Can you get MassHealth to pay your spouse for care?

Right now, the answer is “no.” If you qualify for MassHealth and need a personal care attendant (PCA), you can use MassHealth money to pay anyone to care for you except your spouse. Under current law, you can pay your fiance to provide care and MassHealth won’t mind, but your significant other would be off the payroll the moment you got married.

A new bill pending in the Massachusetts legislature would allow MassHealth to pay spouses of disabled persons for personal care attendant services. The present law was  based on the presumption that a married couple should care for each other; however, that presumption ignores hard economic reality. Many spouses are forced to drop out of the workforce or cut back to part-time hours to provide for care. The current MassHealth PCA rate of $13 per hour is not going to make anyone rich, but it could be the difference for a married couple struggling to keep a roof over their heads while living off of the disabled spouse’s Social Security check and (maybe) part-time employment for the healthy spouse — or putting the disabled spouse in a nursing home.

I encourage my readers to please contact their legislators and Governor Patrick’s office and tell them that this bill deserves a vote and passage into law.

Don’t be too quick to shred!

There’s been a good discussion on the National Academy of Elder Law Attorneys list serve in response to a USA Today article on shredding documents. The thesis of this article, like so many others, is that shredding “unnecessary” documents after tax season is critical to prevent identity theft. So, the article suggests destroying canceled checks once the bank statements have been reconciled, holding on to records for investment transactions to show the purchase or sale price for no more than three years after the transaction, etc.

There’s just one problem with this thesis: taxes aren’t the only reason why one should hold onto records. Before you purge, think ahead.

MassHealth applications for long-term care services require the applicant to produce five years of records., including tax returns, invoices for purchases in excess of $500, bank statements, canceled checks, credit card statements, etc., etc. If this information is not supplied with the application, the application will be rejected. I’ve lost track of the number of times I’ve asked clients to produce documents needed for a MassHealth application only to be told that they’ve been lost or destroyed. Then there’s the problem of getting duplicates of canceled checks or old bank statements. We’ve had one small bank tell us that they didn’t issue copies of statements if the statement was at least three years old. If there is a question about whether a transaction may have been a gift, we need to supply documentation showing what was purchased so that we can argue that there was no gift made or intended. For these reasons, I recommend that seniors hold on to five full years of financial records, preferably set up in chronological order.

There are other older documents that need to be retained as well. Veterans and their surviving spouses need discharge papers to apply for Veterans Administration benefits, such as Aid and Attendance. Invoices and canceled checks for improvements to one’s home are needed at the time of sale, so that capital gains tax liabilities can be properly calculated.

Pending Legislation in the MA Legislature to Support Family Caregivers —

According to a 2007 survey by the National Alliance for Caregiving, a broad-based coalition of organizations and corporations, family caregivers spent $5,500 of their own money caring for elders, not counting lost wages. Yet MassHealth has taken the position that family caregivers shouldn’t be compensated for the services they provide because family members are “supposed to” take care of their loved ones. Unfortunately, an agency’s peculiar 19th-century vision of a moral good doesn’t recognize hard truths. It is less expensive to keep elders in the community than for the state to pay for nursing home care. Yet spouses and children of disabled elders who put their personal and financial lives on hold — often for years at a time — lose the opportunity to pay into Social Security and save for their own retirements — thus increasing the risk of real poverty in their old age. They may be unable to pay current bills or help put children through college because they have stepped out of paid employment to care for loved ones.

Now the Massachusetts legislature has a chance to make it clear that this difficult work has true economic and social value. State Senator Mark Montigny and State Representative Kay Khan have introduced An Act to Help Families Care For Elders, House Bill 536, Senate Bill 59. The proposed statute would make it clear that elders could enter into fair and reasonable contracts for care with their loved ones where a medical professional or social worker has documented that the services are required to allow the elder to stay or return to the community. It would recognize the fact that families shouldn’t be forced to chose between paying for their own living expenses and caring for a parent. Hearings on this important bill will happen this week.

Please contact your state senator or representative and let him or her know that we shouldn’t penalize our elders because they choose to hire a child rather than strangers from an agency to give them care. You can locate your legislator’s telephone number and e-mail address by going to the Legislature’s main page and scroll down the left side of the page to the links by city or town.