Home care backers hope Baker will reconsider spousal plan
Backers of legislation to allow spouses to become paid home care providers hope a new look by the Baker administration at the finances underpinning the proposed program will buoy the bill's prospects in the Legislature.
Similar legislation passed the Senate unanimously last year, before stalling out in the House Ways and Means Committee. Yet when Senate Minority Leader Bruce Tarr offered the proposal as an amendment to the state budget in May, the Senate rejected it without debate, in part, based on a MassHealth analysis that the program would cost $17 million, according Senate Ways and Means staff.
Al Norman, of Mass Home Care, told the Committee on Children and Families on Tuesday that after helping to write the bill years ago he has "painfully watched it get hijacked by bad staff work."
Norman said he found out just last week that the $17 million cost estimate was based on "erroneous assumptions" that the Centers for Medicare and Medicaid would reject the program, costing the state federal matching funds for personal home care.
Sixteen other states, including California, allow spouses to be paid home care providers. The Veterans Administration also allows Massachusetts veterans to select their spouses as designated caregivers.
"That is just sloppy," Norman told lawmakers.
Norman said he was told this week by Health and Human Services Secretary Marylou Sudders that the $17 million estimate was wrong, and that the administration was taking another look at the policy believing the potential cost to be minimal, if not revenue neutral. A Sudders spokeswoman could not immediately confirm the conservation.
The bill (H 70), which was filed by Rep. Jennifer Benson and has 51 co-sponsors in the House and Senate, would allow spouses to qualify as paid home care givers for any community-based care program that allows other family members to serve in that capacity.
"I have not been able to see any reason spouses should be taken out of that picture," said Rep. James O'Day.
Norman said he has seen moral opposition in other states to compensating spouses based on marital vows, and some "unfounded" concerns that a policy change would have a "woodwork effect" of inducing demand for spouses to be paid for routine household maintenance tasks.
AARP State Director Mike Festa, a former House lawmaker and elder affairs secretary, told the committee there would be "no cost" associated with allowing spouses to provide care that would otherwise be provided by another personal care attendant.
A survey of voters aged 45 and older conducted by AARP found that 86 percent support allowing spouses to become paid personal care attendants and 70 percent say they have provided care, either currently or in the past, to an ill or aging family members.
Rep. Aaron Vega, D-Holyoke, teased Festa during the hearing that he had to stop reading his email over the weekend when the volume of messages flooding his inbox in support of the bill climbed to over 150. AARP generated thousands of emails sent to committee lawmakers by AARP members in the run-up to Tuesday's hearing.
Norman cited research published in The Gerontologist on California's spousal caregiver program that found "no financial disadvantage to Medicaid" and some benefits, including a lower rate of preventable hospital stays.
"It really seems like common sense to do this, which is maybe why we're having so much trouble here getting this done," said Rep. Shaunna O'Connell, R-Taunton, on the committee.
Spouses who qualify for personal care attendant status would be given training, support and oversight just as any other family members approved to deliver home care, according to advocates. They would not be paid for household chores such as cooking or cleaning that they would otherwise do as a spouse or member of the household.
"I just hope we can do this this year," Norman said. "I'm really getting tired of saying no to these to these spouses."
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