News from Beacon Hill7/3/08 Conference Committee Budget Enacted The Fiscal Year 2009 Conference Committee Budget was released July 2nd and was approved by both the House and the Senate the next day. As with all budgets the results were mixed, but a few significant victories are included. Following is a quick summary of important items: • Line item 4000-0600 - PNA The nursing home Personal Needs Allowance (PNA) was funded at $72.80 a month. The House budget cut the PNA to $65 and the Senate maintained it at its current level of $72.80. Residents use this funding to purchase personal items such as clothing, shoes, toiletries and phone calls. Continued stay reviews for nursing home residents will continue to use the current “Score 3” clinical eligibility criteria for MassHealth reimbursement. The Senate had removed continued stay reviews from the protective Score 3 criteria. This will prevent MassHealth from denying nursing home payments to all but extremely frail and sick residents. Nursing home payment rates may increase to $45 million to fund labor and benefit costs for their workers. The rates may be reduced, however, if projected cost savings from elder Medicaid utilization do not equal this amount. • Line item 4000-0650 - Community First The Community First Waiver initiative is funded at $20 million. Of that amount, up to $5 million may be used to fund the settlement agreement in Rolland v. Celluci, a case mandating improved services for nursing home residents with developmental disabilities.
• Line item 9110-1640 - Geriatric Mental Health The Geriatric Mental Health account is funded at $225,000. The House budget funded it at this level but the Senate zero-funded the account. • Line item 9110-1650 - Family Caregivers The Family Caregivers account is funded at $253,000. The House budget funded it at this level but the Senate zero-funded the account. • Line item 9110-9002 - COA The Councils on Aging account is funded at $8.615 million. . This funding level will enable the COAs to reach their goal of $7 per elder. Included in the account is $80,000 for the LGBT Aging Project • Line Item 9110-1455 The Prescription Advantage Program was funded at $57.533 million. Language in the account requires that program enrollment be continuously open. The Outside Section specifies that the Secretary may increase member cost-sharing to reflect prescription drug price trends, but must notify the Legislature 90 days in advance of any increase.
2/4/08 Governor Patrick Releases Fiscal Year 2009 Budget Proposal On January 23rd Governor Patrick released his Fiscal Year 2009 Budget. Overall most human services accounts were flat funded or contained a modest cost of living increase. Notable exceptions include expanded funding for early childhood education and expanded funding for homelessness prevention initiatives. The Citizenship for New Americans Program also received a significant funding increase from $500,000 to $1.25 million. Accounts within the Executive Office of Elder Affairs are generally flat funded or minimally increased. One exception to this is the Prescription Advantage Program line item which is decreased by approximately $2.9 million. This decrease in funding occurred because the account has been under expended in prior years and because enrollment in the program is relatively static at 68,000 members. An additional new account was included in the budget for $45.8 million dollars to implement the new Community First Waiver Initiative. The Community First Initiative is designed to keep frail elders out of institutional care and to help transition those in nursing homes back to the community. One overall troubling issue in the Governor’s budget is the removal of earmark language from line items. For example, language setting the nursing home Personal Needs Allowance at $72.80 was included in last year’s MassHealth Senior Care line item. This budget removes that language from the line item but lists it elsewhere as an earmark the Governor “intends to honor”. This format occurs throughout the budget and offers no guarantee that the specific earmark will be funded. As always, the Governor’s budget is the first of three budget documents for the fiscal year. The second budget will be issued by the House of Representatives in the Spring, followed by the Senate budget in early Summer. The goal is to have a final budget signed by the Governor by July 1st.
10/9/07 Mike Festa named Secretary of Elder AffairsRepresentative Michael Festa has been named by the Patrick Administration as the Secretary of the Executive Office of Elder Affairs. In his role as Representative from Malden, Secretary Festa was a champion for community-based care for the elderly and a leader in passing the Equal Choice legislation to expand community care options. In addition, Sandra Albright has been named as the new Undersecretary of Elder Affairs. The long-time director of Kit Clark Senior Services, Ms. Albright brings decades of experience and expertise to her new position. The PASS Group looks forward to working with Secretary Festa and Undersecretary Albright in the coming months. 7/18/07 Governor Patrick signs the FY2008 budget
On Friday, July 13, 2007 Governor Patrick signed the Fiscal Year 2008 Budget and issued his veto message. Compared to prior Administrations the Governor issued very few vetoes, leaving most appropriations and line items as they were passed by the Legislature. One disappointment was the Governor’s veto of $2 million for rate increases to adult day health programs. The Massachusetts Adult Day Services Program is seeking an override of that veto. Of special note to nursing home advocates is the language in the Budget increasing the Personal Needs Allowance (PNA). The PNA is a monthly deduction from the income of nursing home residents on MassHealth that is used to pay for a resident’s personal expenses. The FY2008 Budget increases the PNA from $60 to $72.80, the first increase since 1990. The Coalition to Reform Elder Care (CORE), which is coordinated by Greater Boston Elderly Legal Services, took a lead in championing this increase. Another success in the budget was the funding of the Department of Public Health’s Birth Defects Monitoring Program. The earmarking of $450,000 for this program will allow DPH to continue the identification and monitoring of birth defects in the Commonwealth and will secure additional federal research funding for birth defects. The March of Dimes Massachusetts played a strong role in obtaining this funding.
6/30/07 Conference Budget Report On Friday, June 29th the Conference Committee on the Fiscal Year 2008 Budget issued its budget report. The Conference Committee budget contains good news for PASS Group clients. Among the items supported by the PASS Group clients and included in the Conference Budget are the following:
The Conference Committee budget now goes to the House and Senate for passage and on to the Governor’s office for his review. The Governor has 10 days to approve the budget and veto any items he disapproves.
6/1/07: News from Beacon Hill SENATE BUDGET DEBATE CONCLUDES WITH MIXED RESULTS FOR ADVOCATES The Senate Fiscal Year 2008 budget debate concluded on May 24th with mixed results for advocates. Most human services accounts received level funding or small increases, and most amendments to increase expenditures were rejected. This was the first budget for the new Senate President Therese Murray and the new Chair of Ways & Means Steven Panagiotakos. Hopefully their cautious fiscal approach with human services will loosen up over time. Some highlights of the budget process for PASS Group clients include:
The budget now moves to Conference Committee, where the House and Senate budgets will be consolidated into a final document. Many changes can occur in the Conference process, and we will keep you informed as to the outcome of their discussions.
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