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2 | 2 | | HOUSE DOCKET, NO. 242 FILED ON: 1/11/2023 |
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3 | 3 | | HOUSE . . . . . . . . . . . . . . . No. 642 |
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4 | 4 | | The Commonwealth of Massachusetts |
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5 | 5 | | _________________ |
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6 | 6 | | PRESENTED BY: |
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7 | 7 | | Mathew J. Muratore |
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8 | 8 | | _________________ |
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9 | 9 | | To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General |
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10 | 10 | | Court assembled: |
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11 | 11 | | The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: |
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12 | 12 | | An Act relative to individuals from birth to age twenty-two in need of short-term inpatient |
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13 | 13 | | skilled nursing and rehabilitation services. |
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14 | 14 | | _______________ |
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15 | 15 | | PETITION OF: |
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16 | 16 | | NAME:DISTRICT/ADDRESS :DATE ADDED:Mathew J. Muratore1st Plymouth1/10/2023Susannah M. Whipps2nd Franklin1/25/2023Kathleen R. LaNatra12th Plymouth1/26/2023Lenny Mirra2nd Essex1/26/2023James B. EldridgeMiddlesex and Worcester2/18/2023 1 of 3 |
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17 | 17 | | HOUSE DOCKET, NO. 242 FILED ON: 1/11/2023 |
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18 | 18 | | HOUSE . . . . . . . . . . . . . . . No. 642 |
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19 | 19 | | By Representative Muratore of Plymouth, a petition (accompanied by bill, House, No. 642) of |
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20 | 20 | | Mathew J. Muratore and others relative to short-term inpatient skilled nursing and rehabilitation |
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21 | 21 | | services for persons twenty-two years of age or younger. Elder Affairs. |
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22 | 22 | | The Commonwealth of Massachusetts |
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23 | 23 | | _______________ |
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24 | 24 | | In the One Hundred and Ninety-Third General Court |
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25 | 25 | | (2023-2024) |
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26 | 26 | | _______________ |
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27 | 27 | | An Act relative to individuals from birth to age twenty-two in need of short-term inpatient |
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28 | 28 | | skilled nursing and rehabilitation services. |
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29 | 29 | | Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority |
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30 | 30 | | of the same, as follows: |
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31 | 31 | | 1 SECTION 1. Chapter 111 of the General Laws is hereby amended by striking out Section |
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32 | 32 | | 24J in its entirety and inserting in place thereof the following section: |
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33 | 33 | | 3 Section 4J. No individual from birth to age twenty-two who is in need of long-term |
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34 | 34 | | 4inpatient skilled nursing and rehabilitation services shall be admitted to a nursing home unless, |
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35 | 35 | | 5prior to such admission, an application has been made by or on behalf of such individual for |
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36 | 36 | | 6certification by the Department's Multi-Disciplinary Medical Review Team of eligibility for |
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37 | 37 | | 7nursing home care in the nursing home to which the individual seeks admission. Notwithstanding |
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38 | 38 | | 8any law or regulation to the contrary, any individual from birth to age twenty-two in need of |
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39 | 39 | | 9short-term inpatient skilled nursing and rehabilitation services may be admitted to a nursing |
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40 | 40 | | 10home upon the referral of his or her primary care physician or hospital discharge team without |
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41 | 41 | | 11application to or certification by the Department’s Multi-Disciplinary Medical Review Team. |
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42 | 42 | | 12For purposes of this section, “long-term inpatient skilled nursing and rehabilitation services” 2 of 3 |
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43 | 43 | | 13means admission to a nursing home for such services in excess of one year from the date of |
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44 | 44 | | 14admission, and “short-term inpatient skilled nursing and rehabilitation services” means |
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45 | 45 | | 15admission to a nursing home for such services for up to and including one year from the date of |
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46 | 46 | | 16admission. A majority of the members of the medical review team shall consist of currently |
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47 | 47 | | 17licensed health and allied health professionals who are not employees of the Commonwealth and |
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48 | 48 | | 18who have been engaged full-time in primary care practice in their respective areas of |
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49 | 49 | | 19specialization within the two years immediately prior to the commencement of service on the |
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50 | 50 | | 20medical review team. Such other individuals as the department may, from time to time, deem |
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51 | 51 | | 21appropriate may also serve on the medical review team. No person shall serve on the medical |
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52 | 52 | | 22review team for a period exceeding two years. The medical review team shall, in consultation |
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53 | 53 | | 23with the individual's referring physician, discharge planners at the individual's referring |
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54 | 54 | | 24healthcare institution, the individual's parents, next-of-kin or guardians, the individual's primary |
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55 | 55 | | 25care physician, and, to the extent deemed necessary, the departments of mental health, children |
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56 | 56 | | 26and families, transitional assistance, education, department of early education and care and the |
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57 | 57 | | 27commission for the blind, assess the medical, nursing, therapy, rehabilitation, and restorative |
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58 | 58 | | 28needs of such individuals. In the event that the medical review team fails to render a decision on |
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59 | 59 | | 29certification within ten business days after submission of any application for certification, the |
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60 | 60 | | 30individual shall be deemed approved for admission to the nursing home. In reviewing |
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61 | 61 | | 31applications for certification of eligibility, the medical review team shall not deny certification |
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62 | 62 | | 32on the basis of sex, nationality, religious affiliation, residency or domicile, source of payment or |
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63 | 63 | | 33reimbursement, type of illness or injury sustained or suffered by the individual, or, if the nursing |
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64 | 64 | | 34home to which the individual seeks admission is able to provide requisite care, the ability of any |
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65 | 65 | | 35other health care facility, wherever located, to provide such care. In the event that the medical 3 of 3 |
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66 | 66 | | 36review team denies certification, it shall refer the individual to an alternative care program |
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67 | 67 | | 37appropriate to each individual's needs, and prior to such referral, determine if said program has |
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68 | 68 | | 38the ability to immediately care for the individual. |
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69 | 69 | | 39 SECTION 2. The first sentence of the second paragraph of Section 19 of chapter 118E of |
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70 | 70 | | 40the General Laws is hereby amended by inserting after the phrase “twenty years of age or under” |
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71 | 71 | | 41the following words:- “in need of long-term inpatient skilled nursing and rehabilitation services, |
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72 | 72 | | 42as defined in section four J of chapter one hundred and eleven”. |
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73 | 73 | | 43 SECTION 3. Section 19 of chapter 118E of the General Laws is hereby amended by |
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74 | 74 | | 44inserting after the last sentence of the second paragraph the following sentence:- |
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75 | 75 | | 45“Notwithstanding any law or regulation to the contrary, any individual from birth to age twenty- |
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76 | 76 | | 46two in need of short-term inpatient skilled nursing and rehabilitation services, as defined in |
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77 | 77 | | 47section four J of chapter one hundred and eleven, may be admitted to a nursing home upon the |
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78 | 78 | | 48referral of his or her primary care physician or hospital discharge team without application to or |
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79 | 79 | | 49certification by the department of public health’s medical review team.” |
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