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. 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 |
GET ADDITIONAL HELP
If you have explored all of the community MassHealth and income-based assisted living options and you do not find something that fits, we can talk through your other options. Call us or book a free introductory phone conversation to learn more.