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S. 2273 (as reported favorably by Elder Affairs, Health Care Finance, and engrossed in the Senate

AN ACT REGARDING CHOICE OF LONG TERM CARE SETTING

Be it enacted by the Senate and House of Representatives in General Court
assembled, and by the authority of the same, as follows:

SECTION 1.

Section 9 of chapter one hundred and eighteen E is hereby amended by striking, in the second paragraph, the following sentence: "provided, further, that said benefits shall be available to otherwise eligible persons seeking admission to and residents of long-term care facilities whose income and resources are insufficient to meet the cost of their medical care as determined by the financial eligibility requirements of said program." And replacing it with the following new sentences: "provided, further, that said benefits shall be available to otherwise eligible persons seeking long term care whose income and resources are insufficient to meet the cost of their
medical care as determined by the financial eligibility requirements of said program. For the purposes of this chapter, the division shall establish clinical eligibility for a long term care benefit, so-called.  Any person determined by the division as clinically eligible for said long term care benefit shall be given the choice of care setting that is the least restrictive and most appropriate to meet his or her needs. The dollars that are provided for said long term care benefit shall follow such individual as his or her setting of care changes, but for each such individual, the division of health care finance and policy shall establish a rate that reflects the individual’s clinical case-mix acuity and his care and benefit needs in the most appropriate setting.

SECTION 2. The division shall promulgate regulations to implement the provisions of section 1, and shall submit a section 1115(a) research and demonstration waiver no later than July 1, 2006 to implement the provisions of section 1. Said waiver shall establish an income eligibility up to 300 percent of the federal benefit rate under the supplemental security income program, and an asset test of not less than $10,000. Said waiver shall maximize the federal financial participation for all enrollees, and meet budget neutrality requirements established for such waivers.

SECTION 3. Section 9 of Chapter one hundred and eighteen E is hereby further amended by adding at the end thereof the following new language: "All persons seeking admission to a long term care facility paid for by MassHealth shall receive pre-admission counseling for long term care services, which shall include an assessment of their community-based service options. All persons seeking care in a long term care facility on a private pay basis shall be offered said pre-admission counseling on a voluntary basis. For the purpose of this section, all said pre-admission counseling shall be conducted by the executive office of elder affairs, or its subcontractors. The division shall report to the general court on an annual basis the number of individuals who received pre-admission counseling under this section, and the number of diversions to the community generated by this pre-admission counseling  program, so-called."