Budget Amendment ID: FY2018-S3-296-R1

Redraft EHS 296

Spouses as Caregivers

Messrs. Tarr, Humason, Ross and O'Connor and Ms. L'Italien moved that the proposed new text be amended <w:t>by inserting after section __, the following new section:-</w:t>

“SECTION__. There shall be a spouses as caregivers task force to analyze the advantages and disadvantages of obtaining a waiver from the Center for Medicaid and Medicare Services (CMS) to amend the Commonwealth of Massachusetts’ 1915(c) elderly waiver, such that any program of home and community based services in which family members are permitted to serve as paid caregivers, funded pursuant to Section 9 of Chapter 118E, shall include spouses within the definition of a family member.

The task force shall consist of 11 members: the secretary of health and human services, or designee, the secretary of elder affairs, or designee, the secretary of administration and finance, or designee, the director of mediacaid, or designee, a representative of  AARP Massachusetts, the house and senate chairs of the joint committee on elder affairs, or their designees, a member of the general court appointed by the senate president, a member of the general court appointed by the senate minority leader; a member of the general court appointed by the house speaker, a member of the general court appointed by the house minority leader;

The task force shall: (i) identify and review relevant federal and state laws and  regulations, and the feasibility, efficacy and practicality of seeking and securing a waiver from the center for medicaid and medicare service to allow spouses to serve as paid caregivers; (ii) the task force shall prepare and submit a report to the clerks of the senate and house and the joint committee on elder affairs, no later than May 31, 2018”

 

 


Budget Amendment ID: FY2018-S3-297-R1

Redraft EHS 297

Licensure of Nursing Facilities

Messrs. Tarr, Eldridge, Moore, Cyr and Humason, Ms. Chandler, Ms. Flanagan, Messrs. Rush, Pacheco, Lewis, Boncore and Fattman, Ms. L'Italien, Ms. Lovely, Messrs. Ross, deMacedo and O'Connor, Ms. O'Connor Ives and Ms. Gobi moved that the proposed new text be amended <w:t>that the proposed new text be amended by inserting after section 100 the following section:-</w:t>

“SECTION 100A.  (a)  Notwithstanding any general or special law to the contrary, facilities licensed pursuant to section 71 of chapter 111 of the General Laws and constructed not later than March 19, 1968, shall be subject to the construction and equipment requirements for long-term care facilities specified in 105 CMR 150.017 (B)(1) to 105 CMR 150.017(B)(16)(e), inclusive, and codified effective January 1, 2017; provided, however, that new construction, conversions, alterations, additions or other structural changes in a proposed or existing facility shall conform to the department of public health’s current standards of construction.

(b)  For facilities licensed pursuant to section 71 of chapter 111 of the General Laws, resident rooms shall accommodate not more than 4 persons; provided, however, that facilities that receive approval of construction or reconstruction plans by the department of public health or relevant local authorities for plans directly impacting resident rooms or that are newly certified for participation in the Medicare or Medicaid programs on or after November 29, 2016, resident rooms shall accommodate not more than 2 residents.  Any limitation to the number of residents accommodated in resident rooms pursuant to this section shall  apply to those rooms directly impacted by the construction or reconstruction."


Budget Amendment ID: FY2018-S3-298

EHS 298

Health Purchasing Cooperatives

Messrs. Tarr, Ross and O'Connor moved that the proposed new text be amended by inserting, after section __, the following new sections:-

 

SECTION_. Section 12 of Chapter 176J of the General Laws is hereby amended in line 35 by striking the number "6" and inserting in place thereof the following:- "8"

 

SECTION_. Said section 12 of chapter 176J of the General Laws is hereby amended in line 39 by striking the number "85,000" and inserting in place thereof the following:-"100,000"

 

SECTION_. Section 13(b) of chapter 176J of the General Laws is hereby amended by striking subsection (v) in its entirety.


Budget Amendment ID: FY2018-S3-299

EHS 299

Senior FarmShare

Ms. Gobi and Mr. Humason moved that the proposed new text be amended in section 2, in item 9110-1900, by adding the following:- “and provided further that not less than $50,000 shall be expended for the Senior FarmShare program.” and by striking out the figures “$7,257,869” and inserting in place thereof the following figures “7,307,869”.


Budget Amendment ID: FY2018-S3-300-R2

2nd Redraft EHS 300

Nursing Home Licensure

Messrs. Tarr, Humason and Ross and Ms. O'Connor Ives moved that the proposed new text be amended <w:t>by inserting after section 65 the following section:-</w:t>

“SECTION 65A.  Section 20N of chapter 233 of the General Laws, as inserted by section 126 of chapter 46 of the acts of 2015, is hereby amended by adding the following 3 subsections:-

(c) Each social worker employed by the department of children and families shall be provided with a state-issued identification card showing the name and position of the worker and containing a recent picture. In performing any of the social worker’s duties, the social worker shall display the identification card and such card shall be accepted as proof of the social worker’s identity unless the person to whom it is displayed has a good faith basis for denying its authenticity.

(d) No person, facility, school or law enforcement agency, jail or house of correction shall require a social worker employed by the department of children and families to provide, in connection with the performance of the social worker’s duties: (i) documentation including, but not limited to, a driver’s license, other than the state-issued identification card described in subsection (c); or (ii) the social worker’s home address or personal telephone number.

(e) The home address and personal telephone number of a social worker employed by the department of children and families shall be redacted from law enforcement agency reports before such reports are released to any person.”.


Budget Amendment ID: FY2018-S3-301

EHS 301

Services for Victims of Childhood Sexual Abuse

Messrs. Cyr and deMacedo moved that the proposed new text be amended in section 2, in item 4800-0038, by inserting after the words “payroll costs” the following:- “; provided further that not less than $140,000 shall be expended for the Children's Cove Cape & Islands Child Advocacy Center”; and in said item, by striking out the figures “$291,471,283” and inserting in place thereof the figures “$291,611,283”


Budget Amendment ID: FY2018-S3-302

EHS 302

Martha's Vineyard Homelessness Caseworker

Mr. Cyr moved that the proposed new text be amended in section 2, in item 7004-0099, by inserting after the words “security requirements,” the following:- “; provided further, that not less than $40,000 shall be expended for a caseworker position under the Housing Assistance Corporation to assist residents of Martha’s Vineyard who are homeless or at risk for homelessness” and in said item by striking out the figures “$7,263,469” and inserting in place thereof the figures “$7,303,469”


Budget Amendment ID: FY2018-S3-303

EHS 303

Massachusetts Down Syndrome Congress

Ms. Flanagan, Messrs. Cyr and Eldridge, Ms. L'Italien, Messrs. Tarr and O'Connor, Ms. Lovely, Messrs. Moore, Barrett and Montigny moved that the proposed new text be amended in section 2, in item 5911-1003, by adding at the end thereof the following: "and provided further, that $175,000 shall be expended for the Massachusetts Down Syndrome Congress, Inc."


Budget Amendment ID: FY2018-S3-304-R2

2nd Redraft EHS 304

Sight Loss Services

Mr. Cyr moved that the proposed new text be amended in section 2, in item 4513-1111, <w:t>by inserting after the words “funds,” the following:- “; provided further, that not less than $25,000 shall be expended for Sight Loss Services , Inc. Cape Cod &amp; Islands to maintain operations and services for older adults in Barnstable County” and in said item by striking out the figures “$3,460,977” and inserting in place thereof the figures “$3,485,977”</w:t>


Budget Amendment ID: FY2018-S3-305-R1

Redraft EHS 305

SBIRT implementation

Ms. Flanagan, Messrs. Cyr, Lewis, Eldridge and O'Connor moved that the proposed new text be amended in section 2, in item 4512-0200, <w:t xml:space="preserve">by adding the following words:- “; provided further, that not less than $200,000 shall be expended for the implementation of section 97 chapter 71 of the General Laws to support school districts that are not currently funded by the department of public health; and </w:t>

in said section 2, in said item 4512-0200, by striking out the figure “$129,675,888” and inserting in place thereof the following figure:- “129,875,888”.


Budget Amendment ID: FY2018-S3-306-R1

Redraft EHS 306

Special Commission on Unaccompanied Homeless Youth and the Annual Youth Court

Messrs. Cyr, Eldridge, Brady and O'Connor moved that the proposed new text be amended in section 2, in item 4000-0300, <w:t>by inserting after the words "subsequent month" the following:- “; provided further, that funds shall be expended for the work of the Massachusetts Special Commission on Unaccompanied Homeless Youth to determine the scope of need among unaccompanied youth and young adults ages 24 and younger who are experiencing homelessness, including funding research on lesbian, gay, bisexual, transgender, queer, and questioning youth, and other disproportionately homeless youth, and to identify and implement potential models for appropriate service delivery to unaccompanied homeless youth in urban, suburban, and rural areas of the commonwealth;”</w:t>


Budget Amendment ID: FY2018-S3-307

EHS 307

Behavioral Health Integration

Ms. Flanagan, Messrs. Moore, Brownsberger, Eldridge and Montigny moved that the proposed new text be amended in section 2, in item 4000-0300, by adding at the end thereof the following: "provided further, that MassHealth shall expend up to $100,000 to identify regulatory and billing barriers to the integration of primary care and behavioral health and the solutions to eliminate said barriers; and provided further, that MassHealth shall report to the House and Senate Committees on Ways and Means and the Joint Committee on Mental Health, Addiction and Recovery by January 1, 2018 on said barriers and their plan to address and eliminate these barriers by June 30, 2018." 


Budget Amendment ID: FY2018-S3-308-R1

Redraft EHS 308

DYS Fingerprinting

Ms. Flanagan and Mr. Humason moved that the proposed new text be amended <w:t>by inserting after section 9 the following 2 sections:-</w:t>

“SECTION 9A.  Subsection (a) of section 7 of chapter 15D, as so appearing, is hereby amended by inserting after the words “funded program”, in line 38, the following words:-  ; provided, however, that this shall not include the department of youth services.

SECTION 9B. Chapter 18A of the General Laws is hereby amended by inserting after section 8 the following section:-

Section 8A. (a) Each current or prospective department employee, intern or volunteer or subcontractor providing residential or support services with the potential for unsupervised contact with youth committed to the care or custody of the department shall be subject to a background check that shall include: (i) a fingerprint-based check of the state and national criminal history databases pursuant to Public Law 92-544; (ii) a criminal offender record information check pursuant to section 172 of chapter 6; (iii) a check for supported findings of abuse or neglect pursuant to section 51B of chapter 119; (iv) a sex offender registry information check pursuant to section 178K of chapter said 6; and (v) where relevant to the employee’s duties, a registry of motor vehicles information check.

(b) Fingerprints shall be submitted to the identification section of the department of state police for a state criminal history check and forwarded to the Federal Bureau of Investigation for a national criminal history check, according to the policies and procedures established by the state identification section and by the department of criminal justice information services. Fingerprint submissions may be retained by the Federal Bureau of Investigation, the state identification section and the department of criminal justice information services to assist the department in its review of suitability for initial or continued employment, licensure, certification or approval. The department of criminal justice information services may disseminate the results of a state and national criminal history check to authorized staff of the department to determine the suitability of current and prospective employees who have the potential for unsupervised contact with youth committed to the care or custody of the department and sub-contractors, interns, volunteers or other individuals employed or retained by the department who have the potential for unsupervised contact with youth committed to the care or custody of the department. Notwithstanding subsections 9 and 9½ of section 4 of chapter 151B, if the department receives information from a fingerprint-based check that does not include a final disposition or is otherwise incomplete, the department may request that an applicant, including new and renewing applicants, provide additional information to assist the department in determining the suitability of the individual for licensure, certification, approval, funding or employment.

(c) The department of criminal justice information services shall disseminate the results of the criminal background check to authorized staff of the department. The department of criminal justice information services shall only disseminate information under this section that would otherwise be available to the department by law. When the department receives the results of the national criminal background checks, it shall treat the information according to the department’s background check procedures regarding criminal offender record information.

(d) A person required to submit fingerprints under this section including, but not limited to, current and prospective employees, interns, sub-contractors and volunteers in a department program who have the potential for unsupervised contact with youth committed to the care or custody of the department, may be charged a fee to be established by the secretary of administration and finance, in consultation with the secretary of public safety and the commissioner of youth services, to offset the costs of operating and administering a fingerprint-based criminal background check system. The fee shall not exceed $45 per person. The secretary of administration and finance, in consultation with the secretary of public safety and the commissioner of youth services, may increase the fee accordingly if the Federal Bureau of Investigation increases its fingerprint background check service fee. The department may reimburse employees and applicants for employment, internship or volunteer positions, for all or part of the fee. Fees collected from fingerprinting activity under this chapter shall be deposited into the Fingerprint-Based Background Check Trust Fund established in section 2HHHH of chapter 29.

(e) The department shall promulgate regulations necessary to carry out this section.”.


Budget Amendment ID: FY2018-S3-309

EHS 309

DCF Child Welfare Trial Attorneys

Ms. Flanagan, Messrs. Cyr, Moore, Brady, Timilty and O'Connor moved that the proposed new text be amended in section 2, in item 4800-0015, in line 5, by inserting after "employees" the following: "provided further, that the department shall expend not less than $1,000,000 for the hiring of additional new trial attorneys to handle child welfare cases” and in said item by striking out the figure, " $100,134,611" and inserting in place thereof the figure "$101,134,611".


Budget Amendment ID: FY2018-S3-310

EHS 310

Sexual Assault Nurse Examiner Program

Mr. Rush, Ms. Creem, Mr. Cyr, Ms. L'Italien, Messrs. Keenan, Brownsberger, Moore, McGee and O'Connor moved that the proposed new text be amended in section 2, in item 4510-0810, by striking out the figure “$4,728,855” and inserting in place thereof the following figure:- “$5,028,855”


Budget Amendment ID: FY2018-S3-311-R1

Redraft EHS 311

Office of State Veterans’ Homes and Housing 1

Messrs. Rush and O'Connor moved that the proposed new text be amended in section 2, in item 1410-0010, <w:t>by adding the following words:- “; provided further, that not less than $85,000 shall be expended on staff to carry out the duties of the office established in section 12 of chapter 115A”; and in said section 2, in said item 1410-0010, by striking out the figure “$3,524,629” and inserting in place thereof the following figure:- “$3,609,629”.</w:t>


Budget Amendment ID: FY2018-S3-312

EHS 312

Self Esteem Boston

Mr. Rush, Ms. Flanagan and Mr. Boncore moved that the proposed new text be amended in section 2, in item 4512-0200, by adding at the end thereof the following:- “; provided further that not less than $150,000 shall be expended for Self Esteem Boston’s direct service and provider training programs”; and in said item, by striking out the figures “$129,675,888” and inserting in place thereof the figures “$129,825,888”


Budget Amendment ID: FY2018-S3-313

EHS 313

Office of State Veterans’ Homes and Housing 2

Messrs. Rush and O'Connor moved that the proposed new text be amended in section 2, in item 1410-0010, by adding at the end thereof the following:- “; provided further that not more than $318,000 shall be expended to staff positions within the office of state veterans’ homes and housing, established pursuant to chapter 141 of the acts of 2016, and further provided that not more than $130,000 of the $318,000 expenditure shall fund the position of executive director”;  and in said item, by striking out the figures “$3,524,629” and inserting in place thereof the figures “$3,842,629”


Budget Amendment ID: FY2018-S3-314

EHS 314

Virtual Manufacturing

Messrs. Rush and Boncore moved that the proposed new text be amended by inserting, after section __, the following new section:-

"SECTION __. Section 7 of chapter 94C of the General Laws, as appearing in the 2014 Official  Edition, is further amended by adding the following subsection:-

Every person with a principal place of business located in the commonwealth who is in the business of manufacturing or distributing any controlled substances, but at no time takes physical possession of such substances, shall upon payment of a fee, the amount of which shall be determined annually by the secretary of administration and finance under the provision of section 3B of chapter 7, register with the commissioner of public health, in accordance with the department’s regulations, said registration to be effective for 1 year from the date of issuance."


Budget Amendment ID: FY2018-S3-316-R1

Redraft EHS 316

Revere Substance Use Disorder Initiatives

Mr. Boncore moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by inserting at the end thereof the following:-</w:t>

provided that $50,000 shall be expended for the Substance Use Disorder Initiative in the City of Revere,” and in said item by striking out the figures "$475,000” and inserting in place thereof the figures “525,000.


Budget Amendment ID: FY2018-S3-317

EHS 317

Home Base Program 2

Mr. Rush, Ms. Flanagan and Mr. O'Connor moved that the proposed new text be amended in section 2, in item 1410-0012, by striking out the words “and provided further, that $650,000 shall be expended for education and training in veterans’ mental and behavioral health issues, including suicide prevention and substance abuse and treatment, administered by a qualified nonprofit organization”, and inserting in place thereof the following:-  “and provided further, that $1,300,000 shall be expended for education and training in veterans’ mental and behavioral health issues, including suicide prevention and substance abuse and treatment, administered by Home Base”; and in said item, by striking the figures “$4,370,641” and inserting in place thereof the figures “$5,020,641”


Budget Amendment ID: FY2018-S3-318

EHS 318

Home Base Program 1

Messrs. Rush and O'Connor moved that the proposed new text be amended in section 2, in item 1410-0012, by striking out the words:- “a qualified nonprofit organization” and inserting in place thereof the following words:- “Home Base”


Budget Amendment ID: FY2018-S3-319-R2

2nd Redraft EHS 319

Healthy Incentives Program

Ms. Gobi, Messrs. Cyr, Eldridge, Moore and McGee, Ms. L'Italien, Messrs. Hinds and Humason, Ms. O'Connor Ives and Mr. Lesser moved that the proposed new text be amended in section 2, in item 4400-1001, <w:t>by adding the following words:- “; provided further, that $1,350,000 shall be expended to the Food Insecurity Nutrition Incentive grant program for project costs for the Massachusetts’ Healthy Incentives Program”; and in said section 2, in said item 4400-1001, by striking out the figure “$3,097,232” and inserting in place thereof the following figure:- “$4,447,232”.</w:t>


Budget Amendment ID: FY2018-S3-320-R1

Redraft EHS 320

Safe and Successful Youth Initiative

Ms. Chang-Diaz, Messrs. Cyr, Montigny, Moore, Brady, McGee, Hinds, Eldridge, Humason, Brownsberger, Boncore and Lesser moved that the proposed new text be amended in section 2, in item 4000-0005, <w:t>by striking the figure "6,500,000" and inserting in place thereof the following figure:- "7,500,000".</w:t>


Budget Amendment ID: FY2018-S3-321

EHS 321

Office for Refugees and Immigrants Services

Ms. Creem, Messrs. Cyr and Lewis moved that the proposed new text be amended in section 2, in item 4401-1000, by adding after the words "office of refugees and immigrants" the following new language:- “with whom the department of transitional assistance entered into service agreements within fiscal year 2017"


Budget Amendment ID: FY2018-S3-324

EHS 324

Competitive Integrated Employment Services (CIES)

Ms. Flanagan, Ms. L'Italien, Ms. Gobi, Messrs. Humason and O'Connor moved that the proposed new text be amended in section 2, in item 4401-1000, by striking the words "that the department shall expend funds for the young parents program" and inserting in place thereof the following words: "that the department shall spend no less than the amount spent in fiscal year 2017 for the young parents program and the competitive integrated employment services program;".


Budget Amendment ID: FY2018-S3-325-R1

Redraft EHS 325

Task Force on Child Welfare Data Reporting

Ms. Flanagan, Ms. L'Italien, Messrs. Moore, Eldridge, Barrett, Tarr, Brownsberger and Lewis moved that the proposed new text be amended <w:t xml:space="preserve">by inserting after section 101 the following 2 sections:- </w:t>

“Section 101A. There shall be a task force on child welfare data reporting. The task force shall develop basic data measures, progress measures and key outcome measures to inform the legislature and the public about the status and demographics of the caseload of the department of children and families, the department’s progress in achieving child welfare goals, including safety, permanency and well-being, the status of proceedings in the juvenile court department that involve children in the department’s caseload and the status of children who are or have been involved in both the child welfare and juvenile justice systems.

The task force shall develop criteria for measuring outcomes for children and families in the key child welfare domains of safety, permanency and well-being for children including, but not limited to, the outcomes of: (i) protecting children from abuse and neglect; (ii) safely maintaining children in their own homes whenever possible and appropriate; (iii) achieving stability and permanency for children in their living situations; (iv) preserving the continuity of family relationships; (v) enhancing the capacity of families to provide for the needs of children; (vi) ensuring that children receive appropriate services to meet their educational needs; (vii) ensuring that children receive the services necessary to meet their physical and mental health needs; (viii) achieving permanency and opportunity for young adults; (ix) complying with timeframes and deadlines for court hearings; and (x) minimizing the incidence of juvenile justice system involvement for children involved with the department of children and families.

The task force shall also make recommendations to: (i) ensure that department of children and families’ annual, biannual and quarterly reports include appropriate data measures that are clearly defined, placed in the context of historical or other comparative data when necessary to convey the meaning of the reported data and include the department’s current understanding as to why certain trends may be appearing in the data; (ii) eliminate reports that are no longer necessary; and (iii) ensure that reports are submitted on time and posted on the department’s website. The task force shall also make recommendations about periodic reports from the courts on cases involving children involved with the department of children and families.

Not later than 45 days after the end of each quarter, the department of children and families shall publish on its website caseload profile reports that provide statewide, regional and area office summaries that include data covering the number of maltreatment reports received during the year; screen in and support decisions; number of children in placement; adoptions and guardianships legalized; consumer demographics including race and primary language; information relating to children that are in placement, including most recent intake, placement type, race, age group, continuous time in placement, gender, and service plan goal; and information relating to children that are not in placement, including most recent intake and age group.

The task force shall be comprised of the following members or their designees: the child advocate, who shall serve as co-chair; the commissioner of the department of children and families, who shall serve as co-chair; the senate and house chairs of the joint committee on children, families and persons with disabilities; the chief justice of the juvenile court department; the executive director of the Massachusetts Law Reform Institute, Inc.; the chief counsel of the committee for public counsel services; the executive director of Children’s League of Massachusetts, Inc.; 1 member with expertise in child welfare data and outcome measurement to be chosen by the child advocate; and 1 member with expertise in the department of children and families’ information technology, data collection and reporting systems to be chosen by the commissioner of the department of children and families. The task force shall consult with other individuals who have relevant expertise as needed.

The task force shall meet not less than quarterly and in the first 6 months of its first year, the full task force or its working groups shall meet not less than monthly. Annually, not later than January 31, the task force shall file its recommendations, together with drafts of legislation necessary to implement the recommendations, with the clerks of the senate and house of representatives, who shall forward the report to the senate and house chairs of the joint committee on children, families and persons with disabilities.

SECTION 101B.  Section 101A is hereby repealed.”; and

by inserting after section 110 the following section:-

“SECTION 110A. Section 101B shall take effect on February 1, 2022.”


Budget Amendment ID: FY2018-S3-326-R1

Redraft EHS 326

Saugus United Against Substance Abuse

Mr. McGee moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by adding the following words:- “provided further, that no less than $10,000 shall be expended to the Saugus United Against Substance Abuse Coalition for anti-drug and substance abuse programs”; and by striking out the figure “$475,000” and inserting in place thereof the following figure:-“$485,000”.</w:t>


Budget Amendment ID: FY2018-S3-328

EHS 328

Stabilizing of State Nursing Facilities

Messrs. McGee, Boncore, Eldridge and Cyr, Ms. Flanagan, Messrs. Lewis and Timilty, Ms. Lovely, Messrs. O'Connor and Lesser moved that the proposed new text be amended in section 2, in item 4000-0641, by adding at the end thereof the following: “provided that effective July 1, 2017 the executive office of health and human services shall expend in MassHealth nursing facility rates not less than $17.8 million over the amount spent in state fiscal year 2017 to fund the Medicaid share of the nursing home assessment established by section 63 of chapter 118E of the General Laws” and in said item, by striking out figures "345,100,000" and inserting in place thereof the figures "$362,900,000"


Budget Amendment ID: FY2018-S3-329

EHS 329

Emergency Medical Services System Trust Fund

Ms. Donoghue moved that the proposed new text be amended by inserting, after section __, the following new section:

“SECTION __. Chapter 29 of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after section 2VVVV, the following section:-

Section 2WWWW. There shall be an Emergency Medical Services System Trust Fund. The commissioner of public health shall administer the fund and is authorized to make expenditures from the fund to support the emergency medical services and mobile integrated health care systems in Massachusetts, including, but not limited to: (i) costs of the office of emergency medical service, including coordination and oversight of the Massachusetts emergency medical services system; (ii) costs of regional emergency medical services councils and the central medical emergency direction centers; (iii) costs of the administration and oversight of mobile integrated health care in Massachusetts; and (iv) other operations of the office of emergency medical services and the office of mobile integrated health care for program administration and development.

There shall be credited to the fund: (i) revenue generated from fees, fines, and penalties required under chapters 111C and 111O and the regulations promulgated thereunder; (ii) revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund; and (iii) funds public or private sources for emergency medical services and mobile integrated health care, including, but not limited to, gifts, grants, donations, rebates and settlements received by the Commonwealth that are specifically designated to be credited to the fund. The department may incur expenses and the comptroller may certify for payment amounts in anticipation of expected receipts; provided, however, that no expenditure shall be made from the fund that shall cause the fund to be deficient at the close of a fiscal year. Amounts credited to the fund shall not be subject to further appropriation and money remaining in the fund at the close of a fiscal year shall not revert to the General Fund.”


Budget Amendment ID: FY2018-S3-330

EHS 330

Medication-Assisted Treatment at the Lowell Community Health Center

Ms. Donoghue moved that the proposed new text be amended in section 2, in item 4510-0110, by inserting at the end thereof the following:- “; provided further, that not less than $200,000 shall be expended for the Lowell Community Health Center to provide the training necessary to expand its medication-assisted treatment and peer-to-peer support programs”; and in said item, by striking out the figure “$1,042,354” and inserting in place thereof the following figure:- “1,242,354”


Budget Amendment ID: FY2018-S3-331-R1

Redraft EHS 331

Annuity Payment for Gold Star Families

Messrs. McGee, Rush, O'Connor, Tarr and Ross moved that the proposed new text be amended <w:t>by inserting after section 50 the following section:-</w:t>

“SECTION 50A.  The third paragraph of section 6B of chapter 115 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out the last sentence and inserting in place thereof the following 2 sentences:- Such payments shall be due and payable from the date of the parents’ and surviving spouse’s application; provided, however, that the first payment shall be retroactive to the applicant’s initial date of eligibility if the deceased member or the parent or spouse making application was a resident of the commonwealth at the time of death and the parent or spouse making application is a resident of the commonwealth at the time of application.  For the purposes of calculating any retroactive payment of benefits under this section, the initial date of eligibility shall mean the later of: (i) the date of death of the member of the armed forces of the United States; or (ii) July 1, 1998 in the case of parents and November 11, 2005 in the case of a spouse.”; and

by inserting after section 100 the following section:-

“SECTION 100A.  Notwithstanding any general or special law to the contrary, parents who became eligible for an annuity under section 6B of chapter 115 of the General Laws on or after July 1, 1998 and surviving spouses who became eligible for an annuity under said section 6B of said chapter 115 on or after November 11, 2005 and who currently receive payments under said section 6B of said chapter 115 shall be eligible for a retroactive benefit payment if the initial application filed under said section 6B of said chapter 115 was filed more than 1 year after the date of death of the member of the armed forces of the United States. The retroactive payment shall equal $2,000 for each year between the date of the initial application filed under said section 6B of said chapter 115 and the later of either: (i) the date of death of the member of the armed forces of the United States; or (ii) July 1, 1998 in the case of parents and November 11, 2005 in the case of a spouse. In order to be eligible for the retroactive payment of benefits under this section, the member of the armed forces of the United States or the parent or spouse seeking retroactive payment shall have been a resident of the commonwealth at the time of death of the member and the parent or spouse seeking retroactive payment shall be a resident of the commonwealth at the time of application for retroactive payment.”

 


Budget Amendment ID: FY2018-S3-333

EHS 333

Vocational and housing stabilization services for people in recovery

Ms. Donoghue and Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4512-0200, by inserting at the end thereof the following:- “; provided that not less than $2,000,000 shall be expended for the RECOVER Program established in section 2J of chapter 111 of the General Laws, as appearing in the 2014 Official Edition”; and in said item, by striking out the figure “$129,675,888” and inserting in place thereof the following figure:- “$131,675,888”

and further amended, in said section 2, in item 7004-9322, by inserting at the end thereof the following:- “; provided further, that not less than $4,000,000 shall be expended for the Secure Jobs Recovery Pilot Program established in section 31 of chapter 23B of the General Laws, as appearing in the 2014 Official Edition”; and in said item, by stroking out the figure “800,000” and inserting in the place thereof the following figure:- “4,800,000”

and further amended by inserting, after section __, the following new section:-

“SECTION __. Chapter 111 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after section 2I the following section:-

Section 2J. (a) The department shall establish the RECOVER Program. The purpose of the program shall be to provide grants to support partnerships between substance use disorder treatment providers, including sober homes, and vocational services providers. Subject to appropriation, the grants shall be used to finance all or a portion of the costs of vocational programs that are designed to meet the medical, social, psychological, and employment needs of participants.

(b) There shall be at least 1 open solicitation period each year during which the department shall accept and consider new applications. Not less than 12 weeks before the annual open solicitation period, the commissioner shall release the criteria upon which the applications shall be judged. Preference shall be given to proposals that involve social enterprise models.

(c) Partnering providers may apply to the program for a grant in a specific amount to fund a specified vocational training program. The grants may be made in addition to other forms of local, state, and federal assistance.

(d) The commissioner may establish rules and regulations to govern the application and distribution of grants under the program.

(e) The commissioner shall report annually on the activities and status of the program to the clerks of the senate and the house, who shall forward the report to the senate and house committees on ways and means, the joint committee on mental health and substance abuse, the joint committee on labor and workforce development, and the joint committee on public health. The report shall include a list and description of all programs that received grant funds, the size of the grant awarded to each program, other sources of public funds that supported each program, a detailed analysis of the impact of each program, including the number of individuals participating, the types of services each participant received, the health, legal, and employment statuses of the participants at the time they completed the program and 1, 6, 12, and 24 months following their completion of the program, and the state’s estimated savings due to reduced incarceration rates, reduced dependence on state assistance, and any other cost factors that the commissioner deems relevant.”

and further amended by inserting, after section __, the following new section:-

“SECTION __. Chapter 23B of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after section 30 the following section:-

Section 31. (a) Subject to appropriation, the department shall establish the Secure Jobs Recovery Pilot Program. The purpose of the program shall be to provide job training, job search services, and 12 months of housing stabilization services, if not otherwise available, to individuals recovering from a substance use disorder who are receiving assistance under items 7004-0102, 7004-0101, 7004-0108, 7004-9024 or 7004-9316.

(b) The program shall be administered by agencies that have demonstrated experience working in partnership with regional administering agencies, including, but not limited to: Community Teamwork, Inc.; Father Bill's & MainSpring, Inc.; HAP, Inc.; Jewish Vocational Services; and SER-Jobs for Progress, Inc.

(c) The undersecretary of housing and community development shall report annually on the activities and status of the program to the clerks of the senate and the house, who shall forward the report to the senate and house committees on ways and means, the joint committee on mental health and substance abuse, the joint committee on labor and workforce development, and the joint committee on public health. The report shall include, for each type of service or program provided, information on the: (1) housing situation, including stability of housing, of program participants; (2) employment status, including employment history, of program participants; (3) total number of program participants; and (4) number of program participants who are no longer receiving assistance under items 7004-0102, 7004-0101, 7004-0108, 7004-9024 or 7004-9316.

(d) The department shall utilize rental assistance provided under item 7004-9024 to ensure effective participation under this program.

(e) Participating agencies shall seek additional federal, state or private funds to ensure the effective continuation of regional partnerships.”

and further amended by inserting, after section __, the following new section:-

“SECTION __. Section 77 of chapter 6 of the of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out the definition of the term “Handicapped person” and it replacing it with the following definition:-

“Handicapped person,” an individual who has a physical or mental disability, including an individual recovering from a substance use disorder, which for such individual constitutes or results in a substantial handicap to employment and can reasonably be expected to benefit in terms of employability from vocational rehabilitation services or an individual whose ability to function independently in his family or community may be improved significantly by the provision of independent living rehabilitation services.”


SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2119

Senate, May 24, 2017 -- Text of amendment (334) (offered by Senator Flanagan) to the Ways and Means amendment (Senate, No. 3) to the House Bill making appropriations for the fiscal year 2018 for the maintenance of the departments, boards, commissions, institutions and certain activities of the Commonwealth, for interest, sinking fund and serial bond requirements and for certain permanent improvements

 

The Commonwealth of Massachusetts

 

_______________

In the One Hundred and Ninetieth General Court
(2017-2018)

_______________

 

By inserting, after section _, the following new sections:-

“SECTION ____. Chapter 175 of the General Laws is hereby amended by inserting after section 47BB the following section:-Section 47CC. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by a carrier or utilization review organization to determine the medical necessity and appropriateness of healthcare services.“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs.“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.(b) Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.(B) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest. (ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.(iii) Offering opportunities for public review and comments.(C) Are based on high quality studies, research, and medical practice.(D) Are created by an explicit and transparent process that:(i) Minimizes biases and conflicts of interest;(ii) Explains the relationship between treatment options and outcomes;(iii) Rates the quality of the evidence supporting recommendations; and (iv) Considers relevant patient subgroups and preferences.(E) Are continually updated through a review of new evidence, research and newly developed treatments. (2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted. (3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.(d) A step therapy override exception determination shall be expeditiously granted if:(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider. (f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.(g) This section shall not be construed to prevent:(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION ___. Chapter 176A of the General Laws is hereby amended by inserting after section 8EE the following section:-Section 8FF. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by an insurer, health plan, or utilization review organization to determine the medical necessity and appropriateness of healthcare services.“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs, .“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.(b) Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.(B)  Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.(iii) Offering opportunities for public review and comments.(C) Are based on high quality studies, research, and medical practice.(D) Are created by an explicit and transparent process that:(i) Minimizes biases and conflicts of interest;(ii) Explains the relationship between treatment options and outcomes;(iii) Rates the quality of the evidence supporting recommendations; and(iv) Considers relevant patient subgroups and preferences.(E) Are continually updated through a review of new evidence, research and newly developed treatments.(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.(d) A step therapy override exception determination shall be expeditiously granted if:(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.(g) This section shall not be construed to prevent:(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION ____. Chapter 176B of the General Laws is hereby amended by inserting after section 4EE the following section:-Section 4FF. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by an insurer, health plan, or utilization review organization to determine the medical necessity and appropriateness of healthcare services.“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered under a health benefit plan as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs.“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.(b) Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.(B) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.(iii) Offering opportunities for public review and comments.(C) Are based on high quality studies, research, and medical practice.(D) Are created by an explicit and transparent process that:(i) Minimizes biases and conflicts of interest;(ii) Explains the relationship between treatment options and outcomes;(iii) Rates the quality of the evidence supporting recommendations; and(iv) Considers relevant patient subgroups and preferences.(E) Are continually updated through a review of new evidence, research and newly developed treatments.(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.(d) A step therapy override exception determination shall be expeditiously granted if:(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.(g) This section shall not be construed to prevent:(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION ___. Chapter 176G of the General Laws is hereby amended by inserting after section 4W the following section:-Section 4X. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by an insurer, health plan, or utilization review organization to determine the medical necessity and appropriateness of healthcare services.“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered under a health benefit plan as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs, .“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.(b) Any individual or group health maintenance that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.(B) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.(iii) Offering opportunities for public review and comments.(C) Are based on high quality studies, research, and medical practice.(D) Are created by an explicit and transparent process that:(i) Minimizes biases and conflicts of interest;(ii) Explains the relationship between treatment options and outcomes;(iii) Rates the quality of the evidence supporting recommendations; and(iv) Considers relevant patient subgroups and preferences.(E) Are continually updated through a review of new evidence, research and newly developed treatments.(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.(d) A step therapy override exception determination shall be expeditiously granted if:(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.(g) This section shall not be construed to prevent:(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION ___. Sections 1 to 5, inclusive, shall apply to all policies, contracts and certificates of health insurance subject to section 17K of chapter 32A, section 47CC of chapter 175, section 8FF of chapter 176A, section 4FF of chapter 176B and section 4X of chapter 176G of the General Laws which are delivered, issued or renewed on or after January 1, 20XX.”


Budget Amendment ID: FY2018-S3-335

EHS 335

Preserve Adult Foster Care

Ms. Flanagan, Mr. Moore, Ms. L'Italien, Messrs. Timilty, Brady, Brownsberger, McGee and Rush, Ms. Gobi, Messrs. Eldridge, Hinds and Tarr, Ms. O'Connor Ives, Messrs. Humason, Keenan, Cyr and Welch, Ms. Lovely, Messrs. O'Connor, Lewis and Montigny and Ms. Creem moved that the proposed new text be amended in section 2, in item 4000-0601, by adding at the end thereof the following: “provided further, that the payment rates for the adult foster care program shall not be lower than the rates in effect for fiscal year 2016” 


Budget Amendment ID: FY2018-S3-336

EHS 336

Veterans Mediation

Ms. Gobi and Mr. Rush moved that the proposed new text be amended in section 2, in item 1410-0012, by adding the following:- “provided, that not less than $100,000 shall be expended for the Veterans Mediation program administered by Quabbin Mediation, Inc.;” and by striking out the figures “$4,370,641” and inserting in place thereof the following figures $4,470,641”.


Budget Amendment ID: FY2018-S3-338

EHS 338

High Acuity Pediatric Care

Mr. Boncore moved that the proposed new text be amended in section 2, in item 4000-0300, by inserting at the end thereof the following:-

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 ensure that any payment rate provisions applicable to acute care freestanding hospitals providing for an enhanced rate above the base rate also apply to pediatric specialty units. ”


Budget Amendment ID: FY2018-S3-339-R1

Redraft EHS 339

Lawrence Family Health Services

Ms. L'Italien moved that the proposed new text be amended in section 2, in item 4510-0110, <w:t>by adding the following words:- “; provided further, that not less than $200,000 shall be expended to support the Lawrence Family Medical Residency program at the Greater Lawrence Family Health Center, Inc.”; and in said section 2, in said item 4510-0110, by striking out the figure “$1,042,354” and inserting in place thereof the following figure:- “1,242,354”.</w:t>


Budget Amendment ID: FY2018-S3-340

EHS 340

Psychological Center Women's View

Ms. L'Italien moved that the proposed new text be amended in section 2, in item 4512-0201, by adding at the end thereof the following: “provided further, that no less than $20,000 shall be allocated to The Psychological Center-Women’s View Program.”


Budget Amendment ID: FY2018-S3-341

EHS 341

Treehouse Foundation

Ms. Lovely, Messrs. Humason and Moore and Ms. Flanagan moved that the proposed new text be amended in section 2, in item 4800-0038, provided further, that not less than $100,000 shall be expended for Treehouse Foundation of Easthampton for planning to replicate the Intergenerational Treehouse Community model in the MetroWest region”; and further move to amend the bill, in said line item, by striking the figures “$291,471,283” and inserting in place thereof the figures “$291,571,283”.


Budget Amendment ID: FY2018-S3-342

EHS 342

Postpartum Depression Pilot Program

Ms. Lovely, Messrs. Humason and McGee moved that the proposed new text be amended in section 2, in item 4510-0110, by inserting the following new line item:- "4510-0112 For the department of public health to conduct a postpartum depression pilot program at community health centers in the cities of Holyoke, Lynn and Worcester and the Jamaica Plain section of the city of Boston $200,000"


Budget Amendment ID: FY2018-S3-343-R1

Redraft EHS 343

Best Buddies

Ms. Lovely, Messrs. Eldridge, Ross, O'Connor and Montigny moved that the proposed new text be amended in section 2, in item 7061-0012, <w:t>by adding the following words:- "; provided further, that $150,000 shall be expended for peer-to-peer inclusion programs for students with intellectual disabilities through the Massachusetts chapter of Best Buddies International, Inc.".</w:t>


Budget Amendment ID: FY2018-S3-344

EHS 344

Berkshire Emergency Shelter Initiative

Messrs. Hinds and Lesser moved that the proposed new text be amended in section 2, in item 7004-0102, by adding at the end thereof the following: “provided that not less than $150,000 be expended to Berkshire County Regional Housing Authority for the purpose of coordinating homeless shelters and safety net services in Berkshire county”; and in said item, by striking out the figures “$46,180,000” and inserting in the place thereof the figures “$46,330,000”


Budget Amendment ID: FY2018-S3-345-R1

Redraft EHS 345

Berkshire Youth Development Project

Mr. Hinds moved that the proposed new text be amended in section 2, in item 4512-0200, <w:t>by adding at the end thereof the following:- “provided that not less than $200,000 shall be expended to the Berkshire County Youth Development Project for youth intervention services”; and in said item, by striking out the figures “$129,675,888” and inserting in place thereof the figures “$129,875,888”</w:t>


Budget Amendment ID: FY2018-S3-346

EHS 346

Moratorium on Mandated Benefits

Mr. Tarr moved that the proposed new text be amended by inserting, after section___, the following new section:-

"SECTION_. Notwithstanding any general or special law to the contrary, there is a 5 year moratorium on the addition of any new mandatory health care benefits, except as otherwise required by federal law


Budget Amendment ID: FY2018-S3-348

EHS 348

Senior Financial Literacy

Messrs. Tarr, Brownsberger, Moore, Brady, Ross and O'Connor moved that the proposed new text be amended by adding the following new section:

“SECTION XX. Notwithstanding any general or special law to the contrary, there shall be a special commission established to study and develop a statewide financial literacy program on personal financial management to be offered to senior citizens in the Commonwealth. The commission shall be overseen by the Office of Elder Affairs and the Office of Health and Human Services in conjunction with the Office of the State Treasurer. The focus of the commission will be to provide a universal program for the purpose of teaching senior citizens how to best manage their personal finances, maintain their financial independence, and avoid financial exploitation. The course shall include materials on the use of computers and smart phones relative to personal financial management and shall assist participating senior citizens in the program on how to best utilize technology to aid to their personal financial management.

The commission shall consist of the house and senate chairs of the joint committee on elder affairs, who shall be the co-chairs; the house and senate chairs of the joint committee on education or their designees; the speaker of the house of representatives or a designee; the president of the senate or a designee; the house minority leader or a designee; the senate minority leader or a designee; the state treasurer or a designee; the secretary of  the executive office of elder affairs or a designee; the secretary of health and human services or a designee;  2 representatives of the Council on Aging; and 2 residents of the Commonwealth who are 65 years or older.

The commission shall submit its finalized proposal for the senior financial literacy program, along with any recommendations, to the house and senate committees on ways and means, the joint committee on elder affairs, the joint committee on education and the clerks of the house of representatives and the senate by February 1, 2018.”


Budget Amendment ID: FY2018-S3-349-R1

Redraft EHS 349

Health Information and Analysis Oversight Council

Mr. Tarr moved that the proposed new text be amended <w:t>by inserting after section__, the following new section:-</w:t>

SECTION__. Section 2A of Chapter 12C of the General Laws is hereby amended by inserting after the words “cybersecurity” the following: “and 2 members who shall be a representative of surcharge payers as defined in section 1 of Chapter 12C of the general laws; 1 of whom shall represent acute care hospitals”

And further moves to amend said section, by inserting after the words “health care economist”, the following: “and 1 member who shall represent a major health insurer”

And moves to further amend said section, by striking the following: “Members of the council shall not be employed by, a consultant to, a member of the board of directors of, affiliated with, have a financial stake in or otherwise be a representative of: (i) an acute hospital; (ii) an ambulatory surgical center; or (iii) a surcharge payor” and inserting in place thereof  the following: “Members of the council shall not hold full-time or part-time employment in state government”

And further moves to amend said section, by inserting after clause (6) of subsection (c), the following new clause:- (7) undertake a process to evaluate and recommend alternative methodologies to fund the agency’s operating expenses.”

 

 


Budget Amendment ID: FY2018-S3-350

EHS 350

Increased Bed Capacity

Messrs. Tarr, Ross and O'Connor moved that the proposed new text be amended by inserting, after section___, the following new section:-

“SECTION _. Notwithstanding any general or special law to the contrary, the department of public health shall prepare a report examining overall substance abuse bed capacity across the full continuum of care from both detox and post-detox treatment as well as a plan to ensure access to both short and long term care and all needed case management and medication assisted treatment (MAT) supports.

The department of public health shall submit the report and plan to the clerks of the house and senate and the joint committee on public health no later than December 31, 2017.”

 

 


Budget Amendment ID: FY2018-S3-351-R1

Redraft EHS 351

Healthy Relationships Grant Program

Messrs. Eldridge, Barrett, Ross, Moore and O'Connor moved that the proposed new text be amended in section 2, in item XXXX-XXXX, <w:t xml:space="preserve">by inserting after item 4513-1130 the following item:- </w:t>

4513-1131 For a competitive grant program in public schools for grades 5 to 12, inclusive, that shall promote healthy relationships and address teen dating violence; provided, that the department of elementary and secondary education shall develop a grant program for 10 schools on anti-teen dating violence programming to be implemented in the 2017 school year; provided further, that the grant program shall be for schools in which the majority of students are eligible for free or reduced lunch; and provided further, that at least 1 grantee shall be a school located in a municipality with a population of not more than 25,000………………………$150,000”.


Budget Amendment ID: FY2018-S3-352

EHS 352

North Andover Youth Center

Mr. Tarr moved that the proposed new text be amended in section 2, in item 4800-0038, by inserting the following:-

“provided further that not less than $25,000 shall be expended to the North Andover Youth Center toward youth services.” and moves to further amend said item by striking the figure “291,471,283” and inserting in place thereof the following figure “291,496,283”


Budget Amendment ID: FY2018-S3-354

EHS 354

Transportation Voucher for Substance Abuse Treatment

Messrs. Tarr and O'Connor moved that the proposed new text be amended in section 2, in item 4512-0200, by inserting the following:-

"provided that not less than $100,000 shall be expended for a transportation voucher account pilot program to provide clients who have been determined by an emergency service program to be eligible for substance abuse treatment services from an ESP site or off site at the client’s residence, drop-in center or emergency department;" and in said item by striking the figure “129,675,888” and inserting in place thereof the following figure “129,775,888”.

 


Budget Amendment ID: FY2018-S3-356-R1

Redraft EHS 356

Bulk Purchase of Medication Task Force

Mr. Boncore moved that the proposed new text be amended <w:t>be amended in section 91, by inserting after the word “designee”, in line 1346, the following words:- “; the president of the Massachusetts Biotechnology Council, Inc. or a designee; the chairman of the Massachusetts Chamber of Commerce Inc. or a designee”.</w:t>

 


Budget Amendment ID: FY2018-S3-358

EHS 358

Reporting of Assault on DYS Staff

Messrs. Tarr and O'Connor moved that the proposed new text be amended by inserting, after section ___, the following new section:-

 

"Section _. provided that the department of youth services shall report on an annual basis, the number and types of incidents of physical assault upon staff personnel, and the manner in which those assaults were addressed through judicial and/or administrative means, to the Joint Committee on the Judiciary, the Joint Committee on Children, Families and Persons with Disabilities and the Secretary of Health and Human Services not later than December 31, 2017”


Budget Amendment ID: FY2018-S3-359

EHS 359

Health Purchasing Cooperatives

Mr. Tarr moved that the proposed new text be amended by inserting, after section __, the following new sections:-

 

SECTION_. Section 12 of Chapter 176J of the General Laws is hereby amended in line 35 by striking the number "6" and inserting in place thereof the following:- "8"

 

SECTION_. Said section 12 of chapter 176J of the General Laws is hereby amended in line 39 by striking the number "85,000" and inserting in place thereof the following:-"100,000"

 

SECTION_. Section 13(b) of chapter 176J of the General Laws is hereby amended by striking subsection (v) in its entirety.


Budget Amendment ID: FY2018-S3-362

EHS 362

Quincy Dementia Friendly Community

Mr. Keenan moved that the proposed new text be amended in section 2, in item 9110-9002, by inserting at the end thereof the following:- "; provided further, that not less than $25,000 shall be expended on a grant for the Quincy department of elder affairs"; and in said item, by striking out the figures “$14,030,000” and inserting in place thereof the figures “$14,055,000”


Budget Amendment ID: FY2018-S3-365

EHS 365

MassHealth Cost Containment Council

Messrs. Tarr, Ross and O'Connor moved that the proposed new text be amended by inserting, after Section__, the following new section:-

Section__.  MassHealth Cost Containment Council

Notwithstanding any general or special law to the contrary, there shall be established, for a period of not more than 12 months following the passage of this act, the MassHealth Cost Containment Council, the purpose of which shall be to examine the current system of providing health care insurance coverage and benefits to those qualify for such converages and benefits pursuant to existing state and federal statutes and regulations due to income or other circumstance through Medicaid and other similar programs.

The council shall be chaired by the secretary of health and human services or a designee, and shall consist of 18 members: the House and Senate chairs and the ranking minority members of the Joint Committee on Health Care Financing or their designees, the secretary of administration and finance or a designee, a representative of the Health Policy Commission appointed by the governor, a representative of the Center for Health Information Analysis appointed by the governor, the dean of the University of Massachusetts School of Medicine or a designee, the assistant secretary of the MassHealth program, an expert in state and federal health care law appointed by the Attorney General, a representative of MassHealth consumers appointed by the Speak of the House, a representative of MassHealth consumers appointed by the Senate President, 3 members representing health care providers in the Commonwealth appointed by the governor, a representative of the Massachusetts Law Reform Institute appointed by the Attorney General, and 3 members with expertise in health care financing from institutions of higher learning in the Commonwealth appointed by the Governor.

The commission shall examine the current system in the Commonwealth of providing for health care coverage and benefits for low income residents and analyze its cost-effectiveness and efficiency in delivering quality care and outcomes, and seek to identify any and all strategies, methods and techniques to reduce and contain the costs of such coverage and benefits consistent with federal law; provided, however, that the commission shall consider waivers from the provisions of federal law and regulation where appropriate.

In conducting its operations the Commission shall hold not less than 3 public hearings in diverse geographic locations across the Commonwealth, and shall also accept testimony by electronic and posted mail.

The commission shall report its findings, together with any legislative recommendations, not later than August 31, 2017, to the clerks of the House and the Senate, and in an appropriate manner electronically on the internet.

 


Budget Amendment ID: FY2018-S3-366

EHS 366

Gold Star Annuity

Messrs. Keenan and O'Connor moved that the proposed new text be amended by inserting at the end thereof the following new section:-

SECTION X. Section 6B of Chapter 115 of the General Laws, as appearing in the 2014 edition, is hereby amended in lines 19, 28 and 35 by striking out the figure “$2,000” and inserting in place thereof the figure “$2,500”.


Budget Amendment ID: FY2018-S3-367

EHS 367

Whipple Senior Center

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 9110-1633, by inserting at the end of the item the following new language:-

“and provided further that not less than $200,000 shall be expended for the cost associated with care and services provided at Whipple Senior Center in the Town of Weymouth” and in said item by striking out the figures "$52,271,372" and inserting in place there of the figures “52,471,372”


Budget Amendment ID: FY2018-S3-368

EHS 368

Pharmacy Benefit Managers Audit

Messrs. Tarr and Montigny moved that the proposed new text be amended by inserting, after section__, the following new section:-

Section __. Notwithstanding any general or special law to the contrary, the auditor of the Commonwealth, in consultation with the Secretary of Health and Human Service, shall develop a system and regulations to facilitate the comprehensive auditing of pharmacy benefit managers, so-called.


Budget Amendment ID: FY2018-S3-369

EHS 369

Weymouth Teen Center Youth Jobs Program

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4800-0038, by inserting after the word “Amherst” the following:-

“and provided further that not less than $200,000 shall be expended to the Weymouth Teen Center to provide job skills training, remedial education services, and to promote a social service program promoting growth and social welfare” and in said item by striking out the figures “$291,471,283” and inserting in place there of the figures “291,671,283”


Budget Amendment ID: FY2018-S3-370

EHS 370

MetroWest Free Medical Clinic

Mr. Eldridge moved that the proposed new text be amended in section 2, in item 4000-0300, by adding the following: “; provided further, that $75,000 be expended for the MetroWest Free Medical Program”; and in said item by striking out the figure "$102,102,732" and inserting in place thereof the following figure:- “$102,152,732”.


Budget Amendment ID: FY2018-S3-371

EHS 371

Strengthening prescription drug safety and drug stewardship

Messrs. Keenan, Cyr, Montigny and Moore, Ms. O'Connor Ives, Messrs. O'Connor and Lesser and Ms. Lovely moved that the proposed new text be amended by inserting the following new sections:-

SECTION _. Section 55 of Chapter 52 of the Acts of 2016, as amended by Chapter 351 of the Acts of 2016, is hereby repealed.

SECTION _. Section 77 of Chapter 52 of the Acts of 2016 is hereby repealed.


Budget Amendment ID: FY2018-S3-372-R1

Redraft EHS 372

Middlesex County Opioid Assessment

Mr. Eldridge moved that the proposed new text be amended in section 2, in item 0340-0200, <w:t>by adding at the end thereof the following:- “; and provided further, that not less than $25,000 shall be expended to the Middlesex county district attorney’s office for a countywide assessment of opioid prevention, intervention, and treatment programs”; and in said item by striking out the figure "$16,586,540" and inserting in place thereof the figure:- "$16,611,540".</w:t>


Budget Amendment ID: FY2018-S3-373

EHS 373

Open Table Food Pantry

Mr. Eldridge moved that the proposed new text be amended in section 2, in item 2511-0105, by adding the following:- “; provided, further, that not less than $75,000 be expended for Open Table in the town of Concord”; and in said item by striking out the figure “$16,500,000” and inserting in place thereof the following figure:- “$16,550,000”.


Budget Amendment ID: FY2018-S3-374

EHS 374

Crossroads

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4590-1507, by inserting at the end the following:-

“; and provided further, that not less than $25,000 be allocated for Crossroads of Boston and Duxbury for their summer and year-round out-of-school program serving at-risk youth”; and in said item by striking out the figures “$3,000,000” and inserting in place thereof the figures “$3,025,000”.


Budget Amendment ID: FY2018-S3-375-R1

Redraft EHS 375

Lyme Disease Public Health Campaign

Messrs. O'Connor, McGee, deMacedo, Ross and Fattman and Ms. Lovely moved that the proposed new text be amended in section 2, in item 4516-1000, <w:t>by inserting after the word “services”, in line 8, the following words:- “; provided further, that not less than $50,000 shall be expended for a statewide tickborne disease prevention campaign to educate the public and medical providers on best practices in prevention, diagnosis and treatment”; and</w:t>

in said section 2, in said item 4516-1000, by striking out the figure “$12,520,173” and inserting in place thereof the following figure:- “$12,570,173”.


Budget Amendment ID: FY2018-S3-376

EHS 376

Early childhood mental health consultation services

Ms. Flanagan and Mr. Moore moved that the proposed new text be amended in section 2, by inserting after item 3000-6025 the following item: "3000-6075 For early child hood mental health consultation (ECMHC) services in early education and care programs in the commonwealth; provided, that preference shall be given to those services designed to limit the number of expulsions and suspensions from the programs; and provided further, that eligible recipients for such grants shall include municipal school districts, regional school districts, educational collaboratives, head start programs, licensed childcare providers, child care resource and referral centers and other qualified entities......$2,500,000."


Budget Amendment ID: FY2018-S3-377

EHS 377

Veterans Aid Reimbursement

Mr. Barrett moved that the proposed new text be amended by inserting, after section X, the following new section: -

SECTION X.  Section 6 of chapter 115 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by adding the following sentence:-

The commonwealth shall make payments to cities and towns equal to 100 per cent of the amount of benefits paid by cities and towns to or on behalf of recipients living in permanent housing located on real property owned by the federal government or living in institutions or transitional housing as defined in 108 CMR 2.02 if such housing is located on real property owned by the federal government; provided, however, that such payments shall be made to the city or town wherein the recipient resides only for 48 months of residence; and, provided further, that such payments shall not be made for a recipient who has resided elsewhere in the city or town for the six consecutive months immediately preceding his or her move into such housing.


Budget Amendment ID: FY2018-S3-378-R1

Redraft EHS 378

HIV/AIDS Prevention

Ms. Forry, Mr. Cyr, Ms. Chang-Diaz, Messrs. Eldridge, Keenan, Lewis, McGee and O'Connor moved that the proposed new text be amended in section 2, in item 4512-0103, <w:t>in said item by striking out the figure "$30,770,279" and inserting in place thereof the figure "$31,270,279".</w:t>


Budget Amendment ID: FY2018-S3-379

EHS 379

Interface Mental Health Referral Service

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 5046-0000, by inserting at the end the following:-

"provided further, that not less than $250,000 shall be expended for William James College’s Interface mental health referral service in Plymouth County; and provided further, that not less than $14,000 shall be expended for William James College’s Interface mental health referral service for the town of Hull", and in said item by striking out the figures "387,130,580" and inserting in place thereof the figures "387,394,580"


Budget Amendment ID: FY2018-S3-380

EHS 380

Secure Jobs

Messrs. Barrett, Moore and O'Connor moved that the proposed new text be amended in section 2, in item 4400-1020, By striking out item 7004-9322 and inserting in place thereof the following item:-

“4400-1020 For operation of the Secure Jobs Connect program for employment support, job training and job search services for homeless or previously homeless families receiving assistance from the department of housing and community development under items 7004-0101, 7004-0108, 7004-9024 or 7004-9316; provided, that participants receiving assistance under items 7004-0101 and 7004-0108 shall receive a minimum of 12 months of housing stabilization services under said items; provided, that services shall be delivered by community-based agencies that have demonstrated experience working in partnership with regional administering agencies, including, but not limited to: Community Teamwork, Inc.; Father Bill's & MainSpring, Inc.; HAP, Inc.; Jewish Vocational Service, Inc.; SER-Jobs for Progress, Inc.; South Middlesex Opportunity Council; and Worcester Community Action Council, Inc.;  provided further, that the department of housing and community development shall make available rental assistance pursuant to item 7004-9024 to ensure effective participation in this program; and provided further, that service delivery agencies shall seek additional federal, state or private funds to ensure the effective continuation of regional partnerships; provided further, that the department shall report to the house and senate committees on ways and means not later than March 15, 2018, by type of service or program provided, on the: (i) housing situation, including the stability of housing, for program participants; (ii) employment status, including employment history, of program participants; (iii) total number of program participants; and (iv) number of program participants who are no longer receiving assistance under said item 7004-0101, 7004-0108, 7004-9024 or 7004-9316...........................$800,000”


Budget Amendment ID: FY2018-S3-381

EHS 381

Manet Community Health Center behavioral health and substance abuse program

Messrs. Keenan and O'Connor moved that the proposed new text be amended in section 2, in item 4512-0205, by inserting at the end thereof the following:-

provided further, that not less than $150,000 shall be expended for an integrated behavioral health and substance abuse assessment, counseling and treatment program developed by Manet Community Health Center;


Budget Amendment ID: FY2018-S3-382

EHS 382

Rest Home Rate Study

Messrs. Brownsberger, O'Connor and Moore moved that the proposed new text be amended by inserting, after section __, the following new section:-

 

"SECTION __.  The centers for health information and analysis shall conduct a study to determine the funding required to establish rates of reimbursement for rest homes using cost data from 2015.  The report resulting from this study shall be filed with the clerks of the senate and house of representatives, the chairs of the joint committee on public health, the joint committee on health care financing and the senate and house committees on ways and means not later than by January 1, 2018."

 


Budget Amendment ID: FY2018-S3-383-R1

Redraft EHS 383

Youth Connect

Mr. Boncore moved that the proposed new text be amended in section 2, in item 5042-5000, <w:t>by inserting at the end thereof the following:- provided further, that not less than $50,000 shall be extended to YouthConnect to provide community-based mental health services to high-risk youth and their families residing in the East Boston community.</w:t>


Budget Amendment ID: FY2018-S3-384

EHS 384

YMCA Youth At Risk Programs

Ms. Lovely, Messrs. Brownsberger, McGee and O'Connor moved that the proposed new text be amended in section 2, in item 4590-1507, by striking out the figures "$1,100,000" and inserting in place thereof the figures "$1,300,000."


Budget Amendment ID: FY2018-S3-385-R1

Redraft EHS 385

Massachusetts Model of Community Coalitions

Mr. Hinds moved that the proposed new text be amended in section 2, in item 4590-0250, <w:t>by adding at the end thereof the following:- “provided that not less than $100,000 be expended for the Massachusetts Model of Community Coalitions”; and in said line item, by striking out the figures “$11,944,395” and inserting in place thereof the figures “$12,044,395”</w:t>


Budget Amendment ID: FY2018-S3-387

EHS 387

DTA Specialist Caseload

Ms. Flanagan moved that the proposed new text be amended by inserting, after section __, the following new section:- “SECTION ___: Section 5 of chapter 18 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out, in lines 71 and 72, the words "and shall have a caseload of not more than 60 recipients".”


Budget Amendment ID: FY2018-S3-390

EHS 390

Cohasset Adult Disabled Housing

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 5920-2010, by inserting at the end the following:-

"; and provided further that no less than $180,000 be expended to the town of Cohasset for the completion of an accessible four-bedroom home for clients of the department of developmental services at the 689-1 site at 72 Elm Street in Cohasset, also known as the Trettis House"; and in said item by striking out the figures "216,612,361" and inserting in place thereof the figures of "216,792,361"


Budget Amendment ID: FY2018-S3-391-R1

Redraft EHS 391

Safe Alternatives in Winthrop

Mr. Boncore moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by inserting at the end thereof the following:-</w:t>

provided further that not less than $25,000 be expended for operational costs at the Community Action for Safe Alternatives program in the Town of Winthrop.


Budget Amendment ID: FY2018-S3-392-R1

Redraft EHS 392

Suicide Prevention

Ms. Forry, Messrs. Cyr, Eldridge, Moore, Keenan and Barrett, Ms. Lovely, Messrs. O'Connor, Lewis and Montigny moved that the proposed new text be amended in section 2, in item XXXX-XXXX, <w:t>by inserting after item 4513-1026 the following item:-</w:t>

“4513-1027 For The Samaritans, Inc.; provided, that funds may be used for suicide prevention services....................................................................................$400,000”.


Budget Amendment ID: FY2018-S3-394

EHS 394

Child Sexual Abuse Prevention Task Force Reporting Date

Ms. Flanagan and Mr. O'Connor moved that the proposed new text be amended by inserting, after section ___, the following new section: - “Section ___ . Chapter 431 of the Acts of 2014, as so appearing, is hereby amended by striking out, in its last line, the words, “June 30, 2017” and inserting in place thereof the following words:- “December 31, 2018”.


Budget Amendment ID: FY2018-S3-395

EHS 395

UMass Down Syndrome Clinic

Ms. Chandler and Mr. Moore moved that the proposed new text be amended in section 2, by inserting after item 4510-0810 the following item:- 

"4510-3010 For a grant to the Down Syndrome Program at the Children’s Medical Center at the University of Massachusetts Memorial Medical Center based on the patient-centered medical home concept………………$150,000"


Budget Amendment ID: FY2018-S3-398

EHS 398

DTA Caseworkers

Ms. Flanagan and Mr. Cyr moved that the proposed new text be amended in section 2, in item 4400-1100, By striking out the figure “71,349,034” and inserting in place thereof the following figure: “75,349,034”.


Budget Amendment ID: FY2018-S3-399

EHS 399

Restoration of Vets Operational Funding

Messrs. Tarr, Rush and O'Connor moved that the proposed new text be amended in section 2, in item 1410-0010, by striking out the figures “$3,524,629” and inserting in place thereof the figure:- “$3,759,629”.


Budget Amendment ID: FY2018-S3-400

EHS 400

Attleboro Area Social Responsibility Consortium

Mr. Ross moved that the proposed new text be amended in section 2, in item 4590-1507, by adding at the end thereof the following:- “provided further, that not less than $20,000 shall be expended for The Attleboro Area Social Responsibility Consortium for a pilot transportation program;” and in said item, by striking out the figures “$3,000,000” and inserting in place thereof the figures “$3,020,000”


Budget Amendment ID: FY2018-S3-401-R1

Redraft EHS 401

East Boston Health Center

Mr. Boncore moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>at the end thereof, by inserting the following new words:- "; provided further, that not less than $150,000 shall be expended for a federally qualified community health center with a 24 hours a day, 7 days a week emergency department licensed as a satellite emergency facility under 105 CMR 130".</w:t>


Budget Amendment ID: FY2018-S3-402

EHS 402

Restoration of Funding for Veteran Outreach Centers

Messrs. Tarr, Rush and O'Connor moved that the proposed new text be amended in section 2, in item 1410-0012, by striking out the figures “$4,370,641” and inserting in place thereof the figures “$5,020,641”.


Budget Amendment ID: FY2018-S3-403

EHS 403

Restoration of Vets War Memorial Funding

Messrs. Tarr, Rush and O'Connor moved that the proposed new text be amended in section 2, in item 1410-1616, by striking out the figures “$150,000” and inserting in place thereof the figures “$350,000”


Budget Amendment ID: FY2018-S3-405

EHS 405

Naloxone Expiration Exchange

Messrs. Tarr, Montigny and O'Connor moved that the proposed new text be amended by inserting after section__,  the following new section:-

“SECTION __.  Notwithstanding any special or general law to the contrary, to minimize the disposal of expired opioid antagonist and to ensure the availability and use of unexpired opioid antagonist a municipality or non-municipal public agency which is duly registered with the Massachusetts Controlled Substances Registry may convey or exchange Naloxone, or other opioid antagonist approved by the department of public health, with another duly registered entity for the purpose of ensuring the availability of unexpired Naloxone or other approved opioid antagonist; provided, further, that such exchange shall be recorded in a memorandum between such registered entities in a manner prescribed by the department; provided, that such written documentation shall include: (a) the names and addresses of the registered entities participating in the exchange, (b) itemizations of the substances transferred including substance name, weight or volume of substance, and number of units, (c) the name, title, and signature of each qualified, licensed practitioner designated by the registered municipality or agency as medical director for purposes of 105 CMR 700.003(D) certifying the chain of custody of the exchange and compliance with department procedures, (d) the date of exchange, and (e) instructions to transmit the document in a timely manner to the department of public health."


Budget Amendment ID: FY2018-S3-407

EHS 407

Report on Biometric Fraud Protection for Public Assistance Programs

Messrs. Tarr, Ross and O'Connor moved that the proposed new text be amended by inserting after Section __, the following section:-

“SECTION __. Notwithstanding any general or special law to the contrary, the department of transitional assistance, in conjunction with the executive office of health and human services, shall provide a report on current fraud detection measures within the agency and department to reduce fraud in public assistance benefit programs and to study the feasibility of implementing a biometric authentication system. The report shall include, but not be limited to, the cost savings that would result from the elimination of duplicate assistance fraud in public assistance programs and the feasibility of using biometric technology to create a reliable system of identification. The report, along with any legislative recommendations, shall be filed with the clerks of the house of representatives and the senate within 90 days of the passage of this act.”


Budget Amendment ID: FY2018-S3-408-R1

Redraft EHS 408

Duxbury Senior Center Improvements

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 9110-9002, <w:t>line 6, by inserting after the word "affairs;" the following:-</w:t>

"provided further, that not less than $50,000 shall be expended to the town of Duxbury for improvements at the Senior Center; provided further that no less than $30,000 be expended to the town of Norwell for the purchase of an emergency generator for the Norwell Senior Center"; and in said item by striking out the figures "14,030,000" and inserting in place thereof the following figures:- "14,110,000".


Budget Amendment ID: FY2018-S3-409-R1

Redraft EHS 409

Drug Story Theater of the South Shore

Messrs. deMacedo and O'Connor moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by adding the following words:- “provided further, that no less than $50,000 shall be expended for the Drug Story Theater of the South Shore’s program for substance use prevention, treatment and education”; and</w:t>

in said section 2, in said item 4512-0205, by striking out the figure “$475,000” and inserting in place thereof the following figure:- “$525,000”.


Budget Amendment ID: FY2018-S3-410

EHS 410

Big Brothers Big Sisters of Massachusetts Bay Mentor 2.0

Mr. deMacedo moved that the proposed new text be amended in section 2, in item 4590-1507, in line 11, by inserting after the word "Inc." the following: "and provided further that not less than $200,000 shall be expended for the Big Brothers Big Sisters of Massachusetts Bay Mentor 2.0 program"; and in said item by striking out the figures "$3,000,000” and inserting in place thereof the figures "$3,200,000”.


Budget Amendment ID: FY2018-S3-412-R2

2nd Redraft EHS 412

Brookline Alzheimer's Caregivers Respite Program

Ms. Creem moved that the proposed new text be amended in section 2, in item 9110-9002, <w:t>by adding the following words:- “;provided further, that not less than $15,000 shall be allocated for the operation of the Alzheimer's caregivers respite program at the Brookline Senior Center”; and in said section 2, in said item 9110-9002, by striking out the figure "$14,030,000" and inserting in place thereof the following figure:- "$14,045,000".</w:t>


Budget Amendment ID: FY2018-S3-413

EHS 413

Healthy Lives Program at Brookline Mental Health Center

Ms. Creem and Mr. Barrett moved that the proposed new text be amended in section 2, in item 4000-0300, by adding at the end thereof the following:- "; provided further, that not less than $250,000 shall be expended for the Brookline Community Mental Health Center, Inc. to expand the Healthy Lives program"


Budget Amendment ID: FY2018-S3-414

EHS 414

International Institute of New England

Ms. Creem, Messrs. McGee and Eldridge moved that the proposed new text be amended in section 2, in item 5046-0000, by adding at the end thereof the following:- “; and provided further, that not less than $250,000 shall be expended to the International Institute of New England for culturally and linguistically appropriate mental health services for immigrants and refugees who have experienced torture and trauma”, and in said item by striking out the figures ʺ$387,130,580” and inserting in place thereof the figures “$387,380,580”


Budget Amendment ID: FY2018-S3-415

EHS 415

Bristol County Samaritans

Messrs. Rodrigues and Montigny moved that the proposed new text be amended in section 2, in item 4513-1026, by inserting after the word “program” the following “and provided further that $50,000 shall be expended for The Samaritans of Fall River/New Bedford, Inc.”; and in said item by striking out the figure "$4,340,051" and inserting in place thereof the figure "$4,390,051"


Budget Amendment ID: FY2018-S3-416-R1

Redraft EHS 416

Fall River Veterans Center

Mr. Rodrigues moved that the proposed new text be amended in section 2, in item 1410-0012, <w:t xml:space="preserve">by adding the following:- "provided, that not less than $25,000 shall be expended for the Fall River Veterans Center;" </w:t>


Budget Amendment ID: FY2018-S3-418

EHS 418

Cranberry Health Research Center

Messrs. Rodrigues and Cyr moved that the proposed new text be amended in section 2, in item 4513-1111, by inserting at the end thereof the following:- "; and provided further, that notwithstanding any general or special law to the contrary, $100,000 shall be appropriated to the University of Massachusetts – Dartmouth to be expended for the operation of the Cranberry Health Research Center at the University of Massachusetts – Dartmouth”; and in said item by striking out the figures “$3,460,977” and inserting in place thereof the figures “$3,560,977”.

 

 


Budget Amendment ID: FY2018-S3-419-R1

Redraft EHS 419

Domestic Violence and Sexual Assault Prevention

Mr. Rodrigues moved that the proposed new text be amended in section 2, in item 4513-1130, <w:t>by inserting after the word “violence;” the following; “provided further, that not less than $75,000 be allocated for the Katie Brown Educational Program for a pilot instructional initiative, the Train the Trainer program, to train educators and increase the number of Southeastern Massachusetts students who acquire invaluable knowledge about the prevention of relationship violence;”</w:t>


Budget Amendment ID: FY2018-S3-420

EHS 420

Macular Degeneration

Ms. Creem moved that the proposed new text be amended in section 2, in item 4513-1111, by adding at the end thereof the following:- “; provided that $100,000 shall be expended for macular degeneration research into prevention and treatment at The Schepens Eye Research Institute, Inc”; and in said item, by striking out the figures “$3,460,977” and inserting in place thereof the figures “$3,560,977”


Budget Amendment ID: FY2018-S3-421

EHS 421

Plymouth Region Family Resource Center

Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4800-0200, in line 2, by inserting after the word "commonwealth", the following:-

"and provided that not less than $500,000 shall be expended to establish and operate a family resource center in Plymouth" and in said item by striking out the figures "12,161,116" and inserting in place thereof the figures "12,211,116"


Budget Amendment ID: FY2018-S3-422

EHS 422

Patient Protection and Affordable Care Act

Mr. Tarr moved that the proposed new text be amended in section 2, in item 4000-0328, by adding at the end thereof the following:"provided further, that said office shall further review and analyze the Patient Protection and Affordable Care Act, 42 u.s.c. 18001 et seq. to identify opportunities to control or reduce the cost of Medicaid programs by obtaining waivers to allow greater flexibility in the administration of such programs, and shall report such opportunities and the means to capture them to the House and Senate Committee on Ways and Means and the Joint Committee on Health Care Financing not later than six months following the passage of this Act"


Budget Amendment ID: FY2018-S3-423

EHS 423

Betsy Lehman Center for Patient Safety

Ms. Creem moved that the proposed new text be amended in section 2, in item 4100-0060, by striking out the words "and provided further, that funds may be expended for the operation of the Betsy Lehman center for patient safety and medical error reduction" and inserting in place thereof the following words:- “and provided further, that up to $1,563,617 of this appropriation may be expended for the operation of the Betsy Lehman Center for Patient Safety”


Budget Amendment ID: FY2018-S3-424-R3

3rd Redraft EHS 424

CANDO

Mr. Moore and Ms. Chandler moved that the proposed new text be amended in section 2, in item 5911-1003, <w:t>by adding at the end thereof the following: “provided further, that not less than $50,000 shall be expended for the Center for Autism and Neurodevelopmental Disorders at the UMass Memorial Medical Center and the University of Massachusetts Medical School based on the patient-centered medical home concept.”; and in said item, by striking out the figures “$69.797.140” and inserting in place thereof the figures "69,847,140".</w:t>


Budget Amendment ID: FY2018-S3-425-R4

4th Redraft EHS 425

Avon Coalition for Every Student

Mr. Timilty moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by adding the following words:- “provided further, that not less than $225,000 shall be expended in equal amounts for substance abuse coalitions and community partnerships in the cities and towns of Avon, Braintree, Canton, East Bridgewater, Easton, Milton, Randolph, Sharon and Stoughton”; and in said section 2, in said item 4512-0205, by striking out the figure “$475,000” and inserting in place thereof the following figure:- “$700,000”.</w:t>


Budget Amendment ID: FY2018-S3-426

EHS 426

Silent Spring Institute

Ms. Creem moved that the proposed new text be amended in section 2, in item 4510-0600, by adding at the end thereof the following:-  “; provided, that not less than $25,000 shall be expended to the Silent Spring Institute, Inc.”; and in said item by striking out the figures “$3,818,321” and inserting in place thereof the figures “$3,843,321”


Budget Amendment ID: FY2018-S3-431

EHS 431

GIC Provider Rates

Messrs. Tarr and O'Connor moved that the proposed new text be amended by inserting, after section ___, the following new section:-

"SECTION __. Chapter 32A as appearing in the 2014 Official Edition is hereby amended by inserting after section 20 the following section:-

 

Section 20A. (a) For purposes of this section the words insurer and administrator shall include any insurance carrier, nonprofit hospital or medical service corporation or third-party health care administrator operating within the scope of its license and providing coverage for an individual under a plan offered by the commission under section 4, 4A, 10B, 12 or 15.

 

(b) No insurer or administrator shall pay more than 160 per cent of the average Medicare hospital base rate, as determined by the center for health information and analysis, for inpatient and outpatient services.

 

(c) No insurer or administrator shall pay more than 160 per cent of the Medicare fee schedule, for physician or other services.

 

(d) For all services for which Medicare does not provide a rate, no insurer or administrator shall pay more than 160 per cent of the average Medicare base rate or Medicare fee schedule for a comparable service, as determined by the commission in consultation with the center for health information and analysis.

 

(e) No individual insured under the group insurance commission shall be denied care by any provider licensed to provide medical care in the commonwealth.

(f) The commission, in consultation with the center for health information and analysis, may review and make recommendations to revise the reimbursement rate every 3 years.


Budget Amendment ID: FY2018-S3-431.1

Further EHS 431.1

Extending the Wellness Program Tax Credit

Messrs. deMacedo and O'Connor moved that the amendment be amended by striking the underlying text in its entirety and inserting in place thereof the following:-

by inserting after section __ the following:-

"Section __. The Massachusetts wellness program tax credit, as established by Chapter 224 of the Acts of 2012, is hereby extended by repealing Sections 41A, 56A and 298 of Chapter 224 of the Acts of 2012."


Budget Amendment ID: FY2018-S3-433

EHS 433

Emergency Room Utilization Management Program

Messrs. Keenan and O'Connor moved that the proposed new text be amended in section 2, in item 4510-0110, by inserting at the end thereof the following:-

"provided further, that not less than $50,000 shall be expended for the operation and expansion of an innovative emergency department diversion and utilization management program by Manet Community Health Center for the south shore region;" and in said item, by striking out the figures "$1,042,354" and inserting in place thereof the figures "$1,092,354"


Budget Amendment ID: FY2018-S3-434

EHS 434

Transparency with the Health Connector Board

Messrs. Tarr and Ross moved that the proposed new text be amended by inserting after section ___ the following new section:-

“SECTION __.  Chapter 176Q, as so appearing, is hereby amended by inserting after section 18 the following two new sections:-

176Q:19 Health Connector Transparency

Section 19. The connector shall be subject to the open meeting law as established under G.L.c. 30A, §§18-25 and subject to public records request as established under G.L.c. 66. A public record for purposes of this section shall include but not be limited to board votes, meeting minutes, financial records, contract, and staff salaries. This information shall also be made publicly available on the website of the connector.

176Q:20 Return on Investment

Section 20. The secretary of administration and finance shall on an annual basis review and evaluate the return on investments made by the connector. Said review and evaluation along with any recommendations shall be filed with the clerks of the house and senate, the house and senate committee on ways, and joint committee on health care financing no later than December 31 annually.”

 


Budget Amendment ID: FY2018-S3-435

EHS 435

Brockton Council on Aging Building Expansion

Mr. Brady moved that the proposed new text be amended in section 2, in item 9110-9002, by adding at end thereof the following :'' provided further, that not less than $50,000 shall be expended for the expansion of the council on aging building in the City of Brockton", and in said item by striking out the figure"$14,030,000" and inserting in place thereof the figure "$14,080,000".

 


Budget Amendment ID: FY2018-S3-436

EHS 436

Quality and patient safety of certain drug dispensing policies

Mr. Keenan, Ms. Flanagan, Mr. Lewis, Ms. Gobi, Ms. Lovely, Messrs. O'Connor and Lesser moved that the proposed new text be amended by inserting the following new section:-

SECTION _. The health policy commission, in consultation with the department of public health and the division of insurance, shall study and analyze health insurance payer practices that require certain categories of drugs, including those that are administered by injection or infusion, to be dispensed by a third-party specialty pharmacy directly to a patient or to a health care provider with the designation that such drugs be used for a specific patient and not for the general use of the provider.  The commission shall file a report of its findings, including recommended legislation, with the house and senate committees on ways and means, the joint committee on health care financing and the joint committee on public health not later than July 1, 2018.


Budget Amendment ID: FY2018-S3-440

EHS 440

Lodging for persons in recovery exempted from room occupancy tax

Messrs. Keenan and Montigny moved that the proposed new text be amended in section 35, by striking the words "and (vii)" in line 464 and inserting in place thereof the words:-

"(vii) alcohol and drug free housing that is certified pursuant to section 18A of chapter 17; and (viii)"


Budget Amendment ID: FY2018-S3-441-R2

2nd Redraft EHS 441

Plymouth County Children's Advocacy Center

Messrs. Brady, deMacedo and O'Connor moved that the proposed new text be amended in section 2, in item 4800-0038, <w:t>by adding at the end thereof the following: "provided further that funding shall be expended on children’s advocacy centers and services for child victims of sexual abuse and assault; provided further, that not less than $100,000 be expended for the Plymouth County Children’s Advocacy Center": and in said item by striking out the figures "$291,471,283" and inserting in place thereof the figures "$291,571,283"</w:t>

 


Budget Amendment ID: FY2018-S3-444-R1

Redraft EHS 444

Medicaid Managed Care Organizations

Mr. Moore, Ms. Flanagan and Ms. Gobi moved that the proposed new text be amended in section 2, <w:t>by inserting after section 100 the following section:</w:t>

"SECTION 100A. Notwithstanding any general or special law to the contrary, an acute care hospital contracting with a managed care organization that provides coverage for MassHealth members may apply for a 1-year hardship waiver for an exemption from reimbursement contracting rate restrictions set by the office of Medicaid.”


Budget Amendment ID: FY2018-S3-448-R1

Redraft EHS 448

Veterans Substance Abuse Treatment

Mr. Moore, Ms. Chandler and Mr. Cyr moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by adding the following words:- “provided further, that not less than $50,000 be expended for the establishment of a substance abuse treatment clinic in Shrewsbury for veterans operated by Veterans Inc., to be staffed by licensed mental health providers”; and in said section 2, in said item 4512-0205, by striking out the figure “$475,000” and inserting in place thereof the following figure:- “$525,000”.</w:t>

 


Budget Amendment ID: FY2018-S3-449

EHS 449

Worcester County CAC

Mr. Moore and Ms. Chandler moved that the proposed new text be amended in section 2, in item 4800-0038, by adding at the end thereof the following:- provided further, that not less than $80,000 shall be expended for the Children's Advocacy Center of Worcester County; and in said item, by striking out the figures "$291,471,283" and inserting in place thereof the figures "$291,551,283".


Budget Amendment ID: FY2018-S3-450-R2

2nd Redraft EHS 450

FIT Body & Soul Diabetes Prevention

Messrs. Welch and Lesser moved that the proposed new text be amended in section 2, in item 4513-1111, <w:t>by inserting the following:-"provided, that not less than $25,000 shall be expended for the FIT Body and Soul diabetes prevention program in Springfield"; and, in said item 4513-1111 by striking out the figure "$3,460,977" and inserting in place thereof the following figure:- "$3,485,977".</w:t>


Budget Amendment ID: FY2018-S3-451

EHS 451

Congenital Heart Defects

Ms. O'Connor Ives, Messrs. Rush and McGee and Ms. Gobi moved that the proposed new text be amended in section 2, in item 4513-1000, by adding at the end thereof the following: "provided that not less than $100,000 shall be expended for the program's critical congenital heart defects screening activities"


Budget Amendment ID: FY2018-S3-452-R2

2nd Redraft EHS 452

Martin Luther King, Jr. Family Services

Mr. Welch moved that the proposed new text be amended in section 2, in item 4000-0005, <w:t>by inserting the following:- "provided, that not less than $25,000 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"; and, in said item 4000-0005 by striking out the figure "$6,500,000" and inserting in place thereof the following figure:- "$6,525,000".</w:t>


Budget Amendment ID: FY2018-S3-453-R2

2nd Redraft EHS 453

South End Community Center

Mr. Welch moved that the proposed new text be amended in section 2, in item 4000-0005, <w:t>by inserting the following:- provided, that not less than $20,000 shall be expended for the South End Community Center's Youth Corp program in Springfield"; and, in said item 4000-0005 by striking out the figure "$6,500,000" and inserting in place thereof the following figure:- "$6,520,000".</w:t>


Budget Amendment ID: FY2018-S3-454

EHS 454

Substance Abuse Coalition in Franklin

Mr. Ross moved that the proposed new text be amended in section 2, in item 4512-0200, by adding at the end thereof the following:- “provided further, that not less than $50,000 shall be expended for the substance abuse coalition in the city known as the Town of Franklin;” and in said item, by striking out the figures “$129,675,888” and inserting in place thereof the figures “$129,725,888”


Budget Amendment ID: FY2018-S3-455

EHS 455

NABVET

Messrs. Welch and Lesser moved that the proposed new text be amended in section 2, in item 1410-0012, by inserting the following:- "provided further, that not less than $100,000 shall be expended for the Springfield chapter of NABVET’s Veteran’s First Outreach Center to provide outreach services to veterans in Hampden county".


Budget Amendment ID: FY2018-S3-456

EHS 456

Community Health Center Workforce Development and Loan Forgiveness

Messrs. Barrett, Eldridge, Cyr, Timilty, McGee and Keenan, Ms. Lovely and Mr. O'Connor moved that the proposed new text be amended in section 2, by inserting after item 4000-0051 the following item:- "4000-0265 For a primary care workforce development and loan forgiveness grant program at community health centers, for the purpose of enhancing recruitment and retention of primary care physicians and other clinicians at community health centers throughout the Commonwealth; provided, that the grant shall be administered by the Massachusetts League of Community Health Centers in consultation with the secretary of the executive office of health and human services and relevant member agencies; provided further, that the funds shall be matched by other public and private funds; and provided further, that the League shall work with said secretary and said agencies to maximize all sources of public and private funds...............$500,000"


Budget Amendment ID: FY2018-S3-457

EHS 457

Detention Diversion Advocacy Program

Messrs. Barrett and Eldridge, Ms. L'Italien, Messrs. Pacheco and Hinds and Ms. Flanagan moved that the proposed new text be amended in section 2, in item 4200-0200, by adding at the end thereof the following:- “provided, that the department shall expend not less than $500,000 for the Detention Diversion Advocacy Program to be coordinated by the Robert F. Kennedy Children’s Action Corps to prevent high-risk juveniles presenting before the court from penetrating further into the juvenile justice system”; and in said item, by striking out the figures “$28,529,665” and inserting in place thereof the figures “$29,029,665”


Budget Amendment ID: FY2018-S3-458

EHS 458

Employer Contribution Clarification

Mr. Tarr moved that the proposed new text be amended in section 96, in line 1464 following the word “account”, by inserting the following: “, a multiemployer welfare and health plan”

And in line 1495 following the word “employees”, by inserting the following: “, and whether those employees are defined as full-time equivalent or part-time.”


Budget Amendment ID: FY2018-S3-459

EHS 459

Contingency Plan for Cost Sharing Reduction Payments

Ms. Chandler, Messrs. Lewis, Moore, Welch and O'Connor moved that the proposed new text be amended by inserting after section 114, the following section:-

"SECTION 115. The division of insurance and the commonwealth health insurance connector authority shall jointly establish a contingency plan to provide a pathway to minimize market disruption should the federal department of health and human services or the federal department of the treasury cease cost sharing reduction payments to eligible health insurance carriers as required under sections 1402 and 1412 of the federal Patient Protection and Affordable Care Act. The contingency plan shall include a description of intended steps the division and connecter may take to mitigate costs for both members and health insurance carriers. The contingency plan shall be made publicly available on both the division and connector’s websites and filed with the clerks of the senate and house of representatives; the chairs of the joint committee on health care financing and the house and senate chairs of the ways and means committee not later than September 1, 2017."


Budget Amendment ID: FY2018-S3-460

EHS 460

Edward M. Kennedy Community Health Center

Ms. Chandler, Messrs. Eldridge, Moore and Barrett moved that the proposed new text be amended in section 2, by adding after item 4000-0007 the following item:-

"4000-0014 For the Edward M. Kennedy Community Health Center, Inc. to professionally 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............................................................. $100,000"


Budget Amendment ID: FY2018-S3-462

EHS 462

Access to Naloxone for BSAS Providers

Messrs. Keenan and Cyr, Ms. Flanagan and Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4512-0200, by adding at the end thereof the following: "provided further, that not less than $500,000 shall be expended on Naloxone (Narcan) for distribution to addiction treatment provider programs funded through this line item"; and in said item, by striking out the figures "$129,675,888" and inserting in place thereof the figures "$130,175,888"


Budget Amendment ID: FY2018-S3-463

EHS 463

Utilization of public health benefits by large employers

Messrs. Keenan, Montigny and Tarr moved that the proposed new text be amended by inserting the following new section:-

SECTION X. Chapter 12C of the General Laws is hereby amended by inserting the following new section:-

Section 23. The Center shall annually prepare a public health program beneficiary employer report. For the purposes of this section, a "public health program beneficiary" shall mean a person who receives medical assistance or medical benefits, or who receives assistance through the health safety net trust fund, under chapter 118E of the General Laws.

The report shall provide the following information for each employer of 50 or more public health program beneficiaries: (1) The name and address of the employer; (2) the number of public health program beneficiaries who are employees of the employer; (3) the number of public health program beneficiaries who are spouses or dependents of employees of the employer; (4) whether the employer offers health benefits to its employees; and (5) the cost to the Commonwealth of providing public health program benefits for their employees and enrolled dependents.

The report shall not include the names of any individual public health access program beneficiaries and shall be subject to privacy standards pursuant to Public Law 104-191, and the Health Insurance Portability and Accountability Act of 1996.

The report shall be submitted annually on February 1 to the clerks of the house and the senate, to the joint committee on health care financing, and to the house and senate committees on ways and means.

SECTION XX. Section 3 of Chapter 62E of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out, in line 12, “and” immediately preceding “(3) for purposes of administering the tax laws and the child support enforcement program of the commonwealth” and inserting after “(3) for purposes of administering the tax laws and the child support enforcement program of the commonwealth” the following new subparagraph:-

(4) for the purpose of assisting the center for health information and analysis in preparing a public health program beneficiary employer report.


Budget Amendment ID: FY2018-S3-467-R1

Redraft EHS 467

MassHealth ACO Performance

Mr. Welch moved that the proposed new text be amended <w:t xml:space="preserve">by inserting after section 100 the following section:- </w:t>

“SECTION 100A. Notwithstanding any general or special law to the contrary, the secretary of health and human services shall provide regular updates regarding the performance of the MassHealth’s Accountable Care Organization program to the chairs of the joint committee on health care financing and the house and senate committees on ways and means.  Regular updates shall include, but not be limited to: (i) the quarterly operation reports as defined by special terms and conditions of requirement 62, of the Massachusetts MassHealth section 1115 (a) Medicaid demonstration agreement,; (ii) the annual report on the Accountable Care Organization demonstration as defined by special terms and conditions requirement 63 of the Massachusetts MassHealth section 1115(a) Medicaid demonstration agreement;  and (iii) the quarterly expenditure reports as defined by special terms and conditions requirement 65 of the Massachusetts MassHealth section 1115(a) Medicaid demonstration agreement. Updates shall be provided to the chairs of the joint committee on health care financing not less than 15 days prior to the submission of the reports to the Centers for Medicare and Medicaid Services. The secretary shall also forward a copy of all finalized reports upon their submission to the Centers for Medicare and Medicaid Services to the chairs of the joint committee on health care financing and the house and senate committees on ways and means.

Notwithstanding any general or special law to the contrary, the joint chairs of the committee on health care financing may request additional updates regarding the performance of the MassHealth’s Accountable Care Organization program beyond the updates included within this section. The secretary shall provide a response to any additional request updates within 30 days of the request.”


Budget Amendment ID: FY2018-S3-469-R2

2nd Redraft EHS 469

Strengthening the Home Care Program

Messrs. Welch, Cyr, Rush, Eldridge, Pacheco and McGee, Ms. Gobi, Messrs. Lewis, Hinds, Montigny, Brady, Keenan, O'Connor, Lesser and Moore moved that the proposed new text be amended <w:t xml:space="preserve">by inserting after section 9 the following section:- </w:t>

“SECTION 9A. Chapter 19A of the General Laws is hereby amended by inserting after section 4C the following section:-

Section 4D. (a) When used in this section, the following terms shall have the following meanings unless the context otherwise requires:

“Employee organization”, a labor union or other organization, agency or employee representation committee, association, group or plan in which employees participate and which exists in whole or in part for the purpose of dealing with employers concerning matters incidental to employment relationships.

"Home care worker", a person employed by a home care worker agency to provide personal care, homemaker, companion or chore services under the home care program established in section 4.

"Home care worker agency", an entity employing home care workers to provide services under the home care program established in section 4 that is under contract with an aging services access point established pursuant to section 4B.

(b) The department shall establish and maintain a home care worker registry for home care workers employed by a home care worker agency.

A home care worker agency shall report the required home care worker registry information for each home care worker it employs on a paid, unpaid, temporary or permanent basis who is not exempt from the reporting requirement. Any exemptions from reporting shall be established in regulations promulgated by the department.

The department shall collect the following reported information concerning each home care worker: (i) the worker’s full name; (ii) their assigned unique identification number; (iii) their gender; (iv) their home address; (v) their mailing address; (vi) the full legal name of any home care worker agency employing the home care worker; (vii) the worker’s job title and (viii) a list of home care trainings or certifications completed by the home care worker.

Reported information for each employed home care worker shall be submitted and regularly updated by each home care worker agency subject to this section. The registry shall be updated at least quarterly. A home care worker agency shall collect and maintain the required information and submit updated information in a timely manner as determined by the department. A home care worker shall not be responsible for any costs related to the registry.

The department shall only make each home care worker’s full name, identification number, name of any home care worker agency employing the home care worker and a list of home care trainings or certifications completed by the home care worker available to the public unless such information is exempt from disclosure by the department. Upon request from an employee organization, home care worker agency or aging services access point, the department shall provide all reported information to such entity.

The department shall promulgate rules and regulations and shall provide such forms and notifications as may be necessary to implement this section; provided, however, that the department shall minimize any duplicate reporting that may be required of home care agencies.”; and

by inserting after section 103 the following section:-

“SECTION 103A. A home care worker agency subject to section 4D of chapter 19A of the General Laws shall report the required home care worker registry information for each home care worker pursuant to said section 4D of said chapter 19A not later than 1 year after the effective date of this act.”


Budget Amendment ID: FY2018-S3-470-R1

Redraft EHS 470

Group Purchasing Cooperatives Task Force

Mr. Welch moved that the proposed new text be amended <w:t xml:space="preserve">in section 89, by striking out, in line 1291, the figure “12” and inserting in place there of the following figure:- “13”; and </w:t>

in said section 89, by inserting after the word “Inc.”, in line 1297, the following words:- “, 1 of whom shall be a representative of the Retailers Association of Massachusetts, Inc.”.


Budget Amendment ID: FY2018-S3-472

EHS 472

Health Care Industry Plan Review Retained Revenue

Mr. Welch moved that the proposed new text be amended in section 2, by inserting item 4516-1039, as follows: "For the department of public health, which may expend, to support the operations of the determination of need program and health care facility plan review within the department of public health, not more than $400,000 in retained revenues collected from application fees collected under section 25C of chapter 111 of the General Laws; provided, that notwithstanding any general or special law to the contrary, for the purpose of accommodating timing discrepancies between the receipt of retained revenues and related expenditures, the department 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; and provided further, that any unexpended funds in this item shall not revert but shall be made available until June 30, 2019................................................................................................................................. $400,000"


Budget Amendment ID: FY2018-S3-473

EHS 473

Commission on the status of grandparents raising grandchildren

Messrs. deMacedo and Cyr, Ms. L'Italien, Mr. Brownsberger, Ms. Flanagan, Messrs. Humason, Tarr, Moore, Ross, O'Connor and Montigny moved that the proposed new text be amended in section 2, by adding the following new line item: "0950-0030 For the commission on the status of grandparents raising grandchildren…...$111,714"


Budget Amendment ID: FY2018-S3-474-R1

Redraft EHS 474

Brain Injury Services

Ms. Chandler, Messrs. Eldridge, Moore, Keenan, McGee and Brady, Ms. O'Connor Ives, Ms. Lovely, Messrs. O'Connor, Barrett and Lewis moved that the proposed new text be amended in section 2, in item 4120-6000, <w:t>by striking out the figures “$16,183,512” and inserting in place thereof the figures “$16,333,512”.</w:t>


Budget Amendment ID: FY2018-S3-475

EHS 475

School based health centers

Messrs. Lewis and McGee moved that the proposed new text be amended in section 2, in item 4590-0250, by adding at the end thereof the following:- “provided further that the Department shall review and revise school based health center quality standards and metrics to allow school based health centers to meet community need and improve population health through efforts that include, but are not limited to, operation of the centers after school hours, the provision of mental and behavioral health services, treatment of youth regardless of which school they attend, provision of dental care to youth in the community, or other appropriate efforts to address population health and the social determinants of health; and provided further that the Department shall study whether alternative financial models, including the opportunity to bill as an urgent care center, may allow for improved public health outcomes, and report any findings and recommendations to the Clerks of the House and Senate, the Joint Committee on Public Health, and the Joint Committee on Health Care Financing by July 1, 2018”; and provided further that $500,000 shall be expended for an additional procurement for school based health centers; and in said item, by striking out the figure "$11,944,395" and inserting in place thereof the figure "$12,444,395"


Budget Amendment ID: FY2018-S3-477

EHS 477

Elder Homelessness Prevention and Support

Messrs. Lewis and Cyr, Ms. Chang-Diaz, Messrs. Eldridge, Brownsberger, Brady, O'Connor and Montigny moved that the proposed new text be amended in section 2, in item 9110-1700, by striking out the figure “$186,000” and inserting in place thereof the following figure:- "$286,000”.


Budget Amendment ID: FY2018-S3-478

EHS 478

Modernizing Smart Tiering of Health Insurance

Mr. Brady moved that the proposed new text be amended by adding the follow section:

"SECTION XXXX":

Chapter 176J is amended by striking out section 11 and inserting in place thereof the following:

Section 11. (a) A carrier that offers a health benefit plan that: (i) provides or arranges for the delivery of health care services through a closed network of health care providers; and (ii) as of the close of any preceding calendar year, has a combined total of 5,000 or more eligible individuals, eligible employees and eligible dependents, who are enrolled in health benefit plans sold, issued, delivered, made effective or renewed to qualified small businesses or eligible individuals, shall offer to all eligible individuals and small businesses in at least 1 geographic area at least 1 plan with either:

(1) a reduced or selective network of providers;

(2) an accountable care provider network;

(3) a smart tiering plan in which health services are tiered and member cost sharing is based on the tier placement of the services; or,

(4) a plan in which providers are tiered and member cost sharing is based on the tier placement of the provider.

 

The commissioner of insurance shall annually determine a base premium rate discount of at least 20 per cent for the reduced or selective or tiered network plan and at least 30 per cent for the accountable care provider network plan, in either case as compared to the base premium of the carrier's most actuarially similar plan with the carrier's non-selective or non-tiered network of providers. The savings may be achieved by means including, but not limited to: (i) the exclusion of providers with similar or lower quality based on the standard quality measure set with higher health status adjusted total medical expenses or relative prices, as determined under section 10 of chapter 12C;  (ii) increased member cost-sharing for members who utilize providers for non-emergency services with similar or lower quality based on the standard quality measure set and with higher health status adjusted total medical expenses or relative prices, as determined under said section 10 of said chapter 12C or (iii) limiting the provider network to an accountable care organization.

 

(b) A tiered network plan shall only include variations in member cost-sharing between provider tiers which are reasonable in relation to the premium charged and ensure adequate access to covered services. Carriers shall tier providers based on quality performance as measured by the standard quality measure set and by cost performance as measured by health status adjusted total medical expenses and relative prices. Where applicable quality measures are not available, tiering may be based solely on health status adjusted total medical expenses or relative prices or both. Smart tiering plans may take into account the number of services performed each year by the provider. For smart tiering plans, if a medically necessary and covered service is available at not more than 5 facilities in the state, as determined by the health policy commission, that service shall not be placed into the most expensive cost-sharing tier.

 

The commissioner shall promulgate regulations requiring the uniform reporting of tiering information, including, but not limited to: requiring at least 90 days before the proposed effective date of any tiered network plan or any modification in the tiering methodology for any existing tiered network plan; the reporting of a detailed description of the methodology used for tiering providers, including: the statistical basis for tiering; a list of providers to be tiered at each member cost-sharing level; a description of how the methodology and resulting tiers will be communicated to each network provider, eligible individuals, and small groups; requiring at least 60 days advance notice period from a carrier to a provider before the provider is assigned or re-assigned into a tier; and a description of the appeals process a provider may pursue to challenge the assigned tier level.  A carrier that uses a tiered network shall disclose to providers the methods and criteria used to establish tiers and assign providers to tiers before assigning or reassigning a provider to a tier, and the benefits associated with each tier.  A carrier shall administer a tiered network in accordance with the methods and criteria disclosed to providers and shall administer an appeals program for providers that wish to challenge their assigned tier level.

 

(c) The commissioner shall determine network adequacy for a tiered network plan based on the availability of sufficient network providers in the carrier's overall network of providers.

 

(d) The commissioner shall determine network adequacy for a selective network plan based on the availability of sufficient network providers in the carrier's selective network.

 

(e) The commissioner shall determine network adequacy for an accountable care provider network plan based on the services offered by the accountable care organization.

 

(f) In determining network adequacy under this section the commissioner of insurance may take into consideration factors such as the location of providers participating in the plan and employers or members that enroll in the plan, the range of services provided by providers in the plan and plan benefits that recognize and provide for extraordinary medical needs of members that may not be adequately dealt with by the providers within the plan network.

 

(g) Carriers may: (i) reclassify provider tiers; and (ii) determine provider participation in selective and tiered plans not more than once per calendar year except that carriers may reclassify providers from a higher cost tier to a lower cost tier or add providers to a selective network at any time. If the carrier reclassifies provider tiers or providers participating in a selective plan during the course of an account year, the carrier shall provide affected members of the account with information regarding the plan changes at least 30 days before the changes take effect. Carriers shall provide information on their websites about any tiered or selective plan, including but not limited to, the providers participating in the plan, the selection criteria for those providers and where applicable, the tier in which each provider is classified.

 

(h) A smart tiering plan shall be a tiering product, which offers a cost-sharing differential based on services rather than facilities providing services. A service covered in a smart tiering plan may be reimbursed through bundled payments for acute and chronic diseases.

 

(i) The division of insurance shall review smart tiering plans in a manner consistent with other products offered in the commonwealth. The division of insurance may disapprove a smart tiering plan if it determines that the carrier differentiated cost-sharing obligations solely based on the provider. There shall be a rebuttable presumption that a plan has violated this subsection if the cost-sharing obligation for all services provided by a provider, including a health care facility, accountable care organization, patient centered medical home, or provider organization, is the same.

 

(j) The commissioner when reviewing smart tiering plans shall promote the following goals: (1) avoid creating consumer confusion; (2) minimize the administrative burdens on payers and providers in implementing smart tiering plans; and (3) allow patients to get their services in the proper locations.

 

(k) The division of insurance shall report annually specific findings and legislative recommendations, including the following: (1) the utilization trends of eligible employers and eligible individuals enrolled in plans offered under this section; (2) the extent to which tiered product offerings have reduced health care costs for patients and employers; (3) the effects that tiered product offerings have on patient education relating to health care costs and quality; (4) the effects that tiered product offerings have on patient utilization of local hospitals and the resulting impact on overall state health care costs, including the state's compliance with the health care cost growth benchmark established under section 9 of chapter 6D; (5) opportunities to incentivize tiered product offerings for both health systems and employers. The report shall also include the number of members enrolled by plan type, aggregate demographic, geographic information on all members and the average direct premium claims incurred, as defined in section 6, for selective and tiered network products compared to non-selective and non-tiered products. The report shall be submitted to clerks of the house of representatives and the senate, the senate and house committees on ways and means and the joint committee on health care financing.

 

For the purpose of this section, an accountable care provider network shall mean a single clinically or financially integrated organization of hospitals, physicians, and home care providers that: (1) is certified by the health policy commission as an accountable care organization, (2) is paid by the carrier using an alternative payment arrangement with both significant downside risk and quality measures; (3) requires members to select a primary care physician and (4) provides the majority of its inpatient hospital care in community hospitals.  An accountable care provider network shall arrange for specialized care that it does not directly provide through provider contracts managed or arranged for by the accountable care organization.

 


Budget Amendment ID: FY2018-S3-479

EHS 479

Prostate cancer research and awareness

Messrs. Lewis, Cyr, Moore, Rush, Eldridge, Welch, Timilty and Brady, Ms. L'Italien, Mr. McGee, Ms. Creem, Mr. O'Connor, Ms. Gobi and Mr. deMacedo moved that the proposed new text be amended in section 2, by striking out item 4590-0925 and inserting in place thereof the following item:-

4590-0925  For the costs of a prostate cancer research program, integrated with education and awareness and focusing on men with African-American, Hispanic or Latino heritage, family history of the disease and other men at high risk; provided, that the department of public health shall oversee and manage said program and shall grant not less than $850,000 of the funds from this item to a non-profit AdMeTech foundation that shall leverage existing partnerships with Prostate Cancer Action Council and other state- funded non-profit research organizations and current and past federally, state and privately funded prostate cancer programs aimed at saving lives, improving quality of life and reducing health care costs.……………………………………………………..…$1,000,000”


Budget Amendment ID: FY2018-S3-480-R1

Redraft EHS 480

Children's vision commission

Mr. Lewis moved that the proposed new text be amended <w:t>by inserting, after section x, the following new section:-</w:t>

"SECTION X. There shall be established a special commission to study and report on childhood vision and eye health in the commonwealth. The commission shall study children’s vision care and quality, including vision screening, eye examinations and appropriate preventative measures, and develop recommendations for ensuring screenings for all children. The commission shall review the commonwealth’s success at preventative measures, including screening, and treating all of its children for vision impairments and eye disease and identify populations that do not receive screening, eye examinations, or necessary related treatments.

The commission shall consist of the commissioner of the department of public health, or a designee, who shall serve as chair; the commissioner of the department of elementary and secondary education, or a designee; the commissioner of early education and care, or a designee; the house and senate chairs of the joint committee on public health, or their designees; two members of the Children’s Vision Massachusetts Coalition; a member of the Massachusetts School Nurses Organization; a member of the Massachusetts Society of Optometrists; a member of the Massachusetts Society of Eye Physicians and Surgeons; and a member of the Massachusetts Chapter of the American Academy of Pediatrics.

The commission shall submit a report, along with any recommendations for legislation, to the clerks of the house of representatives and senate, the house and senate chairs of the joint committee on health care financing, and the house and senate chairs of the joint committee on public health on or before February 1, 2018."


Budget Amendment ID: FY2018-S3-481

EHS 481

Unaccompanied youth homeless funding

Messrs. Lewis, Cyr, Eldridge and Brownsberger, Ms. Chang-Diaz, Ms. Lovely and Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4000-0007, by striking out the figure "$2,500,000" and inserting in place thereof the following figure:- "$4,000,000"


Budget Amendment ID: FY2018-S3-483

EHS 483

Operation house call

Mr. Lewis, Ms. L'Italien, Messrs. Barrett, O'Connor and deMacedo moved that the proposed new text be amended in section 2, in item 4510-0710, by inserting after the words “surveillance and evaluation” the following words:- provided further, that not less than $50,000 shall be expended for Operation House Call at The Arc of Massachusetts to maintain and expand training to medical students and other graduate level health care professionals to work with individuals with autism and other developmental and intellectual disabilities;"


Budget Amendment ID: FY2018-S3-484

EHS 484

Office of health equity

Messrs. Lewis and Cyr moved that the proposed new text be amended in section 2, in item 4000-0300, by adding the following words:- “provided further, that funds may be expended for the operation of the office of health equity within the executive office of health and human services." 


Budget Amendment ID: FY2018-S3-485

EHS 485

Department of developmental services

Messrs. Lewis, Cyr and O'Connor moved that the proposed new text be amended in section 2, in item 5911-1003, by striking out the figure “$69,797,140” and inserting in place thereof the figure “72,297,140”


Budget Amendment ID: FY2018-S3-487

EHS 487

Malden high school Starr Center

Mr. Lewis moved that the proposed new text be amended in section 2, in item 4590-0250, by inserting the following:- "provided further, that no less than $100,000 shall be expended for the purpose of establishing and supporting a school-based health center at Malden High School in the City of Malden"; and by striking out the figure “$11,944,395” and inserting in place thereof the figure:- “12,044,395”.


Budget Amendment ID: FY2018-S3-488

EHS 488

Children's Advocacy Center of Bristol County

Messrs. Rodrigues, Montigny, Ross and Pacheco moved that the proposed new text be amended in section 2, in item 4800-0038, by adding the following: ";provided further that not less than $400,000 be expended for the Children's Advocacy Center of Bristol County"; and in said item, by striking out the figures "$291,471,283" and inserting in place thereof the figures "$291,871,283"


Budget Amendment ID: FY2018-S3-489

EHS 489

Quality Care for ALS Patients

Messrs. Rush, Timilty and O'Connor moved that the proposed new text be amended in section 18 by inserting after the word “section”, in line 200, the following words:- “; provided further, that the office shall ensure that such payments address the unique needs of Medicaid beneficiaries with long term chronic ventilator needs at long term acute care hospitals”; and in said section, by inserting after the word “payments”, in line 202, the words “and shall also consult with long term acute care hospitals that care for Medicaid beneficiaries with long term chronic ventilator needs and end stage ALS conditions.”


Budget Amendment ID: FY2018-S3-490

EHS 490

Information Technology to support the administration of public assistance, health benefits and other human service programs

Messrs. Keenan and O'Connor moved that the proposed new text be amended in section 2, in item 4000-1700, by striking the figures "$130,060,702" and inserting in place thereof the figures "$133,564,037"


Budget Amendment ID: FY2018-S3-491

EHS 491

Plainville Senior Center Parking Lot Repairs

Mr. Ross moved that the proposed new text be amended in section 2, in item 9110-9002, by adding at the end thereof the following:- “provided further, that not less than $100,000 shall be expended to the town of Plainville for improvements to their senior center;” and in said item, by striking out the figures “$14,030,000” and inserting in place thereof the figures “$14,130,000”


Budget Amendment ID: FY2018-S3-492

EHS 492

Pappas Rehabilitation Hospital for Children Bed Minimum

Messrs. Timilty and Brady moved that the proposed new text be amended in section 2, in item 4590-0915, by inserting after the words "pharmacy services," the following: "provided further, that the Pappas Rehabilitation Hospital for Children shall maintain not less than 120 beds for clients in its inpatient setting".


Budget Amendment ID: FY2018-S3-493

EHS 493

Pappas Rehabilitation Hospital Summer Program

Messrs. Timilty and Brady moved that the proposed new text be amended in section 2, in item 4590-0915, by adding at the end thereof the following: "provided that $300,000 be expended for the Pappas Rehabilitation Hospital Summer Program"; and in said item, by striking out the figures "$155,920,732" and inserting in place thereof the figures "$156,220,732"


Budget Amendment ID: FY2018-S3-494

EHS 494

Adult Autism Services

Ms. L'Italien and Mr. O'Connor moved that the proposed new text be amended in section 2, in item 5920-3020, by striking the figure "$13,403,338" and replacing it with the following figure:- "$15,403,338".


Budget Amendment ID: FY2018-S3-495

EHS 495

Public Health Hospitals Funding

Messrs. Timilty, Cyr and Brady moved that the proposed new text be amended in section 2, in item 4590-0915, by striking out the figure “$155,920,732” and inserting in place thereof the following figure:- "$156,920,732".


Budget Amendment ID: FY2018-S3-496-R1

Redraft EHS 496

Enough Pay to Stay

Ms. L'Italien, Messrs. Cyr, Moore and Lewis, Ms. Flanagan, Messrs. Tarr and Barrett, Ms. Lovely, Mr. O'Connor, Ms. Chang-Diaz, Ms. O'Connor Ives and Ms. Creem moved that the proposed new text be amended in section 2, <w:t>Notwithstanding and general or special law to the contrary, any remaining or unexpended funds, including any federal financial participation funds generated by the Community First Trust Fund established in section 35AAA of chapter 10 of the General Laws, shall be expended to provide adjustments to rates and capitations for home and community based services provided through line item 9110-1630, 9110-1633, 9110-0600, and 4000-0601; provided further that funds shall be provided for an add on to established capitations in line item 9110-1633; provided further that funds shall be provided for an adjustment to approved program rates issued under line items 9110-1630 and 9110-0600 to provide a rate add-on for wages, compensation and/or salary related costs for personnel providing homemaker and personal care homemaker services; provided further that funds shall be provided for adjusting rates for home health aide services funded through line item 4000-0601 for the purpose of providing Title XIX services</w:t>


Budget Amendment ID: FY2018-S3-497

EHS 497

Health care facility safety

Messrs. Lewis, Brady and O'Connor and Ms. O'Connor Ives moved that the proposed new text be amended in section 2, in item 4510-0712, by striking out the figure “$2,128,302”, each time it appears, and inserting in place thereof the following figure:- "$3,128,302".


Budget Amendment ID: FY2018-S3-498-R1

Redraft EHS 498

Mobile Integrated Health Implementation

Messrs. Timilty, Brownsberger, Moore and O'Connor moved that the proposed new text be amended in section 2, in item 4510-0710, <w:t>by adding the following words:- “; provided further, that not less than $400,000 shall be expended for the development and implementation of the Mobile Integrated Healthcare program”; and in said section 2, in said item 4510-0710, by striking out the figure “$10,503,176” and inserting in place thereof the following figure:- “$10,903,176”.</w:t>


Budget Amendment ID: FY2018-S3-500-R2

2nd Redraft EHS 500

Adult Community Health

Messrs. Keenan and Moore and Ms. O'Connor Ives moved that the proposed new text be amended in section 2, in item 5046-0000, <w:t>by striking the figure “$387,130,580” and inserting in place thereof the figure “$388,130,580”</w:t>


Budget Amendment ID: FY2018-S3-501

EHS 501

Autism Waiver I

Ms. L'Italien, Messrs. Eldridge and Moore moved that the proposed new text be amended in section 2, in item 5920-3010, by inserting at the end thereof the following:- “; provided further, that the department shall report to the house and senate committees on ways and means, the joint committee on education and the joint committee on children, families and persons with disabilities on the number of contracted support services provided for families with autistic children under this item and the costs associated with such services no later than January 9, 2018; provided further, that such report shall include, but not be limited to, the services provided by the children’s autism spectrum disorder waiver, with information regarding the number of children enrolled in the waiver and receiving services, linguistic and cultural diversity, age, gender and geographic representation of the applicants and the children enrolled in the program and department plans to continue to assess the demand for waiver services, any executive office of health and human services plans to expand the waiver for children on the autism spectrum of all ages in the future and any other information determined relevant by the department; and provided further, that the department shall submit copies of amended waivers to the house and senate committees on ways and means, the joint committee on education and the joint committee on children, families and persons with disabilities upon submission of the amendment.”;

 

and by striking, in line 3, the figure "$4,500,000" and inserting in place thereof the following figure:- "$5,750,000";

 

and by striking the figure "$6,474,349" and inserting in place thereof the following figure:- "$7,724,349"


Budget Amendment ID: FY2018-S3-502

EHS 502

Observation Days

Messrs. Tarr, Humason and Ross moved that the proposed new text be amended by inserting after section ___ the following new section:-

"SECTION ___. Notwithstanding any general or special law to the contrary, the executive office of health and human services shall form an advisory committee of hospital, nursing home and other provider representatives to assist with the development of a statewide two year pilot program managed by the executive office of health and human services which would waive the requirements for a hospital inpatient stay lasting at least three consecutive days in order to obtain coverage for Medicare patients seeking post-hospital extended care services in a skilled nursing facility (42 U.S.C. § 1395x(l)).  Said pilot proposal shall be issued to the federal Centers for Medicare and Medicaid Services no later than January 1, 2018 for their consideration."

 


Budget Amendment ID: FY2018-S3-503

EHS 503

Autism Waiver II

Ms. L'Italien and Mr. Eldridge moved that the proposed new text be amended in section 2, in item 5920-3010, by inserting at the end thereof the following:- “; provided further, that the department shall report to the house and senate committees on ways and means, the joint committee on education and the joint committee on children, families and persons with disabilities on the number of contracted support services provided for families with autistic children under this item and the costs associated with such services no later than January 9, 2018; provided further, that such report shall include, but not be limited to, the services provided by the children’s autism spectrum disorder waiver, with information regarding the number of children enrolled in the waiver and receiving services, linguistic and cultural diversity, age, gender and geographic representation of the applicants and the children enrolled in the program and department plans to continue to assess the demand for waiver services, any executive office of health and human services plans to expand the waiver for children on the autism spectrum of all ages in the future and any other information determined relevant by the department; and provided further, that the department shall submit copies of amended waivers to the house and senate committees on ways and means, the joint committee on education and the joint committee on children, families and persons with disabilities upon submission of the amendment.”


Budget Amendment ID: FY2018-S3-504

EHS 504

Autism Insurance Resource Center

Ms. L'Italien moved that the proposed new text be amended in section 2, in item 4000-0700, by inserting, at the end thereof, the following:- "provided that not less than $108,445 shall be expended for continued operation of the Autism Insurance Resource Center at the University of Massachusetts Medical School’s Eunice Kennedy Shriver Center to provide information, technical assistance, and support to families of individuals with autism, including individuals who have MassHealth” and by striking out the figure “$513,375,371” and inserting in place thereof the following figure:- “$513,483,816”.


Budget Amendment ID: FY2018-S3-505-R1

Redraft EHS 505

Alzheimer's Public Awareness

Ms. L'Italien, Messrs. Cyr, Brownsberger, Lewis and Moore, Ms. Gobi, Mr. Barrett, Ms. Flanagan, Ms. Lovely, Messrs. O'Connor and Montigny moved that the proposed new text be amended in section 2, in item 4513-1111, <w:t>by inserting at the end thereof the following:- "provided further, that not less than $50,000 shall be expended for a grant to a statewide Alzheimer's disease advocacy and education organization for a public awareness and education campaign as recommended by the Centers for Disease Control and Prevention", and by striking the figure "$3,460,977" and inserting in place thereof the following figure:- "$3,510,977"</w:t>


Budget Amendment ID: FY2018-S3-506

EHS 506

Elder Protective Services

Mr. Cyr, Ms. L'Italien, Messrs. Eldridge, Moore and Brownsberger, Ms. Chang-Diaz, Ms. Gobi, Messrs. Brady, Barrett, Tarr, O'Connor and Montigny moved that the proposed new text be amended in section 2, in item 9110-1636, by striking out the figures “$29,207,919” and inserting in place thereof the following figures:- "$32,310,545"


Budget Amendment ID: FY2018-S3-507

EHS 507

Comprehensive Family Planning Services

Messrs. Cyr, Boncore, Eldridge, Moore and Brownsberger, Ms. L'Italien, Messrs. Brady and Barrett, Ms. Flanagan, Mr. Hinds, Ms. Chang-Diaz, Messrs. Lewis and Lesser moved that the proposed new text be amended in section 2, in item 4513-1000, by striking out the figures “$5,511,509” and inserting in place thereof the figures “$5,811,508” and further amended by striking out the final figures “5,711,509” and inserting in place thereof the figures “$6,011,509”


Budget Amendment ID: FY2018-S3-508-R2

2nd Redraft EHS 508

Greater Milford Area Substance Regional Substance Abuse and Intervention Program

Mr. Fattman moved that the proposed new text be amended in section 2, in item 4512-0205, <w:t>by adding the following words:- “provided further, that not less than $50,000 shall be expended for the Milford Police Department and the Juvenile Advocacy Group to maintain a regional substance abuse outreach and intervention program in the Greater Milford area”; and in said section 2, in said item 4512-0205, by striking out the figure “$475,000” and inserting in place thereof the following figure:- “$525,000”.</w:t>


Budget Amendment ID: FY2018-S3-510

EHS 510

Montachusett Veterans Outreach Center Women’s Housing Program

Ms. Gobi and Ms. Flanagan moved that the proposed new text be amended in section 2, in item 1410-0012, by adding the following:- “provided further that no less than $124,000 be provided for the operation of the Montachusett Veterans Outreach Center women’s housing program;” and in said item by striking out the figure “$4,370,641” and inserting in place thereof the figure “$4,494,641”


Budget Amendment ID: FY2018-S3-511

EHS 511

Cash Assistance Expenditures

Messrs. Fattman, Humason, Tarr and O'Connor moved that the proposed new text be amended by inserting, after section __, the following new sections:-

"SECTION __. Section 5I(b) of Chapter 18 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out in the last sentence “court.” and inserting in place thereof the following-: “court; or marijuana or marijuana products not prescribed under the law for medicinal purposes” and by striking out in section 5j “; or on cruise ships.” and inserting in place thereof the following:- “;on cruise ships; or at establishments or businesses that sell marijuana or marijuana products not prescribed under the law for medicinal purposes.”

SECTION __. Notwithstanding and general or special law to the contrary, the provisions of section___ shall not take effect until July 1, 2018 or until such time as the Joint Committee on Marijuana Policy has filed a report and legislation has been filed and enacted pursuant to Part 2, Chap. 1, Sec. 1, Art. II of the Constitution.”


Budget Amendment ID: FY2018-S3-513-R1

Redraft EHS 513

Children with Complex Medical Needs II

Ms. L'Italien and Mr. O'Connor moved that the proposed new text be amended <w:t>by inserting after section 100 the following section:-</w:t>

“SECTION 100A.  The center for health information and analysis shall provide a report related to costs associated with the hospitalization of medically complex pediatric home care patients. The report shall include: (i) the number of medically complex pediatric home care patients, including those who have aged into adulthood, who are hospitalized annually and the  length of their stay; (ii) the estimated cost to MassHealth of the annual hospitalization of medically complex pediatric home care patients; (iii) the estimated cost to private payers of the annual hospitalization of medically complex pediatric home care patients; and (iv) a cost analysis comparing continuous skilled nursing service costs to the cost of likely avoidable hospitalizations.

The center shall consult with the Massachusetts Pediatric Home Nursing Campaign and the Home Care Alliance of Massachusetts, Inc. and may consult with providers of continuous skilled nursing for children with complex medical needs.  The report shall be made publicly available on the center’s website and shall be filed with the clerks of the senate and house of representatives, the chairs of the joint committee on health care financing and the senate and house committees on ways and means not later than April 1, 2018."


Budget Amendment ID: FY2018-S3-515

EHS 515

Clarifying the Data That Will be Provided by CHIA

Mr. Timilty moved that the proposed new text be amended by striking the phrase  “the weighted average rate per provider across the market, for every provider” in lines 126-127 and inserting in place thereof the following: “an all-payer weighted average rate per hospital and physician group, respectively, across the market, for providers”; and further amend said  section by striking the phrase “a weighted average payer rate for procedures and services broken down by individual provider” in lines 129-130 and inserting in place thereof the following: “an all-payer weighted average rate per hospital and physician group, respectively.”

 

 


Budget Amendment ID: FY2018-S3-518

EHS 518

Medication Synchronization

Ms. L'Italien moved that the proposed new text be amended by inserting the following new section:

 

"SECTION X. An individual or group health insurance policy providing prescription drug coverage in the state must permit and apply a pro-rated daily cost-sharing rate to prescriptions that are dispensed by a network pharmacy for a partial supply if the prescriber or pharmacist determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing the patient’s medications.

No individual or group health insurance policy providing prescription drug coverage shall deny coverage for the dispensing of a medication that is dispensed by a network pharmacy on the basis that the dispensing is for a partial supply if the prescriber or pharmacist determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of synchronizing the patient’s medications. The individual or group health plan must allow a pharmacy to override any denial codes indicating that a prescription is being refilled too soon for the purposes of medication synchronization.

No individual or group health insurance policy providing prescription drug coverage shall use payment structures incorporating pro-rated dispensing fees.  Dispensing fees for partially filled or refilled prescriptions shall be paid in full for each prescription dispensed, regardless of any pro-rated copay for the beneficiary or fee paid for alignment services."


SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2120

Senate, May 24, 2017 -- Text of amendment (519) (offered by Senator L'Italien) to the Ways and Means amendment (Senate, No. 3) to the House Bill making appropriations for the fiscal year 2018 for the maintenance of the departments, boards, commissions, institutions and certain activities of the Commonwealth, for interest, sinking fund and serial bond requirements and for certain permanent improvements

 

The Commonwealth of Massachusetts

 

_______________

In the One Hundred and Ninetieth General Court
(2017-2018)

_______________

 

SECTION X. Chapter 175 of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after section 47BB the following new section:-

Section 47CC. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.

“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by a carrier or utilization review organization to determine the medical necessity and appropriateness of healthcare services.

“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs.

“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.

“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.

(b) Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.

(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:

(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.

(B) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:

(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.

(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.

(iii) Offering opportunities for public review and comments.

(C) Are based on high quality studies, research, and medical practice.

(D) Are created by an explicit and transparent process that:

(i) Minimizes biases and conflicts of interest;

(ii) Explains the relationship between treatment options and outcomes;

(iii) Rates the quality of the evidence supporting recommendations; and

(iv) Considers relevant patient subgroups and preferences.

(E) Are continually updated through a review of new evidence, research and newly developed treatments.

(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.

(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.

(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.

(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.

(d) A step therapy override exception determination shall be expeditiously granted if:

(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;

(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;

(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;

(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;

(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.

(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.

(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.

(g) This section shall not be construed to prevent:

(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;

(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION XX. Chapter 176A of the General Laws, as Appearing in the 2016 Official Edition, is hereby amended by inserting after section 8EE the following new section:-

Section 8FF. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.

“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by an insurer, health plan, or utilization review organization to determine the medical necessity and appropriateness of healthcare services.

“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs, .

“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.

“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.

(b) Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.

(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:

(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.

(B)  Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:

(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.

(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.

(iii) Offering opportunities for public review and comments.

(C) Are based on high quality studies, research, and medical practice.

(D) Are created by an explicit and transparent process that:

(i) Minimizes biases and conflicts of interest;

(ii) Explains the relationship between treatment options and outcomes;

(iii) Rates the quality of the evidence supporting recommendations; and

(iv) Considers relevant patient subgroups and preferences.

(E) Are continually updated through a review of new evidence, research and newly developed treatments.

(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.

(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.

(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.

(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.

(d) A step therapy override exception determination shall be expeditiously granted if:

(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;

(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;

(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;

(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;

(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.

(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.

(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.

(g) This section shall not be construed to prevent:

(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;

(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION XXX. Chapter 176B of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after section 4EE the following new section:-

Section 4FF. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:-

“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.

“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by an insurer, health plan, or utilization review organization to determine the medical necessity and appropriateness of healthcare services.

“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered under a health benefit plan as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs.

“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.

“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.

(b) Any subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.

(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:

(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.

(B) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:

(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.

(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.

(iii) Offering opportunities for public review and comments.

(C) Are based on high quality studies, research, and medical practice.

(D) Are created by an explicit and transparent process that:

(i) Minimizes biases and conflicts of interest;

(ii) Explains the relationship between treatment options and outcomes;

(iii) Rates the quality of the evidence supporting recommendations; and

(iv) Considers relevant patient subgroups and preferences.

(E) Are continually updated through a review of new evidence, research and newly developed treatments.

(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.

(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.

(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.

(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.

(d) A step therapy override exception determination shall be expeditiously granted if:

(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;

(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;

(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;

(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;

(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.

(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.

(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.

(g) This section shall not be construed to prevent:

(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;

(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION XXXX. Chapter 176G of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by inserting after section 4W the following new section:-

Section 4X. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:

“Clinical practice guidelines” means a systematically developed statement to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances and conditions.

“Clinical review criteria” means the written screening procedures, decision abstracts, clinical protocols and practice guidelines used by an insurer, health plan, or utilization review organization to determine the medical necessity and appropriateness of healthcare services.

“Step therapy protocol” means a protocol or program that establishes the specific sequence in which prescription drugs for a specified medical condition and medically appropriate for a particular patient and are covered under a health benefit plan as a pharmacy or medical benefit by a carrier, including self-administered and physician-administered drugs, .

“Step Therapy Override Exception Determination” means a determination as to whether step therapy should apply in a particular situation, or whether the step therapy protocol should be overridden in favor of immediate coverage of the patient’s and/or prescriber’s preferred drug. This determination is based on a review of the patient’s and/or prescriber’s request for an override, along with supporting rationale and documentation.

“Utilization review organization” means an entity that conducts utilization review, other than a health carrier performing utilization review for its own health benefit plans.

(b) Any individual or group health maintenance that provides coverage for prescription drugs and uses step-therapy protocols shall have the following requirements and restrictions.

(1) Clinical review criteria used to establish step therapy protocols shall be based on clinical practice guidelines that:

(A) That recommend drugs be taken in the specific sequence required by the step therapy protocol.

(B) Are developed and endorsed by a multidisciplinary panel of experts that manages conflicts of interest among the members of the writing and review groups by:

(i) Requiring members to disclose any potential conflict of interests with entities, including insurers, health plans, and pharmaceutical manufacturers and recluse themselves of voting if they have a conflict of interest.

(ii) Using a methodologist to work with writing groups to provide objectivity in data analysis and ranking of evidence through the preparation of evidence tables and facilitating consensus.

(iii) Offering opportunities for public review and comments.

(C) Are based on high quality studies, research, and medical practice.

(D) Are created by an explicit and transparent process that:

(i) Minimizes biases and conflicts of interest;

(ii) Explains the relationship between treatment options and outcomes;

(iii) Rates the quality of the evidence supporting recommendations; and

(iv) Considers relevant patient subgroups and preferences.

(E) Are continually updated through a review of new evidence, research and newly developed treatments.

(2) In the absence of clinical guidelines that meet the requirements in section (1), peer reviewed publications may be substituted.

(3) When establishing a step therapy protocol, a utilization review agent shall also take into account the needs of atypical patient populations and diagnoses when establishing clinical review criteria.

(4) This section shall not be construed to require insurers, health plans or the state to set up a new entity to develop clinical review criteria used for step therapy protocols.

(c) When coverage of medications for the treatment of any medical condition are restricted for use by a carrier or utilization review organization via a step therapy protocol, the patient and prescribing practitioner shall have access to a clear readily accessible and convenient process to request a Step Therapy Exception Determination. A carrier or utilization review organization may use its existing medical exceptions process to satisfy this requirement. The process shall be disclosed to the patient and health care providers, including documenting and making easily accessible on the carriers’ or utilization review organization’s website.

(d) A step therapy override exception determination shall be expeditiously granted if:

(1) The required drug is contraindicated or will likely cause an adverse reaction by or physical or mental harm to the patient;

(2) The required drug is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;

(3) The enrollee has tried the step therapy-required drug while under their current or a previous health plan, or another drug in the same pharmacologic class or with the same mechanism of action and such drugs were discontinued due to lack of efficacy or effectiveness, diminished effect, or an adverse event;

(4) The patient is stable on a drug recommended by their health care provider for the medical condition under consideration while on a current or previous health insurance or health benefit plan;

(5) The step therapy-required drug is not in the best interest of the patient, based on medical appropriateness.

(e) Upon the granting of a step therapy override exception determination, the carrier or utilization review organization shall authorize coverage for the drug prescribed by the enrollee’s treating health care provider.

(f) The carrier or utilization review organization shall respond to step therapy override exception request or an appeal within seventy two hours of receipt. In cases where exigent circumstances exist a carrier or utilization review  organization shall respond within twenty four hours of receipts. Should a response by a carrier or utilization review  organization not be received within this time allotted the exception or appeal shall be deemed granted.

(g) This section shall not be construed to prevent:

(1) A carrier or utilization review  organization from requiring an enrollee try an AB-rated generic equivalent prior to providing reimbursement for the equivalent branded drug;

(2) A health care provider from prescribing a drug he or she determines is medically appropriate.

SECTION XXXXX. Sections 1 to 5, inclusive, shall apply to all policies, contracts and certificates of health insurance subject to section 17K of chapter 32A, section 47CC of chapter 175, section 8FF of chapter 176A, section 4FF of chapter 176B and section 4X of chapter 176G of the General Laws which are delivered, issued or renewed on or after January 1, 20XX.”


Budget Amendment ID: FY2018-S3-520

EHS 520

Epinephrine Bulk Purchase Program

Messrs. Lesser, Lewis and Montigny, Ms. Creem and Ms. Lovely moved that the proposed new text be amended by inserting, after section __, the following new section:-

"SECTION X.  Chapter 29 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after section 2VVVV the following section:-

Section 2WWWW.  (a) There shall be a Municipal Epinephrine Bulk Purchase Trust Fund to be administered and expended by the commissioner of public health or a designee for the municipal epinephrine bulk purchase program.  Municipalities may join the program to purchase epinephrine for municipal first responder agencies and elementary and secondary schools located within the district.  The state office of pharmacy services shall assist with the purchasing and distribution of epinephrine on behalf of the program.  The department of public health shall provide technical assistance to participating municipalities to ensure that municipalities complete all training and registration requirements.

(b)  The fund shall consist of: (i) payments made by participating municipalities for the purchase of epinephrine; (ii) revenue from appropriations or other monies authorized by the general court and specifically designated to be credited to the fund; and (iii) funds from public or private sources, including, but not limited to, gifts, grants, donations, rebates and settlements received by the commonwealth that are specifically designated to be credited to the fund.  Funds received under clauses (ii) or (iii) shall be apportioned in a manner determined by the department and shall be applied to provide price reductions for municipalities purchasing epinephrine through the program.  Amounts credited to the fund shall not be subject to further appropriation and monies remaining in the fund at the end of a fiscal year shall not revert to the General Fund.  The commissioner shall report annually not later than October 1 to the house and senate committees on ways and means on the fund’s activity.  The report shall include, but not be limited to, revenue received by the fund, revenue and expenditure projections for the forthcoming fiscal year and details of all expenditures from the fund, the municipalities participating in the program, the amount of epinephrine purchased by each municipality and the discount procured through bulk purchasing.

SECTION XX. The department of public health may promulgate regulations or guidelines to implement the municipal epinephrine bulk purchase program established pursuant to section 2WWWW of chapter 29 of the General Laws, as appearing in section X above."


Budget Amendment ID: FY2018-S3-522

EHS 522

The Women's Center

Mr. Montigny moved that the proposed new text be amended in section 2, in item 4513-1130, by adding at the end thereof the following:-  “provided further, that not less than $100,000 shall be expended for The Women’s Center in New Bedford to provide domestic violence and sexual assault prevention, education, and counseling programs;"


Budget Amendment ID: FY2018-S3-523

EHS 523

South Holyoke Safe Neighborhood Initiative

Mr. Humason moved that the proposed new text be amended in section 2, in item 4590-1507, by inserting at the end thereof the following:- "provided further, that $50,000 shall be expended for the South Holyoke Safe Neighborhood Initiative"; and further in said item, by striking out the figures "$3,000,000" and inserting in place thereof the figures "$30,050,000"


Budget Amendment ID: FY2018-S3-524

EHS 524

Department of Mental Health

Messrs. Pacheco and Brady moved that the proposed new text be amended in section 2, in item 5095-0015, by striking out the words “provided further, that of these 671 beds, not less than 45 beds shall be continuing care inpatient beds on the campus of Taunton state hospital; and provided further, that the department shall operate not less than 260 adult continuing care inpatient beds at Worcester recovery center and hospital”; and

in said section 2, in said item 5095-0015, by adding the following words:- “provided further, that of these 671 beds, not less than 50 beds shall be continuing care inpatient beds on the campus of Taunton State Hospital; provided further, that within the existing appropriation the department may operate more beds at Taunton State Hospital; and provided further, that the department shall operate not fewer than 260 adult continuing care inpatient beds at Worcester recovery center and hospital; provided further, that the department shall not take action in fiscal year 2018 to reduce the number of state-operated continuing care inpatient beds or other state-operated programs at the Taunton State Hospital campus or relocate administrative hospital services associated with the operation of the hospital off-campus; provided further, that the department shall not enter into new vendor-operated lease agreements for expansion of existing vendor-operated programs; provided further, that the department shall not enter into new interagency agreements or expansion of existing interagency agreements, programs or facilities until the department, in conjunction with the division of capital asset management and maintenance, develops a comprehensive long-term use master plan for the campus on or after March 2, 2018 with appropriate community input that is consistent with maintaining publicly-provided mental health services currently delivered on-campus at Taunton State Hospital; provided further, that the plan shall include maintaining existing affiliations with institutions of higher education and possible future relationships with those institutions and others to maintain the sustainability of Taunton State Hospital; provided further, that the plan shall be consistent with maintaining the campus of Taunton State Hospital as a publicly-run mental health facility and shall not prohibit the inclusion of behavioral health programs or publicly-run pilot programs to meet the needs of servicing individuals with mental health, behavioral health and those dual-diagnosed on the campus as part of the comprehensive master plan; and provided further, that the master plan shall be submitted to the executive office for administration and finance, the executive office of health and human services, the joint committee on mental health and substance abuse and the house and senate committees on ways and means.”


Budget Amendment ID: FY2018-S3-525

EHS 525

Foster Care Reimbursement Rates

Mr. Moore, Ms. Lovely and Mr. O'Connor moved that the proposed new text be amended in section 2, in item 4800-0038, by striking out the figures "$291,471,283" and inserting in place thereof the figures:- "$301,138,783".

 


Budget Amendment ID: FY2018-S3-526

EHS 526

Heidrea for Heroes

Mr. deMacedo moved that the proposed new text be amended in section 2, in item 1410-0010, by inserting at the end the following:-; “and provided further, that not less than $150,000 be allocated for Heidrea for Heroes”; and in said item by striking out the figures “$3,524,629” and inserting in place thereof the figures “3,674,629”.


SENATE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 2150

Senate, May 25, 2017 -- Text of amendment (527) (offered by Senator James T. Welch) to the Ways and Means amendment (Senate, No. 3) to the House Bill making appropriations for the fiscal year 2018 for the maintenance of the departments, boards, commissions, institutions and certain activities of the Commonwealth, for interest, sinking fund and serial bond requirements and for certain permanent improvements

 

The Commonwealth of Massachusetts

 

_______________

In the One Hundred and Ninetieth General Court
(2017-2018)

_______________

 

by inserting after section XX the following new sections:-   “SECTION A. Chapter 6D of the General Laws, as appearing in the 2014 Official Edition,  is hereby  amended by inserting after section 16, the following section:-

“Section 16A.  (a) The non-contracted commercial rate for emergency services and the non-contracted commercial rate for non-emergency services shall be effective for a 5 year period. The commission shall, upon consideration of advice and any other pertinent evidence, set the non-contracted commercial rate for emergency services and the non-contracted commercial rate for non-emergency services so that: (i) each rate shall result in meaningful cost savings to patients; (ii) each rate, in operation, shall encourage in-network participation by health care providers; and (iii) each rate, in operation, shall be understandable and easily administrable by health care providers and carriers. 

(b) The commission shall thereafter conduct a review of the established rates in the fourth year of their operation, and make changes to those rates consistent with subsection (a) to be effective for the next five year period.”

SECTION B.  Chapter 111 of the General Laws, as appearing in the 2014 Official Edition,  is hereby amended by striking out section 228 and inserting in place thereof the following section:-

“(a) Prior to an admission, procedure or service a health care provider shall, disclose upon the request of a patient or prospective patient, within 2 working days, the allowed amount or charge of the admission, procedure or service, including the amount for any facility fees required; provided, however, that if a health care provider is unable to quote a specific amount in advance due to the health care provider's inability to predict the specific treatment or diagnostic code, the health care provider shall disclose the estimated maximum allowed amount or charge for a proposed admission, procedure or service, including the amount for any facility fees required. Such disclosure shall be deemed satisfied by a health care provider if the patient or prospective patient is given a notice of network status effect pursuant to sections 28 and 29 of chapter 176O.

(b) If a patient or prospective patient is covered by a health plan, a health care provider who participates as a network provider shall, provide to a prospective patient, based on the information available to the provider at the time of the request, sufficient information regarding the proposed admission, procedure or service for the patient or prospective patient to make an informed decision about the costs associated with that admission, procedure or service.  Such disclosure shall be deemed satisfied by a health care provider if the patient or prospective patient is given a notice of network status effect pursuant to sections 28 and 29 of chapter 176O. A health care provider may assist a patient or prospective patient in using the health plan's toll-free number and website pursuant to section 23 of chapter 176O.

(c) A health care provider referring a patient to another provider shall disclose: (1) if it is part of or represented by the same provider organization as defined in section 11 of chapter 6D; and (2) the network status of that other provider consistent with section 28 and 29 of chapter 176O.

As used in this section, ''allowed amount'', shall mean the contractually agreed upon amount paid by a carrier to a health care provider for health care services provided to an insured.”

SECTION C.  Section 1 of chapter 176O of the General Laws, as appearing in the 2014 Official Edition,  is hereby amended by inserting before the definition of “Adverse Determination” the following definition:-

“Acknowledgment of network status effect”, written consent by an insured attesting to the receipt of a notice of network status effect submitted to a health care provider prior to the receipt of the health care services included within the notice of network status effect.”

SECTION D.  Said section 1 of said chapter 176O of the General Laws, as so appearing , is hereby further amended by inserting before the definition of “Incentive plan” the following definition:-

“In-network contracted rate”, the contracted rate paid by an insured's carrier for health care services delivered by a health care provider included in the carrier’s network.

SECTION E.  Said section 1 of said chapter 176O of the General Laws, as so appearing, is hereby further amended by inserting after the definition of “Licensed health care provider group” the following definition:-

“Medicare rate”, the amount that Medicare would reimburse for delivered health care services.

SECTION F.  Said section 1 of said chapter 176O of the General Laws, as so appearing, is hereby further amended by inserting after the definition of “Network” the following definitions:-

“Non-contracted commercial rate for emergency services”, the amount set pursuant to section 16A of chapter 6D used to determine the rate of payment to a health care provider for the provision of emergency health care services to an insured and the health care provider is not in the carrier’s network.

“Non-contracted commercial rate for non-emergency services”, the amount set pursuant to section 16A of chapter 6D used to determine the rate of payment to a health care provider for non-emergency services and the health care provider is not in the carrier’s network.

“Non-emergency Services”, health care services rendered to an insured experiencing a condition other than an emergency medical condition.

“Notice of network status effect”, a notice distributed to an insured prior to receiving non-emergency services from a health care provider within a reasonable period of time that permits the insured to seek health care services from an alternative provider based on the results of the notice.

SECTION G. Said section 23 of said chapter 176O, as so appearing, is hereby further amended by adding the following subsection:-

“(b) All carriers shall inform an insured or the insured’s health care provider, as applicable, at the time the insured or the insured’s health care provider request, pursuant to  section 228 of chapter 111, a prospective or concurrent review in relation to a notice of network status effect: (1) the network status under such covered person's health benefit plan of the health care provider who will be providing the health care services; (2) the amount the health carrier will reimburse such health care provider for such health care services, consistent with section 28 of chapter 176O; and (3) the amount of any facility fee, copayment, deductible, coinsurance or other out of pocket amount for any covered health care benefits to be paid by the insured.”

SECTION H. Said chapter 176O of the General Laws, as so appearing,  is hereby further amended by inserting after section 27, the following sections:-

“Section 28.  (a) A health care provider that has delivered health care services to an insured to treat an emergency medical condition, where that health care provider is a member of the insured’s carrier’s network but not a participating provider in the insured’s health benefit plan, that health care provider shall only bill for the in-network contracted rate; provided that amounts billed shall be paid by the insured and the insured’s carrier consistent with the terms of the insured’s health benefit plan;

(b) A health care provider that delivered health care services to an insured but is not contracted to be a network  provider with the insured’s carrier shall be reimbursed for those services in an amount and manner to be determined as follows if the out of network health care provider:

(i) has obtained an acknowledgement of network status effect from the insured, the health care provider shall bill the insured directly for the health care services provided in the amounts indicated for those health care services in the notice of status effect;or

(ii) has not obtained an acknowledgement of network status effect from the insured, they shall only bill for any non-emergency service rendered the greater of: (i) the in-network contracted rate; (ii) the Medicare rate; or (iii) the non-contracted commercial rate for non-emergency services; provided that amounts billed shall be paid by the insured and the insured’s carrier consistent with the terms of the insured’s health benefit plan as if the health care provider were a participating provider under that plan; or

(iii) has not obtained an acknowledgement of network status effect from the insured and delivered health care services due to treat an emergency medical condition, the out of network health care provider shall only bill for any service the greater of: i) the in-network contracted rate; or ii) the non-contracted commercial rate for non-emergency services; provided that amounts billed shall be paid by the insured and the insured’s carrier consistent with the terms of the insured’s health benefit plan as if the health care provider were a participating provider under that plan.

(c) Nothing in this section shall require a carrier to pay for health care services delivered to an insured that are not covered benefits under the terms of the insured’s health benefit plan.

Section 29.  (a) A notice of network status effect shall include, but not be limited to, the following: (i) a description of the network status of all health care providers delivering health care services to the insured; (ii) an itemized estimate of payments due for anticipated health care services performed pursuant to the insured’s health benefit plan for in network providers; (iii) an itemized estimate of payments due for anticipated health care services performed by out of network providers; and (iv) any facility fee, copayment, deductible, coinsurance or other out of pocket amount for any covered health care benefits.

(b) An acknowledgement of notice of network status effect will be valid only if an insured, their parent, legal guardian, health care agent pursuant to chapter 201D, or caregiver pursuant to chapter 201F has indicated in writing that they have received, read, and understand the contents of such notice prior to the provision of health care services.

Section 30. (a) The Division shall promulgate regulations necessary to implement the provisions of sections 28 and 29 of this Chapter.”

SECTION I.  Notwithstanding any general or special law to the contrary, the non-contracted commercial rate for non-emergency services shall be equal to the eightieth percentile of all charges for a particular health care service performed by a health care provider in the same or similar specialty and provided in the same geographical area, as reported in a benchmarking database maintained by the Division of Insurance working in conjunction with the commission and the center.

SECTION J.  Notwithstanding any general or special law to the contrary, the non-contracted commercial rate for emergency services shall be equal to the eightieth percentile of all charges for a particular health care service performed by a health care provider in the same or similar specialty and provided in the same geographical area, as reported in a benchmarking database maintained by the Division of Insurance working in conjunction with the commission and the center.

SECTION K. Notwithstanding any general or special law to the contrary, any facility that has obtained provider-based status from Medicare pursuant to the requirements of 42 C.F.R. §413.65 shall upon obtaining that designation notify members of their patient panel that: i) the facility is now considered to be a hospital out-patient department of the main hospital provider; and ii) the health care services delivered at the facility will also incur a facility fee due to that status.  Such facility shall also post such notice in a conspicuous place in every room of that facility where a patient or prospective patient would have a meaningful opportunity to consider that information prior to receiving health care services from that facility.

SECTION L.  Sections J and K shall take effect on July 1, 2018.

SECTION M.  Sections J and K are hereby repealed.

SECTION N.  Section M shall take effect on December 31, 2019.

SECTION O. Section A shall take effect on January 1, 2020.”.


Budget Amendment ID: FY2018-S3-528

EHS 528

Arlington Youth Conseling Center

Ms. Forry moved that the proposed new text be amended in section 2, in item 5042-5000, by inserting after the words “Safety Partnership, Inc.” the following words:- “; provided further, that not less than $150,000 shall be expended to the Arlington Youth Counseling Center.”;

 

and in said item by striking out the figure “$91,381,786” and inserting in place thereof the following figure:- “$91,531,786”.


Budget Amendment ID: FY2018-S3-529-R1

Redraft EHS 529

Prevention and Wellness Trust Fund

Messrs. Lewis, Moore and Boncore, Ms. Chandler, Messrs. Keenan, Cyr, Welch, Eldridge, McGee and Brady, Ms. Flanagan, Messrs. Hinds and Brownsberger, Ms. Chang-Diaz, Messrs. O'Connor, Barrett, Montigny and Lesser, Ms. Forry and Ms. Creem moved that the proposed new text be amended <w:t>by inserting after section 34 the following section:-</w:t>

“SECTION 34A. Subsection (b) of section 7B of said chapter 64C, as so appearing, is hereby amended by adding the following paragraph:-

In addition to the excise imposed by the first paragraph, an excise shall be imposed on fruit-flavored or other nontobacco-flavored cigars and smoking tobacco at the rate of 170 per cent of the wholesale price of such products. The excise shall be imposed on cigar distributors at the time the fruit-flavored or other nontobacco-flavored cigars or smoking tobacco are manufactured, purchased, imported, received or acquired in the commonwealth. The excise shall not be imposed on any such cigars or smoking tobacco that: (i) are exported from the commonwealth; or (ii) are not subject to taxation by the commonwealth pursuant to any federal law. The excise imposed pursuant to this paragraph shall be deposited in the Prevention and Wellness Trust Fund established under section 2G of chapter 111.”; and

by inserting after section 43 the following section:-

“SECTION 43A. Chapter 111 of the General Laws is hereby amended by striking out section 2G, as so appearing, and inserting in place thereof the following 2 sections:-

Section 2G. (a) There shall be a Prevention and Wellness Trust Fund to be expended, without further appropriation, by the department of public health. The fund shall consist of revenues collected by the commonwealth, including: (i) revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund including, but not limited to, revenue received pursuant to the second paragraph of section 7B of chapter 64C; (ii) fines and penalties allocated to the fund; (iii) funds from public and private sources, including gifts, grants and donations to further community-based prevention activities; (iv) interest earned on revenues in the fund; and (v) funds provided from any other source. The commissioner of public health, as trustee, shall administer the fund. The commissioner, in consultation with the prevention and wellness advisory board established in section 2H shall make expenditures from the fund consistent with subsections (d) and (e); provided, however, that not more than 10 per cent of the amounts held in the fund in any 1 year shall be used by the department for the combined cost of program administration, technical assistance to grantees and program evaluation.

(b) The department may incur expenses and the comptroller may certify for payment, amounts in anticipation of expected receipts; provided, however, that no expenditure shall be made from the fund which shall cause the fund to be in deficit at the close of a fiscal year. Revenues deposited in the fund that are unexpended at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in the following fiscal year.

(c) All expenditures from the fund shall support the commonwealth’s efforts to meet the health care cost growth benchmark established in section 9 of chapter 6D and  at least 1 of the following purposes: (i) increase access to community-based preventive services and interventions which complement and expand the ability of MassHealth to promote coordinated care, integrate community-based services with clinical care and develop innovative ways of addressing social determinants of health; (ii) reduce the impact of health conditions which are the largest drivers of poor health, health disparities, reduced quality of life and high health care costs though community-based interventions; or (iii) develop a stronger evidence-base of effective prevention interventions.

(d) Using a competitive grant process, the commissioner shall annually award not less than 90 per cent of the money in the fund to municipalities, community-based organizations, health care providers, regional planning agencies and health plans that apply for the implementation, evaluation and dissemination of evidence-based community preventive health activities. To be eligible to receive a grant under this subsection, a recipient shall be a partnership that includes at minimum: (i) a municipality or regional planning agency; (ii) a community-based health or social service provider; (iii) a public health or community action agency with expertise in implementing communitywide health interventions; (iv) a health care provider or a health plan; and (v) where feasible, a Medicaid-certified accountable care organization or a Medicaid-certified community partner organization. Expenditures from the fund for such purposes shall supplement and not replace existing local, state, private or federal public health related funding. An entity that is awarded funds through this program shall demonstrate the ability to: (A) utilize best practices in accounting; (B) contract with a fiscal agent who will perform accounting functions on its behalf; or (C) be provided with technical assistance by the department to ensure best practices are followed.

(e)(1) A grant proposal submitted under subsection (d) shall include, but not be limited to: (i) a plan that defines specific goals for the reduction in preventable health conditions and health care costs over a multi-year period; (ii) the evidence-based or evidence-informed programs the applicant shall use to meet the goals; (iii) a budget necessary to implement the plan, including a detailed description of the funding or in-kind contributions the applicant will be providing in support of the proposal; (iv) any other private funding or private sector participation that the applicant anticipates in support of the proposal; (v) a commitment to include women, racial and ethnic minorities and low-income individuals; and (vi) the anticipated number of individuals that would be affected by the implementation of the plan.

(2) Priority may be given to proposals in a geographic region of the state with a higher than average prevalence of preventable health conditions as determined by the commissioner of public health, in consultation with the prevention and wellness advisory board. If no proposals were offered in areas of the commonwealth with particular need, the department shall ask for a specific request for proposals for that specific region. If the commissioner determines that no suitable proposals have been received such that the specific needs remain unmet, the department may work directly with municipalities or community-based organizations to develop grant proposals.

(3) The department of public health shall, in consultation with the prevention and wellness advisory board, develop guidelines for an annual review of the progress being made by each grantee. Each grantee shall participate in an evaluation or accountability process implemented or authorized by the department.

(f) The department of public health shall, annually on or before November 1, report on expenditures from the fund from the previous fiscal year and anticipated revenues for the forthcoming fiscal year. The report shall include, but not be limited to: (i) the revenue credited to the fund; (ii) revenue and expenditure projections and details of all anticipated expenditures from the fund for the next fiscal year; (iii) the amount of fund expenditures attributable to the administrative costs of the department of public health; (iv) an itemized list of the funds expended through the competitive grant process and a description of the grantee activities; and (v) the results of the evaluation of the effectiveness of the activities funded through the grants. The report shall be provided to the chairs of the house and senate committees on ways and means, the joint committee on public health and the joint committee on health care financing and shall be posted on the department of public health’s website.

(g) With the advice and guidance of the prevention and wellness advisory board, the department of public health shall report annually on its strategy for administration and allocation of the fund, including relevant evaluation criteria. The report shall set forth the rationale for such strategy, which may include: (i) a list of the most prevalent preventable health conditions in the commonwealth, including health disparities experienced by populations based on race, ethnicity, gender, disability status, sexual orientation or socioeconomic status; (ii) a list of the most costly preventable health conditions in the commonwealth; and (iii) a list of evidence-based or promising community-based programs related to the conditions identified in clauses (i) and (ii). The report shall recommend specific areas of focus for allocation of funds. If appropriate, the report shall reference goals and best practices established by the National Prevention, Health Promotion  and Public Health Council and the Centers for Disease Control and Prevention including, but not limited to the HI-5 Initiative, the National Prevention Strategy, the Healthy People report and the Guide to Community Prevention.

(h) The department of public health shall promulgate regulations necessary to carry out this section.

Section 2H. (a) There shall be a prevention and wellness advisory board to: (i) make recommendations to the commissioner concerning the administration and allocation of the Prevention and Wellness Trust Fund established in section 2G; (ii) establish evaluation criteria; and (iii) perform any other functions specifically granted to it by law.

(b) The board shall consist of the commissioner of public health or a designee who shall serve as chair; the house and senate chairs of the joint committee on public health or their designees; the house and senate chairs of the joint committee on health care financing or their designees; the  secretary of health and human services or a designee; the executive director of the center for health information and analysis or a designee; the executive director of the health policy commission or a designee; and 15 persons to be appointed by the governor, 1 of whom shall be a person with expertise in the field of public health economics, 1 of whom shall be a person with expertise in public health research, 1 of whom shall be a person with expertise in the field of health equity, 1 of whom shall be a person from a local board of health for a city or town with a population of at least 50,000, 1 of whom shall be a member of a board of health for a city or town with a population of less than 50,000; 2 of whom shall be representatives of health insurance carriers, 1 of whom shall be a person from a consumer health advocacy organization, 1 of whom shall be a person from a hospital association, 1 of whom shall be a person from a statewide public health organization, 1 of whom shall be a representative of business interests, 1 of whom shall be a public health nurse or a school nurse, 1 of whom shall be a person from an association representing community health workers, 1 of whom shall represent a statewide association of community-based service providers addressing public health and 1 of whom shall be a person with expertise in the design and implementation of communitywide public health interventions.

(c)(1) The board shall evaluate the grant program authorized in section 2G and shall issue a report at intervals to be determined by the board, but not less than every 5 years from the beginning of each grant period. The report shall include an analysis of all relevant data to determine the effectiveness of the program including, but not limited to: (i) the extent to which the program impacted the prevalence, severity or control of preventable health conditions and the extent to which the program is projected to impact those factors in the future; (ii) the extent to which the program reduced health care costs or the growth in health care cost trends and the extent to which the program is projected to reduce those costs in the future; (iii) whether health care costs were reduced and who benefited from the reduction; (iv) the extent to which health outcomes or health behaviors were positively impacted; (v) the extent to which access to evidence-based community services was increased; (vi) the extent to which social determinants of health or other communitywide risk factors for poor health were reduced or mitigated; (vii) the extent to which grantees increased their ability to collaborate, share data and align services with other providers and community-based organizations for greater impact; (viii) the extent to which health disparities experienced by populations based on race, ethnicity, gender, disability status, sexual orientation or socioeconomic status were reduced across all metrics; and (ix) recommendations for whether the program should be discontinued, amended or expanded and a timetable for implementation of those recommendations.

(2) The department of public health shall contract with an outside organization that has expertise in the analysis of public health and health care financing to assist the board in conducting its evaluation. The outside organization shall be provided access to actual health plan data from the all-payer claims database as administered by the center for health information and analysis and data from MassHealth; provided, however, that the data shall be confidential and shall not be a public record under clause twenty-sixth of section 7 of chapter 4.

(3) The board shall report the results of its evaluation and its recommendations, if any, and drafts of legislation necessary to carry out the recommendations to the house and senate committees on ways and means, the joint committee on public health and the joint committee on health care financing and shall post the board’s report on the department of public health’s website.”; and

by inserting after section 108 the following section:-

SECTION 108A.  Section 2G of chapter 111 of the General Laws, inserted by section 43A, and shall take effect on September 1, 2017.


Budget Amendment ID: FY2018-S3-531

EHS 531

Seekonk Senior Center Relocation

Mr. Tarr moved that the proposed new text be amended in section 2, in item 9110-9002, by adding at the end thereof the following: "provided further, that not less than $118,000 shall be expended to the town of Seekonk for the relocation of the Senior Center"; and in said item, by striking out the figures "$14,030,000" and inserting in place thereof the figures "$14,148,000"


Budget Amendment ID: FY2018-S3-532

EHS 532

Elder Mental Health Services

Ms. Flanagan, Messrs. Eldridge, Cyr and Moore, Ms. L'Italien, Messrs. Brownsberger, Brady and Tarr, Ms. Lovely, Messrs. O'Connor and Lesser moved that the proposed new text be amended in section 2, in item 5046-0000, by adding at the end thereof the following: "provided further, that the department  of mental health  and the executive office of elder affairs shall execute an elder mental health interagency service agreement for adult home and community behavioral health services to adults over the age of 60; and provided further, that not less than $500,000 shall be expended for these services."


Budget Amendment ID: FY2018-S3-534

EHS 534

GIC Provider Rate Cap and Balance Billing Protections

Messrs. Tarr and Lewis moved that the proposed new text be amended by inserting, after section ___, the following new section:-

“SECTION _. Section 20 of chapter 32A of the General Laws, as so appearing, is hereby amended by striking out, in lines 3 and 4, the words, "as an indemnity plan.

moves to further amend by inserting the following new section:-

SECTION _. Said chapter 32A is hereby amended by inserting after section 20 the following section:-

Section 20A. (a) For purposes of this section the words insurer and administrator shall include any insurance carrier, nonprofit hospital or medical service corporation or third-party health care administrator operating within the scope of its license and providing coverage for an individual under a plan offered by the commission under section 4, 4A, 10B, 12 or 15.

(b) No insurer or administrator shall pay more than 160 per cent of the average Medicare hospital base rate, as determined by the center for health information and analysis, for inpatient and outpatient services.

(c) No insurer or administrator shall pay more than 160 per cent of the Medicare fee schedule, for physician or other services.

(d) For all services for which Medicare does not provide a rate, no insurer or administrator shall pay more than 160 per cent of the average Medicare base rate or Medicare fee schedule for a comparable service, as determined by the commission in consultation with the center for health information and analysis.

(e) No individual insured under the group insurance commission shall be denied care by any provider licensed to provide medical care in the commonwealth.

(f) The commission, in consultation with the center for health information and analysis, may review and make recommendations to revise the reimbursement rate every 3 years.”.


Budget Amendment ID: FY2018-S3-535-R1

Redraft EHS 535

Julies Family Learning Center

Ms. Forry moved that the proposed new text be amended in section 2, in item 4800-0038, <w:t>by adding the following: “provided further, that no less than $75,000 shall be expanded for Julie’s Family Learning Program; “ and in said item by striking out the figures “$291,471,283” and inserting in place thereof the following figure: “$291,546,283".</w:t>


Budget Amendment ID: FY2018-S3-536-R1

Redraft EHS 536

Commission on the delivery of trauma care

Mr. deMacedo moved that the proposed new text be amended <w:t>by inserting after section 100 the following section:-</w:t>

“SECTION 100A. There shall be a commission to investigate ways to increase access and interoperability of data collected by the department of public health, including the trauma registry established pursuant to section 11 of chapter 111C of the General Laws.

The commission shall evaluate ways to encourage the utilization of data collected from the trauma registry to study the patterns and impact of healthcare inequality and develop support programs and resources necessary to meet the unmet needs of residents of the commonwealth affected by healthcare inequality and their families. The commission may consider methods to encourage partnerships with academic medical centers and schools of public health to analyze and interpret existing data collected by the commonwealth, including data collected through the trauma registry, to ascertain geographical differences in healthcare access and quality. The commission may request information from state, county or municipal departments, boards, bureaus, commissions or agencies to further the goals of the commission.

The commission shall be comprised of: the commissioner of public health or a designee; the senate and house chairs of the joint committee on public health; 1 member of the senate who shall be appointed by the minority leader; 1 member of the house who shall be appointed by the minority leader; and 4 persons who shall be appointed by the commissioner in consultation with the Massachusetts Chapter of the American College of Surgeons and the Chair of the American College of Surgeons, Committee on Trauma, 2 of whom shall be a research scientists with an expertise in healthcare quality and disparity with experience in medicine and public health and 2 of whom shall be members of the public with expertise in injury prevention or trauma surgery. The commission may hold public hearings; provided, however, that the hearings shall be held in a manner to ensure diverse geographic representation.

The department shall hold its first meeting not later than November 1, 2017. The department shall file a report of its recommendations, if any, together with any proposed legislation, with the clerks of the senate and the house of representatives not later than December 31, 2018.”.


Budget Amendment ID: FY2018-S3-537

EHS 537

GIC Funding

Messrs. Tarr, O'Connor and Lewis moved that the proposed new text be amended in section 2, in item 1108-5200, by striking out the figure “$1,701,048,734” and inserting in place thereof the following figure:- “1,724,048,734”.


Budget Amendment ID: FY2018-S3-538

EHS 538

Prescription Copay Assistance

Messrs. Fattman, Tarr and O'Connor moved that the proposed new text be amended by inserting, after section __, the following section:-

SECTION __. Section 226 of chapter 139 of the acts of 2012 is hereby amended by striking out the figure “2015” and inserting in place thereof the following figure:- 2019.”


Budget Amendment ID: FY2018-S3-539

EHS 539

Common Application

Messrs. Tarr and Ross moved that the proposed new text be amended in section 2, in item 4000-0328, by striking out the words by striking the words “provided further, that the office of Medicaid and the department of transitional assistance shall prioritize aligning their benefits application processes as a step toward the development of a common application”, and inserting in thereof the following:-"provided further that the office of Medicaid and the department of transitional assistance shall undertake an alignment of their benefit application processes and the development of a common application, and shall report the progress of such efforts, together with any necessary legislative changes to implement a common application, no later than September 1, 2017."


Budget Amendment ID: FY2018-S3-540

EHS 540

Infant Care Necessities

Messrs. Tarr and Ross moved that the proposed new text be amended by inserting at the end thereof, following new section:-

Section __. The Department of Public Health shall make a request for approval from the United States Department of Agriculture for the expenditure of benefits on diapers for children and infants under the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).


Budget Amendment ID: FY2018-S3-541

EHS 541

Rebates for Health Care Services Extension

Messrs. Tarr, Humason, deMacedo and O'Connor moved that the proposed new text be amended by inserting after section__, the following new section:-

SECTION__. Notwithstanding any special or general law to the contrary, subsection (b) to (d) of section 3 of Chapter 175H of the General Laws shall be effective until July 1, 2022.


Budget Amendment ID: FY2018-S3-542

EHS 542

Glendale Park

Mr. Lewis moved that the proposed new text be amended in section 2, in item 1599-0026, by inserting at the end thereof the following:- “; provided further, that $50,000 shall be expended to provide for a swing set that is compliant with the Americans with Disabilities Act for Glendale Park in the City of Everett”.


Budget Amendment ID: FY2018-S3-544-R2

2nd Redraft EHS 544

Louis D. Brown Peace Institute and Women Survivors of Homicide

Ms. Forry, Messrs. Cyr and O'Connor moved that the proposed new text be amended in section 2, <w:t xml:space="preserve">by inserting after item 4513-1023 the following item:- </w:t>

“4513-1098 For The Louis D. Brown Peace Institute Corporation, a community-based support organization dedicated to serving families and communities impacted by violence, providing statewide support services for survivors of homicide victims, including outreach services, burial assistance, grief counseling and other support services; provided, that The Louis D.  Brown Peace Institute shall establish and administer a process to distribute a total of $100,000 to the Massachusetts Survivors of Homicide Victims Network organizations throughout the commonwealth in the form of grants; and provided further, that The Louis D.  Brown Peace Institute shall report to the department of public health on the amounts and recipients of the grants by March 1, 2018……………………………….$100,000”.


Budget Amendment ID: FY2018-S3-545

EHS 545

Access to health and human services on Martha's Vineyard and Nantucket

Mr. Cyr moved that the proposed new text be amended in section 2, in item 4000-0300, by inserting after the words "subsequent month," the following:- “; provided further, that the executive office shall expend no less than $100,000 to increase access to health and human services on Martha's Vineyard and Nantucket, and such funds shall be used to cover feasible travel costs associated with arranging access to health and human services”; and in said item by striking out the figure “$102,102,732” and inserting in place thereof the figure “$102,202,732”


Budget Amendment ID: FY2018-S3-546-R1

Redraft EHS 546

Veterans’ Homelessness Service Centers

Messrs. Hinds, Cyr, Rush, Brownsberger and Humason moved that the proposed new text be amended in section 2, in item 1410-0250, <w:t>by adding at the end thereof the following:- “provided, that the department shall make a payment equal to the fiscal year 2017 amount for each veterans’ homelessness service center funded by this item in fiscal year 2017; provided further, that each homelessness service center receiving funds under this item shall report to the house and senate committees on ways and means not later than March 15, 2018 on: (i) the number of veterans served annually; (ii) the costs and types of programs, including evidence-based programs, offered to veterans; and (iii) a 5-year spending plan or outline that shall include a discussion of the implementation or further development of evidence-based programs and program evaluation"</w:t>


Budget Amendment ID: FY2018-S3-547

EHS 547

YWCAs

Messrs. Moore, McGee and O'Connor moved that the proposed new text be amended in section 2, in item 4590-1507, by adding at the end thereof the following: “provided further, that the department shall award not less than $1,100,000 to the YWCA organizations, which shall be distributed equally between the YWCA’s member organizations.”; and in said item, by striking out the figures “$3,000,000” and inserting in place thereof the figures “$4,100,000”.  


Budget Amendment ID: FY2018-S3-548

EHS 548

Gavin Foundation and South Boston Collaborative Level Funding

Ms. Forry and Mr. Lewis moved that the proposed new text be amended in section 2, in item 4512-0200, by inserting the following: "provided further, that programs in substantial regulatory and contractual compliance shall receive not less than the same level of funding in fiscal year 2018 as received in fiscal year 2017”.


Budget Amendment ID: FY2018-S3-549-R1

Redraft EHS 549

Veterans' Outreach Centers

Messrs. Hinds, Cyr, Rush, McGee and Humason moved that the proposed new text be amended in section 2, in item 1410-0012, <w:t>by adding the following:- “provided further, that the department shall make a payment equal to the amount appropriated for each veterans’ outreach center funded by this item in fiscal year 2017; provided further, that each center receiving funds under this item shall report to the house and senate committees on ways and means not later than March 15, 2018 on: (i) the number of veterans served annually; (ii) the costs and types of programs, including evidence-based programs, offered to veterans; and (iii) a 5-year spending plan or outline that shall include a discussion of the implementation or further development of evidence-based programs and program evaluation"</w:t>


Budget Amendment ID: FY2018-S3-550-R1

Redraft EHS 550

LGBTQ Youth

Messrs. Cyr, Eldridge, Brownsberger, Lewis, Moore and McGee, Ms. Flanagan and Mr. Boncore moved that the proposed new text be amended in section 2, in item 4590-1507, <w:t xml:space="preserve">by inserting after the word " programs", in line 4, the following words:- "; provided, that the department of public health shall award not less than $500,000 for competitively procured grants to youth at-risk programs utilizing an evidence-based positive youth development model, including programs that serve lesbian, gay, bisexual, transgender, queer and questioning youth". </w:t>


Budget Amendment ID: FY2018-S3-553-R1

Redraft EHS 553

SIF Impact Study

Messrs. Boncore, Cyr, Keenan, Eldridge, Lewis, Moore and Brownsberger moved that the proposed new text be amended <w:t>by inserting after section 100 the following section:-</w:t>

“SECTION 100A. The department of public health shall evaluate the feasibility of supervised injection facilities to understand the public safety and health impacts of such interventions on communities and persons struggling with addiction.  The department shall consult with law enforcement, local health authorities, experts in the field of medicine, addiction, harm reduction and other entities including, but not limited to, the Massachusetts Medical Society and shall consult with domestic and international communities that have implemented such policies. The commissioner of public health shall release the findings of the feasibility study to the chairs of the joint committee on mental health, substance use and recovery, the chairs of the joint committee on public health, the chairs of the joint committee on the judiciary and the chairs of the senate and house committees on ways and means not later than March 1, 2018”.


Budget Amendment ID: FY2018-S3-554

EHS 554

South Boston En Accion

Ms. Forry moved that the proposed new text be amended in section 2, in item 4800-0038, by adding at the end thereof the following: “provided, that no less than $25,000 shall be expanded to South Boston en Acción (SBEA) for leadership development training; ESOL, STEM and basic computer skills instruction; English-Spanish immersion training and Spanish-English immersion training”; and in said item, by striking out the figures “$291,471,283” and inserting in place thereof the figures “$291,496,283”.


Budget Amendment ID: FY2018-S3-556

EHS 556

Nursing Home Residents Protection

Messrs. Montigny, Brownsberger and Tarr moved that the proposed new text be amended in section 2, in item 4000-0601, by adding at the end thereof the following:-  “and provided further, that no nursing home may reassign a patient's bed during a leave of absence eligible for reimbursement under this item."


Budget Amendment ID: FY2018-S3-558

EHS 558

Berkshire Opioid Abuse Prevention Collaborative

Mr. Hinds moved that the proposed new text be amended in section 2, in item 4512-0200, by adding at the end thereof the following:- "provided further that of the $1,000,000 from the Massachusetts Opioid Abuse Prevention Collaborative (MOAPC) grant program no less than $200,000 be allocated for the Berkshire Opioid Abuse Prevention Collaborative".


Budget Amendment ID: FY2018-S3-559

EHS 559

Preventing Patient Abuse and Death in Nursing Homes

Mr. Montigny moved that the proposed new text be amended by inserting, after section __, the following new section:-

SECTION __. Section 73 of chapter 111 of the General Laws, as appearing in the 2014 Official Edition, is hereby amended by striking out, in line 14, the word “fifty” and inserting in place thereof the following figure:- $20,965


Budget Amendment ID: FY2018-S3-560-R1

Redraft EHS 560

Combating "V.I.P. Syndrome" to Protect Health Care Integrity and Quality

Mr. Montigny moved that the proposed new text be amended <w:t>by inserting, after section xx, the following new section:-</w:t>

"SECTION 35A.  Chapter 111 of the General Laws is hereby amended by inserting after section 53H the following section:-

Section 53I.  (a) Notwithstanding any general or special law to the contrary, no health care provider shall knowingly or intentionally violate department rules and regulations adopted under this chapter, at the direct request of a patient, authorized caregiver or other interested person.  Any violation shall be documented and reported by the health care provider to the department within 72 hours.  The department may impose penalties including, but not limited to, a fine of up to $10,000 per violation or complaint to the relevant board of registration.  A health care provider who fails to report a violation, as so provided, may be subject to additional penalties up to $100,000 per violation.

(b)  Notwithstanding any general or special law to the contrary, a health care provider shall not knowingly or intentionally designate, mark, label or confer any special status unrelated to medical diagnosis, treatment or care to a patient due to socio-economic status or direct relationship to the health care provider.  The department may impose penalties including, but not limited to, a fine of up to $10,000 per violation or complaint to the relevant board of registration.

(c) A penalty assessed under this section shall not preclude the department from assessing fees for violations under this chapter.

(d) A health care provider reporting a violation pursuant to this section shall be afforded protection from retaliatory action in accordance with section 187 of chapter 149.

(e) All violations under this section shall be published in a clear and conspicuous manner on the department’s website.

(f) The commissioner may promulgate regulations to enforce this section."


Budget Amendment ID: FY2018-S3-561

EHS 561

Prostate Health Education Network

Ms. Forry and Mr. Cyr moved that the proposed new text be amended in section 2, in item 4590-0925, by inserting the following Language "Provided Further that not less than $100,000 be expended for the prostate Health Education Network, Incfor the purposes of providing education and awareness to the African American community on Prostate Cancer, its prevention, and treatment ".


Budget Amendment ID: FY2018-S3-562-R1

Redraft EHS 562

Preventing Death and Disability From Stroke

Messrs. Montigny, Rush and Moore, Ms. Gobi, Ms. O'Connor Ives and Mr. O'Connor moved that the proposed new text be amended in section 2, <w:t>by inserting after item 4513-1111 the following new item:-</w:t>

“4513-1121 For a statewide STOP stroke program; provided, that funds shall be expended for stroke treatment and ongoing prevention services; provided further, that the department of public health shall provide educational programming as part of the F.A.S.T. campaign on the signs and symptoms of stroke and stroke warning signs with a focus on communities that have the highest incidence of stroke, which shall not be used for personnel costs; provided further, that the department of public health shall provide quality improvement measures that align with the stroke consensus metrics by utilizing a nationally-recognized data set platform, and expand the statewide registry that compiles information and statistics on stroke care using confidentiality standards not less secure than a nationally-recognized data set platform, known as the stroke registry data platform; provided further, that the department shall expend funds to require all primary stroke service hospitals and emergency medical services' agencies to report data consistent with nationally-recognized guidelines on the treatment of individuals with confirmed stroke in the commonwealth; provided further, that funds shall be expended to oversee the operation and administration of designated primary stroke service hospital programs, established by 105 CMR 130.1400; provided further, that such funds shall be used to collect and analyze data from designated primary stroke service hospitals in the commonwealth and for the salary of a full-time staff who may be responsible for ensuring compliance with primary stroke service designation criteria and/or for data analysis……………………………………………………………………………… $630,000.”

and by inserting after section___the following new section:-

“SECTION X. Chapter 111 of the General laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after Section 51J the following 3 sections:-

Section 51K. Designation of acute stroke ready hospitals, primary stroke centers and comprehensive stroke centers.

The department shall designate hospitals that meet the criteria set forth in this Act as an acute stroke ready hospital, primary stroke center or comprehensive stroke center.

A hospital shall apply to the department for designation provided the hospital has been certified by The Joint Commission, American Heart Association or other department-approved, nationally recognized certifying body as an acute stroke ready hospital, primary stroke center or comprehensive stroke center.

Until the adoption of rules and regulations authorized by this subsection, the department shall designate primary stroke service hospitals as acute stroke ready hospitals capable of providing care previously denoted in regulations as primary stroke service care. The department shall promulgate such rules and regulations within 180 days of passage of this Act.

Until the department begins the designation of all three tiers of stroke facilities, hospitals may maintain primary stroke service designation utilizing the existing processes and criteria for a 6-month period. Primary stroke service hospitals at the time that the department begins the designation process shall be recognized as acute stroke-ready hospitals. After that time, all primary stroke service hospitals will be considered acute stroke-ready hospitals, regardless of additional capacity, until they apply for and receive a higher designation of primary stroke center or comprehensive stroke center.

Section 51L. Emergency medical services providers; assessment and transportation of stroke patients to designated stroke center.

All  regional EMS councils, as defined in section 1 of chapter 111C,  shall establish pre-hospital care protocols related to the assessment, treatment, transport and rerouting of stroke patients by licensed emergency medical services providers in this state to acute stroke ready hospitals, primary stroke centers and comprehensive stroke centers facilities.  Such protocols shall include plans for the triage and transport of suspected stroke patients, including, but not limited to, those who may have an emergent large vessel occlusion, to an appropriate facility, within a specified timeframe of onset of symptoms and additional criteria to determine which level of care is the most appropriate destination. EMS authorities will base their protocols on national recognized guidelines for transport of acute stroke patients.  Such protocols will also consider the capability of an emergency receiving facility to improve outcomes for those patients suspected, based on clinical severity, of having an emergent large vessel occlusion. The department shall promulgate regulations to address  protocols within 180 days of passage of this Act.

The department shall make available the list of designated stroke centers, including the identification of hospitals with continuous neurointerventional coverage, to the medical director of each licensed emergency medical services provider; shall maintain a copy of the list in the office designated within the department to oversee emergency medical services; and shall post a list of all designated stroke centers and the level of care to the department website. The department shall update the list of designated stroke centers at least annually.

Section 51M Continuous improvement of quality of care for stroke patients.

The department shall maintain a data oversight process which shall include:

(a) A Massachusetts stroke registry database that compiles information and statistics on stroke care which align with nationally recognized stroke measures.

(b) Hospitals designated by the department as acute stroke ready hospitals, primary stroke centers or comprehensive stroke centers shall utilize a nationally recognized data platform to collect the stroke data set which is required by the state and by the acute stroke ready hospitals, primary stroke centers or comprehensive stroke centers designating body.

(c) These data elements will be collected via the data registry platform and transmitted to the State for inclusion in the Massachusetts stroke registry.

(d) The department will convene a group of experts with input from key stroke stakeholders and professional societies, including, but not limited to, a representative from the American Stroke Association, the Massachusetts Neurologic Association, Society of Neurointerventional Surgery, Massachusetts Council of Community Hospitals, and Massachusetts College of Emergency Physicians, to form a state stroke advisory taskforce that will assist with data oversight, program management and advice regarding the stroke system of care. This task force will meet at least quarterly to review data and provide advice.”


Budget Amendment ID: FY2018-S3-563

EHS 563

Mattapan Integrative Care Partnership Program

Ms. Forry moved that the proposed new text be amended in section 2, in item 4510-0110, by adding at the end thereof the following: “provided, that not less than $50,000 shall be expended for the Mattapan Integrative Care Partnership Pilot program among the Mattapan Community Health Center, Mattahunt Community Center, Mattahunt Elementary School, and the Wheelock College Social Work Department for a behavioral health practice at the Mattapan Community Health Center and support a full time licensed social worker to bring mental health care to the community’s youth and to improve the coordination of care”


Budget Amendment ID: FY2018-S3-564

EHS 564

TADF Benefit

Mr. Tarr moved that the proposed new text be amended in section 2, in item 4403-2000, by striking the following words:-provided further, that notwithstanding any general or special law to the contrary, the department of transitional assistance shall calculate benefits provided under item 4403-2000, in the same manner as the previous fiscal year; provided further, that the department’s calculation of benefits shall not preclude the department from making eligibility or benefit changes that lead to an increase in eligibility or benefits, and inserting in place thereof the following words: "provided further, that notwithstanding any general or special law to the contrary the department of transitional assistance shall calculate benefits provided under item 4403-2000 in a manner that achieves fairness among all similar recipients, and that results in the most cost-effective provision of benefits and avoids hardships for recipients, taking into account all benefits to which they have access