Rhode Island Administrative Code

My Page Title1.1Overview and legal authorityR.I. Gen. Laws § 40-8.12-3 mandated the Executive Office of Health and Human Services (EOHHS) to establish a fund to ensure insurance coverage through HealthSource RI is affordable for parents and caretakers of Medicaid-eligible childre…

My Page Title1.1 PurposeA.The purpose of the Rhode Island Early Intervention (EI) Program is to provide a comprehensive, and coordinated, system of home and community based services and supports for families of infants and toddlers with developmental disabilities or delays.B.The …

My Page Title1.1 Overview of this ChapterA.This Chapter establishes the Medicaid Integrated Health Care Coverage (IHCC) groups for elders, adults with disabilities, and certain individuals who qualify as medically needy (MN) due to high health care expenses. In addition, sections…

My Page Title2.1Scope and PurposeA.In September 2016, the State implemented its integrated eligibility system (IES) which has the capacity to crosswalk with the State’s health insurance marketplace, HealthsourceRI.com (HSRI) and, through a single application process, evaluate eli…

My Page Title3.1Incorporated MaterialsA.These Regulations hereby adopt and incorporate 20 C.F.R. Part 416 (2023) by reference, not including any further editions or amendments thereof, and only to the extent that the provisions therein are not inconsistent with these Regulations.…

My Page Title1.1OverviewA.The IHCC groups established in this Section provide the principal Medicaid non-Long-Term Services and Supports (LTSS) eligibility pathways for elders and adults with disabilities who have Supplemental Security Income (SSI), an SSI characteristic, and/or …

My Page Title2.1Scope and PurposesA.A medically needy (MN) spenddown, previously referred to as the “Flexible Test of Income”, is a cost-sharing approach that provides a Medicaid eligibility pathway for certain people who have income above the limit for their applicable coverage …

My Page Title3.1Scope and PurposeMedicaid coverage may start retroactively for up to three (3) months prior to the month of application for IHCC groups, unless explicitly excluded. To qualify, a person must have met the criteria for Medicaid eligibility during the retroactive per…

My Page Title1.1Overview of this RuleA.The purpose of this Rule is describe the managed care service delivery options for Elders and Adults with Disabilities and long-term care beneficiaries. The purpose is also to set forth in clear language the respective roles and responsibili…

My Page Title1.1Scope and ApplicabilityA.One of the principal objectives of health and human services policymakers is to support Medicaid-eligible adults with disabilities who work by enabling them to obtain or maintain the coverage they need to retain their independence and opti…

My Page Title1.1OverviewThe provisions set forth herein pertain to the scope of Medicaid long-term services and supports (LTSS) and the various pathways for initial and continuing eligibility.1.2Legal AuthorityA.This Chapter of Rules related to Medicaid LTSS is promulgated pursua…

My Page Title2.1Scope and PurposeA.Medically Needy (MN) eligibility for Medicaid long-term services and supports (LTSS), previously referred to as the “Flexible Test of Income”, enables people with income above the Federal benefit cap to obtain Medicaid LTSS coverage in certain c…

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My Page Title4.1OverviewThe purpose of this regulation is to set forth the Long-Term Services and Supports (LTSS) application review and renewal process in accordance with current State and federal laws and regulations. 4.2Legal AuthorityA.Title XIX of the U.S. Social Security Ac…

My Page Title5.1OverviewThe process for determining function/clinical eligibility for long-term services and supports (LTSS) centers on a comprehensive evaluation that includes a functional assessment and consideration of each applicant's unique medical, social, physical and beha…

My Page Title6.1Overview and PurposeA.Financial eligibility for Medicaid LTSS is determined using a multi-faceted process that considers countable income and resources at the time of application, the allocation of joint spousal resources from the point the need for LTSS began, an…

My Page Title7.1Purpose and OverviewThe purpose of this rule is to set forth requirements related to resident discharges and transfers initiated by state licensed long-term care facilities, without regard to the resident’s source of payment. All such transfer/ discharges that are…

My Page Title8.1OverviewA.Medicaid LTSS beneficiaries are required by Federal law and Regulations, the State Plan, and the Section 1115 waiver to contribute income toward the Medicaid cost of care, irrespective of whether LTSS is provided in a health care institution or a home or…

My Page Title1.1Overview and PurposeA.Medicaid covers certain inpatient, comprehensive services, subacute and long-term services and supports as institutional benefits. The word "institutional" with respect to federal Medicaid requirements applies to benefits authorized under Tit…

My Page Title2.1Introduction and OverviewUse of and accountability for funds of residents residing in community medical care, ICF/DD facilities and nursing facilities is an essential requirement for the protection of the residents’ rights. In order to ensure proper program and fi…

My Page Title1.1Overview and PurposeA.Under the broad authority of the State’s Section 1115 waiver granted pursuant to § 1115 of the Social Security Act, 42 U.S.C. § 1315, Rhode Island has established a core set of home and community-based services (HCBS) which are available to l…

My Page Title2.1PurposeThis Rule applies to the Personal Choice self-directed program and the home and community-based services provided by Personal Care Aides (PCAs) under this program. This Rule sets out the eligibility criteria and program operations for self-direction, a serv…

My Page Title3.1OverviewA.In 1982, Congress created a new Medicaid State Plan option under § 134 of the Tax Equity and Fiscal Responsibility Act (TEFRA), also referred to as the Katie Beckett (KB) provision, which enables otherwise ineligible children who have severe disabling im…

1.1 Applicability A. These regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws §§ 23-17.8-9, 40.1-1-13, 40.1-2-2, 40.1-5-3, 40.1-5.4-11, 40.1-8.5-7, 40.1-21-12, 40.1-22-4, 40.1-24-9, 40.1-24.5-2, 40.1-26-11, and 40.1-27-3; as well as R.I. Gen. Law…

1.1 Authority, Purpose, and Applicability A. These regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws §§ 23-17.8-9(6), 40.1-1-13(a)(12), 40.1-2-2, 40.1-21-12, 40.1-22-4, 40.1-24-9, 40.1-24.5-2(c), 40.1-26-11, and 40.1-27-3(6).and are established …

My Page Title1.1Authority, Purpose and ApplicabilityA.These Regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws §§ 40.1-1-13, 40.1-2-2, 40.1-3-7, 40.1-5-3(g), 40.1-5.4-11, 40.1-8.5-7(1), 40.1-24-9, 40.1-24-11, 40.1-24.5-2(c), and 40.1-25.1-6 and a…

1.1 Statement of Purpose A. It is the purpose of these rules and regulations to implement R.I. Gen. Laws § 40.1-1-10 and § 40.1-1-10.1, the Parent Deinstitutionalization Subsidy Aid Program subject to available funds. B. The program is founded for the express purpose of providing…

1.1 INTRODUCTION These rules and regulations are promulgated pursuant to R.I. Gen. Laws §§ 40.1-21-15 through 40.1-21-17 for the purpose of providing rules and regulations for the administration of the Self-Sufficiency Trust fund. 1.2 PURPOSE AND SCOPE A. The Self-Sufficiency Tru…

My Page Title1.1PurposeA.The Mission of the Department of Children, Youth and Families (hereinafter the Department) is to partner with families and communities to raise safe and healthy children and youth in a caring environment.B.The Department has a responsibility to promote, s…

My Page Title1.1PurposeThese regulations contain the requirements for reporting child abuse and neglect to the Department of Children, Youth and Families, and the Department’s criteria to screen in or screen out all reports and assign for investigation, if the report meets the co…

My Page Title1.1PurposeA.The Rhode Island Department of Children, Youth and Families (hereinafter the Department) is mandated by federal and state law and Department policy to make reasonable efforts to prevent a child's removal from his/her home, to reunify the child and family,…

My Page Title3.1PURPOSEA.These Regulations establish the licensing requirements for foster care and pre-adoptive homes licensed by the Department of Children, Youth and Families. The licensing requirements are designed to ensure that children in foster and pre-adoptive care are i…

My Page Title4.1GENERAL PROVISIONS4.1.1LEGAL BASISA.R.I. Gen. Laws § 40-13.2 - Certification of Child Care and Youth Serving Agency Workers B.R.I. Gen. Laws Chapter 42-72 - Department of Children, Youth and FamiliesC.R.I. Gen. Laws § 42-72.1 - Licensing and Monitoring of Child Ca…

My Page Title5.1GENERAL PROVISIONS5.1.1Legal BasisA.These regulations for the licensing of child placing agencies are promulgated pursuant to the Licensing Act for the Placement and Care of Children.B.As defined in the Act, a "child placing agency" shall mean "any private or publ…

My Page Title6.1GENERAL PROVISIONSA.Purpose 1.The purpose of these Regulations is to comply with R.I. Gen. Laws § 40.1-5-6, which requires any child who is under the age of eighteen whose health insurance is publicly funded to have an emergency service intervention by a provider …

My Page Title1.1PurposeThis regulation details the responsibilities of the Department’s Legal Counsel which represents the Department in Family Court proceedings related to child abuse and neglect, in commitment trials and in termination of parental rights, civil litigation in st…

My Page Title1.1PurposeA.R.I. Gen. Laws § 14-1-36.2 provides that children and youth placed in the custody of the Department of Children, Youth and Families (hereinafter, the Department) receive suitable treatment, rehabilitation and care in the least restrictive environment.B.Th…

My Page Title1.1PurposeThe Department of Children, Youth and Families ensures that each youth placed on probation by order of the Family Court receives a level of supervision that is consistent with orders of the Family Court, as well as youth and public safety.1.2AuthorityThese …

My Page Title1.1AuthorityThese regulations are promulgated pursuant to the authority set forth in R.I. Gen. Laws Chapter 38-2, for the purpose of establishing the procedures and methods for obtaining access to public records of the Rhode Island Department of Health.1.2Definitions…

My Page Title2.1AuthorityA.These Regulations are promulgated pursuant to the authority set forth in R.I. Gen. Laws §§ 23-1-3(b), 23-1-17, and 23-1-54, and are for the purpose of establishing the specific licensing, laboratory or administrative fees contained in the individual sta…

My Page Title3.1AuthorityThese regulations are promulgated pursuant to the authority conferred by R.I. Gen. Laws Chapter 42-92, for the purposes of providing equal access to justice for small businesses and individuals and governing the application and award of reasonable litigat…

My Page Title4.1AuthorityThese Regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws Chapter 42-35 for the purpose of establishing uniform procedures and practices governing administrative proceedings before the Department of Health and all boards, …

My Page Title1.1Authority and PurposeThese amended Rules and Regulations Governing Vital Records are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 23-3-3, as amended, and are established for the purpose of adopting an efficient statewide vital records sys…

My Page Title2.1AuthorityThese Rules and Regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws §§ 23-1-18(2), 23-8-1, and 23-12-4 for the purpose of establishing a unified procedure for the reporting of cancer to the Rhode Island Cancer Registry.2.2…

My Page Title3.1AuthorityA.These regulations are promulgated pursuant to the authority conferred in R.I. Gen. Laws § 23-13.3-3(f), and are hereby adopted for the purpose of establishing a unified procedure for the reporting of birth defects of newborns and spontaneous fetal death…

My Page Title4.1Authority These rules and regulations pertaining to the Rhode Island Traumatic Brain Injury/Spinal Cord Injury Registry are promulgated pursuant to the authority conferred in R.I. Gen. Laws § 23-1-49 for the purpose of establishing a unified procedure for the repo…

My Page Title5.1AuthorityThese Regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 23-17.17-4(b) and are established for the purpose of defining the reporting requirements for health plans and Insurers to submit data and information to the Rhode…

My Page Title6.1AuthorityA.These Regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 5-37.7-5 for the purpose of establishing safeguards and confidentiality protections for the Health Information Exchange (HIE) in order to improve the quality, s…

My Page Title7.1AuthorityA.These rules and regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws § 23-17.17-4, as amended, and are established for the purpose of the development and reporting of quality performance measures to guide quality improvem…

My Page Title1.1AuthorityA.These rules and regulations are promulgated pursuant to the authority conferred under R.I. Gen. Laws §§ 23-13-9, 13 and 14, and are established for the purpose of updating a comprehensive metabolic, endocrine, hemoglobin, and other disorders y screening…