Top 10 Most Important Cuts to MassHealth for Seniors, the Disabled, and their Families

Continued from March 7th 2011

Here are the major cuts that impact our clients. The following is a link that has a more inclusive list of budget cuts..

http://www.massbudget.org/documentsearch/findDocument?doc_id=614&dse_id=1293

1. Restorative Dental Care

700,000 adults relied on MassHealth for restorative dental care in 2010. Just over 18% were seniors.

2. Reduction in Hours for Day Services to Disabled Adults

Coverage for day services has been cut from six to five hours a day.

3. Personal Care Attendant Services Limited

Many disabled adults require only limited assistance. For instance they might need help getting in and out of bed, dressing and bathing, but are otherwise self sufficient. The 2011 plan establishes a floor. If your need is less than 14 hours a week, you will no longer be eligible.

4. Prescription Advantage Cuts

$26 Million has been cur tom the Prescription Advantage program, Some low income elderly will no longer have subsidies for the portion of their prescription drug costs not covered by Medicare Part D.

5. Respite Services Cut

$12.7 Million in funding will be cut for respite and intensive family support services. These services support the family care givers. Giving parents of disabled children, or children of parents with disabilities support and a safety net.

Stay tuned for the last 5 next week…

Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients – Conclusion

Our current health care reform has several provisions to incentivize states to expand at home care, but there is still a strong “institutional bias” that requires states to fund nursing homes, but makes the payment of nurses for at home care optional.   Despite the savings, participation in  a new Federal pilot program that promotes at home health care is optional for states.

Another trend that has been found is that the population in nursing homes is changing to those who are either sicker, or more economically disadvantaged.   Those with the ability to pay, are moving to assisted living facilities.  Those who do not have as great a medical need (i.e. Healthier, but still in need of assistance) are also better served in more independent living facilities.  This new movement creates a nursing home population that is more disadvantaged both from a medical and a financial perspective.

NPR reports that “By federal law, people who face going into a nursing home must be told about alternatives. But in Miller's study in one state, nearly 30 percent of younger people in nursing homes said they weren't told about options. Often doctors and other health care providers just don't know what's available — and recommend a nursing home instead.”

Many times, when younger people chose to not to into a nursing home, it is at the expense of family members.  These family members provide care at no cost to the state.  While the state gets a free pass, the care giver family members can bear a huge burden in terms of  health, time and stress.

There are alternatives for many younger people to nursing home care.  With an experienced legal advocate by your side, you can also consider independent living facilities.  Many severely disabled people still live full and rich lives, not even in a facility, but with at home care.  It will frequently take an experienced attorney to protect your rights, and to help you determine what care is most appropriate for your situation.

 

We welcome hearing from you if you or a family member has special needs, and is looking for alternatives to nursing homes, or looking for ways to protect your family financially from the costs of long term care.

Call one of elder law attorneys at Cohen & Oalican, LLP Boston, Andover and Raynham.

National Healthcare Decisions Day

We want to make you aware that April 16, 2010 is National Healthcare Decisions Day. Despite increased public awareness over the last ten years millions of Americans still do not have health care proxies. We urge all of our friends and clients to join other national, state and community organizations in encouraging everyone to sign a health care proxy for themselves. Beyond signing the document it is just important to communicate with your appointed agent and your family regarding what your wishes are regarding health care decisions. To learn more about this effort, visit www.nationalhealthcaredecisionsday.org.


Health care proxies and living wills are simple estate planning tools that enable all of us to direct how are health care decisions are made in the event we become incapacitated. The absence of these documents can force families to seek guardianships in the probate court. Although this is not the end of the world, going to court means incurring unnecessary legal expense, stress and delays. In addition the health care proxy gives the patient and their family the peace of mind of knowing that their wishes will be honored regarding medical care. For all of us both personally and professionally (for those of us who work in related fields) it is important to keep in mind the important role these documents play. It is critical that we make sure that everyone has advanced directives.

Health care proxies are relatively straight forward documents. In Massachusetts, the proxy must be witnessed by two people. There is no requirement that the document be notarized but we think it is a good idea just in case you need to use it in another State which does have this requirement. In addition to naming your agent it is always a good idea to have an alternate just in case your first choice is not available. Finally, we recommend including a medical directive which describes in broad strokes what your wishes are regarding end of life decisions. Rather than having this in a separate living will which goes into lost of detail, we’ve found over the years that a medical directive in the health care proxy itself works better. A medical directive serves two functions. First, it can serve as a supportive guide to your health care agent helping them make the decision you would want. Second it allows health care providers a means of confirming that an agent is making decisions consistent with the written expressed wish of the patient.


In an effort towards encouraging everyone to have a health care proxy, we are making our firm’s health care proxy forms available. If you wish to download the forms, please go to our website at www.cohenoalican.com to receive a copy of our form. Remember that our form must be witnessed by two people (neither of whom can be the agent or alternate) and notarized.