I. Mass 2010 Budget Update VETOES BY THE GOVERNOR
The Governor has vetoed two times in the budget for 2010.
- Funds for Care Management (at the ASAPS) had been reduced previously and now the Governor reduced them again for a total of 4.7 million dollars.
- Language about the PNA for nursing/rest home residents was eliminated.
ACTION STEPS:
I. Contact the following and urge them to:
- Override the Governor's veto of the PNA language. Maintain the PNA at $72.80/month.
- Override the Governor's veto of line item 9110-1633(care management at ASAPs).
Speaker Robert DeLeo at:
Robert.deleo@state.ma.us
617-722-2500
Chair Charles Murphy
Rep.charlesmurphy@hwm.state.ma.us
617-722-2990
II. Contact your own state representative and urge them to contact the Speaker and Chair Murphy to bring the PNA and Care Management vetoes to the floor for override votes.
FINAL 2010 BUDGET BY THE LEGISLATURE
The budget which was sent to the Governor mostly includes the less preferable Senate version.
Line items are funded at much lower levels or eliminated with only a few bright spots.
Here are a few examples:
- Mental Health - No funding
- Caregiving - No funding
- Wage Pass Thru for CNAs - No funding
- Home Care Purchased Services -Reduced funding
- Protective Services -Level funded
- COAs/Senior Centers- Level funded
- PNA - Preserved
- Bed Hold - Preserved at 10 days
ACTION STEPS:
- Contact the Governor(888-870-7770 or FAX- 617-727-9725) and ask him to sign the PNA and Bed Hold(and other items you support).
- Contact your state Senator and Rep and thank them for maintaining or preserving those identified items.
SENATE VERSION: The Senate has completed its version of the budget and now it shall be combined with the House version all of which shall be debated by a Conference Committee of 6 people before returning to each house for another vote.
Legislative leaders and the Governor are uncertain that the taxes which are included are sufficient to meet expenses.
It is difficult to glean specifics in the Senate version of the budget as they combined a number of line items.
Next is a review of the Senate action compared with the House. It is followed with recommended action steps.
- Mental Health was eliminated(it was funded at $ 125,00 in the House version which was a reduction). Support House.
- Suicide Prevention(Line item 4513-1026) is higher in the House version.
- Protective Services was the same for each House and about the same as this year.
- Councils on Aging were about the same as the House version and the same as this year.
- Housing(combined line items) is lower than the House version.Support House.
- Home Care Accounts(combined line items) is lower than the House version. Support House.
- Bed Hold (medical and non-medical)was restored.It was also restored in the House but the language is altered.
- PNA was restored in the House and in the Senate at $ 72.80/month.
- Wage Pass Thru(for nursing home CNAs) was reduced in the Senate and not earmaked by the House. Its future is unclear.
ACTION STEPS:
- Contact your individual State Senator and Rep and ask them to support the preferable version of each item above and to maintain those items at the highest funded levels.
- Ask them to so inform members of the Conference Committee - including the Chairs of the House(Rep.Robert Murphy- 617-722-2990) and Senate(Senator Steve Pangiotakos- 617-722-1630) Ways and Means Committees.
Urge them to support taxes which are sufficient and appropriate to meet the need.
The Senate debated the budget the week of May 18.
The Ways and Means Committee recommended many cuts to the budget due to an expectation that revenues would be even lower than the House had indicated.
On May 20, the Senate agreed to new taxes:
- Increase the sales tax from 5 to 6 1/4 % but only for 10 months instead of 12.
- Give cities and towns the ability to raise some taxes(restaurant and hotels) on their own.
- Add a sales tax to alcohol sales.
It is unclear what impact these new revenue sources will have on expenditures in the Budget. Will some items be reduced or eliminated or saved?
The Senate debate will continue this week.
The House floor debate was completed on this week of 4/27 and produced these results:
- Passage of 6 1/4 % sales tax.
- Restoring funds to the home care purchased services account
- Keeping a separate Medicaid account for seniors and persons with disabilities.
- Maintain the 10 day bed hold.
- Maintain the $ 72.80 PNA
- Did not restore the elder mental health line item.
- Suicide prevention funding(for the DPH)increased to 4.3 million.
ACTION STEPS:
- Contact your state rep and thank them for these accomplishments.
- Contact your State Senator and urge them to keep the above in their budget and to restore the elder mental health line item to at least $ 225,000.
The Ways & Means Committee's proposed budget was released on 4/15. It reduced the overall budget from 2009.
There are significant consequencies for elder services:
- The elder mental health line item(9110-1640) has been cut to about $ 100,00(from $ 225,000).
- The ASAPS(Home Cares) will see a reduction of about 4,000 people in their caseloads.
- There is no language for the Bed Hold in the budget.
- There is no language for the PNA(Personal Needs Allowance) in the budget.
Amendments have been submitted and some are as follows:
- Elder Mental Health(# 232) by Rep. Scaccia
- Bed Hold(# 485) by Rep. Fernandes.
- PNA(# 427) by Rep Peisch.
- Home Care(# 404) by Rep Wolf.
ACTION STEP:
Please contact your Mass State Representative to support amendments which will return these items or increase their monies.
II. Mass House Budget for 2010
House speaker DeLeo has indicated that currenrt revenues will necessitate billions in decreases for the Fiscal year 2010 budget.
The Ways & Means Committee will release its budget proposal in several weeks. It is unclear hwhat impact this will have on elder mental health priorities.
You still can contact your State Representative and advocate for elder mental health priorities(ex.- Line item 9110-1640; 4513-1026; line items in EOEA for home care-- see Public Policy 2010 budget for more).
III.
New House Committee Chairs
New assignments were announced.(for 2009-2010).
Some include:
- Elder Affairs - Alice Wolf(Chair)
- Mental Health/Sub Abuse - Elizabeth Malia(Chair)
- Ways & Means - Charles Murphy(Chair); Barbara L'Italien(Vice Chair)
IV.
MOVING MASSHEALTH OUT OF ELDER AFFAIRS
The Governor has decided to delay or put off this move. There remains a desire by the administration to make this move but there is now a willingness to talk with stakeholders about this effort.
We'll inform you of the next step(s).
Please read below.
The Patrick Administration(in Mass) has decided to move the long term care section of Masshealth out of Elder Affairs and back to Medicaid. It was separated from Elder Affairs (a number of years ago) in order to have more services for elders in one place. Historically, services for elders from the Commonwealth of Massachusetts have been located in various places. This has made it difficult for elders and providers to access services.
If this move is made it will bring different parts of Medicaid together but services for elders will again be scattered around state agencies.
The Governor or Legislative Leadership(ex.- House Speaker, Senate President, et.al.) have the authority to change this initiative.
ACTION STEP:
If you agree that this is a move in the wrong direction then contact
Governor Patrick(888-870-7770),
House Speake DeLeo, and/or Senate President Murray. Urge them to maintain Long term care services of MassHealth in Elder Affairs.
V.
MASS STATE BUDGET
Governor Patrick announced his revised budget cutbacks for 2009 and his proposed budget for 2010.
2009 - (click for more information)
Councils on Aging will see reduced funding.
Most other elder related funding is not changed.
There seems to be much level funding of services.
The Councils on Aging should receive their lost funding from this fiscal year.
There is some re-organization within EOEA and Medicaid.
It is difficult to determine immediately what impact there will be on elder mental health in the budget.
We will have more information as it becomes available.
VI
GUARDIANSHIP
Governor Patrick signed the Probate Court Reform Bill. It includes provisions to make significant changes in Massachusetts Guardianship Procedures. See below for more information(# VII).
It will be in effect as of July1, 2009. Implementation and rules will be written by a committee of he Probate Court.
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VII.
FEDERAL STIMULUS BILL AND IMPACT ON ELDERS
This bill has been passed by each house and signed by the President.
Read below for more information.
The Federal House Appropriations Committee passed this economic stimulus bill which goes on to the House.The Senate and the President are next and the hope is that it will be done by Mid February.
There are several pieces which will impact elders.
They include:
- Additional funds for Meals on Wheels
- Additional funds for congregate meals
- Low income energy assistance
- Raise the SSI in 2009 in a one time payment
- Increased funds for states and their Medicaid programs.
For the full text go to:
VIII.
Congress has made some important changes in Medicare services.
I. In section 203 the co-payment for mental health services will be reduced from 50% to 20%. This will be reduced at 5 % per year over 6 years.
2. In section 606 clinical social workers would be allowed to bill Medicare directly for services provided to residents who are in a Medicare A (SNF) bed.
XIX.
ELDER MENTAL HEALTH LINE ITEMS IN MASS BUDGET
A.. EOEA-Line item 9110-1640. Proposed $ 3.985 million and was reduced to $ 225,000.
B. DMH- Line item 5640-1000. Proposed for a million and failed.
C. The Governor's proposed budget for Fiscasl 2009 only calls for $225,000 in the EOEA line item and nothing in the DMH line item.
D, The Fiscal 2009 budget maintained $225,00 in the elder mental health line item(9110-1640).There was no increase in funding.
X.
Guardianship
This bill(S. 2622)now a law in the Mass will:
1. Create a new standard for "incapacitated person" based on functioning(lack of capacity). Diagnosis will not be the only criteria.
2. The guardian's powers will be limited(ex.- the guardian will go to the Probate court when a nursing home placement is in the works).
3. The guardian must submit detailed annual reports.
4. There is a requirement for a more comprehensive and integrated medical certficate.
It has been passed by the entire legislature and signed by the Governor.
We will update when we have more information about the regulatory and implementation process.
It should be in place 7/09.
XI. RESIGNATION OF ELDER AFFAIRS SECRETARY Mike Festa, the Secretary of Elder Affairs , has announced his resignation from that position. Ellie Shea Delaney will fill that post until a decision has been made about someone to fill it on a permanent basis.
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