Having trouble navigating changes to MassHealth requirements? You are not alone.

Where Caring For Your Loved One is Our Priority

Whether you are just learning about Adult Day Health (ADH) programs, or have a loved-one in attendance already, the recent changes to MassHealth eligibility requirements may be confusing and disconcerting. We understand, and we are here to help.

Adult day health centers are critical for the wellbeing of our communities. ADH programs keep members of our communities aging in their homes for longer, help to promote stability for working caregivers and save the state of Massachusetts almost $60,000 per person each year compared to nursing home care.

Recently, MassHealth has revised their eligibility requirements for accessing ADH services. This has many ADH providers, like Cooperative Elder Services (CESI), and the various agencies referring their members to ADH programs, concerned not only about enrolling new participants but also about our current participants.

How do we know if someone will continue to be eligible? And what if someone is deemed as no longer appropriate for ADH? Where will they go?

Here are five things you need to know about these changes:

  1. Each person already in a program will be reassessed.  If questions or concerns about someone arise, MassHealth has created a revalidation form for programs to fill out and share with them. CESI and ADH programs across Massachusetts have been working diligently to complete these and return them so we can be working as quickly as possible if someone is ineligible.
  2. Our intake and admission processes will not change for new participants. That means the same team that has helped answer questions, lead tours, communicate with doctors’ offices, and work with families will still be in place. We will make necessary changes on our end, but are working to ensure minimum disruption to our service partners and families.
  3. If someone is deemed ineligible, we will work with you on a solution. CESI will work with case managers on discharge planning. Ideally, there will be no gaps in services but it is not clear yet how that will occur.
  4. We are doing everything we can to understand these new regulations, and make the transition easier on those we serve. Our leadership team recently attended a training provided by MassHealth to ensure we could answer that for our concerned community partners, and for internal planning purposes.
  5. We are also working every day on advocacy for our participants, caregivers, and staff alike. We are calling legislators, sending them mailings, inviting them for tours of our centers, and making trips to the State House.

To that last point, CESI has always advocated for families and we will continue to fight to ensure impacted families are able to access the services they need. We will work with state leaders to understand the importance of Adult Day Health programming and we will continue to work with families to ensure they know their options for adult day health services. 

We want to hear from you

Do you have a great story about how ADH has positively impacted your family, or someone you have worked with personally? Please share with us. You can reach out via email at outreach@elderdayservices.org, or by calling 781-863-1166 extension 104.

Please call your local legislators and tell them why you know ADH is important for your community. 

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