Consolidated Amendment #B to H.5150

Consolidated Amendment "B" to H5150

Health and Human Services/Public Health/Elder Affairs/Mental Health and Disability Services

Fiscal Note: $8,017,000

Amendments 83 and 705 are recategorized from Public Health to Labor and Economic Development;

Amendment 735 is recategorized from Public Health to Public Safety.

Amendments from Health and Human Services: 93, 95, 120, 140, 187, 216, 227, 261, 262, 263, 273, 285, 287, 325, 362, 389, 419, 422, 461, 462, 463, 464, 465, 476, 484, 486, 487, 493, 520, 528, 531, 538, 553, 561, 563, 579, 583, 606, 610, 612, 615, 616, 623, 628, 634, 701, 773

Amendments from Public Health: 6, 12, 18, 31, 32, 71, 90, 106, 112, 115, 116, 121, 122, 129, 154, 158, 159, 179, 180, 205, 209, 219, 238, 247, 248, 254, 259, 260, 272, 278, 282, 296, 298, 303, 312, 316, 341, 354, 358, 424, 427, 430, 431, 432, 433, 434, 458, 469, 483, 508, 519, 527, 529, 532, 568, 573, 590, 637, 638, 639, 642, 652, 680, 681, 709, 716, 730, 734, 738, 749, 767, 771, 772

Amendments from Elder Affairs: 20, 75, 102, 104, 118, 148, 228, 267, 324, 344, 394, 405, 413, 438, 507, 656, 670

Amendments from Mental Health & Disability Services: 2, 21, 24, 27, 33, 53, 55, 61, 63, 78, 105, 130, 297, 377, 442, 445, 447, 450, 457, 518, 564, 575, 592, 625, 647, 715, 750

Mr. Michlewitz of Boston and others move to amend section 2, in item 4000-0005, by inserting after the words “administration of these programs” the following words: - ; provided further that not less than $50,000 shall be expended to the South End Community Center’s Community Youth Corp Program; provided further, that not less than $25,000 shall be expended for the Merrimack Valley Public Safety Youth Center in the city of Lawrence;

And further amend said item by striking out the figure “10,000,000” and inserting in place thereof the figure:- 10,075,000;

And further amend said section 2, in item 4000-0300, by inserting after the words “base rates” the following words:- , and shall make a supplemental payment not less than $3,000,000 to any pediatric chronic and rehabilitation long-term care hospital in the commonwealth, above base rates, to compensate for high-complexity pediatric care;

And further amend said section 2, in item 4000-0300, by inserting after the words “General Fund on June 30, 2021” the following words:- ; provided further, that, for fiscal year 2021 and beyond, in establishing Medicaid reimbursement rates for Medicaid eligible inpatient services provided by chronic disease rehabilitation hospitals located in the commonwealth that serve solely children and adolescents, the executive office of health and human services shall apply a multiplier of 1.5 times the hospital’s fiscal year 2020 current inpatient per diem rate in fiscal year 2021; provided further, that for fiscal year 2022 and beyond, such rates of reimbursement shall not be lower than the rates in effect for the prior fiscal year; provided further, that the Mass Health supplemental payment advance of $1,500,000 made to Franciscan Hospital for Children, Inc. in December of 2019 shall be defined as a grant; provided further, that not less than $30,000 shall be expended for a western Massachusetts academic medical center with a neonatal intensive care unit within an acute hospital in Hampden county for the purpose of supporting, enhancing and expanding programming associated with its rooming-in program for infants and mothers with opioid use disorder; provided further, that not less than $125,000 shall be expended for the purposes defined in item 1599-2009 in section 2 of chapter 182 of the acts of 2008;

And further amend said item by striking out the figure “113,534,922” and inserting in place thereof the figure:- 116,689,922;

And further amend said section 2, in item 4000-0500, by inserting after the words “chronic health conditions” the following words:- ; provided further that not less than $500,000 shall be appropriated to an organization that is a 501(c)(3) MassHealth Accountable Care Organization solely governed by Federally Qualified Health Centers to support the ongoing work of its partnership with the commonwealth’s Primary Care Association and Federally Qualified Health Centers participating in these shared efforts to advance and sustain telehealth efforts targeted at reducing and eliminating health disparities;

And further amend said item by striking out the figure “5,942,777,046” and inserting in place thereof the figure:- 5,943,277,046;

And further amend said section 2, in item 4000-0700, by inserting after the words “training purposes” the following words:- ; provided further, that not less than $30,000 shall be appropriated to Elder Services of Cape Cod and the Islands, Inc. for the purchase of PPE and other equipment to prevent the spread of disease;

And further amend said item by striking out the figure “3,372,845,665” and inserting in place thereof the figure:- 3,372,875,665;

And further amend said section 2, in item 4003-0122, by adding the following words:- ; provided further, that not less than $25,000 shall be expended to Casa Dominicana, Inc. to assist in citizenship education, citizenship application assistance, ESL classes, and computer training for low-income adults; and provided further, that not less than $25,000 shall be expended to the Lawrence Family Development, Inc. to assist in citizenship education, citizenship application assistance, ESL classes and computer training for low-income adults;

And further amend said item, by striking out the figure “1,526,575” and inserting in place thereof:- the figure 1,576,575;

And further amend said section 2, in item 4110-1000, by adding the following words:- ; provided further, that not less than $75,000 shall be expended for the Talking Information Center, Incorporated to provide human voiced broadcasts of local news, articles, and items of interest to visually impaired and otherwise disabled listeners;

And further amend said item, by striking out the figure “7,174,905” and inserting in place thereof the figure:- 7,249,905;

And further amend said section 2, by inserting after item 4512-0204 the following item:-

4512-0205For grants and contracts with substance use programs to provide comprehensive prevention, intervention and recovery services; provided that, not less than $25,000 shall be expended for The Gavin Foundation Inc. to adapt residential treatment facilities in response to the 2019 novel coronavirus pandemic and to support treatment and recovery services; provided further, that not less than $10,000 shall be expended for the Joseph Nee Collaborative Center for substance abuse treatment and recovery programming; provided further, that not less than $75,000 shall be expended for Self Esteem Boston Educational Institute Inc.’s direct service and provider training programs; provided further, that not less than $10,000 shall be expended for substance abuse and addiction awareness and education efforts at the Woburn Coalition Against Substance Abuse; provided further that, not less than $10,000 shall be expended for substance abuse and addiction awareness and education efforts at the Reading Coalition Against Substance Abuse, Inc.; provided further, that not less than $32,000 shall be expended for the town of Natick to continue their efforts to fight opiate abuse; provided further, that not less than $50,000 shall be expended for Baystate Health Eastern Region for a grant program to prevent and treat addiction to opioid and related substances; and provided further, that not less than $100,000 shall be expended for the city known as the town of Braintree’s community partnership on substance abuse………………………………..……$312,000;

And further amend said section 2, in item 4512-0206, by adding the following words:- provided that, not less than $50,000 shall be expended for the 10 Boys and 10 Girls Initiative to promote community based harm reduction; and provided further, that not less than $30,000 shall be expended to the town of Topsfield for COVID-19 related expenses;

And further amend said section by striking out the figure “4,700,000” and inserting in place thereof the figure:- 4,780,000;

And further amend said section 2, in item 4512-0500, by adding the following words:- ; provided, that not less than $50,000 shall be expended for the Forsyth Institute's Center for Children's Oral Health to expand its ForsythKids programming focused on children and adolescents and to explore the emerging association between oral health status and academic performance;

And further amend said item by striking out the figure “1,734,246” and inserting in place thereof the figure: - 1,784,246;

And further amend said section 2, in item 4513-1020, by striking the figure “31,259,772” and inserting in place thereof the figure: - 32,259,772;

And further amend section 2, in item 4513-1026, by adding the following words:- ; and provided further, that not less than $25,000 shall be expended for The Samaritans of Fall River/New Bedford, Inc.;

And further amend said item by striking out the figure “6,095,372” and inserting in place thereof the figure:- 6,120,372;

And further amend said section 2, in item 4513-1130, by inserting after the words “involved families” the following words:- ; provided further, that not less than $50,000 shall be expended for the Katie Brown Educational Program, Inc. 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; provided further, that not less than $10,000 shall be expended for the purpose of providing additional resources to police officers for domestic violence investigations in the town of Salisbury;

And further amend said item by striking out the figure “45,851,295” and inserting in place thereof the figure:- 45,911,295;

And further amend said section 2, in item 4513-1131, by inserting after the words “or less” the following words:- ; provided further, that not less than $50,000 shall be expended for the operation of the Cranberry Health Research Center at the University of Massachusetts at Dartmouth; and provided further, that not less than $50,000 shall be expended for the Harmony House in the city of Chicopee;

And further amend said item by striking out the figure “1,000,000” and inserting in place thereof the figure:- 1,100,000;

And further amend said section 2, in item 4590-0250, by inserting after the words “health center programs” the following words:- ; provided further, that not less than $20,000 shall be expended for the funding of a public health nurse to assist in COVID-19 contact tracing, vaccination site planning and preparation and mobilization for COVID-19 vaccine distribution planning in the town of Abington;

And further amend said item by striking out the figure “13,773,583” and inserting in place thereof the figure:- 13,793,583;

And further amend said section 2, in item 4590-0915, by inserting after the words “public health hospitals” the following words:- ; provided further, that Tewksbury hospital shall maintain the same number of beds in fiscal year 2021 as was maintained in fiscal year 2020; provided further, that the Pappas Rehabilitation Hospital for Children shall maintain not less than 120 beds for clients in its inpatient setting to the extent feasible within the appropriation; and provided further, that not less than $75,000 shall be expended for the Pappas Rehabilitation Hospital for Children Summer Program;

And further amend said item by striking out the figure “165,977,256” and inserting in place thereof the figure:- 166,052,256;

And further amend said section 2, in item 4590-1506, by inserting after the words “law enforcement agencies” the following words: - ; and provided further, that not less than $50,000 shall be expended for Springfield Partners, Inc. for the AWAKE program in Springfield, to provide comprehensive youth development and violence prevention services to at-risk youth;

And further amend said item by striking out the figure “3,000,000” and inserting in place thereof the figure:- 3,050,000;

And further amend said section 2, in item 4590-1507, by inserting after the words “questioning youth” the following words:- ; provided further, that not less than $325,000 shall be expended for the YWCA organizations, which shall be distributed equally between the Alliance of YWCA’s member organizations; provided further, that not less than $900,000 shall be expended for the Alliance of Massachusetts YMCAs, Inc. which shall be distributed between the alliance’s member organizations; provided further, that not less than $25,000 shall be expended for the Lawrence Sueños Basketball Summer League to support the recreational, social, and health benefits the league provides to low-income youth in the City of Lawrence; and provided further, that not less than $100,000 shall be expended for the Big Brothers Big Sisters of Massachusetts Bay Mentor 2.0 program;

And further amend said item by striking out the figure “1,900,000” and inserting in place thereof the figure:- 3,250,000;

And further amend said section 2, in item 5042-5000, by inserting after the words “settings” the following words:- ; provided, that funds shall be expended to provide services to address behavioral health needs arising from the impact of COVID-19, including the impact of remote learning, and services to assist school districts with behavioral health support; provided further, that not less than $50,000 shall be allocated to the Massachusetts Association for Mental Health, Inc. to partner with the BIRCh Center to develop a plan for establishment of a school based behavioral health technical assistance center;

And further amend said item, by striking out the figure “94,530,000” and inserting in place thereof the figure:- 94,580,000;

And further amend said section 2, in item 5046-0000, by inserting after the words “outcomes measured” the following words:- ; provided further, that not less than $50,000 shall be expended on a grant to the Massachusetts Chapter of the National Association of Social Workers, for the purpose of providing assistance in connecting consumers to licensed clinical social workers through the Therapy Matcher program; provided further, that not less than $100,000 shall be expended to the International Institute of New England, Inc. for culturally and linguistically appropriate mental health services for immigrants and refugees who have experienced torture and trauma;

And further amend said item, by striking out the figure “500,048,605” and inserting in place thereof the figure:- 500,198,605;

And further amend said section 2, in item 5095-0015, by adding the following words:- ; and provided further, that not less than $25,000 shall be expended to Melrose Wakefield Healthcare, Inc., for direct costs associated with the 2019 novel coronavirus treatment;

And further amend said item, by striking out the figure “229,635,223” and inserting in place thereof the figure:- 229,660,223;

And further amend said section 2, in item 5911-1003, by adding the following words:- ; and provided further, that regional employment collaboratives shall be funded at not less than the amount funded in fiscal year 2020;

And further amend said section 2, in item 5920-2025, by inserting after word “need” the following words:- ; and provided further, that not less than $50,000 shall be expended for the Community Access to the Arts, Inc. in the town of Great Barrington;

And further amend said item, by striking out the figure “239,513,699” and inserting in place thereof the figure:- 239,563,699;

And further amend said section 2, in item 9110-1604, by inserting after the words “fiscal year 2022” the following words:- ; and provided further, that no less than $10,000 shall be expended for the installation of automated external defibrillators at the Liberty Hill Senior Housing Complex in the city of Marlborough;

And further amend said item by striking out the figure “7,753,422” and inserting in place thereof the figure:- 7,763,422;

And further amend said section 2, in item 9110-1635, by inserting after the words “distribution of the funds” the following words:- ; provided further, that not less than $75,000 shall be expended for the Central Boston Elder Services, Inc. for the Technology for Seniors pilot program;

And further amend said item by striking out the figure “17,433,295” and inserting in place thereof the figure:- 17,508,295;

And further amend said section 2, in item 9110-1900, by inserting after the words “share program” the following words:- ; and provided further, that not less than $375,000 shall be expended for home delivered meals;

And further amend said item by striking out the figure “9,708,808” and inserting in place thereof the figure:- 10,083,808;

And further amend said section 2, in item 9110-9002, by inserting after the words “$12 per-elder” the following words:- ; provided further, that not less than $25,000 shall be expended for a food storage and distribution center at the Allen Avenue School in North Attleboro to serve the senior population of the North Attleboro Council on Aging; provided further, that not less than $75,000 shall be expended for the Andover Senior Center in the town of Andover for improvements to its facility; provided further, that not less than $25,000 shall be expended for education and enrichment programs at the Council on Aging in the city of Lawrence; provided further, that not less than $50,000 shall be expended for the cost associated with care and services provided at Whipple Senior Center in the town of Weymouth; provided further, that not less than $100,000 shall be expended for the town of Holbrook to conduct a feasibility study for the design and construction of a new senior center;

And further amend said item by striking out the figure “$17,000,000” and inserting in place thereof the figure:- 17,275,000;

And further amend the bill by inserting, after section 13A, inserted by Consolidated “A”, the following section:-

SECTION 13B. Chapter 29 of the General Laws is hereby amended by inserting after section 2IIIII, inserted by section 13A, the following section:-

Section 2JJJJJ. (a) There shall be established and set up on the books of the commonwealth a separate fund known as the Nonpublic Ambulance Service Reimbursement Trust Fund to be administered by the secretary of health and human services. There shall be credited to the fund: (i) all revenues generated from the funds collected pursuant to subsection (b) of section 67A of chapter 118E; (ii) an amount equal to any federal financial participation revenues claimed and received by the commonwealth for eligible expenditures made from the fund; (iii) any revenue from appropriations or other money authorized by the general court and specifically designated to be credited to the fund; and (iv) interest earned on any money in the fund. Amounts credited to the fund shall be expended without further appropriation. Money remaining in the fund at the end of a fiscal year shall not revert to the General Fund and shall be available for expenditure in subsequent fiscal years. No expenditure shall be made from said fund which shall cause said fund to be in deficit at the close of a fiscal year.

(b) Money in the fund shall be expended for Medicaid payments to nonpublic ambulance services defined in subsection (a) of section 67A of chapter 118E.

(c) Revenues generated from clauses (i) and (ii) of the second sentence of subsection (a) shall be expended exclusively for nonpublic ambulance services defined in subsection (a) of section 67A of chapter 118E and shall not be used to replace payment commitments between the nonpublic ambulance services and the commonwealth. The expenditures shall be established by the executive office of health and human services in a manner consistent with the requirements and conditions of federal financial participation under 42 U.S.C. 1396b(w) and 42 C.F.R. 433.68, including the prohibitions against hold harmless provisions as defined under 42 U.S.C. 1396b(w)(4) and 42 C.F.R. 433.68(f) and shall be made only under federally-approved payment methods and consistent with federal funding requirements and all federal payment limits as determined by the secretary of health and human services. Federal financial participation shall be sought in a manner that achieves the maximum amount of federal revenue such that the assessment amount equals the state share of the qualifying Medicaid ambulance service payments related to this section.

(d) The schedule of payment amounts to be established and distributed by the executive office of health and human services under this section shall be developed in a manner that: (i) promotes the provider capacity, access and quality management needs of the Medicaid program as those needs are determined by the secretary of health and human services; (ii) considers the cost of services delivered by providers for which the providers are not fully reimbursed or otherwise compensated, including, but not limited to, free care and services delivered in good faith reliance on authorization; (iii) considers existing Medicaid reimbursement rates; (iv) closes the gap between Medicaid rates and average commercial rates; and (v) is proportional, to the extent possible, to the respective ambulance assessed amounts paid by each nonpublic ambulance service relative to this section. The executive office of health and human services shall consult with stakeholders, including the Massachusetts Ambulance Association, Incorporated, in the development and implementation of the payments. In order to accommodate timing discrepancies between the receipt of revenue and related expenditures, the comptroller may certify for payment amounts not to exceed the most recent revenue estimates as certified by the secretary of health and human services to be transferred, credited or deposited under this section.

(e) Annually, not later than September 30, the executive office of health and human services shall file a report with the house and senate committees on ways and means which shall include: (i) a detailed accounting of all money transferred, credited or deposited into and from the fund; (ii) the reasons for any unspent amount in the fund; and (iii) an analysis of the respective uniform assessment paid by nonpublic ambulance services, defined in section 67A of chapter 118E.

And further amend the bill by inserting, after section 14, the following 2 sections:-

SECTION 14A. Section 9 of chapter 46 of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by inserting after the word “home”, in line 23, the first time it appears, the following words:- or who is enrolled in a PACE program as defined in 42 U.S.C. 1396u-4;

SECTION 14B. Said section 9 of said chapter 46, as so appearing, is hereby further amended by striking out, in lines 25 and 26, the words “or nursing home” and inserting in place thereof:- , nursing home or a PACE program as defined in 42 U.S.C. 1396u-4;

And moves to further amend the bill by adding, after section 23, the following section:-

SECTION 23A. Chapter 118E of the General Laws is hereby amended by inserting after section 67 the following section:-

Section 67A. (a) The following words shall, unless the context clearly requires otherwise, have the following meanings:

“Ambulance service”, as defined in section 1 of chapter 111C.

“Executive office”, the executive office of health and human services.

“Gross patient service revenue”, the total dollar amount of nonpublic ambulance charges for services rendered in a fiscal year.

“Nonpublic ambulance assessed charges”, gross patient service revenue attributable to all patients less bad debt, charity care and payer discounts.

“Nonpublic ambulance service”, ambulance services which are not provided by a city or town, county, district or other governmental body and are licensed pursuant to section 6 of chapter 111C.

“Total nonpublic ambulance service assessment amount”, an amount not less than 1-quarter of 1 per cent lower than the maximum limit for a provider assessment pursuant to 42 C.F.R. 433.68(f), inclusive of an annual amount of $500,000; provided, that the annual amount of $500,000 shall be for administrative costs of the executive office.

(b) A nonpublic ambulance service’s liability to the Nonpublic Ambulance Service Reimbursement Trust Fund, established in section 2JJJJJ of chapter 29, shall equal the product of: (i) the ratio of its nonpublic ambulance assessed charges to all nonpublic ambulance services’ nonpublic ambulance assessed charges statewide; and (ii) the total nonpublic ambulance service assessment amount. Annually, before October 1, the executive office shall establish each nonpublic ambulance service’s liability to said fund using the best data available as determined by the executive office and shall update each nonpublic ambulance service’s liability to said fund as updated information becomes available. The executive office shall specify, by regulation an appropriate mechanism for interim determination and payment of a nonpublic ambulance service's liability to the fund. A nonpublic ambulance service's liability to the fund shall, in the case of a transfer of ownership, be assumed by the successor in interest to the nonpublic ambulance service.

(c) There shall be imposed in each fiscal year a uniform assessment upon the nonpublic ambulance assessed charges of all nonpublic ambulance services. Such uniform assessment shall not be implemented unless and until the executive office receives notice of federal matching funds approval from the federal Centers for Medicare and Medicaid Services.

(d) All nonpublic ambulance services, regardless of payment model, shall be subject to the uniform assessment pursuant to subsection (c), including, but not limited to, those nonpublic ambulance services in fee-for-service and managed care arrangements. The uniform assessment shall be set as a percentage of the nonpublic ambulance assessed charges of each such nonpublic ambulance service and, for each fiscal year, the percentage shall be equal to the ratio of: (i) the total nonpublic ambulance service assessment amount for the same fiscal year; to (ii) the total nonpublic ambulance assessed charges in the same fiscal year and as the amount of those charges is determined by the executive office under this section. A nonpublic ambulance service’s liability to the fund shall, in the case of a transfer of ownership, be assumed by the successor in interest to the nonpublic ambulance service.

(e) The executive office shall establish an appropriate mechanism for enforcing each nonpublic ambulance service’s liability to the fund in the event that a nonpublic ambulance service does not make a scheduled payment to the fund.

And further amend the bill by inserting, after section 32, the following 4 sections:-

SECTION 32A. Section 226 of chapter 139 of the acts of 2012 is hereby amended by striking out the figure “2021”, inserted by section 15 of chapter 142 of the acts of 2019, and inserting in place thereof the following figure- 2023.

SECTION 32B. Section 4 of chapter 19 of the acts of 2020 is hereby amended by striking out the words “January 31, 2021” and inserting in place thereof the following words:- July 31, 2021.

SECTION 32C. Section 5 of said chapter 19 is hereby amended by striking out the words “December 31, 2021” and inserting in place thereof the following words:- October 31, 2022.

SECTION 32D. Section 6 of said chapter 19 is hereby amended by striking out the words “January 31, 2021” and inserting in place thereof the following words:- July 31, 2021.

And further amend the bill by adding, after section 44E, as added by Consolidated “A”, the following section:-

SECTION 44F. The department of public health shall issue a report detailing the rules, regulations, guidance and best practices in place as of the effective date of this act to prevent the transmission of the 2019 novel coronavirus, also known as COVID-19, from patients being discharged from hospital facilities to nursing homes, skilled nursing facilities, rehabilitation centers and other congregate care facilities. The report shall include summaries and references to the rules, regulations, guidance and best practices on: (i) testing patients, including the frequency of testing; (ii) testing staff, including the frequency of testing; (iii) protocols related to non-COVID-19 hospitalizations, including discharge procedures; (iv) protocols related to COVID-19 hospitalizations, including discharge procedures; (v) personal protective equipment for patients over 70 years of age, including for staff who directly treat said patients; and (vi) precautions for the transfer of patients from a hospital facility to a nursing home, skilled nursing facility, rehabilitation center or other congregate care facility.

No later than February 1, 2021, the department of public health shall make the report publicly available on the department’s website and submit the report to the clerks of the house and senate, the joint committee on public health and the joint committee on elder affairs.