving benefits under a state-funded, healthcare assistance program to apply for any health insurance for which he or she is eligible, including health insurance available through the health benefits exchange. Nothing shall preclude the state from using funds appropriated for Affordable Care Act transition expenses to reduce the impact on an individual who has been transitioned from a state program to a health insurance plan available through the health benefits exchange. It shall not be deemed cost-effective for the state if it would result in a loss of benefits or an increase in the cost of healthcare services for the person above an amount deemed de minimus as determined by state regulation.History of Section.P.L. 2013, ch. 144, art. 19, § 2.
RI Gen L § 40-8.13-1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-1 - Definitions.

§ 40-8.13-1. Definitions.For purposes of this section the following terms shall have the meanings indicated:(1) "Beneficiary" means an individual who is eligible for medical assistance under the Rhode Island Medicaid state plan established in accordance with 42 U.S.C. § 1396, and includes individuals who are additionally eligible for benefits under the Medicare program (42 U.S.C. § 1395 et seq.) or other health plan.(2) "Duals demonstration project" means a demonstration project established pursuant to the financial alignment demonstration established under section 2602 of the Patient Protection and Affordable Care Act (Pub. L. No. 111-148) [42 U.S.C. § 1315b], involving a three-way contract between Rhode Island, the federal Centers for Medicare and Medicaid Services ("CMS"), and qualified health plans, and covering healthcare services provided to beneficiaries.(3) "EOHHS" means the Rhode Island executive office of health and human services.(4) "EOHHS level-of-care tool" refers to a set of criteria established by EOHHS and used in January, 2014 to determine the long-term-care needs of a beneficiary as well as the appropriate setting for delivery of that care.(5) "Long-term-care services and supports" means a spectrum of services covered by the Rhode Island Medicaid program and/or the Medicare program, that are required by individuals with functional impairments and/or chronic illness, and includes skilled or custodial nursing facility care, as well as various home- and community-based services.(6) "Managed care organization" means any health plan, health-maintenance organization, managed care plan, or other person or entity that enters into a contract with the state under which it is granted the authority to arrange for the provision of, and/or payment for, long-term-care supports and services to eligible beneficiaries under a managed long-term-care arrangement.(7) "Managed long-term-care arrangement" means any arrangement under which a managed care organization is granted some or all of the responsibility for providing and/or paying for long-term-care services and supports that would otherwise be provided or paid under the Rhode Island Medicaid program. The term includes, but is not limited to, a duals demonstration project, and/or phase I and phase II of the integrated care initiative established by the executive office of health and human services.(8) "Plan of care" means a care plan established by a nursing facility in accordance with state and federal regulations and that identifies specific care and services provided to a beneficiary.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-2 - Beneficiary choice.

§ 40-8.13-2. Beneficiary choice.Any managed long-term-care arrangement shall offer beneficiaries the option to decline participation and remain in traditional Medicaid and, if a duals demonstration project, traditional Medicare. Beneficiaries must be provided with sufficient information to make an informed choice regarding enrollment, including:(1) Any changes in the beneficiary's payment or other financial obligations with respect to long-term-care services and supports as a result of enrollment;(2) Any changes in the nature of the long-term-care services and supports available to the beneficiary as a result of enrollment, including specific descriptions of new services that will be available or existing services that will be curtailed or terminated;(3) A contact person who can assist the beneficiary in making decisions about enrollment;(4) Individualized information regarding whether the managed care organization's network includes the healthcare providers with whom beneficiaries have established provider relationships. Directing beneficiaries to a website identifying the plan's provider network shall not be sufficient to satisfy this requirement; and(5) The deadline by which the beneficiary must make a choice regarding enrollment, and the length of time a beneficiary must remain enrolled in a managed care organization before being permitted to change plans or opt out of the arrangement.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-3 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-3 - Ombudsman process.

§ 40-8.13-3. Ombudsman process.EOHHS shall designate an ombudsperson to advocate for beneficiaries enrolled in a managed long-term-care arrangement. The ombudsperson shall advocate for beneficiaries through complaint and appeal processes and ensure that necessary healthcare services are provided. At the time of enrollment, a managed care organization must inform enrollees of the availability of the ombudsperson, including contact information.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-4 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-4 - Provider/plan liaison.

§ 40-8.13-4. Provider/plan liaison.EOHHS shall designate an individual, not employed by or otherwise under contract with a participating managed care organization, who shall act as liaison between healthcare providers and managed care organizations, for the purpose of facilitating communications and ensuring that issues and concerns are promptly addressed.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-6 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-6 - Payment incentives.

§ 40-8.13-6. Payment incentives.In order to encourage quality improvement and promote appropriate utilization incentives for providers in a managed long-term-care arrangement, a managed care organization may use incentive or bonus payment programs that are in addition to the rates identified in § 40-8.13-5.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-7 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-7 - Willing provider.

§ 40-8.13-7. Willing provider.A managed care organization must contract with and cover services furnished by any nursing facility licensed under chapter 17 of title 23 and certified by CMS that provides Medicaid-covered nursing facility services pursuant to a provider agreement with the state, provided that the nursing facility is not disqualified under the managed care organization's quality standards that are applicable to all nursing facilities; and the nursing facility is willing to accept the reimbursement rates described in § 40-8.13-5.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-8 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-8 - Level-of-care tool.

§ 40-8.13-8. Level-of-care tool.A managed long-term-care arrangement must require that all participating managed care organizations use only the EOHHS level-of-care tool in determining coverage of long-term-care supports and services for beneficiaries. EOHHS may amend the level-of-care tool provided that any changes are established in consultation with beneficiaries and providers of Medicaid-covered long-term-care supports and services, and are based upon reasonable medical evidence or consensus, in consideration of the specific needs of Rhode Island beneficiaries. Notwithstanding any other provisions herein, however, in the case of a duals demonstration project, a managed care organization may use a different level-of-care tool for determining coverage of services that would otherwise be covered by Medicare, since the criteria established by EOHHS are directed towards Medicaid-covered services; provided, that the level-of-care tool is based on reasonable medical evidence or consensus in consideration of the specific needs of Rhode Island beneficiaries.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-9 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-9 - Case management/plan of care.

§ 40-8.13-9. Case management/plan of care.No managed care organization acting under a managed long-term-care arrangement may require a provider to change a plan of care if the provider reasonably believes that such an action would conflict with the provider's responsibility to develop an appropriate care plan under state and federal regulations.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-10 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-10 - Care transitions.

§ 40-8.13-10. Care transitions.In the event that a beneficiary:(1) Has been determined to meet level-of-care requirements for nursing facility coverage as of the date of his or her enrollment in a managed care organization; or(2) Has been determined to meet level of care requirements for nursing facility coverage by a managed care organization after enrollment; and there is a change in condition whereby the managed care organization determines that the beneficiary no longer meets such level-of-care requirements, the nursing facility shall promptly arrange for an appropriate and safe discharge (with the assistance of the managed care organization if the facility requests it), and the managed care organization shall continue to pay for the beneficiary's nursing facility care at the same rate until the beneficiary is discharged.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-11 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-11 - Reporting requirements.

§ 40-8.13-11. Reporting requirements.EOHHS shall report to the general assembly and shall make available to interested persons a separate accounting of state expenditures for long-term-care supports and services under any managed long-term-care arrangement, specifically and separately identifying expenditures for home- and community-based services, assisted-living services, hospice services within nursing facilities, hospice services outside of nursing facilities, and nursing facility services. Such reports shall be made twice annually, six (6) months apart, beginning six (6) months following the implementation of any managed long-term-care arrangement, and shall include a detailed report of utilization of each service. In order to facilitate reporting, any managed long-term-care arrangement shall include a requirement that a participating managed care organization make timely reports of the data necessary to compile the reports.History of Section.P.L. 2014, ch. 145, art. 18, § 6.
RI Gen L § 40-8.13-12 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.13 - Long-Term Managed Care Arrangements|Section 40-8.13-12 - Community-based supportive living program.

§ 40-8.13-12. [Repealed.]History of Section.P.L. 2015, ch. 141, art. 5, § 19; P.L. 2019, ch. 88, art. 13, § 9; repealed by P.L. 2021, ch. 162, art. 12, § 7, effective July 1, 2021.
RI Gen L § 40-8.14-2 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.14 - Quality Self-Directed Services|Section 40-8.14-2 - Scope of coverage.

§ 40-8.14-2. Scope of coverage.Individual providers may provide all authorized HCBS-covered services in accordance with the participant's service plan at home and other Medicaid certified settings, to the extent the applicable federal and state laws and rules and regulations allow.History of Section.P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1.
RI Gen L § 40-8.14-3 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.14 - Quality Self-Directed Services|Section 40-8.14-3 - Use of employee workforce.

§ 40-8.14-3. Use of employee workforce.The requirement under § 40-8.14-2 shall not restrict the state's ability to afford participants and participants' representatives who choose not to employ an individual provider, or are unable to do so, the option of receiving direct-support services through a personal choice option or through the employees of provider agencies, rather than through an individual provider.Nothing in this chapter shall restrict the state's ability to afford Medicaid LTSS beneficiaries authorized to receive HCBS-covered services with the freedom of choice guaranteed under Title XIX to enter into service delivery agreements with any authorized Medicaid provider.History of Section.P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1.
RI Gen L § 40-8.14-5 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.14 - Quality Self-Directed Services|Section 40-8.14-5 - Authority of the department of administration.

§ 40-8.14-5. Authority of the department of administration.In accordance with chapter 8.15 of this title, the director shall have the authority to:(1) Meet and negotiate with any provider representative chosen pursuant to § 40-8.15-2(a);(2) In coordination with the secretary, negotiate over any of the topics in § 40-8.14-4(c) and any other appropriate matters governing the workforce of individual providers without infringing on participants' or their responsible parties' rights and responsibilities to hire, direct, supervise, or terminate the employment of their individual providers; and(3) Execute a collective bargaining agreement, subject to any approval required under § 40-8.15-5.History of Section.P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1.
RI Gen L § 40-8.14-6 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.14 - Quality Self-Directed Services|Section 40-8.14-6 - Severability.

§ 40-8.14-6. Severability.Should any part of this chapter be declared invalid or unenforceable, or the enforcement or compliance with it is suspended, restrained, or barred, either by the state or by the final judgment of a court of competent jurisdiction, the remainder of this chapter shall remain in full force and effect.History of Section.P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1.
RI Gen L § 40-8.15-1 (2021)
2021 Rhode Island General Laws|Title 40 - Human Services|Chapter 40-8.15 - Individual Providers of Direct-Support Services|Section 40-8.15-1 - Definitions.

§ 40-8.15-1. Definitions.For the purposes of this chapter:(1) "Direct-support services" has the meaning given to it under § 40-8.14-1.(2) "Director" has the meaning given to it under § 40-8.14-1.(3) "Individual provider" has the meaning given to it under § 40-8.14-1.(4) "Participant" has the meaning given to it under § 40-8.14-1.(5) "Participant's representative" has the meaning given to it under § 40-8.14-1.(6) "Provider representative" has the meaning given to it under § 40-8.14-1.(7) "Secretary" has the meaning given to it under § 40-8.14-1.History of Section.P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.