FILED ON: 12/15/2021
HOUSE . . . . . . . . . . . . . . . No. 4298
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The Commonwealth of Massachusetts
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In the One Hundred and Ninety-Second General Court
(2021-2022)
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An Act relative to the governance, structure and care of veterans at the Commonwealth’s veterans’ homes.
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 6 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking sections 40 and 41 and inserting in place thereof the following 2 sections:-
Section 40. (a) There shall be a board of trustees of the veterans’ home in Chelsea, consisting of five persons, at least three of whom shall be war veterans. Upon the expiration of the term of office of a member, their successor shall be appointed by the secretary of health and human services, with the approval of the governor, to serve for five years. The secretary shall designate one of the members as chairperson. The members shall serve without compensation, but shall receive their necessary expenses incurred in the discharge of their official duties.
(b) There shall be a board of trustees of the veterans’ home in Holyoke, consisting of five persons, who shall be residents of the counties of Berkshire, Franklin, Hampden and Hampshire. Each of said counties shall be represented on said board by at least one trustee who is a resident therein. Upon the expiration of the term of office of a member, their successor shall be appointed by the secretary of health and human services, with the approval of the governor, to serve for five years. The secretary shall designate one of the members as chairman. The members shall serve without compensation, but shall receive their necessary expenses incurred in the discharge of their official duties.
(c) The boards of trustees for the soldier’s homes in Chelsea and Holyoke, hereinafter referred to as the local boards, shall represent the local community, residents, and family members of each home on the Veterans’ Homes Council established in section 41. Each member of the local boards shall serve ex officio on the council. The local boards shall nominate a candidate for superintendent of their respective veterans’ homes to the full council for approval. The council shall adopt the necessary rules, regulations, by-laws, roles and responsibilities for the local boards. All members of the local boards shall complete annual training regarding their roles and responsibilities, including training relative to all applicable statutes and rules mandated by the office of the comptroller and the executive office for administration and finance as well as procurement rules for public agencies.
Section 41. (a) There is hereby established the Veterans’ Homes Council. The council shall consist of the executive director of veterans’ homes and housing established in section 12 of chapter 115A, who shall serve as chair; the adjutant general of the Massachusetts national guard; 2 members appointed by the governor; 1 member appointed by the secretary of health and human services; 1 member appointed by the speaker of the house; 1 member appointed by the senate president; and 10 members of the local boards of trustees serving ex officio. All members of the council shall be appointed by the governor. Members of the council shall serve for a term of 5 years or until a successor is appointed. An appointed member may be removed for cause at any time during the member’s term by the governor. A vacancy must be filled for the balance of the unexpired term in the same manner as the original appointment. Members of the council shall serve without compensation but may receive reasonable reimbursement for travel and expenses incurred in the discharge of their duties. A majority of the appointed and serving members of the council shall constitute a quorum of the council for the transaction of business. Actions of the council must be approved by a majority vote of the members present at a meeting where a quorum is present. All members of the council shall complete annual training regarding their roles and responsibilities, including training relative to all applicable statutes and rules mandated by the office of the comptroller and the executive office for administration and finance as well as procurement rules for public agencies.
(b) The council shall manage and control all veterans’ homes established in the commonwealth, and all property, real and personal, belonging to the commonwealth and occupied or used by said homes, and shall hold and administer in trust the property included in the ''legacy fund'' and the ''effects accounts,'' if and when the transfer thereof to the commonwealth is effected pursuant to a decree of a court of competent jurisdiction, and in accordance with the terms and conditions imposed by such decree9
(c) The council shall also (i) adopt the necessary rules, regulations, by-laws, roles and responsibilities for the boards of trustees of the veterans’ homes in Chelsea and Holyoke; (ii) adopt standardized rules and regulations governing outpatient treatment, admission to and hospitalization in the homes; (iii) develop and amend bylaws that are consistent at all current or future state-operated veterans’ homes, which shall include, but shall not be limited to, admissions eligibility and procedures, procurement, per diem rates, and staffing levels; (iv) have the authority to review and comment on rules promulgated by the executive office of veterans affairs concerning the homes before the rules are submitted for public comment; (v) review and provide written comments to the executive director of veterans’ homes and housing and the secretary of veterans affairs regarding the system of governance and oversight for the homes, which shall include all rules, regulations and laws necessary for effective management and preserving the health and welfare of the veterans admitted to state-operated veteran health care and long-term care facilities; (vi) develop a system of reviewing charges, complaints, and comments from, but not limited to, residents, family members of residents, and the ombudspersons for the homes; and (vii) consider nationally recognized models and guidelines for the delivery of health care in state-operated veterans’ homes in the development of any by-laws, rules, procedures and protocols.
SECTION 2. Section 70 and 71 of chapter 6 of the General Laws are hereby repealed.
SECTION 3. Chapter 111 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by inserting after section 71 the following section:-
Section 71A. The department of public health shall conduct inspections of all state-operated veterans’ homes not less than twice per year or more frequently as the department deems necessary. After such inspection, the department shall give the superintendent of the home, the executive director of veterans’ homes and housing, the secretary of veterans affairs, and the veteran advocate established in chapter 115B notice in writing of every violation of applicable rules and regulations, and the department shall specify a reasonable period of time not exceeding 30 days after receipt thereof to provide a plan to correct such violations within a reasonable time. Inspection reports and corrections of violations shall be made available to the public.
SECTION 4. Chapter 115A of the General Laws is hereby amended by striking out section 12, as so appearing, and inserting in place thereof the following section:-
Section 12. (a) There shall be within the department of veterans’ services an office of veterans’ homes and housing. The secretary of veterans’ services shall appoint an executive director of veterans' homes and housing who shall have: (i) at least 5 years of experience in health care management and (ii) military or other experience working with veterans. The duties of the executive director shall include, but shall not be limited to: (i) oversight of the office; and (ii) service as an advisor to the secretary of veterans' services on matters relative to veterans' housing. The position of executive director shall be classified pursuant to section 45 of chapter 30. The executive director may, with the approval of the secretary of veterans' services, appoint and remove any employees necessary to carry out the duties of the office. Unless otherwise provided by law, all such appointments and removals shall be made pursuant to chapter 31. The office shall: (i) coordinate and oversee implementation and enforcement of laws, regulations and policies relative to the veterans' homes and other housing for veterans; and (ii) investigate and make recommendations on best practices for providing housing for veterans. The executive director shall have access to all property of the commonwealth under the oversight of the department of veterans services to carry out the duties of the office; provided, however, that the members of the boards of trustees of the veterans homes in Chelsea and Holyoke, and the members of the veterans’ homes council shall not be subject to the control of the executive director; and provided further, that the executive director shall not have control over the day-to-day operations of state-operated veterans’ homes.
(b) Annually, not later than November 1, the office shall submit a report to the general court on the state of the veterans' homes. The report shall include findings relative to: (i) the quality of care provided at the homes; (ii) the financial status of the homes; (iii) the uniformity of programs at the homes; (iv) the capital needs of the homes; (v) the quality of care provided at the homes; and (vi) the status of the United States Department of Veterans Affairs' accreditation, including the efforts necessary to maintain compliance and the efforts necessary to become fully compliant with the United States Department of Veterans Affairs' standards at each soldiers' home. The report shall also include an analysis of activities of the office and of the veterans’ homes council. The office shall submit the report to the governor, the clerks of the house of representatives and senate, and the joint committee on veterans and federal affairs.
SECTION 5. Chapter 115A of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by adding the following 4 new sections:-
Section 13. (a) Each state-operated veterans’ home shall have a superintendent as its administrative head, who shall report to the executive director of veterans’ homes and housing. The superintendent for each state-operated veterans’ home shall (i) be licensed as a nursing home administrator pursuant to section 109 of chapter 112 of the General Laws and (ii) be a veteran or have experience with management of veterans in a nursing home or long-term care facility. The local boards of trustees shall nominate candidates for the position of superintendent of their respective homes to the council established in section 41 of chapter 6 for their review and approval. Recommendations for the removal of a superintendent shall be submitted by the local boards of trustees or the governor to the council for their review.
Section 14. (a) Each state-operated veterans’ home shall employ an ombudsperson as a full-time, paid position for the purpose of advocating on behalf of residents and staff of the home and of receiving, investigating and resolving through administrative action, in a timely manner, complaints filed by residents and staff of the home, individuals acting on their behalf or any individual organization or government agency that has reason to believe that the home, an organization or a government agency has engaged in activities, practices or omissions that constitute violations of applicable statutes or regulations or that may have an adverse effect upon the health, safety, welfare or rights of residents or staff of the home. Said ombudsperson may work with leadership at the home or the executive director of veterans’ homes and housing as needed to resolve any complaint and shall inform the party that initiated the complaint once a resolution has been reached. The ombudsperson shall report to the executive director of veterans’ homes and housing established in section 12 of chapter 115A. Said ombudsperson may also facilitate family meetings, provide outreach, and lead orientation meetings for new residents of the homes and their families. Said ombudsperson shall not be subject to the provisions of section 9A of chapter 30 or chapter 31.
(b) No person shall discharge, discipline or otherwise retaliate against any resident or staff of a state-operated veterans’ home, individual acting on their behalf or individual organization for filing a complaint with the ombudsperson for a state-operated veterans’ home or for disclosing information in an investigation resulting from any such complaint, provided that the complaint was not made or the information was not disclosed with the knowledge that it was false or with willful disregard for its truth or falsity. The ombudsperson for each home shall make every effort to ensure the confidentiality of those who submit complaints to them.
Section 15. (a) All state-operated veterans’ homes in the commonwealth shall apply for and maintain certification by the Centers for Medicare and Medicaid Services to participate in the Medicare and Medicaid programs, pursuant to subpart B of part 483 of title 42 of the U.S. code of federal regulations. The superintendent of each state-operated veterans’ home in coordination with the executive director of veterans’ homes and housing shall ensure that compliance with the requirements of said subpart of the U.S. code of federal regulations is maintained and that compliance failures are addressed in a timely manner. Should any compliance failures be identified during the annual survey conducted by the division of health care facility licensure and certification, the superintendent in coordination with the executive director shall submit a report to the governor, the secretary of veterans affairs, the secretary of health and human services, the Veterans’ Homes Council no later than 30 days after the compliance failures are identified outlining the compliance failures and a plan for taking corrective action.
(b) The superintendent of each state-operated veterans’ home, in coordination with the executive director of veterans’ homes and housing, shall ensure that the home adheres to guidelines for trauma-informed care as outlined by the U.S. Centers for Disease Control and Prevention.
Section 16. The superintendent of each state-operated veterans’ home, in coordination with the executive director of veterans’ homes and housing, shall conduct a yearly review of the homes’ health record system and assure the home is equipped with the prevailing technology of the time to best serve the veteran and their family's access to records. A copy of the review shall be sent to the governor, the president of the senate, the speaker of the house, the senate and the house committees on ways and means, and the chairs of the joint committee on veterans and federal affairs.
SECTION 6. The General Laws are hereby amended by inserting after chapter 115A the following new chapter:-
Chapter 115B.
Section 1. As used in this chapter, the following words shall have the following meanings unless the context clearly requires otherwise:
''Nominating committee'', the nominating committee established in section 3.
''Veteran advocate'', the veteran advocate appointed under section 3.
''Executive agency'', a state agency within the office of the governor, including the executive office of education, the executive office of public safety and security, executive office of health and human services, and their constituent agencies, the Massachusetts interagency council on housing and homelessness and the executive office of housing and economic development.
''Office'', the office of the veteran advocate.
Section 2. There shall be an office of the veteran advocate which shall be independent of any supervision or control by any executive agency. The office shall:
(a) ensure that veterans in the care of the commonwealth or receiving services under the supervision of an executive agency in any public or private facility shall receive humane and dignified treatment at all times, with full respect for the veteran's personal dignity and right to privacy;
(b) ensure that veterans in the care of the commonwealth or receiving services under the supervision of an executive agency in any public or private facility shall receive timely, safe and effective services;
(c) aid and coordinate with local veterans service officers to ensure veterans are receiving all state and federal benefits available;
(d) examine, on a system-wide basis, the care and services that executive agencies provide veterans;
(e) advise the public and those at the highest levels of state government about how the commonwealth may improve its services to and for veterans and their families;
(f) develop internal procedures appropriate for the effective performance of their duties’
(g) act as a liaison to all state agencies providing services to veterans to ensure the veteran receives the necessary services and care;
(h) assist in developing procedures for the agency to best serve the veteran community;
(i) act as a liaison to the department of veteran affairs and all other relevant federal agencies to advocate on behalf of the veterans of the commonwealth;
and
(j) investigate individual incidents where a veteran or veterans have suffered a fatality, near fatality or serious bodily or emotional injury while receiving services from an executive agency or a constituent agency; or circumstances which result in a reasonable belief that an executive agency or a constituent agency failed in its duty to care for a veteran and, as a result, the veteran was at imminent risk of, or suffered serious bodily or emotional injury or death.
Section 3. The office of the veteran advocate shall be under the direction of the veteran advocate. The veteran advocate shall be the administrative head of the office and shall devote full-time to the duties of the office. The veteran advocate shall be appointed by a majority vote of the attorney general, the state auditor and the governor from a list of 3 nominees submitted by a nominating committee to recommend a veteran advocate. The nominating committee shall consist of: the secretary of health and human services, or a designee, who shall serve as chair; the secretary of veterans’ affairs, or a designee; the secretary of public safety, or a designee; the commissioner of mental health, or a designee; the house and senate chairs of the joint committee on veterans and federal affairs; the adjutant general of the Massachusetts national guard; a representative of the veterans of foreign wars department of Massachusetts ; a representative of the American legion department of Massachusetts; the chairperson of the board of trustees of the veterans’ home in Chelsea; and the chairperson of the board of trustees of the veterans’ home in Holyoke. The nominating committee shall submit salary recommendations for the candidates commensurate with the candidates experience and other similar state positions. The work of the nominating committee shall be coordinated by the executive office of health and human services.
Any person appointed to the position of veteran advocate shall be selected without regard to political affiliation and on the basis of integrity and demonstrated ability in veteran welfare, justice, auditing, law, health care, management analysis, public administration and investigation or criminal justice administration. The veteran advocate may, subject to appropriation, appoint such other personnel as the veteran advocate deems necessary for the efficient management of the office.
The veteran advocate shall serve for a term of 5 years. In the case of a vacancy in the position of the veteran advocate, a successor shall be appointed in the same manner for the remainder of the unexpired term. No person shall be appointed as veteran advocate for more than 2 full terms.
The veteran advocate may be removed from office for cause by a majority vote of the attorney general, the state auditor and the governor. Such cause may include substantial neglect of duty, gross misconduct or conviction of a crime. The cause for removal of the veteran advocate shall be stated in writing and shall be sent to the clerks of the senate and house of representatives and to the governor at the time of removal and shall be a public document.
Section 4. The veterans advocate shall report annually to the governor, the president of the senate, the speaker of the house, the senate and the house committees on ways and means, and the chairs of the joint committee on veterans and federal affairs on the activities of the office, including an analysis of the delivery of service to veterans and recommendations for changes in agency procedures which would enable the commonwealth to better provide services to and for veterans and their families and priorities for implementation of those changes to services. The report shall be made public.