1 of 1
SENATE DOCKET, NO. 1319 FILED ON: 1/16/2025
SENATE . . . . . . . . . . . . . . No. 474
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Patricia D. Jehlen
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act relative to assisted living and the frail elder waiver.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :Patricia D. JehlenSecond MiddlesexThomas M. Stanley9th Middlesex 1 of 3
SENATE DOCKET, NO. 1319 FILED ON: 1/16/2025
SENATE . . . . . . . . . . . . . . No. 474
By Ms. Jehlen, a petition (accompanied by bill, Senate, No. 474) of Patricia D. Jehlen and
Thomas M. Stanley for legislation to direct the administration to amend the frail elder home and
community-based waiver to permit eligible older adults to choose to reside in certified assisted
living residences. Elder Affairs.
[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE SENATE, NO. 372 OF 2023-2024.]
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act relative to assisted living and the frail elder waiver.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Notwithstanding any general or special law to the contrary, the executive
2office of health and human services shall, not later than 90 days after the effective date of this
3act, pursue and submit applications for new state plan amendments, state plan options or state
4plan waiver or demonstration requests for federal approval that will establish an assisted living
5service to allow individuals qualifying for Medicaid and at risk of entering a nursing home to
6reside in a certified assisted living residence; provided, however, that the average daily rate
7developed for such service, when combined with the average daily benefit assistance provided by
8the Supplemental Security Income program inclusive of the state supplementary payment
9program authorized under section 131 of chapter 6 of the General Laws and chapter 118A of the
10General Laws, shall not exceed 80 per cent of the cost of substantially similar institutional care 2 of 3
11for the equivalent waiver year as demonstrated by the Factor G value of Appendix J of the
12current MassHealth frail elder home and community-based services waiver, 0059.R08.00;
13provided further, that MassHealth shall implement a rate schedule for such assisted living service
14that uses disproportionate share payment methodologies to ensure equal economic access to the
15assisted living care setting for long-term care services and supports when measured with
16consideration for the level of access that MassHealth members have for institutional services.
17 SECTION 2. The executive office of health and human services shall, not later than 120
18days after the effective date of this act, report to the house and senate committees on ways and
19means on the status of submitted and pending applications described in section 1 and the
20projected fiscal impact to the commonwealth of federal approval for such applications. The
21report shall include, but not be limited to, comment on the deliberations and decisions regarding:
22(i) amending the current MassHealth frail elder waiver to include assisted living services as a
23new waiver service in a manner comparable to how the District of Columbia Medicaid program
24has delivered services to members residing in assisted living settings; (ii) implementing a new
25home and community-based services waiver under section 1915(c) of the Social Security Act for
26the sole purpose of establishing assisted living services as an option for MassHealth members in
27a manner comparable to how the Ohio Medicaid program has delivered services to members
28residing in assisted living settings; and (iii) enabling assisted living as a setting of choice for
29MassHealth members participating in managed care programs with reference to “in lieu of
30services and setting” authority as enabled by 42 C.F.R. 435.3(e)(2) in a manner comparable to
31how the California Medicaid program has delivered services to members residing in assisted
32living settings. 3 of 3
33 SECTION 3. The executive office of aging and independence shall, not later than 180
34days after the effective date of this act, report to the joint committee on elder affairs on the
35current structural, organizational or cultural barriers that are experienced by MassHealth
36members and such members’ potential to reside at an assisted living residence that is located
37within their community. The report shall include, but not be limited to, particular consideration
38of residents within qualified census tracts or difficult development areas and such residents’
39ability and likelihood to access assisted living residences in comparison to their ability and
40likelihood to access nursing facility services.