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On November 12, the House of Representatives passed the FY21 budget. I am sharing with you a summary of a few sections, compiled by House Chair of the Elder Affairs Committee, Representative Ruth Balser.

FY21 House Budget:

Elder Affairs Funding Highlights

COVID-19 has been particularly hard on our elder population. The House budget recognizes this fact by making a significant additional investment of $54 million beyond the FY20 budget on programs for aging adults, and adopts several important policies that will benefit older adults.

The state has over time made a commitment to building a continuum of care so that older adults who choose to remain in the community, rather than live in a nursing home, will be able to do so.

This approach is further supported in this budget by making a new investment of $17 million for rate adjustments for home care services. Additionally in an outside section, we establish a commission to develop a licensure process for home care agencies, a move that will pave the way for ensuring quality home care.  Also, there is language in the home care line item that requires that a range of home care providers receive training that will ensure sensitivity to the LGBTQ community.

The pandemic has heightened our awareness of the supports that aging adults need in order to live successfully in the community.   With that in mind, the House budget increases the appropriations for geriatric mental health services, elder protective services, and supportive senior housing.

The Elder Affairs committee has heard testimony indicating that there seems to be transmission of the virus from individuals leaving hospitals when their care is concluded and returning to nursing homes.  The House budget includes a section that requires DPH to issue a report on preventing the transmission of COVID-19 from hospitals to nursing homes, in order to prevent future outbreaks.

Below is a detailed breakdown by line item and section:

The following appropriations were increased from last year: 

Home and Community Based Services Rates (9110-1635): This new line item provides $17,433,295 for adjustments to rates for home and community based services provided by home health aides, homemakers and personal care homemakers. Agencies must spend the additional funding on worker compensation and other eligible costs, such as PPE.

MassHealth Senior Care (4000-0601): Provides $3,894,496,052 for health care services for MassHealth members who are seniors and for the operation of MassHealth Senior Care Options program under section 9D of chapter 118E. This appropriation reflects a $14,801,236 increase over FY20. 

Community Choice (9110-0600): Provides $237,165,314 for health care services for MassHealth members who are seniors eligible for community-based waiver services, so that more people can receive services in the community. This appropriation reflects an increase of $4,650,300 over FY20. 

Elder Home Care (9110-1630) & Elder Home Care Case Management (9110-1633): Provides $183,184,468 for the Elder Home Care Program, a $4,227,484 increase over FY20, and $64,433,467 for Elder Home Care Case Management, a $5,466,706 increase over FY20, so that eligible elders can continue to live independently and safely at home. Line item 9110-1630 also includes language to ensure LGBTQ training for a range of home care service providers.

Elder Protective Services (9110-1636): Provides $35,696,127 for protective services case management, guardianship services, the statewide elder abuse hotline, money management services and the elder-at-risk program. This appropriation reflects a $2,975,000 increase over FY20. 

Geriatric Mental Health (9110-1640): Provides $1,000,000 for Regional Elder Mental Health Outreach Teams that assess older adults for mental illnesses, provide counseling, provide and/or connect elders to crucial social services, facilitate connections to PCPs, and provide support municipal staff and community partners who interact with elders experiencing mental health issues. This appropriation represents a $200,000 increase over FY20. 

Prescription Advantage (9110-1455): Provides $17,249,455 to lower prescription drug costs for seniors and people with disabilities. For seniors on Medicare, Prescription Advantage fills gaps in coverage. For people not on Medicare, the program provides primary coverage. This line item also includes $1,000,000 for the SHINE program, which provides free health insurance information and counseling to all Massachusetts residents with Medicare. The appropriation reflects a $2,148,142 increase over FY20. 

Congregate and Shared Housing (9110-1660): Provides $2,655,211 for Congregate and Shared Housing and Naturally Occurring Retirement Communities, which combine housing and services for older adults and people with disabilities. Congregate Housing Coordinators help residents access community resources, manage issues that arise from shared living, and plan social activities. This appropriation reflects a $391,753 increase over FY20. 

Supportive Senior Housing at State and Federally-Assisted Housing Sites (9110-1604): Provides $7,753,422 for supportive senior housing programs, including $1.4M for 10 additional supportive sites. Elder Supportive Housing Programs employ Supportive Housing Coordinators who provide tenancy preservation support and manage on-site 24/7 emergency coverage. Supportive Housing Coordinators also direct programs for residents including congregate meals, social activities, workshops, health clinics, and educational programs. This appropriation reflects a $1,842,534 increase over FY20. 

The following appropriations were level-funded from last year: 

Elder Homelessness (9110-1700): Maintains $286,000 for assessment, placement, and homelessness prevention services for homeless and at-risk elders.

Elder Nutrition (9110-1900):  Maintains $9,708,808 for home-delivered and congregate meals for elders.

Councils on Aging (9110-9002):  Maintains $12 per elder to fund the Formula Grant.

Alzheimers Public Awareness and Education Campaign: Provides $150,000 for a grant for an Alzheimer’s public awareness and education campaign.

Executive Office of Elder Affairs (9110-0100): Provides $2,217,972 for the operation of the executive office of elder affairs and the regulation of assisted living facilities.

The following appropriation was in line with the Governor’s budget: 

MassHealth Nursing Home Supplemental Rates (4000-0641): Provides $395,400,000 for Massachusetts nursing home rates, in line with the Governor’s budget.

Outside Sections:

Outside Section 44: This section establishes a commission to study and make recommendations to establish a statewide licensing process for home care agencies in the Commonwealth. Licensing home care agencies will protect consumers and home care workers.

Outside Section 44f: This section requires the Department of Public Health to issue a report detailing the rules, regulations, guidance and best practices for preventing the transmission of COVID-19 from patients being discharged from hospitals to nursing homes, skilled nursing facilities, and rehabilitation centers.

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