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Budget Summary FY2016

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Department of Elder Affairs
Data Current as of:  8/19/2015





FISCAL YEAR 2016 BUDGET SUMMARY ($000)
ACCOUNT FY2016
Conference
FY2016
Vetoes
FY2016
Overrides
FY2016
GAA
MassHealth Senior Care 2,976,350 0 0 2,976,350
MassHealth Nursing Home Supplemental Rates 302,900 -5,300 5,300 302,900
Department of Elder Affairs Administration 2,344 0 0 2,344
HCBS Policy Lab 150 0 0 150
Prescription Advantage 18,668 0 0 18,668
Elder Enhanced Home Care Services Program 70,255 0 0 70,255
Supportive Senior Housing Program 5,494 0 0 5,494
Elder Home Care Purchased Services 104,595 0 0 104,595
Elder Home Care Case Management and Administration 35,547 0 0 35,547
Elder Protective Services 23,123 0 0 23,123
Elder Congregate Housing Program 2,155 0 0 2,155
Elder Homeless Placement 186 0 0 186
Elder Nutrition Program 7,253 0 0 7,253
Grants to Councils on Aging 13,650 0 0 13,650
TOTAL    3,562,671 -5,300 5,300 3,562,671

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account description amount
DEPARTMENT OF ELDER AFFAIRS 3,562,670,858
 
4000-0600 MassHealth Senior Care
For health care services provided to MassHealth members who are seniors and for the operation of the MassHealth senior care options initiative 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 of the community choices initiative shall not be reduced below the services provided in fiscal year 2015; provided further, that the eligibility requirements for this demonstration project shall not be more restrictive than those established in fiscal year 2015; provided further, that funds shall be expended from this item to implement the pre-admission counseling and assessment program under the fourth paragraph of section 9 of said chapter 118E, which shall be implemented on a statewide basis through the aging and disability resource consortia; provided further, that notwithstanding any general or special law to the contrary, funds shall be expended from this item to maintain a personal needs allowance of $72.80 per month 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, for any nursing home or non-acute chronic disease hospital that provides kosher food to its residents, the executive office of elder affairs, in consultation with the center for health information and analysis, in recognition of the special innovative program status granted by the executive office of health and human services, 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 MassHealth shall maintain the same respite benefits for adult foster caregivers that were in affect January 1, 2015; provided further, that notwithstanding any general or special law to the contrary, nursing facility rates effective October 1, 2015 may be developed using the costs of calendar year 2007; provided further, that MassHealth shall reimburse nursing home facilities for up to and including 20 medical leave of absence days and shall reimburse the facilities for up to 10 nonmedical leave of absence days; provided further, that medical leave of absence days shall include an observation stay in a hospital in excess of 24 hours; provided further, that not later than January 1, 2016, MassHealth shall report to the house and senate committees on ways and means the following for the fiscal year 2015: (i) the number of nursing facility clients on a leave of absence, delineated by the nursing facility, by medical leave of absence days and medical leave of absence days that exceeded 10 days per hospital stay, nonmedical leave of absence days and the total number of days on leave of absence unduplicated member count; (ii) licensed beds monthly capacity levels per nursing home and the monthly total number of empty beds per nursing facility, total number of all nursing home residents and total MassHealth nursing home residents; (iii) 6 separate MassHealth payment rates and the average payment amount rate per nursing facility client resident; (iv) actual number of nursing home residents for each of the 6 payment categories in clause (iii); (v) the aggregate payment amount per nursing facility by month; and (vi) all reports shall delineate by nursing home, including grand totals where appropriate; and provided further, that no nursing home may reassign a patient's bed during a leave of absence eligible for reimbursement under this item
                General Fund ............... 99.90%
                Community First Trust Fund - Budgeted ............... 0.10%
2,976,350,333
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 2016 the executive office of health and human services, in consultation with the center for health information and analysis, shall establish nursing facility Medicaid rates that cumulatively total $297,600,000 more than the annual payment rates established under the rates in effect as of June 30, 2002; provided, that an amount for expenses related to the collection and administration of section 63 of chapter 118E of the General Laws shall be transferred to the executive office of health and human services; provided further, that the payments made under this item shall be allocated in an amount sufficient to implement section 622 of chapter 151 of the acts of 1996; provided further, that not less than $2,500,000 or 70 per cent of any supplemental rate reimbursements in excess of $297,600,000 made pursuant to this item in fiscal year 2016 shall be expended to fund a rate add-on for wages, benefits and related employee costs of direct care staff of nursing homes; provided further, that not less than $2,800,000 shall be expended as incentive payments to nursing facilities meeting the criteria determined under the MassHealth Nursing Facility Pay for Performance Program and that have established and participated in a cooperative effort in each qualifying nursing facility between representatives of employees and management that is focused on implementing that criteria and improving the quality of services available to MassHealth members and that shall decide jointly how to expend such incentive payments; and provided further, that the MassHealth agency shall adopt all additional regulations and procedures necessary to carry out this section
302,900,000
9110-0100 Department of Elder Affairs Administration
For the operation of the executive office of elder affairs and regulation of assisted living facilities
2,343,832
9110-0104 HCBS Policy Lab
For the support of the Home and Community-Based Services Policy Lab Fund established in section 2MMMM of chapter 29 of the General Laws; provided, that in addition to this item, the secretary of elder affairs may transfer an amount not to exceed a total of $150,000 from the funds appropriated to items 9110-1500, 9110-1630, 9110-1636 and 9110-1900 to this item; provided further, that the comptroller shall transfer the amount appropriated in this item into the Home and Community-Based Services Policy Lab Fund not later than July 15, 2015; provided further, that the comptroller shall transfer any funds transferred to this item from items 9110-1500, 9110-1630, 9110-1636 and 9110-1900 into the Home and Community-Based Services Policy Lab Fund not more than 30 days after they are made available; provided further, that not later than September 15, 2015, the secretary shall file a report with the joint committee on elder affairs, the joint committee on health care financing and the house and senate committees on ways and means detailing an initial plan for the research and analytic activities to be supported by the fund pursuant to section 254 of chapter 165 of the acts of 2014; and provided further, that the executive office of elder affairs shall identify and pursue non-state sources of funding for the home and community-based services policy lab
150,000
9110-1455 Prescription Advantage
For the costs of the drug insurance program authorized in 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 funds shall be expended for the operation of the pharmacy outreach program established in 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 shall be subject to appropriation; provided further, that notification shall be given to the house and senate committees on ways and means at least 30 days prior to any coverage or benefits expansions; provided further, that the executive office shall seek to obtain maximum federal funding for discounts on prescription drugs available to the executive office and to prescription advantage enrollees; 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, Public Law 108-173, to ensure that residents of the commonwealth take advantage of this benefit; provided further, that a person shall also be eligible to enroll in the program at any time within a year after reaching age 65; provided further, that the executive office shall allow those who meet the program eligibility criteria to enroll in the program at any time during the year; provided further, that $90,000 shall be expended for the serving the health insurance needs of everyone (SHINE) program; provided further, that these funds shall be used to assist seniors in choosing the Medicare plan that best fits their budgets while meeting their health care needs; and provided further, that the department shall report to the house and senate committees on ways and means not later than March 1, 2016 on the number of seniors served by the SHINE program and their average annualized premium savings
18,668,169
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 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, that the secretary of elder affairs shall seek to obtain federal financial participation for all services provided to seniors who qualify for Medicaid benefits pursuant to the waiver in Section 1915C of the Social Security Act, as codified at 42 U.S.C. Section 1396n(c); and provided further, that the executive office of elder affairs shall report not later than March 12, 2016, to the house and senate committees on ways and means on: (i) the number of seniors receiving services through this item and item 9110-1630; and (ii) the number of seniors on a waitlist for these services, by month, from January 2011 to January 2016
                General Fund ............... 98.62%
                Community First Trust Fund - Budgeted ............... 1.38%
70,255,327
9110-1604 Supportive Senior Housing Program
For the operation of the supportive senior housing program at state or federally-assisted housing sites; provided, that funds shall be expended to fund existing sites
5,493,672
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, geriatric mental health services and other services provided to the elderly; provided, that sliding-scale fees shall be charged to qualified elders; provided further, that the secretary of elder affairs may waive collection of sliding-scale fees in cases of extreme financial hardship; provided further, that not more than $11,500,000 in revenues accrued from sliding-scale fees shall be retained by the individual home care corporations without reallocation 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 and the 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 CMR 3.01 and 651 CMR 3.03; provided further, that no rate increase shall be awarded in fiscal year 2016 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 aide services which would cause a reduction in client services; provided further, that funding shall be expended for provider training and outreach to gay, lesbian, bisexual, transgender, queer and questioning elders and caregivers; 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
                General Fund ............... 93.64%
                Community First Trust Fund - Budgeted ............... 6.36%
104,595,483
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 items 9110-1630 and 9110-1500; provided, that the contracts shall include the costs of administrative personnel, home care case managers, travel, rent and other costs considered 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 in this item to item 9110-1630
35,546,961
9110-1636 Elder Protective Services
For the elder protective services program, including, but not limited to, protective services case management, guardianship services, the statewide elder abuse hotline, money management services and the elder-at-risk program; provided, that not less than $50,000 shall be expended for the establishment of and administrative support of regional Financial Abuse Specialist Teams to improve the ability of elder protective services programs to investigate and respond to reports of financial exploitation as recommended by the Elder Protective Service Commission established by section 204 of Chapter 139 of the Acts of 2012; and provided further, that the Executive Office of Elder Affairs shall provide a report to the House and Senate Chairs of the Joint Committee on Elder Affairs on the implementation of FAST Teams on or before June 30, 2016
23,123,139
9110-1660 Elder Congregate Housing Program
For congregate and shared housing services and naturally occurring retirement communities for the elderly; provided, that not less than $642,000 shall be expended for providers of naturally occurring retirement communities with whom the department of elder affairs entered into service agreements within fiscal year 2015 at proportions of total available funding equal to those provided in fiscal year 2015
2,154,626
9110-1700 Elder Homeless Placement
For residential assessment and placement programs for homeless elders
186,000
9110-1900 Elder Nutrition Program
For the elder nutrition program; provided, that no less than the amount appropriated in item 9110-1900 of section 2 of chapter 38 of the acts of 2013 shall be expended for the senior farm share program; and provided further, that not less than $750,000 shall be expended for home delivered meals
7,253,316
9110-9002 Grants to Councils on Aging
For grants to the councils on aging and for grants to or contracts with nonpublic entities which are consortia or associations of councils on aging; provided, that all monies appropriated in this item shall be expended under the distribution schedules for formula and incentive grants established by the secretary of elder affairs; provided further, that the distribution schedules shall be submitted to the house and senate committees on ways and means not later than February 17, 2016; provided further, that not less than $150,000 shall be expended for the Rossetti-Cowan Senior Center in Revere; provided further, not less than $50,000 shall be expended for the design of a new council on aging building in the town of Halifax; provided further, that not less than $100,000 shall be expended for the senior center in the town of Holliston; provided further, that not less than $65,000 shall be expended for the Sterling Senior Center; provided further, that not less than $200,000 shall be expended for improvements and expansion of the department of elder affairs in the city known as the town of Braintree; provided further, that not less than $50,000 shall be expended for the costs associated with care and services provided at the Whipple Senior Center in the city known as the town of Weymouth; provided further, that not less than $75,000 shall be expended as a grant to the town of Easton for the Easton Council on Aging; provided further, that not less than $60,000 be provided to the Worcester Regional Transit Authority for the establishment of a Senior Van and Paratransit Service in the Town of Boylston; provided further, that not less than $50,000 shall be expended for a senior center in the town of Marlborough; and provided further, that not less than $50,000 shall be expended for the Winchendon Senior Center
13,650,000

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