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The greatest threat the home care system has face since it was created in 1973!

By November 6, 2017No Comments

Friends, Neighbors and Advocates,

Ethos, and our sister Aging Services Access Points, are facing a very serious threat in the state Senate’s health care bill, which will seriously diminish our role as a non-profit, community-based resource for elders who wish to remain at home. 

Attached are the amendments to this bill that Mass Home Care, our trade association, is pushing.   Sections 130 and 132 are the really serious threats.  

  • Section 130 opens the door for any elder on Medicare to be passively enrolled into SCO, something which federal law does not currently allow. It also allows prospective enrollment into the SCO program for anyone on Medicare who does not have enough income and assets to pay $27,000 for a nursing facility.That’s most of our current non-Medicaid clients.
  • Section 132 automatically enrolls all Medicaid members enrolled in home care into SCOs, and transfers funds out of home care to pay for their services.

Between sections 130 and 132, most of the people now in home care would be disenrolled from home care, and the resulting drop in clients would result in a drop in appropriation. It is like a vise squeezing out both Medicaid and Medicare clients.

Senate Health Care Affordability SWMS version KEY SECTIONS S 2202 11 2 17

We are seeking the deletion of Section 132 and a substantial rewrite of Section 130.   Together, they will have a very serious financial impact on Ethos, forcing a curtailment of services and a likely layoff of staff.  Waitlists could also be required. 

This is perhaps the greatest threat the home care system has face since it was created in 1973! Will you please help us by contacting your state senator?

Please feel free to use the email below as a template for your communication with your state senator.  If you are not sure who your state senator is, go to   


Dale Mitchell
CEO, Ethos


Dear Senator:

On behalf of the low-income elders served by Ethos, I am very concerned about 4 sections of the Senate Health Care bill, S2202, that forcibly enroll “lower income” seniors in your district into managed care plans – Sections 130, 132 and 133.     

Two of these sections – 130 and 132 – will also have a serious and possibly crippling impact on Aging Services Access Points (ASAP) like Ethos,  your district’s principal resources for elders seeking assistance staying at home and in the communities they love.  

Because these two sections require that Seniors who are currently receiving state home care services be forcibly transferred to (generally for-profit) managed care entities, these  sections sections will result in a loss of at least $400,000 per year for (non-profit) Ethos and millions more for other ASAPS. Services will have to be cutback, staff will have to be laid off and it is entirely possible that seniors seeking state-funded home care will have to be put on wait lists. 

Please support the following amendments

  • Amendment 23/ Regarding Transfers of Home Care Funding, filed by Sen. L’Italien. This amendment will strike Section 130 from S.2202.   Section 130 requires the forcible enrollment of certain elders currently receiving Ethos home care services into Senior Care Options (SCO) managed care plans.  This Section will eviscerate the Home Care program and seriously weaken Ethos as a community-based resource for elders in your district.   

Ethos estimates it could lose up to $400,000 per year through this amendment, forcing service cutbacks, lay-offs and home care wait lists.   Amendment 23 is a TOP PRIORITY FOR ETHOS.


  • Amendment 24/ Regarding Financial Eligibility for Medicaid, filed by Sen. L’Italien. This amendment will eliminate the requirement that certain elders be forcibly enrolled in Senior Care Options (SCO) programs.   Ethos supports self-determination and opposes the elimination of choice that is currently available to elders seeking help staying at home.   Ethos believes elders should be able to choose home care services as well as SCO or other managed care services.   


  • Amendment 9/ Regarding Coordinated Care Protocols in Public Housing, filed by Sen. Cyr. This amendment will eliminate the right granted to public and subsidized housing managers forcibly enroll elderly residents in Senior Care Options (SCO) managed care plans.  Ethos supports self-determination and opposed the elimination of choice that is currently available to elders in public and subsidized housing when they seek help staying in their homes.   Ethos works closely with many public and subsidized housing managers to assist needy elderly and disabled residents.   It does not believe their duties should be expanded to include resident health care decision-making. 


  • Amendment 13/ Improving Access to Home and Community-Based Counseling, filed by Sen. Jehlen.  This amendment will require that elders receive (or specifically waive their right to) community-based “options counseling” prior to nursing home admissions.   This requirement is currently in effect in Oregon and New Jersey.     


Thank you for your attention to and consideration of these important matters.