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June 8, 2006
SENATE BUDGET COMES OUT FAVORABLE FOR SENIORS
Last week the Massachusetts Senate passed their budget. The Senate budget contains several benefits for seniors not included in the House budget. Whenever the House and Senate pass budgets that are not identical, the differences must be hammered out by the Conference Committee. The Conference Committee is made up of 3 members from the House and 3 members of the Senate.
The six items added by the Senate are called “outside sections”. These outside sections will aid families and individuals who face nursing home placement. If you feel strongly about any of these outside sections, I ask that you call your Senator and Representative and ask that they support these outside sections. Here they are:
1) Outside Sec. 31
Community Spouse Resource Allowance Restoration(CSRA)
Without getting fancy, the CSRA is the amount of money the spouse at home is allowed to keep if her spouse needs nursing home care. This only affects married couples. Prior to 2003 if one spouse needed nursing home care, the spouse living at home could keep all of their money, up to about $90,000. Now the rule says you may only keep all of your assets if they amount to less than $19,908. If you have more than that, you get to keep half, up to $99,540, the current year, indexed for inflation amount.
For many years Massachusetts allowed the maximum allowance for the CSRA. In 2003, then Governor Swift used her 9B powers to cut the CSRA to the minimum federal amount, $19,908.
I am hoping that our legislature will return us to the rule in effect prior to 2003. Restoring the CSRA will allow elderly spouses, usually women and widows, to maintain a measure if financial security. Allowing them to keep more money will spare them from impoverishment and premature nursing home placement. Massachusetts has one of the highest costs of living in the country and making this change would be the right thing to do for seniors in Massachusetts.
2) Outside Sec. 77
Nursing Home 10 Day Bedhold
The 10 day bedhold deals with the following situation. Lets say that Uncle Fred is in the nursing home. Uncle Fred’s favorite niece, Patti is about to get married. The family would like to bring Uncle Fred to Virginia for the wedding. The problem is that Uncle Fred cannot afford to go to the wedding. He doesn’t have $1,000 to pay for the 3 days that he would be missing from the nursing home. The rule says that MassHealth will only pay the nursing home if you are there. If you’re not there, you have to pay. It’s almost like prison, because you can’t afford to leave.
The bedhold will pay for up to 10 days per year for medical and non-medical leaves of absence. Even with this policy, what happens if you were hospitalized for more than 10 days? You lose your room, unless you or a family member agrees to private pay for it.
3) Outside Sec.41
Long Term Care Commission
This outside section would establish a Long Term Care Commission to study provisions affecting the elderly. Outside Section 41 names a member of the National Academy of Elder Law Attorney to serve on the Commission.
4) Outside Sec. 61A
Emergency 30 Day Drug Coverage
This provision would give a 30 day supply of drugs for Medicare Part D beneficiaries who cannot access needed medications. In the past MassHealth paid for all prescriptions, but under the new and confusing Medicare Part D Plan, Medicare is now responsible for the prescriptions.
It seems to me that MassHealth should pay for all prescriptions costs not covered by Medicare Part D, but I guess 30 days is better than nothing.
3) Home Equity Exclusion Increased to $750,000
Line Item No. 4000-0600
The Deficit Reduction Act (DEFRA), passed on February 8, 2006, excluded people from MassHealth (Medicaid) if the equity in the applicant’s home exceeded $500,000. The Senate has opted, as allowed under DEFRA, to increase this amount to $750,000.
Also included in this line item is language retaining the current MassHealth clinical criteria for nursing home placement. In an effort to reduce state spending on nursing homes, MassHealth was going to become more restrictive in who it was going to pay for. Our present system is called Score 3. This means that you need assistance with at least 3 activities of daily living for MassHealth to pay for your care.
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, Massachusetts. He also holds Masters in accounting and a Masters 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 our web site at www.elderlawcenter.org