Massachusetts Assisted Living Subsidization Resources

Finding the right senior living and care options for your loved one can be challenging. Depending on your budget, it can be even more challenging to determine which options are affordable and what programs might be able to help. At 2Sisters Senior Living Advisors, we strive to help each family find the right fit for their loved one, but there are instances where we cannot help. Such circumstances include those who do not qualify financially to live in assisted living for 6 months or more without financial aid or a subsidization program. To assist these families, we have researched state and national programs that might be relevant and have outlined them here. Please note that this is simply a resource guide, not a comprehensive list. We are not regularly updating the list and recommend that you contact the agencies directly for more information.

 

Additionally, Mass Options is a free service available to assist caregivers, loved ones and individuals seeking information about services that may be available to them: https://www.massoptions.org/massoptions/; (844) 422-6277

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GROUP ADULT FOSTER CARE (GAFC)

The Massachusetts Executive Office of Health & Human Services reimburses the Adult Living Facility provider for personal care services and program administration for MassHealth eligible residents. Approximately $1,200/month is reimbursed per participant for care services only. The resident is responsible for rent. Our research has found that GAFC openings are typically internally waitlisted. We have also found that each facility designates specific GAFC apartments, usually companion suites.

Qualifications Must meet MassHealth clinical and financial criteria; resident must be at least 22 years old; resident must require assistance with at least 1 Activity of Daily Life (ADL); countable monthly income must be less than $1,195.
Resources MassHealth Customer Service: 800-841-2900; www.mass.gov/elders

 

SUPPLEMENTAL SECURITY INCOME (SSI)

The Social Security Administration offers a rental subsidy program (SSI-G) designed for disabled and older adults who have little or no income to obtain a minimum standard of living. This subsidy program covers the rent for Group Adult Foster Care (GAFC) in participating Assisted Living Residences (ALR) for eligible participants.

Qualifications Must be clinically eligible for AND participate in the GAFC program; participant’s countable monthly income must be less than $1,195 AND have assets valued at or below $2,000 ($3,000 for a couple); participant must live in a state-certified ALR that accepts SSI-G payments for rental or room/board.
Resources Supplemental Security Income: www.socialsecurity.gov/otherssasites;

Mass Supplemental Payment Program: www.mass.gov/eohhs/consumer/basic-needs/financial/ssp.html;

Mass Supplemental Payment Program Customer Service: 877-863-1128

Caregiver Homes Program: https://www.payingforseniorcare.com/cash-and-counseling/ma-caregiver-homes.html

 

PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE)

This program is a national, comprehensive health plan and coordinated care system. It is funded jointly by Medicaid and Medicare. It delivers all medical and supportive services while maintaining elders’ independence in their homes (including participating ALRs). Enrollment requires participant to receive care from PACE providers.

Care and services for patients include:

  • adult day care (nursing, physical and occupational therapies; meals; social work; and personal care)
  • home health care
  • personal care
  • medical care
  • prescription drugs
  • hospital and nursing home care

Only certain ALR’s participate in PACE. Of those, few have openings and require a certain amount of time for residents to pay privately before going into the program. Often there are designated apartments for PACE residents. Some communities have ‘PACE Plus’ where the resident pays a portion for care and PACE pays a portion for care. An ALR’s status/policies with the PACE contract can change at any time.

Qualifications Must be 55 years or older and eligible for Mass Health (or be willing to pay the premium privately); Able to live safely in a community at the time of enrollment; Certified by the State to need nursing home care; Live in a PACE service area.

 

Resources

 

MASS Executive Office of Elder Affairs (617) 727-7750 http://www.mass.gov/eohhs/consumer/insurance/pace
Elder Service Plan of Harbor Health Services (617) 533-2400 www.elderserviceplan.org
Elder Service Plan of Cambridge Health Alliance (617) 575-5850 www.challiance.org
Elder Service Plan of East Boston (617) 568-4602 www.ebnhc.org
Elder Service Plan of the North Shore (877) 803-5564 www.pacenorthshore.org
Summit Elder Care (800) 698-7566 www.summiteldercare.org
Upham’s Elder Service Plan (617) 288-0970 www.uphamselderserviceplan.org

 

SENIOR CARE OPTIONS (SCO)

This is a comprehensive, managed care health plan/coordinated care system via MassHealth and Medicare. This program provides both healthcare and social services for low-income elders. Members/patients have individualized care plans that are developed and provided by a team of clinical professionals. Patients must receive their care within the designated SCO network.

Qualifications Must be eligible for MassHealth Standard; must be 65 years or older; must live in an area serviced by SCO
Resources www.mass.gov/elders

MassHealth Customer Service: 800-841-2900

Guide to Senior Care Options for Providers: https://www.mass.gov/files/documents/2016/07/wc/sco-guide-to-senior-care-options-program.pdf

 

LOW INCOME HOUSING TAX CREDIT

This is a federally-authorized program to maintain affordable rental housing for low-income residents. It provides landlords a tax credit in exchange for rent-restricting a unit(s) on their property. This program may vary by community and typically has a long waitlist. This program does not provide for additional services/care fees.

 

Qualifications There are two important federal requirements that affect eligibility for Assisted Living Residences (communities may have additional requirements, as well):

·         Meeting the age requirement of the community (typically 55 or 62)

·         Income limit (typically 60% of the area median income; may be lower in some communities)

Resources Contact the community directly for more information.

 

FRAIL ELDER HOME & COMMUNITY-BASED SERVICES WAIVER

The Frail Elderly Waiver is offered by MassHealth for residents who require nursing home level care to receive their care and support services in their homes or community living residences instead of in a nursing home.

Qualifications Applicant’s eligibility depends on age, location, functional ability and financial status; Must be at least 60 years old; People between 60-64 years must be physically disabled; Applicants must require the level of care provided in a nursing home setting but be willing to receive the care at home; Cost to provide care cannot exceed what it would at a nursing home; Must meet MassHealth financial requirements.
Resources Paying for Senior Care:

MassHealth Senior Guide to Health Care Coverage: https://www.mass.gov/files/documents/2016/10/mp/saca-1-english-mb.pdf