Bills: HF276, HF413, HF411

Keywords: human services, Medical Assistance, Medicaid, long-term services and supports, LTSS, public assistance, application process, eligibility determination, customer service survey, wait times, form complexity, lead agencies, Department of Human Services, Department of Children Youth and Families, streamlining, administrative reform, case management, reassessment, intake system, adaptive eligibility form

Transcript Highlights:

• that they use in their LTSS reports.
• who receive Medicaid LTSS, in large part, a lot of people who need LTSS might not qualify for Medicaid
• LTSS.
• LTSS within the same year.
• We're showing here, among LTSS users, what percentage receive HCBS versus institutional LTSS or both,

Keywords: 995, all

Summary: The Massachusetts Commission on the Status of Persons with Disabilities’ Long-Term Services and Supports and Health Equity Subcommittee met to hear a presentation from the Lurie Institute for Disability Policy at Brandeis University. Monica Mitra introduced the institute’s work on disability health equity and long-term services and supports, and staff described several research centers focused on community living policy, disability and pregnancy, and parents with disabilities. The presentation emphasized participatory research, accessible dissemination, and the connection between health equity and access to home- and community-based services. Joe Caldwell discussed the Community Living Policy Center’s work on Medicaid HCBS, the direct care workforce crisis, housing, and policy advocacy, including efforts related to the Money Follows the Person program and the Medicaid access rule’s interested parties advisory group. Sid Pickern highlighted a workforce study interviewing direct care workers, a forthcoming policy brief on the access rule, and housing research including Massachusetts’ Alternative Housing Voucher Program. Teresa Nguyen described the Community Living Equity Center’s focus on disparities in community living for people of color, especially a study on self-direction and community living outcomes, and asked for help recruiting participants. Lauren Bixby demonstrated the community living data dashboard, which compares adults who need LTSS with those receiving Medicaid LTSS using ACS and TMSIS data. She explained that the dashboard can be filtered by state and demographics, but noted major race and ethnicity data gaps for Massachusetts and other states. Commissioners praised the dashboard and the institute’s work, asked questions about data sources and the 1115 waiver, and discussed possible connections to the Health Equity Compact. No votes were taken; the meeting ended with an invitation for follow-up, including a forthcoming direct care workforce brief and the institute’s October 28 lecture.

Transcript Highlights:

• and Supports, LTSS and Supports, LTSS solutions<00:08:08.000> at<00:08:08.240> Amera
• States also use LTSS programs as a way to rebalance their LTSS systems from institutional settings to
• States also use LTSS programs as a way to rebalance their LTSS systems from institutional settings to
• Medicaid um LTSS expenditures in New Medicaid um LTSS expenditures in New Hampshire<00:15:44.079>
• It's a very small have LTSS needs.

Keywords: 928, house, all

Summary: The Committee to Study Long-Term Managed Care met to approve prior minutes and outline its schedule, with meetings set for September 24 and September 29 ahead of an October 1 report deadline. The chair said the committee would use the first two meetings to digest testimony, likely ask follow-up questions of DHS, and then work toward conclusions and a report format. The minutes from the previous meeting were approved unanimously. The main testimony came from Sharon Alexander of Amera Health, who argued in favor of moving from fee-for-service Medicaid long-term services and supports to a managed LTSS model. She described managed LTSS as a capitated, quality-driven system used in about 26 states, and said it can improve care coordination, accountability, access to home- and community-based services, and budget predictability. She cited Amera Health’s experience in Pennsylvania and Delaware, including care coordination, housing and transportation support, caregiver programs, and quality benchmarks tied to state oversight. She also said nursing facilities would remain an important option for people who need that level of care. Committee members asked about how the programs are administered, how rates are set, how care managers work, and how quality is measured. Alexander said states contract with managed care organizations at actuarially sound capitated rates, with annual contracts, reporting, and oversight. She explained that care managers typically conduct quarterly assessments and follow up after trigger events such as hospitalization, and that housing coordinators may assist with transitions to the community. On quality, she said states use CMS-related and HCBS benchmark measures covering service timeliness, care planning, transitions, and other outcomes, and that New Hampshire could build on existing metrics rather than starting from scratch. She also noted that rural areas face workforce and transportation challenges, which managed care plans try to address through technology and self-direction options.

Transcript Highlights:

• You know, we work very hard at LTSS to make sure that we have a very strong continuum of LTSS community
• I'm sure there's other LTSS programs that draw federal financial participation.
• LTSS programs...
• All of the LTSS programs are represented, including skilled nursing facilities.
• All of the LTSS programs are represented, including skilled nursing facilities.

Keywords: 995, all

Summary: The subcommittee met with MassHealth LTSS Chief Leslie Darcy to review the Personal Care Attendant (PCA) program and the legislative work group focused on its long-term sustainability and cost containment. Darcy and Charlie described the work group’s five meetings and three consensus recommendations: enforce the 66-hour overtime cap, address fraudulent activity in the PCA program, and eliminate MassHealth handling of PCA paperwork/administrative work for members without a live-in exemption because those members are subject to EVV. They explained EVV as an electronic visit verification system replacing paper timesheets, and noted the rollout is expected to be completed this fall. The group estimated about $7 million in savings from the consensus recommendations and agreed to continue meeting through June to consider additional ideas. Darcy presented data showing the PCA program served about 56,000 members in state fiscal year 2024 and has grown from $1.2 billion in FY20 to $1.6 billion in FY24, with projections near $2 billion by 2027. She said much of the growth is driven by wage increases and older adults using more services, and compared PCA costs with other LTSS programs. The discussion also covered overtime spending, the role of federal financial participation, and how Massachusetts’ PCA program differs from other states because it has no hard caps on hours or activities. Several members emphasized the program’s value for independent living and community participation, while also acknowledging the need to control growth without undermining services. Members asked about undocumented immigrants and MassHealth funding, and Darcy explained that some eligibility categories are state-funded only and do not receive federal matching funds. Another member asked about workforce recruitment and wage pressures; Darcy said recent collective bargaining agreements raised PCA wages, with some workers eventually reaching $25 per hour and the entry wage reaching $20. The group also discussed whether IADL hours are disproportionately high compared with ADL needs, and reviewed data suggesting potential savings if IADL hours were limited relative to ADL hours, though no consensus recommendation was made on that point. The meeting ended with approval of the prior minutes by roll call vote, an update that the next health equity informational hearing is scheduled for May 19, and a motion to adjourn carried unanimously.

Transcript Highlights:

• It is Medicaid, or Medi-Cal here in California, that is the primary payer of LTSS.
• adults who need LTSS experience financial worries.
• LTSS is a lack of affordable LTSS.
• It's imperative that we take the steps to improve access to our LTSS system.
• And fourth, it's what we've been discussing today: addressing the LTSS financing crisis.

Summary: The joint Assembly Budget Subcommittee hearing focused first on long-term services and supports for older adults, especially the “forgotten/overlooked middle” who earn too much for Medi-Cal but cannot afford private long-term care. Administration witnesses from DHCS, the Department of Aging, and Social Services described Medicare’s limited long-term care coverage, Medi-Cal’s role, the elimination of the Medi-Cal asset test, and ongoing state studies and listening sessions on financing options. Testimony from advocates and researchers emphasized rising homelessness among older adults, the need for better navigation and coordination across health, aging, housing, and social service systems, and short-term policy steps such as share-of-cost reform, housing stability supports, and protecting home- and community-based services. Members highlighted the need for a coordinated, no-wrong-door approach and asked for the most impactful budget investments to address affordability and homelessness risk. The second major topic was the Community-Based Adult Services (CBAS) program. CDA reported that CBAS helps participants remain in the community, that 304 centers operate statewide serving about 42,000 people, and that demand is stable but access gaps remain in some regions. DHCS explained that a 2024 rate increase authorized by SB 159 became inoperative after Proposition 35, and that a separate 10% rate change on the fee schedule was the result of a DHCS system error; the department said it would not require recoupment, though managed care plans may act under their contracts. CBAS providers and advocates warned that reimbursement rates have not kept pace with costs, that several centers have closed, and that clawbacks could trigger more closures. They requested $74.8 million ongoing General Fund to close part of the rate gap and preserve the program, while members expressed concern about closures and the cost savings of keeping people out of more expensive institutional care. The hearing then moved to In-Home Supportive Services (IHSS) and statewide collective bargaining. CDSS reviewed provider recruitment and retention efforts, including electronic timesheets, direct deposit, and the now-completed IHSS Career Pathways program, which trained more than 59,000 providers. CDSS also summarized its AB 102 workgroup report on statewide versus regional bargaining, saying the final report would be sent to the Legislature soon and that statewide bargaining appeared more viable than regional bargaining, though it would require clear statutory scope and major fiscal changes. The department estimated that each $1 per hour statewide wage increase would cost at least $1.3 billion to $1.5 billion annually. Labor advocates argued that IHSS wages, benefits, and training are too inconsistent across counties and called for statewide bargaining, consumer participation, and ongoing state funding. County representatives supported stronger wages but cautioned that counties need protection from new costs and administrative burdens, and consumer advocates warned that moving bargaining to the state could weaken local consumer control and the program’s consumer-driven structure.

Transcript Highlights:

• Rachel, can you remind me if you have also decided to become a subcommittee member of the LTSS and Health
• I think we're going to do some of that same work across some other areas in LTSS.
• I think we're going to do some of that same work across some other areas in LTSS.
• I mean, to be very transparent, at LTSS, you know, we are a third of the budget and we are about 15%
• So a lot of these LTSS programs are entitlement programs, but is that not true?

Keywords: 995, all

Summary: The subcommittee opened with roll call and approved the November 2025 minutes. Commissioner Charlie Carr then introduced Leslie Darcy, chief of LTSS at MassHealth, who provided an update on the PCA working group and on federal and state budget pressures affecting MassHealth and long-term services and supports. Darcy said the PCA working group had completed its work and submitted recommendations, including reinstating the 66-hour overtime cap, strengthening program integrity, and ending paid paperwork time for EVV users; she said those changes were implemented on 11/26 and were expected to save $7.4 million. She also described additional consensus recommendations to lower the overtime cap from 66 to 60 hours, create a seven-hour weekly meal-prep support limit, and continue exploring benchmarks, though the group could not reach consensus on a benchmark standard. Darcy warned that a federal bill enacted about six months earlier would significantly affect MassHealth, with an estimated $3.5 billion loss to the Commonwealth by 2028. She outlined upcoming changes including revised immigrant eligibility rules in October 2026, work requirements for certain non-disabled adults beginning in January 2027, six-month redeterminations for some adults, and shorter retroactive coverage periods. In response to questions, she said people with disabilities and Medicare beneficiaries would be exempt from the work and six-month redetermination requirements. She also explained that reduced federal ACA subsidies were being offset in Massachusetts by state spending, including $250 million in additional state support to keep premiums lower for middle-income families. Members raised concerns about community hospitals, the health safety net, and the impact of federal funding changes on provider rates and uncompensated care. Darcy said restrictions on provider taxes would limit MassHealth’s ability to use those revenues to support rates, and she noted a current $300 million shortfall in the health safety net. She said FY27 would likely include a rate freeze, targeted reductions, one-time budget measures, and further work groups to examine programs such as adult foster care, which she said had grown 40% in two years. Carr emphasized that the situation was serious but potentially fluid, and the meeting ended with no further business; the subcommittee agreed to adjourn before the next meeting and noted an upcoming February presentation from the Department of Public Health.

Transcript Highlights:

• I have in population served by LTSS. In the first paragraph, I’m missing a word.
• I have in population served by LTSS. In the first paragraph, I’m missing a word.
• I have in population served by LTSS. In the first paragraph, I’m missing a word.
• I have in population served by LTSS. In the first paragraph, I’m missing a word.
• I have in population served by LTSS. In the first paragraph, I’m missing a word.

Keywords: 928, house, all

Summary: The committee approved the previous meeting minutes and then reviewed a draft preliminary report on long-term managed care. The chair explained the report is intended to frame issues and outline legislative options, not make a final recommendation, especially given unresolved questions about the federal One Big Beautiful Bill (OB3). The report’s key issues included the current financing of county and private nursing homes through Medicaid rates, ProShare, MQUIP, and related funding mechanisms, and the concern that those payments could be affected or eliminated under a managed care model. Members also discussed managed care organizations’ role in Medicaid and cited other states’ experiences, noting examples of savings in Florida and Tennessee but higher costs in California. One member raised Indiana as another important comparison, and the committee agreed to add it to the report’s state examples. The committee also reviewed sections on dual eligibility, D-SNP, PACE, and CFI waivers. The chair raised concerns about whether OB3 creates incentives for states to move toward D-SNP and whether federal changes could affect provider taxes, state-directed payments, and intergovernmental transfers. Henry Litman, the state Medicaid director, said he would confirm details on D-SNP incentives and explained that ProShare is based on certified public expenditure rather than an IGT, while county cap financing is the relevant intergovernmental transfer issue. He said IGTs are not going away and that the main risk is whether current financing mechanisms could be preserved if the state later changed course. Members discussed the possibility of a waiver not being granted or renewed and the high fiscal impact that could have on counties and property taxes. The committee then discussed the population that any long-term managed care model should cover. Members agreed that there is no appetite to move developmental disability or acquired brain disorder populations into long-term managed care at this time, and the chair changed the report’s terminology from “elderly” to “aging population.” The chair also noted that the status quo option should reflect the recent shift toward home and community-based services and reduced nursing home utilization since earlier county reports. The report’s four policy options were summarized as: maintain the status quo; pursue D-SNP for dual eligibles, with DHHS potentially submitting an application as early as 2027; adopt an HCBS carveout; or move fully to managed care for the aging population. No final policy recommendation was made, and the committee discussed making edits to the draft before circulation, including adding Indiana, clarifying OB3-related issues, and changing the report title from “final” to “preliminary” or “interim.”

Transcript Highlights:

• So the entirety of LTSS, long-term services and supports, is part of what the county cap helps fund.
• So,<00:47:34.160> the<00:47:34.480> entirety<00:47:34.880> of<00:47:35.040> LTSS
• <00:47:36.000> long-term So, the entirety of LTSS long-term So, the entirety of LTSS long-term
• would<00:58:54.880> need<00:58:56.160> um<00:58:56.799> full<00:58:57.920> LTSS
• c><00:58:58.880> make<00:58:58.960> it<00:58:59.200> worth would need um full LTSS

Keywords: 928, house, all

Summary: The committee to study long-term managed care met to approve the prior meeting minutes, with a clarification that “OB3” referred to the “one big beautiful bill.” The minutes were then approved. Chair Jim Kofalt outlined the day’s agenda, which included testimony from the Granite State Home Health and Hospice Association, the New Hampshire Association of Counties, and later DHHS. He also noted that future meetings were expected soon and that the meetings were being livestreamed on YouTube. Granite State Home Health and Hospice Association, represented by Kellyanne Totten and Amy Moore, urged inclusive planning and a cautious, phased approach if managed care is considered. They emphasized that home care providers are not uniform, with different licensing and service models, and said any pilot should include varied provider types, rural and southern regions, and agencies of different sizes. They warned that workforce shortages, inflation, and a possible 9% CMS cut to Medicare home health payments could force agencies to reduce service areas or service types. They also said the 2023 Medicaid CFI rate increase has begun to lose its effect. In response to questions, they said the rural health transformation fund may help with planning and telehealth but likely cannot be used directly for rates or recruitment/retention. They also described the New England Home Care Nurse Residency Program, a Department of Labor grant, as a way to bring new registered nurses into home care with added training and school partnerships. The New Hampshire Association of Counties, through county nursing home administrators Craig Labore and David Ross, revisited the earlier Step Two managed care discussions from 2016-2018. They said prior consultants found the long-term services and supports system was underfunded and needed investment to stabilize providers and expand community-based care. They argued the same concerns remain today and said a managed model would jeopardize the Medicaid quality incentive payment program and, for county nursing homes, the proportionate share payment program. Their testimony was generally opposed to moving forward with managed long-term services and supports without significant additional funding and safeguards.

Transcript Highlights:

• I maybe do this in LTSS and then if I can't make 100% of them, I'll try to just be in tune, you know?
• I maybe do this in LTSS and then if I can't make 100% of them, I'll try to just be in tune, you know?
• I maybe do this in LTSS and then if I can't make 100% of them, I'll try to just be in tune, you know?

Keywords: 995, all

Summary: The subcommittee met to approve the April and May minutes, welcome a new member, and hear an update from Gina Frey of EOHHS on statewide health and human services workforce development efforts. Frey described cross-secretariat initiatives under the Workforce Skills Cabinet, including MA Repay loan repayment awards, expanded community college and tuition supports, ESOL/work-readiness programming for immigrants, and efforts to build career pathways and reduce attrition in nursing, behavioral health, direct care, and primary care. She also reviewed a $46 million ARPA-funded home and community-based services grant program that supported 82 grantees, led to hiring 8,752 new staff, over 1,000 interns, 2,000 new certifications, and a drop in vacancy rates from 22% to 12%. Members raised concerns about the impact of immigration policy changes on the direct care workforce, including losses of trained workers in provider agencies, and asked whether any exemption or other relief efforts were underway. Frey said EOHHS is tracking the issue closely but did not identify a specific exemption effort. The discussion also touched on Medicaid and related program changes, with Frey noting the administration is focused on understanding potential impacts to eligibility and work requirements. Rep. Howard asked about initiatives for direct support professionals and wraparound supports, and Frey said those efforts are often led by individual agencies such as MassAbility and DDS, with EOHHS coordinating across them. The latter part of the meeting shifted to planning FY26 subcommittee goals and possible events. Members discussed using the Health Policy Commission’s Behavioral Health Workforce Center and possibly asking for a study comparing compensation in DDS and related direct care roles against health care and education jobs. They also discussed a possible cross-state public event on immigration’s impact on the workforce, especially for people with disabilities and direct support services, and agreed to continue refining goals and event ideas by email and at the next meeting. Frey provided a website link and contact information for Amy Doyle at the Health Policy Commission to facilitate future presentations.

Transcript Highlights:

• It was called the LTSS Trust Act and rebranded as the WACares Fund a couple of years later.
• The LTSS Trust Commission makes recommendations to the legislature and the agencies on a variety of things
• The LTSS Trust Commission is our oversight body. It is one of many, but it's the main one.
• must set the premium rate at the lowest amount necessary to maintain the actuarial solvency of the LTSS

Summary: The Pension Funding Council met on October 8 with introductions from council members and staff, then received a detailed presentation from the Office of the State Actuary on long-term economic assumptions and the state pension systems’ financial condition. OSA reported that the combined pension systems are currently 100% funded on a smoothed basis, with open plans above 95% funded, and that legacy Plan 1 systems remain on a path toward full funding under current policy. The actuaries recommended updating assumptions to 3% inflation, 3.5% general salary growth, and a 7.25% investment return, while keeping Plan 1 membership growth at 1%. They also explained asset smoothing, the role of recent strong investment returns, and the expected budget impacts of the recommended changes. Representatives from the Economic and Revenue Forecast Council and the State Investment Board offered supporting perspectives, generally describing the assumptions as reasonable and consistent with their own outlooks. The council also heard an overview of the Long-Term Services and Supports Trust Program (WACares) from DSHS and OSA. Program staff described the program’s social insurance structure, premium collection, benefit eligibility, and upcoming implementation milestones. OSA reported that the program’s first actuarial valuation showed a positive actuarial balance under the base scenario and recommended no change to the current 0.58% premium rate during the program’s early learning phase, noting that future changes would depend on experience and the program’s risk-management framework. OSA also said the recommendation would remain the same regardless of the outcome of the pending ballot measure affecting investment options. During public comment, a representative of the Washington State School Retirees Association urged continued work on Plan 1 funding and related legislation, while the Association of Washington Cities cautioned against increasing pension assumptions in a way that could raise future employer costs and reduce flexibility for current local government services. In action, the council adopted a motion to maintain the current long-term economic assumptions by a 4-2 vote, adopted the recommendation to keep the WACares premium rate at 0.58% by a 6-0 vote, and then elected Katie Chapman as council chair by unanimous vote. The meeting then adjourned.

Transcript Highlights:

• health equity, and we looked not only at the impact of services and the disability-related things under LTSS
• And we looked at it... ...disability-related things on the LTSS, but in other areas.
• And we looked at disparities in the program and how Medicaid, for example, and LTSS is disparate in many

Keywords: 995, all

Summary: The Massachusetts Commission on the Status of Persons with Disabilities held its quarterly meeting on September 10, with roll call, approval of the June minutes as amended, and welcoming remarks for newly appointed commissioner Rachel Caprilyan and reappointed commissioners. Chair Denise Garlick outlined plans for a statewide community hearing series, beginning with a November 4 hybrid hearing at Needham Town Hall focused on the Boston/Metro West region, and described the creation of a nonvoting advisory council to broaden the commission’s expertise across health care, transportation, housing, education, employment, business, and local disability commissions. Commissioners discussed the nomination process, the need for geographic diversity, and the goal of having the council in place by the December quarterly meeting. The main presentation addressed proposed federal Medicaid and SNAP changes in H.R. 1, with Jennifer Bertrand of the Massachusetts Developmental Disabilities Council warning that the law could cut federal Medicaid spending by $1 trillion over 10 years, impose work requirements, require redeterminations every six months, restrict provider taxes, and reduce SNAP benefits. She said these changes could increase uninsurance, create administrative barriers, and threaten home- and community-based services, with a Massachusetts analysis projecting 141,000 to 203,000 MassHealth members could lose coverage over six months. Commissioners and attendees responded that the changes could harm people with disabilities, caregivers, and provider organizations, increase institutionalization risk, and intensify competition for limited state resources; several emphasized the need for disability groups and broader health care stakeholders to coordinate advocacy. Subcommittee reports highlighted recent and upcoming work. The Disability Employment Subcommittee reported on a June “Strength and Support” event, an August presentation by Run the Gamut, and an upcoming MAPC/Employment First workshop in Worcester, while the Long-Term Services and Supports and Health Equity Subcommittee discussed a presentation from the Lurie Institute for Policy Research on community living dashboards and disparities in Medicaid and LTSS. Commissioners also shared announcements about upcoming events, including the Paul Spooner Generational Leisure Summit, the Disability Policy Consortium’s John Winsky Memorial Award ceremony, the Massachusetts Health Council’s annual celebration, and a September 17 hearing on insurance coverage for hearing aids. The meeting ended with congratulations to commissioner Carl Richardson for an accessibility award and a motion to adjourn, which passed.

Transcript Highlights:

• Who's this—is that Charlie and... or LTSS? No, no, for the other one.
• she can guide me in this question, but I think this type of information will fall better under the LTSS

Keywords: 995, all

Summary: The Workforce Support Subcommittee of the Status of Persons with Disabilities met, approved the prior November minutes, and heard a presentation from the Association of Developmental Disabilities Providers (ADDP) on its 2025 workforce metrics survey. ADDP described its membership and the survey’s scope, noting 102 of 132 members responded. The report showed continued improvement in staffing: overall vacancy rates fell from 19% in 2024 to 15% in 2025, with declines across programs such as adult long-term residential, community-based day supports, supported employment, and day rehabilitation. However, vacancies remain high, especially for licensed practical nurses and clinicians, and nearly 4,000 positions were still unfilled. Providers also reported that almost 1,800 people remain waiting for day services. A major new focus in the survey was health insurance costs. Nearly 90% of respondents reported premium increases averaging 11%, and providers said those increases make it harder to offer competitive wages and benefits and hurt recruitment and retention. ADDP said the survey will be repeated in the fall and emphasized that while Chapter 257 investments appear to have helped reduce vacancies, rising insurance costs, immigration-related workforce pressures, and other affordability issues could threaten progress. Commissioners and presenters discussed the need to maintain gains, the importance of keeping the survey manageable while preserving historical comparisons, and the role of immigration and workforce policy in staffing stability. The subcommittee then elected new co-chairs, unanimously approving Rachel Caprillion and Leo Sarkisian. Members discussed possible topics and speakers for the next meeting, including training and turnover, direct support professional pipelines, apprenticeships, PCA training, and workforce models from other states. Several names and organizations were suggested for outreach, including Josh Cutler, Juan Vega, JVS, HSRI, and NASDDDS. The meeting ended with a motion to adjourn, which was seconded and approved.

Transcript Highlights:

• And the money that's saved there will help go toward the buy down our LTSS cut budget.
• LTSS cut budget.<01:45:12.720> Senator<01:45:13.080> Rasmusson,<01:45:13.560> you
• >> I think the A4 repeals the whole LTSS thing altogether. Which I really like, Mr. Chair.
• >> I think the A4 repeals the whole LTSS >> I think the A4 repeals the whole LTSS thing
• that are related to the topics that LTSS that are related to the topics that LTSS does. does. does

Keywords: 1187, senate, all

Transcript Highlights:

• Speaker, the continuum of care for older adults, the spectrum of long-term services and supports, LTSS
• physical, cognitive, or mental health, while older adults and individuals with disabilities may receive LTSS

Keywords: 995, all

Summary: The House opened with routine ceremonial business, including the Pledge of Allegiance and adoption of several resolutions, such as congratulations to the Williamsburg Grange on its 125th anniversary and to Fire Captain Melissa Blodgett on her retirement. The chamber also concurred in a Senate petition to establish a sick leave bank for a Bristol County Sheriff’s Department employee and suspended Joint Rule 12 to advance local petitions, including one involving the Dalton Fire District and another renaming a Chelmsford bridge. The main floor action centered on several Ways and Means bills. The House advanced a bill amending laws relative to individuals with disabilities, replacing outdated and offensive terminology in the General Laws with person-first language; members spoke at length in support, emphasizing dignity, inclusion, and the bill’s non-substantive nature. The bill was engrossed by a roll call vote, 152-0. The House also took up and engrossed a bill to improve Massachusetts home care, which would create a licensing and oversight framework for private-pay home care agencies, establish standards for contracts, background checks, training, insurance, and consumer protections, and create advisory committees to guide implementation. An amendment establishing a Family Caregiver Commission was adopted 154-0, and the bill itself was then engrossed 153-1. In addition, the House passed or engrossed several other measures, including a bill authorizing the Massachusetts Water Resources Authority to provide sewer services to land in Sharon, a sick leave bank bill for a Trial Court employee, a Marblehead parking fines bill, a Hingham municipal property bill for a center for active living, and a Taunton bill allowing continued employment of Police Chief Edward J. Walsh. The chamber also handled numerous calendar items, holding or passing over many while advancing a few. The session ended with a special adjournment in memory of former Representative George L. Sacco Jr., and the House adjourned to meet the next day at 11 a.m. in informal session.

Transcript Highlights:

• And the one that the disability community and this particular subcommittee, LTSS, is very worried about
• So we might say, gee, you know, I think the roundtable that we saw on LTSS and health equity is an example

Keywords: 995, all

Summary: The Massachusetts Permanent Commission on the Status of Persons with Disabilities held its quarterly meeting virtually and in person at the State House. The commission approved the March minutes and elected its officers by unanimous roll call vote: Denise Garlick as chair, Chris White as vice chair, Carl Richardson as treasurer, and Osmondahar as secretary. The meeting also welcomed several new commissioners, including Rep. Jay Livingstone, Rep. Vanna Howard, Rep. Lindsay Sabadosa, Rep. John Marzi, and Leo Sarkisian, with brief introductions from the new legislative members. A substantial portion of the meeting focused on the commission’s current work and the broader policy environment affecting people with disabilities. Commissioners and subcommittee leaders raised concerns about federal threats to Medicaid/MassHealth, Section 504 accessibility protections, DEI-related rollbacks, immigration policy impacts on the direct care workforce, and the loss of funding for youth employment and vocational rehabilitation programs. Members also discussed ableist language in public discourse and the need for stronger advocacy and communication in response to these developments. Subcommittee reports highlighted recent activity on disability employment, workforce supports, and long-term services and supports/health equity. Presentations included veterans with disabilities, employment programming for young adults with disabilities, immigration and labor protections, MassHealth’s PCA working group, and a health equity roundtable. The commission also discussed future plans to create an advisory board, develop successor and mentoring planning, and launch regional “meeting the moment” listening sessions across the Commonwealth to strengthen outreach and leadership development. The meeting ended with an open invitation for commissioners to share urgent information with staff for broader distribution and a unanimous motion to adjourn.

Transcript Highlights:

• Mark Cohen, the professor and co-director of the LeadingAge LTSS Center at UMass Boston, who's also a
• national expert on LTSS financing.

Keywords: 995, all

Summary: The Aging and Independence/Elder Affairs Committee heard testimony on several bills, with the main focus on H.769/S.468, an act to improve care and prepare for the new era of Alzheimer’s and dementia. Legislators and advocates described the bill’s provisions, including expanded dementia training for first responders, a dementia services coordinator/director in state government, improved hospital discharge and caregiver access protections, dementia care coordination benefits for certain MassHealth members, public awareness and data collection requirements, and expanded support for geriatric workforce recruitment. Representative Danielle Gregoire and Senator Gomez framed the measure as a zero-cost, bipartisan continuation of the 2018 Alzheimer’s and Dementia Act, while the Alzheimer’s Association, Boston Public Health Commission, police representatives, clinicians, and family caregivers all testified in support, emphasizing public health needs, early diagnosis, caregiver involvement, and safer emergency and hospital care. The committee also heard testimony on H.796/S.476, which would establish an Office of Older Adult Advocate and a special commission on a statewide long-term services and supports benefit program. Representative Steve Ultrino supported an independent older adult advocate to help navigate fragmented state services and improve constituent services, while committee members asked about funding and the office’s relationship to existing secretariats. On the long-term care commission bill, NAFA Massachusetts and LeadingAge Massachusetts supported creating a stakeholder commission to review actuarial findings and explore public-private financing options for long-term care, stressing that neither public nor private coverage alone is sufficient and that middle-income families need more planning tools and options. The committee also took testimony on H.786/S.466, a bill to protect vulnerable elders by expanding the Executive Office of Elder Affairs’ authority to investigate abuse or neglect in non-traditional custodial settings such as prisons, jails, shelters, group homes, and certain treatment facilities. Prisoners Legal Services said the bill would close a jurisdictional gap that leaves some older adults without an investigative agency once they age out of DPPC coverage. No votes were taken during the hearing, and the meeting ended with a motion to adjourn.

Transcript Highlights:

• The legislature formed an LTSS advisory council to find those cost-saving strategies for the legislature
• The legislature formed an LTSS advisory council to find those cost-saving strategies for the legislature
• The legislature formed an LTSS advisory council to find those cost-saving strategies for the legislature
• The legislature formed an LTSS advisory council to find those cost-saving strategies for the legislature
• The legislature formed an LTSS advisory council to find those cost-saving strategies for the legislature

Keywords: 1187, senate, all

Bills: SB1423, SB1426, SB1502, SB1377, SB1983, SB1466, SB1645, SB1647, SB1847, SB1565, SB1562, SB1329, SB1383, SB1833, SB1555, SB1344

Keywords: Oklahoma Hospital Advisory Council, hospital licensure, public health, State Department of Health, State Board of Health, hospital regulations, healthcare regulation, hospital standards, hospital construction, hospital operations, stroke care, stroke system, emergency medical services, EMS transport, psychiatric treatment, chemical dependency treatment, substance use disorder, drug storage, pharmacy, quality indicators

Transcript Highlights:

• I'm Hagar Dickman, Director of California LTSS Advocacy for Justice in Aging.

Keywords: 988, house, all

Transcript Highlights:

• the program over time based on feedback from the public that was shared with our oversight body, the LTSS
• The rental assistance programs will help Medicaid LTSS clients receive care in their own home.

Summary: The committee met for what was described as its final meeting, with members and staff reflecting on the work of the Joint Legislative Executive Committee on Aging and Long-Term Care and noting that future work would likely shift to standing health and wellness committees. The meeting began with introductions and then moved into updates on major initiatives that originated from the committee, including Washington Cares, the Dementia Action Collaborative, and Medicaid long-term care programs. Presenters emphasized that these efforts were developed through long-term legislative-executive collaboration and were intended to help Washington prepare for the state’s aging population. On Washington Cares, DSHS described the program’s development from a 2014 research effort to its 2019 enactment, premium collection beginning in 2023, portability improvements in 2024, and 2025 changes including a grandfathered opt-out fix and a framework for supplemental private long-term care insurance. The agency said benefits are expected to go fully live next summer, with a pilot of up to 400 applicants planned for next January. On dementia policy, the Dementia Action Collaborative reported on the state dementia plan, Project ECHO training for providers, and pilot dementia-capable community programs at area agencies on aging, citing preliminary results that about 85% of family caregivers said services helped people remain at home. DSHS also reviewed Medicaid Transformation Project initiatives, including Medicaid Alternative Care, Tailored Supports for Older Adults, presumptive eligibility, and health-related social needs benefits such as rental assistance, nutrition support, and home modifications. The committee then heard an emerging issues panel from ombuds and disability advocates. Patricia Hunter of the long-term care ombuds program raised concerns about staffing shortages, resident rights, surveillance technology, private equity ownership of facilities, and illegal discharges or evictions. Betty Sweeterman of the Developmental Disabilities Ombuds discussed people stuck in hospitals without medical need, gaps in behavioral health services for people with developmental disabilities, and the need for better workforce training. Todd Carlyle of Disability Rights Washington urged expansion and bundling of community supports such as PACT, GOSH, and peer bridgers to reduce repeated institutionalization and support discharge from inpatient psychiatric settings. Provider and labor panels followed, with nursing home, assisted living, supported living, and union representatives all emphasizing workforce shortages, low wages, Medicaid rate inadequacy, case management bottlenecks, behavioral health complexity, and the need for more flexible care models and stronger accountability for rate increases. No formal votes were taken; the meeting ended with public comment on manufactured housing and closing remarks thanking staff and participants for the committee’s work.