§ 35-17-1. Purpose and membership.
(a) In order to provide for a more stable and accurate method of financial planning and
budgeting, it is hereby declared the intention of the legislature that there be a
procedure for the determination of official estimates of anticipated medical assistance
expenditures and public assistance caseloads, upon which the executive budget shall
be based and for which appropriations by the general assembly shall be made.
(b) The state budget officer, the house fiscal advisor, and the senate fiscal advisor
shall meet in regularly scheduled caseload estimating conferences (C.E.C.). These
conferences shall be open public meetings.
(c) The chairpersonship of each regularly scheduled C.E.C. will rotate among the state
budget officer, the house fiscal advisor, and the senate fiscal advisor, hereinafter
referred to as principals. The schedule shall be arranged so that no chairperson shall
preside over two (2) successive regularly scheduled conferences on the same subject.
(d) Representatives of all state agencies are to participate in all conferences for which
their input is germane.
(e) The department of human services shall provide monthly data to the members of the
caseload estimating conference by the fifteenth day of the following month. Monthly
data shall include, but is not limited to, actual caseloads and expenditures for the
following case assistance programs: Rhode Island Works, SSI state program, general
public assistance, and child care. For individuals eligible to receive the payment
under § 40-6-27(a)(1)(vi) [repealed], the report shall include the number of individuals enrolled in a managed
care plan receiving long-term care services and supports and the number receiving
fee-for-service benefits. The executive office of health and human services shall
report relevant caseload information and expenditures for the following medical assistance
categories: hospitals, long-term care, managed care, pharmacy, and other medical services.
In the category of managed care, caseload information and expenditures for the following
populations shall be separately identified and reported: children with disabilities,
children in foster care, and children receiving adoption assistance and RIte Share
enrollees under § 40-8.4-12(j). The information shall include the number of Medicaid recipients whose estate may
be subject to a recovery and the anticipated amount to be collected from those subject
to recovery, the total recoveries collected each month and number of estates attached
to the collections and each month, the number of open cases and the number of cases
that have been open longer than three months. The executive office will also report
separately the amount that the Medicaid expenditures have been reduced by third-party
liability payments to providers, supplemental income verification tools, the department
of administration's office of internal audit and program integrity unit, and recoveries
from ABLE accounts.
(f) Beginning July 1, 2021, the department of behavioral healthcare, developmental disabilities
and hospitals shall provide monthly data to the members of the caseload estimating
conference by the twenty-fifth day of the following month. Monthly data shall include,
but is not limited to, actual caseloads and expenditures for the private community
developmental disabilities services program. Information shall include, but not be
limited to: the number of cases and expenditures from the beginning of the fiscal
year at the beginning of the prior month; cases added and denied during the prior
month; expenditures made; and the number of cases and expenditures at the end of the
month. The information concerning cases added and denied shall include summary information
and profiles of the service-demand request for eligible adults meeting the state statutory
definition for services from the division of developmental disabilities as determined
by the division, including age, Medicaid eligibility and agency selection placement
with a list of the services provided, and the reasons for the determinations of ineligibility
for those cases denied. The department shall also provide, monthly, the number of
individuals in a shared-living arrangement and how many may have returned to a twenty-four-hour
(24) residential placement in that month. The department shall also report, monthly,
any and all information for the consent decree that has been submitted to the federal
court as well as the number of unduplicated individuals employed; the place of employment;
and the number of hours working. The department shall also provide the amount of funding
allocated to individuals above the assigned resource levels; the number of individuals
and the assigned resource level; and the reasons for the approved additional resources.
The department will also collect and forward to the house fiscal advisor, the senate
fiscal advisor, and the state budget officer, by November 1 of each year, the annual
cost reports for each community-based provider for the prior fiscal year. The department
shall also provide the amount of patient liability to be collected and the amount
collected as well as the number of individuals who have a financial obligation. The
department will also provide a list of community-based providers awarded an advanced
payment for residential and community-based day programs; the address for each property;
and the value of the advancement. If the property is sold, the department must report
the final sale, including the purchaser, the value of the sale, and the name of the
agency that operated the facility. If residential property, the department must provide
the number of individuals residing in the home at the time of sale and identify the
type of residential placement that the individual(s) will be moving to. The department
must report if the property will continue to be licensed as a residential facility.
The department will also report any newly licensed twenty-four-hour (24) group home;
the provider operating the facility; and the number of individuals residing in the
facility. Prior to December 1, 2017, the department will provide the authorizations
for community-based and day programs, including the unique number of individuals eligible
to receive the services and at the end of each month the unique number of individuals
who participated in the programs and claims processed.
(g) The executive office of health and human services shall provide direct assistance
to the department of behavioral healthcare, developmental disabilities and hospitals
to facilitate compliance with the monthly reporting requirements in addition to preparation
for the caseload estimating conferences.