FY09 Budget Amendments -- Health and Human Services 2

Mr. Morrissey moved that the bill be amended, in Section 2, in item 4510-0110, by inserting after the words, “Duffy Health Center;” the following:- provided further, that not less than $300,000 shall be expended for the Manet Community Health Center.

Mr. Morrissey moved that the bill be amended, in Section 2, in item 4400-1001, by inserting after the words “federal nutrition programs;” the following:- “provided however, that any activities, educational programs and materials, including the annual report on the status of hunger in the commonwealth, developed and implemented by Project Bread with funds provided through this grant for the purpose of expanding participation and outreach for school based federal child nutrition programs shall be conducted in collaboration with state agencies and private non profit organizations working on behalf of child health and nutrition issues including but not limited to the Department of Elementary and Secondary Education and the School Nutrition Association of Massachusetts”

Messrs. Morrissey, Spilka and Creem moved that the bill be amended, in Section 2, in item 5920-2010, by striking out the figure, “$137,187,683” and inserting in place thereof the following figure:- $138,030,000.


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EHS 775 MANET COMMUNITY HEALTH CENTER Mr. Morrissey moved that the bill be amended, in Section 2, in item 4510-0110, by inserting after the words, “Duffy Health Center;” the following:- provided further, that not less than $300,000 shall be expended for the Manet Community Health Center. EHS 776 SCHOOL NUTRITION Mr. Morrissey moved that the bill be amended, in Section 2, in item 4400-1001, by inserting after the words “federal nutrition programs;” the following:- “provided however, that any activities, educational programs and materials, including the annual report on the status of hunger in the commonwealth, developed and implemented by Project Bread with funds provided through this grant for the purpose of expanding participation and outreach for school based federal child nutrition programs shall be conducted in collaboration with state agencies and private non profit organizations working on behalf of child health and nutrition issues including but not limited to the Department of Elementary and Secondary Education and the School Nutrition Association of Massachusetts” EHS 777 STATE OPERATED GROUP HOMES Messrs. Morrissey, Spilka and Creem moved that the bill be amended, in Section 2, in item 5920-2010, by striking out the figure, “$137,187,683” and inserting in place thereof the following figure:- $138,030,000. EDU 778 HEAD START Mr. Buoniconti and Ms. Candaras moved that the bill be amended, in Section 2, in item 3000-5000, by striking out the figure “$9,000,000” and inserting in place thereof the figure “$10,000,000” EHS 779 DEPARTMENT OF YOUTH SERVICES - DIRECT CARE WORKERS Ms. Spilka and Ms. Candaras move that the bill be amended, in Section 2, in item 4200-0300, by inserting at the end thereof the following wording:- “; provided further that the department shall expend not less than $1,600,000 to adjust the wages, compensation or salary on an equal percentage basis to direct care staff earning less than $25,000 in annual compensation who are employed by private human service providers that deliver services under contracts with the departments of youth services within the executive office of health and human services, this shall be in addition to any other wage adjustment”. Redraft EHS 780 CITIZENSHIP SERVICES FOR NEW AMERICANS Messrs. Marzilli , Augustus, Downing, Galluccio, McGee, Morrissey, Petruccelli, Ms. Jehlen and Ms. Walsh moved that the bill be amended, in Section 2, in item 4003-0122, by striking out the figure “$500,000” and inserting in place thereof the following figure:- “650,000”. EHS 781 DPH DIVISION OF HEALTH CARE QUALITY Mr. Moore moved that the bill be amended, in Section 2, in item 4510-0710, by striking out the figure “8,717,714” and inserting in place thereof the figure “8,906,018.” EHS 782 FALLS PREVENTION PILOT PROGRAM Mr. Moore moved that the bill be amended, in Section 2, in item 4510-0100, by adding at the end thereof the following:- "provided further that not less than $100,000 shall be expended for the purpose of a falls prevention pilot program in the department of public health. Said program shall provide direct assistance to health care facilities, long-term care providers, home care providers and community groups to reduce falls among the elderly, particularly those duly eligible for Medicare and Medicaid;" and in said item, by striking out the figure "$21,911,667" and inserting in place thereof the figure "$22,011,667". EHS 783 DIVISION OF HEALTH CARE FINANCE AND POLICY REPORT Mr. Moore moved that the bill be amended, in Section 2, in item 4100-0060, by adding at the thereof the following:- "provided, that the Commissioner shall report to the Joint Committee on Health Care Financing and the House and Senate Committees on Ways and Means on or before December 15, 2008, regarding the scope of work of the division and recommendations for assessments on entities other than acute care hospitals consistent with said scope of work." EHS 784 PRESERVING CORE SERVICES AT DPH Mr. Moore moved that the bill be amended, in Section 2, in item 510-0100 by striking out the figure “21,911,667” and inserting in place thereof the following figure:- “22,228,418” EHS 785 MASS HEALTH AND COMMONWEALTH CARE OUTREACH AND ENROLLMENT GRANTS Messrs. Moore, Montigny, Antonioni, O’Leary, Petruccelli, Downing, Morrissey, Marzilli, and Ms. Spilka moved that the bill be amended, in Section 2, by inserting after item 4000-0320 the following item:- "4000-0352 For MassHealth enrollment outreach grants to public and private nonprofit groups to be administered by the executive office in consultation with the Health Care Reform Outreach and Education Unit; provided, that grants shall be awarded to groups statewide, including areas in which the United States Census deems there exists a high percentage of uninsured individuals and areas in which there are limited health care providers; provided further, that funds shall be awarded as grants to community and consumer-focused public and private nonprofit groups to provide enrollment assistance, education and outreach activities directly to consumers who may be eligible for MassHealth, the Commonwealth Care Program, or the Commonwealth Choice Program, and who may require individualized support due to geography, ethnicity, race, culture, immigration or disease status and representative of communities throughout the commonwealth; provided further, that funds shall be allocated to provide informational support and technical assistance to recipient organizations and to promote appropriate and effective enrollment activities through the statewide health access network; provided further, that not less than $350,000 shall be allocated to Community Partners, Inc. of Amherst, to provide online informational support and technical assistance to recipient organizations and to promote appropriate and effective enrollment activities through its statewide health access network; provided further, that the cost of information support and technical assistance shall not exceed 10 per cent of the appropriation and shall not be used to defray current state obligations to provide this assistance; provided further, that in awarding said grants, the executive office of health and human services, in consultation with the Health Care Reform Outreach and Education Unit, shall provide written guidance to selected grantees with specific strategies of how to expend funds in the most efficient manner to target populations and avoid duplication of activities, including examples of best practices among prior year outreach grant recipients; and provided further, that the secretary shall report to the house and senate committees on ways and means on the exact amounts distributed in fiscal year 2008 by February 1, 2008, and the extent to which any portion of resulting expenditures are eligible for federal reimbursement .................................................................$3,500,000" Redraft EHS 786 TELEHOME CARE PILOT PROGRAM Messrs. Moore, Augustus, Tarr moved that the bill be amended, in Section 2, in item 4000-0600 by adding at the end thereof the following:- “provided further, that not less than $250,000 shall be provided for a demonstration project evaluating the feasibility and efficacy of managing and treating patients with specified chronic medial conditions using TeleHome Care; provided further, that recipients of TeleHome Care shall be selected based on factors that include, but are not limited to: the presence of a chronic medical condition such as congestive heart failure, diabetes or COPD, and/or the fact that they have required or will require services of unusually high frequency, urgency or duration; provided further, that reimbursement for TeleHealth Services provided pursuant to this section shall be provided only to federally certified home health agencies and only in connection with Federal Food and Drug Administration-approved and interoperable devices, and incorporated as part of the patient's plan of care; provided further, that demonstration rates or fees shall be established and shall reflect TeleHealth service costs on a monthly basis in order to account for daily variation in the intensity and complexity of patients' TeleHealth service needs” and in said item, by striking out the figure “2,158,355,058” and inserting in place thereof the following figure:- “2,158,605,058”. EHS 787 SCHOOL HEALTH SERVICES AND SCHOOL-BASED HEALTH CENTERS Messrs. Moore, O'Leary, Augustus, Antonioni, Petruccelli, Morrissey, Timilty, Montigny, Joyce, and Ms. Spilka and Walsh moved that the bill be amended, in Section 2, in item 4590-0250, by striking out the figure "$ 15,000,000" and inserting in place thereof the figures: "$18,000,000"; and in said item, in line 3, by striking out the figure "$300,000" and inserting in place thereof the figure "$600,000;" and in said item, by striking out the figures "16,782,134" and inserting in place thereof the figures "20,082,134". EHS 788 RESIDENTIAL RATE INITIATIVE Mr. Moore, Joyce and Ms. Spilka moved that the bill be amended, in Section 2, by inserting after item 5920-2000 the following item:- "5920-2006, For the implementation of a residential rate initiative; provided, that the department shall submit a report to the house and senate committees on ways and means not later than January 18, 2009, detailing the use of such funds to establish a rate system for vendor-operated residential services..........$2,250,000" Redraft EHS 789 Mr. Moore moved that the bill be amended, in Section 2, in item 4000-0355, by striking out the figure “$1,428,000” and inserting in place thereof the following figure:- “$1,888,616”. And, in said Section 2, by inserting, after item 4000-0355, the following new item:- “4000-0360 For the health care quality and cost council established pursuant to section 3 of chapter 58 of the acts of 2006; provided that the council may expend an amount not to exceed $100,000 from the monies received from the sale of data reports; provided, that notwithstanding any general or special law to the contrary, for the purpose of accommodating timing discrepancies between the receipt of retained revenues and related expenditures, the department may incur expenses and the comptroller may certify for payment amounts not to exceed the lower of this authorization or the most recent revenue estimate as reported in the state accounting system………………………………….…$100,000”; EHS 790 JUVENILE COURT CLINICS Ms. Spilka, Ms. Candaras, Ms. Jehlen and Mr. Marzilli move that the bill be amended, in Section 2, by striking out item 5055-0000 and inserting in place thereof the following item:- “5500-0000 For forensic services provided by the department; provided, that not less than $1,186,000 shall be expended to sustain and expand services provided through juvenile court clinics in fiscal year 2009………$8,105,485”. EHS 791 AGEWELL BOSTON Ms. Walsh and Ms. Creem moved that the bill be amended, in Section 2, in item 9110-1660, by inserting at the end the following:- “provided that $90,000 shall be expended for the AgeWell Boston program operated by Ethos”; and by striking out the figure “$2,223,031” and inserting in place thereof the following figure “$2,313,031.” Redraft EHS 792 CONTINUING FEE WAIVER PROTECTION FOR MASSHEALTH Messrs. Marzilli , McGee and Ms. Jehlen moved that the bill be amended, in Section 2, in item 4518-0200, by inserting after the words “compensation of employees” the following:- “, and provided further, that the registrar of vital records shall exempt from payment of a fee any person requesting a copy of a birth certificate for the purpose of establishing eligibility for Medicaid”. EHS 793 SPECIAL OLYMPICS Ms. Resor moved that the bill be amended, in Section 2, in item 5920-2000, by inserting at the end thereof the following:- “; provided further, that not less than $100,000 shall be expended for the Massachusetts Special Olympics, so-called.” EHS 794 JEWISH FAMILY SERVICES Mr. Buoniconti moved that the bill be amended, in Section 2, in item 9110-1660, by inserting at the end thereof the following words:- “; and provided further that not less than $75,000 shall be expended for the Jewish Family Services of Western Massachusetts to implement the Aging-Well at Home Program in Springfield” EHS 795 DPPC OVERSIGHT OFFICER Ms. Resor, and Mr. Marzilli moved that the bill be amended, in Section 2, in item 1107-2501, by inserting in line 1 after the words “disabled persons protection commission;” the following:- “provided that no less than $141,000 shall be expended for an investigator and oversight officer.” EHS 796 SUBSTANCE ABUSE PREVENTION Mr. McGee moved that the bill be amended, in Section 2, in item 4512-0200, by adding the following: - “Provided further that $100,000 shall be expended for the prevention of substance abuse in the town of Saugus.” EHS 797 54TH MASSACHUSETTS VOLUNTEERS AND THE COLORED LADIES Ms. Wilkerson moved that the bill be amended, in Section 2, in item 1410-0012, by inserting after the word “Natick” the following: “; provided further that not less than $100,000 shall be expended for the 54th Massachusetts Volunteers and The Colored Ladies” EHS 798 PROJECT COPE Mr. McGee moved that the bill be amended, in Section 2, in item 4512-0201 by adding the following: - “Provided further, that no less than $85,000 shall be provided to Project COPE, Inc. in Lynn for the prevention and education of the problems associated with OxyContin and Heroin use.” EHS 799 ALBANY STREET SHELTER (CASPAR) Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4512-0200, by adding the following: “; and provided further that not less than $250,000 shall be expended for the Albany Street Shelter operated by Cambridge and Somerville Program for Drug and Alcohol Rehabilitation (CASPAR)”; EHS 800 TEEN PREGNANCY PREVENTION Ms. Spilka, Messrs. McGee, Montigny, Marzilli and Knapik move that the bill be amended, in Section 2, in item 4530-9000, by striking out the figure “$4,055,586” and inserting in place thereof the following figure:- “$5,055,586”. EHS 801 CROSSROADS FAMILY SHELTER Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4403-2120, by adding the following: “; and provided further that not less than $179,381 shall be expended for the Crossroads Family Shelter in East Boston”; EHS 802 SAUGUS SENIOR CENTER Mr. McGee moved that the bill be amended, in Section 2, in item in item 4513-1000 by inserting the following text; - “Provided further, that $200,000 shall be expended for an elder health and outreach program in Saugus.” EHS 803 ELDER ABUSE - PROTECTIVE SERVICES Messrs. Petruccelli, Spilka and Joyce moved that the bill be amended, in Section 2, in item 9110-1636, by striking out the figure “$16,246,087” and inserting in place thereof the following figure:- “$17,078,812”. EHS 804 ASPERGER'S ASSOCIATION OF NEW ENGLAND Ms. Spilka and Messrs. Tolman, Montigny, Timilty, Morrissey, Joyce and Brown move that the bill be amended, in Section 2, in item 5920-3010, by inserting at the end thereof the following wording:- “; and provided further, that $100,000 be allocated to the Asperger’s Association of New England to provide support services to individuals with high functioning autism or Asperger’s syndrome”. EHS 805 NON-PROFIT CHRONIC AND REHABILITATION HOSPITALS Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0300, by adding the following: “; and provided that not less than $2,000,000 will be made available for supplemental payments to one or more of the three largest Medicaid participating licensed non-profit chronic and rehabilitation hospitals with less than 500 beds, with Medicaid participation measured and ranked by the number of Medicaid days in the most recently completed fiscal year, but excluding for purposes of this clause any such hospital that is eligible for a rate or payment benefit pursuant to either line item 4000-0500 or line item 4000-0600 by virtue of being within a class of providers specifically identified therein and any such hospital that is not an inpatient rehabilitation facility for Medicare payment purposes providing both adult and pediatric services”; EHS 806 SOUTH BOSTON HEALTH CENTER Mr. Hart moved that the bill be amended, in Section 2, in item 4512-0200, by inserting after the word “costs” the words “provided further that not less than $250,000 shall be expended to maintain the current levels of substance abuse programs at the South Boston Health Center located in the South Boston section of Boston,” and in said item striking the figure “$79,337,940” and inserting “$79,587,940” EHS 807 WITHDRAWN EHS 808 PAYMENTS TO HIGH PUBLIC PAYER HOSPITALS Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0500, by adding the following: “; and provided further that not less than $11,900,000 shall be expended on disproportionate share payments to high public payer hospitals”; EHS 809 OFFICE OF ORAL HEALTH FUNDING Mr. Marzilli moved that the bill be amended, in Section 2, in item 4512-0500, by striking out the figure “$3,119,016” and inserting in place thereof the following figure:- “$3,844,016.” EHS 810 PEDIATRIC SPECIALTY UNIT Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0300, by adding the following: “;and provided further, that notwithstanding section 1 of chapter 118G of the General Laws or any general or special law to the contrary, for fiscal year 2008 the definition of a “pediatric specialty unit” shall mean an acute care hospital with a burn center verified by the American Burn Center and the American College of Surgeons and a level 1 trauma center for pediatrics verified by the American College of Surgeons or a pediatric unit of an acute care hospital in which the ratio of licensed pediatric beds to total licensed hospital beds as of July 1, 1994, exceeded 0.20; provided further, that in calculating that ratio, licensed pediatric beds shall include the total of all pediatric service beds, and the total of all licensed hospital beds shall include the total of all licensed acute care hospital beds, consistent with Medicare's acute care hospital reimbursement methodology as put forth in the Provider Reimbursement Manual Part 1, Section 2405.3G; provided further, that a hospital with a unit designated as a pediatric specialty unit, or an acute care hospital with a burn center verified by the American Burn Center and the American College of Surgeons and a level 1 trauma center for pediatrics verified by the American College of Surgeons as defined in this item shall be exempt from the inpatient and outpatient efficiency standards being applied to their rate methodology”; EHS 811 OFFICE OF ORAL HEALTH Mr. Marzilli moved that the bill be amended, after Section 85, by adding the following new sections:- SECTION XX. Chapter 111 of the General Laws is hereby amended by inserting after section 4L the following section:- “Section 4M (a) The department shall have an office of oral health with responsibility for the following, though not limited to, oral public health activities: (1) Provide recommendations and guidance to the department and other state departments, agencies, community providers, the legislature and others for preventing oral diseases of all Massachusetts residents and for improving, promoting and protecting the oral health of state residents with a focus on underserved populations and reducing oral health disparities; (2) Surveillance, study and appraisal of the state's oral health needs and resources; (3) Foster the development, expansion and evaluation of oral health services for residents of the state in collaboration with key state partners, including but not limited to other executive office of health and human services agencies and departments, including but not limited to MassHealth, department of youth services; department of social services; department of mental retardation, department of mental health and the executive office of elderly affairs; board of registration in dentistry; and other public agencies including but not limited to department of education and department of early education and care; (4) Provide information and education concerning oral health to the dental and health community and public; (5) Promote and provide technical assistance, monitoring and evaluation of population-based dental programs, such as community water fluoridation and school prevention programs and mobile and portable dental programs, as well as other programs to improve access to services; (6) Policy development to promote the public's oral health; and (7) Other related programs, policies and preventive measures that impact oral health. (b) (1) In order to improve, promote and protect the oral health of all residents of the Commonwealth, a full-time dental director shall be located in the office of medicaid and shall work collaboratively with the department of public health to facilitate integration of programs to improve oral health. The director shall be funded through an interagency agreement between the executive office of health and human services and the department of public health. (2) The full-time dental director shall be a Massachusetts licensed dentist with public health experience and shall oversee the MassHealth dental program and work in collaboration with the office of oral health on dental public health programs for MassHealth recipients to increase access, oral health prevention activities, and other initiatives to address oral health disparities, including but not limited to workforce shortages. SECTION XX. The office of oral health in the department of public health shall evaluate programs and develop quality assurance activities, including but not limited to, an update on progress to date on the recommendations of the 2000 report of the special legislative commission on oral health. The update shall be delivered to the house and senate chairs of the joint committee on public health on or before May 1, 2009.” EHS 812 WITHDRAWN EHS 813 EQUITY IN HEALTH CARE FUNDING Messrs. Tisei and Morrissey moved that the bill be amended in subsection (c) of Section 69 by striking the figure “$346,000,000” and inserting in place thereof the figure“$377,500,000”; and be further amended in the same by inserting after the words: “from the General Fund to the” and prior to the words “MassHealth provider payment account” the following:- “following funds and line items: $12,500,000 to the Essential Community Provider Trust Fund, established in section 2PPP of chapter 29 of the General Laws, for the purpose of making expenditures as described in Section 70 in fiscal year 2009; $14,000,000 to be added to line item 4000-0300 for payments to the fourteen (14) disproportionate share hospitals, as defined by 114.1 CMR 36.04 and M.G.L. 118G §1, that provide the largest volume of uncompensated care in the Commonwealth, as determined by the Division of Health Care Finance and Policy and have no corporate affiliation with any managed care organization under contract with MassHealth, and provided that to the extent that this funding level is insufficient to cover the unreimbursed free care costs of the qualifying hospitals under this section, the $14,000,000 shall be distributed equitably among them, in proportion to the relative amount of unreimbursed free care costs incurred by each facility; $5,000,000 to be added to line item 4000-0265 for the establishment of the Community Hospital Primary Care Physician Recruitment Fund for the support of community hospital recruitment of primary care physicians into their primary service areas, provided that grants from said fund shall be administered by the Massachusetts council of community hospitals; and (iv)” EHS 814 PILOT CASE MANAGEMENT AND HCV SURVEILLANCE Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4513-1111, by adding the following: “; and provided further that not less than $100,000 shall be expended for a case management pilot project; and provided further that not less than $120,000 shall be expended for HCV surveillance throughout the Commonwealth”; EHS 815 NUTRITIONAL ASSISTANCE Ms. Resor, Ms. Jehlen, Messrs. Galluccio, Downing, and McGee moved that the bill be amended, in Section 2, by inserting after item 4403-2120 the following item:- “4404-1000 For a program of nutritional assistance to residents of the commonwealth who are qualified aliens within the meaning of section 431 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, so called, and non-citizens otherwise permanently residing under color of law in the United States; provided, that such a resident shall be eligible for such benefits only if such resident (1) is ineligible for federal food stamp benefits pursuant to the provisions of sections 401, 402, or 403 of such Act, and (2) would be eligible for federally funded food stamps, but for his or her citizenship status, provided further, that the Department shall seek to maximize eligibility for federal food stamp benefits wherever possible; provided further, that the department shall establish a schedule of benefits so as not to exceed the amounts appropriated herein………$2,000,000”. EHS 816 STATE STREET COMMUNITY CENTER Mr. Buoniconti moved that the bill be amended, in Section 2, in item 4800-0038, by inserting at the end thereof the following words:- “and provided further, that not less than $100,000 shall be expended for the State Street Community Center in the city of Springfield” EHS 817 EXODUS OUTREACH RECOVERY PROGRAM Mr. Hart moved that the bill be amended, in Section 2, in item 4512-0200 by adding the following:- “provided further, that not less than $100,000 shall be expended for the Exodus Outreach Recovery Program; and provided further, that not less than $250,000 shall be expended for the Prince Hall Youth Mentoring Program;” and in said item by striking out the figures “$79,337,940” and by inserting in place thereof the figures “79,687,940”. EHS 818 WITHDRAWN EHS 819 SAMARITAN HOUSE I Mr. Pacheco moved that the bill be amended, in Section 2, in item 4406-3000, by inserting after the figure “2009” the following:- “provided further however that not less than $150,000 shall be expended for a contract with the St. Frances Samaritan House in Taunton,” EHS 820 WITHDRAWN Redraft EHS 821 DOMESTIC VIOLENCE SERVICES Mr. Petruccelli, Mr. Augustus, Ms. Resor, Mr. Knapik, Ms. Creem and Ms. Spilka moved that the bill be amended, in Section 2, in item 4800-1400, by striking the words, “For shelters and support services for people at risk of domestic violence; provided, that the department shall pursue the establishment of public-private partnership agreements established for family stabilization services funded from sources other than the commonwealth; provided further that services shall include supervised visitation programs and scattered site transitional housing programs, including programs to assist victims of domestic violence in finding and maintaining permanent housing; provided further, that participant in battered women’s programs shall be provided with information regarding local transitional housing resources; provided further, that funding shall be made available to enhance counseling services for children who have witnessed domestic violence; provided further, that funding shall be made available for emergency shelters for substance abusing battered women; provided further, that funding shall be made available for a statewide domestic violence hotline; provided further, that the department shall continue to provide any match funding required by federal program regulations; provided further, that domestic violence prevention specialists shall be funded from this item;” and inserting in place thereof the following:- For shelter and support services for people at risk of domestic violence; provided that no less than $27,000,000 be expended for domestic violence emergency shelter and services, advocacy, outreach and prevention, including community based services and systems advocacy and of that amount no less than $6,000,000 be expended for infrastructure stabilization of local non-profit domestic violence services organizations And that the bill be further amended, in the same section, by inserting, after the words, “Western Mass Women’s Initiative Survivor’s Project;” the following:- provided further that no less than $75,000 shall be expended for Abby’s House in Worcester And that the bill be further amended, in the same section, by striking the words, “provided further, that not less than $100,000 shall be expended for a domestic violence prevention program called ‘Teens-At-Risk’, operated by Portal To Hope for the communities of Everett, Lynn, Malden and Medford” and inserting, in place thereof, the following:- provided further that not less than $100,000 shall be expended for a domestic violence prevention program called ‘Teens-At-Risk’, operated by Portal To Hope for the communities of Everett, Lynn, Malden, Medford and Winthrop without the need of approval by the commissioner of public health EHS 822 REBOUND YOUTH RESIDENTIAL RECOVERY PROGRAM Mr. Hart moved that the bill be amended, in Section 2, in item 4512-0200, by striking the words “provided further, that not less than $833,000 shall be expended for the Volunteers of America Rebound Youth Residential Recovery Program” and inserting in place thereof “provided further, that not less than $933,000 shall be expended for the Volunteers of America Rebound Youth Residential Recovery Program” EHS 823 WITHDRAWN EHS 824 DOMESTIC VIOLENCE SERVICES FOR IMMIGRANTS AND REFUGEES Ms. Jehlen moved that the bill be amended, in Section 2, in item 4513-1130 by striking the following wording:- “for sexual abuse and domestic violence services for qualified aliens, in accordance with 8 U.S.C. section 1641 (c), and refugees and ” and inserting in place thereof the following wording:- “and that not less than $300,000 shall be expended for sexual abuse and domestic violence services for immigrants and refugees”. EHS 825 ACCOUNTABILITY IN HEALTH CARE SPENDING Mr. Knapik moved that the bill be amended in section 75 by inserting after the words “resulting free car charges.” the words:- “The unit shall also examine the premium assistance payments paid by the commonwealth health insurance connector to health insurers in the commonwealth care health insurance program. Such examination shall include, but not be limited to, the amount of payments made to each insurer; how each health insurer expends such payments; the distribution of enrollment among the health insurers; and the rates paid by the health insurer to health care providers on behalf of enrollees.” EHS 826 VETERANS BENEFITS CLEARING HOUSE DORCHESTER Mr. Hart moved that the bill be amended, in Section 2, in item 1410-0250 by inserting the words “provided further than no less than $100,350 shall be expended for the Veterans Benefits Clearing Housing in the Dorchester section of Boston and in said item by striking out the figures “$2,603,730” and inserting “$2,704,080” EHS 827 DIVISION OF HEALTH CARE FINANCE AND POLICY Mr. Tisei moved that the bill be amended, in Section 2, in item 4100-0060, by striking out the figure “$17,513,039” and inserting in place thereof the following figure:- “17,013,069”. EHS 828 STEP, INC., TREATMENT, EDUCATION AND PREVENTION Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4512-0200, by adding the following: “; and provided further that not less than $750,350 shall be expended for a contract with STEP, Inc., for sobriety treatment, education and prevention”; EHS 829 WITHDRAWN EHS 830 DPH ADMINISTRATION Mr. Tisei moved that the bill be amended, in Section 2, in item 4510-0100, by striking out the figure “$21,911,667” and inserting in place thereof the following figure:- “17,090,934”. EHS 831 YMCA IN EAST BOSTON Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0112, by adding the following: “; and provided further that not less than $50,000 shall be expended for the YMCA in East Boston”; EHS 832 ELDER AFFAIRS OFFICE OF THE SECRETARY Mr. Tisei moved that the bill be amended, in Section 2, in item 9110-0100, by striking out the figure “$3,691,705” and inserting in place thereof the following figure:- “2,916,031”. EHS 833 DPH YOUTH VIOLENCE PREVENTION Mr. Hart moved that the bill be amended, in Section 2, in item 4590-1506, by striking the figure “$3,000,000” and inserting in place thereof the figure, $7,000,000” EHS 834 CHILD CARE Ms. Spilka moves that the bill be amended, in Section 2, by striking out item 3000-4050 and inserting in place thereof the following item:- “3000-4050 For financial assistance for families currently involved with or transitioning from transitional aid to families with dependent children to enroll in an early education and care program; provided, that early education and care shall be available to former participants who are working for up to 1 year after termination of their transitional benefits; provided further, that post-transitional early education and care benefits shall be provided to participants who are working for up to 1 year after the transitional period; provided further, that all early education and care providers that are part of a public school system shall accept vouchers funded through this item; provided further, that the department may provide early education and care benefits to parents who are under 18 years of age, who are currently enrolled in a job training program, and who would qualify for benefits under chapter 118 of the General Laws but for the deeming of the grandparents’ income; provided further, that all teens eligible for year-round full-time early education and care services shall be participating in school, education, work and training-related activities or a combination thereof for at least the minimum number of hours required by regulations; provided further, that recipients of transitional aid shall not be charged fees for care provided under this item; provided further, that early education and care slots funded from this item shall be distributed geographically in a manner that provides fair and adequate access to early education and care for all eligible individuals; provided further, that informal early education and care benefits may be funded from this item; provided further, that not more than $2 per child per hour shall be paid for the services; provided further, that all children eligible for services under this item shall receive said services; provided further, that the commissioner of early education and care may transfer funds to this item from items 3000-1000 and 3000-4060, as necessary, pursuant to an allocation plan, which shall detail by object class the distribution of the funds to be transferred and which the commissioner shall file with the house and senate committees on ways and means at least 30 days before the transfer; and provided further, that not more than 3 per cent of any item may be transferred in fiscal year 2009 ……………………………………………………………… $176,367,855”. EHS 835 WITHDRAWN EHS 836 HEALTH CARE FOR THE HOMELESS Ms. Wilkerson moved that the bill be amended, in Section 2, in item 4510-0110, by adding at the end thereof the following: “; provided further, that $300,000 shall be expended for medical respite services provided by the Boston Health Care for the Homeless Program” and by striking out the figures “6,917,772” and inserting in place thereof the figures “7,217,772.” Bottom line figure of line item 4510-0110 increase by $300,000 EHS 837 CARITAS CARNEY HOSPITAL Mr. Hart moved that the bill be amended in section 70 by inserting the following: “Provided the Secretary shall make available from said fund $4,000,000 in one-time grant for a disproportionate share financially distressed hospital located in Suffolk county with a locked inpatient adolescent psychiatric unit that participates in the Masshealth program.” Redraft EHS 838 EQUITY IN HOSPITAL FUNDING Messrs. Tisei and Morrissey moved that the bill be amended in amended, in Section 2, in item 4000-0265, by inserting after the words “grant program at community health centers” the following words:- “and community hospitals” And moved in the same by inserting after the words “other clinicians at community health centers” the following words:- “and community hospitals" EHS 839 FERGUSON INDUSTRIES RETAINED REVENUE Mr. Tisei moved that the bill be amended, in Section 2, in item 4110-4000, by striking out the wording and inserting in place thereof the following wording:- “For the administration of the Ferguson Industries for the Blind; provided, that retired workshop employees shall receive grants equal to three-fourths of the salaries of current workshop employees; and provided further, that any funds received for goods and services purchased by private and public sector entities at Ferguson Industries shall be placed in a retained revenue account to be used by Ferguson Industries for its operational expenses.” EHS 840 HEALTH CARE QUALITY AND COST COUNCIL Mr. Tisei moved that the bill be amended, in Section 2, in item 4000-0355, by striking out the figure “$1,428,000” and inserting in place thereof the following figure:- “1,000,000”. EHS 841 HEALTH CARE QUALITY AND COST COUNCIL MEMBERSHIP Messrs. Tisei, Tarr, Knapik, Hedlund and Brown moved that the bill be amended by inserting after section 90 the following section:- Chapter 6A of the General Laws is hereby amended by striking section 16K and inserting in place thereof the following:- Section 16K. There shall be a health care quality and cost council within, but not subject to control of, the executive office of health and human services. The council shall establish health care quality improvement and cost containment goals. The goals shall be designed to promote high-quality, safe, effective, timely, efficient, equitable and patient-centered health care. The council shall receive staff assistance from the executive office of health and human services and may, subject to appropriation, employ such additional staff or consultants as it may deem necessary. The council shall consist of the secretary for administration and finance, secretary of health and human services, the auditor of the commonwealth or his designee, the inspector general or his designee, the attorney general or his designee, the commissioner of insurance, the executive director of the group insurance commission, and 7 persons to be appointed by the governor, 1 of whom shall be a representative of a health care quality improvement organization recognized by the federal Centers for Medicare and Medicaid services, 1 of whom shall be a representative of the Institute for Healthcare Improvement, Inc. recommended by the organization’s board of directors, 1 of whom shall be a representative of the Massachusetts Chapter of the National Association of Insurance and Financial Advisors, 1 of whom shall be a representative of the Massachusetts Association of Health Underwriters, 1 of whom shall be a representative of the Massachusetts Medicaid Policy Institute, 1 of whom shall be an expert in health care policy from a foundation or academic institution and 1 of whom shall represent a non-governmental purchaser of health insurance. The representatives of nongovernmental organizations shall serve staggered 3-year terms; but another representative shall be appointed to complete an unexpired term if a vacancy exists. The council shall be chaired by the secretary for administration and finance. EHS 842 PORTAL TO HOPE Messrs. Tisei, Galluccio, Petruccelli and Jehlen moved that the bill be amended, in Section 2, in item 4800-1400, by striking out the figure “$100,000” and inserting in place thereof the following figure:- “$150,000”, and by striking out the figure “$23,248,406” and inserting in place thereof the following figure:- $23,298,406”. EHS 843 ADULT COMMUNITY SERVICES Messrs. Joyce, Antonioni, and Morrissey, Knapik and Ms. Jehlen and Candaras moved that the bill be amended, in Section 2, in item 5046-0000, by striking out the figure “$321,748,305” and inserting in place thereof the following figure:- “$322,415,939” EHS 844 TRANSPARENCY IN HEALTH CARE COSTS Messrs. Tisei, Tarr, Knapik, Hedlund and Brown moved that the bill be amended by inserting after section 90 the following section:- “SECTION 91. Notwithstanding any general or special law to the contrary, the secretary of administration and finance and the secretary of health and human services shall prepare and submit a report to the general court about the allocation for and use of state funds by acute care hospitals, non-acute care hospitals, Medicaid managed care organizations, other managed care organizations, community health centers and carriers contracting with the commonwealth health insurance connector authority. The report shall include: (1) a comprehensive review of the current manner, amount and purposes of annual state funding received by those entities, including a description of the source of the funding; (2) an assessment of the change in total state funding for those entities over the past 5 years, with particular attention paid to the impact of chapter 58 of the acts of 2006; (3) an assessment of how those entities use state funds; (4) an assessment of whether the current payment structure assures the delivery of quality health care in the most cost-effective way; (5) an analysis of financial and management practices of those entities by benchmarking performance with respect to quality and cost effectiveness against national performance levels and similar health care providers in the commonwealth; (6) identification of common factors that may contribute to the fiscal instability of those entities; (7) recommendations for the development of performance and operational benchmarks; (8) recommendations for ensuring that the entities are spending state and other funds in a fiscally-responsible manner and providing quality care; (9) recommendations for legislative and other action necessary to strengthen state oversight and ensure greater accountability of state resources; (10) an assessment of the manner in which hospitals seek payment from consumers, including an analysis of the impact that court filing fees have on their ability to collect payment; and (11) recommendations for regulations regarding the due diligence that facilities shall exercise in seeking to collect payment from consumers before seeking reimbursement from the commonwealth. The secretaries shall have access to all documents of acute care hospitals, non-acute care hospitals, Medicaid managed care organizations, other managed care organizations, community health centers, carriers contracting with the commonwealth health insurance connector authority and any related entities that relate to that organization’s use of state funds; provided, however, that the secretaries shall not request any documents that are in the possession of any agencies of the executive office of administration and finance or the executive office of health and human services. The secretaries shall keep all information and documents obtained under this section confidential and shall not disclose such information or documents to any person except as necessary in a case brought by the attorney general under this chapter. Such information and documents shall not be public records and shall be exempt from disclosure under section 10 of chapter 66. For the purpose of conducting their duties under this section, the secretaries may contract with an outside organization with the requisite financial expertise to enable the secretaries to prepare the report. The secretaries shall submit the report, along with any recommendations for legislative or other action, to the clerks of the senate and house of representatives not later than December 31, 2008. EHS 845 TRANSPARENCY IN HEALTH CARE FUNDING TRANSFERS Messrs. Tisei, Tarr, Knapik, Hedlund and Brown moved that the bill be amended in section 69 by adding after the words “that sufficient revenues are available to support projected program expenditures.” the following words:- “At the end of each month the secretary of administration and finance shall post on the official website of the commonwealth a report detailing the amounts of any transfers made from the general fund to the commonwealth care trust fund or the health safety net trust fund or amongst those funds.” EHS 846 UNIVERSAL IMMUNIZATION Mr. Tisei moved that the bill be amended, in Section 2, in item 4580-1000, by striking out the figure “$51,581,508” and inserting in place thereof the following figure:- “50,176,508”. EHS 847 TREATMENT PLAN Mr. Tolman moved that the bill be amended, in Section 2, in item 4512-0202 by inserting after the words “and the department of corrections;” the following:-“provided further, that prior to release from said facility a one year treatment plan shall be developed for the individual.” EHS 848 LIVING INDEPENDENTLY FOR EQUALITY OF BROCKTON Mr. Creedon moved that the bill be amended, in Section 2, in item 4120-4000 be amended by inserting the following language:- “; provided further, that not less than $25,000 shall be expended on Living Independently for Equality, Inc of Brockton for the operation of participants to meet other physically challenged individuals and take part in a number of therapeutic activities” EHS 849 BAKER HOUSE Mr. Hart moved that the bill be amended, in Section 2, in item 0810-0000, by inserting the following: “;provided further that no less than $260,000 shall be expanded for the Ella J. Baker House in the City of Boston for violence prevention programs for high risk youth.” Redraft EHS 850 COMISSION FOR THE BLIND Messrs. Creedon and Hedlund and Baddour moved that the bill be amended, in Section 2, in item 4110-1000, by striking the figure “$4,365,633” and inserting in place thereof the figure “$4,553,764”. EHS 851 SUICIDE PREVENTION COUNSELING Mr. Brown moved that the bill be amended, in Section 2, in item 5046-0000, by inserting the following:- “provided further, that not less than $50,000 shall be expended to continue and expand the triage counseling services in the Needham public schools.” EHS 852 CONWAY CHILDREN'S ADVOCACY CENTER Messrs. Creedon and Morrissey and Hedlund moved that the bill be amended, in Section 2, in item 4800-0038, by inserting the following language:- “provided further, that not less than $100,000 shall be expended for the Conway Children’s Advocacy Center of Plymouth County;” EHS 853 HANDICAP ACCESSIBILITY FOR EASTON ATHLETIC FIELD Messrs. Creedon and Joyce moved that the bill be amended, in Section 2, in item by inserting the following language:- “provided however, that $50,00 shall be expended for handicap accessibility to the athletic field located at Oliver Ames High School in the town of Easton” EHS 854 CARITAS CARNEY HOSPITAL Mr. Hart moved that the bill be amended in section 70 by inserting the following: “Provided the Secretary shall make available from said fund $4,000,000 in one-time grant for a disproportionate share financially distressed hospital located in Suffolk county with a locked inpatient adolescent psychiatric unit that participates in the Masshealth program.” EHS 855 LEARN TO COPE Mr. Creedon moved that the bill be amended, in Section 2, in item 4512-0200, by inserting the following language:- “provided further, that not less than $100,000 shall be expended for the operation of Learn to Cope, a support group providing parents of children addicted to opiates with substance abuse recovery resources and emotional support;” Mr. Creedon further moves to amend the item by striking out the figures “79,337,940” and inserting in place thereof:- “79,437,940” EHS 856 HAITIAN MULTI-SERVICE CENTER Mr. Hart moved that the bill be amended, in Section 2, in item 4510-0100, by adding the following: “; provided further, that not less than $158,000 shall be expended for the Haitian Multi-Service Center in the Dorchester section of the city of Boston” EHS 857 PKU DISORDERS-NECPAD Mr. Creedon moved that the bill be amended, in Section 2, in item 4513-1111, by inserting the following language: - “provided further, that not less than $50,000 shall be expended for the operation of NECPAD, a support organization which provides patient education and support for people diagnosed with PKU and related disorders and their families; and provided further, that none of these funds shall be expended for any personal-related cost;” And Mr. Creedon further moves to amend the item by striking out the figure”14,197,093” and inserting in place thereof the following:- “$14,247,093” EHS 858 WORK, INC Mr. Hart moved that the bill be amended, in Section 2, in item 5920-2025, by inserting at the end the following:-“;provided that an additional $400,000 shall be expended on a contract with Work, Inc. for enhanced or expanded services and employment opportunities for citizens with disabilities” EHS 859 WITHDRAWN EHS 860 BIRTH DEFECTS MONITORING PROGRAM Ms. Creem and Mr. Timilty moved that the bill be amended, in Section 2, in item 4513-1000, by striking the words “and the Massachusetts Birth Defects Monitoring Program” and inserting in place the following “provided further, that not less than $450,000 shall be expended for the Massachusetts Birth Defects Monitoring Program;” EHS 861 VOCATIONAL REHABILITATION FOR THE BLIND Messrs. Creedon and Hedlund and Baddour moved that the bill be amended, in Section 2, in item 4110-3010, by striking the figure “$2,920,455” and inserting in place thereof the figure “$3,104,688”. EHS 862 CERTIFIED BATTERERS INTERVENTION PROGRAM Ms. Creem and Mr. Timilty moved that the bill be amended, in Section 2, in item 4513-1130, by striking out the wording: “provided further, that funds shall be expended for certified batterer intervention program services;” and inserting in place thereof the following wording:-- “provided further, that no less than $1,050,574 shall be expended for domestic violence certified batterer intervention program services;” EHS 863 HELPING ELDERS AT RISK THROUGH HOMES PROGRAM (HEARTH) Ms. Creem and Mssrs. Joyce and Hart moved that the bill be amended, in Section 2, in item 9110-1660, by striking the figure, “100,000” and replacing it with the figure “$216,000”; EHS 864 EMPLOY+ABILITY Mr. Joyce moved that the bill be amended, in Section 2, in item 5920-2000, by adding the following:- “; provided further, that not less than $100,000 shall be expended for Employ+Ability in the town of Braintree” EHS 865 ENHANCED COMMUNITY OPTIONS PROGRAM Ms. Jehlen and Messrs. Moore and Joyce moved that the bill be amended, in Section 2, in item 9110-1500, by striking out the figure “$48,024,305” and replacing it with the following:- “$49,306,583” EHS 866 NEWTON COMMUNITY SERVICE CENTERS Ms. Creem moved that the bill be amended, in Section 2, in item 4000-0112, by striking the figure “$80,000”; and replacing it with the figure “$155,000.” ottom line figure of line item 4000-0112 increase by $75,000 EHS 867 CHARLESTOWN SUBSTANCE ABUSE PILOT PROGRAM Mr. Galluccio moves that the bill be amended, in Section 2, in item 4512-0200, by adding the following: - “provided further that not less than $75,000 be expended for the Charlestown Substance Abuse Coalition for securing placement of at-risk adults in job training programs, apprenticeships, and permanent employment.” EHS 868 CITY WIDE DIALOGUES Mr. Hart moved that the bill be amended, in Section 2, in item 4590-1506, by inserting at the end thereof the following, “;provided further, $50,000 shall be expended for the City-Wide Dialogues on Boston's Ethnic & Racial Diversity, a program that provides a safe venue for honest, respectful discussions across racial and ethnic lines, including neighborhood diversity dialogues and youth-police dialogues.” EHS 869 WITHDRAWN EHS 870 PROVIDENCE BEHAVIORAL HEALTH HOSPITAL Ms. Candaras, Mr. Knapik and Mr. Buoniconti moved that the bill be amended in Section 69, at the end thereof, the following:- “The Secretary of the Executive Office of Health and Human Services shall make a payment of up to $7,000,000 from the Medical Assistance Trust Fund to the acute hospital system in Hampden County which operates Providence Behavioral Health Hospital in Holyoke.” EHS 871 HOUSE OF POSSIBILITIES Messrs. Joyce and Creedon moved that the bill be amended, in Section 2, in item 5920-3000, by inserting the following:- “; provided further, that not less than $50,000 shall be expended towards the construction costs of House of Possiblities, a respite home for special needs children and adults in the town of Easton”. EHS 872 NEW ENGLAND SHELTER FOR HOMELESS VETERANS Mr. McGee moved that the bill be amended, in Section 2, in item 1410-0251, by striking the figure, “$2,276,862” and inserting in place thereof the figure: - “$2,426,862” EHS 873 SUBSTANCE ABUSE STEP-DOWN RECOVERY SERVICES Ms. Candaras, Mr. Augustus, Mr. Buoniconti, Ms. Jehlen and Mr. Antonioni moved that the bill be amended, in Section 2, by inserting after item 4512-0200 the following item:- “4512-0201 For substance abuse step-down recovery services, otherwise known as level B beds and services, and other critical recovery services with severely reduced capacity; provided, that no funds shall be expended in the AA object class for any personnel-related costs; and provided further, that the department shall submit quarterly to the house and senate committees on ways and means a report on the number of individuals served by the step-down recovery services program………………………………….$5,000,000” EHS 874 FURTHER REGULATING TREATMENT OF DISABLED PERSONS Mr. Joyce and Ms. Jehlen moved that the bill be amended by inserting, after Section ____, the following new Section: - “SECTION ___. Chapter 6A is hereby amended by adding the following section:- Section 16P. (a) As used in this section, the following words shall, except as otherwise provided, have the following meanings:- “Level IV treatment intervention”, any procedure which involves the systematic use of noxious or intrusive stimuli which are generally known to be painful or otherwise unpleasant to individuals, including but not limited to, procedures that: (1) cause physical pain to the individual, whether administered directly or through intermediate devices, such as skin electric shock, inhalants, or ingestible substances (excluding alcoholism treatments, such as disulfiram, Antabuse or Antabus) ; (2) involve sleep or food deprivation; (3) include the introduction of additives to make food unpleasant; or (4) involve the prompting of an individual to engage in a behavior which then results in an aversive stimulus being applied as a punitive consequence. “Statewide peer review committee”, the review committee established in subsection (c). “Department”, the Department of Mental Retardation. “Executive office”, the executive office of health and human services. “Individual treatment plan”, a plan approved by the statewide peer review committee pursuant to regulations promulgated under this section. “Secretary”, secretary of the executive office of health and human services. (b) The Department hereby creates a new classification of behavioral treatment interventions, to be known as Level IV treatment interventions. The Department shall, with the advice and consent of the statewide peer review committee, promulgate rules and regulations consistent with this chapter regarding the use of Level IV treatment interventions to address behaviors that present a pattern of conduct or behavior caused by a disorder which poses a serious danger to self or others of risk of injury or harm to self or others by any consumer of any public or private agency receiving funding or subsidy through the commonwealth. Such rules and regulations shall be consistent with federal and state protections for protected persons insofar as practicable; provided, however, that the Department, with the advice and consent of the statewide peer review committee, may make such adjustments, exceptions or waivers as in their judgment are necessary to carry out the purposes of this section or to facilitate compliance. The Department regulations regulating the use of Level IV interventions will govern all uses of such procedures by any public or private agency receiving funding through the Commonwealth of Massachusetts. Level IV interventions are designed for the treatment of certain types of dangerous or self destructive behaviors following a pre-determined treatment protocol which includes highly punitive techniques designed to teach an individual not to repeat those challenging behaviors. Level IV interventions are the most intrusive form of treatment intervention and they shall be considered to only be used as a method to address behaviors that directly present a clear risk of injury or harm to self or others. Level IV interventions are not appropriate for addressing minor behavior problems, even if said behaviors are identified as antecedents to targeted challenging behaviors, unless less intrusive interventions have been attempted and documented to have failed in addressing such minor behaviors. Level IV interventions should only be considered when reinforcement-based interventions and other less intrusive treatments have failed, including programs developed by clinicians specially skilled in positive behavior supports. Documentation of the fidelity of the application of all less intrusive interventions and the completion of formal procedural reliability assessments must be provided in all proposed Level IV treatment intervention submissions. Level IV interventions are restricted to those techniques and procedures that are considered as evidence-based practices and meet the standards of being scientifically validated, as demonstrated by their publication in peer-reviewed professional journals. All such proposed interventions must have been demonstrated as clinically effective in the reduction of similar topographies of challenging behaviors with participants within similar age ranges or diagnostic categories, and in similar settings. All such proposed interventions for children must be consistent with the Individuals with Disabilities Education Act of 2004 (IDEA) and No Child Left Behind. (c) There shall be a statewide peer review committee on Level IV treatment interventions. The statewide peer review committee shall be located within, but not subject to control by, the executive office. The governor, shall appoint 3 licensed psychologists, 2 of whom meet the guidelines and standards of clause (2) below, and have 10 or more years of experience in applied behavior analysis and behavior treatment of severe behavior problems. In the case where a public or private agency in the Commonwealth receives funding from another state or jurisdiction and seeks to utilize a Level IV procedure with a client whose permanent residence from that state or jurisdiction, said state or jurisdiction may recommend an individual who meets the guidelines and standards of clause (2) below to serve as an “ad-hoc” member of the statewide peer review committee to review any and/or all proposed Level IV interventions for residents from said state or jurisdiction. The statewide peer review committee shall: (1) review, approve and oversee all Level IV treatment interventions being implemented with any person in the Commonwealth who is served by a public or private agency receiving funding or subsidy through the executive office as provided under this section; (2) appoint a Chair who is a board certified behavior analyst, or holds specialty certification in cognitive and behavior psychology from the American Board of Professional Psychology, or is a licensed psychologist with documented education, professional training and experience in applied behavior analysis and behavior treatment, and 5 years of full-time experience serving individuals within the same age range or diagnostic category; demonstrating similar topographies of challenging behaviors and utilizing similar treatment approaches as those proposed in the behavior treatment plan under review; (3) review individual treatment plans and approve the use of Level IV treatment interventions within such treatment plans; (4) set guidelines and standards for facility peer review committees; (5) review and make recommendations to the executive office for any requested exclusions or waivers from the regulations governing Level IV treatment interventions; and (6) be assisted in its duties by the executive office, which shall provide technical, technological, operational and administrative support. A member of the statewide peer review committee shall be indemnified from any civil action brought for damages to the same extent as provided for public employees in chapter 258; and shall be indemnified for all expenses incurred in the defense thereof provided, however, that the claim arose out of acts performed by such member while acting within the scope of the member’s official duties. (d) All Level IV interventions shall be designed by an individual who is a Board Certified Behavior Analyst, or holds Specialty Certification in Cognitive and Behavioral Psychology from the American Board of Professional Psychology, or is a Licensed Psychologist with documented education, professional training and experience in applied behavior analysis and behavioral treatment, and 5 years of full-time experience serving individuals within the same age range and diagnostic category; demonstrating similar topographies of challenging behaviors and utilizing similar treatment approaches as those proposed in the Level IV plan under review. Individuals responsible for the design of Level IV interventions will comply fully with the Ethical Principles of Psychologists and the Code of Conduct of the American Psychological Association. All Level IV interventions submitted for review and approval must meet the standards outlined within the Guidelines for Responsible Conduct of the Behavior Analysis Certification Board, and include documentation that the challenging behaviors being addressed are not a function of a medical or psychiatric disorder. Additionally, all such proposed interventions must include evidence of the completion of a formal comprehensive functional behavioral assessment, a preference assessment, and reinforcement strategies designed to teach functionally equivalent replacement behaviors. In addition to the ongoing empirical measurement of all targeted challenging and replacement behaviors throughout any approved Level IV intervention, all such Level IV interventions must also include ongoing objective documentation of the trauma suffered by the individual or others as a result of the challenging behaviors addressed within the treatment plan. (e) Level IV interventions shallonly be implemented by staff persons that have received specific training in the application of the intervention and the individualized treatment plan. Documentation listing all qualified staff who received specific training in the Level IV intervention and the individuals who designed the treatment protocol and who administered each application of the Level IV intervention shall be incorporated in the client record. The statewide peer review committee shall require that all Level IV interventions shall be implemented only under the direct supervision and physical presence of the Board Certified Behavior Analyst, ABPP Certified Cognitive and Behavioral Specialist, or Licensed Psychologist with documented education, professional training and experience in applied behavior analysis and behavioral treatment. (f) Each facility seeking to use Level IV treatment interventions shall establish a facility peer review committee, approved by the statewide peer review committee. Prior to application to the statewide peer review committee for authority to implement a behavior treatment intervention, consent shall be obtained from the client (if competent) and the facility peer review committee. The facility peer review committee shall include (1) psychologists with documented education, professional training and experience in applied behavior analysis and behavioral treatment and (2) a psychologist with broad clinical expertise outside the specialty of behavior analysis. In cases of extreme emergencies, the agency serving the individual shall not be required to apply for approval to the facility peer review committee, but shall apply directly to the statewide peer review committee for a 30-day temporary approval of the intervention; provided, that the agency has secured informed consent from the client (if competent). If such emergency application is approved by the statewide peer review committee, the application must also be submitted, prior to implementation, to the probate court of the county in which the client resides for approval through a substituted judgment review process. (g) Level IV treatment interventions shall be permitted only when approved by the statewide peer review committee and by a court-ordered substituted judgment treatment plan for an individual client. Prior to rendering a decision, the statewide peer review committee may permit the proponent of the use of such interventions and any other interested person the opportunity to present materials in support of or in opposition to the proposed treatment plan. The decision of the statewide peer review committee shall be in writing, with supporting reasons provided for its decision. A finding by the statewide peer review committee permitting Level IV treatment interventions with respect to any individual treatment plan shall be submitted thereafter to the probate court of the county in which the client resides as part of the court’s independent review and approval of said treatment plan. (h) Level IV interventions shall not be initially approved by the statewide peer review committee unless the proponent of the use of such interventions provides clear and convincing evidence through the evaluation protocol and ongoing behavior data, that (a) the target behavior presents an immediate risk of serious physical injury or harm to self or others; (b) the Level IV procedure will lead to positive outcomes and a significant decrease in the target behaviors; and (c) that less intrusive treatments continue to be unsuccessful or would present an immediate risk of serious physical injury or harm. Level IV treatment interventions maybe initially approved for no more than 30 days by the statewide peer review committee, and may be re-approved thereafter for additional 30-day periods, not to exceed six months. Request for re-approval shall be subject to such conditions as the statewide peer review committee may designate, including a review of all existing data to confirm that the use of the Level IV treatment intervention has led to positive outcomes and a significant decrease in the target behaviors. Any request for the use of the Level IV treatment intervention beyond the 30-day trial shall require re-submission to the statewide peer review committee and the probate court of the county in which the client resides as part of the court’s independent review and approval of said treatment plan. The statewide peer review committee shall petition the Commissioner of the Department of Mental Retardation to review cases in which the continued use of Level IV treatment interventions are requested beyond the six month limit. (i) The executive office may, after a hearing pursuant to chapter 30A, deny, refuse, revoke, limit or suspend a license of any recipient of funding or subsidy through the executive office for failure to comply with the provisions of this section. (j) Except for emergency regulations adopted pursuant to section 2 of chapter 30A, any regulation, as defined in section 1 of said chapter 30A, or any amendment or repeal of any such regulation adopted by the Department pursuant to this section, shall, after compliance with all applicable provisions of this section and said chapter 30A, except section 5, be submitted to the general court. Said Department shall file the proposed regulation, amendment or repeal with the clerk of the house of representatives, together with a statement of compliance with the pertinent provisions of said chapter 30A, except section 5. The clerk of the house of representatives, with the approval of the president of the senate and the speaker of the house of representatives, shall refer such regulations to the joint committee on children, families and persons with disabilities. Within 30 days after such referral, said legislative committee may hold a public hearing on the regulations and shall issue a report to said Department. Said report shall contain any proposed changes to the regulations voted upon by the legislative committee. The Department and the statewide peer review committee shall review said report and shall adopt final regulations as deemed appropriate in view of said report and shall file with the chairmen of the legislative committee its final regulations. If the final regulations do not contain the changes proposed by the legislative committee, the Department and the statewide peer review committee shall send a letter to the legislative committee accompanying the final regulations stating the reasons why such proposed changes were not adopted. Not earlier than 45 days after the filing of such letter and final regulations with said legislative committee, said Department shall file the final regulations with the state secretary as provided in section 5 of said chapter 30A and said regulations shall thereupon take effect. If no such proposed changes to the regulations are made to the Department and the statewide peer review committee within 60 days of the initial filing of the proposed regulation or any amendment or a repeal of such regulation with the clerk of the house of representatives, the Department may file the final regulations with the state secretary as provided in section 5 of said chapter 30A and said regulations shall thereupon take effect. SECTION 2. Within 90 days after the passage of this act, the Department, with the advice and consent of the statewide peer review committee shall draft, pursuant to chapter 30A, proposed rules and regulations to the General Court regarding the development, review, approval, and on-going review and monitoring process for behavior intervention treatments. SECTION 3. The implementation of any Level IV intervention beyond the scope of a court-ordered treatment plan or the approval of the statewide peer review committee, or by a staff member who does not meet the requirement of this section will be considered an act of mistreatment, pursuant to section 13K of chapter 265 and shall be reported to the Disabled Persons Protection Commission. SECTION 4. Except as provided herein, this act shall not otherwise alter the procedures for substituted judgment review by the Probate and Family Court. EHS 875 TURNING 22 ANNUALIZATION Messrs. Joyce, Hedlund, Marzilli, Moore, Brown, Augustus, Creedon, Morrissey and Ms. Resor moved that the bill be amended, in Section 2, in item 5920-5000, by striking out the figure “$17,664,660” and inserting in place thereof the following figure:- “$19,664,660”. EHS 876 SCORE 3 LANGUAGE Ms. Jehlen, Ms. Candaras, Ms. Resor and Mr. Creedon moved that the bill be amended, in Section 2, in item 4000-0600, by inserting after the words “standards for determining admission to” the following words:- “and continued stay in”. EHS 877 LATINO AFTER SCHOOL INITIATIVE Mr. Galluccio moves that the bill be amended, in Section 2, in item 4512-0200, by adding the following: - “provided further that, not less than $250,000 be expended for the Latino After School Initiative.” EHS 878 NORTHEAST VETERANS BUSINESS OUTREACH CENTER Mr. McGee moved that the bill be amended, in Section 2, in item 1410-0012, by inserting the following words: - “provided further, that not less than $250,000 shall be expended for the Northeast Veterans Business Resource Center in the city of Lawrence, a 501 (c)(3) nonprofit corporation for the purpose of training and assisting our American military veterans in the areas of employment, self employment and entrepreneurship.” EHS 879 WITHDRAWN EHS 880 MASSACHUSETTS HOSPITAL SCHOOL Mr. Joyce moved that the bill be amended, in Section 2, in item 4590-0915, by inserting after the words “pharmacy services” the following:- “; provided further, that $45,000 shall be made available for the position of Volunteer and Development Coordinator at the Massachusetts hospital school” EHS 881 HOMELESS PREVENTION Mr. Galluccio moves that the bill be amended, in Section 2, in item 4403-2120, by m striking out the figure “$85,567,847” and inserting in place thereof “$86,277,382.” EHS 882 FAMILY SUPPORT AND STABILIZATION SERVICES Mr. McGee moved that the bill be amended, in Section 2, in item 4800-0038, by inserting after the words “court diversion program” the following words: “provided further, that not less than $2,100,000 shall be expended on family support and stabilization services in the Lynn area office,”; and in said item by striking out the figures “312,209,552” and inserting in place thereof the by figures “312,709,552”. EHS 883 LYNN VETERANS HOUSING FIRST Mr. McGee moved that the bill be amended, in Section 2, in item 1410-0250, by adding the following: - “provided further, that not less than $60,000 shall be obligated for a contract with the Lynn Veterans Housing First Program located in the city of Lynn” EHS 884 VETERANS FUEL AND SHELTER AMENDMENT Mr. Hart moved that the bill be amended by inserting, after Section 85 the following new section: SECTION_________ Section 5 of Chapter 115 of the General Laws, as appearing in the 2006 Official edition is hereby amended by striking out paragraph eight and inserting in place thereof the following paragraphs:- The benefits provided herein shall include an amount for “Shelter” not to fall below $600 per month for eligible veterans and dependents who do not pay their own heating costs. The benefits provided herein shall include an amount for “Shelter” not to fall below $500 per month for eligible veterans and dependents who pay their own heating costs. T he benefits provided herein shall include an amount for “fuel” not below $250 per month for eligible veterans and dependents who pay their own heating costs; Provided further that said benefits shall be paid throughout the year. EHS 885 WITHDRAWN EHS 886 SAFE AFTERCARE OPTIONS Mr. Antonioni moved that the bill be amended, in Section 2, in item 5047-0001, by inserting at the end thereof the following:- "provided further, that the department shall require a performance specification to be developed for safe aftercare options for adults upon release from acute inpatient mental health care services". EHS 887 NATIONAL GUARD LIFE INSURANCE PREMIUMS Mr. McGee moved that the bill be amended by inserting after Section___, the following section: “SECTION___: Section 6 of Chapter 130 of the Acts of 2005 is hereby amended by striking said Section 6 and inserting in place thereof the following: “The monthly premiums for any coverage held in the serviceman’s group life insurance program administered by the Veterans Administration, the state sponsored life insurance program or an equivalent group life insurance program of the servicemember’s choosing, provided that the reimbursement or premium shall not exceed the cost of the monthly premium cost of serviceman’s group life insurance for a member of the Massachusetts National Guard shall be borne by the commonwealth if said premiums are not paid or reimbursed by the United States.” Redraft EHS 888 HEALTH SAFETY NET FUND REPORT Ms. Menard and Tucker, moves to amend the bill by inserting, after Section_______, the following new Section:- Notwithstanding any general or special law to the contrary, the secretary of health and human services shall submit a report on the results of the payment methodology used in hospital fiscal year 2008 for health services from the Health Safety Net Trust Fund as implemented by the health safety net office pursuant to section 39 of chapter 118G of the General Laws. The report shall include the proposed reimbursement methodology to be used in hospital fiscal year 2009 for health services from the Health Safety Net Trust Fund as determined by the health safety net office pursuant to section 39 of chapter 118G of the General Laws. The report shall detail all modifications made to the payment systems in effect for acute hospitals used by the United States Department of Health and Human Services Centers for Medicare & Medicaid Services to administer the Medicare Program under Title XVIII of the Social Security Act, including any adjustments to account for: (1) the differences between the program administered by the office and the Title XVIII Medicare program, including the services and benefits covered; (2) grouper and DRG relative weights for purposes of calculating the payment rates to reimburse acute hospitals at rates no less than the rates they are reimbursed by Medicare; (3) the extent and duration of covered services; (4) the populations served; and (5) any other adjustments based upon circumstances of individual hospitals. The report shall also detail the proposed hospital fiscal year 2009 reimbursement methodology for outpatient rates and adjustments made under (1) and (2) above. The report shall include analysis of the executive office’s implementation of the Medicaid provider rate provisions required in section 128 of chapter 58 of the acts of 2006. The report shall include an analysis of the distribution of funds during fiscal years 2007 and 2008 in addition to the proposal of the executive office for fiscal year 2009 to physicians and acute hospitals. The secretary shall submit the report to the joint committee on health care financing and the house and senate committees on ways and means on or before August 1, 2008. EHS 889 HEALTH CARE SERVICES Mssrs. Galluccio, Tolman, Petruccelli, and Ms. Jehlen move to amend the bill in section 2, item 4000-0500, by adding the following:- “; and provided further, that the executive office shall make expenditures pursuant to section 122 of chapter 58 of the acts of 2006 in fiscal year 2009 in a manner consistent with the overall supplemental funding level agreed to for the public entity for fiscal year 2008;” And move to further amend the bill in section 69, in line 26, by striking out the following: “fiscal year 2008” and inserting in place thereof the following: “fiscal year 2009”. EHS 890 HIGHER PUBLIC PAYER Mr. Galluccio, Mr. Tolman, Ms. Tucker, Mr. Petruccelli, Mr. Baddour, Ms. Jehlen, and Mr. Creedon move to amend the bill in Section 2, item 4000-0500, by adding the following:- “; and provided further, that $11,900,000 shall be expended on disproportionate share payments to high public payer hospitals.” EHS 891 CHILDREN YOUTH AND FAMILIES Mr. O'Leary moved that the bill be amended, in Section 2, in item 4800-0038, by adding at the end thereof the following:- "; provided further, that not less than $35,000 shall be expended for the Barnstable County Council for Children, Youth and Families; " Redraft EHS 892 An Amendment Relative to Health Care Costs Mr. Tarr moved that the bill be amended, in Section 2, in item 4100-0060, by adding at the end thereof the following words:- “provided further, that the division shall provide a report not less than quarterly on the projected costs and enrollment figures of Commonwealth Care; provided further, that such report shall be filed with the House and Senate clerks”. EHS 893 An Amendment Relative to Safety Net Hospitals Mr. Tarr moved that the bill be amended, in Section 2, in item 4100-0060, by adding the following at the end thereof:- “provided further, that the division shall produce a report including but not limited to the following items: the status of the federal “1115 waiver”, so-called, and the likely impact of any foreseeable changes to the waiver The amount and type of state and federal payments to the five hospitals receiving the most funding as a result of status as “Safety Net Hospitals”, so-called, and the percentage of total funding being received by each hospital Any potential financial obligations of the Commonwealth which may arise as a result of decreased federal funding for safety net hospitals The extent to which any managed care plan authorized pursuant to Chapter 58 of the general laws is not in compliance with licensing requirements maintained by the Division of Insurance. Said report shall be filed with the clerks of the House and Senate not later than 120 days following the passage of this act”. EHS 894 BREAST CANCER RESEARCH Ms. Menard moved that the bill be amended, in Section 2, in item 7100-0300 by adding the follow:- “provided further, that not less than $250,000 shall be expended for research on breast cancer prevention performed in collaboration with the University of Massachusetts at Lowell, the Silent Spring Institute and the Massachusetts Breast Cancer Coalition.” EHS 895 YMCAS OF MASSACHUSETTS Ms. Menard and Tisei, Downing, Timilty and Spilka moved that the bill be amended, in Section 2, in item 4000-0012 by inserting after the phrase “commitment of matching funds from the organization;” the following:- “provided further, that not less than $675,000 be expended for the YMCAs of Massachusetts, Inc., for distribution to the Athol YMCA, the YMCA of Attleboro, the Becket-Chimney Corners YMCA, the Cambridge YMCA, the Cape Cod YMCA, the Community YMCA of Danvers, the Greenfield YMCA, the Hampshire Regional YMCA, the Hockomock Area YMCA, the Greater Holyoke YMCA, the Greater Lowell Family YMCA, the Malden YMCA, the YMCA of Melrose, the MetroWest YMCA, the Montachusett Regional YMCA, the YMCA of the North Shore, the Northern Berkshire YMCA, the Old Colony YMCA, the Pittsfield Family YMCA, the Somerville YMCA, the South Shore YMCA, the YMCA Southcoast, the YMCA of Greater Springfield, the Tri-Community YMCA of Southbridge, the YMCA of Greater Westfield, the YMCA of Martha’s Vineyard, and the Winchendon Clark Memorial YMCA.” EHS 896 RETIREMENT BENEFITS FOR EMTS Ms. Menard moves to amend the bill by inserting, after Section_____, the following new Section:- SECTION 1. Paragraph (g) of subdivision (2) of section 3 of chapter 32 of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by inserting, after line 307, the following new paragraph:- Any municipality may elect to place in Group 4 uniformed employees of a municipal or public emergency medical service who are certified at any level as an Emergency Medical Technician (EMT) by the department of public health. This placement of such EMTs into Group 4 shall take effect in a municipality upon its acceptance in the following manner: in a city having Plan D or a Plan E charter, by majority vote of its city council and approved by the manager; in any other city by majority vote of the city council and approved by the mayor; in a town, by vote of the board of selectmen. EHS 897 VIOLENCE PREVENTION Ms. Wilkerson moved that the bill be amended, in Section 2, in item 4590-1506, by striking the figure “$3,000,000” and inserting in place thereof the figure, $3,500,000.” Back tot the Top

Mr. Buoniconti and Ms. Candaras moved that the bill be amended, in Section 2, in item 3000-5000, by striking out the figure “$9,000,000” and inserting in place thereof the figure “$10,000,000”

Ms. Spilka and Ms. Candaras move that the bill be amended, in Section 2, in item 4200-0300, by inserting at the end thereof the following wording:- “; provided further that the department shall expend not less than $1,600,000 to adjust the wages, compensation or salary on an equal percentage basis to direct care staff earning less than $25,000 in annual compensation who are employed by private human service providers that deliver services under contracts with the departments of youth services within the executive office of health and human services, this shall be in addition to any other wage adjustment”.

Mr. Moore moved that the bill be amended, in Section 2, in item 4510-0710, by striking out the figure “8,717,714” and inserting in place thereof the figure “8,906,018.”

Mr. Moore moved that the bill be amended, in Section 2, in item 4510-0100, by adding at the end thereof the following:- "provided further that not less than $100,000 shall be expended for the purpose of a falls prevention pilot program in the department of public health. Said program shall provide direct assistance to health care facilities, long-term care providers, home care providers and community groups to reduce falls among the elderly, particularly those duly eligible for Medicare and Medicaid;" and in said item, by striking out the figure "$21,911,667" and inserting in place thereof the figure "$22,011,667".

Mr. Moore moved that the bill be amended, in Section 2, in item 4100-0060, by adding at the thereof the following:- "provided, that the Commissioner shall report to the Joint Committee on Health Care Financing and the House and Senate Committees on Ways and Means on or before December 15, 2008, regarding the scope of work of the division and recommendations for assessments on entities other than acute care hospitals consistent with said scope of work."

Mr. Moore moved that the bill be amended, in Section 2, in item 510-0100 by striking out the figure “21,911,667” and inserting in place thereof the following figure:- “22,228,418”

MASS HEALTH AND COMMONWEALTH CARE OUTREACH AND ENROLLMENT GRANTS

Messrs. Moore, Montigny, Antonioni, O’Leary, Petruccelli, Downing, Morrissey, Marzilli, and Ms. Spilka moved that the bill be amended, in Section 2, by inserting after item 4000-0320 the following item:-
"4000-0352 For MassHealth enrollment outreach grants to public and private nonprofit groups to be administered by the executive office in consultation with the Health Care Reform Outreach and Education Unit; provided, that grants shall be awarded to groups statewide, including areas in which the United States Census deems there exists a high percentage of uninsured individuals and areas in which there are limited health care providers; provided further, that funds shall be awarded as grants to community and consumer-focused public and private nonprofit groups to provide enrollment assistance, education and outreach activities directly to consumers who may be eligible for MassHealth, the Commonwealth Care Program, or the Commonwealth Choice Program, and who may require individualized support due to geography, ethnicity, race, culture, immigration or disease status and representative of communities throughout the commonwealth; provided further, that funds shall be allocated to provide informational support and technical assistance to recipient organizations and to promote appropriate and effective enrollment activities through the statewide health access network; provided further, that not less than $350,000 shall be allocated to Community Partners, Inc. of Amherst, to provide online informational support and technical assistance to recipient organizations and to promote appropriate and effective enrollment activities through its statewide health access network; provided further, that the cost of information support and technical assistance shall not exceed 10 per cent of the appropriation and shall not be used to defray current state obligations to provide this assistance; provided further, that in awarding said grants, the executive office of health and human services, in consultation with the Health Care Reform Outreach and Education Unit, shall provide written guidance to selected grantees with specific strategies of how to expend funds in the most efficient manner to target populations and avoid duplication of activities, including examples of best practices among prior year outreach grant recipients; and provided further, that the secretary shall report to the house and senate committees on ways and means on the exact amounts distributed in fiscal year 2008 by February 1, 2008, and the extent to which any portion of resulting expenditures are eligible for federal reimbursement .................................................................$3,500,000"

Messrs. Moore, Augustus, Tarr moved that the bill be amended, in Section 2, in item 4000-0600 by adding at the end thereof the following:- “provided further, that not less than $250,000 shall be provided for a demonstration project evaluating the feasibility and efficacy of managing and treating patients with specified chronic medial conditions using TeleHome Care; provided further, that recipients of TeleHome Care shall be selected based on factors that include, but are not limited to: the presence of a chronic medical condition such as congestive heart failure, diabetes or COPD, and/or the fact that they have required or will require services of unusually high frequency, urgency or duration; provided further, that reimbursement for TeleHealth Services provided pursuant to this section shall be provided only to federally certified home health agencies and only in connection with Federal Food and Drug Administration-approved and interoperable devices, and incorporated as part of the patient's plan of care; provided further, that demonstration rates or fees shall be established and shall reflect TeleHealth service costs on a monthly basis in order to account for daily variation in the intensity and complexity of patients' TeleHealth service needs” and in said item, by striking out the figure “2,158,355,058” and inserting in place thereof the following figure:- “2,158,605,058”.

Messrs. Moore, O'Leary, Augustus, Antonioni, Petruccelli, Morrissey, Timilty, Montigny, Joyce, and Ms. Spilka and Walsh moved that the bill be amended, in Section 2, in item 4590-0250, by striking out the figure "$ 15,000,000" and inserting in place thereof the figures: "$18,000,000"; and in said item, in line 3, by striking out the figure "$300,000" and inserting in place thereof the figure "$600,000;" and in said item, by striking out the figures "16,782,134" and inserting in place thereof the figures "20,082,134".

Mr. Moore, Joyce and Ms. Spilka moved that the bill be amended, in Section 2, by inserting after item 5920-2000 the following item:-
"5920-2006, For the implementation of a residential rate initiative; provided, that the department shall submit a report to the house and senate committees on ways and means not later than January 18, 2009, detailing the use of such funds to establish a rate system for vendor-operated residential services..........$2,250,000"

Mr. Moore moved that the bill be amended, in Section 2, in item 4000-0355, by striking out the figure “$1,428,000” and inserting in place thereof the following figure:- “$1,888,616”. And, in said Section 2, by inserting, after item 4000-0355, the following new item:-
“4000-0360 For the health care quality and cost council established pursuant to section 3 of chapter 58 of the acts of 2006; provided that the council may expend an amount not to exceed $100,000 from the monies received from the sale of data reports; provided, that notwithstanding any general or special law to the contrary, for the purpose of accommodating timing discrepancies between the receipt of retained revenues and related expenditures, the department may incur expenses and the comptroller may certify for payment amounts not to exceed the lower of this authorization or the most recent revenue estimate as reported in the state accounting system………………………………….…$100,000”;

Ms. Spilka, Ms. Candaras, Ms. Jehlen and Mr. Marzilli move that the bill be amended, in Section 2, by striking out item 5055-0000 and inserting in place thereof the following item:- “5500-0000 For forensic services provided by the department; provided, that not less than $1,186,000 shall be expended to sustain and expand services provided through juvenile court clinics in fiscal year 2009………$8,105,485”.

Ms. Walsh and Ms. Creem moved that the bill be amended, in Section 2, in item 9110-1660, by inserting at the end the following:- “provided that $90,000 shall be expended for the AgeWell Boston program operated by Ethos”; and by striking out the figure “$2,223,031” and inserting in place thereof the following figure “$2,313,031.”

Messrs. Marzilli , McGee and Ms. Jehlen moved that the bill be amended, in Section 2, in item 4518-0200, by inserting after the words “compensation of employees” the following:- “, and provided further, that the registrar of vital records shall exempt from payment of a fee any person requesting a copy of a birth certificate for the purpose of establishing eligibility for Medicaid”.

Ms. Resor moved that the bill be amended, in Section 2, in item 5920-2000, by inserting at the end thereof the following:- “; provided further, that not less than $100,000 shall be expended for the Massachusetts Special Olympics, so-called.”

Mr. Buoniconti moved that the bill be amended, in Section 2, in item 9110-1660, by inserting at the end thereof the following words:- “; and provided further that not less than $75,000 shall be expended for the Jewish Family Services of Western Massachusetts to implement the Aging-Well at Home Program in Springfield”

Ms. Resor, and Mr. Marzilli moved that the bill be amended, in Section 2, in item 1107-2501, by inserting in line 1 after the words “disabled persons protection commission;” the following:- “provided that no less than $141,000 shall be expended for an investigator and oversight officer.”

Mr. McGee moved that the bill be amended, in Section 2, in item 4512-0200, by adding the following: - “Provided further that $100,000 shall be expended for the prevention of substance abuse in the town of Saugus.”

Ms. Wilkerson moved that the bill be amended, in Section 2, in item 1410-0012, by inserting after the word “Natick” the following: “; provided further that not less than $100,000 shall be expended for the 54th Massachusetts Volunteers and The Colored Ladies”

Mr. McGee moved that the bill be amended, in Section 2, in item 4512-0201 by adding the following: - “Provided further, that no less than $85,000 shall be provided to Project COPE, Inc. in Lynn for the prevention and education of the problems associated with OxyContin and Heroin use.”

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4512-0200, by adding the following: “; and provided further that not less than $250,000 shall be expended for the Albany Street Shelter operated by Cambridge and Somerville Program for Drug and Alcohol Rehabilitation (CASPAR)”;

Ms. Spilka, Messrs. McGee, Montigny, Marzilli and Knapik move that the bill be amended, in Section 2, in item 4530-9000, by striking out the figure “$4,055,586” and inserting in place thereof the following figure:- “$5,055,586”.

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4403-2120, by adding the following: “; and provided further that not less than $179,381 shall be expended for the Crossroads Family Shelter in East Boston”;

Mr. McGee moved that the bill be amended, in Section 2, in item in item 4513-1000 by inserting the following text; - “Provided further, that $200,000 shall be expended for an elder health and outreach program in Saugus.”

Messrs. Petruccelli, Spilka and Joyce moved that the bill be amended, in Section 2, in item 9110-1636, by striking out the figure “$16,246,087” and inserting in place thereof the following figure:- “$17,078,812”.

Ms. Spilka and Messrs. Tolman, Montigny, Timilty, Morrissey, Joyce and Brown move that the bill be amended, in Section 2, in item 5920-3010, by inserting at the end thereof the following wording:- “; and provided further, that $100,000 be allocated to the Asperger’s Association of New England to provide support services to individuals with high functioning autism or Asperger’s syndrome”.

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0300, by adding the following: “; and provided that not less than $2,000,000 will be made available for supplemental payments to one or more of the three largest Medicaid participating licensed non-profit chronic and rehabilitation hospitals with less than 500 beds, with Medicaid participation measured and ranked by the number of Medicaid days in the most recently completed fiscal year, but excluding for purposes of this clause any such hospital that is eligible for a rate or payment benefit pursuant to either line item 4000-0500 or line item 4000-0600 by virtue of being within a class of providers specifically identified therein and any such hospital that is not an inpatient rehabilitation facility for Medicare payment purposes providing both adult and pediatric services”;

Mr. Hart moved that the bill be amended, in Section 2, in item 4512-0200, by inserting after the word “costs” the words “provided further that not less than $250,000 shall be expended to maintain the current levels of substance abuse programs at the South Boston Health Center located in the South Boston section of Boston,” and in said item striking the figure “$79,337,940” and inserting “$79,587,940”

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0500, by adding the following: “; and provided further that not less than $11,900,000 shall be expended on disproportionate share payments to high public payer hospitals”;

Mr. Marzilli moved that the bill be amended, in Section 2, in item 4512-0500, by striking out the figure “$3,119,016” and inserting in place thereof the following figure:- “$3,844,016.”

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0300, by adding the following: “;and provided further, that notwithstanding section 1 of chapter 118G of the General Laws or any general or special law to the contrary, for fiscal year 2008 the definition of a “pediatric specialty unit” shall mean an acute care hospital with a burn center verified by the American Burn Center and the American College of Surgeons and a level 1 trauma center for pediatrics verified by the American College of Surgeons or a pediatric unit of an acute care hospital in which the ratio of licensed pediatric beds to total licensed hospital beds as of July 1, 1994, exceeded 0.20; provided further, that in calculating that ratio, licensed pediatric beds shall include the total of all pediatric service beds, and the total of all licensed hospital beds shall include the total of all licensed acute care hospital beds, consistent with Medicare's acute care hospital reimbursement methodology as put forth in the Provider Reimbursement Manual Part 1, Section 2405.3G; provided further, that a hospital with a unit designated as a pediatric specialty unit, or an acute care hospital with a burn center verified by the American Burn Center and the American College of Surgeons and a level 1 trauma center for pediatrics verified by the American College of Surgeons as defined in this item shall be exempt from the inpatient and outpatient efficiency standards being applied to their rate methodology”;

Mr. Marzilli moved that the bill be amended, after Section 85, by adding the following new sections:-
SECTION XX. Chapter 111 of the General Laws is hereby amended by inserting after section 4L the following section:-
“Section 4M (a) The department shall have an office of oral health with responsibility for the following, though not limited to, oral public health activities:
(1) Provide recommendations and guidance to the department and other state   departments, agencies, community providers, the legislature and others for preventing oral diseases of all Massachusetts residents and for improving, promoting and protecting the oral health of state residents with a focus on underserved populations and reducing oral health disparities;
(2)   Surveillance, study and appraisal of the state's oral health needs and resources;
(3)   Foster the development, expansion and evaluation of oral health services for residents of the state in collaboration with key state partners, including but not limited to other executive office of health and human services agencies and departments, including but not limited to MassHealth, department of youth services; department of social services; department of mental retardation, department of mental health and the executive office of elderly affairs; board of registration in dentistry; and other public agencies including but not limited to department of education and department of early education and care;
(4)   Provide information and education concerning oral health to the dental and health community and public;
(5)   Promote and provide technical assistance, monitoring and evaluation of population-based dental programs, such as community water fluoridation and school prevention programs and mobile and portable dental programs, as well as other programs to improve access to services;
(6)   Policy development to promote the public's oral health; and
(7)   Other related programs, policies and preventive measures that impact oral health.
(b) (1) In order to improve, promote and protect the oral health of all residents of the Commonwealth, a full-time dental director shall be located in the office of medicaid and shall work collaboratively with the department of public health to facilitate integration of programs to improve oral health. The director shall be funded through an interagency agreement between the executive office of health and human services and the department of public health.
(2) The full-time dental director shall be a Massachusetts licensed dentist with public health experience and shall oversee the MassHealth dental program and work in collaboration with the office of oral health on dental public health programs for MassHealth recipients to increase access, oral health prevention activities, and other initiatives to address oral health disparities, including but not limited to workforce shortages.
SECTION XX. The office of oral health in the department of public health shall evaluate programs and develop quality assurance activities, including but not limited to, an update on progress to date on the recommendations of the 2000 report of the special legislative commission on oral health. The update shall be delivered to the house and senate chairs of the joint committee on public health on or before May 1, 2009.”

Messrs. Tisei and Morrissey moved that the bill be amended in subsection (c) of Section 69 by striking the figure “$346,000,000” and inserting in place thereof the figure“$377,500,000”; and be further amended in the same by inserting after the words: “from the General Fund to the” and prior to the words “MassHealth provider payment account” the following:- “following funds and line items:
$12,500,000 to the Essential Community Provider Trust Fund, established in section 2PPP of chapter 29 of the General Laws, for the purpose of making expenditures as described in Section 70 in fiscal year 2009;
$14,000,000 to be added to line item 4000-0300 for payments to the fourteen (14) disproportionate share hospitals, as defined by 114.1 CMR 36.04 and M.G.L. 118G §1, that provide the largest volume of uncompensated care in the Commonwealth, as determined by the Division of Health Care Finance and Policy and have no corporate affiliation with any managed care organization under contract with MassHealth, and provided that to the extent that this funding level is insufficient to cover the unreimbursed free care costs of the qualifying hospitals under this section, the $14,000,000 shall be distributed equitably among them, in proportion to the relative amount of unreimbursed free care costs incurred by each facility;
$5,000,000 to be added to line item 4000-0265 for the establishment of the Community Hospital Primary Care Physician Recruitment Fund for the support of community hospital recruitment of primary care physicians into their primary service areas, provided that grants from said fund shall be administered by the Massachusetts council of community hospitals; and (iv)”

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4513-1111, by adding the following: “; and provided further that not less than $100,000 shall be expended for a case management pilot project; and provided further that not less than $120,000 shall be expended for HCV surveillance throughout the Commonwealth”;

Ms. Resor, Ms. Jehlen, Messrs. Galluccio, Downing, and McGee moved that the bill be amended, in Section 2, by inserting after item 4403-2120 the following item:- “4404-1000 For a program of nutritional assistance to residents of the commonwealth who are qualified aliens within the meaning of section 431 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, so called, and non-citizens otherwise permanently residing under color of law in the United States; provided, that such a resident shall be eligible for such benefits only if such resident (1) is ineligible for federal food stamp benefits pursuant to the provisions of sections 401, 402, or 403 of such Act, and (2) would be eligible for federally funded food stamps, but for his or her citizenship status, provided further, that the Department shall seek to maximize eligibility for federal food stamp benefits wherever possible; provided further, that the department shall establish a schedule of benefits so as not to exceed the amounts appropriated herein………$2,000,000”.

Mr. Buoniconti moved that the bill be amended, in Section 2, in item 4800-0038, by inserting at the end thereof the following words:-
“and provided further, that not less than $100,000 shall be expended for the State Street Community Center in the city of Springfield”

Mr. Hart moved that the bill be amended, in Section 2, in item 4512-0200 by adding the following:- “provided further, that not less than $100,000 shall be expended for the Exodus Outreach Recovery Program; and provided further, that not less than $250,000 shall be expended for the Prince Hall Youth Mentoring Program;” and in said item by striking out the figures “$79,337,940” and by inserting in place thereof the figures “79,687,940”.

Mr. Pacheco moved that the bill be amended, in Section 2, in item 4406-3000, by inserting after the figure “2009” the following:- “provided further however that not less than $150,000 shall be expended for a contract with the St. Frances Samaritan House in Taunton,”

Mr. Petruccelli, Mr. Augustus, Ms. Resor, Mr. Knapik, Ms. Creem and Ms. Spilka moved that the bill be amended, in Section 2, in item 4800-1400, by striking the words, “For shelters and support services for people at risk of domestic violence; provided, that the department shall pursue the establishment of public-private partnership agreements established for family stabilization services funded from sources other than the commonwealth; provided further that services shall include supervised visitation programs and scattered site transitional housing programs, including programs to assist victims of domestic violence in finding and maintaining permanent housing; provided further, that participant in battered women’s programs shall be provided with information regarding local transitional housing resources; provided further, that funding shall be made available to enhance counseling services for children who have witnessed domestic violence; provided further, that funding shall be made available for emergency shelters for substance abusing battered women; provided further, that funding shall be made available for a statewide domestic violence hotline; provided further, that the department shall continue to provide any match funding required by federal program regulations; provided further, that domestic violence prevention specialists shall be funded from this item;” and inserting in place thereof the following:-

For shelter and support services for people at risk of domestic violence; provided that no less than $27,000,000 be expended for domestic violence emergency shelter and services, advocacy, outreach and prevention, including community based services and systems advocacy and of that amount no less than $6,000,000 be expended for infrastructure stabilization of local non-profit domestic violence services organizations

And that the bill be further amended, in the same section, by inserting, after the words, “Western Mass Women’s Initiative Survivor’s Project;” the following:-
provided further that no less than $75,000 shall be expended for Abby’s House in Worcester

And that the bill be further amended, in the same section, by striking the words, “provided further, that not less than $100,000 shall be expended for a domestic violence prevention program called ‘Teens-At-Risk’, operated by Portal To Hope for the communities of Everett, Lynn, Malden and Medford” and inserting, in place thereof, the following:-

provided further that not less than $100,000 shall be expended for a domestic violence prevention program called ‘Teens-At-Risk’, operated by Portal To Hope for the communities of Everett, Lynn, Malden, Medford and Winthrop without the need of approval by the commissioner of public health

Mr. Hart moved that the bill be amended, in Section 2, in item 4512-0200, by striking the words “provided further, that not less than $833,000 shall be expended for the Volunteers of America Rebound Youth Residential Recovery Program” and inserting in place thereof “provided further, that not less than $933,000 shall be expended for the Volunteers of America Rebound Youth Residential Recovery Program”

Ms. Jehlen moved that the bill be amended, in Section 2, in item 4513-1130 by striking the following wording:- “for sexual abuse and domestic violence services for qualified aliens, in accordance with 8 U.S.C. section 1641 (c), and refugees and ” and inserting in place thereof the following wording:- “and that not less than $300,000 shall be expended for sexual abuse and domestic violence services for immigrants and refugees”.

Mr. Knapik moved that the bill be amended in section 75 by inserting after the words “resulting free car charges.” the words:- “The unit shall also examine the premium assistance payments paid by the commonwealth health insurance connector to health insurers in the commonwealth care health insurance program. Such examination shall include, but not be limited to, the amount of payments made to each insurer; how each health insurer expends such payments; the distribution of enrollment among the health insurers; and the rates paid by the health insurer to health care providers on behalf of enrollees.”

Mr. Hart moved that the bill be amended, in Section 2, in item 1410-0250 by inserting the words “provided further than no less than $100,350 shall be expended for the Veterans Benefits Clearing Housing in the Dorchester section of Boston and in said item by striking out the figures “$2,603,730” and inserting “$2,704,080”

Mr. Tisei moved that the bill be amended, in Section 2, in item 4100-0060, by striking out the figure “$17,513,039” and inserting in place thereof the following figure:- “17,013,069”.

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4512-0200, by adding the following: “; and provided further that not less than $750,350 shall be expended for a contract with STEP, Inc., for sobriety treatment, education and prevention”;

Mr. Tisei moved that the bill be amended, in Section 2, in item 4510-0100, by striking out the figure “$21,911,667” and inserting in place thereof the following figure:- “17,090,934”.

Mr. Petruccelli moved that the bill be amended, in Section 2, in item 4000-0112, by adding the following: “; and provided further that not less than $50,000 shall be expended for the YMCA in East Boston”;

Mr. Tisei moved that the bill be amended, in Section 2, in item 9110-0100, by striking out the figure “$3,691,705” and inserting in place thereof the following figure:- “2,916,031”.

Mr. Hart moved that the bill be amended, in Section 2, in item 4590-1506, by striking the figure “$3,000,000” and inserting in place thereof the figure, $7,000,000”

Ms. Spilka moves that the bill be amended, in Section 2, by striking out item 3000-4050 and inserting in place thereof the following item:-
“3000-4050 For financial assistance for families currently involved with or transitioning from transitional aid to families with dependent children to enroll in an early education and care program; provided, that early education and care shall be available to former participants who are working for up to 1 year after termination of their transitional benefits; provided further, that post-transitional early education and care benefits shall be provided to participants who are working for up to 1 year after the transitional period; provided further, that all early education and care providers that are part of a public school system shall accept vouchers funded through this item; provided further, that the department may provide early education and care benefits to parents who are under 18 years of age, who are currently enrolled in a job training program, and who would qualify for benefits under chapter 118 of the General Laws but for the deeming of the grandparents’ income; provided further, that all teens eligible for year-round full-time early education and care services shall be participating in school, education, work and training-related activities or a combination thereof for at least the minimum number of hours required by regulations; provided further, that recipients of transitional aid shall not be charged fees for care provided under this item; provided further, that early education and care slots funded from this item shall be distributed geographically in a manner that provides fair and adequate access to early education and care for all eligible individuals; provided further, that informal early education and care benefits may be funded from this item; provided further, that not more than $2 per child per hour shall be paid for the services; provided further, that all children eligible for services under this item shall receive said services; provided further, that the commissioner of early education and care may transfer funds to this item from items 3000-1000 and 3000-4060, as necessary, pursuant to an allocation plan, which shall detail by object class the distribution of the funds to be transferred and which the commissioner shall file with the house and senate committees on ways and means at least 30 days before the transfer; and provided further, that not more than 3 per cent of any item may be transferred in fiscal year 2009 ……………………………………………………………… $176,367,855”.

Ms. Wilkerson moved that the bill be amended, in Section 2, in item 4510-0110, by adding at the end thereof the following: “; provided further, that $300,000 shall be expended for medical respite services provided by the Boston Health Care for the Homeless Program” and by striking out the figures “6,917,772” and inserting in place thereof the figures “7,217,772.” Bottom line figure of line item 4510-0110 increase by $300,000

Mr. Hart moved that the bill be amended in section 70 by inserting the following: “Provided the Secretary shall make available from said fund $4,000,000 in one-time grant for a disproportionate share financially distressed hospital located in Suffolk county with a locked inpatient adolescent psychiatric unit that participates in the Masshealth program.”

Messrs. Tisei and Morrissey moved that the bill be amended in amended, in Section 2, in item 4000-0265, by inserting after the words “grant program at community health centers” the following words:- “and community hospitals”
And moved in the same by inserting after the words “other clinicians at community health centers” the following words:- “and community hospitals"

Mr. Tisei moved that the bill be amended, in Section 2, in item 4110-4000, by striking out the wording and inserting in place thereof the following wording:-
“For the administration of the Ferguson Industries for the Blind; provided, that retired workshop employees shall receive grants equal to three-fourths of the salaries of current workshop employees; and provided further, that any funds received for goods and services purchased by private and public sector entities at Ferguson Industries shall be placed in a retained revenue account to be used by Ferguson Industries for its operational expenses.”

Mr. Tisei moved that the bill be amended, in Section 2, in item 4000-0355, by striking out the figure “$1,428,000” and inserting in place thereof the following figure:- “1,000,000”.

Messrs. Tisei, Tarr, Knapik, Hedlund and Brown moved that the bill be amended by inserting after section 90 the following section:-
Chapter 6A of the General Laws is hereby amended by striking section 16K and inserting in place thereof the following:-
Section 16K. There shall be a health care quality and cost council within, but not subject to control of, the executive office of health and human services. The council shall establish health care quality improvement and cost containment goals. The goals shall be designed to promote high-quality, safe, effective, timely, efficient, equitable and patient-centered health care. The council shall receive staff assistance from the executive office of health and human services and may, subject to appropriation, employ such additional staff or consultants as it may deem necessary. The council shall consist of the secretary for administration and finance, secretary of health and human services, the auditor of the commonwealth or his designee, the inspector general or his designee, the attorney general or his designee, the commissioner of insurance, the executive director of the group insurance commission, and 7 persons to be appointed by the governor, 1 of whom shall be a representative of a health care quality improvement organization recognized by the federal Centers for Medicare and Medicaid services, 1 of whom shall be a representative of the Institute for Healthcare Improvement, Inc. recommended by the organization’s board of directors, 1 of whom shall be a representative of the Massachusetts Chapter of the National Association of Insurance and Financial Advisors, 1 of whom shall be a representative of the Massachusetts Association of Health Underwriters, 1 of whom shall be a representative of the Massachusetts Medicaid Policy Institute, 1 of whom shall be an expert in health care policy from a foundation or academic institution and 1 of whom shall represent a non-governmental purchaser of health insurance. The representatives of nongovernmental organizations shall serve staggered 3-year terms; but another representative shall be appointed to complete an unexpired term if a vacancy exists. The council shall be chaired by the secretary for administration and finance.

Messrs. Tisei, Galluccio, Petruccelli and Jehlen moved that the bill be amended, in Section 2, in item 4800-1400, by striking out the figure “$100,000” and inserting in place thereof the following figure:- “$150,000”, and by striking out the figure “$23,248,406” and inserting in place thereof the following figure:- $23,298,406”.

Messrs. Joyce, Antonioni, and Morrissey, Knapik and Ms. Jehlen and Candaras moved that the bill be amended, in Section 2, in item 5046-0000, by striking out the figure “$321,748,305” and inserting in place thereof the following figure:- “$322,415,939”

Messrs. Tisei, Tarr, Knapik, Hedlund and Brown moved that the bill be amended by inserting after section 90 the following section:-
“SECTION 91. Notwithstanding any general or special law to the contrary, the secretary of administration and finance and the secretary of health and human services shall prepare and submit a report to the general court about the allocation for and use of state funds by acute care hospitals, non-acute care hospitals, Medicaid managed care organizations, other managed care organizations, community health centers and carriers contracting with the commonwealth health insurance connector authority. The report shall include: (1) a comprehensive review of the current manner, amount and purposes of annual state funding received by those entities, including a description of the source of the funding; (2) an assessment of the change in total state funding for those entities over the past 5 years, with particular attention paid to the impact of chapter 58 of the acts of 2006; (3) an assessment of how those entities use state funds; (4) an assessment of whether the current payment structure assures the delivery of quality health care in the most cost-effective way; (5) an analysis of financial and management practices of those entities by benchmarking performance with respect to quality and cost effectiveness against national performance levels and similar health care providers in the commonwealth; (6) identification of common factors that may contribute to the fiscal instability of those entities; (7) recommendations for the development of performance and operational benchmarks; (8) recommendations for ensuring that the entities are spending state and other funds in a fiscally-responsible manner and providing quality care; (9) recommendations for legislative and other action necessary to strengthen state oversight and ensure greater accountability of state resources; (10) an assessment of the manner in which hospitals seek payment from consumers, including an analysis of the impact that court filing fees have on their ability to collect payment; and (11) recommendations for regulations regarding the due diligence that facilities shall exercise in seeking to collect payment from consumers before seeking reimbursement from the commonwealth.
The secretaries shall have access to all documents of acute care hospitals, non-acute care hospitals, Medicaid managed care organizations, other managed care organizations, community health centers, carriers contracting with the commonwealth health insurance connector authority and any related entities that relate to that organization’s use of state funds; provided, however, that the secretaries shall not request any documents that are in the possession of any agencies of the executive office of administration and finance or the executive office of health and human services. The secretaries shall keep all information and documents obtained under this section confidential and shall not disclose such information or documents to any person except as necessary in a case brought by the attorney general under this chapter. Such information and documents shall not be public records and shall be exempt from disclosure under section 10 of chapter 66.
For the purpose of conducting their duties under this section, the secretaries may contract with an outside organization with the requisite financial expertise to enable the secretaries to prepare the report. The secretaries shall submit the report, along with any recommendations for legislative or other action, to the clerks of the senate and house of representatives not later than December 31, 2008.

Messrs. Tisei, Tarr, Knapik, Hedlund and Brown moved that the bill be amended in section 69 by adding after the words “that sufficient revenues are available to support projected program expenditures.” the following words:-
“At the end of each month the secretary of administration and finance shall post on the official website of the commonwealth a report detailing the amounts of any transfers made from the general fund to the commonwealth care trust fund or the health safety net trust fund or amongst those funds.”

Mr. Tisei moved that the bill be amended, in Section 2, in item 4580-1000, by striking out the figure “$51,581,508” and inserting in place thereof the following figure:- “50,176,508”.

Mr. Tolman moved that the bill be amended, in Section 2, in item 4512-0202 by inserting after the words “and the department of corrections;” the following:-“provided further, that prior to release from said facility a one year treatment plan shall be developed for the individual.”

Mr. Creedon moved that the bill be amended, in Section 2, in item 4120-4000 be amended by inserting the following language:- “; provided further, that not less than $25,000 shall be expended on Living Independently for Equality, Inc of Brockton for the operation of participants to meet other physically challenged individuals and take part in a number of therapeutic activities”

Mr. Hart moved that the bill be amended, in Section 2, in item 0810-0000, by inserting the following:

“;provided further that no less than $260,000 shall be expanded for the Ella J. Baker House in the City of Boston for violence prevention programs for high risk youth.”

Messrs. Creedon and Hedlund and Baddour moved that the bill be amended, in Section 2, in item 4110-1000, by striking the figure “$4,365,633” and inserting in place thereof the figure “$4,553,764”.

Mr. Brown moved that the bill be amended, in Section 2, in item 5046-0000, by inserting the following:- “provided further, that not less than $50,000 shall be expended to continue and expand the triage counseling services in the Needham public schools.”

Messrs. Creedon and Morrissey and Hedlund moved that the bill be amended, in Section 2, in item 4800-0038, by inserting the following language:- “provided further, that not less than $100,000 shall be expended for the Conway Children’s Advocacy Center of Plymouth County;”

Messrs. Creedon and Joyce moved that the bill be amended, in Section 2, in item by inserting the following language:- “provided however, that $50,00 shall be expended for handicap accessibility to the athletic field located at Oliver Ames High School in the town of Easton”

Mr. Creedon moved that the bill be amended, in Section 2, in item 4512-0200, by inserting the following language:- “provided further, that not less than $100,000 shall be expended for the operation of Learn to Cope, a support group providing parents of children addicted to opiates with substance abuse recovery resources and emotional support;”

Mr. Creedon further moves to amend the item by striking out the figures “79,337,940” and inserting in place thereof:- “79,437,940”

Mr. Hart moved that the bill be amended, in Section 2, in item 4510-0100, by adding the following: “; provided further, that not less than $158,000 shall be expended for the Haitian Multi-Service Center in the Dorchester section of the city of Boston”

Mr. Creedon moved that the bill be amended, in Section 2, in item 4513-1111, by inserting the following language: - “provided further, that not less than $50,000 shall be expended for the operation of NECPAD, a support organization which provides patient education and support for people diagnosed with PKU and related disorders and their families; and provided further, that none of these funds shall be expended for any personal-related cost;”

And Mr. Creedon further moves to amend the item by striking out the figure”14,197,093” and inserting in place thereof the following:- “$14,247,093”

Mr. Hart moved that the bill be amended, in Section 2, in item 5920-2025, by inserting at the end the following:-“;provided that an additional $400,000 shall be expended on a contract with Work, Inc. for enhanced or expanded services and employment opportunities for citizens with disabilities”

Ms. Creem and Mr. Timilty moved that the bill be amended, in Section 2, in item 4513-1000, by striking the words “and the Massachusetts Birth Defects Monitoring Program” and inserting in place the following “provided further, that not less than $450,000 shall be expended for the Massachusetts Birth Defects Monitoring Program;”

Messrs. Creedon and Hedlund and Baddour moved that the bill be amended, in Section 2, in item 4110-3010, by striking the figure “$2,920,455” and inserting in place thereof the figure “$3,104,688”.

Ms. Creem and Mr. Timilty moved that the bill be amended, in Section 2, in item 4513-1130, by striking out the wording: “provided further, that funds shall be expended for certified batterer intervention program services;”
and inserting in place thereof the following wording:-- “provided further, that no less than $1,050,574 shall be expended for domestic violence certified batterer intervention program services;”

Ms. Creem and Mssrs. Joyce and Hart moved that the bill be amended, in Section 2, in item 9110-1660, by striking the figure, “100,000” and replacing it with the figure “$216,000”;

Mr. Joyce moved that the bill be amended, in Section 2, in item 5920-2000, by adding the following:- “; provided further, that not less than $100,000 shall be expended for Employ+Ability in the town of Braintree”

Ms. Jehlen and Messrs. Moore and Joyce moved that the bill be amended, in Section 2, in item 9110-1500, by striking out the figure “$48,024,305” and replacing it with the following:- “$49,306,583”

Ms. Creem moved that the bill be amended, in Section 2, in item 4000-0112, by striking the figure “$80,000”; and replacing it with the figure “$155,000.”
ottom line figure of line item 4000-0112 increase by $75,000

Mr. Galluccio moves that the bill be amended, in Section 2, in item 4512-0200, by adding the following: - “provided further that not less than $75,000 be expended for the Charlestown Substance Abuse Coalition for securing placement of at-risk adults in job training programs, apprenticeships, and permanent employment.”

Mr. Hart moved that the bill be amended, in Section 2, in item 4590-1506, by inserting at the end thereof the following, “;provided further, $50,000 shall be expended for the City-Wide Dialogues on Boston's Ethnic & Racial Diversity, a program that provides a safe venue for honest, respectful discussions across racial and ethnic lines, including neighborhood diversity dialogues and youth-police dialogues.”

Ms. Candaras, Mr. Knapik and Mr. Buoniconti moved that the bill be amended in Section 69, at the end thereof, the following:- “The Secretary of the Executive Office of Health and Human Services shall make a payment of up to $7,000,000 from the Medical Assistance Trust Fund to the acute hospital system in Hampden County which operates Providence Behavioral Health Hospital in Holyoke.”

Messrs. Joyce and Creedon moved that the bill be amended, in Section 2, in item 5920-3000, by inserting the following:- “; provided further, that not less than $50,000 shall be expended towards the construction costs of House of Possiblities, a respite home for special needs children and adults in the town of Easton”.

Mr. McGee moved that the bill be amended, in Section 2, in item 1410-0251, by striking the figure, “$2,276,862” and inserting in place thereof the figure: - “$2,426,862”

Ms. Candaras, Mr. Augustus, Mr. Buoniconti, Ms. Jehlen and Mr. Antonioni moved that the bill be amended, in Section 2, by inserting after item 4512-0200 the following item:-
“4512-0201 For substance abuse step-down recovery services, otherwise known as level B beds and services, and other critical recovery services with severely reduced capacity; provided, that no funds shall be expended in the AA object class for any personnel-related costs; and provided further, that the department shall submit quarterly to the house and senate committees on ways and means a report on the number of individuals served by the step-down recovery services program………………………………….$5,000,000”

Mr. Joyce and Ms. Jehlen moved that the bill be amended by inserting, after Section ____, the following new Section: -
“SECTION ___. Chapter 6A is hereby amended by adding the following section:-
Section 16P.
(a) As used in this section, the following words shall, except as otherwise provided, have the following meanings:-
“Level IV treatment intervention”, any procedure which involves the systematic use of noxious or intrusive stimuli which are generally known to be painful or otherwise unpleasant to individuals, including but not limited to, procedures that: (1) cause physical pain to the individual, whether administered directly or through intermediate devices, such as skin electric shock, inhalants, or ingestible substances (excluding alcoholism treatments, such as disulfiram, Antabuse or Antabus) ; (2) involve sleep or food deprivation; (3) include the introduction of additives to make food unpleasant; or (4) involve the prompting of an individual to engage in a behavior which then results in an aversive stimulus being applied as a punitive consequence.
“Statewide peer review committee”, the review committee established in subsection (c).
“Department”, the Department of Mental Retardation.
“Executive office”, the executive office of health and human services.
“Individual treatment plan”, a plan approved by the statewide peer review committee pursuant to regulations promulgated under this section.
“Secretary”, secretary of the executive office of health and human services.

(b) The Department hereby creates a new classification of behavioral treatment interventions, to be known as Level IV treatment interventions. The Department shall, with the advice and consent of the statewide peer review committee, promulgate rules and regulations consistent with this chapter regarding the use of Level IV treatment interventions to address behaviors that present a pattern of conduct or behavior caused by a disorder which poses a serious danger to self or others of risk of injury or harm to self or others by any consumer of any public or private agency receiving funding or subsidy through the commonwealth. Such rules and regulations shall be consistent with federal and state protections for protected persons insofar as practicable; provided, however, that the Department, with the advice and consent of the statewide peer review committee, may make such adjustments, exceptions or waivers as in their judgment are necessary to carry out the purposes of this section or to facilitate compliance. The Department regulations regulating the use of Level IV interventions will govern all uses of such procedures by any public or private agency receiving funding through the Commonwealth of Massachusetts.
Level IV interventions are designed for the treatment of certain types of dangerous or self destructive behaviors following a pre-determined treatment protocol which includes highly punitive techniques designed to teach an individual not to repeat those challenging behaviors. Level IV interventions are the most intrusive form of treatment intervention and they shall be considered to only be used as a method to address behaviors that directly present a clear risk of injury or harm to self or others. Level IV interventions are not appropriate for addressing minor behavior problems, even if said behaviors are identified as antecedents to targeted challenging behaviors, unless less intrusive interventions have been attempted and documented to have failed in addressing such minor behaviors. Level IV interventions should only be considered when reinforcement-based interventions and other less intrusive treatments have failed, including programs developed by clinicians specially skilled in positive behavior supports.   Documentation of the fidelity of the application of all less intrusive interventions and the completion of formal procedural reliability assessments must be provided in all proposed Level IV treatment intervention submissions.
Level IV interventions are restricted to those techniques and procedures that are considered as evidence-based practices and meet the standards of being scientifically validated, as demonstrated by their publication in peer-reviewed professional journals. All such proposed interventions must have been demonstrated as clinically effective in the reduction of similar topographies of challenging behaviors with participants within similar age ranges or diagnostic categories, and in similar settings. All such proposed interventions for children must be consistent with the Individuals with Disabilities Education Act of 2004 (IDEA) and No Child Left Behind.
            (c) There shall be a statewide peer review committee on Level IV treatment interventions. The statewide peer review committee shall be located within, but not subject to control by, the executive office. The governor, shall appoint 3 licensed psychologists, 2 of whom meet the guidelines and standards of clause (2) below, and have 10 or more years of experience in applied behavior analysis and behavior treatment of severe behavior problems.
            In the case where a public or private agency in the Commonwealth receives funding from another state or jurisdiction and seeks to utilize a Level IV procedure with a client whose permanent residence from that state or jurisdiction, said state or jurisdiction may recommend an individual who meets the guidelines and standards of clause (2) below to serve as an “ad-hoc” member of the statewide peer review committee to review any and/or all proposed Level IV interventions for residents from said state or jurisdiction.
            The statewide peer review committee shall: (1) review, approve and oversee all Level IV treatment interventions being implemented with any person in the Commonwealth who is served by a public or private agency receiving funding or subsidy through the executive office as provided under this section; (2) appoint a Chair who is a board certified behavior analyst, or holds specialty certification in cognitive and behavior psychology from the American Board of Professional Psychology, or is a licensed psychologist with documented education, professional training and experience in applied behavior analysis and behavior treatment, and 5 years of full-time experience serving individuals within the same age range or diagnostic category; demonstrating similar topographies of challenging behaviors and utilizing similar treatment approaches as those proposed in the behavior treatment plan under review; (3) review individual treatment plans and approve the use of Level IV treatment interventions within such treatment plans; (4) set guidelines and standards for facility peer review committees; (5) review and make recommendations to the executive office for any requested exclusions or waivers from the regulations governing Level IV treatment interventions; and (6) be assisted in its duties by the executive office, which shall provide technical, technological, operational and administrative support.
            A member of the statewide peer review committee shall be indemnified from any civil action brought for damages to the same extent as provided for public employees in chapter 258; and shall be indemnified for all expenses incurred in the defense thereof provided, however, that the claim arose out of acts performed by such member while acting within the scope of the member’s official duties.
            (d) All Level IV interventions shall be designed by an individual who is a Board Certified Behavior Analyst, or holds Specialty Certification in Cognitive and Behavioral Psychology from the American Board of Professional Psychology, or is a Licensed Psychologist with documented education, professional training and experience in applied behavior analysis and behavioral treatment, and 5 years of full-time experience serving individuals within the same age range and diagnostic category; demonstrating similar topographies of challenging behaviors and utilizing similar treatment approaches as those proposed in the Level IV plan under review. Individuals responsible for the design of Level IV interventions will comply fully with the Ethical Principles of Psychologists and the Code of Conduct of the American Psychological Association. All Level IV interventions submitted for review and approval must meet the standards outlined within the Guidelines for Responsible Conduct of the Behavior Analysis Certification Board, and include documentation that the challenging behaviors being addressed are not a function of a medical or psychiatric disorder. Additionally, all such proposed interventions must include evidence of the completion of a formal comprehensive functional behavioral assessment, a preference assessment, and reinforcement strategies designed to teach functionally equivalent replacement behaviors. In addition to the ongoing empirical measurement of all targeted challenging and replacement behaviors throughout any approved Level IV intervention, all such Level IV interventions must also include ongoing objective documentation of the trauma suffered by the individual or others as a result of the challenging behaviors addressed within the treatment plan.
(e) Level IV interventions shallonly be implemented by staff persons that have received specific training in the application of the intervention and the individualized treatment plan. Documentation listing all qualified staff who received specific training in the Level IV intervention and the individuals who designed the treatment protocol and who administered each application of the Level IV intervention shall be incorporated in the client record.
The statewide peer review committee shall require that all Level IV interventions shall be implemented only under the direct supervision and physical presence of the Board Certified Behavior Analyst, ABPP Certified Cognitive and Behavioral Specialist, or Licensed Psychologist with documented education, professional training and experience in applied behavior analysis and behavioral treatment.
(f) Each facility seeking to use Level IV treatment interventions shall establish a facility peer review committee, approved by the statewide peer review committee. Prior to application to the statewide peer review committee for authority to implement a behavior treatment intervention, consent shall be obtained from the client (if competent) and the facility peer review committee. The facility peer review committee shall include (1) psychologists with documented education, professional training and experience in applied behavior analysis and behavioral treatment and (2) a psychologist with broad clinical expertise outside the specialty of behavior analysis. In cases of extreme emergencies, the agency serving the individual shall not be required to apply for approval to the facility peer review committee, but shall apply directly to the statewide peer review committee for a 30-day temporary approval of the intervention; provided, that the agency has secured informed consent from the client (if competent). If such emergency application is approved by the statewide peer review committee, the application must also be submitted, prior to implementation, to the probate court of the county in which the client resides for approval through a substituted judgment review process.
(g) Level IV treatment interventions shall be permitted only when approved by the statewide peer review committee and by a court-ordered substituted judgment treatment plan for an individual client. Prior to rendering a decision, the statewide peer review committee may permit the proponent of the use of such interventions and any other interested person the opportunity to present materials in support of or in opposition to the proposed treatment plan. The decision of the statewide peer review committee shall be in writing, with supporting reasons provided for its decision.   A finding by the statewide peer review committee permitting Level IV treatment interventions with respect to any individual treatment plan shall be submitted thereafter to the probate court of the county in which the client resides as part of the court’s independent review and approval of said treatment plan.
(h) Level IV interventions shall not be initially approved by the statewide peer review committee unless the proponent of the use of such interventions provides clear and convincing evidence through the evaluation protocol and ongoing behavior data, that (a) the target behavior presents an immediate risk of serious physical injury or harm to self or others; (b) the Level IV procedure will lead to positive outcomes and a significant decrease in the target behaviors; and (c) that less intrusive treatments continue to be unsuccessful or would present an immediate risk of serious physical injury or harm.
            Level IV treatment interventions maybe initially approved for no more than 30 days by the statewide peer review committee, and may be re-approved thereafter for additional 30-day periods, not to exceed six months. Request for re-approval shall be subject to such conditions as the statewide peer review committee may designate, including a review of all existing data to confirm that the use of the Level IV treatment intervention has led to positive outcomes and a significant decrease in the target behaviors. Any request for the use of the Level IV treatment intervention beyond the 30-day trial shall require re-submission to the statewide peer review committee and the probate court of the county in which the client resides as part of the court’s independent review and approval of said treatment plan. The statewide peer review committee shall petition the Commissioner of the Department of Mental Retardation to review cases in which the continued use of Level IV treatment interventions are requested beyond the six month limit.
(i) The executive office may, after a hearing pursuant to chapter 30A, deny, refuse, revoke, limit or suspend a license of any recipient of funding or subsidy through the executive office for failure to comply with the provisions of this section.
(j) Except for emergency regulations adopted pursuant to section 2 of chapter 30A, any regulation, as defined in section 1 of said chapter 30A, or any amendment or repeal of any such regulation adopted by the Department pursuant to this section, shall, after compliance with all applicable provisions of this section and said chapter 30A, except section 5, be submitted to the general court. Said Department shall file the proposed regulation, amendment or repeal with the clerk of the house of representatives, together with a statement of compliance with the pertinent provisions of said chapter 30A, except section 5. The clerk of the house of representatives, with the approval of the president of the senate and the speaker of the house of representatives, shall refer such regulations to the joint committee on children, families and persons with disabilities. Within 30 days after such referral, said legislative committee may hold a public hearing on the regulations and shall issue a report to said Department. Said report shall contain any proposed changes to the regulations voted upon by the legislative committee. The Department and the statewide peer review committee shall review said report and shall adopt final regulations as deemed appropriate in view of said report and shall file with the chairmen of the legislative committee its final regulations. If the final regulations do not contain the changes proposed by the legislative committee, the Department and the statewide peer review committee shall send a letter to the legislative committee accompanying the final regulations stating the reasons why such proposed changes were not adopted. Not earlier than 45 days after the filing of such letter and final regulations with said legislative committee, said Department shall file the final regulations with the state secretary as provided in section 5 of said chapter 30A and said regulations shall thereupon take effect.
If no such proposed changes to the regulations are made to the Department and the statewide peer review committee within 60 days of the initial filing of the proposed regulation or any amendment or a repeal of such regulation with the clerk of the house of representatives, the Department may file the final regulations with the state secretary as provided in section 5 of said chapter 30A and said regulations shall thereupon take effect.
SECTION 2. Within 90 days after the passage of this act, the Department, with the advice and consent of the statewide peer review committee shall draft, pursuant to chapter 30A, proposed rules and regulations to the General Court regarding the development, review, approval, and on-going review and monitoring process for behavior intervention treatments.
SECTION 3. The implementation of any Level IV intervention beyond the scope of a court-ordered treatment plan or the approval of the statewide peer review committee, or by a staff member who does not meet the requirement of this section will be considered an act of mistreatment, pursuant to section 13K of chapter 265 and shall be reported to the Disabled Persons Protection Commission.
SECTION 4. Except as provided herein, this act shall not otherwise alter the procedures for substituted judgment review by the Probate and Family Court.

Messrs. Joyce, Hedlund, Marzilli, Moore, Brown, Augustus, Creedon, Morrissey and Ms. Resor moved that the bill be amended, in Section 2, in item 5920-5000, by striking out the figure “$17,664,660” and inserting in place thereof the following figure:- “$19,664,660”.

Ms. Jehlen, Ms. Candaras, Ms. Resor and Mr. Creedon moved that the bill be amended, in Section 2, in item 4000-0600, by inserting after the words “standards for determining admission to” the following words:- “and continued stay in”.

Mr. Galluccio moves that the bill be amended, in Section 2, in item 4512-0200, by adding the following: - “provided further that, not less than $250,000 be expended for the Latino After School Initiative.”

Mr. McGee moved that the bill be amended, in Section 2, in item 1410-0012, by inserting the following words: - “provided further, that not less than $250,000 shall be expended for the Northeast Veterans Business Resource Center in the city of Lawrence, a 501 (c)(3) nonprofit corporation for the purpose of training and assisting our American military veterans in the areas of employment, self employment and entrepreneurship.”

Mr. Joyce moved that the bill be amended, in Section 2, in item 4590-0915, by inserting after the words “pharmacy services” the following:- “; provided further, that $45,000 shall be made available for the position of Volunteer and Development Coordinator at the Massachusetts hospital school”

Mr. Galluccio moves that the bill be amended, in Section 2, in item 4403-2120, by m striking out the figure “$85,567,847” and inserting in place thereof “$86,277,382.”

Mr. McGee moved that the bill be amended, in Section 2, in item 4800-0038, by inserting after the words “court diversion program” the following words: “provided further, that not less than $2,100,000 shall be expended on family support and stabilization services in the Lynn area office,”; and in said item by striking out the figures “312,209,552” and inserting in place thereof the by figures “312,709,552”.

Mr. McGee moved that the bill be amended, in Section 2, in item 1410-0250, by adding the following: - “provided further, that not less than $60,000 shall be obligated for a contract with the Lynn Veterans Housing First Program located in the city of Lynn”

Mr. Hart moved that the bill be amended by inserting, after Section 85 the following new section:

SECTION_________ Section 5 of Chapter 115 of the General Laws, as appearing in the 2006 Official edition is hereby amended by striking out paragraph eight and inserting in place thereof the following paragraphs:-
The benefits provided herein shall include an amount for “Shelter” not to fall below $600 per month for eligible veterans and dependents who do not pay their own heating costs.
The benefits provided herein shall include an amount for “Shelter” not to fall below $500 per month for eligible veterans and dependents who pay their own heating costs.
T he benefits provided herein shall include an amount for “fuel” not below $250 per month for eligible veterans and dependents who pay their own heating costs; Provided further that said benefits shall be paid throughout the year.

Mr. Antonioni moved that the bill be amended, in Section 2, in item 5047-0001, by inserting at the end thereof the following:- "provided further, that the department shall require a performance specification to be developed for safe aftercare options for adults upon release from acute inpatient mental health care services".

Mr. McGee moved that the bill be amended by inserting after Section___, the following section:
“SECTION___: Section 6 of Chapter 130 of the Acts of 2005 is hereby amended by striking said Section 6 and inserting in place thereof the following: “The monthly premiums for any coverage held in the serviceman’s group life insurance program administered by the Veterans Administration, the state sponsored life insurance program or an equivalent group life insurance program of the servicemember’s choosing, provided that the reimbursement or premium shall not exceed the cost of the monthly premium cost of serviceman’s group life insurance for a member of the Massachusetts National Guard shall be borne by the commonwealth if said premiums are not paid or reimbursed by the United States.”

Ms. Menard and Tucker, moves to amend the bill by inserting, after Section_______, the following new Section:-
Notwithstanding any general or special law to the contrary, the secretary of health and human services shall submit a report on the results of the payment methodology used in hospital fiscal year 2008 for health services from the Health Safety Net Trust Fund as implemented by the health safety net office pursuant to section 39 of chapter 118G of the General Laws. The report shall include the proposed reimbursement methodology to be used in hospital fiscal year 2009 for health services from the Health Safety Net Trust Fund as determined by the health safety net office pursuant to section 39 of chapter 118G of the General Laws.
The report shall detail all modifications made to the payment systems in effect for acute hospitals used by the United States Department of Health and Human Services Centers for Medicare & Medicaid Services to administer the Medicare Program under Title XVIII of the Social Security Act, including any adjustments to account for: (1) the differences between the program administered by the office and the Title XVIII Medicare program, including the services and benefits covered; (2) grouper and DRG relative weights for purposes of calculating the payment rates to reimburse acute hospitals at rates no less than the rates they are reimbursed by Medicare; (3) the extent and duration of covered services; (4) the populations served; and (5) any other adjustments based upon circumstances of individual hospitals. The report shall also detail the proposed hospital fiscal year 2009 reimbursement methodology for outpatient rates and adjustments made under (1) and (2) above.
The report shall include analysis of the executive office’s implementation of the Medicaid provider rate provisions required in section 128 of chapter 58 of the acts of 2006. The report shall include an analysis of the distribution of funds during fiscal years 2007 and 2008 in addition to the proposal of the executive office for fiscal year 2009 to physicians and acute hospitals.
The secretary shall submit the report to the joint committee on health care financing and the house and senate committees on ways and means on or before August 1, 2008.

Mssrs. Galluccio, Tolman, Petruccelli, and Ms. Jehlen move to amend the bill in section 2, item 4000-0500, by adding the following:- “; and provided further, that the executive office shall make expenditures pursuant to section 122 of chapter 58 of the acts of 2006 in fiscal year 2009 in a manner consistent with the overall supplemental funding level agreed to for the public entity for fiscal year 2008;”

And move to further amend the bill in section 69, in line 26, by striking out the following: “fiscal year 2008” and inserting in place thereof the following: “fiscal year 2009”.

Mr. Galluccio, Mr. Tolman, Ms. Tucker, Mr. Petruccelli, Mr. Baddour, Ms. Jehlen, and Mr. Creedon move to amend the bill in Section 2, item 4000-0500, by adding the following:- “; and provided further, that $11,900,000 shall be expended on disproportionate share payments to high public payer hospitals.”

Mr. O'Leary moved that the bill be amended, in Section 2, in item 4800-0038, by adding at the end thereof the following:- "; provided further, that not less than $35,000 shall be expended for the Barnstable County Council for Children, Youth and Families; "

Mr. Tarr moved that the bill be amended, in Section 2, in item 4100-0060, by adding at the end thereof the following words:- “provided further, that the division shall provide a report not less than quarterly on the projected costs and enrollment figures of Commonwealth Care; provided further, that such report shall be filed with the House and Senate clerks”.

Mr. Tarr moved that the bill be amended, in Section 2, in item 4100-0060, by adding the following at the end thereof:- “provided further, that the division shall produce a report including but not limited to the following items:

the status of the federal “1115 waiver”, so-called, and the likely impact of any foreseeable changes to the waiver
The amount and type of state and federal payments to the five hospitals receiving the most funding as a result of status as “Safety Net Hospitals”, so-called, and the percentage of total funding being received by each hospital
Any potential financial obligations of the Commonwealth which may arise as a result of decreased federal funding for safety net hospitals
The extent to which any managed care plan authorized pursuant to Chapter 58 of the general laws is not in compliance with licensing requirements maintained by the Division of Insurance.

Said report shall be filed with the clerks of the House and Senate not later than 120 days following the passage of this act”.

Ms. Menard moved that the bill be amended, in Section 2, in item 7100-0300 by adding the follow:- “provided further, that not less than $250,000 shall be expended for research on breast cancer prevention performed in collaboration with the University of Massachusetts at Lowell, the Silent Spring Institute and the Massachusetts Breast Cancer Coalition.”

Ms. Menard and Tisei, Downing, Timilty and Spilka moved that the bill be amended, in Section 2, in item 4000-0012 by inserting after the phrase “commitment of matching funds from the organization;” the following:- “provided further, that not less than $675,000 be expended for the YMCAs of Massachusetts, Inc., for distribution to the Athol YMCA, the YMCA of Attleboro, the Becket-Chimney Corners YMCA, the Cambridge YMCA, the Cape Cod YMCA, the Community YMCA of Danvers, the Greenfield YMCA, the Hampshire Regional YMCA, the Hockomock Area YMCA, the Greater Holyoke YMCA, the Greater Lowell Family YMCA, the Malden YMCA, the YMCA of Melrose, the MetroWest YMCA, the Montachusett Regional YMCA, the YMCA of the North Shore, the Northern Berkshire YMCA, the Old Colony YMCA, the Pittsfield Family YMCA, the Somerville YMCA, the South Shore YMCA, the YMCA Southcoast, the YMCA of Greater Springfield, the Tri-Community YMCA of Southbridge, the YMCA of Greater Westfield, the YMCA of Martha’s Vineyard, and the Winchendon Clark Memorial YMCA.”

Ms. Menard moves to amend the bill by inserting, after Section_____, the following new Section:-

SECTION 1. Paragraph (g) of subdivision (2) of section 3 of chapter 32 of the General Laws, as appearing in the 2006 Official Edition, is hereby amended by inserting, after line 307, the following new paragraph:-

Any municipality may elect to place in Group 4 uniformed employees of a municipal or public emergency medical service who are certified at any level as an Emergency Medical Technician (EMT) by the department of public health. This placement of such EMTs into Group 4 shall take effect in a municipality upon its acceptance in the following manner: in a city having Plan D or a Plan E charter, by majority vote of its city council and approved by the manager; in any other city by majority vote of the city council and approved by the mayor; in a town, by vote of the board of selectmen.

Ms. Wilkerson moved that the bill be amended, in Section 2, in item 4590-1506, by striking the figure “$3,000,000” and inserting in place thereof the figure, $3,500,000.”