40000600 - MassHealth Senior Care

Account Description FY2009
GAA
FY2009  
Total  
Spending
  
4000-0600 MassHealth Senior Care
For health care services provided to MassHealth members who are seniors, and for the operation of the senior care options program under section 9D of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to these recipients in prior fiscal years; provided further, that funds shall be expended for the 'community choices' initiative; provided further, that no payment for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that benefits for this demonstration project shall not be reduced below the services provided in fiscal year 2008; provided further, that the eligibility requirements for this demonstration project shall not be more restrictive than those established in fiscal year 2008; provided further, that the executive office of health and human services shall submit a report to the house and senate committees on ways and means detailing the projected costs and the number of individuals served by the 'community choices' initiative in fiscal year 2009 delineated by the federal poverty level; provided further, that the report shall be submitted not later than February 2, 2009; provided further, that notwithstanding any general or special law to the contrary, not less than $5,000,000 shall be expended from this item for the purpose of providing an increase to $72.80 per month in the personal needs allowance for individuals residing in nursing homes and rest homes who are eligible for MassHealth, Emergency Aid to the Elderly Disabled and Children program or Supplemental Security Income; provided further, that notwithstanding any general or special law to the contrary, the regulations, criteria and standards for determining admission to and continued stay in a nursing home in fiscal year 2009 shall not be more restrictive than those regulations, criteria and standards in effect on January 1, 2004 until the executive office of health and human services and the executive office of elder affairs submit a multi-year plan to the house and senate committees on ways and means and the joint committee on health care financing detailing the suggested timeline for phasing in changes to nursing home clinical criteria, provided that these changes shall not adversely affect current nursing home residents and shall not jeopardize the effectiveness of the 2176 home and community based waiver; provided further, care management under section 3 of chapter 211 of the Acts of 2006 shall be implemented through Aging & Disability Resource Consortiums, which shall include a combination of one or more Aging Services Access Points and Independent Living Centers, and section 2 of section 211, the pre-admission counseling and assessment program, established pursuant to the last paragraph of section 9 of chapter 118E of the General Laws, shall be implemented through the development of said aging and disability resource consortiums; provided further, that notwithstanding any general or special law to the contrary, for any nursing home or non-acute chronic disease hospital that provides kosher food to its residents, the department, in consultation with the division, in recognition of the unique special innovative program status granted by the executive office, shall continue to make the standard payment rates established in fiscal year 2006 to reflect the high dietary costs incurred in providing kosher food; provided further, that funds shall be expended for the purpose of a housing with services demonstration project known as the 'Caring Homes' initiative designed to delay or prevent nursing home placement by providing care-giving services to an elder; provided further, that under said demonstration project, eligible MassHealth enrollees shall be able to live in the home of an individual or relative, with the exception of spouses and dependent children, to provide for their long term supports, pursuant to regulations promulgated by said executive office; provided further that effective July 1, 2008 for the fiscal year ending June 30, 2009, the division of health care finance and policy shall establish nursing facility MassHealth rates that are $45 million in payments above the payments made to nursing facilities for the fiscal year ended 2008, for the purpose of funding inflationary labor and benefit costs, funded by any additional funds that may become available in this item due to a decrease in Medicaid utilization and that are not otherwise projected to be expended for other services from this item; provided further, that in the event said additional funds that may become available in this item do not total at least $45 million, said nursing facility MassHealth rate increase shall be proportionally reduced; provided further, that the secretary of elder affairs and the director of the office of Medicaid shall report monthly to the secretary of administration and finance and to the house and senate committees on ways and means the total projected expenditures from this item and the extent to which said $45 million nursing facility MassHealth rate increase may be funded in fiscal year 2009; and provided further, that the secretary of elder affairs and the director of the office of Medicaid shall provide a monthly report to the secretary of administration and finance and to the house and senate committees on ways and means showing Medicaid nursing facility utilization in the current fiscal year compared to Medicaid nursing facility utilization in the same period for the prior fiscal year

2,158,355,058 2,101,532,200  

Veto Explanation: I am reducing this item to an amount consistent with my House 2 recommendation.

 
 
HISTORICAL SPENDING CATEGORIES ($000)
column definitions
SPENDING CATEGORY
FY2005
Expended

FY2006
Expended

FY2007
Expended

FY2008
Expended

FY2009
GAA
FY2009
Budget
Reductions
Operating Expenses 0 35 0 0 0 0
Public Assistance 1,695,341 1,859,305 1,686,807 2,013,469 2,158,355 -56,823
TOTAL 1,695,341 1,859,340 1,686,807 2,013,469 2,158,355 -56,823

 

FY2009 Spending Category Chart

Pie Chart: Public Assistance=100%



 
Earmarks

EARMARK DESCRIPTION

City / Town
FY2009
GAA
  FY2009    
  9C Cuts    
Personal Needs Allowance Statewide5,000,000 0  
Rate Earmark: Kosher Food Chelsea, Brookline, Worcester, Longmeadow, Swampscott, New Bedford, Canton1,300,000 0