Adult children of seniors who need care at home can be caught in a difficult bind—wanting to provide the kind of substantial hands-on assistance that will permit a parent to remain at home instead of moving to a long-term care facility, but finding themselves unable to do so given their own financial need to work and the demands of their jobs. The MassHealth Personal Care Attendant (“PCA”) program can offer a solution for many families who find themselves in this situation. The PCA program can provide a person with approximately $13 per hour to pay a caregiver (including a child or other family member, so long as they are not the parent’s legal guardian or spouse).
In order to qualify for the PCA program, the parent must meet certain financial and clinical requirements. Clinically, the parent must require “hands on” assistance with at least two activities of daily living, such as transferring, toileting, dressing, bathing, and eating.
To be financially eligible, the parent is limited to between $980 and $2,199 of income per month, depending on their required level of clinical need and age. If the parent exceeds this income threshold, the parent can meet a deductible and still obtain assistance through the PCA program.
There is also an asset limit of $2,000. However, the Office of Medicaid is currently not imposing any penalty period for transferring assets at this time for this type of “community” MassHealth. In other words, there is currently no “five-year look back” for this program. Therefore, we can create eligibility for the PCA program for many families.
That said, it is extremely important that a parent seek counsel of an elder law attorney prior to making any transfer of assets to evaluate eligibility, advise on the impact of making transfers on things like income and capital gains taxes and a child’s divorce or creditors, and to discuss the impact of the transfer if the parent needs care in a nursing home down the line. There are generally ways to manage these concerns, but legal guidance is advisable.
You can read more about the PCA program in the MassHealth PCA Consumer Handbook.