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April 2004 Letter to 4 State Representatives

April 16, 2004 

Representative Peter P. Larkin
State House Room 238
Boston, MA 02133 

Dear Representative Larkin: 

I am writing to ask your support for the following two amendments: 

  1.  An amendment (being offered by Representatives Sullivan and Cabral) to increase the   Protective Services account by $2 million to $11.6 million. 

  2. An amendment to Outside Section 79 (being offered by Representative Festa) which would create an expanded Medicaid 2176 community based waiver program at 300% of the Supplemental Security Income (SSI) level and a $20,000 asset test level.  Currently, these levels are 100% of SSI and a $2,000 asset test.  The waiver program is a very targeted and limited program, available only to those people 60 and over who, but for the provision of community-based services, would require a nursing facility level of care. Under the current levels, it is easier to qualify for nursing home care than it is to qualify for care in the community.   

Under federal law, a state may have a community based waiver program at 300% of the federal benefit rate under SSI.  The expansion of the community based waiver income eligibility criteria together with a $20,000 asset test level would allow more elders to be eligible for the program while they are still living at home in the community, and would prevent or delay nursing home admissions.  There are currently 3,846 slots in the state's enhanced home care program.  The state appropriates $37.48 million for the enhanced program (line item 9110‑1500).  Approximately 85% of these enhanced elders are not currently eligible for the waiver program because of the current income and asset levels.    

Expansion of the community based waiver to the level permitted by the federal guidelines would allow many more elders who are currently served by the enhanced program to be eligible for the waiver program, which would enable the Commonwealth to receive matching funds at the rate of 50 cents on the dollar for these services.  The state currently receives no federal matching funds for services to elders who are served by the enhanced program but are not currently eligible for the community based waiver program. 

Thank you for your continuing support for the Prescription Advantage Plan, the Councils on Aging, Choices, and the State Home Care Programs, including the enhanced program. 

Sincerely, 

Robert P. Dean
Executive Director