FOR IMMEDIATE RELEASE: March 4, 2013

Looking Out for Our Seniors
By Senator Katherine Clark

Ralph Waldo Emerson wrote that “the years teach much which the days never knew.” When we, as policymakers and taxpayers, make decisions affecting our seniors, we would do well to keep that sentiment in mind. 

As we start our budget discussions on Beacon Hill this month, the needs of our seniors will be front and center.  I will continue to advocate funding for local aid, transportation, elder nutrition programs like Meals on Wheels, home care services, and fuel assistance, all of which serve seniors in our communities.

Like our funding decisions, our elder policies and regulations at all levels of government should be designed to honor a lifetime of hard work and contribution, and to help those who really need it, not to punish seniors who have always followed the rules.

How we determine eligibility for public assistance (through MassHealth) for nursing home care is one such issue.  Currently, when MassHealth determines an elderly individual’s eligibility for support for nursing home care, the agency is required to look back over the last five years of the person’s financial history to ensure that no assets were transferred for less than fair market value.  In other words, the agency must search for evidence that a person transferred assets to others – family members, churches, etc. – in the hopes of reducing his or her own net worth and therefore qualifying for public assistance at some point in the future.

There is, of course, nothing wrong with this practice in theory.  MassHealth and all government agencies can and should be wary of any intentional schemes to defraud the taxpayers. However, in the case of the MassHealth “look-back” period, this often goes too far.

Many people innocently make gifts to grandchildren or others without full knowledge of these rules, and without ever contemplating how those gifts may be interpreted should they suffer a catastrophic illness or emergency that requires immediate nursing home care.  Once that crisis strikes, they may find themselves ineligible.

One problem with the current system is that there are no criteria in place for determining a person’s intent in making a transfer of assets.  To remedy this situation, I have introduced legislation that would protect innocent seniors from ineligibility for MassHealth nursing home care.  

The bill would establish specific criteria that would be used to determine intent.  For example, a regular pattern of small gifts (to a grandchild, for example), donations to a religious institution, or a transfer of funds for an unexpected illness or financial crisis of a family member during the look-back period would not necessarily disqualify a person from eligibility.  Instead, these types of transactions would shift the burden of proof to MassHealth to show that the transfer was made purely to qualify for benefits.

This minor change can have a profound impact on a family.  A family facing a health crisis for an aging parent or grandparent should not have to contend with arcane rules that do not reflect the intent of the financial decisions that their loved one made years earlier.  And it should not take expensive legal representative to sort it all out. 

This is a common sense solution for families and seniors; it is one of many policy changes that we need to allow our seniors to continue to live their lives with dignity.

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