§ 42-12.3-8 - Enhanced services for children.
SECTION 42-12.3-8
§ 42-12.3-8 Enhanced services forchildren. – (a) The department of human services shall develop a panel of enhanced servicesto be available as appropriate to RIte Track and medical assistance recipientsunder the age of eighteen (18), who are considered at risk, as defined bydepartment of human services regulations. These services shall include, but notbe limited to: care coordination, home visitation, nutrition counseling,parenting skills education. These services may be performed through a fee forservice, contractual arrangement, or capitated rate as determined by thedepartment of human services. The provision of enhanced services is subject toavailable appropriations; in the event that appropriations are not adequate forthe provision of these services, the department has the authority to limit theamount, scope, and duration of these enhanced services, and to limiteligibility for enhanced services to children under the age of eight (8).Nothing in this section shall prohibit the department of human services fromproviding enhanced services to a medical assistance recipient, within existingappropriations.
(b) Except as provided in subsection (c) below, thedepartment of human services shall also provide pediatric palliative careservices to eligible children under the age of nineteen (19) years who have aterminal illness, provided that such services qualify for federal financialparticipation. These services shall be designed to achieve an improved qualityof life and to meet the physical and emotional needs experienced by the patientduring the course of the terminal illness and death. The services offered shallbe determined by the department and may include, but are not limited to,consultations for pain and symptom management, case management and assessment,social services, counseling, volunteer support services, and respite services.The services shall be provided by licensed health care facilities that meet thecriteria established by regulations promulgated by the department. Thedepartment is further authorized to establish limits on the services providedunder this section.
(c) The department shall be the payor of last resort withrespect to services provided under subsection (b) above. With respect tochildren under the age of nineteen (19) years who are covered by an individualor family health insurance plan or program that provides payment in whole or inpart for the type of pediatric palliative health care services listed insubsection (b) above, the department shall coordinate benefits with theseprimary payors, and provided further that payments by the department shall bein accordance with the department's fee schedules.