Massachusetts 2025-2026 Regular Session

Massachusetts Senate Bill S474 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	1 of 1
2	2	SENATE DOCKET, NO. 1319 FILED ON: 1/16/2025
3	3	SENATE . . . . . . . . . . . . . . No. 474
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Patricia D. Jehlen
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to assisted living and the frail elder waiver.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :Patricia D. JehlenSecond MiddlesexThomas M. Stanley9th Middlesex 1 of 3
16	16	SENATE DOCKET, NO. 1319 FILED ON: 1/16/2025
17	17	SENATE . . . . . . . . . . . . . . No. 474
18	18	By Ms. Jehlen, a petition (accompanied by bill, Senate, No. 474) of Patricia D. Jehlen and
19	19	Thomas M. Stanley for legislation to direct the administration to amend the frail elder home and
20	20	community-based waiver to permit eligible older adults to choose to reside in certified assisted
21	21	living residences. Elder Affairs.
22	22	[SIMILAR MATTER FILED IN PREVIOUS SESSION
23	23	SEE SENATE, NO. 372 OF 2023-2024.]
24	24	The Commonwealth of Massachusetts
25	25	_______________
26	26	In the One Hundred and Ninety-Fourth General Court
27	27	(2025-2026)
28	28	_______________
29	29	An Act relative to assisted living and the frail elder waiver.
30	30	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
31	31	of the same, as follows:
32	32	1 SECTION 1. Notwithstanding any general or special law to the contrary, the executive
33	33	2office of health and human services shall, not later than 90 days after the effective date of this
34	34	3act, pursue and submit applications for new state plan amendments, state plan options or state
35	35	4plan waiver or demonstration requests for federal approval that will establish an assisted living
36	36	5service to allow individuals qualifying for Medicaid and at risk of entering a nursing home to
37	37	6reside in a certified assisted living residence; provided, however, that the average daily rate
38	38	7developed for such service, when combined with the average daily benefit assistance provided by
39	39	8the Supplemental Security Income program inclusive of the state supplementary payment
40	40	9program authorized under section 131 of chapter 6 of the General Laws and chapter 118A of the
41	41	10General Laws, shall not exceed 80 per cent of the cost of substantially similar institutional care 2 of 3
42	42	11for the equivalent waiver year as demonstrated by the Factor G value of Appendix J of the
43	43	12current MassHealth frail elder home and community-based services waiver, 0059.R08.00;
44	44	13provided further, that MassHealth shall implement a rate schedule for such assisted living service
45	45	14that uses disproportionate share payment methodologies to ensure equal economic access to the
46	46	15assisted living care setting for long-term care services and supports when measured with
47	47	16consideration for the level of access that MassHealth members have for institutional services.
48	48	17 SECTION 2. The executive office of health and human services shall, not later than 120
49	49	18days after the effective date of this act, report to the house and senate committees on ways and
50	50	19means on the status of submitted and pending applications described in section 1 and the
51	51	20projected fiscal impact to the commonwealth of federal approval for such applications. The
52	52	21report shall include, but not be limited to, comment on the deliberations and decisions regarding:
53	53	22(i) amending the current MassHealth frail elder waiver to include assisted living services as a
54	54	23new waiver service in a manner comparable to how the District of Columbia Medicaid program
55	55	24has delivered services to members residing in assisted living settings; (ii) implementing a new
56	56	25home and community-based services waiver under section 1915(c) of the Social Security Act for
57	57	26the sole purpose of establishing assisted living services as an option for MassHealth members in
58	58	27a manner comparable to how the Ohio Medicaid program has delivered services to members
59	59	28residing in assisted living settings; and (iii) enabling assisted living as a setting of choice for
60	60	29MassHealth members participating in managed care programs with reference to “in lieu of
61	61	30services and setting” authority as enabled by 42 C.F.R. 435.3(e)(2) in a manner comparable to
62	62	31how the California Medicaid program has delivered services to members residing in assisted
63	63	32living settings. 3 of 3
64	64	33 SECTION 3. The executive office of aging and independence shall, not later than 180
65	65	34days after the effective date of this act, report to the joint committee on elder affairs on the
66	66	35current structural, organizational or cultural barriers that are experienced by MassHealth
67	67	36members and such members’ potential to reside at an assisted living residence that is located
68	68	37within their community. The report shall include, but not be limited to, particular consideration
69	69	38of residents within qualified census tracts or difficult development areas and such residents’
70	70	39ability and likelihood to access assisted living residences in comparison to their ability and
71	71	40likelihood to access nursing facility services.