This is not the official budget document.

Budget Summary FY2018

Search for line item

Go

Office of the Secretary of Health and Human Services
Data Current as of:  12/6/2017



FISCAL YEAR 2018 BUDGET SUMMARY ($000)
ACCOUNT FY2018
Conference		 FY2018
Vetoes		 FY2018
Overrides		 FY2018
GAA
Safe and Successful Youth Initiative 4,320 -70 70 4,320
Unaccompanied Homeless Youth Services 675 -675 675 675
Edward M Kennedy Community Health Center 100 0 0 100
Personal Care Attendant Council 1,633 0 0 1,633
Family Resource Centers 500 0 0 500
EOHHS and MassHealth Administration 102,682 -425 425 102,682
MassHealth Recoveries from Current and Prior Fiscal Years RR 225,000 0 0 225,000
EOHHS Contingency Contracts Retained Revenue 56,750 0 0 56,750
State Plan Amendment Support 50 0 0 50
MassHealth CommonHealth Plan 164,396 0 0 164,396
MassHealth Managed Care 5,553,252 0 0 5,553,252
MassHealth Senior Care 3,520,335 -5,000 5,000 3,520,335
MassHealth Nursing Home Supplemental Rates 352,600 -7,500 7,500 352,600
MassHealth Fee for Service Payments 2,397,299 -209,400 0 2,187,899
MassHealth Breast and Cervical Cancer Treatment 6,192 0 0 6,192
MassHealth Family Assistance Plan 526,813 0 0 526,813
Small Business Employee Premium Assistance 34,042 0 0 34,042
MassHealth Affordable Care Act Expansion Populations 2,238,691 0 0 2,238,691
Children's Behavioral Health Initiative 247,338 0 0 247,338
Children's Medical Security Plan 12,097 0 0 12,097
MassHealth HIV Plan 27,374 0 0 27,374
Medicare Part D Phased Down Contribution 441,755 0 0 441,755
Hutchinson Settlement 71,730 0 0 71,730
Health and Human Services IT Costs 124,870 0 0 124,870
TOTAL    16,110,495 -223,070 13,670 15,901,095

Hide line item language

account description amount
OFFICE OF THE SECRETARY OF HEALTH AND HUMAN SERVICES 15,968,457,197
Direct Appropriations
4000-0005 Safe and Successful Youth Initiative
For youth violence prevention program grants administered by the executive office of health and human services; provided, that the grants shall be targeted at reducing youth violence among young persons at highest risk of being perpetrators or victims of gun and community violence; provided further, that the secretary shall report to the house and senate committees on ways and means not later than March 15, 2018 detailing: (i) successful grant applications; (ii) a set of clearly-defined goals and benchmarks on which grant recipients shall be evaluated; and (iii) outcomes and findings from the grant awards for fiscal year 2017; provided further, that funds may be set aside for the administration of these programs; provided further, that these funds shall be available to those municipalities with the highest annual number of youth homicides and serious assaults as determined by the executive office; provided further, that not less than $25,000 shall be expended to Springfield Partners for Community Action, Inc. for the AWAKE program in the city of Springfield, to provide comprehensive youth development and violence prevention services to at-risk youth; provided further, that not less than $25,000 shall be expended for the Martin Luther King Jr. Family Services, Inc. to provide comprehensive youth development and violence prevention services to at-risk youth; and provided further, that not less than $20,000 shall be expended for the South End Community Center of Springfield, Inc.'s Youth Corp program
 		4,320,000
4000-0007 Unaccompanied Homeless Youth Services
For housing and supportive services for unaccompanied youth pursuant to section 16X of chapter 6A of the General Laws; provided, that not less than $40,000 shall be expended for the Y2Y homeless shelter in Cambridge; and provided further, that the secretary of health and human services shall report to the house and senate committees on ways and means not later than March 1, 2018 on: (i) the number of youths served through this item; (ii) the types of services received by participating youths; (iii) the number of youths who transition into stabilized housing and the zip code of the stabilized housing; (iv) the number of youths who remain in stabilized housing after 90 days, when applicable; (v) the number of youths turned away from the program; (vi) the amount of funding awarded to vendors for the delivery of services and the names of each vendor; and (vii) other quantifiable data related to client outcomes as determined by the secretary 		675,000
4000-0014 Edward M Kennedy Community Health Center
For the Edward M. Kennedy Community Health Center, Inc. to professionally train community health workers to serve as the patient link to medical and social services for the disenfranchised population throughout the Worcester and MetroWest regions 		100,000
4000-0050 Personal Care Attendant Council
For the operation of the PCA quality home care workforce council established in section 71 of chapter 118E of the General Laws 		1,632,510
4000-0051 Family Resource Centers
For the operation and support of the network of child and family service programs throughout the commonwealth, including family resource centers supported through this item and item 4800-0200; provided, that centers within this item shall: (i) be consistent with the requirements of section 16U of chapter 6A of the General Laws; (ii) demonstrate adherence to an evidence-based model of service; and (iii) use measurable outcomes to assess quality; provided further, that the secretary of the executive office of health and human services shall maintain the fiscal year 2017 contract with a third party administration service organization to oversee the execution of, and agency's compliance with, subsection (b) of said section 16U of said chapter 6A; provided further, that the executive office shall provide biannual progress updates to the secretary of administration and finance, the joint committee on children, families and persons with disabilities and the house and senate committees on ways and means; provided further, that not later than March 15, 2018, the executive office shall file a biannual report with the house and senate committees on ways and means; provided further, that the report shall detail the number of children and families served at each center, the types of programs, program outcomes, client feedback and progress on data sharing between centers; and provided further, that the network of child and family service programs shall coordinate with the executive office of health and human services, the department of early education and care and municipal police departments to provide emergency assistance to runaway children at times when the juvenile court is not open, consistent with the requirements of section 39H of chapter 119 of the General Laws 		500,000
4000-0300 EOHHS and MassHealth Administration
For the operation of the executive office of health and human services, including the operation of the managed care oversight board; provided, that the executive office shall provide technical and administrative assistance to agencies under the purview of the secretariat receiving federal funds; provided further, that funds appropriated in this item shall be expended for administrative and contracted services related to the implementation and operation of programs under chapter 118E of the General Laws; provided further, that in consultation with the center for health information and analysis, no rate increase shall be provided to existing Medicaid provider rates without taking all measures possible under Title XIX of the Social Security Act to ensure that rates of payment to providers shall not exceed the rates necessary to meet only the cost of efficiently and economically operated providers in order to provide services of adequate quality; provided further, that funds may be expended for the operation of the office of health equity within the executive office; provided further, that no expenditures, whether made by the executive office or another commonwealth entity, shall be made that are not federally reimbursable, including those related to Titles XIX or XXI of the Social Security Act, the MassHealth demonstration waiver under section 1115(a) of the Social Security Act or the community first demonstration waiver under section 1115 of the Social Security Act, except as required for: (i) the equivalent of MassHealth standard benefits for children under age 21 who are in the care or custody of the department of youth services or the department of children and families; (ii) dental benefits provided to clients of the department of developmental services who are age 21 or over; (iii) managed care capitation payments for MassHealth members who are residents of Institutions for Mental Disease for more than 15 days in any calendar month, and otherwise as explicitly authorized; or (iv) cost-containment efforts, the purposes and amounts of which shall be submitted to the executive office for administration and finance and the house and senate committees on ways and means 30 days before making these expenditures; provided further, that in calculating rates of payment for children enrolled in MassHealth receiving inpatient and outpatient services at acute care pediatric hospitals and pediatric specialty units as defined in section 8A of said chapter 118E, the executive office shall make a supplemental payment not less than $7,400,000 to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care; provided further, that the executive office may continue to recover provider overpayments made in the current and prior fiscal years through the Medicaid management information system and these recoveries shall be considered current fiscal year expenditure refunds; provided further, that the executive office may collect directly from a liable third party any amounts paid to contracted providers under said chapter 118E for which the executive office later discovers another third party is liable if no other course of recoupment is possible; provided further, that funds shall be provided in an amount not less than the total appropriated in item 1599-2009 in section 2 of chapter 182 of the acts of 2008; provided further, that the commissioner of mental health shall approve any prior authorization or other restriction on medication used to treat mental illness under written policies, procedures and regulations of the department of mental health; provided further, that the executive office shall report to the house and senate committees on ways and means not later than January 13, 2018 on the number of members served in the dual eligible initiative, the average expenditure per member, the average expenditure per member prior to the demonstration project and the number of clients that receive care at skilled nursing facilities; provided further, that the executive office shall submit a report not later than December 1, 2017 to the house and senate committees on ways and means and the joint committee on health care financing detailing utilization in fiscal year 2017 of the Health Safety Net Trust Fund established in section 66 of said chapter 118E, including: (a) the number of persons whose medical expenses were billed to the Health Safety Net Trust Fund; (b) the total dollar amount billed to the Health Safety Net Trust Fund; (c) the age, income level and insurance status of recipients using the Health Safety Net Trust Fund; (d) the types of services paid for out of the Health Safety Net Trust Fund; and (e) the amount disbursed from the Health Safety Net Trust Fund to each hospital and community health center; provided further, that the office of Medicaid shall coordinate with the health policy commission in the development of care delivery and payment models in the MassHealth program, including patient-centered medical homes and accountable care organizations, in order to ensure alignment of such models with the commission's certification programs under sections 14 and 15 of chapter 6D of the General Laws; provided further, that the executive office shall report to the house and senate committees on ways and means not later than January 1, 2018 on the feasibility of offering all applications, application information, service information and guidelines in electronic form, paper form and on the MassHealth website for MassHealth and MassHealth-related programs in both classical and traditional Chinese translations; provided further, that any unexpended balance in these accounts shall revert to the General Fund on June 30, 2018; provided further, that not later than January 18, 2018, the executive office shall submit a report to the house and senate committees on ways and means detailing the methodology used to project caseload and utilization in fiscal year 2017 and fiscal year 2018; provided further, that the executive office of health and human services, in consultation with the department of transitional assistance, shall report to the joint committee on ways and means, the joint committee on health care financing, and the joint committee on children, families and persons with disabilities, no later than January 1, 2018, on the feasibility of offering MassHealth applicants or recipients the opportunity to complete a common application for MassHealth and for programs administered by the department of transitional assistance, including the federal Supplemental Nutrition Assistance Program, the program for emergency aid to elders, disabled and children pursuant to chapter 117A and the program for transitional assistance to families with dependent children pursuant to chapter 118; provided further, that the executive office shall submit monthly MassHealth caseload reports in a searchable electronic format to the executive office for administration and finance and the house and senate committees on ways and means by the 15th day of the subsequent month; provided further, that not later than December 1, 2017, the executive office, in coordination with the department of public health and the office of Medicaid, shall report to the house and senate committees on ways and means on a plan to expand lead testing and follow-up services including, but not limited to: (1) a review of all services currently offered for lead poisoning-related services; (2) a plan of implementation for expanded lead poisoning-related services, including steps required to increase reimbursement opportunities for services such as lead poisoning testing, prevention, follow-up, investigation and treatment; (3) spending and revenue cost estimates for implementing such expanded services; (4) revenue maximization opportunities associated with pursuing such services; and (5) an analysis of the short- and long-term cost effectiveness associated with providing such services; provided further, that not less than $250,000 shall be expended for the Brookline Community Mental Health Center, Inc. to expand the Healthy Lives program; provided further, that $75,000 shall be expended for The MetroWest Free Medical Program, Inc.; provided further, that the executive office shall expend not less than $100,000, of which not less than $25,000 of said funds shall be expended to contract with Martha's Vineyard Community Services, Inc., to increase access to health and human services on the islands of Martha's Vineyard and Nantucket and such funds shall be used to cover feasible travel costs associated with arranging access to health and human services
 		102,682,373
4000-0328 State Plan Amendment Support
For the executive office of health and human services, which shall use the funding in this item to pursue, enhance and submit applications for existing or new state plan amendments, state plan options, state waiver or demonstration requests and federal grants for federal approval under the Patient Protection and Affordable Care Act, 42 U.S.C. 18001 et seq., including, but not limited to, the following purposes: (i) the development and implementation of a modern, digital integrated eligibility system as required by the last paragraph of section 16 of chapter 6A of the General Laws in order to achieve maximum federal reimbursement; (ii) the receipt of federal reimbursement for services provided to an eligible Medicaid beneficiary that are available without charge to the beneficiary, including services that are available without charge to the community at large, known as "free care"; (iii) the 1915(i) home and community-based services state plan authorized under 42 U.S.C. 1396n(i); (iv) the authorization of coverage for postpartum placement of long acting reversible contraception; (v) the pursuit of expanded federal reimbursement for lead poisoning testing and follow-up services; and (vi) the pursuit of Medicaid coverage for justice-involved individuals including, but not limited to, individuals on parole, probation, home confinement or pre-trial supervision or residing in a halfway house and deemed eligible under federal definition; provided further, that not later than November 1, 2017, the executive office shall report to the house and senate committees on ways and means with an update on changes, since the last filing of this report, to submitted and pending applications and the projected fiscal impact of federal approval for each of these applications; provided further, that not later than March 15, 2018, the executive office of health and human services, in consultation with the executive office for administration and finance and the Massachusetts office of information technology, shall publish a plan to implement modern, digital and integrated eligibility determination processes as required by the last paragraph of said section 16 of said chapter 6A, which shall include the estimated capital and operating resources to implement the modern, digital and integrated eligibility determination processes and any additional resources required to: (a) allow integrated enrollment and common application for benefits between the health connector, the office of Medicaid, the department of transitional assistance, the department of early education and care and the department of housing and community development; and (b) implement interim solutions to integrate applications between the office of Medicaid and the department of transitional assistance; and provided further, that the office of Medicaid and the department of transitional assistance shall prioritize aligning their benefit application processes as a step toward the development of a common application 		50,000
4000-0430 MassHealth CommonHealth Plan
For the CommonHealth program to provide primary and supplemental medical care and assistance to disabled adults and children under sections 9A, 16 and 16A of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to the recipients in prior fiscal years; provided further, that the executive office of health and human services shall maximize federal reimbursement for state expenditures made on behalf of those adults and children; provided further, that children shall be determined eligible for medical care and assistance if they meet the disability standards as defined by the executive office, which shall not be more restrictive than those in effect on July 1, 1996; and provided further, that the executive office shall process CommonHealth applications within 45 days of receipt of a completed application or within 90 days if a determination of disability is required 		164,396,477
4000-0500 MassHealth Managed Care
For health care services provided to medical assistance recipients through the executive office of health and human services' managed care delivery systems, including a behavioral health contractor, the Primary Care Clinician Plan, Primary Care Accountable Care Organizations, MassHealth managed care organizations and Accountable Care Partnership Plans and for MassHealth benefits provided to children, adolescents and adults under section 9 of chapter 118E of the General Laws and clauses (a) to (d), inclusive, and clause (h) of subsection (2) of section 9A of said chapter 118E and section 16C of said chapter 118E; provided, that no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said section 9A of said chapter 118E whose family incomes, as determined by the executive office, exceed 150 per cent of the federal poverty level; provided further, that funds may be expended for infrastructure and capacity building grants to promote delivery system reform, achieve federal financial participation and serve populations in need more efficiently and effectively; provided further, that of said funds, funds may be expended for community health centers; provided further, that the executive office shall maximize federal reimbursements for state expenditures made to these providers provided further, that expenditures from this item shall be made only for the purposes expressly stated in this item; provided further, that not later than March 15, 2018, the executive office shall submit a report to the house and senate committees on ways and means detailing: (i) the outcomes achieved by accountable care organizations and community partners including, but not limited to, financial performance, patient satisfaction and quality and aggregate and per-member reductions in spending off of cost trends; (ii) the results of benchmarks on accountable care organizations' and community partners' progress toward an integrated care delivery system; and (iii) the projected and to date cost effectiveness of spending on traditionally non-reimbursed flexible services to address health-related social needs including, but not limited to, housing stabilization and support, utility assistance, non-medical transportation, physical activity and nutrition, and sexual assault and domestic violence supports; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years 		5,553,251,863
4000-0601 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 recipients in prior fiscal years; 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 funds shall be expended from this item to maintain a personal needs allowance of $72.80 per month for individuals residing in nursing 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 and 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 on October 1, 2017 may be developed using the costs of calendar year 2007 or any subsequent year selected by the secretary of health and human services; provided further, that MassHealth shall reimburse nursing facilities for up to 20 medical leave-of-absence days and 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; and provided further, that no nursing home may reassign a patient's bed during a leave of absence that is eligible for reimbursement under this item 		3,520,335,443
4000-0641 MassHealth Nursing Home Supplemental Rates
For nursing facility Medicaid rates; provided, that in fiscal year 2018 the executive office of health and human services, in consultation with the center for health information and analysis, shall establish 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, that in fiscal year 2018 the executive office of health and human services, in consultation with the center for health information and analysis, shall establish rates that cumulatively total $317,100,000 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, including certified nurses' aides and housekeeping, laundry and dietary staff; provided further, that MassHealth shall adopt all additional regulations and procedures to carry out this section; provided further, that not later than March 1, 2018, MassHealth shall report to the house and senate committees on ways and means on the impact on wages for direct care workers at the nursing homes receiving funds; 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; 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
 352,600,000
4000-0700 MassHealth Fee for Service Payments
For health care services provided to medical assistance recipients under the executive office of health and human services' health care indemnity or third party liability plan, to medical assistance recipients not otherwise covered under the executive office's managed care or senior care plans and for MassHealth benefits provided to children, adolescents and adults under section 9 of chapter 118E of the General Laws and clauses (a) to (d), inclusive, and clause (h) of subsection (2) of section 9A of said chapter 118E and section 16C of said chapter 118E; provided, that no payments 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 no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said section 9A of said chapter 118E whose family incomes as determined by the executive office exceed 150 per cent of the federal poverty level; provided further, that children who have aged out of the custody of the department of children and families shall be eligible for benefits through the age limit specified in MassHealth's approved state plan; provided further, that funds shall be expended from this item for members who qualify for early intervention services; provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years; provided further, that MassHealth may expend an additional $13,000,000 in the aggregate for acute care hospitals that have greater than 63 percent of their gross patient service revenue from governmental payers and free care as determined by the executive office; provided further, that not less than $1,000,000 shall be made available to establish a one-year pilot program to increase efficiencies and align system-wide goals within a regional hospital system located in Western Massachusetts to improve the overall sustainability of the system and to create a comprehensive approach to system-wide needs and a transition into the structure of the new 1115 Medicaid Waiver; provided further, that the pilot program will include measurable milestones that shall demonstrate progress in at least one of the following areas: (i) care coordination, integration and delivery transformations; (ii) electronic health records and information exchange advancements; (iii) increasing alternative payment methods and accountable care organizations; (iv) enhancing patient safety; (v) increasing access to behavioral health services; (vi) increasing coordination between system hospitals and community-based providers and organizations; and (vii) preparing the system to undertake risk as a potentially designated ACO; provided further, that MassHealth shall maintain the same level of federally-optional chiropractic services that were in effect in fiscal year 2016 that were included in its state plan or demonstration program in effect on January 1, 2002 for members enrolled in the primary care clinician program; provided further, that the executive office shall not, in fiscal year 2018, fund programs relating to case management with the intention of reducing length of stay for neonatal intensive care unit cases; provided further, that $500,000 shall be equally distributed to the teaching community health centers with family medicine residency programs in the city of Worcester and in the South Boston section of the city of Boston not later than June 30, 2018, and the secretary of health and human services shall designate an agency to administer the funds and shall retain 5 per cent of the total funds: (a) to report to the house and senate committees on ways and means and the executive office on the use of the funds by teaching community health centers; and (b) to audit such centers in order to confirm the use of the funds by each center for training purposes; provided further, that notwithstanding this item, funds may be expended from this item for the purchase of third-party insurance including, but not limited to, Medicare for any medical assistance recipient; provided further, that the executive office may reduce MassHealth premiums or copayments or offer other incentives to encourage enrollees to comply with wellness goals; provided further, that funds may be expended from this item for activities relating to customer service, disability determinations or utilization management and review, including patient screenings and evaluations, regardless of whether the activities are performed by a state agency, contractor, agent or provider; provided further, that not later than March 1, 2018 the executive office shall report to the house and senate committees on ways and means on: (1) dental coverage available to MassHealth recipients as of January 1, 2018 as it compares to dental coverage available to MassHealth recipients on January 1, 2010; (2) utilization of dental services in fiscal year 2017 and fiscal year 2018; (3) the actual and projected costs and revenue associated with dental coverage in fiscal year 2017 and fiscal year 2018; (4) the estimated cost effectiveness of dental coverage as a contributor to MassHealth total cost of care; and (5) a schedule to include within its covered services for adults at least those federally optional services for dental care and dentures which were included in its state plan in effect on January 1, 2010 and the accompanying cost of implementation; provided further, that the executive office shall maintain full-year coverage for adult dental fillings and adult denture coverage; provided further, that not less than $1,000,000 shall be expended in a one-time payment to a western Massachusetts regional academic health system to address regional physician shortages and enhance access to rural and urban preventive care by recruiting, training and retaining residents of the commonwealth into careers in medicine and to conduct projects on population and community health through collaboration with a medical school in the commonwealth; provided further, that for items 4000-0320, 4000-0430, 4000-0500, 4000-0601, 4000-0641, 4000-0700, 4000-0875, 4000-0880, 4000-0885, 4000-0940, 4000-0950, 4000-0990, 4000-1400, 4000-1420 and 4000-1425, the executive office shall provide to the senate and house committees on ways and means quarterly reports on implemented or anticipated administrative and programmatic changes that generate savings, gross and net, in fiscal year 2018; provided further, that reports shall delineate each change's impact on members, member cost-sharing and membership levels and the action taken to implement the change; provided further, that reports shall delineate savings generated by caseload, program integrity or other administrative or programmatic changes and whether those savings were included in the governor's proposed fiscal year 2018 general appropriations act; and provided further, that the first report shall be filed no later than August 1, 2017, and subsequent reports shall be filed at the start of each quarter and note any deviation from the planned changes included in the first report and updates to saving estimates or realizations
 2,187,898,930
4000-0875 MassHealth Breast and Cervical Cancer Treatment
For MassHealth benefits to eligible individuals who require medical treatment for breast or cervical cancer under 42 U.S.C. section 1396a(a)(10)(A)(ii)(XVIII) and section 10D of chapter 118E of the General Laws; provided, that the executive office of health and human services shall provide these benefits to individuals whose incomes, as determined by the executive office, do not exceed 250 per cent of the federal poverty level, subject to continued federal approval; and provided further, that funds may be expended from this item for health care services provided to these recipients in prior fiscal years 		6,191,803
4000-0880 MassHealth Family Assistance Plan
For MassHealth benefits under clause (c) of subsection (2) of section 9A of chapter 118E of the General Laws and section 16C of said chapter 118E for children and adolescents whose family incomes, as determined by the executive office of health and human services, are above 150 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to those children and adolescents in prior fiscal years; and provided further, that funds may be expended from this item for health care subsidies provided to eligible individuals under the last paragraph of section 9 and section 16D of said chapter 118E 		526,812,502
4000-0885 Small Business Employee Premium Assistance
For the cost of health insurance subsidies paid to employees of small businesses in the insurance reimbursement program under section 9C of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to persons in prior fiscal years; provided further, that funds may be expended only for employees who are ineligible for subsidized insurance through the health connector and ineligible for any MassHealth program; provided further, that enrollment in this program may be capped to ensure that MassHealth expenditures shall not exceed the amount appropriated; and provided further, that funds may be expended from this item for health care services provided to individuals eligible under clause (j) of subsection (2) of section 9A of said chapter 118E 		34,042,020
4000-0940 MassHealth Affordable Care Act Expansion Populations
For health care services related to the Patient Protection and Affordable Care Act, Public Law 111-148; provided, that funds may be expended from this item for health care services to individuals ages 19 to 64, inclusive, whose family incomes, as determined by the executive office of health and human services, do not exceed 133 per cent of the federal poverty level and those who are eligible under clauses (b) and (d) of subsection (2) of section 9A of chapter 118E of the General Laws; and provided further, that MassHealth shall maintain the same level of vision services that were in effect in fiscal year 2017 for members enrolled in the Care Plus program 		2,238,691,278
4000-0950 Children's Behavioral Health Initiative
For administrative and program expenses associated with the children's behavioral health initiative under the settlement agreement in the case of Rosie D. v. Romney, 410 F. Supp. 2d 18 (D. Mass. 2006), to provide comprehensive, community-based behavioral health services to children suffering from severe emotional disturbances; provided, that funds may be expended from this item for health care services provided to these persons in prior fiscal years; provided further, that the secretary of health and human services shall provide one report per 6-month period to the house and senate committees on ways and means on the implementation of the initiative; provided further, that said reports shall include, but not be limited to: (i) the results of the scheduled plan to date, including a schedule detailing commencement of services and associated costs by service type; (ii) an analysis of compliance with the terms of the settlement agreement to date; (iii) a detailed itemization of services and utilization by service type, geographical location and the age of the member receiving the service; (iv) data detailing the time that elapsed between a member's request for services and commencement of an initial assessment for services; (v) the time to complete the initial assessment and the time that elapsed between initial assessment for services and commencement of services; and (vi) a quarterly update of whether projected expenditures are likely to exceed the amount appropriated in this item; provided further, that any unexpended balance in this item shall revert to the General Fund on June 30, 2018; and provided further, that funds shall not be transferred from this item without notifying the house and senate committees on ways and means not less than 30 days before such a transfer 		247,337,564
4000-0990 Children's Medical Security Plan
For the children's medical security plan to provide primary and preventive health services for uninsured children from birth to age 18, inclusive; provided, that the executive office of health and human services shall prescreen enrollees and applicants for Medicaid eligibility; provided further, that no applicant shall be enrolled in the program until the applicant has been denied eligibility for the MassHealth program; provided further, that the MassHealth benefit request shall be used as a joint application to determine the eligibility for both MassHealth and the children's medical security plan; provided further, that the executive office shall maximize federal reimbursements for state expenditures made on behalf of the children; provided further, that the executive office shall expend all necessary funds from this item to ensure the provision of the maximum benefit levels for this program under section 10F of chapter 118E of the General Laws; provided further, that the maximum benefit levels for this program shall be made available only to those children who have been determined by the executive office to be ineligible for MassHealth benefits; and provided further, that funds may be expended from this item for health care services provided to these persons in prior fiscal years 		12,096,978
4000-1400 MassHealth HIV Plan
For the provision of MassHealth benefits to persons diagnosed with human immunodeficiency virus with incomes up to 200 per cent of the federal poverty level; provided, that funds may be expended from this item for health care services provided to those persons in prior fiscal years 		27,374,419
4000-1420 Medicare Part D Phased Down Contribution
For payment to the Centers for Medicare and Medicaid Services in compliance with Title XIX of the Social Security Act, as codified at 42 U.S.C. chapter 7, subchapter XIX 		441,754,986
4000-1425 Hutchinson Settlement
For administrative and program expenses associated with community support services for persons with acquired brain injury who were residing in long-term care facilities under the mediated solution to the final settlement agreement in the case of Hutchinson ex rel. Julien v. Patrick, 683 F. Supp. 2d 121 (D. Mass. 2010); provided, that funds may be expended from this item for health care services provided to these persons in prior fiscal years 		71,730,289
4000-1700 Health and Human Services IT Costs
For the provision of information technology services within the executive office of health and human services 		124,870,082

account description amount
Retained Revenues
4000-0320 MassHealth Recoveries from Current and Prior Fiscal Years RR
For the executive office of health and human services, which may expend for medical care and assistance rendered in the current year not more than $225,000,000 from the monies received from recoveries and collections of any current or prior year expenditures; provided, that notwithstanding any general or special law to the contrary, the balance of any personal needs accounts collected from nursing and other medical institutions upon the death of a medical assistance recipient and held by the executive office for more than 3 years may be credited to this item; and provided further, that no funds from this item shall be used for item 4000-0300 		225,000,000
4000-0321 EOHHS Contingency Contracts Retained Revenue
For the executive office of health and human services, which may expend not more than $56,750,000 for contingency fee contracts related to pursuing federal reimbursement or avoiding costs in its capacity as the single state agency under Titles XIX and XXI of the Social Security Act and as the principal agency for all of the agencies within the executive office and other federally-assisted programs administered by the executive office; provided, that such contingency contracts shall not exceed 3 years except with prior review and approval by the executive office for administration and finance; provided further, that not later than September 15, 2017, the secretary of health and human services shall submit to the secretary of administration and finance and the house and senate committees on ways and means, a report detailing: (i) the amounts of the agreements; (ii) a delineation of all ongoing and new projects; and (iii) the amount of federal reimbursement and cost avoidance derived from the contracts for the previous fiscal year's activities; provided further, that after providing payments due under the terms of the contingency contracts, the executive office may use available funds to support special MassHealth projects that will receive enhanced federal revenue opportunities, including MassHealth eligibility operations and systems enhancements that support reforms and improvements to MassHealth programs; provided further, that any enhanced federal financial participation received for these special projects, including the Implementation Advanced Planning Document or other eligibility operations and systems enhancements that support reforms and improvements to MassHealth shall be deposited into this item; provided further, that notwithstanding any general or special law to the contrary, the executive office may enter into interdepartmental service agreements with the University of Massachusetts Medical School to perform activities that the secretary of health and human services, in consultation with the comptroller, determines to be within the scope of the proper administration of Title XIX and other federal funding provisions to support the programs and activities of the executive office; provided further, that activities may include: (a) providing administrative services including, but not limited to, utilization management activities and eligibility determinations based on disability and supporting case management activities and similar initiatives; (b) providing consulting services related to quality assurance, program evaluation and development, integrity and soundness and project management; and (c) providing activities and services to pursue federal reimbursement, avoid costs or identify third-party liability and recoup payments made to third parties; provided further, that federal reimbursement for any expenditure made by the University of Massachusetts Medical School for federally reimbursable services the university provides under these interdepartmental service agreements or other contracts with the executive office shall be distributed to the university and recorded distinctly in the state accounting system; provided further, that the secretary may negotiate contingency fees for activities and services related to pursuing federal reimbursement or avoiding costs and the comptroller shall certify these fees and pay them upon the receipt of this revenue, reimbursement or demonstration of costs avoided; provided further, that contingency fees paid to the University of Massachusetts Medical School shall be limited to $40,000,000 for state fiscal year 2018 except for contingency fees paid pursuant to an interdepartmental service agreement for recoveries related to special disability workload projects; and provided further, that for the purpose of accommodating timing discrepancies between the receipt of retained revenues and payments required under contingency contracts, the comptroller shall certify for payment amounts not to exceed the lower of this authorization or the most recent revenue estimate as reported in the state accounting system 		56,750,000

account description amount
Intragovernmental Service Spending 63,037,949
4000-0102 Chargeback for Human Services Transportation
For the cost of transportation services for health and human services clients and the operation of the health and human services transportation office
                Intragovernmental Services Fund ............... 100%
8,878,161
4000-0103 Chargeback for Human Services Administration
For the costs of core administrative functions performed within the executive office of health and human services; provided, that the secretary of health and human services, notwithstanding any general or special law to the contrary, may identify administrative activities and functions common to the separate agencies, departments, offices, divisions and commissions within the executive office and may designate those functions as core administrative functions in order to improve administrative efficiency and preserve fiscal resources; provided further, that common functions that may be designated core administrative functions include, without limitation, human resources, financial management and leasing and facility management; provided further, that all employees performing functions so designated may be employed by the executive office and the executive office shall charge the agencies, departments, offices, divisions and commissions for these services; provided further, that upon the designation of a function as a core administrative function, the employees of each agency, department, office or commission who perform these core administrative functions may be transferred to the executive office of health and human services; provided further, that the reorganization shall not impair the civil service status of any transferred employee who immediately before the effective date of this act either holds a permanent appointment in a position classified under chapter 31 of the General Laws or has tenure in a position by reason of section 9A of chapter 30 of the General Laws; and provided further, that nothing in this item shall impair or change an employee's status, rights or benefits under chapter 150E of the General Laws
                Intragovernmental Services Fund ............... 100%
22,189,327
4000-1701 Chargeback for Health and Human Services IT
For the cost of information technology services provided to agencies of the executive office of health and human services
                Intragovernmental Services Fund ............... 100%
31,970,461

account description amount
Federal Grant Spending 4,324,731
4000-1169 State Innovation Models - Model Design Test Assistance Fund
For the purposes of a federally funded grant entitled, State Innovation Models: Model Design Test Assistance Fund 		4,299,731
4000-1436 Adult Core Contraception
For the purposes of a federally funded grant entitled, Adult Core Contraception 		25,000

account description amount