Can You Help Team S & B Get More Seniors Access to Long Term Care In Their Homes?

Update from Attorney Daniel M. Surprenant

The Massachusetts chapter of the National Academy of Elder Law Attorneys, (“MassNAELA”) has filed legislation to correct a significant problem facing our seniors. The problem is related to Medicaid, also known as MassHealth. MassHealth has many programs available to help seniors stay at home with services and support instead of being forced to move to a skilled nursing facility. However, eligibility for the programs can be complicated and the income thresholds can limit many individuals from qualifying.

To be eligible for MassHealth assistance with the cost of home care, a senior is limited to $2,742 per month of gross income.  If their income is even $1 dollar over that limit, they have to meet a deductible and spend down their income in excess of $542 before they can get services.  It is nearly impossible for the senior to spend everything except for the $542 on medical care and still be able to pay other bills, such as rent, taxes, insurance, and food.

As a result, often one of two things happen.  The senior either ends up going to a skilled nursing facility where MassHealth will cover their full cost because there is no income limit (costing the Commonwealth more and forcing the senior out of their home too soon) or the senior stays home with insufficient care, putting them in danger.  The latter can also mean higher costs if it results in repeated hospitalizations. Let’s also keep in mind that seniors prefer to stay in their home. An added benefit it that it also costs the Commonwealth of Massachusetts a lot less money to pay for care at home than for care in a skilled nursing facility.

The current legislation if called the Community Care Bill – An Act to Support Equal Access to Community Care for Elders and the Disabled. This bill would ease the financial barriers to community based MassHealth services through PACE (Programs of All-inclusive Care for the Elderly) and HCBS (Home and Community Based Services Waiver) for seniors and people with disabilities, by providing that applicants and enrollees in both programs with income over program limits be charged a premium equal to income above program income limits rather than a financially prohibitive deductible.

Representative Higgins and Senator Comerford initiated the following bills, HD753 and SD608.  A fact sheet can be found here. These bills correct the issue by allowing a senior who is over the income limit to meet the deductible by just spending down their income that is over the limit. 

  • For example, the current threshold for benefits is $2,742.  If the senior’s income is $3,000, they would have to spend $258 per month on their medical expenses before they could get assistance instead of $2,458 per month on medical expenses, which is the current law.

Please help us help MassNAELA fix this so more seniors can stay home with less costly support and services.  Here’s how you can help:

  • Reach out to your state representatives and senators.
  • How to find your legislator:
    • Type in your address and it will tell you who your state Rep and Senator are
    • Click the name and it will take you to their contact information
    • For more information, please contact Nomita Ganguly –; 781.354.2444.

Letter Writing and Emailing

When there is time before a committee meeting or vote on a bill, writing a letter can be a very persuasive way of getting your message across to your legislator. Here are some dos and don’ts for making your letter as strong as possible.

  • DO make sure you are sending your correspondence to the correct elected official!
  • DO make sure you give your voting address. They’ll want to be confident that you are one of their constituents.
  • DO be specific about the issue. List the bill number and the title of the bill, if known, and what the bill addresses.
  • DO be brief. State your position in precise words and explain why you feel that way. Don’t be afraid to make it personal. Talk about why this issue matters to you. Also let your elected official know if you have personal expertise in, or experience with, the issue.
  • DO ask that your legislator write back to you letting you know where they stand on the issue.

Calling your elected officials

When placing your call to a member of the Massachusetts State Legislature, you can call the legislator’s office directly or use the general number of (617) 722-2000 and ask to be connected to the correct office. If your elected official is unavailable to speak to you, ask to speak to the staff person who handles the issue you are concerned about.

  • DO provide your name, address and phone number to confirm that you are a constituent and to give your legislator’s office an opportunity to get back in touch with you if needed.

We thank you in advance for you support on this issue. With approximately 10,000 baby boomers turning age 65 each day, this issue will only become worse with time.

Attorney Daniel M. Surprenant, CELA, Managing Partner