SENATE DOCKET, NO. 2802        FILED ON: 10/16/2023

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No.         

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Patrick M. O'Connor

_________________

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 providing equity for self-directed complex caregivers.

_______________

PETITION OF:

SENATE DOCKET, NO. 2802        FILED ON: 10/16/2023

SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No.         

The Commonwealth of Massachusetts

_______________

In the One Hundred and Ninety-Third General Court
(2023-2024)

_______________

An Act providing equity for self-directed complex caregivers.

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

SECTION XX. (a) As used in this section, the following words shall have the following meanings:-

“complex care member”, an individual enrolled in MassHealth whose medical needs, as determined by MassHealth or its designee, are such that they require more than two continuous hours of in-home skilled nursing services to remain in the community.

“continuous skilled nursing services”, skilled nursing care provided by a licensed nurse to complex-care members who require more than two continuous hours of nursing services per day as authorized by MassHealth,

“primary caregiver”, a legally responsible individual primarily responsible for caring for a family member, regardless of age, with chronic or other health conditions, disabilities, or functional limitations, who is: (i) enrolled in the community case management program as a complex-care member; and (ii) authorized to receive more than 2 hours of continuous skilled nursing care services.

“Self-directed home and community-based services model of care,” a service of care, which is planned and purchased under the direction and control of a complex care member, including the amount, duration, scope, provider, and location of the home and community-based services.

(b) Notwithstanding any general or special law to the contrary, and to the extent permitted under federal law, the secretary of health and human services shall, within 3 months of the effective date of this act, apply to the federal Centers for Medicare & Medicaid Services for a home and community-based services waiver under section 1915(c) of the federal Social Security Act to allow complex care members to receive waiver services under a self-directed home and community-based service model of care. The waiver application shall: (i) prioritize individuals who receive benefits and services as a complex care member; (ii) afford complex care members the opportunity to direct some or all of their waiver services without regard to their support needs; (iii) allow primary caregivers to be compensated for providing services to a complex care member under the waiver application; (iv) require services to be provided in accordance with an individualized assessment and person-centered service plan; (iv) ensure that the process and procedures for applying for waiver services are fully accessible and equitable to families of complex care members who are from linguistically and culturally diverse communities; and (v) maximize federal financial participation for the coverage and benefits under this section; provided, however, that coverage and benefits provided under this section shall not be contingent upon the availability of federal financial participation.

(c) On January 15, 2024, and every year thereafter, the secretary of health and human services shall file a report with the clerks of the house of representatives and senate, the executive office on administration and finance, the house and senate committees on ways and means, and the joint committee on health care financing and on the status of the waiver application and on the operation of waiver, once obtained. The report on the operation of the waiver shall include, but not be limited to, a description of the number of individuals receiving services under the waiver, the race and primary language of the individual, and the fiscal impact, including the amount of federal financial participation received.