Categorized | Pushback

Is Massachusetts Ready To Be An ‘Age Friendly’ State?

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In his Third State of the Commonwealth speech on Jan. 23, 2018, Gov. Charlie Baker announced “that AARP has formally designated Massachusetts as one of only two age-friendly states in the country.”

By Al Norman

In his Third State of the Commonwealth speech on Jan. 23, 2018, Gov. Charlie Baker announced “that AARP has formally designated Massachusetts as one of only two age-friendly states in the country.”  It turns out, only two states have applied for this designation. The governor said he had a goal of “making Massachusetts the most age-friendly state in the nation.” Baker sent a letter to AARP Massachusetts in which he said: “By enrolling in the network of Age-Friendly States, Massachusetts embraces the opportunity to promote and celebrate aging.”

If Gov.  Baker wants to make Massachusetts “age friendly,” here are 14  straightforward policy changes he can promote and celebrate:

? Stop forcing elders on Medicaid to enroll in health plans they did not choose. If such plans are so good, “passive enrollment” is not needed. Let seniors choose plans voluntarily, on their merits.

? Give all seniors enrolled in such managed care plan access to an independent agent who can help them determine what long term supports they need.

? Allow spouses to be paid as Personal Care Attendants, just like other family members currently.

? Don’t limit personal care services just to those who need “physical assistance.” Give people with dementia and other diseases who need cueing and supervision to in order to eat, bath, dress or toilet the chance to get such assistance too.

? Allow elders who are nursing facility eligible to live in small group home settings instead.

? Raise the minimum wage for the 30,000 home care aides in this state to $15 an hour, and continue to lift wages to keep up with inflation.

? Ensure that anyone seeking nursing facility care is given their legal rights to a free pre-admission assessment of their options for community-based care. This law has been on the books for 12 years and has never been fully implemented.

? Give all 3,000 “low acuity” elders in nursing facilities a special review to see if a community care plan can bring them home.

? Set a goal of having home and community based care become 75 percent of all Medicaid long term care spending by appropriating enough funding to pay for community care as a first resort.

? Stop cutting rates for Adult Foster Care, Adult Day Care and other community-based programs that need more funding, not less.

? Monitor nursing facilities to make sure that any resident who says they wish to return home is put in touch with counselors who can assess their potential to get back home.

? Lobby the federal government not to block grant Medicaid or create a per capita cap on funding.

? Push Congress to fund the continuation of the SHINE health insurance counseling program to help seniors know what kind of health plan makes the most sense for their individual needs.

? Stop allowing “desk reviews” of the care that elders need. All seniors should have a face-to-face eligibility determination by a care assessor who does not own services, not a “third party administrator” who adds another layer of bureaucracy, and delays care approvals.

In 2006 I helped rewrite Medicaid law to allow members to receive care “in the least restrictive setting” appropriate to their need. The purpose of this law was to prevent seniors from being isolated and segregated in nursing facilities when a more integrated approach was possible. Another Republican Governor, Mitt Romney, signed that bill into law. During the Romney Administration, the government referred often to its “Community First” mission, and wrote up a detailed “Olmstead Plan” for how to implement and promote care in the most integrated setting.

Now the buzzword is “age-friendly.” We don’t need to “promote aging.” We have 1.6 million older people who are already doing that. What we need to do is return to our “Community First” vision from a dozen years ago, and give seniors policies and programs that will help them live independently at home. That would really make Massachusetts, an “age-friendly” place to live.

Al Norman worked in the aging field in Massachusetts for 37 years as an elder advocate and lobbyist. He can be reached at




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