Tag Archive for: Home Care

Disability advocates rally against proposed cap on in-home aides

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This article was originally published on WBGH.

Hundreds of disability advocates gathered at the State House in Boston Wednesday for a rally to support the state program that provides caregivers to help people with disabilities and seniors live at home instead of in nursing facilities.

The Personal Care Attendant (PCA) program — part of MassHealth — serves more than 50,000 people across the state, but Gov. Maura Healey is eyeing caps in next year’s budget that would slow the growth of the program.

PCAs help people with daily living tasks like meal preparation, using the bathroom, getting dressed and getting out of bed. PCAs are hired and trained directly by the disabled “consumer.”

Last year, the Healey administration’s proposed budget would have removed 6,000 people from the program. But advocates pushed back and the legislature did not make cuts.

The PCA program annual costs have grown, from about $1.2 billion in 2020, to an estimated $2 billion by 2027. Due to projected rising costs, the Healey administration is proposing a cap that would tie spending on the program to benchmarks set by the Health Policy Commission in 2026.

Advocates say that could result in people not getting PCA services, or PCAs not getting wage increases in the future.

But the state says it would help put the program on a “ sustainable long-term fiscal trajectory. ”

“Our proposed budget does not make any cuts to the PCA program in FY26,” said Stacey Nee, a MassHealth spokesperson, in a statement to GBH News. “PCA spending continues to grow as a share of the state budget at an unsustainable rate. We propose aligning the program with other areas of health care spending in order to ensure that the program remains sustainable for the members who rely on it most.”

Matt Pellegrino, executive director of Northeast Independent Living Program, attended the rally and said the PCA program is unique in the level of care it provides. He said the increase in cost to the program shows how important it is.

“The program grows because the need is there, and there’s no other alternative to this program,” he said. “There [are] different services that might help someone in the home, but not at the same level, not with the self-direction that the program allows.”

State Senator Robyn Kennedy said that in the long run, the PCA program is still more cost-effective for the state.

“Compassion is cost-effective. Caring for people is cost-effective,” Kennedy said at the rally. “Arbitrary caps will not save us money. It will hurt individuals and put costs on other parts of our system … The most cost-effective care is home care. It’s helping individuals stay with their family, stay with their community, stay at home.”

Murshid Buwembo, a wheelchair user who works at the Boston Center for Independent Living, said that PCAs are a “driving engine” for people with disabilities.

“Without them we cannot go to work, we cannot live a better life,” he said. “If I’m working, I also pay taxes … I’m also part of that economic cycle.”

“Wheelchair users are humans too and we have to treat them like they are humans,” said Janice Guzman, a PCA, speaking in Spanish.

Gov. Maura Healey says GOP tax cuts would ‘devastate’ programs, put 2 million at risk of losing health care

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This article was originally published on the Berkshire Eagle.

BOSTON — Tax breaks that U.S. House Republicans outlined in a budget blueprint could “devastate” a slew of government programs, Gov. Maura Healey said Wednesday, and Medicaid cuts would put nearly 2 million state residents at risk of losing health care coverage.

“Democrats should be using every tool at their disposal,” she said in response to a question about resisting Republican initiatives.

The House budget resolution approved Tuesday night still needs to be hashed out in committees and in Senate negotiations before Congress votes on a final version.

“I mean, I don’t know how much worse it needs to get,” Healey told reporters after speaking at an event. “The $4.5 trillion tax cuts proposed by House Republicans are going to devastate — are going to devastate so many people, are going to wipe out so many programs, and are going to have a far-reaching impact, not just on the people who are going to lose their health care, who are going to lose their food programs, their housing.”

The budget resolution would extend expiring tax cuts from Trump’s first administration, which would total $4.5 trillion. The resolution could also translate into $880 billion in cuts to Medicaid, as Republicans look to rein in “unsustainable spending.”

Republican leaders say their budget would grow the economy by $2.6 trillion over the next decade, save $829 billion in “discretionary spending,” extend Trump’s “signature tax cuts,” and boost funding for border security and national defense.

Healey said her team examined the the budget resolution.

“We took a look at it as a team, just so you know, if that were to be passed, in our state alone, 2 million residents, including 700,000 children and 200,000 seniors, would lose health care,” she said.

Healey’s fiscal 2026 budget included more than $16 billion in federal revenue, with the bulk tied to Medicaid.

“Health care costs would double for more than 300,000 residents who use the Health Connector marketplace, and 1.2 million kids and families who rely on food assistance would have that taken away at a time when grocery prices are high and only getting higher,” Healey said at the chamber event. “So these kinds of cuts are immense. They’re going to cause unnecessary suffering.”

Addressing 700 business leaders, Healey asked, “Who do you think’s going to pay for that?”

“What’s going to happen to health care premiums? What’s going to happen to our health care system, health plans, and all the workers and businesses who depend on that when that federal funding goes away?” the governor continued.

As the U.S. House Ways and Means Committee dove into the budget resolution on Wednesday, U.S. Rep. Richard Neal invoked recent polling that found more than 80 percent of Americans “find it unacceptable to gut Medicaid to pay for billionaire giveaways.” Most of those people are Trump supporters, the congressman said.

“You’d think all this outcry would give our colleagues some pause. But you’d be wrong,” Neal said. “Instead, Republicans are doubling down on ignoring the American people’s fears by pursuing an agenda that could cut Medicaid by $880 billion and SNAP by $230 billion, while at the same time handing out a $1.1 trillion giveaway to those making over $743,000. The richest 1 percent.”

Pause is ‘not good enough’: Health facility workers, patients, and advocates rally to oppose closures

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This article was originally published on Boston.com

As AC/DC’s “Thunderstruck” blared down Beacon Hill, hundreds of nurses, teachers, patients, and advocates gathered along the front steps of the Statehouse Tuesday morning to protest Gov. Maura Healey’s proposed budget cuts that would limit health services at two state facilities and eliminate many case management positions from the Department of Mental Health.

The “Care, Not Cuts” rally formed in response to the Healey administration’s January announcement that it would be shuttering both Pappas Rehabilitation Hospital for Children in Canton and Pocasset Mental Health Center on Cape Cod in its proposed 2026 budget.

The night before the protest took place, Healey announced her administration would pause plans to close both facilities to “bring together a diverse group of stakeholders … to conduct a further review of the care offered at these facilities and make recommendations on the best path forward to ensure we are providing the highest quality of care with the resources at hand,” Healey said in a statement.

Many staff members and parents at Pappas said the pause is a good move forward — but not the end of the fight.

Pappas serves 36 patients between the ages of 7 to 22 who have physical and cognitive disabilities. Many state studies and reviews suggested that the decades-old infrastructure and technology is not up to date at Pappas.

Debbie Porter, a teacher at Pappas for 27 years and an Easton resident, said “Pappas is worth it” and that anyone who comes to see the 160-acre campus can see the work put into it by the staff.

“We’re here to support our students,” Porter said. “We know everything that Pappas has to offer them, and we want to continue for our students now and for our students and patients in the future.”

Franklin resident Kim Daley has served as an instructional support teacher at Pappas for 15 years and said Pappas is “encouraged” by the pause but acknowledged that more work needs to be done to make a full stop and receive funding.

“A pause is a time to reflect,” Daley said, “And we want that reflection to be that Pappas is staying where it is in Canton with the appropriate funding.”

Speakers from the American Federation of Labor and Congress of Industrial Organizations, Pappas, Pocasset Mental Health Center, and the Department of Mental Health shared how vital their services are to its communities and acknowledged Healey’s recent action.

“This is only a pause,” Alanna Stanley, a nurse at Pocasset since 2016, told the crowd. “We still need the governor to stop the cuts to case management and find the resources that we know are there to ensure a better mental health system for all.”

Many people made their way to the second floor of the Statehouse to speak directly to legislators. Sen. Paul Feeney, who serves the Bristol and Norfolk district and is a proponent for Pappas, said the facility has been “a miracle” for patients and families.

“For kids that have been standing up and fighting and persisting their entire lives, they didn’t realize that they were going to have to get into this fight,” Feeney said. “But you know what? They responded better than anyone I’ve ever seen.”

Parents of Pappas alums and the children themselves also shared some words to the full room.

“The services they [Pappas] offer, you can’t get anywhere else,” former patient Ann MacDonald said at the event. “The things I was able to do and the education I learned at Pappas are things people without disabilities take for granted every day.”

Back at the steps, Alma Alisch spoke to the large crowd with her son Billy, wearing a Brown University knit hat, sitting right next to the podium in his wheelchair. Alisch told the rally goers about traveling 200 miles each day to Boston Children’s Hospital for Billy’s cerebral palsy. It was unmanageable between her three other children and her husband’s sudden heart attack and eventual passing.

Alisch, from Seekonk, said since Billy’s admittance to Pappas in 2016, he has been engaged in recreational activities, such as swimming, and school. Billy especially enjoyed reading and writing and wrote a book about his late father, whose birthday happened to be on the day of the rally.

“[The pause is] not good enough,” Alisch said in an interview. “We won’t stop until we win.”

Healey seeks controls as home care costs soar

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This article was originally published on Daily Hampshire Gazette.

BOSTON — Gov. Maura Healey is proposing to limit spending on a rapidly growing home care program that is popular among the state’s expanding senior population but has become one of the state’s most expensive budget items.

The program, which provides personal care assistants (PCAs) for seniors and people with disabilities, has seen its costs soar from $1.2 billion in fiscal 2020, to an estimated $2 billion by fiscal 2027.

PCAs help individuals with daily tasks like bathing, dressing, meal preparation, and grocery shopping, allowing them to remain independent in their own homes rather than moving to nursing facilities. Providers warn that spending limits could affect this critical service for a high-needs population.

Program costs have risen by 67% over the past seven years, the Healey administration says, with state health officials projecting it could become the highest per capita cost for home care services in the nation by 2027.

In response, Healey’s annual budget proposes tying PCA spending to health care spending benchmarks from the Health Policy Commission to “ensure the program can sustainably serve its most complex consumers,” according to administration budget materials.

The governor recommended level-funding the program this budget year, after causing waves of protests last year when she proposed cuts to the program.

The proposal to tie program growth to benchmarks would cap MassHealth’s PCA spending at the HPC’s health care cost growth benchmark – a significant reduction in growth for the home care program.

The HPC set the cost growth benchmark at 3.6% this year, meaning health care spending is not supposed to exceed that increase over calendar year 2025. The PCA program grew from $1.2 billion in fiscal year 2020 to $1.6 billion in fiscal year 2023 — a 33% increase over three years.

Under Healey’s plan, any future growth to the PCA program would be subject to the HPC’s rulemaking process, including public feedback on proposed increases, according to the Executive Office of Health and Human Services.

“MassHealth is proud to have one of the most comprehensive Personal Care Attendant (PCA) programs in the country,” a MassHealth spokesperson said. “Spending on this important program continues to grow at an unsustainable rate and is on track to reach approximately $2 billion by FY27. Our proposal would align the program with other areas of health care spending. Our main goal is to ensure sustainable growth in the PCA program’s spending so that members can continue to rely on it.”

However, providers and advocates say that capping spending growth will cut off a rising number of people who need these services.

“All I can see is the need for the program to grow,” said Maura Sullivan, CEO of The Arc of Massachusetts, a nonprofit that advocates for people with intellectual and developmental disabilities.

Sullivan argued that with the state’s aging population and a growing number of adults with disabilities, there’s more need than ever for the state to invest in independent living programs.

In 2020, 14% of Massachusetts residents were aged 65 or older, and projections from the UMass Donahue Institute predict that number will reach 27% by 2050.

“We have an aging population. We have an aging disability population. We have more babies and young people living with disabilities who maybe would not have been saved just a decade ago, and now they’re thriving and living and deserve to live in their communities,” Sullivan said. “So all I see right now is a need to grow this wonderful program that allows people to access their community and thrive.”

Last year, the budget cuts Healey proposed would have saved $57 million, but disability advocates said 6,000 people would have lost services they needed to live at home. Healey recommended cutting off services for adults who received less than 10 hours of Activities of Daily Living (ADL) support from PCAs, and capping the hours that assisted living providers could do meal prep from 13 hours per week to seven.

The Legislature disagreed with Healey’s proposal and made no cuts to the program in fiscal 2025.

Sullivan said she worries similar service cuts would have to be considered with a spending benchmarks model.

“People with disabilities need this investment, and ultimately, we’ll all need this investment, because we’re all aging,” she said.

Sullivan serves on a commission convened by Healey to recommend ways to rein in program costs. She said she couldn’t say much about that commission’s work as they are not ready to release their recommendations, but they are “working hard with the administration to come up with a plan for sustainability.”

Commission member Rebecca Gutman, vice president of 1199 SEIU, the union that represents PCAs, said a report would be released in March with some of their ideas.

“Ultimately, that group is made up of advocates, and so as you can imagine, the advocates want to make sure that everybody’s getting the services they need, but we’re also very willing to engage if there’s efficiency to be made,” she said.

1199SEIU reached a contract with the state in 2023 that has gradually increased pay for PCAs, going from a flat rate of $18 per hour to a wage scale that goes up to $25 per hour based on experience. The union said the changes were necessary, as there’s a shortage of the workers – the majority of whom are women of color.

They negotiate a new contract in 2026.

“We don’t want to see people receiving care on the backs of women of color, we want to make sure that all of our members and all of our workers are paid fairly,” Gutman said. “But really, our primary focus is making sure that people with disabilities and elders get the care that they need, and the only way that will happen is if the program is funded and if there are decent jobs for the folks providing the care.”

Asked if she thought the projected $2 billion cost in fiscal 2027 was unsustainable and whether cuts were necessary, Gutman said the focus should be on improving efficiency rather than drastic reductions.

“Our budget should reflect our values,” she said. “And I think our values should show that we value the lives of people with disabilities and others, and we’re all going to be in that situation someday, if we’re so lucky.”