Massachusetts Home Care Program

Funds for the Massachusetts Home Care Program and Enhanced Community Options Program (ECOP) are limited, and there is a waiting list. For more information, see Home Care Waiting List from the Central Massachusetts Agency on Aging.

What is the Massachusetts Home Care Program?

The Massachusetts Home Care Program is a program of support services to help Massachusetts seniors live independently in their own homes. The program also offers respite services to caregivers.

To qualify, seniors must meet income limits and show a need for support services. Depending on income, there may be a monthly co-payment for services.

Case managers from local Aging Services Access Points (ASAPs) assess each senior's need for services, develop a personal care plan, arrange for services, and monitor the program.

Am I eligible?

The Massachusetts Home Care Program is for seniors with limited income who need help to safely live at home. The program also offers respite care for caregivers of seniors, regardless of income. Monthly co-payments may apply.

Home care services are for seniors who:

• are 60 years of age or older
• are residents of Massachusetts
• do not live in a rest home, nursing facility, convalescent home, hospital, or assisted living residence
• meet the financial eligibility guidelines based on gross family income
• are not receiving services from an all-inclusive program such as Adult Family Care, Group Adult Foster Care, or PACE
• have been assessed by an ASAP case worker and found to be in need of services

Respite care services are available to caregivers when:

• the senior is age 60 or older, or under 60 with a diagnosis of Alzheimer's Disease or a related disorder
• the senior is a resident of Massachusetts
• the senior does not live in a rest home, nursing facility, convalescent home, hospital, or assisted living residence
• the caregiver is not paid for services
• the respite services are not requested primarily so the caregiver can work
• respite services replace services the caregiver usually performs
• the caregiver is experiencing stress or an emergency situation
• the senior has been assessed by an ASAP case worker and found to be in need of services
• the caregiver is 18 or older
• the caregiver is either a family member, or unrelated to the senior but living in the same household

Priority for Home Care services is based on how much help a senior needs to perform daily tasks, and how many needs are unmet. Seniors with critical unmet needs, such as personal care tasks (bathing, dressing, etc.), meal preparation and food shopping, and transportation to medical appointments receive higher priority.

What are the income limits?

Effective January 1, 2009, the maximum gross annual income for the Massachusetts Home Care Program is:

• $ 24,837 for family size of 1
• $ 35,144 for family size of 2

There are no income limits for respite services. However, there is a co-payment for services based on income. See What are the costs?

Income eligibility is based on gross family income. The family consists of the senior and his/her spouse, if living together. Countable income includes the following:

• wages or salary
• capital gains, dividends, and interest income
• net income from self-employment
• net rental income
• Social Security, Railroad Retirement, and survivor's benefits
• disability insurance payments
• unemployment and worker's compensation
• public assistance
• alimony
• pensions and annuities

Your ASAP can give you a complete list.

What are the costs?

Fees for Home Care services and respite services are on a sliding scale, based on the senior's gross family income. The family includes the senior and his/her spouse if living together. The caregiver's income is not counted.

Financial eligibility guidelines for the Massachusetts Home Care Program are adjusted each year on January 1 according to the SSA COLA increase. There was no COLA increase for 2010.

What benefits will I get?

A case worker from your local ASAP will visit you in your home to assess your needs and your eligibility for the Massachusetts Home Care Program. If there is a caregiver, the case worker will also assess the need for respite services.

If you qualify for the Home Care Program, you will get:

• an individualized care plan
• authorization and scheduling of services
• ongoing monitoring of needs and services
• home visits by your case worker, at least every six months

Home Care services include:

• personal care services to help with bathing, dressing, toileting, eating, and other daily personal care tasks
• home health services, including skilled nursing care, home health aide, and therapies
• medication assistance
• Adult Day Health services to provide health care, supervision, and socialization
• Dementia Day Care to provide a structured supervised setting for seniors with cognitive disabilities
• Social Day Care services to provide socialization, recreation, and supervision out of the home
• homemaker services, including housekeeping and meal planning and preparation
• food shopping and delivery services
• laundry
• home delivered meals, for homebound seniors unable to attend congregate meal sites
• nutritional counseling
• transportation
• chore services to maintain your home or yard
• companion services, to accompany you on errands or appointments, or at home
• adaptive housing to equip or modify your home to meet your needs
• personal emergency response system, for medical emergencies
• emergency shelter if needed
• translation services
• other services, as needed

Respite care includes any of these services on a temporary basis, plus temporary placements in adult family care, nursing facilities, rest homes, or hospitals.

Standard Home Care is for seniors with low to moderate needs, who do not need daily nursing care. The amount of Home Care services you get depends on your needs and the availability of funding.

Frail seniors who are medically eligible for nursing facility care can get a higher level of service from the Enhanced Community Options Program (ECOP). See below.

What is the Enhanced Community Options Program (ECOP)?

The Enhanced Community Options Program (ECOP) is a program of home care for frail seniors who are medically eligible for nursing facility care but want to live at home. ECOP provides a higher level of service than standard Home Care. ECOP members get two to three times the services of standard Home Care.

To be medically eligible for nursing facility care:

• You must need at least one skilled nursing or therapist service daily (for example, an IV, feeding tube, oxygen, sterile dressings, catheters, skilled-nursing evaluation, physical therapy, speech therapy, occupational therapy)
  
  OR

• You must need a nursing service at least 3 times per week, plus two other services. Other services can be assistance with Activities of Daily Living (ADL), or additional nursing services. Activities of Daily Living services include help bathing, dressing, toileting, getting in or out of a bed or chair, walking (or moving a wheelchair), or eating.

Seniors do not have to be eligible for MassHealth to take part in the ECOP program.

How do I apply?

You should call your local Aging Services Access Point to apply for the Home Care Program or the Enhanced Community Options Program. See the list below from the Senior Connection web site, or call 1-800-AGE-INFO to find the ASAP that serves your community.

• Massachusetts Area Agencies on Aging (AAA's) and Aging Service Access Points (ASAP's)

• AgeInfo line: 1-800-AGE-INFO (1-800-243-4636)

A case worker will do a quick eligibility screening over the phone. If you appear to be eligible, a case worker will conduct a home visit to further assess your needs and complete the application.

Useful links:

These links are external links to web sites that are not part of MassResources.org. When you click on these links, you will leave our site. Click "Back" on your browser to return.

1. Code of Massachusetts Regulations - Home Care Program (651 CMR 3.00)
   Massachusetts regulations about the Home Care Program, including definitions, eligibility criteria, services, and determination of need. (requires Adobe Reader)

2. Home Care Program
   Overview, eligibility requirements, included services, and payment information for the Massachusetts Home Care Program. Includes Home Care Payment Information. From the Executive Office of Elder Affairs.

3. Elder Affairs - Home Care Program Financial Eligibility Guidelines
   Program Instructions outlining the Financial Eligibility Guidelines effective January 1, 2009 for the Home Care Program and the 2009 voluntary co-payment, cost sharing, and respite care co-payment schedules. From the Executive Office of Elder Affairs.

Home Care Program section last updated on 4/21/10