[{"_1":2,"_124":-5,"_125":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100,112],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6181843,"mediaKeyId","5111964-3d7a03661977dcdd091a3aefa8e51434","parentId",5111964,"title","Mass. committee hears broad support for allowing family members, including spouses and guardians, to be paid MassHealth caregivers","audioSeconds",3512,"startMs",1230000,"endMs",4742000,"viewUrl","/Search/View?dp=1&key=5111964-3d7a03661977dcdd091a3aefa8e51434&start=1230&end=4742","thumbnailUrl","https://assets.pipeline.soar.com/5111964-3d7a03661977dcdd091a3aefa8e51434/thumbnail_1230000.jpg","articleUrl","/articles/6181843/Massachusetts/Mass-committee-hears-broad-support-for-allowing-family-members-including-spouses-and-guardians-to-be-paid-MassHealth-caregivers","mediaUrl","https://secure.pipeline.soar.com/6181843-6ec58c9026c6bea4e6769bb96961c215/orig.mp4?Expires=1770810219&Signature=LeyaVquwIpw1OVo-BiMxQPmdN55t4UL4oN7aW6hDdv~0NO0aMTMf4WfxRU9tMAyaEKwz1ncW~bS6bdn~0W4HGTkm1saPg4XsXtM-j0Ay9ZHYxXYltE~aXsWQyq~KHgqBwk7hM6J4F7ccqOpq7yl5mZS6ptlh3ae0C6JPeyvA8cJoCm9mltYPNvPyC08FsWjppwHwFMyrXSr6SH9JURyTw~ekkiAZ3Utwm9KrnVrkNA34a7OVgcv1WLbZwEZs5jHzasHwT7yXs44iJ2HrW5t2pctuVePe7NCftZRWuyiHZPfnSImo6wBJP~CKCQxtOz4DUapQWXbQ9Y93w7mMYHmGgQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Massachusetts Legislature","date","2025-07-01T00:00:00Z","article","The Joint Committee on Healthcare Financing convened a public hearing July 4 at the State House to hear testimony on legislation that would permit legally responsible family members, including spouses and guardians, to serve as paid caregivers under MassHealth home- and community-based programs (House Bill 1394 / Senate Bill 886 and related proposals).

Why the bills matter: supporters said the change would recognize care family members already provide, reduce financial hardship, and help keep people at home instead of in institutional settings. Christine Stanton, director of the Milton Council on Aging and a parent and guardian, told the committee: “This is an injustice.”

Advocates and providers offered three principal arguments. First, many families cannot hire outside staff because of wages, training needs, or geographic isolation; paying a family member can fill gaps that otherwise leave people without care. Lorena Silva, CEO of Vitra Health, testified the current rule “is outdated, inequitable, and harmful to families across the state.” Second, testimony from adult foster care and provider groups said expanding eligibility would draw on already-present caregivers and could produce state savings by avoiding institutional care. Third, speakers repeatedly framed the bills as equity measures that would help single parents, low-income families, and communities of color who rely on family-based care.

Who testified: family members and guardians described daily, unpaid caregiving and the financial toll. Christine Stanton said her son requires full assistance with activities of daily living and that current rules bar a parent or legal guardian from being paid under AFC or PCA programs even when no other caregiver is available. Daphne Egan, a single parent of a 22-year-old with complex needs, said she frequently works 16 hours a day without pay and called the rule “unjust” for single parents. Professional providers and trade groups — including Vitra Health, the Massachusetts Council for Adult Foster Care, and the Home Care Aid Council — urged the committee to allow spouses, guardians, and other legally responsible relatives to be compensated, and several witnesses referenced federal waiver pathways that would permit the change.

Clarifications and limits: witnesses and providers noted federal rules and MassHealth safeguards that would shape any change. Wendy Daigle of the Massachusetts Council for Adult Foster Care described the availability of federal waiver provisions and gave examples of daily stipends for adult foster care programs as part of her testimony. Testimony also noted existing MassHealth tools — background checks, training requirements, and service limits — that would continue to apply if family members were permitted to be paid caregivers.

Discussion vs. action: the committee took testimony only; there were no committee votes or formal actions recorded at this hearing. Multiple legislators and commission chairs signaled interest in the bills and took questions; Representative Adam Scanlon and others expressed strong support, saying the change would improve continuity of care and reduce workforce pressure.

What remains unresolved: proponents urged the committee to report the bills favorably and asked the executive branch to seek any necessary federal approvals. Witnesses acknowledged cost concerns raised in a 2018 MassHealth memo but argued that those projections did not account for current workforce shortages and potential savings from avoided hospitalizations or nursing home placements.

The committee is accepting written testimony through the stated deadline and will consider the legislation as part of its 2025 docket. Testifiers asked for a favorable report but did not describe any final executive action taken during this session.","mediaType","Video","parentTitle","Joint Committee on Health Care Financing\t7/1/2025","oneSentenceSummary","The Joint Committee on Healthcare Financing convened a public hearing July 4 at the State House to hear testimony on legislation that would permit legally responsible family members, including spouses and guardians, to serve as paid caregivers under MassHealth home- and community-based programs (House Bill 1394 / Senate Bill 886 and related proposals).","taxTitle","2025 Legislature MA, Massachusetts","taxId",77682,"location","Massachusetts","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6181833,"Providers and agencies urge clearer, more transparent MassHealth rate-setting to address home care workforce shortage",4669,981000,5650000,"/Search/View?dp=1&key=5111964-3d7a03661977dcdd091a3aefa8e51434&start=981&end=5650","https://assets.pipeline.soar.com/5111964-3d7a03661977dcdd091a3aefa8e51434/thumbnail_981000.jpg","/articles/6181833/Massachusetts/Providers-and-agencies-urge-clearer-more-transparent-MassHealth-rate-setting-to-address-home-care-workforce-shortage","https://secure.pipeline.soar.com/6181833-3e803b1e6cdb931fa5c0509c572e3e08/orig.mp4?Expires=1770810219&Signature=diNd3776XfH51cVro~6eLXasvbQtZrxm7T8cS5FqWXoQQ2UEo5UnNWZnUBCA2TfevbOyMv-aq7KfsZdLNHEfQYl8rLiDN779gXVQ6AbWHHIxT3tPb-0dium9eg5PQG4-eqQwo-lY-yMGkL2zpkbkWlFj~5eGi8UaH7ZlqIUf12EtfI~unDCeIKj32xH4DL7Q5tKQ7fZeaffJoPLatBCy~6QT5kOJThO4mCO6f2JwpLG-Q6L75c7uW8fdpETR0xTXtZCr5lFwhGRgZaj349EfdSPlVIVvKXcceoH04SvVoHeggD3XhIVp~boHp7fW7VMAhDBKDfeEutCHnZGyfksqfw__&Key-Pair-Id=KUT5TJCACFTXG","At a July 4 hearing, home health and home care providers and coalition representatives urged the Joint Committee on Healthcare Financing to advance legislation that would clarify how MassHealth and the Executive Office of Health and Human Services set rates for home health and home care (House Bill 767 / Senate Bill 870).

What advocates asked for: witnesses requested a transparent rate-setting process that accounts for all operating costs — including wage changes, paid family leave, payroll taxes, benefits and travel — and that requires EOHHS to file reports with the Legislature whenever new home health or home care rates are promulgated. “This legislation does not set rates for MassHealth or EOHHS. Instead, the bill seeks to improve the rate setting process by increasing the transparency, consistency, and accuracy of the methodology used to determine rates,” Representative John Gentile told the committee.

Scope of testimony: Harrison Collins of the Home Care Alliance of Massachusetts and Julie Watts Fekir of the Home Care Aide Council described persistent workforce shortages and waiting lists for in-home services, reporting that hospitals have patients cleared for discharge but waiting for home care because agencies lack staff. Provider witnesses listed specific cost drivers that current rate methodology does not consistently incorporate: minimum wage increases, paid family leave, health insurance and other employee benefits, recruitment and training costs, mileage/travel reimbursements, and administrative overhead.

Evidence offered: providers cited a February 2025 hospital report and executive office data showing patients delayed in discharge due to unavailable home services. Agencies asked the committee to require the executive branch to include detailed cost factors and to file concurrent reports with the Legislature so policymakers can see how rates relate to access and staffing.

Discussion vs. action: committee members asked follow-up questions; the hearing recorded testimony only and included no formal vote. Providers emphasized this bill would not itself set rates but would require a transparent process to inform rate setting and future budgets.

Next steps: providers asked the committee to report the bill favorably so the Legislature could receive standardized, verifiable inputs when evaluating home care rates and budgets.","Home health and home care providers told the Joint Committee on Healthcare Financing July 4 that unclear and outdated rate-setting practices have contributed to a worker shortage and service delays; they urged the Legislature to require transparent methodology and reporting (H.767 / S.870).",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6181838,"Advocates push MassHealth to cover ABA and essential therapies for adults with autism",1003,1482000,2485000,"/Search/View?dp=1&key=5111964-3d7a03661977dcdd091a3aefa8e51434&start=1482&end=2485","https://assets.pipeline.soar.com/5111964-3d7a03661977dcdd091a3aefa8e51434/thumbnail_1482000.jpg","/articles/6181838/Massachusetts/Advocates-push-MassHealth-to-cover-ABA-and-essential-therapies-for-adults-with-autism","https://secure.pipeline.soar.com/6181838-ba886627110c22c3d079c45cec96b3d8/orig.mp4?Expires=1770810219&Signature=GB5NAenp0iUwo52t-2oQB-Dck~FObpeVyV8kdU1BqSnFYYwZilF9KXSMzTPT0sQnJ3N7FU7SRDW7alIOfBu1L9BM4P08K1h9qGu0VQKDlgisSlp7KJx3UnSnGhtat2avIF7Zmw0FMGVcnarpYPKAp3-nNNgwD0~xSmGb6CekhBi3eOvKuV2hJJfl9bS7TQvn9yvUebv2C5pZD7cN82Guxd6euk~fK2eE5zE1K7nKsM1U~ymiSWNwXMMCZpZYqmb7jY2794x7IBSbdLGyFyRRn4azWpXSQ9QJ0IwRVbh233--f61t1p-QtwB0QhN21-slKUHoR4WOjr6pZB9KHlx-uA__&Key-Pair-Id=KUT5TJCACFTXG","The Joint Committee on Healthcare Financing heard testimony July 4 from parents, advocates and disability organizations urging MassHealth to extend coverage of applied behavior analysis (ABA) and other medically necessary services to adults with autism and intellectual and developmental disabilities (House Bill 1351 / Senate Bill 871).

Why it matters: advocates said ABA and other interventions are medically necessary for many adults with profound autism and that terminating coverage at age 21 creates a “cliff” that can lead to regression, emergency placements and higher state costs. Mara Sullivan, CEO of The Arc of Massachusetts, summarized the sponsors’ request: “Simply put this bill requires MassHealth to cover applied behavior analysis ABA for people with autism or intellectual and developmental disabilities over the age of 21 as private insurance already does.”

Testimony highlights: family members described concrete examples of skill loss and increased safety risks when services end at 21. Herb Cabral, a parent who has testified on this issue for years, described long-term gains from ABA for his son and warned that withdrawing services risks skill erosion. Josh Gladstone of the Massachusetts Developmental Disabilities Council emphasized that workforce shortages compound the problem: when day programs and provider capacity collapse, adults lose supports they previously relied on.

Costs and data: witnesses cited a 2023 autism commission report and pilot program data. The commission’s report included an estimate used in testimony that reflected average costs for services in a narrow age band; proponents also shared pilot results showing reduced maladaptive behaviors and said a CHIA cost study would be appropriate for legislative consideration. Advocates suggested looking at private insurance spending and pilot data to model MassHealth costs and potential offsets from avoiding crisis placements.

Discussion vs. action: the hearing recorded testimony only; no votes were taken. Committee members asked about population size and cost estimates; advocates offered program data and urged the committee to commission formal fiscal analysis where appropriate.

Next steps: advocates urged a favorable report and recommended further study and cost modeling by the committee or by state analytic agencies to quantify fiscal impacts. The committee remains open to written testimony through the deadline stated at the hearing.","The Joint Committee on Healthcare Financing heard testimony July 4 urging MassHealth to cover applied behavior analysis (ABA) and other medically necessary therapies for people with autism over age 21 (House Bill 1351 / Senate Bill 871).",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6181823,"School advocates back bill to return school‑based Medicaid dollars directly to school health budgets",786,6647000,7433000,"/Search/View?dp=1&key=5111964-3d7a03661977dcdd091a3aefa8e51434&start=6647&end=7433","https://assets.pipeline.soar.com/5111964-3d7a03661977dcdd091a3aefa8e51434/thumbnail_6647000.jpg","/articles/6181823/Massachusetts/School-advocates-back-bill-to-return-schoolbased-Medicaid-dollars-directly-to-school-health-budgets","https://secure.pipeline.soar.com/6181823-9c79be8230d76106702ab0162172c62a/orig.mp4?Expires=1770810219&Signature=RowobQ8peHW2HdDRm5zLhB2lhPv0VSgffzM4mhnqejlSC4-FZ81nxhTE3hPwrJnPPKLjpG5BRpS0chBCys7vtvYP3CVm6Ch0M36w5NC9OWtFJFgcvaHx7tj3sei4kLNe6TWiRB0kK7ZpprSMKXrpGDzpk-BJfCNH8VAJq~zPKTEAEoZW-OxyU9woCpo5v-KR2ou1yZqta0QVhIe9qIvDXmpFa6LGO8lbmIty7zh7wuyEEu236O9qdHDJJYhdi0fDH~YLwHUqWN8RkiGnbiEKU0aEHBwEaM2rHV2l83by1MSNqvxBP4ayk4fGkkj~FOHkyFTEdwY4KMaezqcJl5VF8g__&Key-Pair-Id=KUT5TJCACFTXG","Advocates for school‑based health services and therapy providers testified July 4 in support of S.862, a bill that would direct Medicaid reimbursement for medically necessary school services back to school budgets so districts can staff and sustain school‑based health and mental‑health programs.

Why the bill: witnesses said school-based delivery is where most children get mental-health and therapeutic care and that current reimbursement practice — where Medicaid funds flow to municipalities and may not be reinvested in the schools that generated them — disincentivizes districts from billing and building programs. Kelly English of the Children’s Mental Health Campaign said the measure “offers a critical and timely solution by ensuring these crucial dollars are returned directly to the school health budget.”

Testimony highlights: John Crocker, director of school mental health for Methuen Public Schools and founder of the Massachusetts School Mental Health Consortium, told the committee that students who receive services in schools are far more likely to complete treatment and that reinvesting Medicaid reimbursements in school health staffing would support prevention and reduce costly crises. Karen Hepler of the Massachusetts Association for Occupational Therapy described administrative barriers that have reduced participation in school Medicaid billing since a 2019 change, and she urged the committee to direct funds to school districts so they can build billing capacity and sustain services required by students’ IEPs.

Discussion vs. action: the committee took testimony and asked clarifying questions about municipal budgeting and how returned funds would be managed; no legislative votes were taken.

Next steps: advocates requested a favorable report so districts can more readily bill Medicaid and reinvest federal dollars into school‑based health and therapy staff while the Legislature considers implementation details.","Education and therapy providers urged the Joint Committee on Healthcare Financing to pass S.862 to ensure Medicaid reimbursements for school‑based medically necessary services are returned directly to school health budgets rather than absorbed by municipalities, arguing doing so would expand school mental and physical health services.",{"_33":113,"_35":36,"_37":38,"_39":114,"_41":115,"_43":116,"_45":117,"_47":118,"_49":119,"_51":120,"_53":121,"_55":56,"_57":58,"_59":122,"_61":62,"_63":64,"_65":123,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6181828,"Advocates press lawmakers to fix MassHealth spend‑down so frail elders can remain in the community",391,5892000,6283000,"/Search/View?dp=1&key=5111964-3d7a03661977dcdd091a3aefa8e51434&start=5892&end=6283","https://assets.pipeline.soar.com/5111964-3d7a03661977dcdd091a3aefa8e51434/thumbnail_5892000.jpg","/articles/6181828/Massachusetts/Advocates-press-lawmakers-to-fix-MassHealth-spenddown-so-frail-elders-can-remain-in-the-community","https://secure.pipeline.soar.com/6181828-ba050ab4906e645c62c63c3f0ade281e/orig.mp4?Expires=1770810219&Signature=R5nHg4JWWa-TKbPKc48VaX5AI1DU8RAEP9STeNls70jnnFrOSKsnW~AeXgR3NoqwNC-CxQa2t~ZyFehV3t8NFIuMv3iplCYEUOxDCBthhdrvWg9QsrWValc6Ow5N3qZHf9TO35gdvbKMdRjitfpZWmLZnyCKd52l~Iaf94uwORN5~jb39LZ0lqN4WDQ-kESfhXyTKhLZyCSksO7avhPDcuH6UA0KIo8J3WB-GKYqWC9Bxqd8hkuJ8OTowKQdblZYbVDxfuw1tna0mBjmXOFgbg0Om1h9poVB5VURexsovRcCOv3~-R3~mYsr-WRZ3Bq5I9TMTqXxsG1XtVmEolBjww__&Key-Pair-Id=KUT5TJCACFTXG","At the July 4 hearing, elder-care advocates and elder‑law attorneys urged the Joint Committee on Healthcare Financing to advance bills that would adjust MassHealth’s income eligibility rules so that older adults who exceed the current income trigger by a modest amount can remain eligible for community-based programs such as PACE (House Bill 1371 / Senate Bill 841).

Why the change: witnesses said the current deductible/spend-down formula can force people with slightly higher income to spend nearly all of their monthly income on medical care before MassHealth pays anything — leaving them with as little as $542 per month for living expenses and often pushing them toward nursing home placement. Clarence Richardson, executive director of the Massachusetts chapter of the National Academy of Elder Law Attorneys, explained the mechanics with a hypothetical: a person with $3,000 monthly income could face a six‑month deductible of $14,748 before MassHealth coverage begins, effectively forcing institutionalization for people who otherwise could remain in the community.

Evidence and fiscal notes: advocates argued the change would be fiscally sensible because community-based care is generally less costly than institutional nursing-home care. Jen Maynard of the MassPACE Association and elder‑law witnesses said MassHealth previously signaled support for adjustments and had discussed implementation timelines; they recommended the Legislature adopt a premium option that keeps people financially able to live at home.

Discussion vs. action: no committee votes occurred; witnesses requested favorable reports and called for implementation planning in coordination with MassHealth to ensure budget and operational readiness.

Next steps: advocates urged the committee to move the bill and to work with MassHealth on implementation timing and fiscal analysis so eligible elders can access PACE and waiver services without an untenable spend-down.","Advocates and elder‑law experts urged the Joint Committee on Healthcare Financing to approve legislation allowing certain applicants to pay a premium rather than meet a large six‑month spend‑down so they can access community programs such as PACE and waiver services (House Bill 1371 / Senate Bill 841).","actionData","errors"]

Article not found

Mass. committee hears broad support for allowing family members, including spouses and guardians, to be paid MassHealth caregivers

Providers and agencies urge clearer, more transparent MassHealth rate-setting to address home care workforce shortage

Advocates push MassHealth to cover ABA and essential therapies for adults with autism

School advocates back bill to return school‑based Medicaid dollars directly to school health budgets

Advocates press lawmakers to fix MassHealth spend‑down so frail elders can remain in the community