| ACCOUNT | FY2019 Conference |
FY2019 Vetoes |
FY2019 Overrides |
FY2019 GAA |
|
|---|---|---|---|---|---|
| 4000-0005 | Safe and Successful Youth Initiative | 8,145 | 0 | 0 | 8,145 |
| 4000-0007 | Unaccompanied Homeless Youth Services | 3,300 | 0 | 0 | 3,300 |
| 4000-0009 | Office of Health Equity | 100 | 0 | 0 | 100 |
| 4000-0014 | Edward M Kennedy CHC | 200 | -100 | 100 | 200 |
| 4000-0020 | Nursing and Allied Health Workforce Development | 350 | 0 | 0 | 350 |
| 4000-0050 | PCA Council | 1,779 | 0 | 0 | 1,779 |
| 4000-0051 | Family Resource Centers | 500 | 0 | 0 | 500 |
| 4000-0250 | HIX Retained Revenue | 15,000 | 0 | 0 | 15,000 |
| 4000-0300 | EOHHS and Medicaid Administration | 104,536 | -408 | 408 | 104,536 |
| 4000-0320 | MassHealth Retained Revenue | 225,000 | 0 | 0 | 225,000 |
| 4000-0321 | EOHHS Contingency Contracts Retained Revenue | 56,750 | 0 | 0 | 56,750 |
| 4000-0328 | State Plan Amendment Support | 50 | 0 | 0 | 50 |
| 4000-0430 | MassHealth CommonHealth Plan | 170,899 | 0 | 0 | 170,899 |
| 4000-0500 | MassHealth Managed Care | 5,759,010 | 0 | 0 | 5,759,010 |
| 4000-0601 | MassHealth Senior Care | 3,587,517 | -4,000 | 4,000 | 3,587,517 |
| 4000-0641 | MassHealth Nursing Home Supplemental Rates | 365,400 | 0 | 0 | 365,400 |
| 4000-0700 | MassHealth Fee for Service Payments | 2,646,228 | -12,800 | 12,800 | 2,646,228 |
| 4000-0875 | MassHealth Breast and Cervical Cancer Treatment | 6,192 | 0 | 0 | 6,192 |
| 4000-0880 | MassHealth Family Assistance Plan | 468,899 | 0 | 0 | 468,899 |
| 4000-0885 | Small Business Employee Premium Assistance | 34,042 | 0 | 0 | 34,042 |
| 4000-0940 | MassHealth Affordable Care Act Expansion Populations | 2,138,679 | 0 | 0 | 2,138,679 |
| 4000-0950 | Children's Behavioral Health Initiative | 256,758 | 0 | 0 | 256,758 |
| 4000-0990 | Children's Medical Security Plan | 12,097 | 0 | 0 | 12,097 |
| 4000-1400 | MassHealth HIV Plan | 27,484 | 0 | 0 | 27,484 |
| 4000-1420 | Medicare Part D Phased Down Contribution | 425,568 | 0 | 0 | 425,568 |
| 4000-1425 | Hutchinson Settlement | 100,020 | 0 | 0 | 100,020 |
| 4000-1700 | Health and Human Services Information Technology Costs | 102,736 | 0 | 0 | 102,736 |
| TOTAL | 16,517,238 | -17,308 | 17,308 | 16,517,238 | |
| account | description | amount |
|---|---|---|
| OFFICE OF THE SECRETARY OF HEALTH AND HUMAN SERVICES | 16,587,303,321 | |
| 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 any new grants awarded from this item in fiscal year 2019 shall comply with the grant application requirements set forth in item 4000-0005 of section 2 of chapter 38 of the acts of 2013; provided further, that the executive office of health and human services may select the same evaluator in fiscal year 2019 as selected in fiscal year 2018; provided further, that the secretary shall report to the house and senate committees on ways and means not later than March 15, 2019 detailing: (a) successful grant applications; (b) a set of clearly-defined goals and benchmarks on which grant recipients shall be evaluated; and (c) outcomes and findings from the grant awards for fiscal year 2018; 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 $20,000 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; provided further, that not less than $75,000 be expended to the South End Community Center's Community Youth Corp Program; provided further, that not less than $25,000 shall be expended for the Merrimack Valley Public Safety Youth Center in the city of Lawrence; provided further, that funds may be set aside for the administration of these programs; and 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 of health and human services |
8,145,000 |
| 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 the secretary of health and human services shall report to the house and senate committees on ways and means not later than March 1, 2019 on: (a) the number of youths served through this item; (b) the types of services received by participating youths; (c) the number of youths who transition into stabilized housing and the zip code of the stabilized housing; (d) the number of youths who remain in stabilized housing after 90 days, when applicable; (e) other quantifiable data related to client outcomes as determined by the secretary; (f) the number of youths turned away from the program; and (g) the amount of funding awarded to vendors for the delivery of services and the names of each vendor |
3,300,000 |
| 4000-0009 | Office of Health Equity
For the office of health equity established in section 16AA of chapter 6A of the General Laws; provided, that the office may enter into service agreements with the department of public health to fulfill the obligations of the office; and provided further, that the office shall submit a report to the house and senate committees on ways and means not later than December 12, 2018 on the development of the office of health equity within the executive office of health and human services and the implementation of programming as set forth in said section 16AA, including personnel costs and an organizational structure plan |
100,000 |
| 4000-0014 | Edward M Kennedy CHC
For the Edward M. Kennedy Community Health Center, Inc. to 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 |
200,000 |
| 4000-0020 | Nursing and Allied Health Workforce Development
For the nursing and allied health workforce development initiative, to develop and support strategies that increase the number of public higher education faculty members and students who participate in programs that support careers in fields related to nursing and allied health; provided, that the amount appropriated in this item shall be transferred to the Massachusetts Nursing and Allied Health Workforce Development Trust Fund established in section 33 of chapter 305 of the acts of 2008; and provided further, that funds shall be transferred to the fund according to an allotment schedule adopted by the executive office of administration and finance |
350,000 |
| 4000-0050 | PCA Council
For the operation of the PCA quality home care workforce council established in section 71 of chapter 118E of the General Laws |
1,779,222 |
| 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: (a) be consistent with the requirements of section 16U of chapter 6A of the General Laws; (b) demonstrate adherence to an evidence-based model of service; and (c) 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 2018 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, 2019 the executive office shall file a biannual report with the house and senate committees on ways and means; detailing 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 Medicaid 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 the executive office shall ensure that any collaborative assessments for children receiving services from multiple agencies within the secretariat shall be performed within existing resources; provided further, that the executive office shall continue to develop and implement the common client identifier; 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 the executive office and its agencies, when contracting for services on the islands of Martha's Vineyard and Nantucket, shall take into consideration the increased costs associated with the provision of goods, services and housing on said islands; 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, as codified at 42 U.S.C. chapter 7, subchapter XIX to ensure that rates of payment to providers shall not exceed the rates that are necessary to meet 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 under the department of public health and the executive office of health and human services; 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, as codified at 42 U.S.C. chapter 7, subchapters XIX or XXI, or the MassHealth demonstration waiver approved under section 1115(a) of the Social Security Act, as codified at 42 U.S.C. section 1315(a) act or the community first section 1115 demonstration waiver under section 1115 of the Social Security Act, as codified at 42 U.S.C section 1315, except as required for: (a) for the administration of the executive office; (b) for the equivalent of MassHealth standard benefits for children under 21 years of age who are in the care or custody of the department of youth services or the department of children and families; (c) for dental benefits provided to clients of the department of developmental services who are 21 years of age or older; (d) for 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 (e) for 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 not less than 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 $14,800,000 to any acute care pediatric hospital and pediatric specialty unit in the commonwealth, above base rates, to compensate for high-complexity pediatric care |
104,535,714 |
| 4000-0328 | State Plan Amendment Support
For the executive office of health and human services 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: (a) 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; (b) 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"; (c) the 1915(i) home and community-based services state plan authorized under 42 U.S.C. 1396n(i); (d) the authorization of coverage for postpartum placement of long acting reversible contraception; and (e) 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, 2018 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, 2019 the executive office of health and human services, in consultation with the executive office for administration and finance and the executive office for technology services and security, 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 commonwealth health insurance 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 standards shall be no more restrictive than those in effect on July 1, 1996; and provided further, that the executive office shall process a CommonHealth application within 45 days of receipt of a completed application or within 90 days if a determination of disability is required |
170,898,671 |
| 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 household incomes, as determined by the executive office, exceed 150 per cent of the federal poverty level; provided further, that not later than March 15, 2019 the executive office shall submit a report to the house and senate committees on ways and means detailing: (a) total number of members participating in the ACO program; (b) disenrollment trends from the Partnership Plan, Primary Care ACO, and MCO-administered Accountable Care Organizations within the designated plan selection; (c) the outcomes achieved by accountable care organizations and community partners including, but not limited to, financial performance, patient safety, patient satisfaction and quality and aggregate and per-member reductions in spending compared to prior cost trends; (d) the results of benchmarks on accountable care organizations' and community partners' progress toward an integrated care delivery system; and (e) a summary of spending and activities related to traditionally nonreimbursed services to address health-related social needs including, but not limited to, home and community-based services, housing stabilization and support, utility assistance, nonmedical transportation, physical activity, nutrition and sexual assault and domestic violence supports; provided further, that such summary shall include, to the maximum extent practicable, aggregated data on the results of preventative health care services such as health-related social needs screening, the number of referrals to human service providers to address such screening, the result of such referrals and changes in health status; provided further, that such data shall be stratified by demographic factors to support an analysis of the impact on health disparities; provided further, that where data is not available, a report on progress toward establishing necessary data systems shall be provided; (f) provided further, that said summary shall include outcome measures for at-risk populations with chronic health conditions; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
5,759,010,341 |
| 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 notwithstanding any general or special law to the contrary the executive office of health and human services shall establish payment rates for adult day health programs that are, in the aggregate, not less than $2,000,000 more than was paid for such programs in fiscal year 2018; provided further, that notwithstanding any general or special law to the contrary the executive office of health and human services shall establish payment rates for the adult foster care program that are, in the aggregate, not less than $2,000,000 more than was paid for such programs in fiscal year 2018; 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 health and human services, 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 nursing facility rates effective on October 1, 2018 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 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, 2019, MassHealth shall report to the house and senate committees on ways and means the following for fiscal year 2018: (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 |
3,587,516,725 |
| 4000-0641 | MassHealth Nursing Home Supplemental Rates
For nursing facility Medicaid rates; provided, that in fiscal year 2019 the executive office of health and human services, in consultation with the center for health information and analysis, shall establish rates that cumulatively total $327,100,000 more than the annual payment rates established under the rates in effect as of June 30, 2002; provided further, that not less than $38,300,000 shall be expended to fund a rate add-on for wages, shift differentials, bonuses, benefits and related employee costs paid to direct care staff of nursing homes; provided further, that MassHealth regulations for this rate add-on shall prioritize spending on hourly wage increases, shift differentials or bonuses paid to certified nurses' aides and housekeeping, laundry, dietary and activities staff; provided further, that MassHealth shall adopt all regulations and procedures to carry out this item; provided further, that MassHealth shall provide to the house and senate committee on ways and means an interim report not later than June 15, 2019 and a final report not later than December 31, 2019 on the impact of wages for direct care workers at the nursing home receiving said 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 |
365,400,000 |
| 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 household incomes as determined by the executive office exceed 150 per cent of the federal poverty level; provided further, that not less than $1,000,000 shall be made available 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 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 notwithstanding any general or special law to the contrary the executive office shall expend not less than $4,000,000 to begin to align MassHealth fee-for-service payment rates for outpatient and diversionary behavioral health services with payment rates of MassHealth accountable and managed care products; provided further, that funds for said rate add-on shall be expended for MassHealth recipients that receive benefits under items 4000-0430,4000-0500, 4000-0601, 4000-0700, 4000-0880 and 4000-0940; provided further, that $750,000 shall be equally distributed to the teaching community health centers with family medicine residency programs in the cities of Worcester and Lawrence and in the South Boston section of the city of Boston not later than December 1, 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 of health and human services 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 MassHealth shall expend $13,000,000 in the aggregate for acute care hospitals that have more than 63 percent of their gross patient service revenue from governmental payers and free care as determined by the executive office; provided further, that in fiscal year 2019 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 (PCC) program; provided further, that the executive office shall not, in fiscal year 2019, fund programs relating to case management with the intention of reducing length of stay for neonatal intensive care unit cases; 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 such activities are performed by a state agency, contractor, agent or provider; provided further, that not later than March 1, 2019 the executive office shall report to the house and senate committees on ways and means on: (a) dental coverage available to MassHealth recipients as of January 1, 2019 as it compares to dental coverage available to MassHealth recipients on January 1, 2010; (b) utilization of dental services in fiscal year 2018 and fiscal year 2019; (c) the actual and projected costs and revenue associated with dental coverage in fiscal year 2018 and fiscal year 2019; and (d) the estimated cost effectiveness of dental coverage as a contributor to MassHealth total cost of care; and provided further, that the executive office shall maintain full-year coverage for adult dental fillings and adult denture coverage and shall begin said coverage for adult periodontic services on June 1, 2019 |
2,646,228,033 |
| 4000-0875 | MassHealth Breast and Cervical Cancer Treatment
For the executive office of health and human services to expend for the provision of benefits to eligible individuals who require medical treatment for either breast or cervical cancer under section 2 of the Breast and Cervical Cancer Prevention and Treatment Act of 2000, Public Law 106-354, codified at 42 U.S.C. 1396a(a)(10)(A)(ii)(XVII) 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 household 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 |
468,898,836 |
| 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 commonwealth health insurance connector authority 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 providing 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 household 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 in fiscal year 2019 MassHealth shall maintain the same level of vision services that were in effect in fiscal year 2018 for members enrolled in the Care Plus program |
2,138,679,253 |
| 4000-0950 | Children's Behavioral Health Initiative
For administrative and program expenses associated with the children's behavioral health initiative under the Remedial Order entered by the court 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 not less than $2,000,000 shall be expended as a rate add-on for MassHealth home and community-based behavioral health services including but not limited to outpatient therapy, in-home therapy and intensive care coordination provided to children and youth eligible through said item; provided, that funds may be expended from this item for health care services provided to said persons in prior fiscal years; provided further, that the secretary of health and human services shall report biannually 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: (a) the results of the scheduled plan to date, including a schedule detailing commencement of services and associated costs by service type; (b) an analysis of compliance with the terms of the settlement agreement to date; (c) a detailed itemization of services and service utilization by service type, geographical location and the age of the member receiving the service; (d) data detailing the time that elapsed between a member's request for services and commencement of an initial assessment for services; (e) the time to complete the initial assessment and the time that elapsed between initial assessment for services and commencement of services; and (f) 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 28, 2019; 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 |
256,757,691 |
| 4000-0990 | Children's Medical Security Plan
For the executive office of health and human services to expend for the children's medical security plan to provide health services for uninsured children from birth through 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 this program under section 10F of chapter 118E of the General Laws; provided further, that 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 those 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 said persons in prior fiscal years |
27,483,527 |
| 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 |
425,567,964 |
| 4000-1425 | Hutchinson Settlement
For administrative and program expenses associated with community support services for persons with an 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 |
100,019,725 |
| 4000-1700 | Health and Human Services Information Technology Costs
For the provision of information technology services within the executive office of health and human services |
102,736,495 |
| account | description | amount |
|---|---|---|
| Retained Revenues | ||
| 4000-0250 | HIX Retained Revenue
For the executive office of health and human services which may expend for the costs of the operations and maintenance of the health insurance exchange not more than $15,000,000 from monies received from the commonwealth health insurance connector authority; provided, that for the purpose of accommodating timing discrepancies between the receipt of retained revenue and related expenditures, the office may incur expenses and the comptroller may 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 |
15,000,000 |
| 4000-0320 | MassHealth Retained Revenue
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 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 an annual report not later than September 14, 2018 detailing: (a) the amounts of the agreements; (b) a delineation of all ongoing and new projects; and (c) the amount of federal reimbursement and cost avoidance derived from the contracts for the previous fiscal year's activities; 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; 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 Documents 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 2019 except for contingency fees paid under 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 | 69,826,323 | |||||
| 4000-0102 | Human Services Transportation Chargeback
For the cost of transportation services for health and human services clients and the operation of the health and human services transportation office
|
13,177,866 | ||||
| 4000-0103 | Core Administration Chargeback
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
|
24,626,686 | ||||
| 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
|
32,021,771 | ||||
| account | description | amount |
|---|---|---|
| Federal Grant Spending | 239,000 | |
| 4000-1169 | State Innovation Models - Model Design Test Assistance Fund
For the purposes of a federally funded grant entitled, Demonstration Ombudsman Programs |
139,000 |
| 4000-1436 | Adult Core Contraception
For the purposes of a federally funded grant entitled, Adult Core Contraception |
100,000 |
| account | description | amount |
|---|