DEPARTMENT OF ELDER AFFAIRS

M.G.L. pt. Part I, tit. Title II, ch. c. 19A

in effect

M.G.L. c. 19A, § 1 Establishment; secretary, powers and duties

c. 19A, § 1. Establishment; secretary, powers and duties Section 1. There shall be a department of aging and independence, in this chapter called the department, which shall be under the supervision and control of a secretary of aging and independence, hereinafter called the secretary. The secretary shall be appointed by and serve at the pleasure of the governor. In the event of a vacancy in the office of the secretary, or in the secretary's absence or disability, as determined by the governor, the governor shall designate an assistant secretary of aging and independence to serve as secretary until the vacancy is filled, or until the absence or disability ceases, as determined by the governor, and the assistant secretary so designated shall have all the powers and duties of the secretary. The secretary shall devote full time to the duties of the office. The secretary shall be the executive and administrative head of the department and shall be responsible for administering and enforcing the provisions of law relative to the department and each administrative unit thereof. The secretary shall administer chapter 118E relative to medical care and assistance to eligible persons age 65 and older except for acute care services as defined by the secretary of health and human services. The secretary shall be responsible for administering and coordinating a comprehensive system of long-term care benefits and services for older adults, including institutional, home-based and community-based care and services.

M.G.L. c. 19A, § 2 Offices of administration and of program planning and management; assistant secretaries

c. 19A, § 2. Offices of administration and of program planning and management; assistant secretaries Section 2. There shall be in the department an office of administration and an office of program planning and management, each under the supervision of an assistant secretary of aging and independence, in this chapter called an assistant secretary, subject to the direction, control, and supervision of the secretary. Each assistant secretary shall be a person of skill and experience including five years of administrative experience in the field of the assistant secretary's appointment, shall be appointed by the secretary, and shall serve at the assistant secretary's pleasure. The position of assistant secretary shall not be subject to chapter thirty-one and the provisions of section nine A of chapter thirty shall not apply to any person holding such appointment. Each assistant secretary shall devote full time to the duties of the office.

M.G.L. c. 19A, § 3 Divisions and administrative units; directors; description of organization, filing

c. 19A, § 3. Divisions and administrative units; directors; description of organization, filing Section 3. The secretary may from time to time, subject to appropriation, establish within the department such divisions and such administrative units within such divisions as may be necessary for the efficient and economical administration of the department, and, when necessary for such purpose, the secretary may abolish any such division or merge any of them and may abolish or merge any such other administrative units within divisions as the secretary may deem advisable. The secretary shall prepare and keep current a statement of the organization of the department, of the assignment of functions to its various administrative units, offices, and employees, and of the places at which and the methods whereby the public may receive information or make requests. Such statement shall be known as the department's description of organization. A current copy of the description of organization shall be kept on file in the office of the state secretary and in the office of the secretary of administration. Each division shall be under the supervision of a director who shall have skill and experience in the field of the director's appointment.

M.G.L. c. 19A, § 4 Home care program; needs and services of adults with disabilities; powers and duties of secretary

c. 19A, § 4. Home care program; needs and services of adults with disabilities; powers and duties of secretary Section 4. The department shall be the principal agency of the commonwealth to mobilize the human, physical, and financial resources available to plan, develop, and implement innovative programs to insure the dignity and independence of older adults, including the planning, development, and implementation of a home care program for older adults in the communities of the commonwealth. The department shall also serve as an advocate for the needs of adults with disabilities as these needs and services overlap the needs and services of older adults. To accomplish the objectives hereinbefore set forth, the secretary is hereby authorized: (a) to provide assistance to communities in solving local problems with regard to older adults including, but not limited to, problems in identifying and coordinating local resources to serve the needs of older adults; (b) to facilitate communications and the free flow of information between communities and the offices, agencies, and employees of the commonwealth; (c) to encourage and assist communities to plan, develop and implement home care programs which shall be operated either by agencies organized by the commonwealth or any political subdivision thereof or by nonprofit corporations organized under chapter one hundred and eighty and which shall be designated by the department. Any hospital or nursing home licensed by the department of public health pursuant to the provisions of chapter one hundred and eleven shall not be eligible to operate home care programs under this chapter. A majority of the governing body of the aforesaid home care providers shall be persons sixty years of age or older who reside in the cities or towns served by said provider. A majority of the governing body of the aforesaid home care providers, except those serving the city of Boston, shall be appointed by the councils on aging of the cities and towns served by said provider. The secretary may contract with a home care provider that does not comply with the provisions relating to the composition of the governing body if such home care provider, prior to entering into such contract, shall have presented a plan, approved by the secretary, of adoption of by-laws requiring a majority of such governing body to be composed of persons sixty years of age or older who reside in the cities or towns serviced by said provider and a majority of the governing board to be appointed by the councils on aging of the cities or towns serviced by said provider. As a condition of such contract, such home care provider shall implement such plan within one hundred and eighty days of the signing of the contract. If no home care provider who complies with the provision of this clause relating to the composition of the governing body is available to provide a home care service, the secretary may enter into a contract with a nonconforming home care provider until an organization with a complying governing body becomes available to provide a comparable service. If the secretary has entered into a contract with a nonconforming home care provider and a conforming provider becomes available, the contract shall remain in force for such period of time as the secretary deems necessary; provided, however, that the term of such contract shall not exceed one year. Home care programs shall include, but not be limited to, case management, homemaker and chore services, transportation, protective services, and information and referral; provided, however, that the department may include additional services where feasible; and provided, further, that any council on aging may be a member of its designated area agency on aging without being required to join or make payment to a home care provider. (d) to provide and act as a clearinghouse for information, data, and other materials relative to older adults; (e) to initiate and carry out studies and analyses which will aid in solving local, regional, and statewide problems concerning older adults; (f) to coordinate through advice and counsel those programs of other state agencies designed to assist in the solution of local, regional, and statewide problems concerning older adults; (g) to advise and inform the governor on the affairs and problems of older adults in the commonwealth; (h) to exercise the powers and discharge the duties assigned to the secretary in the fields of health care, housing, nutrition, homemaker services, economic opportunity, local and regional planning, transportation, and education and preretirement programs; (i) to further the cooperation of local, state, and federal and private agencies and institutions providing for services or having responsibility for older adults; (j) to represent and act on behalf of the commonwealth in connection with federal grant programs applicable to programs for older adults in the functional areas described in this section; (k) to seek, accept, and otherwise take advantage of all federal aid available to the department, and to assist other agencies of the commonwealth, local agencies, and community groups in taking advantage of all federal grants and subventions available for older adults; (l) to render advice and assistance to communities and other groups in the preparation and submission of grant applications to state and federal agencies relative to programs for older adults; (m) to review and coordinate those activities of agencies of the commonwealth and of any political subdivision of the commonwealth at the request of such subdivision, which affect the full and fair utilization of community resources for programs for older adults, and initiate programs that will help assure such utilization; (n) to encourage the formation of councils on aging and to assist local communities in the development of said councils. (o) to conduct yearly studies and evaluations pertaining to the quality of care and social services for nursing home patients and report such findings and recommendations to the general court. (p) to establish a corps of older adult volunteers in each planning and service area, as designated by the department pursuant to 42 USC Sec. 3025, the purpose of which shall be to provide visiting services to the residents of nursing homes within such area. In order to assist in the discharge of the duties of the office, the secretary may request from any agency of the commonwealth information pertinent to the affairs and problems of older adults. Nothing in this section shall be construed to be a limitation of the other powers and duties assigned by law to the secretary.

M.G.L. c. 19A, § 4A Sliding fee scale for home care services; financial eligibility limits

c. 19A, § 4A. Sliding fee scale for home care services; financial eligibility limits Section 4A. The department shall establish a sliding fee scale to provide home care services for certain persons whose income exceeds the limits established under Title XX of the Social Security Act. On July first of each year, the department shall increase the financial eligibility limits for home services, including the sliding fee scale, by a percentage equal to the percentage increase in federal social security benefits for that fiscal year. The department shall forward to the house and senate committees on ways and means on or before March first of each year, a full report on the status of the home care program audit.

M.G.L. c. 19A, § 4B Aging services access points

c. 19A, § 4B. Aging services access points Section 4B. The department shall manage the home care program established in section 4 with respect to clinical screening, service authorization activities and case management for Medicaid community-based long-term care made available to eligible older adults pursuant to chapter 118E and the regulations promulgated thereunder; provided, however, that the programs and activities authorized by this section shall be administered and coordinated in accordance with the single state agency requirement under 42 CFR Part 431 and other applicable requirements of Title XIX of the Social Security Act, or its successor title. The primary goal of the coordinated system of care shall be to assist older adults in maintaining their residences in the community-consistent with their clinical and psychosocial needs in the most cost-effective manner possible. As used in this section, the word ''Medicaid'' shall mean medical care and assistance provided to eligible persons pursuant to said chapter 118E and said Title XIX or its successor title, the term ''executive office'' shall mean the executive office of health and human services and the term ''community long-term care'' shall mean those Medicaid services determined by the department in consultation with the secretary of health and human services. The coordinated system of care shall be administered by agencies under contract with the department that shall be known as aging services access points, hereinafter referred to as ASAPs. ASAPs shall be designated by the department and may be operated nonprofit agencies, home care providers as defined in clause (c) of the third paragraph of section 4, a combination of home care corporations acting jointly or by state agencies. Pursuant to the terms of those contracts, ASAPs shall coordinate services on behalf of Medicaid eligible older adults; provided, however, that the department shall maintain exclusive responsibility for determining the financial or categorical eligibility of older adults for Medicaid and the secretary of health and human services shall establish rates and methods of payment for Medicaid services delivered pursuant to this section. Administrative payments to ASAPs for Medicaid-funded functions including, but not limited, to screenings, assessments, case management and coordination of care shall be established by the department in consultation with the secretary of health and human services. Administrative payments for home care-funded services under said section 4 shall be established by the department in consultation with the secretary of health and human services. The department, in consultation with the secretary of health and human services, may develop a capitation system of payment for services in which ASAPs shall be at financial risk for any Medicaid services authorized and purchased on behalf of an eligible person that exceed the amount of said capitation payments. The department shall establish performance and outcome goals for Medicaid and home care-related functions of ASAPs and may establish such goals for any other responsibilities contracted to ASAPs for managing the coordinated system. Continuation of the contracts authorized by this section shall be dependent on the achievement of the Medicaid-related performance and outcome goals, as determined by the department. ASAPs shall be responsible for: (1) providing information and referral services to older adults; provided, however, that referrals for terminally ill older adults shall include referrals to licensed and certified hospices for determination of eligibility, appropriateness and consumer interest in services; (2) conducting intake, comprehensive needs assessments, preadmission screening and clinical eligibility determinations for older adults seeking institutional and community care services from Medicaid or the home care program, which in the case of hospice clients, shall adhere to Medicare and Medicaid conditions of participation pursuant to 42 C.F.R. 418 and 114.3 C.M.R. 43.00; (3) developing a comprehensive service plan based on the needs of an older adult, provided, however, that a medical plan of care for an older adult shall be developed by a licensed or certified health care provider; (4) arranging, coordinating, authorizing and purchasing community long-term care services called for in the comprehensive service plan; and (5) monitoring the outcomes of and making periodic adjustments to a service plan in consultation with service and health care providers. The establishment of a comprehensive service plan for an older adult shall not establish an entitlement to services for that eligible person for services beyond that established by law or beyond the amounts appropriated therefor. ASAP responsibilities for Medicaid-related functions shall be those established by the department. When renewing the annual terms of a contract the subsequent fiscal year, the department shall seek to promote continuity in the the coordinated system of care consistent with this section; provided, however, that substantive changes to the terms and conditions of an annual agreement, including changes to the functional responsibilities of ASAP's as defined in this section, shall be negotiated after the department's written findings that such changes are necessary as a result of changes in federally reimbursable services, rates of federal reimbursement rates or state fiscal demands or that the division is prepared to implement a more comprehensive, cost-effective and coordinated system of long-term care than that established in this section. The written finding required by this paragraph shall be submitted to the executive office, the secretary of administration and finance and the legislature's joint committee on human services and elderly affairs. ASAPs shall not provide direct services except for case management; information and referral, and protective services as defined in regulations of the home care program established pursuant to 651 C.M.R. 3.00 et seq. and nutrition services established pursuant to 651 CMR 4.00 et seq. and the Older Americans Act, as amended, 42 U.S.C. 3021 et seq. Except for the direct services provided by ASAPs pursuant to this section, no ASAP shall have a direct or indirect financial ownership interest in an entity that provides institutional or community long-term care services on a compensated basis. The department may grant a waiver of the restrictions in this paragraph upon a finding that public necessity and convenience require such a waiver. Overall management, administration and oversight activities related to the screening and authorization of community long-term care services and related case management services shall be the responsibility of the department. The department shall actively explore with interested parties programmatic options that would decrease the reliance of nursing facilities on Medicaid funding and shall promote increased residential and community long-term care program options for older adults needing long-term care services. The department shall also explore future coordinated systems of service delivery options as identified in the coordinated aging, rehabilitation and disability services project.

M.G.L. c. 19A, § 4C Pharmacy outreach program; medication education and intervention resource center; executive office of aging and independence

c. 19A, § 4C. Pharmacy outreach program; medication education and intervention resource center; executive office of aging and independence Section 4C. (a) For the purposes of this section, the following words shall have the following meanings: ''Eligible person'', a resident of the commonwealth at the time of application. ''Office'', the executive office of aging and independence. ''Participating manufacturer'', a pharmaceutical manufacturer which offers prescription medications or nonprescription medications at a reduced cost or free of charge to indigent persons pursuant to a voluntary drug assistance program. ''Prescription medications'', prescription drugs that have been approved as safe and effective by the federal Food and Drug Administration or are otherwise legally marketed in the United States and that are manufactured and offered by pharmaceutical companies. (b) There is hereby established the pharmacy outreach program for the purposes of assisting residents of the commonwealth in obtaining free or low cost prescription medications or nonprescription medications from pharmaceutical manufacturers and educating such persons about health care issues related to medications. The office shall administer the program in conjunction with an outside vendor who shall be selected by the office pursuant to procurement regulations promulgated under the authority of the executive office of administration and finance. (c) The pharmacy outreach program shall assist eligible persons in procuring free or low cost prescription medications or nonprescription medications by: (1) evaluating the likelihood of success of an eligible person's obtaining free or low cost prescription medications or nonprescription medications from a participating manufacturer under the guidelines formulated; (2) assisting an eligible person with the preparation of an application for prescription medications or nonprescription medications to participating manufacturers; and (3) coordinating and assisting a physician registered pursuant to section 2 of chapter 112 with communications, including applications, made on behalf of an eligible person to a participating manufacturer for the purpose of obtaining approval of the eligible person in any voluntary drug assistance program. (d) The pharmacy outreach program shall also establish a medication education and intervention resource center which shall: (1) create and maintain a statewide toll free telephone number staffed by individuals who are qualified to counsel and advise eligible persons and anyone participating in the prescription drug subsidized insurance program pursuant to sections 39 and 40, on questions that they may have about prescription drugs or nonprescription drugs; (2) sponsor and organize presentations, workshops and screenings in conjunction with other organizations that serve the interests of older adults and other eligible persons on issues of mental and physical health; (3) offer and provide information on prescription medications and nonprescription medications including, but not limited to, information on drug interactions and abuse; and (4) offer in-person counseling to eligible persons for the purpose of explaining proper medication use and discouraging medication misuse. (e) The office shall promulgate such regulations as are necessary to implement the pharmacy outreach program.

M.G.L. c. 19A, § 4D Home care worker registry

c. 19A, § 4D. Home care worker registry Section 4D. (a) As used in this section, the following terms shall have the following meanings unless the context clearly requires otherwise: ''Employee organization'', a labor union or other organization, agency or employee representation committee, association, group or plan in which employees participate and which exists in whole or in part to deal with employers concerning matters incidental to employment relationships. ''Home care worker'', a person employed by a home care worker agency to provide personal care, homemaker, companion or chore services under the home care program established in section 4. ''Home care worker agency'', an entity employing home care workers to provide services under the home care program established in section 4 that is under contract with an aging services access point established in section 4B. (b) The department shall establish and maintain a home care worker registry for home care workers employed by a home care worker agency. A home care worker agency shall report the required home care worker registry information for each home care worker it employs on a paid, unpaid, temporary or permanent basis who is not exempt from the reporting requirement. Any exemptions from reporting shall be established in regulations promulgated by the department; provided, however, that the regulations shall include, but not be limited to, exemptions for victims of domestic violence, rape, sexual assault or stalking. The department shall collect the following reported information concerning each home care worker: (i) the worker's full name; (ii) their assigned unique identification number; (iii) their gender; (iv) their home address; (v) their mailing address; (vi) the full legal name of any home care worker agency employing the home care worker; (vii) the worker's job title; and (viii) a list of home care trainings or certifications completed by the home care worker. Reported information for each employed home care worker shall be submitted and regularly updated by each home care worker agency subject to this section. The registry shall be updated at least quarterly. A home care worker agency shall collect and maintain the required information and submit updated information in a timely manner as determined by the department. A home care worker shall not be responsible for any costs related to the registry. The department shall only make a home care worker's full name, identification number, name of any home care worker agency employing the home care worker and a list of home care trainings or certifications completed by the home care worker available to the public unless such information is exempt from disclosure by the department. Upon request from an employee organization, home care worker agency or aging services access point, the department shall provide all reported information to such entity. The department shall promulgate rules and regulations and shall provide such forms and notifications as may be necessary to implement this section; provided, however, that the department shall minimize any duplicate reporting that may be required of a home care agency.

M.G.L. c. 19A, § 4E Definitions

c. 19A, § 4E. Definitions Section 4E. As used in sections 4F to 4I, inclusive, the following words shall, unless the context clearly requires otherwise, have the following meanings: ''CDC workforce council'', ''workforce council'' or ''the council'', the home care program consumer directed care workforce council established pursuant to section 4F. ''Consumer'', a person to whom a CDC worker provides consumer directed care services and who is responsible for recruiting, hiring, training and managing a CDC worker. ''Consumer directed care'' or ''CDC'', the service delivery option within the state home care program, established by the department pursuant to section 4, that provides eligible consumers with consumer directed care services and the option to select, hire, manage and dismiss consumer directed care workers providing such services. ''Consumer directed care worker'' or ''CDC worker'', a person who has been selected by a consumer or the consumer's surrogate to provide consumer directed care to the consumer under the department's home care program CDC service delivery option. ''Surrogate'', a consumer's legal guardian or a person identified in a written agreement signed by the consumer or consumer's legal guardian granting the surrogate the authority to act on behalf of the consumer to select, hire, manage and dismiss CDC workers; provided, however, that a surrogate shall not serve as the CDC worker for the same consumer they serve as a surrogate.

M.G.L. c. 19A, § 4F Home care program CDC workforce council; appointee terms; quorum; reimbursement for expenses

c. 19A, § 4F. Home care program CDC workforce council; appointee terms; quorum; reimbursement for expenses Section 4F. (a)(1) There shall be a home care program CDC workforce council which shall be within the department, but which shall not be subject to the control of the department, to ensure the effectiveness and quality of home care programs' CDC services. (2) The CDC workforce council shall consist of 5 members to be appointed in accordance with this section. The secretary of the department, or their designee, shall be a permanent member of the council and shall serve as chair. The secretary of health and human services shall appoint 2 members representing the interests of CDC consumers and 2 members representing aging services access points that coordinate CDC services. (b)(1) Appointees to the council shall serve 3–year terms. If a vacancy occurs among the members appointed by the secretary of health and human services, a new council member shall be appointed by the secretary of health and human services to serve the remainder of the unexpired term or, if the vacancy occurs as the result of the completion of a term, to serve a full term, and such appointment shall become effective upon the member taking the appropriate oath. (2) Members of the council may serve for successive terms. (3) A majority of the council shall constitute a quorum for the transaction of any business. (c) Members of the council shall not receive compensation for their council service; provided, however, that members shall be reimbursed for their actual expenses necessarily incurred in the performance of their duties.

M.G.L. c. 19A, § 4G Promotion of CDC services; coordination with state and local public, private and nonprofit agencies; list of CDC workers paid through home care program CDC option

c. 19A, § 4G. Promotion of CDC services; coordination with state and local public, private and nonprofit agencies; list of CDC workers paid through home care program CDC option Section 4G. (a) The CDC workforce council shall develop and implement a communications plan to promote CDC services and raise awareness of the CDC option for eligible consumers and potential CDC workers. (b) The CDC workforce council may coordinate activities with other state and local public, private and nonprofit agencies to carry out its duties. The council may coordinate with the agencies to provide a local presence for the council and to provide consumers or consumers' surrogates greater access to CDC information. (c) The department shall provide to the council a list of all CDC workers who have been paid through the home care program CDC option and shall update the list not less than every 6 months to ensure that the council has a complete and accurate list. The information provided on the list shall be limited to the names and contact information for each CDC worker; provided, however, that the list shall not include any personally identifiable information of the consumers. All CDC workers, upon hire, or at any other reasonable time, shall be provided an opportunity to submit a written request to the department to be excluded from the list.

M.G.L. c. 19A, § 4H Consumer or the consumer's surrogate right to recruit, hire, train, manage and terminate any CDC worker; when considered a public employee; collective bargaining; council liability

c. 19A, § 4H. Consumer or the consumer's surrogate right to recruit, hire, train, manage and terminate any CDC worker; when considered a public employee; collective bargaining; council liability Section 4H. (a) A consumer or the consumer's surrogate shall retain the right to recruit, hire, train, manage and terminate any CDC worker providing services to the consumer. (b)(1) Consumer directed care workers shall be considered public employees, as defined by and solely for the purposes of chapter 150E and section 17J of chapter 180. Chapter 150E shall apply to consumer directed care workers unless chapter 150E is inconsistent with sections 4F to 4I, inclusive, in which case said sections shall control. Consumer directed care workers shall be treated as state employees solely for the purposes of section 17A of chapter 180. Consumer directed care workers shall not be considered public employees or state employees for any other purpose other than those in this paragraph. Consumer directed care workers shall not be eligible for benefits through the group insurance commission, the state board of retirement or the state employee workers' compensation program. (2) The CDC workforce council shall be the employer, as defined by and solely for the purposes of chapter 150E and sections 17A and 17J of chapter 180 and deductions under sections 17A and 17J of chapter 180 may be made by any entity authorized by the commonwealth to compensate consumer directed care workers through the home care program consumer directed care option. (c) Consumer directed care workers who are employees of the council under this section shall not be considered public employees or employees of the council for any other purpose. Nothing in this chapter shall alter the obligations of the commonwealth or the consumer to provide their share of social security, federal and state unemployment taxes, Medicare and worker's compensation insurance under the Federal Insurance Contributions Act, federal and state unemployment law or the Massachusetts Workers' Compensation Act. (d) Pursuant to section 9A of chapter 150E, no consumer directed care worker shall engage in a strike or induce, encourage or condone any strike, work stoppage, slowdown or withholding of services by any consumer directed care worker. (e) The appropriate bargaining unit for the purpose of collective bargaining shall be a statewide unit of all consumer directed care workers. The showing of interest required to request an election or for an intervener seeking to appear on the ballot shall be 10 per cent of the bargaining unit. (f) The council or its contractors shall not be held vicariously liable for the action or inaction of any consumer directed care worker. (g) The members of the council shall be immune from any liability resulting from the implementation of sections 4F to 4H, inclusive.

M.G.L. c. 19A, § 4I Council powers

c. 19A, § 4I. Council powers Section 4I. (a) The CDC workforce council may make and execute contracts and all other instruments necessary or convenient for the performance of its duties or exercise of its powers, including contracts with public and private agencies, organizations, corporations and individuals to pay them for services rendered or furnished. (b) Subject to appropriation and appropriate business or consumer service need, the chair of the council with the council's approval may establish offices, employ and discharge employees, agents and contractors, as necessary, and prescribe employees' duties and powers and set the employees' compensation, incur expenses and create such liabilities as are reasonable and proper for the administration of sections 4F to 4H, inclusive. (c) The council may solicit and accept for use any grant of money, services or property from the federal government, the commonwealth or any political subdivision or agency thereof, and take any action necessary to cooperate with the federal government, the commonwealth, or any political subdivision or agency thereof, in making an application for any grant. (d) The council may coordinate its activities and cooperate with similar agencies in other states. (e) The council may establish technical advisory committees to assist the council. (f) The council may keep records and engage in research and the gathering of relevant statistics. (g) The council may acquire, hold or dispose of real or personal property, or any interest therein, and construct, lease or otherwise provide facilities for the activities conducted pursuant to sections 4F to 4I, inclusive; provided, however, that the workforce council shall not exercise any power of eminent domain. (h) The council may delegate to the appropriate persons the power to execute contracts and other instruments on its behalf and delegate any of its powers and duties pursuant to sections 4F to 4I, inclusive. (i) The council may perform other acts necessary or convenient to execute the powers expressly granted to it.

M.G.L. c. 19A, § 5 Citizen advisory boards

c. 19A, § 5. Citizen advisory boards Section 5. The secretary may appoint from time to time, such citizen advisory boards as the secretary deems appropriate and necessary. Said citizen advisory boards shall advise and assist the secretary on matters relating to the special needs of older adults and assist the secretary in making appraisals of needs of older adults and the evaluations of programs required by this act. The secretary in making appointments to said boards shall insure that members so appointed shall represent all regions of the commonwealth, the segments of the population served by the department and statewide older adult groups; provided, however, that at least fifty per cent of the members of any board so appointed shall be fifty-five years of age or over. Members of any citizen advisory boards established by this section shall receive no compensation for their services, but may be reimbursed for their expenses necessarily incurred in the performance of their duties.

M.G.L. c. 19A, § 6 Regulations

c. 19A, § 6. Regulations Section 6. The secretary shall make, and from time to time revise, regulations for the conduct of the business of the department and such other regulations as may be required by law.

M.G.L. c. 19A, § 7 Acceptance of gifts or grants

c. 19A, § 7. Acceptance of gifts or grants Section 7. The secretary may accept on behalf of the commonwealth any gifts or grants of money or property, whether real or personal, from any source, whether public or private, for the purpose of assisting the secretary in the discharge of the duties of the office.

M.G.L. c. 19A, § 8 Employees; appointments and removal; age restriction

c. 19A, § 8. Employees; appointments and removal; age restriction Section 8. The secretary, subject to appropriation, shall appoint and may remove all employees in the department. Unless otherwise provided by law, all such appointments and removals shall be in accordance with chapter thirty-one. In making such appointments, the secretary shall make every reasonable effort to assure that at least twenty-five per cent of all employees of the department are fifty-five years of age or older.

M.G.L. c. 19A, § 9 Experts and technical consultants; appointment

c. 19A, § 9. Experts and technical consultants; appointment Section 9. Subject to appropriation, the secretary may, without regard to chapter thirty-one, but subject to the approval of the governor, appoint such experts and technical consultants as the secretary shall determine to be necessary to perform the functions of said office; provided that the provisions of section nine A of chapter thirty shall not apply to any person holding any such appointment.

M.G.L. c. 19A, § 10 Civil service status or tenure of employees

c. 19A, § 10. Civil service status or tenure of employees Section 10. If an employee serving in a position which is classified under chapter thirty-one or in which the employee has tenure by reason of section nine A of chapter thirty shall be appointed to a position within the department of any agency under the department which is not subject to the provisions of chapter thirty-one, the employee shall upon termination of such employee's service in such unclassified position be restored to the position which the employee held immediately prior to such appointment; provided, however, that if such employee's service in such unclassified position shall have been terminated for cause, such employee's right to be so restored shall be determined by the civil service commission in accordance with the standards applied by said commission in administering chapter thirty-one. Such restoration shall be made without impairment of such employee's civil service status or tenure under section nine A of chapter thirty and without loss of seniority, retirement, or other rights to which uninterrupted service in such prior position would have entitled such employee. During the period of such appointment, each person so appointed from a position in the classified civil service shall be eligible to take any competitive promotional examination to which the employee would have otherwise been eligible.

M.G.L. c. 19A, § 11 Interagency cooperation

c. 19A, § 11. Interagency cooperation Section 11. The department shall collaborate with the executive office of housing and livable communities in the location, design, construction and management of housing built for older adults and shall upon request provide technical assistance to local housing authorities and other groups.

M.G.L. c. 19A, § 12 Biennial evaluations of programs and projects; standards, restriction; publication of summaries; annual report

c. 19A, § 12. Biennial evaluations of programs and projects; standards, restriction; publication of summaries; annual report Section 12. The secretary shall measure and evaluate the impact of all programs authorized by this chapter, their effectiveness in achieving stated goals in general, and in relation to their cost, their impact on related programs, and their structure and mechanisms for delivery of services, including, where appropriate, comparisons with appropriate control groups composed of persons who have not participated in such programs. Goals and standards for evaluation purposes shall be developed jointly by the department of aging and independence and statewide organizations representing the interests of older adults. Evaluations shall be conducted by persons not immediately involved in the administration of the program or project evaluated. Subject to appropriation, evaluations shall be conducted every two years by an evaluator who does not supply service to the department and who is not in the regular employ of the commonwealth. The secretary may not make grants or contracts under this chapter until the secretary has developed and published general standards to be used by the secretary in evaluating the programs and projects assisted under this chapter. Results of evaluations conducted pursuant to such standards shall be included in the annual reports required by this section. In carrying out evaluations under this section, the secretary shall, whenever possible, arrange to obtain the opinions of program and project participants about the strengths and weaknesses of the programs and projects. The secretary shall, on or before the second Wednesday in February in each year, publish summaries of the results of evaluative research and evaluation of program and project impact and effectiveness, the contents of which shall be available to the general court and the public. All studies, evaluations, proposals, and data produced or developed shall become the property of the commonwealth. Such information as the secretary may deem necessary for purposes of the evaluations conducted under this section shall be made available to the secretary, upon request, by the departments and agencies of the commonwealth. The secretary shall expend such sums as may be appropriated therefor, not exceeding one per cent of the funds appropriated to the department for this chapter, to conduct program and project evaluations as required by this chapter. Not later than one hundred and twenty days after the close of each fiscal year, the secretary shall prepare and submit to the governor and the general court a full and complete report on the activities carried out under this chapter. Such annual reports shall include statistical data reflecting services and activities provided individuals during the preceding fiscal year.

M.G.L. c. 19A, § 14 Definitions applicable to Secs. 14 to 26

c. 19A, § 14. Definitions applicable to Secs. 14 to 26 Section 14. For the purposes of sections fourteen to twenty-six, inclusive, the following words and terms shall, unless the context otherwise requires, have the following meaning: ''Abuse'', an Act or omission which results in serious physical or emotional injury to an older adult or financial exploitation of an older adult; or the failure, inability or resistance of an older adult to provide for the older adult one or more of the necessities essential for physical and emotional well-being without which the older adult would be unable to safely remain in the community; provided, however, that no person shall be considered to be abused or neglected for the sole reason that such person is being furnished or relies upon treatment in accordance with the tenets and teachings of a church or religious denomination by a duly accredited practitioner thereof. ''Caretaker'', the person responsible for the care of an older adult, which responsibility may arise as the result of a family relationship, or by a voluntary or contractual duty undertaken on behalf of an older adult, or may arise by a fiduciary duty imposed by law. ''Conservator'', a person who is appointed to manage the estate of a person pursuant to chapter two hundred and one. ''Court'', the probate and family court. ''Department'', the department of aging and independence. ''Older adult'', an individual who is sixty years of age or over. ''Emergency'', a situation in which an older adult is living in conditions which present a substantial risk of death or immediate and serious physical or mental harm. ''Financial exploitation'', an act or omission by another person, which causes a substantial monetary or property loss to an older adult, or causes a substantial monetary or property gain to the other person, which gain would otherwise benefit the older adult but for the act or omission of such other person; provided, however, that such an act or omission shall not be construed as financial exploitation if the older adult has knowingly consented to such act or omission unless such consent is a consequence of misrepresentation, undue influence, coercion or threat of force by such other person; and, provided further, that financial exploitation shall not be construed to interfere with or prohibit a bona fide gift by an older adult or to apply to any act or practice in the conduct of any trade or commerce declared unlawful by section two of chapter ninety-three A. ''Guardian'', a person who has qualified as a guardian of an older adult pursuant to chapter two hundred and one, but shall not include a guardian ad litem. ''Protected person'', an older adult for whom a conservator or guardian has been appointed or other protective order has been made. ''Protective services'', services which are necessary to prevent, eliminate or remedy the effects of abuse to an older adult. ''Protective services agency'', a public or nonprofit private agency, corporation, board, or organization designated by the department pursuant to this chapter to furnish protective services to older adults.

M.G.L. c. 19A, § 15 Reports of abuse; liability

c. 19A, § 15. Reports of abuse; liability Section 15. (a) Any physician, physician assistant, medical intern, dentist, nurse, family counselor, probation officer, social worker, policeman, firefighter, emergency medical technician, animal control officer, licensed psychologist, coroner, registered physical therapist, registered occupational therapist, osteopath, podiatrist, director of a council on aging, outreach worker employed by a council on aging, executive director of a licensed home health agency or executive director of a homemaker service agency or manager of an assisted living residence who has reasonable cause to believe that an older adult is suffering from or has died as a result of abuse, shall immediately make a verbal report of such information or cause a report to be made to the department or its designated agency and shall within forty-eight hours make a written report to the department or its designated agency. Any person so required to make such reports who fails to do so shall be punished by a fine of not more than one thousand dollars. (b) The executive director of a home care corporation, licensed home health agency or homemaker service agency shall establish procedures within such agency to ensure that homemakers, home health aides, case managers or other staff of said agency who have reasonable cause to believe that an older adult has been abused shall report such case to the executive director of the corporation or agency. The executive director shall immediately make a verbal report of such information or cause a report to be made to the department or its designated agency and shall within forty-eight hours make a written report to the department or its designated agency. (c) In addition to a person required to report under the provisions of subsection (a) of this section, any other person may make such a report to the department or its designated agency, if any such person has reasonable cause to believe that an older adult is suffering from or has died as a result of abuse. (d) No person required to report pursuant to the provisions of subsection (a) shall be liable in any civil or criminal action by reason of such report; provided, however, that such person did not perpetrate, inflict or cause said abuse. No other person making such a report pursuant to the provisions of subsection (b) or (c) shall be liable in any civil or criminal action by reason of such report if it was made in good faith; provided, however, that such person did not perpetrate, inflict or cause said abuse. Any person making a report under subsection (a), (b) or (c) who, in the determination of the department or the district attorney may have perpetrated, inflicted or caused said abuse may be liable in a civil or criminal action by reason of such report. No employer or supervisor may discharge, demote, transfer, reduce pay, benefits or work privileges, prepare a negative work performance evaluation, or take any other action detrimental to an employee or supervisee who files a report in accordance with the provisions of this section by reason of such report. (e) Reports made pursuant to subsections (a) and (b) shall contain the name, address and approximate age of the older adult who is the subject of the report, information regarding the nature and extent of the abuse, the name of the person's caretaker, if known, any medical treatment being received or immediately required, if known, any other information the reporter believes to be relevant to the investigation, and the name and address of the reporter and where said reporter may be contacted, if the reporter wishes to provide said information. The department shall publicize the provisions of this section and the process by which reports of abuse shall be made. (f) Any privilege established by sections one hundred and thirty-five A and one hundred and thirty-five B of chapter one hundred and twelve or section twenty B of chapter two hundred and thirty-three relating to the exclusion of confidential communications shall not prohibit the filing of a report pursuant to the provisions of subsection (a), (b) or (c).

M.G.L. c. 19A, § 16 Protective services system

c. 19A, § 16. Protective services system Section 16. (a) Subject to appropriation, the department shall develop a coordinated system of protective services for older adults who are determined to be abused. In planning this system, the department shall require input from other protective service agencies and other agencies currently involved in the provision of social, health, legal, nutritional and other services to older adults, as well as older adult advocacy organizations. (b) Within this protective services system, the department shall establish a mechanism for the receipt of reports made pursuant to section fifteen which shall operate and be accessible on a twenty-four hour per day basis. If the department or its designated agency has reasonable cause to believe that an older adult has died as a result of abuse, the death shall be reported immediately to the district attorney of the county in which the abuse occurred. Within forty-five days of the receipt of a report made pursuant to subsection (a) of said section fifteen, the department or its designated agency shall notify the reporter, in writing, of its response to the report. Such notification shall be made to a person who makes a report pursuant to subsection (c) of said section fifteen if said reporter so requests. (c) Subject to appropriation, the department shall designate at least one local agency to act on behalf of the department with a geographic area as defined by the department. The department may designate any public agency or private nonprofit organization which has the capacity to implement a service plan through direct access to social, health and mental health services. The department shall utilize existing resources and services of public and nonprofit private agencies in providing protective services. The department shall insure that assessment, evaluation and service delivery shall be provided through the designated local agency closest to the older adult's community. In designating agencies, the department shall insure that: (1) persons conducting assessment, evaluation and service delivery have demonstrated experience in providing protective and other social health services to older adults, have these protective functions as their primary employment responsibility, and have other professional qualifications as determined by the secretary; (2) continuity of care under one protective services worker is assured throughout assessment, evaluation and services delivery to the extent possible; and (3) the department and the designated agencies have the capacity to respond to an emergency and provide or arrange for services to alleviate the immediate danger of abuse of an older adult on twenty-four hours per day basis. The department shall monitor assessments, evaluations and the provision of protective services by designated local agencies. (d) The department shall issue regulations establishing criteria and procedures for the designation of protective services agencies or for the termination or designation or redesignation of protective services agencies. (e) The department shall be responsible for continuing coordination and supervision of the system. In carrying out these duties, the department shall, subject to appropriation: (1) adopt rules and regulations for the system; (2) continuously monitor the effectiveness of the system and perform evaluative research about it; and (3) utilize grants from federal, state and other public and private sources to support the system. (f) The department shall require that all designated local agencies of the department provide training to protective services caseworkers that is specifically focused on recognizing the signs and symptoms of cognitive impairments, including, but not limited to, Alzheimer's disease, and understanding how cognitive impairment may affect screening, investigation and service planning.

M.G.L. c. 19A, § 17 Protective services agencies; authorized activities

c. 19A, § 17. Protective services agencies; authorized activities Section 17. A protective services agency is authorized: (1) to receive and investigate reports of abuse; (2) to furnish protective services to an older adult with the elderly person's consent; (3) to petition the court for appointment of a conservator or guardian or for issuance of an emergency order for protective services; (4) to furnish protective services to an older adult on an emergency basis as hereinafter provided; (5) to furnish protective services to a protected person with the consent of such person's guardian or conservator; (6) to serve as conservator, guardian, or temporary guardian of a protected person; and (7) to perform all other functions determined by the department to be necessary for the administration of this chapter.

M.G.L. c. 19A, § 18 Assessment and evaluation of reports; investigations; arrangement for protective services

c. 19A, § 18. Assessment and evaluation of reports; investigations; arrangement for protective services Section 18. (a) The department or its designated agency shall assess and evaluate the information reported pursuant to the provisions of section fifteen. Such assessment shall include a visit to the residence of the older adult who is the subject of the report and may include consultations with appropriate service agencies and individuals who have knowledge of the older adult's situation including the person filing the report. The older adult who is the subject of the report shall receive written notice that an assessment is being conducted and shall have the right to review the file and report developed as a result of the assessment. If the assessment results in a determination that the older adult is suffering from abuse, the department or the designated agency shall evaluate the older adult's functional capacity, situation, and resources and shall develop a service plan for the provision of protective services. Said plan shall be appropriate to the needs of the older adult and shall utilize the least restrictive alternatives. The department shall adopt rules and regulations establishing time limits for the completion of assessments and evaluations and for the implementation of service plans; provided, however, that if an emergency exists, assessments shall be completed within twenty-four hours of the receipt of the report. If an assessment results in a determination that the older adult has suffered serious abuse, the department or designated agency shall report such determination to the district attorney of the county where the abuse occurred within forty-eight hours. The district attorney may investigate and decide whether to initiate criminal proceedings. (b) The department or the designated agency shall provide or arrange for protective services in accordance with the service plan developed pursuant to the provisions of subsection (a). Protective services shall include, but not be limited to, the following: the capacity to respond to an emergency; protective services case work; the capacity to provide or arrange for a homemaker, home-health aide, transportation, legal assistance, counseling, nutrition services, guardianship and conservatorship, protective order through the court, emergency shelter, foster care, and adult day care services. The department or the designated agency is authorized to arrange for additional services necessary to assist and protect older adults who have been abused, including, but not limited to, the following: medical care, mental health care and emergency financial assistance.

M.G.L. c. 19A, § 19 Consent to protective services; interference with provision of services

c. 19A, § 19. Consent to protective services; interference with provision of services Section 19. (a) Any older adult who requests or affirmatively consents to the receipt of protective services may receive said services. If the person withdraws or refuses consent, the service shall not be provided or continued except as provided in section twenty. (b) No person shall interfere with the provision of protective services to an older adult who requests or consents to receive such services. In the event that interference occurs on a continuing basis, the department, a protective services agency, or the public guardian may petition the court to enjoin such interference.

M.G.L. c. 19A, § 20 Lack of capacity to consent to protective services; hearings; emergency orders; placement or commitment

c. 19A, § 20. Lack of capacity to consent to protective services; hearings; emergency orders; placement or commitment Section 20. (a) If the department or its designated agency has reasonable cause to believe that an older adult is suffering from abuse and lacks the capacity to consent to the provision of protective services, the department or its designated agency may petition the court for a finding that the older adult is incapable of consenting to the provision of protective services. Said petition shall set forth the specific facts upon which the department or the designated agency relied in making the determination. The court shall hold a hearing on the matter within fourteen days of the filing of the petition. The court shall give notice to the older adult who is the subject of the petition at least five days prior to the date set for the hearing. The older adult who is the subject of the petition shall have the right to be present, be represented by counsel, present evidence, and examine and cross-examine witnesses. If the older adult who is the subject of the petition is indigent, the court shall appoint counsel to represent such older adult. If the court determines that the older adult lacks the capacity to retain counsel or waive the right to counsel, the court shall appoint a guardian ad litem to represent the interests of such older adult. If, after hearing, the court determines, based on the preponderance of the evidence, that such older adult has been abused, is in need of protective services and lacks the capacity to consent and no other person who is authorized to consent is available or willing to consent, the court may appoint a conservator, guardian or other person authorized to consent to the provision of protective services; provided, however, that the court shall establish the least restrictive form of fiduciary representation that will satisfy the needs of such older adult. In addition to or in the alternative, the court may issue an order requiring the provision of services. The order shall contain a specific description of the services to be provided and insure that the least restrictive alternatives are utilized. An order for protective services for an older adult pursuant to this subsection shall remain in effect for a period of six months, unless otherwise stipulated in such order. The court may, for good cause shown, extend an order for protective services. Such extension shall remain in effect for a period of six months, unless otherwise stipulated in such order. (b) If an emergency exists and the department, its designated agency, a member of the immediate family or a caretaker has reasonable cause to believe that an older adult is suffering from abuse and lacks the capacity to consent to the provision of protective services, said department, designated agency, member of the immediate family or caretaker may petition the court for an emergency order of protective services. The court shall give notice to the older adult who is the subject of the petition at least twenty-four hours prior to the hearing. The court may dispense with notice upon finding that immediate and reasonable foreseeable physical harm to the individual or others will result from the twenty-four hour delay and that reasonable attempts have been made to give such notice. If the older adult who is the subject of the petition is indigent, the court shall appoint counsel to represent such older adult. If after the hearing, the court determines, based on the preponderance of the evidence, that the older adult has been or is being abused, that an emergency exists, and that the older adult lacks the capacity to consent to the provision of services, the court may order the provision of protective services on an emergency basis. The court shall order only those services necessary to remove the conditions creating the emergency and shall specially designate the authorized services in its order. If the court determines that the older adult lacks the capacity to retain counsel or waive the right to counsel, the court shall appoint a guardian ad litem to represent the interest of such older adult following the entry of such emergency order. The order for emergency protective services shall remain in effect for a period not to exceed fourteen days. Said order may be extended for an additional period not to exceed fourteen days if the court finds that the extension is necessary to remove the emergency. (c) The court shall not order an institutional placement or change of residence unless it finds that no less restrictive alternative will meet the needs of the older adult. No older adult may be committed to a mental health facility pursuant to this chapter. The older adult or the older adult's court-appointed representative, the department, or the designated agency may petition to have any order issued pursuant to subsection (a) or (b) set aside or modified at any time.

M.G.L. c. 19A, § 21 Geriatric evaluation process

c. 19A, § 21. Geriatric evaluation process Section 21. (a) Subject to appropriation, the department shall establish a geriatric evaluation process for the purpose of conducting a comprehensive physical, mental, or social evaluation of an older adult for whom a petition has been filed in a court for appointment of a conservator or guardian, under the provisions of clause (3) of section seventeen, or for an emergency order for protective services. (b) The evaluation of an older adult conducted by the geriatric evaluation process shall include at least the following: (1) the name and address of the place where the person is residing and of the person or agency, if any, who is providing services at present; (2) a description of the treatment and services, if any, presently being provided to the person; (3) an evaluation of the person's present physical, mental, and social conditions; and (4) a recommendation concerning the least restrictive course of services, care or treatment consistent with the person's needs. (c) Subject to appropriation, the cost of this evaluation shall be borne by the department. (d) Such older adult shall have the right, at such older adult's own expense to secure an independent medical and psychological or psychiatric examination relevant to the issue involved in any hearing under this section and to present a report of the independent evaluation or the evaluator's personal testimony as evidence at the hearing.

M.G.L. c. 19A, § 22 Financial eligibility guidelines; reimbursements by older adults

c. 19A, § 22. Financial eligibility guidelines; reimbursements by older adults Section 22. The department shall establish, by regulation, financial eligibility guidelines which provide a procedure for reimbursement by older adults for all or part of cost of protective services. If the department or the designated agency determines, pursuant to section eighteen, that an older adult who is in need of protective services has sufficient resources to pay for part or all of the cost of protective services, it shall initiate said procedures for reimbursement. If the department or designated agency determines that an older adult does not have sufficient resources, no reimbursement for any such costs shall be charged to the older adult. No older adult shall be required to reimburse the department for part or all of the cost of protective services unless such elderly person has been notified prior to the commencement of service provision that a reimbursement will be charged. No older adult shall be required to reimburse the department for protective services before service provision commences.

M.G.L. c. 19A, § 23 Records; disclosure; destruction; regulations; penalties

c. 19A, § 23. Records; disclosure; destruction; regulations; penalties Section 23. (a) Except as otherwise provided in this section, all records containing personal data which are created, collected, used, maintained or disseminated pursuant to this chapter shall not be public records, and shall be governed by the provisions of chapter sixty-six A, the notice provisions of section sixty-three of chapter thirty and the enforcement provisions of section three B of chapter two hundred and fourteen. (b) If the department, any designated agency, or any other agency obligated to make an assessment under this chapter determines that the allegations in a report cannot be substantiated, it shall within 3 years of such determination, either (i) destroy said report and any other records containing personal data created because of the receipt of said report or (ii) physically remove therefrom all personal identifiers; provided, however, that the department, the designated agency or any other agency obligated to make assessments may create and hold whatever statistical records it needs for purposes of planning and reporting, as may be prescribed by regulations adopted by the department pursuant to section two of chapter thirty. Each government agency shall promulgate regulations prescribing the manner of creating and holding its own such statistical records, and the department shall adopt such regulations for itself and any designated agency. Each government agency shall annually report such statistical records to the executive office of elder affairs. (c) The department, any designated agency, or any other agency obligated to make an assessment under this chapter shall inform in writing an individual, upon his request, whether he is a data subject, as that term is defined in section one of chapter sixty-six A, with respect to records created or maintained under this chapter, and if so, the department or agency shall make such data fully available to him or his authorized representative, upon his request, in a form comprehensible to him, unless doing so is prohibited or excused under the provisions of this or any other statute. In making any disclosure or information to a data subject the department or agency may remove personal identifiers relating to a third person, except where such third person is an officer or employee of a government or non-governmental department or agency obligated to make assessments under this chapter. (d) Any agent or employee of the department, a designated agency, or any other agency obligated to make an assessment under this chapter who violates the provisions of chapter sixty-six A, as modified by this section, with respect to records created or maintained under this chapter shall be punished by a fine of not more than five hundred dollars, or, if harm shall have resulted to any one whose privacy was sought to be protected by the provision violated, by a fine of not more than one thousand dollars, and, if such agent or employee is employed by the commonwealth, he shall also be subject to administrative disciplinary action pursuant to regulations adopted by the department or agency under section two of chapter thirty A. (e) No provision of chapter sixty-six A, section one hundred and thirty-five of chapter one hundred and twelve or this section relating to confidential data or confidential communications shall prohibit the department or designated agency from making reports to the district attorney under subsection (b) of section sixteen or subsection (a) of section eighteen, or from providing in such reports to the district attorney any information obtained by the department or a designated agency under section fifteen or section eighteen. No person providing notification or information to a district attorney or testimony in court pursuant to the provisions of this subsection shall be liable in any civil or criminal act by reason of such action. Nothing herein shall be construed to limit the prosecutorial power of a district attorney. No provision of chapter sixty-six A, section one hundred and thirty-five of chapter one hundred and twelve, or any other provision of law relating to confidential data or confidential communications shall prohibit the department, by its appropriate employees, or any designated protective services agency, by its appropriate employees from testifying in any judicial proceeding pursuant to subsections (a) and (b) of section twenty, chapter two hundred and one, or chapter two hundred and nine A where the employee has acquired the information which is the subject of his testimony while conducting an assessment in accordance with section eighteen. Such testimony shall not include the identity of the reporter of abuse under section fifteen.

M.G.L. c. 19A, § 24 Reports

c. 19A, § 24. Reports Section 24. Within one hundred and twenty days following the end of each fiscal year, the department shall submit a report to the governor, the general court and the public which shall include a description of the activities of the department and all designated agencies pursuant to sections fourteen to 26, inclusive, during the preceding fiscal year. Said report shall contain statistical information about the number and types of reports received under section fifteen; the results of the assessments and evaluations conducted and the amount, type and costs of services provided under section eighteen; and information on the quality of services provided and the results of such services in terms of alleviating abuse. Said report shall identify problems that may arise in the implementation of this chapter and shall contain the recommendations of the department for action on the part of the legislature.

M.G.L. c. 19A, § 25 Rules and regulations

c. 19A, § 25. Rules and regulations Section 25. The secretary shall adopt and from time to time revise rules and regulations for the implementation of the provisions of sections fifteen to twenty-four, inclusive.

M.G.L. c. 19A, § 26 Powers and responsibilities of other departments or agencies

c. 19A, § 26. Powers and responsibilities of other departments or agencies Section 26. Nothing in this chapter shall be construed to be a limitation of the powers and responsibilities assigned by law to other departments or agencies.

M.G.L. c. 19A, § 36 Eligibility for public assistance programs; reverse mortgage proceeds

c. 19A, § 36. Eligibility for public assistance programs; reverse mortgage proceeds Section 36. All proceeds from reverse mortgage loans held by or available to persons sixty years of age or older shall not be taken into consideration in determining eligibility or continuing eligibility for, or the amount of payment from, any medical or other public assistance program or any state or federal low interest loan or grant, unless such proceeds have become countable resources.

M.G.L. c. 19A, § 37 Hot lunch program; incorporation into school lunch program

c. 19A, § 37. Hot lunch program; incorporation into school lunch program Section 37. The school committee of any city or town with the approval of the secretary of aging and independence may extend the school lunch period for the purpose of serving lunches to authorized older adults. Independent schools in any city or town so approved may also participate. Private nonprofit organizations or public non-school agencies approved by the secretary of aging and independence may also serve lunches to authorized older adults at locations convenient to older adults. The governing body of each city and town shall be responsible for developing a plan for a year-round hot lunch program for older adults. The department of aging and independence may contract with public or independent school systems, private nonprofit organizations or public non-school agencies for the preparation and serving of meals to older adults in accordance with the provisions of this section. To the extent feasible, the department may select as the primary contractors under this program agencies and organizations which receive funding under Title III of the Older Americans Act, as amended, or state funds to operate nonprofit congregate and home delivered meals programs for older adults, as set forth in regulations of the department. Such primary contractors shall subcontract with one or more of the school systems, organizations or agencies set forth in the previous paragraph in order to incorporate the existing school lunch programs for older adults into the nutrition services program under Title III of the Older Americans Act, as amended. Such meals may be prepared by such public school systems, independent schools, agencies and organizations on site or be prepared in central production centers for service at sites more convenient to older adults; provided, however, that no person shall pay more than one dollar for each meal. The operation of such school lunch programs by public or independent school systems, private nonprofit organizations or public non-school agencies shall be subject to the following conditions and restrictions: (1) Each program shall solicit voluntary contributions for each meal furnished in accordance with the requirements of Title IIIB of the Older Americans Act of 1965, as amended. Contributions, other income earned by these programs and United States department of agriculture commodities and cash in lieu of commodities for which each such program shall become eligible shall be used with state and federal funds received to increase the number of meals served under the program, facilitate access to such meals and provide other supportive services directly related to nutrition services. Each program shall establish appropriate procedures to safeguard and account for all contributions. (2) The lunches served shall meet the nutritional standards established in accordance with Title III of the Older Americans Act of 1965, as amended. (3) The procedures determined by each designated school committee or independent school in serving such lunches shall be approved by the department of aging and independence. As used in this section, the words ''authorized older adults'' shall mean persons sixty years of age and over and their spouses. Subject to appropriation, the commonwealth may reimburse any city, town, or regional public or independent school system or any public non-school or private nonprofit agency for certain costs approved by the department as are incurred in excess of the voluntary contributions received for each such lunch prepared and served. Subject to appropriation, such approved costs shall be reimbursed upon written request by such city, town, regional public or independent school system, public non-school or private nonprofit agency to the secretary of aging and independence on a form as the secretary may prescribe. If the secretary approves such request, he shall certify to the comptroller that such payments are due and the state treasurer shall pay the same.

M.G.L. c. 19A, § 38 Liability of counselors and coordinators; description of duties and responsibilities

c. 19A, § 38. Liability of counselors and coordinators; description of duties and responsibilities Section 38. No person trained and designated by the department of aging and independence as a counselor or coordinator in the serving health information needs of older adults program, whether acting on a compensated or volunteer basis shall be liable in any civil or criminal action by reason of the good faith performance of such person's official duties. The department shall make publicly available a description of the function and the responsibilities of such counselor.

M.G.L. c. 19A, § 39 Subsidized catastrophic prescription drug insurance program; department of aging and independence

c. 19A, § 39. Subsidized catastrophic prescription drug insurance program; department of aging and independence Section 39. (a) For the purposes of this section and section 40, the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Department,'' the department of aging and independence. ''Eligible person,'' a resident of the commonwealth who: (1) is 65 years of age or older; or (2) has a gross annual household income less than or equal to 188 per cent of the federal poverty level, does not work more than 40 hours per month and meets: (i) the disability requirements of the CommonHealth program, so-called, under clause (h) of subsection (2) of section 9A of chapter 118E, notwithstanding the income eligibility requirements under said clause (h); or (ii) the disability requirements of the CommonHealth program, so-called, under section 16 of said chapter 118E, notwithstanding the income eligibility requirements under said clause (h); or (iii) the disability requirements of the CommonHealth program, so-called, under section 16A of said chapter 118E; or (3) was enrolled in the Pharmacy Program, so-called, or the Pharmacy Program Plus, so-called, as of March 31, 2001; and (4) is not eligible for pharmacy benefits or coverage under said chapter 118E other than under said clause (h) of said subsection (2) of said section 9A, said section 16, or said section 16A of said chapter 118E. ''Enrollee,'' an eligible person who has applied and enrolled in the program established by this section. ''Enrollment,'' the process during which the program accepts and receives applications for the purpose of review, determination of eligibility and approval of applicants for entry into the program. ''Mail service program,'' a program to dispense prescription drugs by postal delivery service designated and administered by the department, and any entity with which it contracts, upon an enrollee's submission of a prescription and the applicable co-payment. ''Maintenance drug,'' a prescription drug prescribed to an individual for a chronic condition, the use of which is medically necessary for a consecutive period of 90 days or longer. ''Open Enrollment,'' a period of time as determined by the secretary during which the program accepts enrollment forms from eligible applicants age 66 or over who did not enroll during the period in which they were initially eligible. ''Out-of-Pocket Expenditures,'' the total amount paid by an enrollee to satisfy the applicable annual deductible and co-payments, not including monthly premiums. ''Pharmacy benefit manager,'' an entity under contract with the department, whether organized on a for-profit or a not-for-profit basis, contracted to manage the program established by this section. ''Program,'' the subsidized catastrophic prescription drug insurance program. ''Review commission,'' the prescription drug review commission. ''Secretary,'' the secretary of the department of aging and independence. (b) The department shall administer a subsidized catastrophic prescription drug insurance program designed to provide eligible persons with prescription drug coverage. Said program shall be the payer of last resort for the provision of such outpatient prescription drug coverage. The program shall be actuarially sound. Enrollment in the program shall be voluntary and shall be funded each fiscal year, subject to appropriation, from the Tobacco Settlement Fund established by section 2XX of chapter 29. The program may apply on behalf of enrollees to obtain Transitional Assistance Program Medicare drug benefits pursuant to 42 U.S.C. sections 1395 et seq., but the program shall permit enrollees to decline before enrollment with a discount drug card sponsor; and the program shall not reduce a person's prescription drug benefit under this section. (c) The secretary shall enter into a competitively procured contract with 1 or more entities including, but not limited to, a pharmacy benefit manager, to administer benefits under the program. The secretary shall take all necessary steps to ensure that the program is structured in a way that maximizes savings, efficiencies, affordability, benefits and coverage. The procurement shall explicitly be made a part of, or said contract shall be performed in conjunction with, the aggregate purchasing program established by section 271 of chapter 127 of the acts of 1999, or any successor statute. The department shall contract with entities to perform marketing, enrollment, billing, claims processing, claims management or any other function it deems necessary. (d) No outpatient prescription drug shall be excluded from any formulary established for the program unless another outpatient prescription drug is available on said formulary that is therapeutically equivalent to the excluded outpatient prescription drug; but the secretary may establish a formulary that excludes certain outpatient prescription drugs or classes of outpatient prescription drugs upon said secretary's written determination, pursuant to subsection (r), that the exclusion is necessary to maintain the fiscal viability of the program. The review commission shall review and comment on the formulary and any changes thereto. (e) Notwithstanding any general or special law to the contrary, the department shall, subject to appropriation, engage in outreach marketing efforts to maximize enrollment in the program for the purpose of spreading the risk, so-called, of the program established herein. (f) Not later than 30 days prior to enrolling eligible persons in said program, and annually thereafter, the department shall establish a schedule of monthly premiums and annual deductibles based on a sliding income scale payable by enrollees whose gross annual household income is greater than 188 per cent of the federal poverty level. The department shall establish a separate schedule of monthly premiums and deductibles based on a sliding income scale payable by married applicants whose gross annual household income is greater than 188 per cent of the federal poverty level. The commonwealth shall be liable for the cost of the monthly premium and annual deductible established by the schedules for any and all enrollees whose gross annual household income is less than or equal to 188 per cent of the federal poverty level, unless the secretary determines in writing, pursuant to subsection (r), that requiring such enrollees to pay premiums or deductibles is necessary to maintain the fiscal viability of the program. Each enrollee shall separately pay the applicable monthly premium and annual deductible according to the applicable monthly premium and deductible schedule established by the secretary. (g) The determination of eligibility for the program shall be based on an enrollee's gross annual household income. The department or its designee shall verify income for the program based on the submission of the most recently required federal income tax return for the household or, if an applicant is not required to file a return, the submission of copies of 1099 forms or other easily obtainable means of income verification. Residency shall be verified by the submission of such documentation as the department deems reasonable. (h) After an enrollee satisfies their applicable out-of-pocket annual deductible amount, the program shall pay the costs of any outpatient prescription drug in excess of an enrollee's applicable co-payment amount. Subject to this section, the program shall pay the costs of all outpatient prescription drugs after an enrollee's out-of-pocket expenditures for outpatient prescription drugs exceed the lesser of (a) 10 per cent of such enrollee's gross annual household income; or (b) $2,000 in out-of-pocket expenditures made by an enrollee for co-payments and deductibles in a fiscal year. The plan shall pay the cost of all outpatient prescription drugs for married enrollee's who are both enrolled and residing in the same household after such enrollee's combined out-of-pocket expenditures for outpatient prescription drugs exceed the lesser of (a) 10 per cent of such married enrollee's combined gross annual household income; or (b) $3,000 in combined out-of-pocket expenditures made by such married enrollee's for co-payments and deductibles in a fiscal year. For purposes of this paragraph, out-of-pocket expenditures shall not include any amounts paid by an enrollee as a condition to receiving outpatient prescription drugs from any other source. (i) Program enrollees shall be responsible for retail and mail service co-payments for each outpatient prescription as established by the secretary. (j) Subject to this section, the department shall offer a mail service program and may require the use of a mail service program for maintenance drugs. (k) In order to maintain the fiscal viability of the program, after the first 12 months of said program, cost sharing required of enrollees whose gross household income is greater than 188% FPL in the form of co-payments, premiums and deductibles, or any combination thereof, shall be adjusted annually by the department to reflect price trends for outpatient prescription drugs, as determined by the secretary. The review commission shall review the actuarial assumptions of such adjustments. Not later than 30 days prior to making any such adjustments, the secretary shall submit to the chairman of the senate and house committees on ways and means the reasons therefor and all actuarial assumptions and other supporting materials upon which such adjustments are based. (l) During the initial 12–month period the program is in effect, an eligible person may enroll at any time, after which, application to the program shall be made during an open enrollment period established by the department, but a person shall be eligible to enroll in the program at any time within the year of reaching age 65. The department shall establish a surcharge for any eligible person whose gross annual household income is greater than 188 per cent of the federal poverty level and who fails to enroll within their first year of eligibility. (m) Coverage shall be effective as of the date an application for enrollment is approved by the department. The secretary shall close enrollment or an established open enrollment period or modify premium and eligibility income levels upon a written determination by the secretary that program expenditures are projected to exceed the amount appropriated for the program or, based on not less than 9 months of claims and enrollment data for the current fiscal year, expenditures in the subsequent fiscal year are clearly projected to annualize beyond the expenditures projected by the department in the subsequent fiscal year. (n) The department, and any entity with which it contracts, shall inform enrollees in writing of the program's scope, coverage, cost sharing requirements and any limitations on access to outpatient prescription drugs. The department shall create a process that provides for a clear and timely process by which enrollees can seek review of a decision by the department or any contracted entity to deny or limit coverage or benefits under this section. (o) The appeal process shall, at a minimum, provide enrollees with the opportunity to (1) obtain a nonpreferred drug at the co-payment level of a preferred drug, or to obtain any prescription drug excluded by the program, upon the separate written certification by the enrollee's physician, satisfactory to the department, that the nonpreferred or excluded drug is medically necessary and there is no therapeutically equivalent preferred drug available to the enrollee on the formulary established for the program, and documentation, satisfactory to the department from the enrollee exhibiting that payment for such drug would create a financial hardship to said enrollee; (2) appeal the exclusion of any prescription drug from any formulary established for said program, upon the separate written certification by the enrollee's physician, satisfactory to the department, that the nonpreferred or excluded drug is medically necessary, that there is no therapeutically equivalent preferred drug available to the enrollee on the formulary established for the program, and documentation, satisfactory to the department, from the enrollee exhibiting that payment for such drug will create a financial hardship to said enrollee. An enrollee may apply to be exempt from any mail service requirement of the program upon a separate written certification by the enrollee's physician, satisfactory to the department, that due to a disability or other significant limiting factor, the use of such a mail service program would be medically inappropriate for the enrollee. (p) A retail pharmacy shall not be required to dispense an outpatient prescription upon the failure of an enrollee to make the required co-payment. (q) The secretary shall promulgate such rules and regulations as may be necessary to implement and administer the program. (r) In the event that the secretary determines that the program is unsustainable and that modifications to the terms of the program are necessary to sustain the long term viability and cost effectiveness of the program, said secretary shall submit a report to the clerks of the house and senate and the prescription drug review commission certifying said determination and detailing necessary program modifications; provided, that not less than 30 days prior to implementing any such program modifications, said secretary shall issue public notification and convene a public hearing on any such findings and proposed changes. Notwithstanding this section, the secretary shall make necessary adjustments or rescind any modifications to the terms of the program, including to the program formulary or to the cost sharing required of low income enrollees, to the extent necessary to obtain federal financial participation or federal reimbursement for program expenditures. (s) The secretary may negotiate with pharmaceutical companies in order to reduce the pricing or cost of prescription medications made available through the program. The secretary may adopt any tools or programs available to achieve reduced pricing or cost of prescription medications. Nothing included in this section shall preclude the secretary from negotiating with manufacturers on other initiatives that may benefit the program.

M.G.L. c. 19A, § 40 Prescription drug review commission; membership; recommendations

c. 19A, § 40. Prescription drug review commission; membership; recommendations Section 40. (a) There shall be a prescription drug review commission, hereinafter referred to as the commission, to oversee the program established in section 39. The commission shall consist of: the speaker of the house of representatives; the president of the senate; the chairs of the house and senate ways and means committees or their designees; the co-chairs of the joint committee on health care or their designees; the secretary of aging and independence or a designee and 9 members to be appointed by the governor, including 2 representatives of older adult advocacy organizations, 2 representatives of disability advocacy organizations, a health care economist from a university or college within the commonwealth, 2 representatives from retail pharmacies, an individual who is a full-time employee of a pharmaceutical manufacturer and an individual who is a full-time employee of a biotechnology manufacturer. A representative of the contracted pharmacy benefit manager shall also participate, but shall not be a voting member of the commission. (b) The commission shall be co–chaired by the speaker of the house of representatives and the president of the senate. The commission shall adopt such rules and establish such procedures as it deems necessary for the oversight of the program established in section 39. No action of the commission shall be considered approved unless it is endorsed by a majority vote of the commission. (c) The commission shall meet annually and shall, not less than annually, submit written recommendations to the governor regarding changes to the administration, management, eligibility criteria, benefits, funding or any other aspect of the program. (d) To facilitate the commission's development of the recommendations, the department, and any entity with which it contracts, shall review the operations of the program and, not less than biannually, prepare and submit the following summary information to said commission:— (1) financial reports of said program, including actual and projected costs and revenues and an analysis of the adequacy of appropriated funding; (2) enrollment information, including enrollee demographics and benefit utilization data; (3) specific problems associated with the program and suggested strategies to resolve such problems; (4) a review of the pharmacy benefit manager's designated formulary for the program and any proposed changes thereto; (5) an analysis of current and future technological advancements that may result in cost savings or otherwise affect the program; (6) an analysis of the program's cost sharing requirements including, but not limited to, co-payments, premiums and deductibles, in relation to actual market trends in outpatient prescription drug costs, prescription drug inflation and any proposed changes thereto; (7) an analysis of the drug utilization pattern of enrollees with disabilities including, but not limited to, the cost associated with such utilization and the implications for expanding benefits to all individuals with disabilities who reside in the commonwealth; and (8) all other information requested by the commission. In developing its recommendations, the commission shall consult with representatives of parties who may be affected by the commission's recommendations including, but not limited to, the drug formulary commission, as established by section 13 of chapter 17.

M.G.L. c. 19A, § 41 Veterans Independence Plus Initiative Trust Fund

c. 19A, § 41. Veterans Independence Plus Initiative Trust Fund Section 41. There shall be established upon the books of the commonwealth a separate fund to be known as the Veterans Independence Plus Initiative Trust Fund. The secretary shall be the trustee of the fund and may expend monies in the fund, without further appropriation, for the administration of the Veterans Independence Plus Initiative, a joint initiative of the United States Department of Veterans Affairs and the Administration on Aging in the United States Department of Health and Human Services. Revenues collected by the department from this initiative shall be deposited in the fund. The department may incur expenses and the comptroller may certify for payment amounts in anticipation of expected receipts, provided that no expenditure shall be made from the fund which shall cause the fund to be in deficit at the close of a fiscal year. Any remaining balance in the fund at the end of a fiscal year shall not revert to the General Fund but shall remain in the fund and be available to the department during the following fiscal year for the purposes of this section. The secretary may expend from the fund for services provided in prior fiscal years.

M.G.L. c. 19A, § 42 Commission on malnutrition prevention among older adults

c. 19A, § 42. Commission on malnutrition prevention among older adults Section 42. There shall be within the department a commission on malnutrition prevention among older adults. The commission shall consist of 17 members, including the secretary of aging and independence or a designee, who shall serve as chair; the commissioner of public health or a designee; the commissioner of transitional assistance or a designee; the commissioner of agricultural resources or a designee; 2 members of the house of representatives or their designees, 1 of whom shall be appointed by the speaker of the house and 1 of whom shall be appointed by the minority leader of the house; 2 members of the senate or their designees, 1 of whom shall be appointed by the senate president and 1 of whom shall be appointed by the minority leader of the senate; and 9 persons to be appointed by the governor, 1 of whom shall be a physician, 1 of whom shall be a university researcher, 1 of whom shall be a community-based registered dietitian or nutritionist working with a program funded pursuant to the Older Americans Act, 1 of whom shall be a representative of a hospital or integrated health system, 2 of whom shall be nurses working in home care, 1 of whom shall be a registered dietitian or nutritionist working with a long-term care or assisted living facility, 1 of whom shall be a registered dietitian or nutritionist representing the Massachusetts Dietetic Association and 1 of whom shall be a representative from the Massachusetts Association of Councils on Aging, Inc. The commission shall make an investigation and comprehensive study of the effects of malnutrition on older adults and of the most effective strategies for reducing it. The commission shall monitor the effects that malnutrition has on health care costs and outcomes, quality indicators and quality of life measures on older adults. The commission shall: (i) consider strategies to improve data collection and analysis to identify malnutrition risk, health care cost data and protective factors for older adults; (ii) assess the risk and measure the incidence of malnutrition occurring in various settings across the continuum of care and the impact of care transitions; (iii) identify evidence-based strategies that raise public awareness of older adult malnutrition including, but not limited to, educational materials, social marketing, statewide campaigns and public health events; (iv) identify evidence-based strategies, including community nutrition programs, used to reduce the rate of malnutrition among older adults and reduce the rate of rehospitalizations and health care acquired infections related to malnutrition; (v) consider strategies to maximize the dissemination of proven, effective malnutrition prevention interventions, including community nutrition programs, medical nutrition therapy and oral nutrition supplements, and identify barriers to those interventions; and (vi) examine the components and key elements of clauses (i) to (v), inclusive, consider their applicability and develop strategies for pilot testing, implementation and evaluation. The commission shall file a report annually on its activities and on any findings and recommendations to the house and senate chairs of the joint committee on aging and independence and chairs of the house and senate committees on ways and means not later than December 31.

M.G.L. c. 19A, § 42A Reporting of animal cruelty, abuse or neglect

c. 19A, § 42A. Reporting of animal cruelty, abuse or neglect Section 42A. (a) An employee of the department, its designated agency or a person employed pursuant to a contract with the department or its designated agency, when acting in their professional capacity or within the scope of their employment, who has knowledge of or observes an animal whom they know or reasonably suspect has been the victim of animal cruelty, abuse or neglect, may report the known or suspected animal cruelty, abuse or neglect to the entities that investigate reports of animal cruelty, abuse or neglect, as described in section 57 of chapter 22C, or any local animal control authority. (b) The report may be made within 2 working days of receiving the information concerning the animal, by facsimile transmission or a written report or by telephone. In cases where an immediate response may be necessary to protect the health and safety of the animal, the report shall be made by telephone as soon as possible. (c) When 2 or more employees of the department or its designated agency, or persons employed pursuant to a contract with the department or its designated agency, are present and jointly have knowledge of known or reasonably suspected animal cruelty, abuse or neglect, and where there is agreement among them, a report may be made by 1 person by mutual agreement. A reporter who has knowledge that the person designated to report has failed to do so may thereafter make the report. (d) No person making such report shall be liable in any civil or criminal action by reason of such report if the report was made in good faith. Any privilege established by sections 135A and 135B of chapter 112 or by section 20B of chapter 233 relating to confidential communications shall not prohibit the filing of a report pursuant to this section. (e) Nothing in this section shall impose a duty on the department or its designated agency to investigate known or reasonably suspected animal cruelty, abuse or neglect. (f) Nothing in this section shall prevent the department, area office or subdivision or its designated agency from entering into an agreement, contract or memorandum of understanding with the entities that investigate reports of animal cruelty, abuse or neglect as described in section 57 of chapter 22C to require such reports or to engage in training in identification and reporting of animal abuse, cruelty and neglect.

M.G.L. c. 19A, § 43 Prevention and elimination of discrimination based on sexual orientation and gender identity and expression; training program

c. 19A, § 43. Prevention and elimination of discrimination based on sexual orientation and gender identity and expression; training program Section 43. The department shall develop a curriculum and training program on the prevention and elimination of discrimination based on sexual orientation and gender identity and expression and on improving access to services for lesbian, gay, bisexual and transgender older adults and caregivers. The training program shall be completed by: (i) all providers of services who contract with or receive funding from the department, (ii) aging services access points, (iii) the MassHealth's office of long term care or (iv) whose services are certified by the department. Within 12 months after commencing employment, providers shall complete the training program.

M.G.L. c. 19A, § 44 Portable orders for life-sustaining treatment (POLST) program

c. 19A, § 44. Portable orders for life-sustaining treatment (POLST) program Section 44. (a) To facilitate the effective and efficient use of portable medical orders across care settings, the department shall, notwithstanding any general or special law to the contrary, develop, implement and administer a program governing the statewide use of portable orders for life-sustaining treatment, in this section referred to as POLST. The POLST program shall transition from the use of medical orders for life-sustaining treatment, also known as MOLST, to the national POLST model. The department shall consult with the department of public health and the executive office of health and human services in the development and implementation of the POLST program. (b) Any patient information submitted to or held by the POLST program shall be kept confidential and shall be exempt from disclosure under clause Twenty-sixth of section 7 of chapter 4 and chapter 66 and shall be governed by chapter 66A. (c) The department may develop, implement and administer a secure electronic system as part of the POLST program, in this section referred to as the ePOLST system. The ePOLST system shall be a secure electronic database or other similar secure software or information system that enables automated query and retrieval of POLST program information by a health care professional. The department shall promulgate regulations governing the protection of and access to POLST information. The POSLT program includes, but is not limited to, POLST forms, health care proxy forms, guardianship documentation and clinical notes documenting conversations that led to the creation of POLST forms. (d) The department shall establish and maintain procedures to ensure that POLST patient information that may be collected, recorded, transmitted and maintained shall not be disclosed to persons except as provided for in regulations promulgated in accordance with this chapter. (e) The department may contract with another agency or private vendor, as necessary, to ensure the effective operation of ePOLST. Any such contractor shall be bound to comply with, at a minimum, the provisions regarding confidentiality of POLST program information and the regulations promulgated in accordance with this chapter. (f) The department may enter into reciprocal agreements with other states that have compatible ePOLST systems to facilitate access to POLST program information. (g) The secretary may establish an advisory committee to provide advice regarding POLST program issues, including, but not limited to, appropriate user training, policies governing the use of POLST and aspects of program implementation to facilitate the effective and efficient use of portable medical orders across care settings. (h) The department shall promulgate regulations necessary to implement the requirements of this chapter.

Source: Massachusetts General Court (malegislature.gov)URL: https://malegislature.gov/Laws/GeneralLaws/PartI/TitleII/Chapter19AFetched: 10/20/2026