Caregivers at Home

Happy Holidays and Happy New Year! The New Year is a time when many elders and their families take action and hire a caregiver to help around the house.

At-home care can be a great alternative to a move into an assisted living facility, and there are many options for care. These options include hiring family, hiring independent third parties, and hiring a home-care agency. Before you select a caregiver, consider the following:

• Caregiver Contracts: No matter which type of care provider you select, be sure to have a contract with the caregiver that is carefully drafted to comply with Medicaid rules and regulations. Without a caregiver contract, your caregiver payments might be considered a gift and you might be subjected to a period of ineligibility if you require government assistance to pay for long-term care.

• Legal Responsibilities: In Massachusetts, the law presumes an employer-employee relationship. Even if you treat your caregiver as an independent contractor, and the caregiver agrees to the arrangement, you could still be considered an employer for purposes of Massachusetts worker’s compensation and wage laws. Employer-employee issues are avoided if you hire a home-care agency, because the agency is the employer of individual caregivers. (Check out the Law at M.G.L.c. 149 § 148B: http://is.gd/5ww3G)

• Liabilities: Even unintentional violations of the Independent Contractor Law are subject to civil citation (first offense up to $10,000) or criminal prosecution (up to six months imprisonment). (Check out the Law at M.G.L.c. 149 § 27C: http://is.gd/5wwaz)

• Reasonable Payments: Be sure that your payments to your caregiver are reasonable and proportionate to the services provided. If you make unreasonably large payments to your caregiver, it may cause problems for long-term care benefits down the line. If you are not sure about market rates, hire a geriatric care manager to value the services you are receiving.

If you are considering an independent caregiver, you may wish to seek the advice of an attorney to protect yourself from liability and to prevent problems with Medicaid if more comprehensive care is required down the road. If you cannot afford an attorney, you may qualify for free legal assistance. http://www.masslegalservices.org/directory and http://www.larcma.org/.

-Audrey

Something to Celebrate – Medicaid Services to the Elderly Preserved

We all have something to celebrate this season! Terry Dougherty, the Interim Medicaid Director of Massachusetts, notified the elder law bar that the adult dental program, podiatry services, PCA services, and day habilitation services will all remain intact and provided without limitations or restructuring of the benefit!

Rates will not be reduced for day habilitation programs, adult foster care, community health centers, and clinical labs. There will be no additional co-payments on office visits, dental services or non-emergency transportation, and co-pays will not be increased on the pharmacy products.

This change is the result of unexpected revenues from a significant tax settlement. Follow this link to the press release issued by Governor Patrick: http://is.gd/5eXbf

Happy Monday!

-Audrey