Governor Patrick today has proposed lifting the enhanced home care and home care line items in FY 15 by an additional $16.48 million, an increase of 10.9%. This represents the largest investment the Patrick Administration had made in the Home Care Program.
| Line-item |
Description |
Final FY13 Budget |
Final FY 14 Budget |
FY 15 House 2 GovPatrick |
| 4000-0600 |
MassHealth senior care plans |
$2,756,130,662 |
$ 2,853,835,505 |
$3,179,589,454 |
| 9110-0100 |
Elder Affairs Administration |
$1,990,108 |
$2,080,965 |
$ 2,364,575 |
| 9110-1455 |
Rx Advantage |
$18,500,869 |
$15,969,825* |
$16,213,523 |
| 9110-1500 |
Enhanced Community Options Prog. |
$47,461,487 |
$52,946,054 |
$ 63,077,339 |
| 9110-1604 |
Supportive Senior Housing Program |
$4,014,802 |
$4,150,900 |
$ 5,450,900 |
| 9110-1630 |
Home Care Purchased Services |
$97,780,898 |
$98,752,624 |
$104,411,964 |
| 9110-1633 |
Home Care Case Management |
$35,738,377 |
$35,545,490 |
$ 35,546,961 |
| 9110-1636 |
Protective Services |
$17,250,554 |
$22,033,832 |
$ 22,710,663 |
| 9110-1638 |
Workforce Training NEW |
— |
— |
$ 1,200,000 |
| 9110-1660 |
Congregate Housing Program |
$1,824,616 |
$2,086,626 |
$ 2,086,626 |
| 9110-1700 |
Elder Homeless |
$186,000 |
$186,000 |
$ 186,000 |
| 9110-1900 |
Elder Nutrition |
$6,375,328 |
$6,375,328 |
$ 6,328,321 |
| 9110-2500 |
Veterans |
$ 750,000 |
$750,000 |
Moved to Trust |
| 9110-9002 |
Grants to COAs |
$9,433,748 |
$10,500.000 |
$ 10,500,000 |
* Rx Advantage does not include $360,000 for SHINE
According to Mass Home Care, the Governor “saved his best home care budget for last.” The Administration projects that this funding will cover the enrollment projected for the enhanced home care and home care programs. In the enhanced program (ECOP) 9110-1500, the funding increase will avoid a waiting list, and allow more than 5,000 elders to remain living at home. According to EOEA, the average ECOP client remains living at home one year and nine months longer than they would have without this program.
In the basic home care program, 9110-1630, the Governor’s investment will allow care managers to authorize an additional hour of homemaker per month to consumers, according to the Administration. Because the monthly service package average has not changed since 2009, the home care package has lost purchasing power. The Administration says the added funding for the 1630 account will raise the service plan capacity to what it was in 2007. Before today’s budget numbers, the basic home care services line item in 2014 had fallen -8% below 2008 levels.
The Governor also created a new one-time line item with $1.2 million for workforce training. These funds are for the “core training competencies and certification programs for care managers, as well as personal care/home care aides, and for protective services investigators.” The Administration says the home care program is “now supporting a much more complex and acute consumer population. EOEA is seeking to establish this fund to help ensure the service delivery network is readily poised to best support the current consumer base.”
The Governor’s budget also adds 10 new supportive housing sites to the existing 31 sites now operating across the state. This program allows approximately 1,500 seniors in public housing to age in place, and provides affordable and stable housing for seniors with services in their building.
Two items on advocates’ lists were not directly addressed in House 2, and are expected to be on the short list of items to seek from the General Court, while maintaining the Governor’s funding improvements:
- A $6.1 million homemaker salary reserve
- A $3.34 million increase in the care management/operations budget for the ASAPs.
“This is a very smart investment by the Governor,” explained Mass Home Care Executive Director Al Norman. “Home care saves the taxpayers money as soon as it’s appropriated. Every day an elder is kept at home, and out of a nursing facility, is a good day for the elder and the state and federal taxpayers.” According to state figures, home care is estimated to save $1.2 billion in nursing facility expenditures over the next 6 years. Nursing home use has plummeted -33% between 2000 and 2012.
“This appropriation should assure that there are no waiting lists for home care in FY 15,” Norman said. “It’s also an important legacy for this Governor in response to the elderly population.”
Line Item Language
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| Current Year Projected Spending |
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| 4000-0600 |
MassHealth Senior Care |
For health care services provided to MassHealth members who are seniors and for the operation of the senior care options (SCO) program under section 9D of chapter 118E of the General Laws; provided, that funds may be expended from this item for health care services provided to these recipients in prior fiscal years; provided further, that funds shall be expended for the “community choices” initiative; provided further, that no payment for special provider costs shall be made from this item without the prior written approval of the secretary of administration and finance; provided further, that SCO benefits shall not be reduced below the services provided in fiscal year 2014; provided further, that notwithstanding any general or special law to the contrary, funds shall be expended from this item for the purpose of maintaining a personal needs allowance of up to $72.80 per month for individuals residing in nursing homes and rest homes who are eligible for MassHealth, the Emergency Aid to Elders, Disabled and Children program or Supplemental Security Income; provided further, that funds may be expended from this item to implement the pre-admission counseling and assessment program under the third paragraph of section 9 of chapter 118E of the General Laws, which shall be implemented on a statewide basis through aging and disability resource consortia; provided further, that notwithstanding any general or special law to the contrary, for any nursing home or non-acute chronic disease hospital that provides kosher food to its residents, the executive office of elder affairs, in consultation with the center for health information and analysis, in recognition of the special innovative program status granted by the executive office of health and human services, shall continue to make the standard payment rates established in fiscal year 2006 to reflect the high dietary costs incurred in providing kosher food; and provided further, that notwithstanding any general or special law to the contrary, nursing facility rates effective July 1, 2014 may be developed using the costs of calendar year 2005 |
$2,908,122,947 |
$3,179,589,454 |
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| Current Year Projected Spending |
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| 9110-0100 |
Department of Elder Affairs Administration |
For the operation of the executive office of elder affairs |
$2,080,965 |
$2,364,575 |
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| Account |
Account Name |
Account Language |
Current Year Projected Spending |
Total |
| 9110-1455 |
Prescription Advantage |
For the costs of the drug insurance program under section 39 of chapter 19A of the General Laws; provided, that amounts received by the executive office of elder affairs’ vendor as premium revenue for this program may be retained and expended by the vendor for the purposes of the program; provided further, that funds shall be expended for the operation of the pharmacy outreach program under section 4C of chapter 19A of the General Laws; provided further, that notwithstanding any general or special law to the contrary, unless otherwise prohibited by state or federal law, prescription drug coverage or benefits payable by the executive office of elder affairs and the entities with which it has contracted for administration of the subsidized catastrophic drug insurance program under said section 39 of said chapter 19A, shall be the payer of last resort for this program for eligible persons with regard to any other third-party prescription coverage or benefits available to the eligible persons; provided further, that the executive office shall seek to obtain maximum federal funding for discounts on prescription drugs available to the executive office and to prescription advantage enrollees; provided further, that the executive office shall take steps for the coordination of benefits with the Medicare prescription drug benefit created under the federal Medicare Prescription Drug Improvement and Modernization Act of 2003 to ensure that Massachusetts residents take advantage of this benefit; provided further, that a person shall be eligible to enroll in the program at any time within a year after reaching age 65; and provided further, that the executive office shall allow those who meet the program eligibility criteria to enroll in the program at any time during the year |
$16,988,821 |
$16,213,523 |
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| Current Year Projected Spending |
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| 9110-1500 |
Elder Enhanced Home Care Services Program |
For the provision of enhanced home care services, including case management to elders who meet the eligibility requirements of the home care program and who need services above the level customarily provided under the program to remain safely at home, including elders previously enrolled in the managed care in housing, enhanced community options and chronic care enhanced services programs; provided, that the secretary of elder affairs shall actively seek to obtain federal financial participation for all services provided to seniors who qualify for Medicaid benefits under the section 1915C waiver |
$53,277,339 |
$63,077,339 |
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| Current Year Projected Spending |
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| 9110-1604 |
Supportive Senior Housing Program |
For the operation of the supportive senior housing program at state or federally assisted housing sites |
$4,150,900 |
$5,450,900 |
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| Current Year Projected Spending |
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| 9110-1630 |
Elder Home Care Purchased Services |
For the operation of the elder home care program, including contracts with aging service access points or other qualified entities for the home care program, health aides, home health and respite services, geriatric mental health services and other services provided to the elderly; provided, that a sliding fee shall be charged to qualified elders; provided further, that the secretary of elder affairs may waive collection of sliding fees in cases of extreme financial hardship; provided further, that not more than $11,500,000 in revenues accrued from sliding fees shall be retained by the individual home care corporations without re-allocation by the executive office of elder affairs, and shall be expended for the purposes of the home care program, consistent with guidelines to be issued by the executive office; and provided further, that the secretary of elder affairs may transfer an amount not to exceed 3 per cent of the funds appropriated in this item to item 9110-1633 for case management services and the administration of the home care program |
$99,777,344 |
$104,411,964 |
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| Current Year Projected Spending |
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| 9110-1633 |
Elder Home Care Case Management and Administration |
For the operation of the elder home care case management program, including contracts with aging service access points or other qualified entities for home care case management services and the administration of the home care corporations funded through item 9110-1630 and item 9110-1500; provided, that the contracts shall include the costs of administrative personnel, home care case managers, travel, rent and other costs deemed appropriate by the executive office of elder affairs; provided further, that no funds appropriated in this item shall be expended for the enhancement of management information systems; and provided further, that the secretary of elder affairs may transfer an amount not to exceed 3 percent of the funds appropriated to line item 9110-1630 |
$35,545,490 |
$35,546,961 |
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| Current Year Projected Spending |
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| 9110-1636 |
Elder Protective Services |
For the operation of the elder protective services program |
$22,033,832 |
$22,710,663 |
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| Current Year Projected Spending |
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| 9110-1638 |
Home Care Workforce Training Fund |
For the provision of training to further the professional competencies of the workforce serving the consumers of the home care program under section 4 of chapter 19A of the General Laws; provided, that eligible training recipients may include outreach workers, case managers, home care aides and protective services investigators |
$0 |
$1,200,000 |
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| Current Year Projected Spending |
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| 9110-1660 |
Elder Congregate Housing Program |
For congregate and shared housing services for the elderly |
$2,086,626 |
$2,086,626 |
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| Current Year Projected Spending |
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| 9110-1700 |
Elder Homeless Placement |
For residential assessment and placement programs for homeless elders |
$186,000 |
$186,000 |
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| Current Year Projected Spending |
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| 9110-1900 |
Elder Nutrition Program |
For the elder nutrition program |
$6,375,328 |
$6,328,321 |
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| Current Year Projected Spending |
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| 9110-9002 |
Grants to Councils on Aging |
For grants to the councils on aging and for grants to or contracts with non-public entities which are consortia or associations of councils on aging |
$10,500,000 |
$10,500,000 |
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