Budget Amendment ID: FY2019-S4-620-R1

Redraft EHS 620

Protecting Medically Complex and Fragile Children

Ms. Friedman, Messrs. Rodrigues, Feeney and Eldridge, Ms. L'Italien, Messrs. Brownsberger, Lewis, Crighton, Pacheco, Cyr, Moore, Welch, Barrett, Tarr, O'Connor, Ross and DiDomenico moved that the proposed new text be amended in section 2, in item 4000-0601, by inserting after section 4 the following section:-

“SECTION 4A. Chapter 12C of the General Laws, as appearing in the 2016 Official Edition, is hereby amended by adding the following section:-

Section 24. The center, in conjunction with MassHealth, shall prepare a biennial report related to the pediatric patients requiring continuous skilled nursing care, as defined in 101 CMR 350.02 and 130 CMR 403.402. The report shall include, but not be limited to: (i) the number of pediatric patients requiring continuous skilled nursing care; (ii) the average, median and total number of continuous skilled nursing hours authorized by MassHealth per day, week, month and year; (iii) the average, median and total number of authorized continuous skilled nursing hours actually delivered per day, week, month and year; (iv) whether there are any distinguishing characteristics of patients that do not have authorized continuous skilled nursing hours filled; (v) any identifiable gaps in the number of filled authorized hours based on patient acuity or other factors; (vi) the proportion of utilization to authorization of service hours in comparison to patient acuity; (vii) the number of nurses providing continuous skilled nursing care to more than 1 patient at a time and the proportion of utilization to authorization of said patients; (viii) the number of nurses who contract with MassHealth to provide continuous skilled nursing care and whether the number is sufficient to fill all authorized continuous skilled nursing hours; (ix) the training, experience and education level of the nurses who contract with MassHealth to provide continuous skilled nursing care; and (x) a review of the adequacy of the reimbursement rates for continuous skilled nursing, as defined in 101 CMR 350.04(2), and a comparison of those rates with the median reimbursement rate paid to all nurses in the commonwealth.

Not later than January 1 of each odd numbered year, the report shall be filed with the secretary of  health and human services, the clerks of the senate and the house of representatives, the joint committee on health care financing, the joint committee on public health and the senate and house committees on ways and means. The center shall make the report publicly available on its website.”.