The Joint Committee on Aging and Independence on May 12th held a public hearing on a series of bills related to home and community-based services, Assisted Living Residences and Continuing Care Retirement Communities.
Tara Gregorio, President of Mass Senior Care, filed written testimony to the Committee on two bills of particular importance to the nursing facility provider community:
- Senate Bill 474, An Act Relative to Assisted Living and the Frail Elder Waiver – the bill would expand MassHealth coverage to individuals residing in Assisted Living Residences in the Commonwealth. Gregorio noted that while we support the intent of the legislation, Mass Senior Care strongly believes that existing MassHealth-covered long-term service and supports (LTSS) -- both nursing facility and community care -- must be fully funded before Medicaid services can be responsibly expanded into another setting. As it stands today, existing LTSS programs across Massachusetts are severely underfunded. From Adult Day Health and Home Care programs to MassHealth nursing facility care where 70% of residents have their care paid for by MassHealth, which underfunds each resident day by $47 per day, according to a 2023 federal government analysis, resulting in a $825,000 annual loss per nursing facility or $305 million annual loss for the sector. The bill would also require EOHHS to file a state plan amendment to add the Assisted Living to the Frail Elder Waiver within 90 days. Gregorio noted that a change of this magnitude necessitates a deliberate and careful analysis of all the factors related to adding a new Medicaid service, in particular the new costs associated with it. This is even more essential right now, given potential federal funding cuts that could dramatically impact our state budget. Gregorio concluded by recommending the Committee amend the bill to direct EOHHS to study the proposal and prepare a cost analysis report that details the estimated net state cost of expanding Medicaid coverage to include individuals residing in a certified assisted living residence.
- House Bill 784, An Act Relative to Assisted Living Facility Residences Appeal of Findings – the proposed bill would require the Executive Office of Aging and Independence (EOAI) to implement an informal dispute resolution process for assisted living residences to contest issued findings for which corrective action is required. A similar and successful process exists for nursing facilities to dispute and resolve contested Department of Public Health (DPH) survey actions. Gregorio noted that we have seen the success of this model with nursing facilities resolving disputes with DPH survey actions. Having the opportunity to appeal to an informal dispute committee and receive a review of a potential finding adds an important layer of oversight and builds trust and accountability on both the agency side and the assisted living residence side. Gregorio requested that the Committee report out this bill favorably.