Public Policy - State Legislation
State Budget
The Rhode Island House of Representatives voted to approve the FY2011 budget on June 4, 2010, and the budget became law without the Governor’s signature. The budget does not include any articles specifically related to community health centers. However, the budget relies on over $95 million in federal funding that had not been approved at that point in time.
As of August 10, 2010: A pared-down version of the FMAP “Extenders” bill was signed into law. The legislation provides approximately $70 million dollars for the state budget, leaving Rhode Island with a smaller-than-feared budget gap, of around $38 million.
There were a few significant pieces of legislation that impact the overall budget, although not health care specifically.
Personal Income Tax Structure: A significant piece of legislation revamping the personal income tax structure in Rhode Island also passed. The bill significantly lowers the tax rate of the top tax bracket, from 9.9% to 5.99%. The overhaul also reduces the number of tax brackets and tax credits, eliminates the flat-tax option for taxpayers, eliminates the option to claim itemized deductions, and increases the amount of the standard deduction for most taxpayers.
Education Funding Formula: The General Assembly passed a school funding formula bill, ending Rhode Island’s designation as the only state in the nation without such a law. The new method allocates $850 million in state funding based on changes in student enrollment, the needs of the students based on income, and the community’s ability to pay for education costs. The formula will go into effect in 2012 and be fully implemented over the following ten years, allowing districts losing funding to adjust accordingly.
Some health-related laws passed during the 2010 legislative session:
S2220 Confidentiality of Health Care Communications and Information Act: The law creates a statutory exception to the Confidentiality of Health Care and Communication and Information Act requiring health care providers of children to report instances of sexual abuse to the appropriate law enforcement agency. The exception only allows information necessary to prove sexual abuse occurred to be released and protects all other patient information.
S2417 Distressed Essential Community Hospitals: Exemption of Landmark Medical Center (Woonsocket, RI) and any purchasers from Rhode Island sales and use taxes for 12 years in recognition that Landmark is a distressed essential community hospital. The law also designates Landmark Medical Center as a rural hospital for purposes of Medicare billing and reimbursement.
S2632/H7606A Discount Medical Plans: The legislation is intended to protect consumers from unfair or deceptive marketing schemes of discount medical plans by imposing standards on discount medical plan organizations, including requiring registration by the discount medical plans with the Department of Health prior to selling plans in Rhode Island. The law also prohibits misleading or deceptive advertisements or other communication toward prospective consumers.
H7273/S2130 Licensing of Radiologic Technology: The act repeals the existing radiologic technology licensing act and enacts a revised version. The revised act allows the Director of Health to license radiologic technologists in accordance with current standards of practice established by national professional associations which examine, register, certify, or approve individuals and education programs relating to operators of sources of radiation.
H7378 MHRH Name Change: The title of the Department of Mental Health, Retardation, and Hospitals is amended to read Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH).
H7417 Medical Examiners: The bill requires the Office of State Medical Examiners to establish a child death review team with the goal of decreasing the prevalence of preventable child deaths, and to report recommendations for community intervention strategies. The multidisciplinary review team will include representatives from state agencies, health care, child welfare, and law enforcement.
H7450 Sexually Transmitted Infection Prescriptions: Certain licensed health care providers can prescribe medications for a patient’s sexual partner(s) for the treatment of Chlamydia or gonorrhea if the patient is diagnosed with either infection. The law also provides some immunity for the health care providers and employers from civil or criminal liability for prescribing in good faith under this act.
H7550 Health Care Quality Program, Hospital Acquired Infections: The law expands the definition of ‘consumer information’ to include the provision of written guidelines to every individual before and during a hospital stay for the purpose of preventing hospital acquired infections. The written guidelines must also be provided within a reasonable time period in the case of emergency hospitalizations.
H7603 Extended Medical Benefits: The coverage offered to individuals eligible for extended medical benefits (i.e. COBRA) is expanded to additionally include dental and vision benefits.
H7853 Utilization of Unused Prescription Drugs Act: The Department of Health and Board of Pharmacy will develop and implement a pilot program through which unused prescription drugs (but not including drugs defined as controlled substances) will be transferred from nursing facilities, assisted living residences, residential care facilities or community health organizations that store prescription drugs and are licensed at the M1 level by the Department of Health to charitable clinics for the purpose of re-prescribing and dispensing the medication to Rhode Islanders who need medical assistance.
Global Medicaid Waiver
In January of 2009, Rhode Island’s Global Medicaid Waiver was approved by the Centers for Medicare and Medicaid Services (CMS) and went into effect. The Waiver has the potential to redesign the services provided to Rhode Islanders with Medicaid through the establishment of a new Federal-State agreement that Rhode Island greater administrative flexibility and a more expeditious process for amendments to the program. Goals of the Global Waiver include a rebalancing of the publicly funded long term care system, increased access to enhanced care management and medical homes for beneficiaries, and payment and purchasing reform to ensure the cost-effectiveness and sustainability of the program. Although the state has greater authority to make programmatic changes, critical changes (including scope of covered benefits and eligibility of populations) still require CMS approval.
RIHCA’s President and CEO, Jane Hayward has testified before the state House and Senate regarding the waiver, and companion oversight legislation. The oversight legislation was passed by the General Assembly in June 2009 and signed into law by the Governor on July 1, 2009.
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