Massachusetts, through the MassHealth (Medicaid) program, is on the cutting edge of senior care options. Specifically, the state has developed several programs aimed at providing seniors with an appropriate level of care in their own homes, rather than having a nursing home placement as the default solution when a senior requires care.
Two MassHealth programs that are currently available will even pay caregivers (who can be family members) to care for seniors in their homes. Since the adult children of ailing seniors are often the first line of care, this provides a much needed solution for families who would otherwise be paying out of pocket to keep mom or dad home for as long as possible.
MassHealth’s Adult Foster Care program (AFC)
Adult Foster Care (AFC), is a program for frail seniors who cannot live alone safely. Elderly program participants live with their caregivers who provide daily care. Caregivers may be family members or non-family members, however, caregivers cannot be spouses or legally responsible relatives. The senior can be living in the caregiver’s home or vice versa.
AFC caregivers receive up to $1,500 per month ($18,000 per year) from MassHealth to provide care to seniors who otherwise would need institutional care. Caregivers are supported and trained by AFC service providers, including a social worker and registered nurse.
To become eligible, a senior must be a MassHealth member, be unable to live alone because of a medical, physical, cognitive or mental condition and need daily assistance with one or more activities of daily living (ADLs) such as bathing, dressing, eating, toileting, exercising, taking medications, and moving about inside the home, while not requiring full-time skilled nursing care. Caregivers must be approved by the program (interview, references, CORI check), and be able to provide 24-hour supervision.
MassHealth’s Personal Care Attendant Program (PCA)
The Personal Care Attendant Program (PCA), like AFC, is a MassHealth program that helps people with long-term disabilities live independently at home.
One of the main differences with the PCA program is that the senior and caregiver have a more formal employer/employee relationship. The PCA program gives each eligible senior funds to hire a personal care attendant to help with ADLs. The senior becomes the employer, and is in charge of hiring, firing, training, and supervising the PCA, while the caregiver is paid hourly and must submit regular time sheets to MassHealth. Currently, MassHealth PCA workers receive wages of $12.48 an hour.
To be eligible for the PCA program a senior must be a MassHealth member, be prescribe the personal care services by their doctor or nurse practitioner, be unable to take care of their personal needs themselves and require physical help with two or more ADLs. Like the AFC program, PCAs may be family members, however, they cannot be spouses or legally responsible relatives.
The first step for either program is to become eligible for MassHealth, which may require repositioning some of the seniors assets and/or income. Each program under MassHealth has different eligibility rules and penalties, so seeking counsel is advised.
These MassHealth programs are instrumental in helping Massachusetts seniors living comfortably in a family setting rather than in a nursing home or other facility. At the same time, they reward family caregivers for their hard work and provide asset transfer options that may be useful in planning ahead for nursing home care should that become necessary down the line. To see how your family may benefit for these and other MassHealth programs, contact the Heritage Law Center today.