State seeks to reassure adult day health centers
State health officials have committed to changing a plan to implement new rules for day health centers for sick and frail adults after drawing a torrent of concerns that their plan risked cutting critical services for thousands of people.
MassHealth, which covers the state’s poor and elderly residents, proposed new rules several weeks ago in an effort to tighten oversight and ensure “program integrity.” But the proposal caused a backlash in the adult day health industry, where executives said the rewritten rules would have eliminated nursing care and supervision for people who had nowhere else to turn.
On Thursday, MassHealth director Daniel Tsai met with members of the industry and clarified that the state never intended to disqualify thousands of people from the program.
MassHealth spokeswoman Sharon Torgerson said Friday that the Massachusetts Adult Day Services Association, a trade group for the industry, provided “helpful feedback” on the rules.
“MassHealth agrees with the suggested clarifications and will be incorporating the language into the final regulation,” she said.
Michele Keefe, executive director of the industry association, said Friday that she felt relieved after getting assurances from MassHealth.
“My concerns have been allayed because I spoke directly with Daniel Tsai . . . and him making a commitment to us,” Keefe said. “We’ll have to take them at their word.”
Adult day health centers provide nursing, therapy, personal care, nutritional help, and other services. Advocates for the program say that for some adults, day health services are a better and cheaper alternative to nursing homes, allowing them to receive support and still live independently.
Adults served by the program include those with chronic physical and mental conditions, from diabetes and congestive heart failure to dementia and schizophrenia. They also include people who need help with daily activities, such as using the bathroom.
Executives of adult day health centers across the state had feared that MassHealth’s initial proposal to change regulations would have sharply restricted eligibility, causing as many as 6,000 to lose access to services.
Hundreds of people, including industry executives and elderly patients with wheelchairs and walkers, turned out to a public hearing in September to protest the planned rule changes. They filled a meeting room in Worcester, frequently clapping, cheering, and waving signs when speakers testified against the changes.
Following that hearing, and inquiries from the Globe, MassHealth officials clarified their intentions with the industry.
MassHealth officials said they have been talking to the industry since mid-September. They had argued that only about 200 people could potentially become ineligible for services under their new rules, and said their proposal had been “widely misinterpreted or misunderstood.”
The state spent an estimated $109 million on adult day health in the last fiscal year, up from $94 million five years earlier. That is just a fraction of the overall budget for MassHealth, which costs the state and federal governments some $16 billion a year and covers 1.9 million Massachusetts residents.
Many of the seniors enrolled in day health services said they are grateful for the program, and had worried that rule changes could cause them to lose access to the centers.
Enomine Gaston, who became deeply depressed after she lost her husband to an illness several years ago, said she has found much-needed help for her health conditions at the Rogerson Communities adult day health program in Roslindale. Three days a week, she is monitored by nurses there. She exercises and eats her meals. She chats with friends and occupies her mind with knitting, crochet, and crossword puzzles.
“Everybody is very caring,” said Gaston, 84.
Henry Jenkins, 79, started attending the same center after suffering a stroke 11 years ago. He couldn’t walk or talk or eat or use the bathroom without help.
Now, Jenkins speaks clearly and walks every day, thanks to the care of nurses and other workers at his adult day health center, he says. “I feel fine, I feel excellent. . . . I’m very, very independent.”
Mary Spivey began attending Rogerson’s adult day health center in Roxbury after she started falling eight years ago. She has severe arthritis, high blood pressure, and high cholesterol.
“I definitely need it,” said Spivey, 82. “This is the motivation for me to get up, get dressed, and go out every day. What would I do if I don’t do that? . . . That would be devastating for me.”
MassHealth officials expect to finalize the regulations in November.