Amendment ID: S2572-35
Amendment 35
Funding Violence Prevention Services through Medicaid
Mr. Crighton, Ms. Edwards and Messrs. Moore, Timilty, Brady, Payano and Pacheco move that the proposed new text be amended by adding the following new sections:-
SECTION XX. (a) As used in this section:
(A)(1) "Community violence" means intentional acts of interpersonal violence committed in public areas by individuals who are not family members or intimate partners of the victim;
(2) "Community violence prevention and intervention services" means trauma-informed, supportive and psychotherapeutic services provided by a prevention professional and/or a certified violence prevention professional, within or outside of a clinical setting, for the purpose of promoting improved health outcomes and positive behavioral change, preventing injury recidivism and reducing the likelihood that individuals who are victims of community violence will commit or promote violence themselves. "Community violence prevention and intervention services" may include, but are not limited to, the provision of community-based services and/or the provision of hospital-based services, provided such hospital service providers ensure continuity of care after completion of hospital-based programming by delivering services in the community and/or maintaining referral relationships with providers of community-based violence prevention and intervention services; outreach and ongoing case management by violence prevention professionals who are certified or seeking certification as defined in subsection (c) or other team member outreach; comprehensive assessment and treatment planning; in-home or community-based trauma-specific therapy, such as cognitive behavior strategies; integrated access to educational, employment and housing support services, coordinated access to Medication Assisted Treatment, psychopharmacology, and other healthcare services; stakeholder engagement and education. Community violence prevention and intervention services are person-centered, team-based interventions that may also include peer support and counseling, mentorship, conflict mediation, crisis intervention, patient education or screening services to victims of community violence, and collaboration or integration with other rehabilitative or social services. “Community violence prevention and intervention services” are intensive, longitudinal interventions responsive to individual risks and needs.
(3)"Interpersonal violence" means the intentional use of physical force or power against other persons by an individual or small group of individuals;
(4)"Prevention professional" has the same meaning as described by the National Uniform Claim Committee (NUCC), or its successor, under NUCC Code Number 405300000X; and
(5)"Certified violence prevention professional" means a prevention professional who meets all of the conditions specified in subsection (c) of this section.
(B)(1) The secretary of the executive office of health and human services shall establish coverage of community violence prevention and intervention services that meet the definition described in section XX under Medicaid. The secretary shall seek any federal approvals necessary to implement this section, including, but not limited to, a state plan amendment through the federal Centers for Medicare and Medicaid Services. This subsection shall be implemented only to the extent that federal financial participation is available, and any necessary federal approvals have been obtained.
The Secretary of the executive office of health and human services shall provide regulatory and administrative oversight to Medicaid covered community violence prevention and intervention services. EOHHS shall qualify providers of community violence prevention and intervention services that meet the definition described in section XX. This shall not preclude EOHHS from purchasing other services from community-based providers with the intention of reducing violence.
Minimally, services shall be made available to any Medicaid beneficiary who has: (A) Received medical treatment for an injury sustained as a result of an act of community violence, or (B) been referred by local and/or state police as being at risk for engagement in violence or of becoming a victim of violence; or (C) been referred by a certified or licensed health care provider, correctional institution, school or school officer, social services provider or state agency; or, D) has been exposed to community violence and seeks assistance from any of the above or directly from a community violence prevention and intervention provider, and is subsequently determined to be at risk and in need of community violence prevention and intervention services.
(2)The secretary shall utilize the Violence Prevention Federal Reinvestment Trust Fund to expand the purchase of community violence prevention and intervention services, as defined above.
(3)The secretary shall treat selected, existing violence prevention expenditures, including selected expenditures by the Safe and Successful Youth Initiative for community violence prevention and intervention services with providers it deems as Medicaid qualified, as certified public expenditures and ensure that all federal financial participation claimed on such expenditures are directed into the Violence Prevention Federal Reinvestment Trust.
(4)Massachusetts Medicaid will claim Federal Financial Participation on all annual expenditures from the Violence Prevention Federal Reinvestment Trust and will ensure that all federal revenues are directed into the Trust.
(5)The provisions of this subsection shall be implemented only to the extent permitted by federal law.
(C) Certification as a certified violence prevention professional shall involve completing at least six months of full-time experience in community violence prevention, completing a training and certification program for certified violence prevention professionals, approved in accordance with subsection (d) of this section and maintaining such certification, and completing at least six hours of continuing education every two years. Any violence prevention professional employed by a provider of community violence prevention and intervention services shall be considered to be “seeking certification” until such time certification is obtained. Violence prevention professionals in the continuous employ of a provider of community violence prevention and intervention services for twelve or more months shall be considered certified through work experience. Professionals so certified shall also be required to complete at least six hours of continuing education every two years to maintain such certification.
(D)No later than 9 months after the passage of this legislation, the executive office of health and human services shall approve at least three training and certification programs for certified violence prevention professionals. Such programs shall be aligned with national best practices regarding violence prevention and intervention work for strategies such as street outreach, targeted trauma-informed care, hospital-based violence intervention, or cognitive behavioral interventions. Training should include at least thirty-five hours of initial training and at least six hours of continuing education every two years. The executive office of health and human services should convene a committee of community and hospital-based service providers and other key experts to determine the content and requirements for training.
(1)Any entity that employs or contracts with a certified violence prevention professional to provide community violence prevention services shall:
(a) Maintain documentation that each certified violence prevention professional has met all of the conditions described in subsection (c) of this section; and
(b) Ensure that each certified violence prevention professional is providing community violence prevention services in compliance with any applicable standards of care, rules, regulations and governing law of the state or federal government.
(2)No person, unless certified as a violence prevention professional pursuant to this section, may use the title "certified violence prevention professional" or make use of any title, words, letters, abbreviations or insignia indicating or implying that he or she is a certified violence prevention professional.
(3)Nothing in this section shall alter the scope of practice for any health care professional.
SECTION XX. To enhance violence prevention services and decrease the disproportionate impact of violence in historically marginalized populations, there shall be established and set up on the books of the Commonwealth a separate fund to be known as the Violence Prevention Federal Reinvestment Trust Fund, in this section called the fund. There shall be credited to the fund revenues equal to the amount of federal financial participation received by the Commonwealth's General Fund for expenditures for evidence-based and/or evidence-informed violence prevention services and any other federal reimbursements, grants, premiums, gifts, interest or other contributions from any source received that are specifically designated to be credited to the fund. The secretary of health and human services shall be the trustee of the fund.
The secretary may expend, without further appropriation: not more than $25 million per year from the fund to expand and support evidence-based and/or evidence-informed violence prevention programming. For the purpose of accommodating timing discrepancies between the receipt of revenues and related expenditures, the fund may incur expenses, and the comptroller shall certify for payment, amounts not to exceed the most recent revenue estimate as certified by the MassHealth director, as reported in the state accounting system. 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 and shall be available for expenditure in subsequent fiscal years.
The secretary shall report annually, on or before January 1, 2026 to the house and senate committees on ways and means and the house and senate chairs of the joint committee on public safety and homeland security, the joint committee on public health and the joint committee on education on the revenue and expenditure activity within the trust fund.