SENATE DOCKET, NO. 887        FILED ON: 1/17/2013

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 292

The Commonwealth of Massachusetts

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PRESENTED BY:

Patricia D. Jehlen

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To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act promoting equal choice and related cost savings.

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PETITION OF:

SENATE DOCKET, NO. 887        FILED ON: 1/17/2013

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 292

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 1857 OF 2011-2012.]

The Commonwealth of Massachusetts

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In the Year Two Thousand Thirteen

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An Act promoting equal choice and related cost savings.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
 

SECTION 1. Chapter 118 E is hereby amended by adding after section 10F, the following new section:--

Section 10G. The division shall provide coverage for residential habilitation services for individuals age sixty or older, if such individual has been determined by the division to be clinically eligible for long term care services, and requires said residential habilitation services in order to remain living in the least restrictive setting appropriate to meet his needs in accordance with section 6 of this chapter.

The term ‘residential habilitation’ shall mean ongoing services and supports provided to beneficiaries in a residential setting that are designed to assist beneficiaries in acquiring, maintaining, or improving the skills necessary to live in a community setting. Residential habilitation provides beneficiaries with daily staff intervention including care, supervision, and assistance in activities of daily living, instrumental activities of daily living, and community integration in a residential setting qualified by the division with 24-hour staffing . Residential habilitation may include the provision of medical and health-care services that are integral to meeting the daily needs of beneficiaries. 

SECTION 2. Section 9 of Chapter 118E of the General Laws, as amended by Chapter 211 of the Acts of 2006, is hereby amended by inserting, after the words "long-term care needs of the individuals," the following:-

The division shall provide, without requiring prior authorization, for up to sixty (60) days of eligibility for MassHealth Home and Community Based Services, including personal care services, for individuals who, upon discharge from an acute hospital, medical center, nursing facility, or health care facility including rehabilitation facilities and state hospitals, are presumed to be financially eligible for the MassHealth program and clinically eligible for home and community based services, as determined by an Aging Services Access Point or an Independent Living Center; provided  further the division shall promulgate such standards and regulations as may be necessary for the administration of said presumptive eligibility program.

SECTION 3. Section 9 of Chapter 118 E is hereby amended by adding in the second sentence of the second paragraph, after the words “requirements for Title XIX” the following new language:--

“Any program of home and community based services funded pursuant to the provisions of this chapter or pursuant to the provisions chapter one hundred and eighteen G, in which family members are permitted to serve as paid caregivers, shall include spouses within the definition of family member.”

SECTION 4. Section 12 of chapter one hundred and eighteen E as so appearing, is hereby amended in the first paragraph by inserting at the end thereof the following new sentence:-

“Notwithstanding the provisions of any general or special law to the contrary, the division shall develop or amend any standards and regulations applicable to the personal care attendant program to include as eligible members those individuals who are otherwise eligible for said program, but who require supervision and cueing in order to perform two or more activities of daily living.”