Your MassHealth Services

In the spring we announced that the state Medicaid office was developing a plan to restructure its program and services. Why should you care? Many critical services come through this state agency. In our state, Medicaid provides these services through MassHealth or CommonHealth, public insurance programs (for the rest of the article we will use MassHealth for CommonHealth as well). At The Arc, Medicaid and Social Security are called the “Lifeline” for people with disabilities.

MassHealth recipients not only may receive health, oral health, and behavioral health services but they can receive services that help to live in the community. These include personal care attendant services (PCA), adult foster or family care (AFC, also “group adult foster care”), day habilitation Services (day hab), continuous or block nursing (Nursing), adult Day Health, and home health services.

Medicaid is now beginning the second phase of deciding how to restructure the program or what it calls “MassHealth Innovations”. Secretary Marylou Sudders announced early this year that the growth of the Medicaid program was not sustainable in its present form. She also said that the administration was committed to maintain a substantial program. During this phase, MassHealth officials are convening 8 workgroups on topics such as “strategic design”, “payment model design”, “health homes”, and “LTSS payment and care delivery models”. Several individuals from our broader community will participate in these groups.

Tsai and Taberner

Dan Tsai listening while Scott Taberner jots down comments

The Arc of Massachusetts has brought together staff and volunteers to develop a coherent policy on “MassHealth Innovations” in order to work effectively as the administration develops a plan. We were pleased that Assistant Secretary Dan Tsai (Medicaid Director) agreed to hold some focus groups in our community this past week. On Monday, a session with providers of I/DD services took place at ADDP. On Tuesday, August 11, a focus group with families and a self-advocate was held at The Arc of South Norfolk. In addition, MassHealth leadership made a number of home visits to get a first-hand sense view of family life and the use of MassHealth services. Assistant Secretary Tsai was joined by Chief Medical Officer Carolyn Langer and Director of Behavioral Health and Supportive Services, Scott Taberner. The focus groups included attendance by Commissioner Elin Howe, Assistant Commissioner Gail Grossman and Medicaid Program Director, Robin Lee.

We appreciate the time that participants took to help educate MassHealth officials. Likewise we thank Secretary Tsai and colleagues for making the time to listen and share the priorities of the innovations project. We also want to recognize DDS Commissioner Howe and her team not only for their participation as DDS can play an important role as plans are developed. There is much work ahead. As an advocacy organization we not only need to be able to advise planners as they make key decisions, but to keep you informed. We want the best possible outcomes for our constituents and others served by MassHealth and Medicaid.

Every quarter, MassHealth will host a public stakeholder session—we will keep you informed but you can also check at the MassHealth site (the next one will be in November, one was held on August 12). We asked that a several week notice be provided so we can help notify people.

We want to direct you to some MassHealth resources if you want more information. Please find the links below.

April presentation by MassHealth to Stakeholders

MassHealth’s summary of stakeholder sessions

General page on “MassHealth Innovations”

6 Comments:

  1. Linda Diaz and Tina Diaz

    How do we apply for Adult Foster Care. I have a 22 year old grandson with special needs. He requires a lot of my daughters help with every day things. How do we know if he qualities

    • Dear Linda and Tina-
      You can apply to any agency who provides Adult Foster Care (aka Adult Family Care) Here is the general eligibility requirements-
      To qualify for the services of an Adult Foster Care provider, a potential participant must receive a physician’s order detailing the participant’s specific daily needs. The agency providers who administer the program offer these and other services to participants through the registered nurse and care manager team members:

      Bathing, dressing and transferring.
      Meal preparation, shopping and transportation.
      Nursing services and oversight.

      To find a list of AFC agencies near you visit- http://www.massafc.org/provider-list
      Please note that most Chapters of The Arc are qualified to provide AFC services.

  2. Linda Diaz and Tina Diaz

    What is the process for applying for Foster Adult Care for a 22 year old disabled adult

  3. hello, my son have some mental problem, he needs medical attention , I am really concerned about him, please let me know how you can help him, his is now in Boston, it is a desperate mother asking for help, thanks for now!

    • Hello Marlene,
      We recommend giving our Director of Outreach and Education, Kerry Mahoney a call at 781-891-6270 x6109. She can provide you with some guidance on how to move forward.

  4. Do you know if the bills for day hab services and transportation to and from the program are eligible to go towards the one time deductible under commonhealth. Also do you know if commonhealth counts income for adult disabled who begins receiving benefits under retiring parents child benefit for disabled adult children in soc sec?

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