The Legislative Workgroup studies the current Congressional, State Senate and House legislation to determine which bills align with the Dignity Alliance mission. A bill should contribute to one of our goals. The membership is notified of any bills of interest, and is given the opportunity to sign on.
Please advocate for our endorsed bills by contacting your legislators.
Visit the Advocacy Page for a detailed list of our goals.
Visit State Leg Endorsements 2021-2024 for history.

2025-2026 Legislative Agenda
Dignity Dozen Plus One
Dignity Dozen Plus One (pdf) (with footnotes and additional information)
The “Dignity Dozen + 1” includes the priority legislation sponsored by Dignity Alliance Massachusetts aimed at addressing the needs and concerns of Massachusetts older adults, people with disabilities and caregivers. The “Dignity Dozen + 1” aims a public spotlight on improvements for nursing home residents (7 bills), improvements for older adults and people with disabilities living in the community (4 bills), and reducing the harm caused by private equity ownership and investments in long-term care (2 bills).
- An Act increasing the personal needs allowance for long term care residents.
Senator Joan Lovely and Rep. Thomas Stanley filed in House. Mark Montigny and Pat Jehlen filed an identical bill in the Senate.
The bill seeks to increase the monthly amount withheld from a nursing home resident’s income to be used for personal needs (PNA) not covered by the nursing home where they reside. It has been set at $72.80 per month since FY 2008 and has not been increased to meet the buying power reduction caused by inflation. If inflation calculations had been included from FY 2008, the monthly allotment should be $113.42. The PNA would be increased to that amount and would be annually adjusted to account for inflation helping nursing home residents to live with dignity. - An Act relative to the administration of anti-psychotic or other psychotropic substances to nursing home residents
Rep. Sally Kerans, House Sponsor; Sen. Bruce Tarr, Senate Sponsor
This bill is intended to tighten restrictions on the prescribing of anti-psychotics and related drugs for nursing home residents. Each week, dangerous antipsychotic (AP) drugs are administered to approximately 250,000 nursing home residents, often without clinical justification. These medications pose significant risks for elderly individuals, including heart attacks, strokes, Parkinsonism, falls, and even death. Despite these severe adverse outcomes, too many nursing homes routinely use AP drugs to sedate residents living with dementia instead of providing the appropriate care and services that these residents need and are entitled to under federal law. In Massachusetts, an estimated 20.9% or more than one in five nursing home residents are given antipsychotic meds which is at least ten times the percentage of schizophrenia occurring in the population. - An Act requiring the certification of medical directors in skilled nursing facilities.
Sen. Jacob Oliveira, Senate Sponsor; and Rep. Steve Ultrino, House Sponsor
Federal law requires every nursing home to have a designated medical director to offer professional medical guidance to the care of its residents. However, there is no requirement that such physicians be certified by national standards for providing geriatric care to nursing home residents and nursing home often fail to identify their medical directors and the amount of time they spend in their oversight role. This bill would require that within a reasonable time, all medical directors are certified and publicly identified so that they can be held accountable for safe, high quality resident care. - An Act relative to investments by entities of the Commonwealth
Rep. Sally Kerans, House Sponsor; Sen. Sal DiDomenico, Senate Sponsor
Most legislators and other state government leaders are well aware of the shortcomings of the health care system, especially in long-term care facilities, when private equity firms become major players in the delivery of health care. Massachusetts has been a pioneer in prohibiting the investment of public pension and other funds in areas that violate the morals of its citizens consistent with the historic values articulated in the “City on a Hill” proclamation of Governor John Winthrop and the proper role of a “commonwealth,” Massachusetts law has prohibited state investments in Northern Ireland and South Africa which has helped to bring about historic change in those countries and in the manufacture, distribution and sale of firearms. It can be argued that cuts in funding and quality of health care systems acquired by private equity firms are at least as dangerous to life and health as the other areas where public investment is prohibited by state law. This bill would curtail any investment in state and local funds in private equity firms involved in health care. - An Act relative to investments by entities of the Commonwealth
Rep. Sally Kerans, House Sponsor; Sen. Sal DiDomenico, Senate Sponsor
Most legislators and other state government leaders are well aware of the shortcomings of the health care system, especially in long-term care facilities, when private equity firms become major players in the delivery of health care. Massachusetts has been a pioneer in prohibiting the investment of public pension and other funds in areas that violate the morals of its citizens consistent with the historic values articulated in the “City on a Hill” proclamation of Governor John Winthrop and the proper role of a “commonwealth,” Massachusetts law has prohibited state investments in Northern Ireland and South Africa which has helped to bring about historic change in those countries and in the manufacture, distribution and sale of firearms. It can be argued that cuts in funding and quality of health care systems acquired by private equity firms are at least as dangerous to life and health as the other areas where public investment is prohibited by state law. This bill would curtail any investment in state and local funds in private equity firms involved in health care. - An Act improving older adult tax relief to address the rising cost of home ownership
Sen. Julian Cyr, Senate Sponsor; Rep. Thomas Stanley, House Sponsor
Massachusetts has been a leader in helping its older residents with the burden of taxation which often forces them to move to institutional care rather than to be able to afford to age in place in their homes. This issue has been eased by the Senior Citizen Circuit Breaker law which provides residents – both home owners and renters – with a refundable tax credit when property taxes, the property tax portion of rent, water and sewer bills exceed certain levels. However, the significant rising cost of home owner’s insurance, required by mortgage lenders and prudent for property owners without a mortgage has become a factor that also burdens our older residents whose income is limited. Including fifty percent of the cost of home owner’s insurance in the calculations for the Circuit Breaker law would ease this burden on a growing part of our population. - An Act to establish the Office of Older Adult Advocate
Sen. Paul Mark, Senate Sponsor, Rep. Steve Ultrino, House Sponsor
The concerns of older adults extend well beyond the programs and policies administered by the Executive Office of Aging and Independence (formerly Elder Affairs). Furthermore, the failure of several recent administrations to treat the top state official responsible of older adult programs and protections is a full member of the Governor’s Cabinet (as provided in the General Laws), and the subordinate role of the Secretary of Aging and Independence to the Secretary of Health and Human Services in budget and policy matters is an affront to the growing population of older adults in Massachusetts – now growing faster than the number of new births – leaves older adults at a major disadvantage in decision made at the highest level of state government that affect their lives. The Legislature has recognized this gap in areas dealing with children and veterans, but not regarding the needs and concerns of older adults. Even if the Healey Administration invited the Secretary of Aging and Independence to participate as an equal partner in Cabinet meetings, the needs of older adults extend to areas beyond that agency to other areas of state government, such as affordable and accessible housing, transportation, consumer affairs, public health, the economy and jobs. This bill, modelled on the recently enacted Veterans Advocate law, would provide an independent voice to focus on the needs of our older citizens. There has been an Office of the Child Advocate for several years, as well, demonstrating the need for more oversight. - An Act to improve transparency and accountability for residents of long-term care.
Sen. Joan Lovely, Senate Sponsor; no comparable House Sponsor (although Sally Kerans is filing a bill on name changes using section of this bill)
The enactment of Chapter 197 of the Acts of 2024 was a major milestone in the Commonwealth’s efforts to improve transparency and accountability in long-term care, especially for nursing home and assisted living residents. However, there are additional steps that should be taken to make care for older adults and people with disabilities even more transparent and accountable. This bill would further strengthen long-term care in Massachusetts for many of our most vulnerable citizens and the staff who care for them. We applaud the progress made to date to improve long-term care, but that applause could be more resounding with these few additional improvements. - An Act to Strengthen the Long-Term Care workforce and capital trust fund.
Senator Bruce Tarr, Senate Sponsor; Rep. Manny Cruz, House Sponsor
This bill expands the advisory board for the trust fund to include representatives of consumer advocates, increases transparency by making non-government board members subject to the state’s conflict of interest law, and prioritizes investments in small homes and single occupancy rooms. Once these priority investments are substantial achieved, other priorities can be proposed. - An Act improving continuity of care for Mass Health members with chronic conditions
Sen. Brendan Crighton, Senate Sponsor; Rep. Lindsay Sabadosa, House Sponsor.
What this proposed legislation is intended to do: Section 1: For a set of “community long-term care services” (Adult Day Health, Adult Foster Care, Day Habilitation, Home Health Aide, PCA, and 1915(c) services itemized in the Frail Elder Waiver (but not limited to the Frail Elder Waiver), to extend and Section 2: Adds further clarification to the current ASAP statute, specifying the duty of “Service Authorization”, when authorized by an ASAP nurse, satisfies prior authorization requirements for community long-term care services when the ASAP is not performing as a direct service provider (further specifying that this clarification extends to the SCO program). This bill puts the topic of Prior Authorization as delay to service into the public square for 2025-2026.
States that have been identified MN, VT, and NH have recently passed laws intended to rationalize the application of Prior Authorization to LTSS. This bill is modeled on several draft provisions from the VT legislation that passed earlier in 2024. - An Act promoting infection prevention and privacy for residents of nursing homes
Sen. Joan Lovely, Senate Sponsor; Rep. Jeffrey Turco, House Sponsor
This bill would set state policy as requiring nursing homes to provide single-occupancy rooms for all residents (although residents could approve two persons in case of spouses) to provide greater privacy and reduce infections. Massachusetts currently requires not more than two residents per room, although 31 nursing homes have sued the Department of Public Health suspending full enforcement of the two-person per room regulation. The case has been stalled for nearly three years. In the meantime, reports are now surfacing that even nursing homes that accepted the regulation and moved to two residents per room, are now reverting to four or more residents per room in an effort to increase profits. Substantial research has documented the importance of single rooms for residents of nursing homes. - An Act clarifying responsibility for policy and budgetary decision-making in nursing homes.
Sen. John Velis; Rep. Jeffrey Turco, House Sponsor.
Finally, the buck for poor nursing home care will stop here! No longer will, “I was just following orders from corporate,” be acceptable! This bill is intended to clarify that the top management in nursing homes is responsible for policy and budgetary decisions that impact quality and safety of resident care and that they, or even the owners of nursing homes, will be held accountable when budgets and staffing are insufficient to provide safe, high quality resident care based on the needs of individual resident care plans. The concept is based on the Massachusetts Supreme Judicial Court decision in Commonwealth v. Clinton which found management of the Holyoke Soldiers Home responsible for policy decisions made during COVID. - An Act protecting the rights of older adults and people with disabilities
Senator Brucc Tarr, Senate Sponsor; Rep. Jeffrey Turco, House Sponsor
Despite improvements brought about by the federal 1987 Nursing Home Reform Act and state laws and regulations, residents of nursing homes in Massachusetts have fewer rights and protections than clients of the Department of Mental Health and Department of Social Services. Even when the generic theme of some rights is comparable, the regulations lack the specificity provided in the other agencies. The result is that Massachusetts residents of nursing homes have less dignity, independence, choice and protection than older adults or people with disabilities who are DMH and DSS clients In addition to all legal rights set forth in federal44 and state law, residents of nursing facilities that are licensed or regulated by the Department of Public Health shall have all of the rights equal to those afforded to people with disabilities in facilities or programs operated or funded by the Departments of Mental Health and Disability Services. Like other rights and provisions of federal45 and state,46 law designed to protect nursing facility residents, may be enforced in a civil action brought pursuant to G.L. 93A.