Lawmakers Work On Final FY 17 Budget

In one of its final late night budget votes, the State Senate approved on a voice vote an amendment that increases funding for the state’s elder home care program by just over $1 million, to create a program for elders whose income is just over the limits allowable under current eligibility guidelines.

State House

The amendment allows the Executive Office of Elder Affairs to admit elders whose annual income is between $27,015 and $31,066. This includes seniors who “(i) are unable to afford sufficient unsubsidized home care for their needs; (ii) pose a risk of higher-cost state-provided care in a nursing facility should they be ineligible for home care; or (iii) lose home care eligibility as a result of a spouse’s death;”

Dan O’Leary, President of Mass Home Care, said the Senate action “will provide some much needed relief to ‘near poor’ seniors who cannot pay the full cost of home care services on their limited income.” O’Leary said elders who qualify for this program will pay for some of the cost of their care on a sliding fee basis.

“When we keep an elder living independently at home, we are also saving the taxpayers the cost of keeping them in an institution,” O’Leary said.

O’Leary credited Senate President Stan Rosenberg (D-Amherst) for guiding the amendment to its final passage.

“The President has taken a personal interest in looking after the well-being of our seniors.” O’Leary noted.

The measure now goes to a Joint Conference Committee to work out the final provisions of the budget. O’Leary credited Representative Paul Donato (D-Medford) with attempting to secure similar “near poor” language in the House during budget debate.

Here is the text of the amendment adopted this evening by the Senate:

“Ms. Jehlen, Ms. L’Italien, Ms. Lovely and Ms. Chang-Diaz moved that the amendment be amended by striking out the text in its entirety and inserting in place thereof the following:-

the proposed new text be amended, in section 2, in item 9110-1633, by inserting after the word “provided”, in line 5, the following words: “, that the secretary of elder affairs shall develop a pilot program to provide home care services to certain persons whose annual income exceeds, by 15 per cent or less, the current income eligibility limit based on regulations promulgated by the secretary; provided further, that such persons may include those who:

(i) are unable to afford sufficient unsubsidized home care for their needs; (ii) pose a risk of higher-cost state-provided care in a nursing facility should they be ineligible for home care; or (iii) lose home care eligibility as a result of a spouse’s death; provided further, that an amount not to exceed $1,075,000 shall be used for the pilot program which shall be allocated between items 9110-1630 and 9110-1633; provided further, the secretary shall report to the house and senate committee on ways and means not later than February 1, 2018 on: (a) caseload and expenditures made from the pilot program; (b) projected cost effectiveness from the piloted population including, but not limited to, estimated savings from reduced medical costs, avoided nursing facility admissions and cost sharing by recipients; and (c) the estimated fiscal impact and cost benefits of expanding home care to all eligible persons whose annual income exceeds the current income eligibility by 15 per cent or less; provided further.”

On the floor of the Senate, one of the bill’s sponsors, Senator Barbara L’Italien (D-Andover) told her colleagues:  “I’ve been working on homecare affordability for the last year. This is something we tried to do last year in the Senate, by tapping some of the federal balancing incentive program funds. It was not agreed to on the House side. We’ve tried to do it a number of times now. We have people I call the near-poor, who are not able to access services so they either go without or default into nursing homes at a much higher cost.”

L’Italien was followed by Senator Patricia Jehlen (D-Somerville) who added these comments: “This creates a pilot for people who are near-poor, but have too much money to qualify for our current home care program. There’s a pool of $1.075 million, and a report from EOEA to see if it’s working and keeping folks out of working homes and whether it’s wise to extend it to everyone who is near poor. Think of someone $5 a month over home care eligibility. Can’t afford to pay but can’t qualify, and this person maybe goes shopping, comes back home, trips, falls, breaks a hip. Goes to hospital, rehab, a nursing home, and it’s a terrible trajectory for everyone. For 200 people— thanks to this amendment—that will not happen next year. She’ll receive the services she needs.”

In other budget action, the Senate rejected the following:

  • An amendment that would have increased the operating funds for Aging Services Access Points by $1.7 million.
  • An amendment that would have increased the care management rate for home care by $2.46 million.
  • An amendment that would have added $8.9 million to the rates for home health aides.
  • An amendment that would have preventing MassHealth penalties against an individual who “demonstrates that a transfer of assets by said individual or his spouse was intended exclusively for a purpose other than qualifying for MassHealth or was intended to be a transfer for fair market value.”

The Senate also voted to  adopt these amendments:

  • A measure that prevents cuts to the Health Safety Net for low income people. The amendments says that “the health safety net office shall maintain eligibility criteria for the health safety net at the level in effect as of March 1, 2016.” This amendment did not  restore the additional $15 million sought, but Senate Ways and Means, like the House, did appropriate $15 million to the HSN above what the Governor included in House 2. The Health Safety Net amendment will have to be reconciled with the House version which did not include the moratorium on benefit cuts.
  • An amendment that provides $200,000 for a Department of Mental Health and Executive office of Elder Affairs “elder mental health interagency service agreement for adult home and community-based behavioral health services to adults over the age of 60;”
  • An amendment that creates in MassHealth a new “dental hygiene practitioner” allowed to perform following services: interpreting radiographs; the placement of space maintainers; pulpotomies on primary teeth; an oral evaluation and assessment of dental disease and the formulation of an individualized treatment plan authorized by the collaborating dentist; and nonsurgical extractions of permanent teeth.” A dental hygiene practitioner will also be allowed under certain conditions to  dispense and administer analgesics, anti-inflammatories and antibiotics.

SOURCE: Mass Home Care