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State to test subsidy program for home care of elderly, disabled

Since her elderly mother broke her hip and began using a wheelchair 10 years ago, Elizabeth Connolly has provided 24-hour care.

Bathing, cleaning, and cooking for her mother, who's now 100 years old, was a financial hardship, as her four children approached college age. But when doctors encouraged Connolly, now 59, to check her mother into a nursing home, Connolly refused.

"We're not going to let her die in a hospital," the Stoneham woman recalled telling them.

A new program enacted by the state Executive Office of Elder Affairs and the Office of Medicaid is aimed at easing the financial burden on families like Connolly's, by paying them about $18,000 a year to care for an elderly or adult disabled family member at home. The Connolly family is one of several dozen to benefit from a pilot program that will be instituted statewide on Dec. 1.

The Enhanced Adult Family Care Program addresses a growing shortage of paid professional caregivers, and the wishes of many elderly people to spend their last days at home.

"It just takes the pressure off," said Al Norman , executive director of Mass Home Care, an association of nonprofit providers. "You don't have to find new caregivers, you don't have to find new housing -- you're maximizing existing resources to keep people out of foster care homes."

In December 2004, Mass Home Care proposed the program to the Executive Office of Elder Affairs after studying a similar plan in Oregon. Representative Barbara L'Italien, Democrat of Andover, introduced an amendment to the budget for fiscal year 2006, and the state Senate and House agreed to provide the program at least $2 million a year.

MassHealth, which runs the program, anticipates about 30 new enrollees each month.

"Even with the $18,000, if you think of it as a wage, it's still abysmally low, but this is the best we can do," Norman said. "We're going to improve on it and build on it in time."

Compared with existing adult foster care support, the program broadens the spectrum of caregivers to include most family members and friends, other than a spouse, parent, or legally responsible relative. Elders and persons with disabilities may move into a caregiver's home or the caregiver may move in with the participant.

Financial eligibility for MassHealth, the state-funded health insurance program, is determined based on assets and income. The participant must require physical assistance with at least three basic activities, including bathing, dressing, and eating; or with the management of behaviors such as wandering or being verbally abusive or disruptive, said Jennifer Davis Carey , secretary of the Executive Office of Elder Affairs.

The new program also provides caregivers with support from healthcare professionals by linking them via computer to a nationwide network of credentialed care managers, known as SeniorLink.

Connolly is grateful that her mother can still attend Sunday dinners with the family, and that her four children have now pitched in to care for their grandmother.

"This is what family is supposed to do," said Connolly.

April Simpson can be reached at

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