Current Actions

Support ASAP Home Care Funding Line Items

Mon, 28 Apr 2025 04:00:00 GMT

The Massachusetts State Legislature is in the midst of its Fiscal Year 2026 State budget deliberations. The Senate proposed budget does not include adequate funding for key home care line items 9110-1630 and 9110-1633, which fund home care services provided through Aging Services Access Points (ASAPs) in Massachusetts.

Sen. Patricia Jehlen submitted two amendments to fully fund these line items to sufficient levels for FY26. Jehlen's amendments would raise funding for line item 9110-1630 to $293,655,704 and $115,205,880 for line item 9110-1633, to cover the actual utilization in these line items. It is imperative that these line items be adequately funded to continue the important work that the Administration, the Legislature, the ASAP and provider networks have done to increase our direct care workforce and to ensure that we will not have to create pending referral lists for these important services.

Please use this action alert below to write to your legislator to urge your Senator to support Amendments #464 and #466 to the FY26 Senate Budget.

Oppose Cuts to Medicaid Federal Funding

Wed, 26 Feb 2025 05:00:00 GMT

The House of Representatives passed their budget proposal that proposes devastating cuts to Medicaid, which would result in millions losing access to Medicaid services across the country and especially in Massachusetts. Medicaid is the lifeline that keeps disabled people and children in their homes and communities—yet Congress is considering proposals that would slash funding, impose work requirements, and limit access to critical services, including home-based care services.

These proposed changes would threaten over 1.7 million members of the Commonwealth who are currently enrolled in Medicaid; removing their access to life saving home-based care services they need/deserve.

Please use this action alert to contact your members of Congress today to urge them to oppose any cuts and work requirements.

Urge Your State Legislature to Support a Cap on Temporary Staffing for Home Health and Hospice Services

Fri, 24 Jan 2025 05:00:00 GMT

In recent years, we have seen temporary nurse staffing (TNS) agencies become increasingly active in the home health and hospice care delivery arena. Historically – home health and hospice agencies have utilized TNS’ on an emergency basis. But more recently, provider agencies have faced an influx of interest in the home-based care space by these TNS’. Because these entities demand contracts that far exceed what is currently reimbursed to home health and hospice agencies, they pose a threat to providers' ability to recruit and retain its workforce. This will threaten older adults' access to available home health and hospice services. Currently, there is a Department of Public Health (DPH) regulation which sets caps on temporary nurse staffing rates. However – the underlying Massachusetts General Law (MGL) which gave DPH authority and directed them to establish this regulation, did not include home health and hospice.

Because of this, Senator John Velis and Representative Paul Donato have introduced legislation which would amend the MGL to include home health and hospice and which would give DPH the authority to set caps temporary nurse staffing rates for home health and hospice services.

Use this action alert to urge your legislator to co-sponsor H.2408/S.1633, An Act Relative to Staffing at Home Health and Hospice Agencies.

Urge Your Legislator to Support Licensure of Home Care Services

Thu, 23 Jan 2025 05:00:00 GMT

Massachusetts remains one of a handful of states without a licensure structure as a condition to provide home care services. In 2017, Governor Baker signed into law a framework for the Department of Public Health to establish a licensure structure for 'skilled' home health services. This framework did not include non-medical personal care services.

For many years, the Home Care Alliance has supported and advocated for legislation which would establish a licensure structure in Massachusetts. It is our vision that this regulatory structure would establish a baseline set of standards for home care agencies to comply with in order to lift up the industry at large and protect consumers.

Take action today by writing to your state legislators urging them to co-sponsor SD.1036/HD.1449, an Act to Improve Massachusetts Home Care, which would create a licensure system that would establish baseline standards for agencies, to ensure a quality network of providers for consumers and keeping services affordable for those who rely on them.

Urge Legislator to Support Extension of Telehealth Flexibilities

Tue, 17 Dec 2024 05:00:00 GMT

Congress is once again working to pass a final fiscal budget before the March 14th deadline. With crucial telehealth flexibilities set to expire on March 31st, it is imperative that a provision is included in any budget package that would extend the telehealth flexabilites.

Originally created during the first Trump administration, these telehealth flexibilities expanded the types of practitioners eligible to offer telehealth services and allow Medicare beneficiaries to receive virtual care in their homes and through audio-only calls. home-based care patients and providers have benefited immensely from authorized telehealth flexibilities for the Face to Face (F2F).

If these flexibilities are not extended, the consequences will be dire for patients. This would leave only doctors and NPs the ability to conduct the F2F encounter, straining limited staff resources. These would lead to a lowering in overall care for patients who need it them most. Providers cannot return to spending time traveling and accruing the costs and risks involved. Providers need to be given the ability to provide care to those who need it in a way that is most convenient.

We need your help! Please use this action alert to urge Members of Congress to support the telehealth extension provision by voting to pass this stopgap package or for the telehealth extension to be included in any final package or CR.

Support Supplemental Budget to Fund ASAP Home Care Rates

Fri, 29 Nov 2024 05:00:00 GMT

This week, the Healey Administration introduced a supplemental budget which includes over $60 million in funding for ASAP Home Care line items for FY25. The State Home Care Program is a program of the ASAP (Aging Services Access Point) network across Massachusetts, and it incorporates services such as homemaking, personal care, home-delivered meals, day programs, complex care oversight by a nurse, and so much more. These services are critically important to help older adults remain at home and prevent or delay more costly nursing home stays, while enhancing quality of life, and lowering healthcare costs.

The Massachusetts State Home Care Program is funded through two primary line items in the state budget. Both of these items were woefully underfunded in the FY25 budget. The accounts will run a deficit even based on current utilization, and this deficit grows even more alarming when looking at anticipated growth in the case load throughout the coming fiscal year:

Line Item 9110-1630 (Elder Home Care Purchased Services); Expected FY25 deficit: If no additional program growth: anticipated deficit of $35,218,056; Based on current utilization trends of 8% growth: anticipated deficit of $46,107,642;
Line Item 9110-1633 (Elder Home Care Case Management); Expected FY25 deficit: If no additional program growth: anticipated deficit of FY25 of $4,028,366 Based on current utilization trends of 8% growth: anticipated deficit of $8,622,226;

The supplemental budget would help to mitigate the a potential deficit for both line items for the rest of FY2025. Please use this action alert to write to your legislator urging them to support the supplemental budget proposal!

Tell CMS to pull the 80/20 provision from the Medicaid Access Rule

Mon, 29 Apr 2024 04:00:00 GMT

In the Medicaid Access Rule, CMS finalized a requirement that no less than 80% of all Medicaid payments, including but not limited to base payments and supplemental payments, be spent on compensation to direct care workers, for homemaker services, home health aide services, and personal care services. This requirement applies to services delivered under sections 1915(c), (i), (j), (k), and potentially also 1115 of the Social Security Act as well as those delivered through managed care contracts. Notably, it would not apply to 1905(a) State plan personal care and home health services.

The rule defines “compensation” narrowly as:

Salary and wages;
Benefits (such as health and dental benefits, paid leave, and tuition reimbursement);
The employer share of payroll taxes for direct care workers; and
Other remuneration as defined by the Fair Labor Standards Act

Importantly, the rule’s definition neglects to include other crucial costs necessary to provide services.

There are significant negative outcomes that would occur if the 80-20 provision is finalized, including:

This provision will reduce, not increase, access. Individuals who rely on HCBS to live their lives in home-based settings will lose services, particularly if providers cannot meet these new requirements or are forced to restrict innovative, value-added care supports.
The provision appears to have been arbitrarily created and not based on data or an explained rationale.
The restrictive threshold definitions will serve to limit resources for caregiver support and other enhanced care-focused operations, resulting in reduced quality, health and safety, and oversight in HCBS.
The blanket approach undermines state autonomy, creates stark inequities across and within states, limits the ability to modify program requirements, and penalizes providers and states that have more regulation and oversight.
The provision seeks to establish precedent that CMS/HHS has the authority to dictate how state Medicaid dollars are spent by private entities.
CMS imposes this mandate with no existing or planned infrastructure for collecting and reporting out accurate information, financing to support added resource needs, or data to ensure that the dollars are being distributed as intended.

Support ASAP Home Care Programs

Wed, 04 Jun 2025 04:00:00 GMT

The State Legislature is in the midst of their budget deliberation and we need your help to make sure that ASAP home care programs receive the funding they need to support the growing demand for services!

We are requesting that the FY26 budget conference committee retain the House recommendation of $280,355,704 for Home Care Purchase of Services (line-item 9110-1630) and the joint recommendation of $110,705,880 for Home Care Case Management (line-item 9110-1633), the two key items that support the home care services that help to keep older adults out of costly nursing homes and allow them to age at home safely and with dignity.

Without appropriate funding, consumers will not be able to receive the care they need in the setting of their choice! Please help us by using this action alert to write to members of the FY26 Conference Committee to support home care programs!

Support the Credit for Caring Act (S. 3702/H.R. 7165): Empowering Family Caregivers

Thu, 15 May 2025 04:00:00 GMT

The caregiving community is rallying behind legislation aimed at alleviating the financial strain faced by millions of family caregivers across the nation. The Credit for Caring Act of 2024 (S. 3702/H.R. 7165), introduced by Senators Michael Bennet, Shelley Moore Capito, Elizabeth Warren, Susan Collins, Maggie Hassan, and Lisa Murkowski, alongside Representatives Linda Sánchez and Mike Carey, seeks to provide essential financial support to these unsung heroes. Passage of this legislation is critical to recognizing and valuing the invaluable contributions of family caregivers and ensuring their ability to continue providing quality care to their loved ones.

What does the legislation do?

Offers a federal tax credit of up to $5,000 for eligible working family caregivers, aiming to alleviate financial burden and enable caregivers to focus more on providing quality care.
Covers out-of-pocket expenses such as home care, adult day care, and transportation, providing tangible assistance to caregivers and reducing financial stress.
Provides a nonrefundable tax credit adjusted for inflation, ensuring ongoing support and recognition of caregivers' contributions to society.

Why is this important?

Family caregivers face significant financial strain due to the costs associated with caregiving, including expenses that often exceed 25% of their income. Many caregivers experience financial setbacks, including depleting personal savings and reducing retirement savings, while others are forced to leave the workforce or reduce their hours. The Credit for Caring Act of 2024 addresses these challenges by offering much-needed financial support to caregivers, enabling them to continue providing essential care to their loved ones while also acknowledging their invaluable contributions to society.

Factsheet: Link to File

What does the legislation do?

Offers a federal tax credit of up to $5,000 for eligible working family caregivers, aiming to alleviate financial burden and enable caregivers to focus more on providing quality care.
Covers out-of-pocket expenses such as home care, adult day care, and transportation, providing tangible assistance to caregivers and reducing financial stress.
Provides a nonrefundable tax credit adjusted for inflation, ensuring ongoing support and recognition of caregivers' contributions to society.

Why is this important?

Factsheet: Link to File

Tell Congress to stop the Medicaid HCBS 80/20 pass through!

Thu, 15 May 2025 04:00:00 GMT

In the Medicaid Access Rule CMS finalized a requirement that no less than 80% of all Medicaid payments, including but not limited to base payments and supplemental payments, be spent on compensation to direct care workers, for homemaker services, home health aide services, and personal care services. This requirement applies to services delivered under sections 1915(c), (i), (j), (k), and potentially also 1115 of the Social Security Act as well as those delivered through managed care contracts. Notably, it would not apply to 1905(a) State plan personal care and home health services.

The rule defines “compensation” narrowly as:

Salary and wages;
Benefits (such as health and dental benefits, paid leave, and tuition reimbursement);
The employer share of payroll taxes for direct care workers; and
Other remuneration as defined by the Fair Labor Standards Act

Importantly, the rule’s definition neglects to include other crucial costs necessary to provide services.

There are significant negative outcomes that would occur if the 80-20 provision is finalized, including:

This provision will reduce, not increase, access. Individuals who rely on HCBS to live their lives in home-based settings will lose services, particularly if providers cannot meet these new requirements or are forced to restrict innovative, value-added care supports.
The provision appears to have been arbitrarily created and not based on data or an explained rationale.
The restrictive threshold definitions will serve to limit resources for caregiver support and other enhanced care-focused operations, resulting in reduced quality, health and safety, and oversight in HCBS.
The blanket approach undermines state autonomy, creates stark inequities across and within states, limits the ability to modify program requirements, and penalizes providers and states that have more regulation and oversight.
The provision seeks to establish precedent that CMS/HHS has the authority to dictate how state Medicaid dollars are spent by private entities.
CMS imposes this mandate with no existing or planned infrastructure for collecting and reporting out accurate information, financing to support added resource needs, or data to ensure that the dollars are being distributed as intended.

Support Reforms Home Care Rate Setting Processes

Thu, 15 May 2025 04:00:00 GMT

Currently, agencies have been heavily reliant on non-guaranteed supplemental rate add-ons that have been passed by legislators through the state budget process. The Alliance has been actively working to pass legislation that would end the need for the Legislature to fund these supplemental rate add-ons for home care and home health workers every year. The goal is to ensure the existing rate setting process works and provides consistent rates that accurately reflect the true cost of providing home care and home health services to consumers across the Commonwealth.

This legislation would clarify the rate setting processes that are already in place for both home health and home care services. It does not set the rates or dictate the amount for future rates set by Mass Health and EOHHS. It would make the rate setting process more transparent and ensure rates set by the state follow proper laws and reflect the actual operating costs incurred by home health and home care providers.

Use this action alert to write to your legislator urging them to co-sponsor S.870/H.767, An Act Clarifying Rate Setting Processes for Home Care Services.