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Budget Summary FY2017

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Department of Elder Affairs
Data Current as of:  8/9/2016



FISCAL YEAR 2017 BUDGET SUMMARY ($000)
ACCOUNT FY2017
Conference		 FY2017
Vetoes		 FY2017
Overrides		 FY2017
GAA
MassHealth Senior Care 3,516,116 0 0 3,516,116
MassHealth Nursing Home Supplemental Rates 347,900 -17,800 17,800 347,900
Department of Elder Affairs Administration 2,077 0 0 2,077
Prescription Advantage 18,522 -350 0 18,172
Elder Enhanced Home Care Services Program 70,548 0 0 70,548
Supportive Senior Housing Program 5,668 0 0 5,668
Elder Home Care Purchased Services 102,571 -10 10 102,571
Elder Home Care Case Management and Administration 33,796 0 0 33,796
Elder Protective Services 28,048 0 0 28,048
Elder Congregate Housing Program 2,060 0 0 2,060
Elder Homeless Placement 186 0 0 186
Elder Nutrition Program 7,256 0 0 7,256
Grants to Councils on Aging 14,837 -702 702 14,837
TOTAL    4,149,585 -18,862 18,512 4,149,235

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account description amount
DEPARTMENT OF ELDER AFFAIRS 4,185,826,144
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 		3,516,116,093
4000-0640 MassHealth Nursing Home Supplemental Rates
For nursing facility Medicaid rates; provided, that in fiscal year 2017 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 $309,600,000 more than the annual payment rates established under the rates in effect as of June 30, 2002; provided further, that not less than $35,500,000 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 $20,500,000 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, MassHealth shall adopt all additional regulations and procedures to carry out this section; provided further, that no later than January 30, 2017, MassHealth shall report to the house and senate committees on ways and means an analysis of the impact on the wages for direct care workers at the nursing homes receiving said funds; 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; provided further, 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; and 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
 347,900,000
9110-0100 Department of Elder Affairs Administration
For the operation of the executive office of elder affairs and the regulation of assisted living facilities 		2,076,565
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 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 under 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 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 before 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 under the federal Medicare Prescription Drug Improvement and Modernization Act of 2003, Public Law 108-173, to ensure that residents take advantage of this benefit; provided further, that residents shall also be eligible to enroll in the program at any time within a year after reaching age 65; and 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 		18,171,922
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 1915(c) 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 13, 2017, to the house and senate committees on ways and means on: (a) the number of seniors receiving services through this item and item 9110-1630; and (b) the number of seniors on a waitlist for these services, by month, from January 2011 to January 2017 		70,548,399
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 		5,668,475
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 $16,000,000 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 home care program, consistent with guidelines to be issued by the executive office; provided further, that no rate increase shall be awarded in fiscal year 2017 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 to caregivers; provided further, that the secretary of elder affairs may transfer not more than 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; provided further, that not less than $10,000 shall be allocated for the operation of the Brookline Senior Center's Alzheimer's Caregiver Respite Program; provided further, that the secretary of elder affairs shall develop a pilot program to provide home care services to certain persons whose annual income exceeds, by 15 per cent or less, the income eligibility limit as of January 1, 2016; provided further, that such persons may include those who: (a) are unable to afford sufficient unsubsidized home care for their needs; (b) pose a risk of higher-cost state-provided care in a nursing facility should they be ineligible for home care; or (c) lose home care eligibility as a result of a spouse's death; provided further, that an amount not to exceed $1,075,000 shall be used for the pilot program which shall be allocated between items 9110-1500, 9110-1630 and 9110-1633; and provided further, the secretary shall report to the house and senate committees on ways and means not later than February 1, 2018 on: (a) caseload and expenditures made from the pilot program; (b) projected cost effectiveness from the piloted population including, but not limited to, estimated savings from reduced medical costs, avoided nursing facility admissions and cost sharing by recipients; and (c) the estimated fiscal impact and cost benefits of expanding home care to all eligible persons whose annual income exceeds the income eligibility limit in effect on January 1, 2016 by 15 per cent or less
                General Fund ............... 94.60%
                Community First Trust Fund ............... 5.40%
102,570,589
9110-1633 Elder Home Care Case Management and Administration
For the operation of the elder home care 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 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; and provided further, that the secretary of elder affairs may transfer not more than 3 per cent of the funds appropriated in this item to item 9110-1630 		33,795,743
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 		28,048,120
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 in fiscal year 2016 at proportions of total available funding equal to those provided in fiscal year 2016 		2,059,798
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 not 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 		7,256,375
9110-9002 Grants to Councils on Aging
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 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 15, 2017; provided further, that no less than $25,000 shall be allocated for the operation of the South Boston Neighborhood House and its Senior Programs; provided further, that no less than $50,000 shall expended for the maintenance of the heating system at the Gladys L. Hurrell Senior Center in Rehoboth; provided further, that $200,000 shall be expended for the construction, design, improvement, and addition of a council on aging facility at Dedham town hall; provided further, that not less than $25,000 shall be expended to the Westfield Senior Center; provided further, that not less than $55,000 shall be expended for the operations of the Council on Aging in the town of Wareham; provided further, that not less than $75,000 shall be expended for the cost associated with care and services provided at Whipple Senior Center in Weymouth; provided further, that no less than $50,000 shall be expected for ABCD North End/West End elderly program; provided further, that not less than $50,000 shall be expended to the towns of Maynard and Acton for the senior van program; provided further, that no less than $100,000 shall be expended to provide furnishings and equipment for a Senior Community Center in Greenfield; provided further, that not less than $20,000 shall be granted to Quincy's Council on Aging to enable the agency to create a dementia-capable system of home and community-based services and supports; provided further, that not less than $7,000 shall be expended for the costs associated with care and services provided through the Marshfield Council on Aging at the Marshfield Council on Aging Home; provided further, that not less than $50,000 shall be expended for the expansion of the council on aging building in the town of Halifax; and provided further, that not less than $50,000 shall be expended for the Franklin Senior Center; and provided further, that not less than $50,000 shall be expended on the Catholic Charities' Haitian Multi Service Center
 		14,837,000

account description amount
Federal Grant Spending 36,591,065
9110-1074 Older Americans Act
For the purposes of a federally funded grant entitled, Older Americans Act - Title III and Title VII 		109,606
9110-1075 Title VII Ombudsman
For the purposes of a federally funded grant entitled, Title VII Ombudsman 		336,169
9110-1076 Title IIIB Supportive Service
For the purposes of a federally funded grant entitled, Title IIIB Supportive Service 		10,182,633
9110-1077 National Family Caregiver Support Program
For the purposes of a federally funded grant entitled, National Family Caregiver Support Program 		3,700,000
9110-1079 IIID Preventative Health
For the purposes of a federally funded grant entitled, Title III-D Preventative Health 		436,823
9110-1094 State Health Insurance Assistance Program
For the purposes of a federally fund grant entitled, State Health Insurance Assistance Program 		1,097,000
9110-1173 Older Americans Act
For the purposes of a federally funded grant entitled, Older Americans Act - Title III Nutrition Program 		13,383,620
9110-1174 Nutrition Services Incentive Program
For the purposes of a federally funded grant entitled, Nutrition Services Incentive Program 		4,885,300
9110-1178 Community Service Employment Program
For the purposes of a federally funded grant entitled, Community Service Employment Program 		1,881,340
9110-1190 MA Chronic Disease Self-Management Education Program
For the purposes of a federally funded grant entitled, MA Chronic Disease Self-Management Education Program 		100,714
9110-1191 Enhanced Alcohol and Drug Recovery Options Counseling Program
For the purposes of a federally funded grant entitled, Enhanced Alcohol and Drug Recovery Options Counseling Program 		198,706
9110-1194 2013 MIPPA ADRC
For the purposes of a federally funded grant entitled, 2013 MIPPA ADRC 		79,154
9110-1197 Alzheimer's Disease Supportive Service Program
For the purposes of a federally funded grant entitled, Alzheimer's Disease Supportive Service Program 		200,000

account description amount