Rhode Island General Laws Title 42. State Affairs and Government § 42-66.4-4. Provision of long-term home healthcare program

(a) When a long-term home healthcare program as defined under this chapter is available, the office of healthy aging shall notify the eligible person, in writing, of the provisions of this chapter.

(b) If a 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 remain and is deemed by the person’s physician able to remain in the person’s own home or the home of a responsible relative or other responsible adult if the necessary services are provided, that person or that person's representative shall inform the office of healthy aging. If a long-term home healthcare program as defined under this chapter is provided, the office of healthy aging shall authorize an assessment under the provisions of this chapter. If the results of the assessment indicate that the person can receive the appropriate level of care at home, the case manager 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 this plan, the office of healthy aging 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.

(c) At the time of the initial assessment, and at the time of each subsequent assessment, the case manager shall establish a monthly budget in accordance with which the case manager shall authorize payment for the services provided under the plan. Total monthly expenditures made under this title for each person shall not exceed a maximum of one hundred percent (100%) or any lesser percentage as may be determined by the director, of the average of the monthly rates payable under this title for skilled nursing/intermediate care facility services as provided for in the department of human services principles of reimbursement for skilled nursing/intermediate care facility services eligible requests of the medical assistance program. If an assessment of the person's needs demonstrates that the person 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 office of healthy aging may authorize payment for those services.