| ACCOUNT | FY 2008 Conference |
FY 2008 Vetoes |
FY 2008 Overrides |
FY 2008 GAA |
|
|---|---|---|---|---|---|
| 4000-0600 | MassHealth Senior Care | 2,053,754 | -2,000 | 2,000 | 2,053,754 |
| 4000-0640 | MassHealth Nursing Home Supplemental Rates | 288,500 | 0 | 0 | 288,500 |
| 9110-0100 | Department of Elder Affairs Administration | 2,916 | 0 | 0 | 2,916 |
| 9110-1455 | Prescription Advantage | 63,791 | -3,287 | 0 | 60,504 |
| 9110-1500 | Elder Enhanced Home Care Services Program | 47,411 | 0 | 0 | 47,411 |
| 9110-1604 | Supportive Senior Housing Program | 4,189 | 0 | 0 | 4,189 |
| 9110-1630 | Elder Home Care Purchased Services | 105,225 | 0 | 0 | 105,225 |
| 9110-1633 | Elder Home Care Case Management and Administration | 39,869 | 0 | 0 | 39,869 |
| 9110-1636 | Elder Protective Services | 15,009 | 0 | 0 | 15,009 |
| 9110-1640 | Geriatric Mental Health Services Program | 225 | 0 | 0 | 225 |
| 9110-1650 | Family Caregivers Program | 250 | 0 | 0 | 250 |
| 9110-1660 | Congregate Housing Program | 2,623 | 0 | 0 | 2,623 |
| 9110-1700 | Residential Placement for Homeless Elders | 350 | 0 | 0 | 350 |
| 9110-1900 | Elder Nutrition Program | 6,325 | 0 | 0 | 6,325 |
| 9110-9002 | Grants to Councils on Aging | 7,885 | 0 | 0 | 7,885 |
| TOTAL | 2,638,322 | -5,287 | 2,000 | 2,635,036 | |
| account | description | amount |
|---|---|---|
| DEPARTMENT OF ELDER AFFAIRS | 2,635,035,672 | |
| Budgetary Direct Appropriations | ||
| 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 benefit for this demonstration project shall not be reduced below the services provided in fiscal year 2007; provided further, that the eligibility requirements for this demonstration project shall not be more restrictive than those established in fiscal year 2007; 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 2008 delineated by the federal poverty level; provided further, that the report shall be submitted not later than February 1, 2008; 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 2008 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, 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 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 no less than $270,000 shall be expended for nursing facility pre-admission counseling for long-term care services, which shall include an assessment of community-based options; provided further, that in fiscal year 2008, the division of health care finance and policy shall adjust rates for providers of adult day health by no less than $2,000,000 in the aggregate, which shall be above any previously authorized rate increase; provided further, that effective July 1, 2007 for the fiscal year ending June 30 2008, the division of health care finance and policy shall establish MassHealth nursing facility rates that result in payments to nursing facilities that are not less than $80,000,000 above the payments made to said facilities in fiscal year 2007; provided further, that not later than October 1, 2007, the Office of Medicaid shall submit a Money Follows the Person Rebalancing Demonstration grant in accordance with section 6071 of the federal Deficit Reduction Act of 2005, P.L. 109-171, to assist individuals seeking to transition from institutions who wish to live in the community; and provided further, that the Office of Medicaid shall forward a copy of this application to the house and senate committee on ways and means, the house and senate chairpersons of the joint committee on elder affairs, and the house and senate chairpersons of the joint committee on health care financing; and provided further, that the executive office of elder affairs shall make no change in the reimbursement system or operations of adult day health programs as they relate to transportation of program participants, except that the executive office may grant periodic rate increases, as appropriate, for transportation services |
2,053,753,985 |
| 4000-0640 | MassHealth Nursing Home Supplemental Rates
For nursing facility Medicaid rates; provided, that notwithstanding any general or special law to the contrary, in fiscal year 2008 the division of health care finance and policy shall establish nursing facility Medicaid rates that cumulatively total $288,500,000 more than the annual payment rates established by the division under the rates in effect as of June 30, 2002; provided further, that the division shall adjust per diem rates to reflect any reductions in Medicaid utilization; provided further, that the payments made pursuant to this line item shall be allocated in the following manner in fiscal year 2008: (1) effective July 1, 2007, an annual amount of $99,000,000 in the aggregate to fund the use of 2000 base year cost information for rate determination purposes; provided, that not more than $9,000,000 of this amount shall be expended for purposes of reimbursing nursing facilities for up to 10 bed hold days for patients of the facility on medical and non-medical leaves of absence; (2) effective July 1, 2007, an annual amount of $122,500,000 for enhanced payment rates to nursing homes; (3) effective July 1, 2007, an annual amount of $50,000,000 to fund a rate add-on for wages, hours and benefits and related employee costs of direct care staff of nursing homes; provided further, that as a condition for such a rate add-on, the division shall require that each nursing home document to the division that such funds are spent only on direct care staff by increasing the wages, hours and benefits of direct care staff, increasing the facility's staff-to-patient ratio, or by demonstrably improving the facility's recruitment and retention of nursing staff to provide quality care, which shall include expenditure of funds for nursing facilities which document actual nursing spending that is higher than the median nursing cost per management minute in the base year used to calculate Medicaid nursing facility rates; provided further, that a facility's direct care staff shall include all nursing personnel including registered nurses, licensed practical nurses, and certified nurses' aides hired by the facility from any temporary nursing agency or nursing pool registered with the department of public health, provided further, that the division shall credit wage increases that are over and above any previously collectively bargained wage increases; provided further, that in monitoring compliance for this rate add-on, the division's regulations shall adjust any spending compliance test to reflect any Medicaid nursing facility payment reductions, including, but not limited to, rate reductions imposed on or after October 1, 2002; provided further, that the expenditure of these funds shall be subject to audit by the division in consultation with the department of public health and the executive office of health and human services; provided further, that in implementing this section, the division shall consult with the Nursing Home Advisory Council; (4) effective July 1, 2007, an annual amount of $16,450,000 (a) to fund rate adjustments for reasonable capital expenditures by nursing homes, giving priority to nursing homes located or constructed in under-bedded areas as determined by the executive office, in consultation with the division, that meet quality standards established by the executive office of health and human services in conjunction with the department of public health and the division for the purposes of encouraging the upgrading and maintenance of quality of care in nursing homes; and (b) to fund rate adjustments to eligible nursing homes that meet utilization standards established by the executive office of health and human services in conjunction with the division for the purpose of reducing unnecessary nursing home admissions and facilitating the return of nursing home residents to non-institutional settings; provided further, that to the extent that the annual amount of $16,450,000 in this clause is not fully allocated, the division shall first provide operating or capital rate adjustments for publicly operated, urban and geographically-isolated nursing homes;(5) $300,000 for the purposes of an audit of funds distributed under clause (3); provided further, that the division, in consultation with the department of public health and with the assistance of the executive office of health and human services, shall establish penalties sufficient to deter noncompliance to be imposed against any facility that expends any or all monies in violation of clause (3), including but not limited to recoupment, assessment of fines or interest; provided further, that the division shall report to the house and senate committees on ways and means not later than October 1, 2007 a preliminary analysis of funds expended under this subsection in fiscal year 2007 and a description and timeline for auditing of these funds; (6) $250,000 to fund expenses of the division related to the implementation and administration of section 25 of chapter 118G of the General Laws; and (7) an amount sufficient to implement section 622 of chapter 151 of the acts of 1996; and provided further, that any additional funds that may become available through this item due to decreased Medicaid utilization shall first fund a per-diem rate add-on for large Medicaid providers as specified in 114.2 CMR 6.06 (10) (a), as in effect on September 1, 2003 and then fund further enhanced rates to nursing homes |
288,500,000 |
| 9110-0100 | Department of Elder Affairs Administration
For the operation of the executive office and regulation of assisted living facilities; provided, that the secretary shall continue to support community care ombudsman services; and provided further, that the executive office of elder affairs shall report annually to the house and senate committees on ways and means the number of assisted living units certified and the total revenues generated from application and certification fees for such units |
2,916,031 |
| 9110-1455 | Prescription Advantage
For the costs of the drug insurance program authorized by section 39 of chapter 19A of the General Laws; provided, that amounts received by the executive office of elder affairs' vendor as premium revenue for this program may be retained and expended by the vendor for the purposes of the program; provided further, that not less than $600,000 shall be made available for the operation of the pharmacy outreach program established by section 4C of said chapter 19A; provided further, that notwithstanding any general or special law to the contrary, unless otherwise prohibited by state or federal law, prescription drug coverage or benefits payable by the executive office of elder affairs, and the entities with which it has contracted for administration of the subsidized catastrophic drug insurance program pursuant to said section 39 of said chapter 19A, shall be the payer of last resort for this program for eligible persons with regard to any other third-party prescription coverage or benefits available to such eligible persons; provided further, that the executive office shall notify the house and senate committees on ways and means not less than 90 days in advance of any action to limit or cap the number of enrollees in the program; provided further, that this program is subject to appropriation and expenditures shall not exceed, in fiscal year 2008, the amount authorized in this item; provided further, that no action shall be taken to expand the benefits of the program, extend benefits to additional populations or reduce cost sharing in the program without approval of the general court; provided further, that the department shall file all legislation required to implement such actions for review and analysis by the general court; provided further, that the executive office shall take steps for the coordination of benefits with the Medicare prescription drug benefit created pursuant to the federal Medicare Prescription Drug Improvement and Modernization Act of 2003, to ensure that Massachusetts residents take advantage of said benefit; provided further, that the department shall provide assistance for prescription drug costs to enrollees who qualify for Medicare Part D as well as assistance for premiums, deductibles, payments, and co-payments required by the Part D or Medicare Advantage plans; or by other plans which provide creditable prescription drug coverage as defined by section 104 of said Medicare Modernization Act, and which provide coverage of the cost of prescription drugs actuarially equal to or better than that provided by Medicare Part D; provided further, that the secretary shall not implement cost sharing increases during fiscal year 2008 unless the executive office has given 90 days notice to the general court and has received approval of the proposed plan from a majority of the general court; provided further, that a person shall also be eligible to enroll in the program at any time within a year after reaching age 65; and provided further, that the department shall allow those who meet the program eligibility criteria to enroll in the program at any time during the year |
60,504,455 |
| 9110-1500 | Elder Enhanced Home Care Services Program
For the provision of enhanced home care services, including case management to elders who meet the eligibility requirements of the home care program and who need services above the level customarily provided under the program to remain safely at home, including elders previously enrolled in the managed care in housing, enhanced community options, and chronic care enhanced services programs; provided further, that the secretary shall actively seek to obtain federal financial participation for any and all services provided to seniors who qualify for medicaid benefits pursuant to the section 2176 waiver; provided further, that the executive office shall collect income data on persons receiving services provided in this item; provided further, that the executive office shall submit a report to the house and senate committees on ways and means detailing the population served by this item delineated by both 2007 federal poverty line income levels and 2007 social security income standards; provided further, that the report shall be submitted not later than February 1, 2008; and provided further, that the executive office shall submit a report not later than October 15, 2007 to the house and senate committees on ways and means which shall include the number of individuals on a waiting list for these services on October 1, 2007, compared to the number of individuals on a waiting list on July 1, 2007 |
47,410,832 |
| 9110-1604 | Supportive Senior Housing Program
For the operation of the supportive senior housing program at state or federally-assisted housing sites; provided, that the funds shall be expended to fully fund existing sites |
4,188,633 |
| 9110-1630 | Elder Home Care Purchased Services
For the operation of the elder home care program, including contracts with aging service access points or other qualified entities for the home care program, home care, health aides, home health and respite services and other services provided to the elderly; provided, that a sliding fee shall be charged to qualified elders; provided further, that the secretary of elder affairs may waive collection of sliding fees in cases of extreme financial hardship; provided further, that not more than $7,500,000 in revenues accrued from sliding fees shall be retained by the individual home care corporations without re-allocation by the executive office of elder affairs, and shall be expended for the purposes of the home care program, consistent with guidelines to be issued by the executive office; provided further, that the executive office shall report quarterly to the house and senate committees on ways and means on the receipt and expenditure of revenues accrued from the sliding fees; provided further, that the executive office shall report monthly to the house and senate committees on ways and means and the executive office for administration and finance on the amount expended from this item for purchase of service expenditures by category of service as set forth in 651 C.M.R. 3.01 and 651 C.M.R. 3.06; provided further, that no rate increase shall be awarded in fiscal year 2008 which would cause a reduction in client services or the number of clients served; provided further, that no funds shall be expended from this item to pay for salary increases for direct service workers who provide state-funded homemaker and home health aid services which would cause a reduction in client services; and provided further, that the secretary of elder affairs may transfer an amount not to exceed 3 per cent of the funds appropriated in this item to item 9110-1633 for case management services and the administration of the home care program |
105,224,938 |
| 9110-1633 | Elder Home Care Case Management and Administration
For the operation of the elder home care case management program, including contracts with aging service access points, or other qualified entities for home care case management services and the administration of the home care corporations funded through item 9110-1630 and item 9110-1500; provided, that such contracts shall include the costs of administrative personnel, home care case managers, travel, rent and other costs deemed appropriate by the executive office of elder affairs; provided further that no funds appropriated in this item shall be expended for the enhancement of management information systems; and provided further, that the secretary of elder affairs may transfer an amount not to exceed 3 per cent of the funds appropriated herein to item 9110-1630 |
39,869,177 |
| 9110-1636 | Elder Protective Services
For the elder protective services program, including protective services case management, guardianship services, the statewide elder abuse hotline, and the elder-at-risk program; provided, that not less than $800,000 shall be expended for money management services |
15,009,445 |
| 9110-1640 | Geriatric Mental Health Services Program
For the Geriatric Mental Health Services program, including residential care, case management, and day treatment services, to deinstitutionalize or divert elders with serious and persistent mental illness from institutionalized settings |
225,000 |
| 9110-1650 | Family Caregivers Program
For the family caregivers program |
250,000 |
| 9110-1660 | Congregate Housing Program
For congregate and shared housing services for the elderly; provided, that $375,000 shall be expended for an aging-in-place pilot project operated by of Jewish Family & Children's Service of Greater Boston (JF&CS) in Brookline and Malden, and by Jewish Family Service of Metrowest (JFS/MW) in Framingham; provided further, that not less than $216,000 shall be allocated to the Helping Elders at Risk Through Homes (HEARTH) program; provided further, that $150,000 shall be used to fully fund a supportive housing program at Edward F Doolan Apartments in the city of Fall River; provided further, that an amount $75,000 shall be expended for the Jewish Family Services of Western Massachusetts to implement the Aging-Well at Home Program in Springfield; provided further, that no less than $75,000 shall be expended to fund the aging-in-place pilot project operated by the Jewish Family Service of the North Shore in Swampscott; provided further, that not less than $75,000 shall be expended for the multicultural Alzheimer's service project of Springfield; and provided further that not less than $50,000 be expended for the Tuttle House facility in Dorchester |
2,622,873 |
| 9110-1700 | Residential Placement for Homeless Elders
For residential assessment and placement programs for homeless elders; provided, that $50,000 shall be expended for Living Waters Ministry of Hope for homeless outreach programs |
350,000 |
| 9110-1900 | Elder Nutrition Program
For the elder lunch program; provided further, that not less than $40,000 shall be expended for a youth/elder outreach position at the Roche Family Community Center in West Roxbury; provided, that not less than $50,000 shall be expended for the Senior FarmShare program; provided further, that not less than $15,000 shall be expended for the Grandparents as Parents Initiative; and provided further that $350,000 shall be expended for Community Physicians Associates for the purposes of administering a geriatrics program which shall include, but not be limited to inpatient care, outpatient care, rehabilitation and post-acute care, long-term care and assisted living counseling, and education of caregivers |
6,325,303 |
| 9110-9002 | Grants to Councils on Aging
For the local services program for grants to the councils on aging and for grants to or contracts with non-public entities which are consortia or associations of councils on aging; provided, that notwithstanding the foregoing, all monies appropriated in this item shall be expended in accordance with the distribution schedules for formula and incentive grants established by the secretary; provided further, that not less than $60,000 shall be provided to the LGBT Aging; and provided further, that such distribution schedules shall be submitted to the house and senate committees on ways and means |
7,885,000 |
| account | description | amount |
|---|---|---|
| Federal Grant Spending | 6,427,477 | |
| 9110-1074 | Older Americans Act - Title III and Title VII
For the purposes of a federally funded grant entitled, Older Americans Assistance, Title III and Title VII |
3,174,762 |
| 9110-1077 | National Family Caregiver Support Program
For the purposes of a federally funded grant entitled, Older Americans Act, Title III-E, National Family Caregiver Support Program |
1,394,234 |
| 9110-1095 | Health Information Counseling and Assistance
For the purposes of a federally funded grant entitled, Rebalancing Long Term Systems Project |
28,868 |
| 9110-1178 | Community Service Employment Program
For the purposes of a federally funded grant entitled, Community Service Employment Program |
530,839 |
| 9110-1755 | State Pharmacy Assistance Program Transitional Grant
For the purposes of a federally funded grant entitled, State Pharmacy Assistance Program Transitional Grant |
1,202,034 |
| 9110-2457 | Springfield Multicultural Alzheimer's Services Project
For the purposes of a federally funded grant entitled, Springfield Multicultural Alzheimer's Project |
8,974 |
| 9110-2760 | New England Massachusetts Aging and Disability Resource Center
For the purposes of a federally funded grant entitled, New England Massachusetts Aging and Disability Resource Center |
77,884 |
| 9110-2761 | Aging and Disability Resource Center - Center for Medicaid and Medicare Services
For the purposes of a federally funded grant entitled, Aging and Disability Resource Center- Center for Medicaid and Medicare Services |
9,882 |