Remove the hurdles to assisted living

Retain the services allowed during COVID when emergency ends

AS THE POPULATION of Massachusetts ages, assisted living is becoming an increasingly popular option – safer and more supportive than being home alone, but not as intensive as a nursing home’s round-the-clock, medically-focused care. With a COVID-19 emergency order set to expire on March 31, state leaders are facing a choice about whether to permanently update our policies to provide seniors with the support they need.

When we surveyed our residents and their families about the value of assisted living, one phrase came up again and again: Peace of mind. Assisted living, which has been certified and regulated for nearly three decades in Massachusetts, combines residential and personalized support services designed to meet the needs—both scheduled and unscheduled—of those who require help with activities of daily living. Residents can receive help bathing, dressing, grooming, eating, and with other similar personal care needs.

While nurses serve residents in every assisted living community, state law historically prohibited them from providing any skilled care whatsoever to residents. In the cases where a resident needs care, they must have a family member administer it or arrange and pay separately for an outside provider.

During the COVID-19 pandemic, a state emergency order has allowed assisted living residences to deliver a handful of additional health services, including blood sugar monitoring for residents with diabetes, simple wound care for skin tears or other minor injuries, and assistance with oxygen. Unless state lawmakers act to make these common-sense health services permanent by the end of March, families could once again be forced to administer them personally or pay for private nurses.

We don’t believe that otherwise healthy older adults should have to pack up and move into expensive skilled nursing facilities due to their need for services as simple as a finger prick to check blood sugar. Some residents are going across the border to New Hampshire, Rhode Island, or Connecticut, where in-house treatments are permitted in assisted living.

Also distinct in Massachusetts, compared to more than 40 other states, is that the Commonwealth does not extend a Medicaid waiver to cover assisted living. Currently, our waiver only allows qualifying older adults to choose between home care services or skilled nursing facilities. It does not provide them with the popular option between those settings on the continuum of care – to live and receive care in assisted living.

How could we fix this? The state could extend the frail elder waiver to assisted living as a cost-effective approach to both save the Commonwealth dollars and provide independence and quality of life to older adults. The Healey administration could act on their own to develop such a policy with federal officials as part of the Medicaid waiver, or legislators could adopt a bill sponsored by Sen. Pat Jehlen of Somerville that would lead to research and a report from the Executive Office of Health and Human Services on how to implement this program.

Additionally, Massachusetts could help seniors (and keep more affordable residences open) by enhancing rates for Massachusetts’ support programs, such as Program of All-inclusive Care for the Elderly, Senior Care Options, and Group Adult Foster Care.

By strengthening our financial support and services for residents in assisted living, we have an opportunity to improve the lives of older adults who just need a little help to remain active and independent in the communities they love.

Brian Doherty is president and CEO of the Massachusetts Assisted Living Association.