Older residents are footnotes in the political life of Massachusetts


By Al Norman

The start of a new year always reminds me of what I did not get accomplished the year before. As a lobbyist for the elderly, I admit that often it seems that the list of what I did not get done is longer than what I got done. Here are a half-dozen examples of things that I never got done in 2014:

alnorman_headshotSmall homes for seniors — I have been working for almost a decade to get the state to create “small homes” for up to four elderly people who otherwise would have to be in a nursing home. I got a small grant from a private foundation, and several homes were opened on the North Shore. Then a federal bureaucrat saw a story in The Boston Globe about this “back to the ranch” project, and said we did not have guidelines for these homes.

After nearly 10 years, the state has been unable to write regulations. Despite a promise from state officials, a new Medicaid program to help fund this program was not been submitted as 2014 closed.

Spouses as paid caregivers — I have been trying for at least eight years to pass a law allowing spouses of people on Medicaid to serve as a paid caregiver for someone trying to stay out of a nursing home. You can hire your sister, your Aunt, your daughter, your nephew, your neighbor Ernie — just about anyone — except your spouse. The State Senate unanimously passed this bill last June, but the House let it die. Medicaid staff worked on writing a plan to allow spouses as caregivers. They never completed it.

Cueing for personal care consumers — One of the largest home care programs in the state, the Personal Care Assistant (PCA) program, serves people who need hands on care only. If you have Parkinson’s disease, and cannot eat on your own, you can get a worker to feed you. But if you have Alzheimer’s and cannot remember to eat, you get no PCA help, because you don’t need hands on care.

Fast tracking of Mass Health applications — Filling out an application for Medicaid is harder than programming a NASA rocket. The 28 page application can take weeks to complete, and requires professional help. A bill to allow care workers to “fast track” Medicaid applications for people coming out of nursing homes back to the community died a slow death on Beacon Hill this past year.

Medication management — language to allow elders to have someone come into their homes and make sure that they take the right medications at the right time went nowhere again in 2014 — even though this is a service that could keep people out of nursing homes.

Ending Medicaid age discrimination — If you are 64 years old and apply for Medicaid, there is no asset limit. But when you turn 65, if you have more than $2,000 in assets, you cannot stay on Medicaid. This is age discrimination, pure and simple. But no one wants to touch it.

It would be easy to conclude from this list that I am just a lousy lobbyist. That’s probably true — but it’s not the whole story. Our elected officials are very sympathetic, in theory, to the needs of the elderly. So are the state officials who run the agencies who serve seniors. But despite the fact that seniors are now roughly 20 percent of the state’s population, and one of the few demographics growing rapidly, the sad fact is that the elderly agenda is not a priority on Beacon Hill — or anyone else. Want to see how we value the elderly; just watch a few episodes of the Simpsons.

I began working with seniors when I was a young man in my 30s. I am now on Social Security. Decades of neglect have passed, and I am still here to tell the truth: older people are a social afterthought. They are a footnote in the political life of this Commonwealth.

Al Norman is the executive director of Mass Home Care. He can be reached at info@masshomecare.org or at 978-502-3794.