Amendment #481 to H4000

Rural Services Access Commission

Representatives Andrews of Orange, Gobi of Spencer, Madden of Nantucket and Garlick of Needham move to amend the bill by adding the following section:

“SECTION XXXX.  Chapter 3 of the General Laws, is hereby amended by inserting after section 69 the following section:-

Section 69. (a) There shall be a permanent commission to study rural access to public assistance and state-sponsored services. The commission shall consist of 19 members including: the secretary of health and human services or a designee, who shall serve as the chair; the commissioner of transitional assistance or a designee; the child advocate or a designee; the secretary of elder affairs or a designee; the secretary of labor and workforce development or a designee; the secretary of transportation or a designee; the secretary of education or a designee; the undersecretary of housing and community development or a designee; the commissioner of early education and care or a designee; the director of the Massachusetts Broadband Institute; a representative from the State Office on Rural Health; a representative from the Massachusetts League of Community Health Centers; a representative from Children’s Trust Fund; a representative from the Massachusetts Association of Community Action Programs; a representative from the Massachusetts Model of Community Coalitions; a representative of Mass Home Care; a representative from a food bank or food pantry located in the commonwealth, appointed by the governor; a representative of a regional planning agency located in Berkshire, Franklin, or Hampshire counties, appointed by the governor, and a representative of the Citizens’ Housing and Planning Association.

(b) The commission shall examine and make recommendations regarding barriers faced by low-to moderate-income individuals  living in rural areas to obtain public assistance and state-sponsored services including, but not  limited to, fuel assistance, child care subsidies, direct cash assistance, emergency housing  services and health and human service programs which provide services to children, families, persons with disabilities and elders. The commission’s analysis shall include, but not be limited to, the cost of traveling to and from regional offices, the cost of delivering services in rural areas and the success of outreach efforts in rural communities.

(c) The commission shall examine and make recommendations relative to establishing community-based access points within communities, in cooperation with community partners, to co-locate multiple agency-specific resource centers.  The commission’s analysis shall include, but not be limited to, recommendations regarding the development of an interagency mobile delivery model for one-stop service centers, rotating between local agency, community-identified or known community hubs; contract incentives to support service models that encourage collaboration, co-location and/or cost sharing in rural areas.

(d) The commission shall examine and make recommendations to coordinate delivery of services between local and state agencies, expanding the use of technology, to increase access to services and eliminating application requirements for in-person visits to state agencies.  The commission’s analysis shall include, but not be limited to, recommendations strengthening communications options, including ensuring internet access and video conferencing technology in community-identified or known community hubs, development of mobile applications and mobile friendly websites to promote client outreach and engagement.

(e) The commission shall examine and make recommendations relative to expanding broadband access to rural communities and service providers, reviewing community anchor institutions, identifying gaps and recommending additional anchor sites to expand broadband access to service providers.

(f) The commission shall examine and make recommendations regarding further integration of eligibility and application processes for key state-sponsored services and establishing categorical eligibility for state-sponsored services.

(g) The commission shall examine and make recommendations to strengthen information and referral services available in rural areas through the collection of more comprehensive information regarding available services in rural areas, developing locally-based resource guides for rural areas, and supporting consistent adoption of “managed referral” processes.

(h) The commission shall examine and make recommendations to support consumer directed care through the adoption of alternate transportation models, including, but not limited to, the establishment of the use of vehicle ownership programs, and travel vouchers through sponsoring agencies to offset travel costs for clients in rural communities.

(i) The commission shall examine and make recommendations regarding the cost implications for service delivery in rural communities.  The commission’s analysis shall include, but not be limited to, refining provider rate setting methodologies to account for rural provider costs, increasing provider reimbursement rates for child transportation, and the establishment of an administrative overhead rate for state sponsored services. The commission’s analysis shall also include an examination of the commonwealth’s approach to grant making to ensure rural communities are not particularly disadvantaged due to population density.

(j) The commission shall examine and make recommendations regarding the development and infrastructure for rural community coalitions that bring together community members to coordinate work on common data-driven and evidence-based initiatives to promote integrated models of care for mental health, substance abuse, and primary care services.

(k) The commission shall examine and make recommendations regarding the expansion of telemedicine and health information technology to improve access, quality, and cost effectiveness of health care services in rural communities; inventory rural healthcare implementation of telemedicine and barriers to further development.

(l) The commission shall examine and make recommendations to establish satellite locations for local universities, community colleges, and other learning and education programs in select rural areas. The commission’s analysis shall include, but not be limited to, developing enhanced and coordinated state infrastructure that identifies and addresses rural workforce needs, including recommendations relative to licensing and credentialing of workers in early childhood development, family child care provider shortages for children in state-funded slots.

(m) The commission shall examine and make recommendations to improve the availability of access to primary care services, improve health outcomes and quality, retain and recruit health care workers, lower health costs, to promote use of technology to better manage and coordinate health services, and to implement data-driven and evidence-based strategies to address health care worker shortages in rural communities.

(n) The powers of the commission shall include, but not be limited to, the following: (1) to use such voluntary and uncompensated services of private individuals, agencies and organizations as may from time to time be offered and required, including provision of meeting places and refreshments; (2) to hold regular, public meetings and to hold fact-finding hearings and other public events as the commission deems necessary; (3) to direct a staff, in this section to be called commission staff, to perform its duties; (4) to establish and maintain such offices as the commission deems necessary, subject to appropriation; (5) to enact by-laws for its own governance but not inconsistent with any general or special law; and (6) to recommend policies and make recommendations to agencies and officers of the commonwealth and local subdivisions of government to effectuate the purposes of this commission.

(o) The commission may accept and solicit funds, including any gifts, donations, grants or bequests, or any federal funds for any of the purposes of this section. Such funds shall be deposited into a separate account with the state treasurer, received by said treasurer on behalf of the commonwealth, and expended by the commission in accordance with law.

(p) Not later than December 31 of each year, the commission shall report its findings and activities of the preceding year, including any policy recommendations, together with drafts of legislation, if any, necessary to carry its recommendations into effect, to the governor, the clerks of the senate and the house, the house and senate committees on ways and means, the joint committee on children, families and persons with disabilities and the joint committee on elder affairs.