Caregivers Family

Elder Law: Keeping mom at home
By By Ronald Surabian/Elder Law Center
Thu Mar 20, 2008, 02:16 PM EDT
Malden -

Malden - Let’s face it: no one wants to go to a nursing home.
For elders who have supportive families, this is sometimes possible. Today I want to talk about something called Enhanced Group Foster Care. It is a program offered by the Commonwealth that will compensate family members for taking care of their mom or dad. It is aimed at children who either move in with their parent, or have their parent move in with them, instead of going to a nursing home.
The caregiver who accepts this responsibility will receive up to $50 per day, or about $18,000 per year for caring for their parent. As a bonus, this income is non-taxable under section 131 of the Internal Revenue Code, as qualified foster care payments. These payments are for 24-hour care of the senior, but the child can get a break from their caregiver duties for up to 14 days per year under the respite care program.
This would provide a break to the caregiver for a vacation. And, if the senior is willing, there are adult day care programs that provide care at a senior day care facility so that the child can have free time during the week to work, shop or do as they please, knowing that their parent is safe, and being taken care of.
Who Is Eligible
Elders, or disabled adult family members over the age of 16, that need assistance with three Activities of Daily Living (ADL’s), and are financially eligible for MassHealth (Medicaid in Massachusetts) are eligible. Activities of daily living are bathing, dressing, toileting, transferring (this means from bed to wheelchair), ambulating, and eating. Elders who are wandering, verbally or physically abusive, resisting care, or have socially inappropriate or disruptive symptoms only need help with two activities of daily living to qualify. Elders who need less care can also be eligible for this program, however, their caregiver pay is reduced.
Who is Eligible To Be A Caregiver
The program pays family, or non-family caregivers to care for an elder or adult disabled family member over the age of 16. Spouses, and legal guardians are NOT eligible to be paid caregivers under this program. The most common caregivers are children and siblings.
I spoke with Linda Morreale-Steele, a registered nurse and program director for North Region of Caregiver Homes of Massachusetts. Caregiver Homes is an approved Adult Foster Care Program and provides services throughout Massachusetts.
“This program is all about choice,” she said. “It gives elders who could be in a nursing home an option that was previously unavailable.”
Caregiver Homes starts by assessing the elder and developing a care plan and maintaining contact through regular telephone calls and home visits. They also provide continuing education and training to the caregiver to stay current with the changing needs of the seniors.
The elder’s health status is also monitored by daily notes taken by the caregiver and entered into a computer program that connects to Caregiver Homes through the internet. These notes are monitored by an registered nurse and care manager on a daily basis.
When a family member is not available, Caregiver Homes recruits, and trains non-family members to provide care to the senior. For more information, call the placement coordinator for Caregiver Homes at (866) 797-2333.
This article gives general information and not specific advice on individual matters. Persons wanting individualized advice on matters discussed should contact an advisor experienced in those matters. To the extent this article provides information on legal matters, it is based on law in effect in Massachusetts on the date of posting (laws in effect in other states are often quite different).
Ronald H. Surabian is a CPA and attorney who works at the Elder Law Center in Saugus. He also holds Masters in accounting and a master’s degree in tax law. He currently serves on the board of directors of the Massachusetts Chapter of the National Academy of Elder Law Attorneys.
If you have any questions please call me at the Elder Law Center, One Essex Street, Saugus, MA 01906 (781)233-4444. To view this or any prior article, please visit www.elderlawcenter.org



Comments (1)


malden senior
2008-03-20T18:31:53
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On the face of it this sounds great until you realize you must become a pauper (spending down or give away assets) get on Medicaid (with a wait for approval) apply asking for help from a agency (like Mystic Valley Elders) get on a waiting list and hope for a long awaited phone Call

News Release MVES executive director

Malden - Senior Notes
Locals rally at State House for elder independence
Local seniors and members of organizations that support elder independence converged on the Statehouse on Tuesday, Feb. 26, to tell legislators that elders should have a choice when it comes to long-term care services.
The group of more than 300, including 25 people from the Mystic Valley area, said that the state continues to be overly reliant on nursing home care when most elders want to live independently in their own homes.
“We invest 66 percent of our MassHealth long-term care dollars in nursing homes,” said Mystic Valley Elder Services Executive Director Dan O’Leary. “Yet our official state policy is ‘Community First.’ It’s time to rearrange our budget to reflect what seniors want: care at home. Let the money follow the person back home.”
To emphasize the needed shift in funding, group members waved “Deval Dollars” in support of the governor’s plan to “rebalance” money from nursing homes to community-care programs. Legislators were urged to implement the Equal Choice law, passed in 2006, that guarantees seniors live in the “least restrictive setting” possible.
Silver Legislator Senate President Sally Hoyt also spoke about the importance of independence for elders. The rally took place while lawmakers prepare the Fiscal 2009 budget.

Home Care interest Medicare Beneficiares

i) PROCESSES- The processes described in this clause are the following:
`(I) In developing standards referred to in such subparagraph, the Secretary shall convene a Technical Advisory Group consisting of stakeholders, including individuals and organizations representing the interests of Medicare beneficiaries, the National Association for Home Care & Hospice, and the Visiting Nurse Associations of America, health care academia, and health care professionals, in equal numbers from each and limited to parties without an existing contractual relationship with the Secretary, to advise the Secretary concerning the establishment of such standards in order to distinguish between real changes in case mix and changes in coding or classification of different units of services that do not reflect real changes in case mix. The Technical Advisory Group shall be given the opportunity to review and comment on any proposed rulemaking or final determination by the Secretary on such standards prior to such rulemaking or determination.
`(II) If the Secretary engages an outside contractor to participate in the evaluation of case mix changes described in subclause (I), the Secretary shall only utilize a contractor that has not previously participated in the design and establishment of the case mix adjustment factors under subparagraph (B).
`(III) If the Secretary determines that any increase in case mix relates to changes in the volume or nature of services provided to home health services patients, the Secretary shall evaluate that increase through actual review of claims and services and shall not use any proxy or surrogate for determining whether the change in volume or nature of services is reasonable and necessary.
`(IV) The Secretary shall establish the standards referred to in subclause (I) by regulation.
`(V) With respect to establishment of such standards, the Secretary shall make public all data, reports, and supporting materials, including any comments by the Technical Advisory Group pursuant to subclause (I), regarding the standards at the time of notice of such standards.
`(ii) CRITERIA- The criteria described in this clause are the following:
`(I) The impact of changes in the program under this title that may affect the characteristics of individuals receiving home health services.
`(II) The impact of changes in the provision of health care services by providers of services other than home health agencies.
`(III) Distinctions in the characteristics of individuals initiating home health services from the community and institutional care settings.
`(IV) Whether any changes in coding resulted in a change in expenditures overall annually and disregarding changes in coding that do not have an overall expenditure impact.
`(V) Any other factors determined appropriate by the Secretary in consultation with the Technical Advisory Group under clause (i)(I).'.
(b) Voiding of Proposed Case Mix Adjustment- The Secretary of Health and Human Services shall not take any action to implement or otherwise carry out provisions contained in the final rule published on August 29, 2007, on pages 49762-49945 of volume 72 of the Federal Register, insofar as such provisions propose to make a case mix adjustment to the standardized payment amounts under the prospective payment system for home health services under section 1895 of the Social Security Act (42 U.S.C. 1395fff) to account for changes in coding that were not related to an underlying change in patient health status. The Secretary shall republish any rates specified in such rule to take into account the application of the previous sentence. The Secretary shall only institute an adjustment under subparagraph (B)(iv) of such section in compliance with subparagraph (D) of such section, as added by subsection (a)(2).