Amendment #1612 to H5500

Expanding Access to Elder Community Options Program through Optimized Funding

Ms. Bowen of Beverly moves to amend the bill in section 2 by inserting after item 9110-0600 the following item:

"9110-XXXX For health care services provided to MassHealth members who are older adults eligible for community-based waiver services; provided, that such services shall be provided to members participating in a new MassHealth waiver established during calendar year 2026 titled “Limited Frail Elder Waiver” and approved under 1915(c) of the Social Security Act; provided further, that the waiver shall serve as a pathway to, and be operated in coordination with, the “Frail Elder Waiver” that is enabled in item 9110-0600; provided further, that no expenditures from this item shall be authorized until after a Limited Frail Elder Waiver program is approved; provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years; provided further, that the financial eligibility requirements shall be less restrictive than the Frail Elder Waiver and shall leverage state policy flexibilities clarified by CMS State Medicaid Director Letter SMD #21 004 which permit states to tailor financial eligibility rules for Home- and Community-Based Services (HCBS) populations without altering institutional eligibility standards; provided further, that the resource limit for the Limited Frail Elder Waiver program shall be no less than $130,000; provided further, that the Limited Frail Elder Waiver program shall elect to implement an individual cost limit on combined waiver and state plan services; provided further, that for “waiver year one” of the Limited Frail Elder Waiver program the individual cost limit shall be established at no less than $1,300 per month; provided further, that the target population of the Limited Frail Elder Waiver program shall reserve capacity to first enroll individuals in the state home care program who are either participating in or waitlisted for the Elder Community Options Program (ECOP); provided further, that in addition to the Limited Frail Elder Waiver program being constrained by a maximum number of unduplicated participants served throughout a waiver year, there shall be a point-in-time limitation of participants who may be served in a month; provided further, that the secretary of aging and independence shall be granted substantial deference for establishing point-in-time participant limitations to ensure the limitation level allows for both the maximum transition of ECOP-eligible consumers and the reasonably expected demand for the waiver outyears; provided further, that the secretary of administration and finance shall reduce the amount available in item 9110-1630 by an amount equivalent to 75% of the net cost of services that are reimbursed from this item; provided further, that the secretary of administration and finance shall reduce the amount available in item 9110-1633 by an amount equivalent to 25% of the net cost of services that are reimbursed from this item.    ………$122,000,000”