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S
UBSIDIZED
 
SUPPORT
 
FOR
 
ELDERS
 
LIVING
 
IN
 
THE
 
COMMUNITY
Prepared by The Law Office of William J. Brisk 1340 Centre Street, Suite 205Newton Center, MA 02459617/ 244-4373, fax: 617/ 630-1990www.briskelderlaw.com© 2009
MASSACHUSETTS HOME CARE PROGRAM
Massachusetts has designated Aging Services Access Points (ASAP) which serves distinctcommunities, by providing eligible seniors care advice and home care services through theCommonwealth's State Subsidized Home Care Program. A Care Advisor conducts acomprehensive in-home assessment, in consultation with a nurse, to determine programeligibility. The senior, family members and Care Advisor develop a care plan, which isreassessed on a regular basis. Co-payments for services are based on sliding fee scales.Some of the services which may be available with state subsidy include:
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Personal Care
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Home Health Services
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Homemaking
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Home Delivered Meals
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Nutrition Education and Counseling/Transportation
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Personal Emergency Response Systems
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Adult Day Care Programs
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Companionship
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Respite Care
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Chore Services
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Grocery Shopping
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Laundry Services
Eligibility for this program is based on functional ability and not a medical diagnosis.Although eligibility may vary, in general to be eligible for a state subsidy a person must:
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Be 60 years of age or older 
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Be unable to do certain tasks independently
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Have an annual income of less than $23,475 for an individual or $33,217 for a couple (thischanges every year on January 1)
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Not have any way to get the assistance he or she needs except though the Home CareProgram.The following four levels of service are available under the Home Care Program:
1. Standard Home Care
A consumer can receive services that cost up to $260 per month through the standard HomeCare Program. Consumers can choose to hire their own worker or they can receive servicesfrom a worker from a vendor agency that Springwell subcontracts with. A Springwell Care
ELDER LAW
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ESTATE P L A N N I NG
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LITIGATION
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M E D I C A I D
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P R O B A T E
1340 Centre Street, Suite 205, Newton Center, MA 02459
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Phone: 617.244.4373
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Fax: 617.630.1990www.briskelderlaw.com 
 
Advisor has regular contact with the elder to ensure services meet needs and visits the elder aminimum of every 6 months.
2. Respite Home Care
Seniors whose family caregiver needs relief may be eligible for services under the Respite HomeCare Program. The goal of respite care is to support families giving care so they can continue tohelp their relative. (Respite care is not intended to provide custodial care while the caregiver is atwork.) The cost of respite service is determined on a sliding fee schedule. People of any incomecan be served, and many people qualify for cost subsidies. Consumers can choose to hire their own worker or they can receive services from a vendor agency that Springwell subcontracts with.Families qualify for the respite program if:
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The caregiver is 18 years of age or older. (The caregiver does not have to be a relative of the elder.); and
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The person receiving the care is 60 years of age or older, or has a medical diagnosis of Alzheimer's disease; and
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One caregiver is providing daily care to an elder on an ongoing basis. (Paid caregivers areusually not eligible.); and
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The caregiver is feeling stressed because of providing care.
3. Enhanced Community Options Program (ECOP)
If the services required to meet the needs of a senior are greater than 2 times the amount that asenior would receive under the Standard Home Care Program and the senior is clinically eligiblefor nursing facility services, then the senior may be eligible for services under ECOP. As of August 2008 the services, the senior needed would have to cost a minimum of $520.00.Consumers can choose to hire their own worker or they can receive services from a vendor agency that Springwell subcontracts with. Seniors receiving services through ECOP are visitedby their Care Advisor a minimum of every three months.
4. Community Choices
The Community Choices Program, offers the frailest seniors additional support. This program isdesigned to provide a senior with services that cost up to 50% of Nursing Home care.To be eligible for the Community Choices Program a person must meet all 4 of the followingcriteria:A. Mass Health Member, age 60 or older B. Enrolled in or eligible for the Home and Community Based Waiver ProgramC. Meets one of the following criteria:
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Actively sought nursing facility care within the last six months; or 
ELDER LAW
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ESTATE PLANNING
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LITIGATION
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MEDICAID
 
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PROBATE
1340 Centre Street, Suite 205, Newton Center, MA 02459
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P:617.244.4373
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F: 617.630.1990 www.briskelderlaw.com 
2
 
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Recently (within the last 30 days) experienced a serious medical event, regression inphysical or cognitive functional ability or accumulative deterioration in functionalability; or 
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Was discharged from a nursing facility within the last 30 days; or 
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Is at risk of nursing facility admission due to the instability or lack of capacity of informal or formal supports.D. Has one of more of the following clinical characteristics: 
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Needs 24 hour supervision because of complex health conditions; or 
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Experiences a significant cognitive impairment; or 
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Is unable to manage/administer prescribed medications; or 
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Experiences frequent episodes of incontinence; or 
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Requires daily supervision and assistance with multiple ADLs.
PERSONAL CARE ATTENDANT PROGRAM
The Personal Care Attendant (PCA) Program is a MassHealth program designed to giveindividuals with long-term disabilities both control over how their own personal care needs aremet and the choice to live at home independently.The PCA Program is consumer-directed, meaning that the individual with the disability(consumer) is the employer.Personal Care Attendants (PCAs) are hired, trained and supervised by the consumer. As theemployer, a consumer sets up a PCA schedule and trains PCAs to meet his or her own personalneeds. PCAs are paid based on timesheets that are sent to a Fiscal Intermediary.If the consumer cannot independently manage his or her PCA program, the consumer may havethe help of a surrogate. The surrogate is often a family member but may be any other personidentified by the consumer who has the ability to manage the program.PCAs can help with Activities of Daily Living (ADLs) namely:
1.
Mobility/transfers
2.
Bathing or grooming
3.
Dressing/undressing
4.
Eating
5.
Toiletingand, also, with Taking medications, and Passive Range-of-Motion exercises.
ELDER LAW
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ESTATE PLANNING
●
LITIGATION
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MEDICAID
 
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PROBATE
1340 Centre Street, Suite 205, Newton Center, MA 02459
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P:617.244.4373
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F: 617.630.1990 www.briskelderlaw.com 
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