SECTION 1. Legislative findings and purpose:
(a) The General Assembly hereby finds and declares that:
(1) The State of Rhode Island is engaged in an ongoing Medicaid/fiscal transformation project administered by the executive office of health and human services (“EOHHS”), with significant implications for children, families, and vulnerable populations.
(2) Medicaid and related federal, state, and local funding streams are essential to sustaining the full continuum of care, including children’s behavioral health services, child welfare-related services, community-based providers, and family support systems.
(3) Rhode Island receives federal funding through multiple mechanisms including, but not limited to, Medicaid state plan funding, TANF, Title IVB AND E, Maternal, Infant, and Early Childhood Home Visiting (“MIECHV”), Block Grants, Family First Prevention Services Act (FFPSA), enhanced federal matching funds, and federal grants administered across multiple state agencies.
(4) State and local funds, including general revenue, play a critical role in supplementing federal resources, and the commission's examination shall include how federal maximization strategies interact with and optimize these state investments to support a continuum of care for children.
(5) Coordinated legislative study and oversight are necessary to ensure that Medicaid/Fiscal transformation efforts maximize all available federal revenue while preserving access, quality, and provider stability across the continuum of care.
(b) Purpose. The purpose of this act is to establish a legislative commission to study Medicaid transformation initiatives and to identify opportunities to maximize revenue in support of children, families, and the broader continuum of care.
SECTION 2. Title 40 of the General Laws entitled "HUMAN SERVICES" is hereby amended by adding thereto the following chapter: 40-23-1. Establishment of the legislative commission.
(a) There is hereby established a joint commission to study ways to maximize revenue for child welfare and children's behavioral health services (“the commission”).
(b) The commission shall study:
(1) The goals, scope, and implementation of the Medicaid transformation project;
(2) Opportunities to maximize and better coordinate federal funding in support of children’s services, behavioral health, and family-serving systems across state agencies; and
(3) Any other topics determined by the commission in furtherance of the purpose of the commission. 40-23-2. Membership of the commission. The twenty-seven (27) members of the commission shall consist of the following members:
(1) Legislative members.
(i) The chairperson of the house finance committee, or designee;
(ii) The chairperson of the senate finance committee, or designee;
(iii) The chairperson of the house finance subcommittee on health and human services, or designee;
(iv) The chairperson of the senate finance subcommittee on health and human services, or designee;
(v) Two (2) members of the house of representatives appointed by the speaker of the house; and
(vi) Two (2) members of the senate appointed by the president of the senate.
(2) Executive and judicial branch members.
(i) The Medicaid director, or designee;
(ii) The secretary of the executive office of health and human services (“EOHHS”), or designee;
(iii) The director of the department of human services (“DHS”), or designee;
(iv) The director of the department of children, youth, and families “(DCYF”), or designee;
(v) The director of the Rhode Island department of health (“RIDOH”), or designee;
(vi) The commissioner of the Rhode Island department of elementary and secondary education (RIDE), or designee;
(vii) The commissioner of the office of the health insurance commissioner (“OHIC”), or designee;
(viii) The director of the department of labor and training (“DLT”), or designee;
(ix) A representative of the Rhode Island family court, appointed by the chief judge of the court; and
(x) The child advocate, or designee.
(3) Provider, coalition, and expert members.
(i) A representative of the Rhode Island coalition of children and families (“RICCF”) to be appointed by the coalition’s governing body;
(ii) A representative of the community providers network of Rhode Island (CPNRI) to be appointed by the CPNRI executive committee;
(iii) A representative of Leadership RI to be appointed by the chair of the board of directors;
(iv) A representative of the Hassenfeld Child Health Innovation Institute to be appointed by the institute’s governing body;
(v) A representative of the Rhode Island College school of social work with expertise in children’s behavioral health to be appointed by the president of the college;
(vi) A community based provider with expertise in juvenile justice, to be appointed by the speaker of the house;
(vii) A community based provider with expertise in child welfare, to be appointed by the speaker of the house;
(viii) A community based provider with expertise in children’s behavioral health, to be appointed by the president of the senate; and
(ix) A community based provider with expertise in children with intellectual and developmental differences, to be appointed by the president of the senate.
(c) Appointing authorities shall make appointments within thirty (30) days of the effective date of this chapter. 40-23-3. Duties and scope of the commission. The commission shall:
(1) Review the structure, objectives, and implementation timeline of Medicaid transformation in the context of maximizing financing initiatives affecting children and family- serving systems.
(2) Examine how Medicaid policy changes impact:
(i) Children’s behavioral health services;
(ii) Child welfare–related services;
(iii) Community-based providers; and
(iv) Family support and prevention services.
(3) Identify all federal funding sources supporting Medicaid and related services, including but not limited to:
(i) Medicaid state plan funding;
(ii) Section 1115, 1915(b), and 1915(c) waivers;
(iii) Enhanced FMAP and time-limited federal funding;
(iv) TANF, Title IVB and IVE, MICVIH; and
(v) Federal grants administered by the department of human services, the department of children, youth and families, the department of health, and the department of elementary and secondary education.
(4) Assess opportunities to:
(i) Maximize federal revenue;
(ii) Improve cross-agency coordination of federal funds;
(iii) Reduce fragmentation or duplication; and
(iv) Mitigate the impact of expiring or declining federal funding.
(5) Evaluate barriers to accessing or drawing down federal funds for children’s behavioral health and family-serving systems.
(6) Solicit public input through at least two (2) public hearings and consider testimony from stakeholders not represented on the commission. 40-23-4. Reporting requirements.
(a) The commission shall issue an interim report to the general assembly no later than January 15, 2027, summarizing preliminary findings.
(b) The commission shall issue a final report no later than June 30, 2027, which shall include:
(1) Findings and analysis;
(2) Recommendations for statutory changes;
(3) Budgetary and fiscal recommendations; and
(4) Administrative or policy recommendations to maximize federal revenue and protect the continuum of care.
(c) The report shall be submitted to the speaker of the house, the president of the senate, and the chairs of the house and senate finance committees. 40-23-5. Administration and support.
(a) The commission shall elect a chairperson from among the legislative members.
(b) The executive office of health and human services shall provide staff support and data access as requested by the commission.
(c) Members of the commission shall serve without compensation.
SECTION 3. This act shall take effect upon passage.