- Written by Roseann Martoccia, Executive Director
- Published: 25 January 2018
The growing elder demographic, better access to home care and what lies ahead
Based on census projections, it is estimated that 87,882 elders in Massachusetts are below 300% of poverty and have a disability. Currently, home care programs in the Commonwealth serve just over 47% of these elders through enrollment in Home Care, Enhanced Care Services and Choices. A goal for these three programs going forward is to reach and service a greater percentage of elders who need long-term supports and services and are not eligible for MassHealth. The two primary reasons are to keep them living independently in the community and to help them maintain their economic security.
Living Below the Line: Economic Insecurity Among Massachusetts Elders’ describes the needs of elders and their financial situation to meet basic living expenses (food, housing and health care). The 2014 study was conducted by the MA Association of Older Americans and Wider Opportunities for Women, and it describes the income (adjusted by county and household size) that elders need to afford the basics without going into debt or needing financial assistance from public or other sources. The report goes on further to say that “elders having difficulty living independently due to poor health are most likely to have elevated health care costs, and are highly likely to lack economic security.” Nearly three-quarters of elders who have difficulty with self-care are defined as “economically insecure,” and seventy-one percent of elders reporting having trouble living independently are also economically insecure.
These are precisely the elders who lack disposable income to purchase care privately and many of whom may not have informal or family caregivers to pitch in to provide the care they need. An important first step was taken in 2017 through regulatory changes brought forth by the Executive Office of Elder Affairs. People with incomes up to approximately $49,000 a year are now able to enroll in home care programs using a sliding scale to pay for a portion of their care based on their income.
While we will continue to advocate for resources in our state to support elders and their families, the potential for reductions in Social Security and Medicare may also be on the horizon. According to a Forbes article published December 3, 2017, there is likelihood that these two income and health programs will be impacted. Reductions in these programs have the potential to achieve savings in what is expected to be an increased deficit. The timing of such budget debates and actions are expected in 2018 or 2019. The Office of Management and Budget (OMB) projects revenue loss to increase the deficit by $1 trillion or more in 2019. With the numbers growing, it’s time to provide access to services, care supports and shore up income security for elders.