Chapter 1 Department of Human Services

40-1-1. Advisory council — Appointment of members.

  1. Within the department of human services there shall be an advisory council consisting of nine (9) qualified electors of the state, who shall be appointed by the governor as provided in this section. In the month of February in each year the governor shall appoint a member, or members, of the council, each to hold office until the first day of March in the fifth year after his or her appointment and until his or her successor is appointed and qualified, to succeed the member whose term shall next expire.
  2. Any vacancy that may occur in the council shall be filled by appointment by the governor for the remainder of the unexpired term and members of the council shall be chosen with due regard to their knowledge of social welfare problems and the director of the department shall designate some person to act as secretary of the council.
  3. The council shall meet at least four (4) times during any one year and at such additional times as the director of the department shall designate. The members of the council shall elect one of their members as chairperson upon the appointment of any new member for a full term and whenever the office becomes vacant.

History of Section. P.L. 1939, ch. 660, § 88; G.L. 1956, §§ 40-1-1 , 40-1-2 ; P.L. 1962, ch. 23, § 1; Reorg. Plan No. 1, 1970; G.L. 1956, § 40-1-1 ; P.L. 1974, ch. 126, § 1; P.L. 1997, ch. 326, § 123.

40-1-2. Functions of advisory council.

The council shall make suggestions to and shall advise the director of the department concerning the policies, rules, and regulations of the department. The council shall have no administrative power.

History of Section. P.L. 1939, ch. 660, § 88; impl. am. P.L. 1949, ch. 2166, § 1; G.L. 1956, § 40-1-3 ; Reorg. Plan No. 1, 1970; G.L. 1956, § 40-1-2 ; P.L. 1974, ch. 126, § 1.

40-1-3. Advisory committees to agencies within department.

The director of the department of human services shall be authorized to appoint advisory committees as he or she thinks appropriate to make suggestions to and to advise the various agencies within the department. The members of the committees shall serve without pay. The chairperson of each committee shall be designated by the director and shall sit ex-officio with the department advisory committee.

History of Section. P.L. 1974, ch. 126, § 1.

40-1-4. Organization of department.

All functions, services, and duties of the department of human services shall be organized by the director with the approval of the governor as to:

  1. Community services to include generally and specifically the administration of all forms of human services excluding child welfare services, which are the responsibility of the department of children, youth and families.
  2. Management services to include generally and specifically all central management, financial, forms of relief, and other services concerned with the business and servicing operations of the department.
  3. Veterans’ affairs to include all forms of services to veterans of the armed forces. There shall be within the department of human services an office of veterans services.

History of Section. P.L. 1939, ch. 660, § 92; P.L. 1951, ch. 2724, § 2; Reorg. Plan No. 1, 1970; G.L. 1956, § 40-1-4 ; P.L. 1976, ch. 290, § 11; P.L. 1984, ch. 81, § 16; P.L. 1988, ch. 566, § 1.

Cross References.

Department of behavioral healthcare, developmental disabilities and hospitals, § 40.1-1-3.1 et seq.

Department of corrections, § 42-56-1 et seq.

Soldiers’ graves, care, § 30-25-10 et seq.

Veterans’ home, § 30-24-1 et seq.

Veterans services, § 30-17.1-6 et seq.

40-1-4.1. Name change.

The department of social and rehabilitative services is hereby renamed the department of human services. Whenever in the general or public laws there appears any reference to the department of social and rehabilitative services, the reference shall be construed to refer to the department of human services.

History of Section. P.L. 1985, ch. 181, art. 35, § 1.

40-1-5. Reorganizations within department.

Notwithstanding any other provisions of law, any division, bureau, or other unit or agency within the department of human services, however entitled or described, may at any time be reorganized, divided, consolidated, abolished, or otherwise reconstituted by the director of human services with the approval of the governor, as may be desirable for the proper administration and performance of the powers, functions, and duties assigned to the department, and any change shall conform with the requirements of § 40-1-4 .

History of Section. P.L. 1939, ch. 660, § 94; P.L. 1951, ch. 2724, § 2; G.L. 1956, § 40-1-6 ; Reorg. Plan No. 1, 1970.

40-1-6. Officers required to be veterans.

The respective officers appointed by the director of human services to be in charge of the state’s administration of veterans’ relief, of graves’ registration, and the commandant and the assistant commandant of the Rhode Island veterans’ home, in addition to any other qualifications required for their respective positions as already provided in law, shall each be an honorably discharged war veteran of any war in which the United States has been engaged.

History of Section. P.L. 1941, ch. 989, § 1; P.L. 1948, ch. 1997, § 1; impl. am. P.L. 1949, ch. 2166, § 1; G.L. 1956, § 40-1-7 ; Reorg. Plan No. 1, 1970.

Cross References.

Extension to veterans of undeclared wars, §§ 30-22-3 , 30-22-4 .

40-1-7. Offices of department.

The department of administration shall furnish the state department of human services offices in which to transact its business and keep its records. The offices shall be open for business each day of the year, except Sundays and legal holidays, during such hours as may be prescribed by the director.

History of Section. P.L. 1917, ch. 1470, art. 1, § 26; G.L. 1923, ch. 413, art. 1, § 25; P.L. 1926, ch. 829, § 1; G.L. 1938, ch. 50, § 13; impl. am. P.L. 1939, ch. 660, § 80; impl. am. P.L. 1951, ch. 2727, art. 1, § 3; G.L. 1956, § 40-1-8 ; Reorg. Plan No. 1, 1970.

40-1-8. Appointment of employees.

The director of the department of human services, subject to the provisions of chapter 4 of title 36, shall be the appointing authority for all employees of the department, and the director may assign this function to subordinate officers and employees as may to him or her seem feasible or desirable.

History of Section. P.L. 1963, ch. 99, § 1; G.L. 1956, § 40-1-9 ; Reorg. Plan No. 1, 1970.

Collateral References.

Malpractice by social workers. 58 A.L.R.4th 977.

40-1-9. Adaptive telephone equipment loan program fund.

  1. There is hereby created an adaptive telephone equipment loan program fund that shall be administered by the general treasurer and the principal and interest of which shall be used solely for the purpose of providing funds for the purchase, maintenance, replacement, and distribution of telephone telecommunications devices and special-needs equipment, and the administrative expenses of the general treasurer incurred in conjunction therewith, for the deaf, the severely hearing impaired, and severely speech impaired who have been duly certified as such in accordance with § 39-2-5(7) [Subdivision (7) was deleted].
  2. The regulated telephone utilities shall pay over to the general treasurer any and all sums received as a monthly surcharge in accordance with § 39-2-5(7) [Subdivision (7) was deleted]. The general treasurer shall invest and reinvest the sums so received in accordance with the laws of Rhode Island.
  3. Upon receipt of duly authenticated vouchers from the director of the department of human services, the general treasurer may draw upon the principal or income of the fund to effectuate the provisions of § 39-2-5(7) [Subdivision (7) was deleted].

History of Section. P.L. 1985, ch. 48, § 3; P.L. 1987, ch. 554, § 1; P.L. 1993, ch. 115, § 4.

Compiler’s Notes.

Subsection (7) of § 39-2-5 , referred to in this section, was deleted by P.L. 2004, ch. 378, § 4, and P.L. 2004, ch. 504, § 4.

Cross References.

Adaptive telephone equipment loan program committee, § 39-23-1 et seq.

40-1-10. Transfer of functions from the department of community affairs.

  1. There is hereby transferred to the department of human services those functions formerly administered by the department of community affairs relating to:
    1. Administrative support to federal grants;
    2. Community services block grants;
    3. Domestic violence project;
    4. Community agency liaison and funding (women and human services);
    5. Community agency liaison and funding (energy and community services);
    6. Displaced homemaker centers;
    7. Federal surplus commodity distribution;
    8. Health center grants;
    9. Community action fund;
    10. Commission on Indian affairs.
  2. In addition to any of its other powers and responsibilities, the department is authorized and empowered to accept any grants made available by the United States government or any agency thereof, and the department, with the approval of the governor, is authorized and empowered to perform such acts and enter into all necessary contracts and agreements with the United States, or any agency thereof, as may be necessary in the manner and degree as shall be deemed to be in the best interests of the state. The proceeds of grants so received shall be paid to the general treasurer of the state and by him or her deposited in a separate fund and shall be utilized for the purposes of the grant or grants.

History of Section. P.L. 1985, ch. 181, art. 61, § 4.

40-1-11. Displaced homemakers center.

There is hereby established within the department of human services a displaced homemakers center.

History of Section. P.L. 1985, ch. 181, art. 61, § 11.

40-1-12. “Displaced homemaker” defined.

As used in this chapter, unless the context requires otherwise, “displaced homemaker” means a person who:

  1. Worked in the home for a substantial number of years providing unpaid household services for family members;
  2. Who is not gainfully employed;
  3. Has or would have difficulty in securing employment; and
  4. Was dependent on the income of another family member but is no longer supported by the income, or was dependent on assistance from the state or federal government but is no longer eligible for assistance for reasons other than willful failure to comply with rules and regulations.

History of Section. P.L. 1985, ch. 181, art. 61, § 11.

40-1-13. Duties of director and center staff.

  1. The director shall cooperate with federal, state, and local agencies to coordinate the service programs established pursuant to § 40-1-14 .
  2. The director shall promulgate rules concerning the eligibility of persons for the job training and other programs of the multipurpose service center; the granting of stipends for the job training programs from available funds; and a sliding fee scale for the service programs.

History of Section. P.L. 1985, ch. 181, art. 61, § 11.

40-1-14. Powers and scope of activities.

  1. In order to enable the displaced homemaker to contribute to society and maintain independence and economic security, the director shall establish a multipurpose service center for displaced homemakers. The director may make a grant to a nonprofit agency or organization to carry out the various programs.
  2. The center shall develop, by working with federal, state and local governmental agencies, private employers, and charitable or nonprofit agencies, job counseling and placement services specifically designed for displaced homemakers, which services shall:
    1. Counsel displaced homemakers with respect to appropriate job opportunities;
    2. Identify community needs and endeavor to develop and to create new jobs for displaced homemakers in the private and public sector;
    3. Provide displaced homemakers with the necessary counseling, training, skills, and referral services to become gainfully employed and independent;
    4. Develop plans to include more displaced homemakers in existing training and placement programs;
    5. Refer displaced homemakers to agencies that may provide information and assistance with respect to health care, financial matters, education, nutrition, and legal problems; and
    6. Take into account and build upon the skills and experiences of the displaced homemaker.
  3. The center shall develop an outreach program with a special emphasis directed toward reaching displaced homemakers in their middle years.

History of Section. P.L. 1985, ch. 181, art. 61, § 11.

40-1-15. Reimbursement to health center.

The director shall reimburse certain health centers at a rate of twenty-four dollars ($24.00) per patient visit for physician services including case management. In accordance with the state Medicaid plan as provided in chapter 8 of this title, any rules or regulations as established in accordance with § 40-8-13 , calling for a lower rate per patient visit, shall be raised to conform to the new rate as set forth above. For the purpose of this section, the reimbursement fee shall apply only to the following health centers:

  1. Providence Ambulatory Health Care Foundation;
  2. Health Services, Inc. of Woonsocket;
  3. Blackstone Valley Community Action;
  4. Cranston Health and Family Planning Center;
  5. East Providence Community Health Center;
  6. New Visions of Newport County;
  7. Tri-Town Health Center;
  8. Warwick Community Health Center;
  9. Chad Brown Health Center;
  10. Health Center of South County;
  11. North Kingstown Regional Health Center; and
  12. Pawtucket Neighborhood Health Center.

History of Section. P.L. 1986, ch. 287, art. 26, § 3.

40-1-16. Visiting nurse association — Payment.

  1. For purposes of this chapter:
    1. “Agency” means the Kent County Visiting Nurse Association; Newport Visiting Nurse Service; VNA, Inc.; Visiting Nurse Services of Woonsocket; Little Compton Visiting Nurse Association; Northwest Community Nursing & Health Service; Visiting Nurse Services of Pawtucket; and Visiting Nurse Services of Washington County and Jamestown;
    2. “Home visit” means a visit, by the agency to a client during which skilled nursing services, physical, speech, and/or occupational therapy services, and/or home health aide services are rendered to the client, and the visit is reportable on the Medicare cost report; and
    3. “Reference year” means the previous fiscal year.
  2. The director shall apportion any appropriation for visiting nurse association in accordance with the following:
    1. Ten percent (10%) of the appropriation shall be divided equally among the agencies.
    2. Ninety percent (90%) of the appropriation shall be divided by the statewide total number of home visits for the reference year.
    3. Each agency shall receive an amount equal to the quotient in subsection (b)(2) multiplied by the number of home visits by the agency in the reference year.

History of Section. P.L. 1989, ch. 305, § 1.

40-1-17. Receipt and use of funds.

To carry out the purposes of this chapter, the department of human services, with the approval of the governor, shall have the authority to receive and expend monies from any other sources, public or private, including, but not limited to, legislative enactments, bond issues, gifts, devises, grants, bequests, or donations. The department of human services, with the approval of the governor, is authorized to enter into any contracts necessary to obtain and expend those funds.

History of Section. P.L. 2018, ch. 47, art. 2, § 4.

Chapter 2 Administration of State Institutions

40-2-1. Records of institution residents — Reports of injury or death — Communications to department.

The department of human services shall keep a record showing the name, residence, sex, age, nativity, occupation, condition, and date of entrance or commitment of every inmate, patient, or pupil in the several institutions under the control of the department; the date, cause, and terms of discharge and the condition of the persons at the time of leaving, and also all transfers from one institution to another; and if any inmate, patient, or pupil dies, the date and cause of death. These and other facts as the department may, from time to time, require shall be furnished by the managing officer of each institution to the director of the department of human services within twenty-four (24) hours after the commitment, entrance, death, or discharge of any inmate, patient, or pupil. In case of an accident, injury, or death under peculiar circumstances of an inmate, patient, or pupil, the managing officer shall make a special report within twenty-four (24) hours thereafter to the director, giving the circumstances of the injury or death as fully as possible. The record shall be accessible only to the director of the department, and the officers, agents, and employees thereof, except by permission of the director or upon order of the governor or of a judge of a court of record. Whenever it is required by law that a notice, order, or other communication be made to the department, it shall be a sufficient compliance with the law if the notice, order, or other communication is made to the director of human services.

History of Section. P.L. 1917, ch. 1470, art. 1, § 6; G.L. 1923, ch. 413, art. 1, § 6; G.L. 1938, ch. 50, § 3; impl. am. P.L. 1939, ch. 660, § 80; Reorg. Plan No. 1, 1970.

Cross References.

Patient help in unclassified service, § 36-4-2 .

Supervision by department of human services, § 42-12-4 .

Veterans’ home, § 30-24-1 et seq.

Collateral References.

Privilege accorded state or local governmental administrative records relating to private individual member of public affecting defamation action. 40 A.L.R.4th 318.

40-2-2. Support of families of residents.

The director of human services may contribute to the support of the destitute family of any adult resident of this state, committed to any one of the state institutions under his or her supervision, whenever he or she is satisfied that the destitution has resulted from the commitment; provided, the contributions shall not continue beyond the period of commitment. The general assembly shall annually appropriate such sum as it may deem necessary for the payment of contributions, and the state controller shall draw his or her order or orders upon the general treasurer for the payment of the sum, or so much thereof as may be necessary for such purpose, upon the receipt by him or her of proper vouchers signed by the director.

History of Section. P.L. 1926, ch. 861, § 4; P.L. 1929, ch. 1382, § 6; P.L. 1932, ch. 1884, § 1; G.L. 1938, ch. 50, § 4; impl. am. P.L. 1939, ch. 660, §§ 65, 80; G.L. 1956, § 40-2-6 ; Reorg. Plan No. 1, 1970.

40-2-3. Application of funds deposited to care and treatment of residents.

The director of the department of human services shall apply any funds now or hereafter deposited in the name of any discharged or deceased patient or inmate in any institution under the control of the department of human services as partial or full payment, as the case may be, for the care and treatment of the patient or inmate.

History of Section. P.L. 1954, ch. 3289, § 1; G.L. 1956, § 40-2-7 ; Reorg. Plan No. 1, 1970.

40-2-4. Notice of balance to credit of deceased or discharged resident.

When a balance remains after the payment of the amount due the department of human services for care and treatment, the director shall cause notice of the balance to be mailed, postage prepaid, to each discharged patient or inmate at his or her last known address or to the nearest known next of kin of any deceased patient or inmate.

History of Section. P.L. 1954, ch. 3289, § 2; G.L. 1956, § 40-2-8 ; Reorg. Plan No. 1, 1970.

40-2-5. Payment of balance to general treasurer.

The balance, as shall remain after the amount due the department of human services for the care and treatment of any discharged or deceased patient or inmate is applied in payment thereof, shall be paid over to the general treasurer by the director.

History of Section. P.L. 1954, ch. 3289, § 3; G.L. 1956, § 40-2-9 ; Reorg. Plan No. 1, 1970.

40-2-6. Establishment of right to balance paid to treasurer.

Any person or persons claiming a right to any moneys paid to the general treasurer may establish the right in the same manner as is provided in the case of unclaimed bank deposits in the hands of the general treasurer.

History of Section. P.L. 1954, ch. 3289, § 4; G.L. 1956, § 40-2-10 ; Reorg. Plan No. 1, 1970.

40-2-7. Property abandoned by deceased or discharged residents.

All personal property, excepting moneys, that shall have been left by any discharged or deceased patient or inmate in any institution under the control of the department of human services and that, now or hereafter, shall not have been claimed by any of the discharged or deceased patients or inmates, or their next of kin, within one year from the date of discharge or decease, shall be deemed to have been abandoned. All abandoned personal property shall be disposed of as provided in this chapter.

History of Section. P.L. 1955, ch. 3448, § 1; G.L. 1956, § 40-2-11 ; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 124.

Cross References.

Burial permits, issuance, § 23-3-19 .

40-2-8. Transfer of abandoned property to general treasurer.

The director of the department of human services shall order the transfer of abandoned personal property to the state general treasurer.

History of Section. P.L. 1955, ch. 3448, § 2; G.L. 1956, § 40-2-12 ; Reorg. Plan No. 1, 1970; P.L. 1979, ch. 218, § 1.

40-2-9. Description of abandoned property transferred.

The director shall, upon ordering transfer of the abandoned personal property, cause to be forwarded to the state general treasurer a list or declaration setting forth the name of each discharged or deceased patient or inmate and a description of each article of personal property abandoned as described in § 40-2-7 .

History of Section. P.L. 1955, ch. 3448, § 3; G.L. 1956, § 40-2-13 ; Reorg. Plan No. 1, 1970; P.L. 1979, ch. 218, § 1; P.L. 1997, ch. 326, § 124.

40-2-10. Sale of abandoned property — Remission of proceeds.

The state general treasurer, upon receipt of the abandoned personal property and a list or declaration, shall sell the articles at public sale advertised in a manner that, to the general treasurer, shall seem satisfactory, and the general treasurer shall remit the proceeds received from the sale to the director, together with a list or declaration setting forth the amount of money to be credited to the account of each discharged or deceased patient or inmate.

History of Section. P.L. 1955, ch. 3448, § 4; G.L. 1956, § 40-2-14 ; Reorg. Plan No. 1, 1970; P.L. 1979, ch. 218, § 1.

40-2-11. Application of proceeds of sale.

The proceeds from advertised public sale or sales, when received, shall be treated in the same manner as is provided for in §§ 40-2-3 40-2-6 .

History of Section. P.L. 1955, ch. 3448, § 5; G.L. 1956, § 40-2-15 ; Reorg. Plan No. 1, 1970.

40-2-12. [Repealed.]

History of Section. P.L. 1917, ch. 1470, art. 4, § 1; P.L. 1918, ch. 1613, § 1; G.L. 1923, ch. 413, art. 4, § 1; G.L. 1938, ch. 54, § 1; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-2-16 ; Reorg. Plan No. 1, 1970; Repealed by P.L. 2016, ch. 100, § 1, effective June 17, 2016; P.L. 2016, ch. 109, § 1, effective June 17, 2016.

Compiler’s Notes.

Former § 40-2-12 concerned protection of health of residents.

40-2-13. Resident physicians and dentists.

The director of the department of human services shall appoint resident physicians, dentists, and other physicians, as may be necessary to give proper attention to the physical and mental welfare of the inmates of the institutions under the control of the department. The general assembly shall annually appropriate such sum as it may deem necessary to compensate the appointees.

History of Section. P.L. 1917, ch. 1470, art. 1, § 11; P.L. 1920, ch. 1901, § 1; P.L. 1922, ch. 2230, § 6; G.L. 1923, ch. 413, art. 1, § 11; P.L. 1925, ch. 639, § 2; P.L. 1930, ch. 1508, § 1; P.L. 1932, ch. 1888, § 1; P.L. 1935, ch. 2250, §§ 50, 149; G.L. 1938, ch. 50, § 5; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-2-17 ; Reorg. Plan No. 1, 1970.

40-2-14. Examination of inmates for contagious disease — Investigation and report of sources.

The department is hereby authorized and directed, by the attending physician at any of the institutions or by another physician as the director of the department may from time to time designate, to use every available means to ascertain the existence of any dangerous, infectious, or contagious disease, including syphilis in the infectious stages and gonococcus infection, among the inmates, prisoners, patients, and pupils of the institutions, and to make examination of any of them suspected of having syphilis in the infectious stages or gonococcus infection, and immediately to investigate the source of the infection, and, if ascertained, to report the source of the infection to the department of health; and any person committed to or received into any of the institutions by, through, or under any order of court or any process of law shall be deemed to be an inmate, prisoner, patient, or pupil of the institution, as the case may be, within the provisions of §§ 40-2-12 40-2-17 .

History of Section. P.L. 1917, ch. 1470, art. 4, § 2; P.L. 1918, ch. 1613, § 1; G.L. 1923, ch. 413, art. 4, § 2; G.L. 1938, ch. 54, § 2; impl. am. P.L. 1939, ch. 660, § 180; G.L. 1956, § 40-2-18 ; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 124.

Compiler’s Notes.

Section 40-2-12 , referred to in this section, was repealed by P.L. 2016, ch. 100, § 1, and P.L. 2016, ch. 109, § 1, effective June 17, 2016.

40-2-15. Treatment and isolation of diseased residents — Detention after time for release.

Every inmate, prisoner, patient, or pupil in any of the institutions, who has any dangerous, infectious or contagious disease, including syphilis in the infectious stages and gonococcus infection, shall be forthwith placed under medical treatment, and, if in the opinion of the attending physician it is necessary, shall be isolated until danger of contagion has passed or until the attending physician determines that further isolation is unnecessary; and if danger of contagion shall not have passed or if further isolation is still necessary at the expiration of sentence or at the time for discharge or release from the institution, that inmate, prisoner, patient, or pupil shall be detained in the institution and continued under medical treatment until the attending physician shall determine that his or her discharge or release from the institution will not endanger the public health; and during the period of detention, the person so detained shall be supported in the same manner as before the detention.

History of Section. P.L. 1917, ch. 1470, art. 4, § 3; P.L. 1918, ch. 1613, § 1; G.L. 1923, ch. 413, art. 4, § 3; G.L. 1938, ch. 54, § 3; G.L. 1956, § 40-2-19 ; Reorg. Plan No. 1, 1970; P.L. 1999, ch. 83, § 93; P.L. 1999, ch. 130, § 93.

40-2-16. Records of venereal disease.

For the statistical purposes of the department of health, the department of human services shall keep records of all cases of venereal diseases in the institutions, but the records shall not be open to public inspection, and the department of human services shall make every reasonable effort to keep secret the identity of those persons with the diseases so far as may be consistent with the enforcement of the provisions of §§ 40-2-12 40-2-17 and with the protection of the public health.

History of Section. P.L. 1917, ch. 1470, art. 4, § 5; P.L. 1918, ch. 1613, § 1; G.L. 1923, ch. 413, art. 4, § 5; G.L. 1938, ch. 54, § 5; impl. am. P.L. 1939, ch. 660, §§ 80, 180; G.L. 1956, § 40-2-20 ; Reorg. Plan No. 1, 1970; P.L. 1999, ch. 83, § 93; P.L. 1999, ch. 130, § 93.

Compiler’s Notes.

Section 40-2-12 , referred to in this section, was repealed by P.L. 2016, ch. 100, § 1, and P.L. 2016, ch. 109, § 1, effective June 17, 2016.

Cross References.

Reports concerning sexually transmitted diseases, § 23-11-5 .

40-2-17. Powers as to health of residents.

In carrying out the provisions of §§ 40-2-12 40-2-16 , the department is hereby vested with full powers of inspection, examination, isolation, and disinfection of all inmates, prisoners, patients, or pupils in any of the institutions, and the powers may be delegated to, and exercised by, any attending physician at any of the institutions or by another physician as the director of the department may from time to time designate.

History of Section. P.L. 1917, ch. 1470, art. 4, § 4; P.L. 1918, ch. 1613, § 1; G.L. 1923, ch. 413, art. 4, § 4; G.L. 1938, ch. 54, § 4; G.L. 1956, § 40-2-21 ; Reorg. Plan No. 1, 1970.

Compiler’s Notes.

Section 40-2-12 , referred to in this section, was repealed by P.L. 2016, ch. 100, § 1, and P.L. 2016, ch. 109, § 1, effective June 17, 2016.

40-2-18. Religious instructors and services.

The director of the department of human services shall appoint religious instructors who shall conduct religious services at times and at places within institutions under the control of the department, and who shall perform other duties consistent with their office, as may be required of them by the director of human services. The general assembly shall annually appropriate such sum as it may deem necessary to compensate the religious instructors.

History of Section. P.L. 1917, ch. 1470, art. 1, § 12; P.L. 1922, ch. 2230, § 7; G.L. 1923, ch. 413, art. 1, § 12; P.L. 1925, ch. 639, § 3; P.L. 1935, ch. 2250, § 149; G.L. 1938, ch. 50, § 6; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-2-22 ; Reorg. Plan No. 1, 1970.

40-2-19. Tenure of officers — Duties — Time devoted to duty — Holding other offices — Sales to state — Bond.

All officers appointed by the director under this chapter shall hold their respective offices during his or her pleasure, and may be removed and their successors appointed by the director at any time. In addition to the duties prescribed for the officers by law, they shall perform other duties as the director may, from time to time, require not inconsistent with law, and the officers shall make reports and keep records as the director may, from time to time, require in addition to the records and reports that the officers may be required to keep and make by any other provision of law. The officers, except those named in §§ 40-2-13 40-2-18 , shall give their entire time to the duties of their respective offices, and shall not hold any other state office except that of notary public or any other position of pay or profit in the service of the state, and shall not furnish for pay or profit any materials, merchandise, or supplies to the state. The director may require any of the officers to give bond to the state for the faithful performance of their duties in a sum and with surety as to the director may seem advisable.

History of Section. P.L. 1917, ch. 1470, art. 1, § 19; P.L. 1922, ch. 2230, § 11; G.L. 1923, ch. 413, art. 1, § 19; G.L. 1938, ch. 50, § 8; G.L. 1956, § 40-2-23 ; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 124.

Cross References.

Exemption of employees from militia duty, § 30-1-7 .

40-2-20. Compensation of officers and employees.

The director shall fix the compensation of the officers and employees of the several institutions appointed under the authority of this chapter, and of the other institutions under his or her control, within the sum or sums appropriated to be expended for the purpose.

History of Section. P.L. 1917, ch. 1470, art. 1, § 20; G.L. 1923, ch. 413, art. 1, § 20; G.L. 1938, ch. 50, § 9; G.L. 1956, § 40-2-24 ; Reorg. Plan No. 1, 1970.

40-2-21. Reports on schools in institutions — Inspections — Qualifications of teachers.

The director of the department of human services shall annually make to the department of elementary and secondary education in the month of July, a report of all the schools maintained in the institutions under its control, the report to be in the manner and form as prescribed by law for other educational institutions. The council on elementary and secondary education may visit and inspect the schools and make suggestions to the director of the department of human services for the improvement of them, as it may deem advisable. All teachers employed in the schools shall hold certificates of qualification as required by law of public school teachers.

History of Section. P.L. 1917, ch. 1470, art. 1, § 23; G.L. 1923, ch. 413, art. 1, § 22; G.L. 1938, ch. 50, § 11; impl. am. P.L. 1939, ch. 660, § 80; impl. am. P.L. 1951, ch. 2752, § 21; impl. am. P.L. 1956, ch. 3721, § 1; G.L. 1956, § 40-2-28; P.L. 1960, ch. 73, § 1; Reorg. Plan No. 1, 1970.

40-2-22. Departmental seal.

The department shall have a seal that shall have engraved thereon the words “department of human services, state of Rhode Island,” and the seal shall be affixed to all written contracts that the department is authorized and directed to make under the provisions of this chapter, and the contracts shall be signed by the director of the department. The seal shall also be affixed to other orders and papers issued by the department as the department may by rule or order direct.

History of Section. P.L. 1917, ch. 1470, art. 1, § 25; G.L. 1923, ch. 413, art. 1, § 24; G.L. 1938, ch. 50, § 12; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-2-29; Reorg. Plan No. 1, 1970.

Compiler’s Notes.

In 2021, “state of Rhode Island” was substituted for “state of Rhode Island and Providence Plantations” in this section at the direction of the Law Revision Director to reflect the 2020 amendments to the state constitution that changed the state’s name.

40-2-23. Annual report to general assembly.

  1. The director shall make an annual report to the general assembly during the month of January, setting forth:
    1. The condition and needs of the several institutions under his or her control; the number of inmates in each institution; and an abstract of all reports received from officers incident to the performance of their duties.
    2. A complete financial statement of the several institutions, together with estimates of the amounts required for the ensuing year, for salaries and pay, for construction and repairs, and for all other expenses of maintenance.
    3. Information and recommendations as to the director may seem proper for the efficient administration and development of the several institutions, and for promoting the physical, mental, and moral welfare of the inmates thereof, and for measures whereby the number of prospective inmates may be decreased and the number of past inmates kept from returning may be increased, and for any additional legislation needed for these purposes.
    4. Other information or recommendations as may be requested by the governor or by the general assembly.
  2. The annual report shall be made a matter of public record.

History of Section. P.L. 1917, ch. 1470, art. 1, § 21; P.L. 1922, ch. 2230, § 12; G.L. 1923, ch. 413, art. 1, § 21; G.L. 1938, ch. 50, § 10; G.L. 1956, § 40-2-30; Reorg. Plan No. 1, 1970.

40-2-24. Prohibition against duplication of keys.

Every key for maximum security units of the several institutions under the control of the department of human services shall contain embossed thereon the state seal with the words “do not duplicate,” and whoever reproduces or causes to be reproduced any key without a written order from the director of human services shall be guilty of a misdemeanor.

History of Section. P.L. 1962, ch. 138, § 1; Reorg. G.L. 1956, § 40-2-31; Plan No. 1, 1970.

Chapter 3 Displaced Persons Committee

40-3-1. Appointment of members.

The governor is hereby authorized and directed to appoint a committee of twelve (12) duly qualified electors of this state to be known as the Rhode Island displaced persons committee. The members of the committee shall serve at the pleasure of the governor.

History of Section. P.L. 1949, ch. 2399, § 1; G.L. 1956, § 40-6-1 ; Reorg. Plan No. 1, 1970.

40-3-2. Officers and subcommittees.

The displaced persons committee shall elect, from its members, a chairperson and a vice-chairperson and such other officers as it may determine, including an executive committee, and define their duties. The committee may appoint such subcommittees as it deems advisable and define their duties.

History of Section. P.L. 1949, ch. 2399, § 2; G.L. 1956, § 40-6-2 ; Reorg. Plan No. 1, 1970.

40-3-3. Duties.

It shall be the duty of the displaced persons committee to expedite the processing of applications for admission to the United States of America and to the state, and to promote the rehabilitation and readjustment of displaced persons entering Rhode Island pursuant to federal law; to stimulate the interest of the community in the rehabilitation problems of displaced persons; to aid in interpreting and publicizing the problems relating to displaced persons; to cooperate with all governmental and private agencies serving displaced persons, to the end that duplication of effort may be avoided; to provide information and advice to displaced persons; and to perform other duties as the committee may, from time to time, determine, with the approval of the governor, to be appropriate and advisable.

History of Section. P.L. 1949, ch. 2399, § 3; G.L. 1956, § 40-6-3 ; Reorg. Plan No. 1, 1970.

Cross References.

Americanization schools, § 16-29-1 et seq.

Chapter 4 Town and City Directors

40-4-1. Designation of directors.

The directors of public aid of the several cities and towns shall hereafter be known as “directors of public welfare,” and wherever in any general law, public law, or resolution of the general assembly, or in any document, record, instrument, or proceeding authorized by any law or resolution, unless the context or subject matter otherwise requires, the words “director of public aid” or the words “directors of public aid,” or any reference to the director of public aid appear, the words or reference shall be construed to mean “director of public welfare” or “directors of public welfare” as the case may be.

History of Section. P.L. 1936, ch. 2312, § 1; G.L. 1938, ch. 67, § 1; G.L. 1956, § 40-7-1 ; Reorg. Plan No. 1, 1970.

Repealed Sections.

Former §§ 40-4-1 — 40-4-7 (P.L. 1942, ch. 1240, §§ 1-5; G.L. 1956, §§ 40-4-1 — 40-4-7; P.L. 1964, ch. 62, § 1), concerning the social service index division, were repealed by P.L. 1970, ch. 168, § 1.

Cross References.

Care of poor persons, § 40-5-2 .

Election and qualification, § 45-4-1 et seq.

Exemption from costs and bond on petition for appointment of guardian, § 33-15-15 .

Hearings of appeals with respect to general assistance, § 40-6-13 .

Proceedings against relatives for support, §§ 40-5-14 , 40-5-15 .

Prosecution of law violations, § 45-15-4 .

Recognizance for costs not required on complaints, § 12-6-5 .

Uniform Interstate Family Support Act, § 15-23.1-101 et seq.

Chapter 5 Support of the Needy

40-5-1. Obligation of towns.

Every town shall be required to relieve and support all poor and indigent persons lawfully settled therein, whenever they shall stand in need of relief and support, and to afford temporary relief to other poor and indigent persons.

History of Section. G.L. 1896, ch. 79, § 1; G.L. 1909, ch. 93, § 1; G.L. 1923, ch. 105, § 1; G.L. 1938, ch. 69, § 1; G.L. 1956, § 40-8-1 ; Reorg. Plan No. 1, 1970.

NOTES TO DECISIONS

Individual Relief.

Although a town is liable to afford temporary relief to poor and indigent persons who are within its boundaries but are not settled there, the town cannot be held liable to an individual when he voluntarily furnishes relief without a request from the overseers to do so. Caswell v. Hazard, 10 R.I. 490 , 1873 R.I. LEXIS 25 (1873).

40-5-2. Oversight of poor by directors of public welfare.

The directors of public welfare shall have the care and oversight of all such poor and indigent persons settled in their respective towns.

History of Section. G.L. 1896, ch. 79, § 2; G.L. 1909, ch. 93, § 2; G.L. 1923, ch. 105, § 2; G.L. 1938, ch. 69, § 2; G.L. 1956, § 40-8-2 ; Reorg. Plan No. 1, 1970.

40-5-3. Manner of support of poor.

The directors of public welfare shall see that poor and indigent persons in their respective towns are suitably relieved, supported, and employed, either in the workhouse or in other tenements belonging to towns, or in such other way and manner as the inhabitants of the respective towns at any legal meeting shall direct, or otherwise at the discretion of the directors. They may also afford temporary relief to other poor and indigent persons at the cost of the town.

History of Section. G.L. 1896, ch. 79, § 3; G.L. 1909, ch. 93, § 3; G.L. 1923, ch. 105, § 3; G.L. 1938, ch. 69, § 3; G.L. 1956, § 40-8-3 ; Reorg. Plan No. 1, 1970.

Cross References.

Power of towns to appropriate money, § 45-2-3 .

40-5-4. Manner of relief in Providence.

The city council of the city of Providence may prescribe the mode in which, and extent to which, the director of public welfare of the city shall afford temporary relief to poor and indigent persons who are not supported and employed in the asylum, or other tenements belonging to or used by the city.

History of Section. G.L. 1896, ch. 79, § 4; G.L. 1909, ch. 93, § 4; G.L. 1923, ch. 105, § 4; G.L. 1938, ch. 69, § 4; G.L. 1956, § 40-8-4 ; Reorg. Plan No. 1, 1970.

40-5-5 — 40-5-9. [Repealed.]

Repealed Sections.

Sections §§ 40-5-5 — 40-5-9 (G.L. 1896, ch. 79, §§ 15, 16, 17, 25, 26; G.L. 1909, ch. 93, §§ 15, 16, 17, 25, 26; G.L. 1923, ch. 105, §§ 15, 16, 17, 25, 26; P.L. 1926, ch. 842, § 1; G.L. 1938, ch. 69, §§ 14, 15, 16, 20, 21; P.L. 1939, ch. 660 § 80; P.L. 1942, ch. 1212, art. 3, § 2; G.L. 1956, §§ 40-8-5 , 40-8-6 , 40-8-7 , 40-8-8 , 40-8-9 ; impl. am. P.L. 1962, ch. 5, § 1; Reorg. Plan No. 1, 1970) concerning admission of minors to state home and school, cost of care in state home and school, prohibition of punishment in asylums and houses for poor, close confinement as punishment, and use of chains or other bonds, were repealed by P.L. 1990, ch. 492, § 12, effective July 12, 1990.

40-5-10. Complaint as to neglect of pauper.

Whenever any pauper shall not be suitably cared for by the town to which he or she is chargeable, any person, upon first issuing five (5) days’ notice to the state director of human services or directors of public welfare of the town of the situation of the pauper, and on continued neglect of the town, may complain in writing to the superior court, setting forth as nearly as may be the nature of the grievance complained of.

History of Section. G.L. 1896, ch. 79, § 18; C.P.A. 1905, § 1108; G.L. 1909, ch. 93, § 18; G.L. 1923, ch. 105, § 18; G.L. 1938, ch. 69, § 17; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-8-10 ; Reorg. Plan No. 1, 1970; P.L. 1990, ch. 442, § 13.

40-5-11. Investigation of complaints.

The superior court may, after ordering notice to the town of the pendency of the complaint, appoint a commission of not exceeding three (3) persons, who shall visit the pauper or paupers concerning whom the complaint is made and, upon hearing the allegations and evidence of the parties, report to the court, as soon as may be, whether or not the complaint is well founded.

History of Section. G.L. 1896, ch. 79, § 19; C.P.A. 1905, § 1109; G.L. 1909, ch. 93, § 19; G.L. 1923, ch. 105, § 19; G.L. 1938, ch. 69, § 18; G.L. 1956, § 40-8-11 ; Reorg. Plan No. 1, 1970.

NOTES TO DECISIONS

Due Process.

Defendant town was denied due process of law by proceedings under prior law because no right to judicial trial was secured and the findings of the commission were made final both as to law and fact, the order of the court being a mere ministerial function without the right of review of such findings. Church v. South Kingstown, 22 R.I. 381 , 48 A. 3, 1901 R.I. LEXIS 15 (1901).

Nature of Commission.

A commission created under this section is not a court because its members are not required to take an oath, it is not authorized to administer oaths to witnesses nor to render any judgment, and is authorized only to report to the court or justice whether or not the complaint is well-founded. Church v. South Kingstown, 22 R.I. 381 , 48 A. 3, 1901 R.I. LEXIS 15 (1901).

40-5-12. [Repealed.]

History of Section. G.L. 1896, ch. 79, § 24; G.L. 1909, ch. 93, § 24; G.L. 1923, ch. 105, § 24; G.L. 1938, ch. 69, § 19; G.L. 1956, § 40-8-12 ; Reorg. Plan No. 1, 1970; Repealed by P.L. 2004, ch. 201, § 3, effective July 1, 2004; P.L. 2004, ch. 350, § 3, effective July 1, 2004.

Compiler’s Notes.

Former § 40-5-12 concerned burial of nonresident paupers. For present comparable provisions, see § 40-6-3.10 .

40-5-13. Obligation of kindred for support.

  1. The kindred of any poor person, if any he or she shall have in the line or degree of father or grandfather, mother or grandmother, children or grandchildren, by consanguinity, or children by adoption, living within this state and of sufficient ability, shall be holden to support the pauper in proportion to their ability.
  2. The uncompensated costs of care provided by a licensed nursing facility to any person may be recovered by the nursing facility from any person who is obligated to provide support to that patient under subsection (a) hereof, to the extent that the individual so obligated received a transfer of any interests or assets from the patient receiving such care, which transfer resulted in a period of Medicaid ineligibility imposed pursuant to 42 U.S.C. § 1396p(c), as amended from time to time, on a person whose assets have been transferred for less than fair market value.

    Recourse hereunder shall be limited to the fair market value of the interests or assets transferred at the time of transfer. For the purposes of this section “the costs of care” shall mean the costs of providing care, including nursing care, personal care, meals, transportation and any other costs, charges, and expenses incurred by the facility. Costs of care shall not exceed the customary rate the nursing facility charges to a patient who pays for his or her care directly rather than through a governmental or other third party payor. Nothing contained in this section shall prohibit or otherwise diminish any other causes of action possessed by any such nursing facility. The death of the person receiving nursing facility care shall not nullify or otherwise affect the liability of the person or persons charged with the costs of care hereunder.

History of Section. G.L. 1896, ch. 79, § 5; G.L. 1909, ch. 93, § 5; G.L. 1923, ch. 105, § 5; G.L. 1938, ch. 69, § 5; G.L. 1956, § 40-8-13 ; Reorg. Plan No. 1, 1970; P.L. 2015, ch. 141, art. 5, § 7.

Cross References.

Duty of parents to support children, § 15-9-1 et seq.

Obligation of children to support parents, § 15-10-1 et seq.

NOTES TO DECISIONS

Purpose.

By enacting this section, the legislature intended to impose a burden on family members, when able, to provide support for one another. The imposition of a criminal punishment on those who avoid their familial obligations demonstrates the legislative intent to prevent some family members from becoming public charges. Landmark Medical Ctr. v. Gauthier, 635 A.2d 1145, 1994 R.I. LEXIS 2 (R.I. 1994).

Appeal in Guardianship Proceedings.

A ward’s grandmother, as his nearest relative and provider and responsible for his support, may appeal as a person aggrieved from a probate court decision appointing a guardian. Roullard v. McSoley, 54 R.I. 232 , 172 A. 326, 1934 R.I. LEXIS 54 (1934).

Minor grandchild of ward was entitled to appeal from decree allowing guardian’s account, since minor grandchild was an aggrieved person due to potential financial liability for support of grandmother. Whitmarsh v. McGair, 84 R.I. 226 , 122 A.2d 748, 1956 R.I. LEXIS 47 (1956).

Collateral References.

Incompetent person’s estate, allowance from, to parents. 99 A.L.R.2d 946, 24 A.L.R.3d 890.

Nature of care contemplated by statute imposing general duty to care for indigent relatives. 92 A.L.R.2d 348.

Reimbursement of public for financial assistance to elderly persons. 29 A.L.R.2d 731.

40-5-14. Enforcement of support obligation of kindred.

The district court at any session thereof in any county where any kindred shall reside, upon the petition of the director of public welfare of any town, or the department of human services of the state through its representative duly appointed for that purpose, who shall have been at any expense for the relief and support of any pauper, may on due hearing, either upon the appearance or default of the kindred, they being summoned as prescribed in § 40-5-15 , assess and apportion such sum within the limitation of time prescribed by § 40-5-17 as the court shall judge reasonable therefor, upon such of the kindred as the court shall judge to be of sufficient ability, and according thereto, and may enforce payment thereof by warrant of distress.

History of Section. G.L. 1896, ch. 79, § 6; C.P.A. 1905, § 1216; G.L. 1909, ch. 93, § 6; G.L. 1923, ch. 105, § 6; P.L. 1930, ch. 1580, § 1; G.L. 1938, ch. 69, § 6; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-8-14 ; Reorg. Plan No. 1, 1970; P.L. 1990, ch. 492, § 13; P.L. 1997, ch. 326, § 125.

Cross References.

Uniform Interstate Family Support Act, § 15-23.1-101 et seq.

40-5-15. Citation and proceedings against kindred.

The director of public welfare of any town, or the department of human services of the state through its representative duly appointed, shall apply to the clerk of the district court for, and the clerk shall thereupon issue, a citation substantially in the form of the citation prescribed in § 44-5-26 ; and the citation shall contain the name or names of the kindred, and the citation and petition shall in all respects follow the procedure, and be subject to the jurisdiction of the district courts as set forth in §§ 8-8-3 8-8-5 .

History of Section. G.L. 1896, ch. 79, § 7; C.P.A. 1905, § 1224; G.L. 1909, ch. 93, § 7; G.L. 1923, ch. 105, § 7; P.L. 1930, ch. 1580, § 1; G.L. 1938, ch. 69, § 7; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, § 40-8-15 ; P.L. 1969, ch. 239, § 42; Reorg. Plan No. 1, 1970.

40-5-16. Proceedings against kindred not named in citation.

Upon suggestion made, other kindred of ability, not named in the citation, may be notified, and the process may be continued; and upon due notice, whether they appear or are defaulted, the court may proceed against them in the same manner as if they had been named in the citation.

History of Section. G.L. 1896, ch. 79, § 11; G.L. 1909, ch. 93, § 11; G.L. 1923, ch. 105, § 11; G.L. 1938, ch. 69, § 11; G.L. 1956, § 40-8-16 ; Reorg. Plan No. 1, 1970.

40-5-17. Limitation of proceedings.

An assessment shall not extend to any expense for any relief afforded more than six (6) months previous to the filing of the petition.

History of Section. G.L. 1896, ch. 79, § 8; G.L. 1909, ch. 93, § 8; G.L. 1923, ch. 105, § 8; G.L. 1938, ch. 69, § 8; G.L. 1956, § 40-8-17 ; Reorg. Plan No. 1, 1970.

40-5-18. Assessment of kindred for future support — Warrant for arrears.

The court may further assess and apportion upon any kindred such weekly sums for the future as they shall judge sufficient for the support of the pauper, to be paid quarterly into the clerk’s office of the court, to the use of the director, until further order of the court; and upon application, from time to time, of the director, the clerk of the court shall issue and may renew a warrant of distress for the arrears of any preceding quarter.

History of Section. G.L. 1896, ch. 79, § 9; G.L. 1909, ch. 93, § 9; G.L. 1923, ch. 105, § 9; G.L. 1938, ch. 69, § 9; G.L. 1956, § 40-8-18 ; Reorg. Plan No. 1, 1970.

40-5-19. Order as to residence of pauper.

The court may further order with any kindred who may desire it, that the pauper shall live and be relieved, for such time with one and for such time with another, as they shall judge proper, having regard to the comfort of the pauper as well as to the convenience of the kindred.

History of Section. G.L. 1896, ch. 79, § 10; G.L. 1909, ch. 93, § 10; G.L. 1923, ch. 105, § 10; G.L. 1938, ch. 69, § 10; G.L. 1956, § 40-8-19 ; Reorg. Plan No. 1, 1970.

40-5-20. Recovery of costs by respondent.

If the petition be not entered, or be discontinued or withdrawn, or adjudged groundless, the respondent shall recover costs.

History of Section. G.L. 1896, ch. 79, § 12; G.L. 1909, ch. 93, § 12; G.L. 1923, ch. 105, § 12; G.L. 1938, ch. 69, § 12; G.L. 1956, § 40-8-20 ; Reorg. Plan No. 1, 1970.

40-5-21. Alteration of orders and assessments.

Upon application of any party interested, the court may, from time to time, vary any order by it made in the premises, or alter any assessment or apportionment by it made as provided in this chapter, to meet a change of circumstances.

History of Section. G.L. 1896, ch. 79, § 13; G.L. 1909, ch. 93, § 13; G.L. 1923, ch. 105, § 13; G.L. 1938, ch. 69, § 13; G.L. 1956, § 40-8-21 ; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 125.

Chapter 5.1 Family Independence Act [Repealed.]

40-5.1-1 — 40-5.1-47. [Repealed.]

Repealed Sections.

This chapter (P.L. 1996, ch. 129, § 10; P.L. 1996, ch. 131, § 10; P.L. 1996, ch. 132, § 10; P.L. 1996, ch. 133, § 10; P.L. 1997, ch. 30, art. 34, § 7; P.L. 1997, ch. 171, §§ 1, 2; P.L. 1997, ch. 326, § 126; P.L. 1998, ch. 31, art. 11, § 2; P.L. 1998, ch. 412, § 1; P.L. 1999, ch. 83, § 94; P.L. 1999, ch. 130, § 94; P.L. 2000, ch. 55, art. 10, § 1; P.L. 2001, ch. 77, art. 10, § 1; P.L. 2001, ch. 180, § 84; P.L. 2002, ch. 65, art. 25, § 1; P.L. 2003, ch. 127, § 1; P.L. 2003, ch. 181, § 1; P.L. 2003, ch. 376, art. 12, § 1; P.L. 2004, ch. 595, art. 25, §§ 1-3; P.L. 2004, ch. 596, § 1; P.L. 2005, ch. 117, art. 12, § 1; P.L. 2006, ch. 216, § 16; P.L. 2006, ch. 246, art. 32, § 1; P.L. 2006, ch. 617, § 1; P.L. 2007, ch. 73, art. 18, § 6; P.L. 2007, ch. 73, art. 20, § 1; P.L. 2008, ch. 9, art. 9, § 1), relating to the Family Independence Act, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

Section 40-5.1-8 was amended in 2008 by P.L. 2008, ch. 9, art. 9, § 1, but due to the repeal of this chapter by P.L. 2008, ch. 100, art. 16, § 2, that section as amended is not set out.

Chapter 5.2 The Rhode Island Works Program

40-5.2-1. Short title.

This chapter is hereby entitled “The Rhode Island works program,” and is Rhode Island’s welfare to work program.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-2. The Rhode Island works program — Statement of purpose.

  1. The purpose of the Rhode Island works program is to help parents who are eligible for cash assistance to support their children by preparing for, accepting, and retaining employment. It is the intent of the Rhode Island general assembly that the Rhode Island works program shall provide employment and support services along with temporary cash assistance so that parents can participate in the workforce rather than depend on public assistance to support themselves and their children.
  2. Under this law, parents are mandated to enter into an employment plan, as a condition of eligibility for cash assistance, and unless they are found to be temporarily exempt from the work requirements, they must participate in intensive employment services at the department of labor and training as the first step in their employment plan. Because it is believed that employment is the most effective anti-poverty measure, all activities and services provided through the Rhode Island works program are designed to promote economic independence through employment and the development of employment skills and to strengthen families through parental responsibility and short-term assistance.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-3. Legislative intent.

  1. It is the intent of the general assembly:
    1. To fundamentally change the public assistance program formerly known as the family independence program in order to provide temporary financial assistance to eligible families with children while requiring the entry or reentry of the adult members of the family into the workplace with necessary supports as quickly as possible; and
    2. To follow the policies and guidance of the federal public assistance legislation as closely as possible; and
    3. To promote efficiencies through interdepartmental cooperation, specifically with the department of human services, the single state agency responsible for administration and implementation of this chapter. This shall include developing and implementing child support payment and enforcement, the case-management system, payment of cash assistance, issuance of food stamps, childcare subsidies, and medical assistance to eligible children and families in need.
  2. The department shall collaborate with community agencies and other state departments to achieve the goals of this chapter. Partners may include, but are not limited to, the:
    1. Department of labor and training, which shall provide employment and training services in accordance with this chapter;
    2. Department of elementary and secondary education, which provides adult education and literacy programs;
    3. Community College of Rhode Island, which provides vocational training at the postsecondary level;
    4. Rhode Island commerce corporation, which is responsible for expansion of job opportunities in the state for low-income families with children;
    5. Department of labor and training, which is responsible for the planning and coordination of workforce development policy and strategies in the state’s employment, education, and economic development systems;
    6. Department of children, youth and families, which administers the child welfare services, regulates child daycare providers, and is ultimately responsible for the guardianship of children at-risk;
    7. Rhode Island housing and mortgage finance corporation, which is responsible for expanding housing opportunities for low-income families; and
    8. Family court, which is responsible for enforcing the support obligations of absent parents and protecting those children whose health and well-being is at risk because of an absence of family resources.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-4. Collaboration between the department of human services and the department of labor and training.

Promoting economic independence through the Rhode Island works program.

  1. The department of human services, through the Rhode Island works program, in collaboration with the department of labor and training, shall promote economic independence and help maintain and strengthen family life by enabling persons with dependent children to assume responsibility for their families through the dignity of work.
  2. The department of labor and training, the lead agency responsible for employment, job training, and workforce development services for the state of Rhode Island, is hereby authorized to establish and provide intensive employment services to cash assistance recipients in accordance with state and federal law, regulation, and funding.
  3. The intensive employment services authorized by this section shall include, but are not limited to, the provision of job skill assessment, including assessment of English literacy and numeracy, job counseling, job testing, job matching, supervised job search, job development, and job-readiness services beyond those currently available through federal authority. Through the intensive employment services, the department shall identify physical and mental challenges that indicate the participant should be referred to the office of rehabilitation services (ORS) for development of a rehabilitation employment plan and/or that require accommodations in securing employment. The intensive employment services shall also include an employer outreach program to encourage the employment of Rhode Island works program participants in the private sector and to disseminate information regarding both federal and state tax credit programs for which public assistance recipients are eligible.
  4. The intensive employment services shall help participants identify strengths, barriers, and employment opportunities taking into account the participant’s work readiness and employment history, as well as vocational training that can increase the participant’s earning ability. The department of labor and training shall provide personnel qualified to manage and oversee structured job-search activities of program participants that result in employment, including part-time, at or above the state minimum wage, as quickly as possible, and/or within the time frames permissible under federal guidelines applicable to the works program cash assistance program.
  5. Intensive employment services shall be delivered jointly through co-location of staff from the department of labor and training and the department of human services, with primary activities being provided throughout the state’s one-stop career centers. Where the centers are not accessible to Rhode Island works program participants, the department of labor and training and the department of human services shall work in collaboration to identify alternative sites.
  6. The department of human services and the department of labor and training are hereby authorized to operate or contract for work-readiness activities and intensive work-readiness activities for those individuals whose employment plan includes participation in such activities. Work-readiness activities are of limited duration, and are designed to help prepare participants for work by assuring that participants are familiar with general workplace expectations and exhibit work behavior and attitudes necessary to compete successfully in the labor market. To the extent practicable, work-readiness activities should involve supervised community work experience or unpaid work experiences in the private sector. Intensive work-readiness services include activities that are designed to prepare participants who have limited literacy and work history with the minimum skills necessary to achieve entry-level employment.
  7. The department of labor and training and the department of human services may collaborate on the delivery of short-term training vouchers for parents/participants approved for the service; the development of unpaid work experience and community service programs; and the oversight of any performance-based work programs that are subcontracted to meet the special needs of hard-to-employ parents/participants who receive temporary cash assistance under this chapter.
  8. If during intensive employment services, a parent/participant in the program is assessed as being more likely to succeed in competitive employment if first provided a short-term intensive intervention, the department of human services and the department of labor and training staff may jointly define next steps.
  9. The Rhode Island department of labor and training shall continuously survey employers in the state to identify employment positions for persons eligible for family assistance.
  10. The department of human services and the department of labor and training shall establish performance standards for the intensive employment services available through the works program to ensure that the goals of this act are met and that the state meets the federal work participation requirements.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-5. Rhode Island works — Promotion of work.

The department of human services and the department of labor and training shall promote work by:

  1. Providing assessments, intensive employment services, support services, and transitional cash assistance with the expectation that participants in the works program move quickly towards employment.
  2. Developing stronger employment skills that will lead to self-sufficiency to establish long-term attachment to the workforce.
  3. Recognizing the equal responsibility of both parents to provide economic support for their children.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-6. Goals.

The Rhode Island works program shall strive to:

  1. Eliminate or reduce the harmful effects of poverty on families and children by fostering employment and opportunity as a means to economic independence;
  2. Assist participants to gain employment as rapidly as possible, giving due consideration to individual circumstances, labor market conditions, the needs of the dependent children for continuing care and protection, and the ultimate goal of long-term economic independence;
  3. Eliminate the stigma of welfare by promoting a philosophy and a perception that the purpose of welfare is to eliminate or reduce the harmful effects of poverty on families and children by promoting work opportunities for all Rhode Island residents;
  4. Support and coordinate with activities that promote self-sufficiency and strengthen family life;
  5. Provide a comprehensive support service package that includes: child support, medical assistance, food stamps, child care, transportation, and other support services necessary to promote economic independence;
  6. Promote successful transition from public assistance to employment and reduce the likelihood that participants will need to return to cash assistance through the provision of job-readiness activities, employment-related skills training, and education activities concurrently with or as necessary, prior to employment or seeking employment, family support skills, and follow-up services for problem resolution and job advancement;
  7. Develop partnerships through the joint efforts of the department of labor and training and the department of human services with employers to create job opportunities and meet the needs of both employers and participants;
  8. Develop partnerships with the office of adult education to provide full-time intensive work-readiness services to participants with limited literacy and work experience as well as part-time adult education services that are accessible to working participants so they can increase their earning ability;
  9. Provide a program where it is more advantageous to work than not to work by rewarding self-sufficiency; and
  10. Implement a program that is clear, focused, and simple to administer.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-7. Work participation rates.

  1. The director of the department of human services and the director of the department of labor and training, to the extent that federal/Temporary Assistance to Needy Families (TANF) funds are made available, shall commit their department resources and focused efforts to meet the federal TANF work participation rate requirements.
  2. In the event that there are changes in the federal TANF program, the department of human services shall seek support through the general assembly to make all necessary changes and shall take all necessary steps to comply with the federal law.
  3. The works program cash assistance program administered according to this chapter is designed to meet or exceed the minimum federal TANF required participation rate for all families.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-8. Definitions.

As used in this chapter, the following terms having the meanings set forth herein, unless the context in which such terms are used clearly indicates to the contrary:

  1. “Applicant” means a person who has filed a written application for assistance for herself or himself and her or his dependent child(ren). An applicant may be a parent or non-parent caretaker relative.
  2. “Assistance” means cash and any other benefits provided pursuant to this chapter.
  3. “Assistance unit” means the assistance-filing unit consisting of the group of persons, including the dependent child(ren), living together in a single household who must be included in the application for assistance and in the assistance payment if eligibility is established. An assistance unit may be the same as a family.
  4. “Benefits” shall mean assistance received pursuant to this chapter.
  5. “Community service programs” means structured programs and activities in which cash assistance recipients perform work for the direct benefit of the community under the auspices of public or nonprofit organizations. Community service programs are designed to improve the employability of recipients not otherwise able to obtain paid employment.
  6. “Department” means the department of human services.
  7. “Dependent child” means an individual, other than an individual with respect to whom foster care maintenance payments are made, who is: (i) Under the age of eighteen (18); or (ii) Under the age of nineteen (19) and a full-time student in a secondary school (or in the equivalent level of vocational or educational training).
  8. “Director” means the director of the department of human services.
  9. “Earned income” means income in cash or the equivalent received by a person through the receipt of wages, salary, commissions, or profit from activities in which the person is self-employed or as an employee and before any deductions for taxes.
  10. “Earned income tax credit” means the credit against federal personal income tax liability under § 32 of the Internal Revenue Code of 1986, 26 U.S.C. § 32, or any successor section, the advanced payment of the earned income tax credit to an employee under § 3507 of the code, 26 U.S.C. § 3507 [repealed], or any successor section and any refund received as a result of the earned income tax credit, as well as any refundable state earned income tax credit.
  11. “Education directly related to employment” means education, in the case of a participant who has not received a high school diploma or a certificate of high school equivalency, related to a specific occupation, job, or job offer.
  12. “Family” means: (i) A pregnant woman from and including the seventh month of her pregnancy; or (ii) A child and the following eligible persons living in the same household as the child: (iii) Each biological, adoptive or stepparent of the child, or in the absence of a parent, any adult relative who is responsible, in fact, for the care of such child; and (iv) The child’s minor siblings (whether of the whole or half blood); provided, however, that the term “family” shall not include any person receiving benefits under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq. A family may be the same as the assistance unit.
  13. “Gross earnings” means earnings from employment and self-employment further described in the department of human services rules and regulations.
  14. “Individual employment plan” means a written, individualized plan for employment developed jointly by the applicant and the department of human services that specifies the steps the participant shall take toward long-term economic independence developed in accordance with § 40-5.2-10(e) . A participant must comply with the terms of the individual employment plan as a condition of eligibility in accordance with § 40-5.2-10(e) .
  15. “Job search and job readiness” means the mandatory act of seeking or obtaining employment by the participant, or the preparation to seek or obtain employment.

    In accord with federal requirements, job search activities must be supervised by the department of labor and training and must be reported to the department of human services in accordance with TANF work verification requirements.

    Except in the context of rehabilitation employment plans, and special services provided by the department of children, youth and families, job-search and job-readiness activities are limited to four (4) consecutive weeks, or for a total of six (6) weeks in a twelve-month (12) period, with limited exceptions as defined by the department. The department of human services, in consultation with the department of labor and training, shall extend job-search, and job-readiness assistance for up to twelve (12) weeks in a fiscal year if a state has an unemployment rate at least fifty percent (50%) greater than the United States unemployment rate if the state meets the definition of a “needy state” under the contingency fund provisions of federal law.

    Preparation to seek employment, or job readiness, may include, but may not be limited to: the participant obtaining life-skills training; homelessness services; domestic violence services; special services for families provided by the department of children, youth and families; substance abuse treatment; mental health treatment; or rehabilitation activities as appropriate for those who are otherwise employable. The services, treatment, or therapy must be determined to be necessary and certified by a qualified medical or mental health professional. Intensive work-readiness services may include: work-based literacy; numeracy; hands-on training; work experience; and case management services. Nothing in this section shall be interpreted to mean that the department of labor and training shall be the sole provider of job-readiness activities described herein.

  16. “Job skills training directly related to employment” means training or education for job skills required by an employer to provide an individual with the ability to obtain employment or to advance or adapt to the changing demands of the workplace. Job skills training directly related to employment must be supervised on an ongoing basis.
  17. “Minor parent” means a parent under the age of eighteen (18). A minor parent may be an applicant or recipient with his or her dependent child(ren) in his or her own case or a member of an assistance unit with his or her dependent child(ren) in a case established by the minor parent’s parent.
  18. “Net income” means the total gross income of the assistance unit less allowable disregards and deductions as described in § 40-5.2-10(g) .
  19. “On-the-job training” means training in the public or private sector that is given to a paid employee while he or she is engaged in productive work and that provides knowledge and skills essential to the full and adequate performance of the job. On-the-job training must be supervised by an employer, work-site sponsor, or other designee of the department of human services on an ongoing basis.
  20. “Participant” means a person who has been found eligible for assistance in accordance with this chapter and who must comply with all requirements of this chapter, and has entered into an individual employment plan. A participant may be a parent or non-parent caretaker relative included in the cash assistance payment.
  21. “Recipient” means a person who has been found eligible and receives cash assistance in accordance with this chapter.
  22. “Relative” means a parent, stepparent, grandparent, great grandparent, great-great grandparent, aunt, great-aunt, great-great aunt, uncle, great-uncle, great-great uncle, sister, brother, stepbrother, stepsister, half-brother, half-sister, first cousin, first cousin once removed, niece, great-niece, great-great niece, nephew, great-nephew, or great-great nephew.
  23. “Resident” means a person who maintains residence by his or her continuous physical presence in the state.
  24. “Self-employment income” means the total profit from a business enterprise, farming, etc., resulting from a comparison of the gross receipts with the business expenses, i.e., expenses directly related to producing the goods or services and without which the goods or services could not be produced. However, items such as depreciation, personal business and entertainment expenses, and personal transportation are not considered business expenses for the purposes of determining eligibility for cash assistance in accordance with this chapter.
  25. “State” means the state of Rhode Island.
  26. “Subsidized employment” means employment in the private or public sectors for which the employer receives a subsidy from TANF or other public funds to offset some or all of the wages and costs of employing a recipient. It includes work in which all or a portion of the wages paid to the recipient are provided to the employer either as a reimbursement for the extra costs of training or as an incentive to hire the recipient, including, but not limited to, grant diversion.
  27. “Subsidized housing” means housing for a family whose rent is restricted to a percentage of its income.
  28. “Unsubsidized employment” means full- or part-time employment in the public or private sector that is not subsidized by TANF or any other public program.
  29. “Vocational educational training” means organized educational programs, not to exceed twelve (12) months with respect to any participant, that are directly related to the preparation of participants for employment in current or emerging occupations. Vocational educational training must be supervised.
  30. “Work activities” mean the specific work requirements that must be defined in the individual employment plan and must be complied with by the participant as a condition of eligibility for the receipt of cash assistance for single and two-family (2) households outlined in § 40-5.2-12 .
  31. “Work experience” means a work activity that provides a participant with an opportunity to acquire the general skills, training, knowledge, and work habits necessary to obtain employment. The purpose of work experience is to improve the employability of those who cannot find unsubsidized employment. An employer, work site sponsor, and/or other appropriate designee of the department must supervise this activity.
  32. “Work supplementation,” also known as “grant diversion,” means the use of all or a portion of a participant’s cash assistance grant and food stamp grant as a wage supplement to an employer. The supplement shall be limited to a maximum period of twelve (12) months. An employer must agree to continue the employment of the participant as part of the regular work force, beyond the supplement period, if the participant demonstrates satisfactory performance.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2021, ch. 162, art. 13, § 6, effective July 6, 2021.

Federal Act References.

26 U.S.C. § 3507, referred to in this section, was repealed by Act Aug. 10, 2010, Pub. L. No. 111-226, Title II, Subtitle B, § 219(a)(1).

40-5.2-9. The Rhode Island works program — General eligibility requirements.

  1. All families who wish to make application to the department of human services for assistance under this chapter shall have the opportunity to do so.
  2. Cash assistance shall be provided to eligible needy families only with dependent children who meet all the requirements of this chapter.
  3. Eligibility for benefits provided in accordance with this chapter is determined on a family or assistance unit basis.
  4. The following persons shall be included in the assistance unit, unless the person receives state supplemental assistance or supplemental security benefits under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., if living in the same household with any dependent child: all minor blood-related, step, or adoptive brothers and sisters, and all natural, step, or adoptive parents of the children, including cohabitating adults who share a minor child.
  5. A minor parent may be in the assistance unit that may also include all natural, step, or adoptive parents of the minor parent and all minor blood-related, step or adoptive brothers and sisters.
  6. If the parents are not residing together, a child shall be considered residing with the parent who has physical custody of the child the majority of the time. If the child resides with the parents in their separate households equal time, the parent who applies for assistance for that child first in time shall be the eligible parent.
  7. Each person in the assistance unit shall develop all potential sources of income for which the person may be eligible. Each person shall apply for the income, cooperate in applying for the income, and accept the income if eligible.
  8. Eligibility for cash assistance exists if the assistance unit’s net income is less than the payment standard for the assistance group size.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-10. Necessary requirements and conditions.

The following requirements and conditions shall be necessary to establish eligibility for the program.

  1. Citizenship, alienage, and residency requirements.
    1. A person shall be a resident of the state of Rhode Island.
    2. Effective October 1, 2008, a person shall be a United States citizen, or shall meet the alienage requirements established in § 402(b) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, PRWORA, Pub. L. No. 104-193 and as that section may hereafter be amended [8 U.S.C. § 1612]; a person who is not a United States citizen and does not meet the alienage requirements established in PRWORA, as amended, is not eligible for cash assistance in accordance with this chapter.
  2. The family/assistance unit must meet any other requirements established by the department of human services by rules and regulations adopted pursuant to the administrative procedures act, as necessary to promote the purpose and goals of this chapter.
  3. Receipt of cash assistance is conditional upon compliance with all program requirements.
  4. All individuals domiciled in this state shall be exempt from the application of subdivision 115(d)(1)(A) of Pub. L. No. 104-193, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, PRWORA [21 U.S.C. § 862a], which makes any individual ineligible for certain state and federal assistance if that individual has been convicted under federal or state law of any offense that is classified as a felony by the law of the jurisdiction and that has as an element the possession, use, or distribution of a controlled substance as defined in § 102(6) of the Controlled Substances Act (21 U.S.C. § 802(6)).
  5. Individual employment plan as a condition of eligibility.
    1. Following receipt of an application, the department of human services shall assess the financial conditions of the family, including the non-parent caretaker relative who is applying for cash assistance for himself or herself as well as for the minor child(ren), in the context of an eligibility determination. If a parent or non-parent caretaker relative is unemployed or under-employed, the department shall conduct an initial assessment, taking into account: (A) The physical capacity, skills, education, work experience, health, safety, family responsibilities, and place of residence of the individual; and (B) The child care and supportive services required by the applicant to avail himself or herself of employment opportunities and/or work readiness programs.
    2. On the basis of this assessment, the department of human services and the department of labor and training, as appropriate, in consultation with the applicant, shall develop an individual employment plan for the family that requires the individual to participate in the intensive employment services. Intensive employment services shall be defined as the work requirement activities in § 40-5.2-12(g) and (i).
    3. The director, or his or her designee, may assign a case manager to an applicant/participant, as appropriate.
    4. The department of labor and training and the department of human services in conjunction with the participant shall develop a revised individual employment plan that shall identify employment objectives, taking into consideration factors above, and shall include a strategy for immediate employment and for preparing for, finding, and retaining employment consistent, to the extent practicable, with the individual’s career objectives.
    5. The individual employment plan must include the provision for the participant to engage in work requirements as outlined in § 40-5.2-12 .
      1. The participant shall attend and participate immediately in intensive assessment and employment services as the first step in the individual employment plan, unless temporarily exempt from this requirement in accordance with this chapter. Intensive assessment and employment services shall be defined as the work requirement activities in § 40-5.2-12(g) and (i).
      2. Parents under age twenty (20) without a high school diploma or general equivalency diploma (GED) shall be referred to special teen-parent programs that will provide intensive services designed to assist teen parents to complete high school education or GED, and to continue approved work plan activities in accord with Rhode Island works program requirements.
    6. The applicant shall become a participant in accordance with this chapter at the time the individual employment plan is signed and entered into.
    7. Applicants and participants of the Rhode Island works program shall agree to comply with the terms of the individual employment plan, and shall cooperate fully with the steps established in the individual employment plan, including the work requirements.
    8. The department of human services has the authority under the chapter to require attendance by the applicant/participant, either at the department of human services or at the department of labor and training, at appointments deemed necessary for the purpose of having the applicant enter into and become eligible for assistance through the Rhode Island works program. The appointments include, but are not limited to: the initial interview, orientation and assessment; job readiness; and job search. Attendance is required as a condition of eligibility for cash assistance in accordance with rules and regulations established by the department.
    9. As a condition of eligibility for assistance pursuant to this chapter, the applicant/participant shall be obligated to keep appointments; attend orientation meetings at the department of human services and/or the Rhode Island department of labor and training; participate in any initial assessments or appraisals; and comply with all the terms of the individual employment plan in accordance with department of human services rules and regulations.
    10. A participant, including a parent or non-parent caretaker relative included in the cash assistance payment, shall not voluntarily quit a job or refuse a job unless there is good cause as defined in this chapter or the department’s rules and regulations.
    11. A participant who voluntarily quits or refuses a job without good cause, as defined in § 40-5.2-12(l) , while receiving cash assistance in accordance with this chapter, shall be sanctioned in accordance with rules and regulations promulgated by the department.
  6. Resources.
    1. The family or assistance unit’s countable resources shall be less than the allowable resource limit established by the department in accordance with this chapter.
    2. No family or assistance unit shall be eligible for assistance payments if the combined value of its available resources (reduced by any obligations or debts with respect to such resources) exceeds one thousand dollars ($1,000).
    3. For purposes of this subsection, the following shall not be counted as resources of the family/assistance unit in the determination of eligibility for the works program:
      1. The home owned and occupied by a child, parent, relative, or other individual;
      2. Real property owned by a husband and wife as tenants by the entirety, if the property is not the home of the family and if the spouse of the applicant refuses to sell his or her interest in the property;
      3. Real property that the family is making a good-faith effort to dispose of, however, any cash assistance payable to the family for any such period shall be conditioned upon disposal of the real property within six (6) months of the date of application and any payments of assistance for that period shall (at the time of disposal) be considered overpayments to the extent that they would not have occurred at the beginning of the period for which the payments were made. All overpayments are debts subject to recovery in accordance with the provisions of the chapter;
      4. Income-producing property other than real estate including, but not limited to, equipment such as farm tools, carpenter’s tools, and vehicles used in the production of goods or services that the department determines are necessary for the family to earn a living;
      5. One vehicle for each adult household member, but not to exceed two (2) vehicles per household, and in addition, a vehicle used primarily for income-producing purposes such as, but not limited to, a taxi, truck, or fishing boat; a vehicle used as a family’s home; a vehicle that annually produces income consistent with its fair market value, even if only used on a seasonal basis; a vehicle necessary to transport a family member with a disability where the vehicle is specially equipped to meet the specific needs of the person with a disability or if the vehicle is a special type of vehicle that makes it possible to transport the person with a disability;
      6. Household furnishings and appliances, clothing, personal effects, and keepsakes of limited value;
      7. Burial plots (one for each child, relative, and other individual in the assistance unit) and funeral arrangements;
      8. For the month of receipt and the following month, any refund of federal income taxes made to the family by reason of § 32 of the Internal Revenue Code of 1986, 26 U.S.C. § 32 (relating to earned income tax credit), and any payment made to the family by an employer under § 3507 of the Internal Revenue Code of 1986, 26 U.S.C. § 3507 [repealed] (relating to advance payment of such earned income credit);
      9. The resources of any family member receiving supplementary security income assistance under the Social Security Act, 42 U.S.C. § 301 et seq.;
      10. Any veteran’s disability pension benefits received as a result of any disability sustained by the veteran while in the military service.
  7. Income.
    1. Except as otherwise provided for herein, in determining eligibility for and the amount of cash assistance to which a family is entitled under this chapter, the income of a family includes all of the money, goods, and services received or actually available to any member of the family.
    2. In determining the eligibility for and the amount of cash assistance to which a family/assistance unit is entitled under this chapter, income in any month shall not include the first one hundred seventy dollars ($170) of gross earnings plus fifty percent (50%) of the gross earnings of the family in excess of one hundred seventy dollars ($170) earned during the month.
    3. The income of a family shall not include:
      1. The first fifty dollars ($50.00) in child support received in any month from each noncustodial parent of a child plus any arrearages in child support (to the extent of the first fifty dollars ($50.00) per month multiplied by the number of months in which the support has been in arrears) that are paid in any month by a noncustodial parent of a child;
      2. Earned income of any child;
      3. Income received by a family member who is receiving Supplemental Security Income (SSI) assistance under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq.;
      4. The value of assistance provided by state or federal government or private agencies to meet nutritional needs, including: value of USDA-donated foods; value of supplemental food assistance received under the Child Nutrition Act of 1966, as amended, and the special food service program for children under Title VII, nutrition program for the elderly, of the Older Americans Act of 1965 as amended, and the value of food stamps;
      5. Value of certain assistance provided to undergraduate students, including any grant or loan for an undergraduate student for educational purposes made or insured under any loan program administered by the United States Commissioner of Education (or the Rhode Island council on postsecondary education or the Rhode Island division of higher education assistance);
      6. Foster care payments;
      7. Home energy assistance funded by state or federal government or by a nonprofit organization;
      8. Payments for supportive services or reimbursement of out-of-pocket expenses made to foster grandparents, senior health aides, or senior companions and to persons serving in SCORE and ACE and any other program under Title II and Title III of the Domestic Volunteer Service Act of 1973, 42 U.S.C. § 5000 et seq.;
      9. Payments to volunteers under AmeriCorps VISTA as defined in the department’s rules and regulations;
      10. Certain payments to native Americans; payments distributed per capita to, or held in trust for, members of any Indian Tribe under P.L. 92-254, 25 U.S.C. § 1261 et seq., P.L. 93-134, 25 U.S.C. § 1401 et seq., or P.L. 94-540; receipts distributed to members of certain Indian tribes which are referred to in § 5 of P.L. 94-114, 25 U.S.C. § 459d, that became effective October 17, 1975;
      11. Refund from the federal and state earned income tax credit;
      12. The value of any state, local, or federal government rent or housing subsidy, provided that this exclusion shall not limit the reduction in benefits provided for in the payment standard section of this chapter;
      13. The earned income of any adult family member who gains employment while an active RI Works household member. This income is excluded for the first six (6) months of employment in which the income is earned, or until the household’s total gross income exceeds one hundred eighty-five percent (185%) of the federal poverty level, unless the household reaches its forty-eight-month (48) time limit first;
      14. Any veteran’s disability pension benefits received as a result of any disability sustained by the veteran while in the military service.
    4. The receipt of a lump sum of income shall affect participants for cash assistance in accordance with rules and regulations promulgated by the department.
  8. Time limit on the receipt of cash assistance.
    1. On or after January 1, 2020, no cash assistance shall be provided, pursuant to this chapter, to a family or assistance unit that includes an adult member who has received cash assistance for a total of forty-eight (48) months (whether or not consecutive), to include any time receiving any type of cash assistance in any other state or territory of the United States of America as defined herein. Provided further, in no circumstances other than provided for in subsection (h)(3) with respect to certain minor children, shall cash assistance be provided pursuant to this chapter to a family or assistance unit that includes an adult member who has received cash assistance for a total of a lifetime limit of forty-eight (48) months.
    2. Cash benefits received by a minor dependent child shall not be counted toward their lifetime time limit for receiving benefits under this chapter should that minor child apply for cash benefits as an adult.
    3. Certain minor children not subject to time limit. This section regarding the lifetime time limit for the receipt of cash assistance shall not apply only in the instances of a minor child(ren) living with a parent who receives SSI benefits and a minor child(ren) living with a responsible adult non-parent caretaker relative who is not in the cash assistance payment.
    4. Receipt of family cash assistance in any other state or territory of the United States of America shall be determined by the department of human services and shall include family cash assistance funded in whole or in part by Temporary Assistance for Needy Families (TANF) funds [Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.] and/or family cash assistance provided under a program similar to the Rhode Island families work and opportunity program or the federal TANF program.
      1. The department of human services shall mail a notice to each assistance unit when the assistance unit has six (6) months of cash assistance remaining and each month thereafter until the time limit has expired. The notice must be developed by the department of human services and must contain information about the lifetime time limit, the number of months the participant has remaining, the hardship extension policy, the availability of a post-employment-and-closure bonus; and any other information pertinent to a family or an assistance unit nearing the forty-eight-month (48) lifetime time limit.
      2. For applicants who have less than six (6) months remaining in the forty-eight-month (48) lifetime time limit because the family or assistance unit previously received cash assistance in Rhode Island or in another state, the department shall notify the applicant of the number of months remaining when the application is approved and begin the process required in subsection (h)(5)(i).
    5. If a cash assistance recipient family was closed pursuant to Rhode Island’s Temporary Assistance for Needy Families Program (federal TANF described in Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), formerly entitled the Rhode Island family independence program, more specifically under § 40-5.1-9(2)(c) [repealed], due to sanction because of failure to comply with the cash assistance program requirements; and that recipient family received forty-eight (48) months of cash benefits in accordance with the family independence program, then that recipient family is not able to receive further cash assistance for his/her family, under this chapter, except under hardship exceptions.
    6. The months of state or federally funded cash assistance received by a recipient family since May 1, 1997, under Rhode Island’s Temporary Assistance for Needy Families Program (federal TANF described in Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), formerly entitled the Rhode Island family independence program, shall be countable toward the time-limited cash assistance described in this chapter.
  9. Time limit on the receipt of cash assistance. (1) No cash assistance shall be provided, pursuant to this chapter, to a family assistance unit in which an adult member has received cash assistance for a total of sixty (60) months (whether or not consecutive) to include any time receiving any type of cash assistance in any other state or territory of the United States as defined herein effective August 1, 2008. Provided further, that no cash assistance shall be provided to a family in which an adult member has received assistance for twenty-four (24) consecutive months unless the adult member has a rehabilitation employment plan as provided in § 40-5.2-12(g)(5) . (2) Effective August 1, 2008, no cash assistance shall be provided pursuant to this chapter to a family in which a child has received cash assistance for a total of sixty (60) months (whether or not consecutive) if the parent is ineligible for assistance under this chapter pursuant to subsection (a)(2) of this section to include any time they received any type of cash assistance in any other state or territory of the United States as defined herein.
  10. Hardship exceptions.
    1. The department may extend an assistance unit’s or family’s cash assistance beyond the time limit, by reason of hardship; provided, however, that the number of families to be exempted by the department with respect to their time limit under this subsection shall not exceed twenty percent (20%) of the average monthly number of families to which assistance is provided for under this chapter in a fiscal year; provided, however, that to the extent now or hereafter permitted by federal law, any waiver granted under § 40-5.2-34 , for domestic violence, shall not be counted in determining the twenty percent (20%) maximum under this section.
    2. Parents who receive extensions to the time limit due to hardship must have and comply with employment plans designed to remove or ameliorate the conditions that warranted the extension.
  11. Parents under eighteen (18) years of age.
    1. A family consisting of a parent who is under the age of eighteen (18), and who has never been married, and who has a child; or a family consisting of a woman under the age of eighteen (18) who is at least six (6) months pregnant, shall be eligible for cash assistance only if the family resides in the home of an adult parent, legal guardian, or other adult relative. The assistance shall be provided to the adult parent, legal guardian, or other adult relative on behalf of the individual and child unless otherwise authorized by the department.
    2. This subsection shall not apply if the minor parent or pregnant minor has no parent, legal guardian, or other adult relative who is living and/or whose whereabouts are unknown; or the department determines that the physical or emotional health or safety of the minor parent, or his or her child, or the pregnant minor, would be jeopardized if he or she was required to live in the same residence as his or her parent, legal guardian, or other adult relative (refusal of a parent, legal guardian, or other adult relative to allow the minor parent or his or her child, or a pregnant minor, to live in his or her home shall constitute a presumption that the health or safety would be so jeopardized); or the minor parent or pregnant minor has lived apart from his or her own parent or legal guardian for a period of at least one year before either the birth of any child to a minor parent or the onset of the pregnant minor’s pregnancy; or there is good cause, under departmental regulations, for waiving the subsection; and the individual resides in a supervised supportive-living arrangement to the extent available.
    3. For purposes of this section, “supervised supportive-living arrangement” means an arrangement that requires minor parents to enroll and make satisfactory progress in a program leading to a high school diploma or a general education development certificate, and requires minor parents to participate in the adolescent parenting program designated by the department, to the extent the program is available; and provides rules and regulations that ensure regular adult supervision.
  12. Assignment and cooperation.  As a condition of eligibility for cash and medical assistance under this chapter, each adult member, parent, or caretaker relative of the family/assistance unit must:
    1. Assign to the state any rights to support for children within the family from any person that the family member has at the time the assignment is executed or may have while receiving assistance under this chapter;
    2. Consent to and cooperate with the state in establishing the paternity and in establishing and/or enforcing child support and medical support orders for all children in the family or assistance unit in accordance with title 15, as amended, unless the parent or caretaker relative is found to have good cause for refusing to comply with the requirements of this subsection.
    3. Absent good cause, as defined by the department of human services through the rulemaking process, for refusing to comply with the requirements of subsections (l)(1) and (l)(2), cash assistance to the family shall be reduced by twenty-five percent (25%) until the adult member of the family who has refused to comply with the requirements of this subsection consents to and cooperates with the state in accordance with the requirements of this subsection.
    4. As a condition of eligibility for cash and medical assistance under this chapter, each adult member, parent, or caretaker relative of the family/assistance unit must consent to and cooperate with the state in identifying and providing information to assist the state in pursuing any third party who may be liable to pay for care and services under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2009, ch. 68, art. 20, § 1; P.L. 2011, ch. 151, art. 23, § 3; P.L. 2019, ch. 88, art. 13, § 2; P.L. 2020, ch. 79, art. 1, § 26; P.L. 2021, ch. 162, art. 13, § 6, effective July 6, 2021.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

Federal Act References.

26 U.S.C. § 3507, referred to in subsection (f)(3)(viii) of this section, was repealed by Act Aug. 10, 2010, Pub. L. No. 111-226, Title II, Subtitle B, § 219(a)(1).

The Child Nutrition Act of 1966, referred to in subsection (g)(3)(iv) of this section, is codified at 42 U.S.C. § 1771 et seq. For federal regulations concerning child nutrition programs, see 7 C.F.R. 210.1 et seq.

Title III of the Domestic Volunteer Service Act of 1973, referred to in subsection (g)(3)(viii) of this section, was formerly codified as 42 U.S.C. §§ 5301, 5302 and was repealed effective Oct. 1, 1979. Title II of the Domestic Volunteer Service Act of 1973 is not repealed and is codified as 42 U.S.C. § 5000 et seq.

25 U.S.C. § 1261 et seq., referred to in subsection (g)(3)(x) of this section, has been omitted from the U.S. Code.

25 U.S.C. § 459d, referred to in subsection (g)(3)(x) of this section, has been transferred to 25 U.S.C. § 5505.

40-5.2-11. Cash assistance.

  1. A family or assistance unit found by the department to meet the eligibility criteria set forth in this chapter shall be eligible to receive cash assistance as of the date a signed, written application, signed under a penalty of perjury, is received by the department.
  2. The family members or assistance unit shall be eligible for cash assistance for so long as they continue to meet the eligibility criteria outlined in accordance with this chapter. Parents and adult non-parent caretaker relatives receiving cash assistance shall be eligible so long as they meet the terms and conditions of the work requirements of § 40-5.2-12 . An adult caretaker relative shall be eligible for assistance as a member of the assistance unit so long as he or she meets all the eligibility requirements of this chapter.
  3. The monthly amount of cash assistance shall be equal to the payment standard for the family minus the countable income of the family in that month. The department is authorized to reduce the amount of assistance in the month of application to reflect the number of the days between the first day of the month and the effective date of the application.
  4. A decision on the application for assistance shall be made or rejected by the department no later than thirty (30) days following the date submitted and shall be effective as of the date of application.
  5. The payment standard is equal to the sum of the following: four hundred twenty-five dollars ($425) (three hundred sixty dollars ($360) for a family residing in subsidized housing) for the first person; one hundred fifty-nine dollars ($159) for the second person; one hundred thirty-seven dollars ($137) for the third person; and one hundred four dollars ($104) for each additional person.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2021, ch. 162, art. 13, § 6, effective July 6, 2021.

40-5.2-12. Work requirements for receipt of cash assistance.

  1. The department of human services and the department of labor and training shall assess the applicant/parent or non-parent caretaker relative’s work experience, educational, and vocational abilities, and the department, together with the parent, shall develop and enter into a mandatory, individual employment plan in accordance with § 40-5.2-10(e) .
  2. In the case of a family including two (2) parents, at least one of the parents shall be required to participate in an employment plan leading to full-time employment. The department may also require the second parent in a two-parent (2) household to develop an employment plan if, and when, the youngest child reaches six (6) years of age or older.
  3. The written, individual employment plan shall specify, at minimum, the immediate steps necessary to support a goal of long-term, economic independence.
  4. All applicants and participants in the Rhode Island works employment program must attend and participate in required appointments, employment plan development, and employment-related activities, unless temporarily exempt for reasons specified in this chapter.
  5. A recipient/participant temporarily exempted from the work requirements may participate in an individual employment plan on a voluntary basis, however, the individual remains subject to the same program compliance requirements as a participant without a temporary exemption.
  6. The individual employment plan shall specify the participant’s work activity(ies) and the supportive services that will be provided by the department to enable the participant to engage in the work activity(ies).
  7. Work requirements for single-parent families.  In single-parent households, the participant parent or non-parent caretaker relative in the cash assistance payment, shall participate as a condition of eligibility, for a minimum of twenty (20) hours per week if the youngest child in the home is under the age of six (6), and for a minimum of thirty (30) hours per week if the youngest child in the home is six (6) years of age or older, in one or more of their required work activities, as appropriate, in order to help the parent obtain stable, full-time, paid employment, as determined by the department of human services and the department of labor and training; provided, however, that he or she shall begin with intensive employment services as the first step in the individual employment plan. Required work activities are as follows:
    1. At least twenty (20) hours per week must come from participation in one or more of the following ten (10) work activities:
      1. Unsubsidized employment;
      2. Subsidized private-sector employment;
      3. Subsidized public-sector employment;
      4. Work experience;
      5. On-the-job training;
      6. Job search and job readiness;
      7. Community service programs;
      8. Vocational educational training not to exceed twelve (12) months;
      9. Providing childcare services to another participant parent who is participating in an approved community service program; and
      10. Adult education in an intensive work-readiness program.
    2. Above twenty (20) hours per week, the parent may participate in one or more of the following three (3) activities in order to satisfy a thirty-hour (30) requirement:
      1. Job skills training directly related to employment;
      2. Education directly related to employment; and
      3. Satisfactory attendance at a secondary school or in a course of study leading to a certificate of general equivalence if it is a teen parent under the age of twenty (20) who is without a high school diploma or General Equivalence Diploma (GED).
    3. In the case of a parent under the age of twenty (20), attendance at a secondary school or the equivalent during the month, or twenty (20) hours per week on average for the month in education directly related to employment, will be counted as engaged in work.
    4. A parent who participates in a work experience or community service program for the maximum number of hours per week allowable by the Fair Labor Standards Act (FLSA) is deemed to have participated in his or her required minimum hours per week in core activities if actual participation falls short of his or her required minimum hours per week.
    5. A parent who has been determined to have a physical or mental impairment affecting employment, but who has not been found eligible for Social Security Disability benefits or Supplemental Security Income must participate in his or her rehabilitation employment plan as developed with the office of rehabilitation services that leads to employment and/or to receipt of disability benefits through the Social Security Administration.
    6. A required work activity may be any other work activity permissible under federal TANF provisions or state-defined Rhode Island works program activity, including up to ten (10) hours of activities required by a parent’s department of children, youth and families service plan.
  8. Exemptions from work requirements for the single-parent family.  Work requirements outlined in subsection (g) shall not apply to a single parent if (and for so long as) the department finds that he or she is:
    1. Caring for a child below the age of one; provided, however, that a parent may opt for the deferral from an individual employment plan for a maximum of twelve (12) months during the twenty-four (24) months of eligibility for cash assistance and provided, further, that a minor parent without a high school diploma or the equivalent, and who is not married, shall not be exempt for more than twelve (12) weeks from the birth of the child;
    2. Caring for a disabled family member who resides in the home and requires full-time care;
    3. A recipient of Social Security Disability benefits or Supplemental Security Income or other disability benefits that have the same standard of disability as defined by the Social Security Administration;
    4. An individual receiving assistance who is a victim of domestic violence as determined by the department in accordance with rules and regulations;
    5. An applicant for assistance in her third trimester or a pregnant woman in her third trimester who is a recipient of assistance and has medical documentation that she cannot work;
    6. An individual otherwise exempt by the department as defined in rules and regulations promulgated by the department.
  9. Work requirement for two-parent families.

    (1) In families consisting of two (2) parents, one or both parents are required, and shall be engaged in, work activities as defined below, for an individual or combined total of at least thirty-five (35) hours per week during the month, not fewer than thirty (30) hours per week of that are attributable to one or more of the following listed work activities; provided, however, that he or she shall begin with intensive employment services as the first step in the individual employment plan. Two-parent work requirements shall be defined as the following:

    1. Unsubsidized employment;
    2. Subsidized private-sector employment;
    3. Subsidized public-sector employment;
    4. Work experience;
    5. On-the-job training;
    6. Job search and job readiness;
    7. Community service program;
    8. Vocational educational training not to exceed twelve (12) months;
    9. The provision of childcare services to a participant individual who is participating in a community service program; and
    10. Adult education in an intensive work-readiness program.

      (2) Above thirty (30) hours per week, the following three (3) activities may also count for participation:

      (i) Job skills training directly related to employment;

      (ii) Education directly related to employment; and

      (iii) Satisfactory attendance at secondary school or in a course of study leading to a certificate of general equivalence.

      (3) A family with two (2) parents, in which one or both parents participate in a work experience or community service program, shall be deemed to have participated in core work activities for the maximum number of hours per week allowable by the Fair Labor Standards Act (FLSA) if actual participation falls short of his or her required minimum hours per week.

      (4) If the family receives childcare assistance and an adult in the family is not disabled or caring for a severely disabled child, then the work-eligible individuals must be participating in work activities for an average of at least fifty-five (55) hours per week to count as a two-parent family engaged in work for the month.

      (5) At least fifty (50) of the fifty-five (55) hours per week must come from participation in the activities listed in subsection (i)(1).

      Above fifty (50) hours per week, the three (3) activities listed in subsection (i)(2) may also count as participation.

      (6) A family with two (2) parents receiving child care in which one or both parents participate in a work experience or community service program for the maximum number of hours per week allowable by the Fair Labor Standards Act (FLSA) will be considered to have met their required core hours if actual participation falls short of the required minimum hours per week. For families that need additional hours beyond the core activity requirement, these hours must be satisfied in some other TANF work activity.

  10. Exemptions from work requirements for two-parent families.  Work requirements outlined in subsection (i) shall not apply to two-parent families if (and for so long as) the department finds that:
    1. Both parents receive Supplemental Security Income (SSI);
    2. One parent receives SSI, and the other parent is caring for a disabled family member who resides in the home and who requires full-time care; or
    3. The parents are otherwise exempt by the department as defined in rules and regulations.
  11. Failure to comply with work requirements — Sanctions and terminations.
    1. The cash assistance to which an otherwise eligible family/assistance unit is entitled under this chapter shall be reduced for three (3) months, whether or not consecutive, in accordance with rules and regulations promulgated by the department, whenever any participant, without good cause as defined by the department in its rules and regulations, has failed to enter into an individual employment plan; has failed to attend a required appointment; has refused or quit employment; or has failed to comply with any other requirements for the receipt of cash assistance under this chapter. If the family’s benefit has been reduced, benefits shall be restored to the full amount beginning with the initial payment made on the first of the month following the month in which the parent: (i) Enters into an individual employment plan or rehabilitation plan and demonstrates compliance with the terms thereof; or (ii) Demonstrates compliance with the terms of his or her existing individual employment plan or rehabilitation plan, as such plan may be amended by agreement of the parent and the department.
    2. In the case where appropriate child care has been made available in accordance with this chapter, a participant’s failure, without good cause, to accept a bona fide offer of work, including full-time, part-time, and/or temporary employment, or unpaid work experience or community service, shall be deemed a failure to comply with the work requirements of this section and shall result in reduction or termination of cash assistance, as defined by the department in rules and regulations duly promulgated.
    3. If the family/assistance unit’s benefit has been reduced for a total of three (3) months, whether or not consecutive in accordance with this section due to the failure by one or more parents to enter into an individual employment plan, or failure to comply with the terms of his or her individual employment plan, or the failure to comply with the requirements of this chapter, cash assistance to the entire family shall end. The family/assistance unit may reapply for benefits, and the benefits shall be restored to the family/assistance unit in the full amount the family/assistance unit is otherwise eligible for under this chapter beginning on the first of the month following the month in which all parents in the family/assistance unit who are subject to the employment or rehabilitation plan requirements under this chapter: (i) Enter into an individual employment or rehabilitation plan as applicable, and demonstrate compliance with the terms thereof, or (ii) Demonstrate compliance with the terms of the parent’s individual employment or rehabilitation employment plan in effect at the time of termination of benefits, as such plan may be amended by agreement of the parent and the department.
    4. Up to ten (10) days following a notice of adverse action to reduce or terminate benefits under this subsection, the client may request the opportunity to meet with a social worker to identify the reasons for non-compliance, establish good cause, and seek to resolve any issues that have prevented the parent from complying with the employment plan requirements.
    5. Participants whose cases had closed in sanction status pursuant to Rhode Island’s prior Temporary Assistance for Needy Families Program (federal TANF described in Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), the family independence program, more specifically, § 40-5.1-9(2)(c) [repealed], due to failure to comply with the cash assistance program requirements, but who had received less than forty-eight (48) months of cash assistance at the time of closure, and who reapply for cash assistance under the Rhode Island works program, must demonstrate full compliance, as defined by the department in its rules and regulations, before they shall be eligible for cash assistance pursuant to this chapter.
  12. Good cause.  Good cause for failing to meet any program requirements including leaving employment, and failure to fulfill documentation requirements, shall be outlined in rules and regulations promulgated by the department of human services.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2011, ch. 151, art. 23, § 3; P.L. 2014, ch. 352, § 1; P.L. 2014, ch. 405, § 1; P.L. 2015, ch. 217, § 1; P.L. 2015, ch. 237, § 1; P.L. 2020, ch. 79, art. 1, § 26.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-5.2-13. Income deeming.

Parent, stepparent, grandparent, and sponsor income deeming.

  1. Parents.  For purposes of determining eligibility for and the amount of cash assistance to which a family is entitled under this chapter, the income of a child shall include the income of his/her parent(s). For purposes of this section, the term “income” has the meaning prescribed in § 40-5.2-10(g) .
  2. Stepparents.  For purposes of determining eligibility for and the amount of cash assistance to which a family is entitled under this chapter, the income of a child shall include the income of the child’s stepparent (if living in the same house as the child) minus the sum of: (1) The first ninety dollars ($90) of the stepparent’s earned income for the month; (2) The standard of need for a family of the same composition as the stepparent (but excluding any person included in the child’s family); (3) Amounts paid by the stepparent to individuals not living in the stepparent’s home and claimed by him or her as dependent for federal tax purposes; and (4) Alimony or child support payments made by the stepparent with respect to individuals not living in such household.
  3. Grandparents.  The income of a child whose parent is under the age of eighteen (18) shall include any income of the child’s grandparents, if the grandparents are living in the same home as the child and his or her parent, to the same extent that income of a stepparent is included under subsection (b).
  4. Sponsors.  Sponsor deeming with respect to eligible aliens who are applicants for cash assistance shall be applied in accordance with Section 421 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. No. 104-193, PRWORA) [8 U.S.C. § 1631] and under rules and regulations to be promulgated by the department.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-14. Reporting of income and resources by participants.

All participants are responsible for reporting changes in income, resources, family composition or other factors that can affect the family’s eligibility or payment level within ten (10) days of the change in circumstances.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-15. Reporting absence.

Whenever adult family member(s) become aware that a minor child in their household has been or will be temporarily absent from the home, the adult family member(s) have the responsibility to report such absence of a minor child from the home by the end of the five-day (5) period that begins with the date that the adult family member(s) become aware that the minor child has been or will be absent from the home for a period of thirty (30) or more consecutive days.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-16. Minimum payment.

No payment of assistance under § 40-5.2-11(e) shall be made for any month if the amount of such payment would be less than ten dollars ($10.00), but a family with respect to whom a payment of assistance is denied solely by reason of this section shall otherwise be deemed to be a recipient of assistance under this chapter.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-17. Assistance not assignable; exemption from process.

Except as otherwise provided for herein, cash assistance shall not be transferable or assignable at law or in equity, and none of the money paid or payable under this chapter shall be subject to execution, levy, attachment, garnishment, or other legal process, or to the operation of any bankruptcy or insolvency law.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-18. Up-front cash program.

The department has the authority under this chapter to develop a non-assistance up-front cash program for recipients in accordance with federal TANF guidelines.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-19. Appropriate child care necessary for work requirement.

Notwithstanding any other provision of this chapter, no single parent, or both parents meeting all other program requirements, shall be required to work or participate in employment plan activities or rehabilitative plan activities to the extent that appropriate child care is necessary for the parent to do so and the department determines that appropriate child care is unavailable for fiscal or other reasons.

  1. For purposes of this section, “appropriate child care” means child care that is provided by a person or organization qualified and authorized to provide care by the department of children, youth and families or such other lawful providers as determined by the department of children, youth and families. Child care shall be considered “necessary” under this section for any children below the age of thirteen (13), or any children age thirteen (13) years or older, who are under supervision of the family court or who require care because of a physical or mental impairment.
  2. The department shall provide transportation support in either the form of a bus pass for use in traveling to work activities, training, or other plan-related needs, or in the form of an allowance for transportation costs necessary to comply with the employment plan as defined in department rules and regulations.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-20. Childcare assistance — Families or assistance units eligible.

  1. The department shall provide appropriate child care to every participant who is eligible for cash assistance and who requires child care in order to meet the work requirements in accordance with this chapter.
  2. Low-income child care.  The department shall provide child care to all other working families with incomes at or below one hundred eighty percent (180%) of the federal poverty level if, and to the extent, these other families require child care in order to work at paid employment as defined in the department’s rules and regulations. Beginning October 1, 2013, the department shall also provide child care to families with incomes below one hundred eighty percent (180%) of the federal poverty level if, and to the extent, these families require child care to participate on a short-term basis, as defined in the department’s rules and regulations, in training, apprenticeship, internship, on-the-job training, work experience, work immersion, or other job-readiness/job-attachment program sponsored or funded by the human resource investment council (governor’s workforce board) or state agencies that are part of the coordinated program system pursuant to § 42-102-11 . Effective from January 1, 2021, through June 30, 2022, the department shall also provide childcare assistance to families with incomes below one hundred eighty percent (180%) of the federal poverty level when such assistance is necessary for a member of these families to enroll or maintain enrollment in a Rhode Island public institution of higher education provided that eligibility to receive funding is capped when expenditures reach $200,000 for this provision.
  3. No family/assistance unit shall be eligible for childcare assistance under this chapter if the combined value of its liquid resources exceeds one million dollars ($1,000,000), which corresponds to the amount permitted by the federal government under the state plan and set forth in the administrative rulemaking process by the department. Liquid resources are defined as any interest(s) in property in the form of cash or other financial instruments or accounts that are readily convertible to cash or cash equivalents. These include, but are not limited to: cash, bank, credit union, or other financial institution savings, checking, and money market accounts; certificates of deposit or other time deposits; stocks; bonds; mutual funds; and other similar financial instruments or accounts. These do not include educational savings accounts, plans, or programs; retirement accounts, plans, or programs; or accounts held jointly with another adult, not including a spouse. The department is authorized to promulgate rules and regulations to determine the ownership and source of the funds in the joint account.
  4. As a condition of eligibility for childcare assistance under this chapter, the parent or caretaker relative of the family must consent to, and must cooperate with, the department in establishing paternity, and in establishing and/or enforcing child support and medical support orders for any children in the family receiving appropriate child care under this section in accordance with the applicable sections of title 15, as amended, unless the parent or caretaker relative is found to have good cause for refusing to comply with the requirements of this subsection.
  5. For purposes of this section, “appropriate child care” means child care, including infant, toddler, preschool, nursery school, and school-age, that is provided by a person or organization qualified, approved, and authorized to provide the care by the state agency or agencies designated to make the determinations in accordance with the provisions set forth herein.
    1. Families with incomes below one hundred percent (100%) of the applicable federal poverty level guidelines shall be provided with free child care. Families with incomes greater than one hundred percent (100%) and less than one hundred eighty percent (180%) of the applicable federal poverty guideline shall be required to pay for some portion of the child care they receive, according to a sliding-fee scale adopted by the department in the department’s rules, not to exceed seven percent (7%) of income as defined in subsection (h) of this section.
    2. Families who are receiving childcare assistance and who become ineligible for childcare assistance as a result of their incomes exceeding one hundred eighty percent (180%) of the applicable federal poverty guidelines shall continue to be eligible for childcare assistance until their incomes exceed two hundred twenty-five percent (225%) of the applicable federal poverty guidelines. To be eligible, the families must continue to pay for some portion of the child care they receive, as indicated in a sliding-fee scale adopted in the department’s rules, not to exceed seven percent (7%) of income as defined in subsection (h) of this section, and in accordance with all other eligibility standards.
  6. In determining the type of child care to be provided to a family, the department shall take into account the cost of available childcare options; the suitability of the type of care available for the child; and the parent’s preference as to the type of child care.
  7. For purposes of this section, “income” for families receiving cash assistance under § 40-5.2-11 means gross, earned income and unearned income, subject to the income exclusions in §§ 40-5.2-10(g)(2) and 40-5.2-10(g)(3) , and income for other families shall mean gross, earned and unearned income as determined by departmental regulations.
  8. The caseload estimating conference established by chapter 17 of title 35 shall forecast the expenditures for child care in accordance with the provisions of § 35-17-1 .
  9. In determining eligibility for childcare assistance for children of members of reserve components called to active duty during a time of conflict, the department shall freeze the family composition and the family income of the reserve component member as it was in the month prior to the month of leaving for active duty. This shall continue until the individual is officially discharged from active duty.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2013, ch. 144, art. 15, § 3; P.L. 2013, ch. 144, art. 18, § 2; P.L. 2014, ch. 145, art. 15, § 2; P.L. 2014, ch. 478, § 1; P.L. 2015, ch. 141, art. 17, § 2; P.L. 2015, ch. 203, § 1; P.L. 2015, ch. 226, § 1; P.L. 2016, ch. 142, art. 7, § 7; P.L. 2017, ch. 302, art. 9, § 1; P.L. 2019, ch. 88, art. 13, § 2; P.L. 2020, ch. 79, art. 1, § 26; P.L. 2021, ch. 162, art. 13, § 6, effective July 6, 2021.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-5.2-21. Eligibility for medical benefits.

  1. Every member of any family/assistance unit eligible for cash assistance under this chapter shall be eligible for medical assistance through the RIte Care or RIte Share programs, as determined by the department, subject to the provisions of § 40-8-1(d) and provided, further, that eligibility for medical assistance, must qualify for federal financial participation pursuant to the provisions of Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq.
  2. If a family becomes ineligible for cash assistance payments under this chapter as a result of excess earnings from employment, the family/assistance unit shall continue to be eligible for medical assistance through the RIte Care or RIte Share program for a period of twelve (12) months or until employer-paid family healthcare coverage begins, subject to the provisions of § 40-8-1(d) , whichever occurs first; and provided, further, that those eligible for medical assistance must qualify for federal financial participation pursuant to the provisions of Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2020, ch. 79, art. 1, § 26.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-5.2-22. Emergency expenses.

  1. To the extent that the department has allocated resources for this purpose, the department is authorized to provide assistance to families receiving assistance in accordance with this chapter to meet emergency needs that cannot be met with the cash resources available to the family. The emergency assistance shall be limited to the lesser of actual cost or the sum of two hundred dollars ($200). Except as provided by the department by regulation, no expense shall be reimbursable unless the department has pre-approved the expenditure. Emergency assistance includes, but is not limited to, payment of moving expenses for families who are forced to move their place of residence and payments for emergency transportation needs used in connection with participation in any program approved under this chapter.
  2. In the event of a catastrophe caused by fire, flood, lightning, severe wind, or other act of nature, the department may establish by regulation the authorization of catastrophic assistance funds not subject to the limit of two hundred dollars ($200) specified in subsection (a). These regulations shall specify the criteria under which funds for shelter, clothing, or essential household equipment and furnishings may be authorized in the event of a catastrophe.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-23. Post-employment incentive bonus.

The family/assistance unit may be eligible for an incentive bonus payment, if the participant is employed and is working at least thirty (30) hours per week or more for a single-parent family and thirty-five (35) hours per week for a two-parent family at the time of closure on cash assistance and remains employed and continues to work at least thirty (30) hours per week or thirty (35) hours per week or more, not to exceed a period of twelve (12) months in accordance with rules and regulations promulgated by the department.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-24. Overpayment and underpayment of benefits.

The department shall promptly take all necessary steps to correct any overpayment or underpayment of cash assistance paid under this chapter, and, in the case of:

  1. An overpayment to an individual who is a current recipient of cash assistance (including a recipient whose overpayment occurred during a prior period of ineligibility), recovery will be made by repayment by the individual or by reducing the amount of any future cash assistance payable to the family of which he or she is a member, except that the recovery shall not result in the reduction of cash assistance payable for any month, such that cash assistance, when added to its income, is less than ninety percent (90%) of the standard of assistance for a family/assistance unit with the same composition with no other income (and, in the case of an individual to whom no payment is made for a month solely by reason of recovery of any overpayment, the individual shall be deemed to be a recipient of cash assistance for that month);
  2. An overpayment to any individual who is no longer receiving cash assistance under the plan, recovery shall be made by appropriate action by the department under federal and state law against the income or resources of the individual, the family, or the prior assistance unit; and
  3. An underpayment, the corrective payment shall be disregarded in determining the income of the family, and shall be disregarded in determining its resources in the month the corrective payment is made and in the following month; except that no recovery need be attempted or carried out under subsection (2), other than in a case involving fraud on the part of the recipient where the cost of recovery would equal or exceed the amount of overpayment involved.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-25. Hearings.

Any applicant, recipient, or participant aggrieved because of a decision by the department, including but not limited to, a decision regarding eligibility for benefits, the amount of benefits, terms of an employment plan, or a delay in making a decision with respect to an application for assistance shall be entitled to an appeal. The department shall provide an applicant, recipient, or participant with written notice of a decision to deny benefits under this chapter and shall provide recipients written notice at least ten (10) days in advance of a decision to terminate or reduce benefits to the family/assistance unit. Notices shall be easy to understand and shall explain the reason for the department’s decision and cite the relevant section of the department’s regulations. The family may appeal the decision by filing a written request with the department within thirty (30) days of the date the notice was mailed. If the recipient files the request within ten (10) days of the date the notice was mailed, the recipient may receive benefits without reduction pending the outcome of the appeal.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-26. Records as to assistance.

  1. All records pertaining to the administration of public assistance pursuant to this chapter and chapter 8 of this title are hereby declared to constitute a confidential matter.
  2. In furtherance thereof:
    1. It shall be unlawful for any person to make use of, or cause to be used, any information contained in records for purposes not directly connected with administration thereof, except with the consent of the individual concerned.
    2. The director of the department shall have the power to establish rules and regulations governing the custody, use, and preservation of the records, papers, files, and communications dealing with the administration of public assistance. The rules and regulations shall have the same force and effect as law.
    3. The records shall be produced in response to subpoena duces tecum properly issued by any federal or state court; provided, however, that the purpose for which the subpoena is sought is directly connected with the administration of public assistance. No subpoena shall be issued by a court asking either for the records, or for persons having custody or access to the records, unless the litigation involved in matters is directly connected with the administration of public assistance.
    4. Any person who by law is entitled to a list of individuals receiving any of the assistance as provided in this chapter shall not publish, or cause to be published, the list except by the express consent of the director of the department, or to make use of thereof for purposes not directly connected with the administration thereof.
    5. Any person violating any of the provisions of this section, or the lawful rules and regulations made hereunder, shall be guilty of a misdemeanor and shall be fined not more than two hundred dollars ($200), or shall be imprisoned for not more than six (6) months, or both.
    6. Nothing in this section shall be deemed to prohibit the director of the department, or his or her agents duly authorized for that purpose, from issuing any statistical material data, or publishing, or causing the data to be published whenever he or she shall deem it to be in the public interest.
    7. The director of the department may inquire into the records of any state department or agency in the course of his or her administration of public assistance.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-27. Department of human services.

  1. Except as otherwise provided for herein, the director of the department of human services is responsible for implementation of this chapter.
  2. No later than March 1 of each year, the director shall submit a plan to the general assembly showing how, within available resources, the department expects to operate the programs authorized under this chapter in the succeeding fiscal year. The director will provide an annual report of program impact on families served by the Rhode Island works program and indicators of success. The report shall also reflect the child support guidelines issued from time to time by the Rhode Island family court.
  3. The department is empowered and authorized to submit its plan for services under the act to the federal government or any agency or department thereof having funds available for benefits to low-income families for approval pursuant to the provisions of the Social Security Act, 42 U.S.C. § 301 et seq. The department shall act for the state in any negotiations relative to the submission and approval of the plan and/or waivers and may make any arrangement or changes in its plan and/or waivers not inconsistent with this chapter that may be required or permitted by the Social Security Act or rules and regulations promulgated pursuant thereto to obtain and retain approval and to secure for this state the benefits of the provisions of the federal act relating to family assistance. The department shall make reports to the federal government or any agency or department thereof, in the form and nature required by it, and shall in all respects comply with any request or direction of the federal government or any agency or department thereof that may be necessary to assure the correctness and verification of the reports.
  4. The department of human services is hereby authorized and directed to expedite the implementation of this act by submitting to the federal government, on behalf of the state, the state plan amendments and any federal waiver requests it deems necessary to fully implement the provisions of this act and to secure for this state the benefits of federal financial participation and/or grants for the above-referenced programs, as amended, pursuant to Titles IV and XIX of the federal Social Security Act, 42 U.S.C. §§ 601 et seq. and 1396 et seq., and Subchapter II-B of the Child Care and Development Block Grant codified at 42 U.S.C. § 9858 et seq., and as these acts may hereafter be re-codified or amended by acts as may be considered and enacted by the Congress of the United States.
    1. Any provisions of this chapter and chapters 6 and 6.2 of this title and § 42-12-3 that are inconsistent with federal law or regulations shall be void unless the department receives an exemption or waiver from the federal government to implement the provision.
    2. The department of human services is hereby authorized and directed to implement this act only in accordance with the terms and conditions of state plan amendments, waivers, or other approvals granted by the federal government and changes in rules, regulations, and policies of the department that are promulgated pursuant to chapter 35 of title 42.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-28. Rules and regulations.

The director of the department of human services shall, pursuant to chapter 35 of title 42, promulgate rules and regulations necessary to carry out the provisions of this chapter. Any reference to the department’s rulemaking process is pursuant to this section.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-29. Noncustodial parents — Employment obligations.

Any noncustodial parent who is required by order of the family court to pay support to any family receiving assistance of any kind under this chapter, and who is unemployed and, in whole or in part as a result of the unemployment, has failed to comply with all of the terms of the support order may, if permitted by a justice of the family court, purge his or her contempt by accepting employment approved by the court, paying wages no less than the state minimum wage and/or by participation on a full-time basis in a rapid job-placement program.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-30. Fraudulently obtaining assistance.

Any person who, by any fraudulent device, obtains or attempts to obtain public assistance pursuant to this chapter to which he or she is not entitled, or who willfully fails to report income or resources as provided in this chapter, shall be guilty of larceny and, upon conviction thereof, shall be punished by imprisonment of not more than five (5) years and by a fine of not more than one thousand five hundred dollars ($1,500), or both, if the value of the public assistance to which he or she is not entitled shall exceed five hundred dollars ($500); or by imprisonment by less than one year or by a fine of not more than five hundred dollars ($500), or by both, if the value of the public assistance to which he or she is not entitled shall not exceed five hundred dollars ($500).

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-31. Authorization to pay assistance.

Authorization to pay all forms of assistance specified in this chapter shall be made by representatives of the department and the state controller is hereby authorized to draw his or her orders upon the general treasurer for payments upon receipt by him or her of proper vouchers approved by the department. Subject to any necessary federal approval, the department is authorized to make payments of cash assistance by check, direct deposit, electronic benefit transfer or other means designated by the department.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-32. Cashing of assistance checks.

  1. For purposes of this section, the term “banking institution” shall mean: (1) Any state or federally chartered bank, savings bank, loan and investment bank, or credit union located within this state; and (2) Any currency-exchange specialist located within this state and enrolled with the department of human services pursuant to regulations to be adopted by the department.
  2. Each banking institution shall cash, at its main office or any of its branch offices within the state, any check drawn by the state and payable within the state to a recipient of cash assistance under this chapter, if the check is negotiated to the banking institution by the original payee of the check, and if the payee produces reasonable identification required by this section and as provided for in regulations adopted pursuant to subsection (d).
  3. Nothing in this section shall be interpreted as limiting any rights that the banking institution may have against the payee by contract or law, with regard to items that are negotiated to it as provided for in this section, that are not paid upon presentment or where the payee breaches a warranty made under § 6A-3-417 . This section shall not apply to any check negotiated to a banking institution if the institution has reason to believe that the check will not be paid on presentment or that the tendering party may be in breach of one or more of the warranties contained in § 6A-3-417 .
  4. Provided that a banking institution properly employed the identification procedures prescribed in regulations adopted pursuant to this subsection at the time a cash assistance check was cashed by the institution, the state shall honor and make payment on the cash assistance check and the banking institution shall not be liable to reimburse the state for a loss incurred as a result of the wrongful payment of a check by a banking institution. The director of the department of human services shall adopt regulations specifying: (1) The forms of reasonable identification that a banking institution shall accept when cashing a cash assistance check pursuant to subsection (b); and (2) The identification procedures the institution must employ to receive payment thereon and to avoid liability for wrongful payment of any check. The regulations shall provide that the forms of reasonable identification shall include, but need not be limited to: (1) A cash assistance photo identification card issued by the department of human services; (2) A valid identification card issued by the administrator of the division of motor vehicles pursuant to § 3-8-6 ; (3) A valid driver’s license; (4) An identification card issued by the office of healthy aging; and (5) A valid identification card issued by the United States Immigration and Naturalization Service.
  5. The department shall issue a stop-payment order with respect to any assistance check reported as lost, stolen, or undelivered. The department shall not issue a replacement cash assistance check for a period of three (3) business days from the date of the report of the loss, theft, or nondelivery.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-33. Child clothing allowance.

One month each year, each child who lives in a family receiving cash assistance under this chapter in that month shall be given a supplementary payment of no less than one hundred dollars ($100) for the purchase of clothing in accordance with Title IV-A of the Social Security Act, 42 U.S.C. § 601 et seq.

History of Section. P.L. 2008, ch. 100, art. 16, § 1; P.L. 2021, ch. 162, art. 13, § 6, effective July 6, 2021.

40-5.2-34. Screening for domestic violence — Waiver of program requirements.

  1. The department shall:
    1. Screen and identify individuals with a history of domestic violence applying for or receiving assistance while maintaining the confidentiality of such individuals;
    2. Refer these individuals to counseling and supportive services; and
    3. Waive, pursuant to a determination of good cause and for so long as necessary, cash assistance program requirements relating to time limits for individuals receiving assistance, residency requirements, child support cooperation requirements, and work requirements, in cases where compliance with these requirements would make it more difficult for individuals receiving assistance under this chapter to escape domestic violence or unfairly penalize individuals who are or have been victimized by domestic violence, or individuals who are at risk of further domestic violence.
  2. For purposes of this section, the term “individual with a history of domestic violence” means an individual who has been subjected to:
    1. Physical acts that resulted in, or threatened to result in, physical injury to the individual;
    2. Sexual abuse;
    3. Sexual activity involving a dependent child;
    4. Being forced as the caretaker relative of a dependent child to engage in nonconsensual sexual acts or activities;
    5. Threats of, or attempts at, physical or sexual abuse;
    6. Mental abuse; or
    7. Neglect or deprivation of medical care.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-35. Child support pass-through.

For any month in which a noncustodial parent makes a child support payment in the month when due and the support is collected by the department of human services, for a child or children receiving cash assistance pursuant to this chapter, the first fifty dollars ($50.00) of the child support payment, or the actual amount of the child support payment if the payment is less than fifty dollars ($50.00), shall be paid to the family in which the child resides. If more than one noncustodial parent makes a child support payment to children living in the same family, there shall only be one payment of fifty ($50.00) paid to the family from the child support collected. This payment is known as the “pass through” payment and shall be sent to the family within two (2) business days of the determination that the amount is due and owing and no later than within two (2) business days of the end of the month in which the support was collected.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-36. Appropriation of funds.

The general assembly shall annually appropriate sums as it may deem necessary for the purposes of carrying out the provisions of this chapter; and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of these sums, or so much thereof as may from time to time be required, upon receipt by him or her of the vouchers approved by the director of the state department of human services.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-37. Severability.

If any provision of this chapter or the application thereof to any person or circumstances is held invalid, the invalidity shall not affect other provisions or applications of the chapter that can be given effect without the invalid provision or application, and to this end, the provisions of this chapter are declared to be severable.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-38. Application and effect of this chapter on applicants and recipients.

  1. All provisions of this chapter, with the exception of subsection (b), shall be effective and apply to all applicants and recipients on or after July 1, 2008.
  2. For all current recipients as of July 1, 2008, who have received cash assistance, either state or federally funded, since May 1, 1997, under Rhode Island’s Temporary Assistance for Needy Families Program (federal TANF described at Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), formerly entitled the family independence program, or received cash assistance from another state, either state or federally funded, since May 1, 1997, under that state’s similar Temporary Assistance for Needy Families Program (federal TANF described at Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), prior to October 1, 2008, application and implementation of the time limits described in § 40-5.2-10(h) will occur on and after July 1, 2009.
  3. All cash assistance received, either state or federally funded, since May 1, 1997, under Rhode Island’s Temporary Assistance for Needy Families Program (federal TANF described at Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), formerly entitled the family independence program, or in another state under that state’s similar Temporary Assistance for Needy Families Program (federal TANF described at Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.) prior to July 1, 2009, shall be counted toward the time limits of cash assistance described in § 40-5.1-10(h) [repealed].
  4. The department will not close families who previously received cash assistance, either state or federally funded, since May 1, 1997, under Rhode Island’s Temporary Assistance for Needy Families Program (federal TANF described at Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.), formerly entitled the family independence program, or in another state under that state’s similar Temporary Assistance for Needy Families Program (federal TANF described at Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.) prior to the effective date of the Rhode Island works program due to the time limit outlined in § 40-5.2-10(h) of this chapter until July 1, 2009. Except, however, all those families who previously received family independence program cash assistance, either state or federally funded or in another state, as described above, and who will reach the family independence program sixty-month (60), lifetime time limit in accordance with prior Rhode Island general law, § 40-5.1-8(d), prior to July 1, 2009, shall be closed at the time they would have reached the sixty-month (60) time limit in accordance with prior Rhode Island general law, § 40-5.1-8(d). Nothing in this section shall be deemed to mean that any recipient of cash assistance, either state or federally funded, through the prior family independence program shall receive more than the time limit of sixty (60) months of cash assistance that had been permissible under prior Rhode Island general law, § 40-5.1-8(d).
  5. Those families or assistance units receiving cash assistance shall be notified in writing as to the time limits imposed on the receipt of cash assistance in accordance with the Rhode Island works program under this chapter, as well as all the other program requirements.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

40-5.2-39. References to the family independence program.

Any references in the Rhode Island general laws to the family independence act, family independence program, or family independence program cash assistance or benefits shall be deemed to be applicable and shall be effective in accordance with the Rhode Island works program outlined in this chapter.

History of Section. P.L. 2008, ch. 100, art. 16, § 1.

Chapter 5.3 Youth Pregnancy and At-Risk Prevention Services Program

40-5.3-1. Short title.

This chapter is hereby entitled “Youth Pregnancy and At-Risk Prevention Services Program.”

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

40-5.3-2. Youth pregnancy and at-risk prevention services program — Findings — Legislative intent — Goals.

The legislature hereby finds and declares the following:

  1. Young people, especially at-risk youth, are more vulnerable to teen pregnancy, child abuse, gang and drug-related activity, juvenile crime, school failure, neglect, and other illicit activities during the potentially unsupervised summer months, as well as the hours between the end of school and the time their parents or guardians return home from work.
  2. Without community-based prevention and mentoring programs, the threats to the well-being and safety of our youth continue.
  3. In order to minimize the risk to young people, it is the intent of the general assembly to expand after-school and summer community-based prevention, mentoring, and development programs and to implement those programs in accordance with the federal Temporary Assistance for Needy Families Program (“TANF” program) described in Title IV-A of the federal Social Security Act, 42 U.S.C. § 601 et seq.
  4. The goal of the program shall be to focus on the particular TANF goal of preventing youth pregnancies as well as reducing other at-risk behavior described in this section.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

40-5.3-3. Youth pregnancy and at-risk prevention services program — Establishment.

  1. There is hereby established an after-school and summer youth prevention and development program to be administered by the department of human services. The establishment of the program pursuant to this chapter shall be contingent upon the availability and receipt of federal funding for the purpose set forth in § 40-5.3-2 . The department shall ensure that the goals of this chapter are met and that the state meets the federal requirements. The director of the department, to the extent that federal TANF funds are made available, may allocate to the program up to two hundred fifty thousand dollars ($250,000) annually.
  2. In the event that there are changes in the federal TANF program, the department shall seek support through the general assembly to make all necessary changes and shall take all necessary steps to comply with the federal law.
  3. Except as otherwise provided for herein, the director is responsible for implementation of this chapter.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

40-5.3-4. Youth pregnancy and at-risk prevention services program — Eligibility requirements.

  1. The Rhode Island Alliance of Boys and Girls Clubs is hereby authorized, on behalf of its member organizations, to make an application to the department for funding under this chapter.
  2. The following requirements and conditions shall be necessary to establish eligibility for funding:
    1. The organization must demonstrate that its members are affiliated and in good standing with a nationally chartered organization as described in Title 36, Subtitle II, Part B of the Patriotic and National Organizations, 36 U.S.C. § 311 et seq.;
    2. The organization must provide tested and proven programs;
    3. The organization must demonstrate that its members provide programs that are facility-based;
    4. The organization must demonstrate that its members’ programs are offered for a minimum of ten (10) hours weekly during the school year and twenty (20) hours weekly during the summer;
    5. The organization must demonstrate that its members’ programs exist in a minimum of seven (7) towns and cities within the state;
    6. The organization must demonstrate that its members’ programs are administered in accordance with this chapter and designed to meet or exceed the minimum federal TANF guidelines;
    7. The organization must demonstrate that it is eligible to receive federal TANF funding; and
    8. The organization must be able to raise four dollars ($4) for every one dollar received from the state through federal funding.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1; P.L. 2016, ch. 512, art. 1, § 27.

Federal Act References.

Chapter 311 of Title 36, Subtitle II, Part B, of the U.S. Code, referred to in this section, may be found at 36 U.S.C. § 31101 et seq.

40-5.3-5. Annual report to general assembly.

No later than March 1st of each year, the director shall submit a report to the general assembly showing how, within available resources, the department expects to operate the programs authorized under this chapter in the succeeding fiscal year. The director will provide an annual report of program impact on youth and indicators of success.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

40-5.3-6. Report to federal government.

The department shall make reports to the federal government, or any agency or department thereof, in the form and nature required by it, and shall in all respects comply with any request or direction of the federal government, or any agency or department thereof, that may be necessary to assure the correctness and verification of the reports.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

40-5.3-7. Rules and regulations.

The director of the department shall promulgate rules and regulations necessary to carry out the provisions of this chapter. Any reference to the department’s rulemaking process is pursuant to this section.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

40-5.3-8. Severability.

If any provision of this chapter, or the application thereof, to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of the chapter that can be given effect without the invalid provision or application, and to this end the provisions of this chapter are declared to be severable.

History of Section. P.L. 2014, ch. 437, § 1; P.L. 2014, ch. 467, § 1.

Chapter 6 Public Assistance Act

40-6-1. Short title — “Public assistance” and “department” defined.

  1. This chapter shall be known and may be cited as the “Public Assistance Act.”
  2. Definitions.  As used in this chapter, the following terms shall have the meanings set forth herein, unless the context in which the terms are used clearly indicates to the contrary:
    1. “Department” shall mean the Rhode Island department of human services.
    2. “Public assistance” means general public assistance (GPA); supplemental security income (SSI); RI works pursuant to chapter 5.2 of this title; childcare assistance; medical assistance, and supplemental nutritional assistance program (SNAP) pursuant to 7 U.S.C. § 2011 et seq.; which programs are administered and/or financed in whole or in part by the Rhode Island department of human services.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1996, ch. 129, § 11; P.L. 1996, ch. 131, § 11; P.L. 1996, ch. 132, § 11; P.L. 1996, ch. 133, § 11; P.L. 2011, ch. 156, § 1; P.L. 2011, ch. 407, § 1.

Repealed Sections.

The former chapter (P.L. 1939, ch. 660, § 95; P.L. 1944, ch. 1505, §§ 1-25; P.L. 1950, ch. 2413, § 1; P.L. 1952, ch. 2957, § 1; P.L. 1952, ch. 2984, §§ 1, 2; P.L. 1953, ch. 3104, § 1; P.L. 1953, ch. 3163, § 1; P.L. 1954, ch. 3303, §§ 2-6; G.L. 1956, §§ 40-9-1 — 40-9-9.1, 40-9-11 40-9-3 1, 40-6-1 40-6-3 0; P.L. 1959, ch. 93, § 1; P.L. 1960, ch. 34, § 1; P.L. 1961, ch. 78, § 1; P.L. 1962, ch. 22, § 1; P.L. 1963, ch. 121, §§ 1, 2; P.L. 1964, ch. 242, art. 8, § 1; P.L. 1965, ch. 172, § 1; P.L. 1965, ch. 210, § 1; P.L. 1970, ch. 63, § 1; P.L. 1970, ch. 71, § 1; P.L. 1970, ch. 309, § 1; Reorg. Plan No. 1, 1970; P.L. 1971, ch. 21, art. 3, § 1; P.L. 1971, ch. 110, § 1; P.L. 1971, ch. 290, § 1; P.L. 1972, ch. 295, art. 2, § 1; P.L. 1973, ch. 152, § 1; P.L. 1973, ch. 153, § 1; P.L. 1974, ch. 170, § 1; P.L. 1974, ch. 192, § 1; P.L. 1974, ch. 198, art. 4, § 1; P.L. 1976, ch. 84, §§ 1, 2; P.L. 1977, ch. 247, §§ 1-3; P.L. 1977, ch. 268, § 1; P.L. 1978, ch. 6, §§ 1-3; P.L. 1978, ch. 242, § 1; P.L. 1979, ch. 258, § 1; P.L. 1980, ch. 243, § 1; P.L. 1980, ch. 333, § 1; P.L. 1981, ch. 144, § 1; P.L. 1982, ch. 229, § 1; P.L. 1982, ch. 252, § 1; P.L. 1983, ch. 99, § 1; P.L. 1983, ch. 167, art. 19, § 1; P.L. 1983, ch. 297, § 1; P.L. 1985, ch. 300, § 1; P.L. 1985, ch. 476, § 1; P.L. 1986, ch. 125, § 1; P.L. 1986, ch. 327, § 1), consisting of §§ 40-6-1 40-6-3 0 and concerning public assistance, was repealed by P.L. 1987, ch. 118, art. 14, § 1, effective October 1, 1987. Sections 40-6-3 and 40-6-4 (P.L. 1939, ch. 660, § 95; P.L. 1953, ch. 3163, § 1; G.L. 1956, §§ 40-9-3 , 40-9-4 ; P.L. 1962, ch. 22, § 1; Reorg. Plan No. 1, 1970) previously were repealed by P.L. 1974, ch. 125. Section 40-6-9.1 (P.L. 1979, ch. 258, § 1; G.L. 1956, § 40-6-9.1 ) previously was repealed by P.L. 1986, ch. 327, § 2. Section 2 of P.L. 1987, ch. 118, art. 13 enacts a new chapter 6 of this title, effective October 1, 1987.

Collateral References.

Eligibility of aliens for food assistance benefits under federal constitutional or statutory provisions. 89 A.L.R. Fed. 2d 1.

40-6-2. Purpose.

It is the purpose of this chapter to provide public assistance to residents of the state who are in need and who meet the eligibility requirements of the various programs that constitute public assistance. It shall be the responsibility of the department to provide assistance to residents of Rhode Island found by the department to be eligible for assistance in accordance with this chapter and the rules and regulations lawfully promulgated by the department. In that the state has resources to meet the needs of its residents, the department shall determine, upon application, eligibility for those programs financed in whole or in part by the federal government before providing general public assistance as provided in § 40-6-3 .

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-3. General public assistance.

It is the purpose of this section to provide general public assistance to any person who is a resident of the state and who is eligible, in accordance with the rules and regulations of the department, and is in need; provided, further, that benefits under this program shall be provided only to residents who are citizens of the United States or aliens lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law, and benefits shall not be provided to illegal or undocumented aliens. In that there are limited resources available to meet the needs of the residents of this state and recognizing that needs of certain children and families have been provided by this state pursuant to chapter 5.1 of this title, it is the intent of this chapter that general public assistance shall not be provided to any individual who is eligible or who would, but for income and resources, be eligible for cash assistance pursuant to chapter 5.1 of this title and the rules and regulations of the department. General public assistance shall not be available to any individual who has been found eligible for supplemental security income (SSI) as provided in § 40-6-27 , and the general public medical assistance, as provided for in this chapter, shall not be available to any individual who has been found eligible for medical assistance as provided pursuant to Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., as both of these programs are financed in part by the limited resources of this state.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 46, § 1; P.L. 1996, ch. 129, § 11; P.L. 1996, ch. 131, § 11; P.L. 1996, ch. 132, § 11; P.L. 1996, ch. 133, § 11.

Compiler’s Notes.

Chapter 5.1 of this title, referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

40-6-3.1. Eligibility for general public assistance.

  1. The state, acting by and through the department, shall provide assistance (in the form specified in § 40-6-3.2 ) to residents of the state found by the department, in accordance with this chapter and rules and regulations of the department, to be eligible for general public assistance; provided further, that benefits under this program shall be provided only to residents who are citizens of the United States or aliens lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law, and benefits shall not be provided to illegal or undocumented aliens.
  2. Individuals eligible for GPA.
    1. General public assistance shall be provided to the following individuals and families provided all other eligibility requirements of this chapter are met: Individuals age eighteen (18) or older, provided that they do not have a dependent child who is living in his or her home, and provided that they are determined by the department, in accordance with this chapter and departmental regulations, to be suffering from an illness, injury, or medical condition as determined by physical examination by a licensed physician, that is reasonably expected to last for a period of at least thirty (30) days from the date the application for general public assistance is filed with the department and that precludes the individual from working. The illness, injury, or medical condition may be based on a primary diagnosis of alcoholism or substance abuse. The total physical or mental incapacity shall be verified by a medical practitioner and/or a qualified substance abuse counselor designated by the department, within forty-five (45) days of the date the individual is found by the department to be totally incapacitated. If total physical or mental incapacity cannot be reasonably verified, then the individual shall not be eligible for general public assistance under this subsection.
    2. The department shall provide an application for medical assistance (Medicaid) benefits to each applicant for general public assistance and shall use a uniform medical form for both programs to secure information from the applicant’s treating physician. A decision on the application for general public assistance shall be made within thirty (30) days of receipt of a completed application.
    3. Individuals found eligible on the basis of illness, injury, or medical condition under subsection (b) shall be eligible for assistance only in the forms specified in § 40-6-3.2(a)(2) and (a)(3), and only for an initial period of up to six (6) months, renewable for a period of up to an additional six (6) months. In order to receive assistance for a period greater than twelve (12) months, individuals must reapply for general public assistance.
  3. Resources.  Ownership of real or personal property shall disqualify individuals from receiving general public assistance; provided, however, that the following property or resources owned by the individuals shall be exempted:
    1. A home occupied by the individuals;
    2. One motor vehicle having an equity value not exceeding four thousand six hundred fifty dollars ($4,650) or a vehicle necessary to transport a family member with a disability, where the vehicle is specially equipped to meet the specific needs of the person with a disability or if the vehicle is a special type of vehicle that makes it possible to transport the person with the disability;
    3. Cash or liquid assets not exceeding four hundred dollars ($400);
    4. Such tools of the trade not to exceed an aggregate value of one thousand dollars ($1,000) and household furnishings and effects as the director shall determine by regulation.
  4. Income.  (1)(i) Income shall not disqualify an individual from receiving general public assistance provided that the income, as defined and determined by the department, is within the income limitations established by the regulations of the department. (ii) Pursuant to the purposes set forth in § 40-6-3 and notwithstanding the provisions of § 40-6-3.3 [Repealed], individuals found ineligible for cash assistance under chapter 5.1 of this title due to provisions of the chapter regarding alien sponsors, the deeming of alien sponsor income or the deeming of stepparent income, shall not be eligible for general public assistance. (2) Notwithstanding the provisions of § 40-6-3.3 [Repealed], the receipt of lump-sum income shall disqualify an individual from receiving general public assistance. (3) The department shall promulgate rules and regulations regarding the treatment of lump-sum income.
  5. Postsecondary education.  (1) An individual age eighteen (18) or older, attending a school, college, or university as a full-time student or attending a full-time program of vocational or technical training, all beyond the level of secondary education, shall not be eligible for general public assistance under this chapter, excepting, however, those individuals active as students with the department’s vocational rehabilitation programs who have been certified as unemployable by the department.

    (2) Notwithstanding the foregoing prohibition, an individual, age eighteen (18) or older, pursuing a course of study on a part-time basis beyond the level of secondary education, may be eligible for general public assistance, provided the student remains available for and is actively seeking employment, and provided that the individual meets all other eligibility requirements for general public assistance pursuant to this chapter.

  6. Cooperation in applying for SSI and medical assistance.  All applicants and recipients of general public assistance shall, within thirty (30) days of application for general public assistance or notice from the department, be required to apply for and cooperate in the determination for benefits under the federal Supplemental Security Income (SSI) program and/or medical assistance, as provided pursuant to Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., provided the applicant or recipient is determined by the department to be potentially eligible for benefits.
  7. Report of income or resources by recipients.  If, at any time during the receipt of general public assistance, the recipient thereof becomes possessed of income or resources in excess of the amount previously reported by him or her, it shall be his or her duty and a condition of eligibility to notify the department of this fact immediately on the receipt or possession of additional income or resources.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1991, ch. 44, art. 23, § 2; P.L. 1992, ch. 133, art. 46, § 1; P.L. 1993, ch. 138, art. 25, § 1; P.L. 1994, ch. 70, art. 18, § 1; P.L. 1996, ch. 129, § 11; P.L. 1996, ch. 131, § 11; P.L. 1996, ch. 132, § 11; P.L. 1996, ch. 133, § 11; P.L. 1998, ch. 72, § 1.

Compiler’s Notes.

Chapter 5.1 of this title, referred to in subsection (d) of this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

NOTES TO DECISIONS

Due Process.

The department promulgation and enforcement of a rule implementing changes in eligibility requirements under this section without providing the affected class with notice of the new incapacity standards, and without providing persons whose benefits were terminated with individualized notice of the reasons of the termination decision, deprived the class of their benefits under this section without due process of law, contrary to art. 1, § 2 of the Rhode Island Constitution and the Fourteenth Amendment to the United States Constitution.Avanzo v. Rhode Island Dep't of Human Servs., 625 A.2d 208, 1993 R.I. LEXIS 139 (R.I. 1993).

Retroactivity.

The department erroneously counted months prior to the effective date of the 1992 amendments to this section toward the six-month eligibility limit for disability benefits under this section and erroneously gave the statute retroactive effect, given that there was no indication in the language of the amending Act that any such retroactive effect was intended. Only in the event that a statute contains clear and explicit language requiring retroactive application will a statute be interpreted to operate retroactively. Avanzo v. Rhode Island Dep't of Human Servs., 625 A.2d 208, 1993 R.I. LEXIS 139 (R.I. 1993) (decided prior to 1993 amendment).

Collateral References.

Validity, construction, and application of state statutes limiting or barring public health care to indigent aliens. 113 A.L.R.5th 95.

40-6-3.2. Form of assistance.

  1. General public assistance shall be provided in the form of:
    1. Financial assistance payable by check;
    2. Beginning on July 1, 1992, each hospital licensed under chapter 17 of title 23, other than state-operated hospitals, shall provide free services and charity care for reasonable and necessary inpatient and outpatient hospital services as the department by regulation requires to serve all persons seeking services from the hospital who are determined to be eligible for general public assistance. The latter shall be treated as free service and charitable care. Each hospital shall, in addition, continue to provide free services and charitable care to other persons in accordance with each hospital’s charter and mission statement and with §§ 23-17-19.1(13) and 23-17-26 . Eligibility for general public assistance shall be determined by the department of human services. Each hospital required under this section to provide services to individuals eligible for general public assistance shall, upon request of the auditor general of the state, provide the auditor general with information as he or she shall request regarding the services provided. The auditor general shall make annual reports to the finance committees of the Rhode Island house and senate on general public assistance hospital care. The obligations of hospitals under this section shall terminate when vendor payments for hospitals have been restored;
    3. Vendor payment of medical assistance as the department by regulation determines for only the following reasonable and necessary medical services: Outpatient physician services and a limited formulary of prescription drugs to be established by the department, when the services and drugs are provided in, or approved by, an authorized health center, or by such other providers and at such locations as may, from time to time, be designated by the department. No payment shall be made for medical expenses incurred prior to the date the individual makes written application for assistance.
  2. The department is authorized to promulgate rules and regulations to detect and prevent program abuse by recipients and providers of assistance.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1991, ch. 6, art. 11, § 1; P.L. 1991, ch. 44, art. 23, § 3; P.L. 1992, ch. 133, art. 46, § 1; P.L. 1993, ch. 138, art. 25, § 1; P.L. 1994, ch. 70, art. 18, § 1.

40-6-3.3. [Repealed.]

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 46, § 1; P.L. 1994, ch. 70, art. 18, § 1; Repealed by P.L. 1996, ch. 129, § 23, P.L. 1996, ch. 131, § 23, P.L. 1996, ch. 132, § 23 and P.L. 1996, ch. 133, § 23, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6-3.3 concerned amount and standards for general public assistance.

40-6-3.4 — 40-6-3.6. [Repealed.]

Repealed Sections.

Former §§ 40-6-3.4 —40-6-3.6 (P.L. 1987, ch. 118, art. 13, § 2), concerning authorization to pay general public assistance, reimbursement of cities and towns, and reports of expenditures of cities and towns, were repealed by P.L. 1992, ch. 133, art. 46, § 2, effective July 7, 1992.

40-6-3.7. Local welfare offices.

There shall be in each city or town a public welfare office or offices where persons may make application for any type of public assistance, unless the director of the department of human services designates other suitable offices within the state where persons may make application. Suitable quarters for the office shall be provided by cities and towns, and for the expense of maintaining the offices, the cities and towns shall be reimbursed as a general public assistance expense. In situations where, in the judgment of a city or town, the amount of work does not justify the establishment of a local office or where, for other reasons, a city or town does not desire a local office, the state may, with the approval of the cities or towns concerned, establish an office that may serve two (2) or more cities or towns.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1991, ch. 6, art. 11, § 3.

40-6-3.8. [Repealed.]

History of Section. P.L. 1987, ch. 118, art. 13, § 2; Repealed by P.L. 1992, ch. 133, art. 46, § 2, effective July 1, 1992.

Compiler’s Notes.

Former § 40-6-3.8 concerned eligibility for general public assistance to continue secondary level education.

40-6-3.9. [Repealed.]

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 46, § 1; Repealed by P.L. 1993, ch. 138, art. 25, § 2, effective July 1, 1993.

Compiler’s Notes.

Former § 40-6-3.9 concerned general public assistance medical benefits.

40-6-3.10. Funeral and burial expenses.

  1. The department may provide for vendor payment of reasonable funeral and burial expenses of deceased residents of this state who are found eligible in accordance with rules and regulations of the department. The department shall, from time to time, establish cost standards for the reasonable funeral and burial expenses, which cost standards shall establish the maximum amount payable by this department for the expenses and the maximum, total allowable funeral and burial costs. The amount payable under this section shall be determined with due regard to the income and resources of the deceased and his or her legally-liable relatives, if any, and shall be reduced dollar-for-dollar by contributions of friends or other kindred in excess of the maximum total allowable funeral and burial costs established by the department.
  2. Application for payment of funeral and burial expenses shall be made on behalf of a decedent before final funeral arrangements with a funeral director are concluded. Provided, that any legally liable relative and/or agent of the decedent may make an application under this section within thirty (30) days after the death of the decedent.
  3. In determining either eligibility for benefits and/or the amount of any reduction in benefits paid under this section, the department shall exclude any of the following forms of income:
    1. Veterans’ benefits; and/or
    2. Social Security lump-sum benefits.
  4. The department’s standard, basic-allowance payment shall be set at nine hundred dollars ($900).
  5. The amount of the contribution that friends or other kindred, except for legally-liable relatives, may make for upgraded services and merchandise, without affecting eligibility for the basic allowance, shall be set at one thousand six hundred dollars ($1,600).
  6. Whenever the person having custody of an unclaimed deceased body as specified in § 23-18.1-1 contacts the department of human services to report the unclaimed body of a deceased person, the department shall deem this referral as an application of payment for funeral and burial expenses, and the department shall process that application in accordance with the provisions of this section.
  7. In the event that the department determines that the unclaimed deceased body is not eligible for a vendor payment of reasonable funeral and burial expenses because of the availability of the decedent’s assets, the director of the department may nonetheless authorize the burial of the person and he or she may notify the specified funeral home of the existence of the decedent’s assets.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 2000, ch. 365, § 1; P.L. 2000, ch. 470, § 1; P.L. 2004, ch. 201, § 2; P.L. 2004, ch. 350, § 2.

40-6-3.11. “Dependent child” defined.

For purposes of this chapter, the term “dependent child” shall mean a dependent child as defined by Title IV-A of the Social Security Act, 42 U.S.C. § 601 et seq., as amended.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-3.12. Enteral nutrition products.

  1. As used in this section:
    1. “Enteral nutrition” means a supplemental feeding that is provided via the gastrointestinal tract by mouth (orally), or through a tube, catheter, or stoma that delivers nutrients distal to the oral cavity.
    2. “Nutritional risk” means actual or potential for developing malnutrition, as evidenced by clinical indicators, the presence of chronic disease, or increased metabolic requirements due to impaired ability to ingest or absorb food adequately.
  2. The department shall provide for vendor payment of enteral nutrition products, in accordance with rules and regulations of the department, when determined to be medically necessary on an individual, case-by-case basis and ordered by a physician in accordance with Rhode Island department of health form(s) on enteral nutrition products.
  3. Protocols for the use of enteral nutrition as a medically necessary treatment for malabsorption caused by Crohn’s disease, ulcerative colitis, gastroesophageal reflux, chronic intestinal pseudo-obstruction, and inherited diseases of amino acids and organic acids may be developed by the director. The determination of medical necessity for enteral nutrition products shall be based upon a combination of clinical data and the presence of indicators that would affect the relative risks and benefits of the products including, but not limited to:
    1. Enteral nutrition, whether orally or by tube feeding, is used as a therapeutic regimen to prevent serious disability or death in a person with a medically diagnosed condition that precludes the full use of regular food.
    2. The person presents clinical signs and symptoms of impaired digestion malabsorption, or nutritional risk, as indicated by the following anthropometric measures:
      1. Weight loss that presents actual or potential for developing malnutrition, as follows:
        1. In adults, showing involuntary or acute weight loss of greater than, or equal to, ten percent (10%) of usual body weight during a three-(3) to six-month (6) period, or body mass index (bmi) below 18.5 kg/m2;
        2. In neonates, infants, and children, showing:
          1. Very low birth weight (lbw), even in the absence of gastrointestinal, pulmonary, or cardiac disorders;
          2. A lack of weight gain, or weight gain less than two (2) standard deviations below the age-appropriate mean in a one-month period for children under six (6) months, or two-month (2) period for children aged six (6) to twelve (12) months;
          3. No weight gain or abnormally slow rate of gain for three (3) months for children older than one year, or documented weight loss that does not reverse promptly with instruction in appropriate diet for age; or
          4. Weight for height less than the tenth (10th) percentile; and
      2. Abnormal laboratory test pertinent to the diagnosis.
    3. The risk factors for actual or potential malnutrition have been identified and documented. Risk factors include, but are not limited to, the following:
      1. Anatomic structures of the gastrointestinal tract that impair digestion and absorption;
      2. Neurological disorders that impair swallowing or chewing;
      3. Diagnosis of inborn errors of metabolism that require medically necessary formula used for specific metabolic conditions and food products modified low in protein (for example, phenylketonuria (pku) tyrosinemia, homocystinuria, maple syrup urine disease, propionic aciduria and methylmalonic aciduria);
      4. Prolonged nutrient losses due to malabsorption syndromes or short-bowel syndromes, diabetes, celiac disease, chronic pancreatitis, renal dialysis, draining abscess, or wounds, etc.;
      5. Treatment with anti-nutrient or catabolic properties (for example, anti-tumor treatments, corticosteroids, immunosuppressant, etc.);
      6. Increased metabolic and/or caloric needs due to excessive burns, infection, trauma, prolonged fever, hyperthyroidism, or illnesses that impair caloric intake and/or retention; or
      7. A failure-to-thrive diagnosis that increases caloric needs while impairing caloric intake and/or retention.
    4. A comprehensive medical history and a physical examination have been conducted to detect factors contributing to nutritional risk.
    5. Enteral nutrition is indicated as the primary source of nutritional support essential for the management of risk factors that impair digestion or malabsorption, and for the management of surgical preparation or postoperative care.
    6. A written plan of care has been developed for regular monitoring of signs and symptoms to detect improvement in the person’s condition. Nutritional status should be monitored regularly:
      1. For improvements in anthropometric measures;
      2. For improvements in laboratory test indicators; and
      3. In children, to assess growth and weight for height.
  4. Enteral nutrition products shall not be considered medically necessary under certain circumstances including, but not limited to, the following:
    1. A medical history and physical examination have been performed and other possible alternatives have been identified to minimize nutritional risk.
    2. The person is underweight, but has the ability to meet nutritional needs through the use of regular food consumption.
    3. Enteral products are used as supplements to a normal or regular diet in a person showing no clinical indicators of nutritional risk.
    4. The person has food allergies, lactose intolerance, or dental problems, but has the ability to meet his or her nutritional requirements through an alternative food source.
    5. Enteral products are to be used for dieting or a weight-loss program.
    6. No medical history or physical examination has been taken and there is no documentation that supports the need for enteral nutrition products.

History of Section. P.L. 2008, ch. 253, § 5; P.L. 2014, ch. 269, § 5; P.L. 2014, ch. 519, § 5.

40-6-4. [Repealed.]

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 47, § 1; P.L. 1993, ch. 138, art. 25, § 1; Repealed by P.L. 1996, ch. 129, § 12, P.L. 1996, ch. 131, § 12, P.L. 1996, ch. 132, § 12, and P.L. 1996, ch. 133, § 12, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6-4 concerned aid to families with dependent children.

40-6-4.1. Ineligibility for aid or assistance — Commitment to training school or adult correctional institutions.

In the event that any child is committed to the training school or adult correctional institutions, and the child’s parent(s) or qualifying relative are receiving or are eligible for aid to families with dependent children (AFDC) as provided pursuant to § 40-6-4 [repealed], Title IV-A of the Social Security Act, 42 U.S.C. § 601 et seq., and the rules and regulations of the department, the eligibility of the parent(s) or qualifying relative for AFDC benefits for the child who is placed in the training school shall be suspended during the time the child is committed. The department of children, youth and families or department of corrections shall provide a list or computer compilation to the department of human services, on a monthly basis, that shall identify the name, and if available, the date of birth and social security number of each child committed to the training school or adult correctional institutions, and the name of the parent(s) or qualifying relative, of each child committed to the training school or adult correctional institutions. Notwithstanding the provisions of § 42-72-8 , all information provided by this section shall remain confidential and shall be used only for the purposes of this section. Nothing in this section shall be construed to suspend the eligibility of the parent(s) or qualifying relative for AFDC benefits for any children not committed to the training school or adult correctional institutions.

History of Section. P.L. 1996, ch. 269, § 1.

40-6-5. [Repealed.]

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 48, § 1; P.L. 1992, ch. 133, art. 99, § 1; Repealed by P.L. 1996, ch. 129, § 12, P.L. 1996, ch. 131, § 12, P.L. 1996, ch. 132, § 12, and P.L. 1996, ch. 133, § 12, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6-5 concerned amount and standards of aid to families with dependent children.

40-6-5.1. [Repealed.]

History of Section. P.L. 1988, ch. 129, art. 26, § 1; Repealed by P.L. 1996, ch. 129, § 12, P.L. 1996, ch. 131, § 12, P.L. 1996, ch. 132, § 12, and P.L. 1996, ch. 133, § 12, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6-5.1 concerned employment search as part of AFDC program.

40-6-5.2. Cashing of AFDC, GPA checks.

  1. For the purposes of this section, the term “banking institution” shall mean: (1) Any state or federally chartered bank, savings bank, loan and investment bank, or credit union located within this state; and (2) Any currency-exchange specialist located within this state and enrolled with the department of human services pursuant to regulations to be adopted by the department.
  2. Each banking institution shall cash, at its main office or any of its branch offices within the state, any check drawn by the state and payable within the state to a recipient of aid to families with dependent children (AFDC) or general public assistance (GPA), if the check is negotiated to the banking institution by the original payee of the check, and if the payee produces reasonable identification required by this section and as provided for in regulations adopted pursuant to subsection (d) hereof.
  3. Nothing in this section shall be interpreted as limiting any rights the banking institution may have against the payee by contract or at law, with regard to items that are negotiated to it as provided for in this section, that are not paid upon presentment, or where the payee breaches a warranty made under § 6A-3-417 . This section shall not apply to any check negotiated to a banking institution if the institution has reason to believe that the check will not be paid on presentment or that the tendering party may be in breach of one or more of the warranties contained in § 6A-3-417 .
  4. Provided that a banking institution properly employed the identification procedures prescribed in regulations adopted pursuant to this subsection at the time an AFDC or GPA check was cashed by such institution, the state shall honor and make payment on the AFDC or GPA check, and the banking institution shall not be liable to reimburse the state for a loss incurred as a result of the wrongful payment of a check by the banking institution. The director of the department of human services shall adopt regulations specifying: (1) The forms of reasonable identification that a banking institution shall accept when cashing an AFDC or GPA check pursuant to subsection (b); and (2) The identification procedures the institution must employ to receive payment thereon and to avoid liability for the wrongful payment of any such check. The regulations shall provide that the forms of reasonable identification shall include, but need not be limited to: (i) An AFDC or GPA photo-identification card issued by the department of human services; (ii) A valid identification card issued by the administrator of the division of motor vehicles pursuant to § 3-8-6 ; (iii) A valid driver’s license; (iv) An identification card issued by the office of healthy aging; and (v) A valid identification card issued by the United States Immigration and Naturalization Service.
  5. The department of human services shall issue a stop-payment order with respect to any AFDC or GPA check reported as lost, stolen, or undelivered. The department of human services shall not issue a replacement AFDC or GPA check for a period of three (3) business days from the date of the report of such loss, theft, or nondelivery.

History of Section. P.L. 1991, ch. 120, § 1; P.L. 1993, ch. 63, § 1.

40-6-5.3. [Repealed.]

History of Section. P.L. 1993, ch. 244, § 1; P.L. 1995, ch. 370, art. 22, § 3; Repealed by P.L. 1996, ch. 129, § 12, P.L. 1996, ch. 131, § 12, P.L. 1996, ch. 132, § 12, and P.L. 1996, ch. 133, § 12, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6-5.3 concerned AFDC medical assistance and managed care program.

40-6-6. Authorization to pay assistance.

Authorization to pay all forms of assistance specified in this chapter shall be made by representatives of the department, and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for payments upon receipt by him or her of proper vouchers approved by the department.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 46, § 1.

40-6-7. [Repealed.]

History of Section. P.L. 1987, ch. 118, art. 14, § 2; Repealed by P.L. 1990, ch. 65, art. 26, § 2, effective July 1, 1990.

Compiler’s Notes.

Former § 40-6-7 concerned supplemental security income.

40-6-7.1. Expanded eligibility for pregnant women and young children.

With respect to pregnant women and with respect to children under the age of five (5), the state hereby adopts the optional expanded income and resource eligibility standards set forth in amendments to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq. Pregnant women and children up to the age of five (5), in accordance with federal regulation, whose income is greater than the AFDC standard but less than the federal poverty level, are hereby declared to be eligible for medical assistance under this chapter.

History of Section. P.L. 1987, ch. 463, § 1; P.L. 1996, ch. 129, § 11; P.L. 1996, ch. 131, § 11; P.L. 1996, ch. 132, § 11; P.L. 1996, ch. 133, § 11.

40-6-7.2. Presumptive eligibility for pregnant women.

With respect to pregnant women, the state hereby adopts the optional presumptive-eligibility program set forth in amendments to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq. The department of human services is hereby directed to prepare the necessary forms and give the necessary training to providers of prenatal care to enable the providers to participate in the presumptive-eligibility program pursuant to the above-referenced federal laws. The director of the department of human services is authorized to promulgate such regulations as may be necessary to implement the presumptive-eligibility program.

History of Section. P.L. 1987, ch. 463, § 1.

40-6-8. Supplemental nutrition assistance program (SNAP).

  1. The department shall have the responsibility to administer the food stamp program for the state in compliance with the provisions of the federal Food Stamp Act of 1964, as amended, 7 U.S.C. § 2011 et seq. The supplemental nutrition assistance program (SNAP) is and shall be the new title of the program formerly known as the food stamp program. All references in the Rhode Island general laws to food stamps shall be deemed to mean, apply to, refer to, and be interpreted in accordance with the supplemental nutrition assistance program (SNAP).
  2. The department is empowered and authorized to submit its plan for food stamps to the federal government, or any agency or department of it. The department shall act for the state in any negotiations relative to the submission and approval of a plan, and may make any arrangement or changes in its plan not inconsistent with this chapter that may be required by the Food Stamp Act or the rules and regulations promulgated pursuant to it to obtain and retain such approval and to secure for this state the benefits of the provisions of the federal act relating to food stamps. The department shall make reports to the federal government, or any agency or department of it, in the form and nature required by it, and in all respects comply with any request or direction of the federal government, or any agency or department of it, that may be necessary to assure the correctness and verification of the reports.
  3. The department is authorized and directed to pay one hundred percent (100%) of the state’s share of the administrative cost involved in the operation of the food stamp program.
  4. No person shall be ineligible for food stamp benefits due solely to the restricted eligibility rules otherwise imposed by § 115(a)(2) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. No. 104-193), 21 U.S.C. § 862a(a)(2), and as this section may hereafter be amended.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1997, ch. 30, art. 34, § 2; P.L. 2002, ch. 65, art. 26, § 1; P.L. 2004, ch. 595, art. 25, § 4; P.L. 2010, ch. 181, § 1; P.L. 2010, ch. 186, § 1.

Collateral References.

Liability of state or federal government for losses associated with distribution of food stamps. 116 A.L.R. Fed. 457.

Selection and suspension or disqualification of participating stores under Food Stamp Act of 1964 (7 U.S.C. § 2011 et seq.). 121 A.L.R. Fed. 653.

Violations and enforcement of Food Stamp Act of 1964 (7 U.S.C. § 2011 et seq.). 120 A.L.R. Fed. 331.

40-6-8.1. Prohibited uses of electronic benefit transfer cards.

  1. The department shall adopt rules prohibiting purchases with cash assistance funds held on electronic benefit transfer cards in venues as described in this section.
  2. The department is hereby empowered, and shall maintain policies and practices as necessary, to prohibit cash assistance provided under this chapter from being used in any electronic benefit transfer transaction at:
    1. Liquor stores (holding solely a retailers class A license);
    2. Casinos or at facilities that conduct casino gaming as defined in chapter 61.2 of title 42;
    3. Gambling facilities as defined by chapter 9 of title 41;
    4. Retail establishments that provide adult-oriented entertainment in which performers disrobe or perform in an unclothed state for entertainment as defined in the Social Security Act, 42 U.S.C. § 608(a).
  3. Eligible recipients of direct-cash assistance, who use cash assistance funds held on electronic benefit transfer cards in such establishments, shall, for a first offense, have their cash assistance reduced for one month by the portion of the family’s benefit attributable to one parent, in accordance with rules and regulations promulgated by the department; for a second offense, have their cash assistance reduced for three (3) months by the portion of the family’s benefit attributable to one parent, in accordance with rules and regulations promulgated by the department; and for a third offense, shall be disqualified from the direct-cash assistance program for a period of one year.
  4. A store owner who commits fraud against the department of human services by violating § 11-41-34 , and who also possesses a license to sell alcoholic beverages under chapter 7 of title 3, shall be referred to the appropriate licensing authority for possible disciplinary action pursuant to title 3.
  5. A store owner who commits fraud against the department of human services by violating § 11-41-34 , and who also possesses a license to sell lottery tickets under chapter 61 of title 42, shall be referred to the director of the state lottery for possible disciplinary action.

History of Section. P.L. 2016, ch. 377, § 1; P.L. 2016, ch. 499, § 1.

40-6-9. Assignment and subrogation for recovery of child, spousal and medical support rights.

  1. An applicant for or recipient of public assistance under this chapter, or under Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., for and on behalf of himself or herself and for and on behalf of a child or children, shall be deemed, without the necessity of signing any document for purposes of recovery, to have made an assignment and given a right of subrogation to the executive office of health and human services and/or the department of human services, as applicable, of any and all rights and interests in any cause of action, past, present, or future, that the applicant or recipient may have against any person failing to, or obligated to, provide for the support, maintenance, and medical care of the applicant, recipient, and/or minor child or children, for the period of time that assistance is being paid by the executive office of health and human services and/or the department. The executive office of health and human services and/or the department shall be subrogated to any and all rights, title, and interest the applicant or recipient may have against any and all property belonging to the obligated or non-supporting person in the enforcement of any claim for child, spousal, and medical support, whether liquidated through court order or not. The applicant or recipient shall also be deemed, without the necessity of signing any document, to have appointed the executive office of health and human services and/or the department of human services as his or her true and lawful attorney in fact to act in his or her name, place, and stead to perform the specific act of instituting suit to establish paternity or secure support and medical care; collecting any and all amounts due and owing for child, spousal, and medical support; endorsing any and all drafts, checks, money orders, or other negotiable instruments representing support payments that are received by the executive office of health and human services and/or the department; and retaining any portion thereof permitted under federal and state statutes as reimbursement for financial, medical, and any other assistance previously paid to or for the recipient, child, or children.
  2. An applicant for, or a recipient of, medical assistance provided by the executive office of health and human services and/or the department pursuant to this chapter or chapter 8 of this title or Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., for and on behalf of himself or herself, and for and on behalf of any other person for whom he or she may legally assign rights to any medical support or any other medical care, shall be deemed, without the necessity of signing any document for purposes of reimbursement, to have made an assignment and given a right of subrogation to the executive office of health and human services and/or the department of human services of any and all rights and interests that he, she, or such other person may have: (1) To payment for any medical support; and (2) To any payment from any third party that has a legal liability to pay for care and services available and provided to the applicant or recipient. The executive office of health and human services and/or the department of human services shall, in accordance with this section and all applicable state and federal laws, be entitled to any payments by a third party to recover costs from the full amount of an applicant’s or recipient’s liability settlement(s). For this purpose, the executive office of health and human services may place a lien against an applicant’s or recipient’s liability settlement(s).
  3. In addition to the assignments and subrogation rights provided in subsections (a) and (b) of this section, an applicant for, or a recipient of, financial assistance provided by the executive office of health and human services and/or department pursuant to this chapter, whenever the assistance is necessary by reason of accident, injury, or illness for which a third party may be liable, for and on behalf of himself or herself, and for and on behalf of any other person for whom he or she may legally act, shall be deemed, without the necessity of signing any document, to have assigned and subrogated to the executive office of health and human services and/or the department of human services, from amounts recovered or recoverable from any third party, an amount of money equal to the amount of financial assistance provided as a result of the accident, illness, or injury.
  4. With respect to an assignment and subrogation rights established pursuant to this section, an applicant or recipient shall provide to the executive office of health and human services and/or the department of human services all relevant information regarding the assigned and subrogated rights, and shall execute any documents relating thereto, in accordance with rules and regulations to be adopted by the executive office of health and human services and/or the department.
  5. With respect to any assignment and subrogation rights for medical or financial support or other recoveries under this section, the executive office of health and human services and/or the department of human services shall be considered to have acquired the rights of the individual to payment by any third party for the medical care and support, financial support, and other recoveries.
  6. An applicant for, or a recipient of, medical assistance provided by the executive office of health and human services in accordance with chapter 8 of this title shall also be subject to the provisions of chapter 57.1 of title 27. Funds available to be paid for the payment of child support shall supersede any payment made pursuant to this chapter and chapter 57.1 of title 27.
  7. The executive office of health and human services and/or the department of human services shall, in accordance with this section and all applicable state and federal laws, be entitled to any payments by a third party to recover costs from the full amount of an applicant’s or recipient’s liability settlement(s). For this purpose, the executive office of health and human services may place a lien against an applicant’s or recipient’s liability settlement(s). Nothing in these sections shall limit the executive office of health and human services and/or the department of human services from recovery, to the extent of the distribution, in accordance with all state and federal laws.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1995, ch. 99, § 2; P.L. 1996, ch. 129, § 20; P.L. 1996, ch. 131, § 20; P.L. 1996, ch. 132, § 20; P.L. 1996, ch. 133, § 20; P.L. 2012, ch. 241, art. 11, § 4; P.L. 2014, ch. 145, art. 19, § 2.

NOTES TO DECISIONS

Reimbursement.

The Department of Human Services was not entitled to reimbursement from the proceeds of a lump-sum workers’ compensation settlement for prior financial assistance paid to an injured employee when the employee had been ineligible to collect workers’ compensation benefits. Tibbetts v. Stanley Bostitch, Inc., 706 A.2d 925, 1998 R.I. LEXIS 23 (R.I. 1998).

40-6-9.1. Data matching — Healthcare coverages.

  1. For purposes of this section, the term “medical assistance program” shall mean medical assistance provided in whole or in part by the department of human services pursuant to chapters 5.1, 8, 8.4 of this title, 12.3 of title 42 and/or Title XIX or XXI of the federal Social Security Act, as amended, 42 U.S.C. § 1396 et seq. and 42 U.S.C. § 1397aa et seq., respectively. Any references to the department shall be to the department of human services.
  2. In furtherance of the assignment of rights to medical support to the department of human services under § 40-6-9(b) , (c), (d), and (e), and in order to determine the availability of other sources of healthcare insurance or coverage for beneficiaries of the medical assistance program, and to determine potential third-party liability for medical assistance paid out by the department, all health insurers, health-maintenance organizations, including managed care organizations, and third-party administrators, self-insured plans, pharmacy benefit managers (PBM), and other parties that are by statute, contract, or agreement, legally responsible for payment of a claim for a healthcare item of service doing business in the state of Rhode Island shall permit and participate in data matching with the department of human services, as provided in this section, to assist the department to identify medical assistance program applicants, beneficiaries, and/or persons responsible for providing medical support for applicants and beneficiaries who may also have healthcare insurance or coverage in addition to that provided, or to be provided, by the medical assistance program and to determine any third-party liability in accordance with this section. The department shall take all reasonable measures to determine the legal liability of all third parties (including health insurers, self-insured plans, group health plans (as defined in § 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. § 1167(1)]), service benefit plans, health-maintenance organizations, managed care organizations, pharmacy benefit managers, or other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a healthcare item or service), to pay for care and services on behalf of a medical assistance recipient, including collecting sufficient information to enable the department to pursue claims against such third parties. In any case where such a legal liability is found to exist and medical assistance has been made available on behalf of the individual (beneficiary), the department shall seek reimbursement for the assistance to the extent of the legal liability and in accordance with the assignment described in § 40-6-9 . To the extent that payment has been made by the department for medical assistance to a beneficiary in any case where a third party has a legal liability to make payment for the assistance, and to the extent that payment has been made by the department for medical assistance for healthcare items or services furnished to an individual, the department (state) is considered to have acquired the rights of the individual to payment by any other party for the healthcare items or services in accordance with § 40-6-9 . Any health insurer (including a group health plan, as defined in § 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. § 1167(1)], a self-insured plan, a service-benefit plan, a managed care organization, a pharmacy benefit manager, or other party that is, by statute, contract, or agreement, legally responsible for payment of a claim for a healthcare item or service), in enrolling an individual, or in making any payments for benefits to the individual or on the individual’s behalf, is prohibited from taking into account that the individual is eligible for, or is provided, medical assistance under a plan under 42 U.S.C. § 1396 et seq. for this state, or any other state.
  3. All health insurers, including, but not limited to, health-maintenance organizations, third-party administrators, nonprofit medical-service corporations, nonprofit hospital-service corporations, subject to the provisions of chapters 18, 19, 20, and 41 of title 27, as well as, self-insured plans, group health plans (as defined in § 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. § 1167(1)]), service-benefit plans, managed care organizations, pharmacy benefit managers, or other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a healthcare item or service) doing business in this state shall:
    1. Provide member information within fourteen (14) calendar days of the request to the department to enable the medical assistance program to identify medical assistance program recipients, applicants and/or persons responsible for providing medical support for those recipients and applicants who are, or could be, enrollees or beneficiaries under any individual or group health insurance contract, plan, or policy available or in force and effect in the state;
    2. With respect to individuals who are eligible for, or are provided, medical assistance by the department, upon the request of the department, provide member information within fourteen (14) calendar days of the request to determine during what period the individual or his or her spouse or dependents may be (or may have been) covered by a health insurer and the nature of the coverage that is, or was provided by the health insurer (including the name, address, and identifying number of the plan);
    3. Accept the state’s right of recovery and the assignment to the state of any right of an individual or other entity to payment from the party for an item or service for which payment has been made by the department;
    4. Respond to any inquiry by the department regarding a claim for payment for any healthcare item or service that is submitted not later than three (3) years after the date of the provision of the healthcare item or service; and
    5. Agree not to deny a claim submitted by the state based solely on procedural reasons, such as on the basis of the date of submission of the claim, the type or format of the claim form, or a failure to present proper documentation at the point-of-sale that is the basis of the claim, if—
      1. The claim is submitted by the state within the three-year (3) period beginning on the date on which the item or service was furnished; and
      2. Any action by the state to enforce its rights with respect to the claim is commenced within six (6) years of the state’s submission of such claim.
  4. This information shall be made available by these insurers and health-maintenance organizations and used by the department of human services only for the purposes of, and to the extent necessary for, identifying these persons, determining the scope and terms of coverage, and ascertaining third-party liability. The department of human services shall provide information to the health insurers, including health insurers, self-insured plans, group health plans (as defined in § 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. § 1167(1)]), service-benefit plans, managed care organizations, pharmacy benefit managers, or other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a healthcare item or service) only for the purposes described herein.
  5. No health insurer, health-maintenance organization, or third-party administrator that provides, or makes arrangements to provide, information pursuant to this section shall be liable in any civil or criminal action or proceeding brought by beneficiaries or members on account of this action for the purposes of violating confidentiality obligations under the law.
  6. The department shall submit any appropriate and necessary state plan provisions.
  7. The department of human services is authorized and directed to promulgate regulations necessary to ensure the effectiveness of this section.

History of Section. P.L. 2002, ch. 65, art. 35, § 3; P.L. 2007, ch. 73, art. 18, § 4; P.L. 2008, ch. 100, art. 17, § 15.

Compiler’s Notes.

Chapter 5.1 of this title, referred to in subsection (a) of this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

40-6-10. Effect of assistance on receipt of workers’ compensation benefits.

  1. No individual shall be entitled to receive assistance provided under this chapter or chapter 5.1 of this title and/or medical assistance under chapter 8 of this title for any period beginning on or after July 1, 1982, with respect to which benefits are paid or payable to individuals under any workers’ compensation law of this state, any other state, or the federal government, on account of any disability caused by accident or illness. In the event that workers’ compensation benefits are subsequently awarded to an individual with respect to which the individual has received assistance payments under this chapter or chapter 5.1 of this title and/or medical assistance under chapter 8 of this title, then the executive office of health and human services shall be subrogated to the individual’s rights in the award to the extent of the amount of the payments and/or medical assistance paid to or on behalf of the individuals.
  2. Whenever an employer or insurance carrier has been notified by the executive office of health and human services that an individual is an applicant for, or a recipient of, assistance payments under this chapter or chapter 5.1 of this title, and/or medical assistance under chapter 8 of this title, for a period during which the individual is or may be eligible for benefits under the workers’ compensation act, chapters 29 — 38 of title 28, the notice shall constitute a lien in favor of the executive office of health and human services, upon any pending award, order, or settlement to the individual under the workers’ compensation act. The employer, or his or her insurance carrier, shall be required to reimburse the executive office of health and human services the amount of the assistance payments and/or medical assistance paid to or on behalf of the individual for any period for which an award, order, or settlement is made.
  3. Whenever an individual becomes entitled to or is awarded workers’ compensation for the same period with respect to which the individual has received assistance payments under this chapter or chapter 5.1 of this title and/or medical assistance under chapter 8 of this title, and whenever notice of the receipt of assistance payments has been given to the division of workers’ compensation of the department of labor and training of this state and/or the workers’ compensation commission, the division or commission is hereby required to and shall incorporate, in any award, order, or approval of settlement, an order requiring the employer or his or her insurance carrier to reimburse the executive office of health and human services the amount of the assistance payments and/or medical assistance paid to, or on behalf of, the individual for the period for which an award, order, or settlement is made.
  4. Any claims or payments to a recipient of medical assistance provided by the executive office of health and human services in accordance with chapter 8 of this title shall also be subject to the provisions of § 28-33-27 . Funds available to be paid for the payment of child support shall supersede any payment made pursuant to this chapter and chapter 57.1 of title 27.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1996, ch. 129, § 20; P.L. 1996, ch. 131, § 20; P.L. 1996, ch. 132, § 20; P.L. 1996, ch. 133, § 20; P.L. 2012, ch. 241, art. 11, § 4; P.L. 2020, ch. 79, art. 1, § 27.

Compiler’s Notes.

Chapter 5.1 of this title, referred to throughout this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

NOTES TO DECISIONS

Reimbursement.

The Department of Human Services was not entitled to reimbursement from the proceeds of a lump-sum workers’ compensation settlement for prior financial assistance paid to an injured employee when the employee had been ineligible to collect workers’ compensation benefits. Tibbetts v. Stanley Bostitch, Inc., 706 A.2d 925, 1998 R.I. LEXIS 23 (R.I. 1998).

40-6-11. Report of income by recipients.

If at any time during the continuance of public assistance pursuant to this chapter and/or chapter 8 of this title, the recipient thereof becomes possessed of income or resources in excess of the amount previously reported by him or her, it shall be his or her duty, and a condition of eligibility, to notify the department providing assistance of this fact immediately on the receipt or possession of additional income or resources.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-12. Records as to assistance.

  1. All records pertaining to the administration of public assistance pursuant to this chapter and chapter 8 of this title are hereby declared to constitute confidential matter. It shall be unlawful for any person to make use of, or cause to be used, any information contained in records for purposes not directly connected with the administration thereof, except with the consent of the individual concerned.
  2. The director of the department shall have the power to establish rules and regulations governing the custody, use, and preservation of the records, papers, files, and communications dealing with the administration of public assistance. The rules and regulations shall have the same force and effect as law. The records shall be produced in response to subpoena duces tecum properly issued by any federal or state court; provided, however, that the purpose for which the subpoena is sought is directly connected with the administration of public assistance. No subpoena shall be issued by a court asking either for the records, or for persons having custody or access to the records, unless the litigation involved in such matters is directly connected with the administration of public assistance.
  3. Any person, who by law is entitled to a list of individuals receiving any of the assistance as provided in this section, shall not publish, or cause to be published, the list except by the express consent of the director of the department, or to make use thereof for purposes not directly connected with the administration thereof. Any person violating any of the provisions of this section, or the lawful rules and regulations made pursuant to this section, shall be guilty of a misdemeanor, and shall be fined not more than two hundred dollars ($200) or shall be imprisoned for not more than six (6) months, or both.
  4. Nothing in this section shall be deemed to prohibit the director of the department, or his or her agents duly authorized for that purpose, from issuing any statistical material or data, or publishing, or causing the data to be published, whenever he or she shall deem it to be in the public interest. The director of the department may inquire into the records of any state department or agency in the course of his or her administration of public assistance.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1997, ch. 326, § 127; P.L. 2006, ch. 216, § 17.

40-6-12.1. Warrants — Release of information.

  1. The department of human services shall provide to the statewide warrant squad the current address of any individual if all of the following conditions are met:
    1. There is an outstanding arrest warrant or body attachment issued by a state court in Rhode Island for the individual; and
    2. The individual is a fugitive felon as defined by the department in accordance with 42 U.S.C. § 608(a)(9); and
    3. The individual is receiving general public assistance, or cash assistance under chapter 5.1 of this title either for himself or herself or his or her dependents; and
    4. The law enforcement officer seeking the information certifies in writing that an attempt by the warrant squad to locate and apprehend that individual has been unsuccessful; and
    5. The warrant squad provides the department the name, date of birth, and social security number of the individual.
  2. If all the above conditions are met, the department shall release the address upon the request and certification of the officer, and a release pursuant to this section shall not constitute a violation of §§ 40-6-12 , 40-5.1-31 [repealed], or 38-2-2(4) .

History of Section. P.L. 1991, ch. 300, § 1; P.L. 1996, ch. 129, § 21; P.L. 1996, ch. 131, § 21; P.L. 1996, ch. 132, § 21; P.L. 1996, ch. 133, § 21.

Compiler’s Notes.

Chapter 5.1 of this title, referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

40-6-13. Appeals — Hearings.

  1. Any applicant or recipient aggrieved because of a decision by the department or delay in making a decision shall be entitled to an appeal and shall be afforded reasonable notice and opportunity for a hearing. Hearings with respect to public assistance shall be conducted by the department.
  2. With respect to general public assistance benefits, advance notice of the department’s intended action to deny, terminate, reduce, or suspend benefits shall be in writing and mailed to an applicant or recipient at his or her last known or designated address at least ten (10) day(s) prior to the effective date of its intended action; the recipient shall be afforded an administrative hearing to contest the department’s intended action; provided, that the applicant or recipient makes a written request for a hearing and provided that the written request is received by the department within ten (10) days of the mailing date of the department’s notice to the applicant or recipient; and provided further, that the department shall continue payment of general public-assistance benefits, pending a hearing, to a recipient who includes a written request for continuation of benefits in or with the recipient’s timely filed written request for a hearing in accordance with this subsection.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1993, ch. 138, art. 25, § 1.

Collateral References.

Propriety of telephone testimony or hearings in public welfare proceedings. 88 A.L.R.4th 1094.

40-6-14. Assistance not assignable — Exemption from process.

Public assistance provided under this chapter shall not be transferable or assignable, at law or in equity, and none of the money paid or payable under this chapter shall be subject to execution, levy, attachment, garnishment, or other legal process, or to the operation of any bankruptcy or insolvency law.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 1992, ch. 133, art. 46, § 1.

40-6-15. Fraudulently obtaining assistance.

Any person who by any fraudulent device obtains, or attempts to obtain, or aids or abets any person to obtain, public assistance, pursuant to this chapter, to which he or she is not entitled, or who willfully fails to report income or resources as provided in this chapter, shall be guilty of larceny and, upon conviction thereof, shall be punished by imprisonment of not more than five (5) years or by a fine of not more than one thousand dollars ($1,000), or both, if the value of the public assistance to which he or she is not entitled shall exceed five hundred dollars ($500); or by imprisonment by less than one year or by a fine of not more than five hundred dollars ($500), or by both, if the value of the public assistance to which he or she is not entitled shall not exceed five hundred dollars ($500).

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

NOTES TO DECISIONS

In General.

In a case charging defendant with fraudulently obtaining public assistance under R.I. Gen. Laws § 40-6-15 , the trial court properly denied defendant’s motion for mistrial after a Department of Human Services investigator testified that defendant’s family owned timeshares, because the trial court gave a curative instruction and found that the jurors understood the instruction to disregard statement and could follow that instruction. State v. LaPlante, 962 A.2d 63, 2009 R.I. LEXIS 9 (R.I. 2009).

40-6-16. Fraudulent use of food stamps.

  1. Any person who by any fraudulent device obtains, or attempts to obtain, or aids or abets any person to obtain, food stamps issued pursuant to the Food Stamp Act of 1964, as amended, 7 U.S.C. § 2011 et seq., shall be guilty of larceny, and upon conviction thereof, shall be punished by imprisonment of not more than five (5) years or by fine of not more than one thousand dollars ($1,000), or both, if the value of the food stamps to which one is not entitled shall exceed five hundred dollars ($500); or by imprisonment by less than one year or by a fine of not more than five hundred dollars ($500), or both, if the value of the food stamps to which one is not entitled, shall not exceed five hundred dollars ($500).
  2. Upon conviction of the felony or misdemeanor, the individual shall be ineligible to participate in the food stamp program for not less than six (6) and not more than twenty-four (24) months, as determined by the court; provided, that the disqualification applies only to the individual so convicted and does not render the entire household ineligible for the program.

History of Section. P.L. 1987, ch. 118, art. 13, § 2; P.L. 2006, ch. 216, § 17.

40-6-17. Receipt and use of federal funds.

The state shall have authority to receive and expend through the department any funds that may become available from the federal government for public assistance purposes. The department, with the approval of the governor, shall have authority to meet federal requirements with respect to the administration of funds as may be set forth as conditions precedent to receiving the federal funds.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-18. Agreements with other states.

The department shall have the authority to enter into reciprocal agreements with other states and territories of the United States providing for the payment of assistance to former residents of this state residing in other states.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-19. Complainant in actions to invoke penalties.

The director of the department, or any person designated by him or her, may be the party complainant to any complaint and warrant brought to invoke the penalties provided for in this chapter, and the party complainant shall be exempt from giving surety for costs in any action.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-20. Prosecution of criminal actions.

All criminal actions for any violation of this chapter, or any rule or regulation promulgated under this chapter pertaining to the department, shall be prosecuted by the attorney general or by any qualified member of the Rhode Island bar who shall be designated by the director and approved by the attorney general to institute and prosecute such actions.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-21. Child support — Income tax refund offset.

The department is authorized and directed to promulgate rules and regulations to implement the federal and state programs for offset and collection of past-due child and spousal support from income tax refunds, as authorized by Sections 6305(b) and 6402(c) of the Internal Revenue Code, 26 U.S.C. §§ 6305(b) and 6402(c), and implementing regulations, and as authorized by chapter 30.1 of title 44. The rules and regulations shall provide the child support obligor with an opportunity for an administrative hearing to contest the offset.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-21.1. Voluntary acknowledgement of paternity — Hospital-based program.

  1. The department of human services is authorized and directed to establish, in accordance with the requirements of Title IV-D, § 466(a)(5) of the Social Security Act, 42 U.S.C. § 666(a)(5), a hospital-based program for the voluntary acknowledgement of paternity during the period immediately preceding or following the birth of a child. The department of human services shall require all public and private birthing hospitals in this state, as defined herein, to participate in the hospital-based paternity acknowledgement program and to provide the services, materials, and reports as may be required by federal law and regulations. The program must be operational in hospitals no later than January 1, 1995. The department is authorized to promulgate rules and regulations necessary to implement the hospital-based program and to enter into cooperative agreements with other state agencies to effectuate the program.
  2. The requirement for participation in the program by hospitals is in addition to the birth-registration requirements under chapter 3 of title 23; provided, however, that the department of human services shall work in cooperation with the department of health, registrar of vital records, to avoid duplication of obligations imposed on hospitals to the extent permitted by federal law and regulations.
  3. The term “birthing hospital” means a hospital that has a licensed obstetric care unit or is licensed to provide obstetric services, or a licensed birthing center associated with a hospital. A birthing center is a facility outside a hospital that provides maternity services.

History of Section. P.L. 1994, ch. 236, § 3.

40-6-21.2. Child medical support garnishment — State income tax offset.

  1. The department of human services may garnish the wages, salary, or other income of, and withhold amounts from state income tax refunds due to, any person who:
    1. Is required by court or administrative order to provide coverage of the cost of health services to a child eligible for medical assistance under chapter 8 of this title and Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.; and
    2. Has received payment from a third party for the costs of the services but has not used the payments to reimburse either the other parent or guardian of the child or the provider of the services, to the extent necessary to reimburse the department of human services for its costs, but claims for current and past-due child support shall take priority over these claims.
  2. Garnishment proceedings may be commenced and enforced in the family court under chapters 5, 8, 9, 11 [repealed], 13, 15, and 16 of title 15.
  3. Withholding from state income tax refunds shall be enforced in accordance with chapter 30.1 of title 44.

History of Section. P.L. 1994, ch. 237, § 3.

Compiler’s Notes.

Chapter 11 of title 15, referred to in subsection (b) of this section, was repealed effective January 1, 1997. For comparable provisions, see § 15-23.1-101 et seq.

40-6-22. Disclosure of information — Penalty.

  1. For purposes of this section, a “financial institution” means a bank, savings bank, national bank, trust company, building and loan association, loan and investment company, credit union, safe deposit company, any person or corporation registered to sell securities under the provisions of chapter 11 of title 7, or federal savings and loan institution authorized to do business under the laws of this state.
  2. A financial institution, upon written request or upon request made by computer file on magnetic tape, signed or submitted by an authorized employee of the department of human services, shall inform the department of the amount deposited in the financial institution to the credit of a person named in, or otherwise identified in, the request as an applicant for, or recipient of, public assistance under this chapter or chapter 8 of this title. Upon the request, the financial institution shall provide the requested deposit information, in writing or by computer file on magnetic tape, to the department of human services within sixty (60) days from the receipt of the request. The department shall not submit its information request by computer file on magnetic tape to a financial institution that does not maintain deposit information on computer files, and the financial institution shall not be required to provide deposit information by computer file on magnetic tape.
  3. A financial institution shall be subject to a penalty of one hundred dollars ($100) for each willful failure to provide the department with the requested information. The department may recover the penalty by civil action in any court of competent jurisdiction.
  4. The department of human services may disclose information obtained pursuant to this section to an agency or department of another state administering a public assistance program, provided that the department of human services has executed a reciprocal agreement with the agency or department for the reciprocal disclosure of deposit information.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-23. Release of wage and earnings information.

  1. Notwithstanding any other provisions of law, every employer or payor of earnings shall make available to the department, upon written request by the department, any wage or earnings information in its possession, regarding an employee, former employee, or person providing goods or services who is a recipient, an applicant, or former recipient for assistance under the provisions of this chapter.
  2. Any employer or payor who refuses to make available wage or earnings information shall be guilty of a misdemeanor, and shall be fined not more than five hundred dollars ($500) or shall be imprisoned for not more than six (6) months, or both.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-24. Recipient not deemed pauper.

No person receiving assistance under this chapter shall be deemed a pauper for purposes of chapter 5 of this title by reason thereof.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-25. Rules and regulations.

The department is authorized to prescribe forms and promulgate rules and regulations that it deems necessary in order to effectuate the intent and provisions of this chapter. Furthermore, it is the legislative intent of the general assembly that the authority granted in this chapter to the department to promulgate rules and regulations, with respect to eligibility for assistance, amount, and standards of assistance and administration of programs, be liberally construed.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-26. Severability.

If any provision in any section of this chapter, or the application thereof, to any person or circumstances is held invalid, its invalidity does not affect other provisions or applications of the chapter that can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 1987, ch. 118, art. 13, § 2.

40-6-27. Supplemental Security Income.

    1. The director of the department is hereby authorized to enter into agreements on behalf of the state with the Secretary of the Department of Health and Human Services or other appropriate federal officials, under the Supplemental Security Income (SSI) program established by Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., concerning the administration and determination of eligibility for SSI benefits for residents of this state, except as otherwise provided in this section. The state’s monthly share of supplementary assistance to the Supplemental Security Income program shall be as follows:
      1. Individual living alone:$39.92
      2. Individual living with others:$51.92
      3. Couple living alone:$79.38
      4. Couple living with others:$97.30
      5. Individual living in state-licensed assisted-living residence:$332.00
      6. [Deleted by P.L. 2021, ch. 162, art. 12, § 1.]
      7. Individual living in state-licensed supportive residential-care settings that, depending on the population served, meet the standards set by the department of human services in conjunction with the department of children, youth and families, the office of healthy aging, and/or the department of behavioral healthcare, developmental disabilities and hospitals: $300.00.

        Provided, however, that the department of human services shall, by regulation, reduce, effective January 1, 2009, the state’s monthly share of supplementary assistance to the Supplemental Security Income (SSI) program for each of the above-listed payment levels, by the same value as the annual federal cost of living adjustment to be published by the federal Social Security Administration in October 2008 and becoming effective on January 1, 2009, as determined under the provisions of Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq.; and provided further, that it is the intent of the general assembly that the January 1, 2009, reduction in the state’s monthly share shall not cause a reduction in the combined federal and state payment level for each category of recipients in effect in the month of December 2008; provided further, that the department of human services is authorized and directed to provide for payments to recipients in accordance with the above directives.

    2. As of July 1, 2010, state supplement payments shall not be federally administered and shall be paid directly by the department of human services to the recipient.
    3. Individuals living in institutions shall receive a twenty-dollar ($20.00) per-month personal needs allowance from the state that shall be in addition to the personal needs allowance allowed by the Social Security Act, 42 U.S.C. § 301 et seq.
    4. Individuals living in state-licensed supportive residential-care settings and assisted-living residences who are receiving SSI supplemental payments under this section shall be allowed to retain a minimum personal needs allowance of fifty-five dollars ($55.00) per month from their SSI monthly benefit prior to payment of any monthly fees in addition to any amounts established in an administrative rule promulgated by the secretary of the executive office of health and human services for persons eligible to receive Medicaid-funded long-term services and supports in the settings identified in subsection (a)(1)(v).
    5. The department is authorized and directed to make a determination of the medical need and whether a setting provides the appropriate services for those persons who:
      1. Have applied for or are receiving SSI, and who apply for admission to supportive residential-care settings and assisted-living residences on or after October 1, 1998; or
      2. Who are residing in supportive residential-care settings and assisted-living residences, and who apply for or begin to receive SSI on or after October 1, 1998.
    6. The process for determining medical need required by subsection (a)(5) of this section shall be developed by the executive office of health and human services in collaboration with the departments of that office and shall be implemented in a manner that furthers the goals of establishing a statewide coordinated long-term-care entry system as required pursuant to the Medicaid section 1115 waiver demonstration.
    7. To assure access to high-quality, coordinated services, the executive office of health and human services is further authorized and directed to establish certification or contract standards that must be met by those state-licensed supportive residential-care settings, including adult supportive-care homes and assisted-living residences admitting or serving any persons eligible for state-funded supplementary assistance under this section. The certification or contract standards shall define:
      1. The scope and frequency of resident assessments, the development and implementation of individualized service plans, staffing levels and qualifications, resident monitoring, service coordination, safety risk management and disclosure, and any other related areas;
      2. The procedures for determining whether the certifications or contract standards have been met; and
      3. The criteria and process for granting a one-time, short-term good-cause exemption from the certification or contract standards to a licensed supportive residential-care setting or assisted-living residence that provides documented evidence indicating that meeting, or failing to meet, the standards poses an undue hardship on any person eligible under this section who is a prospective or current resident.
    8. The certification or contract standards required by this section shall be developed in collaboration by the departments, under the direction of the executive office of health and human services, so as to ensure that they comply with applicable licensure regulations either in effect or in development.
  1. The department is authorized and directed to provide additional assistance to individuals eligible for SSI benefits for:
    1. Moving costs or other expenses as a result of an emergency of a catastrophic nature, which is defined as a fire or natural disaster; and
    2. Lost or stolen SSI benefit checks or proceeds of them; and
    3. Assistance payments to SSI-eligible individuals in need because of the application of federal SSI regulations regarding estranged spouses; and the department shall provide the assistance in a form and amount that the department shall by regulation determine.

History of Section. P.L. 1987, ch. 578, § 1; P.L. 1989, ch. 93, § 1; P.L. 1990, ch. 65, art. 26, § 1; P.L. 1991, ch. 240, § 4; P.L. 1992, ch. 133, art. 53, § 1; P.L. 1998, ch. 31, art. 15, § 2; P.L. 1998, ch. 427, § 2; P.L. 1999, ch. 217, § 2; P.L. 2002, ch. 65, art. 35, § 1; P.L. 2003, ch. 103, art. 3, § 1; P.L. 2008, ch. 100, art. 26, § 1; P.L. 2009, ch. 68, art. 18, § 1; P.L. 2010, ch. 23, art. 3, § 1; P.L. 2011, ch. 151, art. 23, § 1; P.L. 2015, ch. 141, art. 5, § 8; P.L. 2016, ch. 511, art. 1, § 18; P.L. 2019, ch. 88, art. 13, § 3; P.L. 2021, ch. 162, art. 12, § 1, effective July 1, 2021.

Federal Act References.

Section 1115 of the Social Security Act, referred to in this section, is codified as 42 U.S.C. § 1315.

40-6-27.1. Supplementary cash assistance program for severely disabled and elderly residents.

  1. There is hereby established a cash assistance program for disabled and elderly legal immigrant residents of the state who received a state supplementary assistance payment under § 40-6-27 on July 1, 1997, who are in need, and who become ineligible after July 1, 1997, for federally funded assistance under the Supplemental Security Income program, Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., due solely to the restricted eligibility rules imposed by § 402(a)(1) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub. L. No. 104-193) [8 U.S.C. § 1612], and as such section may hereafter be amended.
  2. Benefits under this program shall be provided only to residents specified in subsection (a) who are aliens lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law and benefits shall not be provided to illegal or undocumented aliens.
  3. The income and resource rules, methodologies, and limits shall be the same as those in the Supplemental Security Income program, Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq.
  4. The monthly amount of cash assistance shall be equal to the appropriate payment standard as provided in subsection (e) minus the countable income of the recipient in that month.
  5. The department is authorized and directed to make monthly payments of cash assistance to eligible recipients in accordance with the following standards of assistance:
    1. Institutionalized individuals, forty dollars ($40.00) per month;
    2. All other individuals, two hundred dollars ($200) per month.
  6. Individuals who are receiving a state supplementary assistance payment under § 40-6-27 on July 1, 1997, and who become ineligible for benefits under the Supplemental Security Income program, Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq., due solely to their immigrant status shall be deemed eligible for supplementary cash assistance under this section and shall begin to receive payment in the month following the last month in which supplemental security income benefits under § 40-6-27 are received.
  7. The department is directed to promulgate regulations to implement the supplementary cash assistance program including provisions relating to the determination of eligibility, and providing recipients with advanced, written notification of a decision to reduce or terminate benefits. Any notice of a decision to reduce or terminate benefits shall include an explanation of the reasons therefore, and the notice shall advise the recipient of a right to appeal under the administrative procedures act, § 42-35-1 et seq.

History of Section. P.L. 1997, ch. 30, art. 34, § 3; P.L. 2006, ch. 216, § 17.

40-6-27.2. Supplementary cash assistance payment for certain Supplemental Security Income recipients.

There is hereby established a $206 monthly payment for disabled and elderly individuals who, on or after July 1, 2012, receive the state supplementary assistance payment for an individual in a state-licensed assisted-living residence under § 40-6-27 and further reside in an assisted-living facility that is not eligible to receive funding under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq.

History of Section. P.L. 2012, ch. 241, art. 18, § 5; P.L. 2014, ch. 145, art. 15, § 1; P.L. 2015, ch. 141, art. 5, § 8; P.L. 2016, ch. 511, art. 1, § 18; P.L. 2019, ch. 88, art. 13, § 3; P.L. 2021, ch. 162, art. 12, § 1, effective July 1, 2021.

40-6-28. Interim cash assistance for individuals with disabilities.

  1. Interim cash assistance payments shall be provided to individuals determined by the director, or his or her designee, to have applied for and to have been approved for medical assistance (“Medicaid”) under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., and to have applied for and to be pursuing a claim for Supplemental Security Income benefits under Title XVI of the Social Security Act, 42 U.S.C. § 1381 et seq.
  2. Interim cash assistance payments shall continue until the recipient of the payments receives disability benefits from the Social Security Administration, or until he or she has exhausted available administrative appeals. The individual may be required to present documentation that he or she is actively pursuing his or her claim.
  3. The department is authorized and directed to make payments of interim cash assistance to eligible recipients hereunder up to the standards of assistance established pursuant to § 40-6-3.3 [Repealed], and subject to the limits of the annual appropriation provided in subsection (f). In the event that the annual appropriation provided for in subsection (f) is not adequate for the provision of interim cash assistance payments to eligible individuals, the director is authorized to limit the amount and duration of the payments.
  4. The department is authorized to determine income- and resource-eligibility limits for the interim cash assistance program, provided that the limits shall be no stricter than those established pursuant to § 40-6-3.1 .
  5. The department is directed to promulgate regulations to implement the interim cash assistance program, including provisions to ensure recoupment of cash assistance by the state upon a determination of a recipient’s eligibility for SSI benefits by the Social Security Administration.
  6. Out of the sum appropriated to the department of human services for general public assistance for the state fiscal year ending June 30, 1996, the sum of four hundred thousand dollars ($400,000), net of recoveries of disability benefits from the Social Security Administration, shall be used solely for the purposes and subject to the limitations as provided in this section, and the state controller is hereby authorized and directed to draw his or her order upon the general treasurer for the payment of such sums or such portions thereof as may be required from time to time upon receipt by him or her of duly authenticated vouchers. The director is authorized to request appropriations for subsequent state fiscal years, as he or she deems necessary to carry out the purposes of this section.

History of Section. P.L. 1995, ch. 370, art. 19, § 2; P.L. 1997, ch. 326, § 127; P.L. 1999, ch. 83, § 95; P.L. 1999, ch. 130, § 95.

40-6-29. Healthcare benefits — Employers — Discrimination against public assistance recipients.

  1. No employer in the state who shall hire, contract with, or employ an individual (hereinafter “recipient”) who has been determined eligible to receive public assistance or medical assistance under chapters 6 and 5.1 and 8.4 of this title, or chapter 12.3 of title 42 and/or Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., shall discriminate against the recipient(s) on the basis that the recipient(s) receive healthcare coverage as an element of their eligibility under those chapters and act.
  2. The department of human services is hereby authorized and directed to amend its regulations and any appropriate state plan(s) pursuant to the federal Social Security Act, 42 U.S.C. § 301 et seq., to provide for imposition of a fine on the failure of any employer to comply with the requirements of this section.
  3. The amount of the fine imposed by subsection (b) of this section shall be equal to one hundred dollars ($100) for each day for each individual for which the failure occurs.
  4. No fine shall be imposed by subsection (b) if:
    1. The failure was due to reasonable cause and not willful neglect; and
    2. The failure is corrected during the thirty-day (30) period (or such period as the director of the department of human services may determine appropriate) beginning on the first day any of the individuals upon whom the fine is imposed know, or exercising reasonable diligence would have known, that the failure existed. In the case of a failure due to reasonable cause and not to willful neglect, the director may waive part or all of the fine imposed by subsection (a) to the extent that the payment of the fine would be excessive relative to the failure involved.
  5. No employer may refuse to provide employee data information lawfully requested by the department of human services about specific employees whom the department had determined eligible, or is in the process of determining eligibility, to receive public healthcare benefits.
  6. As used in this section, the term “group health plan” has the meaning given the term in § 5000(b)(1) of the Internal Revenue Code of 1986, 26 U.S.C. § 5000(b)(1).
  7. A group health plan offered by an employer:
    1. May not take into account, for any item or services to be furnished to a recipient at the time the recipient is covered under the plan by reason of the current employment of that recipient (or the recipient’s spouse), that the recipient is entitled to healthcare coverage as an element of their eligibility; and
    2. Shall provide that any recipient, and any recipient’s spouse and minor dependents, shall be entitled to the same benefits under the plan under the same conditions as any employee, and the spouse and dependents of the employee.
  8. It is unlawful for an employer to offer any financial or other incentive for a recipient not to enroll (or to terminate enrollment) under a group health plan, unless the incentive is also offered to all individuals who are eligible for coverage under the plan. Any entity that violates the previous sentence is subject to a civil money penalty not to exceed five thousand dollars ($5,000) for each violation, which may be imposed by the department of human services.

History of Section. P.L. 1996, ch. 129, § 17; P.L. 1996, ch. 131, § 17; P.L. 1996, ch. 132, § 17; P.L. 1996, ch. 133, § 17; P.L. 1998, ch. 31, art. 33, § 2; P.L. 2020, ch. 79, art. 1, § 27.

Compiler’s Notes.

Chapter 5.1 of this title, referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

Chapter 6.1 Work Training Program

40-6.1-1. Work training program.

There is hereby created a work training program to augment the general public assistance program created pursuant to § 40-6-8 .

History of Section. P.L. 1979, ch. 410, art. 4, § 1.

40-6.1-2. Participation requirement — Assignment of work.

As provided in this chapter, employable persons receiving financial support from the state shall be required to participate in the work training program and to perform such work as may be assigned to them by the director of the department of human services (hereinafter called the “director”), or his or her designee. The director shall assign such work as is available in connection with the affairs of the state, and all of the several cities and towns participating in the general public assistance program (GPA) shall be required to provide work-training opportunities for residents of their respective cities and towns who receive GPA support. The director shall determine if the work is suitable and whether the GPA recipient is able to perform the work. Notwithstanding the foregoing, the recipients shall not be utilized in any work position to replace or perform work ordinarily performed by regular employees of any department or agency of state or municipal government, nor to replace or perform work ordinarily performed by a craft or trade person in private employment.

History of Section. P.L. 1979, ch. 410, art. 4, § 1; P.L. 1997, ch. 326, § 128; P.L. 2020, ch. 79, art. 1, § 28.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-6.1-3. Work hours.

No recipient shall be required to work in excess of eight (8) hours per day, nor in excess of forty (40) hours per week. The actual number of work-training hours required shall be determined by dividing the total grant of the recipient received under the general public assistance program (GPA), by the then-prevailing minimum wage. The grant of each recipient shall then be increased by the amount of thirty dollars ($30.00) per week, or a portion thereof proportionate to the number of hours actually worked compared to a standard forty-hour (40) week. The increase shall be considered to result from the recipient’s participation in the program, and shall be included in determining the number of hours to be worked.

History of Section. P.L. 1979, ch. 410, art. 4, § 1.

40-6.1-4. Ineligibility of nonparticipants for support.

Should any recipient fail, without good cause, to participate in the work training program, the recipient shall be determined to be ineligible for support under the general public assistance program (GPA). In case the recipient is a parent of minor children, then that portion of his or her grant attributable to the parent shall be removed from the grant, and the director shall take whatever action he or she deems appropriate under the nonsupport provisions of chapter 9 of title 15.

History of Section. P.L. 1979, ch. 410, art. 4, § 1.

40-6.1-5. Rules and regulations.

The director shall promulgate rules and regulations as are necessary to determine the employability of the general public assistance program (GPA) recipients, the conditions for employment under the work training program, and other regulations needed to effectuate the provisions of this chapter.

History of Section. P.L. 1979, ch. 410, art. 4, § 1.

40-6.1-6. Additional expenditures and manpower requirements.

Any additional expenditures or manpower required to administer the work training program shall be borne within the existing budget of the department of human services.

History of Section. P.L. 1979, ch. 410, art. 4, § 1.

40-6.1-7. Severability.

If any provision in any article of this chapter or the application thereof to any person or circumstance is held invalid, its invalidity does not affect other provisions or applications of the chapter that can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 1979, ch. 410, art. 8, § 1.

Chapter 6.2 Child Care — State Subsidies

40-6.2-1. [Repealed.]

History of Section. P.L. 1983, ch. 144, § 1; P.L. 1986, ch. 488, § 1; P.L. 1988, ch. 490, § 1; P.L. 1989, ch. 171, § 1; Repealed by P.L. 1996, ch. 129, § 23, P.L. 1996, ch. 131, § 23, P.L. 1996, ch. 132, § 23 and P.L. 1996, ch. 133, § 23, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6.2-1 concerned subsidies for low-income family child care.

40-6.2-1.1. Rates established.

  1. Through June 30, 2015, subject to the payment limitations in subsection (c), the maximum reimbursement rates to be paid by the departments of human services and children, youth and families for licensed childcare centers and licensed family childcare providers shall be based on the following schedule of the 75th percentile of the 2002 weekly market rates adjusted for the average of the 75th percentile of the 2002 and the 2004 weekly market rates:

    Click to view

    Effective July 1, 2015, subject to the payment limitations in subsection (c), the maximum reimbursement rates to be paid by the departments of human services and children, youth and families for licensed childcare centers and licensed family childcare providers shall be based on the above schedule of the 75th percentile of the 2002 weekly market rates adjusted for the average of the 75th percentile of the 2002 and the 2004 weekly market rates. These rates shall be increased by ten dollars ($10.00) per week for infant/toddler care provided by licensed family childcare providers and license-exempt providers and then the rates for all providers for all age groups shall be increased by three percent (3%). For the fiscal year ending June 30, 2018, licensed childcare centers shall be reimbursed a maximum weekly rate of one hundred ninety-three dollars and sixty-four cents ($193.64) for infant/toddler care and one hundred sixty-one dollars and seventy-one cents ($161.71) for preschool-age children.

  2. Effective July l, 2018, subject to the payment limitations in subsection (c), the maximum infant/toddler and preschool-age reimbursement rates to be paid by the departments of human services and children, youth and families for licensed childcare centers shall be implemented in a tiered manner, reflective of the quality rating the provider has achieved within the state’s quality rating system outlined in § 42-12-23.1 .
    1. For infant/toddler child care, tier one shall be reimbursed two and one-half percent (2.5%) above the FY 2018 weekly amount, tier two shall be reimbursed five percent (5%) above the FY 2018 weekly amount, tier three shall be reimbursed thirteen percent (13%) above the FY 2018 weekly amount, tier four shall be reimbursed twenty percent (20%) above the FY 2018 weekly amount, and tier five shall be reimbursed thirty-three percent (33%) above the FY 2018 weekly amount.
    2. For preschool reimbursement rates, tier one shall be reimbursed two and one-half (2.5%) percent above the FY 2018 weekly amount, tier two shall be reimbursed five percent (5%) above the FY 2018 weekly amount, tier three shall be reimbursed ten percent (10%) above the FY 2018 weekly amount, tier four shall be reimbursed thirteen percent (13%) above the FY 2018 weekly amount, and tier five shall be reimbursed twenty-one percent (21%) above the FY 2018 weekly amount.
  3. [Deleted by P.L. 2019, ch. 88, art. 13, § 4.]
  4. By June 30, 2004, and biennially through June 30, 2014, the department of labor and training shall conduct an independent survey or certify an independent survey of the then-current weekly market rates for child care in Rhode Island and shall forward the weekly market rate survey to the department of human services. The next survey shall be conducted by June 30, 2016, and triennially thereafter. The departments of human services and labor and training will jointly determine the survey criteria including, but not limited to, rate categories and sub-categories.
  5. In order to expand the accessibility and availability of quality child care, the department of human services is authorized to establish, by regulation, alternative or incentive rates of reimbursement for quality enhancements, innovative or specialized child care, and alternative methodologies of childcare delivery, including nontraditional delivery systems and collaborations.
  6. Effective January 1, 2007, all childcare providers have the option to be paid every two (2) weeks and have the option of automatic direct deposit and/or electronic funds transfer of reimbursement payments.
  7. Effective July 1, 2019, the maximum infant/toddler reimbursement rates to be paid by the departments of human services and children, youth and families for licensed family childcare providers shall be implemented in a tiered manner, reflective of the quality rating the provider has achieved within the state’s quality rating system outlined in § 42-12-23.1 . Tier one shall be reimbursed two percent (2%) above the prevailing base rate for step 1 and step 2 providers, three percent (3%) above prevailing base rate for step 3 providers, and four percent (4%) above the prevailing base rate for step 4 providers; tier two shall be reimbursed five percent (5%) above the prevailing base rate; tier three shall be reimbursed eleven percent (11%) above the prevailing base rate; tier four shall be reimbursed fourteen percent (14%) above the prevailing base rate; and tier five shall be reimbursed twenty-three percent (23%) above the prevailing base rate.
  8. Through December 31, 2021, the maximum reimbursement rates paid by the departments of human services, and children, youth and families to licensed childcare centers shall be consistent with the enhanced emergency rates provided as of June 1, 2021, as follows: Click to view The maximum reimbursement rates paid by the departments of human services, and children, youth and families to licensed family childcare providers shall be consistent with the enhanced emergency rates provided as of June 1, 2021, as follows: Click to view
    1. Effective January 1, 2022, the maximum reimbursement rates to be paid by the departments of human services and children, youth and families for licensed childcare centers shall be implemented in a tiered manner, reflective of the quality rating the provider has achieved within the state’s quality rating system outlined in § 42-12-23.1 . Maximum weekly rates shall be reimbursed as follows: Click to view The maximum reimbursement rates for licensed family childcare providers paid by the departments of human services, and children, youth and families is determined through collective bargaining. The maximum reimbursement rates for infant/toddler and preschool age children paid to licensed family childcare providers by both departments is implemented in a tiered manner that reflects the quality rating the provider has achieved in accordance with § 42-12-23.1 .

75th LICENSED PERCENTILE CHILDCARE OF WEEKLY CENTERS MARKET RATE INFANT $182.00 PRESCHOOL $150.00 SCHOOL-AGE $135.00 LICENSED 75th FAMILY PERCENTILE CHILDCARE OF WEEKLY PROVIDERS MARKET RATE INFANT $150.00 PRESCHOOL $150.00 SCHOOL-AGE $135.00

Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 Infant/Toddler $257.54 $257.54 $257.54 $257.54 $273.00 Preschool Age $195.67 $195.67 $195.67 $195.67 $260.00 School Age $200.00 $200.00 $200.00 $200.00 $245.00

Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 Infant/Toddler $224.43 $224.43 $224.43 $224.43 $224.43 Preschool Age $171.45 $171.45 $171.45 $171.45 $171.45 School Age $162.30 $162.30 $162.30 $162.30 $162.30

LICENSED CHILDCARE CENTERS Tier One Tier Two Tier Three Tier Four Tier Five Infant/Toddler $236.36 $244.88 $257.15 $268.74 $284.39 Preschool $207.51 $212.27 $218.45 $223.50 $231.39 School-Age $180.38 $182.77 $185.17 $187.57 $189.97

History of Section. P.L. 1987, ch. 546, § 1; P.L. 1992, ch. 163, § 1; P.L. 1996, ch. 129, § 13; P.L. 1996, ch. 131, § 13; P.L. 1996, ch. 132, § 13; P.L. 1996, ch. 133, § 13; P.L. 1997, ch. 30, art. 34, § 4; P.L. 1998, ch. 31, art. 11, § 3; P.L. 2004, ch. 595, art. 27, § 1; P.L. 2005, ch. 117, art. 10, § 1; P.L. 2006, ch. 246, art. 14, § 1; P.L. 2006, ch. 601, § 1; P.L. 2006, ch. 612, § 1; P.L. 2007, ch. 73, art. 15, § 1; P.L. 2008, ch. 100, art. 27, § 1; P.L. 2015, ch. 141, art. 17, § 1; P.L. 2018, ch. 47, art. 15, § 7; P.L. 2019, ch. 88, art. 13, § 4; P.L. 2021, ch. 162, art. 13, § 7, effective July 6, 2021.

Applicability.

P.L. 2004, ch. 595, art. 27, § 2, provides that the amendment to this section by that act takes effect upon passage [July 30, 2004] and applies to payments to child care providers for child care services rendered on and after June 6, 2004. Any rules or regulations necessary or advisable to implement the provisions of the amendment shall be effective immediately as an emergency rule upon the department’s filing thereof with the secretary of state as it is found that the current fiscal crisis in this state has caused an imminent peril to public health, safety and welfare, and the department is exempted from the requirements of §§ 42-35-3(b) and 42-35-4(b)(2) relating to agency findings of imminent peril to public health, safety and welfare and the filing of statements of the agency’s reasons thereof.

40-6.2-2. [Repealed.]

History of Section. P.L. 1983, ch. 144, § 1; P.L. 1986, ch. 488, § 1; Repealed by P.L. 1996, ch. 129, § 14, P.L. 1996, ch. 131, § 14, P.L. 1996, ch. 132, § 14, and P.L. 1996, ch. 133, § 14, effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Compiler’s Notes.

Former § 40-6.2-2 concerned rules and regulations.

40-6.2-3. [Repealed.]

History of Section. P.L. 1983, ch. 144, § 1; P.L. 1984, ch. 255, § 1; G.L. 1956, § 40-6.2-3 ; Repealed by P.L. 1986, ch. 488, §§ 1, 2, effective June 25, 1986.

Compiler’s Notes.

Former § 40-6.2-3 concerned a program report.

40-6.2-4, 40-6.2-5. [Repealed.]

Repealed Sections.

These sections (P.L. 1996, ch. 129, § 18; P.L. 1996, ch. 131, § 18; P.L. 1996, ch. 132, § 18; P.L. 1996, ch. 133, § 18; P.L. 1998, ch. 31, art. 11, § 4; P.L. 1999, ch. 480, § 1; P.L. 2000, ch. 55, art. 9, § 1; P.L. 2001, ch. 77, art. 9, § 1; P.L. 2002, ch. 65, art. 22, § 1; P.L. 2005, ch. 117, art. 10, § 1), concerning healthcare coverage for family daycare providers and healthcare coverage for center-based care providers, were repealed by P.L. 2008, ch. 9, art. 13, § 1, effective July 1, 2008.

Chapter 6.3 Bonus Program

40-6.3-1. Bonus program.

The director of human services (hereinafter referred to as the “director”) shall implement a cash bonus program for one year for welfare recipients who have been receiving aid to families with dependent children (AFDC) for a period of at least thirty (30) consecutive months next prior to the effective date of this chapter. The recipients agree to forego all welfare benefits of whatever nature and return to full-time employment, except any medical assistance coverage in conformity with rules and regulations promulgated by the director. The program shall be limited to the first one hundred (100) recipients who choose to participate and are otherwise qualified. Applications for the bonus program will be accepted commencing thirty (30) days after the start of the state’s fiscal year and terminating ninety (90) days after the start of the state’s fiscal year or as soon as the first one hundred (100) recipients have been qualified for acceptance into the program.

History of Section. P.L. 1985, ch. 247, § 1.

40-6.3-2. Disbursement of bonus.

  1. The director is hereby authorized to approve a maximum bonus for each qualified recipient in the sum of three thousand dollars ($3,000). The amount shall be distributed as follows:
    1. After the recipient completes three (3) months of continuous, full-time employment, the director shall distribute to each recipient the sum of five hundred dollars ($500);
    2. After the recipient completes six (6) months of continuous, full-time employment, the director shall distribute to each recipient the additional sum of seven hundred fifty dollars ($750);
    3. After the recipient completes nine (9) months of continuous, full-time employment, the director shall distribute to each recipient the additional sum of seven hundred fifty dollars ($750); and
    4. After the recipient completes twelve (12) months of continuous, full-time employment, the director shall distribute to each recipient the additional sum of one thousand dollars ($1,000).
  2. In the event any recipient becomes unemployed at any time during the program, the recipient shall forfeit receipt of any incremental payment of a bonus not fully earned at the time of unemployment.

History of Section. P.L. 1985, ch. 247, § 1.

40-6.3-3. Initial training and work experience.

A participant in this program shall be required to participate in an eight-week (8) period of training and work experience. The period shall not be included when determining the time of disbursement as set forth in § 40-6.3-2 . The training and work experience period may be “on-the-job” training conducted by the employer or other training and work experience as authorized by the director. A participant in this program shall be paid, at the least, the state minimum wage during the eight-week (8) period of training and work experience.

History of Section. P.L. 1985, ch. 247, § 1.

40-6.3-4. Private participation.

  1. Any employer who participates in this program shall be entitled to a two hundred fifty dollar ($250) tax credit per participant when a participant has worked twenty-four (24) consecutive months for the employer. The eight-week (8) period of training and work experience set forth in § 40-6.3-3 shall not count when determining the twenty-four (24) consecutive months.
  2. During the eight-week (8) training and work-experience period, the state shall subsidize the employer for wages earned by the participant. The rate of subsidy shall not exceed the state minimum wage.
  3. The employer shall, as soon as possible, place the participant on any medical plan or insurance provided by the employer to any other employee at the same or similar level.

History of Section. P.L. 1985, ch. 247, § 1.

40-6.3-5. Rules and regulations.

The director shall promulgate rules and regulations as are necessary to determine the qualifications for the recipients to participate in this pilot program; for determining the standards relating to “continuous employment”; for determining the conditions terminating participation resulting from a recipient’s unemployment; for subsidizing the wage of participants; for determining the type of eight-week (8) period of training and work experience; for transitional medical assistance; and to otherwise effectuate this bonus program.

History of Section. P.L. 1985, ch. 247, § 1.

40-6.3-6. Appropriation.

There is hereby appropriated the sum of two hundred fifty thousand dollars ($250,000) to carry out the purpose of this chapter, and the state controller is hereby directed to draw his or her orders upon the general treasurer for the payment of the sum, or so much thereof as may be required, from time to time, upon receipt by him or her of vouchers duly authenticated.

History of Section. P.L. 1985, ch. 247, § 1.

Chapter 6.4 Incentive for Training and Employment

40-6.4-1. Short title.

This chapter shall be known and may be cited as the “Rhode Island Incentive for Training and Employment Act” (RIITE).

History of Section. P.L. 1987, ch. 280, § 1.

40-6.4-2. Definitions.

As used in this chapter, the following terms shall have the following meanings:

  1. “AFDC” means aid to families with dependent children.
  2. “Department” means the state department of human services.
  3. “Director” means the director of the department of human services.
  4. “Person with disabilities” means an individual who is under a physical or mental impairment that constitutes a substantial barrier to employment and who either is: (i) Receiving any form of state or federal aid, or (ii) Has a household income below the federal poverty level.

History of Section. P.L. 1987, ch. 280, § 1; P.L. 1999, ch. 83, § 96; P.L. 1999, ch. 130, § 96.

40-6.4-3. Program established.

The director, in consultation with the director of the division of vocational rehabilitation, shall establish a three-year (3) demonstration work-preparation and supportive work-employment program to place AFDC recipients and people with disabilities in private-sector employment. At least one-third (1/3) of the supportive work-employment program costs shall be covered by payment for services by the participating private employers. The program shall include the use of grant diversion to enable the director to provide all or part of the AFDC or other federal grant to an employer to cover part of the cost of wages paid to the recipient. The program shall also seek all available federal and private funds. The director shall seek federal approval, including waivers of applicable federal regulations as are necessary, to conduct the demonstration program for AFDC recipients and people with disabilities, using grant diversion. The demonstration program shall test the effectiveness of a supported work grant-diversion program in placing AFDC recipients and handicapped persons in long-term employment at wage levels and with advancement potential sufficient to permit economic self-sufficiency and permanent removal from AFDC or other government aid.

History of Section. P.L. 1987, ch. 280, § 1; P.L. 1999, ch. 83, § 96; P.L. 1999, ch. 130, § 96.

40-6.4-4. Program voluntary — Elements of program.

The program shall serve both those AFDC recipients and people with disabilities who are ready to work and those who are potentially able to work given adequate support and job-readiness training. Participation in the program shall be strictly voluntary in all respects. The demonstration program shall include the following elements:

  1. Provisions for referral and outreach, that will ensure the participation of those who are ready to work and those who require job-readiness training;
  2. Utilization of the current system of supportive services, such as job-readiness training, child care, transportation, and transitional medical benefits, provided through the department of human services or other applicable provider agencies; and
  3. An evaluation component to provide accountability and replicability, to demonstrate the cost-effectiveness of the supported work grant-diversion model, and to enable comparison with other work models.

History of Section. P.L. 1987, ch. 280, § 1; P.L. 1999, ch. 83, § 96; P.L. 1999, ch. 130, § 96.

40-6.4-5. Recruitment, assessment, training, and referral of program candidates.

  1. The director shall contract with one or more government agencies or nonprofit community-based organizations for the purpose of recruitment, screening, assessment, job-readiness preparation, and referral to supportive work. The government agencies or private organizations shall have a demonstrated record of service to AFDC recipients and/or people with disabilities, and shall have experience in conducting outreach and recruitment, intake and assessment of clients, and providing job-readiness training. The organizations shall:
    1. Recruit, screen and assess the job-readiness skills of AFDC recipients and persons with disabilities for the supported work program;
    2. Where appropriate, provide job-readiness skills training for program participants, including, but not limited to, remedial reading, writing, and mathematics skills training; and
    3. Refer appropriate candidates for work in the supported work program.
  2. At least one-third (1/3) of the participants referred to and placed in the supported work program shall currently be enrolled in employment readiness training and referred from a nonprofit, community-based organization or from other organizations certified by the director as conducting appropriate job-readiness training.

History of Section. P.L. 1987, ch. 280, § 1; P.L. 1999, ch. 83, § 96; P.L. 1999, ch. 130, § 96.

40-6.4-6. Program operator.

  1. The director shall contract with a program operator to place participants in private-sector employment. The program operator shall have demonstrated experience in administering a large-scale supported work program that utilizes grant diversion, including:
    1. Experience in developing comprehensive and diverse cooperative agreements with the private sector;
    2. Providing on-the-job supervision of program participants and graduated stress and peer support;
    3. Performing task analysis of entry-level jobs; and
    4. Restructuring work to meet the needs of the participant population.
  2. The program operator shall place participants under contract with private-sector companies in supported work environments and, at the end of supported work training, shall place the participants in permanent unsubsidized jobs in private-sector companies. The supported work training shall not exceed nine (9) months in duration for each participant; provided, however, that the director, in his or her discretion, may extend the period of supportive work training for a person with a disability for not more than nine (9) additional months if the director determines that an extension is necessary to enable the person with a disability to obtain the full benefit of the program.

History of Section. P.L. 1987, ch. 280, § 1; P.L. 1999, ch. 83, § 96; P.L. 1999, ch. 130, § 96.

40-6.4-7. Rules and regulations.

The director is authorized to promulgate such rules and regulations as are necessary and proper to carry out the purposes of this chapter.

History of Section. P.L. 1987, ch. 280, § 1.

40-6.4-8. [Repealed.]

History of Section. P.L. 1987, ch. 280, § 1; Repealed by P.L. 2006, ch. 216, § 18, effective July 3, 2006.

Compiler’s Notes.

Former § 40-6.4-8 concerned appropriations of moneys.

Chapter 6.5 Child Day Care Grant Program

40-6.5-1. Grant program — Child day care.

The director of human services shall establish a program of grants to establish and/or expand child daycare programs, not to exceed fifty thousand dollars ($50,000) per grantee, and not to exceed a total expenditure of two hundred and fifty thousand dollars ($250,000).

History of Section. P.L. 1988, ch. 647, § 1.

40-6.5-2. Rules and regulations.

The director shall promulgate reasonable rules and regulations establishing eligibility requirements, and provide that at least fifty percent (50%) of the total grant funds available be distributed to nonprofit agencies that meet the following standards:

  1. Each grantee shall employ, educate, or train significant numbers of parents whose incomes are below the statewide median family income;
  2. Each grantee shall demonstrate a need for additional child daycare services in their service delivery area; and
  3. In selecting additional grantees for the remainder of the available funds, priority shall be given to grant proposals that would develop: (i) child daycare programs and opportunities for children with special healthcare needs; and (ii) specialized childcare programs, such as programs for parents who work nontraditional hours and programs for sick child care. All grantees must demonstrate that childcare services established under this childcare grant program will be certified or licensed in accordance with Rhode Island law.

History of Section. P.L. 1988, ch. 647, § 1; P.L. 1999, ch. 83, § 97; P.L. 1999, ch. 130, § 97.

Chapter 6.6 Quality Family Child Care Act

40-6.6-1. Short title.

This chapter shall be known and may be cited as the “Rhode Island Quality Family Child Care Act of 2013.”

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-2. Definitions.

As used in this chapter, the following terms shall have the meanings set forth herein, unless the context in which such terms are used clearly indicates to the contrary:

  1. “CCAP” means “Child Care Assistance Program” the program administered by the department of human services that provides financial assistance to families for child care.
  2. “CCAP family childcare provider” means an individual who:
    1. Participates in CCAP as a department of human services CCAP approved provider; and
    2. Is either licensed by the department of children, youth and families to provide childcare services in the provider’s own home, or license exempt but approved by the department of human services to participate in CCAP.
  3. “Director” means the director of the department of administration.
  4. “Provider organization” means an organization that includes CCAP family childcare providers and has as one of its purposes the representation of CCAP family childcare providers in their relations with the state.
  5. “Provider representative” or “representative” means a provider organization that is certified as the exclusive negotiating representative of CCAP family childcare providers as provided in § 40-6.6-9 .

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-3. Child Care Assistance Program Parent Advisory Council.

  1. There is established a Child Care Assistance Program Parent Advisory Council. The council shall consist of seven (7) members, six (6) of whom shall be the parents or guardians of children who participate, or have participated in, CCAP within the two (2) years previous to being appointed to the advisory council. The director of the department of human services, or his or her designee, shall serve on the council and act as its chair. A majority of members of the council shall constitute a quorum for the transaction of any business.
  2. The council members shall be appointed for three-year (3) terms. Two (2) shall be appointed by the governor, two (2) by the speaker of the house of representatives, and two (2) by the president of the senate.
  3. The council shall advise the governor and the director, or his or her designee, and any provider representative regarding issues relating to the quality, affordability, and accessibility of child care offered through CCAP. In particular, the council shall make recommendations regarding:
    1. Strategies for improving quality, affordability, and access to child care for CCAP families; and
    2. The structure of the CCAP program, including, but not limited to, the application and renewal process, eligibility rules and standards, and family co-payment levels.

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-4. Right of CCAP family childcare providers to choose provider representative — Subjects of negotiation.

  1. CCAP family childcare providers may, in accordance with the procedures set forth in § 40-6.6-9 , choose a provider organization to be their provider representative and to negotiate with the director, or his or her designee, over the terms and conditions of CCAP family childcare providers’ participation in CCAP, including, but not limited to: (1) Expanding training and professional development opportunities; (2) Improving the recruitment and retention of qualified CCAP family childcare providers; (3) Reimbursement rates and other economic matters; (4) Benefits; (5) Payment procedures; and (6) A grievance-resolution process.
  2. Notwithstanding the above, all matters within the scope of the department of children, youth and families (DCYF) childcare-licensing regulations and the DCYF’s regulatory authority over childcare licensing shall be excluded from and not subject to negotiations and/or the collective bargaining process as recognized in this section. DCYF’s authority to initiate licensing action pertaining to family childcare providers shall be exclusively governed by provisions in § 42-72.1-6 and chapter 35 of title 42.
  3. Notwithstanding the above, CCAP family childcare providers must first be qualified as CCAP family childcare providers by the department of human services and must operate in conformance with the relevant sections of chapter 12 of title 42 and regulations promulgated by the department.
  4. The director shall work in consultation with the secretary of the executive office of health and human services, as well as the director of the department of human services, regarding the terms and conditions of CCAP family childcare providers’ participation in CCAP including, but not limited to, the terms and conditions in subsection (a).

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-5. Good-faith negotiations.

It shall be the obligation of the director, or his or her designee, to meet and confer 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. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-6. Unresolved issues — Impasse procedures.

In the event that the provider representative and the director, or his or her 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. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-7. 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 and/or regulations shall be subject to passage of those state or federal appropriations or statutory and/or regulatory revisions.

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-8. Duty to represent all CCAP family childcare providers fairly — Service charge and deductions.

  1. A provider organization certified as the provider representative shall represent all CCAP family childcare providers in the state fairly and without discrimination, without regard to whether or not the CCAP family childcare providers are members of the provider organization.
  2. Each CCAP family childcare provider may choose whether to be a member of the provider organization; provided, however, that after a first contract is ratified, the provider representative shall be authorized to collect from non-member CCAP family childcare providers a service charge as a contribution toward the negotiation and administration of the written contract. The service charge shall not exceed the regular dues paid by CCAP family childcare providers who are members of the provider representative. The state shall deduct the service charge, membership dues, and any voluntary deductions authorized by individual CCAP family childcare providers, from the payments to CCAP family childcare providers.

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-9. Certification and decertification of provider organization.

  1. Petitions to certify a provider organization to serve as the provider representative of CCAP family childcare providers, petitions to intervene in the 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 CCAP family childcare providers wish to certify or decertify a provider representative shall be resolved by a secret ballot election among CCAP family childcare providers, for which purpose the board may designate a neutral third party to conduct said secret ballot election.
  2. The only appropriate unit shall consist of all CCAP family childcare providers in the state.
  3. 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. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1; P.L. 2020, ch. 79, art. 1, § 29.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-6.6-10. 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. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-11. CCAP family childcare providers not state employees.

Nothing in this chapter shall be construed to make CCAP family childcare 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. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-12. Right of families to select, direct, and terminate CCAP family childcare providers.

Nothing in this chapter shall be construed to alter the rights of families to select, direct, and terminate the services of CCAP family childcare providers.

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-13. Strikes not authorized.

CCAP family childcare providers shall not engage in any strike or other collective cessation of the delivery of childcare services.

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

40-6.6-14. State action exemption.

The state action exemption to the application of state and federal antitrust laws is applicable to the activities of CCAP family childcare providers and their provider representative authorized under this chapter.

History of Section. P.L. 2013, ch. 456, § 1; P.L. 2013, ch. 465, § 1.

Chapter 7 New England Welfare Compact

40-7-1. Compact enacted.

The New England welfare compact is hereby enacted into law and entered into with all other jurisdictions legally joining therein in the form substantially as follows:

NEW ENGLAND WELFARE COMPACT

ARTICLE I. — POLICY, PURPOSE AND SCOPE

The policy of the states party to this compact is to make welfare services available among the compacting states on the basis of the mutual removal of barriers caused by restrictive residence requirements of the several states. However, it is recognized that law and policy relating generally to the provision of welfare services by a particular state should not be determined by interstate compact and will remain a matter for determination by that party state and its subdivisions.

ARTICLE II. — WELFARE SERVICE DEFINED

As used in this compact, the term “welfare service” means and includes public assistance and child welfare services furnished by a party state or a subdivision thereof, provided that such assistance or service is pursuant to a federally-aided plan, arrangement, or program, and any other category of welfare assistance which is federally aided at the time when a claim of eligibility for assistance or service is made pursuant to this compact.

ARTICLE III. — PROVISION OF SERVICE

  1. No person who has removed himself or herself from his or her place of abode in one party state to another party state shall be ineligible for a welfare service in such other party state because of failure to meet that state’s residence requirements for eligibility. However, if a person is already receiving a welfare service at the time he or she removes himself or herself from his or her place of abode to another party state and if he or she continues to be in need of such service, the party state from which he or she removes himself or herself shall be obligated to bear the cost of such service for ninety (90) days from the date of his or her removal. In any such case, the party state to which the person removes himself or herself shall not be obligated to provide the service at its own expense during such ninety (90)-day period. The cost of providing a welfare service to any person made eligible therefor by reason of this compact shall be charged within a state in accordance with the laws of such state.
  2. The appropriate official, department or agency of the state where application for a welfare service is made pursuant to this compact shall be entitled to request and receive any pertinent information available from any other party state with respect to such applicant.

ARTICLE IV. — EXCEPTIONS AND LIMITATIONS

Nothing in this compact shall be construed to:

  1. Invalidate any agreement between a party state and a nonparty state relating to the provision neither of welfare services nor to invalidate any statutory authority for such agreements.
  2. Obligate a party state to provide a welfare service pursuant to this compact, which it does not provide to its own residents.

ARTICLE V. — COMPACT ADMINISTRATOR

In each party state there shall be a compact administrator who shall be the head of the state welfare agency. The compact administrator shall act as general coordinator of activities under the compact in his or her state and cooperate with the compact administrators of other party states. The compact administrators of the respective party states shall have power to promulgate reasonable rules and regulations to carry out the terms and provisions of this compact.

ARTICLE VI. — ENACTMENT AND WITHDRAWAL

  1. This compact shall be open to membership by the states of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. It shall enter into full force and effect as to any two (2) or more of the aforementioned states upon enactment thereof by such states.
  2. A state party to this compact may withdraw therefrom by enacting a statute repealing the same. Such withdrawal shall take effect six (6) months after notice thereof has been communicated officially and, in writing, to the governors and compact administrators of all other party states. However, the withdrawal of any state shall not affect the rights of any person who is receiving a welfare service pursuant to the provisions of this compact.

ARTICLE VII. — CONSTRUCTION AND SEVERABILITY

This compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this compact shall be severable and if any phrase, clause, sentence or provision of this compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby. If this compact shall be held contrary to the constitution of any state party thereto, the compact shall remain in full force and effect as to the remaining states and in full force and effect as to the state affected as to all severable matters.

History of Section. P.L. 1965, ch. 105, § 1; G.L. 1956, § 40-9.1-1 ; Reorg. Plan No. 1, 1970.

40-7-2. Compact administrator.

The compact administrator provided in article V of the compact shall be the director of the department of human services.

History of Section. P.L. 1965, ch. 105, § 1; G.L. 1956, § 40-9.1-2 ; Reorg. Plan No. 1, 1970.

40-7-3. Authority of governor to effectuate entry into compact.

The governor on behalf of the state is authorized and directed to execute any formal documents necessary to effectuate the entry of this state into the New England Welfare Compact with any one or more of the states of Connecticut, Massachusetts, New Hampshire, and Vermont in substantially the form provided in this chapter.

History of Section. P.L. 1965, ch. 105, § 3; G.L. 1956, § 40-9.1-3 ; Reorg. Plan No. 1, 1970.

40-7-4. Effect of existing reciprocal agreements.

Entry by the state into the New England Welfare Compact with another state shall supersede existing reciprocal agreements with that state but shall in no way abrogate or replace compacts or agreements entered into with other states pursuant to § 40-6-18 .

History of Section. P.L. 1965, ch. 105, § 4; G.L. 1956, § 40-9.1-4 ; Reorg. Plan No. 1, 1970.

Chapter 8 Medical Assistance

40-8-1. Declaration of policy.

  1. Whereas, in the state of Rhode Island there are many persons who do not have sufficient income and resources to meet the cost of medical care and who, except for income and resource requirements, would be eligible for aid or assistance under § 40-5.1-9 [repealed] or § 40-6-27 ; and
  2. Whereas, it is in the best interest of all the citizens of this state to promote the welfare of persons with the characteristics of persons eligible to receive public assistance and ensure that they will receive adequate medical care and treatment in time of need;
  3. Now, therefore, it is declared to be the policy of this state to provide medical assistance for those persons in this state who possess the characteristics of persons receiving public assistance under the provisions of § 40-5.1-9 [repealed] or § 40-6-27 , and who do not have the income and resources to provide it for themselves or who can do so only at great financial sacrifice. Provided, further, that the medical assistance must qualify for federal financial participation pursuant to the provisions of Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., as such provisions apply to medically needy only applicants and recipients.
  4. Medical assistance shall be provided under this chapter without regard to the availability of federal financial participation: (1) To a person who does not meet the citizenship or alienage criteria under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., and who was lawfully residing in the United States before August 22, 1996, and who was a resident of this state prior to July 1, 1997; and provided, however, that the person meets all other eligibility requirements under this chapter or under Title XIX or Title XXI of the Social Security Act.
  5. Medical assistance shall also be provided under this chapter to a non-citizen child who was lawfully admitted for permanent residence on or after August 22, 1996, or who first becomes otherwise entitled to reside in the United States on or after August 22, 1996; provided, however, that the person meets all other eligibility requirements under this chapter or under Title XIX or Title XXI of the Social Security Act.

History of Section. P.L. 1966, ch. 266, § 2; G.L. 1956, § 40-10.1-1; Reorg. Plan No. 1, 1970; P.L. 1983, ch. 3, art. 3, § 1; P.L. 1983, ch. 167, art. 18, § 1; P.L. 1989, ch. 53, § 1; P.L. 1996, ch. 129, § 19; P.L. 1996, ch. 131, § 19; P.L. 1996, ch. 132, § 19; P.L. 1996, ch. 133, § 19; P.L. 1997, ch. 30, art. 34, § 5; P.L. 2006, ch. 246, art. 40, § 1; P.L. 2007, ch. 73, art. 18, § 7; P.L. 2008, ch. 9, art. 10, § 1; P.L. 2009, ch. 68, art. 23, § 3.

Compiler’s Notes.

P.L. 2008, ch. 9, art. 10, § 3 provides: “This article shall take effect on May 1, 2008. Any rules or regulations necessary or advisable to implement the provisions of this article shall be effective immediately as an emergency rule upon the department’s filing thereof with the secretary of state as it is hereby found that the current fiscal crisis in this state has caused an imminent peril to public health, safety and welfare, and the department is hereby exempted from the requirements of §§ 42-35-3(b) and 42-35-4(b)(2) relating to agency findings of imminent peril to public health, safety and welfare and the filing of statements of the agency’s reasons thereof.”

Section 40-5.1-9, referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

Cross References.

Medical assistance fraud control, § 40-8.2-1 et seq.

Law Reviews.

Laura Pickering, Comment: Give Them a Reason They Can Understand: An Examination of Rhode Island’s Medicaid Ineligibility Notices to the State’s Most Vulnerable Populations, 21 Roger Williams U. L. Rev. 588 (2016).

NOTES TO DECISIONS

Reimbursement Under Catastrophic Health Insurance.

Inpatient psychiatric hospital services for Medicaid-eligible persons who may obtain such services at state expense are not reimbursable under the Catastrophic Health Insurance Plan (§ 42-62-1 et seq.). Carrillo v. Rohrer, 448 A.2d 1282, 1982 R.I. LEXIS 997 (R.I. 1982).

Under § 42-62-8(a), a person who is eligible for Medicaid or other state or federal program that provides a means of defraying health-service costs is ineligible for Catastrophic Health Insurance Plan coverage only for the costs of those services available under such programs. Carrillo v. Rohrer, 448 A.2d 1282, 1982 R.I. LEXIS 997 (R.I. 1982).

Suits Against the State.

The federal bankruptcy statute abrogates the state’s eleventh amendment immunity in the case of a bankrupt debtor’s action against the state seeking the recovery of funds due the debtor pursuant to the Rhode Island Medical Assistance Program. Rhode Island Ambulance Servs. v. Begin (In re Rhode Island Ambulance Servs.), 92 B.R. 4, 1988 Bankr. LEXIS 1748 (Bankr. D.R.I. 1988).

Collateral References.

Social security: Right to disability benefits as affected by refusal to submit to, or cooperate in, medical or surgical treatment. 114 A.L.R. Fed. 141.

40-8-2. Definitions.

As used in this chapter, unless the context shall otherwise require:

  1. “Dental service” means and includes emergency care, X-rays for diagnoses, extractions, palliative treatment, and the refitting and relining of existing dentures and prosthesis.
  2. “Department” means the department of human services.
  3. “Director” means the director of human services.
  4. “Drug” means and includes only drugs and biologicals prescribed by a licensed dentist or physician as are either included in the United States pharmacopoeia, national formulary, or are new and nonofficial drugs and remedies.
  5. “Inpatient” means a person admitted to and under treatment or care of a physician or surgeon in a hospital or nursing facility that meets standards of and complies with rules and regulations promulgated by the director.
  6. “Inpatient hospital services” means the following items and services furnished to an inpatient in a hospital other than a hospital, institution, or facility for tuberculosis or mental diseases:
    1. Bed and board;
    2. Nursing services and other related services as are customarily furnished by the hospital for the care and treatment of inpatients and drugs, biologicals, supplies, appliances, and equipment for use in the hospital, as are customarily furnished by the hospital for the care and treatment of patients;
      1. Other diagnostic or therapeutic items or services, including, but not limited to, pathology, radiology, and anesthesiology furnished by the hospital or by others under arrangements made by the hospital, as are customarily furnished to inpatients either by the hospital or by others under such arrangements, and services as are customarily provided to inpatients in the hospital by an intern or resident-in-training under a teaching program having the approval of the Council on Medical Education and Hospitals of the American Medical Association or of any other recognized medical society approved by the director.
      2. The term “inpatient hospital services” shall be taken to include medical and surgical services provided by the inpatient’s physician, but shall not include the services of a private-duty nurse or services in a hospital, institution, or facility maintained primarily for the treatment and care of patients with tuberculosis or mental diseases. Provided, further, it shall be taken to include only the following organ transplant operations: kidney, liver, cornea, pancreas, bone marrow, lung, heart, and heart/lung, and other organ transplant operations as may be designated by the director after consultation with medical advisory staff or medical consultants; and provided that any such transplant operation is determined by the director or his or her designee to be medically necessary. Prior written approval of the director, or his or her designee, shall be required for all covered organ transplant operations.
      3. In determining medical necessity for organ transplant procedures, the state plan shall adopt a case-by-case approach and shall focus on the medical indications and contra-indications in each instance; the progressive nature of the disease; the existence of any alternative therapies; the life-threatening nature of the disease; the general state of health of the patient apart from the particular organ disease; and any other relevant facts and circumstances related to the applicant and the particular transplant procedure.
  7. “Nursing services” means the following items and services furnished to an inpatient in a nursing facility:
    1. Bed and board;
    2. Nursing care and other related services as are customarily furnished to inpatients admitted to the nursing facility, and drugs, biologicals, supplies, appliances, and equipment for use in the facility, as are customarily furnished in the facility for the care and treatment of patients;
    3. Other diagnostic or therapeutic items or services, legally furnished by the facility or by others under arrangements made by the facility, as are customarily furnished to inpatients either by the facility or by others under such arrangement;
    4. Medical services provided in the facility by the inpatient’s physician, or by an intern or resident-in-training of a hospital with which the facility is affiliated or that is under the same control, under a teaching program of the hospital approved as provided in subsection (6); and
    5. A personal-needs allowance of fifty dollars ($50.00) per month.
  8. “Relative with whom the dependent child is living” means and includes the father, mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, uncle, aunt, first cousin, nephew, or niece of any dependent child who maintains a home for the dependent child.
  9. “Visiting nurse service” means part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse other than in a hospital or nursing home.

History of Section. P.L. 1966, ch. 266, § 2; P.L. 1968, ch. 189, § 1; G.L. 1956, § 40-10.1-2; Reorg. Plan No. 1, 1970; P.L. 1977, ch. 61, § 1; P.L. 1987, ch. 430, § 1; P.L. 1991, ch. 6, art. 13, § 1; P.L. 1992, ch. 22, § 1; P.L. 1993, ch. 138, art. 21, § 2; P.L. 1994, ch. 70, art. 20, § 1; P.L. 1999, ch. 217, § 1; P.L. 1999, ch. 363, § 1.

NOTES TO DECISIONS

Mental Health Care.

Where the legislature amended subsection (d) now (6) of this section in 1977 to resolve the ambiguity concerning its application to mental health care, specifically excluding such care in the amended statute, such action constituted evidence that the previous statutory language meant the exact contrary. Roe v. Affleck, 120 R.I. 679 , 390 A.2d 361, 1978 R.I. LEXIS 713 (1978).

Collateral References.

Limitation on right of chiropractors and osteopathic physicians to participate in public medical welfare programs. 8 A.L.R.4th 1056.

Gender Reassignment or “Sex Change” Surgery as Covered Procedure Under State Medical Assistance Program. 60 A.L.R. 6th 627.

40-8-3. Eligibility requirements.

Medical care benefits shall be provided under this chapter to at least any person:

  1. Who has attained the age of sixty-five (65) years; or
  2. Who has no vision or whose vision is so defective as to prevent performance of ordinary activities for which eyesight is essential; or
  3. Who is at least eighteen (18) years of age and who is permanently and totally disabled; or
  4. Who is under the age of eighteen (18) years, and who has been deprived of parental support or care by reason of the death, continued absence from the home, unemployment, or physical or mental incapacity of a parent (called hereafter “dependent child”) and who is living with a relative in a place of residence maintained by one or more of these relatives as his or her or their own home, or is in foster boarding care; or
  5. The relative as defined in subsection (8) of § 40-8-2 , with whom the dependent child is living; provided the person:
    1. Is a resident of this state; and
    2. Is not receiving public assistance under the provisions of § 40-5.1-9(b) [repealed] or § 40-6-27 ; and
    3. Is not an inmate of a public institution other than as a patient in a medical institution; and
    4. Is not a patient in an institution for tuberculosis or mental disease, unless the person has attained the age of sixty-five (65) years; provided, however, that this clause shall become void and of no effect if and when legislation enacted by the Congress of the United States shall become effective providing for payments for medical care on behalf of persons who have not attained the age of sixty-five (65) years who are patients in an institution for tuberculosis or mental disease; and
    5. Has insufficient income and resources. The department shall establish income and resource rules, regulations, and limits in accordance with Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., as applicable to the medically needy only applicants and recipients. The income limits established by the department must be more than the AFDC standard in effect on July 16, 1996, under the Rhode Island state plan approved under part A of Title IV of the federal Social Security Act, 42 U.S.C. § 601 et seq., but shall not be more than one hundred thirty-three and one-third percent (1331/3%) of the AFDC standard in effect on July 16, 1996, under the Rhode Island state plan approved under part A of Title IV of the federal Social Security Act; provided, however, that subject to the maximum percentage increase allowable under § 1931(b)(2)(B), the department shall increase the income limits on July 1, 1999, by six and six-tenths percent (6.6%), and on January 1, of each year commencing in the year 2000 by a percentage equal to the annual federal adjustment percentage as determined under the provisions of Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq. The department shall establish resource limits equal to two thousand dollars ($2,000) for an individual and three thousand dollars ($3,000) for a family. Provided, however, the department shall apply to the United States Department of Health and Human Services for a waiver relating to application of the reduced resource limit, and subject to the granting of the waiver by the Secretary of the United States Department of Health and Human Services, the resource limit shall be applied to all applicants who: (A) Become eligible for benefits under this chapter on or after the effective date of this amendment and (B) Who were not receiving benefits under this chapter prior to July 1, 1993. In the event the secretary does not approve the waiver request, the current department regulations relating to resource limits shall remain in effect for all eligible beneficiaries. For the purposes of this subsection, a vehicle necessary to transport a family member with a disability, where the vehicle is specially equipped to meet the specific needs of the person with a disability or if the vehicle is a special type of vehicle that makes it possible to transport the person with the disability, shall not be counted as resources of the applicants and recipients.

History of Section. P.L. 1966, ch. 266, § 2; G.L. 1956, § 40-10.1-3; Reorg. Plan No. 1, 1970; P.L. 1978, ch. 249, § 1; P.L. 1983, ch. 3, art. 3, § 1; P.L. 1989, ch. 53, § 1; P.L. 1990, ch. 65, art. 27, § 1; P.L. 1993, ch. 138, art. 21, § 2; P.L. 1996, ch. 129, § 19; P.L. 1996, ch. 131, § 19; P.L. 1996, ch. 132, § 19; P.L. 1996, ch. 133, § 19; P.L. 1998, ch. 72, § 2; P.L. 1999, ch. 31, art. 14, § 1.

Compiler’s Notes.

Section 40-5.1-9, referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

Effective Dates.

P.L. 1996, ch. 129, § 23, P.L. 1996, ch. 131, § 23, P.L. 1996, ch. 132, § 23 and P.L. 1996, ch. 133, § 23 provide that the amendment of this section by those acts shall be effective on the later of May 1, 1997 or the first day of the second month following the month of receipt by the Rhode Island Department of Human Services of all federal approvals and/or federal waivers from the Secretary of the U.S. Department of Health and Human Services necessary to implement the provisions of the acts, provided, however, that the Rhode Island Department of Human Services is authorized and directed to seek such federal approvals and/or federal waivers upon passage of the acts.

Cross References.

Compliance of health benefit contracts and medical assistance program with federal law, § 27-18.1-1 et seq.

Federal Act References.

Section 1931 of the Social Security Act, referred to in subsection (5)(v) of this section, is codified at 42 U.S.C. § 1396u-1.

Law Reviews.

Laura Pickering, Comment: Give Them a Reason They Can Understand: An Examination of Rhode Island’s Medicaid Ineligibility Notices to the State’s Most Vulnerable Populations, 21 Roger Williams U. L. Rev. 588 (2016).

NOTES TO DECISIONS

Medicaid.

Rhode Island’s Medicaid program was not a state income disability act, and thus did not fall within the list of collateral source payments that were admissible to reduce a plaintiff’s damages under § 9-19-34.1 . Section 9-19-34.1 was not a remedial statute, and the term “income disability act” meant an act that provided income to persons who were disabled; Medicaid did not fit this definition because many Medicaid recipients were not disabled, such as those who were aged 65 or older. Esposito v. O'Hair, 886 A.2d 1197, 2005 R.I. LEXIS 222 (R.I. 2005).

40-8-3.1. Life estate in property — Retained powers.

When an applicant or recipient of Medicaid owns a life estate in property that is his or her principal place of residence with the reserved power and authority, during his or her lifetime, to sell, convey, mortgage, or otherwise dispose of the real property without the consent or joinder by the holder(s) of the remainder interest, the principal place of residence shall not be regarded as an excluded resource for the purpose of Medicaid eligibility, unless the applicant or recipient individually, or through his or her guardian, conservator, or attorney in fact, conveys all outstanding remainder interest to him or herself.

An applicant or recipient who, by a deed created, executed and recorded on or before June 30, 2014, has reserved a life estate in property that is his or her principal place of residence with the reserved power and authority, during his or her lifetime, to sell, convey, mortgage, or otherwise dispose of the real property without the consent or joinder by the holder(s) of the remainder interest, shall not be ineligible for Medicaid on the basis of the deed, regardless of whether the transferee of the remainder interest is a person or persons, trust, or entity.

History of Section. P.L. 2014, ch. 145, art. 19, § 3.

40-8-4. Direct vendor payment plan.

  1. The department shall furnish medical care benefits to eligible beneficiaries through a direct vendor payment plan. The plan shall include, but need not be limited to, any or all of the following benefits, which benefits shall be contracted for by the director:
    1. Inpatient hospital services, other than services in a hospital, institution, or facility for tuberculosis or mental diseases;
    2. Nursing services for the period of time as the director shall authorize;
    3. Visiting nurse service;
    4. Drugs for consumption either by inpatients or by other persons for whom they are prescribed by a licensed physician;
    5. Dental services; and
    6. Hospice care up to a maximum of two hundred and ten (210) days as a lifetime benefit.
  2. For purposes of this chapter, the payment of federal Medicare premiums or other health insurance premiums by the department on behalf of eligible beneficiaries in accordance with the provisions of Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., shall be deemed to be a direct vendor payment.
  3. [Deleted by P.L. 2021, ch. 162, art. 12, § 2.]
  4. [Deleted by P.L. 2021, ch. 162, art. 12, § 2.]
  5. No state agency shall pay a vendor for medical benefits provided to a recipient of assistance under this chapter until and unless the vendor has submitted a claim for payment to a commercial insurance plan, Medicare, and/or a Medicaid managed care plan, if applicable for that recipient, in that order. This includes payments for skilled nursing and therapy services specifically outlined in Chapters 7, 8, and 15 of the Medicare Benefit Policy Manual.

History of Section. P.L. 1966, ch. 266, § 2; P.L. 1968, ch. 189, § 2; G.L. 1956, § 40-10.1-4; Reorg. Plan No. 1, 1970; P.L. 1977, ch. 269, § 1; P.L. 1988, ch. 356, § 1; P.L. 1989, ch. 53, § 1; P.L. 1991, ch. 6, art. 13, § 1; P.L. 1993, ch. 138, art. 21, § 2; P.L. 2007, ch. 73, art. 17, § 1; P.L. 2007, ch. 230, § 1; P.L. 2011, ch. 151, art. 23, § 2; P.L. 2015, ch. 141, art. 5, § 9; P.L. 2021, ch. 162, art. 12, § 2, effective July 1, 2021.

Cross References.

Public and medical assistance, effect of payments on workers’ compensation awards, § 40-6-10 .

NOTES TO DECISIONS

Benefits Prior to 1977 Amendment.

Prior to the effective dates of the 1977 amendments of § 40-8-2 and this section, medical care benefits under the Rhode Island Medical Assistance Act included inpatient hospital services rendered in a psychiatric hospital to a child under age 21 who was an eligible beneficiary under the act. Roe v. Affleck, 120 R.I. 679 , 390 A.2d 361, 1978 R.I. LEXIS 713 (1978).

Collateral References.

Gender Reassignment or “Sex Change” Surgery as Covered Procedure Under State Medical Assistance Program. 60 A.L.R. 6th 627.

Limitation on right of chiropractors and osteopathic physicians to participate in public medical welfare programs. 8 A.L.R.4th 1056.

40-8-4.1. Lowest price.

  1. Notwithstanding any provision of law to the contrary, no medical assistance provider shall bill or charge the department of human services more than the provider’s usual and customary charge, as defined within.
  2. The term “usual and customary” means the lowest charge, fee, or rate charged by a provider for any product or service at the time the product or service was provided. For the purpose of determining the lowest charge, fee, or rate:
    1. If the provider offers discounts or rebates, the amount after applying discounts or rebates shall be utilized;
    2. If the provider offers a sale for a limited period of time on any good or service, the sale price shall be utilized during the sale period;
    3. If the provider regularly accepts less than its full charge from any customer, that amount accepted shall be utilized;
    4. If any good or service is offered free of charge by the provider, no charge shall be made to the department for the provision of the product or service to the department or a client of the department who satisfies the terms of the offer;
    5. If any good or service is covered under any warranty or guarantee offered by the provider, the amount charged to the department shall not exceed the amount that would otherwise be payable solely by the customer; and
    6. If a provider structures or packages its goods or services in a manner that is exclusively or primarily used for Medicaid, Medicare, or other third-party payors, the charge for the most similar good or service offered to any other consumer shall be utilized.
  3. The following items shall not be utilized in determining the “usual and customary” or lowest charge, fee, or rate:
    1. Discounts offered solely to bona fide employees or family members of employees;
    2. Discounts offered solely on the basis of age shall be utilized in determining the usual and customary charge only when the client of the department satisfies the age requirement;
    3. Free goods or services or discounts provided to a limited number of persons on the basis of financial hardship;
    4. Charges by an organization on a sliding-fee scale for a good or service where the organization’s charge is based on ability to pay;
    5. Charges not collected as a result of bad debts incurred by the provider. A bad debt exists where sound business judgment indicates that there is no reasonable likelihood of recovery of the amount owed; and
    6. Charges for educational-related services governed by 42 U.S.C. § 1396b(c).
  4. The department may waive the application of this section if the department determines the action is necessary to ensure a continuum of care and service to persons served by community mental health centers, or to avert serious economic hardships to mental health centers.

History of Section. P.L. 2009, ch. 68, art. 23, § 12.

40-8-5. Agencies through which benefits paid.

Benefits shall be applied for, and paid in accordance with, prescribed regulations through the state offices or state or private agencies or organizations as the director may designate, and as shall be approved by the federal government, or any department or agency thereof, making funds available in support of the medical care benefits provided for in this chapter or for administration purposes. The regulations shall meet the federal requirements as may be set forth as conditions precedent to receiving the federal funds.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-5; Reorg. Plan No. 1, 1970.

40-8-6. Review of application for benefits.

The director, or someone designated by him or her, shall review each application for benefits filed in accordance with regulations, and shall make a determination of whether the application will be honored and the extent of the benefits to be made available to the applicant, and shall, within thirty (30) days after the filing, notify the applicant, in writing, of the determination. If the application is rejected, the notice to the applicant shall set forth therein the reason therefor. The director may at any time reconsider any determination.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-6; Reorg. Plan No. 1, 1970.

Law Reviews.

Laura Pickering, Comment: Give Them a Reason They Can Understand: An Examination of Rhode Island’s Medicaid Ineligibility Notices to the State’s Most Vulnerable Populations, 21 Roger Williams U. L. Rev. 588 (2016).

40-8-6.1. Provider care during pendency of application.

  1. Definitions.  The following terms shall have the meanings indicated: “Applied income” — The amount of income a Medicaid beneficiary is required to contribute to the cost of his or her care. “Authorized representative” — An individual who signs an application for Medicaid benefits on behalf of a Medicaid applicant. “Complete application” — An application for Medicaid benefits filed by, or on behalf of, an individual receiving care and services from a long-term-care provider (LTC provider), including attachments and supplemental information as necessary, that provides sufficient information for the secretary or designee to determine the applicant’s eligibility for coverage. An application shall not be disqualified from status as a complete application hereunder except for failure on the part of the Medicaid applicant, or his or her authorized representative, to provide necessary information or documentation, or to take any other action necessary to make the application a complete application. “Long-term-care provider (LTC provider)” means any of the following: a home-care provider, home nursing-care provider or nursing facility licensed pursuant to the provisions of chapter 17 of title 23; an assisted-living residence provider licensed pursuant to chapter 17.4 of title 23; an adult-day-services provider licensed pursuant to § 23-1-52 ; or a Program of All-Inclusive Care for the Elderly (PACE) as certified by the Centers for Medicare and Medicaid Services (CMS) and participating in the Rhode Island Medicaid program. As used in this chapter, the terms “long-term-care provider” and “LTC provider” are interchangeable. “Medicaid applicant” — An individual who is receiving care from an LTC provider during the pendency of an application for Medicaid benefits. “Release” means a written document that:
    1. Indicates consent to the disclosure to an LTC provider by the secretary or designee;
    2. Of information concerning an application for Medicaid benefits filed on behalf of a resident or patient of that LTC provider;
    3. For the purpose of ensuring the ability to be paid for its services by that LTC provider; and
    4. That includes the following elements:
      1. The name of the LTC provider;
      2. A description of the information that may be disclosed under the release;
      3. The name of the person or persons acting on behalf of the LTC provider to whom the information may be disclosed;
      4. The period of time for which the release will be in effect, which may extend from the date of the application for benefits until the expiration of any appeal, or any appeal period, following the determination of that application; and
      5. The signature of the Medicaid applicant, or authorized representative, or other person legally authorized to sign on behalf of the Medicaid applicant, such as guardian or attorney-in-fact. “Secretary” means the secretary of the Rhode Island executive office of health and human services. “Uncompensated care” — Care and services provided by an LTC provider to a Medicaid applicant without receiving compensation therefore from Medicaid, Medicare, the Medicaid applicant, or other source. The acceptance of any payment representing actual or estimated applied income shall not disqualify the care and services provided from qualifying as uncompensated care.
    1. Uncompensated care during pendency of an application for benefits.  A nursing facility may not discharge a Medicaid applicant for non-payment of the facility’s bill during the pendency of a complete application; nor may a nursing facility charge a Medicaid applicant for care provided during the pendency of a complete application, except for an amount representing the estimated, applied income. A nursing facility may discharge a Medicaid applicant for non-payment of the facility’s bill during the pendency of an application for Medicaid coverage that is not a complete application, but only if the nursing facility has provided the patient (and his or her authorized representative, if known) with thirty (30) days’ written notice of its intention to do so, and the application remains incomplete during that thirty-day (30) period.
    2. Uncompensated care while determination is overdue.  When a complete application has been pending for ninety (90) days or longer, then upon the request of an LTC provider providing uncompensated care, the state shall make payment to the LTC provider for the care provided to the applicant in full as though the application were approved, beginning on the date of such request. Payment under this subsection shall not be made for the period prior to the LTC provider’s request, but shall continue thereafter until the application is decided. In the event the application is denied, the state shall not have any right of recovery, offset, or recoupment with respect to payments made hereunder for the period of determination. In the event the application is approved, the state may offset payments due for the period between the date of the application and the determination by any amounts paid hereunder.
  2. Notice of application status.  When an LTC provider is providing uncompensated care to a Medicaid applicant, then the LTC provider may inform the secretary or designee of its status, and the secretary or designee shall thereafter inform the nursing facility of any decision on the application at the time the decision is rendered and, if coverage is approved, of the date that coverage will begin. In addition, an LTC provider providing uncompensated care to a Medicaid applicant may inquire of the secretary or designee as to the status of that individual’s application, and the secretary or designee shall respond within five business days as follows:
    1. Without release — If the LTC provider has not obtained a signed release, the secretary or designee must provide the following information, only, in writing: (i) Whether or not the application has been approved; (ii) The identity of any authorized representative; and (iii) If the application has not yet been decided, whether or not the application is a complete application.
    2. With release — If the LTC provider has obtained a signed release, the secretary or designee must additionally provide any further information requested by the LTC provider, to the extent that the release permits its disclosure.

History of Section. P.L. 2015, ch. 141, art. 5, § 10; P.L. 2016, ch. 150, § 1; P.L. 2016, ch. 158, § 1.

40-8-7. Appeals — Hearing.

Any applicant for or recipient of benefits aggrieved because of a decision, or delay in making a decision, shall be entitled to an appeal and shall be afforded reasonable notice and opportunity for a fair hearing conducted by the director.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-7; Reorg. Plan No. 1, 1970.

40-8-8. Judicial review.

Findings of fact by the director shall be final and his or her decision shall be subject to judicial review only by certiorari if the decision is arbitrary, capricious, or unreasonable or inconsistent with law.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-8; Reorg. Plan No. 1, 1970.

40-8-9. Fraudulent receipt of assistance as larceny — Penalty.

Whoever knowingly makes a false statement or misrepresents a material fact with intent thereby to defraud the state of any benefit or wrongfully to obtain or increase any benefit either for himself or herself or for any other person shall, upon conviction, be punished by a fine of not less than twenty dollars ($20.00) nor more than fifty dollars ($50.00), or by imprisonment for not more than thirty (30) days, or by both a fine and imprisonment. Each false statement or representation shall constitute a separate and distinct offense.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-9; Reorg. Plan No. 1, 1970.

Cross References.

Medical assistance fraud control, § 40-8.2-1 et seq.

Collateral References.

Criminal liability under state laws in connection with application for, or receipt of, public welfare payments. 22 A.L.R.4th 534.

Filing of false insurance claims for medical services as ground for disciplinary action against dentist, physician, or other medical practitioner. 70 A.L.R.4th 132.

Imposition of civil penalties, under state statute upon medical practitioner for fraud in connection with claims under Medicaid, Medicare, or similar welfare programs for providing medical services. 32 A.L.R.4th 671.

40-8-9.1. Notice.

Whenever an individual who is receiving medical assistance under this chapter transfers an interest in real or personal property, the individual shall notify the executive office of health and human services within ten (10) days of the transfer. The notice shall be sent to the individual’s local office and the legal office of the executive office of health and human services and include, at a minimum, the individual’s name, social security number or, if different, the executive office of health and human services identification number, the date of transfer, and the dollar value, if any, paid or received by the individual who received benefits under this chapter. In the event an individual fails to provide notice required by this section to the executive office of health and human services and in the event an individual has received medical assistance, any individual and/or entity, who knew or should have known that the individual failed to provide the notice and who receives any distribution of value as a result of the transfer, shall be liable to the executive office of health and human services to the extent of the value of the transfer. Moreover, any such individual shall be subject to the provisions of § 40-6-15 and any remedy provided by applicable state and federal laws and rules and regulations. Failure to comply with the notice requirements set forth in the section shall not affect the marketability of title to real estate transferred while the transferor is receiving medical assistance.

History of Section. P.L. 2012, ch. 241, art. 11, § 6.

40-8-10. Recovery of benefits paid in error.

Any person, who through error or mistake of himself or herself or another, receives medical care benefits to which he or she is not entitled or with respect to which he or she was ineligible, shall be required to reimburse the state for the benefits paid through error or mistake.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-10; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 129.

40-8-11. Civil action to recover benefits.

Any sums required to be reimbursed to the state under the provisions of § 40-8-10 and any benefits obtained by false statement or misrepresentation may be collected by civil action. All civil actions shall be instituted in the name of the director, and he or she shall be exempt from giving any surety for costs. In any action, the director may be represented by any qualified attorney whom he or she has designated and employed for this purpose, or, at the director’s request, by the attorney general.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-11; Reorg. Plan No. 1, 1970.

40-8-12. Federal approval.

  1. The department is empowered and authorized to submit its plan for medical assistance to the federal government, or any agency or department thereof having funds available for medical care benefits provided for in this chapter, for approval pursuant to the provisions of the federal Social Security Act, 42 U.S.C. § 1396 et seq. The department shall act for the state in any negotiations relative to the submission and approval of the plan and may make any arrangement or changes in its plan not inconsistent with this chapter that may be required by the Social Security Act, or the rules and regulations promulgated pursuant thereto, to obtain and retain the approval and to secure for this state the benefits of the provisions of the federal act relating to medical assistance for the needy.
  2. The department shall make reports to the federal government, or any agency or department thereof, in the form and nature required by it, and shall, in all respects, comply with any request or direction of the federal government, or any agency or department thereof, that may be necessary to assure the correctness and verification of the reports.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-12; Reorg. Plan No. 1, 1970; P.L. 2006, ch. 216, § 19.

40-8-13. Rules, regulations, and fee schedules.

The director shall make and promulgate rules, regulations, and fee schedules not inconsistent with state law and fiscal procedures as he or she deems necessary for the proper administration of this chapter and to carry out the policy and purposes thereof, and to make the department’s plan conform to the provisions of the federal Social Security Act, 42 U.S.C. § 1396 et seq., and any rules or regulations promulgated pursuant thereto.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-13; Reorg. Plan No. 1, 1970.

40-8-13.1. [Repealed.]

History of Section. P.L. 1995, ch. 370, art. 32, § 1; P.L. 2000, ch. 55, art. 12, § 1; P.L. 2006, ch. 216, § 19; P.L. 2009, ch. 5, art. 15, § 1; Repealed by its own terms pursuant to P.L. 2009, ch. 68, art. 23, § 6, effective March 30, 2010.

Compiler’s Notes.

Former § 40-8-13.1 concerned reimbursement for out-of-state hospital services.

40-8-13.2. [Repealed.]

History of Section. P.L. 2002, ch. 65, art. 33, § 1; P.L. 2007, ch. 73, art. 13, § 2; P.L. 2009, ch. 68, art. 23, § 6; Repealed by its own terms and pursuant to § 40-8-13.4(g) , effective March 30, 2010.

Compiler’s Notes.

Former § 40-8-13.2 concerned prospective rate methodology for in-state hospital services.

Repealed Sections.

Former § 40-8-13.2 (P.L. 1996, ch. 100, art. 25, § 1), concerning the inpatient hospital services reimbursement limit, was repealed by P.L. 1996, ch. 100, art. 25, § 4, effective June 30, 1997.

40-8-13.3. Payment for services provided by in-state and out-of-state hospitals.

The department of human services and/or the secretary of the executive office of health and human services is hereby authorized and directed to amend its rules and regulations and amend the Rhode Island state plan for medical assistance (Medicaid) pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., in order to provide for payment to hospitals for services provided to eligible recipients in accordance with this chapter. The amended rules and regulations will continue to recognize the importance, impact, and cost of the graduate medical education and training programs supported by the hospitals in Rhode Island. The provisions of this section shall be effective upon the promulgation of the amendments and new payment methodology pursuant to this section and § 40-8-13.4 , on July 1, 2010, at which time the provisions of §§ 40-8-13.2 , 27-19-14 , 27-19-15 and 27-19-16 shall be repealed in their entirety.

History of Section. P.L. 2009, ch. 68, art. 23, § 7; P.L. 2010, ch. 23, art. 20, § 1.

40-8-13.4. Rate methodology for payment for in-state and out-of-state hospital services.

  1. The executive office of health and human services (“executive office”) shall implement a new methodology for payment for in-state and out-of-state hospital services in order to ensure access to, and the provision of, high-quality and cost-effective hospital care to its eligible recipients.
  2. In order to improve efficiency and cost-effectiveness, the executive office shall:
      1. With respect to inpatient services for persons in fee-for-service Medicaid, which is non-managed care, implement a new payment methodology for inpatient services utilizing the Diagnosis Related Groups (DRG) method of payment, which is, a patient-classification method that provides a means of relating payment to the hospitals to the type of patients cared for by the hospitals. It is understood that a payment method based on DRG may include cost outlier payments and other specific exceptions. The executive office will review the DRG-payment method and the DRG base price annually, making adjustments as appropriate in consideration of such elements as trends in hospital input costs; patterns in hospital coding; beneficiary access to care; and the Centers for Medicare and Medicaid Services national CMS Prospective Payment System (IPPS) Hospital Input Price index. For the twelve-month (12) period beginning July 1, 2015, the DRG base rate for Medicaid fee-for-service inpatient hospital services shall not exceed ninety-seven and one-half percent (97.5%) of the payment rates in effect as of July 1, 2014. Beginning July 1, 2019, the DRG base rate for Medicaid fee-for-service inpatient hospital services shall be 107.2% of the payment rates in effect as of July 1, 2018. Increases in the Medicaid fee-for-service DRG hospital payments for the twelve-month (12) period beginning July 1, 2020, shall be based on the payment rates in effect as of July 1 of the preceding fiscal year, and shall be the Centers for Medicare and Medicaid Services national Prospective Payment System (IPPS) Hospital Input Price Index.
      2. With respect to inpatient services, (A) It is required as of January 1, 2011, until December 31, 2011, that the Medicaid managed care payment rates between each hospital and health plan shall not exceed ninety and one-tenth percent (90.1%) of the rate in effect as of June 30, 2010. Increases in inpatient hospital payments for each annual twelve-month (12) period beginning January 1, 2012, may not exceed the Centers for Medicare and Medicaid Services national CMS Prospective Payment System (IPPS) Hospital Input Price index for the applicable period; (B) Provided, however, for the twenty-four-month (24) period beginning July 1, 2013, the Medicaid managed care payment rates between each hospital and health plan shall not exceed the payment rates in effect as of January 1, 2013, and for the twelve-month (12) period beginning July 1, 2015, the Medicaid managed care payment inpatient rates between each hospital and health plan shall not exceed ninety-seven and one-half percent (97.5%) of the payment rates in effect as of January 1, 2013; (C) Increases in inpatient hospital payments for each annual twelve-month (12) period beginning July 1, 2017, shall be the Centers for Medicare and Medicaid Services national CMS Prospective Payment System (IPPS) Hospital Input Price Index, less Productivity Adjustment, for the applicable period and shall be paid to each hospital retroactively to July 1; (D) Beginning July 1, 2019, the Medicaid managed care payment inpatient rates between each hospital and health plan shall be 107.2% of the payment rates in effect as of January 1, 2019, and shall be paid to each hospital retroactively to July 1; (E) Increases in inpatient hospital payments for each annual twelve-month (12) period beginning July 1, 2020, shall be based on the payment rates in effect as of January 1 of the preceding fiscal year, and shall be the Centers for Medicare and Medicaid Services national CMS Prospective Payment System (IPPS) Hospital Input Price Index, less Productivity Adjustment, for the applicable period and shall be paid to each hospital retroactively to July 1; the executive office will develop an audit methodology and process to assure that savings associated with the payment reductions will accrue directly to the Rhode Island Medicaid program through reduced managed care plan payments and shall not be retained by the managed care plans; (F) All hospitals licensed in Rhode Island shall accept such payment rates as payment in full; and (G) For all such hospitals, compliance with the provisions of this section shall be a condition of participation in the Rhode Island Medicaid program.
    1. With respect to outpatient services and notwithstanding any provisions of the law to the contrary, for persons enrolled in fee-for-service Medicaid, the executive office will reimburse hospitals for outpatient services using a rate methodology determined by the executive office and in accordance with federal regulations. Fee-for-service outpatient rates shall align with Medicare payments for similar services. Notwithstanding the above, there shall be no increase in the Medicaid fee-for-service outpatient rates effective on July 1, 2013, July 1, 2014, or July 1, 2015. For the twelve-month (12) period beginning July 1, 2015, Medicaid fee-for-service outpatient rates shall not exceed ninety-seven and one-half percent (97.5%) of the rates in effect as of July 1, 2014. Increases in the outpatient hospital payments for the twelve-month (12) period beginning July 1, 2016, may not exceed the CMS national Outpatient Prospective Payment System (OPPS) Hospital Input Price Index. Beginning July 1, 2019, the Medicaid fee-for-service outpatient rates shall be 107.2% of the payment rates in effect as of July 1, 2018. Increases in the outpatient hospital payments for the twelve-month (12) period beginning July 1, 2020, shall be based on the payment rates in effect as of July 1 of the preceding fiscal year, and shall be the CMS national Outpatient Prospective Payment System (OPPS) Hospital Input Price Index. With respect to the outpatient rate, (i) It is required as of January 1, 2011, until December 31, 2011, that the Medicaid managed care payment rates between each hospital and health plan shall not exceed one hundred percent (100%) of the rate in effect as of June 30, 2010; (ii) Increases in hospital outpatient payments for each annual twelve-month (12) period beginning January 1, 2012, until July 1, 2017, may not exceed the Centers for Medicare and Medicaid Services national CMS Outpatient Prospective Payment System OPPS hospital price index for the applicable period; (iii) Provided, however, for the twenty-four-month (24) period beginning July 1, 2013, the Medicaid managed care outpatient payment rates between each hospital and health plan shall not exceed the payment rates in effect as of January 1, 2013, and for the twelve-month (12) period beginning July 1, 2015, the Medicaid managed care outpatient payment rates between each hospital and health plan shall not exceed ninety-seven and one-half percent (97.5%) of the payment rates in effect as of January 1, 2013; (iv) Increases in outpatient hospital payments for each annual twelve-month (12) period beginning July 1, 2017, shall be the Centers for Medicare and Medicaid Services national CMS OPPS Hospital Input Price Index, less Productivity Adjustment, for the applicable period and shall be paid to each hospital retroactively to July 1; (v) Beginning July 1, 2019, the Medicaid managed care outpatient payment rates between each hospital and health plan shall be one hundred seven and two-tenths percent (107.2%) of the payment rates in effect as of January 1, 2019 and shall be paid to each hospital retroactively to July 1; (vi) Increases in outpatient hospital payments for each annual twelve-month (12) period beginning July 1, 2020, shall be based on the payment rates in effect as of January 1 of the preceding fiscal year, and shall be the Centers for Medicare and Medicaid Services national CMS OPPS Hospital Input Price Index, less Productivity Adjustment, for the applicable period and shall be paid to each hospital retroactively to July 1.
    2. “Hospital,” as used in this section, shall mean the actual facilities and buildings in existence in Rhode Island, licensed pursuant to § 23-17-1 et seq. on June 30, 2010, and thereafter any premises included on that license, regardless of changes in licensure status pursuant to chapter 17.14 of title 23 (hospital conversions) and § 23-17-6(b) (change in effective control), that provides short-term, acute inpatient and/or outpatient care to persons who require definitive diagnosis and treatment for injury, illness, disabilities, or pregnancy. Notwithstanding the preceding language, the Medicaid managed care payment rates for a court-approved purchaser that acquires a hospital through receivership, special mastership or other similar state insolvency proceedings (which court-approved purchaser is issued a hospital license after January 1, 2013), shall be based upon the new rates between the court-approved purchaser and the health plan, and such rates shall be effective as of the date that the court-approved purchaser and the health plan execute the initial agreement containing the new rates. The rate-setting methodology for inpatient-hospital payments and outpatient-hospital payments set forth in subsections (b)(1)(ii)(C) and (b)(2), respectively, shall thereafter apply to increases for each annual twelve-month (12) period as of July 1 following the completion of the first full year of the court-approved purchaser’s initial Medicaid managed care contract.
  3. It is intended that payment utilizing the DRG method shall reward hospitals for providing the most efficient care, and provide the executive office the opportunity to conduct value-based purchasing of inpatient care.
  4. The secretary of the executive office is hereby authorized to promulgate such rules and regulations consistent with this chapter, and to establish fiscal procedures he or she deems necessary, for the proper implementation and administration of this chapter in order to provide payment to hospitals using the DRG-payment methodology. Furthermore, amendment of the Rhode Island state plan for Medicaid, pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., is hereby authorized to provide for payment to hospitals for services provided to eligible recipients in accordance with this chapter.
  5. The executive office shall comply with all public notice requirements necessary to implement these rate changes.
  6. As a condition of participation in the DRG methodology for payment of hospital services, every hospital shall submit year-end settlement reports to the executive office within one year from the close of a hospital’s fiscal year. Should a participating hospital fail to timely submit a year-end settlement report as required by this section, the executive office shall withhold financial-cycle payments due by any state agency with respect to this hospital by not more than ten percent (10%) until the report is submitted. For hospital fiscal year 2010 and all subsequent fiscal years, hospitals will not be required to submit year-end settlement reports on payments for outpatient services. For hospital fiscal year 2011 and all subsequent fiscal years, hospitals will not be required to submit year-end settlement reports on claims for hospital inpatient services. Further, for hospital fiscal year 2010, hospital inpatient claims subject to settlement shall include only those claims received between October 1, 2009, and June 30, 2010.
  7. The provisions of this section shall be effective upon implementation of the new payment methodology set forth in this section and § 40-8-13.3 , which shall in any event be no later than March 30, 2010, at which time the provisions of §§ 40-8-13.2 , 27-19-14 , 27-19-15 , and 27-19-16 shall be repealed in their entirety.

History of Section. P.L. 2009, ch. 68, art. 23, § 7; P.L. 2010, ch. 23, art. 20, § 1; P.L. 2010, ch. 120, § 2; P.L. 2011, ch. 151, art. 15, § 1; P.L. 2013, ch. 144, art. 19, § 1; P.L. 2014, ch. 145, art. 18, § 1; P.L. 2015, ch. 141, art. 5, § 10; P.L. 2016, ch. 142, art. 7, § 2; P.L. 2017, ch. 302, art. 9, § 4; P.L. 2019, ch. 88, art. 13, § 5.

40-8-13.5. Hospital Incentive Program (HIP).

The secretary of the executive office of health and human services is authorized to seek the federal authorities required to implement a hospital incentive program (HIP). The HIP shall provide the participating licensed hospitals the ability to obtain certain payments for achieving performance goals established by the secretary. HIP payments shall commence no earlier than July 1, 2016.

History of Section. P.L. 2015, ch. 141, art. 5, § 10.

40-8-14. Appropriations.

The general assembly shall annually appropriate a sum as it may deem necessary to carry out the purposes of this chapter, and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of the sum or sums or so much thereof as may be required from time to time, upon the receipt by him or her of properly authenticated vouchers.

History of Section. P.L. 1966, ch. 266, § 2; G.L., § 40-10.1-14; Reorg. Plan No. 1, 1970.

40-8-15. Lien on deceased recipient’s estate for assistance.

    1. Upon the death of a recipient of Medicaid under Title XIX of the federal Social Security Act (42 U.S.C. § 1396 et seq. and referred to hereinafter as the “Act”), the total sum for Medicaid benefits so paid on behalf of a beneficiary who was fifty-five (55) years of age or older at the time of receipt shall be and constitute a lien upon the estate, as defined in subsection (a)(2), of the beneficiary in favor of the executive office of health and human services (“executive office”). The lien shall not be effective and shall not attach as against the estate of a beneficiary who is survived by a spouse, or a child who is under the age of twenty-one (21), or a child who is blind or permanently and totally disabled as defined in Title XVI of the federal Social Security Act, 42 U.S.C. § 1381 et seq. The lien shall attach against property of a beneficiary, which is included or includable in the decedent’s probate estate, regardless of whether or not a probate proceeding has been commenced in the probate court by the executive office or by any other party. Provided, however, that such lien shall only attach and shall only be effective against the beneficiary’s real property included or includable in the beneficiary’s probate estate if such lien is recorded in the land evidence records and is in accordance with subsection (e). Decedents who have received Medicaid benefits are subject to the assignment and subrogation provisions of §§ 40-6-9 and 40-6-10 .
    2. For purposes of this section, the term “estate” with respect to a deceased individual shall include all real and personal property and other assets included or includable within the individual’s probate estate.
  1. The executive office is authorized to promulgate regulations to implement the terms, intent, and purpose of this section and to require the legal representative(s) and/or the heirs-at-law of the decedent to provide reasonable written notice to the executive office of the death of a beneficiary of Medicaid benefits who was fifty-five (55) years of age or older at the date of death, and to provide a statement identifying the decedent’s property and the names and addresses of all persons entitled to take any share or interest of the estate as legatees or distributees thereof.
  2. The amount of reimbursement for Medicaid benefits imposed under this section shall also become a debt to the state from the person or entity liable for the payment thereof.
  3. Upon payment of the amount of reimbursement for Medicaid benefits imposed by this section, the secretary of the executive office, or his or her designee, shall issue a written discharge of lien.
  4. Provided, however, that no lien created under this section shall attach nor become effective upon any real property unless and until a statement of claim is recorded naming the debtor/owner of record of the property as of the date and time of recording of the statement of claim, and describing the real property by a description containing all of the following: (1) Tax assessor’s plat and lot; and (2) Street address. The statement of claim shall be recorded in the records of land evidence in the town or city where the real property is situated. Notice of the lien shall be sent to the duly appointed executor or administrator, the decedent’s legal representative, if known, or to the decedent’s next of kin or heirs at law as stated in the decedent’s last application for Medicaid benefits.
  5. The executive office shall establish procedures, in accordance with the standards specified by the Secretary, United States Department of Health and Human Services, under which the executive office shall waive, in whole or in part, the lien and reimbursement established by this section if the lien and reimbursement would cause an undue hardship, as determined by the executive office, on the basis of the criteria established by the secretary in accordance with 42 U.S.C. § 1396p(b)(3).
  6. Upon the filing of a petition for admission to probate of a decedent’s will or for administration of a decedent’s estate, when the decedent was fifty-five (55) years or older at the time of death, a copy of the petition and a copy of the death certificate shall be sent to the executive office. Within thirty (30) days of a request by the executive office, an executor or administrator shall complete and send to the executive office a form prescribed by that office and shall provide such additional information as the office may require. In the event a petitioner fails to send a copy of the petition and a copy of the death certificate to the executive office and a decedent has received Medicaid benefits for which the executive office is authorized to recover, no distribution and/or payments, including administration fees, shall be disbursed. Any person and/or entity that receives a distribution of assets from the decedent’s estate shall be liable to the executive office to the extent of such distribution.
  7. Compliance with the provisions of this section shall be consistent with the requirements set forth in § 33-11-5 and the requirements of the affidavit of notice set forth in § 33-11-5 .2. Nothing in these sections shall limit the executive office from recovery, to the extent of the distribution, in accordance with all state and federal laws.
  8. To ensure the financial integrity of the Medicaid eligibility determination, benefit renewal, and estate recovery processes in this and related sections, the secretary of health and human services is authorized and directed to, by no later than August 1, 2018: (1) Implement an automated asset verification system, as mandated by § 1940 of the Act, that uses electronic data sources to verify the ownership and value of countable resources held in financial institutions and any real property for applicants and beneficiaries subject to resource and asset tests pursuant to the Act in § 1902(e)(14)(D); (2) Apply the provisions required under §§ 1902(a)(18) and 1917(c) of the Act pertaining to the disposition of assets for less than fair market value by applicants and beneficiaries for Medicaid long-term services and supports and their spouses, without regard to whether they are subject to or exempted from resources and asset tests as mandated by federal guidance; and (3) Pursue any state plan or waiver amendments from the United States Centers for Medicare and Medicaid Services and promulgate such rules, regulations, and procedures he or she deems necessary to carry out the requirements set forth herein and ensure the state plan and Medicaid policy conform and comply with applicable provisions of Title XIX.

History of Section. P.L. 1982, ch. 191, § 1; P.L. 1992, ch. 133, art. 28, § 1; P.L. 1995, ch. 99, § 1; P.L. 2012, ch. 241, art. 11, § 5; P.L. 2018, ch. 47, art. 13, § 1.

Federal Act References.

Section 1940 of Title XIX, referred to in subsection (i) of this section, is codified as 42 U.S.C. § 1396w. Section 1902 is codified as 42 U.S.C. § 1396a, and section 1917 is codified as 42 U.S.C. § 1396p.

NOTES TO DECISIONS

Filing Claims Against Estate.

Because the Department of Human Services did not file suit—and was not required to file suit—in order to seek reimbursement of the medical assistance benefits it had paid on the decedent’s behalf, R.I. Gen. Laws § 33-11-50 did apply and did not bar the claim DHS filed with the estate. In re Estate of Manchester, 66 A.3d 426, 2013 R.I. LEXIS 84 (R.I. 2013).

As the six-month limitation period for filing claims against a decedent’s estate was not triggered until the Department of Human Services received notice that the estate had been opened, and as it filed its claim only two months after receiving notice—well within the six-month window—its claim was not time-barred. In re Estate of Manchester, 66 A.3d 426, 2013 R.I. LEXIS 84 (R.I. 2013).

40-8-16. Notification of long-term care alternative.

  1. The department of human services, before authorizing care in a nursing home or intermediate-care facility for a person who is eligible to receive benefits pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., and who is being discharged from a hospital to a nursing home, shall notify the person, in writing, of the provisions of the long-term-care alternative, a home- and a community-based program.
  2. If a person, eligible to receive benefits pursuant to Title XIX of the federal Social Security Act, requires services in a nursing home and desires to remain in his or her own home or the home of a responsible relative or other adult, the person or his or her representative shall so inform the department.
  3. The department shall not make payments pursuant to Title XIX of the federal Social Security Act for benefits until written notification documenting the person’s choice as to a nursing home or home- and community-based services has been filed with the department.

History of Section. P.L. 1987, ch. 500, § 1.

40-8-17. Waiver request.

  1. Formation.  The executive office of health and human services is directed and authorized to apply for and obtain any necessary waiver(s), waiver amendment(s), and/or state plan amendments from the Secretary of the United States Department of Health and Human Services, including, but not limited to, an extension of the section 1115(a) demonstration waiver amended, as appropriate, and renamed to reflect the state’s effort to coordinate all publicly financed health care. The secretary of the office shall ensure that the state’s health and human services departments and the people and communities they serve in the Medicaid program shall have the opportunity to contribute to and collaborate in the formulation of any request for a new waiver, waiver extension, and/or state plan amendment(s). Any actions shall: (1) Continue efforts to rebalance the system of long-term services and supports by assisting people in obtaining care in the most appropriate and least restrictive setting; (2) Pursue further utilization of care-management models that promote preventive care, offer a health home, and provide an integrated system of services; (3) Use smart payments and purchasing to finance and support Medicaid initiatives that fill gaps in the integrated system of care; and (4) Recognize and ensure access to non-medical services and supports, such as peer navigation and employment and housing stabilization services, that are essential for optimizing a person’s health, wellness, and safety and that reduce or delay the need for long-term services and supports.
  2. Effective July 1, 2009, any provision presently in effect in the Rhode Island general laws where the executive office of health and human services is authorized to apply for and obtain any necessary waiver(s), waiver amendment(s), and/or state plan amendment(s) for the purpose of providing medical assistance to recipients, shall authorize the executive office of health and human services to proceed with appropriate category changes in accordance with the special terms and conditions of the Rhode Island Global Consumer Choice Compact section 1115(a) Demonstration Waiver or any extension thereof, as amended and/or renamed under the authority provided in this section.

History of Section. P.L. 1987, ch. 500, § 2; P.L. 1988, ch. 84, § 26; P.L. 2008, ch. 100, art. 17, § 3; P.L. 2009, ch. 68, art. 23, § 11; P.L. 2013, ch. 144, art. 19, § 1.

Federal Act References.

Section 1115 of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1315.

40-8-18. Local education agencies as EPSDT providers.

  1. It is the intent of this section to provide reimbursement for early and periodic screening, diagnosis and treatment (EPSDT) services through local education agencies for children who are eligible for medical assistance. A local education agency’s participation as an EPSDT provider is voluntary. Further, it is the intent that collaboration among the department of human services (DHS), the department of elementary and secondary education, and local education agencies (LEAs) will result in state and local funds being used to maximize federal funding for such EPSDT services.
  2. The services available to eligible children under Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., for early and periodic screening, diagnosis, and treatment (EPSDT) may be provided by local education agencies.
    1. Voluntary participation as an EPSDT provider shall require the local education agency to provide the state match to obtain federal financial participation for EPSDT services and associated administrative costs by certifying to the department of human services that sufficient qualifying local funds (local certified match) have been expended for the services and administrative costs; provided, however, that a local education agency shall not be required to provide local certified match for those EPSDT services for which the department of human services, or another state agency, agrees to provide the state match to obtain federal financial participation for EPSDT services.
    2. The local certified match shall be established in the local education agency pursuant to federal Title XIX provisions. Failure of the local education agency to provide the local match shall result in the penalties described in subsection (f).
    3. The department of human services shall pay the local education agency from the federal matching funds for EPSDT services pursuant to fee schedules established by rules and regulations of the department of human services, and for associated administrative costs pursuant to administrative cost reimbursement methodologies to be approved by the federal government, upon certification of the local match by the local education agency in accordance with federal Title XIX provisions. Payments made to the local education agency pursuant to this section shall be used solely for educational purposes and shall not be made available to local communities for purposes other than education. The local fiscal effort to support education referred to in subsection (d) shall not be reduced in response to the availability of these federal financial participation funds to the local education agency. These federal financial participation funds must supplement, not supplant, local maintained fiscal effort to support education.
    4. For the purposes of this subsection, the term “local education agency” shall include any city, town, state, or regional school district or the school for the deaf or the William M. Davies, Jr. career and technical high school, the Metropolitan Career and Technical Center, any public charter school established pursuant to chapter 77 of title 16, any educational collaborative established pursuant to chapter 3.1 of title 16, or the department of children, youth and families (DCYF).
    1. Each community shall maintain local fiscal effort for education. For the purpose of this subsection, to “maintain local fiscal effort” means each community shall contribute local funds to its school committee in an amount not less than its local contribution for schools in the previous fiscal year.
    2. Further, state support for education shall not be reduced from the prior fiscal year in response to local community participation in the EPSDT program.
  3. The department of human services and the department of elementary and secondary education shall effect the interagency transfers necessary to comply with the provisions of this section. The department of elementary and secondary education and the department of human services are authorized to promulgate any and all regulations necessary to implement this section. All local school agencies becoming EPSDT providers shall be required to comply with all provisions of Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., relative to responsibilities of a Medicaid provider.
  4. Failure of the local education agency to establish a local certified match under this law sufficient to support its claims for reimbursement of EPSDT services and associated administrative costs will result in the withholding of state funds due that community in accordance with § 16-7-31 in an amount equal to the federal financial participation funds denied by the federal government as a result thereof. The withheld funds will be transferred to the department of human services.
  5. The department of human services, with the aid of the department of education, shall determine which healthcare-related services are eligible for federal Medicaid reimbursement for health-related services provided by local education agencies to children eligible for early periodic screening, diagnosis and treatment. The department of human services, with the assistance of the department of administration, shall also develop the following resources in furtherance of the goal of recouping the maximum amount of administrative costs associated with the services:
    1. A time-study training manual that outlines how to complete a time study by school personnel to enhance recovery of administrative costs; and
    2. A claiming manual that outlines the financial information and claim submission requirements that are needed to complete the claim.

History of Section. P.L. 1992, ch. 289, § 1; P.L. 1992, ch. 399, § 1; P.L. 1999, ch. 241, § 1; P.L. 2000, ch. 55, art. 13, § 1.

40-8-19. Rates of payment to nursing facilities.

  1. Rate reform.
    1. The rates to be paid by the state to nursing facilities licensed pursuant to chapter 17 of title 23, and certified to participate in Title XIX of the Social Security Act for services rendered to Medicaid-eligible residents, shall be reasonable and adequate to meet the costs that must be incurred by efficiently and economically operated facilities in accordance with 42 U.S.C. § 1396a(a)(13). The executive office of health and human services (“executive office”) shall promulgate or modify the principles of reimbursement for nursing facilities in effect as of July 1, 2011, to be consistent with the provisions of this section and Title XIX, 42 U.S.C. § 1396 et seq., of the Social Security Act.
    2. The executive office shall review the current methodology for providing Medicaid payments to nursing facilities, including other long-term-care services providers, and is authorized to modify the principles of reimbursement to replace the current cost-based methodology rates with rates based on a price-based methodology to be paid to all facilities with recognition of the acuity of patients and the relative Medicaid occupancy, and to include the following elements to be developed by the executive office:
      1. A direct-care rate adjusted for resident acuity;
      2. An indirect-care rate comprised of a base per diem for all facilities;
      3. A rearray of costs for all facilities every three (3) years beginning October, 2015, that may or may not result in automatic per diem revisions;
      4. Application of a fair-rental value system;
      5. Application of a pass-through system; and
      6. Adjustment of rates by the change in a recognized national nursing home inflation index to be applied on October 1 of each year, beginning October 1, 2012. This adjustment will not occur on October 1, 2013, October 1, 2014, or October 1, 2015, but will occur on April 1, 2015. The adjustment of rates will also not occur on October 1, 2017, October 1, 2018, and October 1, 2019. Effective July 1, 2018, rates paid to nursing facilities from the rates approved by the Centers for Medicare and Medicaid Services and in effect on October 1, 2017, both fee-for-service and managed care, will be increased by one and one-half percent (1.5%) and further increased by one percent (1%) on October 1, 2018, and further increased by one percent (1%) on October 1, 2019. In addition to the annual nursing home inflation index adjustment, there shall be a base rate staffing adjustment of one-half percent (0.5%) on October 1, 2021, one percent (1.0%) on October 1, 2022, and one and one-half percent (1.5%) on October 1, 2023. The inflation index shall be applied without regard for the transition factors in subsections (b)(1) and (b)(2). For purposes of October 1, 2016, adjustment only, any rate increase that results from application of the inflation index to subsections (a)(2)(i) and (a)(2)(ii) shall be dedicated to increase compensation for direct-care workers in the following manner: Not less than 85% of this aggregate amount shall be expended to fund an increase in wages, benefits, or related employer costs of direct-care staff of nursing homes. For purposes of this section, direct-care staff shall include registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), certified medical technicians, housekeeping staff, laundry staff, dietary staff, or other similar employees providing direct-care services; provided, however, that this definition of direct-care staff shall not include: (i) RNs and LPNs who are classified as “exempt employees” under the federal Fair Labor Standards Act (29 U.S.C. § 201 et seq.); or (ii) CNAs, certified medical technicians, RNs, or LPNs who are contracted, or subcontracted, through a third-party vendor or staffing agency. By July 31, 2017, nursing facilities shall submit to the secretary, or designee, a certification that they have complied with the provisions of this subsection (a)(2)(vi) with respect to the inflation index applied on October 1, 2016. Any facility that does not comply with terms of such certification shall be subjected to a clawback, paid by the nursing facility to the state, in the amount of increased reimbursement subject to this provision that was not expended in compliance with that certification.
    3. Commencing on October 1, 2021, eighty percent (80%) of any rate increase that results from application of the inflation index to subsections (a)(2)(i) and (a)(2)(ii) of this section shall be dedicated to increase compensation for all eligible direct-care workers in the following manner on October 1, of each year.
      1. For purposes of this subsection, compensation increases shall include base salary or hourly wage increases, benefits, other compensation, and associated payroll tax increases for eligible direct-care workers. This application of the inflation index shall apply for Medicaid reimbursement in nursing facilities for both managed care and fee-for-service. For purposes of this subsection, direct-care staff shall include registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), certified medication technicians, licensed physical therapists, licensed occupational therapists, licensed speech-language pathologists, mental health workers who are also certified nurse assistants, physical therapist assistants, housekeeping staff, laundry staff, dietary staff or other similar employees providing direct-care services; provided, however that this definition of direct-care staff shall not include:
        1. RNs and LPNs who are classified as “exempt employees” under the federal Fair Labor Standards Act (29 U.S.C. § 201 et seq.); or
        2. CNAs, certified medication technicians, RNs or LPNs who are contracted or subcontracted through a third-party vendor or staffing agency.
      1. By July 31, 2021, and July 31 of each year thereafter, nursing facilities shall submit to the secretary or designee a certification that they have complied with the provisions of subsection (a)(3) of this section with respect to the inflation index applied on October 1. The executive office of health and human services (EOHHS) shall create the certification form nursing facilities must complete with information on how each individual eligible employee’s compensation increased, including information regarding hourly wages prior to the increase and after the compensation increase, hours paid after the compensation increase, and associated increased payroll taxes. A collective bargaining agreement can be used in lieu of the certification form for represented employees. All data reported on the compliance form is subject to review and audit by EOHHS. The audits may include field or desk audits, and facilities may be required to provide additional supporting documents including, but not limited to, payroll records.
      2. Any facility that does not comply with the terms of certification shall be subjected to a clawback and twenty-five percent (25%) penalty of the unspent or impermissibly spent funds, paid by the nursing facility to the state, in the amount of increased reimbursement subject to this provision that was not expended in compliance with that certification.
      3. In any calendar year where no inflationary index is applied, eighty percent (80%) of the base rate staffing adjustment in that calendar year pursuant to subsection (a)(2)(vi) of this section shall be dedicated to increase compensation for all eligible direct-care workers in the manner referenced in subsections (a)(3)(i), (a)(3)(i)(A), and (a)(3)(i)(B) of this section.
  2. Transition to full implementation of rate reform.  For no less than four (4) years after the initial application of the price-based methodology described in subsection (a)(2) to payment rates, the executive office of health and human services shall implement a transition plan to moderate the impact of the rate reform on individual nursing facilities. The transition shall include the following components:
    1. No nursing facility shall receive reimbursement for direct-care costs that is less than the rate of reimbursement for direct-care costs received under the methodology in effect at the time of passage of this act; for the year beginning October 1, 2017, the reimbursement for direct-care costs under this provision will be phased out in twenty-five-percent (25%) increments each year until October 1, 2021, when the reimbursement will no longer be in effect; and
    2. No facility shall lose or gain more than five dollars ($5.00) in its total, per diem rate the first year of the transition. An adjustment to the per diem loss or gain may be phased out by twenty-five percent (25%) each year; except, however, for the years beginning October 1, 2015, there shall be no adjustment to the per diem gain or loss, but the phase out shall resume thereafter; and
    3. The transition plan and/or period may be modified upon full implementation of facility per diem rate increases for quality of care-related measures. Said modifications shall be submitted in a report to the general assembly at least six (6) months prior to implementation.
    4. Notwithstanding any law to the contrary, for the twelve-month (12) period beginning July 1, 2015, Medicaid payment rates for nursing facilities established pursuant to this section shall not exceed ninety-eight percent (98%) of the rates in effect on April 1, 2015. Consistent with the other provisions of this chapter, nothing in this provision shall require the executive office to restore the rates to those in effect on April 1, 2015, at the end of this twelve-month (12) period.

History of Section. P.L. 1993, ch. 138, art. 20, § 1; P.L. 1996, ch. 100, art. 26, § 1; P.L. 1996, ch. 398, § 1; P.L. 1999, ch. 31, art. 22, § 1; P.L. 2000, ch. 127, § 1; P.L. 2000, ch. 343, § 1; P.L. 2001, ch. 77, art. 13, § 2; P.L. 2002, ch. 419, § 1; P.L. 2003, ch. 376, art. 41, § 1; P.L. 2004, ch. 595, art. 46, § 1; P.L. 2006, ch. 246, art. 15, § 1; P.L. 2007, ch. 73, art. 12, § 1; P.L. 2008, ch. 100, art. 37, § 1; P.L. 2008, ch. 475, § 8; P.L. 2009, ch. 5, art. 14, § 1; P.L. 2009, ch. 68, art. 23, § 1; P.L. 2010, ch. 23, art. 20, § 6; P.L. 2011, ch. 151, art. 14, § 1; P.L. 2012, ch. 304, § 1; P.L. 2012, ch. 327, § 1; P.L. 2013, ch. 144, art. 19, § 1; P.L. 2014, ch. 145, art. 18, § 1; P.L. 2015, ch. 141, art. 5, § 11; P.L. 2016, ch. 142, art. 7, § 2; P.L. 2017, ch. 302, art. 9, § 2; P.L. 2018, ch. 47, art. 13, § 1; P.L. 2019, ch. 88, art. 13, § 5; P.L. 2021, ch. 23, § 2, effective May 27, 2021; P.L. 2021, ch. 24, § 2, effective May 27, 2021.

Compiler’s Notes.

P.L. 2009, ch. 68, art. 23, § 14 provides that the amendment to this section takes effect upon passage [July 1, 2009], and any rules or regulations necessary or advisable to implement the provisions of section 1 of this article shall be effective immediately as an emergency rule upon the department’s filing thereof with the secretary of state as it is hereby found that the current fiscal crisis in this state has caused an imminent peril to public health, safety and welfare, and the department is hereby exempted from the requirements of §§ 42-35-3(b) and 42-35-4(b)(2) relating to agency findings of imminent peril to public health, safety and welfare and the filing of statements of the agency’s reasons thereof.

P.L. 2011, ch. 151, art. 18, § 2 provides: “The executive office of health and human services shall submit a report to the chairpersons of the house and senate finance committees by November 1, 2011, to coincide with the filing of the state plan amendment, detailing the changes to the nursing home reimbursement rates.”

P.L. 2021, ch. 23, § 2, and P.L. 2021, ch. 24, § 2 enacted identical amendments to this section.

40-8-19.1. Nursing facility financial oversight.

  1. On an annual basis, every licensed nursing facility participating in the medical assistance program shall file a financial statement or other financial information acceptable to the department with its annual cost report (BM-64) for the time period covered by the cost report that would provide sufficient information for the department to assess the facility’s financial status.
  2. The department shall, by regulation:
    1. Develop, in consultation with the department of health, criteria for the financial statements or financial information to be submitted in lieu of the financial statement as required in subsection (a);
    2. Develop criteria for reviewing the financial statement or financial information submitted and assessing the financial status of facilities to determine if they have sufficient resources to meet operational and financial expenses and to comply with resident care and facility standards; and
    3. Establish a set of indicators or criteria that would indicate if a facility’s financial status is marginal of if a facility is having severe financial difficulties. These criteria shall include, but not be limited to:
      1. Significant operating losses for two (2) successive years;
      2. Frequent requests for advance on Medicaid reimbursements;
      3. Unfavorable working capital ratios of assets to liabilities;
      4. High proportion of accounts receivable more than ninety (90) days’ old;
      5. Increasing accounts payable, unpaid taxes, and/or payroll-related costs;
      6. Minimal or decreasing equity and/or reserves;
      7. High levels of debt and high borrowing costs.
  3. Whenever a facility’s financial status is determined to be marginal or to have severe financial difficulties, the department shall notify the director of the department of health.
  4. Special rate appeal pursuant to § 23-17-12.7 .  The department shall file a state plan amendment with the United States Department of Health and Human Services to modify the principles of reimbursement for nursing facilities, to be effective on October 1, 2005, or as soon thereafter as is authorized by an approved state plan amendment, to assign a special prospective appeal rate for any facility for which, pursuant to § 23-17-12.6 , the department of health has appointed an independent quality monitor; the department of health has required to engage an independent quality consultant or temporary manager; and/or the department of health pursuant to § 23-17-12.7 has been required to develop and implement a plan of correction and remediation to address concerns regarding resident care and coincident financial solvency. The special prospective appeal rate shall be assigned for a duration of not less than six (6) months, shall be based upon the additional cost of the independent quality monitor, independent quality consultant, or temporary manager, as the case may be, or the approved spending plan set forth in the plan of correction and remediation, and subject to review-of-cost report, and subsequent extension at the discretion of the department, at six-month (6) intervals for a maximum of eighteen (18) months thereafter. In calculating the prospective per diem, the department shall disregard the cost center ceilings for the direct labor and other operating expense cost centers. The department shall recoup any funds specified in the spending plan that have not been expended.

History of Section. P.L. 2005, ch. 156, § 5; P.L. 2005, ch. 248, § 5.

40-8-19.2. Nursing Facility Incentive Program (NFIP).

The secretary of the executive office of health and human services is authorized to seek the federal authority required to implement a nursing facility incentive program (NFIP). The NFIP shall provide the participating licensed nursing facilities the ability to obtain certain payments for achieving performance goals established by the secretary. NFIP payments shall commence no earlier than July 1, 2016.

History of Section. P.L. 2015, ch. 141, art. 5, § 11.

40-8-20. [Repealed.]

History of Section. P.L. 1993, ch. 138, art. 20, § 1; Repealed by P.L. 2003, ch. 376, art. 41, § 2, effective October 1, 2005.

Compiler’s Notes.

Former § 40-8-20 concerned rate increment requests. For present provisions of law, see § 40-8-21 .

40-8-20.1. Prospective rate increments.

The department may consider the granting of a prospective rate that reflects demonstrated cost increases in excess of the rate that has been established by the application of the percentage increase. In order to qualify for the rate increment, demonstrated increased costs must be the result of:

  1. Demonstrated errors made during the rate-determination process;
  2. Significant increases in operating costs resulting from the implementation of new or additional programs, services, or staff specifically mandated by the Rhode Island department of health;
  3. Significant increases in operating costs resulting from capital renovations, expansion, or replacement required for compliance with fire safety codes and/or certification requirements of the Rhode Island department of health, as well as increased energy costs that the facility can demonstrate are a result of the facility having expended funds for heating, lighting, hot water, and similar costs associated with the consumption of energy provided by public utilities;
  4. Significant increases in workers’ compensation and/or health insurance premiums that cannot be accommodated within the nursing facility’s assigned aggregate per diem rate, if cost justified; provided, that the assigned per diem rate in the labor- and payroll-related-expenses cost center does not exceed two percent (2%) of the cost center ceiling; or
  5. Extraordinary circumstances, including, but not limited to, acts of God, and inordinate increases in energy costs (e.g., federal BTU tax, regional or national energy crisis). Inordinate increases in energy costs will be immediately reflected in increased rates above the energy cost center ceiling maximum. Provided, however, that the increases will be rescinded immediately upon cessation of the extraordinary circumstance. All requests for rate increments shall be limited to one request per nursing facility for the factors set forth in subsections (2) and (3); provided, additional requests involving a per diem increase in excess of one percent of the nursing facility’s previously assigned aggregate per diem rate shall also be reviewed. Before a nursing facility shall be permitted to file for a rate increment, increases in operating costs set forth in subsections (2) and (3) must have been incurred for a period of not less than three (3) months in order to establish proof of the increase. Rate adjustments granted as a result of a request filed within one hundred twenty (120) days after the costs were first incurred shall be made effective retroactively to the date the costs were actually incurred; provided, further, any adjustments granted as a result of requests filed more than one hundred twenty (120) days after the costs were first incurred will be effective on the first day of the month following the filing of the request.

History of Section. P.L. 2006, ch. 246, art. 15, § 2; P.L. 2007, ch. 73, art. 12, § 1.

40-8-20.2. Best energy practices for licensed nursing facilities — Energy conservation retention credit.

  1. In order to reduce overall energy consumption and to slow the rate of the growth in state Medicaid expenditures, the state of Rhode Island shall adopt an energy conservation retention credit for licensed nursing facilities that meet the criteria set forth herein. Every licensed nursing facility participating in the Medicaid medical assistance program that: (1) Expends funds for energy conservation measures and the use of renewable fuels, energy sources, and so-called “green” sources of energy that result in a reduction of energy consumption; and (2) Which methods the facility can demonstrate, to the satisfaction of the department, result in the facility’s “pass through” per diem cost being reduced in the next base year in comparison to the immediately preceding base year, shall be permitted to retain the difference in the previous per diem and the new per diem for a period of up to twenty-four (24) months. Provided, that such retained funds shall be utilized by the nursing facility solely for either: (1) Costs directly associated with employing labor at the facility; or (2) To pay down any debt of the nursing facility incurred directly through the purchases of energy saving, conservation, and renewable energy or so-called “green” devices.
  2. The department of human services shall convene a working group of interested parties, including, but not limited to, public utilities, provider trades associations, labor unions representing nursing home employees, and environmental advocates, to establish best energy practices for this industry.

History of Section. P.L. 2007, ch. 73, art. 12, § 2.

40-8-21. Appeals process.

  1. Any provider that is not in agreement, after being provided an exit-audit conference or rate-appeal conference, with a final rate of reimbursement assigned as a result of an audit for its base year, or with the application of the principles of reimbursement for an applicable year, may within fifteen (15) days from the date of notification of audit results or rate assignment, file a written request with the department for a review of the computation of the assigned rate. The foregoing right of appeal shall also apply to demonstrated errors made during the rate determination process.
  2. A review conference will be conducted within fifteen (15) days from the date of receipt of the written request by a designee assigned by the director of the department of human services. As a result of the review conference, the designee may modify the audit adjustments and/or the rate of reimbursement. The designee shall provide the facility with a written decision within thirty (30) days from the date of the review conference.
  3. Appeals beyond the review conference shall be in accordance with the provisions of chapter 35 of title 42. The facility shall file a written request for the hearing no later than fifteen (15) days after receipt of the review conference decision.

History of Section. P.L. 1993, ch. 138, art. 20, § 1; P.L. 2003, ch. 376, art. 41, § 3.

40-8-22. Protection of resources — Long-term care insurance partnership program.

  1. The department of human services shall coordinate a program entitled the Rhode Island Partnership for Long-Term Care whereby private insurance and funds may be utilized to finance long-term care. The department shall seek appropriate amendments to its state plan for medical assistance under Title XIX, 42 U.S.C. § 1396 et seq., of the Social Security Act (Medicaid), or waivers of state plan requirements, to allow protection of resources and income pursuant to this section. The protection shall be provided, to the extent approved by the federal Centers for Medicare and Medicaid Services, for any purchaser of a precertified, long-term-care policy delivered, issued for delivery, or renewed and shall last for the life of the purchaser. Notwithstanding any provision of the general laws, the resources of an individual, to the extent the resources are equal to the amount of qualifying long-term-care insurance benefits payments provided pursuant to a policy of long-term-care insurance precertified in accordance with department regulations and chapter 34.2 of title 27, shall not be considered by the department in a determination of: (1) His or her eligibility for Medicaid; (2) The amount of any Medicaid payment; or (3) In any subsequent recovery by the state of a payment for medical services. The precertified policies shall be known as “Medicaid qualifying long-term care partnership policies.”
  2. The department shall count insurance benefit payments toward resource exclusion to the extent the payments: (1) Are for services covered under the state plan for medical assistance, including nursing home care, or formal services delivered to insureds in the community as part of a care plan; (2) Are for the lower of the actual charge or the amount paid by the insurance company; and (3) Are for services provided after the individual meets the coverage requirements for long-term-care benefits established by the department for this program. The department shall adopt rules and regulations to implement the provisions of this section and relating to determining eligibility of applicants for Medicaid and the coverage requirements for long-term-care benefits.

History of Section. P.L. 1993, ch. 454, § 1; P.L. 2007, ch. 239, § 4.

40-8-23. Contracting standards.

The director shall establish and maintain contracting standards for home health aide, homemaker, and nursing services. These standards shall apply to all such services purchased by the state from licensed providers. The contracting standards shall take into consideration industry guidelines published by national accreditation organizations such as the Joint Commission for the Accreditation of Healthcare Organizations and self-reporting activities by providers.

History of Section. P.L. 1996, ch. 341, § 1.

40-8-24. Less expensive alternative medications.

For pharmaceutical purchases eligible for reimbursement under the Medicaid state plan, the department shall encourage the substitution of generic drugs which are therapeutically equivalent and interchangeable with specific brand name drugs in accordance with § 21-31-16.1 and related regulations of the department of health, except in the event that a brand name is determined by the director to be less costly to the state than the equivalent generic. Calculation of comparative drug costs shall include consideration of the amount paid by the state to the pharmacy for a drug under the current retail pharmacy reimbursement formula, less any discounts or rebates, including those paid pursuant to federal Medicaid law during the previous calendar quarter, and inclusive of all dispensing fees.

History of Section. P.L. 2002, ch. 65, art. 24, § 1; P.L. 2004, ch. 416, § 1; P.L. 2004, ch. 552, § 1.

40-8-25. Nursing facility pharmaceutical waste reduction.

The department shall implement one or more methods to reduce the disposal of unused pharmaceuticals paid for by the medical assistance program for residents of nursing facilities licensed pursuant to chapter 17 of title 23. The department shall make a report to the permanent joint legislative committee on health care oversight on or before March 1, 2005, regarding the methods employed and any resulting cost savings anticipated.

History of Section. P.L. 2004, ch. 282, § 1; P.L. 2004, ch. 465, § 1.

40-8-26. Community health centers.

  1. For the purposes of this section, the term community health centers refers to federally qualified health centers and rural health centers.
  2. To support the ability of community health centers to provide high-quality medical care to patients, the executive office of health and human services (“executive office”) may adopt and implement an alternative payment methodology (APM) for determining a Medicaid per-visit reimbursement for community health centers that is compliant with the prospective payment system (PPS) provided for in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000. The following principles are to ensure that the APM PPS rate determination methodology is part of the executive office overall value purchasing approach. For community health centers that do not agree to the principles of reimbursement that reflect the APM PPS, EOHHS shall reimburse such community health centers at the federal PPS rate, as required per section 1902(bb)(3) of the Social Security Act, 42 U.S.C. § 1396a(bb)(3). For community health centers that are reimbursed at the federal PPS rate, subsections (d) through (f) of this section apply.
  3. The APM PPS rate determination methodology will (i) Fairly recognize the reasonable costs of providing services. Recognized reasonable costs will be those appropriate for the organization, management, and direct provision of services and (ii) Provide assurances to the executive office that services are provided in an effective and efficient manner, consistent with industry standards. Except for demonstrated cause and at the discretion of the executive office, the maximum reimbursement rate for a service (e.g., medical, dental) provided by an individual community health center shall not exceed one hundred twenty-five percent (125%) of the median rate for all community health centers within Rhode Island.
  4. Community health centers will cooperate fully and timely with reporting requirements established by the executive office.
  5. Reimbursement rates established through this methodology shall be incorporated into the PPS reconciliation for services provided to Medicaid-eligible persons who are enrolled in a health plan on the date of service. Monthly payments by the executive office related to PPS for persons enrolled in a health plan shall be made directly to the community health centers.
  6. Reimbursement rates established through this methodology shall be incorporated into the actuarially certified capitation rates paid to a health plan. The health plan shall be responsible for paying the full amount of the reimbursement rate to the community health center for each service eligible for reimbursement under the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000. If the health plan has an alternative payment arrangement with the community health center the health plan may establish a PPS reconciliation process for eligible services and make monthly payments related to PPS for persons enrolled in the health plan on the date of service. The executive office will review, at least annually, the Medicaid reimbursement rates and reconciliation methodology used by the health plans for community health centers to ensure payments to each are made in compliance with the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000.

History of Section. P.L. 2006, ch. 246, art. 35, § 2; P.L. 2017, ch. 302, art. 9, § 2; P.L. 2021, ch. 162, art. 12, § 2, effective July 1, 2021.

40-8-27. Cooperation by providers.

Medicaid providers who employ individuals applying for benefits under any chapter of this title shall comply in a timely manner with requests made by the department for any documents describing employer-sponsored health insurance coverage or benefits the provider offers that are necessary to determine eligibility for the state’s premium assistance program pursuant to § 40-8.4-12 . Documents requested by the department may include, but are not limited to, certificates of coverage or a summary of benefits and employee obligations. Upon receiving notification that the department has determined that the employee is eligible for premium assistance under § 40-8.4-12 , the provider shall accept the enrollment of the employee and his or her family in the employer-based health insurance plan without regard to any seasonal enrollment restrictions, including open-enrollment restrictions, and/or the impact on the employee’s wages. Additionally, the Medicaid provider employing such persons shall not offer “pay in lieu of benefits.” Providers who do not comply with the provisions set forth in this section shall be subject to suspension as a participating Medicaid provider.

History of Section. P.L. 2008, ch. 100, art. 17, § 7.

40-8-28. Vendors doing business in the state of Rhode Island.

All vendors who do business with the state of Rhode Island in accordance with title 37 and who are also employers of Rhode Island medical assistance recipients shall make available in a timely manner to the department at the department’s request, documents describing the health insurance or health benefits offered by the vendor to the employee, including, but not limited to, a certificate of coverage or a summary of benefits and employee obligations for the purposes of, and only to the extent necessary to carry out the provisions of this section of the general laws. The employer shall accept the enrollment of the individual and/or the family in the employer-based health insurance plan without regard to any seasonal enrollment restrictions, including open-enrollment restrictions, without regard to the impact on the member’s wages. This is known as “pay in lieu of benefits.”

History of Section. P.L. 2008, ch. 100, art. 17, § 7.

40-8-29. Selective contracting.

  1. Notwithstanding any other provision of state law, the department of human services is authorized to utilize selective contracting with prior general assembly approval for the purpose of purchasing for Medicaid recipients shared-living provider services, durable medical equipment and supplies, non-emergency transportation, and any other Medicaid services, when appropriate, in order to ensure that all service expenditures under this chapter have the maximum benefit of competition, and afford Rhode Islanders the overall best value, optimal quality, and the most cost-effective care possible. Beneficiaries will be limited to using the services/products of only those providers determined in a competitive bidding process to meet the standards for best quality, performance, and price set by the department in accordance with applicable federal and state laws.
  2. For purposes of this section, “selective contracting” shall mean the process for choosing providers to serve Medicaid beneficiaries based on their ability to deliver the best quality products or services, at the best value or price.
  3. To ensure all services allowable for Medicare reimbursement for beneficiaries who are dually eligible, selective contractors must be willing and able to accept Medicare.

History of Section. P.L. 2008, ch. 100, art. 17, § 7; P.L. 2009, ch. 68, art. 22, § 4; P.L. 2009, ch. 68, art. 23, § 2; P.L. 2009, ch. 69, § 4; P.L. 2010, ch. 23, art. 20, § 1.

40-8-30. Suspension of participating providers.

Any approved medical assistance provider who declines to participate in contracting for benefits in any one of the department’s medical assistance programs, including, but not limited to, any and all managed care programs, may be suspended as a participating provider and denied participation in all state-operated medical assistance programs at the discretion of the department. Prior to suspension, a participating provider shall have the right to appeal such suspension to a state administrative hearing officer, in accordance with the rules of the department of human services.

History of Section. P.L. 2009, ch. 68, art. 22, § 5; P.L. 2009, ch. 69, § 5.

40-8-31. Payments to out-of-state facilities.

Effective September 1, 2014, the executive office of health and human services shall require that any payment to an out-of-state provider from whom a Medicaid-eligible individual receives services must be a facility that applies for, and is approved to participate in, the Rhode Island Medicaid program. This excludes payments to out-of-state providers that do not participate in the Rhode Island Medicaid program but that are determined to be acceptable due to extenuating circumstances by the secretary of the executive office of health and human services. Furthermore, the department of children, youth and families is required to submit a bi-weekly report to the chair of the house committee on finance, the chair of the senate committee on finance, the house fiscal advisor, the senate fiscal advisor, and the office of management and budget detailing payments for placements to out-of-state facilities. The report should also indicate the entity recommending or ordering the placement, the types of services required, and reason for using an out-of-state facility. This change may require the adoption of new or amended rules, regulations and procedures.

History of Section. P.L. 2014, ch. 145, art. 18, § 2.

40-8-32. Support for certain patients of nursing facilities.

  1. Definitions.  For purposes of this section:
    1. “Applied income” shall mean the amount of income a Medicaid beneficiary is required to contribute to the cost of his or her care.
    2. “Authorized individual” shall mean a person who has authority over the income of a patient of a nursing facility, such as a person who has been given or has otherwise obtained authority over a patient’s bank account; has been named as or has rights as a joint account holder; or is a fiduciary as defined below.
    3. “Costs of care” shall mean the costs of providing care to a patient of a nursing facility, including nursing care, personal care, meals, transportation, and any other costs, charges, and expenses incurred by a nursing facility in providing care to a patient. Costs of care shall not exceed the customary rate the nursing facility charges to a patient who pays for his or her care directly rather than through a governmental or other third-party payor.
    4. “Fiduciary” shall mean a person to whom power or property has been formally entrusted for the benefit of another, such as an attorney-in-fact, legal guardian, trustee, or representative payee.
    5. “Nursing facility” shall mean a nursing facility licensed under chapter 17 of title 23, that is a participating provider in the Rhode Island Medicaid program.
    6. “Penalty period” means the period of Medicaid ineligibility imposed pursuant to 42 U.S.C. § 1396p(c), as amended from time to time, on a person whose assets have been transferred for less than fair market value.
    7. “Uncompensated care” — Care and services provided by a nursing facility to a Medicaid applicant without receiving compensation therefore from Medicaid, Medicare, the Medicaid applicant, or other source. The acceptance of any payment representing actual or estimated applied income shall not disqualify the care and services provided from qualifying as uncompensated care.
  2. Penalty period resulting from transfer.  Any transfer or assignment of assets resulting in the establishment or imposition of a penalty period shall create a debt that shall be due and owing to a nursing facility for the unpaid costs of care provided during the penalty period to a patient of that facility who has been subject to the penalty period. The amount of the debt established shall not exceed the fair market value of the transferred assets at the time of transfer that are the subject of the penalty period. A nursing facility may bring an action to collect a debt for the unpaid costs of care given to a patient who has been subject to a penalty period, against either the transferor or the transferee, or both. The provisions of this section shall not affect other rights or remedies of the parties.
  3. Applied income.  A nursing facility may provide written notice to a patient who is a Medicaid recipient and any authorized individual of that patient:
    1. Of the amount of applied income due;
    2. Of the recipient’s legal obligation to pay the applied income to the nursing facility; and
    3. That the recipient’s failure to pay applied income due to a nursing facility not later than thirty (30) days after receiving notice from the nursing facility may result in a court action to recover the amount of applied income due.

      A nursing facility that is owed applied income may, in addition to any other remedies authorized under law, bring a claim to recover the applied income against a patient and any authorized individual. If a court of competent jurisdiction determines, based upon clear and convincing evidence, that a defendant willfully failed to pay or withheld applied income due and owing to a nursing facility for more than thirty (30) days after receiving notice pursuant to subsection (c), the court may award the amount of the debt owed, court costs, and reasonable attorney’s fees to the nursing facility.

  4. Effects.  Nothing contained in this section shall prohibit or otherwise diminish any other causes of action possessed by any such nursing facility. The death of the person receiving nursing facility care shall not nullify or otherwise affect the liability of the person or persons charged with the costs of care rendered or the applied income amount as referenced in this section.

History of Section. P.L. 2015, ch. 141, art. 5, § 13; P.L. 2020, ch. 79, art. 1, § 30.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

Chapter 8.1 Personal Care Attendant Program

40-8.1-1. Authority to establish program — Administration.

The department of human services is hereby authorized to establish a participant-directed personal care attendant program for those with severe physical disabilities, to provide personal attendant care to those disabled individuals who meet certain eligibility criteria hereinafter stated. The department of human services shall be responsible for the administration of the program but may contract with other state agencies or nonprofit organizations in connection with the program.

History of Section. P.L. 1979, ch. 122, § 1.

40-8.1-2. Services provided.

Services that may be provided eligible persons if not available from other sources include:

  1. Any appropriate vocational rehabilitation service, as well as other services that will enhance the ability of individuals with disabilities to live independently and function within the family and community;
  2. Personal care attendant services;
  3. Advocacy services;
  4. Peer counseling;
  5. Housing; and
  6. Transportation.

History of Section. P.L. 1979, ch. 122, § 1; P.L. 1999, ch. 83, § 98; P.L. 1999, ch. 130, § 98.

40-8.1-3. Eligibility for services.

Services available under this chapter may be provided to any person who meets the following criteria:

  1. Has made application therefor to the director of the department of human services in a manner prescribed by the director;
  2. Has a severe physical disability that caused the person to be unduly dependent, the disability to be certified by the division of vocational rehabilitation; and
  3. Has not sufficient income or resources to meet the cost of home-care services, a determination of insufficiency to be made by the division of vocational rehabilitation.

History of Section. P.L. 1979, ch. 122, § 1.

40-8.1-4. When services may be provided.

Personal care attendant services may be provided when:

  1. The requirements of § 40-8.1-3 are met; and
  2. An attendant is available to provide the care needed.

History of Section. P.L. 1979, ch. 122, § 1.

40-8.1-5. Appropriations.

There is hereby appropriated to the department of human services funds adequate to implement an independent-living program, including a participant-directed personal care attendant program, in the amount of ninety-five thousand dollars ($95,000) for fiscal year ending June 30, 1980. Additional funds shall be made available on a yearly basis to maintain the program.

History of Section. P.L. 1979, ch. 122, § 1.

Chapter 8.2 Medical Assistance Fraud

40-8.2-1. Short title.

This chapter shall be known as the “Rhode Island Medical Assistance Fraud Law.”

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-2. Definitions.

Whenever used in this chapter:

  1. “Benefit” means pecuniary benefit as defined herein.
  2. “Claim” means any request for payment, electronic or otherwise, and shall also include any data commonly known as encounter data, that is used, or is to be used, for the development of a capitation fee payable to a provider of managed healthcare goods, merchandise, or services.
  3. “Executive office” means the executive office of health and human services, the agency designated by state law and the Medicaid state plan as the Medicaid single state agency.
  4. “Fee schedule” means a list of goods or services to be recognized as properly compensable under the Rhode Island Medicaid program and applicable rates of reimbursement.
  5. “Kickback” means a return in any form by any individual of a part of an expenditure made by a provider:
    1. To the same provider;
    2. To an entity controlled by the provider; or
    3. To an entity that the provider intends to benefit whenever the expenditure is reimbursed, or reimbursable, or claimed by a provider as being reimbursable by the Rhode Island Medicaid program and when the sum or value returned is not credited to the benefit of the Rhode Island Medicaid program.
  6. “Medicaid fraud control unit” means a duly certified Medicaid fraud control unit under federal regulation authorized to perform those functions as described by § 1903(q) of the Social Security Act, 42 U.S.C. § 1396b(q).
  7. “Medically unnecessary services or merchandise” means services or merchandise provided to recipients intentionally without any expectation that the services or merchandise will alleviate or aid the recipient’s medical condition.
  8. “Office of program integrity” or “OPI” means the division within the executive office of health and human services, authorized pursuant to § 42-7.2-18 , to coordinate state and local agencies, law enforcement entities, and investigative units in order to increase the effectiveness of programs and initiatives dealing with the prevention, detection, and prosecution of Medicaid and public assistance fraud; to develop cooperative strategies to investigate and eliminate Medicaid and public assistance fraud and to recover state and federal funds; and to represent the executive office and act on the secretary’s behalf in any matters related to the prevention, detection, and prosecution of Medicaid fraud under this chapter.
  9. “Pecuniary benefit” means benefit in the form of money, property, commercial interests, or anything else the primary significance of which is economic gain.
  10. “Person” means any person or individual, natural or otherwise, and includes those person(s) or entities defined by the term “provider.”
  11. “Provider” means any individual, individual medical vendor, firm, corporation, professional association, partnership, organization, or other legal entity that provides goods or services under the Rhode Island Medicaid program, or the employee of any person or entity who, on his or her own behalf, or on the behalf of his or her employer, knowingly performs any act or is knowingly responsible for an omission prohibited by this chapter.
  12. “Recipient” means any person receiving medical assistance under the Rhode Island Medicaid program.
  13. “Records” means all documents developed by a provider and related to the provision of services reimbursed or claimed as reimbursable by the Rhode Island Medicaid program.
  14. “Rhode Island Medicaid program” means a state-administered, medical assistance program that is funded by the state and federal governments under Title XIX and Title XXI of the U.S. Social Security Act and any general or public laws and administered by the executive office of health and human services.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 1989, ch. 501, § 2; P.L. 1993, ch. 232, § 1; P.L. 2015, ch. 141, art. 5, § 12.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq. Title XXI of the Social Security Act is codified at 42 U.S.C. § 1397aa et seq.

40-8.2-3. Prohibited acts.

  1. It shall be unlawful for any person intentionally to:
    1. Present, or cause to be presented, for preauthorization or payment to the Rhode Island Medicaid program:
      1. Any materially false or fraudulent claim or cost report for the furnishing of services or merchandise; or
      2. Present, or cause to be presented, for preauthorization or payment, any claim or cost report for medically unnecessary services or merchandise; or
      3. To submit, or cause to be submitted, materially false or fraudulent information for the intentional purpose(s) of obtaining greater compensation than that to which the provider is legally entitled for the furnishing of services or merchandise; or
      4. Submit, or cause to be submitted, materially false information for the purpose of obtaining authorization for furnishing services or merchandise; or
      5. Submit, or cause to be submitted, any claim or cost report or other document that fails to make full disclosure of material information.
      1. Solicit, receive, offer, or pay any remuneration, including any kickback, bribe, or rebate, directly or indirectly, in cash or in kind, to induce referrals from or to any person in return for furnishing of services or merchandise, or in return for referring an individual to a person for the furnishing of any services or merchandise, for which payment may be made, in whole or in part, under the Rhode Island Medicaid program.
      2. Provided, however, that in any prosecution under this subsection, it shall not be necessary for the state to prove that the remuneration returned was taken from any particular expenditure made by a person.
    2. Submit, or cause to be submitted, a duplicate claim for services, supplies, or merchandise to the Rhode Island Medicaid program for which the provider has already received or claimed reimbursement from any source, unless the duplicate claim is filed:
      1. For payment of more than one type of service or merchandise furnished or rendered to a recipient for which the use of more than one type of claim is necessary; or
      2. Because of a lack of a response from, or a request by, the Rhode Island Medicaid program; provided, however, in such instance, a duplicate claim will clearly be identified as such, in writing, by the provider; or
      3. Simultaneous with a claim submission to another source of payment when the provider has knowledge that the other payor will not pay the claim.
    3. Submit, or cause to be submitted, to the Rhode Island Medicaid program a claim for service or merchandise that was not rendered to a recipient.
    4. Submit, or cause to be submitted, to the Rhode Island Medicaid program a claim for services or merchandise that includes costs or charges not related to the provision or rendering of services or merchandise to the recipient.
    5. Submit, or cause to be submitted, a claim or refer a recipient to a person for services or merchandise under the Rhode Island Medicaid program that are intentionally not documented in the provider’s record and/or are medically unnecessary as that term is defined by § 40-8.2-2(7) .
    6. Submit, or cause to be submitted, to the Rhode Island Medicaid program a claim that materially misrepresents:
      1. The description of services or merchandise rendered or provided to a recipient;
      2. The cost of the services or merchandise rendered or provided to a recipient;
      3. The dates that the services or merchandise were rendered or provided to a recipient;
      4. The identity of the recipient(s) of the services or merchandise; or
      5. The identity of the attending, prescribing, or referring practitioner or the identity of the actual provider.
    7. Submit a claim for reimbursement to the Rhode Island Medicaid program for service(s) or merchandise at a fee or charge that exceeds the provider’s lowest fee or charge for the provision of the service or merchandise to the general public.
    8. Submit, or cause to be submitted, to the Rhode Island Medicaid program a claim for a service or merchandise that was not rendered by the provider, unless the claim is submitted on behalf of:
      1. A bona fide provider employee of the provider; or
      2. An affiliated provider entity owned or controlled by the provider; or
      3. A provider by a third-party billing service under a written agreement with the provider, and the claims are submitted in a manner that does not otherwise violate the provisions of this chapter.
    9. Render or provide services or merchandise under the Rhode Island Medicaid program, unless otherwise authorized by the regulations of the Rhode Island Medicaid program, without a provider’s written order and the recipient’s consent, or submit, or cause to be submitted, a claim for services or merchandise, except in emergency situations or when the recipient is a minor or is incompetent to give consent. The type of consent to be required hereunder can include verbal acquiescence of the recipient and need not require a signed consent form or the recipient’s signature, except where otherwise required by the regulations of the Rhode Island Medicaid program.
    10. Charge any recipient, or person acting on behalf of a recipient, money or other consideration in addition to, or in excess of, the rates of remuneration established under the Rhode Island Medicaid program.
    11. Enter into an agreement, combination, or conspiracy with any party other than the Rhode Island Medicaid program to obtain or aid another to obtain reimbursement or payments from the Rhode Island Medicaid program to which the person, recipient, or provider seeking reimbursement or payment is not entitled.
    12. Make a material false statement in the application for enrollment as a provider under the Rhode Island Medicaid program.
    13. Refuse to provide representatives of the Medicaid fraud control unit, upon reasonable request, access to information and data pertaining to services or merchandise rendered to eligible recipients and/or former recipients while recipients under the Rhode Island Medicaid program.
    14. Obtain any monies by false pretenses through the use of any artifice, scheme, or design prohibited by this section.
    15. Seek or obtain employment with or as a provider after having actual or constructive knowledge of a then-existing exclusion issued under the authority of 42 U.S.C. § 1320a-7.
    16. Grant, or offer to grant, employment in violation of a then-existing exclusion issued under the authority of 42 U.S.C. § 1320a-7, having actual or constructive knowledge of the existence of such exclusion.
    17. File a false document to gain employment in a Medicaid-funded facility or with a provider.
    1. A provider or person who violates any provision of subsection (a), excepting subsection (a)(14), (a)(16), or (a)(18), is guilty of a felony for each violation, and upon conviction therefor, shall be sentenced to a term of imprisonment not exceeding ten (10) years, nor fined more than ten thousand dollars ($10,000), or both.
    2. A provider or person who violates the provisions of subsection (a)(14), (a)(16), or (a)(18), shall be guilty of a misdemeanor for each violation and, upon conviction, be fined not more than five hundred dollars ($500).
    3. Any provider who knowingly and willfully participates in any offense, either as a principal or as an accessory or conspirator, shall be subject to the same penalty as if the provider had committed the substantive offense.
  2. The provisions of subsection (a)(2) shall not apply to:
    1. A discount or other reduction in price obtained by a person or provider of services or merchandise under the Rhode Island Medicaid program if the reduction in price is properly disclosed and appropriately reflected in the costs claimed or charges made by the person or provider under the Rhode Island Medicaid program.
    2. Any amount paid by an employer to an employee, who has a bona fide employment relationship with the employer, for employment in the provision of covered services or merchandise furnished under the Rhode Island Medicaid program.
    3. Any amounts paid by a vendor of services or merchandise to a person authorized to act as a purchasing agent for a group of individuals or entities furnishing services or merchandise that are reimbursed by the Rhode Island Medicaid program, as long as:
      1. The purchasing agent has a written agreement with each individual or entity in the group that specifies the amount the agent will be paid by each vendor (where the sum may be a fixed sum or a fixed percentage of the value of the purchases made from the vendor by the group under the contract between the vendor and the purchasing agent); and
      2. In the case of an entity that is a provider of services to the Rhode Island Medicaid program, the agent discloses in writing to the individual or entity, in accordance with regulations to be promulgated by the executive office, and to the office of program integrity upon request, the amount received from each vendor with respect to purchases made by or on behalf of the entity.

History of Section. P.L. 1989, ch. 501, § 3; P.L. 1990, ch. 492, § 17; P.L. 1993, ch. 232, § 1; P.L. 2015, ch. 141, art. 5, § 12.

Repealed Sections.

Former § 40-8.2-3 (P.L. 1982, ch. 424, § 1), concerning the solicitation or acceptance of a benefit, pecuniary benefit, kickback or overpayment, was repealed by P.L. 1989, ch. 501, § 1, effective July 10, 1989.

Collateral References.

Filing of false insurance claims for medical services as ground for disciplinary action against dentist, physician, or other medical practitioner. 70 A.L.R.4th 132.

Imposition of civil penalties, under state statute upon medical practitioner for fraud in connection with claims under Medicaid, Medicare, or similar welfare programs for providing medical services. 32 A.L.R.4th 671.

40-8.2-4. Statute of limitations.

The statute of limitations for any violation of the provisions of this chapter shall be ten (10) years.

History of Section. P.L. 1989, ch. 501, § 3.

Repealed Sections.

Former § 40-8.2-4 (P.L. 1982, ch. 424, § 1), concerning giving false documents to an agent, employee, or official of the Rhode Island Medicaid program, was repealed by P.L. 1989, ch. 501, § 1, effective July 10, 1989.

40-8.2-5. Civil remedy.

Any person, including the secretary of the executive office of health and human services or the office of program integrity acting on behalf of the secretary of the office, injured by any violation of the provisions of § 40-8.2-3 or § 40-8.2-4 may recover through a civil action from the persons inflicting the injury three (3) times the amount of the injury.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

40-8.2-6. Civil actions brought by attorney general on behalf of persons injured by violations of chapter.

  1. The attorney general may bring a civil action in superior court in the name of the state, as parens patriae on behalf of persons residing in this state, to secure monetary relief as provided in this section for injuries sustained by such persons by reason of any violation of this chapter. The court shall exclude from the amount of monetary relief awarded in an action any amount of monetary relief:
    1. That duplicates amounts that have been awarded for the same injury; or
    2. That is properly allocable to persons who have excluded their claims pursuant to subsection (c)(1).
  2. The court shall award the state as monetary relief threefold the total damage sustained as described in subsection (a) and the costs of bringing suit, including reasonable attorney’s fees.
  3. In any action brought under subsection (a), the attorney general shall, at such times, in such manner, and with such content as the court may direct, cause notice thereof to be given by publication.
    1. Any person on whose behalf an action is brought under subsection (a) may elect to exclude from adjudication the portion of the state claim for monetary relief attributable to him or her by filing notice of the election with the court within such time as specified in the notice given pursuant to this subsection.
    2. The final judgment in an action under subsection (a) shall be res judicata as to any claim under § 40-8.2-5 by any person on behalf of whom the action was brought and who fails to give notice within the period specified in the notice given pursuant to this subsection.
  4. An action under subsection (a) shall not be dismissed or compromised without the approval of the court, and notice of any proposed dismissal or compromise shall be given by publication at such times, in such manner, and with such content as the court may direct.
  5. In any action under subsection (a):
    1. The amount of the plaintiff’s attorney’s fees, if any, shall be determined by the court, and any attorney’s fees awarded to the attorney general shall be deposited with the state as general revenues; and
    2. The court may, in its discretion, award a reasonable attorney’s fee to a prevailing defendant upon a finding that the attorney general has acted in bad faith, vexatiously, wantonly, or for oppressive reasons.
  6. Monetary relief recovered in an action under this section shall:
    1. Be distributed in such manner as the court, in its discretion, may authorize; or
    2. Be deemed a civil penalty by the court and deposited with the state as general revenues; subject in either case to the requirement that any distribution procedure adopted afford each person a reasonable opportunity to secure his or her appropriate portion of the net monetary relief.
  7. In any action under this section, the fact that a person or public body has not dealt directly with the defendant shall not bar or otherwise limit recovery. Provided, however, that the court shall exclude from the amount of monetary relief which duplicates amounts which have been awarded for the same injury.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-7. False statements made to gain certification.

Whoever knowingly and willfully makes, or causes to be made, or induces, or seeks to induce, the making of any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that the institution or facility may qualify (either upon initial certification or upon recertification) as a hospital, skilled nursing facility, intermediate-care facility, or home health agency, shall be guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than five hundred dollars ($500) or imprisoned for not more than six (6) months, or both.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-8. Acts of officers, directors, representatives, or agents acting within the scope of their authority.

  1. A corporation, association, firm, partnership, or limited partnership is liable for the acts of its officers, directors, representatives, or agents acting within the scope of their authority. Proof of the acts of any officer, director, representative, or agent shall be received as prima facie proof of the acts of the corporation, association, firm, partnership, or limited partnership itself.
  2. When a corporation, association, firm, partnership, or limited partnership violates this chapter, the violation shall be deemed to be that of the individual directors, members, officers, managers, employees, or agents of the corporation, association, firm, partnership, or limited partnership who knowingly authorized, ordered, aided, abetted, or advised in the acts or omissions constituting, in whole or in part, the violation, whether the individuals acted on their own behalf and for their own benefit, or for the corporation, association, firm, partnership, or limited partnership and in their representative capacity. The individuals, in their capacity as individuals, are subject to the provisions of this chapter and may be joined, if subject to personal jurisdiction, as additional parties defendant in the proceedings against the corporation, association, partnership, or limited partnership.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-9. Damages for overcharges.

When the cost of the services provided to the patient is being paid under the Rhode Island Medicaid program, any person who knowingly and willfully:

  1. Charges a patient, or anyone acting on behalf of a patient, money or other consideration at a rate in excess of the rates established by the state of Rhode Island; or
  2. Charges, solicits, accepts, or receives, in addition to any amount otherwise required to be paid under the Rhode Island Medicaid program, any gift, money, or donation as a precondition of the admission of a patient to a hospital, skilled nursing facility, or intermediate-care facility, or of the continued stay in a facility, shall be liable in a civil action to the patient or person acting on his or her behalf for an amount equal to three (3) times the amount of the charge.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-10. Other civil remedies and criminal penalties.

The penalties and remedies under this statute are not exclusive and shall not preclude the use of any other civil remedy or the application of any other criminal penalty deemed appropriate by the attorney general in accordance with federal law or regulations governing Title XIX or Title XXI or the general or public laws of this state.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq. Title XXI of the Social Security Act is codified at 42 U.S.C. § 1397aa et seq.

40-8.2-11. Barring or suspending participation in program.

Whenever a provider is sentenced or placed on probation for an offense under this chapter, the trial judge may, in his or her discretion, order that the provider be permanently barred from further participation in the program; that the provider’s participation in the program be suspended for a definite period of time not exceeding two (2) years; or that the provider conform to applicable federal regulations. For the purposes of this section, the office of program integrity may submit a recommendation to the trial judge as to whether the provider should be suspended or barred from the program. Nothing contained herein shall be construed to prevent the executive office of health and human services from imposing its own administrative sanctions.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

40-8.2-12. Injunctive relief and civil penalties.

  1. The superior court of this state shall have jurisdiction to prevent and restrain violations of this chapter. In addition to granting prohibitory injunctive and other restraints for a period of time and upon terms and conditions necessary to deter a provider from, and ensure against, the committing of future violations of this chapter, the court may grant injunctive relief reasonably necessary to dissipate the ill effects of the violation. The court may issue appropriate decrees upon consent and stipulation by the parties. The court may also issue restraining orders. Under no circumstances shall the state be required to post bond in any action hereunder.
  2. Attorney general  — Right to injunctive relief. The attorney general may institute proceedings to prevent and restrain violations of this chapter as provided in subsection (a).
  3. Other persons  — Right to injunctive relief. Any person, including the United States, may institute proceedings for injunctive relief, temporary or permanent, as provided in subsection (a) against threatened loss or damage to his or her property or business by a violation of this chapter. A preliminary injunction may be issued upon a showing that the danger of irreparable loss or damage is immediate and, within the court’s discretion, the execution of property bond against damages for an injunction improvidently granted. If the court issues a permanent injunction, the plaintiff shall be awarded reasonable attorney’s fees, filing fees, and reasonable costs of the suit. Reasonable costs for the suit may include, but shall not be limited to, the expenses of discovery and document reproduction.
  4. Civil penalty.  In addition to injunctive relief authorized pursuant to subsection (a), any person who violates this chapter may be liable for a civil penalty in a suit by the attorney general of this state of not more than one thousand dollars ($1,000) for each violation.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-13. Consent decrees.

The attorney general may petition the court to enter a consent decree dismissing any criminal prosecution hereunder, but the court shall review the proceeding to determine whether entry thereof is in the public interest.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-14. Investigative demand.

  1. Demand.
    1. The attorney general, or his or her designated assistant attorney general, shall have the power to issue a subpoena or subpoena duces tecum.
    2. Whenever the attorney general has reasonable cause to believe that any person may have knowledge or be in possession, custody, or control of any documentary material pertinent to an investigation of a possible violation of this chapter, the attorney general may issue in writing and cause to be served upon the person an investigative demand by which he or she may:
      1. Compel the attendance of the person and require him or her to submit to examination and give testimony under oath; and/or
      2. Require the production of documentary material pertinent to the investigation for inspection or copying; and/or
      3. Require an answer to written interrogatories to be furnished under oath. The power to issue investigative demands shall not abate or terminate by reason of the bringing of any action or proceeding under this chapter. The attorney general may issue successive investigative demands to the same person in order to obtain additional information pertinent to an ongoing investigation.
    3. The civil investigative demands shall be filed in the superior court of the county in which the person served with the demand shall dwell or have his or her principal place of business.
  2. Contents of investigative demand.  Each investigative demand shall:
    1. State the section or sections of the chapter, the alleged violation of which is under investigation, and the general subject matter of this investigation;
    2. Prescribe a reasonable return date no less than forty (40) days after service of the investigative demand, provided that an earlier date may be prescribed under compelling circumstances, but in no event less than twenty (20) days;
    3. Specify the time and place at which the person is to appear and give testimony, produce documentary material, and furnish answers to interrogatories or do any or a combination of the aforesaid;
    4. Describe by class any documentary material required to be produced, so as to clearly indicate what is demanded; and
    5. Contain any interrogatories to which written answers under oath are required.
  3. Prohibition against unreasonable demand.  No investigative demand shall:
    1. Contain any requirement that would be unreasonable or improper if contained in a subpoena issued by a court of this state; or
    2. Require the disclosure of any material or information that would be privileged, or that for any other reason would not be required to be disclosed by a subpoena issued by a court of this state, including, but not limited to, trade secrets or confidential scientific, technical, merchandising, production, management, or commercial information, to the extent that the same are protected pursuant to the Rhode Island rules of civil procedure.
  4. Offer of documentary evidence.  Where the information requested upon oral examination or written interrogatory pursuant to an investigative demand may be derived or ascertained from the business records of the person upon whom the demand has been served or from an examination, audit, or inspection of the business records or from a compilation, abstract, or summary based thereon, and the burden of deriving or ascertaining the answer is substantially the same for the attorney general as for the person from whom the information is requested, it is sufficient for that person to specify the records from which the answer may be derived or ascertained, and to afford the attorney general reasonable opportunity to examine, audit, or inspect the records and to make copies, compilations, abstracts, or summaries.
  5. Service of investigative demand.  An investigative demand may be served by any means provided under the Rhode Island rules of civil procedure for service of a complaint in a civil action.
  6. Motion to quash.  Within twenty (20) days after the service of an investigative demand, or at any time before the return date specified therein, whichever period is shorter, the person served may file in a state superior court and serve upon the attorney general a petition for an order of court modifying or setting aside the demand. The time allowed for compliance, in whole or in part, with the demand as deemed proper and ordered by the court shall not run while the petition is pending before the court. The petition shall specify each ground upon which the petitioner relies in seeking relief and may be based upon any failure of the demand to comply with the provisions of this chapter or upon any constitutional or other legal right, privilege, or qualified privilege of the party, including that the material or information sought constitutes trade secrets or confidential scientific, technical, merchandising, production, management, or commercial information. If qualified privilege is raised, the court may order the person to comply with the demand only upon a showing of particularized need and subject to an appropriate protective order. The provisions of this subsection shall be the sole and exclusive means for challenging the requirements of the demand.
  7. Those authorized to examine.  The examinations of all persons pursuant to this section shall be conducted by the attorney general, or his or her designee, before an officer authorized to administer oaths in this state. The statement made shall be taken down stenographically or by a sound-recording device and shall be transcribed.
  8. Right of persons served with investigative demands.
    1. Any person required to attend and give testimony or to submit documentary material pursuant to this section shall be entitled to retain, or on payment of a lawfully prescribed cost to procure, a copy of any document he or she produces and of his or her own statements as transcribed.
    2. Any person compelled to appear under a demand for oral testimony pursuant to this section may be accompanied, represented, and advised by counsel. Counsel may advise the person in confidence, upon the request of the person. The person or counsel may object on the record to any question, in whole or in part, and shall briefly state for the record the reason for the objection. An objection may properly be made, received, and entered upon the record when it is claimed that the person is entitled to refuse to answer the question on grounds of any constitutional or other legal right or privilege, including the privilege against self-incrimination. The person shall not otherwise object to or refuse to answer any question, and shall not by himself or herself or through counsel otherwise interrupt the oral examination. If the person refuses to answer any question, the attorney general may petition the superior court for an order compelling the person to answer the question.
    3. The information and materials supplied to the attorney general pursuant to an investigative demand shall not be permitted to become public or be disclosed by the attorney general, or his or her employees, beyond the extent necessary for enforcement purposes in the public interest.
    4. Upon the completion of a case brought under this chapter, the attorney general shall return any documents, answers, and transcripts, and all copies thereof, that have not passed into the control of the court through the introduction thereof into the record, to the person who provided the documents, answers, or testimony. If no case in which the material may be used has been commenced within a reasonable time after completion of the examination or analysis of all documentary material, but in no event later than two (2) years after production thereof, the attorney general shall, upon written request of the person who produced the material, return all documents, answers, and transcripts, and all copies thereof, to the person who provided them.
    5. The attorney general shall have the authority, at any time, to modify or revoke any investigative demand and to stipulate to protective orders with respect to documents and information submitted in response to a demand. The protective orders shall include provisions appropriate to the full and adequate protection of confidential healthcare information pursuant to chapter 37.3 of title 5.
  9. Witness expenses.  All persons served with an investigative demand, other than those persons whose conduct or practices are being investigated or any officer, director, or person in the employment of a person under investigation shall be paid the same fees and mileage as paid witnesses in the courts of this state. No person shall be excused from attending the inquiry pursuant to the mandate of an investigative demand or from giving testimony or from producing documentary material or from being required to answer questions on the ground of failure to tender or pay a witness fee or mileage, unless demand therefore is made at the time testimony is about to be taken or unless payment thereof is not thereupon made.
  10. Refusal of witness to testify or produce documents.  Any person who shall neglect or refuse to attend and give testimony or to answer any lawful inquiry or to produce documentary material, if in his or her power to do so, in obedience to any investigative demand pursuant to this section, may be adjudged in civil contempt by the superior court until such time as he or she purges himself or herself of contempt by testifying, producing documentary material, or presenting written answers as ordered. Any person who commits perjury or false swearing in response to an investigative demand pursuant to this section shall be punished pursuant to the provisions of chapter 33 of title 11.
  11. Duty to testify  — Immunity.
    1. If, in any investigation brought by the attorney general pursuant to this section, any individual shall refuse to attend or to give testimony or to produce documentary material or to answer a written interrogatory in obedience to an investigative demand or under order of court on the ground that the testimony or material required of him or her may tend to incriminate him or her, that person may be ordered to attend and to give testimony or to produce documentary material or to answer the written interrogatory, or to do an applicable combination of these pursuant to § 12-17-15 . The order described in this subsection shall be an order of court given after hearing in which the attorney general has established a need for the grant of immunity, as hereinafter provided.
    2. The attorney general may petition for an order as described in subsection (k)(1) for any investigation pursuant to this chapter. The petition shall set forth the nature of the investigation and the need for the immunization of any witness.
    3. Testimony so compelled shall not be used against the witness as evidence in any criminal proceedings against him or her in any court. The grant of immunity shall not immunize the witness from civil liability arising from the transactions about which testimony is given, and he or she may nevertheless be presented or subjected to penalty or forfeiture for any perjury, false swearing, or contempt committed in answering, or in failing to answer, or in producing evidence, or failing to do so, in accordance with the order. The foregoing shall not prevent the attorney general from instituting other appropriate contempt proceedings against any person who violates any of the above provisions.
  12. Duty of public officials.  It shall be the duty of all officials of this state and its public bodies, their deputies, assistants, clerks, subordinates, or employees, and all other persons to reorder and furnish to the attorney general when so requested, all information and assistance in their possession or within their power.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 1987, ch. 131, § 2; P.L. 1989, ch. 429, § 1; P.L. 1997, ch. 326, § 130.

40-8.2-15. Consistency with Confidentiality of Health Care Information Act.

No investigative demand pursuant to this chapter shall solicit, extend to, or compel the production, inspection, copying, or release of any record or information otherwise protected as confidential healthcare information pursuant to chapter 37.3 of title 5.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-16. Rendering services to recipients after suspension or revocation of certification.

No provider shall charge the Rhode Island Medicaid program for any services rendered to recipients subsequent to the revocation or suspension of the provider’s certification except as specified by a termination notice.

History of Section. P.L. 1982, ch. 424, § 1.

40-8.2-17. Stays and review of revocation orders.

An order of the executive office of health and human services revoking a provider’s certification may, in the discretion of the program, go into immediate effect or may be stayed. Review of any order may be had in accordance with the Rhode Island administrative procedures act, §§ 42-35-1 42-35-18 . If an administrative hearing is claimed, the program may, in its discretion, stay the effect of a revocation until a hearing is held and a decision is rendered, and for a period not to exceed ten (10) days after the administrative decision is rendered.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

40-8.2-18. Filing and enforcement of administrative decision.

An administrative decision, not appealed, or which has been affirmed after judicial review under the Rhode Island administrative procedures act, §§ 42-35-1 42-35-18 , determining any amounts due to the executive office of health and human services or to a provider, may be filed with the clerk of the superior court for Providence County and shall be enforceable as a judgment of that court.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

40-8.2-19. Certification as a provider — Revocation or suspension of certification.

Before any provider of medical services receives payment from the Rhode Island Medicaid program, and as a condition of receipt of payment, the provider must have in effect a valid certification of eligibility from the Rhode Island executive office of health and human services. This certification of eligibility will take the form of either a separate provider agreement or language as required by federal regulations imprinted on the medical assistance billing form, which must be signed by the provider. This certification may be revoked or suspended, in accordance with administrative rules to be promulgated by the executive office, if a provider fails to meet professional licensure requirements; violates any administrative regulations of the executive office of health and human services; does not provide proper professional services; is the subject of a suspension of payments order; is convicted of Medicaid fraud; or otherwise violates any provision of this chapter.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

40-8.2-20. Eligibility for certification.

A certification will apply to any provider who agrees to provide services in accordance with the laws and regulations governing the Rhode Island Medicaid program and who has in effect a proper professional license when a license is a prerequisite to rendering services. Nothing contained herein shall be construed to mean that certification may not be revoked for failure to provide proper professional services, although a provider’s professional license has not been revoked or suspended.

History of Section. P.L. 1982, ch. 242, § 1.

40-8.2-21. Suspension of payments to a provider.

  1. The executive office of health and human services may issue a suspension of payments order if:
    1. The provider does not meet certification requirements of the Rhode Island Medicaid program; or
    2. The Rhode Island Medicaid program has been unable to collect (or make satisfactory arrangements for the collection of) amounts due on account of overpayments to any provider; or
    3. The office of program integrity and/or the Medicaid fraud control unit of the attorney general’s office has been unable to obtain, from a provider, the data and information necessary to enable it to determine the existence or amount (if any) of the overpayments made to a provider; or
    4. The office of program integrity or the Medicaid fraud control unit of the attorney general’s office has been denied reasonable access to information by a provider that pertains to a patient or resident of a long-term residential-care facility or to a former patient or resident of a long-term residential-care facility; or
    5. The office of program integrity and/or the Medicaid fraud control unit of the attorney general’s office has been denied reasonable access to data and information by the provider for the purpose of conducting activities as described in § 1903(g) of the Social Security Act, 42 U.S.C. § 1396b(g); or
    6. The office of program integrity has been presented with reliable evidence that the provider has engaged in fraud or willful misrepresentation under the Medicaid program.
  2. Any such order of the executive office of health and human services may cease to be effective at such time as the office of program integrity is satisfied that the provider is participating in substantial negotiations that seek to remedy the conditions that gave rise to its order of suspension of payments, or that amounts are no longer due from the provider or that a satisfactory arrangement has been made for the payment of the provider or that a satisfactory arrangement has been made for the payment by the provider of any such amounts.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 1989, ch. 137, § 1; P.L. 2015, ch. 141, art. 5, § 12.

40-8.2-22. Interest on overcharges.

Any provider of services or goods contracting with the executive office of health and human services, pursuant to Title XIX or Title XXI of the Social Security Act, who, without intent to defraud, obtains payments under this chapter in excess of the amount to which the provider is entitled, thereby becomes liable for payment of the amount of the excess with payment of interest allowable by law, under § 6-26-2 , as was in effect on the date payment was made to the provider. The interest period will commence on the date upon which payment was made and will extend to the date upon which repayment is made to the state of Rhode Island.

History of Section. P.L. 1982, ch. 424, § 1; P.L. 2015, ch. 141, art. 5, § 12.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq. Title XXI of the Social Security Act is codified at 42 U.S.C. § 1397aa et seq.

40-8.2-23. Use of Medicaid funds for anti-union purposes prohibited.

Medicaid reimbursement for costs incurred directly related to influencing employees regarding their right to organize, to form a union, or to join a union, shall not be considered to be allowable, whether performed directly by the provider or through contracts with consultants or attorneys.

History of Section. P.L. 1985, ch. 358, § 1.

Chapter 8.3 Uncompensated Care

40-8.3-1. Declaration of purpose.

The legislature hereby finds and declares that preservation of the ability of the private acute-care hospital system of the state to continue to support an increasing uncompensated care burden is of critical importance to the public health and welfare of the citizens of Rhode Island and that implementation of § 1923 of the Social Security Act, 42 U.S.C. § 1396r-4, which permits the federal government to share in the provision of payments to hospitals that provide a significant amount of uncompensated care, is an effective way for the state to assist the hospitals in continuing to provide uncompensated care.

History of Section. P.L. 1996, ch. 100, art. 42, § 1.

40-8.3-2. Definitions.

As used in this chapter:

  1. “Base year” means, for the purpose of calculating a disproportionate share payment for any fiscal year ending after September 30, 2020, the period from October 1, 2018, through September 30, 2019, and for any fiscal year ending after September 30, 2021, the period from October 1, 2019, through September 30, 2020.
  2. “Medicaid inpatient utilization rate for a hospital” means a fraction (expressed as a percentage), the numerator of which is the hospital’s number of inpatient days during the base year attributable to patients who were eligible for medical assistance during the base year and the denominator of which is the total number of the hospital’s inpatient days in the base year.
  3. “Participating hospital” means any nongovernment and nonpsychiatric hospital that:
    1. Was licensed as a hospital in accordance with chapter 17 of title 23 during the base year and shall mean the actual facilities and buildings in existence in Rhode Island, licensed pursuant to § 23-17-1 et seq. on June 30, 2010, and thereafter any premises included on that license, regardless of changes in licensure status pursuant to chapter 17.14 of title 23 (hospital conversions) and § 23-17-6(b) (change in effective control), that provides short-term, acute inpatient and/or outpatient care to persons who require definitive diagnosis and treatment for injury, illness, disabilities, or pregnancy. Notwithstanding the preceding language, the negotiated Medicaid managed care payment rates for a court-approved purchaser that acquires a hospital through receivership, special mastership, or other similar state insolvency proceedings (which court-approved purchaser is issued a hospital license after January 1, 2013), shall be based upon the newly negotiated rates between the court-approved purchaser and the health plan, and the rates shall be effective as of the date that the court-approved purchaser and the health plan execute the initial agreement containing the newly negotiated rate. The rate-setting methodology for inpatient hospital payments and outpatient hospital payments set forth in §§ 40-8-13.4(b)(1)(ii)(C) and 40-8-13.4(b)(2) , respectively, shall thereafter apply to negotiated increases for each annual twelve-month (12) period as of July 1 following the completion of the first full year of the court-approved purchaser’s initial Medicaid managed care contract;
    2. Achieved a medical assistance inpatient utilization rate of at least one percent (1%) during the base year; and
    3. Continues to be licensed as a hospital in accordance with chapter 17 of title 23 during the payment year.
  4. “Uncompensated-care costs” means, as to any hospital, the sum of: (i) The cost incurred by the hospital during the base year for inpatient or outpatient services attributable to charity care (free care and bad debts) for which the patient has no health insurance or other third-party coverage less payments, if any, received directly from such patients; and (ii) The cost incurred by the hospital during the base year for inpatient or outpatient services attributable to Medicaid beneficiaries less any Medicaid reimbursement received therefor; multiplied by the uncompensated-care index.
  5. “Uncompensated-care index” means the annual percentage increase for hospitals established pursuant to § 27-19-14 [repealed] for each year after the base year, up to and including the payment year; provided, however, that the uncompensated-care index for the payment year ending September 30, 2007, shall be deemed to be five and thirty-eight hundredths percent (5.38%), and that the uncompensated-care index for the payment year ending September 30, 2008, shall be deemed to be five and forty-seven hundredths percent (5.47%), and that the uncompensated-care index for the payment year ending September 30, 2009, shall be deemed to be five and thirty-eight hundredths percent (5.38%), and that the uncompensated-care index for the payment years ending September 30, 2010, September 30, 2011, September 30, 2012, September 30, 2013, September 30, 2014, September 30, 2015, September 30, 2016, September 30, 2017, September 30, 2018, September 30, 2019, September 30, 2020, September 30, 2021, and September 30, 2022, shall be deemed to be five and thirty hundredths percent (5.30%).

History of Section. P.L. 1996, ch. 100, art. 42, § 1; P.L. 1997, ch. 30, art. 21, § 1; P.L. 2000, ch. 55, art. 16, § 1; P.L. 2001, ch. 77, art. 25, § 1; P.L. 2002, ch. 65, art. 21, § 1; P.L. 2003, ch. 376, art. 19, § 1; P.L. 2004, ch. 595, art. 9, § 1; P.L. 2005, ch. 117, art. 9, § 1; P.L. 2006, ch. 246, art. 13, § 1; P.L. 2007, ch. 73, art. 19, § 1; P.L. 2008, ch. 100, art. 19, § 1; P.L. 2009, ch. 68, art. 19, § 1; P.L. 2010, ch. 23, art. 15, § 1; P.L. 2011, ch. 151, art. 18, § 1; P.L. 2012, ch. 241, art. 15, § 1; P.L. 2013, ch. 144, art. 12, § 1; P.L. 2014, ch. 145, art. 17, § 1; P.L. 2015, ch. 141, art. 5, § 14; P.L. 2016, ch. 142, art. 7, § 3; P.L. 2017, ch. 302, art. 9, § 3; P.L. 2018, ch. 47, art. 13, § 2; P.L. 2019, ch. 88, art. 13, § 6; P.L. 2021, ch. 162, art. 12, § 3, effective July 1, 2021.

Compiler’s Notes.

Section 27-19-14 , referenced in this section, was repealed by its own terms and pursuant to § 40-8-13.4(g) .

40-8.3-3. Implementation.

  1. For federal fiscal year 2020, commencing on October 1, 2019, and ending September 30, 2020, the executive office of health and human services shall submit to the Secretary of the United States Department of Health and Human Services a state plan amendment to the Rhode Island Medicaid DSH Plan to provide:
    1. That the DSH Plan to all participating hospitals, not to exceed an aggregate limit of $142.4 million, shall be allocated by the executive office of health and human services to the Pool D component of the DSH Plan; and
    2. That the Pool D allotment shall be distributed among the participating hospitals in direct proportion to the individual participating hospital’s uncompensated-care costs for the base year, inflated by the uncompensated-care index to the total uncompensated-care costs for the base year inflated by the uncompensated-care index for all participating hospitals. The disproportionate share payments shall be made on or before July 13, 2020, and are expressly conditioned upon approval on or before July 6, 2020, by the Secretary of the United States Department of Health and Human Services, or his or her authorized representative, of all Medicaid state plan amendments necessary to secure for the state the benefit of federal financial participation in federal fiscal year 2020 for the disproportionate share payments.
  2. For federal fiscal year 2021, commencing on October 1, 2020, and ending September 30, 2021, the executive office of health and human services shall submit to the Secretary of the United States Department of Health and Human Services a state plan amendment to the Rhode Island Medicaid DSH Plan to provide:
    1. That the DSH Plan to all participating hospitals, not to exceed an aggregate limit of $142.5 million, shall be allocated by the executive office of health and human services to the Pool D component of the DSH Plan; and
    2. That the Pool D allotment shall be distributed among the participating hospitals in direct proportion to the individual participating hospital’s uncompensated-care costs for the base year, inflated by the uncompensated-care index to the total uncompensated-care costs for the base year inflated by the uncompensated-care index for all participating hospitals. The disproportionate share payments shall be made on or before July 12, 2021, and are expressly conditioned upon approval on or before July 5, 2021, by the Secretary of the United States Department of Health and Human Services, or his or her authorized representative, of all Medicaid state plan amendments necessary to secure for the state the benefit of federal financial participation in federal fiscal year 2021 for the disproportionate share payments.
  3. For federal fiscal year 2022, commencing on October 1, 2021, and ending September 30, 2022, the executive office of health and human services shall submit to the Secretary of the United States Department of Health and Human Services a state plan amendment to the Rhode Island Medicaid DSH Plan to provide:
    1. That the DSH Plan to all participating hospitals, not to exceed an aggregate limit of $143.8 million, shall be allocated by the executive office of health and human services to the Pool D component of the DSH Plan; and
    2. That the Pool D allotment shall be distributed among the participating hospitals in direct proportion to the individual participating hospital’s uncompensated-care costs for the base year, inflated by the uncompensated-care index to the total uncompensated-care costs for the base year inflated by the uncompensated-care index for all participating hospitals. The disproportionate share payments shall be made on or before July 12, 2022, and are expressly conditioned upon approval on or before July 5, 2022, by the Secretary of the United States Department of Health and Human Services, or his or her authorized representative, of all Medicaid state plan amendments necessary to secure for the state the benefit of federal financial participation in federal fiscal year 2022 for the disproportionate share payments.
  4. No provision is made pursuant to this chapter for disproportionate-share hospital payments to participating hospitals for uncompensated-care costs related to graduate medical education programs.
  5. The executive office of health and human services is directed, on at least a monthly basis, to collect patient-level uninsured information, including, but not limited to, demographics, services rendered, and reason for uninsured status from all hospitals licensed in Rhode Island.
  6. [Deleted by P.L. 2019, ch. 88, art. 13, § 6.]

History of Section. P.L. 1996, ch. 100, art. 42, § 1; P.L. 1997, ch. 30, art. 21, § 1; P.L. 1998, ch. 31, art. 7, § 1; P.L. 1999, ch. 31, art. 15, § 1; P.L. 2000, ch. 55, art. 16, § 1; P.L. 2001, ch. 77, art. 25, § 1; P.L. 2002, ch. 65, art. 21, § 1; P.L. 2003, ch. 376, art. 19, § 1; P.L. 2004, ch. 595, art. 9, § 1; P.L. 2005, ch. 117, art. 9, § 1; P.L. 2006, ch. 246, art. 13, § 1; P.L. 2007, ch. 73, art. 19, § 1; P.L. 2008, ch. 100, art. 19, § 1; P.L. 2009, ch. 68, art. 19, § 1; P.L. 2010, ch. 23, art. 15, § 1; P.L. 2011, ch. 151, art. 18, § 1; P.L. 2012, ch. 241, art. 15, § 1; P.L. 2013, ch. 144, art. 12, § 1; P.L. 2014, ch. 145, art. 17, § 1; P.L. 2015, ch. 141, art. 5, § 14; P.L. 2016, ch. 142, art. 7, § 3; P.L. 2017, ch. 302, art. 9, § 3; P.L. 2018, ch. 47, art. 13, § 2; P.L. 2019, ch. 88, art. 13, § 6; P.L. 2021, ch. 162, art. 12, § 3, effective July 1, 2021.

40-8.3-4. Reports and audits.

As a condition of receipt of a payment under this chapter, each participating hospital shall submit to the department data, reports and/or independent certified audits as may be required by the department to timely comply with the requirements of Section 1923 of the federal Social Security Act, 42 U.S.C. § 1396r-4, as amended, and any implementing regulations or directives duly promulgated by the Secretary of the United States Department of Health and Human Services.

History of Section. P.L. 2004, ch. 595, art. 9, § 2.

40-8.3-5. Hospital payments.

Due to the high ratio of unqualified uncompensated-care expenses to qualified uncompensated-care expenses, the department of human services is hereby authorized and directed to pay by September 1, 2010, from revenues derived from taxes imposed in accordance with § 44-17-1 : (1) Acute-care hospitals in Washington County the amount of five hundred thousand dollars ($500,000) to South County Hospital, and seven hundred and fifty thousand dollars ($750,000) to The Westerly Hospital; (2) Any acute-care hospital in Kent County the amount of eight hundred thousand dollars ($800,000); and (3) Miriam Hospital the amount of one million six hundred thousand dollars ($1,600,000). The department of human services is authorized and directed to pay four million seven hundred fifty thousand dollars ($4,750,000) during state fiscal year 2011 to the following hospitals: one million seven hundred seventy-eight thousand eight hundred forty-three dollars ($1,778,843) to Kent Hospital; six hundred and forty-two thousand three hundred forty dollars ($642,340) to Saint Joseph’s Hospital; one million one hundred thirty-one thousand, nine hundred twenty-nine dollars ($1,131,929) to Miriam Hospital; four hundred thirty-eight thousand and four hundred eighty-two dollars ($438,482) to South County Hospital; two hundred ninety seven thousand eight hundred and six dollars ($297,806) to Westerly Hospital; one hundred thirty-three thousand and six hundred seventy-two dollars ($133,672) to Newport Hospital; one hundred seventy thousand nine hundred and sixty-four dollars ($170,964) to Butler Hospital; and one hundred fifty-five thousand and nine hundred sixty-three dollars ($155,963) to Bradley Hospital of Rhode Island. The department of human services is authorized to pay five hundred thousand dollars ($500,000) to South County Hospital and five hundred thousand dollars ($500,000) to Westerly Hospital in state fiscal year 2012.

History of Section. P.L. 2009, ch. 68, art. 19, § 2; P.L. 2010, ch. 23, art. 20, § 2; P.L. 2011, ch. 151, art. 18, § 3.

Repealed Sections.

Former § 40-8.3-5 (P.L. 2008, ch. 100, art. 19, § 2), concerning hospital payments, was repealed by P.L. 2009, ch. 5, art. 16, § 1.

40-8.3-6. Outpatient adjustment payments for fiscal year 2009.

Effective July 1, 2008, the department of human services is hereby authorized and directed to amend its regulations and the Rhode Island State Plan for Medical Assistance pursuant to Title XIX of the Social Security Act for reimbursement to hospitals for outpatient service as follows:

Hospitals — Outpatient adjustment payments.

  1. Each hospital in the state of Rhode Island, as defined in § 23-17-38.1 , shall receive an adjustment payment during state fiscal year 2009 of an amount determined as follows:
    1. Determine the percent of the state’s total Medicaid outpatient and emergency department services (exclusive of physician services) provided by each hospital during the hospital’s fiscal year ending during 2007;
    2. Determine the sum of all Medicaid payments to hospitals made for outpatient and emergency department services (exclusive of physician services) provided during each hospital’s fiscal year ending during 2007;
    3. Multiply the sum of all Medicaid payments as determined in subsection (a)(2) by fifty-six and five hundredths percent (56.05%) and then multiply that result by each hospital’s percentage of the state’s total Medicaid outpatient and emergency department services as determined in subsection (a)(1) to obtain the total outpatient adjustment for each hospital to be paid in SFY 2009;
    4. Pay each hospital on its total outpatient adjustment as determined in subsection (a)(3).
  2. The amounts determined in subsection (a) are in addition to Medicaid outpatient payments and emergency services payments (exclusive of physician services) paid to hospitals in accordance with current state regulation and the Rhode Island Plan for Medicaid assistance pursuant to Title XIX of the Social Security Act and are not subject to recoupment or settlement.
  3. The payments are expressly conditioned upon approval by the Secretary of the United States Department of Health and Human Services, or his or her authorized representative, of any Medicaid state plan amendment necessary to secure for the state the benefit of federal financial participation in federal fiscal year 2009 for such payments, such amendment to be filed not later than July 9, 2008.

History of Section. P.L. 2009, ch. 68, art. 19, § 2.

Repealed Sections.

Former § 40-8.3-6 (P.L. 2008, ch. 100, art. 19, § 2), concerning outpatient adjustment payments, was repealed by P.L. 2009, ch. 5, art. 16, § 1.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq.

40-8.3-7. Outpatient adjustment payments for fiscal year 2010.

Effective July 1, 2009, the department of human services is hereby authorized and directed to amend its regulations and the Rhode Island State Plan for Medical Assistance pursuant to Title XIX of the Social Security Act for reimbursement to hospitals for outpatient services as follows:

Hospitals — Outpatient adjustment payments.

  1. Each hospital in the state of Rhode Island, as defined in § 23-17-38.1 , shall receive a quarterly adjustment payment during state fiscal year 2010 of an amount determined as follows:
    1. Determine the percent of the state’s total Medicaid outpatient and emergency department services (exclusive of physician services) provided by each hospital during the hospital’s fiscal year ending during 2008;
    2. Determine the sum of all Medicaid payments to hospitals made for outpatient and emergency department services (exclusive of physician services) provided during each hospital’s fiscal year ending during 2008;
    3. Multiply the sum of all Medicaid payments as determined in subsection (a)(2) by seventy-seven and forty-one hundredths percent (77.41%) and then multiply that result by each hospital’s percentage of the state’s total Medicaid outpatient and emergency department services as determined in subsection (a)(1) to obtain the total outpatient adjustment for each hospital to be paid in SFY 2010;
    4. Pay each hospital on or about July 20, 2009, October 20, 2009, January 20, 2010, and April 20, 2010, one-quarter (.25) of its total outpatient adjustment as determined in subsection (a)(3).
  2. The amounts determined in subsection (a) are in addition to Medicaid outpatient payments and emergency services payments (exclusive of physician services) paid to hospitals in accordance with current state regulation and the Rhode Island Plan for Medicaid Assistance pursuant to Title XIX of the Social Security Act and are not subject to recoupment or settlement.

History of Section. P.L. 2009, ch. 68, art. 19, § 2.

Repealed Sections.

Former § 40-8.3-7 (P.L. 2008, ch. 100, art. 19, § 2), concerning inpatient adjustment payments, was repealed by P.L. 2009, ch. 5, art. 16, § 1.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq.

40-8.3-8. Outpatient adjustment payments for fiscal year 2011.

Effective July 1, 2010, the department of human services is hereby authorized and directed to amend its regulations for reimbursement to hospitals for outpatient services as follows:

Hospitals — Outpatient adjustment payments.

  1. Each hospital in the state of Rhode Island, as defined in § 23-17-38.1 , shall receive a quarterly adjustment payment during state fiscal year 2011 of an amount determined as follows:
    1. Determine the percent of the state’s total Medicaid outpatient and emergency department services (exclusive of physician services) provided by each hospital during each hospital’s fiscal year ending during 2009;
    2. Determine the sum of all Medicaid payments to hospitals made for outpatient and emergency department services (exclusive of physician services) provided during each hospital’s fiscal year ending during 2009;
    3. Multiply the sum of all Medicaid payments as determined in subsection (a)(2) by 82.95 percent and then multiply that result by each hospital’s percentage of the state’s total Medicaid outpatient and emergency department services as determined in subsection (a)(1) to obtain the total outpatient adjustment for each hospital to be paid in SFY 2011;
    4. Pay each hospital on or before July 20, 2010, October 20, 2010, January 20, 2011, and April 20, 2011, one-quarter of its total outpatient adjustment as determined in subsection (a)(3).
  2. The amounts determined in subsection (a) are in addition to Medicaid outpatient payments and emergency services payments (exclusive of physician services) paid to hospitals in accordance with current state regulation and the Rhode Island Plan for Medicaid Assistance pursuant to Title XIX of the Social Security Act and are not subject to recoupment or settlement.

History of Section. P.L. 2010, ch. 23, art. 15, § 2.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq.

40-8.3-9. Outpatient adjustment payments for fiscal year 2012.

Effective July 1, 2011, the executive office of health and human services is hereby authorized and directed to amend its regulations for reimbursement to hospitals for outpatient services as follows:

Hospitals — Outpatient adjustment payments.

  1. Each hospital in the state of Rhode Island, as defined in § 23-17-38.1 , shall receive a quarterly adjustment payment during state fiscal year 2012 of an amount determined as follows:
    1. Determine the percent of the state’s total Medicaid outpatient and emergency department services (exclusive of physician services) provided by each hospital during each hospital’s fiscal year ending during 2010;
    2. Determine the sum of all Medicaid payments to hospitals made for outpatient and emergency department services (exclusive of physician services) provided during each hospital’s fiscal year ending during 2010;
    3. Multiply the sum of all Medicaid payments as determined in subsection (a)(2) by 72.57 percent and then multiply that result by each hospital’s percentage of the state’s total Medicaid outpatient and emergency department services as determined in subsection (a)(1) to obtain the total outpatient adjustment for each hospital to be paid in SFY 2012;
    4. Pay each hospital on or before July 20, 2011, October 20, 2011, January 20, 2012, and April 20, 2012, one-quarter of its total outpatient adjustment as determined in subsection (a)(3).
  2. The amounts determined in subsection (a) are in addition to Medicaid outpatient payments and emergency services payments (exclusive of physician services) paid to hospitals in accordance with current state regulation and the Rhode Island Plan for Medicaid Assistance pursuant to Title XIX of the Social Security Act and are not subject to recoupment or settlement.

History of Section. P.L. 2011, ch. 151, art. 18, § 2.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq.

40-8.3-10. Hospital adjustment payments.

Effective July 1, 2021, and for each subsequent year, the executive office of health and human services is hereby authorized and directed to amend its regulations for reimbursement to hospitals for inpatient and outpatient services as follows:

  1. Each hospital in the state of Rhode Island, as defined in § 23-17-38.1 , shall receive a quarterly outpatient adjustment payment each state fiscal year of an amount determined as follows:
    1. Determine the percent of the state’s total Medicaid outpatient and emergency department services (exclusive of physician services) provided by each hospital during each hospital’s prior fiscal year;
    2. Determine the sum of all Medicaid payments to hospitals made for outpatient and emergency department services (exclusive of physician services) provided during each hospital’s prior fiscal year;
    3. Multiply the sum of all Medicaid payments as determined in subsection (a)(2) by a percentage defined as the total identified upper payment limit for all hospitals divided by the sum of all Medicaid payments as determined in subsection (a)(2); and then multiply that result by each hospital’s percentage of the state’s total Medicaid outpatient and emergency department services as determined in subsection (a)(1) to obtain the total outpatient adjustment for each hospital to be paid each year;
    4. Pay each hospital on or before July 20, October 20, January 20, and April 20 one quarter (1/4) of its total outpatient adjustment as determined in subsection (a)(3).
  2. [Deleted by P.L. 2019, ch. 88, art. 13, § 6.]
  3. Each hospital in the state of Rhode Island, as defined in § 23-17-38.1(d)(1) , shall receive a quarterly inpatient adjustment payment each state fiscal year of an amount determined as follows:
    1. Determine the percent of the state’s total Medicaid inpatient services (exclusive of physician services) provided by each hospital during each hospital’s prior fiscal year;
    2. Determine the sum of all Medicaid payments to hospitals made for inpatient services (exclusive of physician services) provided during each hospital’s prior fiscal year;
    3. Multiply the sum of all Medicaid payments as determined in subsection (c)(2) by a percentage defined as the total identified upper payment limit for all hospitals divided by the sum of all Medicaid payments as determined in subsection (c)(2); and then multiply that result by each hospital’s percentage of the state’s total Medicaid inpatient services as determined in subsection (c)(1) to obtain the total inpatient adjustment for each hospital to be paid each year;
    4. Pay each hospital on or before July 20, October 20, January 20, and April 20 one quarter (1/4) of its total inpatient adjustment as determined in subsection (c)(3).
  4. The amounts determined in subsections (a) and (c) are in addition to Medicaid inpatient and outpatient payments and emergency services payments (exclusive of physician services) paid to hospitals in accordance with current state regulation and the Rhode Island Plan for Medicaid Assistance pursuant to Title XIX of the Social Security Act and are not subject to recoupment or settlement.

History of Section. P.L. 2012, ch. 241, art. 15, § 2; P.L. 2014, ch. 145, art. 17, § 2; P.L. 2019, ch. 88, art. 13, § 6; P.L. 2021, ch. 162, art. 12, § 3, effective July 1, 2021.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq.

Chapter 8.4 Health Care for Families

40-8.4-1. Title.

This chapter is hereby entitled “The Health Care for Families Act.”

History of Section. P.L. 1998, ch. 31, art. 33, § 1.

40-8.4-2. Purpose.

It is the intent of the general assembly to continue to meet the goal established in 1993 pursuant to § 42-12.3-2 to ensure access to comprehensive health care by providing or creating access to health insurance to all Rhode Islanders who are uninsured. Over the course of several years, health insurance through the RIte Care program has been extended to pregnant women and children living in families whose income is less than two hundred fifty percent (250%) of the federal poverty level. Many of the parents of these children are uninsured and without the means to purchase health insurance. Federal funds are available to help pay for health insurance for low-income families through the medical assistance program under § 1931 of Title XIX of the Social Security Act, 42 U.S.C. § 1396u-1, which de-links medical assistance from cash assistance and allows for expanded income and resource methodologies. It is the intent of the general assembly, therefore, to implement § 1931 of Title XIX of the Social Security Act and, in addition, to provide expanded access to health insurance for eligible families. Federal funds for some children and pregnant women may also be available under Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq., and it is further the intent of the general assembly to access these funds as appropriate and as authorized in accordance with the legal authority provided by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), and Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq.

History of Section. P.L. 1998, ch. 31, art. 33, § 1; P.L. 2009, ch. 68, art. 23, § 4; P.L. 2020, ch. 79, art. 1, § 31.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-8.4-3. Definitions.

  1. “Family” means a minor child or children and the parent(s) or relative as defined in § 40-5.1-3 [repealed], with whom they reside, including two-parent families in which one parent is working more than one hundred (100) hours per month.
  2. “Minor child” means a child under the age of eighteen (18) or who is eighteen (18) and a full-time student in a secondary school or in the equivalent level of vocational or technical training.

History of Section. P.L. 1998, ch. 31, art. 33, § 1; P.L. 2006, ch. 216, § 20.

Compiler’s Notes.

Section 40-5.1-3, referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

40-8.4-4. Eligibility.

  1. Medical assistance for families.  There is hereby established a category of medical assistance eligibility pursuant to § 1931 of Title XIX of the Social Security Act, 42 U.S.C. § 1396u-1, for families whose income and resources are no greater than the standards in effect in the aid to families with dependent children program on July 16, 1996, or such increased standards as the department may determine. The executive office of health and human services is directed to amend the medical assistance Title XIX state plan and to submit to the United States Department of Health and Human Services an amendment to the RIte Care waiver project to provide for medical assistance coverage to families under this chapter in the same amount, scope, and duration as coverage provided to comparable groups under the waiver. The department is further authorized and directed to submit amendments and/or requests for waivers to the Title XXI state plan as may be necessary to maximize federal contribution for provision of medical assistance coverage provided pursuant to this chapter, including providing medical coverage as a “qualified state” in accordance with Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq. Implementation of expanded coverage under this chapter shall not be delayed pending federal review of any Title XXI amendment or waiver.
  2. Income.  The secretary of the executive office of health and human services is authorized and directed to amend the medical assistance Title XIX state plan or RIte Care waiver to provide medical assistance coverage through expanded income disregards or other methodology for parents or relative caretakers whose income levels are below one hundred thirty-three percent (133%) of the federal poverty level.

History of Section. P.L. 1998, ch. 31, art. 33, § 1; P.L. 2000, ch. 200, § 3; P.L. 2000, ch. 229, § 3; P.L. 2002, ch. 65, art. 32, § 1; P.L. 2005, ch. 117, art. 12, § 2; P.L. 2006, ch. 246, art. 25, § 1; P.L. 2008, ch. 100, art. 10, § 1; P.L. 2009, ch. 68, art. 23, §§ 4, 13; P.L. 2013, ch. 144, art. 19, § 4.

40-8.4-5. Managed care.

The delivery and financing of the healthcare services provided under this chapter shall be provided through a system of managed care. A managed care system integrates an efficient financing mechanism with quality service delivery; provides a “medical home” to ensure appropriate care and deter unnecessary and inappropriate care; and places emphasis on preventive and primary health care.

History of Section. P.L. 1998, ch. 31, art. 33, § 1.

40-8.4-6. Administration.

The department of human services shall ensure that eligibility and enrollment are determined and provided in a timely, efficient, and user-friendly manner, including mail-in applications. The department may enter into any necessary cooperative agreements with the department of health and/or other state agencies to achieve the purposes of this section. Children and families applying for cash assistance through the family independence program, § 40-5.1-1 et seq. [repealed], shall not be required to complete a separate application for medical assistance under this chapter.

By December 1, 2006, the department shall provide to the chair of the senate health and human services committee, the chair of the house health, education and welfare committee, and to the chairs of the house and senate finance committees a report describing a process for renewing eligibility for the RIte care program by using an “ex-parte” process whereby the department uses information provided to the department from the recipients’ cash assistance, food stamp, and/or childcare assistance records and from other reliable sources that are readily available to the department. The report shall include at a minimum: how the ex-parte renewal process will work; the date by which the process could be implemented; the number and types of cases to which the ex-parte renewal process is anticipated to be applied; the costs and anticipated savings of implementing the process; and how the department will assure the accuracy of the eligibility determination when the ex-parte process is used. The department shall consult with, and as appropriate include, members of the RIte care consumer advisory council in preparing this report.

History of Section. P.L. 1998, ch. 31, art. 33, § 1; P.L. 2006, ch. 603, § 1; P.L. 2006, ch. 615, § 1.

Compiler’s Notes.

Chapter 5.1 of this title, § 40-5.1-1 et seq., referred to in this section, was repealed by P.L. 2008, ch. 100, art. 16, § 2, effective June 26, 2008. For comparable provisions, see chapter 5.2 of this title.

40-8.4-7. Buy-In.

The department of human services shall investigate and develop opportunities for individuals and/or employers to buy into, at the individual’s and/or employer’s expense, one or more programs the department may establish under this chapter or chapter 12.3 of title 42 to address un-insurance among Rhode Islanders, and shall provide a report on these efforts to the permanent joint committee on health care oversight established pursuant to § 40-8.4-14 on or before February 15 of each year.

History of Section. P.L. 1998, ch. 31, art. 33, § 1; P.L. 1999, ch. 413, § 2; P.L. 2000, ch. 200, § 3; P.L. 2000, ch. 229, § 3.

40-8.4-8. Appropriations — Authorization to pay for health care.

The general assembly shall annually appropriate to the department of human services the sums as it may deem necessary to carry out the purposes of this chapter. Authorization to pay for healthcare services specified in this chapter shall be made by representatives of the department of human services, and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of the sum or sums or so much thereof as may be required from time to time, upon the receipt by him or her of properly authenticated vouchers; provided, however, that the department of human services may enter into cooperative agreements for the transfer of funds to effectuate the purposes set forth in this chapter.

History of Section. P.L. 1998, ch. 31, art. 33, § 1.

40-8.4-9. Assignment of medical support rights.

Any person who is determined eligible for healthcare assistance under this chapter is hereby deemed to have made an assignment of rights to medical support in accordance with § 40-6-9(b) , and the provisions of § 40-6-9(b) and (d) are incorporated by reference and shall apply to such person.

History of Section. P.L. 1998, ch. 31, art. 33, § 1.

40-8.4-10. Regulations.

  1. The department of human services is authorized to promulgate any regulations necessary to implement this chapter.
  2. When promulgating any rule or regulation necessary to implement this chapter, or any rule or regulation related to RIte Care, the department shall send the notice referred to in § 42-35-3 and a true copy of the rule referred to in § 42-35-4 of the Rhode Island administrative procedures act to each of the co-chairpersons of the permanent joint committee on health care oversight established by § 40-8.4-14 .

History of Section. P.L. 1998, ch. 31, art. 33, § 1; P.L. 2000, ch. 200, § 3; P.L. 2000, ch. 229, § 3.

Compiler’s Notes.

Section 42-35-3 , referred to in this section, was amended by P.L. 2016, ch. 203, § 2, and P.L. 2016, ch. 206, § 2, effective June 29, 2016. Comparable provisions are now found in chapter 35 of title 42.

40-8.4-11. Severability.

If any provision in any section of this chapter, or the application thereof, to any person or circumstances is held invalid, its invalidity does not affect other provisions or applications of this chapter that can be given effect without the invalid provision or application, and to this end the provisions of this chapter are severable.

History of Section. P.L. 1998, ch. 31, art. 33, § 1.

40-8.4-12. RIte Share health insurance premium assistance program.

  1. Basic RIte Share health insurance premium assistance program.  Under the terms of Section 1906 of Title XIX of the U.S. Social Security Act, 42 U.S.C. § 1396e, states are permitted to pay a Medicaid-eligible person’s share of the costs for enrolling in employer-sponsored health insurance (ESI) coverage if it is cost-effective to do so. Pursuant to the general assembly’s direction in the Rhode Island health reform act of 2000, the Medicaid agency requested and obtained federal approval under § 1916, 42 U.S.C. § 1396o, to establish the RIte Share premium assistance program to subsidize the costs of enrolling Medicaid-eligible persons and families in employer-sponsored health insurance plans that have been approved as meeting certain cost and coverage requirements. The Medicaid agency also obtained, at the general assembly’s direction, federal authority to require any such persons with access to ESI coverage to enroll as a condition of retaining eligibility providing that doing so meets the criteria established in Title XIX for obtaining federal matching funds.
  2. Definitions.  For the purposes of this section, the following definitions apply:
    1. “Cost-effective” means that the portion of the ESI that the state would subsidize, as well as wrap-around costs, would on average cost less to the state than enrolling that same person/family in a managed-care delivery system.
    2. “Cost sharing” means any co-payments, deductibles, or co-insurance associated with ESI.
    3. “Employee premium” means the monthly premium share a person or family is required to pay to the employer to obtain and maintain ESI coverage.
    4. “Employer-sponsored insurance” or “ESI” means health insurance or a group health plan offered to employees by an employer. This includes plans purchased by small employers through the state health insurance marketplace, healthsource, RI (HSRI).
    5. “Policy holder” means the person in the household with access to ESI, typically the employee.
    6. “RIte Share-approved employer-sponsored insurance (ESI)” means an employer-sponsored health insurance plan that meets the coverage and cost-effectiveness criteria for RIte Share.
    7. “RIte Share buy-in” means the monthly amount an Medicaid-ineligible policy holder must pay toward RIte Share-approved ESI that covers the Medicaid-eligible children, young adults, or spouses with access to the ESI. The buy-in only applies in instances when household income is above one hundred fifty percent (150%) of the FPL.
    8. “RIte Share premium assistance program” means the Rhode Island Medicaid premium assistance program in which the State pays the eligible Medicaid member’s share of the cost of enrolling in a RIte Share-approved ESI plan. This allows the state to share the cost of the health insurance coverage with the employer.
    9. “RIte Share unit” means the entity within the executive office of health and human services (EOHHS) responsible for assessing the cost-effectiveness of ESI, contacting employers about ESI as appropriate, initiating the RIte Share enrollment and disenrollment process, handling member communications, and managing the overall operations of the RIte Share program.
    10. “Third-party liability (TPL)” means other health insurance coverage. This insurance is in addition to Medicaid and is usually provided through an employer. Since Medicaid is always the payer of last resort, the TPL is always the primary coverage.
    11. “Wrap-around services or coverage” means any healthcare services not included in the ESI plan that would have been covered had the Medicaid member been enrolled in a RIte Care or Rhody Health Partners plan. Coverage of deductibles and co-insurance is included in the wrap. Co-payments to providers are not covered as part of the wrap-around coverage.
  3. RIte Share populations.  Medicaid beneficiaries subject to RIte Share include: children, families, parent and caretakers eligible for Medicaid or the children’s health insurance program (CHIP) under this chapter or chapter 12.3 of title 42; and adults between the ages of nineteen (19) and sixty-four (64) who are eligible under chapter 8.12 of this title, not receiving or eligible to receive Medicare, and are enrolled in managed care delivery systems. The following conditions apply:
    1. The income of Medicaid beneficiaries shall affect whether and in what manner they must participate in RIte Share as follows:
      1. Income at or below one hundred fifty percent (150%) of FPL — Persons and families determined to have household income at or below one hundred fifty percent (150%) of the federal poverty level (FPL) guidelines based on the modified adjusted gross income (MAGI) standard or other standard approved by the secretary are required to participate in RIte Share if a Medicaid-eligible adult or parent/caretaker has access to cost-effective ESI. Enrolling in ESI through RIte Share shall be a condition of maintaining Medicaid health coverage for any eligible adult with access to such coverage.
      2. Income above one hundred fifty percent (150%) of FPL and policy holder is not Medicaid-eligible — Premium assistance is available when the household includes Medicaid-eligible members, but the ESI policy holder (typically a parent/caretaker, or spouse) is not eligible for Medicaid. Premium assistance for parents/caretakers and other household members who are not Medicaid-eligible may be provided in circumstances when enrollment of the Medicaid-eligible family members in the approved ESI plan is contingent upon enrollment of the ineligible policy holder and the executive office of health and human services (executive office) determines, based on a methodology adopted for such purposes, that it is cost-effective to provide premium assistance for family or spousal coverage.
  4. RIte Share enrollment as a condition of eligibility.  For Medicaid beneficiaries over the age of nineteen (19), enrollment in RIte Share shall be a condition of eligibility except as exempted below and by regulations promulgated by the executive office.
    1. Medicaid-eligible children and young adults up to age nineteen (19) shall not be required to enroll in a parent/caretaker relative’s ESI as a condition of maintaining Medicaid eligibility if the person with access to RIte Share-approved ESI does not enroll as required. These Medicaid-eligible children and young adults shall remain eligible for Medicaid and shall be enrolled in a RIte Care plan.
    2. There shall be a limited six-month (6) exemption from the mandatory enrollment requirement for persons participating in the RI works program pursuant to chapter 5.2 of this title.
  5. Approval of health insurance plans for premium assistance.  The executive office of health and human services shall adopt regulations providing for the approval of employer-based health insurance plans for premium assistance and shall approve employer-based health insurance plans based on these regulations. In order for an employer-based health insurance plan to gain approval, the executive office must determine that the benefits offered by the employer-based health insurance plan are substantially similar in amount, scope, and duration to the benefits provided to Medicaid-eligible persons enrolled in a Medicaid managed care plan, when the plan is evaluated in conjunction with available supplemental benefits provided by the office. The office shall obtain and make available to persons otherwise eligible for Medicaid identified in this section as supplemental benefits those benefits not reasonably available under employer-based health insurance plans that are required for Medicaid beneficiaries by state law or federal law or regulation. Once it has been determined by the Medicaid agency that the ESI offered by a particular employer is RIte Share-approved, all Medicaid members with access to that employer’s plan are required to participate in RIte Share. Failure to meet the mandatory enrollment requirement shall result in the termination of the Medicaid eligibility of the policy holder and other Medicaid members nineteen (19) or older in the household who could be covered under the ESI until the policy holder complies with the RIte Share enrollment procedures established by the executive office.
  6. Premium assistance.  The executive office shall provide premium assistance by paying all or a portion of the employee’s cost for covering the eligible person and/or his or her family under such a RIte Share-approved ESI plan subject to the buy-in provisions in this section.
  7. Buy-in.   Persons who can afford it shall share in the cost. — The executive office is authorized and directed to apply for and obtain any necessary state plan and/or waiver amendments from the Secretary of the United States Department of Health and Human Services (DHHS) to require that persons enrolled in a RIte Share-approved employer-based health plan who have income equal to or greater than one hundred fifty percent (150%) of the FPL to buy-in to pay a share of the costs based on the ability to pay, provided that the buy-in cost shall not exceed five percent (5%) of the person’s annual income. The executive office shall implement the buy-in by regulation, and shall consider co-payments, premium shares, or other reasonable means to do so.
  8. Maximization of federal contribution.  The executive office of health and human services is authorized and directed to apply for and obtain federal approvals and waivers necessary to maximize the federal contribution for provision of medical assistance coverage under this section, including the authorization to amend the Title XXI state plan and to obtain any waivers necessary to reduce barriers to provide premium assistance to recipients as provided for in Title XXI of the Social Security Act, 42 U.S.C. § 1397aa et seq.
  9. Implementation by regulation.  The executive office of health and human services is authorized and directed to adopt regulations to ensure the establishment and implementation of the premium assistance program in accordance with the intent and purpose of this section, the requirements of Title XIX, Title XXI, and any approved federal waivers.
  10. Outreach and reporting.  The executive office of health and human services shall develop a plan to identify Medicaid-eligible individuals who have access to employer-sponsored insurance and increase the use of RIte Share benefits. Beginning October 1, 2019, the executive office shall submit the plan to be included as part of the reporting requirements under § 35-17-1 . Starting January 1, 2020, the executive office of health and human services shall include the number of Medicaid recipients with access to employer-sponsored insurance, the number of plans that did not meet the cost-effectiveness criteria for RIte Share, and enrollment in the premium assistance program as part of the reporting requirements under § 35-17-1 .
  11. Employer-sponsored insurance.  The executive office of health and human services shall dedicate staff and resources to reporting monthly as part of the requirements under § 35-17-1 which employer-sponsored insurance plans meet the cost-effectiveness criteria for RIte Share. Information in the report shall be used for screening for Medicaid enrollment to encourage Rite Share participation. By October 1, 2021, the report shall include any employers with 300 or more employees. By January 1, 2022, the report shall include employers with 100 or more employees. The January report shall also be provided to the chairperson of the house finance committee; the chairperson of the senate finance committee; the house fiscal advisor; the senate fiscal advisor; and the state budget officer.

History of Section. P.L. 2000, ch. 200, § 2; P.L. 2000, ch. 229, § 2; P.L. 2002, ch. 65, art. 32, § 1; P.L. 2006, ch. 246, art. 25, § 1; P.L. 2008, ch. 100, art. 10, § 1; P.L. 2009, ch. 68, art. 23, §§ 4, 13; P.L. 2013, ch. 144, art. 19, § 5; P.L. 2018, ch. 47, art. 13, § 3; P.L. 2019, ch. 88, art. 13, § 7; P.L. 2021, ch. 162, art. 12, § 5, effective July 1, 2021.

40-8.4-13. Utilization of available employer-based health insurance.

To the extent permitted under Titles XIX and XXI of the Social Security Act, 42 U.S.C. § 1396 et seq. and 42 U.S.C. § 1397aa et seq., or by waiver from the Secretary of the United States Department of Health and Human Services, the department of human services shall adopt regulations to restrict eligibility for RIte Care under this chapter and/or chapter 12.3 of title 42, or the RIte Share program under § 40-8.4-12 , for certain periods of time for certain individuals or families who have access to, or have refused or terminated employer-based health insurance and for certain periods of time for certain individuals but not including children whose employer has terminated their employer-based health insurance. The department is authorized and directed to amend the medical assistance Title XIX and XXI state plans, and/or to seek and obtain appropriate federal approvals or waivers to implement this section.

History of Section. P.L. 2000, ch. 200, § 2; P.L. 2000, ch. 229, § 2.

40-8.4-14. Permanent joint committee on health care oversight.

  1. The legislature hereby finds and declares that: (1) Access to affordable, quality health and long-term care is of concern for all Rhode Islanders; (2) The complexities of the health-insurance and healthcare-delivery systems result in inefficiencies, confusion, and additional costs for consumers and other participants in the healthcare system; (3) Reform to the health-insurance and healthcare-delivery systems is achievable only through an ongoing, focused, directed, and informed effort; and (4) Steps taken to reduce the numbers of uninsured Rhode Islanders, enhance the quality of care, contain costs, ensure accessibility to services, and promote healthy lifestyles should be monitored, adjusted or expanded as needed. Therefore, there is hereby created a permanent legislative committee to monitor, study, report, and make recommendations on all areas of healthcare provision, insurance, liability, licensing, cost, and delivery of services, and the adequacy, efficacy and efficiency of statutes, rules, regulations, guidelines, practices, and programs related to health care, long-term care, or health insurance coverage in Rhode Island.
  2. The committee consists of twelve (12) members of the general assembly: six (6) of whom shall be members of the house of representatives, to include the chair or deputy chair of the committee on finance, the chair or vice chair of the committee on corporations, the chair or vice chair of the committee on health, education and welfare; and one of whom shall be from the minority party, to be appointed by, and to serve at the discretion of, the speaker of the house of representatives; and six (6) of whom shall be from the senate, to include the chair or vice chair of the committee on finance, the chair or vice chair of the committee on commerce, housing and municipal government, the chair or vice chair of the committee on health and human services; and one of whom from the minority party, to be appointed by, and to serve at the discretion of, the president of the senate.
  3. The committee shall have co-chairpersons, one appointed by the speaker of the house of representatives and one by the president of the senate.
  4. The committee may review or study any matter related to the provision of healthcare services and long-term care that it considers of significance to the citizens of Rhode Island, including the availability of health care, the quality of health care, the effectiveness and efficiency of managed care systems, the efficiency and the operation of state healthcare programs, and the availability of improved processes or new technologies to achieve more effective and timely resolution of disputes, better communication, speedier, more reliable and less costly administrative processes, claims, payments, and other matters involving the interaction among any or all of government, employers, consumers of health care, providers, healthcare facilities, insurers and others. The committee may request information from any healthcare provider, healthcare facility, insurer or others. The committee may request and shall receive from any instrumentality of the state, including the department of human services, the department of business regulation, the department of health, the department of behavioral healthcare, developmental disabilities and hospitals, the office of healthy aging, and the long-term care coordinating council, or any other governmental advisory body or commission, including, but not limited to, the governor’s advisory council on health, information and assistance as it deems necessary for the proper execution of its powers and duties under this section, including the annual report of the governor’s advisory council on health. The committee will undertake a comprehensive study of the state’s regulatory structure for health insurance, including the roles, relevance, impact, and coordination of current state laws and agencies involved in insurance oversight. This study will include any necessary recommendations for the restructuring of the state’s laws and regulatory bodies. The recommendations will be made to the speaker of the house and the president of the senate on or before March 1, 2005.
  5. In addition to the notification regarding regulations required under § 40-8.4-10(b) , the department of human services shall file with the permanent joint committee on health care oversight a detailed plan for the implementation of the programs created under this chapter by August 1, 2000.
  6. The committee shall have the power to hold hearings, shall meet at least quarterly, may make recommendations to the general assembly, state agencies, private industry, or any other entity, and shall report to the general assembly on its findings and recommendations as it determines appropriate.
  7. The office of the health insurance commissioner and the executive office of health and human services shall issue a series of reports to the joint committee on or before October 1 of 2012, on state implementation options related to the U.S. Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010, and any further amendments to or regulations or guidance issued thereunder (“ACA”). These reports shall analyze the state options and make recommendations to the committee for legislative action regarding the following topics:
    1. The feasibility of instituting a basic health program pursuant to Section 131 of the ACA, including a proposed plan for implementation;
    2. The impact of eliminating gender as a rating factor, limiting variation in community rates based on age, and limiting waiting periods for coverage, as required under the Act;
    3. The impact of merging the individual and small group-insurance markets on rates and coverage, including a proposed plan for implementation;
    4. The feasibility of requiring insurance product consistency inside and outside of a state health insurance exchange, including an assessment of coverage and rate impacts; and
    5. The substantially equivalent utilization coverage limits that the legislature may substitute for the current dollar coverage limits on numerous state health insurance mandates, to conform with the Act.

History of Section. P.L. 2000, ch. 200, § 2; P.L. 2000, ch. 229, § 2; P.L. 2001, ch. 180, § 85; P.L. 2002, ch. 302, § 1; P.L. 2002, ch. 367, § 1; P.L. 2004, ch. 405, § 1; P.L. 2004, ch. 503, § 1; P.L. 2004, ch. 576, § 1; P.L. 2012, ch. 361, § 1; P.L. 2012, ch. 385, § 1.

Federal Act References.

The reference in this section to “Section 131” of the Patient Protection and Affordable Care Act may be intended to be a reference to section 1301 of the act. Sections 1301 et seq. of the act are codified at 42 U.S.C. § 18021 et seq.

40-8.4-15. Advisory commission on health care.

  1. There is hereby established an advisory commission to be known as the “advisory commission on health care” to advise the director of the department of human services on all matters relating to the RIte Care and RIte Share programs, and other matters concerning access for all Rhode Islanders to quality health care in the most affordable, economical manner. The director of the department of human services shall serve ex officio as chairperson. The director shall appoint the eighteen (18) members:
    1. Three (3) of whom shall represent the healthcare providers;
    2. Three (3) of whom shall represent the healthcare insurers;
    3. Three (3) of whom shall represent healthcare consumers or consumer organizations;
    4. Two (2) of whom shall represent organized labor;
    5. One of whom shall be the health care advocate in the office of the attorney general;
    6. Three (3) of whom shall represent employers; and
    7. Three (3) of whom shall be other members of the public.
  2. The commission may study all aspects of the provisions of the RIte Care and RIte Share programs involving purchasers of health care, including employers, consumers, and the state, health insurers, providers of health care, and healthcare facilities, and all matters related to the interaction among these groups, including methods to achieve more effective and timely resolution of disputes, better communication, speedier, more reliable and less-costly administrative processes, claims, payments, and other reimbursement matters, and the application of new processes or technologies to such issues.
  3. Members of the commission shall be appointed in the month of July, each to hold office until the last day of June in the second year of his or her appointment or until his or her successor is appointed by the director.
  4. The commission shall meet at least quarterly, and the initial meeting of the commission shall take place on or before September 15, 2000. The commission may meet more frequently than quarterly at the call of the chair or at the call of any three (3) members of the commission.
  5. Members of the permanent joint committee on health care oversight established pursuant to § 40-8.4-14 shall be notified of each meeting of the commission and shall be invited to participate.

History of Section. P.L. 2000, ch. 200, § 2; P.L. 2000, ch. 229, § 2.

40-8.4-16. Pilot program for the uninsured — Legislative findings.

The general assembly hereby finds and declares that:

  1. Although Rhode Island has one of the highest rates of health insurance coverage in the nation, gaps in coverage remain and the rate of coverage dropped significantly during the past year; and
  2. From 2001-2002, the state’s uninsured rate for working-age adults went from eight percent (8%) to eleven percent (11%), one of eighteen (18) states in the country with a significant increase; and
  3. Significant health-insurance-premium rate increases over the past two (2) years, especially for small businesses and the self-insured, are contributing to an increase in the rate of the uninsured; and
  4. The largest segment of uninsured Rhode Island residents are adults with low incomes, many of whom are employed; and
  5. Individuals without health coverage often resort to expensive emergency-room care that ultimately drives up the overall cost of care for everyone and adds to the state’s uncompensated care burden; and
  6. Rhode Island residents’ use of the emergency room services is greater than that of the nation; and
  7. The Institute of Medicine defines primary care as the provision of integrated, accessible healthcare services by clinicians who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients, and practicing in the context of family and community; and
  8. Access to primary health care should be available to every resident of the state regardless of income and whether or not they have access to health insurance.

History of Section. P.L. 2004, ch. 587, § 1.

40-8.4-17. Pilot primary care program established.

  1. To increase primary-care access for those state residents who do not have access to health insurance coverage, or who are unable to afford health insurance coverage, the director of the state department of human services, in collaboration with the director of the department of health, shall develop a plan for a pilot primary-care program for uninsured residents of the state. The pilot program may include enrollee premiums and co-insurance payments that are income-based with premiums and/or co-insurance subsidized by the state. The pilot program may also include catastrophic or reinsurance coverage provided under the auspices of the state. In designing the pilot program, the director may consider a variety of service-delivery and financing models, including capitation payments to private physicians, a buy-in program under RIte Care, and coverage arrangements purchased from qualified community health centers. In developing the pilot program, the director may seek available federal grant monies, including Medicaid, and private foundation grants.
  2. The director shall submit the plan for the pilot primary-care program to the governor, the speaker of the house, the president of the senate, the majority leaders of the house and senate, and the chairpersons of the house and senate finance committees by January 15, 2005. The plan shall include: eligibility criteria for participation in the pilot program; the scope of services to be offered; the geographic area and population to be served; and cost estimates to implement the program.

History of Section. P.L. 2004, ch. 587, § 2; P.L. 2006, ch. 216, § 20.

40-8.4-18. Public health access beneficiary employer report.

The department of human services shall annually prepare a public-health-access-beneficiary employer report. A “public-health-access-program beneficiary” means any person who receives medical benefits from RIte Care, RIte Share, or Medicaid. Any applicant for public health-benefits through RIte-Care, RIte Share, and/or Medicaid shall identify the employer, or the employers, of the proposed beneficiary of the healthcare benefits. The report shall provide the following information for each employer of fifty (50) or more public-health-access beneficiaries:

  1. The name and address of the employer;
  2. The number of public-health-access-program beneficiaries who are employees of the employer;
  3. The number of public-health-access-program beneficiaries who are spouses or dependents of employees of the employer;
  4. Whether the employer offers health benefits to its employees;
  5. Whether the employer participates in the RIte Share program; and
  6. The cost to the state of Rhode Island for providing public-health-access benefits to their employees and enrolled dependents.

    In determining whether the fifty-employee threshold is met, the department of human services shall include all public-health-access-program beneficiaries employed by the employer and its subsidiaries throughout the state. The report shall not include the names of any individual public-health-access-program beneficiaries and shall be subject to privacy standards pursuant to Pub. L. No. 104-91, and the Health Insurance Portability and Accountability Act of 1996. The report shall be submitted annually on the third Tuesday in January to the joint committee on health care oversight, the house finance committee, and the senate finance committee.

History of Section. P.L. 2006, ch. 327, § 1; P.L. 2006, ch. 445, § 1; P.L. 2007, ch. 378, § 1; P.L. 2007, ch. 459, § 1.

40-8.4-19. Managed healthcare delivery systems for families.

  1. Notwithstanding any other provision of state law, the delivery and financing of the healthcare services provided under this chapter shall be provided through a system of managed care. “Managed care” is defined as systems that: integrate an efficient financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate care and deter unnecessary services; and place emphasis on preventive and primary care.
  2. Enrollment in managed care health delivery systems is mandatory for individuals eligible for medical assistance under this chapter. This includes children in substitute care, children receiving medical assistance through an adoption subsidy, and children eligible for medical assistance based on their disability. Beneficiaries with third-party medical coverage or insurance may be exempt from mandatory managed care in accordance with rules and regulations promulgated by the department of human services for such purposes.
  3. Individuals who can afford to contribute shall share in the cost.  The department of human services is authorized and directed to apply for and obtain any necessary waivers and/or state plan amendments from the Secretary of the United States Department of Health and Human Services, including, but not limited to, a waiver of the appropriate sections of Title XIX, 42 U.S.C. § 1396 et seq., to require that beneficiaries eligible under this chapter or chapter 12.3 of title 42, with incomes equal to or greater than one hundred fifty percent (150%) of the federal poverty level, pay a share of the costs of health coverage based on the ability to pay. The department of human services shall implement this cost-sharing obligation by regulation, and shall consider co-payments, premium shares, or other reasonable means to do so in accordance with approved provisions of appropriate waivers and/or state plan amendments approved by the Secretary of the United States Department of Health and Human Services.

History of Section. P.L. 2008, ch. 100, art. 17, § 4; P.L. 2009, ch. 68, art. 22, § 2; P.L. 2009, ch. 69, § 2.

40-8.4-20. Full year coverage for contraception.

No later than July 1, 2019, the executive office of health and human services (EOHHS) shall apply for the appropriate federal approval to provide Medicaid beneficiaries up to three hundred sixty-five (365) days of prescription contraception dispensed as a single prescription.

History of Section. P.L. 2018, ch. 230, § 9; P.L. 2018, ch. 234, § 9.

Chapter 8.5 Health Care for Elderly and Disabled Residents Act

40-8.5-1. Categorically needy medical assistance coverage.

The department of human services is hereby authorized and directed to amend its Title XIX state plan to provide for categorically needy medical assistance coverage as permitted pursuant to Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq., as amended, to individuals who are sixty-five (65) years or older or are disabled, as determined under § 1614(a)(3) of the Social Security Act, 42 U.S.C. § 1382c(a)(3), as amended, whose income does not exceed one hundred percent (100%) of the federal poverty level (as revised annually) applicable to the individual’s family size, and whose resources do not exceed four thousand dollars ($4,000) per individual, or six thousand dollars ($6,000) per couple. The department shall provide medical assistance coverage to such elderly or disabled persons in the same amount, duration, and scope as provided to other categorically needy persons under the state’s Title XIX state plan.

History of Section. P.L. 2000, ch. 104, § 1; P.L. 2000, ch. 165, § 1; P.L. 2005, ch. 351, § 1; P.L. 2005, ch. 394, § 1; P.L. 2006, ch. 263, § 2; P.L. 2006, ch. 286, § 2; P.L. 2007, ch. 424, § 1; P.L. 2008, ch. 100, art. 17, § 5; P.L. 2009, ch. 310, § 16.

40-8.5-1.1. Managed healthcare delivery systems.

  1. To ensure that all medical assistance beneficiaries, including the elderly and all individuals with disabilities, have access to quality and affordable health care, the executive office of health and human services (“executive office”) is authorized to implement mandatory managed-care health systems.
  2. “Managed care” is defined as systems that: integrate an efficient financing mechanism with quality service delivery; provide a “medical home” to ensure appropriate care and deter unnecessary services; and place emphasis on preventive and primary care. For purposes of this section, managed care systems may also be defined to include a primary care case-management model, community health teams, and/or other such arrangements that meet standards established by the executive office and serve the purposes of this section. Managed care systems may also include services and supports that optimize the health and independence of beneficiaries who are determined to need Medicaid-funded long-term care under chapter 8.10 of this title or to be at risk for the care under applicable federal state plan or waiver authorities and the rules and regulations promulgated by the executive office. Any Medicaid beneficiaries who have third-party medical coverage or insurance may be provided such services through an entity certified by, or in a contractual arrangement with, the executive office or, as deemed appropriate, exempt from mandatory managed care in accordance with rules and regulations promulgated by the executive office.
  3. In accordance with § 42-12.4-7 , the executive office is authorized to obtain any approval through waiver(s), category II or III changes, and/or state-plan amendments, from the Secretary of the United States Department of Health and Human Services, that are necessary to implement mandatory, managed healthcare delivery systems for all Medicaid beneficiaries. The waiver(s), category II or III changes, and/or state-plan amendments shall include the authorization to extend managed care to cover long-term-care services and supports. Authorization shall also include, as deemed appropriate, exempting certain beneficiaries with third-party medical coverage or insurance from mandatory managed care in accordance with rules and regulations promulgated by the executive office.
  4. To ensure the delivery of timely and appropriate services to persons who become eligible for Medicaid by virtue of their eligibility for a United States Social Security Administration program, the executive office is authorized to seek any and all data-sharing agreements or other agreements with the Social Security Administration as may be necessary to receive timely and accurate diagnostic data and clinical assessments. This information shall be used exclusively for the purpose of service planning, and shall be held and exchanged in accordance with all applicable state and federal medical record confidentiality laws and regulations.

History of Section. P.L. 2008, ch. 100, art. 17, § 6; P.L. 2009, ch. 68, art. 22, § 3; P.L. 2009, ch. 69, § 3; P.L. 2010, ch. 23, art. 20, § 3; P.L. 2016, ch. 142, art. 7, § 4.

Compiler’s Notes.

P.L. 2008, ch. 100, art. 17, § 16, provides: “This article shall take effect upon passage [June 26, 2008]. Any rules or regulations necessary or advisable to implement the provisions of SECTION 6 and SECTION 14 of this article shall be effective immediately as an emergency rule upon the department’s filing thereof with the secretary of state as it is hereby found that the current fiscal crisis in this state has caused an imminent peril to public health, safety and welfare, and the department is hereby exempted from the requirements of sections 42-35-3(b) and 42-35-4(b)(2) relating to agency findings of imminent peril to public health, safety and welfare and the filing of statements of the agency’s reasons thereof.”

40-8.5-2. Crisis intervention services for adult victims with severe impairments of abuse, neglect and/or exploitation.

  1. As used in this section the terms:
    1. “Adult victim with severe impairments” means:
      1. A person over the age of eighteen (18) who has a disability attributable to a mental or physical impairment, or combination of mental and physical impairments, and results in substantial functional limitations in three (3) or more major life activities;
      2. Is an alleged victim of abuse, neglect, or exploitation pursuant to § 11-5-12 ; or assault pursuant to § 11-5-10.2 or 11-5-11 by a caregiver of the victim;
      3. The adult victim relies on the person believed to have committed the abuse, neglect, and/or exploitation, for assistance in performing three (3) or more major life activities; and
      4. Crisis intervention services are necessary to ensure the immediate health and safety of the adult victim.
    2. “Crisis intervention services” means the short term provision of health care and residential services in the immediate hours and days following the abuse, neglect, and/or exploitation of an adult victim with severe impairments;
    3. “Major life activities” mean: (i) Mobility; (ii) Self-care; (iii) Communication; (iv) Receptive and/or expressive language; (v) Learning; (vi) Self-direction; (vii) Capacity for independent living; or (viii) Economic self-sufficiency;
    4. “Secretary” means the secretary of the executive office of health and human services; and
    5. “Supportive services” means longer-term support services for an adult victim with severe impairments, and when appropriate, that victim’s family.
  2. After July 1, 2007, local police departments may request the department of behavioral healthcare, developmental disabilities and hospitals provide crisis intervention services for the adult victim with severe impairments when:
    1. Necessary to ensure the immediate health and safety of the adult victim; and
    2. The adult victim with severe impairments relies on the person believed to have committed the abuse, neglect, and/or exploitation for assistance in performing three (3) or more major life activities;
    3. After the victim is informed of his or her right to refuse crisis intervention and/or supportive services.
    1. If the department of behavioral healthcare, developmental disabilities and hospitals determines that longer-term supportive services are necessary, the victim, and when appropriate that victim’s family, will be referred to the public and private agencies and departments whose supportive services are within its statutory and/or regulatory responsibility, as are needed by the victim.
    2. In developing the supportive services care plan, the adult victim with severe impairments’ rights to self-determination and lifestyle preferences commensurate with his or her needs shall be of prime consideration.
    3. If the adult victim with severe impairments withdraws consent or refuses to accept crisis intervention or supportive services, the services shall not be provided.
  3. The department of human services is hereby authorized to seek federal approval of a state plan amendment to its Title XIX state plan to initiate crisis intervention services and support services for adults who qualify for Title XIX services and are adult victims with severe impairments of abuse, assault, neglect, or exploitation.
  4. The secretary shall recognize the statewide toll-free, twenty-four-hour-a-day (24), seven-day (7) quality-assurance hotline operated by the department of behavioral healthcare, developmental disabilities and hospitals, and authorized pursuant to § 40.1-26-10 , for the use of the general public to report abuse, neglect, and exploitation and/or request crisis intervention and/or supportive services for adult victims with severe impairments.

History of Section. P.L. 2006, ch. 175, § 2; P.L. 2006, ch. 268, § 2; P.L. 2012, ch. 254, § 3; P.L. 2012, ch. 264, § 3.

Chapter 8.6 Special Program for Care of Severely Disabled Elderly Residents Who Need Nursing Facility Services

40-8.6-1. Special pilot program for care of severely disabled elderly residents who need nursing facility services.

  1. Purpose.  Contingent on appropriation, there is hereby established a special pilot program to be administered by the department of human services to provide payment for nursing facility services and the following ancillary services: pharmacy, physician, laboratory, dental, and vision services for certain low-income elderly Rhode Island residents who are ineligible for federal and state medical assistance coverage.
  2. Eligibility.  To be eligible for payment from the program the individual must be:
    1. Age sixty-five (65) or older;
    2. Legally present in the United States and a resident of the state of Rhode Island;
    3. Determined to meet all eligibility requirements of the federal Medical Assistance Program (Title XIX of the Social Security Act, 42 U.S.C. § 1396 et seq.) but for the citizenship or alienage criteria;
    4. Determined to be ineligible for § 40-8-1 provisions of state-funded medical assistance for aliens; and
    5. Certified by the department of human services to be in need of nursing facility services.
  3. Continuation of coverage.  Eligibility shall be reviewed periodically and renewed as long as the individual continues to meet the criteria.
  4. Payment to nursing facility.  The department shall make payments to the nursing facility in which an eligible individual is residing in the same amount as the payment for nursing facility services under the medical assistance program.

History of Section. P.L. 2003, ch. 376, art. 21, § 1; P.L. 2004, ch. 535, § 1; P.L. 2004, ch. 564, § 1.

40-8.6-2. Appropriation.

The department may establish rules and regulations regarding which nursing facility or facilities may provide services as part of this pilot program, waiting list procedures, and any other administrative functions that are necessary for the conduct of this program.

History of Section. P.L. 2003, ch. 376, art. 21, § 1; P.L. 2004, ch. 535, § 1; P.L. 2004, ch. 564, § 1.

40-8.6-3. Report.

The department shall issue an annual report to the long-term care coordinating council, the general assembly, the senate fiscal advisor, and the house fiscal advisor on the status of this program on or before April 15 of each year. The report shall include at least the number of people served and total expenditures to date.

History of Section. P.L. 2003, ch. 376, art. 21, § 1; P.L. 2004, ch. 535, § 1; P.L. 2004, ch. 564, § 1.

Chapter 8.7 Healthcare Assistance for Working People with Disabilities

40-8.7-1. Short title.

This chapter shall be known and may be cited as “The Sherlock Act.”

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1.

40-8.7-2. Medicaid buy-in program.

The department of human services is hereby authorized to establish a Medicaid buy-in program pursuant to the “Balanced Budget Act of 1997,” 42 U.S.C. § 1396a(a)(10)(A)(ii)(XIII).

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1.

40-8.7-3. Purpose.

The purpose of the Medicaid buy-in program is to:

  1. Enable individuals with disabilities to enter and reenter the work force as soon as possible;
  2. Provide health care and employment support services to individuals with disabilities that will enable those individuals to reduce their dependency on cash benefit programs; and
  3. Allow individuals with disabilities the option to purchase Medicaid coverage that is necessary to enable such individuals to obtain and/or maintain employment.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1; P.L. 2011, ch. 241, § 1; P.L. 2011, ch. 253, § 1.

40-8.7-4. Definitions.

As used in this chapter, the term:

  1. “Employed” means the individual with disabilities is engaged in a work effort that meets substantial and reasonable threshold criteria for hours of work, wages, or other measures, as defined by the department of human services and as permitted by federal law.
  2. “Employment support services” means activities needed to sustain paid work including: benefits counseling; supervision; job coaching; vocational evaluation; case management; job development; customized employment; job training; transportation; training; tools; equipment; and technology, subject to Centers for Medicare and Medicaid Services approval.
  3. “Individual with a disability” means a person who has been designated, but without regard to his or her ability to engage in substantial gainful activity, as specified in the Social Security Act, 42 U.S.C. § 423(d)(4), as a totally and permanently disabled individual by the Social Security Administration or the Rhode Island Medicaid program, pursuant to an application for benefits under Title II, Title XVI, or Title XIX of the Social Security Act, regardless of current receipt of cash benefits under the Social Security Act.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1; P.L. 2011, ch. 241, § 1; P.L. 2011, ch. 253, § 1.

Federal Act References.

Title II, Title XVI, and Title XIX of the Social Security Act, referred to in this section, are codified at 42 U.S.C. § 401 et seq., 42 U.S.C. § 1381 et seq., and 42 U.S.C. § 1396 et seq.

40-8.7-5. Authorization for Medicaid buy-in program and personal care services.

  1. The department of human services is hereby authorized and directed to amend its Title XIX state plan to initiate a Medicaid buy-in program for employed individuals with disabilities.
  2. The department of human services is hereby authorized and directed to amend its Title XIX state plan to initiate community choice first for personal care services, including through a home health agency and/or self-directed plan.
  3. The department of human services is hereby authorized and directed to review and/or amend its Title XIX state plan to initiate the full scope of services authorized under § 1915(i) of the Social Security Act [42 U.S.C. § 1396n], for Medicaid buy-in participants who are eligible upon clinical assessment, subject to Centers for Medicare and Medicaid Services approval.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1; P.L. 2011, ch. 241, § 1; P.L. 2011, ch. 253, § 1.

40-8.7-6. Eligibility.

  1. To be eligible for benefits under the Medicaid buy-in program:
    1. The person shall be an individual with disabilities as defined in § 40-8.7-4 , but without regard to his or her ability to engage in substantial gainful activity, as specified in the Social Security Act, 42 U.S.C. § 423(d)(4);
    2. The person shall be employed as defined in § 40-8.7-4 ;
    3. The person’s net accountable income shall not exceed two hundred fifty percent (250%) of the federal poverty level, taking into account the SSI program disregards and impairment-related work expenses as defined in 42 U.S.C. § 1396a(r)(2);
    4. A maximum of ten thousand dollars ($10,000) of available resources for an individual and twenty thousand dollars ($20,000) for a couple shall be disregarded as shall any additional resources held in a retirement account, in a medical savings account, or any other account, related to enhancing the independence of the individual and approved under rules to be adopted by the department; and
    5. The person shall be a current medical assistance recipient under § 40-8.5-1 [CNIL] or § 40-8-3(5)(v) [MNIL]; or shall meet income, assets, (except as modified by subsection (a)(4) of this section) and eligibility requirements for the medical assistance program under § 40-8.5-1 [CNIL] or § 40-8-3(5)(v) [MNIL], as such requirements are modified and extended by this chapter.
  2. Appeals Process.  The director or designee shall review each application filed in accordance with regulations, and shall make a determination of whether the application will be approved and the extent of the benefits to be made available to the applicant, and shall, within thirty (30) days after the filing, notify the applicant, in writing, of the determination. If the application is rejected, the applicant shall be notified the reason for the denial. The director may at any time reconsider any determination. Any applicant for or recipient of benefits aggrieved because of a decision, or delay in making a decision, shall be entitled to an appeal and shall be afforded reasonable notice and opportunity for a fair hearing conducted by the director, pursuant to chapter 8 of this title.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1; P.L. 2011, ch. 241, § 1; P.L. 2011, ch. 253, § 1.

40-8.7-7. Premiums.

  1. The department of human services is authorized and directed to promulgate such rules to establish the monthly premium payments for employed individuals with disabilities who opt to participate directly in the Medicaid buy-in program. To participate in the Medicaid buy-in program, the employed individual with disabilities shall be required to make payment for coverage in accordance with a monthly payment or payment formula to be established by the department that shall count a portion of the individual’s or couple’s earned income on a sliding-scale basis, in accordance with rules to be established by the department.
  2. The department is further authorized and directed to promulgate such rules to encourage businesses to hire individuals with disabilities, and to allow employed individuals with disabilities who have access to employer-based health insurance and who are determined eligible by the department pursuant to this chapter to coordinate health insurance coverage options.
  3. The department of human services, in consultation with the health insurance commissioner, employer and disability advocacy organizations, shall, by June 30, 2012, investigate, develop, and promulgate rules that may:
    1. Require enrollment in the employer-based health insurance plan as a condition of participation in the Medicaid buy-in program under this chapter, provided that enrollment in the employer-based health insurance plan is cost-effective and its benefits are comparable to the benefits provided by the Medicaid program. Enrollment of the individual and/or the family in the employer-based health insurance plan without regard to any enrollment season restrictions, subject to Centers for Medicare and Medicaid Services approval; or
    2. Provide opportunities for employers to buy into the Medicaid Buy-in program, at the employer’s expense, where the employer’s premium contribution shall be no greater than the employer’s premiums in the existing employer-based health insurance or before September 30, 2012.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1; P.L. 2005, ch. 351, § 2; P.L. 2005, ch. 394, § 2; P.L. 2011, ch. 241, § 1; P.L. 2011, ch. 253, § 1.

40-8.7-8. Work-related protections.

  1. Medicaid buy-in participants shall continue on the Medicaid buy-in program for up to four (4) months after loss of employment due to a medical condition. If the loss of employment is not due to a medical condition, the individual may continue to be eligible for up to four (4) months, but must pay a monthly premium equal to their monthly-unearned income in excess of the medically needy income limit.
  2. Medicaid buy-in participants who return to other Medicaid eligibility categories shall have their accrued savings in a retirement account and/or a medical savings account excluded from countable assets.
  3. The department shall promulgate rules or regulations necessary to institute the work-related protections of this section.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1.

40-8.7-9. Regulations and commencement of program.

  1. The department of human services shall promulgate the rules or regulations necessary to implement the provisions of this act by September 30, 2011, and enrollment of individuals with disabilities in the Medicaid buy-in program shall commence under the new rules on or before January 1, 2012.
  2. The department of human services shall provide quarterly progress reports to the chairpersons of the house and senate finance committees by the fifteenth (15th) day of the following month of each quarter, from date of passage until March 2013.
  3. By March 31, 2013, the department shall report annually to the governor and the chairpersons of the house and senate finance committees on data included, but not limited to, the following:
    1. The number of applications, the number of approved applications, the number of applicants who are currently eligible for other forms of medical coverage;
    2. Demographics including: age, sex, employment supports provided; and primary disabling condition, as permissible under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy and security rules;
    3. Prior and current participation in other public assistance programs including Medicare, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), including the 1619(b) provision;
    4. The number of beneficiaries employed, and the average wage of those beneficiaries prior to and post Medicaid buy-in plan eligibility;
    5. The amounts of premiums collected;
    6. Medicaid claims data including pre-buy-in, while on the buy-in, and if disenrolled, after buy-in to perform an analysis of costs/per member, per month, of buy-in enrollees shall also be provided by the Medicaid agency to the Medicaid Infrastructure Grant recipient, as provided for in the data use agreement;
    7. Findings and recommendations with regard to “best practices” used by other states in the New England region and nationwide that should be considered to increase employment among Medicaid beneficiaries with disabilities and how to best support Medicaid beneficiaries with disabilities who are working; and
    8. Identification and strategies that the finance committees should consider regarding challenges or opportunities for workers with disabilities in Rhode Island as the Affordable Care Act is implemented; including, but not limited to, ensuring that employment supportive policies and supports are integrated into the state’s design and implementation of the following long-term care Affordable Care Act provisions: Section 10202—Balancing Incentive Payments Plan (BIPP); 1915(i) State Plan Amendment; Section 2401—Community First Choice (CFC); Section 2703—Health Homes for Individuals with chronic conditions; Money Follows the Person; 2014 Medicaid Expansion; and the dual eligible integrated care plan models.

History of Section. P.L. 2004, ch. 343, § 1; P.L. 2004, ch. 354, § 1; P.L. 2011, ch. 241, § 1; P.L. 2011, ch. 253, § 1.

Federal Act References.

Section 1619(b) of the Social Security Act, referred to in subsection (c)(3) of this section, is codified at 42 U.S.C. § 1382h(b).

Chapter 8.8 Program of All-Inclusive Care for the Elderly

40-8.8-1. Short title.

This chapter shall be known and may be cited as the “Program of All-Inclusive Care for the Elderly.”

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

40-8.8-2. Program of all-inclusive care for the elderly.

The department of human services is hereby authorized to elect a program of all-inclusive care for the elderly as an optional Medicaid benefit, pursuant to § 1905(a)(26) of the Social Security Act [42 U.S.C. § 1396d(a)(26)], as added by § 4802(a)(1) of the Balanced Budget Act of 1997.

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

40-8.8-3. Purpose.

The purpose of the program of all-inclusive care for the elderly is to offer an alternative to nursing home care for frail elders. The program of all-inclusive care for the elderly is a pre-paid, capitated program of managed care service delivery for beneficiaries who meet special eligibility requirements, including being eligible for nursing home placement, and who elect to enroll. The model of care includes as core services the provision of adult day health care and multidisciplinary team case management, through which access to and allocation of all health services are coordinated.

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

40-8.8-4. Definition.

As used in this chapter, the term “Program of all-inclusive care for the elderly” shall mean a program of services coordinated for the eligible population by an organization approved by the United States Department of Health and Human Services for these purposes. The program of services include at minimum the following benefit package: multidisciplinary assessment and treatment planning; primary care services including physician and nursing services; social work services; restorative therapies; personal care and supportive services; nutritional counseling; recreational therapy; transportation; meals; medical specialty services; laboratory tests; drugs and biologicals; prosthetics and durable medical equipment; acute inpatient care, ambulance and emergency care; and nursing facility care.

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

40-8.8-5. Authorization for program of all-inclusive care for the elderly.

The department of human services is hereby authorized and directed to amend its Title XIX state plan to initiate a program of all-inclusive care for the elderly.

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

40-8.8-6. Eligibility.

To be eligible for benefits under the program of all-inclusive care for the elderly:

  1. The person shall meet the eligibility criteria for both the Rhode Island medical assistance program and for the federal Medicare program; and
  2. The person shall meet the eligibility criteria for the program of all-inclusive care for the elderly as established by the United States Department of Health and Human Services and the state department of human services, including, but not limited to:
    1. Being at least fifty-five (55) years old;
    2. Residing in the program of all-inclusive care for the elderly service area; and
    3. Being certified as eligible for nursing home care by the state department of human services.

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

40-8.8-7. Regulations and commencement of program.

  1. The department of human services shall submit the Medicaid state plan amendment and promulgate any rules or regulations necessary to implement the provisions of this chapter, contingent upon, and immediately following, federal approval of any program of all-inclusive care of the elderly.
  2. Contingent upon completion of the Medicaid state plan amendment process, and the appropriation of necessary funding to implement the program, the program of all-inclusive care for the elderly shall commence on July 1, 2005.

History of Section. P.L. 2005, ch. 110, § 1; P.L. 2005, ch. 114, § 1.

Chapter 8.9 Medical Assistance — Long-Term Care Service and Finance Reform

40-8.9-1. Findings.

  1. The number of Rhode Islanders in need of long-term-care services continues to rise substantially, and the quality of life of these Rhode Islanders is determined by the capacity of the long-term-care system to provide access to the full array of services and supports required to meet their healthcare needs and maintain their independence.
  2. It is in the interest of all Rhode Islanders to endorse and fund statewide efforts to build a fiscally sound, dynamic long-term-care system that supports: consumer independence and choice; the delivery of high-quality, coordinated services; the financial integrity of all participants-purchasers, payers, providers, and consumers; and the responsible and efficient allocation of all available public and private resources.
  3. It is in the interest of all Rhode Islanders to assure that rates paid for community-based long-term-care services are adequate to assure high quality as well as supportive of workforce recruitment and retention.
  4. It is in the interest of all Rhode Islanders to improve consumers’ access information regarding community-based alternatives to institutional settings of care.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1.

40-8.9-2. System reform and rebalancing goal.

On or before July 1, 2007, the department of human services shall begin to implement a model system for integrated long-term care, that expands the capacity of the long-term-care system as a whole to support consumer choice and independence; enables consumers to access coordinated services; ensures quality outcomes through certification standards, performance measures, and incentives and rewards that promote service excellence and generates the information consumers need to make reasoned choices about their health care; and improves the system’s overall stability by reinvesting the benefits that accrue from the more efficient utilization of services to enhance the capacity of each of its component parts. Attaining systemwide reform of the magnitude set forth herein will require rebalancing the system by making significant changes in the organization, financing, and delivery of services that must be implemented incrementally.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2009, ch. 223, § 1.

40-8.9-3. Least-restrictive setting requirement.

The executive office of health and human services (executive office) is directed to recommend the allocation of existing Medicaid resources as needed to ensure that those in need of long-term-care and support services receive them in the least-restrictive setting appropriate to their needs and preferences. The executive office is hereby authorized to utilize screening criteria to avoid unnecessary institutionalization of persons during the full eligibility-determination process for Medicaid community-based care.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2007, ch. 73, art. 14, § 1; P.L. 2016, ch. 142, art. 7, § 5.

40-8.9-4. Unified long-term care budget.

Beginning on July 1, 2007, a unified long-term-care budget shall combine in a single, line-item appropriation within the executive office of health and human services (executive office), annual executive office Medicaid appropriations for nursing facility and community-based, long-term-care services for elderly sixty-five (65) years and older and younger persons at risk of nursing home admissions (including adult day care, home health, PACE, and personal care in assisted-living settings). Beginning on July 1, 2007, the total system savings attributable to the value of the reduction in nursing home days including hospice nursing home days paid for by Medicaid shall be allocated in the budget enacted by the general assembly for the ensuing fiscal year for the express purpose of promoting and strengthening community-based alternatives; provided, further, beginning July 1, 2009, said savings shall be allocated within the budgets of the executive office and, as appropriate, the department of human services, office of healthy aging. The allocation shall include, but not be limited to, funds to support an ongoing, statewide community education and outreach program to provide the public with information on home and community services and the establishment of presumptive eligibility criteria for the purposes of accessing home and community care. The home- and community-care service presumptive eligibility criteria shall be developed through rule or regulation on or before September 30, 2007. The allocation may also be used to fund home and community services provided by the office of healthy aging for persons eligible for Medicaid long-term care, and the co-pay program administered pursuant to chapter 66.3 of title 42. Any monies in the allocation that remain unexpended in a fiscal year shall be carried forward to the next fiscal year for the express purpose of strengthening community-based alternatives.

The caseload estimating conference pursuant to § 35-17-1 shall determine the amount of general revenues to be added to the current service estimate of community-based, long-term-care services for elderly sixty-five (65) and older and younger persons at risk of nursing home admissions for the ensuing budget year by multiplying the combined, cost per day of nursing home and hospice nursing home days estimated at the caseload conference for that year by the reduction in nursing home and hospice nursing home days from those in the second fiscal year prior to the current fiscal year to those in the first fiscal year prior to the current fiscal year.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2007, ch. 73, art. 14, § 1; P.L. 2007, ch. 128, § 1; P.L. 2007, ch. 186, § 1; P.L. 2009, ch. 68, art. 5, § 8; P.L. 2009, ch. 223, § 1; P.L. 2016, ch. 142, art. 7, § 5.

Compiler’s Notes.

This section was amended by three acts (P.L. 2007, ch. 73, art. 14, § 1; P.L. 2007, ch. 128, § 1; P.L. 2007, ch. 186, [ 1) passed by the 2007 General Assembly. Where the acts are not in conflict with each other, the section is set out as amended by all three acts. Where the changes made by the acts conflict, the section is set out as amended by P.L. 2007, ch. 186 as the later enacted act.

P.L. 2007, ch. 73, art. 14, § 1, P.L. 2007, ch. 128, § 1, and P.L. 2007, ch. 186, § 1, enacted similar amendments to this section.

P.L. 2007, ch. 128, § 1, and P.L. 2007, ch. 186, § 1, enacted nearly identical amendments to this section.

40-8.9-5. Administration and regulations.

The single state agency designated to administer the Rhode Island Medicaid program is hereby directed and authorized to develop and submit any requests for waivers, demonstration projects, grants and state plan amendments or regulations that may be considered necessary and appropriate to support the general purposes and specific requirements of this statute. The requests shall be made in consultation with any affected departments and, to the extent feasible, any consumer group, advisory body, or other entity designated for such purposes.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2007, ch. 73, art. 14, § 1; P.L. 2009, ch. 223, § 1.

40-8.9-6. Recognizing long-term reform performance — Reporting.

  1. Annual performance reports showing progress in long-term-care system reform and rebalancing shall be submitted by April 1 of each year by the executive office of health and human services to the finance committees of both the senate and the house of representatives and the long-term care coordinating council and shall include:
    1. The number of Medicaid-eligible persons aged sixty-five (65) years and over and adults with disabilities served in nursing facilities;
    2. The number of Medicaid-eligible persons aged sixty-five (65) years and over and adults with disabilities transitioned from nursing homes to Medicaid-supported home- and community-based care;
    3. The number of persons aged sixty-five (65) years and over and adults with disabilities served in Medicaid and office of healthy aging home and community care, to include home care, adult day services, assisted living, the personal choice program, the program of all-inclusive care of the elderly (PACE) and shared living;
    4. The dollar amounts and percent of expenditures spent on nursing facility care and home- and community-based care for those aged sixty-five (65) years and over and adults with disabilities and the average cost of care for nursing facility care and home- and community-based care;
    5. The amount of savings attributed to the value of the reduction in nursing home days, including hospice nursing home days paid for by Medicaid in accordance with § 40-8.9-4 , and how the savings, if any, are allocated in the current fiscal year and in the proposed budget for the ensuing fiscal year to promote and strengthen community-based alternatives; and
    6. Estimates of the continued investments necessary to provide stability to the existing system and establish the infrastructure and programs required to achieve systemwide reform and the targeted goal of spending fifty percent (50%) of Medicaid long-term-care dollars on nursing facility care and fifty percent (50%) on home- and community-based services.
  2. Beginning in 2019, to measure and show progress in achieving the state’s goals for long-term services and supports reform, the executive office of health and human services shall develop and make public on its website a long-term services and supports performance scorecard based on the measures detailed in subsections (a)(1) through (a)(5) of this section showing data for the most recent four-year (4) period.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2009, ch. 223, § 1; P.L. 2010, ch. 239, § 5; P.L. 2016, ch. 142, art. 7, § 5; P.L. 2018, ch. 148, § 1; P.L. 2018, ch. 255, § 1.

40-8.9-7. Rate reform.

The executive office of health and human services shall design, and require to be submitted by all service providers, cost reports for all community-based, long-term services, including patient liability owed and collected.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2016, ch. 142, art. 7, § 5.

40-8.9-8. System screening.

The executive office of health and human services shall develop and implement a screening strategy for the purpose of identifying entrants to the publicly financed, long-term-care system prior to application for eligibility as well as defining their potential service needs.

History of Section. P.L. 2006, ch. 263, § 1; P.L. 2006, ch. 286, § 1; P.L. 2016, ch. 142, art. 7, § 5.

40-8.9-9. Long-term-care rebalancing system reform goal.

  1. Notwithstanding any other provision of state law, the executive office of health and human services is authorized and directed to apply for, and obtain, any necessary waiver(s), waiver amendment(s), and/or state-plan amendments from the Secretary of the United States Department of Health and Human Services, and to promulgate rules necessary to adopt an affirmative plan of program design and implementation that addresses the goal of allocating a minimum of fifty percent (50%) of Medicaid long-term-care funding for persons aged sixty-five (65) and over and adults with disabilities, in addition to services for persons with developmental disabilities, to home- and community-based care; provided, further, the executive office shall report annually as part of its budget submission, the percentage distribution between institutional care and home- and community-based care by population and shall report current and projected waiting lists for long-term-care and home- and community-based care services. The executive office is further authorized and directed to prioritize investments in home- and community-based care and to maintain the integrity and financial viability of all current long-term-care services while pursuing this goal.
  2. The reformed long-term-care system rebalancing goal is person-centered and encourages individual self-determination, family involvement, interagency collaboration, and individual choice through the provision of highly specialized and individually tailored home-based services. Additionally, individuals with severe behavioral, physical, or developmental disabilities must have the opportunity to live safe and healthful lives through access to a wide range of supportive services in an array of community-based settings, regardless of the complexity of their medical condition, the severity of their disability, or the challenges of their behavior. Delivery of services and supports in less-costly and less-restrictive community settings will enable children, adolescents, and adults to be able to curtail, delay, or avoid lengthy stays in long-term-care institutions, such as behavioral health residential-treatment facilities, long-term-care hospitals, intermediate-care facilities, and/or skilled nursing facilities.
  3. Pursuant to federal authority procured under § 42-7.2-16 , the executive office of health and human services is directed and authorized to adopt a tiered set of criteria to be used to determine eligibility for services. The criteria shall be developed in collaboration with the state’s health and human services departments and, to the extent feasible, any consumer group, advisory board, or other entity designated for these purposes, and shall encompass eligibility determinations for long-term-care services in nursing facilities, hospitals, and intermediate-care facilities for persons with intellectual disabilities, as well as home- and community-based alternatives, and shall provide a common standard of income eligibility for both institutional and home- and community-based care. The executive office is authorized to adopt clinical and/or functional criteria for admission to a nursing facility, hospital, or intermediate-care facility for persons with intellectual disabilities that are more stringent than those employed for access to home- and community-based services. The executive office is also authorized to promulgate rules that define the frequency of re-assessments for services provided for under this section. Levels of care may be applied in accordance with the following:
    1. The executive office shall continue to apply the level-of-care criteria in effect on June 30, 2015, for any recipient determined eligible for and receiving Medicaid-funded long-term services and supports in a nursing facility, hospital, or intermediate-care facility for persons with intellectual disabilities on or before that date, unless:
      1. The recipient transitions to home- and community-based services because he or she would no longer meet the level-of-care criteria in effect on June 30, 2015; or
      2. The recipient chooses home- and community-based services over the nursing facility, hospital, or intermediate-care facility for persons with intellectual disabilities. For the purposes of this section, a failed community placement, as defined in regulations promulgated by the executive office, shall be considered a condition of clinical eligibility for the highest level of care. The executive office shall confer with the long-term-care ombudsperson with respect to the determination of a failed placement under the ombudsperson’s jurisdiction. Should any Medicaid recipient eligible for a nursing facility, hospital, or intermediate-care facility for persons with intellectual disabilities as of June 30, 2015, receive a determination of a failed community placement, the recipient shall have access to the highest level of care; furthermore, a recipient who has experienced a failed community placement shall be transitioned back into his or her former nursing home, hospital, or intermediate-care facility for persons with intellectual disabilities whenever possible. Additionally, residents shall only be moved from a nursing home, hospital, or intermediate-care facility for persons with intellectual disabilities in a manner consistent with applicable state and federal laws.
    2. Any Medicaid recipient eligible for the highest level of care who voluntarily leaves a nursing home, hospital, or intermediate-care facility for persons with intellectual disabilities shall not be subject to any wait list for home- and community-based services.
    3. No nursing home, hospital, or intermediate-care facility for persons with intellectual disabilities shall be denied payment for services rendered to a Medicaid recipient on the grounds that the recipient does not meet level-of-care criteria unless and until the executive office has:
      1. Performed an individual assessment of the recipient at issue and provided written notice to the nursing home, hospital, or intermediate-care facility for persons with intellectual disabilities that the recipient does not meet level-of-care criteria; and
      2. The recipient has either appealed that level-of-care determination and been unsuccessful, or any appeal period available to the recipient regarding that level-of-care determination has expired.
  4. The executive office is further authorized to consolidate all home- and community-based services currently provided pursuant to 42 U.S.C. § 1396n into a single system of home- and community-based services that include options for consumer direction and shared living. The resulting single home- and community-based services system shall replace and supersede all 42 U.S.C. § 1396n programs when fully implemented. Notwithstanding the foregoing, the resulting single program home- and community-based services system shall include the continued funding of assisted-living services at any assisted-living facility financed by the Rhode Island housing and mortgage finance corporation prior to January 1, 2006, and shall be in accordance with chapter 66.8 of title 42 as long as assisted-living services are a covered Medicaid benefit.
  5. The executive office is authorized to promulgate rules that permit certain optional services including, but not limited to, homemaker services, home modifications, respite, and physical therapy evaluations to be offered to persons at risk for Medicaid-funded long-term care subject to availability of state-appropriated funding for these purposes.
  6. To promote the expansion of home- and community-based service capacity, the executive office is authorized to pursue payment methodology reforms that increase access to homemaker, personal care (home health aide), assisted living, adult supportive-care homes, and adult day services, as follows:
    1. Development of revised or new Medicaid certification standards that increase access to service specialization and scheduling accommodations by using payment strategies designed to achieve specific quality and health outcomes.
    2. Development of Medicaid certification standards for state-authorized providers of adult day services, excluding providers of services authorized under § 40.1-24-1(3) , assisted living, and adult supportive care (as defined under chapter 17.24 of title 23) that establish for each, an acuity-based, tiered service and payment methodology tied to: licensure authority; level of beneficiary needs; the scope of services and supports provided; and specific quality and outcome measures. The standards for adult day services for persons eligible for Medicaid-funded long-term services may differ from those who do not meet the clinical/functional criteria set forth in § 40-8.10-3 .
    3. As the state’s Medicaid program seeks to assist more beneficiaries requiring long-term services and supports in home- and community-based settings, the demand for home-care workers has increased, and wages for these workers has not kept pace with neighboring states, leading to high turnover and vacancy rates in the state’s home-care industry, the executive office shall institute a one-time increase in the base-payment rates for FY 2019, as described below, for home-care service providers to promote increased access to and an adequate supply of highly trained home-healthcare professionals, in amount to be determined by the appropriations process, for the purpose of raising wages for personal care attendants and home health aides to be implemented by such providers.
      1. A prospective base adjustment, effective not later than July 1, 2018, of ten percent (10%) of the current base rate for home-care providers, home nursing care providers, and hospice providers contracted with the executive office of health and human services and its subordinate agencies to deliver Medicaid fee-for-service personal care attendant services.
      2. A prospective base adjustment, effective not later than July 1, 2018, of twenty percent (20%) of the current base rate for home-care providers, home nursing care providers, and hospice providers contracted with the executive office of health and human services and its subordinate agencies to deliver Medicaid fee-for-service skilled nursing and therapeutic services and hospice care.
      3. Effective upon passage of this section, hospice provider reimbursement, exclusively for room and board expenses for individuals residing in a skilled nursing facility, shall revert to the rate methodology in effect on June 30, 2018, and these room and board expenses shall be exempted from any and all annual rate increases to hospice providers as provided for in this section.
      4. On the first of July in each year, beginning on July 1, 2019, the executive office of health and human services will initiate an annual inflation increase to the base rate for home-care providers, home nursing care providers, and hospice providers contracted with the executive office and its subordinate agencies to deliver Medicaid fee-for-service personal care attendant services, skilled nursing and therapeutic services and hospice care. The base rate increase shall be a percentage amount equal to the New England Consumer Price Index card as determined by the United States Department of Labor for medical care and for compliance with all federal and state laws, regulations, and rules, and all national accreditation program requirements.
  7. As the state’s Medicaid program seeks to assist more beneficiaries requiring long-term services and supports in home- and community-based settings, the demand for home-care workers has increased, and wages for these workers has not kept pace with neighboring states, leading to high turnover and vacancy rates in the state’s home-care industry. To promote increased access to and an adequate supply of direct-care workers, the executive office shall institute a payment methodology change, in Medicaid fee-for-service and managed care, for FY 2022, that shall be passed through directly to the direct-care workers’ wages who are employed by home nursing care and home-care providers licensed by the Rhode Island department of health, as described below:
    1. Effective July 1, 2021, increase the existing shift differential modifier by $0.19 per fifteen (15) minutes for personal care and combined personal care/homemaker.
      1. Employers must pass on one hundred percent (100%) of the shift differential modifier increase per fifteen-minute (15) unit of service to the CNAs who rendered such services. This compensation shall be provided in addition to the rate of compensation that the employee was receiving as of June 30, 2021. For an employee hired after June 30, 2021, the agency shall use not less than the lowest compensation paid to an employee of similar functions and duties as of June 30, 2021, as the base compensation to which the increase is applied.
      2. Employers must provide to EOHHS an annual compliance statement showing wages as of June 30, 2021, amounts received from the increases outlined herein, and compliance with this section by July 1, 2022. EOHHS may adopt any additional necessary regulations and processes to oversee this subsection.
    2. Effective January 1, 2022, establish a new behavioral healthcare enhancement of $0.39 per fifteen (15) minutes for personal care, combined personal care/homemaker, and homemaker only for providers who have at least thirty percent (30%) of their direct-care workers (which includes certified nursing assistants (CNA) and homemakers) certified in behavioral healthcare training.
      1. Employers must pass on one hundred percent (100%) of the behavioral healthcare enhancement per fifteen (15) minute unit of service rendered by only those CNAs and homemakers who have completed the thirty (30) hour behavioral health certificate training program offered by Rhode Island College, or a training program that is prospectively determined to be compliant per EOHHS, to those CNAs and homemakers. This compensation shall be provided in addition to the rate of compensation that the employee was receiving as of December 31, 2021. For an employee hired after December 31, 2021, the agency shall use not less than the lowest compensation paid to an employee of similar functions and duties as of December 31, 2021, as the base compensation to which the increase is applied.
      2. By January 1, 2023, employers must provide to EOHHS an annual compliance statement showing wages as of December 31, 2021, amounts received from the increases outlined herein, and compliance with this section, including which behavioral healthcare training programs were utilized. EOHHS may adopt any additional necessary regulations and processes to oversee this subsection.
  8. The executive office shall implement a long-term-care-options counseling program to provide individuals, or their representatives, 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 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 long-term-care-options consultation if they so request. Each individual who applies for Medicaid long-term-care services shall be provided with a long-term-care consultation.
  9. The executive office is also authorized, subject to availability of appropriation of funding, and federal, Medicaid-matching funds, to pay for certain services and supports necessary to transition or divert beneficiaries from institutional or restrictive settings and optimize their health and safety when receiving care in a home or the community. The secretary is authorized to obtain any state plan or waiver authorities required to maximize the federal funds available to support expanded access to home- and community-transition and stabilization services; provided, however, payments shall not exceed an annual or per-person amount.
  10. To ensure persons with long-term-care needs who remain living at home have adequate resources to deal with housing maintenance and unanticipated housing-related costs, the secretary is authorized to develop higher resource eligibility limits for persons or obtain any state plan or waiver authorities necessary to change the financial eligibility criteria for long-term services and supports to enable beneficiaries receiving home and community waiver services to have the resources to continue living in their own homes or rental units or other home-based settings.
  11. The executive office shall implement, no later than January 1, 2016, the following home- and community-based service and payment reforms:
    1. [Deleted by P.L. 2021, ch. 162, art. 12, § 6.]
    2. Adult day services level of need criteria and acuity-based, tiered-payment methodology; and
    3. Payment reforms that encourage home- and community-based providers to provide the specialized services and accommodations beneficiaries need to avoid or delay institutional care.
  12. The secretary is authorized to seek any Medicaid section 1115 waiver or state-plan amendments and take any administrative actions necessary to ensure timely adoption of any new or amended rules, regulations, policies, or procedures and any system enhancements or changes, for which appropriations have been authorized, that are necessary to facilitate implementation of the requirements of this section by the dates established. The secretary shall reserve the discretion to exercise the authority established under §§ 42-7.2-5(6)(v) and 42-7.2-6.1 , in consultation with the governor, to meet the legislative directives established herein.

History of Section. P.L. 2008, ch. 100, art. 17, § 8; P.L. 2009, ch. 68, art. 22, § 6; P.L. 2009, ch. 68, art. 23, § 10; P.L. 2008, ch. 69, § 6; P.L. 2009, ch. 223, § 1; P.L. 2010, ch. 23, art. 20, § 5; P.L. 2015, ch. 141, art. 5, § 16; P.L. 2016, ch. 142, art. 7, § 5; P.L. 2016, ch. 511, art. 1, § 19; P.L. 2017, ch. 302, art. 9, § 5; P.L. 2018, ch. 47, art. 13, § 4; P.L. 2019, ch. 88, art. 13, § 8; P.L. 2021, ch. 162, art. 12, § 6, effective July 1, 2021.

Compiler’s Notes.

This section was amended four times by three acts ( P.L. 2009, ch. 68, art. 22, § 6; P.L. 2009, ch. 68, art. 23, § 10; P.L. 2008, ch. 69, § 6; P.L. 2009, ch. 223, § 1) passed by the 2009 General Assembly. Where the changes made by the acts are not in conflict with each other, the section is set out as amended by all three acts. The director of law revision of the joint committee on legislative services has determined that the changes made to subsection (c) by P.L. 2009, ch. 69, § 6 are controlling as the latter enacted version of the section.

Federal Act References.

Section 1115 of the Social Security Act, referred to in subsection (k), is codified as 42 U.S.C. § 1315.

Chapter 8.10 Long-Term Care Service Reform for Medicaid Eligible Individuals

40-8.10-1. Purpose.

In order to ensure that all Medicaid recipients eligible for long-term care have access to the full continuum of services they need, the secretary of the executive office of health and human services, in collaboration with the directors of EOHHS departments, shall offer eligible Medicaid recipients the full range of services as allowed under the terms and conditions of the Rhode Island Medicaid section 1115 demonstration waiver, including institutional services and the home- and community-based services provided for under the previous Medicaid section 1915(c) waivers, as well as additional services for medication management, transition services, and other authorized services as defined in this chapter, in order to meet the individual needs of the Medicaid recipient.

History of Section. P.L. 2009, ch. 68, art. 23, § 9; P.L. 2015, ch. 141, art. 5, § 17.

Federal Act References.

Section 1115 of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1315. Section 1915(c) of the Social Security Act is codified at 42 U.S.C. § 1396n(c).

40-8.10-2. Definitions.

As used in this chapter:

  1. “Core services” mean homemaker services, environmental modifications (home accessibility adaptations, special medical equipment (minor assistive devices), meals on wheels (home delivered meals), personal emergency response (PERS), licensed practical nurse services, community transition services, residential supports, day supports, supported employment, supported living arrangements, private duty nursing, supports for consumer direction (supports facilitation), participant directed goods and services, case management, senior companion services, assisted living, personal care assistance services and respite.
  2. “Preventive services” mean homemaker services, minor environmental modifications, physical therapy evaluation and services, and respite services.

History of Section. P.L. 2009, ch. 68, art. 23, § 9.

40-8.10-3. Levels of care.

  1. 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.
  2. 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.
  3. 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.

40-8.10-4. Long-term care assessment and coordination.

  1. 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.
  2. 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.
  3. 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.
  4. 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.

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.

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.

Federal Act References.

Section 1115 of the Social Security Act, referred to in this section, is codified as 42 U.S.C. § 1315.

Chapter 8.11 Family Caregivers Support Act of 2013

40-8.11-1. Findings.

  1. Family members, partners, and close friends provide the vast majority of long-term services and supports.
  2. 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).
  3. 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.
  4. 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.
  5. 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.
  6. 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.

40-8.11-2. Definitions.

  1. “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.
  2. 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.

40-8.11-3. Caregiver assessment requirement.

  1. 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.
  2. 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.

Compiler’s Notes.

This section was amended by two acts (P.L. 2019, ch. 110, § 1; P.L. 2019, ch. 130, § 1) as passed by the 2019 General Assembly. The section is set out above as amended by P.L. 2019, ch. 130, which was passed by the General Assembly on June 26, 2019. The amendments are the same, except that P.L. 2019, ch. 110, which was passed by the General Assembly on June 27, 2019, does not contain the language “education and training” that was inserted in the third sentence of (a) by P.L. 2019, ch. 130; also, P.L. 2019, ch. 110 inserted “daily or instrumental activities of” preceding “daily living needs” in the first sentence of (a), while P.L. 2019, ch. 130 inserted “daily living or instrumental activities of” preceding “daily living needs” in the first sentence of (a).

Chapter 8.12 Health Care for Adults

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.

40-8.12-2. Eligibility.

  1. 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.
  2. 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.
  3. 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.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-8.12-3. Premium assistance program.

  1. 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.
  2. 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.

Chapter 8.13 Long-Term Managed Care Arrangements

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.

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.

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.

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.

40-8.13-5. Financial principles under managed care.

  1. To the extent that financial savings are a goal under any managed long-term-care arrangement, it is the intent of the legislature to achieve savings through administrative efficiencies, care coordination, improvements in care outcomes and in a way that encourages the highest quality care for patients and maximizes value for the managed-care organization and the state. Therefore, any managed long-term-care arrangement shall include a requirement that the managed care organization reimburse providers for services in accordance with these principles. Notwithstanding any law to the contrary, for the twelve-month (12) period beginning July 1, 2015, Medicaid managed long-term-care payment rates to nursing facilities established pursuant to this section shall not exceed ninety-eight percent (98.0%) of the rates in effect on April 1, 2015.
    1. For a duals demonstration project, the managed care organization:
      1. Shall not combine the rates of payment for post-acute skilled and rehabilitation care provided by a nursing facility and long-term and chronic care provided by a nursing facility in order to establish a single-payment rate for dual eligible beneficiaries requiring skilled nursing services;
      2. Shall pay nursing facilities providing post-acute skilled and rehabilitation care or long-term and chronic care rates that reflect the different level of services and intensity required to provide these services; and
      3. For purposes of determining the appropriate rate for the type of care identified in subsection (a)(1)(ii) of this section, the managed care organization shall pay no less than the rates that would be paid for that care under traditional Medicare and Rhode Island Medicaid for these service types. The managed care organization shall not, however, be required to use the same payment methodology.

        The state shall not enter into any agreement with a managed care organization in connection with a duals demonstration project unless that agreement conforms to this section, and any existing such agreement shall be amended as necessary to conform to this subsection.

    2. For a managed long-term-care arrangement that is not a duals demonstration project, the managed care organization shall reimburse providers in an amount not less than the amount that would be paid for the same care by the executive office of health and human services under the Medicaid program. The managed care organization shall not, however, be required to use the same payment methodology as the executive office of health and human services.
    3. Notwithstanding any provisions of the general or public laws to the contrary, the protections of subsections (a)(1) and (a)(2) of this section may be waived by a nursing facility in the event it elects to accept a payment model developed jointly by the managed care organization and skilled nursing facilities, that is intended to promote quality of care and cost-effectiveness, including, but not limited to, bundled-payment initiatives, value-based purchasing arrangements, gainsharing, and similar models.
  2. Notwithstanding any law to the contrary, for the twelve-month (12) period beginning July 1, 2015, Medicaid managed long-term-care payment rates to nursing facilities established pursuant to this section shall not exceed ninety-eight percent (98.0%) of the rates in effect on April 1, 2015.

History of Section. P.L. 2014, ch. 145, art. 18, § 6; P.L. 2015, ch. 141, art. 5, § 18; P.L. 2016, ch. 142, art. 7, § 6.

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.

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.

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.

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.

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.

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.

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.

Compiler's Notes.

Former § 40-8.13-12 concerned a community-based supportive living program.

Chapter 8.14 Quality Self-Directed Services

40-8.14-1. Definitions.

For purposes of this section:

  1. “Activities of daily living” (ADL) means the routine activities that people tend to do every day without needing assistance. There are six (6) basic ADLs: eating, bathing, dressing, toileting, transferring (walking), and continence.
  2. “Covered home- and community-based services (HCBS)” means any core, preventive, or specialized long-term-care services and supports available in a person’s home or a community-based living arrangement that the state is authorized to provide under the Medicaid state plan, the Medicaid section 1115 waiver, or any similar program.
  3. “Direct-support services” means the range of home- and community-based services (HCBS) covered services that are identified in the Medicaid state plan, Rhode Island’s section 1115 waiver, or any similar program that may provide similar services in the future, and the rules and regulations promulgated by the executive office of health and human services (EOHHS) or a designated agency authorize individual home-care providers to provide. The direct-support services must be provided in accordance with applicable federal and state law, rules, and regulations and include, but are not limited to, personal care assistance, homemaker, and companion services that the state is authorized to provide under the Medicaid state plan, the Medicaid section 1115 waiver, or any similar program in the future, including:
    1. Participant assistance with activities of daily living and instrumental activities of daily living as defined in this chapter;
    2. Assistance with monitoring health status and physical condition;
    3. Assistance with preparation and eating of meals (not the cost of the meal itself);
    4. Assistance with housekeeping activities (bed making, dusting, vacuuming, laundry, grocery shopping, cleaning);
    5. Assistance with transferring, ambulation, and use of special mobility devices assisting the participant by directly providing or arranging transportation; and
    6. Other similar, in-home, non-medical long-term services and supports provided to an elderly person or individual with a disability by an individual provider to meet the person’s daily living needs and ensure that the person may adequately function in the person’s home and have safe access to the community.
  4. “Director” means the director of the Rhode Island department of administration.
  5. “Fiscal intermediary” means a third-party organization under contract with the EOHHS responsible for performing payroll and other employment-related functions on behalf of the participant.
    1. The fiscal intermediary shall:
      1. Be authorized by the secretary or a designated agency to receive and distribute support funds on behalf of a participant in accordance with the participant’s service plan; and
      2. Act as a fiscal intermediary on behalf of a participant in compliance with all rules, regulations, and terms and conditions established by the secretary.
    2. The fiscal intermediary shall not make any decisions regarding hiring, supervising, or firing individual providers.
  6. “Individual provider” means an individual selected by and working under the direction of a Medicaid LTSS beneficiary or the beneficiary’s duly authorized representative to provide direct-support services to the participant in accordance with the beneficiary’s service plan, but does not include an employee of a provider agency, subject to the agency’s direction and control commensurate with agency employee status or an individual providing services to a participant electing the personal choice option in any program.
  7. “Instrumental activities of daily living” means the skills a person needs to live safely and successfully in a residential setting of choice without outside supports. These skills include, but are not limited to, using the telephone, traveling, shopping, preparing meals, doing housework, taking medications properly, and managing money.
  8. “Medicaid LTSS beneficiary” means a person who has been determined by the state to obtain Medicaid-funded long-term services and supports.
  9. “Participant” means a Medicaid LTSS beneficiary who receives direct-support services from an individual provider.
  10. “Participant’s representative” means a participant’s legal guardian or an individual having the authority and responsibility to act on behalf of a participant with respect to the provision of direct-support services.
  11. “Provider representative” means a provider organization that is certified as the exclusive negotiating representative of individual providers as provided in § 40-8.15-7 .
  12. “Secretary” means the secretary of the Rhode Island executive office of health and human services (EOHHS).

History of Section. P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1.

Federal Act References.

Section 1115 of the Social Security Act, referred to in this section, is codified as 42 U.S.C. § 1315.

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.

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.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified as 42 U.S.C. § 1396 et seq.

40-8.14-4. Duties of the executive office for health and human services.

  1. The secretary shall afford to all Medicaid LTSS beneficiaries who receive authorized HCBS-covered services in accordance with a service plan the option of employing an individual provider to provide direct-support services.
  2. The secretary shall modify program operations as necessary to ensure implementation of the individual provider model and to ensure all relevant vendors assist and cooperate as needed, including managed care organizations and providers of fiscal support, fiscal intermediary, financial management, or similar services to provide support to participants and participants’ representatives with regard to employing individual providers, and otherwise fulfill the requirements of this section, including the provisions of subsection (f) of this section.
  3. The secretary shall have the authority to:
    1. Establish reimbursement rates for all individual providers, in accordance with chapter 8.15 of this title, provided that these rates may permit individual provider variations based on traditional and relevant factors otherwise permitted by law; provided, however, that reimbursement rates shall be required to be approved by the general assembly;
    2. Ensure delivery of required orientation programs for individual providers;
    3. Implement training and educational opportunities negotiated in accordance with chapter 8.15 of this title for individual providers, as well as for participants and participants’ representatives who receive services from individual providers, including opportunities for individual providers to obtain certification documenting additional training and experience in areas of specialization;
    4. In collaboration with the provider representative, provide for the maintenance of a public registry of individuals who have consented to be included to:
      1. Allow for routine, emergency, and respite referrals of qualified individual providers who have consented to be included in the registry to participants and participants’ representatives;
      2. Enable participants and participants’ representatives to gain improved access to, and choice among, prospective individual providers, including by having access to information about individual providers’ training, educational background, work experience, national criminal background check results, and availability for hire;
    5. Establish provider qualification standards for individual providers, including undergoing a national criminal background check and behavior that would disqualify someone as an individual provider;
    6. Establish other appropriate terms and conditions for 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;
    7. Establish an advisory board for participants, their representatives, and advocates, to communicate directly with the secretary about the provision of quality direct-support services.
      1. The board shall consist of thirteen (13) members:
        1. One of whom shall be the secretary of the executive office of health and human services, or a designee, who shall serve as chair;
        2. Six (6) of whom shall be consumers of the individual provider model, two (2) to be appointed by the governor, two (2) to be appointed by the president of the senate, and two (2) to be appointed by the speaker of the house;
        3. Three (3) of whom shall be representatives from statewide independent living centers, one to be appointed by the governor, one to be appointed by the president of the senate, and one to be appointed by the speaker of the house;
        4. Three of whom shall be from a 501(c)(3) statewide senior advocacy organization, one to be appointed by the governor, one to be appointed by the president of the senate, and one to be appointed by the speaker of the house.
      2. The board members shall be appointed for three-year (3) terms.
      3. The board shall advise the secretary, or a designee, regarding issues relating to the quality, access, and consumer autonomy offered through the individual provider model; and
    8. Contract with a fiscal intermediary service for the operations of the individual provider model.
  4. The secretary’s authority in this section shall be subject to the state’s obligations to meet and negotiate under § 40-8.15-3 and chapter 7 of title 28, as modified and made applicable to individual providers under § 40-8.15-3 , and to agreements with any exclusive representative of individual providers, as authorized by § 40-8.15-3. Except to the extent otherwise provided by law, the secretary shall not undertake activities in subsections (c)(3) and (c)(4) of this section, prior to October 1, 2019, unless included in a negotiated agreement and an appropriation has been provided by the legislature to the secretary.
  5. The secretary shall cooperate in the implementation of chapter 8.15 of this title with all other relevant state departments and agencies. Any entity providing relevant services, including, but not limited to, providers of fiscal support, fiscal intermediary, financial management, or similar services to provide support to participants and participants’ representatives with regard to employing individual providers shall assist and cooperate with the secretary in the operations of this section, including with respect to the secretary’s obligations under subsections (b) and (f).
  6. The secretary, or a designee, shall, no later than October 1, 2019, and then quarterly thereafter, in accordance with rules and regulations promulgated by EOHHS, compile and maintain a list of the names and addresses of all individual providers who have been paid for providing direct-support services to participants within the previous six (6) months. The list shall not include the name of any participant, or indicate that an individual provider is a relative of a participant or has the same address as a participant. The secretary, or a designee agency, shall share the lists with others as needed for the state to meet its obligations under this chapter and chapter 8.15 of this title. This sharing shall not include access to private data on participants or participants’ representatives. Nothing in this section or chapter 8.15 of this title shall alter the access rights of other private parties to data on individual providers.
  7. The secretary shall immediately commence all necessary steps to ensure that direct-support services are offered in conformity with this section; to gather all information that may be needed for promptly compiling lists required under this section, including information from current vendors; and to complete any required modifications to currently providing direct-support services by October 1, 2019.

History of Section. P.L. 2018, ch. 106, § 1; P.L. 2018, ch. 110, § 1.

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.

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.

Chapter 8.15 Individual Providers of Direct-Support Services

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.

40-8.15-2. Right of individual providers to choose provider representative — Subject of negotiation.

  1. 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.
  2. 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.
  3. 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.
  4. 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.

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.

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.

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.

40-8.15-6. Duty to represent all individual providers fairly — Deduction of membership dues and other voluntary deductions.

  1. 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.
  2. 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.

40-8.15-7. Certification and decertification of provider organization.

  1. 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.
  2. The only appropriate unit shall consist of all individual providers in the state.
  3. 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.
  4. 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.

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.

40-8.15-9. Individual providers not state employees.

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.

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.

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.

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.

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.

Chapter 9 Services for People Who Are Blind or Visually Impaired

40-9-1. Administrator — Other personnel and expenses — Appropriations — References to “bureau for the blind.”

  1. 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.
  2. 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.

Cross References.

Equal rights to public facilities, § 40-9.1-1 et seq.

Supervision by department of human services, § 42-12-4 .

Comparative Legislation.

Assistance for persons who are blind:

Conn. Gen. Stat. §§ 10-293 et seq., 17b-600 et seq.

Mass. Ann. Laws ch. 6, § 129 et seq.

40-9-2. General duties of administrator.

  1. The administrator of services for people who are blind or visually impaired shall devote all of his or her time to the duties of his or her office and keep at his or her office in the state house a register of individuals who are blind or visually impaired in the state, describing their condition, cause of blindness, and capacity for education and industrial training.
  2. The administrator shall, under the direction of the director, generally be charged with:
    1. Maintaining a placement service with the object of determining the fitness of applicants who are blind or visually impaired for work, vocational guidance, and securing occupation when applicants are trained;
    2. Assisting, when called upon by the school-to-careers committee of the governor’s workforce board, that board in its work for students who are blind or visually impaired and in the application of federal aid;
    3. Assisting the department of elementary and secondary education, when called upon by it, in performing its duties under chapter 25 of title 16 [repealed];
    4. Having general charge of the home teaching of persons who are blind or visually impaired in the state;
    5. Having charge of workshops for the training of persons who are blind or visually impaired and salesrooms for the sale of the products of the blind and visually impaired as the director may, from time to time, establish; and
    6. Performing other duties with respect to his or her office as the director may prescribe.

History of Section. G.L. 1923, ch. 413, art. 1, § 27; P.L. 1930, ch. 1590, § 1; G.L. 1938, ch. 184, § 1; impl. am. P.L. 1951, ch. 2752, § 21; G.L. 1956, § 40-11-2 ; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99; P.L. 2006, ch. 216, § 21.

Compiler’s Notes.

Chapter 25 of title 16, referred to in this section, was repealed by P.L. 2012, ch. 241, art. 12, § 8, effective July 1, 2012.

40-9-3. Advisory council — Appointment of members.

Within the department of human services there shall be an advisory council to assist in promoting the interests of people who are blind or visually impaired consisting of nine (9) members, eight (8) of whom shall be qualified electors of the state, who shall be selected with particular regard to their interest in and their knowledge of the conditions regarding the blind and visually impaired and who shall be appointed by the governor as herein provided, and one of whom shall be the chairperson of the state council on independent living services, ex officio. In the month of February in each year, the governor shall appoint one member, except in the month of February 1970 and every fifth year thereafter when he or she shall appoint four (4) members, each member to hold office until the first day of March in the fifth year after his or her appointment and until his or her successor is appointed and qualified, to succeed the member whose term will next expire. Any vacancy that may occur in the council shall be filled by appointment by the governor for the remainder of the unexpired term.

History of Section. P.L. 1939, ch. 660, § 90; P.L. 1940, ch. 801, § 1; redesignated § 91 by P.L. 1951, ch. 2724, § 4; G.L. 1956, § 40-11-3 ; P.L. 1970, ch. 56, § 1; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1989, ch. 262, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-4. Chairperson of advisory council — Secretarial service.

The members of the council shall elect one of their number as chairperson upon the appointment of any new member for a full term and whenever the office may become vacant. The members of the council shall serve without compensation and secretarial service for the council shall be provided by the director of the department.

History of Section. P.L. 1939, ch. 660, § 90; P.L. 1940, ch. 801, § 1; redesignated § 91 by P.L. 1951, ch. 2724, § 4; G.L. 1956, § 40-11-4 ; Reorg. Plan No. 1, 1970.

40-9-5. Functions of advisory council.

The council shall confer with and shall advise the director of human services in promoting the interests of people who are blind or visually impaired in the state and concerning the policies, rules, and regulations appertaining thereto; provided, however, that the advisory council shall have no administrative power.

History of Section. P.L. 1939, ch. 660, § 90; P.L. 1940, ch. 801, § 1; redesignated § 91 by P.L. 1951, ch. 2724, § 4; G.L. 1956, § 40-11-5 ; impl. am. P.L. 1962, ch. 6, § 5; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-6. Home instruction of people who are blind or visually impaired.

The director of human services is hereby authorized and empowered to provide for the instruction at their homes of the adult residents who are blind or visually impaired residents of this state upon such conditions and in such manner as may to him or her seem proper, and the general assembly shall annually appropriate a sum as it may deem necessary for the purposes of this section; and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of the sum or so much thereof as may, from time to time, be necessary, upon receipt by him or her of proper vouchers approved by the director of the department and by the administration of services for people who are blind or visually impaired. Receipts from the toy lending library shall be deposited as general revenue and the activity shall be funded through general revenue appropriations.

History of Section. G.L. 1923, ch. 413, art. 1, § 27; P.L. 1930, ch. 1590, § 1; G.L. 1938, ch. 184, § 1; impl. am. P.L. 1939, ch. 660, § 65; G.L. 1956, § 40-11-6 ; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1995, ch. 370, art. 40, § 121; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-7. Supplies and materials for people who are blind or visually impaired workers — Compensation for services.

The director is hereby authorized and empowered to carry on services for people who are blind or visually impaired by providing for the furnishing of supplies and materials for workers who are blind or visually impaired workers, and compensating people who are blind or visually impaired workers for services through funds made available to the department of human services.

History of Section. G.L. 1938, ch. 184, § 1; P.L. 1940, ch. 802, § 5; G.L. 1956, § 40-11-7 ; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-8. Proceeds of work of blind and visually impaired workers.

For the purpose of carrying out the provisions of § 40-9-7 , the receipts from the sales of handiwork of people who are blind or visually impaired workers shall be collected by the department of human services and turned over to the general treasurer, and the funds shall be made available for expenditure by the department of human services for the purpose of buying supplies and materials for workers who are blind or visually impaired workers and to compensate people who are workers who are blind or visually impaired for services rendered; and the state controller is hereby authorized and directed to draw his or her orders upon the general treasurer for the payment of the sums as may be required, from time to time, upon the receipt by him or her of proper vouchers approved by the director of human services, or his or her duly authorized agent.

History of Section. P.L. 1940, ch. 802, § 6; G.L. 1956, § 40-11-8 ; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-9. Cooperation with department of elementary and secondary education.

The department of elementary and secondary education and the department of human services shall cooperate in measures for the prevention of blindness, the restoration of eyesight, and vocational adjustment of blind and visually impaired persons.

History of Section. P.L. 1938, ch. 2622, § 2; G.L. 1938, ch. 185, § 1; P.L. 1940, ch. 802, § 9; G.L. 1956, § 40-11-9 ; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1.

40-9-10. [Repealed.]

History of Section. P.L. 1936, ch. 2296, § 1; G.L. 1938, ch. 184, § 2; impl. am. P.L. 1939, ch. 660, § 65; impl. am. P.L. 1940, ch. 802, § 2; G.L. 1956, § 40-11-10 ; Reorg. Plan No. 1, 1970; Repealed by P.L. 1990, ch. 492, § 14, effective July 12, 1990.

Compiler’s Notes.

Former § 40-9-10 concerned acceptance of Social Security Act, designation of state agency, and administration of plan.

40-9-10.1. Telephone access to information programs.

  1. The department of human services shall establish, administer, and promote an adaptive telephone equipment loan program. The department of human services, with the assistance of the state’s adaptive telephone equipment loan program committee, established pursuant to § 39-23-1 , shall also develop the appropriate rules, regulations, and service standards necessary to implement the provisions of this subsection.
  2. The department of human services shall establish, administer, and promote a program to provide telephone access to the text of newspaper programs to residents who are blind, deaf/blind, visually impaired, or reading impaired with a single-party telephone line. The department of human services, with the assistance of the governor’s advisory council for the blind, shall also develop the appropriate rules, regulations, and service standards necessary to implement the provisions of this subsection.

History of Section. P.L. 2004, ch. 378, § 5; P.L. 2004, ch. 504, § 5.

40-9-11. Cooperation in federal business enterprises program.

The Rhode Island state department of human services is hereby empowered to cooperate with the United States government’s Department of Education in its “Business Enterprises Program for the Blind” and, in connection with the program, to accept the payments and/or reimbursement for one-half (1/2) of the necessary expenditures for the acquisition of state-controlled vending stands or other business enterprises equipment for the use of persons who are blind, for which appropriation is made by Title II — “Office of Vocational Rehabilitation,” of Public Law 80-165, passed by the Eightieth Congress of the United States, approved July 8, 1947, and known as the “Labor-Federal Security Appropriation Act of 1948.”

History of Section. P.L. 1948, ch. 2007, § 1; G.L. 1956, § 40-11-11 ; Reorg. Plan No. 1, 1970; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-11.1. Authorization to establish vending facilities for the blind on state property.

  1. For the purposes of providing persons who are blind or visually impaired with remunerative employment, enlarging the economic opportunities people who are blind or visually impaired, and stimulating people who are blind or visually impaired to greater efforts in striving to make themselves self-supporting, persons who are blind or visually impaired licensed under the provisions of this chapter shall be authorized to operate vending facilities on any state property.
  2. In authorizing the operation of vending facilities on state property, priority shall be given to persons who are blind or visually impaired licensed by the department of human services administering state services for people who are blind or visually impaired as provided in the Randolph-Sheppard Act, Pub. L. No. 74-732, as amended by Pub. L. No. 83-565 and Pub. L. No. 93-516, 20 U.S.C. § 107 et seq. The director of human services shall, after consultation with the director of administration and other heads of departments, agencies, or instrumentalities of the state in control of the maintenance, operation, and protection of state property; prescribe regulations designed to assure that:
    1. The priority under this section is given to licensed persons who are blind or visually impaired (including the assignment of vending machine income pursuant to § 40-9-11.5 to achieve and protect such priority); and
    2. Wherever feasible, one or more vending facilities are established on all state property to the extent that any facility or facilities would not adversely affect the interest of the state.

History of Section. P.L. 1978, ch. 37, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

Collateral References.

Permissibility of award of damages, or suit in federal court to enforce such award, against state agency under Randolph-Sheppard Vending Stand Act (20 U.S.C. §§ 107 et seq.). 117 A.L.R. Fed. 503.

40-9-11.2. Validity of limitations on placement or operation.

Any limitation on the placement or operation of a vending facility based on a finding that the placement or operation would adversely affect the interests of the state shall be fully justified, in writing, to the director of administration, who shall determine whether the limitation is justified. A determination made by the director of administration pursuant to this provision shall be binding on any department, agency, or instrumentality of the state so affected by the determination.

History of Section. P.L. 1978, ch. 37, § 1.

40-9-11.3. Provision for vending machines in buildings purchased or leased by state.

Whenever any department, agency, or instrumentality of the state shall undertake to acquire by ownership, rent, lease, or to otherwise occupy, in whole or in part, any building, the department, agency, or instrumentality shall make all reasonable attempts to ensure that the building includes a satisfactory site or sites for the location and operation of a vending facility by a person who is blind or visually impaired. Each department, agency, or instrumentality is hereby encouraged to provide timely notice to the director of human services that the acquisition, construction, or renovation of the building is planned in order to permit appropriate planning, selection, and preparation of the site or sites by the state services for people who are blind or visually impaired.

History of Section. P.L. 1978, ch. 37, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-11.4. Compliance with chapter.

To ensure that persons who are blind or visually impaired licensed as vending facility operators are afforded the maximum opportunity by which to engage in the conduct of vending within state buildings, it is hereby intended that all agencies, departments, and institutions comply with the provisions of this chapter.

History of Section. P.L. 1978, ch. 37, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-11.5. Vending machine income.

Vending machine income obtained from the operation of vending machines on state property shall accrue: (1) To the licensee who is blind or visually impaired operating a vending facility on state property, or (2) In the event there is no licensee who is blind or visually impaired operating the facility on state property, to the state services for people who are blind or visually impaired for use in the support of the administration of the business enterprises, vending facilities program.

History of Section. P.L. 1978, ch. 37, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-11.6. Definitions.

  1. “Licensed operator” means a person who is blind or visually impaired who has received from the state services for persons who are blind or visually impaired a license that entitles the person to operate a vending facility, receive the profits therefrom, and take responsibility for the continuous maintenance of the facility to which he or she is assigned.
  2. “Person who is blind or visually impaired” means a person whose visual acuity is found to be twenty/two hundred (20/200) or less in the better eye with best correction, or visual acuity of better than twenty/two hundred (20/200) if the widest diameter of the field of vision subtends an angle no greater than twenty (20) degrees. Blindness shall be determined by a physician skilled in the diseases of the eye, and certification thereof shall be made by the ophthalmological consultant at the state services for people who are blind or visually impaired.
  3. “State property” means any building, land, or other real property owned, leased, or occupied by any department, agency, or instrumentality wholly owned by the state, unless, with respect to any building, land, or other real property, leased or rented by the state, the lease or rental agreement shall prohibit the establishment of the vending facilities. The state shall use its best efforts to obtain permission to establish vending facilities in buildings, land, or other real property hereafter leased or rented by the state.
  4. “Vending facility” means automatic vending machines, cafeterias, snack bars, cart service, shelters, counters, and other appropriate auxiliary equipment necessary for the sale of newspapers, periodicals, confections, tobacco products, foods, beverages, and other articles or services dispensed automatically or manually and prepared on or off the premises in accordance with all applicable health laws, as determined by the state services for people who are blind or visually impaired, and including the vending or exchange of chances for any lottery authorized by state law.

History of Section. P.L. 1978, ch. 37, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

40-9-12. Agreements as to business enterprises program.

The state department of human services is hereby authorized to enter into agreements with the department of elementary and secondary education, and/or its office of vocational rehabilitation for cooperation in the business enterprises program, and, from time to time, to amend the agreements; provided, any agreement or amendment shall be subject to the approval of the commissioner of elementary and secondary education and the governor.

History of Section. P.L. 1948, ch. 2007, § 2; G.L. 1956, § 40-11-12 ; Reorg. Plan No. 1, 1970; P.L. 1990, ch. 492, § 15.

40-9-13. Federal business enterprises funds.

The general treasurer shall receive and provide for the proper custody of all funds paid to the state from the federal treasury under the provisions of Public Law 80-165, 29 U.S.C. § 701 et seq., and shall disburse the funds upon orders drawn by the state controller upon receipt by him or her of properly authenticated vouchers.

History of Section. P.L. 1948, ch. 2007, § 3; G.L. 1956, § 40-11-13 ; Reorg. Plan No. 1, 1970.

40-9-14. Application of receipts from business enterprises program.

All receipts collected by the state department of human services as a result of the operation of the program shall be deposited with the general treasurer and are hereby appropriated to carry out the purposes of §§ 40-9-11 40-9-13 . Any unexpended balance of the receipts, remaining at the end of the fiscal year, shall be carried forward and made available for expenditure in the succeeding fiscal year.

History of Section. P.L. 1948, ch. 2007, § 4; G.L. 1956, § 40-11-14 ; Reorg. Plan No. 1, 1970.

40-9-15. Reports of blindness of persons.

  1. Whenever, upon examination at a clinic, hospital, or other institution, or elsewhere, by a physician, optometrist or other person, the visual acuity of any person is found to be twenty/two hundred (20/200) or less in the better eye with the best correction, or the visual acuity is better than twenty/two hundred (20/200) if the widest diameter of the field of vision subtends an angle no greater than twenty (20) degrees, the superintendent or other person in charge of the clinic, hospital, or other institution, or the physician, optometrist, or other person who conducted or was in charge of the examination if it took place elsewhere than in the clinic, hospital, or other institution, shall, within thirty (30) days, report to the director of the department of human services the result of the examination, and that the blindness of the person examined has been established.
  2. Any state, city, and town agencies administering benefits to the blind or visually impaired by way of tax exemptions, welfare payments, or otherwise, shall report the names of the persons to the administrator of the division of motor vehicles for the purpose of evaluation by the medical advisory board within the division of motor vehicles as to the fitness of the persons to safely operate motor vehicles upon the highways of this state.

History of Section. P.L. 1966, ch. 223, § 1; P.L. 1968, ch. 105, § 1; G.L. 1956, § 40-11-15 ; Reorg. Plan No. 1, 1970; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99.

NOTES TO DECISIONS

Disclosure of Information.

Statutory privilege under this section forbids voluntary disclosure by public employees and prevents disclosure pursuant to the compulsion of a legal subpoena. Boudreau v. Holzer, 109 R.I. 81 , 280 A.2d 88, 1971 R.I. LEXIS 1027 (1971).

40-9-16. Immunity from liability.

No person, who shall render any report required by § 40-9-15 , shall be subject to a suit in a civil action, or liable for civil damages, in any action or proceedings arising out of the information contained in the reports submitted.

History of Section. P.L. 1966, ch. 223, § 1; G.L. 1956, § 40-11-16 ; Reorg. Plan No. 1, 1970.

40-9-17. Confidentiality of reports — Authorized uses — Penalty for disclosure.

  1. All reports mentioned in § 40-9-15 are hereby declared to constitute confidential matter. It shall be unlawful for any person to make use of, or cause to be used, any information contained in the reports for purposes not directly connected with the administration of services for people who are blind or visually impaired or the division of motor vehicles, except with the consent of the individual concerned.
  2. The director of human services shall have the power to establish rules and regulations governing the custody, use, and preservation of the reports, which shall have the same force and effect as law. The reports shall be produced in response to a subpoena duces tecum properly issued by any federal or state court; provided, however, that the purpose for which the subpoena is sought is directly connected with the administration of services for people who are blind or visually impaired. No subpoena shall be issued by a court asking either for the reports, or for persons having custody or access to the reports, unless the litigation involved in the matter is directly connected with the administration of services for people who are blind or visually impaired.
  3. Any person violating any of the provisions of this section, or the lawful rules and regulations made hereunder, shall be deemed guilty of a misdemeanor, and shall be fined not more than two hundred dollars ($200) or shall be imprisoned for not more than six (6) months, or both.
  4. Nothing in this section shall be deemed to prohibit the director of the department of human services, or his or her agents duly authorized for that purpose, from issuing any statistical material or data, or publishing or causing the data to be published whenever he or she shall deem it to be in the public interest.

History of Section. P.L. 1966, ch. 223, § 1; P.L. 1968, ch. 105, § 2; G.L. 1956, § 40-11-17 ; Reorg. Plan No. 1, 1970; P.L. 1976, ch. 211, § 1; P.L. 1999, ch. 83, § 99; P.L. 1999, ch. 130, § 99; P.L. 2006, ch. 216, § 21.

40-9-18. Blindness prevention.

  1. The department of human services shall, in consultation with the governor’s advisory council for the blind and Saving Sight Rhode Island, establish a blindness-prevention program for children of the state of Rhode Island to promote the screening, testing, diagnosis, and treatment of blindness diseases of the eye and other sight disorders.
  2. The department of human services shall promulgate rules and regulations in order to effectuate the purposes of this section.

History of Section. P.L. 2000, ch. 213, § 1.

Chapter 9.1 Equal Rights to Public Facilities

40-9.1-1. Declaration of policy.

It is the policy of this state that:

  1. Persons who are blind, visually impaired, deaf, hard-of-hearing or otherwise have a disability have the same rights as the able-bodied to the full and free use of the streets, highways, walkways, public buildings, public facilities, and other public places.
  2. Persons who are blind, visually impaired, deaf, hard-of-hearing or otherwise have a disability are entitled to full and equal accommodations, advantages, facilities, and privileges on any public conveyance operated on land or water or in the air, or any stations and terminals thereof, not limited to taxis, airplanes, motor vehicles, railroad trains, motor buses, street cars, boats; and in any educational institution, not limited to any kindergarten, primary and secondary school, trade or business school, high school, academy, college and university; and in places of public resort, accommodation, assemblage, or amusement, not limited to hotels, lodging places, restaurants, theater; and in all other places to which the general public is invited, subject only to the conditions and limitations established by law and applicable alike to all persons.
  3. [Deleted by P.L. 2019, ch. 96, § 1 and P.L. 2019, ch. 131, § 1.]

History of Section. P.L. 1975, ch. 55, § 1; P.L. 1979, ch. 159, § 6; P.L. 1997, ch. 85, § 1; P.L. 2019, ch. 96, § 1; P.L. 2019, ch. 131, § 1.

Cross References.

Injury to seeing-eye dogs or persons who are visually impaired, damages, § 4-13-16.1 .

Services to persons who are blind, § 40-9-1 et seq.

Comparative Legislation.

Discrimination based on disability:

Conn. Gen. Stat. § 46a-58 et seq.

Mass. Ann. Laws ch. 272, §§ 92A, 98.

Collateral References.

Construction and application of § 804(f) of Fair Housing Act (42 U.S.C. § 3604(f)), prohibiting discrimination in housing because of individual’s disability. 148 A.L.R. Fed. 1.

Validity, construction, and application of § 302 of Americans with Disabilities Act (42 U.S.C. § 12182), prohibiting discrimination on basis of disability by owners or operators of places of public accommodation. 136 A.L.R. Fed. 1.

Web site as “Public Accomodation” for purposes of Federal or State Civil Rights Statutes. 7 A.L.R.7th Art. 1 (2016).

40-9.1-1.1. Definitions.

  1. “Disability” means a disability as defined in § 42-87-1 .
  2. “Guide dog” means a dog that has been, or is being, specially trained to aid a particular blind or visually impaired person.
  3. “Hearing dog” means a dog that has been, or is being, specially trained to aid a particular deaf or hard-of-hearing person.
  4. “Public area” means a part of a place listed in § 40-9.1-1 that is open to the general public.
  5. “Regular hours” means the hours of any day in which a public place listed in § 40-9.1-1 is open to members of the general public.
  6. “Service animal” means a dog that has been, or is being, specifically trained to assist an individual with a disability, and includes a guide dog or hearing dog.

History of Section. P.L. 1997, ch. 85, § 2; P.L. 2006, ch. 216, § 22; P.L. 2009, ch. 96, § 5; P.L. 2009, ch. 97, § 5; P.L. 2012, ch. 90, § 1; P.L. 2012, ch. 100, § 1; P.L. 2019, ch. 96, § 1; P.L. 2019, ch. 131, § 1.

40-9.1-2. Service animals in public places.

Every person with a disability has the right to be accompanied by a service animal, specially trained for that person, in any place listed in § 40-9.1-1 without being required to pay an extra charge for the personal assistance animal. Each person with a disability using a service animal is solely liable for any damage done to persons, premises, or facilities by the service animal.

History of Section. P.L. 1975, ch. 55, § 1; P.L. 1979, ch. 159, § 7; P.L. 1997, ch. 85, § 1; P.L. 2019, ch. 96, § 1; P.L. 2019, ch. 131, § 1.

Cross References.

Injury to seeing-eye dogs or persons who are visually impaired, damages, § 4-13-16.1 .

40-9.1-2.1. Trainers of service animals.

Every trainer or puppy raiser of a service animal shall have the same rights and privileges as stated in § 40-9.1-2 for every person with a disability. Each trainer or puppy raiser during the training of a service animal is liable for any damage done to persons, premises, or facilities by that service animal.

History of Section. P.L. 1997, ch. 85, § 2; P.L. 2019, ch. 96, § 1; P.L. 2019, ch. 131, § 1.

40-9.1-3. Penalty for injuring or interfering with a service animal — Civil actions — Damages — Costs and attorney’s fees.

  1. It is unlawful for any person, corporation, or the agent of any corporation to:
    1. Withhold, deny, deprive, or attempt to withhold, deny, or deprive, any other person of any right or privilege secured by §§ 40-9.1-2 and 40-9.1-2.1 ;
    2. Intimidate, threaten, coerce, or attempt to threaten, intimidate, or coerce, any other person to interfere with any right or privilege secured by §§ 40-9.1-2 and 40-9.1-2.1 ;
    3. Punish, or attempt to punish, any person for exercising, or attempting to exercise, any right or privilege secured by §§ 40-9.1-2 and 40-9.1-2.1.
  2. It is unlawful for any person to injure a service animal and the person shall be liable for the injuries to the service animal, and if necessary the replacement and compensation for the loss of the service animal.
  3. It is unlawful for the owner of an animal to allow their animal to injure a service animal because the owner failed to control or leash the animal. The owner shall also be liable for the injuries to the service animal, and if necessary the replacement and compensation for the loss of the service animal.
  4. Any person who violates subsection (a)(1) is guilty of a misdemeanor. Any person who purposely or negligently violates subsection (a)(2) or (a)(3) is guilty of a misdemeanor. Violations shall be punished by imprisonment for not more than six (6) months or by a fine of not less than one hundred dollars ($100), or by both fine and imprisonment. Any person or corporation who or that violates subsection (a), (b), or (c) is also liable to the person whose rights under §§ 40-9.1-2 and 40-9.1-2.1 were violated for actual damages for any economic loss and/or punitive damages, to be recovered by a civil action in a court in, and for the county in, which the infringement of civil rights occurred or in which the defendant lives.
  5. In an action brought under this section, the court shall award costs and reasonable attorney’s fees to the prevailing party.

History of Section. P.L. 1975, ch. 55, § 1; P.L. 1986, ch. 179, § 1; P.L. 1997, ch. 85, § 1; P.L. 2019, ch. 96, § 1; P.L. 2019, ch. 131, § 1; P.L. 2020, ch. 79, art. 1, § 33.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

Collateral References.

Award of compensatory damages under 42 U.S.C. § 1981a for violation of Title VII of Civil Rights Act of 1964. 154 A.L.R. Fed. 347.

Punitive damages in actions for violations of Title VII of the Civil Rights Act of 1964 (42 U.S.C. § 1981a; 42 U.S.C. § 2000e et seq.). 150 A.L.R. Fed. 601.

40-9.1-3.1. Misrepresentation of service animal.

  1. It is a violation of this chapter for an individual to take an animal into a public area where pets are not permitted, and state that the animal is a service animal entitled to be present, if the animal is not a service animal.
  2. Businesses may post a decal suitable in a front window or door, stating that service animals are welcome and that misrepresentation of a service animal is a violation of Rhode Island law.
  3. It shall be a violation for any individual to misrepresent a pet or any other animal as a service animal when attempting to gain access to or remain in a public area. A violation of this section occurs when:
    1. An individual expressly represents that an animal in his or her possession is a service animal for the purpose of obtaining any rights or privileges afforded to persons with disabilities accompanied by service animals, but unavailable to people and their pets or other animals; and
    2. The individual knew or should have known that the animal in question did not meet the definition of a service animal.
  4. A violation of this section shall be deemed a civil violation, punishable by up to thirty (30) hours of community service for an organization that serves individuals with disabilities at the discretion of the court.

History of Section. P.L. 2019, ch. 96, § 2; P.L. 2019, ch. 131, § 2.

40-9.1-4. Enforcement of anti-discrimination provisions.

The Rhode Island commission for human rights is empowered and directed, as hereinafter provided, to prevent any person from violating any of the provisions of this chapter; provided, that before instituting a formal hearing, it shall attempt by informal methods of conference, persuasion, and conciliation, to induce compliance with those sections. Upon the commission’s own initiative, or whenever an aggrieved individual or an organization chartered for the purpose of combating discrimination or of safeguarding civil liberties or rights of persons with disabilities, such individual or organization being hereinafter referred to as “the complainant,” makes a charge to the commission that any person, agency, bureau, corporation, or association, hereinafter referred to as “the respondent,” has violated, or is violating, any of the provisions of this chapter, the commission may proceed in the same manner and with the same powers as provided in §§ 28-5-16 28-5-27 , and the provisions of §§ 28-5-13 and 28-5-16 28-5-36 , as to the powers, duties, and rights of the commission, its members, hearing examiners, the complainant, respondent, interviewer, and the court shall apply in any proceedings under this section.

History of Section. P.L. 1997, ch. 85, § 1; P.L. 1999, ch. 83, § 100; P.L. 1999, ch. 130, § 100.

Compiler’s Notes.

Section 28-5-27 , referred to in this section, was repealed by P.L. 1992, ch. 276, § 1, effective July 21, 1992.

40-9.1-5. Therapy pets in public places.

  1. The privileges of access and transportation provided to service animals in § 40-9.1-2 shall be extended to family therapy pets, which are further defined as primary companions which include, but are not limited to, dogs, cats, rabbits, and guinea pigs, that are working in the provision of pet-assisted therapy treatment and education.
  2. The provisions are such that the pet-assisted therapy facilitator is working in conjunction with the therapy pet in a predetermined medical or educational setting, with a selected clientele. The medical interactions are to be individually planned, goal-oriented, and treatment based, and the educational settings are to be classroom based.
  3. Throughout the interactions, the pet-assisted therapy facilitator and the therapy pet will abide by a set code of ethics, and will follow professional guidelines to ensure that the actions and deeds of the pet-assisted therapy facilitator reflect advocacy of profession, pets, and clients, and other professions; while simultaneously ensuring that the interaction of the therapy pet and client remains beneficial and strives to enhance the quality of life through this animal-human bond.
  4. Prior to any interactions, the therapy pet must first meet the immunization criteria, a current certificate of good health, which shall be issued by a licensed, practicing veterinarian; as well as the temperament criteria, a certificate of good temperament, which shall be issued from a certified or practicing dog trainer or animal behaviorist; and training criteria, in which the pet-assisted therapy facilitator and the therapy pet learn to work as a team, learning together to execute safe and effective interaction, which are accepted in the field, specifically other pet-assisted animal facilitators, veterinarians, dog trainers, animal behaviorists, and the state of Rhode Island.
  5. Access and transportation privileges are only extended while the therapy pet is on the way to, or actively participating in, a program.
  6. The animal-assisted therapy facilitator, an individual who has successfully completed, or is in the process of completing, an accepted pet-assisted therapy program, shall be responsible for the control and safety of the pet, which is to include: cleaning up and elimination of wastes; keeping the pet on a proper leash and collar; carrying a smaller animal in a travel crate; adhering to all standard rules, regulations, and laws within both the facility and the state of Rhode Island; and upholding an active insurance policy that will cover an unforeseen mishap and/or accidental occurrence that may result in causing property damage and/or personal injury while actively participating in a program.

History of Section. P.L. 2000, ch. 451, § 1; P.L. 2006, ch. 216, § 22; P.L. 2019, ch. 96, § 1; P.L. 2019, ch. 131, § 1; P.L. 2020, ch. 79, art. 1, § 33.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-9.1-6. Closed-captioning activation required.

  1. On request, a place of public accommodation shall keep closed-captioning activated on any closed-captioning television receiver that is in use during regular hours in any public area.
  2. This section does not require a place of public accommodation to make closed-captioning available in a public area at the place of public accommodation if:
    1. No television receiver of any kind is available in the public area; or
    2. The only public television receiver available in the public area is not a closed-captioning television receiver.

History of Section. P.L. 2012, ch. 90, § 2; P.L. 2012, ch. 100, § 2.

40-9.1-7. Non-interference with federal law.

Nothing in this chapter shall be construed to interfere with any rights provided by federal law to individuals with disabilities.

History of Section. P.L. 2019, ch. 96, § 2; P.L. 2019, ch. 131, § 2.

Chapter 10 Child Welfare Services [Repealed.]

40-10-1 — 40-10-5. [Repealed.]

Repealed Sections.

This chapter (G.L. 1923, ch. 413, art. 1, § 3; P.L. 1926, ch. 862, § 1; P.L. 1938, ch. 2566, §§ 1-4; G.L. 1938, ch. 50, § 2; G.L. 1938, ch. 57, §§ 1-4; G.L. 1956, §§ 40-13-1 — 40-13-5; Reorg. Plan No. 1, 1970), concerning child welfare services, was repealed by P.L. 1979, ch. 248, § 5. For present law concerning the department of children, youth and families, see § 42-72-1 et seq.

Chapter 11 Abused and Neglected Children

40-11-1. Policy.

The public policy of this state is: to protect children whose health and welfare may be adversely affected through injury and neglect; to strengthen the family and to make the home safe for children by enhancing the parental capacity for good child care; to provide a temporary or permanent nurturing and safe environment for children when necessary; and, for these purposes, to require the mandatory reporting of known or suspected child abuse and neglect, investigation of those reports by a social agency, and provision of services, where needed, to the child and family.

History of Section. P.L. 1976, ch. 91, § 2.

Repealed Sections.

Former chapter 11 of this title (P.L. 1964, ch. 130, § 1; P.L. 1969, ch. 244, §§ 1-4; G.L. 1956, §§ 40-13.1-1 — 40-13.1-6; Reorg. Plan No. 1, 1970; P.L. 1971, ch. 45, § 1; P.L. 1974, ch. 148, § 1; P.L. 1974, ch. 193, §§ 1-3; P.L. 1974, ch. 230, § 1; P.L. 1975, ch. 273, § 1), consisting of §§ 40-11-1 40-11-10 and concerning battered and abused children, was repealed by P.L. 1976, ch. 91, § 1, effective May 14, 1976.

Comparative Legislation.

Abused and neglected children:

Conn. Gen. Stat. § 17a-101 et seq.

Mass. Ann. Laws ch. 119, § 1 et seq.

Collateral References.

Mistake or lack of information as to victim’s age as defense to statutory rape. 46 A.L.R.5th 499.

40-11-2. Definitions.

When used in this chapter and unless the specific context indicates otherwise:

  1. “Abused or neglected child” means a child whose physical or mental health or welfare is harmed, or threatened with harm, when his or her parent or other person responsible for his or her welfare:
    1. Inflicts, or allows to be inflicted, upon the child physical or mental injury, including excessive corporal punishment; or
    2. Creates, or allows to be created, a substantial risk of physical or mental injury to the child, including excessive corporal punishment; or
    3. Commits, or allows to be committed, against the child an act of sexual abuse; or
    4. Fails to supply the child with adequate food, clothing, shelter, or medical care, though financially able to do so or offered financial or other reasonable means to do so; or
    5. Fails to provide the child with a minimum degree of care or proper supervision or guardianship because of his or her unwillingness or inability to do so by situations or conditions such as, but not limited to: social problems, mental incompetency, or the use of a drug, drugs, or alcohol to the extent that the parent or other person responsible for the child’s welfare loses his or her ability or is unwilling to properly care for the child; or
    6. Abandons or deserts the child; or
    7. Sexually exploits the child in that the person allows, permits, or encourages the child to engage in prostitution as defined by the provisions in § 11-34.1-1 et seq., entitled “Commercial Sexual Activity”; or
    8. Sexually exploits the child in that the person allows, permits, encourages, or engages in the obscene or pornographic photographing, filming, or depiction of the child in a setting that, taken as a whole, suggests to the average person that the child is about to engage in, or has engaged in, any sexual act, or that depicts any such child under eighteen (18) years of age performing sodomy, oral copulation, sexual intercourse, masturbation, or bestiality; or
    9. Commits, or allows to be committed, any sexual offense against the child as sexual offenses are defined by the provisions of chapter 37 of title 11, entitled “Sexual Assault,” as amended; or
    10. Commits, or allows to be committed, against any child an act involving sexual penetration or sexual contact if the child is under fifteen (15) years of age; or if the child is fifteen (15) years or older, and (1) Force or coercion is used by the perpetrator, or (2) The perpetrator knows, or has reason to know, that the victim is a severely impaired person as defined by the provisions of § 11-5-11 , or physically helpless as defined by the provisions of § 11-37-1(6) .
  2. “Child” means a person under the age of eighteen (18).
  3. “Child protective investigator” means an employee of the department charged with responsibility for investigating complaints and referrals of child abuse and neglect and institutional child abuse and neglect.
  4. “Children’s advocacy center (CAC)” means a community-based organization that is a member of the Rhode Island chapter of children advocacy centers and an accredited member (or working toward accreditation) of the National Children’s Alliance.
  5. “Department” means department of children, youth and families.
  6. “Educational program” means any public or private school, including boarding schools, or any home-schooling program.
  7. “Healthcare provider” means any provider of healthcare services involved in the delivery or care of infants or care of children.
  8. “Institution” means any private or public hospital or other facility providing medical or psychiatric diagnosis, treatment, and care.
  9. “Institutional child abuse and neglect” means situations of known or suspected child abuse or neglect where the person allegedly responsible for the abuse or neglect is a foster parent or the employee of a public or private residential childcare institution or agency; or any staff person providing out-of-home care or situations where the suspected abuse or neglect occurs as a result of the institution’s practices, policies, or conditions.
  10. “Law enforcement agency” means the police department in any city or town or the state police.
  11. “Mental injury” includes a state of substantially diminished psychological or intellectual functioning in relation to, but not limited to, such factors as: failure to thrive; ability to think or reason; control of aggressive or self-destructive impulses; acting-out or misbehavior, including incorrigibility, ungovernability, or habitual truancy; provided, however, that the injury must be clearly attributable to the unwillingness or inability of the parent or other person responsible for the child’s welfare to exercise a minimum degree of care toward the child.
  12. “Person responsible for child’s welfare” means the child’s parent; guardian; any individual, eighteen (18) years of age or older, who resides in the home of a parent or guardian and has unsupervised access to a child; foster parent; an employee of a public or private residential home or facility; or any staff person providing out-of-home care (out-of-home care means child day care to include family day care, group day care, and center-based day care). Provided, further, that an individual, eighteen (18) years of age or older, who resides in the home of a parent or guardian and has unsupervised access to the child, shall not have the right to consent to the removal and examination of the child for the purposes of § 40-11-6 .
  13. “Physician” means any licensed doctor of medicine, licensed osteopathic physician, and any physician, intern, or resident of an institution as defined in subsection (8).
  14. “Probable cause” means facts and circumstances based upon as accurate and reliable information as possible that would justify a reasonable person to suspect that a child is abused or neglected. The facts and circumstances may include evidence of an injury, or injuries, and the statements of a person worthy of belief, even if there is no present evidence of injury.
  15. “Shaken-baby syndrome” means a form of abusive head trauma, characterized by a constellation of symptoms caused by other than accidental traumatic injury resulting from the violent shaking of or impact upon an infant or young child’s head.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1979, ch. 248, § 9; P.L. 1981, ch. 139, § 1; P.L. 1984, ch. 257, § 1; P.L. 1985, ch. 371, § 1; P.L. 1989, ch. 147, § 1; P.L. 1997, ch. 326, § 131; P.L. 1999, ch. 83, § 101; P.L. 1999, ch. 130, § 101; P.L. 2000, ch. 69, § 2; P.L. 2003, ch. 141, § 1; P.L. 2003, ch. 148, § 1; P.L. 2006, ch. 547, § 1; P.L. 2010, ch. 239, § 20; P.L. 2016, ch. 352, § 1; P.L. 2016, ch. 373, § 1; P.L. 2017, ch. 386, § 1; P.L. 2017, ch. 424, § 1; P.L. 2018, ch. 189, § 1; P.L. 2018, ch. 262, § 1.

NOTES TO DECISIONS

Abused or Neglected Child.

This section, in defining an abused and neglected child, and the decisions of this court applying the statute, have not required a finding of “intent.” In re Adam R., 665 A.2d 882, 1995 R.I. LEXIS 239 (R.I. 1995).

Evidence supported a conclusion that the children were abused and neglected since testimony by social workers, parent aides, and a psychologist established that the mother had borderline intellectual functioning and lacked parental and management skills, that the children lived in squalid conditions, and that both the mother and children had been abused by upstairs tenants. In re Adam R., 665 A.2d 882, 1995 R.I. LEXIS 239 (R.I. 1995).

State failed to present a prima facie case of child abuse against the mother and the father where the testimony revealed only that the infant was the victim of child abuse, that the injuries were of various ages, that the older injuries were undetectable even to the eyes of trained medical professionals, and that the infant had three caretakers who could have inflicted the infant’s injuries: the mother, the father, and the daycare provider. In addition, the state’s sole witness, an expert in forensic pediatrics, testified that neither petitioners nor the daycare provider could be ruled out as the perpetrators of the abuse. In re Adner G., 925 A.2d 951, 2007 R.I. LEXIS 90 (R.I. 2007).

Parents’ 42 U.S.C.S. § 1983 action against state child services officers was properly dismissed on the ground of their qualified immunity because, while deprivation of the right to familial integrity implicated the Fourteenth Amendment, their removal of children from the parents’ home was reasonable; the father was indicted for child molestation and both had intimated suicide. Further, R.I. Gen. Laws § 40-11-2 , the statute under which the parents’ son was removed, did not require a finding of abuse; moreover, courts had recognized that an imminent serious risk of neglect justified termination of the parental relationship. Carter v. Lindgren, 502 F.3d 26, 2007 U.S. App. LEXIS 21471 (1st Cir. 2007).

Legally competent evidence supported the trial justice’s findings of neglect; when the child was placed in the temporary custody of the department, the father was unable to provide for the child because of his incarceration, and when the case was tried and a decision rendered, the father had made no arrangements for the child’s well-being and was unable himself to care for the child because of his incarceration. In re Kurt H., 152 A.3d 408, 2017 R.I. LEXIS 9 (R.I. 2017).

Trial justice committed reversible error when the justice found that a parent abused and neglected the parent’s child, after the child suffered a fractured femur, because the evidence was not sufficient to satisfy the clear and convincing standard of R.I. R. Juv. P. 17(b). The parent testified that the parent was not present at the time of the child’s injury, without evidence to the contrary, and the medical testimony left it unclear whether the child’s injury was inflicted as a result of abuse or was merely accidental in nature. In re Adrina T., 162 A.3d 658, 2017 R.I. LEXIS 93 (R.I. 2017).

Under the clear and convincing standard of R.I. R. Juv. P. 17(b), the evidence was insufficient to support a finding of abuse or neglect as to the mother because it was uncontested that the father’s actions were the sole cause of injury to the child’s lip, there was no evidence in the record supporting the trial justice’s finding that the child’s injuries were not the result of a one-time episode of abuse but sustained over a period of time, and the mother called the pediatrician and took the child to the emergency room after discovering her injuries. In re Sophia M., 204 A.3d 605, 2019 R.I. LEXIS 48 (R.I. 2019).

40-11-3. Duty to report — Deprivation of nutrition or medical treatment.

  1. Any person who has reasonable cause to know or suspect that any child has been abused or neglected as defined in § 40-11-2 , or has been a victim of sexual abuse by another child, shall, within twenty-four (24) hours, transfer that information to the department of children, youth and families, or its agent, which shall cause the report to be investigated immediately. As a result of those reports and referrals, protective social services shall be made available to those children in an effort to safeguard and enhance the welfare of those children and to provide a means to prevent further abuse or neglect. The department shall establish and implement a single, statewide, toll-free telephone to operate twenty-four (24) hours per day, seven (7) days per week for the receipt of reports concerning child abuse and neglect, which reports shall be electronically recorded and placed in the central registry established by § 42-72-7 . The department shall create a sign, using a format that is clear, simple, and understandable to students, that contains the statewide, toll-free telephone number for posting in all public and private schools in languages predominately spoken in the state, containing pertinent information relating to reporting the suspicion of child abuse, neglect, and sexual abuse. This sign shall be available to the school districts electronically. The electronically recorded records, properly indexed by date and other essential, identifying data, shall be maintained for a minimum of three (3) years; provided, however, any person who has been reported for child abuse and/or neglect, and who has been determined not to have neglected and/or abused a child, shall have his or her record expunged as to that incident three (3) years after that determination. The department shall continuously maintain a management-information database that includes all of the information required to implement this section, including the number of cases reported by hospitals, healthcare centers, emergency rooms, and other appropriate healthcare facilities.
  2. The reporting shall include immediate notification of the department of any instance where parents of an infant have requested deprivation of nutrition that is necessary to sustain life and/or who have requested deprivation of medical or surgical intervention that is necessary to remedy or ameliorate a life-threatening medical condition, if the nutrition or medical or surgical intervention is generally provided to similar nutritional, medical, or surgical conditioned infants, whether disabled or not.
  3. Nothing in this section shall be interpreted to prevent a child’s parents and physician from discontinuing the use of life-support systems or nonpalliative treatment for a child who is terminally ill where, in the opinion of the child’s physician exercising competent medical judgment, the child has no reasonable chance of recovery from the terminal illness despite every, appropriate medical treatment to correct the condition.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1979, ch. 248, § 9; P.L. 1983, ch. 250, § 1; P.L. 1984, ch. 247, § 1; P.L. 1985, ch. 371, § 1; P.L. 1988, ch. 655, § 1; P.L. 1990, ch. 280, § 1; P.L. 1999, ch. 83, § 101; P.L. 1999, ch. 130, § 101; P.L. 2013, ch. 286, § 1; P.L. 2016, ch. 63, § 2; P.L. 2016, ch. 465, § 2.

Cross References.

Establishment by department of children, youth and families of procedures for reporting child abuse and neglect, § 42-72-5 .

NOTES TO DECISIONS

In General.

A child’s statement that her father had beaten her and threatened to kill her, reported by teachers with whom a social worker had had repeated contact in conjunction with her treatment of the child and whose veracity she had no reason to doubt, the child’s complaints during the preceding week and a half of similar beatings, the reported bruises on her body, her unusual fear of going home, and her violently disruptive and self-abusive behavior were more than sufficient to mandate a report to the Department of Children and Their Families under this section by the social worker. Curtis v. State Dep't for Children & Their Families, 522 A.2d 203, 1987 R.I. LEXIS 423 (R.I. 1987).

Evidence in Criminal Prosecution.

In a prosecution for sexual offenses, the trial court did not limit the defendant’s right to an effective cross-examination of the victim’s mother by barring inquiries as to when she first notified the Department of Children, Youth and Families (DCYF) about her daughter’s disclosure of sexual abuse and whether the mother realized she had an obligation to notify DYCF under this section. State v. Brown, 709 A.2d 465, 1998 R.I. LEXIS 106 (R.I. 1998).

Reasonable Suspicion.

Since, in the context of a discussion about serious child abuse, the student said that she was hit and bruised, and while she was asked about being hit by her parents, she was crying, those undisputed facts alone rendered the rape crisis center employee’s suspicion that the student was being abused eminently reasonable. In fact, the employee could have been accused of breaking the law had she not reported her suspicions to the department of children and their families within 24 hours, given the content of the student’s speech. Wojcik ex rel. Wojcik v. Town of N. Smithfield, 874 F. Supp. 508, 1995 U.S. Dist. LEXIS 93 (D.R.I. 1995), aff'd, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

Under this section, good faith reports by school teachers, based on one student’s journal entries and that student’s sibling’s reaction to a school program on child abuse, created immunity to suit. Wojcik v. Town of N. Smithfield, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

Collateral References.

Validity, construction, and application of state statute requiring doctor or other person to report child abuse. 73 A.L.R.4th 782.

40-11-3.1. Duty to report death of child due to child abuse or neglect.

Any person required to report under the provisions of this title, who has reasonable cause to know or suspect that a child has died as a result of child abuse or neglect shall immediately transfer that information to the department or its agent who shall cause the report to be investigated immediately. Upon receipt of the report, the department or its agent shall immediately transfer the information to the local law enforcement agency or the state police as well as to the office of the medical examiner. The office of the medical examiner shall investigate the report and communicate its preliminary findings, orally within seventy-two (72) hours, and in writing within seven (7) working days to the appropriate law enforcement agency, to the department and, if the person who made the report is an employee or a member of the staff of a hospital, to the hospital. The office of the medical examiner shall also communicate its final findings and conclusions, with the basis therefore, to the same parties within sixty (60) days.

History of Section. P.L. 1984, ch. 257, § 2.

40-11-3.2. False reporting of child abuse and neglect.

Any person who knowingly and willfully makes, or causes to be made, to the department a false report of child abuse or neglect shall be guilty of a misdemeanor and, upon conviction thereof, shall be fined not more than one thousand dollars ($1,000) or imprisoned not more than one year, or both.

History of Section. P.L. 1996, ch. 156, § 1.

40-11-3.3. Duty to report — Sexual abuse of a child in an educational program.

  1. Any person who has reasonable cause to know or suspect that any child has been the victim of sexual abuse by an employee, agent, contractor, or volunteer of an educational program as defined in § 40-11-2 shall, within twenty-four (24) hours, transfer that information to the department of children, youth and families, or its agent; provided, however, that if the person mandated to report is an employee, agent, contractor, or volunteer of an educational program as defined in § 40-11-2 , they shall immediately notify the principal, headmaster, executive director, or other person in charge of the educational program, or his or her designated agent. The principal, headmaster, executive director, or other person in charge of the educational program, or his or her designated agent, shall be responsible for all subsequent notification to the department of children, youth and families, or its agent in the manner required by this section. In the case of a public educational program, the principal, headmaster, executive director, or other person in charge of the educational program, or his or her designated agent, shall also notify the superintendent of the public educational program. Any transferred information shall include the name, title, and contact information for every employee, agent, contractor, or volunteer of the educational program who is believed to have direct knowledge of the allegation. Nothing in this section is intended to require more than one report from any educational program for a specific incident.
  2. In order to provide guidance and consistency in reporting, the commissioner of elementary and secondary education shall promulgate policies and procedures for the creation and handling of reports made by the principal, headmaster, executive director, or other person in charge of the educational program, or his or her designated agent in order to carry out the intent of this section.
  3. The department of children, youth and families, or its agent shall immediately forward the report to state police and local law enforcement, and shall initiate an investigation of the allegations of sexual abuse if it determines that the report meets the criteria for a child protective services investigation. As a result of those reports and referrals, the department shall refer those children to appropriate services and support systems in order to provide for their health and welfare. In the event the department substantiates the allegations of sexual abuse against an employee, agent, contractor, or volunteer of an educational program, the department shall immediately notify the state police; the local law enforcement agency; the department of education; the educational program; the person who is the subject of the investigation; and the parent, or parents, of the child who is alleged to be the victim of the sexual abuse of the department’s findings.
  4. The director of the department of children, youth and families is authorized to promulgate rules and regulations pertaining to the investigation of the allegation of sexual abuse in order to carry out the intent of this section.
  5. For purposes of this section, “reasonable cause to know or suspect” means that it is objectively reasonable for a person to entertain a suspicion, based upon facts that could cause a reasonable person in a like position, drawing, when appropriate, on the person’s training and experience, to suspect child abuse. “Reasonable cause to know or suspect” does not require certainty that child sexual abuse has occurred nor does it require a specific medical indication of child sexual abuse; any “reasonable cause to know or suspect” is sufficient.

History of Section. P.L. 2016, ch. 352, § 2; P.L. 2016, ch. 373, § 2; P.L. 2018, ch. 179, § 1; P.L. 2018, ch. 240, § 1.

40-11-4. Immunity from liability.

Any person participating in good faith in making a report pursuant to this chapter shall have immunity from any liability, civil or criminal, that might otherwise be incurred or imposed. Any participant shall have the same immunity with respect to participation in any judicial proceeding resulting from the report.

History of Section. P.L. 1976, ch. 91, § 2.

NOTES TO DECISIONS

Good Faith.

The “good faith” required by this section that confers immunity is subjective. The “good faith” goes directly to the question of the motivation with which the abuse-reporter acts. Only if an abuse-reporter can prove that he or she had a reasonable suspicion of abuse will he or she be granted immunity from suit. If there is a genuine issue of material fact as to whether the reporter acted in good faith, the question must be decided at trial by the jury. Wojcik ex rel. Wojcik v. Town of N. Smithfield, 874 F. Supp. 508, 1995 U.S. Dist. LEXIS 93 (D.R.I. 1995), aff'd, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

Under this section, good faith reports by school teachers, based on one student’s journal entries and that student’s sibling’s reaction to a school program on child abuse, created immunity to suit. Wojcik v. Town of N. Smithfield, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

Interference With Family Integrity.

A simple investigation, without more, causes nothing but a de minimis interference with a family’s integrity, and such interference cannot possibly rise to the level of a constitutional violation. Therefore, a rape crisis center employee’s decision to call the department of children and their families to report suspected child abuse contained not one iota of constitutional misconduct. Wojcik ex rel. Wojcik v. Town of N. Smithfield, 874 F. Supp. 508, 1995 U.S. Dist. LEXIS 93 (D.R.I. 1995), aff'd, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

Reasonable Suspicion.

Since, in the context of a discussion about serious child abuse, the student said that she was hit and bruised, and while she was asked about being hit by her parents, she was crying, those undisputed facts alone rendered the rape crisis center employee’s suspicion that the student was being abused eminently reasonable. In fact, the employee could have been accused of breaking the law had she not reported her suspicions to the department of children and their families within 24 hours, given the content of the student’s speech. Wojcik ex rel. Wojcik v. Town of N. Smithfield, 874 F. Supp. 508, 1995 U.S. Dist. LEXIS 93 (D.R.I. 1995), aff'd, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

40-11-5. Protective custody by physician or law enforcement officer.

  1. Any physician or duly certified registered nurse practitioner treating a child who has suffered physical injury that appears to have been caused by other than accidental means, or a child suffering from malnutrition or sexual molestation, shall have the right to keep the child in the custody of a hospital or any licensed childcare center or facility for no longer than seventy-two (72) hours, with or without the consent of the child’s parents or guardian, pending the filing of an ex-parte petition to the family court. The expense for that temporary care shall be paid by the parents or legal guardian of the child or, if they are unable to pay, by the department.
  2. Any police or law enforcement officer may take a child into protective custody without the consent of the parents, or others exercising control over the child.
  3. If the officer has reasonable cause to believe that there exists an imminent danger to the child’s life or health unless he or she is taken into protective custody, the officer shall immediately notify and place the child with the director of the department of children, youth and families, or his or her designated agent, who shall care for the child; provided, however, that no child may be detained in protective custody longer than forty-eight (48) hours without the express approval of a justice of the family court.
  4. Any child protective investigator or social caseworker II employed by the department, may take a child into temporary protective custody without the consent of his or her parent or other person responsible for the welfare of the child, if the investigator or social caseworker II has reasonable cause to believe that the child or his or her sibling has been abused and/or neglected and that continued care of the child by his or her parent or other person responsible for the child’s welfare will result in imminent further harm to the child. The investigator or social caseworker II shall have the child examined by a licensed physician or duly certified registered nurse practitioner within twenty-four (24) hours in accordance with the provisions of § 40-11-6(c) ; and, provide further, that the child shall not be detained in protective custody longer than forty-eight (48) hours without the expressed approval of a justice of the family court.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1982, ch. 59, § 1; P.L. 1984, ch. 257, § 1; P.L. 1992, ch. 245, § 1; P.L. 1996, ch. 82, § 1.

Cross References.

Protective services for children, § 42-72-11 .

NOTES TO DECISIONS

Action for False Imprisonment.

Where the defendants’ conduct in admitting a child into a hospital and detaining her there was justified under the statute, an action for false imprisonment could not lie, and as the plaintiffs’ claim that the defendants’ detention of the child constituted assault and battery was premised upon its alleged illegality, since the detention was legally justified, the direction of a verdict against the plaintiffs on this account was also appropriate. Curtis v. State Dep't for Children & Their Families, 522 A.2d 203, 1987 R.I. LEXIS 423 (R.I. 1987).

Evidence.

Doctor’s recommendation that a child be admitted to the hospital was justified under this section, given the injuries that his examination revealed, the child’s statement to him that her father had hit her, and the history he was given when she was brought to the emergency room. That the child’s injuries were minor is of no consequence; any physical injury apparently caused by other than accidental means is sufficient. Curtis v. State Dep't for Children & Their Families, 522 A.2d 203, 1987 R.I. LEXIS 423 (R.I. 1987).

Collateral References.

Failure of state or local government to protect child abuse victim as violation of federal constitutional rights. 79 A.L.R. Fed. 514.

Physical examination of child’s body for evidence of abuse as violative of Fourth Amendment or as raising Fourth Amendment issue. 93 A.L.R. Fed. 530.

Tort liability of public authority for failure to remove parentally abused or neglected children from parental custody. 60 A.L.R.4th 942.

Validity and application of statute allowing endangered child to be temporarily removed from parental custody. 38 A.L.R.4th 756.

40-11-6. Report by physicians and healthcare providers of abuse or neglect.

  1. When any physician, duly certified registered nurse practitioner, or other healthcare provider is involved in the delivery or care of infants born with, or identified as being affected by, substance abuse or withdrawal symptoms resulting from prenatal drug exposure or a fetal alcohol spectrum disorder, or has cause to suspect that a child brought to him or her, or coming to him or her, for examination, care, or treatment, is an abused or neglected child as defined in this chapter, or when he or she determines that a child under the age of twelve (12) years is suffering from any sexually transmitted disease, he or she shall report the incident or cause a report thereof to be made to the department as provided in subsection (b).
  2. An immediate oral report shall be made by telephone or otherwise, to both the department and law enforcement agency, and shall be followed by a report, in writing, to the department and law enforcement agency explaining the extent and nature of the abuse or neglect the child is alleged to have suffered.
  3. The department, upon receipt of such a report by a person other than a physician or duly certified registered nurse practitioner alleging that a child has been physically abused, shall investigate the report, and if the investigation reveals evidence of injury or that the child has been the victim of sexual abuse, the department shall have the child examined by a licensed physician or duly certified registered nurse practitioner. Any child protective investigator shall, with or without the consent of the parent or other person responsible for the child’s welfare, have the right to remove the child from the place where the child may be to secure the examination required by this subsection. Upon completion of the examination, it shall be mandatory for the physician or duly certified registered nurse practitioner to make a written report of his or her findings to the department.
  4. The department shall promulgate rules and regulations to implement the provisions of this section.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1984, ch. 257, § 1; P.L. 1985, ch. 371, § 1; P.L. 1992, ch. 245, § 1; P.L. 2011, ch. 151, art. 17, § 1; P.L. 2017, ch. 386, § 1; P.L. 2017, ch. 424, § 1.

Cross References.

Immunity from liability for reporting, § 40-11-4 .

NOTES TO DECISIONS

Evidence.

Social worker investigator’s decision to temporarily remove child from his home was justified where doctor’s report noted significant handprint bruises and other injuries sufficient to personally endorse removal, and father as well as child’s siblings admitted recent and recurrent incidents of violence. Charron v. Picano, 811 F. Supp. 768, 1993 U.S. Dist. LEXIS 1138 (D.R.I. 1993).

40-11-6.1. Penalty for failure to report or perform required act.

Any person, official, physician, or institution required by this chapter to report known or suspected child abuse or neglect or to perform any other act who knowingly fails to do so or who knowingly prevents any person acting reasonably from doing so shall be guilty of a misdemeanor, and upon conviction thereof, shall be subject to a fine of not more than five hundred dollars ($500) or imprisonment for not more than one year or both. In addition, any person, official, physician, or institution who knowingly fails to perform any act required by this chapter or who knowingly prevents another person from performing a required act shall be civilly liable for the damages proximately caused by that failure.

History of Section. P.L. 1979, ch. 248, § 10.

NOTES TO DECISIONS

Reasonable Suspicion.

Since, in the context of a discussion about serious child abuse, a student said that she was hit and bruised, and while she was asked about being hit by her parents, she was crying, those undisputed facts alone rendered the rape crisis center employee’s suspicion that the student was being abused eminently reasonable. In fact, the employee could have been accused of breaking the law had she not reported her suspicions to the department of children and their families within 24 hours, given the content of the student’s speech. Wojcik ex rel. Wojcik v. Town of N. Smithfield, 874 F. Supp. 508, 1995 U.S. Dist. LEXIS 93 (D.R.I. 1995), aff'd, 76 F.3d 1, 1996 U.S. App. LEXIS 1474 (1st Cir. 1996).

Collateral References.

Validity, construction, and application of state statute requiring doctor or other person to report child abuse. 73 A.L.R.4th 782.

40-11-7. Investigation of reports — Petition for removal from custody — Report to child advocate — Attorney general — Court-appointed special advocate — Children’s advocacy center.

  1. The department shall investigate reports of child abuse and neglect made under this chapter in accordance with the rules the department has promulgated and in order to determine the circumstances surrounding the alleged abuse or neglect and the cause thereof. The investigation shall include personal contact with the child named in the report and any other children in the same household. Any person required to investigate reports of child abuse and/or neglect may question the subjects of those reports with or without the consent of the parent or other person responsible for the child’s welfare. The interviewing of the child or children, if they are of the mental capacity to be interviewed, shall take place in the absence of the person or persons responsible for the alleged neglect or abuse. In the event that any person required to investigate child abuse and/or neglect is denied reasonable access to a child by the parents or other person, and that person required to investigate deems that the best interests of the child so require, they may request the intervention of a local law enforcement agency, or seek an appropriate court order to examine and interview the child. The department shall provide such social services and other services as are necessary to protect the child and preserve the family.
  2. In the event that after investigation it is determined by the department that the child is being or has been abused or neglected but that the circumstances of the child’s family or otherwise do not require the removal of the child for his or her protection, the department may allow the child to remain at home and provide the family and child with access to preventative support and services. In addition, the department is authorized to petition the family court for an order for the provision of treatment of the family and child. Provided, further, the department shall notify the children’s advocacy center of all suspected cases of child sexual abuse.
  3. The department shall have the duty to petition the family court for removal of the child from the care and custody of the parents, or any other person having custody or care of the child, if there is a determination that a child has been abused or neglected; which results in a child death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act that represents an imminent risk of serious harm. In addition, in cases of alleged abuse and/or neglect, the department may petition the family court for the removal of the alleged perpetrator of that abuse and/or neglect from the household of the child or children when the child or children are eleven (11) years of age or older. It shall be the responsibility of the department to make the parent or other person responsible for the child’s welfare aware of the court action, the possible consequences of the court action, and to explain the rights of the parent relative to the court action.
  4. The department shall forward immediately any reports of institutional child abuse and neglect to the child advocate who shall investigate the report in accordance with chapter 73 of title 42, and also to any guardian ad litem and/or attorney of record for the child.
  5. In the event that after investigation the department takes any action regarding placement of the child, the department shall immediately notify the child advocate of such action.
  6. In the event that after investigation the department has reasonable cause to know or suspect that a child has been subjected to criminal abuse or neglect, the department shall forward immediately any information as it relates to that knowledge or suspicion to the law enforcement agency.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1979, ch. 248, § 9; P.L. 1981, ch. 336, § 1; P.L. 1984, ch. 257, § 1; P.L. 1985, ch. 125, § 1; P.L. 1988, ch. 391, § 1; P.L. 1989, ch. 80, § 1; P.L. 1990, ch. 420, § 1; P.L. 2011, ch. 151, art. 17, § 1; P.L. 2012, ch. 241, art. 3, § 1; P.L. 2021, ch. 117, § 1, effective July 2, 2021; P.L. 2021, ch. 118, § 1, effective July 2, 2021.

Compiler's Notes.

P.L. 2021, ch. 117, § 1, and P.L. 2021, ch. 118, § 1 enacted identical amendments to this section.

NOTES TO DECISIONS

Constitutional Rights.

Defendant’s U.S. Const. amend. VI right to counsel was violated by the child protective investigator’s jailhouse interview regarding the charge against defendant of child molestation and the trial court’s subsequent admission into evidence of the statement obtained. The questioning of defendant occurred at a critical stage of the prosecution and the investigator was acting as an agent of the State because the investigator was required by R.I. Gen. Laws § 40-11-7(f) to forward any abuse information she obtained to the appropriate law enforcement agency, which the State could then use to prosecute defendant. State v. Oliveira, 961 A.2d 299, 2008 R.I. LEXIS 115 (R.I. 2008).

Collateral References.

Failure of state or local government to protect child abuse victim as violation of federal constitutional rights. 79 A.L.R. Fed. 514.

Physical abuse of child by parent as ground for termination of parent’s right to child. 53 A.L.R.3d 605.

Tort liability of public authority for failure to remove parentally abused or neglected children from parental custody. 60 A.L.R.4th 942.

40-11-7.1. Family court proceedings.

  1. The family court shall, upon the filing of an ex parte petition, hereunder, immediately take any action it deems necessary or appropriate for the protection of the child, or children, suspected of being abused or neglected, including the removal of the child, or children, from the custody of the parent, or parents, or other person suspected of the abuse or neglect.
  2. A hearing on the petition shall be held within seven (7) days from the filing thereof, for the court to:
    1. Advise the parent, or parents, or other person having care of the child, of the allegations contained in the petition;
    2. Enter either a denial or admission of the allegations contained in the petition;
    3. Ensure that a guardian ad litem and/or a court-appointed special advocate has been appointed to represent the child;
    4. Appoint an attorney to represent the parent, or parents, or any other person having care of the child, alleged to have abused or neglected a child when the parent or custodian is unable to afford representation, as determined by the court;
    5. Advise the parent, or parents, or any other person having care of the child, of his or her right to a probable cause hearing on the ex parte petition to be held as soon as practicable but no later than ten (10) days from the date of the request;
    6. Make inquiry of the mother of the child to determine the identity of the biological father of the child, if necessary;
    7. In the event that a person named as a putative father appears and denies that he is the biological father of the child, the court shall direct that any such putative father execute a written denial of paternity setting forth the implications of the denial in a form to be adopted by the family court in accordance with the provisions of this section. Execution of the document by the putative father shall constitute prima facie evidence of his denial of paternity. Upon execution of the denial of paternity form, the court shall find that the department has no duty to make reasonable efforts to strengthen and encourage the relationship between the child and that putative father and the lack of such efforts may not be cited for any purpose by the putative father in any future proceeding conducted pursuant to the provisions of this chapter, the provisions of chapter 7 of title 15 or chapter 8 of title 15;
    8. Make any interim orders in its discretion respecting the rights of the child.
  3. The family court, upon identification of an alleged biological father by the mother of the child, shall order service of the petition and notice of hearing date to be made upon him in accordance with the rules of juvenile proceedings.
    1. If an alleged putative father appears at the hearing or appears at any subsequent hearing and denies paternity, the court shall direct that any such putative father execute a written denial of paternity setting forth the implications of the denial in a form to be adopted by the family court in accordance with the provisions of this section. Execution of the document by the putative father shall constitute prima facie evidence of his denial of paternity. Upon execution of the denial of paternity form, the court shall make a finding that the department has no duty to make reasonable efforts to strengthen and encourage the relationship between the child and that putative father and the lack of such efforts may not be cited for any purpose by the putative father in any future proceeding conducted pursuant to the provisions of this chapter, the provisions of chapter 7 of title 15 or the provisions of chapter 8 of title 15.
    2. If an alleged putative father appears and neither admits nor denies paternity, the department of children, youth and families shall, within five (5) days, refer the putative father to the department of human services for a determination of paternity in accordance with chapter 8 of title 15.
    3. If a putative father, having been duly served with notice, fails to appear, the court shall find that the department has no duty to make reasonable efforts to strengthen and encourage the relationship between the child and the putative father and the lack of such efforts may not be cited for any purpose in any future proceedings conducted pursuant to the provisions of this chapter, the provisions of chapter 7 of title 15 or the provisions of chapter 8 of title 15.
  4. Execution of a written denial of paternity pursuant to this chapter shall have no legal effect on paternity or child support proceedings commenced under chapter 8 of title 15.
  5. At the probable cause hearing, credible hearsay evidence may, in the discretion of the court, be admissible. The petitioner may submit a signed physician’s report that, while not conclusive, shall constitute prima facie evidence to support continued detention of the child pursuant to the ex parte order pending a trial on the merits.

History of Section. P.L. 1979, ch. 248, § 10; P.L. 1981, ch. 324, § 1; P.L. 1985, ch. 98, § 2; P.L. 1996, ch. 45, § 1.

Cross References.

Investigation of report required, § 40-11-9 .

NOTES TO DECISIONS

Appointment of Guardian Ad Litem or Court-Appointed Special Advocate.

When proposed next friends of foster children sought to bring suit in federal court on behalf of the children, alleging deficiencies in a state’s foster care system violated the children’s federal constitutional and statutory rights, it was error to find that the appointment of guardians ad litem and/or court-appointed special advocates (CASAs) for the children precluded the appointment of next friends, under Fed. R. Civ. P. 17(c), because Rhode Island law in R.I. Gen. Laws §§ 40-11-7.1(b)(3) and 40-11-14 limited the authority of the guardians ad litem and the CASAs to the family court proceedings in which the guardians ad litem or CASAs were appointed. Sam M. v. Carcieri, 608 F.3d 77, 2010 U.S. App. LEXIS 12552 (1st Cir. 2010).

Attorney’s Fees.

The family court had no power to award a counsel fee, even where it found the department had acted frivolously in bringing on a case for trial when it had been earlier unable to establish probable cause. In re Craig F., 518 A.2d 629, 1986 R.I. LEXIS 566 (R.I. 1986).

Parental Compliance With Services.

Although preliminary proceedings taken to protect a child may involve the placement and continued “detention” of an at-risk child in agency care pending an adjudication on an neglect or abuse petition, with the commitment trial establishing the more formal commitment of the child to the agency’s “care, custody, and control” upon an adjudication of abuse or neglect, it is only in conjunction with an adjudication of abuse or neglect that a parent may be required to comply with court-ordered programs and agency services. In re Christina V., 749 A.2d 1105, 2000 R.I. LEXIS 99 (R.I. 2000).

40-11-7.2. Evidence.

  1. A videotape recording made by the department of children, youth and families, a law enforcement officer, a hospital, or a children’s advocacy center of an interview of or statement made by a child who is the subject of an investigation conducted pursuant to § 40-11-7 is admissible in any court proceeding pursuant to this chapter, notwithstanding any objection to hearsay statements contained therein, provided it is relevant and material and provided its probative value substantially outweighs the danger of unfair prejudice to the child’s parent, guardian, or other person responsible for the child’s welfare. The circumstances of the making of the videotape recording, including the maker’s lack of personal knowledge, may be proved to affect its weight.
  2. Prior to the videotaped recording being introduced into evidence the court shall first determine that:
    1. The statement is sworn to under oath by the child and the significance of the oath is explained to the child;
    2. The recording is both visual and aural and is recorded on film or videotaped or by other electronic means;
    3. The recording equipment was capable of making an accurate recording, the operator of the equipment was competent, and the recording is accurate and has not been altered;
    4. Every voice on the recording is identified;
    5. The statement was not made in response to questioning calculated to lead the child to make a particular statement;
    6. The person conducting the interview of the child is available to testify at any court proceeding pursuant to this chapter; and
    7. The child shall be available to testify at any court proceeding pursuant to this chapter.

History of Section. P.L. 1985, ch. 371, § 2; P.L. 2018, ch. 189, § 1; P.L. 2018, ch. 262, § 1.

40-11-7.3. Mediation of child protection matters.

The family court may establish a voluntary mediation program for child protection matters. Once established, the court may, with the consent of the parties, refer to mediation all or any portion of a matter relating to child protection matters.

History of Section. P.L. 1997, ch. 59, § 2.

40-11-8. Injury control unit.

The department shall establish a statewide injury-control unit to make possible more intensive protective services to high-risk families with children, and close coordination with a variety of community groups, medical facilities, and medical groups to ensure early detection and reporting of known or suspected abuse to protect the physical and mental well-being of children.

History of Section. P.L. 1976, ch. 91, § 2.

40-11-9. Duties of law enforcement agency.

Upon the receipt of a report concerning the alleged abuse or neglect of a child, it shall be the duty of the law enforcement agency to investigate further and to report the results of the investigation to the department and/or family court; provided, however, if there is reasonable cause to believe that a crime has been committed, the law enforcement agency shall report the result of the investigation to the department of attorney general. The investigation shall include personal contact with the child named in the report and any other children in the same household. The interviewing of the child, or children, if they are of the mental capacity to be interviewed, shall take place in the absence of the person or persons responsible for the alleged neglect or abuse.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1979, ch. 129, § 2; P.L. 1985, ch. 352, § 1; P.L. 1989, ch. 80, § 1.

Collateral References.

Failure of state or local government to protect child abuse victim as violation of federal constitutional rights. 79 A.L.R. Fed. 514.

Tort liability of public authority for failure to remove parentally abused or neglected children from parental custody. 60 A.L.R.4th 942.

40-11-10. Use of physician’s report for petition for removal.

In the case of an ex parte petition for removal under this chapter, a signed physician’s report that a child is abused or neglected as previously defined shall be sufficient to support approval of the ex parte petition for removal.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1979, ch. 248, § 9.

40-11-11. Abrogation of privileged communications.

The privileged quality of communication between husband and wife and any professional person and his or her patient or client, except that between attorney and client, is hereby abrogated in situations involving known or suspected child abuse or neglect and shall not constitute grounds for failure to report as required by this chapter; failure to cooperate with the department in its activities pursuant to this chapter; or failure to give or accept evidence in any judicial proceeding relating to child abuse or neglect. In any family court proceeding relating to child abuse or neglect, notwithstanding the provisions of chapter 37.3 of title 5, or the provisions of § 9-17-24 , no privilege of confidentiality may be invoked with respect to any illness, trauma, incompetency, addiction to drugs, or alcoholism of any parent.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1988, ch. 106, § 1.

NOTES TO DECISIONS

Criminal Trial.

In a first-degree child abuse case, the trial justice did not err by requiring a licensed clinical social worker to testify about statements defendant made to her while seeking mental-health treatment because any privilege under the Confidentiality of Health Care Information Act, § 5-37.3-6 , was rendered a nullity by § 40-11-11 , which unambiguously abrogated all privileges that might otherwise attach to communications between any professional person and his or her patient or client in situations involving known or suspected child abuse or neglect and any such privileges could not justify a failure to give or accept evidence in any judicial proceeding relating to child abuse or neglect. State v. Lefebvre, 198 A.3d 521, 2019 R.I. LEXIS 5 (R.I. 2019).

Collateral References.

Validity, construction, and application of statute limiting physician-patient privilege in judicial proceedings relating to child abuse or neglect. 44 A.L.R.4th 649.

40-11-12. Award of custody.

  1. If the court shall find that a child is abused or neglected within the meaning of this chapter, the court shall by decree duly enter process as follows.
  2. Place the child under the supervision of the department in his or her own home if the court makes a determination that the child will be safely maintained in the home, or award the care, custody, and control of the child to the department upon terms as the court shall determine. The court may place the custody of the child in the department until such time as it finds that the child may be returned to the parents, or other person previously having custody or care of the child, under circumstances consistent with the child’s safety.
  3. The court may require the parent, or person previously having custody, to undertake a program of counseling, including psychiatric evaluation and/or treatment as a prerequisite to the return of the child to his or her custody.
  4. When a child has been placed in the care, custody, and control of the department pursuant to the provisions of this chapter or of chapter 1 of title 14, the court shall have the power to appoint a guardian of the person of the child.
  5. No petition for guardianship shall be granted unless it contains the written consent of the parent or parents previously having custody of the child and of the department of children, youth and families.
  6. The entry of a decree of guardianship pursuant to this section shall terminate the award of custody to the department and the involvement of the department with the child and the child’s parents. The court may revoke a guardianship awarded pursuant to this section if the court finds, after a hearing on a motion for revocation, that continuation of the guardianship is not in the best interests of the child.
  7. Notice of any hearing on such motion shall be provided by the moving party to the department of children, youth and families, the court-appointed special advocate, the parent or guardian, and any and all other interested parties.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1994, ch. 195, § 1; P.L. 1994, ch. 263, § 1; P.L. 1997, ch. 47, § 1; P.L. 1997, ch. 63, § 1; P.L. 1998, ch. 87, § 3; P.L. 2006, ch. 216, § 23.

NOTES TO DECISIONS

Jurisdiction.

Municipal probate courts lack the jurisdiction to decide petitions for guardianship opposed by a parent, which petitions may not be decided without the participation of the family court, as that court alone has the express statutory power to divest a parent of custody and/or parental rights, along with the expertise and resources essential to exercise such power. Carr v. Prader, 725 A.2d 291, 1999 R.I. LEXIS 54 (R.I. 1999).

Parental Compliance With Agency Services.

Although preliminary proceedings taken to protect a child may involve the placement and continued “detention” of an at-risk child in agency care pending an adjudication on an neglect or abuse petition, with the commitment trial establishing the more formal commitment of the child to the agency’s “care, custody, and control” upon an adjudication of abuse or neglect, it is only in conjunction with an adjudication of abuse or neglect that a parent may be required to comply with court-ordered programs and agency services. In re Christina V., 749 A.2d 1105, 2000 R.I. LEXIS 99 (R.I. 2000).

Collateral References.

Construction and effect of statutes mandating consideration of, or creating presumptions regarding, domestic violence in awarding custody of children. 51 A.L.R.5th 241.

Mental health of contesting parent as factor in award of child custody. 53 A.L.R.5th 375.

Parents’ Mental Illness or Mental Deficiency as Ground for Termination of Parental Rights — Issues Concerning Rehabilitative and Reunification Services. 12 A.L.R.6th 417.

40-11-12.1. Family court review.

  1. Within a period of twelve (12) months after a child is placed in the care of the department of children, youth and families pursuant to the provisions of this chapter or § 14-1-5 , or §§ 42-72-14 and 14-1-11.1 , and the child has resided in foster care or, pursuant to §§ 42-72-14 and 14-1-11.1 , has resided in an out-of-home program that provides services for children with disabilities, including, but not limited to, residential-treatment programs, residential counseling centers, and therapeutic foster-care programs, the department of children, youth and families shall file a motion in the family court requesting a permanency hearing on the status of the child.
  2. Notice of the hearing, along with a copy of the motion, shall be served, in accordance with the rules of procedure of the family court, by the department upon all parties in interest.
  3. At the permanency hearing, all parties shall be allowed to be heard and the foster parents, any pre-adoptive parent, or relative providing care for the child shall be provided with notice of, may attend, and present a report, oral or written, containing recommendations as to the best interest of the child, except that this subsection shall not be construed to require that any foster parent, pre-adoptive parent, or relative providing care for the child be made a party to the review or hearing solely on the basis of such notice and opportunity to be heard.
  4. In determining its order of permanency, the court shall consider, among other things:
    1. The appropriateness of the department’s plan for service to the child and parent;
    2. What services have been offered to strengthen and reunite the family;
    3. Where return home of the child is not likely, what efforts have been or should be made to evaluate or plan for other modes of care;
    4. Any further efforts that have been, or will be made, to promote the best interests of the child; and
    5. The child’s health and safety shall be the paramount concern.
  5. At the conclusion of the hearing, the court shall, in accordance with the best interests of the child, enter an order of permanency:
    1. In the case of a child whose care and custody have been transferred to the department of children, youth and families, direct that the child be returned to, and safety maintained in, the home of the parent, guardian, or relative; or
    2. Direct that the child’s placement in foster care continue on a long-term basis or that the child be placed in an independent-living facility; or
    3. Direct that foster care of the child and reunification efforts be continued if the department of children, youth and families, after a hearing, has demonstrated to the court that continuation of the child in foster care and continued reunification efforts for a determinate period is in the child’s best interests. If the court does not return the child to the care and custody of the parent, guardian, or relative and the court does not direct that foster care of the child and reunification efforts be continued, the department shall institute a proceeding within thirty (30) days of the permanency hearing, pursuant to chapter 7 of title 15, to legally free the child for adoption; or
    4. In the case of a child with an emotional, behavioral, or mental disorder or developmental or physical disability who has, pursuant solely to §§ 42-72-14 and 14-1-11.1 , been placed in an out-of-home program that provides services for children with disabilities, including, but not limited to, residential treatment programs, residential counseling centers, and therapeutic foster-care programs, shall determine whether the continuation of such placement is in the best interest of the child; or
    5. For a child who has been placed in foster care by the department for a period of twelve (12) consecutive months, the court shall order that the department institute proceedings for adoption of the child, except in the event that the court determines it is not in the best interest of the child due to one or more of the following factors:
      1. There is a substantial probability that the child shall be returned to the parent within the next three (3) months; or
      2. The parent has maintained regular and consistent visitation and contact with the child, there is a relationship that is beneficial to the child, and there is a substantial probability that the child shall be returned to the parent within the next three (3) months; or
      3. The child is in the care of a relative and the relative is not willing to adopt the child but is willing and capable of providing the child with a stable and permanent environment; or
      4. Any other significant factor that the court finds would not be in the best interest of the child;
      5. The department has documented in the case plan, which shall be presented to the court, a compelling reason for determining that filing a petition for termination of parental rights and a petition for adoption would not be in the best interests of the child; or
      6. The department has not provided to the family of the child, consistent with the time period in the case plan, the services as the department deems necessary for the safe return of the child to the child’s home, if reasonable efforts are required to be made;
    6. In the case of a child who has been in foster care under the temporary custody or custody of the department for fifteen (15) of the most recent twenty-two (22) months, or if the court has determined a child to be abandoned or has made a determination that the parent has engaged in conduct toward any child of a cruel and abusive nature or that the parent has committed murder of another child of the parent, committed voluntary manslaughter of another child of the parent, aided or abetted, attempted, conspired, or solicited to commit such a murder or such a voluntary manslaughter, or committed a felony assault that has resulted in serious bodily injury to the child or to another child of the parent, the department shall file a petition to terminate the parental rights of the child’s parents, and, concurrently, to identify, recruit, process, and approve a qualified family for an adoption, unless:
      1. The child is being cared for by a relative;
      2. The department has documented in the case plan (which shall be available for court review) a compelling reason for determining that filing the petition would not be in the best interests of the child; or
      3. The department has not provided to the family of the child, consistent with the time period in the case plan, such services as the department deems necessary for the safe return of the child to the child’s home, if reasonable efforts are required to be made with respect to the child.
  6. The court shall possess continuing jurisdiction in proceedings under this section and, in the case of children who are continued in foster care or, pursuant to §§ 42-72-14 and 14-1-11.1 , continued in an out-of-home program that provides services for children with disabilities, including, but not limited to, residential treatment programs, residential counseling centers, and therapeutic foster-care programs, shall conduct a further permanency hearing whenever it deems necessary or desirable, but at least every twelve (12) months. Nothing herein shall be construed to preclude the department from filing a termination of parental rights’ petition pursuant to the provisions of chapter 7 of title 15.
  7. Each child continued in foster care shall be afforded a permanency hearing not less frequently than every twelve (12) months during the continuation of foster care, which hearing shall determine the permanency plan for the child that includes whether, and if applicable when, the child will be returned to the parent or placed for adoption with the state filing a petition for termination of parental rights, or referred for legal guardianship, or that the child be placed in another planned permanent-living arrangement in cases where the department has documented to the court a compelling reason for determining that it would not be in the best interests of the child to return home, or be referred for termination of parental rights, or be placed for adoption, or be placed with a fit and willing relative, or with a legal guardian.
  8. For the purpose of this chapter, “entering foster care” is defined as placement of a child in the temporary custody or custody of the department in a foster family home or in a private or public childcare facility licensed by the state.

History of Section. P.L. 1985, ch. 90, § 1; P.L. 1992, ch. 397, § 1; P.L. 1994, ch. 196, § 1; P.L. 1994, ch. 388, § 1; P.L. 1996, ch. 149, § 2; P.L. 1996, ch. 196, § 2; P.L. 1998, ch. 87, § 3.

NOTES TO DECISIONS

Construction With Other Laws.

This section provides only that the government agency must file a motion for a hearing regarding a child’s placement, since the statutory requirement for the agency to request a permanency hearing is triggered by an initial placement of a child into their care. In re Christina V., 749 A.2d 1105, 2000 R.I. LEXIS 99 (R.I. 2000).

The 12-month period in the termination of parental rights statute is separate and distinct from that in the abused children statute in that a parent’s refusal to cooperate with mandatory, court-ordered services after an adjudication of neglect or abuse and a parent’s lack of cooperation with the department of children, youth and families before such an adjudication represent significantly different behaviors under the law, with the latter only being a factor that a court takes into consideration in resolving a petition for termination of parental rights, not the principal ground for such termination. In re Christina V., 749 A.2d 1105, 2000 R.I. LEXIS 99 (R.I. 2000).

Parental Compliance With Agency Services.

The trial justice did not err in considering and relying upon a mother’s refusal to accept services before the child’s formal commitment to agency care as an appropriate factor to be weighed in the termination of parental rights calculus where the child’s siblings were already committed to agency care and the agency had offered and was continuing to offer services to the mother in connection with those children. In re Christina V., 749 A.2d 1105, 2000 R.I. LEXIS 99 (R.I. 2000).

Running of Twelve-Month Period.

The trial justice did not err in interpreting this section as permitting the court to consider a period of 12 months after a child is placed in the care of the department after a probable-cause hearing or pursuant to an ex parte “detention” order, rather than 12 months from the finding of abuse, neglect or dependency in a commitment trial. In re Christina V., 749 A.2d 1105, 2000 R.I. LEXIS 99 (R.I. 2000).

40-11-12.2. Permanency plan — Order of court.

  1. At every regularly scheduled family court review and/or permanency hearing of any child found to be abused or neglected under § 40-11-12 , or dependent under § 14-1-34 , the department shall present a written reunification and/or permanency plan to the court for approval. The plan shall include whether, and if applicable when, the child will be returned to the parent, placed for adoption, referred for legal guardianship, placed with a fit and willing relative, or (in cases whether the department can show the court compelling reasons why the foregoing placements or referrals would not be in the child’s best interests) placed in another planned permanent-living arrangement. The plan shall clearly set forth the goals and obligations of the department, parent(s), child, and all other parties. The plan may be approved and/or modified by a justice of the family court and incorporated into the orders of the court, at the discretion of the court.
  2. In determining reasonable efforts to be made with respect to a child, and in making such reasonable efforts, the child’s health and safety shall be the paramount concern.
  3. Except as provided in subsection (e), reasonable efforts shall be made to preserve and reunify families:
    1. Prior to the placement of a child in foster care, to prevent or eliminate the need for removing the child from the child’s home, which efforts shall include placement of the child with a blood relative or other family member if such placement is in the best interest of the child; and
    2. To make it possible for a child to safely return to the child’s home.
  4. If continuation of reasonable efforts of the type described in subsection (c) is determined to be inconsistent with the permanency plan for the child, reasonable efforts shall be made to place the child in a timely manner in accordance with the permanency plan and to complete whatever steps are necessary to finalize the permanent placement of the child.
  5. Reasonable efforts of the type described in subsection (c) shall not be required to be made with respect to a parent of a child if the court has determined that:
    1. The parent has subjected any child to conduct of a cruel or abusive nature;
    2. The parent has:
      1. Committed murder of another child of the parent; or
      2. Subjected the child to aggravating circumstances, which circumstances shall be abandonment, torture, chronic abuse, and sexual abuse; or
      3. Committed voluntary manslaughter of another child of the parent; or
      4. Aided or abetted, attempted, conspired, or solicited to commit such a murder or such a voluntary manslaughter; or
      5. Committed a felony assault that results in serious bodily injury to the child or another child of the parent; or
    3. The parental rights of the parent to a sibling have been terminated involuntarily.
  6. If reasonable efforts of the type described in subsection (c) are not made with respect to a child as a result of a determination made by the court in accordance with subsection (e):
    1. A permanency hearing shall be held for the child within thirty (30) days after the determination; and
    2. Reasonable efforts shall be made to place the child in a timely manner in accordance with the permanency plan, and to complete whatever steps are necessary to finalize the permanent placement of the child.
  7. Reasonable efforts to place a child for adoption or with a legal guardian may be made concurrently with reasonable efforts of the type described in subsection (c).
  8. In the case of a child with respect to whom the permanency plan is adoption or placement in another permanent home, the permanency plan shall include documentation of the steps the department is taking to find an adoptive family or other permanent-living arrangement for the child, to place the child with an adoptive family, a fit and willing relative, a legal guardian, or in another planned permanent-living arrangement, and to finalize the adoption or legal guardianship. At a minimum, the documentation shall include child-specific recruitment efforts, such as the use of state, regional, and national adoption exchanges, including electronic-exchange systems. The department shall not act, or fail to act, to deny or delay placement of a child for adoption when an approved family is available outside of Rhode Island and no other prospective pre-adoptive home is available.

History of Section. P.L. 1992, ch. 206, § 1; P.L. 1992, ch. 309, § 1; P.L. 1998, ch. 87, § 3.

40-11-12.3. Guardianship subsidy.

The state may make funds available through the department of children, youth and families for special reimbursement to guardians appointed pursuant to this chapter. These funds will be disbursed in accordance with the guidelines to be promulgated by the department of children, youth and families.

History of Section. P.L. 1994, ch. 195, § 2; P.L. 1994, ch. 263, § 2.

40-11-12.4. Restraining orders.

  1. Whenever the family court has assumed jurisdiction by way of the filing of a petition pursuant to chapter 1 of title 14 or chapter 11 of this title, the court, upon notice to the individual to be restrained and after a hearing, may restrain the individual so notified from interfering with the personal liberty of another, and may restrain the individual so notified from maliciously causing, or attempting to cause, bodily harm to another, and may restrain any individual so notified from maliciously causing, or attempting to cause, bodily harm to another and, upon a finding by the court that any person has been so harmed, or threatened with harm, the court may prescribe treatment including, but not limited to, outpatient counseling to the individual so restrained.
  2. As used in this section, the term “individual” shall include any party to the petition or any person acting on behalf of the party.
  3. Restraining orders pursuant to this provision shall be issued in conformity with the hearing and notice requirements set forth in § 15-15-1 et seq.
    1. The family court shall have the authority to enforce any violation of a restraining order entered pursuant to this section by contempt.
    2. The contempt order shall not be exclusive and shall not preclude any other available civil or criminal remedies.
  4. Any violation of a restraining order under this chapter protecting a person against bodily harm and/or against threat of imminent bodily injury shall be a misdemeanor that shall be punished by a fine of not more than one thousand dollars ($1,000) or by imprisonment for not more than one year, or both. The penalties for violation of this section shall also include the penalties provided in § 12-29-5 .

History of Section. P.L. 1997, ch. 48, § 1.

40-11-12.5. Review of young adults under the court’s legal supervision and receiving care and placement services from DCYF.

  1. In the case of a young adult, between the ages of eighteen (18) and twenty-one (21), who has executed a voluntary placement agreement for continued care and placement responsibility from the department and for legal supervision of the court, the permanency plan shall document the reasonable efforts made by the department and the young adult to finalize a permanency plan that addresses the goal of preparing the young adult for independence and successful adulthood. This includes, but is not limited to, housing assistance to obtain supervised independent living arrangements, shared living arrangements or extended foster and kinship care; education, vocational assessment, job training and employment plan needed to transition the young adult to self-sufficiency; assisting the young adult in obtaining educational goals; a job, employment/vocational skills; any other services and supports that will assist the young adult in accessing available services; applying for public benefits; acquiring important documents, such as ID card, driver’s license, birth certificate, social security card, health insurance cards, medical records; attending to physical and mental health needs; maintaining relationships with individuals who are important to them and acquiring information about siblings and other maternal and paternal relatives.
  2. Initial judicial determination — The department must petition the court to make a determination whether remaining in foster care is in the young adult’s best interests.

    The court must make a determination within one hundred eighty (180) days of the signing of the voluntary placement agreement whether remaining in foster care is in the young adult’s best interest.

  3. The court shall conduct a permanency hearing within one year after the young adult and the department execute a voluntary placement agreement and annually thereafter. At the permanency hearing, the department shall present a written case plan to the court for approval that details the necessary services, care and placement the young adult shall receive to assist the transition to independence and successful adulthood.

    The court must determine whether the department has made reasonable efforts to finalize a permanency goal of preparing the young adult for successful transition to independence.

  4. Notice of the court hearings shall be served by the department upon all parties in interest in accordance with the rules of child welfare procedure of the family court.
  5. Periodic formal reviews, shall be held not less than once every one hundred eighty (180) days to assess the progress and case plan of any young adult under the court’s legal supervision and under the care and placement responsibility of DCYF pursuant to a voluntary agreement for extension of care.

    The permanency plan shall be reviewed by the court at least once every twelve (12) months at a permanency hearing and by the department in an administrative review within one hundred eighty (180) days after the permanency hearing. The young adult is expected to participate in case planning and periodic reviews.

History of Section. P.L. 2018, ch. 47, art. 15, § 3.

40-11-13. Confidentiality of reports and records — Penalty for disclosure.

  1. All records concerning reports of child abuse and neglect, including reports made to the department, shall be confidential except as specifically provided by this chapter or as specifically provided by § 42-72-8 or specifically authorized by the family court in furtherance of the purposes directly connected with this chapter.
  2. Any employee or agent of the department violating any of the provisions of this section shall be guilty of a misdemeanor, and shall be fined not more than two hundred dollars ($200) or shall be imprisoned for not more than six (6) months, or both.
  3. Nothing in this chapter shall limit the right of the attorney general to receive all records and reports of child abuse when the office is engaged in the investigation of or prosecution of criminal conduct by another relating to the child or other children within the same family unit.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1985, ch. 347, § 1; P.L. 1999, ch. 54, § 2; P.L. 1999, ch. 122, § 2.

40-11-13.1. Destruction of reports and records.

All records concerning reports of child abuse and neglect made pursuant to this chapter, including reports made to the department, shall be destroyed three (3) years after the date of a final determination by either the family court or the department that the reported child abuse or neglect did not in fact occur.

History of Section. P.L. 1987, ch. 471, § 1.

40-11-14. Right to representation in court proceedings.

  1. Any child who is alleged to be abused or neglected as a subject of a petition filed in family court under this chapter, shall have a guardian ad litem appointed by the court to represent this child. In addition, any young adult, who is eligible for extended foster care pursuant to § 14-1-6(c) and who has executed a voluntary agreement for extension of care may request the appointment of a guardian ad litem or court-appointed counsel. An appointment shall be in the discretion of the court. The cost of counsel in those instances shall be paid by the state.
  2. A volunteer court-appointed special advocate may be assigned to assist the guardian ad litem, in the court-appointed special advocate’s office (CASA):
    1. In order to assist the family court with the ability to ensure that these volunteers, whose activity involves routine contact with minors, are of good moral character, all persons seeking to volunteer for CASA shall be required to undergo a national criminal records check for the purpose of determining whether the prospective volunteer has been convicted of any crime.
      1. A national criminal records check shall include fingerprints submitted to the Federal Bureau of Investigation (FBI) by the department of children, youth and families (DCYF) for a national criminal records check. The national criminal records check shall be processed prior to the commencement of volunteer activity.
      2. For the purposes of this section, “conviction” means, in addition to judgments of conviction entered by a court subsequent to a finding of guilty or a plea of guilty, those instances where the defendant has entered a plea of nolo contendere and has received a sentence of probation and that sentence has not expired and those instances where a defendant has entered into a deferred sentence agreement with the attorney general.
      3. For the purposes of this section, “disqualifying information” means information produced by a national criminal records check pertaining to conviction for the offenses designated as “disqualifying information” pursuant to DCYF policy.
      4. The department of children, youth and families (DCYF) shall inform the applicant, in writing, of the nature of the disqualifying information and, without disclosing the nature of the disqualifying information, shall notify the family court, in writing, that disqualifying information has been discovered.
      5. In those situations in which no disqualifying information has been found, DCYF shall inform the applicant and the family court, in writing, of this fact.
      6. The family court shall maintain on file evidence that national criminal records checks have completed on all volunteer court-appointed special advocates.
      7. The criminal record check shall be conducted without charge to the prospective CASA volunteers. At the conclusion of the background check required pursuant to this section, DCYF shall promptly destroy the fingerprint record of the applicant obtained pursuant to this chapter.
    2. All persons seeking to volunteer for CASA must submit a satisfactory DCYF clearance and participate in a program of training offered by the CASA office.
  3. If the parent or other person responsible for the child’s care is financially unable to engage counsel as determined by the court, the court may, at the request of that person, and in its discretion, appoint the public defender, or other counsel, to represent the person. The cost of other counsel in those instances shall be paid by the state. In every court proceeding under this chapter in which it is a party, the department shall be represented by its legal counsel.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 1981, ch. 324, § 1; P.L. 1982, ch. 377, § 1; P.L. 2017, ch. 127, § 1; P.L. 2017, ch. 147, § 1; P.L. 2018, ch. 47, art. 15, § 2.

NOTES TO DECISIONS

Adoption.

Guardian ad litem had standing to intervene in an adoption proceeding concerning the child after the parents’ rights had been terminated. In re Christina D., 525 A.2d 1306, 1987 R.I. LEXIS 495 (R.I. 1987).

Appointment of Guardian Ad Litem or Court-Appointed Special Advocate.

When proposed next friends of foster children sought to bring suit in federal court on behalf of the children, alleging deficiencies in a state’s foster care system violated the children’s federal constitutional and statutory rights, it was error to find that the appointment of guardians ad litem and/or court-appointed special advocates (CASAs) for the children precluded the appointment of next friends, under Fed. R. Civ. P. 17(c), because Rhode Island law in R.I. Gen. Laws §§ 40-11-7.1(b)(3) and 40-11-14 limited the authority of the guardians ad litem and the CASAs to the family court proceedings in which the guardians ad litem or CASAs were appointed. Sam M. v. Carcieri, 608 F.3d 77, 2010 U.S. App. LEXIS 12552 (1st Cir. 2010).

40-11-15. Religious practices.

A parent or guardian practicing his or her religious beliefs that differ from general community standards who does not provide specified medical treatment for a child shall not, for that reason alone, be considered a negligent parent or guardian. However, nothing in this section shall: (1) Prevent the child from being considered abused or neglected if the child is harmed, or threatened with harm, as described in § 40-11-2 ; or (2) Preclude the court from ordering medical services or nonmedical services recognized by the laws of this state to be provided to the child where his or her health requires it.

History of Section. P.L. 1976, ch. 91, § 2; P.L. 2004, ch. 270, § 1; P.L. 2004, ch. 599, § 1.

Collateral References.

Power of court or other public agency to order medical treatment over parental religious objections for child whose life is not immediately endangered. 21 A.L.R.5th 248.

Refusal of medical treatment on religious grounds as affecting right to recover for personal injury or death. 3 A.L.R.5th 721.

40-11-16. Severability.

If any provision of this chapter or application thereof is held to be invalid, the remainder of the chapter and the application of that provision to other persons or circumstances shall not be affected.

History of Section. P.L. 1976, ch. 91, § 2.

40-11-17. Shaken-baby syndrome prevention initiative.

  1. The department of health shall collaborate with the department of children, youth and families and other state agencies serving families and children, the medical community, law enforcement, human service providers, and child advocacy organizations to develop and implement a comprehensive, statewide initiative to reduce death and disability resulting from shaken-baby syndrome. The initiative shall include, but not be limited to:
    1. Instituting a patient education program on shaken-baby syndrome prevention for all parents of newborns;
    2. Instituting education and training programs on the prevention and diagnosis of shaken-baby syndrome for other parents, caregivers, physicians, and professionals serving children and families;
    3. Assisting in the development of programs to support and serve victims and families affected by shaken-baby syndrome; and
    4. Conducting surveillance and data collection on the incidence of shaken-baby syndrome and traumatic brain injury in infants and young children.
  2. The department of health shall promulgate all rules and regulations necessary to effectuate the purposes of this section.
  3. The department of health, in collaboration with the department of children, youth and families, shall report annually to the general assembly, the status of the shaken-baby syndrome prevention initiative.

History of Section. P.L. 2006, ch. 547, § 2.

40-11-18. Children’s advocacy centers — Services — Requirements.

  1. Children’s advocacy centers shall provide the following services to children in Rhode Island:
    1. Operation of a child-appropriate or child-friendly facility that provides a comfortable, private setting that is both physically and psychologically safe for clients;
    2. Participation in a multidisciplinary team for response to child abuse allegations;
    3. Operation of a legal entity responsible for program and fiscal operations that has established and implemented basic sound administrative practices;
    4. Promotion of policies, practices, and procedures that are culturally competent and diverse;
    5. Conduct forensic interviews in a manner that is of a neutral, fact-finding nature and coordinated to avoid duplicative interviewing;
    6. Provide specialized medical evaluation and treatment made available to clients as part of the team response, either at the CAC or through coordination and referral with other specialized medical providers;
    7. Offer therapeutic intervention through specialized mental health services made available as part of the team response, either at the child advocacy center or through coordination and referral with other appropriate treatment providers;
    8. Offer victim support and advocacy as part of the team response, either at the child advocacy center or through coordination with other providers, throughout the investigation and subsequent legal proceedings;
    9. Conduct team discussions and provide information sharing regarding the investigation, case status, and services needed by the child and family are to occur on a routine basis;
    10. Develop and implement a system for monitoring case progress and tracking case outcomes for team components; and
    11. Shall establish a safe exchange location for children and families who have a parenting agreement or an order providing for visitation or custody of the children that require a safe exchange location.
  2. As used in this section, “cultural competency” means the capacity to function in more than one culture, requiring the ability to appreciate, understand, and interact with members of diverse populations within the local community.

History of Section. P.L. 2018, ch. 189, § 2; P.L. 2018, ch. 262, § 2.

40-11-19. Parents with disabilities.

The department shall investigate reports of child abuse and neglect as mandated in this chapter. A parent’s disability, as defined in § 42-87-1 , will not constitute sole grounds to initiate an investigation or a finding of child abuse or neglect; provided, that nothing in this section shall:

  1. Prevent a child from being considered abused or neglected if a child is harmed or threatened with harm as described in § 40-11-2 ; or
  2. Preclude the court from ordering the furnishing of supportive parenting services to address any impending or actual danger to the child.

History of Section. P.L. 2021, ch. 19, § 2, effective May 26, 2021; P.L. 2021, ch. 20, § 2, effective May 26, 2021.

Compiler's Notes.

P.L. 2021, ch. 19, § 2, and P.L. 2021, ch. 20, § 2 enacted identical versions of this section.

Chapter 12 Child Placement Agencies [Repealed.]

40-12-1 — 40-12-15. [Repealed.]

Repealed Sections.

This chapter (P.L. 1926, ch. 836, §§ 1-10; P.L. 1929, ch. 1417, § 1; G.L. 1938, ch. 373, §§ 1-10; impl. am. P.L. 1939, ch. 660, § 80; G.L. 1956, §§ 40-14-1 40-14-1 4; Reorg. Plan No. 1, 1970; P.L. 1975, ch. 174, § 1; G.L. 1956, §§ 40-12-1 40-12-1 5), concerning child placement agencies, was repealed by both P.L. 1986, ch. 254, § 1, effective June 19, 1986, and P.L. 1986, ch. 274, § 1, effective July 1, 1986. See § 42-72.1-1 et seq.

Chapter 13 Day Nurseries and Homes for Children [Repealed.]

40-13-1 — 40-13-15. [Repealed.]

Repealed Sections.

This chapter (P.L. 1897, ch. 464, §§ 1, 4, 7; G.L. 1909, ch. 141, §§ 1, 4, 7; P.L. 1910, ch. 548, §§ 1, 3; G.L. 1923, ch. 145, §§ 1, 4, 5, 6, 7; P.L. 1926, ch. 835, § 1; P.L. 1926, ch. 847, § 1; P.L. 1926, ch. 1413, §§ 1-4; P.L. 1929, ch. 1413, § 1; P.L. 1935, ch. 2250, § 50; G.L. 1938, ch. 370, §§ 1, 4, 5, 6, 7, 8; G.L. 1938, ch. 372, §§ 1, 4, 5; G.L. 1938, ch. 374, §§ 1-5; P.L. 1946, ch. 1803, § 1; P.L. 1948, ch. 2111, § 1; P.L. 1953, ch. 3223, § 1; G.L. 1956, §§ 40-15-1 40-15-1 4; R.P.L. 1957, ch. 46, § 1; Reorg. Plan No. 1, 1970; G.L. 1956, §§ 40-13-1 40-13-1 4; P.L. 1971, ch. 237, §§ 2, 3; P.L. 1974, ch. 169, § 1; P.L. 1976, ch. 232, § 1; P.L. 1979, ch. 184, § 1; P.L. 1982, ch. 132, § 2; P.L. 1982, ch. 271, § 1; P.L. 1984, ch. 63, § 1; P.L. 1985, ch. 334, § 2; P.L. 1986, ch. 66, § 2), concerning day nurseries and homes for children, was repealed by both P.L. 1986, ch. 254, § 2, effective June 19, 1986, and P.L. 1986, ch. 274, § 2, effective July 1, 1987. See § 42-72.1-1 et seq.

Chapter 13.1 Family Day Care Home Act [Repealed.]

40-13.1-1 — 40-13.1-5. [Repealed.]

Repealed Sections.

This chapter (P.L. 1984, ch. 100, § 1; G.L. 1956, §§ 40-13.1-1 — 40-13.1-5), containing the Family Day Care Act, was repealed by both P.L. 1986, ch. 254, § 3, effective June 19, 1986, and P.L. 1986, ch. 274, § 3, effective July 1, 1986. See § 42-72.1-1 et seq.

Chapter 13.2 Certification of Childcare and Youth-Serving Workers and Operators

40-13.2-1. Definitions.

For the purpose of this chapter:

  1. “Child” means any person less than eighteen (18) years of age, provided that a person over eighteen (18) years of age and not yet twenty-one (21) years of age who is nevertheless subject to continuing jurisdiction of the family court, pursuant to chapter 1 of title 14; or is identified as emotionally disturbed, as defined in chapter 7 of title 40.1 [repealed]; or is identified as developmentally delayed, in accordance with § 40.1-1-8 ; shall be a child for purposes of this chapter.
  2. “Department” means the department of children, youth and families.
  3. “Director” means the director of the department of children, youth and families, or the designee of the director.
  4. “Person” when used to describe the owner or operator of a facility that must be licensed or registered with the department or when used to describe a youth-serving agency worker includes individuals, associations, and corporations.
  5. “Volunteer” means any person providing volunteer services who has supervisory or disciplinary authority over a child or children or whose work involves routine contact with a child or children without the presence of other employees or volunteers.
  6. “Youth-serving agency” means any facility or program that is operated for more than two (2) hours per day at least one day per week and that provides programs and activities for children and employs persons who have supervisory or disciplinary authority over a child or children. School programs operated by schools certified under the provisions of title 16 are not considered youth-serving agencies pursuant to this chapter.
  7. “Youth-serving agency worker” means any person in the employ of a youth-serving agency who has supervisory or disciplinary authority over a child or children or whose work involves routine contact with a child or children without the presence of other employees. This shall include any private vendor, independent contractor, contract employee or those who are hired by a third party that has contracted with the youth-serving agency to provide services and whose work involves routine contact with a child or children without the presence of other employees.

History of Section. P.L. 1985, ch. 334, § 1; P.L. 1997, ch. 217, § 2; P.L. 1997, ch. 228, § 2; P.L. 1997, ch. 322, § 2; P.L. 2017, ch. 401, § 1.

Compiler’s Notes.

Chapter 7 of title 40.1, referred to in this section, was repealed by P.L. 1997, ch. 73, § 2, effective July 1, 1997. For present comparable provisions, see § 42-72-5(b)(24) .

Collateral References.

Governmental liability for negligence in licensing, regulating, or supervising private day-care home in which child is injured. 68 A.L.R.4th 266.

Tort liability of private nursery school or daycare center, or employee thereof, for injury to child while attending facility. 58 A.L.R.4th 240.

40-13.2-2. Qualification for childcare employment.

Notwithstanding any other provisions of law to the contrary, any person seeking to operate or seeking employment in any facility which is, or is required to be, licensed or registered with the department of children, youth and families, the department of human services, or seeking employment at the training school for youth if that employment involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees, shall undergo an employment background check, a CANTS (child abuse and neglect tracking system) check of substantiated complaints, and criminal records check as provided for in this chapter. The director of the department of children, youth and families and the director of the department of human services may by rule identify those positions requiring background checks, CANTS checks, and criminal records checks.

History of Section. P.L. 1985, ch. 334, § 1; P.L. 1990, ch. 411, § 1; P.L. 2019, ch. 88, art. 3, § 8.

40-13.2-3. Employment background checks.

Any person seeking to operate a facility which is, or is required to be, licensed or registered with the department will submit an affidavit to the department providing information relating to individual employment history as shall be required by rule promulgated by the director. Any person operating a facility which is, or is required to be, licensed or registered with the department shall require all persons seeking employment, if that employment involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees, to execute a similar affidavit prior to employment and will maintain the affidavit on file subject to inspection by the director. Failure to require the affidavit or failure to maintain the affidavit on file will be prima facie grounds to revoke the license or registration of the operator of the facility.

History of Section. P.L. 1985, ch. 334, § 1.

40-13.2-3.1. CANTS (Child Abuse and Neglect Tracking System) check — Operators and employees.

Any person seeking to operate a facility which is, or is required to be, licensed or registered with the department or who is seeking employment, if the employment involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees in any facility which is, or is required to be, licensed or registered with the department or who is seeking such employment at the training school for youth shall, after acceptance by the employer of the affidavit required by § 40-13.2-3 , apply to the appropriate agency for a CANTS (child abuse and neglect tracking system) check. The department is authorized and directed to promulgate rules and regulations to impose such fees or charges as may be appropriate to implement the provisions of this section.

History of Section. P.L. 1990, ch. 411, § 2; P.L. 2011, ch. 151, art. 17, § 2.

40-13.2-4. Criminal records check — Operators of childcare facilities that must be licensed or registered with the department.

Any person seeking to operate a facility, that is, or is required to be, licensed or registered with the department of human services or the department of children, youth and families, shall apply to the Rhode Island bureau of criminal identification, attorney general’s office, or the department of children, youth and families or the state or local police department, for a nationwide criminal records check. The check will conform to the applicable federal standards, including the taking of fingerprints to identify the applicant, and any expense associated with providing the criminal records check shall be paid by the applicant and/or requesting agency. The director of the department of human services or the department of children, youth and families will determine by rule those items of information appearing on a criminal records check that constitute disqualifying information because that information would indicate that the employment could endanger the health or welfare of a child or children. Upon the discovery of any disqualifying information with respect to a proposed operator, the Rhode Island bureau of criminal identification will inform the director of the department of human services or the department of children, youth and families, in writing, of the nature of the disqualifying information.

History of Section. P.L. 1985, ch. 334, § 1; P.L. 1988, ch. 247, § 1; P.L. 1997, ch. 217, § 2; P.L. 1997, ch. 228, § 2; P.L. 1997, ch. 322, § 2; P.L. 2011, ch. 220, § 2; P.L. 2011, ch. 240, § 2; P.L. 2016, ch. 147, § 3; P.L. 2016, ch. 154, § 3; P.L. 2019, ch. 88, art. 3, § 8.

40-13.2-4.1. Criminal records check — Operators of youth-serving agencies.

  1. Any person seeking to operate a facility or program which is a youth-serving agency shall apply to the bureau of criminal identification of the attorney general’s office for a criminal records check. Those items of information appearing on a criminal records check that have been determined to constitute disqualifying information by the director pursuant to § 40-13.2-4 of this chapter shall also constitute items of disqualifying information pursuant to this section.
  2. Upon the discovery of any disqualifying information, as defined in accordance with the rule promulgated by the director, the bureau of criminal identification of the attorney general’s office will inform the applicant, in writing, of the nature of the disqualifying information. In addition, the bureau of criminal identification of the attorney general’s office will inform the applicant, in writing, without disclosing the nature of the disqualifying information, that an item of disqualifying information has been discovered.
  3. In those situations in which no disqualifying information has been found, the bureau of criminal identification of the attorney general’s office will inform the applicant, in writing, of this fact.
  4. The operator or proposed operator of the youth-serving agency will maintain on file a document issued by the bureau of criminal identification of the attorney general’s office stating that no disqualifying information has been discovered as regards the operator or proposed operator of the youth-serving agency, and this document shall be made available for inspection by the parent(s)/guardian(s) of any child enrolled in the programs of the youth-serving agency. The operator will also maintain on file, and make available for inspection by the parent(s)/guardian(s) of any child enrolled in the programs of the youth-serving agency, evidence that criminal records checks have been obtained on all employees of the youth-serving agency pursuant to § 40-13.2-5.1 , and the results of the checks.

History of Section. P.L. 1997, ch. 217, § 3; P.L. 1997, ch. 228, § 3; P.L. 1997, ch. 322, § 3; P.L. 2006, ch. 216, § 24.

40-13.2-5. Criminal records check — Employees of child day care, daycare centers, family daycare homes, group family daycare homes, child-placing agencies and residential childcare facilities that must be licensed by the department.

  1. Any person seeking employment in a “child day care” program, a “family daycare home,” “group family daycare home,” or in a “child daycare center” as defined in § 42-12.5-2 , if that employment involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees, or any adult household member of any operator of a “family daycare home” and “group family daycare home,” or seeking that employment or to volunteer at the training school for youth, shall, after acceptance by the employer of the affidavit required by § 40-13.2-3 , apply to the bureau of criminal identification of the state police or the local police department, or the office of the attorney general, or the department of children, youth and families, for a nationwide criminal records check. The check will conform to applicable federal standards including the taking of fingerprints to identify the applicant. Further, any person seeking employment in a “child day care” program, in a “child daycare center,” and/or in a “child daycare provider” as defined in § 42-12.5-2 , if that employment involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees shall apply to the bureau of criminal identification of the state police or the local police department or the office of the attorney general to conduct all necessary criminal background checks as required by the Child Care and Development Block Grant of 2014 (CCDBGA), Pub. L. No. 113-186. The criminal record checks as required by this section shall be conducted for every five (5) years of continuous childcare employment from the date of the previous criminal background check.
  2. Any person seeking employment in a “child-placing agency” as defined in § 42-72.1-2 , if that employment involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees, shall, after acceptance by the employer of the affidavit required by § 40-13.2-3 , apply to the bureau of criminal identification of the state police or the local police department, or the office of the attorney general or the department of children, youth and families, for a nationwide criminal records check. The check will conform to applicable federal standards including the taking of fingerprints to identify the applicant.
  3. Any person seeking employment in a “childcaring agency,” “children’s behavioral health program,” or in a “foster and adoptive home” as defined in § 42-72.1-2 , that is, or is required to be, licensed or registered with the department of children, youth and families, shall, after acceptance by the employer of the affidavit required by § 40-13.2-3 , apply to the bureau of criminal identification of the state police or the local police department, or the office of the attorney general, or the department of children, youth and families, for a nationwide criminal records check. The check will conform to applicable federal standards including the taking of fingerprints to identify the applicant.
  4. [Deleted by P.L. 2019, ch. 88, art. 3, § 8.]
  5. Upon the discovery of any disqualifying information as defined in accordance with the rule promulgated by the director, the bureau of criminal identification of the state police or the local police department or the office of the attorney general or the department of children, youth and families will inform the applicant, in writing, of the nature of the disqualifying information. In addition, the bureau of criminal identification of the state police or the office of the attorney general, or department of children, youth and families, or the local police department will inform the relevant employer, in writing, without disclosing the nature of the disqualifying information, that an item of disqualifying information has been discovered.
  6. In those situations in which no disqualifying information has been found, the bureau of criminal identification of the state police or the local police department or the office of the attorney general, or the department of children, youth and families will inform both the applicant and the employer, in writing, that no disqualifying information has been found.
  7. Failure to show proof that the employer has initiated requests for background checks required by this section will be prima facie grounds to revoke the license or registration of the operator of the facility.
  8. It will be the responsibility of the bureau of criminal identification of the state police or the office of the attorney general, or the local police department, or the department of children, youth and families, to conduct the nationwide criminal records check pursuant to this section. The nationwide criminal records check will be provided to the applicant for employment. Any expense associated for providing the criminal records check shall be paid by the applicant and/or the requesting agency.

History of Section. P.L. 1985, ch. 334, § 1; P.L. 1988, ch. 247, § 1; P.L. 1997, ch. 217, § 2; P.L. 1997, ch. 228, § 2; P.L. 1997, ch. 322, § 2; P.L. 2004, ch. 37, § 1; P.L. 2004, ch. 118, § 1; P.L. 2006, ch. 216, § 24; P.L. 2016, ch. 147, § 3; P.L. 2016, ch. 154, § 3; P.L. 2019, ch. 88, art. 3, § 8.

NOTES TO DECISIONS

Discharge Based on Criminal Record.

An arbitrator exceeded his powers in making a decision that the Department of Children, Youth and Families lacked just cause to discharge an employee of the State Training School, despite the employee’s convictions of violent crimes subsequent to his employment. State Dep't of Children, Youth & Families v. Rhode Island Council 94, AFSCME, 713 A.2d 1250, 1998 R.I. LEXIS 207 (R.I. 1998).

40-13.2-5.1. Criminal records check — Employee of youth-serving agency.

  1. Any person seeking employment or seeking to volunteer, if that employment or volunteering involves supervisory or disciplinary power over a child or children or involves routine contact with a child or children without the presence of other employees, in any facility or program that is a youth-serving agency shall file with the employer the affidavit required by § 40-13.2-3 . The affidavit shall be maintained on file by the employer and shall be made available for inspection by the parent(s)/guardian(s) of any child who is enrolled in the programs of the youth-serving agency.
  2. Any person seeking employment or seeking to volunteer, if that employment or volunteering involves supervisory or disciplinary authority over a child or children or involves routine contact with a child or children without the presence of other employees, in any youth-serving agency shall apply for a national criminal records check. The national criminal records check shall include fingerprints submitted to the Federal Bureau of Investigation (FBI) by the bureau of criminal identification of the department of the attorney general, the division of the state police, or the local police department for a national criminal records check. The national criminal records check shall be processed prior to the commencement of employment or volunteer activity.
  3. Those items of information appearing on a national criminal records check that have been determined to constitute disqualifying information by the director pursuant to § 40-13.2-4 shall also be items of disqualifying information pursuant to this section.
  4. Upon the discovery of any disqualifying information as defined in accordance with the rule promulgated by the director, the bureau of criminal identification of the department of the attorney general, the division of the state police, or the local police department will inform the applicant, in writing, of the nature of the disqualifying information. In addition, the bureau of criminal identification of the department of the attorney general, the division of the state police, or the local police department will inform the applicant, in writing, without disclosing the nature of the disqualifying information, that an item of disqualifying information has been discovered.
  5. In those situations in which no disqualifying information has been found, the bureau of criminal identification of the department of the attorney general, the division of the state police, or the local police department will inform both the applicant and the employer, in writing, of this fact.
  6. The employer will maintain on file, and make available for inspection by the parent(s)/guardian(s) of any child enrolled in the programs of the youth-serving agency, evidence that criminal records checks have been obtained on all employees of the youth-serving agency pursuant to this section, and the results of the checks.
  7. The applicant shall be responsible for the cost of conducting the national criminal records check through the bureau of criminal identification of the department of the attorney general, the division of the state police, or the local police department.

History of Section. P.L. 1997, ch. 217, § 3; P.L. 1997, ch. 228, § 3; P.L. 1997, ch. 322, § 3; P.L. 2006, ch. 216, § 24; P.L. 2017, ch. 401, § 1.

40-13.2-5.2. Criminal records check — Employees of the department of children, youth and families.

  1. Any person seeking employment with the department of children, youth and families shall apply to the bureau of criminal identification (BCI), department of attorney general, state police, or local police department where the applicant resides, or the department of children, youth and families, for a national and state criminal records check. The check shall conform to the applicable federal standards, including the taking of fingerprints to identify the applicant. The director shall determine by rule those items of information appearing on a criminal records check that constitute disqualifying information because the information would indicate that employment could endanger the health or welfare of a child or children and would be inconsistent with the purpose and intent of the department of children, youth and families.
  2. The department of attorney general, the state police, or the local police department shall forward the results of the nationwide and state criminal record checks, including the nature of any criminal record, on the individual to the individual and to the department of children, youth and families. Upon the discovery of any disqualifying information with respect to an applicant, the department of children, youth and families shall inform the applicant of the disqualifying information.
  3. The cost of criminal record checks required by this section for individuals who are not currently employed by the state of Rhode Island shall be the responsibility of the applicant. The cost of criminal records checks required by this section for individuals who are currently employed by the state of Rhode Island shall be the responsibility of the department of children, youth and families.
  4. Any individual required to submit to a criminal background check, state and/or federal, under subsection (a) above who has submitted to a criminal background check conducted within the previous six (6) months in accordance with § 14-1-34 and/or § 15-7-11 and/or §§ 40-13.2-2 , 40-13.2-4 , 40-13.2-5 , and/or § 40-13.2-9, shall be exempt from an additional check but shall request the department of attorney general, the state police, or the local police department that conducted the check forward the results, including the nature of the criminal record, to the department of children, youth and families.

History of Section. P.L. 2011, ch. 234, § 1; P.L. 2011, ch. 252, § 1; P.L. 2016, ch. 147, § 3; P.L. 2016, ch. 154, § 3.

40-13.2-6. Prior criminal records checks.

If an applicant for employment has undergone a criminal records check pursuant to § 40-13.2-4 , 40-13.2-4.1 , 40-13.2-5 , or 40-13.2-5 .1 within eighteen (18) months of an application for employment, then an employer may request from the bureau of criminal identification of the state police or the local police department or the attorney general’s office for employees of youth-serving agencies pursuant to §§ 40-13.2-4.1 and 40-13.2-5.1 a letter indicating if any disqualifying information was discovered. The bureau of criminal identification will respond by stating if an item of disqualifying information was discovered without disclosing the nature of the disqualifying information or by stating that no disqualifying information was discovered. The letter may be maintained on file to satisfy the requirements of § 40-13.2-4 , 40-13.2-4.1, 40-13.2-5, or 40-13.2-5.1 .

History of Section. P.L. 1985, ch. 334, § 1; P.L. 1988, ch. 247, § 1; P.L. 1997, ch. 217, § 2; P.L. 1997, ch. 228, § 2; P.L. 1997, ch. 322, § 2.

40-13.2-7. Rules and regulations.

The director is authorized to promulgate rules and regulations to carry out the intent of this chapter.

History of Section. P.L. 1985, ch. 334, § 1.

40-13.2-8. Destruction of fingerprint records.

At the conclusion of any background check required by this chapter, the state police or the local police department will promptly destroy the fingerprint card of the applicant.

History of Section. P.L. 1986, ch. 66, § 1; P.L. 1988, ch. 247, § 1.

Chapter 14 Equipment Loan Fund for People with Disabilities

40-14-1. Definitions.

For the purpose of this chapter, the following terms shall have the following meanings:

  1. “Department” means the state department of human services.
  2. “Director” means the director of the department of human services.
  3. “Fund” means the equipment loan fund for people with disabilities.
  4. “Person with a disability” means any person who has a physical or mental impairment, whether congenital or resulting from trauma or disease, that substantially limits one or more major life activities.

History of Section. P.L. 1988, ch. 611, § 1; P.L. 1999, ch. 83, § 102; P.L. 1999, ch. 130, § 102.

Repealed Sections.

Former chapter 14 of this title (P.L. 1963, ch. 107, §§ 1, 3; Reorg. Plan No. 1, 1970), consisting of §§ 40-14-1 40-14-6 and concerning the committee on children and youth, was repealed by P.L. 1979, ch. 248, § 7 and P.L. 1979, ch. 350, § 1. For present comparable provisions, see § 42-73-1 et seq. and § 42-74-1 .

40-14-2. Fund established.

There is hereby established a separate fund within the general fund to be called the equipment loan fund for people with disabilities, which shall be administered by the general treasurer in accordance with the same laws and fiscal procedures as the general funds of the state. There is hereby appropriated to this fund the sum of one hundred thousand dollars ($100,000). The department through its vocational rehabilitation agency shall be responsible for the administration of the program but may contract with organizations in carrying out the provisions of this chapter. All payments of interest and repayments of principal made by recipients of loans under this chapter shall be credited to general revenues.

History of Section. P.L. 1988, ch. 611, § 1; P.L. 1995, ch. 370, art. 40, § 122; P.L. 1999, ch. 83, § 102; P.L. 1999, ch. 130, § 102.

40-14-3. Purpose of fund.

The fund shall provide loans to finance the purchase or replacement of essential equipment used by persons with disabilities for daily living or vocational functioning, including, but not limited to, prostheses, ramps, wheelchairs, wheelchair van lifts, and devices enabling persons with vision impairment to utilize printed materials.

History of Section. P.L. 1988, ch. 611, § 1; P.L. 1999, ch. 83, § 102; P.L. 1999, ch. 130, § 102.

40-14-4. Eligibility.

Eligibility for loans from the fund shall be based upon need pursuant to rules and regulations promulgated by the director. It is the intent of the general assembly that loans from the fund be available to persons with disabilities whose personal financial resources are such that they cannot purchase the equipment directly without undue hardship.

History of Section. P.L. 1988, ch. 611, § 1; P.L. 1999, ch. 83, § 102; P.L. 1999, ch. 130, § 102.

40-14-5. Persons to whom available.

Loans shall be made available directly to the person with a disability or, where appropriate, to the parent or legal guardian of the person with a disability.

History of Section. P.L. 1988, ch. 611, § 1; P.L. 1999, ch. 83, § 102; P.L. 1999, ch. 130, § 102.

40-14-6. Maximum loan.

Loans from the fund shall not exceed a total of five thousand dollars ($5,000) per applicant.

History of Section. P.L. 1988, ch. 611, § 1.

40-14-7. Interest rates.

Interest rates for loans from the fund shall be established by the director; provided, however, that those rates shall be substantially lower than the prevailing rate of interest in this state for comparable loans, and shall not exceed five percent (5%). The term of the loan shall not exceed ten (10) years.

History of Section. P.L. 1988, ch. 611, § 1.

40-14-8. Rules and regulations.

The director shall, with the advice of the governor’s commission on disabilities, promulgate rules and regulations concerning eligibility, interest rates, repayment terms, and other matters as are necessary and proper to carry out the purpose of this chapter.

History of Section. P.L. 1988, ch. 611, § 1; P.L. 1999, ch. 83, § 102; P.L. 1999, ch. 130, § 102.

40-14-9. Reports.

The director shall file reports with the governor and the general assembly on or before January 30, 1989, 1990, and 1991. Each report shall include a detailed accounting of the loans from and repayments to the fund during the preceding calendar year; the director’s recommendation as to whether the fund’s maximum total loan authority, as set forth in § 40-14-6 , should be increased or reduced; and other information as the director deems relevant to an evaluation of the performance of the fund.

History of Section. P.L. 1988, ch. 611, § 1.

40-14-10. Loans.

Loans made under the provisions of this chapter shall be exempt from truth in lending and loan licensure provisions of the Rhode Island general laws.

History of Section. P.L. 1988, ch. 611, § 1.

Chapter 14.1 Technology-Related Assistance for Individuals with Disabilities Program

40-14.1-1. Authority to establish program — Administration.

The department of human services is hereby authorized to establish a technology-related assistance for individuals with disabilities program. The department of human services shall be responsible for the administration of the program but may contract with other state agencies or nonprofit organizations in connection with the program. The director shall promulgate rules and regulations concerning eligibility and such other matters as are necessary and proper to carry out the purposes of this chapter. This program shall be administered in a manner to supplement but not supplant other existing programs.

History of Section. P.L. 1990, ch. 417, § 1.

40-14.1-2. Assistive technology services.

Services that may be provided eligible persons if not available from other sources include assistive technology services and devices. For the purposes of this chapter, “assistive technology services” shall mean any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device. Services shall include:

  1. The evaluation of the needs of an individual with a disability, including a functional evaluation of the individual in the individual’s customary environment;
  2. Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by individuals with disabilities;
  3. Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing of assistive technology devices;
  4. Coordinating of resources and services related to assistive technology devices;
  5. Training or technical assistance for an individual with disabilities, or, where appropriate, the family of an individual with disabilities; and
  6. Training or technical assistance for professionals (including individuals providing education and rehabilitation services), employers, or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of individuals with disabilities. For the purpose of this chapter, “assistive technology device” means any item, piece of equipment, or product system, whether acquired commercially, off the shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

History of Section. P.L. 1990, ch. 417, § 1.

40-14.1-3. Eligibility for services.

Services available under this chapter may be provided to any person who meets the following criteria:

  1. Has made application therefor to the director of the department of human services in a manner prescribed by the director;
  2. Has a physical or mental impairment that substantially limits one or more major life activities;
  3. Who is or would be enabled by assistive technology devices or services to increase, maintain, or improve a level of functioning in daily living and/or vocational functioning; and
  4. Has not sufficient income or resources, including being available from other sources, to meet the cost of any or all of the services described in § 40-14.1-2 , determination of the insufficiency to be made by the division of community services of the department of human services.

History of Section. P.L. 1990, ch. 417, § 1.

Collateral References.

What constitutes substantial limitation on major life activity of working for purposes of Americans with Disabilities Act (42 U.S.C. §§ 12101-12213). 141 A.L.R. Fed. 603.

When is individual regarded as having, or perceived to have, impairment within meaning of Americans with Disabilities Act (42 U.S.C. § 12102(2)(c)). 148 A.L.R. Fed. 305.

40-14.1-4. When services may be provided.

The services as described in § 40-14.1-2 may be provided when: (1) The requirements of § 40-14.1-3 are fulfilled; and (2) Funds are available to provide the services or devices.

History of Section. P.L. 1990, ch. 417, § 1.

40-14.1-5. Appropriations.

There is hereby appropriated to the department of human services funds to implement a technology-related assistance to individuals with disabilities program.

History of Section. P.L. 1990, ch. 417, § 1.

40-14.1-6. Acceptance and use of gifts, grants, or fees.

The department of human services is hereby authorized and empowered to accept and use gifts made unconditionally by will or otherwise, grants or fees from third-party payees for services provided for carrying out the purposes of this chapter.

History of Section. P.L. 1990, ch. 417, § 1.

Chapter 15 Interstate Compact on the Placement of Children

40-15-1. Compact enacted.

The interstate compact on the placement of children is hereby enacted into law and entered into with all other jurisdictions legally joining therein in form substantially as follows:

THE INTERSTATE COMPACT ON THE PLACEMENT OF CHILDREN

ARTICLE I — PURPOSE AND POLICY

It is the purpose and policy of the party states to cooperate with each other in the interstate placement of children to the end that:

  1. Each child requiring placement shall receive the maximum opportunity to be placed in a suitable environment and with persons or institutions having appropriate qualifications and facilities to provide a necessary and desirable degree and type of care.
  2. The appropriate authorities in a state where a child is to be placed may have full opportunity to ascertain the circumstances of the proposed placement, thereby promoting full compliance with applicable requirements for the protection of the child.
  3. The proper authorities of the state from which the placement is made may obtain the most complete information on the basis of which to evaluate a projected placement before it is made.
  4. Appropriate jurisdictional arrangements for the care of children will be promoted.

    As used in this compact:

ARTICLE II — DEFINITIONS

  1. “Child” means a person who, by reason of minority, is legally subject to parental guardianship or similar control.
  2. “Sending agency” means a party state, officer or employee thereof; a subdivision of a party state, or officer or employee thereof; a court of a party state; a person, corporation, association, charitable agency or other entity which sends, brings, or causes to be sent or brought any child to another party state.
  3. “Receiving state” means the state to which a child is sent, brought, or caused to be sent or brought, whether by public authorities or private persons or agencies, and whether for placement with state or local public authorities or for placement with private agencies or persons.
  4. “Placement” means the arrangement for the care of a child in a family free or boarding home or in a child-caring agency or institution but does not include any institution caring for people who are mentally ill, or any institution primarily educational in character, and any hospital or other medical facility.

ARTICLE III — CONDITIONS FOR PLACEMENT

  1. No sending agency shall send, bring, or cause to be sent or brought into any other party state any child for placement in foster care or as a preliminary to a possible adoption unless the sending agency shall comply with each and every requirement set forth in this article and with the applicable laws of the receiving state governing the placement of children therein.
  2. Prior to sending, bringing or causing any child to be sent or brought into a receiving state for placement in foster care or as a preliminary to a possible adoption, the sending agency shall furnish the appropriate public authorities in the receiving state written notice of the intention to send, bring, or place the child in the receiving state. The notice shall contain:
    1. The name, date and place of birth of the child;
    2. The identity and address or addresses of the parents or legal guardian;
    3. The name and address of the person, agency or institution to or with which the sending agency proposes to send, bring, or place the child; and
    4. A full statement of the reasons for such proposed action and evidence of the authority pursuant to which the placement is proposed to be made.
  3. Any public officer or agency in a receiving state which is in receipt of a notice pursuant to paragraph (b) of this article may request of the sending agency, or any other appropriate officer or agency of or in the sending agency’s state, and shall be entitled to receive therefrom, such supporting or additional information as it may deem necessary under the circumstances to carry out the purpose and policy of this compact.
  4. The child shall not be sent, brought, or caused to be sent or brought into the receiving state until the appropriate public authorities in the receiving state shall notify the sending agency, in writing, to the effect that the proposed placement does not appear to be contrary to the interests of the child.

ARTICLE IV — PENALTY FOR ILLEGAL PLACEMENT

The sending, bringing, or causing to be sent or brought into any receiving state of a child in violation of the terms of this compact shall constitute a violation of the laws respecting the placement of children of both the state in which the sending agency is located or from which it sends or brings the child and of the receiving state. Such violation may be punished or subjected to penalty in either jurisdiction in accordance with its laws. In addition to liability for any such punishment or penalty, any such violation shall constitute full and sufficient grounds for the suspension or revocation of any license, permit, or other legal authorization held by the sending agency which empowers or allows it to place, or care for children.

ARTICLE V — RETENTION OF JURISDICTION

  1. The sending agency shall retain jurisdiction over the child sufficient to determine all matters in relation to the custody, supervision, care, treatment and disposition of the child which it would have had if the child had remained in the sending agency’s state, until the child is adopted, reaches majority, becomes self-supporting or is discharged with the concurrence of the appropriate authority in the receiving state. Such jurisdiction shall also include the power to effect or cause the return of the child or its transfer to another location and custody pursuant to law. The sending agency shall continue to have financial responsibility for support and maintenance of the child during the period of the placement. Nothing contained herein shall defeat a claim of jurisdiction by a receiving state sufficient to deal with an act of delinquency or crime committed therein.
  2. When the sending agency is a public agency, it may enter into an agreement with an authorized public or private agency in the receiving state providing for the performance of one or more services in respect of such case by the latter as agent for the sending agency.
  3. Nothing in this compact shall be construed to prevent a private charitable agency authorized to place children in the receiving state from performing services or acting as agent in that state for a private charitable agency of the sending state; nor to prevent the agency in the receiving state from discharging financial responsibility for the support and maintenance of a child who has been placed on behalf of the sending agency without relieving the responsibility set forth in paragraph (a) hereof.

ARTICLE VI — INSTITUTIONAL CARE OF DELINQUENT CHILDREN

A child adjudicated delinquent may be placed in an institution in another party jurisdiction pursuant to this compact but no such placement shall be made unless the child is given a court hearing on notice to the parent or guardian with opportunity to be heard, prior to his or her being sent to such other party jurisdiction for institutional care and the court finds that:

  1. equivalent facilities for the child are not available in the sending agency’s jurisdiction; and
  2. institutional care in the other jurisdiction is in the best interest of the child and will not produce undue hardship.

ARTICLE VII — COMPACT ADMINISTRATOR

The executive head of each jurisdiction party to this compact shall designate an officer who shall be general coordinator of activities under this compact in his or her jurisdiction and who, acting jointly with like officers of other party jurisdictions, shall have power to promulgate rules and regulations to carry out more effectively the terms and provisions of this compact.

ARTICLE VIII — LIMITATIONS

This compact shall not apply to:

  1. The sending or bringing of a child into a receiving state by his or her parent, step-parent, grandparent, adult brother or sister, adult uncle or aunt, or his guardian and leaving the child with any such relative or nonagency guardian in the receiving state;
  2. Any placement, sending or bringing of a child into a receiving state pursuant to any other interstate compact to which both the state from which the child is sent or brought and the receiving state are party, or to any other agreement between said states which has the force of law.

ARTICLE IX — ENACTMENT AND WITHDRAWAL

This compact shall be open to joinder by any state, territory or possession of the United States, the District of Columbia, the Commonwealth of Puerto Rico, and, with the consent of congress, the government of Canada or any province thereof. It shall become effective with respect to any such jurisdiction when such jurisdiction has enacted the same into law. Withdrawal from this compact shall be by the enactment of a statute repealing the same, but shall not take effect until two (2) years after the effective date of such statute and until written notice of the withdrawal has been given by the withdrawing state to the governor of each other party jurisdiction. Withdrawal of a party state shall not affect the rights, duties and obligations under this compact of any sending agency therein with respect to a placement made prior to the effective date of withdrawal.

ARTICLE X — CONSTRUCTION AND SEVERABILITY

The provisions of this compact shall be liberally construed to effectuate the purposes thereof. The provisions of this compact shall be severable and if any phrase, clause, sentence or provision of this compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby. If this compact shall be held contrary to the constitution of any state party thereto, the compact shall remain in full force and effect as to the remaining states and in full force and effect as to the state affected as to all severable matters.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-1 ; Reorg. Plan No. 1, 1970; P.L. 1999, ch. 83, § 103; P.L. 1999, ch. 130, § 103.

Comparative Legislation.

Interstate Compact on Placement of Children:

Conn. Gen. Stat. § 17a-175.

Mass. Ann. Laws Spec. L. ch. S95, § 1 et seq.

NOTES TO DECISIONS

Placement in Other State.

A trial court’s order placing a minor child in Florida without the prior consent of that state manifestly violated the terms of this section and was therefore illegal. In re Paula G., 672 A.2d 872, 1996 R.I. LEXIS 46 (R.I. 1996).

40-15-2. Applicability of license, permit, and bond provisions.

Any requirement of this state for a license, permit, or the posting of a bond to entitle an agency to place children shall not apply to a public sending agency (within the meaning of the Interstate Compact on the Placement of Children) of or in another state party to the Interstate Compact on the Placement of Children.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-2 ; Reorg. Plan No. 1, 1970.

40-15-3. Financial responsibility.

Financial responsibility for any child placed pursuant to the provisions of the Interstate Compact on the Placement of Children shall be determined in accordance with the provisions of article V thereof in the first instance. However, in the event of partial or complete default of performance thereunder, the laws of this state fixing responsibility for the support of children may be invoked.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-3 ; Reorg. Plan No. 1, 1970.

40-15-4. “Appropriate public authorities” defined.

The “appropriate public authorities” as used in article III of the Interstate Compact on the Placement of Children shall, with reference to this state, mean the department of children, youth and families and that department shall receive and act with reference to notices required by article III.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-4; Reorg. Plan No. 1, 1970.

40-15-5. “Appropriate authority in the receiving state” defined.

As used in paragraph (a) of article V of the Interstate Compact on the Placement of Children, the phrase “appropriate authority in the receiving state” with reference to this state shall mean the department of children, youth and families.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-5; Reorg. Plan No. 1, 1970.

40-15-6. Interstate agreements.

The officers and agencies of this state and its subdivisions having authority to place children are hereby empowered to enter agreements with appropriate officers or agencies of or in other party states pursuant to paragraph (b) of article V of the Interstate Compact on the Placement of Children. Any agreement that contains a financial commitment or imposes a financial obligation on this state or subdivision or agency thereof shall not be binding unless it has the approval in writing of the director of administration.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-6; Reorg. Plan No. 1, 1970.

40-15-7. Visitation, inspection, or supervision of children, homes, institutions, or other agencies.

Any requirements for visitation, inspection, or supervision of children, homes, institutions, or other agencies in another party state that may apply under chapter 72.1 of title 42 shall be deemed to be met if performed pursuant to an agreement entered into by appropriate officers or agencies of this state, or a subdivision thereof, as contemplated by paragraph (b) of article V of the Interstate Compact on the Placement of Children.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-7; Reorg. Plan No. 1, 1970; P.L. 1997, ch. 326, § 132.

40-15-8. [Repealed.]

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-8; Reorg. Plan No. 1, 1970; Repealed by P.L. 1997, ch. 326, § 132A, effective July 8, 1997.

Compiler’s Notes.

Former § 40-15-8 concerned declaring former § 40-12-7 inapplicable to placements made pursuant to the Interstate Compact on the Placement of Children.

40-15-9. Court placements.

Any court having jurisdiction to place delinquent children may place such a child in an institution of or in another state pursuant to article VI of the Interstate Compact on the Placement of Children and shall retain jurisdiction as provided in article V thereof.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-9; Reorg. Plan No. 1, 1970.

40-15-10. “Executive head” defined.

As used in article VII of the Interstate Compact on the Placement of Children, the term “executive head” means the governor. The governor is hereby authorized to appoint a compact administrator in accordance with the terms of article VII.

History of Section. P.L. 1967, ch. 55, § 1; G.L. 1956, § 40-22-10; Reorg. Plan No. 1, 1970.

Chapter 16 Community Health Centers

40-16-1. [Repealed.]

History of Section. P.L. 1986, ch. 287, art. 26, § 1; P.L. 1987, ch. 118, art. 27, § 1; P.L. 1988, ch. 129, art. 20, §§ 1, 3; P.L. 1988, ch. 431, § 1; P.L. 1990, ch. 459, § 1; P.L. 1994, ch. 70, art. 36, § 3; P.L. 1996, ch. 100, art. 33, § 1; P.L. 1997, ch. 326, § 133; P.L. 1999, ch. 27, § 1; P.L. 1999, ch. 181, § 1; P.L. 1999, ch. 201, § 1; P.L. 1999, ch. 341, § 1; P.L. 1999, ch. 482, § 1; P.L. 1999, ch. 483, § 1; P.L. 2000, ch. 55, art. 32, § 1; Repealed by P.L. 2006, ch. 246, art. 35, § 1, effective July 1, 2006.

Compiler’s Notes.

Former § 40-16-1 concerned funding of community health centers.

40-16-2. Annual audit.

Any health center receiving funds by virtue of this chapter shall submit to an annual audit of its financial and other records required to substantiate reported numbers of patients served and visits provided, to be conducted by the state auditor general. The auditor general shall annually make a report of the results of the audit to the speaker of the house of representatives, the president of the senate, and the director of human services.

History of Section. P.L. 1986, ch. 287, art. 26, § 1; P.L. 2001, ch. 180, § 86.

40-16-3. Open meetings.

The board of directors of each health center receiving funds pursuant to this section shall annually conduct an open meeting in each neighborhood where a satellite health center is located. Notice of the open meetings provided for above shall be given in accordance with chapter 46 of title 42 required for public bodies. The purpose of these annual open meetings shall be to allow the public to express their views about the services provided by the health centers.

History of Section. P.L. 1986, ch. 287, art. 26, § 1.

40-16-4. Annual report.

Each health center receiving funds pursuant to this section shall submit an annual report on their expenditures, revenues, and patients served by health-center categories by October 1 of each year for the prior fiscal year to the speaker of the house of representatives, the president of the senate, and director of human services.

History of Section. P.L 1986, ch. 287, art. 26, § 1; P.L. 2001, ch. 180, § 86.

Chapter 17 Support of Homeless

40-17-1. Legislative findings.

The general assembly hereby finds that there exists in this state undetermined numbers of homeless persons, many of whom suffer from chronic mental illness and disability, and that this condition exists among families and among individuals of all age groups without regard to ethnic or racial heritage or sex. The existence of this condition is declared to be detrimental to the health, safety, and welfare of the homeless individuals themselves and to the state.

History of Section. P.L. 1987, ch. 278, § 1; P.L. 2011, ch. 348, § 1; P.L. 2011, ch. 359, § 1.

Collateral References.

Laws regulating begging, panhandling, or similar activity by poor or homeless persons. 7 A.L.R.5th 455.

40-17-2. Agency established.

  1. There is hereby created a permanent council to be called the “interagency council on homelessness” consisting of eighteen (18) members and two (2) ex-officio members:
    1. One of whom shall be the chief of the office of housing and community development, or his or her designee, who shall chair the interagency council on homelessness;
    2. One of whom shall be the director of the department of administration, or his or her designee;
    3. One of whom shall be the chair of the housing resources commission, or his or her designee;
    4. One of whom shall be the director of the department of human services, or his or her designee;
    5. One of whom shall be the director of the department of health, or his or her designee;
    6. One of whom shall be the director of the department of children, youth and families, or his or her designee;
    7. One of whom shall be the director of the office of healthy aging, or his or her designee;
    8. One of whom shall be the director of behavioral healthcare, developmental disabilities and hospitals, or his or her designee;
    9. One of whom shall be director of the department of labor and training, or his or her designee;
    10. One of whom shall be the director of the department of corrections, or his or her designee;
    11. One of whom shall be the commissioner of the department of elementary and secondary education, or his or her designee;
    12. One of whom shall be the director of the Rhode Island housing and mortgage finance corporation, or his or her designee;
    13. One of whom shall be the director of the emergency management agency, or his or her designee;
    14. One of whom shall be a representative from the Rhode Island office of veterans services, or his or her designee;
    15. One of whom shall be the public defender, or his or her designee;
    16. One of whom shall be the Medicaid director within the department of human services, or his or her designee;
    17. One of whom shall be the secretary of the executive office of health and human services, or his or her designee;
    18. One of whom shall be the lieutenant governor, or his or her designee;
    19. One of whom shall be an ex-officio member who shall be from the Providence Veterans Administration Medical Center who specializes in health care for homeless veterans; and
    20. One of whom shall be an ex-officio member who shall be the chair, or his or her designee, of the interagency council on homelessness advisory council as described in this chapter herein.
  2. Forthwith upon the effective date of this chapter, the members of the commission shall meet at the call of the chair and organize. Vacancies in the commission shall be filled in like manner as the original appointment.
  3. The department of administration is hereby directed to provide suitable quarters and staff for the commission.
  4. All departments and agencies of the state shall furnish advice and information, documentary, and otherwise to the commission and its agents as is deemed necessary or desirable by the commission to facilitate the purposes of this chapter.

History of Section. P.L. 1987, ch. 278, § 1; P.L. 2011, ch. 348, § 1; P.L. 2011, ch. 359, § 1; P.L. 2013, ch. 176, § 1; P.L. 2013, ch. 216, § 1.

40-17-3. Duties and responsibilities of council.

The duties and responsibilities of the council shall be:

  1. To participate in the process of developing a strategic plan to end homelessness aligned with the federal strategic plan to end homelessness that will serve to reduce the number of homeless individuals and families in Rhode Island;
  2. To coordinate services for the homeless among state agencies and instrumentalities, community-based organizations, faith-based organizations, volunteer organizations, advocacy groups, and businesses;
  3. To coordinate services not specifically for the homeless, but from which the homeless may benefit, among state agencies and instrumentalities, community-based organizations, faith-based organizations, volunteer organizations, advocacy groups, and businesses; and
  4. To identify and seek to remedy gaps in services, specifically in the area of making provisions for the availability, use, and permanent funding stream for permanent supportive housing.

History of Section. P.L. 1987, ch. 278, § 1; P.L. 2011, ch. 348, § 1; P.L. 2011, ch. 359, § 1.

40-17-4. Meeting and reporting requirements.

Meeting and reporting requirements are as follows:

  1. The council shall meet regularly;
  2. The council, in conjunction with the housing resources commission, shall provide the strategic plan and specific recommendations to prevent and end homelessness to the governor, senate president, speaker of the house, the senate committee on housing and municipal government, and the house corporations committee by February 1, 2012;
  3. The council shall provide a report on funding available during calendar year 2011 for services, facilities, programs, or otherwise for people who are homeless. Said report shall be provided to the senate president, speaker of the house, senate fiscal advisor, and house fiscal advisor by January 31, 2012;
  4. The council shall report annually to the governor and the general assembly, no later than March 2013, and annually thereafter, on the progress made in achieving the goals and objectives set forth in the strategic plan; on the current number of homeless individuals, families, and children; and any other pertinent information.

History of Section. P.L. 1987, ch. 278, § 1; P.L. 2011, ch. 348, § 1; P.L. 2011, ch. 359, § 1.

40-17-5. Advisory council established.

  1. There is hereby created a permanent advisory council to the interagency council on homelessness containing representation of advocates; service providers; members of the veteran community, including housing providers and a current or former homeless veteran; current and/or former members of the homeless community; as well as representatives specifically affiliated with youth homelessness. All new members shall be chosen and approved by majority vote of the members present at an official meeting. At no time shall there be less than three (3) representatives of the homeless community, current or former. The chair shall be elected by a majority of the members.
  2. The purpose of the council is to inform the interagency council on homelessness on the current status and issues facing the homeless throughout Rhode Island.

History of Section. P.L. 1987, ch. 278, § 1; P.L. 2001, ch. 180, § 87; P.L. 2006, ch. 216, § 25; P.L. 2011, ch. 348, § 1; P.L. 2011, ch. 359, § 1; P.L. 2013, ch. 176, § 1; P.L. 2013, ch. 216, § 1.

Chapter 18 Long-Term Home Health Care — Alternative to Placement in Skilled Nursing or Intermediate Care Facility

40-18-1. Purpose.

  1. The director of the department of human services, in addition to the medical assistance benefits provided in chapter 8 of this title, shall maintain and coordinate a program of long-term home health care. The purpose of the program of long-term home health care is to provide in-hospital eligible patients, who would be discharged to a skilled nursing facility and/or an intermediate-care facility, with a viable alternative to placement in a skilled nursing facility and/or intermediate-care facility. The director shall utilize a federally approved home- and community-based service waiver to provide a viable alternative. The hereinafter listed services shall be an integral part of the viable alternative.
  2. In addition, the director of the department of human services shall utilize any and all other available departmental resources and community resources to enhance and expand the provision of long-term home health care as the viable alternative to placement in a skilled nursing facility and/or an intermediate-care facility. These resources shall be used to strengthen and expand home- and community-based long-term-care services, which will help people stay at home for care when this is an appropriate alternative to nursing facility care.
  3. In furtherance of subsections (a) and (b) above, the department of human services is authorized and directed to seek any waiver(s) required by the United States Department of Health and Human Services in accordance with otherwise applicable requirements of Title XIX of the federal Social Security Act to establish an enhancement of the program for the provision of adult daycare services and home-based services. The department of human services is directed to seek the waiver(s) in order to claim federal financial participation for the services that shall be provided to residents of the state who are deemed to be in need of adult daycare services and/or home-based services and whose incomes are no greater than two hundred fifty percent (250%) of the federal poverty level.
  4. Upon receipt of the waiver approval(s) referred to in subsection (c) above from the United States Department of Health and Human Services, the department of human services shall file with the house and senate finance committees a report of the terms and conditions of these approved waiver(s) together with a detailed plan for the implementation of them within the aggregate general revenue appropriations for adult daycare and home-based services benefits and administrative costs provided for in the enacted budget for state fiscal year 2003; and, provided further, that any reallocations of these general revenue appropriations between or among departments and/or appropriation line items necessary to implement the approved waiver(s), and/or adjustments to federal revenue appropriations consistent with these waiver approval(s), shall be submitted to the general assembly by the governor in the supplemental appropriations act for state fiscal year 2003 in accordance with § 35-3-8 .

History of Section. P.L. 1988, ch. 451, § 1; P.L. 1996, ch. 84, § 1; P.L. 2002, ch. 65, art. 24, § 2.

Federal Act References.

Title XIX of the Social Security Act, referred to in this section, is codified at 42 U.S.C. § 1396 et seq.

Comparative Legislation.

Home health care:

Mass. Ann. Laws ch. 176A, § 8I; ch. 176G, § 4C.

40-18-2. Definitions.

As used in this chapter, the following words and phrases shall have the following meanings unless the context otherwise requires:

  1. “Adult daycare service” means a comprehensive supervised program on a regularly scheduled basis to adults with disabilities for a substantial part of the day in a single physical location for a specified number of participants daily. The adult daycare center shall be reviewed and approved by the office of healthy aging or other appropriate state agency. Adult daycare services may include, but are not limited to, medical supervision, social and educational activities, snacks and/or hot lunch, and transportation to and from the daycare site. All adult daycare services must meet the conditions set forth in the rules and regulations of the office of healthy aging and must provide these services as an alternative to twenty-four-hour (24) long-term institutional care.
  2. “Case management services” means the coordination of a plan of care and services provided at home to persons with disabilities who are medically eligible for placement in a skilled nursing facility or an intermediate-care facility upon discharge from a hospital. Such programs shall be provided in the person’s home or in the home of a responsible relative or other responsible adult, but not provided in a skilled nursing facility and/or an intermediate-care facility.
  3. “Certified home health” means a home-care services agency that is licensed by the state and is qualified to participate as a home health agency under the provisions of Titles XVII and XIX of the federal Social Security Act, 42 U.S.C. § 1395x, and shall provide, directly or through contract arrangement, a minimum of the following services, which are of a preventative, therapeutic, rehabilitative health guidance, and/or supportive nature to persons at home: skilled nursing services, physical therapy, occupational therapy, speech therapy, and home health aide services.
  4. “Director” means the director of the department of human services.
  5. “Emergency response system” means a twenty-four-hour (24) per-day monitoring service designed for use by elderly adults in the community. The purpose of that system is to provide contact between the elderly adult in the community and the appropriate emergency response agency.
  6. “Government funds” means funds provided under the provisions of chapter 8 of this title.
  7. “Home-care services” means those services provided by: (i) a Medicare/Medicaid certified and state-licensed home health agency; and (ii) a state-licensed home health aide/homemaker agency.
  8. “Home health aide/homemaker agency” means: (i) Home health aide services, at a minimum, includes assistance with personal hygiene, dressing, feeding, and household tasks essential to the patient’s health; and (ii) Homemaker services, at a minimum, includes light work or household tasks such as cooking, cleaning, shopping, and laundry.
  9. “Hospital” means a hospital as defined in chapter 17 of title 23.

History of Section. P.L. 1988, ch. 451, § 1; P.L. 1989, ch. 542, § 89; P.L. 1999, ch. 83, § 104; P.L. 1999, ch. 130, § 104; P.L. 2002, ch. 292, §§ 18, 100.

Federal Act References.

42 U.S.C. § 1395x, referred to in the definition of “Certified home health” is part of Title XVIII of the Social Security Act. Title XVIII of the Social Security Act is codified at 42 U.S.C. § 1395 et seq., and Title XIX of the Social Security Act is codified at 42 U.S.C. § 1396 et seq.

40-18-3. Patient assessment and provision of services.

  1. The services defined and delineated in § 40-18-2 shall be provided only to those hospitalized patients who are medically eligible for placement in a skilled nursing facility and/or intermediate-care facility. Provision of long-term home healthcare services paid for by government funds shall be based upon, but not limited to, a comprehensive assessment that shall include, but not be limited to, an evaluation of the medical, social, and environmental needs of each applicant for the services or program. This assessment shall also serve as the basis for the development and provision of an appropriate plan of care for the applicant. In cases in which the applicant is a patient in a hospital, the assessment shall be completed by persons designated by the director, including, but not limited to, the applicant’s physician, the discharge coordinator of the hospital, and a representative of the department of human services.
  2. Continued provision of long-term home healthcare services paid for by government funds shall be based upon a comprehensive assessment of the medical, social, and environmental needs of the recipient of the services. The assessment shall be performed at least every one hundred eighty (180) days by the department of human services.

History of Section. P.L. 1988, ch. 451, § 1.

40-18-4. Payment for long-term home healthcare programs.

  1. When a long-term home healthcare program as defined under this chapter is available, the department of human services, before authorizing care in a nursing home or intermediate-care facility for a person eligible to receive services under this title, shall notify the person, in writing, of the provisions of this chapter.
    1. If a hospitalized person eligible to receive services under the provisions of this title who requires care, treatment, maintenance, nursing, or other services in a nursing home desires to return to his or her own home or the home of a responsible relative or other responsible adult if the necessary services are provided, that person or his or her representative shall so inform the department of human services.
    2. If a home healthcare program as defined under this chapter is provided, the department of human services shall authorize an assessment and if the results of the assessment indicate that the person can receive the appropriate level of care at home, the official shall prepare for that person a plan for the provision of services comparable to those that would be rendered in a nursing home. In developing the plan, the department shall consult with those persons performing the assessment. The services shall be provided by certified home health agencies, home health aide/homemaker agencies, and adult daycare centers.
      1. At the time of the initial assessment, and at the time of each subsequent assessment, the official shall establish a monthly budget in accordance with which he or she shall authorize payment for the services provided under the plan. Total monthly expenditures made under this title for that person shall not exceed a maximum of one hundred percent (100%) of the average of the monthly rates payable for skilled nursing/intermediate-care facility service as provided for in the department of human services.
      2. Principles of reimbursement for skilled nursing/intermediate-care facility services provided eligible receipts of the medical assistance program. If an assessment of the person’s needs demonstrates that he or she requires services the payment for which would exceed the monthly maximum, but it can be reasonably anticipated that total expenditures for required services for that person will not exceed the maximum calculated over a one-year period, the department of human services may authorize payment for those services.
  2. Notwithstanding any inconsistent provision of law, but subject to expenditure limitations of this chapter, the director, subject to the approval of the state director of the budget, may authorize the utilization of medical assistance funds to pay for services provided by specified home healthcare persons in addition to those services included in the medical assistance program under chapter 8 of this title, so long as federal financial participation is available for those services. Expenditures made under this subsection shall be deemed payments for medical assistance for needy persons.
  3. The department shall not make payments pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., for benefits available under Title XVIII, 42 U.S.C. § 1395 et seq., of the act without documentation that Title XVIII claims have been filed and denied.
  4. The department 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 intermediate-care facility or hospital.

History of Section. P.L. 1988, ch. 451, § 1; P.L. 2006, ch. 216, § 26; P.L. 2020, ch. 79, art. 1, § 34.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

Chapter 19 Comprehensive Adolescent Pregnancy and Parenting Program

40-19-1. Legislative findings.

The general assembly finds:

  1. In 1988, there were one thousand four hundred sixty-one (1,461) births to adolescents under the age of twenty (20) in the state.
  2. Adolescents coping with a pregnancy have a greater risk than the average pregnant woman for:
    1. Inadequate nutrition;
    2. Prenatal care starting well into the second trimester;
    3. Living in poverty households; and finally
    4. More likely to drop out of school.
  3. The literature on adolescents also shows an increase in drug and alcohol use and a rise in depression and suicide.
  4. The student dropout rates in the state are as follows:

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  5. Pregnant and parenting adolescent students face more educational barriers due to student’s high absenteeism, inattentiveness in class, have increased problems of illiteracy and lack the motivation to stay in school during the pregnancy or to return to school after the infant is born.
  6. A prime factor in parenting students dropping out of school is the absence of child care, either in the school, community, or home.
  7. In the fourteen (14) adolescent pregnancy and parenting programs that currently exist in the state, four (4) of which also have childcare centers, the following is evident:
    1. In 1988, thirty-three percent (33%) or four hundred seventy-five (475) out of one thousand four hundred sixty-one (1,461) pregnant adolescents receive community-based services; and
    2. In 1988, sixty-seven percent (67%) or nine hundred eighty-six (986) out of one thousand four hundred sixty-one (1,461) pregnant adolescents do not receive any community-based services.
  8. That of the clients currently enrolled in services in the state the following is established:
    1. In some communities the dropout rate for pregnant students has completely reversed from eighty percent (80%) drop out to ninety percent (90%) graduates; and
    2. Statewide, programs have demonstrated a thirty-five percent (35%) increase in education from intake into programs; and
    3. Students who have child care are more likely to return to school after the pregnancy and remain until graduation; and
    4. Adolescent parents equipped with a high school diploma are more likely to be self-sufficient, capable parents able to find and keep employment while caring for their family and less likely to need public assistance on a long-term basis.
  9. The long-term cost savings are significant as comparisons are made between the cost of providing services to each pregnant and parenting adolescent as one thousand six hundred forty two dollars ($1,642) yearly with an additional cost for daycare services on site in school based programs of three thousand one hundred fifteen dollars ($3,115) yearly as compared to the cost of providing welfare, food stamps, and medical assistance to each client on a yearly basis of eight thousand four hundred dollars ($8,400).
  10. The long-term cost savings is significant as adolescent mothers equipped with a high school diploma are more able to find employment, continue career options, and care for themselves and child, therefore becoming less dependent on public assistance (income maintenance) after graduation.
  11. Rhode Island must provide the earliest possible support to pregnant adolescents for reasons both of compassion and cost-effectiveness.

Cranston 23.7% Newport 27% Pawtucket 30.1% Providence 42.4% Warwick 16.4% West Warwick 29.7% Woonsocket 37.1%

History of Section. P.L. 1991, ch. 269, § 1.

40-19-2. Comprehensive parenting and pregnancy program established.

The state, under the supervision of the department of human services, shall establish the statewide comprehensive adolescent pregnancy and parenting program, which will include the existing department of human service programs, Project Hope, and Pawtucket’s school-based adolescent pregnancy project, providing both school-based and community-based services including, but not necessarily limited to, the following:

  1. To assist pregnant adolescents in accessing early comprehensive and complete prenatal and pediatric care that will be sensitive to the special needs and risks of adolescents and infants;
  2. Mobilize resources and/or provide support services to access adequate parenting programs, family involvement, nutrition programs, transportation, clothing, childcare programs and job training and employment opportunities;
  3. In cooperation with the school systems, coordinate the design of an educational plan to include options for completing high school programs;
  4. In cooperation with the school systems, coordinate the development of plans to reach pregnant students in order to offer services and support to encourage pregnant and parenting students to remain and complete their high school education;
  5. Provide for crisis intervention and emergency assistance;
  6. Home management and parenting and nutrition skill building opportunities;
  7. Encourage program providers to employ staff that is reflective of the racial and ethnic populations of the adolescents in their community.

History of Section. P.L. 1991, ch. 269, § 1.

40-19-3. Powers and duties of the department of human services.

The department of human services shall, within the specific appropriation for this program, establish and evaluate the statewide comprehensive adolescent pregnancy and parenting program to be established pursuant to § 40-19-2 and shall make and establish rules and regulations as are deemed necessary to carry out the purposes of the chapter. The department of human services shall allocate and expend any money in the treasury designated in the department for adolescent pregnancy and parenting programs, solely for the purpose and operation of the adolescent pregnancy programs, including legislative funding for both community-based programs of Warwick’s Project Hope and Pawtucket’s school-based adolescent pregnancy project.

History of Section. P.L. 1991, ch. 269, § 1.

Chapter 19.1 Teen Pregnancy Prevention Partnership Act

40-19.1-1. Coordination of teen pregnancy prevention among state agencies.

  1. Whereas, the department of human services, department of health, department of elementary and secondary education, and department of children, youth and families all have responsibility for teen pregnancy education and prevention programs, and recognizing that teen pregnancy is a multi-faceted issue requiring a comprehensive approach and long-term coordinated activities among federal, state and local agencies; and

    Whereas, the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996 [Pub. L. No. 104-193] encourages states to establish goals and take action to prevent and reduce the incidence of out-of-wedlock pregnancies, with special emphasis on teen pregnancies, and including programs for men; and

    Whereas, the nation’s social costs of teen pregnancy and too-early childbearing are seven billion dollars ($7,000,000,000) annually;

    The general assembly hereby authorizes and directs the director of department of human services, the director of the department of health, the director of the department of children, youth and families, and the commissioner of elementary and secondary education to develop a comprehensive statewide plan to prevent and reduce the incidence of unintended pregnancies among adolescents and to structure and coordinate primary pregnancy-prevention healthcare services and educational programs for at-risk adolescents as outlined in the plan. Such plan shall:

    1. Include numerical goals for calendar years 1998 through 2005 that demonstrate a reduction in the incidence of unintended adolescent pregnancy, especially among at-risk teens;
    2. Identify current and future federal and state funding sources for adolescent pregnancy prevention;
    3. Identify current programs providing pregnancy prevention education for teens;
    4. Incorporate successful primary prevention strategies and programs proven to be effective in reducing unintended adolescent pregnancies. These shall include, but not be limited to, life and educational goal programs, parental education and involvement, comprehensive abstinence education and assertiveness training skills, peer education and abstinence training for peer educators, after-school programs that offer tutoring, substance abuse, sexual abuse, and self-esteem education and male mentors for at-risk male youth, and identification and development of healthcare services accessible to adolescents for the purpose of primary pregnancy prevention. A list shall be made available to the public naming these primary prevention programs and services that are available throughout the state;
    5. Establish numerical goals that designate male involvement in pregnancy prevention and sexual responsibility education programs that shall incorporate educational involvement from local and state law enforcement officials to address child support, and sexual assault laws and penalties;
    6. Include specific programs to identify and educate at-risk teens before they become sexually active;
    7. Identify and access financial resources for teachers training in the areas of family life and sexuality education for teachers, K-12 in elementary and secondary schools;
    8. Establish community and local involvement in the statewide planning effort and development of primary prevention services and educational programs for adolescents, especially in the maternal and child health planning areas of the state with high rates of teenage pregnancy. Organizations and individuals chosen for this shall represent the diversity of their communities including, but not limited to age, youth, gender, race, culture, and ethnicity.
  2. The director of the department of human services, director of the department of health, the director of the department of children, youth and families, and commissioner of elementary and secondary education shall select a teen pregnancy prevention plan coordinator from existing staff who will convene designated representatives by September 1, 1997, to develop the plan, and who will report its findings and recommendations thereof and any requests for extension to the general assembly no later than January 15, 1998, and in six-month (6) intervals thereafter.

History of Section. P.L. 1997, ch. 160, § 1; P.L. 1997, ch. 176, § 1.

Chapter 20 Long-Term Care System Planning

40-20-1. Long-term-care plan and budget.

The directors of the department of human services, the office of healthy aging, the department of health, and the department of behavioral healthcare, developmental disabilities and hospitals shall develop a five-year (5) Rhode Island long-term-care plan and recommended budget prior to January 1, 1998. In developing the plan, the directors shall seek input and comment from members of the public, consumers, and providers. The plan shall be based on the goals and objectives set forth in the long-term care coordinating council’s “Long-Term Care Plan for Rhode Island: 1995-2000” and shall incorporate at least the following:

  1. Guiding principles:
    1. Address and promote physical, mental, and psycho-social well-being.
    2. Allow consumers to choose less restrictive and more cost-effective and appropriate settings for care.
    3. Place emphasis on consumer choice and satisfaction.
    4. Strive to ensure that all services are available as appropriate to needs and resources.
    5. Base the plan on consumer needs, not provider needs.
    6. Recognize that cost-effectiveness, efficiency, and quality of life are important to public and private-pay consumers.
  2. Essential elements:
    1. A long-term-care coordinator responsible for assisting persons to access long-term-care services shall be available to all communities.
    2. A uniform screening and assessment shall be conducted for anyone seeking state-funded long-term-care assistance. The assessment shall be available to private pay consumers as well.
    3. A consumer long-term-care information system shall be developed in collaboration with the long-term care coordinating council.

History of Section. P.L. 1997, ch. 194, § 1; P.L. 1997, ch. 359, § 1.

40-20-2. Long-term-care entry system.

The directors of the department of human services, the office of healthy aging, the department of health, and the department of behavioral healthcare, developmental disabilities and hospitals, shall work collaboratively to design and implement subject to appropriation by October 1, 2006, a standardized, community-based, comprehensive system for entry into state long-term-care programs and services. The system shall include community-based staff to administer pre-screening long-term-care assessments and care-management services, as defined and required under chapter 66.6 of title 42, and to make recommendations for services, including home- and community-based alternatives to residential care, and to assist with access to services. The long-term-care entry system shall include the essential elements contained in § 40-20-1(b) .

History of Section. P.L. 1997, ch. 194, § 1; P.L. 1997, ch. 359, § 1; P.L. 2004, ch. 183, § 1; P.L. 2004, ch. 271, § 1; P.L. 2020, ch. 79, art. 1, § 35.

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

Chapter 21 Medical Assistance — Prescription Drugs

40-21-1. Prescription drug program.

The department of human services is hereby authorized and directed to amend its practices, procedures, regulations, and the Rhode Island state plan for medical assistance (Medicaid) pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., to modify the prescription drug program:

  1. To establish a preferred drug list (PDL);
  2. To enter into supplemental rebate, discount, or other agreements with pharmaceutical companies;
  3. To negotiate either state-specific supplemental rebates or to participate in a multistate pooling, supplemental-rebate program.

    Determinations of drugs included on the PDL will be made by the State Department of Human Services, and a listing of the drugs shall be maintained on a public website. In making these determinations, the department shall consider the recommendations of the Medicaid Pharmaceutical and Therapeutics Committee, whose membership shall include practicing pharmacists and physicians, faculty members of the University of Rhode Island’s College of Pharmacy, and consumers or consumer representatives. Drugs exempt from the PDL shall include: (i) Anti-retrovirals; and (ii) Organ transplant medications. Physicians will be informed about prior authorization procedures for medications not on the PDL, and seventy-two-hour (72) emergency supplies may be dispensed if authorizations cannot be obtained; and

  4. To mandate the dispensing of generic-only drugs with the exception of limited-brand drug coverage for certain therapeutic classes as approved by the Department of Human Services to individuals eligible for medical assistance (Medicaid) under §§ 40-8.4-4 , 42-12.3-4 and 42-12.3-15 .

History of Section. P.L. 2006, ch. 546, § 1; P.L. 2008, ch. 100, art. 17, §§ 2, 14; P.L. 2020, ch. 79, art. 1, § 36.

Compiler’s Notes.

P.L. 2008, ch. 100, art. 17, § 16, provides: “This article shall take effect upon passage [June 26, 2008]. Any rules or regulations necessary or advisable to implement the provisions of SECTION 6 and SECTION 14 of this article shall be effective immediately as an emergency rule upon the department’s filing thereof with the secretary of state as it is hereby found that the current fiscal crisis in this state has caused an imminent peril to public health, safety and welfare, and the department is hereby exempted from the requirements of §§ 42-35-3(b) and 42-35-4(b)(2) relating to agency findings of imminent peril to public health, safety and welfare and the filing of statements of the agency’s reasons thereof.”

Effective Dates.

P.L. 2020, ch. 79, art. 2, § 29, provides that the amendment to this section by that act takes effect on December 31, 2020.

40-21-2. Fee-for-service program.

The Department of Human Services is hereby authorized and directed to amend its regulations and the Rhode Island State Plan for Medical Assistance (Medicaid) pursuant to Title XIX of the federal Social Security Act, 42 U.S.C. § 1396 et seq., to modify the fee-for-service program prescription drug reimbursement formula to establish a ceiling equivalent to the combination of the manufacturer’s wholesale acquisition cost and a dispensing fee of three dollars and forty cents ($3.40) for outpatient prescriptions and two dollars and eighty-five cents ($2.85) for long-term-care prescriptions.

History of Section. P.L. 2006, ch. 546, § 1.

40-21-3. Preferred drug list.

  1. If a patient’s healthcare provider prescribes a prescription drug that is not on the preferred drug list, the prescriber shall consult with the program to confirm that, in his or her reasonable professional judgment, the patient’s clinical condition is consistent with the criteria for approval of the nonpreferred drug. Such criteria shall include:
    1. The preferred drug has been tried by the patient and has failed to produce the desired health outcomes;
    2. The patient has tried the preferred drug and has experienced unacceptable side effects;
    3. The patient has been stabilized on a nonpreferred drug and transition to the preferred drug would be medically contraindicated; or
    4. Other clinical indications identified by the committee for the patient’s use of the nonpreferred drug, which shall include consideration of the medical needs of special populations, including children, elderly, chronically ill, persons with mental health conditions, and persons affected by HIV/AIDS.
  2. In the event that the patient does not meet the criteria in subsection (a), the prescriber may provide additional information to the program to justify the use of a prescription drug that is not on the preferred drug list. The program shall provide a reasonable opportunity for a prescriber to reasonably present his or her justification of prior authorization. If, after consultation with the program, the prescriber, in his or her reasonable professional judgment, determines that the use of a prescription drug that is not on the preferred drug list is warranted, the prescriber’s determination shall be final.

History of Section. P.L. 2006, ch. 546, § 1.

Chapter 22 Food Stamp Employment and Training Program

40-22-1. Short title.

This chapter shall be known and may be cited as the “Food Stamp Employment and Training Program.”

History of Section. P.L. 2008, ch. 375, § 1; P.L. 2008, ch. 387, § 1.

40-22-2. Legislative findings.

  1. Many food stamp recipients need assistance entering the job market or increasing their skills to obtain a good paying job.
  2. There are federal funds available through the food stamp employment and training to pay for education, training, job placement, case management, and other work-readiness services for food stamp recipients and to pay the administrative costs of managing the program.
  3. There are no general revenue funds required to access the federal food stamp employment and training program.

History of Section. P.L. 2008, ch. 375, § 1; P.L. 2008, ch. 387, § 1.

40-22-3. Food stamp employment and training program.

The department of human services is authorized and directed to amend the food stamp employment and training plan submitted to the United States Department of Agriculture to maximize the receipt of federal funds for employment and training for food stamp recipients. The department may, as necessary and appropriate, implement a pilot program with such education, training, and job placement providers as determined by the department.

History of Section. P.L. 2008, ch. 375, § 1; P.L. 2008, ch. 387, § 1.