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  EHS  835

WITHDRAWN

REDRAFT
EHS  836

CASA ESPERANZA

Mr. Tolman and Ms. Walsh moved that the bill be amended, in Section 2, in item 4800-0038 by striking out the figure “$348,850” and inserting thereof the figure “$498,840.”

EHS  837

NON-EMERGENCY AMBULANCE COVERAGE

Mr. Panagiotakos moved that the bill be amended by inserting, after Section  97, the following new Section:-

SECTION  _____.  Chapter 58 of the acts of 2006 is hereby amended by adding at the end thereof the following new section:- Notwithstanding any general law or special law to the contrary, not withstanding a member’s coverage type or enrollment in a Managed Care Organization, the division shall provide coverage for all emergency ambulance calls which result in a transport and shall provide coverage for all medically necessary non-emergency ambulance and wheelchair van trips. Provided that medical necessity for non-emergency ambulance service shall be established by the completion of a Medical Necessity Form signed by a physician, physician’s designee, physician assistant, nurse midwife, dentist, nurse practitioner, managed care representative, or registered nurse.  The member’s record must support the information given on the Medical Necessity Form.  The transportation provider is responsible for the completeness of Medical Necessity Forms.  The completed Medical Necessity Form must be kept by the transportation provider as a record for four years from the date of service.        

EHS  838

RELATIVE TO THE ESSENTIAL COMMUNITY PROVIDER TRUST FUND

Messrs. Tisei and McGee moved that the bill be amended, in Section 2, in item 4000-0300, by inserting after the words “17 executive office cluster agencies,” the following:-

“provided further, that a $1,200,000 one-time essential community provider trust fund grant be awarded to an acute care hospital serving the Melrose and Wakefield communities that operates a family health services clinic;”

EHS  839

ST. LUKE'S REST HOME

Mssrs. Buoniconti and Lees moved that the bill be amended, in Section 2, in item 4405-2000 by adding: 

 “Provided further, that not withstanding any general or special law or regulation to the contrary, rates reimbursed by the Commonwealth through the Division of Health Care Finance and Policy to cover the cost of care provided by non-profit level 4 residential care facilities in Hampden County, which serve publicly-aided homeless and mentally ill residents and which are owned by an integrated health care delivery system, shall be sufficient to cover the cost of care provided by such facilities, and in no event shall be less than ten dollars ($10) more per patient day than the division’s fiscal year 2006 reimbursement per patient day for such facilities”  

EHS  840

SYLVIA'S HAVEN

Messrs. Buoniconti, Knapik moved that the bill be amended, in Section 2, in item 4800-1400 by inserting:-

“; provided further, that not less than $100,000 shall be expended for a contract with Sylvia’s Haven at Devens to provide transitional housing to pregnant and parenting women and girls”;  and in said section by striking out the figure “$21,088,691” and inserting in place thereof the figures “$21,188,691”.  

EHS  841

EDUCATIONAL MATERIALS FOR VETERANS

Messrs. Brewer, Timilty and Tarr moved that the bill amended by inserting, after Section 104, the following new section:-

SECTION _. Section 4 of Chapter 111 of the Massachusetts General Laws, is hereby amended by adding the following new section:

Section 4M. The department of public health is hereby authorized and directed to make available to all veterans, physicians, other health care providers, and other persons at high risk for hepatitis C, educational materials, in written and electronic forms, on the diagnosis, treatment, and prevention of hepatitis C. Such materials shall include the recommendations of the Centers for Disease Control, and any other person or entity having knowledge on hepatitis C, including the American Liver Foundation, and shall be written in terms which are understandable by members of the general public.

EHS  842

WITHDRAWN

GOV  843

DEAF AND HARD OF HEARING INDEPENDENT LIVING SERVICES

Mssrs. Timilty, Tisei, Spilka, Chandler, and Resor moved that the bill be amended, in Section 2, in item 4125-0100, by striking out the figure “$5,539,165” and inserting in place thereof the following figure: - “$5,889,165”.  

REDRAFT
EHS  844

WITHDRAWN

REDRAFT
EHS  845

YMCA PROJECTS

Mr. McGee moved that the bill amended, in Section 2, in item 4000-0112, by adding at the end thereof the following:   “provided further, that not less than $25,000 be expended to the YMCA of Greater Lynn.”

REDRAFT
EHS  846

COMMISSION ON GAY AND LESBIAN YOUTH

Messrs. Tolman Barrios, Brewer, Buonconti, Chandler, Havern, Chandler, Havern, Lees, Resor, Tisei, Fargo, O’Leary and McGee moved that the bill amended, in Section 2, in item 4590- 0250, by striking out the following: “provided further, that not less than $350,000 shall be expended for the governor's commission on gay and lesbian youth;" and inserting in place thereof the following:  “provided further, that not less than $450,000 shall be expended for anti-suicide and anti- violence programs overseen by the Commission on Gay and Lesbian Youth.”

EHS  847

FORSYTH INSTITUTE FOR CHILDREN

Mr. McGee moved that the bill amended, in Section 2, in item 4512-0500, by adding the following: “provided further, that $750,000 shall be expended for the Forsyth Institute’s Center for Children’s Oral Health to fund a school-based demonstration project to offer preventive oral health care to children in high need areas including Boston, Lynn and Hyannis,” and further, by striking the figure “$1,678,150” and replacing it with the figure “$2,428,150"

EHS  848

BROCKTON HOSPITAL

Mr. Creedon moved that the bill amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies;” the following:- “provided further that a $950,000 one-time essential community provider trust fund grant to a disproportionate share acute care hospital located in the southeastern Massachusetts division of the medical assistance psychiatric service area that operates an inpatient psychiatric unit within the city of Brockton;"

EHS  849

FOOD STAMP EMPLOYMENT AND TRAINING

Mr. McGee moved that the bill amended, in Section 2, in item by striking item 4401-1100 and inserting in place thereof the following item:-

4401-1100
Notwithstanding any general or special law to the contrary, the department of transitional assistance may expend reimbursements received from the United States Department of Agriculture for food stamp outreach and employment and training programs and any enhanced funding or bonuses; provided, that the department may expend such revenue for employment and training services provided for in Section 2B……………. $20,000,000  

EHS  850

COMMUNITY HEALTH CENTER IN LYNN

Mr. McGee moved that the bill be amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies,” the following words: -

“provided further that a $400,000 one-time essential community provider trust fund grant shall be awarded to a community health center located in the city of Lynn providing health care to medically underserved and uninsured patients and which provides a 340B pharmacy program.” 

EHS  851

ESSENTIAL COMMUNITY PROVIDER TRUST FUND GRANT FOR HOLYOKE MEDICAL CENTER

Mr. Knapik moved that the bill amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies;” the following:- “provided further, that a $4,000,000 one-time essential community provider trust fund grant shall be awarded to an acute care hospital located in Holyoke that provides clinical training programs for nurses, allied health professionals and technicians through affiliations with community colleges and private universities.”       

EHS  852

ESSENTIAL COMMUNITY PROVIDER TRUST FUND GRANT FOR NOBLE HOSPITAL

Mr. Knapik moved that the bill amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies;” the following:- “provided further, that a $2,500,000 one-time essential community provider trust fund grant shall be awarded to a hospital located in Hampden County, west of the Connecticut River with under 100 beds that participates in Masshealth.”  

EHS  853

ESSENTIAL COMMUNITY PROVIDER TRUST FUND GRANT FOR THE SISTERS OF PROVIDENCE HEALTH SYSTEM, INC.

Mr. Knapik moved that the bill amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies;” the following:- “provided further, that a $4,000,000 one-time essential community provider trust fund grant shall be awarded to a two hospital system located in Hampden County, one of which hospitals provides inpatient psychiatric services for children and adults and a methadone program.”  

  EHS  854

ESSENTIAL COMMUNITY MENATAL HEALTH PROVIDER

Mr. McGee moved that the bill be amended, in Section 2, in item 4000-0300, by inserting after the words “17 executive office cluster agencies,” the following words:-“provided that a $250,000 one-time essential community provider trust fund grant shall be awarded to a free standing inpatient psychiatric hospital that is part of a health care system that serves the department of mental health northeast area.”  

EHS  855

ELDER HEALTH CENTER IN SAUGUS

Mr. McGee moved that the bill amended, in Section 2, in item 4510-0110, in line 2, by inserting after “personnel-related costs; ” the following: “provided further, that not less than $100,000 shall be expended for the elder health center in Saugus”.  

  EHS  856

SELF ESTEEM BOSTON EDUCATIONAL INSTITUTE

Ms. Fargo and Ms. Wilkerson moved that the bill be amended, in Section 2, by inserting in item 4512-200 the following wording:-   “provided further, that not less than $125,000 shall be expended for Self-Esteem Boston’s substance abuse direct service prevention programs and provider training programs.”  

EHS  857

DENTAL THIRD PARTY ADMINISTRATORS

Ms. Chandler, Tucker, and Mr. McGee moved that the bill be amended, in Section 2, in item in item 4000-0300, by adding the following words:- “provided, however, that a contract for a dental third party administrator shall be executed by July 1, 2006 and shall:  require the administrator  to pay a provider 100 per cent of the reimbursable rate; require that credentialing of providers shall occur in 45 days or less;  require acceptance of electronic billing claims from providers;  require payment by electronic fund transfer if requested by a provider, no later than 10 days from the time of service; prohibit any dental third party administrator from requiring prior authorization if the office does not require prior authorization: and,  that any third party administrator shall contract with  providers currently authorized to treat patients enrolled in MassHealth.”  

  EHS  858

PRESCRIPTION DRUG FAIR PRICING PROGRAM

Mr. Montigny, Mr. Tolman and Ms. Tucker moved that the bill be amended by inserting after Section 34, the following new Section:-
“SECTION 34A.  Chapter 118E of the General Laws is hereby amended by inserting after section 12 the following sections:—
Section 12A.
(a) Any prior authorization process required by the division to obtain coverage for a prescription drug shall comply with this section and with 42 U.S.C. section 1396r-8(d).
(b) Coverage for a prescription drug that is not covered by the division without prior authorization shall be authorized if a patient’s health care provider certifies, in a manner determined by the division, that:
(i) the drug is medically necessary; and
(ii) in the case of a prescription drug that is not the preferred choice in a therapeutic category on the preferred drug list,
(A) the preferred choice has not been effective or, with reasonable certainty, is not expected to be effective in treating the patient’s condition; or
(B) the preferred choice causes or is reasonably expected to cause adverse or harmful reactions in the patient.
(c) The prescriber’s certification concerning whether a particular drug has been, or is expected to be, ineffective in treating the patient or is expected to cause an adverse or harmful reaction shall be final.
(d)(1) The division’s prior authorization process shall be designed to minimize administrative burdens on prescribers, pharmacists and consumers.
(2) The prior authorization process shall ensure real-time receipt of requests by telephone, voice mail, facsimile, electronic transmission or mail on a 24-hour, 7 days per week basis.
(3) The prior authorization process shall provide an in-person response to emergency requests by a prescriber, with telephone answering queues that shall not exceed 10 minutes.
(4) Any request for authorization or approval of a drug that the prescriber: indicates is for an emergency or urgent condition; and includes the clinical reasons for the request shall be responded to within 4 hours of the time the program or participating health benefit plan receives the request.
(5) In emergency circumstances, or if the response to a request for prior authorization is not provided within the time period established in subdivision (4) of this subsection, a 72-hour supply of the drug prescribed shall be considered to be authorized by the program or the participating health benefit plan, provided: the drug is a prescription drug approved by the United States Food and Drug Administration; and, for drugs dispensed to a Medicaid beneficiary, that the drug is subject to a rebate agreement with the Centers for Medicare and Medicaid Services.
(6) The division shall provide to participating providers a prior authorization request form designed to permit the prescriber to make prior authorization requests in advance of the need to fill the prescription and designed to be completed without unnecessary delay. The form shall be capable of being stamped with information relating to the participating provider and, if feasible, at least 1 form capable of being copied shall contain known patient information.
(e) The division’s prior authorization process shall require that the prescriber, not the pharmacy, request a prior authorization exception to the requirements of this section. The division may exempt a prescriber from the need to secure prior authorization for a specific drug category if the division determines that the prescriber has written a minimum number of scripts in that category and that the prescriber prescribes prescription drugs on the preferred drug list at or above the minimum threshold for that category.
(f) A denial of authorization for coverage shall be subject to an administrative fair hearing and to all rights under section 14 of chapter 30A.
(g) The division shall, using bulletins, manuals, notices or other appropriate means, educate prescribers and pharmacists who treat MassHealth patients about the requirements of the prior authorization process, including the obligations of providers and pharmacists and the rights of consumers.
Section 12B.
(a) The commissioner, separately or in concert with the authorized representatives of any health benefit plan participating in the prescription drug fair pricing program established by chapter 118H, shall use the division’s preferred drug list of prescription drugs covered without a prior authorization requirement to negotiate with pharmaceutical companies for the payment to the commissioner of supplemental rebates or price discounts for Medicaid. The commissioner may also use the preferred drug list to negotiate for the payment of rebates or price discounts in connection with drugs covered under any other health benefit plan within or outside the commonwealth participating in the prescription drug fair pricing program established by chapter 118H. These negotiations and any subsequent agreement shall comply with 42 U.S.C. section 1396r-8. The program established by chapter 118H, or such portions of the program as the commissioner shall designate, shall constitute a state pharmaceutical assistance program under 42 U.S.C. section 1396r-8(c)(1)(C). This section does not authorize agreements with pharmaceutical manufacturers whereby financial support for medical services covered by the Medicaid program is accepted as consideration for placement of 1 or more prescription drugs on the preferred drug list or for excluding a drug from any prior authorization requirement.
(b) The commissioner shall provide quarterly reports on the progress of negotiating supplemental rebates pursuant to this section to the joint committee on health care and the house and senate committees on ways and means. By September 1, 2006, the commissioner shall include with the next-occurring quarterly report a cost-benefit analysis of alternative negotiation strategies, including strategies used by the state Medicaid agencies in the states of Florida and Michigan to secure supplemental rebates, and any other alternative negotiation strategy that might secure lower net prescription drug costs.
(c) The commissioner shall prohibit the public disclosure of information revealing company-identifiable trade secrets obtained by the department or any officer, employee or contractor of the department in the course of negotiations conducted pursuant to this section. Such confidential information shall be exempt from public disclosure.
Section 12C.
(a) The division shall seek a prescription drug discount program waiver from the Centers for Medicare and Medicaid Services pursuant to section 1115(a) of the Social Security Act. The prescription drug discount program shall provide eligible individuals with a financial subsidy for prescription drugs equal to the average rebate paid to the Medicaid program by pharmaceutical manufacturers. Eligible individuals shall include: Medicare-eligible individuals whose financial eligibility exceeds 188 per cent of the federal poverty level and who do not have an insurance policy that covers drugs; and other individuals whose financial eligibility does not exceed 300 per cent of the federal poverty level and who do not have an insurance program that includes a prescription drug benefit.
(b) The division may establish, as part of the discount program, an annual enrollment fee. Subject to appropriation, the division shall make a payment of at least 2 per cent of the cost of each prescription or refill dispensed to individuals enrolled in the program.
(c) The division may contract with a nonprofit corporation or other entity to administer the program. Such corporation or entity shall agree to assist individuals enrolled in the program to access other free or discount prescription drug programs offered by private entities, including pharmaceutical manufacturers.
(d) The division shall report to the house and senate committees on ways and means and the joint committee on health care, not later than 60 days after the effective date of this section, on the division’s progress in implementing this section and shall report every 90 days thereafter on its progress in obtaining the waiver to those committees.”
Mr. Montigny moved that the bill be further amended by inserting after Section 36, the following new Section:-
“SECTION 36A.  The General Laws are hereby amended by inserting the following new chapter:-
Chapter 118H. The Massachusetts Prescription Drug Fair Pricing Program.
Section 1. (a) There shall be a program to reduce the cost to the commonwealth of providing prescription drugs to its citizens while maintaining high quality in prescription drug therapies. The program shall include, but shall not be limited to, the following components:
(1) developing and using a statewide, uniform preferred list of covered prescription drugs that identifies preferred choices within therapeutic classes for particular diseases and conditions, including generic and therapeutic equivalents;
(2) creating a single purchasing unit for the purchase of prescription drugs by the commonwealth;
(3) using strategies to negotiate with pharmaceutical manufacturers to lower the cost of prescription drugs for program participants, including a supplemental rebate program;
(4) developing educational programs, including a counterdetailing program, designed to provide information and education on the therapeutic and cost-effective use of prescription drugs to consumers, physicians, pharmacists and other health care professionals authorized to prescribe and dispense prescription drugs;
(5) using available cost containment tools, including clinical management tools, utilization review procedures, a prior authorization review process, duplicate prescription monitoring and refill and supply controls, that meet program objectives by reducing the cost to the commonwealth of obtaining and providing prescription drugs;
(6) observing consumer protection rules to maintain high quality in prescription drug therapies and to protect access to needed prescriptions; and
(7) operating a discount program to provide the benefit of negotiated price discounts to uninsured citizens.
(b) The following state agencies shall participate in the program authorized in this chapter, to the extent permitted by federal law:
(1) the division of medical assistance;
(2) the executive office of elder affairs;
(3) the group insurance commission;
(4) the department of public health;
(5) the department of mental health;
(6) the department of mental retardation;
(7) the department of corrections; and
(8) the division of employment and training.
(c) Any public or private health benefit plan that purchases prescription drugs may elect to participate in all or a portion of the program.
Section 2.
(a) State agencies and other participants in the program shall act as a single purchasing unit for negotiating a contract to purchase prescription drugs on behalf of the commonwealth.
(b) The prescription drug procurement unit, created by section 62 of chapter 177 of the acts of 2001, shall implement all or part of the program to the extent permitted by federal law. The secretary of the executive office of elder affairs, the commissioner of the group insurance commission and the commissioners of the departments of public health, mental health and mental retardation may renegotiate or amend existing contracts for the purchase of prescription drugs, including a contract made in conformance with said section 62, if such renegotiation or amendment is necessary to implement all or part of the program and will be of economic benefit to the health benefit plans subject to such contracts and to the beneficiaries of such plans. A renegotiated or substituted contract shall be designed to improve the overall quality of integrated health care services provided to the beneficiaries of these plans.
Section 3.
(a) State agencies and other participants in the program may contract with a third-party pharmacy benefit manager to assist in implementation of the program. Such pharmacy benefit manager shall be a non-profit corporation with expertise in the management of pharmacy benefits.
(b) No contract shall be signed with a pharmacy benefit manager unless the pharmacy benefit manager has agreed to disclose to the commonwealth, in a manner that preserves the confidentiality of any proprietary information:
(1) operating statements of the pharmacy benefit manager;
(2) total revenue attributable to pharmaceutical manufacturer rebates and total revenue not attributable to pharmaceutical manufacturer rebates;
(3) sources of rebate revenue and non-rebate revenue and the amounts of revenue from these sources;
(4) rebate management fees collected;
(5) the terms and conditions of contracts with subcontractors, including contracts with the pharmacy benefit manager’s pharmacy network; and
(6) the terms and conditions of sales or exchanges of prescription drug data concerning beneficiaries or the prescribing practices of the providers.
(c) No contract shall be signed with a pharmacy benefit manager that has entered into an agreement or engaged in 1 or more of the following practices, unless a majority of state agency participants in the program determines, after consideration of all relevant circumstances, that such agreement or practice furthers the financial interests of the commonwealth and does not adversely affect the financial or medical interests of beneficiaries:
(1) any agreement with a pharmaceutical manufacturer to favor the manufacturer’s products over a competitor’s products or to switch the drug prescribed by the patient’s health care provider with a drug agreed to by the pharmacy benefit manager and the manufacturer;
(2) any agreement with a pharmaceutical manufacturer to share manufacturer rebates and discounts with the pharmacy benefit manager or to pay soft money or other economic benefits to the pharmacy benefit manager;
(3) any agreement to share revenue with a mail order or internet pharmacy company;
(4) any agreement or practice to bill the commonwealth’s health benefit plans for prescription drugs at a cost higher than the pharmacy benefit manager pays the pharmacy; or
(5) any agreement to sell prescription drug data concerning beneficiaries or data concerning the prescribing practices of health care providers.
Section 4.
(a) The program shall include the following components:
(1) A preferred list of covered prescription drugs that identifies preferred choices within therapeutic classes for particular diseases and conditions, including generic alternatives.
(i) The preferred drug list shall be implemented as a uniform, statewide, preferred drug list for use by state agencies participating in the program and health benefit plans in the commonwealth shall be encouraged to participate in the program.
(ii) The program may use the MassHealth drug list developed by the division of medical assistance as its preferred drug list. In order to assist the state agencies participating in the program with the development, modification and timely revision of the preferred drug list, such agencies shall appoint a drug list review board. The board may be comprised in whole or in part of representatives of state agencies, including the drug use board established by the division of medical assistance pursuant to federal law, or may be established by contract with a public or private non-profit organization. The board shall:
(A) make recommendations for the adoption and maintenance of the preferred drug list based upon considerations of clinical efficacy, safety and cost-effectiveness;
(B) meet at least quarterly;
(C) to the extent feasible, review all drug classes included in the preferred drug list at least every 12 months and recommend additions to, or deletions from, the preferred drug list;
(D) establish: board procedures for the timely review of prescription drugs newly-approved by the federal Food and Drug Administration, including procedures for the review of newly-approved prescription drugs in emergency circumstances; early refill review standards; a prior authorization review process; duplicate prescription monitoring; and quality and supply controls;
(E) encourage health benefit plans to implement the preferred drug list as a uniform, statewide preferred drug list by inviting the representatives of each health benefit plan providing prescription drug coverage to residents of the commonwealth to participate as observers or non-voting members in the commissioner’s drug utilization review board and by inviting these plans to use the preferred drug list in connection with the plans’ prescription drug coverage.
(iii) Members of the board shall receive per diem compensation and reimbursement of board-related expenses. The board shall consult with a preferred drug list advisory group, which shall include: 1 designee of the commissioner of mental health; 1 designee of the commissioner of public health; 1 designee of the secretary of the executive office of elder affairs; 1 physician with experience treating MassHealth patients; 1 practicing pediatrician with experience treating MassHealth patients; 1 practicing pharmacist with experience serving MassHealth patients; 1 pharmacologist with expertise in psychiatric drugs; 1 representative of a senior citizens advocacy group; 1 representative of a disability advocacy group; and 1 representative of a statewide advocacy group representing the interests of MassHealth members.
(2) A series of educational programs including a counterdetailing program, designed to provide information and education on the therapeutic and cost-effective use of prescription drugs to consumers, physicians, pharmacists and other health care professionals authorized to prescribe and dispense prescription drugs.
(3) Consideration of alternative pricing mechanisms, including consideration of using maximum allowable cost pricing for generic and other prescription drugs.
(4) Consideration of alternative coverage terms, including consideration of providing coverage of over-the-counter drugs where cost-effective in comparison to prescription drugs and authorizing coverage of dosages capable of permitting the consumer to split each pill if cost-effective and medically appropriate for the consumer.
(5) Development of a simple, uniform prescription form designed to implement the preferred drug list and to enable prescribers and consumers to request an exception to the preferred drug list choice with a minimum of cost and time to prescribers, pharmacists and consumers.
Section 5.
(a) The program shall authorize pharmacy benefit coverage when a patient’s health care provider prescribes a prescription drug not on the preferred drug list if a patient’s health care provider certifies that:
(i) the drug is medically necessary; and
(ii) in the case of a prescription drug that is not the preferred choice in a therapeutic category on the preferred drug list,
(A) the preferred choice has not been effective or, with reasonable certainty, is not expected to be effective in treating the patient’s condition; or
(B) the preferred choice causes or is reasonably expected to cause adverse or harmful reactions in the patient.
(b) The prescriber’s certification concerning whether a particular drug has been, or is expected to be, ineffective in treating the patient or is expected to cause an adverse or harmful reaction shall be final.
(c) The program shall authorize coverage, notwithstanding any prior authorization requirement, if the patient agrees to pay any additional cost in excess of the benefits provided by the patient’s health benefit plan. This paragraph shall not apply in circumstances in which a patient’s application is inconsistent with federal Medicaid laws and regulations. This paragraph shall not affect implementation by a participating health benefit plan of tiered co-payments or other similar cost sharing systems.
(d) The program or any participating health benefit plan shall provide information on: how prescribers, pharmacists, beneficiaries and other interested parties can obtain a copy of the preferred drug list; whether changes have been made to the preferred drug list since it was last issued; and the process by which exceptions to the preferred list may be made.
(e)(1) The program’s prior authorization process shall be designed to minimize the administrative burdens on prescribers, pharmacists and consumers.
(2) The prior authorization process shall ensure real-time receipt of requests by telephone, voice mail, facsimile, electronic transmission or mail on a 24-hour, 7 days per week basis.
(3) The prior authorization process shall provide an in-person response to emergency requests by a prescriber, with telephone answering queues that shall not exceed 10 minutes.
(4) Any request for authorization or approval of a drug that the prescriber: indicates is for an emergency or urgent condition; and includes the clinical reasons for the request shall be responded to within 4 hours of the time the program or participating health benefit plan receives the request.
(5) In emergency circumstances, or if the response to a request for prior authorization is not provided within the time period established in subdivision (4) of this subsection, a 72-hour supply of the drug prescribed shall be considered to be authorized by the program or the participating health benefit plan, provided: the drug is a prescription drug approved by the United States Food and Drug Administration; and, for drugs dispensed to a Medicaid beneficiary, the drug is subject to a rebate agreement with the Centers for Medicare and Medicaid Services.
(6) The program or participating plan shall provide to participating providers a prior authorization request form designed to permit the prescriber to make prior authorization requests in advance of the need to fill the prescription and designed to be completed without unnecessary delay. The form shall be capable of being stamped with information relating to the participating provider and, if feasible, at least 1 form capable of being copied shall contain known patient information.
(f) The program’s prior authorization process shall require that the prescriber, not the pharmacy, request a prior authorization exception to the requirements of this section. The program may exempt a prescriber from the need to secure prior authorization for a specific drug category if the program determines that the prescriber has written a minimum number of scripts in that category and the prescriber prescribes prescription drugs on the preferred drug list at or above the minimum threshold for that category.
(g) A denial of authorization for coverage shall be subject to an administrative fair hearing and to all rights under section 14 of chapter 30A.
Section 6.
(a) The commissioner of health and human services or another commissioner of a participating state agency designated by program participants shall implement a pharmacy discount plan, to be known as the healthy Massachusetts discount card plan, for residents without adequate coverage for prescription drugs. As used in this section, a resident without adequate coverage means a resident of the commonwealth with no insurance coverage for prescription drugs or with coverage for which the annual maximum coverage limit under his health benefit plan has been reached. Such plan shall establish a system through which residents without adequate coverage are able to take advantage of discounted prices for prescription drugs negotiated pursuant to this chapter. Such commissioner shall implement the pharmacy discount program authorized by this section without any financial contribution by the state and may establish an enrollment fee in such amount as is necessary to support the administrative costs of the plan. The plan shall be designed to work cooperatively with other state prescription drug assistance programs, including any program created pursuant to a discount program waiver granted by the Centers for Medicare and Medicaid Services to the division of medical assistance. A commissioner may contract with a nonprofit corporation or other entity to administer the program. This corporation or entity shall agree to assist individuals eligible for the program to access other free or discount prescription drug programs offered by private entities, including pharmaceutical manufacturers.
Section 7.
(a) The commissioner of health and human services or another commissioner of a participating state agency designated by program participants shall report quarterly to the joint committee on health care and the house and senate committees on ways and means on the progress of the program in implementing a single state purchasing unit for prescription drugs pursuant to section 2. The report shall provide a status report on the formation or operation of the contract negotiated pursuant to section 2, shall identify any barriers to full implementation of section 2 and shall recommend any changes to the program or other legislative changes advisable to eliminate such barriers. The report shall also report on the program’s progress in securing the participation of other health benefit plans with the commonwealth by means of joint purchasing agreements to enhance the commonwealth’s purchasing power.
(b) Each year, for the duration of the pharmacy benefit manager contract pursuant to section 3, the commissioner of health and human services or another commissioner of a participating state agency designated by program participants shall provide a status report on the contract and the operations of the pharmacy benefit manager to the joint committee on health care and the house and senate committees on ways and means. The report shall include:
(1) a description of the activities of the pharmacy benefit manager;
(2) an analysis of the success of the pharmacy benefit manager in achieving each of the department’s public policy goals, together with the pharmacy benefit manager’s report of its activities and achievements;
(3) an assessment based upon information learned in contracting with the pharmacy benefits manager of administrative costs relating to prescription drug benefits in the Medicaid program and the prescription advantage program established pursuant to section 39 of chapter 19A, including any recommendations for increasing the administrative efficiency of such programs;
(4) any recommendations for enhancing the benefits of or minimizing inefficiencies of the pharmacy benefit manager contract or advancing the commonwealth’s public policy goals relating to pharmaceutical costs, quality and access;
(5) a fiscal report on the costs and savings to the commonwealth of the pharmacy benefit manager contract, including the information disclosed pursuant to paragraph (b) of section 3, in a manner that preserves the confidentiality of any proprietary information; and
(6) if the pharmacy benefit manager engages in any of the activities described in paragraph (c) of section 3, an explanation of the reasons for finding that such agreement or practice furthers the financial interests of the commonwealth and does not adversely affect the financial or medical interests of beneficiaries.
(c) The commissioner of health and human services or another commissioner of a participating state agency designated by program participants shall report quarterly to the joint committee on health care and the house and senate committees on ways and means concerning the cost containment aspects of the program undertaken pursuant to section 4. Such report shall include:
(1) a copy of the preferred drug list, an explanation of the list, a summary of the operation of the prior authorization process or any other cost savings measures instituted as a part of the list and an estimate of expected cost savings as a result of the preferred drug list;
(2) a description of the efforts undertaken to educate consumers and health care providers about the preferred drug list and the program’s utilization review procedures;
(3) a description of the efforts undertaken to establish programs to educate health care providers about the costs of prescribing patterns, including counterdetailing programs;
(4) a report of other cost containment strategies undertaken, including, but not limited to, alternative pricing mechanisms and alternative coverage terms, the expected savings from such strategies and the effect of such strategies on access to prescription drugs for consumers; and
(5) a status report on the development of a uniform prescription form and any barriers to such development.
(d) The joint committee on health care shall closely monitor implementation of the program, including the preferred drug list and utilization review procedures, to ensure that the consumer protection standards are not diminished as a result of implementing the preferred drug list and the utilization review procedures, including any unnecessary delay in access to appropriate medications. Such joint committee shall, by means of an oversight hearing or otherwise, ensure that all affected interests, including consumers, health care providers, pharmacists and others with pharmaceutical expertise have an opportunity to comment on the operation of the program, the preferred drug list and other procedural aspects of the program.”
Mr. Montigny moved that the bill be further amended by inserting after Section 44, the following new Section:-
“SECTION 44A.  The General Laws are hereby amended by adding after chapter 268B the following chapter:-
Chapter 268C. Physician and Pharmaceutical Manufacturer Conduct.
Section 1. As used in this chapter, the following terms shall have the following meanings:—
“Gift”, a payment, entertainment, subscription, advance, services or anything of value, unless consideration of equal or greater value is received. This term shall not include a commercially reasonable loan made in the ordinary course of business, anything of value received by inheritance, a gift received from a member of the reporting person’s immediate family or from a relative within the third degree of consanguinity of the reporting person or of the reporting person’s spouse or from the spouse of any such relative or prescription drugs provided to a physician solely and exclusively for use by the physician’s patients.
“Immediate family”, a spouse and any dependent children residing in the reporting person’s household.
“Medical device”, an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent or other similar or related article, including any component, part or accessory, which is:
(1) recognized in the official National Formulary, or the United States Pharmacopeia, or any supplement to them,
(2) intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment or prevention of disease in man or other animals, or
(3) intended to affect the structure or any function of the body of man or other animals and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of its primary intended purposes.
“Person”, a business, individual, corporation, union, association, firm, partnership, committee or other organization or group of persons.
“Pharmaceutical marketer”, a person who, while employed by or under contract to represent a pharmaceutical manufacturing company, engages in pharmaceutical detailing, promotional activities or other marketing of prescription drugs in the commonwealth to any physician, hospital, nursing home, pharmacist, health benefit plan administrator or any other person authorized to prescribe, dispense or purchase prescription drugs. The term does not include a wholesale drug distributor licensed under section 36A of chapter 112, a representative of such a distributor who promotes or otherwise markets the services of the wholesale drug distributor in connection with a prescription drug or a retail pharmacist registered under section 37 of chapter 112 if such person is not engaging in such practices under contract with a manufacturing company.
“Pharmaceutical manufacturing company”, an entity which is engaged in the production, preparation, propagation, compounding, conversion or processing of prescription drugs, either directly or indirectly by extraction from substances of natural origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis, or an entity engaged in the packaging, 1 repackaging, labeling, relabeling or distribution of prescription drugs. The term does not include a wholesale drug distributor licensed under section 36A of chapter 112 or a retail pharmacist registered under section 37 of chapter 112.
“Pharmaceutical manufacturer agent”, a pharmaceutical marketer or any other person who for compensation or reward does any act to promote, oppose or influence the prescribing of a particular prescription drug or medical device or category of prescription drugs or medical devices. The term shall not include a licensed pharmacist, licensed physician or any other licensed health care professional with authority to prescribe prescription drugs who is acting within the ordinary scope of the practice for which he is licensed.
“Physician”, a person licensed to practice medicine by the board of medicine pursuant to section 2 of chapter 112.
“Prescription drugs”, any and all drugs upon which the manufacturer or distributor has placed, or must, in compliance with federal law and regulations, place, the following, or a comparable, warning: “Caution federal law prohibits dispensing without prescription.”
Section 2. No pharmaceutical manufacturer agent shall knowingly and willfully offer or give to a physician or a member of a physician’s immediate family, and no physician shall knowingly and willfully solicit or accept from any pharmaceutical manufacturer, gifts of any value at any time.
Section 3. A person who violates this chapter shall be punished by a fine of not more than $5,000 or by imprisonment for not more than 2 years, or both.”
Mr. Montigny moved that the bill be further amended by inserting after Section       , the following new Section:-
“SECTION       .  The commissioner of the division of medical assistance, the secretary of the executive office of elder affairs, the commissioner of the group insurance commission and the commissioners of state agencies participating in the Massachusetts prescription drug fair pricing program established by chapter 118H of the General Laws shall take all steps necessary to enable the commonwealth to participate in joint prescription drug purchasing agreements with other states and other health benefit plans. Such steps shall include:
(1) Active collaboration with the National Legislative Association on Prescription Drug Prices in the Association’s efforts;
(2) Active collaboration with the Pharmacy RFP Issuing States Initiative, organized by the West Virginia Public Employees Insurance Agency; and
(3) Execution of joint purchasing agreements or other contracts with any health benefit plan or organization within or outside the commonwealth which such commissioners determine will lower the cost of prescription drugs for the commonwealth and its citizens while maintaining high quality in prescription drug therapies.”
Mr. Montigny moved that the bill be further amended by inserting after Section       , the following new Section:-
“SECTION        . (a) The General Court finds that the National Legislative Association on Prescription Drug Prices is a nonprofit organization of legislators formed for the purpose of making prescription drugs more affordable and accessible to citizens of the member states, including the commonwealth. The General Court further finds that the activities of the Association provide a public benefit to the people of the commonwealth.
(b) Three members of the senate, including 1 member of the minority party, shall be appointed directors of the Association by the senate president, and 3 members of the house of representatives, including 1 member of the minority party, shall be appointed directors of the Association by the speaker of the house.  Directors so appointed shall serve until new members are appointed.

EHS  859

IT COSTS FOR DMR

Mr. Tolman and Mr. Morrissey moved that the bill be amended, in Section 2, in item 5911-1000 by striking out the figures “$13,324,093” and inserting in place thereof the figures “$14,824,093”; and further moves to amend said section 2 in item 5920-1000 by striking out the figures “$55,914,599” and inserting in place thereof the figures “$57,096,999”; and further moves to amend said section 2 in item 5930-1000 by striking out the figures “$172,013,458” and inserting in place thereof the figures “$172,714,258”. 

EHS  860

JEWISH FAMILY SERVICES OF NORTH SHORE

Messrs. McGee and Creem moved that the bill amended, in Section 2, in item 9110-1660 by inserting after the words “Town of Framingham;” the following:- “that $125,000 shall be expended to the program operated by Jewish Family Services in the Town of Swampscott;” an by striking out the figure “$1,716,283” and inserting in place thereof the following figure:-“1,841,283”.  

EHS  861

DEAF/BLIND COMMUNITY ACCESS NETWORK

Ms. Jehlen, Mr. Timilty, Ms. Spilka and Ms. Creem moved that the bill amended, in Section 2, in item in line 4110-1000, in line 4, striking the figures “$350,000“ and

inserting in place thereof the figure “$450,000”, and striking out the

figures “$3,967,118” and inserting in place thereof the figures  “4,067,118”.  

  EHS  862

LYNN HOMELESS PREVENTION

Mr. McGee moved that the bill be amended, in Section 2, in item 4406-3000 by adding at the end thereof the following:-  “provided further, that not less than $50,280 shall be expended for the provision of health services to the homeless and uninsured by Primary Care and Mental Health, Inc. located in the City of Lynn....

EHS  863

EHS - RESOR - ENVIRONMENTAL HEALTH

Ms. Resor and Mr. Timility moved that the bill amended, in Section 2, in item 4510-0600 by striking the figure “$3,509,106” and inserting in place thereof the figures “$4,009,106”.

REDRAFT
EHS  864

PROJECT BREAD HUNGER PREVENTION

Messrs. McGee and Messrs. Tarr,  Antonioni and Augustus and Ms.Tucker and Ms.Spilka and Ms. Menard moved that the bill amended, in Section 2, line item 4400-1001, by striking out “For programs to increase the commonwealth’s participation rate” and inserting in place thereof the following: --  “For programs to increase the commonwealth’s participation rate in food stamps and other federal nutrition programs ; provided, that not less than $1,500,000 shall be expended for a contract with Project Bread-The Walk for Hunger, Inc.,”.

EHS  865

VETERAN'S BENEFIT PAYMENTS

Messrs. Brown, Lees, Hedlund, Knapik, Tarr, Tisei and Timilty moved that the bill be amended, in Section 2, in item 1410-0400, in line 46, by inserting after “countable income” the following words:-

“provided, $647, 241 be designated for reimbursing the following communities for money paid for veteran’s benefits and for payments to certain veterans under Chapter 77 of the Acts of 2005: “$87,007 be designated for Attleboro, $100 be designated for Belchertown, $482,694 be designated for Boston, $37,440 be designated for Hamilton, and $40,000 be designated for Lexington;” and in said item by striking out the figures “$14,412,585” and inserting in place thereof the figures “$15,059,826”.

EHS  866

CHILDREN'S MENTAL HEALTH SERVICES

Mr. Tolman moved that the bill amended, in Section 2, in item 5011-0100, by adding the following:-

 “provided that DMH should review and approve the children's mental health services that are required as part of the remedy approved by the federal court in Rosie D. v. Romney. provided further, that the Department of Mental Health shall report to the House and Senate Ways and Means Committee on a quarterly basis concerning the development and implementation of the children's mental health services that are required as part of the remedy approved by the federal court in Rosie D. v. Romney.” 

And in item 4000-0500, by adding the following:

“provided that funds necessary to develop and implement the first year of the remedy approved by the Court in Rosie D. v. Romney can be expended from this item;

provided further, that the children's mental health services that are included in the first year of the remedy approved by the federal court in Rosie D. v. Romney shall be developed under the direction of the Department of Mental Health and expended solely to implement such remedy; provided further, that the Office of Medicaid shall report to the House and Senate Ways and Means Committee on a quarterly basis concerning the expenditure of funds to implement the remedy approved by the federal court in Rosie D. v. Romney.”

EHS  867

REGISTRATION OF PODIATRISTS

Mr. Brown moved that the bill be amended by inserting, after section XX, the following new section:-

            “Chapter 112 of the General Laws is hereby amended by striking out section 13 and inserting in place thereof the following section:-

            Section 13.  Podiatry as used in this chapter shall mean the diagnosis and treatment of the structures of the human foot and ankle by medical, mechanical, surgical, manipulative and electrical means, and excepting treatment of systematic conditions.  Ankle surgery shall require appropriate certification or documented advanced training, as determined sufficient by the Board of Registration in Podiatry.  This section and sections fourteen to twenty-two, inclusive, shall not apply to surgeons of the United States army, navy or the United States Public Health Service, nor to physicians registered in the commonwealth.  The term physician and surgeon when used in sections twelve B, twelve G, twenty-three N and eighty B shall include a podiatrist acting within the limitation imposed by this section.”

EHS  868

ESSENTIAL COMMUNITY HEALTH SERVICES

Mr. Tolman moved that the bill be amended, in Section 2, after item 4513-1000, by inserting the following item:

“The Secretary shall provide no less than $2,000,000 for a one-time grant for a community health center in the city of Boston providing essential community health services and work training opportunities, including outpatient substance abuse treatment, the highest volume of community-based HIV/AIDS prevention and treatment and medical, mental health care, violence recovery, specialist geriatric services and ensuring access to the highest quality care to all, regardless of ability to pay.”

EHS  869

UNIVERSAL IMMUNIZATION FUNDING

Ms. Fargo moved that the bill amended, in Section 2, in item 4580-1000, by striking out the figure “$36,771,508” and inserting in place thereof the following figure:- “$37,671,508”.

EHS  870

OUTER CAPE HEALTH SERVICES

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies,” the following:-

“provided further that a $90,000 one-time essential community provider trust fund grant shall be awarded to a community health center serving the towns on the outer and lower cape in Barnstable county.”

EHS  871

MID-UPPER CAPE HEATH CENTER

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies,” the following:-

“provided further that $300,000 shall be awarded to a community health center serving the full range of the underserved population in the town of Barnstable and further serving the dental needs of the underserved population throughout the mid-cape area”.

EHS  872

ISLAND EMERGENCY MENTAL HEALTH SERVICES

Mr. O'Leary moved that the bill be amended, in Section 2, in item 5047-0001 by inserting after the words “invoice the third party insurer of all persons serviced by the programs” the following:-

“and provided further, that not less than $253,716 shall be expended for emergency mental health services on Martha’s Vineyard and Nantucket.”.

REDRAFT
EHS  873

SOUTHCOAST HOSPITAL

Mr. Montigny and Messrs. Antonioni, Augustus, Jr., Hedlund, Tarr, and Ms. Fargo moved that the bill be amended, in section 2, in item 4000-0300, by inserting after the words “implemented in fiscal year 2007” the following wording:-
“; provided further, that not less than $2,000,000 shall be expended for a one-time grant from the fund for a non-teaching, community, disproportionate share, acute care hospital located in southeastern Massachusetts, which provides inpatient care to over 7,000 MassHealth or MassHealth HMO patients per year”

REDRAFT
EHS  874

ORAL HEALTH

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4512-0500 by inserting after the words “the number of children waiting to be served by the program” the following:-
“provided further that not less than $90,000 shall be expended to Harbor Health Services, Inc. for support and implementation of a model dental program that provides comprehensive dental care for low-income uninsured adults throughout the Cape”, and in said item by striking out the figure “$1,678,150” and inserting in place thereof the following figure:- “$1,768,150”.

EHS  875

DUKES COUNTY NURSING HOMES

Mr. O'Leary moved that the bill be amended in Section 82 by inserting, at the end thereof, the following words:-

“Notwithstanding any general or special law to the contrary, for a geographically isolated, nonprofit nursing home located on an island in Dukes County, which is the sole community nursing home provider for the island and which is controlled by a nonprofit hospital located on said island, effective the first day that the historical rate relief previously awarded to said nursing home, which ended July 1, 2004, the Division of Health Care Finance and Policy, in conjunction with the Office of Medicaid and the Executive Office of Health and Human Services, shall  retroactively and prospectively establish a Medicaid rate add-on totaling $350,000 annually, to be paid on a Medicaid patient day basis.”

EHS  876

DTA CASEWORKERS

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4400-1100, by striking out the wording “and provided further that the department may allocate funds, not to exceed $1,000,000 from this item to item 4400-1000 for the administrative costs of the department of transitional assistance.”

EHS  877

CAPE COD HOSPITAL

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies,” the following:-

“provided further that a $750,000 one-time essential community provider trust fund grant shall be awarded to a sole community hospital under the Medicare program located in Barnstable county”.

EHS  878

PROVIDING FUNDING FOR OLDER WORKER RETRAINING

Messrs. Montigny, Spilka, Timilty, Tolman and Barrios moved that the bill be amended, in section 2, in item 7003-0702, by inserting after the words “Workforce Investment Board” the following:-

“; provided further, that not less than $1,000,000 shall be expended for grants to providers of workforce development and job training services for projects benefiting older adults”.

REDRAFT
EHS 879

CITIZENSHIP PROGRAM FOR LEGAL IMMIGRANTS

Messrs. Walsh, Creem, Montigny, McGee, Chandler, Tarr, Barrios, Wilkerson, Nuciforo, Buoniconti, Tolman, Joyce, Morrissey and Augustus moved that the bill be amended, in Section 2,  by inserting after item 4000-1420 the following item:

"4003-0122
For a Citizenship for New Americans Program  to assist legal permanent residents in our Commonwealth in becoming citizens of the United States; provided that the office for refugees and immigrants be charged with administering such program; provided further that said program be provided through community-based organizations to the maximum extent possible as determined by the office for refugees and immigrants; provided further that the program funded by this item provide assistance to persons who are within three years of eligibility to become citizens of the United States; provided further that services be designed to include: ESOL/civics classes, citizenship application assistance, interview preparation and support services such as interpretation and referral services...$500,000"

EHS  880

YWCA BOSTON

Ms. Wilkerson moved that the bill amended, in Section 2, in item 4000-0112 by inserting after the words “day nursery;” the following: - “provided further, that not less than $100,000 shall be expended for the YWCA Boston for a wellness program for women and girls affected by the disparities in health care in the city of Boston”

And by striking out the figure “$3,970,000” and inserting in place thereof the following figure: “$4,070,000 ”

REDRAFT
EHS  881

ENCORE PLUS

Ms. Wilkerson moved that the bill amended, in Section 2, in item 4510-0600 by inserting after the word “airport” the following: - “provided further that not less than $100,000 shall be available for the YWCA Boston’sEncorePlus, program for breast cancer education, early detection, and survivorship programs for women most at-risk for a late cancer diagnosis”
And by striking out the figure “$3,509,106” and inserting in place thereof the following figure: “$3,609,106”

EHS  882

SUBSTANCE ABUSE

Ms. Wilkerson moved that the bill amended, in Section 2, in item 4512-0200 by inserting after the words “indigent clients;” the following: - “provided further that that the commissioner of public health shall ensure that monies spent pursuant to this line item is consistent with and proportionate to the level of need among the demographic populations of the commonwealth."

REDRAFT
EHS  883

LGBT AGING PROJECT

Ms. Wilkerson, Ms. Fargo, and Mr. Barrios moved that the bill amended, in Section 2, in item 9110-9002 by inserting after the words "secretary" the following: -"provided that not less than $50,000 shall be provided to the LGBT Aging Project."

And by striking out the figure “$7,550,000” and inserting in place thereof the following figure: “$7,600,000”  

EHS  884

TRANSPLANTS

Ms. Wilkerson moved that the bill amended, in Section 2, in item 4000-0300 after the words “June 30, 2007” the following: - "provided further that an acute care hospital in which the ratio of solid organ transplants to total discharges is greater than .42 percent as of July 1, 2004 and which offers at least three organ transplantation programs shall be exempt from the inpatient and outpatient efficiency standards being applied to its rate methodology.”

REDRAFT
EHS  885

PROJECT ABLE AIDS INITIATIVE

Messrs. Montigny, Havern, Barrios and Tisei , Ms. Fargomoved that the bill be amended, in section 2, in item 4512-0103, by striking out the figure “$35,653,608”, and inserting in place thereof the figure:- “$36,785,682”.

EHS  886

FORSYTH DENTAL

Ms. Wilkerson moved that the bill amended, in Section 2, in item 4512-0500, by inserting after the words “ southeastern Massachusetts” the following: - “provided further, that not less than $750,000 shall be expended for the purposes of a demonstration project known as the “Center for Children's Oral Health” operated by local community health centers and the Forsyth Institute, to fund a school based program to offer preventive oral health care to children in high need areas including Boston, Lynn and Hyannis; provided further, that said grants shall be matched by contributions from, private entities, equal to one times the expenditures on said pilot from this line item; provided further, a report shall be filed with the joint committee on health care financing and house and senate committees on ways and means no later than June  31, 2007on the findings of said project including but not limited to, the number of children receiving care, the number of abscesses, cavities and other dental health problems encountered, and through the collection of longitudinal data said report shall examine the cost-effectiveness and sustainability through Medicaid billing of said program”

And by striking out the figure “1,678,150” and inserting in place thereof the following figure: “$2,428,150

REDRAFT
EHS  887

INPATIENT BEHAVIORAL HEALTH RATE UPDATE

Mr. Tolman and Mr. Knapik moved that the bill be amended, in Section 2, in item 4000-0500, by adding at the end thereof the following:-
“and provided further, that the Massachusetts Behavioral Health Partnership shall determine whether hospitals that are part of the inpatient behavioral health network should receive an annual rate increase not less than the Medical Consumer Price Index-All Urban Consumers for the previous state fiscal year, provided further, that the results of said determination shall be submitted to the House and Senate Committee on Ways and Means and the Committee on Mental Health and Substance Abuse no later than October 1, 2006.”

REDRAFT
EHS  888

LATINAS Y NINOS

Ms. Wilkerson and Mr. Barrios moved that the bill amended, in Section 2, in item 4512-0200, by inserting after the words “alcohol abuse” the following: - “provided further, that not less than $99,925 shall be expended for Latinas Y Ninos to provide a full-time child advocate parent educator specialist to attend to the needs of Latino women in recovery with a focus on pregnant women, new parents, and mothers recently reunified with their children”

And by striking out the figure “60,880,159” and inserting in place thereof the following figure: “
and by striking out the figures “$60,980,084 ”
                      

EHS  889

ASSERTIVE COMMUNITY TREATMENT TEAMS

Mr. Tolman moved that the bill amended, in Section 2, in item 5046-0000, by adding at the end thereof the following:-

“;provided further, that not less than $3,600,000 shall be expended for the creation of 6 new Program of Assertive Community Treatment teams;"  and provided further, that the department shall report to the house and senate committees on ways and means no later than February 16, 2007 on the use of any funds expended for this purpose…$307, 632,778”

EHS  890

PROTECTING ESSENTIAL HEALTH SERVICES

Mr. Tarr moved that the bill be amended by inserting at the end the following two sections:-

SECTION ___.

Section 51G of Chapter 111 of the General Laws is hereby amended in Subsection (4) by adding, after the first sentence, the following: -

Any such notification shall include, but not be limited to, the following:

1.      The reasons for which the closing or discontinuance is being proposed.

2.      An analysis of the economic feasibility of retaining the essential health service or hospital and the economic impacts of the proposed closing or discontinuance

3.      An analysis of the clinical safety of retaining the essential health service or hospital and any threats to public health and safety that would be caused by the proposed closing or discontinuance

SECTION ___.  Section 51G of Chapter 111 of the General Laws is hereby amended in Subsection (4) by adding, after the word “hospital” in the fourth sentence thereof the following:

            The department may, if it determines that an essential health service can be retained in a clinically safe manner without depriving the hospital of a fair net operating income, deny the proposed discontinuance and require the retention of the essential health service either in its original condition or any modification which the department deems to be satisfactory.

            In the event that a hospital proposed for closure is owned or controlled by an entity which holds a license for facilities other than the hospital proposed for closure, and the department determines that the hospital can be retained in a clinically safe manner and without depriving that entity of a fair net operating income, the department may require the retention of said hospital either in its original configuration or any modification which the department deems to be satisfactory.

REDRAFT
EHS  891

COMMONWEALTH RESEARCH CENTER

Mr. Tolman and Ms. Creem moved that the bill amended, in Section 2, by striking out item 5046-0000 and inserting in place thereof the following item:-
“5046-0000 For adult mental health and support services; provided, that the department shall allocate funds in an amount not to exceed $5,000,000 from item 5095-0015 to this item, as necessary, under allocation plans submitted to the house and senate committees on ways and means 30 days before any  transfer for residential and day services for clients formerly receiving care at department facilities; provided further, that $200,000 shall be expended for jail diversion programs; provided further, that of that $200,000, $100,000 shall be expended for the jail diversion program in Framingham; provided further, that the department shall submit a report to the house and senate committees on ways and means no later than July 15, 2006 on the feasibility of expanding this diversion program to other regions of the commonwealth; provided further, that funds spent from this item for the purposes of research in fiscal year 2007 shall exceed by $1,000,000 the amount spent in fiscal year 2006 for these purposes; provided further, that not less than $2,750,000 shall be expended for the expansion of housing for the homeless mentally ill in order to provide additional single occupancy units; provided further, that not less than $75,000 shall be expended on the expansion of employment support services at the Fairwinds Clubhouse in Falmouth; provided further, that not less than $6,000,000 shall be expended for services for clients of the department who are aging into the adult system from the child/adolescent mental health system or other systems of care if the clients meet the clinical eligibility criteria of the department;  and provided further, that the department shall report to the house and senate committees on ways and means no later than February 16, 2007 on the use of any funds expended for this purpose. $305,032,778”.

REDRAFT
EHS  892

ENHANCED COMMUNITY OPTIONS PROGRAM

Messrs. Montigny and Mr. Barrios and Ms. Tucker and Timilty moved that the bill be amended, in section 2, in item 9110-1500, by striking out the figure “$42,831,919” and inserting in place thereof the following figure:- “$43,828,512”.

EHS  893

JOSEPH SMITH COMMUNITY HEALTH CENTER

Mr. Tolman moved that the bill be amended, in Section 2, in item 4513-1000 by inserting at the end thereof the following:-

“provided further, that not less than $500,000 shall be directed to a community health center with locations both in the Allston neighborhood of Boston and in Waltham.”

EHS  894

RESIDENTIAL CARE FACILITIES TRANSFER AND RATE INCREASE

Ms. Tucker and Ms. Jehlen moved that the bill be amended, in Section 2, in item 4405-2000 by striking the words “and provided further that the department shall expend not less than $1,000,000 for rate increases to rest homes in coordination with the division of health care finance and policy” and that it be further amended by striking the figure “210,887, 077” and inserting in place thereof the following:- “186,887,077”

And that the bill be further amended in section 2 by inserting a new line item:-

9110-XXXX 
For vendor payments to rest homes; provided that the executive office shall coordinate with the division of transitional assistance to ensure that payments from line items 4405-2000 and 4408-1000 are made to residents of rest homes; and provided further that the executive office shall expend not less than $3,000,000 for rate increases to rest homes in coordination with the division of health care finance and policy…………………………………..………………………………..$27,000,000

EHS  895

HEPATITIS C

Messrs. Montigny and Barrios moved that the bill be amended, in section 2, in item 4513-1114, by striking out the figure “$562,876” and inserting in place thereof the following figure:- “$1,000,000”.

EHS  896

WITHDRAWN

EHS  897

WITHDRAWN

EHS  898

CARING HEALTH CENTER

Messrs. Buoniconti, Lees and Knapik moved that the bill be amended, in Section 2, in item 4800-0038 by inserting:-

“; and provided further, that not less than $423,000 be expended for Caring Health Center in the City of Springfield;” ; and in said section by striking out the figures “$280,336,159” and replacing the figures thereof with “$280,769,159”.

EHS  899

FOSTER CARE PLACEMENT

Mr. Augustus moved that the bill amended by inserting after Section___, the following new Section:-

Section__. Section 9 of chapter 28A of the General Laws is hereby amended by striking out, in the definition of “Placement Agency”, the words “incorporated under chapter one hundred and eighty.”

EHS  900

DEPARTMENT OF MENTAL HEALTH-HOUSING

Mr. Tolman moved that the bill amended, in Section 2, in item 5046-0000, by striking out the wording and inserting in place thereof the following wording:-

“For adult mental health and support services; provided, that the department shall allocate funds in an amount not to exceed $5,000,000 from item 5095-0015 to this item, as necessary, under allocation plans submitted to the house and senate committees on ways and means 30 days before any  transfer for residential and day services for clients formerly receiving care at department facilities; provided further, that $200,000 shall be expended for jail diversion programs; provided further, that of that $200,000, $100,000 shall be expended for the jail diversion program in Framingham; provided further, that the department shall submit a report to the house and senate committees on ways and means no later than July 15, 2006 on the feasibility of expanding this diversion program to other regions of the commonwealth; provided further, that funds spent from this item for the purposes of research in fiscal year 2007 shall not be less than the amount spent in fiscal year 2006 for these purposes; provided further, that not less than $2,750,000 shall be expended for the expansion of housing for the homeless mentally ill in order to provide additional single occupancy units and other units; provided further, that not less than $75,000 shall be expended on the expansion of employment support services at the Fairwinds Clubhouse in Falmouth; provided further, that not less than $6,000,000 shall be expended for services for clients of the department who are aging into the adult system from the child/adolescent mental health system or other systems of care if the clients meet the clinical eligibility criteria of the department;  and provided further, that the department shall report to the house and senate committees on ways and means no later than February 16, 2007 on the use of any funds expended for this purpose $304,032,778.”

EHS  901

CARING COMMUNITY HEALTH CENTER

Messrs. Buoniconti, Lees and Knapik moved that the bill be amended, in Section 2, in item 4000-0300 by inserting the following language:-

“; and provided further that a $500,000 one-time essential community provider trust fund grant shall be awarded to a community health center in the City of Springfield”.

EHS  902

HOME CARE CASE MANAGEMENT

Ms. Jehlen, Ms. Spilka and Messrs. Tarr, Nuciforo, Tisei and Joyce moved that the bill amended, in Section 2, in item  in item 9110-1633, by striking out the figure "39,311,751" and inserting in place thereof the figure "$40,370,835."

EHS  903

WITHDRAWN

REDRAFT
EHS  904

AUTISM DIVISION

Mr. Antonioni moved that the bill be amended, in Section 2, in item 5920-3010, by inserting after the words “department of metal retardation” the following words:- “provided further, that the department shall report to the house and senate committees on ways and means and the joint committee on education no later than March 1, 2007 on the number of contracted support services provided for families with autistic children under this item and the costs associated with those services; ‘

Mr. Antonioni further moved to amend the item by striking the figure “$2,200,000” and inserting in place thereof the following figure:- “$2,000,000”.

EHS  905

CLINTON HOSPITAL

Mr. Antonioni moved that the bill be amended by inserting, after Section 104, the following new Section:-

“Section XX.  The Secretary of the Executive Office of Health and Human Services shall provide a $1,000,000 one-time grant from the Distressed Provider Expendable Trust Fund for a community hospital with geriatric psychiatry beds providing essential community health services located in the town of Clinton.”.

EHS  906

EMERGENCY SHELTER FUNDING

Mr. Antonioni moved that the bill be amended, in Section 2, in item 4406-3000, by inserting at the end thereof the following:-

“provided further, that not less than $413,035 shall be expended to provide a 3 per cent rate increase for those shelters who received a per bed/per night rate of less than $30.00 in fiscal year 2006”.

EHS  907

GERIATRIC MENTAL HEALTH SERVICES

Messrs. Antonioni, Tolman, Timilty, and Ms. Tucker moved that the bill be amended, in Section 2, by inserting after item 9110-1636 the following item:-

“9110-1640
For community-based, geriatric mental health services for persons enrolled in the state home care program whose mental disabilities place them at risk of losing their ability to function independently in community settings, pursuant to regulations promulgated by the executive office of elder affairs……………………….$1,000,000”.

EHS  908

DURABLE MEDICAL EQUIPMENT--RECYCLING STUDY

Messrs. Tarr, Lees, Tisei, Knapik, Hedlund and Brown moved that the bill be amended by inserting at the end the following new section:-

“SECTION ___.  The Secretary of Administration and Finance and the Secretary of Health and Human services are hereby authorized and directed to evaluate the feasibility of contracting for recycling durable medical equipment purchased and issued by the Commonwealth through any and all of its medical assistance programs.     

Said evaluation shall include but not be limited to a request for qualifications and/or proposals for entities capable of developing, implementing and operating a system of recycling whereby an inventory of such equipment is developed and managed so as to maximize the quality of service delivery to equipment recipients and to minimize costs and losses attributable to waste, fraud and/or abuse.

The Secretary of Administration and Finance shall report the findings of said evaluation, together with cost estimates for the operation of a recycling program, estimates of the savings it would generate, and legislative recommendations, no later than December 31, 2006.”

EHS  909

RESIDENTIAL CARE FACILITIES RATE INCREASE

Ms. Tucker and Ms. Jehlen moved that the bill be amended, in Section 2, in item 4405-2000 by striking the figure “$1,000,000” and inserting in place thereof the following “$3,000,000” and by striking the figure “$210,887,077” and inserting in place thereof the figure “$212,887,077.”

EHS  910

PROVIDENCE BEHAVIORAL HEALTH HOSPITAL

Mssrs. Buoniconti and Lees moved that the bill be amended, in Section 2, in item 4000-0300 by inserting after the words “17 executive office cluster agencies” the following:

“provided further that a $4,000,000 one-time essential community provider trust fund grant shall be awarded to a two hospital system located in Hampden County, one of which hospitals provides inpatient psychiatric services for children and adults and a methadone program”

EHS  911

NORWELL FRIENDSHIP HOME

Mr. Hedlund moved that the bill be amended, in Section 2, in item 5920-3000, by inserting, after the words “acts of 2004;” the following: - “provided further that not more than $50,000 be expended for the Friendship Home project in the town of Norwell.”

REDRAFT
EHS  912

COUNCILS ON AGING

Ms. Jehlen, Ms. Tucker, Ms. Creem,  Messrs Nuciforo, , Hedlund, Moore and Ms. Chandler, Ms. Fargo, Ms. Joyce, Tarr, Knapik, Timilty, McGee and Ms. Chandler moved that the bill amended, in Section 2, in item 9110-9002 by striking out the figure “$7,550,000” ” and inserting in place thereof the figure  “8,450,000”.

EHS  913

NORWELL SENIOR CENTER

Mr. Hedlund moved that the bill be amended, in Section 2, in item 9110-9002 by inserting, after the words “the secretary;” the following: - “provided further, that not more than $900,000 in matching funds shall be expended to the town of Norwell for the construction of a new senior citizen center in said town.”

REDRAFT
EHS  914

CRISIS CENTERS

Mr. Lees and Mr. Barrios moved that the bill be amended, in Section 2, in item 4513-1000, by inserting at the end thereof the following:-
“provided further, that not less than $427,225 shall be expended for increased services related to Rape Crisis Centers, batterers intervention services, and improved disability access for domestic violence and sexual assault prevention and treatment”

and moved that the bill be further amended, in item 4513-1000, by striking the figure “$9,406,787” and inserting in place thereof the following figure:- $9,834,012”

EHS  915

Rural Based Maternal Health Services

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4513-1000 by inserting after the words “health services through combined primary care,” the following:-

"provided further that of said $450,000 not less than $100,000 shall be made available to Outer Cape Health Services to provide rural based maternal-child health services through combined primary care".

EHS  916

ASTHMA ASSESSMENTS

Mr. Morrissey moved that the bill be amended, in Section 2, by inserting after line item 4513-1121 by inserting the following new line item:-

4513-1122      
For the purposes of a grant to a community health center for an Asthma Assessment and Case Management Program to service the communities in Braintree, Hull, Quincy and Weymouth, to promote correct diagnosis and severity assessment, to mitigate the adverse health effects of and contain health care costs of persistent asthma treatment through patient and family education about medication, the triggers of asthma attacks, disease self-management skills including, but not limited to, medication administration, measurement of peak follow and spiromety, and environmental home assessments; provided that, funds shall be expended to support the assignment of one asthma case management nurse to each to service each of the said communities to manage the currently identified 700 patients with an asthma diagnosis as well as all subsequently identified patients;  provided further, that awareness efforts shall be presented in multiple languages and in a culturally appropriate manner where applicable; provided further, that asthma counseling, testing, and case management services shall be integrated into all existing health care service programs to promote public awareness; and provided further, that funds in this item shall supplement the services provided to children and adults with asthma; provided further, that records shall be maintained for the total number of children and adults presenting with and treated for asthma; total number who continue on the case management program; rate of hospital emergency room usage across both groups; number of  patients with persistent asthma on an anti-inflammatory medication; percentage of patients with written asthma action plans; percentage of patients with an established personal best peak flow; percentage of patients with a documented severity assessment; percentage of patients with a documented self management goals; percentage of patients with current environmental tobacco smoke exposure; and the number of hours spent by nurses on case management by site, and said community health center shall provide a written report shall back to the Health Care Finance Committee in July 2007 with analysis of the impact of the program on costs and disease management goals of the program…………........$400,000

EHS  917

DEPARTMENT OF MENTAL RETARDATION INFORMATION TECHNOLOGY

Mr. Morrissey moved that the bill be amended, in Section 2, in item 5911-1000, by striking out the figure “13,324,093” and inserting in place thereof the following:- “14,824,093”

Mr. Morrissey further moved that the bill be amended, in Section 2, in item 5920-1000, by striking out the figure “55,914,599” and inserting in place thereof the following:- “57,096,999”

Mr. Morrissey further moved that the bill be amended, in Section 2, in item 5930-1000, by striking out the figure “172,013,458” and inserting in place thereof the following:- “172,714,258”

EHS  918

WITHDRAWN

EHS  919

AGING IN PLACE PROGRAM TECHNICAL AMENDMENT

Ms. Creem, Ms. Spilka, and Mr. Tolman moved that the bill amended, in Section 2, in item 9110-1660, by striking the words “provided further, that $375,000 shall be expended for the Aging Well At Home Program in the city of Malden and the town of Framingham” and inserting in place thereof the following language:- “provided further, that $375,000 shall be expended for the Aging Well At Home Program operated by Jewish Family & Children’s Service of Greater Boston (JF&CS) in the town of Brookline and the city of Malden, and by Jewish Family Service of Metrowest (JFS/MW) in the town of Framingham.”

EHS  920

MANET COMMUNITY HEALTH CENTER

Mr. Morrissey moved that the bill be amended, in Section 2, in item 4000-0320 after the words “purposes of item 4000-0300” the following:- “provided further that $300,000 shall be expended for the Manet Community Health Center in the city of Quincy”.

EHS  921

BATTERER INTERVENTION PROGRAM

Ms. Creem and Mr. Barrios and Mr. Timilty and Ms. Tucker moved that the bill amended, in Section 2, in item 4800-1400, by inserting before the words “certified batterer intervention programs for indigent batterers and their families the following” the following “provided further not less than $936,410 shall be expended for” and in same item striking the amount “$21,088,691” and inserting in place thereof the following figure:-“21,288,691.”

EHS  922

QUALIFYING QUINCY MEDICAL CENTER FOR THE ESSENTIAL COMMUNITY PROVIDER TRUST FUND GRANT

Mr. Morrissey moved that the bill amended, in Section 2, in item 4000-0300 be amended by inserting after the words “17 executive office cluster agencies,” the following: -

";provided further, that a $4,000,000 one-time essential community provider trust fund grant shall be awarded to a hospital in a city adjacent to Boston affiliated with the teaching hospital that serves the highest number of uninsured patients.” 

REDRAFT
  EHS  923

BEDSIDE ADVOCATES, INC

Ms. Creem and Messrs. Moore, Joyce and TarrMr. Timilty moved that the bill amended, in Section 2, in item 4510-0710 by adding the following:- “provided further, that $20,000 shall be expended for Bedside Advocates, Inc. for the development of a pilot project focused on transitional care for geriatric patients transitioning to their homes from acute care hospitals” and by striking the figures “7,994,057” and inserting in place thereof the figures “8,014,057”

REDRAFT
EHS  924

SMOKING PREVENTION AND CESSATION PROGRAMS

Messrs Morrissey and Mr. Montigny, Mr. Augustus, Jr.,  Ms. Fargo, Havern, Creedon, Joyce, Tolman, Brown, Hedlund, and Chandler moved that the bill be amended, in Section 2, in item 4590-0300, by striking out the following: “For smoking prevention and cessation programs; provided that no funds shall be expended in the AA subsidiary for any personnel-related costs” and inserting in place thereof the following:

“For youth smoking prevention and tobacco control programs, including enforcement of illegal sales to children laws by local boards of health and coordinated treatment resources including the Tobacco Free Helpline and QuitWorks; provided, that no funds shall be expended in the AA subsidiary, so-called, for any personnel-related costs; and further provided that, there is hereby established a tobacco control advisory council which shall review tobacco control programs in the Commonwealth and make recommendations for future tobacco control needs.  Said council shall consist of 20 members: one of whom shall be the secretary of health and human services, or his designee, who shall be a nonvoting member; one of whom shall be the commissioner of public health, or his designee, who shall be a nonvoting member; one of whom shall be the director of the office of Medicaid, or his designee, who shall be a nonvoting member; and 13 of whom shall be appointed by the governor: one member representing the Massachusetts Public Health Association; one member representing Tobacco Free Mass; one member representing the American Cancer Society, New England Division; one member representing the American Heart Association; one member representing the Asthma and Allergy Foundation of America, New England chapter; one member representing the American Lung Association; one member representing the Massachusetts Medical Society; one member representing the Massachusetts Municipal Association; one member representing the Massachusetts Association of Health Boards; one member representing the Massachusetts Association of Health Plans; one member representing the Massachusetts League of Community Health Centers; one member representing Boston Public Health Commission; one member representing the Springfield Health Department; and one member representing the Worcester Health Department; and two members appointed by the speaker of the house, one of whom shall be a representative of a public or private institution with expertise in tobacco cessation and control and one of whom shall be a representative from a community disproportionately affected by tobacco health disparities; and two members to be appointed by the senate president, one of whom shall be a representative of a public or private institution with expertise in tobacco cessation and control and one of whom shall be a representative from a community disproportionately affected by tobacco health disparities.  In the event that an organization, association or other entity or successor organization, association or other entity named herein ceases to exist, the governor shall appoint a comparable replacement appointee.  All appointments shall be for terms of three years.  Once established, the advisory council shall elect a chairperson and establish by-laws which will govern all aspects of its operation.

Said commission shall monitor the performance and effectiveness of tobacco control programs and services in the Commonwealth and shall make recommendations for the expansion or contraction of existing services and/or the provision of new services.  Said recommendations shall be based, to the extent feasible and appropriate, upon an evaluation of scientific data and research, current tobacco use and trends data, outcomes from current programs and services, and the Best Practices Guidelines of the Centers for Disease Control for comprehensive tobacco control programs.  Said commission shall meet not less than quarterly and shall file an annual report at the end of each fiscal year with the Office of the Governor, the Clerk of the House of Representatives and the Clerk of the Senate.  Said report shall include, but not be limited to, an analysis of revenues received that fiscal year from the Tobacco Settlement Fund and tobacco taxes, the percent of such funds allocated to tobacco control programs, trends in youth and adult smoking rates and tobacco-related disease, and recommendations for implementing and improving programs and services”

and in said item by striking out the figure “4,250,000”; and inserting in place thereof the figure “$15,000,000”

EHS  925

TECHNICAL AMENDMENT - ELDER HOMELESSNESS

Ms. Creem moved that the bill amended, in Section 2, in item 9110-1660 by striking out the words “the Committee to End Elder Homelessness, Inc.” and inserting in place thereof the word “HEARTH”  

EHS  926

FAMILY CAREGIVERS

Messrs. Rosenberg and Joyce move that the bill be amended, in Section 2, in item 4000-0600, by inserting after the words “services to an elder:’ the following:- “provided further, that not less than $1 million shall be expended for the Massachusetts Family Caregivers program to provide supportive services to individuals who are providing uncompensated care to people over the age of 60 to allow them to remain living in the community, as state matching funds for the National Family Caregiver Support Program pursuant to the federal Older Americans Act;”  

EHS  927

BAYSTATE VISITING NURSE AND HOSPICE ASSOCIATION

Messrs. Buoniconti and Lees moved that the bill be amended, in Section 2, in item  4000-0300 by inserting the following:-

“; and provided further that a $1,000,000 one-time essential community provider trust fund grant be awarded to the Baystate Visiting Nurse and Hospice Association”.   

REDRAFT
EHS  928

SECOND STEP

Ms. Creem moved that the bill amended, in Section 2, in item 4512-0200 by adding the following:- “provided further, that not less than $75,000 shall be provided to Second Step, Inc. in the city of Newton for the provision of substance abuse prevention and education programs to survivors of domestic violence and their children” and said item is further amended by striking out the figures “60,880,159” and inserting in place thereof the following figures “60,955,159”.

REDRAFT 
EHS  929

SECOND STEP

Ms. Creem moved that the bill amended by adding the following new Section:-
SECTION _____.   Notwithstanding the provisions of any general or special law to the contrary, a member, who is receiving a lesser retirement allowance in accordance with the terms of Option (c) of subdivision (2) of section 12 of chapter 32 of the General Laws, from a retirement system that accepts the provisions of this act, shall have his retirement allowance determined according to the table of mortality selected by the commission pursuant to section 336 of chapter 47 of the acts of 2004. Any retirement system may accept the provisions of this act by a majority vote of the board of each such system, subject to the approval of the legislative body. For the purposes of this act, “legislative body” shall mean, in the case of a city, the city council in accordance with its charter, in the case of a town, the town meeting, in the case of a county, the county retirement board advisory council, in the case of a region, the regional retirement board advisory council, in the case of a district, the district members, and, in the case of an authority, the governing body.  For purposes of this act, the state teachers’ and state employees’ retirement systems shall be deemed to have accepted the provisions of this act. 
The provisions of this Section shall be prospective from the effective date of this act and shall not entitle any member or spouse of a deceased member to any retroactive benefits.

REDRAFT
EHS  930

ADULT DAY HEALTH RATES

Mr. O'Leary, Ms. Chandler, Mr. Joyce, Ms. Creem, Ms. Fargo, Ms. Tucker, Mr. Montigny, Ms. Spilka, Mr. Brewer, Mr. Timilty and Mr. McGee moved that the bill be amended, in Section 2, in item 4000-0600 by inserting at the end thereof the following: _
“provided further that in fiscal year 2007 the division of health care finance and policy shall adjust rates for providers of adult day care by no less than $5,150,000 in the aggregate, which shall be over and above any previously authorized rate increase”.

EHS  931

BIRTH DEFECTS MONITORING

Ms. Creem and Ms. Spilka and Mr. Timilty and Mr. Tisei moved that the bill amended, in Section 2, in item 4510-0600, by inserting after the words “February 1, 2007;” the following: - “provided further, that $750,000 shall be expended for the Massachusetts Birth Defects Monitoring Program;”; and in said item by striking out the figure “$3,509,106” and inserting in place thereof the figure “$4,259,106”.  

REDRAFT
EHS  932

EXTENDED CARE CAREER LADDER INITIATIVE TRUST FUND

Messrs. Montigny, Brewer, Timilty, Moore and Ms. Tucker moved that the bill be amended by inserting after Section 63, the following new Section:-

“SECTION 63A.  Section 410 of chapter 159 of the Acts of 2000 is hereby amended by adding at the end the following:-
There is hereby established an Extended Care Career Ladder Initiative Trust Fund, hereafter known as the “ECCLI Trust” or the “Trust”, which shall provide grants, scholarships or loans to support the continued development of the long-term care workforce as a primary vehicle for improving the quality of patient care in Massachusetts.  The ECCLI Trust continues the important work of the Extended Care Career Ladder Initiative and the Certified Nursing Assistant and Home Health Aid Scholarship Program, which together have successfully increased the number of qualified long-term care workers and enhanced the retention of qualified long-term care workers in coordination with long-term care employers who are transforming the industry towards patient-centered care and improved quality.
The ECCLI Trust shall be established as an expendable trust and shall not be subject to appropriation.  The trust shall be exempt from sections 5D and 6B of chapter 29 of the general laws.  The ECCLI Trust shall be structured to ensure that programs are not hindered or caused to fail as a result of restrictive timelines.  ECCLI-funded programs shall be designed to prepare the continuum of workers needed to support the long-term care industry’s current and future needs.  ECCLI grant periods may be from eighteen months to four years in duration, and may include planning and evaluation phases.  The Trust shall allow and encourage the leveraging of non-state resources to support ECCLI-related activities.
The ECCLI Trust shall be operated by the Commonwealth Corporation, in accordance with the following subsections:

• The Commonwealth Corporation shall be the administrator of the Trust.  The Commonwealth Corporation shall maintain the Trust as a separate account and shall cause it to be audited by an independent accountant on an annual basis in accordance with accepted accounting principles.
• There shall be credited to the Trust, revenue from appropriations or other monies authorized by the general court and specifically designated to be credited to the Trust, and gifts, grants, private contributions, repayment of loans, investment income earned on the Trust’s assets, and all other sources.  Money remaining in the Trust at the end of a fiscal year shall not revert to the general fund and shall remain in the Trust.
• An advisory committee shall be established that represents significant constituencies with interest in the size and quality of the current and future long-term care workforce.  The advisory committee shall include, but not be limited to, the following members or their designees: the house and senate chairmen of the joint committee on healthcare financing; the commissioner of the Massachusetts department of public health; the director of the department of workforce development; the secretary of the executive office of elder affairs; the commissioner of the department of transitional assistance; the commissioner of the department of education; and one representative each from the Massachusetts Community College Executive Office, the Massachusetts Extended Care Federation, the Massachusetts Home and Health Care Association, MassAging, the Massachusetts Council for Homecare Services, Mass AFL-CIO, SEIU Local 1199, and the Massachusetts Workforce Board Association.  The advisory committee shall supply constituent-focused labor market information or other relevant information, review general programmatic parameters and guidelines, assist with the identification of issues and barriers to the Trust’s success and effectiveness and the dissemination of relevant information about the Trust to constituents, and support the general oversight of Trust implementation.  The Commonwealth Corporation shall convene the advisory committee at least quarterly.
• A competitive grant program shall be established that supports long-term care employers, either individually or in consortia, to develop and implement career ladder programs for direct care and entry-level workers.  The Commonwealth Corporation in coordination with the advisory committee shall annually establish the guidelines and funding parameters for the competitive grant program.  In order to receive funding, proposed programs shall demonstrate clear linkages to desired improvements in the quality of patient care or the transition to patient-centered care practices.  The grant program shall incorporate evaluation parameters and resources to assess over time the effectiveness of programmatic interventions, particularly in regard to: worker retention rates, promotions, and wage gains; employer cost reductions; improvements in selected MDS-established indicators of patient care quality; and the success of efforts by employers to institutionalize new workplace and career ladder practices.  Grant-funded projects shall involve regional partners from the workforce development, education, and support services communities as warranted by the project’s scope and purpose.  All project submitters shall coordinate proposal development with the local workforce investment board, which shall provide programmatic technical assistance and ensure that appropriate local resources are fully leveraged.  Funded employers shall provide at least 50 per cent wage release time for all employees participating in occupational training components of the project, and a wage increase upon successful completion of occupational training of at least $.25 per hour.
• A special grant program may be created at the discretion of the advisory committee if certain parameters are not met through the competitive grant program; special programs may be established to address poor regional distribution, the poor or inadequate quality of proposal submissions, scaling up the use of proven practices, under-representation of a significant or critical subgroup of the long-term care workforce, increasing workforce diversity, or the need for specific research or project demonstrations in identified problem areas.  Planning grants may also be offered for partners to define employer needs, to make necessary curriculum and other programmatic improvements to align with employer needs or to determine the feasibility of a proposed workforce development intervention.  Planning grants shall not exceed $20,000 and shall be for durations of no longer than three months.
• The Certified Nursing Assistant and Home Health Aid Scholarship Program shall be funded as a separate but related program of the Trust.  The scholarship program shall be administered by the Massachusetts department of public health, hereafter “the department”, in coordination with the advisory committee established under subsection (c) to ensure coordination of relevant services for participants and that economies of scale are achieved wherever possible.  The department shall establish appropriate guidelines and application criteria for the administration of the program; provided that the scholarships shall cover the full cost of tuition to an approved certified nurses' aide or long-term care direct worker training program; provided further, that the department in coordination with the advisory committee may reduce scholarship amounts to individuals with income over 150 per cent of federal poverty guidelines in the event of insufficient funds; provided further, that approved programs may provide for cross-training; provided further, that funds may also be available to provide adult basic education and English as a second language training for applicants otherwise meeting criteria for the scholarships, as well as pilot training programs using enhanced curricula designed to support increased retention; provided further, that the department shall, in consultation with the nursing home industry, consumer groups, the department of labor and workforce development, the Commonwealth Corporation, training providers and other appropriate state and local agencies, conduct outreach regarding the availability of such scholarships; provided further, that the department shall consult with the scholarship program advisory council and the extended care career ladder initiative to review and recommend new training requirements for certified nurses' aides, home health aides and home care workers to improve the quality of the direct care workforce and the quality of care provided in all long-term care settings by developing skill standards, supporting the transition from training to work, improving retention, promoting portability, recognizing career advancement curricula and addressing language and education barriers; provided further, that the department shall establish and support evaluative measures to determine the effectiveness and responsiveness of the program to meet workforce needs in a timely manner, and to inform training providers when curricular or programmatic improvements may be required; and provided further, that costs for outreach activities shall not exceed 5 per cent of the amount appropriated in this item and administrative costs of the program shall not exceed 5 per cent of the amount appropriated in this item.
• The Commonwealth Corporation shall annually, by September 30 each year, report to the house and senate committees on ways and means, and the joint committee on healthcare financing, the status of grants and scholarships awarded, the number of participants receiving services, and the results or impact of service provision, including the number and types of promotion received, or, in the case of the scholarship program, the number of individuals completing training and securing employment, the average wage gain per participant completing occupational training, employer retention rate improvements, and the results of quantitative and qualitative evaluation efforts.
  
  

EHS  933

MASSHELATH BEHAVIORAL HEALTH BENEFIT

Mr. Berry and Ms. Spilka, Mr. Tisei, Mr. Antonioni, Mr. Timilty, Mr. Creem and Mr. Montigny moved that the bill amended, in Section 2, in item 4000-0500, by adding at the end thereof the following workding:-

““Notwithstanding the provisions of any general or special law to the contrary, the secretary of the executive office of health and human services shall not reassign to a managed care plan under contract with the Office of MassHealth the behavioral health benefit of any eligible person when such benefit is managed by MassHealth’s specialty behavioral health managed care contactor, after the benefit is elected by or initially assigned to such person, unless such person provides written or verbal consent to the reassignment.”   

EHS  934

ELECTIVE ANGIOPLASTY STUDY

Messrs. Panagiotakos, Spilka, Hedlund and Moore moved that the bill be amended, in Section 2, in item 4510-0710 by inserting after the words “satisfaction in long-term care facilities;” the following text:- provided further; Notwithstanding any general or special law to the contrary, any hospital that does not provide on-site open heart surgery but does provide primary or emergency angioplasty and has been approved by the Department of Public Health to participate in a randomized study by the Harvard School of Public Health to provide on-site elective angioplasty, shall be provided not less than $100,000 to cover certain startup costs incurred in participating in the study.  Such costs shall include, but not be limited to, the costs of establishing the data collection and quality review oversight functions of the study

REDRAFT
EHS  935

ABSTINENCE EDUCATION

Mr. Baddour moved that the bill be amended, in Section 2, in item 4510-0100, by striking out the following;-“and provided further, that no state or federal funding shall be used for classroom based abstinence-only programming” and adding in place thereof the following:-“and provided, that the use of state or federal funding for school-based abstinence education shall work only in conjunction with the teaching of comprehensive sexuality education.”

EHS  936

REPORTING REQUIREMENTS

Mr. Rosenberg moved that the bill be amended, in Section 2, in item 4800-0038, by striking the words, “that the department shall report quarterly to the chairs of the joint committee on children and families and the chairs of the house and senate committees on ways and means on the progress of the department’s re-procured system of care;” and inserting in place thereof the following, “that the department shall submit to the chairs of the joint committee on children and families and the chairs of the house and senate committees on ways and means an implementation plan for its re-procured system of care not later than August 15, 2006 and shall report quarterly to said committees on the status of the implementation progress;”

 and further amended in Section 2, in item 4800-0041, by inserting after the words, “shall provide quarterly reports” the following, “to the chairs of the joint committee on children and families and the chairs of the house and senate committees on ways and means”  

REDRAFT
EHS  937

TRAUMA CENTER FUNDING

Messrs. Brown, Tisei and Timilty and Ms. Spilka and Ms. Creem moved that the bill be amended, in Section 2, in item 5046-0000, by inserting after the words "in Falmouth;" the words:- "provided further, that $100,000 shall be expended for the Trauma Center at Riverside Community Care for the purposes of hiring a director and to ensure rapid response to traumatic events including but not limited to suicides;" and in said item by striking out the figures "$304,032,778" and inserting in place thereof the figures "$304,132,778."

EHS  938

WITHDRAWN

REDRAFT
EHS  939

LICENSURE OF HEALTH CARE REPRESENTATIVES AND GIFT BAN

Mr. Montigny moved that the bill be amended by inserting after Section        , the following new Section:-

“SECTION        .  The department of public health, in consultation with the board of registration of pharmacy, shall promulgate regulations requiring the licensing of all pharmaceutical representatives.  As a prerequisite to such licensing, pharmaceutical representatives shall complete such training as may be deemed appropriate by the department.  As a prerequisite to the renewal of such license, pharmaceutical representatives shall complete continuing education as may be deemed appropriate by the department.  The fee for such license shall be $500 per year.  Revenue generated from this fee shall be divided in equal shares, 50 per cent to the office of attorney general, line item 0810-0000, for the investigation and prosecution of Medicaid fraud and other fraudulent drug pricing schemes disadvantaging the commonwealth or its citizens and 50 per cent to the board of registration in pharmacy, line item 4510-0722, to assist the board in implementing patient safety and medical error reduction programs.”

Mr. Montigny moved that the bill be further amended by inserting after Section        , the following new Section:-

“SECTION        .  The General Laws are hereby amended by adding after chapter 268B the following new chapter:-

Chapter 268C.  Physician and Pharmaceutical Manufacturer Conduct
Section 1.  As used in this chapter, the following words shall have the following meanings:-
"Gift", a payment, entertainment, travel, honorarium, subscription, advance, services or anything of value, unless consideration of equal or greater value is received.  “Gift" shall not include anything of value received by inheritance, a gift received from a member of the physician’s immediate family or from a relative within the third degree of consanguinity of the physician or of the physician’s spouse or from the spouse of any such relative, or prescription drugs provided to a physician solely and exclusively for use by the physician’s patients.
"Immediate family", a spouse and any dependent children residing in the reporting person's household.
“Medical device”, an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part, or accessory, which is:
            (1) recognized in the official National Formulary, or the United States Pharmacopeia, or any supplement to them,
            (2) intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or
            (3) intended to affect the structure or any function of the body of man or other animals, and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of its primary intended purposes.

            "Person", a business, individual, corporation, union, association, firm, partnership, committee, or other organization or group of persons.

“Pharmaceutical marketer”, a person who, while employed by or under contract to represent a pharmaceutical manufacturing company, engages in pharmaceutical detailing, promotional activities, or other marketing of prescription drugs in this state to any physician, hospital, nursing home, pharmacist, health benefit plan administrator, or any other person authorized to prescribe, dispense, or purchase prescription drugs.  The term does not include a wholesale drug distributor licensed under section 36A of chapter 112, a representative of such a distributor who promotes or otherwise markets the services of the wholesale drug distributor in connection with a prescription drug, or a retail pharmacist registered under section 37 of chapter 112 if such person is not engaging in such practices under contract with a manufacturing company.

“Pharmaceutical manufacturing company”, any entity which is engaged in the production, preparation, propagation, compounding, conversion, or processing of prescription drugs, either directly or indirectly by extraction from substances of natural origin, or independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis, or any entity engaged in the packaging, repackaging, labeling, relabeling, or distribution of prescription drugs.  The term does not include a wholesale drug distributor licensed under section 36A of chapter 112 or a retail pharmacist registered under section 37 of chapter 112.

“Pharmaceutical manufacturer agent”, a pharmaceutical marketer or any other person who for compensation or reward does any act to promote, oppose or influence the prescribing of a particular prescription drug or medical device or category of prescription drugs or medical devices.  The term shall not include a licensed pharmacist, licensed physician or any other licensed health care professional with authority to prescribe prescription drugs who is acting within the ordinary scope of the practice for which he is licensed.

“Physician”, a person licensed to practice medicine by the board of medicine pursuant to section 2 of chapter 112 who prescribes prescription drugs for any person, or the physician’s employees or agents.

“Prescription drugs”, any and all drugs upon which the manufacturer or distributor has placed or must, in compliance with federal law and regulations, place the following or a comparable warning: “Caution federal law prohibits dispensing without prescription.”

“Public official”, any state, municipal or county employee as defined in section 1 of chapter 268A of the general laws.

Section 2.  No pharmaceutical manufacturer agent shall knowingly and willfully offer or give to a physician or a member of a physician’s immediate family or a health care facility or employee or agent of a health care facility or a public official, and no physician or health care facility or employee or agent of a health care facility or public official shall knowingly and willfully solicit or accept from any pharmaceutical manufacturer, gifts of any value.

Section 3.  A person who violates this section shall be punished by a fine of not more than $5,000 or by imprisonment for not more than 2 years, or both.”

REDRAFT
EHS  940

ADOPTION SERVICES

Mr. Barrios and Ms. Spilka moved that the bill amended, in Section 2, in item 4800-0038 after the phrase “foster parents” to include:- provided further not less than $375,000 shall be expended for Center for Family Connections to provide therapeutic and rehabilitative mental health services, targeted research on well being outcomes and permanency planning for older, hard to place youth and those aging out of the system and further move to amend the item by striking ”$280,336,159” and insert in place thereof the following figure:- $280.711,159.”

EHS  941

RETAINED REVENUE ACCOUNT

Mr. Barrios moved that the bill be amended, in Section 2, in item 4800-0016 after the phrase “administering the program” by inserting the following:- provided, that notwithstanding any general or special law to the contrary, the commissioner of social services may enter into a contract with Roca, Inc., a not for profit community based agency, to manage the transitional employment program and to provide services to participants from the ageing out population, parolees, probationers, youth service releasees, or other community residents considered to have employment needs.

EHS  942

HEALTH CARE SERVICES FUNDING

Ms. Tucker moved that the bill be amended, in Section 2, in item 4000-0700 by striking at the end thereof the amount “$1,517,399,331” and inserting in place thereof “1,520,399,331.”

EHS  943

PARTNERS FOR YOUTH WITH DISABILITIES

Mr. Barrios and Ms. Creem moved that the bill amended, in Section 2, in item 5920-2000 after the phrase “Best Buddies Massachusetts” to include:- provided further that not less than $200,000 shall be expended for Partners for Youth with Disabilities.  

EHS  944

DOMESTIC VIOLENCE SERVICES IN THE GLBT COMMUNITY

Mr. Barrios, Mr. Augustus, Mr. Buoniconti, Ms. Chandler, Ms. Creem, Ms. Fargo, Mr. Havern, Ms. Jehlen, Mr. Joyce, Mr. Lees, Mr. McGee, Mr. Montigny, Ms. Resor, Ms. Spilka, Mr. Timilty, Mr. Tolman and Ms. Wilkerson moved that the bill amended, in Section 2, in item 4513-1000 after the phrase “combined primary care” to include:- provided further that not less than $616,000 shall be expended for the public health model of community engagement and intervention services and crisis housing for sexual violence and intimate partner violence in the GLBT community; and in said item by striking out the figures “$9,406,787” and inserting in place thereof the following figures “$10,022,787.”

REDRAFT
EHS  945

EMERGENCY PRESCRIPTION DRUG COVERAGE FOR SENIORS AND THE DISABLED EXTENSION  

Messrs. Montigny, Moore, Spilka, Joyce, Menard, O'Leary, Creedon, Resor, Brown, Timilty, Barrios, Fargo, Tarr, Walsh, Chandler, Wilkerson, Creem, Havern, Tucker, Knapik, Pacheco, Brewer, Barrios, Jehlen, Nuciforo, Tisei, McGee, Morrissey, Fargo, Antonioni, Augustus, Hudlund, Tarr, and Walsh moved that the bill be amended by inserting after Section        , the following new Section:-
“SECTION        .  Chapter 175 of the Acts of 2005 is hereby amended by inserting at the end the following new sections:
Section 8.  Notwithstanding any general or special law to the contrary, the subsidized catastrophic prescription drug insurance program established in section 39 of chapter 19A of the General Laws (“Prescription Advantage”) shall provide coverage for a 1-time supply of prescribed medications in the amount prescribed, up to a 30 day supply, between July 1, 2006 and December 31, 2006 to enrollees who are also eligible for Medicare prescription drug coverage, and who have not already received a 1-time supply under section 4 of this chapter.  After an enrollee exhausts the availability of the 1-time 30-day supply of a medication under this section or section 4, or after December 31, 2006, the program shall provide coverage, free of charge, for a 1-time, 72-hour supply of such medication.  Both the 30-day supply and the 72-hour supply shall be available in all instances in which the pharmacist cannot bill a Medicare prescription drug plan at the time the prescription is presented.  Any co-pay or deductible that would have been charged to the enrollee under section 39 of chapter 19A shall apply to the 1-time 30 day supply.
Section 9.  Notwithstanding any general or special law to the contrary, the secretary of health and human services, in consultation with the director of Medicaid, shall authorize MassHealth payment for a 1-time supply of prescribed medications in the amount prescribed, up to a 30 day supply, between July 1, 2006 and December 31, 2006 to beneficiaries under chapter 118E of the General Laws  who are also eligible for Medicare prescription drug coverage, and who have not already received a 1-time supply under section 5 of this chapter.  After a beneficiary exhausts the availability of the 1-time 30-day supply of a medication under this section or section 5, or after December 31, 2006, MassHealth shall provide coverage, free of charge, for a 1-time, 72-hour supply of such medication.  Both the 30-day supply and the 72-hour supply shall be available in all instances in which the pharmacist cannot bill a Medicare prescription drug plan at the time the prescription is presented.  Any co-pay or deductible that would have been charged to the beneficiary under MassHealth shall apply to the 1-time 30 day supply.  In the event that the Medicare prescription drug plan covers the prescribed medication at the time the prescription is presented, but charges a co-pay or deductible in excess of what would have been charged to the beneficiary under MassHealth, MassHealth shall pay the excess amount and the beneficiary shall pay what would be payable under MassHealth.”

Section 10.  The executive office of health and human services shall seek reimbursement for costs incurred under this act from the Centers for Medicare and Medicaid Services and any independent prescription drug plans where possible.

EHS  946

WITHDRAWN

EHS  947

EXPANDING WORK REQUIREMENTS FOR TAFDC RECIPIENTS

Ms. Spilka moved that the bill be amended by adding at the end thereof the following new section:-

  “SECTION __:

Notwithstanding any general or special law to the contrary, the families eligible for assistance pursuant to chapter 5 of the acts of 1995 and chapter 118 of the general laws shall receive assistance at levels established by the department of transitional assistance such that families of comparable size and financial circumstances shall be awarded the same level of assistance.  Recipients that are not exempt from the work program administered by the department pursuant to section 110 (e) of chapter 5 of the acts of 1995 shall be required to engage in direct work activities and other qualifying activities up to the number of hours per week required by federal law.  Before referring a recipient or applicant to any direct work activities and other qualifying activities, the department shall develop for said recipient or applicant an employment development plan designed to enable the recipient to attain economic self-sufficiency. The commissioner of the department may provide that recipients subject to the work requirement who, without good cause and after having been required to perform community service pursuant to section 110 (k) of chapter 5 of the acts of 1995, do not satisfy said work requirement shall not receive assistance until they meet the requirement for 2 weeks.  The sanction for not satisfying the work requirement shall not include termination of assistance to the children or other family members of the recipient.”  

REDRAFT
EHS  948

TO INCREASE THE WORK PARTICIATION RATE OF TAFDC RECIPIENTS

Ms. Spilka, Mr. Tolman, and Ms. Creem moved that the bill be amended, in Section 2, in item 4400-1000, by inserting at the end the following words:-

“provided further, that the department shall identify and track its expenditures and those of other state agencies that may be claimed as TANF or maintenance of effort expenditures so that benefits to those recipients who would reduce the commonwealth’s work participation rate may be paid solely with state funds that are not used to meet the commonwealth’s TANF maintenance of effort obligations;

provided further, that all state agencies shall cooperate in the identification, tracking and reporting of such expenditures;

provided further that funds from this item may be expended to cover reasonable costs of and incentives for city and town governments and private entities to identify, track and report to the department, spending that may be claimed by the commonwealth either as TANF or maintenance of effort expenditures;

provided further, that on or before February 1, 2007, the department shall provide to the chairs of the house and senate committees on ways and means and the chairs of the joint committee on children and families, a draft of the report to the federal government for the first quarter of federal fiscal year 2007 on TANF and maintenance of effort spending.”

And that the bill be amended, in Section 2, in item 4401-1000 by adding at the end thereof the following words:

“provided further that, that funds from this item shall be expended to increase the commonwealth’s work participation rates among parents who are subject to the work requirement under the program of Transitional Aid to Families with Dependent Children by providing additional employment services, including but not limited to enhanced assessments of barriers to employment and strategies to address those barriers, additional transportation services including transportation assistance for all parents who are subject to the work requirement, additional education and training activities and other activities that will assist the commonwealth in meeting work participation rates;

provided further, that the department shall file a report with the chairs of the house and senate committees on ways and means and the chairs of the joint committee on children and families on or before January 1, 2007 setting forth the work participation rate among families who are subject to the work requirement, efforts that have been made to increase that work participation rate and any barriers to improving the work participation rate among those who are work-required; provided further, that the department may use funds from this item to improve services to persons with disabilities; ‘

And that the bill be amended by adding at the end thereof the following new section:-

“SECTION __:
Notwithstanding any general or special law to the contrary, the families eligible for assistance pursuant to chapter 5 of the acts of 1995 and chapter 118 of the general laws shall receive assistance at levels established by the department of transitional assistance such that families of comparable size and financial circumstances shall be awarded the same level of assistance.  All recipients and applicants for such assistance shall have disregarded, after work-related expenses but before any dependent care deductions, $30 plus one-half of the remainder of any gross earned income for the entire period of eligibility for assistance. Recipients that are not exempt from the work program pursuant to section 110 (e) of chapter 5 of the acts of 1995 shall be required to engage in work activities, which shall include activities authorized by section 110(j) of said chapter 5 as most recently amended and any other activities countable under federal law, for to the number of hours per week required by federal law.  Before referring a recipient or applicant to any work activities, the department shall develop for said recipient or applicant an employment development plan designed to enable the recipient to attain economic self-sufficiency. The commissioner of the department may provide that recipients subject to the work requirement who, without good cause and after having been required to perform community service pursuant to section 110 (k) of chapter 5 of the acts of 1995, do not satisfy said work requirement or the terms of their employment development plan shall not receive assistance until they meet the requirement for 2 weeks.  The sanction for not satisfying the work requirement or the terms of their employment development plan shall not include termination of assistance to the children or other family members of the recipient.”

    EHS  949

RELATIVE TO MEETING THE WORK  PARTICIPATION RATE FOR TAFDC RECIPIENTS

Ms. Spilka moved that the bill be amended, in Section 2, in item 4401-1000 by adding at the end thereof the following words: “provided further that, that funds from this item may be expended to increase the commonwealth’s work participation rates among parents who are subject to the work requirement under the program of Transitional Aid to Families with Dependent Children by providing additional employment services, including but not limited to enhanced assessments of barriers to employment and strategies to address those barriers, additional transportation services including transportation assistance for all parents who are subject to the work requirement, additional education and training activities and other activities that will assist the commonwealth in meeting work participation rates; provided further, that the department of transitional assistance shall file a report with the chairs of the house and senate committees on ways and means and the chairs of the joint committee on children and families on or before January 1, 2007 setting forth the work participation rate among families who are subject to the work requirement, efforts that have been made to increase that work participation rate and any barriers to improving the work participation rate among those who are work-required; And by striking the figure “$27,087,733” and inserting in place thereof the figure ‘$31,087,733”.

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