The bill amends the General Laws to reform the Medical Assistance Long-Term Care Service and Finance, setting a goal for at least 50% of Medicaid funding for the elderly and adults with disabilities to be allocated to home- and community-based care instead of institutional care. It directs the executive office of health and human services to seek necessary waivers and amendments, and to report annually on funding distribution. The bill introduces a tiered eligibility criteria for services, with more stringent criteria for institutional care, and allows individuals receiving Medicaid-funded services as of April 1, 2021, to continue under the criteria effective on that date. It also authorizes the consolidation of home- and community-based services into a single system and proposes optional services subject to state funding. Insertions include provisions for payment rate increases for home-care providers and skilled nursing services, while deletions remove the requirement for employers to provide an annual compliance statement to the EOHHS.

Additionally, the bill outlines measures to expand home- and community-based service capacity, including revised Medicaid certification standards and payment reforms to increase wages for personal care attendants and home health aides. It mandates a one-time increase in base-payment rates and an annual inflation increase tied to the New England Consumer Price Index. The bill also includes the implementation of a long-term-care-options counseling program, the establishment of a statewide conflict-free case management network, and the authorization to use funding to transition beneficiaries from institutional settings to home or community care. It eliminates outdated statutory reporting requirements and permits behavioral health training for certain home care professionals. The bill includes payment reforms to encourage specialized services to avoid institutional care and takes effect upon passage.

Statutes affected:
7298: 40-8.9-9