Consolidated Amendment "D" to H4600

Public Health/Mental Health & Disability

Fiscal Note: $15,700,000

Amendments 28, 48, 50, 53, 61, 63, 89, 91, 93, 95, 104, 132, 133, 136, 140, 141, 150, 170, 173, 174, 258, 262, 273, 274, 275, 294, 369, 398, 587, 590, 591, 617, 619, 620, 695, 772, 868, 913, 914, 916, 920, 921, 926, 966, 969, 971, 1127, 1130, 1131, 1132, 1133, 1135, 1136, 1149, 1151, 1158, 1160, 1389, 1451, 1453, are recategorized from Public Health to Constitutional Officers and State Administration

Amendments 58 and 704 are recategorized from Mental Health & Disability Services to Constitutional Officers and State Administration

Amendments from Public Health: 20, 49, 62, 69, 71, 128, 129, 139, 151, 168, 185, 190, 201, 202, 203, 204, 245, 283, 293, 304, 322, 336, 337, 338, 340, 344, 402, 419, 423, 439, 451, 491, 492, 502, 503, 537, 538, 545, 548, 549, 554, 559, 560, 579, 593, 599, 602, 605, 626, 631, 632, 634, 637, 638, 643, 689, 691, 700, 711, 715, 727, 729, 736, 743, 746, 767, 774, 780, 782, 785, 805, 812, 828, 834, 844, 860, 862, 869, 871, 895, 907, 908, 923, 924, 928, 931, 940, 943, 959, 973, 977, 988, 999, 1023, 1065, 1070, 1084, 1099, 1124, 1141, 1142, 1150, 1155, 1208, 1218, 1223, 1244, 1252, 1257, 1276, 1285, 1308, 1331, 1337, 1342, 1344, 1353, 1354, 1355, 1361, 1366, 1368, 1375, 1380, 1406, 1414, 1419, 1423, 1426, 1429, 1439, 1459, 1488, 1493

Amendments from Mental Health & Disability Services: 6, 8, 83, 131, 354, 399, 418, 447, 480, 482, 483, 486, 507, 520, 528, 639, 659, 777, 786, 855, 877, 995, 1004, 1007, 1106, 1128, 1219, 1222, 1225, 1227, 1243, 1260, 1269, 1293, 1297, 1407, 1428, 1430

Mr. Michlewitz of Boston and others move to amend House, No. 4600, in section 2, in item 4120-4000, by striking out the figure “$13,395,864” and inserting in place thereof the following figure:- $13,895,864

And further amend said section 2, in item 4510-0100, by inserting after the words “27D of chapter 111 of the General Laws” the following words:- ; provided further, that not less than $350,000 shall be expended to Hope and Comfort, Inc. to support operations and hygiene product acquisition

And further amend said item by striking out the figure “$47,394,484” and inserting in place thereof the following figure:- $47,744,484

And further amend said section 2, in item 4510-0110, by inserting after the words “as codified at 42 U.S.C. section 254c(f)(1)” the following words:- ; provided further, that not less than $100,000 shall be expended for the continuation of a comprehensive substance abuse and narcotic use reduction program at a federally qualified health center located in South Boston; provided further, that not less than $50,000 shall be expended to the Lynn Community Health Center for the operation of the Recuperative Care Center; provided further, that not less than $75,000 shall be expended to Volunteers in Medicine – Berkshires, Inc. to cover costs of expanding services in Pittsfield and Great Barrington and to continue to provide care for income-eligible residents; provided further, that not less than $400,000 shall be expended for the North End Waterfront neighborhood health center; provided further, that not less than $200,000 shall be expended for the Public Health Institute of Western Massachusetts to support the 413Cares centralized database of community services in western Massachusetts; provided further, that $50,000 shall be expended to the Mattapan Community Health Center, Inc. for staff retention to sustain services and meet community needs; provided further, that not less than $125,000 shall be expended for infrastructure and operational upgrades related to expanding access to dental care services at the Geiger Gibson Community Health Center in the Dorchester section of the city of Boston; provided further, that not less than $250,000 shall be expended for NEW Health - Charlestown for the purpose of operating and maintaining treatment of substance use disorder; and provided further, that not less than $150,000 shall be expended to Harbor Health Services, Inc. for the planned expansion of its Plymouth Community Health Center

And further amend said item by striking out the figure “$3,348,660” and inserting in place thereof the following figure:- $4,748,660

And further amend said section 2, in item 4512-0103, by striking out the figure “$30,500,000” and inserting in place thereof the following figure:- $32,000,000

And further amend said section 2, in item 4512-0200, by inserting after the words “other payer” the following words:- ; provided further, that not less than $175,000 shall be expended to Volunteers of America of Massachusetts, Inc. to address the crisis of co-occurring substance abuse and mental health disorders through expansion of clinical services and programming for men in recovery with co-occurring diagnoses at Hello House; provided further, that not less than $100,000 shall be expended for the operation of the Gavin Foundation, Inc. behavioral health continuum of substance use care to provide comprehensive treatment for individuals suffering from substance use disorder and other behavioral health challenges; provided further, that not less than $200,000 shall be expended for the Joseph Nee South Boston Collaborative Center for substance use disorder programming; provided further, that not less than $100,000 shall be expended to the police department in the city of Lynn for its behavioral health unit; provided further, that not less than $100,000 shall be expended for Community Servings, Inc. for the purposes of providing medically tailored meals to persons battling chronic illnesses and workforce training programs to those recovering from addiction; provided further, that not less than $50,000 shall be expended for the Railroad Street Youth Project based in the town of Great Barrington; provided further, that not less than $200,000 shall be expended for the operation of The Dimock Center’s behavioral health continuum of care to provide comprehensive treatment for individuals suffering from substance use disorder and other behavioral health challenges, address workforce challenges and reduce barriers to care

And further amend said item by striking out the figure “$193,502,031” and inserting in place thereof the following figure:- $194,427,031

And further amend said section 2, in item 4512-0204, by inserting after the word “overdose” the following words:- ; provided further, that not less than $25,000 shall be expended for the Merrimack Valley Prevention and Substance Abuse Project, Inc., for resources, community outreach and programs in the Merrimack valley

And further amend said item by striking out the figure “$1,231,718” and inserting in place thereof the following figure:- $1,256,718

And further amend said section 2, in item 4512-0205, by inserting after the word “services” the following words:- ; provided, that not less than $75,000 shall be expended for the purposes of the operation of Resources for Recovery Inc., formerly known as the Dennis Messing Memorial Foundation, located in the Hyde Park section of the city of Boston; provided further, that not less than $50,000 shall be expended for addiction treatment services provided by the greater New Bedford community health center; provided further, that not less than $50,000 shall be expended to the city known as the town of Braintree for Braintree Community Partnership on Substance Use; provided further, that not less than $200,000 shall be expended for One Life at a Time, Inc., located in the city known as the town of Braintree, for the facilitation of access to sober living programs and job training services for people in recovery and associated operational costs; provided further, that not less than $150,000 shall be expended for continued capital improvements to the Cambridge community center and for the expansion of their community-based behavioral health program; provided further, that not less than $25,000 shall be expended to the Michael J. Dias Foundation, Inc. to hire an assistant director of operations to oversee program aspects of their 3 recovery homes; provided further that no less than $250,000 shall be expended to Harbor Health Services, Inc. for a grant program to prevent and treat addiction to opioid and related substances; provided further, that not less than $2,000,000 shall be expended for RIZE Massachusetts Foundation, Inc. to assist in their work to end the opioid epidemic in the commonwealth; provided further, that not less than $50,000 shall be expended for RICKY, Inc. in the town of Norwood for the delivery of substance use recovery care materials to homeless individuals with substance use and mental health disorders within the greater Boston region; provided further, that not less than $25,000 shall be expended to GAAMHA, Inc. in the city of Gardner to support capital improvements to their residential substance use disorder services facility; provided further, that not less than $175,000 shall be expended for Self Esteem Boston Educational Institute, Inc. direct service and provider training programs; and provided further, that not less than $35,000 shall be expended for A Healthy Lynnfield

And further amend said item by striking out the figure “$100,000” and inserting in place thereof the following figure:- $3,085,000

And further amend said section 2, in item 4513-1005, by inserting after the words “due to restrictions applied federally” the following words:- ; provided further, that not less than $1,660,000 of such funds shall be expended for Action for Boston Community Development, Inc. to continue services previously funded by said Title X funding

And further amend said section 2, in line item 4513-1020, by striking out the words:- ; provided further, that not later than September 4, 2024, not less than $12,000,000 shall be expended from this item for early intervention staffing recovery payments necessary to address the staffing crisis and restore early intervention staffing and service hours through hiring, rehiring and retention of clinical and support staff across the early intervention system; provided further, that said funds shall be used to support increased salaries, wages and benefits for early intervention clinicians and support staff; provided further, that said funds may be used to cover supervision, training, non-billable time and other on-boarding cost directly associated with the hiring of new early intervention clinicians and support staff; provided further, that said staffing recovery payments shall be distributed by the department as payment vouchers to all vendors of certified early intervention programs; provided further, that said payments shall be made on a proportional basis, calculated using the most recent early intervention child counts of the department; provided further, that not later than October 3, 2024, the department of public health shall submit a report to the joint committee on children, families and persons with disabilities, the secretary of administration and finance and the house and senate committees on ways and means detailing the total funds expended to certified early intervention vendors from said staffing recovery payments; provided further, that not less than $1,548,522 of said staffing recovery payments shall be designated as a health equity allocation to provide additional targeted relief for early intervention programs serving predominately low-income cities and towns to address the health disparities exacerbated by the 2019 novel coronavirus; provided further, that said health equity allocation shall be distributed by the department to all vendors of certified early intervention programs using a weighted formula that includes the area median household income of the cities and towns in each of the early intervention program catchment areas and the current early intervention child census figure for each city or town; provided further, that the department shall provide a higher cost per child allocation for programs based on a weighted average income figure to ensure a higher allocation for the early intervention programs serving the lower income cities and towns; provided further, that the department shall develop the health equity allocation formula in consultation with the Massachusetts Early Intervention Consortium, Inc.; and provided further, that not later than November 1, 2024, the commissioner of public health shall submit a report to the joint committee on children, families and persons with disabilities, the executive office for administration and finance and the house and senate committees on ways and means detailing the total funds expended to certified early intervention vendors and early intensive behavioral intervention vendors from this item

And further amend said section 2, in item 4513-1027, by inserting after the word “services” the following words:- ; and provided further, that not less than $400,000 shall be expended for the expansion and operation of Hey Sam, the text-based mental health support line tailored specifically to youth and young adults in the commonwealth, and for youth mental health community education, outreach, and communications

And further amend said item by striking out the figure “$1,000,000” and inserting in place thereof the following figure:- $1,400,000

And further amend said section 2, in item 4513-1098, by inserting after the word “violence” the following words:- ; provided further, that not less than $100,000 shall be expended to Survivors Say, Inc. for direct support services to survivors and victims of both high-profile tragedies and other traumas and crimes

And further amend said item by striking out the figure “$200,000” and inserting in place thereof the following figure:- $400,000

And further amend said item by striking out the figure “$300,000” and inserting in place thereof the following figure:- $600,000

And further amend said section 2, in item 4513-1112, striking out the figure “$150,000” and inserting in place thereof the following figure:- $250,000

And further amend said item by inserting after the words “lupus database” the following words:- ; provided further, that not less than $475,000 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; provided further, that not less than $25,000 be expended for the purposes of the operation of VITfriends Vitiligo Support Group, Inc. located in the Hyde Park section of the city of Boston; provided further, that not less than $150,000 shall be expended for the ALS Association  to provide care services for individuals suffering with amyotrophic lateral sclerosis; provided further, that not less than $100,000 shall be expended for the operation of the Cranberry Health Research Center at the University of Massachusetts Dartmouth

And further amend said item by striking out the figure “$13,186,405” and inserting in place thereof the following figure:- $14,036,405

And further amend said section 2, in line item 4513-1136, by inserting after the words “or less” the following words:- ; provided further, that not less than $25,000 shall be expended for domestic violence outreach for the Cape Verdean Association in the city of Brockton

And further amend said item by striking out the figure “75,558,041” and inserting in place thereof the following figure:- $75,583,041

And further amend said section 2, in line item 4513-2020, by inserting after the words “underserved areas of the commonwealth” the following words:- ; provided further, that not less than $50,000 shall be expended to the city of Methuen for the purchase of Care Solace software

And further amend said item by striking out the figure “$6,544,687” and inserting in place thereof the following figure:- $6,594,687

And further amend said section 2, in line item 4590-0250, by inserting after the words “center programs” the following words:- ; provided further, that not less than $50,000 shall be expended for the North Quabbin Community Coalition, Inc.

And further amend said item by striking out the figure “$22,254,866” and inserting in place thereof the following figure:- $22,304,866

And further amend said section 2, in line item 4590-1503, by inserting after the words “screening program” the following words:- ; provided further, that not less than $50,000 shall be expended to the Black Springfield COVID-19 Coalition; provided further, that not less than $50,000 shall be expended to the Martin Luther King Jr. Family Services, Inc.; provided further, that not less than $25,000 shall be expended to the Boys & Girls Club Family Center, Inc.; provided further, that not less than $10,000 shall be expended to Heart2Heart lactation and wellness in Black maternal health

And further amend said item by striking out the figure “$11,857,689” and inserting in place thereof the following figure:- $11,992,689

And further amend said section 2, in line item 4590-1507, by inserting after the words “and questioning youth” the following words:- ; provided, that the department shall award not less than $1,500,000 to the Alliance of Massachusetts YMCAs, Inc. which shall be distributed between the alliance’s member organizations to support educational programming for youth; provided further, that the department shall award not less than $600,000 to the YWCA organizations, which shall be distributed equally between the Alliance of YWCAs member organizations; provided further, that not less than $100,000 shall be expended to the Randolph community programs department in the town of Randolph for continuation of a full-time town social worker; provided further, that not less than $60,000 shall be expended to the Cape Cod Young Men's Christian Association, Inc. for the purpose of designing, permitting, and planning the Upper Cape YMCA in the town of Falmouth; provided further, that the department shall award not less than $250,000 to the Big Sister Association of Greater Boston, Inc.; provided further, that not less than $200,000 shall be expended for the Big Brothers Big Sisters of Eastern Massachusetts for its Mentor 2.0 program; provided further, that not less than $2,000,000 shall be expended to the Massachusetts Alliance of Boys & Girls Clubs, Inc.; provided further, that not less than $75,000 shall be expended for the Watertown Boys’ & Girls’ Club, Inc. for capital improvements; provided further, that not less than $75,000 shall be expended to assist in programming efforts for the South Coast LGBTQ+ Network in New Bedford; provided further, that not less than $200,000 shall be expended to the Possible Zone to implement an innovative pathways program in clean energy/advanced manufacturing for high students in grades 10 to 12, creating equitable opportunities for underserved student populations; provided further, that not less than $50,000 shall be expended for Sueños Basketball, Inc. to support the recreational, social, and health benefits the league provides to low-income youth in the city of Lawrence; provided further, that not less than $25,000 shall be expended to Day Dreaming Organization, Inc. to support baseball programming and youth mentoring in the city of Lawrence; provided further, that not less than $20,000 shall be expended for the Methuen Youth Basketball Association Inc to support the recreational, social, and health benefits the league provides to low-income youth in the city of Methuen; provided further, that not less than $100,000 shall be expended to College Bound Dorchester, Inc. for administration of alternative education and other services for at-risk youth; and provided further, that not less than $15,000 shall be expended for the YMCA of the North Shore, Inc. for the Haverhill YMCA capital campaign project for the construction of a new state of the art facility in the city of Haverhill

And further amend said item by striking out the figure “$7,200,000” and inserting in place thereof the following figure:- $12,470,000

And further amend said section 2, in item 5042-5000, by inserting after the words “group care” the following words:- ; provided further, that not less than $10,000 shall be expended for KyleCares, Inc. for mental health awareness programming in high schools and colleges; provided further, that not less than $50,000 shall be expended for YouthConnect to provide community-based mental health services to high-risk youth and their families residing in the East Boston community; provided further, that not less than $200,000 shall be expended for the BIRCh Center to continue the operations of the school-based behavioral health technical assistance center; provided further, that not less than $250,000 shall be expended for The NAN Project to increase mental health awareness and suicide prevention

And further amend said item by striking out the figure “$130,490,885” and inserting in place thereof the following figure:- $131,000,885

And further amend said section 2, in item 5046-0000, by inserting after the word “measured” the following words:- ; provided further, that not less than $50,000 shall be expended for a grant to the Massachusetts Chapter of the National Association of Social Workers, Inc., to provide assistance in connecting consumers to licensed clinical social workers through the Therapy Matcher program

And further amend said item by striking out the figure “$619,175,134” and inserting in place thereof the following figure:- $619,225,134

And further amend said Section 2, in line item 5911-1003, by inserting after the words “Congress, Inc.” the following:- ; provided further, that not less than $100,000 shall be expended to the Special Olympics Massachusetts, Inc.; provided further, that not less than $150,000 shall be expended for Operation House Call at Arc Massachusetts, Inc. 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; provided further, that not less than $25,000 shall be expended to Latham Centers, Inc., to address urgent technology upgrades that will improve security, programs, and support services for children and adult residents with Prader-Willi syndrome

And further amend said item by striking out the figure “$100,375,397” and inserting in place thereof the following figure:- $100,650,397

And further amend said Section 2, in line item 5911-2000, by inserting after the words “by need” the following:- ; provided further, that not less than $50,000 shall be expended for the Mission Hill Bus Link

And further amend said item by striking out the figure “$40,017,443” and inserting in place thereof the following figure:- $40,067,443

And further amend said section 2, in item 5920-2000, by striking the words “provided, that annualized funding shall be expended for turning 22 clients who began receiving services in fiscal year 2022 under item 5920-5000 of section 2 of chapter 24 of the acts of 2021” and inserting in place thereof the following words:- provided, that annualized funding shall be expended for turning 22 clients who began receiving services in fiscal year 2023 under item 5920-5000 in section 2 of chapter 126 of acts of 2022

And further amend said section 2, in item 5920-3010, by striking the words “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 inserting in place thereof the following:- 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 provided further, that $50,000 shall be expended for The Martin Richard Foundation for programming for disadvantaged youth in the city of Boston

And further amend said item by striking out the figure “$10,957,296” and inserting in place thereof the following figure:- $11,007,296

And further amend the bill in section 45 by inserting after the word “treatment”, in line 752, the following words:- and prevention.

And further amend the bill in said section 45 by inserting after the figure “111”, in line 754, the following words:- or for the prevention of HIV.

And further amend the bill by inserting after section 45 the following section:-

SECTION 45A. Said chapter 94C is hereby further amended by inserting after section 18C the following section:-

Section 18D. (a) For the purposes of this section, the term “opioid antagonist” shall have the same meaning as provided in section 19B.

(b)(1) A practitioner issuing a prescription for an opioid contained in Schedule II of section 3 shall inform the patient of the potential adverse risks of the prescribed opioid and the availability of an opioid antagonist.

(2) Where applicable, the practitioner shall inform, pursuant to paragraph (1), a designee of the patient, or for a patient who is a minor, the patient’s parent or guardian, if at least 1 of the following conditions is present: (i) the patient is prescribed an opioid that individually or in the aggregate with other medications is more than 50 morphine milligram equivalents per day; (ii) the patient is prescribed any dose of an opioid when a benzodiazepine has been prescribed in the last 30 days or is anticipated to be prescribed at the visit; or (iii) the patient presents with an increased risk of overdose, including, but not limited to, a history of overdose or substance use disorder.

(c) A pharmacist dispensing an opioid contained in Schedule II of section 3 shall inform the patient of the potential adverse risks of the prescribed opioid and shall offer to dispense an opioid antagonist to the patient, and where applicable, to a designee of the patient, or for a patient who is a minor, to the patient’s parent or guardian.

And further amend the bill by inserting after section 47 the following section:-

SECTION 47A. Section 53 of said chapter 111, as appearing in the 2022 Official Edition, is hereby amended by striking out the seventh sentence and inserting in place thereof the following sentence:- Such rules and regulations shall require a dialysis unit to have on duty sufficient direct care nursing personnel to ensure that all patients undergoing dialysis have nursing care available at all times provided by registered nurses, licensed practical nurses and other staff trained in chronic dialysis at a ratio of at least 1 direct care nursing personnel to every 3 patients; provided, that such rules and regulations may include circumstances where the department may waive nursing personnel ratio requirements.

And further amend the bill by inserting after section 74A, as inserted by Consolidated Amendment A, the following 2 sections:

SECTION 74B. Item 4590-1507 of section 2 of chapter 28 of the acts of 2023, as amended by section 184 of chapter 77 of the acts of 2023, is hereby further amended by striking out the words “provided further, that not less than $100,000 shall be expended for repairs for the Northern Berkshire YMCA complex located in the city of North Adams” and inserting in place thereof the following words:- provided further, that not less than $100,000 shall be expended to the city of North Adams to complete renovations to the building located on 22 Brickyard court and such funds shall be made available until June 30, 2025.

SECTION 74C. Said item 4590-1507 of said section 2 of said chapter 28, as appearing in section 184 of said chapter 77, is hereby further amended by striking out the words “provided further, that not less than $50,000 shall be expended for capital improvements to the former state armory building in the city of North Adams for the benefit of the Northern Berkshire Youth Basketball program” and inserting in place thereof the following words:- provided further, that not less than $50,000 shall be expended to the North Adams Youth Basketball program located in the city of North Adams for capital improvements and such funds shall be made available until June 30, 2025.