It all started when...

MassHealth proposes to cap PCA hours to 40 per week

By: Burt Pusch, Rh.D, Director 

A 2015 U.S. Department of Labor decision made persons working as personal care attendants (PCAs) eligible to receive overtime pay for hours worked in excess of 40 hours per week.

The 2016 budget for the MassHealth PCA program is $704 million. Currently an estimated 7,300 consumers have PCAs who work more than 40 hours/week for them and/or other people with disabilities. This means approximately 6,000 PCAs are currently collecting overtime pay (1.5 times the regular pay rate). The federal decision to require overtime pay for hours worked in excess of 40 per week is estimated to cost the State of Massachusetts an additional $57 million in 2016.

In an effort to control costs, the Executive Office of Health and Human Services (EOHHS) has proposed to cap PCAs to working only 40 hours per week, regardless of the number of persons with disabilities who employ them. The proposed MassHealth rule changes may have significant implications for persons with disabilities who rely on PCA services and for individuals who work as personal care attendants.

For PCAs, the proposed rules will limit the number of hours they can work as a PCA each week to 40 (unless an exemption is applied for and authorized by MassHealth). PCAs currently earn $13.68 per hour. Working 40 hours per week, the average PCA earns approximately $28,000 per year (before taxes). In many cities throughout Massachusetts, this would not be considered a living wage. Therefore, many PCAs currently work 40 to 60 hours per week for one or more people in order to make ends meet. The proposed rules would essentially stop this practice. A single PCA would only be allowed to work 40 hours per week, unless a consumer received prior approval for working overtime from MassHealth (MassHealth is establishing an exemption policy). 

For persons with disabilities, the proposed rules have the potential to: (1) lose one or more of their current or back-up PCAs who work more than 40 hours per week for them and/or other people with disabilities, (2) reduce the number of hours (and therefore pay) of some of their PCAs, and/or (3) hire additional PCAs to ensure no single PCA works more than 40 hours per week.

 

The proposed 130 CMR 422.000: Medical Assistance Program: Personal Care Services rules:

 

  • Go into effect on July 15, 2016
  • Limit overtime usage beginning September 1, 2016 (PCAs would be limited to working 40 hours/week, regardless of the number of persons with disabilities they work for)
  • Persons with disabilities will have to determine if any of their current or back-up PCAs are working more than 40 hours per week (for them and/or other people with disabilities)
  • If persons have PCAs who are working more than 40/hrs week they have until August 31, 2016 to:
  • Reduce or change their PCAs work schedule so that none of their PCAs work more than 40 hours per week, or
  • Hire additional PCAs or let some PCAs go to ensure no single PCA works more than 40 hours per week, or
  • Request an exemption from MassHealth to allow a PCA to work more than 40 hours per week

 

To learn more about the proposed changes, you can contact Colin Killick at the Disability Policy Consortium (DPC).  You can reach Colin at ckillick@dpcma.org or 617 542-3822.

Persons may review a draft of the proposed changes by going to  www.mass.gov/masshealth/proposedregs or they can request a copy of the proposed regulations in writing or in person from MassHealth Publications, 100 Hancock Street, 6thFloor, Quincy, MA  02171.

The deadline for submitting comments regarding the proposed PCA overtime regulations is July 8, 2016 at 5 pm. Individuals may submit their comments and concerns about the proposed changes to MassHealth by emailing masshealthpublicnotice@state.ma.us. If you email your comments, MassHealth asks that your comments and concerns be attached as a Word document or as text within the body of the email with the name of the regulation (130 CMR422.000:  Medical Assistance Program:  Personal Care Services) in the subject line. All submissions must include thesender’s full name, mailing address, and organization or affiliation, if any.

Individuals may also submit written comments by mail to: EOHHS, c/o D. Briggs, 100 Hancock Street, 6th Floor, Quincy,MA 02171.

OCO attends “Building Careers – Building Lives” Conference in Worcester

By: Bill Griffin, JD, Deputy Director

The One Care Ombudsman Office was delighted to have a presence alongside One Care at the annual Massachusetts Rehabilitation Commission’s Consumer Conference. This conference was entitled, “Building Careers – Building Lives” and occurred at the DCU Center on Thursday June 23rd, 2016. The conference offered an opportunity for consumers, employers, advocates and all people with disabilities to network with one another in an educational environment. The OCO was able to connect with many individuals that day and provide our promotional materials to attendees.

One Care Enrollee Perspective

By: Debra Groomes, Tufts Unify Enrollee, Consumer Advisory Board Member

Since joining Tufts Unify I have been very pleased with the quality of my care and the support I receive from my care team. My Care Manager and I discuss my needs and she helps to resolve issues that I identify that help me manage my day to life regardless of my physical limitations.

For example, I have lots of problem walking and I tend to fall a lot. Not only have I had surgery on my knee but I also have lots of complications with my feet. I am currently living in an apartment building on top of a hill. The laundry room used to be located on the 1st floor, which was very convenient for me since it was the same floor I live on. Unfortunately, the building manager moved the laundry room to another building on the same street and down a steep hill. Due to my mobility issues, this was very inconvenient not only for myself but to other tenants as well. It is impossible for me to move around freely, and there was no way I could manage laundry baskets while maintaining my balance. This left me with little to no access to the laundry room.

I contacted my Care Manager and expressed how it was affecting me not having access to the newly located laundry room. My Care Manager listened and offered me solutions to the problem. I now have a person who comes to my home and assists me with all my laundry on a regular basis. I am so grateful for the program and the impact it has made on my life, I would never want to be without my Care Team.

OCO IMPACT

A new One Care Enrollee contacted the OCO shortly after signing up confused about the Independent Living model and Care Team member roles. The OCO was able to educate the member on the Care model and also work with Customer Service at the plan to verify this Enrollee's Care Team members and also initiate additional communication between the Care Manager and the Enrollee.  

.
GENERAL INFORMATION

       One Care Plans

       Additional Resources