Consolidated Amendment "D" to H4000
Public Health, Mental Health & Disability
Fiscal Note: $16,475,000
Amendment 1043 is recategorized from Transportation to Labor & Economic Development
Amendments from Public Health: 45, 56, 71, 97, 156, 179, 188, 190, 192, 196, 209, 234, 238, 239, 250, 262, 269, 274, 276, 286, 287, 293, 294, 320, 347, 380, 384, 431, 438, 453, 499, 502, 504, 505, 508, 510, 527, 534, 573, 586, 587, 607, 623, 629, 641, 646, 661, 679, 697, 708, 713, 716, 721, 754, 778, 791, 798, 799, 802, 806, 815, 844, 871, 886, 887, 918, 960, 969, 972, 979, 1014, 1028, 1029, 1039, 1040, 1049, 1064, 1072, 1073, 1077, 1080, 1097, 1110, 1121, 1132, 1146, 1149, 1151, 1156, 1164, 1170, 1178, 1182, 1183, 1185, 1192, 1283, 1285, 1286, 1294, 1298, 1318, 1329, 1332, 1333, 1358, 1394, 1438, 1439, 1457, 1495, 1502, 1503, 1506, 1507, 1508, 1549, 1553, 1558, 1573, 1576, 1580, 1582, 1585, 1603, 1605, 1630, 1637, 1645
Amendments from Mental Health & Disability Services: 43, 46, 62, 227, 259, 314, 388, 394, 427, 436, 493, 496, 596, 666, 691, 718, 737, 824, 828, 846, 885, 893, 939, 977, 1015, 1027, 1096, 1098, 1231, 1237, 1250, 1261, 1341, 1344, 1433, 1434, 1455, 1468, 1471, 1528, 1550, 1597, 1606
Mr. Michlewitz of Boston and others move to amend House, No. 4000, in section 2, in item 4125-0100, by inserting after the words “hearing” the following words:- ; provided, that not less than $100,000 shall be expended to New England Homes for the Deaf, Inc. to provide services to residents and train all staff in American sign language
And further amend said item by striking out the figure “$10,616,666” and inserting in place thereof the following figure:- $10,716,666
And further amend said section 2, in line item 4510-0100, by inserting after the words, “Public Law 111-152” the following words:- ; and provided further, that not less than $350,000 shall be expended to support operations and hygiene product acquisition for Hope and Comfort, Inc.
And further amend said item by striking out the figure “$38,263,168” and inserting in place thereof the following figure:- $38,613,168
And further amend said section 2, in line item 4510-0110, by inserting after the words, “section 254c(f)(1)” the following words:- ; provided further, that not less than $50,000 shall be expended to the Lowell Community Health Center, Inc.’s residency program for primary care doctors in the city of Lowell to be used for housing stipends for residents; 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; provided further, that not less than $100,000 shall be expended for the Mattapan Community Health Center, Inc. to support staff retention and recruitment for physicians and dentists to ensure the delivery of patient-centered care in Mattapan, Dorchester, Roxbury and surrounding neighborhoods in the city of Boston; provided further, that not less than $100,000 shall be expended for Codman Square Health Center, Inc. to support the purchase and operation of a mobile health unit to provide primary care, behavioral health, maternal health and substance use disorder treatment in underserved neighborhoods of Dorchester and surrounding areas in 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; provided further, that not less than $400,000 shall be expended to the North End Waterfront neighborhood health center provided further, that not less than $125,000 shall be expended for infrastructure and operational upgrades related to expanding access to dental care and primary care services at Geiger Gibson Community Health Center in the Dorchester section of the city of Boston; provided further, that not less than $15,000 shall be expended to the High Point Treatment Center for the purpose of providing outpatient substance use disorder and mental health services, and programs aiding in men’s mental health care; provided further, that not less than $100,000 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 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 $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
And further amend said item by striking the words “and provided further, that not less than $1,000,000 shall be expended for the establishment of a Massachusetts gender affirming care access program to provide support to federally qualified health centers specializing in gender affirming care” and inserting in place thereof the following words:- and provided further, that not less than $1,000,000 shall be transferred from this item to the Affirming Health Care Trust Fund established in section 2K of chapter 111 of the General Laws, inserted by section 22 1/2 of this act
And further amend said item by striking out the figure “$10,398,660” and inserting in place thereof the following figure:- $11,838,660
And further amend said section 2, in line item 4512-0200, by inserting after the words “other payer” the following words:- ; provided further, that not less than $25,000 shall be expended for the South Shore Peer Recovery Center to run programs dedicated to creating a safe and supportive space for individuals and families affected by substance use disorders, including but not limited to peer support groups, recovery coaching, family education and community outreach services; 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 $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; provided further, that not less than $35,000 shall be expended to the police department in the city of Lynn for its behavioral health unit; provided further, that not less than $25,000 shall be expended to the Newmarket Business Association, Inc. to support the hiring of a strategy and planning project manager for the Recover Boston program; provided further, that not less than $25,000 shall be expended for the Boston Bulldogs Running Club to support their mission of providing a safe community for those affected by drug and alcohol addiction; provided further, that not less than $100,000 shall be expended for the operation of Gavin Foundation Inc.’s 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 Collaborative Center for substance use disorder programming
And further amend said item by striking out the figure “$194,452,031” and inserting in place thereof the following figure:- $194,987,031
And further amend said section 2, in line item 4512-0205, by inserting after the word “services” the following words:- ; provided, that not less than $25,000 shall be expended to Baystate Health Eastern Region for a grant program to prevent and treat addiction to opioid and related substances; provided further, that not less than $10,000 shall be expended to support the Bartlett house at Housing Support, Inc.; provided further, that not less than $175,000 shall be expended to Self Esteem Boston for direct service and provider training programs; provided further, that not less than $100,000 shall be expended for office-based addiction and opioid treatment, a program of the Greater New Bedford Community Health Center; provided further, 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 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 $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 $250,000 shall be expended to Harbor Health Services 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 continued capital improvements to the Cambridge community center and for the expansion of their community-based behavioral health program
And further amend said item by striking out the figure “$100,000” and inserting in place thereof the following figure:- $2,985,000
And further amend said section 2, in item 4512-2022, by inserting after the word “distribution” the following words:- ; provided further, that not less than $30,000 shall be expended for improvements to the Abington public health department
And further amend said item by striking out the figure “$9,232,015” and inserting in place thereof the following figure:- $9,262,015
And further amend said section 2, in item 4513-1005, by inserting after the words “applied federally" the following words:- ; provided further, that not less than $1,660,000 shall be allocated to Action for Boston Community Development, Inc. to continue services previously funded by Title X funding
And further amend said section 2, in item 4513-1020, by striking the words “provided further, that 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 costs 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, 2025, 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 3, 2025, 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:- ; provided further, that funds shall be used for suicide prevention services, including, but not limited to, the operation and expansion of Hey Sam, the text-based mental health support line tailored specifically to youth and young adults in the commonwealth, and youth mental health community education, outreach and communications; 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 youth mental health community education, outreach and communications
And further amend said item by striking out the figure “$400,000” and inserting in place thereof the following figure:- $800,000
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 “$500,000” and inserting in place thereof the following figure:- $600,000
And further amend said section 2, in item 4513-1112, by inserting after the words “block grant funds” 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 Forsyth kids 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 $100,000 shall be expended for the operation of the cranberry health research center at the university of Massachusetts – Dartmouth; provided further, that not less than $25,000 shall be expended for the purposes of the operation of VITfriends 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 $250,000 shall be expended to the Duchenne program at the University of Massachusetts medical school to advance clinical care, research and innovation for patients with complex disorders affecting the human nervous system
And further amend said item by striking the word “funds”, the second time it appears, and inserting in place thereof the following figure:- $4,297,295
And further amend said item by striking out the figure “$12,457,534” and inserting in place thereof the following figure:- $13,557,534
And further amend said section 2, in item 4513-1136, by inserting after the words “25,000 or less” the following words:- ; provided further, that not less than $25,000 shall be expended for capital improvements to the Berkshire Dream Center for Hope House; provided further, that not less than $25,000 shall be expended for the Elizabeth Freeman Center, Inc.; provided further, that not less than $150,000 shall be expended to Portal to Hope Corp. for a community-based domestic violence program that includes a teens-at-risk project for the communities of Everett, Lynn, Malden, Medford and Winthrop; provided further, that not less than $25,000 shall be expended to the Cape Verdean Association for domestic violence outreach in the city of Brockton; provided further, that not less than $50,000 shall be expended 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
And further amend said item by striking out the figure “$74,786,841” and inserting in place thereof the following figure:- $75,061,841
And further amend said section 2, in item 4590-0250, by inserting after the words “center programs” the following words:- ; provided further, that not less than $40,000 shall be expended for the North Quabbin Community Coalition, Inc.; provided further, that not less than $30,000 shall be expended to Lunenburg public schools to create enhancements and supplement existing guidance counseling, mental health and special education delivery
And further amend said item by striking out the figure “$22,123,088” and inserting in place thereof the following figure:- $22,193,088
And further amend said section 2, in item 4590-1503, by inserting after the words “screening program” the following words:- ; provided further, that not less than $25,000 shall be expended for Junie’s Place, Inc. to provide comprehensive, no-cost grief support services to families enduring the profound loss of a child, infant or pregnancy or experiencing a stillbirth
And further amend said item by striking out the figure “$13,149,400” and inserting in place thereof the following figure:- $13,174,400
And further amend said section 2, in line item 4590-1507, by inserting after the words “questioning youth” the following words:- ; provided, 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 $25,000 shall be expended to Methuen Youth Basketball Association, Inc. to enhance youth mentorship initiatives, develop robust sports programming and strengthen violence prevention efforts aimed at promoting teamwork, personal development and community engagement among Methuen youth; provided further, that said programming shall prioritize underserved youth and promote life skills that support academic success and leadership; 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 $1,500,000 shall be expended to the Alliance of Massachusetts YMCAs, Inc. that 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 $200,000 shall be expended to the Boys and Girls Clubs of MetroWest, Inc. for window replacement; provided further, that not less than $50,000 shall be expended for upgrades to a pedestrian crossing at the Milford youth center and other renovations or improvements; provided further, that not less than $25,000 shall be expended to Awake Youth Violence Prevention; provided further, that not less than $50,000 shall be expended to the Black Springfield COVID-19 Coalition; provided further, that not less than $25,000 shall be expended to Parent Villages, Inc. youth outreach center; provided further, that not less than $450,000 shall be expended to the Big Brother Big Sisters of Eastern Massachusetts; provided further, that not less than $200,000 shall be expended to The Possible Zone to implement an innovative pathways program in clean energy and advanced manufacturing for high schoolers in grades 10 through 12 across the city of Boston creating equitable opportunities for underserved student populations; provided further, that not less than $150,000 shall be expended to the Mildred C. Hailey development and youth center for staffing, operations, programming, resources, stipends, supplies and events that support youth and young adult residents of the Mildred C. Hailey development; provided further, that not less than $600,000 shall be expended 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 Big Brothers Big Sisters of Western Massachusetts Inc. to support programs and services provided in Berkshire, Franklin and Hampden counties; provided further, that not less than $75,000 shall be expended to assist in programming efforts for the Southcoast LGBTQ Network, Inc. in New Bedford; provided further, that not less than $25,000 shall be expended to Friends and Mentors, Inc. for costs associated with their at-risk youth mentoring programming in the city of Brockton; and provided further, that not less than $20,000 shall be expended to the town of Randolph for purposes of continued funding for the town’s enhanced social services program
And further amend said item by striking out the figure “$7,081,500” and inserting in place thereof the following figure:- $12,651,500
And further amend said section 2, in line item 5042-5000, by inserting after the word “location” the following words:- ; provided further, that not less than $75,000 shall be expended for Shrewsbury Youth and Family Services in the town of Shrewsbury to provide mental health services in the commonwealth; provided further, that not less than $75,000 shall be expended to Boston Community Pediatrics to support the Integrated Behavioral Health program; provided further, that not less than $250,000 shall be expended to The Nan Project to increase mental health awareness and suicide prevention; provided further, that department case manager staffing levels shall not be reduced below fiscal year 2025 case manager staffing levels
And further amend said item by striking out the figure “$128,586,476” and inserting in place thereof the following figure:- $128,986,476
And further amend said section 2, in line item 5046-0000, by inserting after the words “year 2025” the following words:- ; provided further, that not less than $50,000 shall be expended to the Malden police department to support mental health emergency crisis response in Malden, including, but not limited to, funding for a mental health clinician, trainings for officers in de-escalation, negotiation, integrating communications, assessment, and tactics (ICAT) and other non-lethal response techniques and additional resources; provided further, that not less than $25,000 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; provided further, that not less than $100,000 shall be expended for the behavioral health unit for the Dracut-Tyngsborough-Tewksbury-Chelmsford- Billerica police departments to support mental health emergency crisis response in these 5 communities, including, but not limited to, funding for a mental health clinician, trainings for officers in de-escalation, negotiation, integrating communications, assessment, and tactics (ICAT) and other non-lethal response techniques and additional resources; provided further, that department case manager staffing levels shall not be reduced below fiscal year 2025 case manager staffing levels
And further amend said item by striking out the figure “$661,933,895” and inserting in place thereof the following figure:- $664,608,895
And further amend said section 2, in item 5095-0015, by inserting after the words “closed facility” the following words:- provided further, that not less than $50,000 shall be expended to improve the mental health rooms at the Cape Cod and Islands community health center in Pocasset
And further amend said item by striking the figure “$376,149,057” and inserting in place thereof the following figure:- $376,199,057
And further amend said section 2, in item 5911-1003, by inserting after the words "any such transfer" the following words:- ; provided further, that not less than $150,000 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; provided further, that not less than $125,000 shall be expended for Latham Centers, Inc. to address urgent technology upgrades to security, programs and support services for children and adult residents with complex disabilities; provided further, that not less than $100,000 shall be expended for the city of Everett for the increase of accessibility to services for neurodivergent residents and their families; provided further, that not less than $50,000 shall be expended for Community Teamwork Inc. for the purpose of operating programs promoting children's behavioral health and educational success
And further amend said item by striking out the figure “$105,945,417” and inserting in place thereof the following figure:- “$106,370,417”
And further amend said section 2, in item 5911-2000, by inserting after the words “by need” the following words:- ; and provided further, that not less than $20,000 shall be expended for the town of Great Barrington for south county connector to support microtransit services in Berkshire county
And further amend said item by striking out the figure “$47,172,062” and inserting in place thereof the following figure:- “$47,192,062”
And further amend said section 2, in item 5920-3000, by inserting after the word “supports” the following words:- ; provided, that not less than $25,000 shall be expended for Friendship Home, Inc. to provide programming for individuals with developmental disabilities and their families, including, but not limited to, quality respite care, social and recreational programs and family support services in a safe and caring environment
And further amend said item by striking out the figure “$123,925,257” and inserting in place thereof the following figure:- “$123,950,257”
And further amend the bill by inserting after section 22 the following section:-
SECTION 22½. Chapter 111 of the General Laws is hereby amended by inserting after section 2J the following section:-
Section 2K. (a) As used in this section, the term “gender-affirming health care services” shall, unless the context clearly requires otherwise, mean all supplies, care and services of a medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, rehabilitative or supportive nature relating to the treatment of gender dysphoria.
(b) There shall be established and set up on the books of the commonwealth an expendable trust account known as the Affirming Health Care Trust Fund. The fund shall be administered by the commissioner. The fund shall be credited with: (i) appropriations or other money authorized by the general court and specifically designated to be credited to the fund; (ii) funds from public or private sources, including, but not limited to, gifts, grants, donations, rebates and settlements; (iii) interest earned on amounts in the fund; and (iv) any funds provided from other sources.
(c) Amounts credited to the fund shall be expended, without further appropriation, for gender-affirming health care services, including at institutions over which the commissioner has supervision and control pursuant to section 69E; provided, that the commissioner may also expend money in the fund to cover costs of medical malpractice liability and general liability insurance for health care providers involved in the provision of gender-affirming health care services and to support research relating to LGBTQ+ health promotion and gender-affirming health care services. The unexpended balance in the fund at the end of the fiscal year shall remain available for expenditure in subsequent fiscal years. No expenditure from the fund shall cause the fund to be in a deficit at any point.
(d) Annually, not later than October 1, the department shall report to the clerks of the house of representatives and the senate, the house and senate committees on ways and means and the joint committee on health care financing on the fund’s activity. The report shall include, but shall not be limited to: (i) money received by the fund; (ii) anticipated amounts to be deposited into the fund for the forthcoming fiscal year; (iii) projections for expenditures in the forthcoming fiscal year; (iv) details of all expenditures from the fund; and (v) results from any research efforts supported by the fund.
And further amend the bill by striking out the words “SECTION X”, inserted by Further #348, and inserting in place thereof the following words:- SECTION 67A.
And further amend the bill by inserting after section 67A, inserted by Further #348, the following section:-
SECTION 67B. (a) There shall be established a special legislative commission, pursuant to section 2A of chapter 4 of the General Laws, to conduct a comprehensive investigation and study into the future of the Pappas Rehabilitation Hospital for Children, as designated in chapter 87 of the acts of 2016, formerly known as the Massachusetts hospital school. The investigation and study shall include, but shall not be limited to, a review of the hospital’s finances, programs, pediatric services and infrastructure.
(b) The special legislative commission shall be comprised of: the chairs of the joint committee on public health, who shall serve as co-chairs; 1 member appointed by the president of the senate; 1 member appointed by the speaker of the house of representatives; the commissioner of the department of public health, or their designee; the commissioner of the department of elementary and secondary education, or their designee; the commissioner of the division of capital asset management and maintenance, or their designee; and 6 members to be appointed by the governor, 1 of whom shall be recommended by the select board of the town of Canton, 1 of whom shall be the parent of a current patient at the Pappas Rehabilitation Hospital for Children, 1 of whom shall be a member of the Massachusetts Nurses Association currently employed at the Pappas Rehabilitation Hospital for Children, 1 of whom shall be a member of the Service Employees International Union currently employed at the Pappas Rehabilitation Hospital for Children, 1 of whom shall be a pediatrician licensed to practice medicine in the commonwealth and 1 of whom shall be a person with experience in health care finance and management.
(c) Notwithstanding any general or special law to the contrary, services provided to patients of the Pappas Rehabilitation Hospital for Children shall not be reduced or eliminated, nor shall the Pappas Rehabilitation Hospital for Children be closed or consolidated with any other facility until the completion of the report pursuant to subsection (d).
(d) The special legislative commission shall submit a report of its findings and recommendations, if any, to the clerks of the house of representatives and the senate not later than December 31, 2026.