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Budget Summary FY2017

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40000600 - MassHealth Senior Care
Data Current as of:  8/9/2016

Account Description FY2016
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 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 the benefits of the community choices initiative shall not be reduced below the services provided in fiscal year 2016; provided further, that the eligibility requirements for this demonstration project shall not be more restrictive than those established in fiscal year 2016; 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 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, the 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 effect January 1, 2015; provided further, that nursing facility rates effective October 1, 2016 may be developed using the costs of calendar year 2007; provided further, that MassHealth shall reimburse nursing home facilities for up to 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, 2017, MassHealth shall report to the chairs of the house and senate committees on ways and means the following for fiscal year 2016: (a) 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; (b) 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; (c) 6 separate MassHealth payment rates and the average payment amount rate per nursing facility client resident; (d) the actual number of nursing home residents for each of the 6 payment categories in clause (c); (e) the aggregate payment amount per nursing facility by month; and (f) all reports shall delineate by nursing home, including grand totals where appropriate; and provided further, that no nursing home shall reassign a patient's bed during a leave of absence that is eligible for reimbursement under this item
3,374,938,989 3,516,116,093