reglab/statecodes huggingface dataset:
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.10 - Long-Term Care Service Reform for Medicaid Eligible Individuals › Section 40-8.10-3. - Levels of care.

§ 40-8.10-3. Levels of care.
(a)
The secretary of the executive office of health and human services shall coordinate responsibilities for long-term-care assessment in accordance with the provisions of this chapter. Importance shall be placed upon the proper and consistent determination of levels of care across the state departments for each long-term-care setting, including behavioral health residential treatment facilities, long-term-care hospitals, intermediate-care facilities, and/or skilled nursing facilities. Specialized plans of care that meet the needs of the individual Medicaid recipients shall be coordinated and consistent across all state departments. The development of care plans shall be person-centered and shall support individual self-determination, family involvement, when appropriate, individual choice, and interdepartmental collaboration.
(b)
Levels of care for long-term-care institutions (behavioral health residential treatment facilities, long-term-care hospitals, intermediate-care facilities and/or skilled nursing facilities), for which alternative community-based services and supports are available, shall be established pursuant to § 40-8.9-9. The structure of the three (3) levels of care is as follows:
(1) Highest level of care.
Individuals who are determined, based on medical need, to require the institutional level of care will have the choice to receive services in a long-term-care institution or in a home- and community-based setting.
(2) High level of care.
Individuals who are determined, based on medical need, to benefit from home- and community-based services.
(3) Preventive level of care.
Individuals who do not presently need an institutional level of care but who need services targeted at preventing admission, re-admissions, or reducing lengths of stay in an institution.
(c)
Determinations of levels of care and the provision of long-term-care health services shall be determined in accordance with this section and shall be in accordance with the applicable provisions of § 40-8.9-9.
History of Section.
P.L. 2009, ch. 68, art. 23, § 9; P.L. 2015, ch. 141, art. 5, § 17.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.10 - Long-Term Care Service Reform for Medicaid Eligible Individuals › Section 40-8.10-4. - Long-term care assessment and coordination.

§ 40-8.10-4. Long-term care assessment and coordination.
(a)
The executive office of health and human services shall implement a long-term-care-options counseling program to provide individuals or their representative, or both, with long-term-care consultations that shall include, at a minimum, information about long-term-care options, sources and methods of both public and private payment for long-term-care services; information on caregiver support services, including respite care; and an assessment of an individual’s functional capabilities and opportunities for maximizing independence. Each individual admitted to or seeking admission to a long-term-care facility, regardless of the payment source, shall be informed by the facility of the availability of the long-term-care-options counseling program and shall be provided with a long-term-care-options consultation, if he or she so requests. Each individual who applies for Medicaid long-term-care services shall be provided with a long-term-care consultation.
(b)
Core and preventative home- and community-based services defined and delineated in § 40-8.10-2 shall be provided only to those individuals who meet one of the levels of care provided for in this chapter. Other long-term-care services authorized by the federal government, such as medication management, may also be provided to Medicaid-eligible recipients who have established the requisite need.
(c)
The assessments for individuals conducted in accordance with this section shall serve as the basis for individual budgets for those medical assistance recipients eligible to receive services utilizing a self-directed delivery system.
(d)
Nothing in this section shall prohibit the secretary of the executive office of health and human services, or the directors of that office’s departments from utilizing community agencies or contractors when appropriate to perform assessment functions outlined in this chapter.
History of Section.
P.L. 2009, ch. 68, art. 23, § 9; P.L. 2013, ch. 457, § 1; P.L. 2013, ch. 469, § 1; P.L. 2015, ch. 141, art. 5, § 17.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.10 - Long-Term Care Service Reform for Medicaid Eligible Individuals › Section 40-8.10-5. - Payments.

§ 40-8.10-5. Payments.
The executive office of health and human services shall not make payment for a person receiving a long-term home healthcare program, while payments are being made for that person for inpatient care in a skilled nursing and/or intermediate-care facility or hospital.
History of Section.
P.L. 2009, ch. 68, art. 23, § 9; P.L. 2015, ch. 141, art. 5, § 17.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.10 - Long-Term Care Service Reform for Medicaid Eligible Individuals › Section 40-8.10-6. - Rules and regulations.

§ 40-8.10-6. Rules and regulations.
The secretary of the executive office of health and human services, the directors of the department of human services, the office of healthy aging, the department of children, youth and families and the department of behavioral healthcare, development disabilities and hospitals are hereby authorized to promulgate rules and regulations necessary to implement all provisions of this chapter and to seek necessary federal approvals in accordance with the provisions of the state’s Medicaid section 1115 demonstration waiver.
History of Section.
P.L. 2009, ch. 68, art. 23, § 9; P.L. 2015, ch. 141, art. 5, § 17.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.11 - Family Caregivers Support Act of 2013 › Section 40-8.11-1. - Findings.

§ 40-8.11-1. Findings.
(a)
Family members, partners, and close friends provide the vast majority of long-term services and supports.
(b)
An estimated one hundred and forty-eight thousand (148,000) persons in Rhode Island are providing care at any one time to persons living in the community. The estimated value of their unpaid contributions in 2009 was one billion eight hundred eighty million dollars ($1,880,000,000).
(c)
Family or other caregivers who provide the majority of care in the home are frequently under substantial physical, psychological, and financial stress. The stress, if unrelieved by support for the caregiver, may lead to premature or unnecessary nursing home and institutional placement and health and financial burdens for the caregiver.
(d)
Respite care and other community-based supportive services for the family caregiver can relieve some of the stresses faced by caregivers; maintain and strengthen the family structure; postpone or prevent institutionalization; and lead to better outcomes for both the caregiver and care recipient.
(e)
The percent of Rhode Islanders age sixty-five (65) years of age and older is projected to grow from fourteen percent (14%) of the state population in 2010 to twenty-one percent (21%) by 2030. As persons age, they have greater dependency needs and an increased need for long-term-care services and support. Younger people with disabilities also require continued supportive long-term-care services as they age.
(f)
As informal caregivers and families are a vital part of the long-term-care services and support system, it is an important public purpose to recognize and respect their contributions; to assess their needs; and to provide them with counseling, education, and support services.
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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 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.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.13 - Long-Term Managed Care Arrangements › Section 40-8.13-12. - [Repealed.]

§ 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.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.14 - Quality Self-Directed Services › Section 40-8.14-1. - Definitions.

§ 40-8.14-1. Definitions.
For purposes of this chapter:
(1)
“Director” means the director of the Rhode Island department of administration.
(2)
“Executive office of health and human services (EOHHS)” means the agency in the executive branch of state government that is designated as the Medicaid single state agency and which, in this capacity, oversees the administration of the Medicaid LTSS program.
(3)
“Fiscal intermediary” means a third-party organization operating in accordance with applicable federal and state requirements under contract with the state that is responsible for performing payroll and other employment-related functions on behalf of the participant as set forth in the implementing regulations for the personal choice program promulgated by the secretary of EOHHS.
(4)
“Individual provider” means an individual selected by and working under the direction of a Medicaid LTSS participant or the participant’s duly authorized representative to provide self-directed personal care services to the participant in accordance with a person-centered plan and the implementing regulations promulgated for the program by the secretary of EOHHS. Individual provider does not mean or include an employee of a provider agency, subject to the agency’s direction and control commensurate with agency employee status.
(5)
“Medicaid LTSS participant” means a person who has been determined by the state to be eligible for Medicaid-funded long-term services and supports under the Medicaid state plan and/or the RI section 1115 waiver demonstration and/or Medicaid authorities created in the future.
(6)
“Participant’s representative” means a participant’s legal guardian or a person who has been designated by the participant or otherwise has the authority and responsibility to act on behalf of a participant with respect to the provision of self-directed services, including the self-directed personal care services subject to this act.
(7)
“Provider representative” means a provider organization that is certified as the exclusive negotiating representative of individual providers as provided in § 40-8.15-7.
(8)
“Secretary” means the secretary of the Rhode Island executive office of health and human services (EOHHS).
(9)
“Self-directed personal care services” means home and community-based personal care services a Medicaid LTSS participant is authorized to self-direct to meet their daily living needs, function adequately at home, safely access the community, or other nonprofessional services under the personal choice program, independent provider program, or any similar program that may provide similar services in the future under the Medicaid state plan, section 1115 demonstration waiver, or future Medicaid authorities promulgated by the secretary.
History of Section.
P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1; P.L. 2023, ch. 235, § 2, effective June 23, 2023; P.L. 2023, ch. 236, § 2, effective June 23, 2023.
2023 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.
2023 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 personal care services 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 participants 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; P.L. 2023, ch. 235, § 2, effective June 23, 2023; P.L. 2023, ch. 236, § 2, effective June 23, 2023.
2023 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.
2023 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.
2023 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.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-2. - Right of individual providers to choose provider representative — Subject of negotiation.

§ 40-8.15-2. Right of individual providers to choose provider representative — Subject of negotiation.
(a)
Individual providers may, in accordance with the procedures set forth in § 40-8.15-7, choose a provider organization to be their provider representative and to negotiate with the state, over the terms and conditions of individual providers’ participation in providing direct-support services, including, but not limited to:
(1)
Expanding training and professional development opportunities;
(2)
Improving the recruitment and retention of qualified individual providers;
(3)
Reimbursement rates and other economic matters;
(4)
Benefits;
(5)
Payment procedures; and
(6)
A grievance resolution process.
(b)
Nothing in this chapter or in chapter 8.14 of this title shall interfere with regulatory authority of the Rhode Island department of health (RIDOH) over individual providers licensing. Individual provider licensing shall be excluded from and not subject to the negotiation process recognized and described in this section.
(c)
Notwithstanding the above, individual providers must operate in conformance with the relevant sections of the general laws applicable thereto and regulations promulgated by the state.
(d)
The directors of each department with authority to administer their respective programs shall work in consultation with the secretary regarding the terms and conditions of individual providers’ participation in their respective programs including, but not limited to, the terms and conditions in subsection (a).
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-3. - Good-faith negotiations.

§ 40-8.15-3. Good-faith negotiations.
It shall be the obligation of the director, or a designee, to meet and negotiate in good faith with the provider representative within thirty (30) days after receipt of written notice from the provider representative of the request for a meeting for bargaining purposes. This obligation shall include the duty to cause any agreement resulting from the negotiations to be reduced to a written contract.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-4. - Unresolved issues — Impasse procedures.

§ 40-8.15-4. Unresolved issues — Impasse procedures.
In the event that the provider representative and the director, or a designee, are unable to reach an agreement on a contract, or reach an impasse in negotiations, the procedures of §§ 36-11-7.1 through 36-11-11 shall be followed.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-5. - Economic aspects of contract subject to legislative appropriation.

§ 40-8.15-5. Economic aspects of contract subject to legislative appropriation.
Any aspects of a contract requiring appropriation by the federal government, the general assembly, or revisions to statutes or regulations shall be subject to passage of those appropriations and any necessary statutory and regulatory revisions.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-6. - Duty to represent all individual providers fairly — Deduction of membership dues and other voluntary deductions.

§ 40-8.15-6. Duty to represent all individual providers fairly — Deduction of membership dues and other voluntary deductions.
(a)
A provider organization certified as the provider representative shall represent all individual providers in the state fairly and without discrimination, without regard to whether or not the individual provider is a member of the provider organization.
(b)
Each individual provider may choose whether to be a member of the provider organization. The state, or its designee, shall deduct from payments to care providers membership dues for individual providers who elect to become members and authorize the deduction of membership dues, and any other voluntary deductions authorized by individual providers.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-7. - Certification and decertification of provider organization.

§ 40-8.15-7. Certification and decertification of provider organization.
(a)
Petitions to certify a provider organization to serve as the provider representative of individual providers; petitions to intervene in such an election; and any other petitions for investigation of controversies as to representation may be filed with and acted upon by the labor relations board in accordance with the provisions of chapter 7 of title 28 and the board’s rules and regulations; provided, that any valid petition as to whether individual providers wish to certify or decertify a provider representative shall be resolved by a secret ballot election among individual providers for which purpose the board may designate a neutral third party to conduct the secret ballot election.
(b)
The only appropriate unit shall consist of all individual providers in the state.
(c)
For purposes of this section, no individual provider shall be deemed excluded from the bargaining unit under § 28-7-3(3)(ii) because he or she provides care to a family member or because they are in domestic service in a person’s home.
(d)
The cost of any certification election held under this section will be split equally among all the provider organizations that appear on the ballot.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-8. - Unfair practices.

§ 40-8.15-8. Unfair practices.
It shall be unlawful for the state to do any of the acts made unlawful under § 28-7-13. It shall be unlawful for the provider representative to do any of the acts made unlawful under § 28-7-13.1. Any alleged violation of this provision may be filed with the labor relations board as an unfair labor practice and considered and ruled upon in accordance with chapter 7 of title 28 and the board’s rules and regulations.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-9. - Duties of the executive office for health and human services.

§ 40-8.15-9. Duties of the executive office for health and human services.
(a)
The secretary has authority over the terms and conditions of individual providers’ employment, including compensation as required under § 40-8.15-14, payment, benefit terms, provider qualification standards, other appropriate terms and conditions for the workforce of individual providers without infringing on participants’ or participant representatives’ rights and responsibilities to hire, direct, supervise, and/or terminate the employment of their individual providers, and orientation, training, and the operation of a registry as required under § 40-8.15-15.
(b)
The secretary’s authority in subsection (a) of this section only applies to self-directed personal care services and is subject to the state’s obligation to meet and negotiate with a provider representative pursuant to § 40-8.15-16.
(c)
Notwithstanding the state’s obligations to meet and negotiate under chapter 7 of title 28, nothing in this chapter shall be construed to make individual providers employees of the state for any purpose, including for the purposes of eligibility for the state employee pension program or state employee health benefits.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2; P.L. 2023, ch. 235, § 3, effective June 23, 2023; P.L. 2023, ch. 236, § 3, effective June 23, 2023.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-10. - Right of families to select, direct, and terminate individual providers.

§ 40-8.15-10. Right of families to select, direct, and terminate individual providers.
Nothing in this chapter shall be construed to alter the rights of families to select, direct, and terminate the services of individual providers.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-11. - Strikes not authorized.

§ 40-8.15-11. Strikes not authorized.
Individual providers shall not engage in any strike or other collective cessation of the delivery of direct-support services.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-12. - State action exemption.

§ 40-8.15-12. State action exemption.
The state action exemption to the application of state and federal antitrust laws is applicable to the activities of individual providers and their provider representative authorized under this chapter.
History of Section.
P.L. 2018, ch. 106, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-13. - Severability.

§ 40-8.15-13. 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, § 2; P.L. 2018, ch. 110, § 2.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-14. - Wage ranges.

§ 40-8.15-14. Wage ranges.
(a)
The state shall set wage ranges for all individual providers. All self-directed personal care services performed by individual providers must be compensated at a wage that is within the range set by the secretary for the services provided, but the participant may choose what wage to pay within the applicable range.
(b)
The wage range may be the subject of collective bargaining as provided in this chapter. However, such collective bargaining shall be related solely to self-directed personal care services. All other self-directed services available to personal choice participants other than personal care are excluded from collective bargaining.
(c)
The provisions of this section shall take effect on the date of implementation, as provided in § 40-8.15-16(c).
History of Section.
P.L. 2023, ch. 235, § 4, effective June 23, 2023; P.L. 2023, ch. 236, § 4, effective June 23, 2023.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-8.15 - Individual Providers of Direct-Support Services › Section 40-8.15-15. - Other duties of the executive office for health and human services.

§ 40-8.15-15. Other duties of the executive office for health and human services.
(a)(1)
The secretary shall determine by regulation whether and to what extent individual providers selected by personal choice participants to provide self-directed personal care are required to complete an orientation, pursuant to the secretary’s authority under § 40-8.14-4(c)(2). The secretary shall determine by regulation the specific types of education, experience, or training that may be required for an individual provider to be included on a registry of persons qualified to be self-directed individual providers.
(2)
The subjects of this section shall be collectively bargained with the provider representative. Nothing in this act prohibits a personal choice participant from requiring an individual provider to complete more training or education than is minimally required by the secretary.
(b)
The secretary shall maintain a registry for individual providers pursuant to its authority under § 40-8.14-4(c)(4) and shall collaborate with the provider representative to maintain this registry.
(c)
The provisions of this section shall take effect on the date of implementation, as provided in § 40-8.15-16(c).
History of Section.
P.L. 2023, ch. 235, § 4, effective June 23, 2023; P.L. 2023, ch. 236, § 4, effective June 23, 2023.
2023 Rhode Island General Laws › Title 40 - Human Services › Chapter 40-9 - Services for People Who Are Blind or Visually Impaired › Section 40-9-1. - Administrator — Other personnel and expenses — Appropriations — References to “bureau for the blind.”

§ 40-9-1. Administrator — Other personnel and expenses — Appropriations — References to “bureau for the blind.”
(a)
The director of human services may appoint a man or a woman qualified by training and experience as administrator of services for people who are blind or visually impaired, to hold office during his or her pleasure, subject to the provisions of chapter 4 of title 36; employ assistants, teachers, and agents as may be necessary; fix their compensation within the amounts appropriated therefor; and incur other expenses as may be authorized by the general assembly. The general assembly shall annually appropriate a sum as it may deem necessary to pay the salary of the administrator, assistants, teachers, and agents.
(b)
Whenever in any existing law the term “bureau for the blind” occurs, the term shall hereafter be construed to mean the department of human services.
History of Section.
G.L. 1923, ch. 413, art. 1, § 27; P.L. 1930, ch. 1590, § 1; P.L. 1935, ch. 2250, § 149; G.L. 1938, ch. 184, § 1; impl. am. P.L. 1940, ch. 802, § 2; impl. am. P.L. 1952, ch. 2975, § 17; G.L. 1956, § 40-11-1; P.L. 1962, ch. 6, §§ 1, 5; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1991, ch. 6, art. 10, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.