Suppose you care for a loved one in a nursing home or a long-term care hospital for at least 90 days and want to move back into the community with services. In that case, you may be interested in learning about the Community Living Waiver in Massachusetts. This waiver helps people who have disabilities or who are age 65 or older transition from institutional settings to home and community-based settings. It also allows participants to design and direct their services, including hiring and managing support workers, such as family members.
Ahead, we explore the Community Living Waiver in detail, including its eligibility requirements, services and supports, and caregiver compensation.
The Community Living Waiver is a Medicaid program that aims to provide an alternative to a nursing facility or long-term care hospital care for people who have disabilities or who are age 65 or older. The waiver supports people who want to move from institutional settings to home and community-based settings, such as their homes, apartments, or assisted living facilities. The waiver covers people eligible for MassHealth Standard, the name of the Medicaid program in Massachusetts.
The Community Living Waiver offers a variety of services and supports that are tailored to the individual needs and preferences of each participant. The services are delivered through a person-centered planning process involving the participant, their family, and a transition coordinator. The participant can choose between two service delivery models: agency with choice or participant-directed program.
To qualify for the Community Living Waiver, a person must meet the following criteria:
The Community Living Waiver provides a range of services and supports that are designed to help participants transition from institutional settings to home and community-based settings and to live independently and safely in their chosen environments. Some of the services and supports include:
One of the benefits of the Community Living Waiver is that it allows participants to design and direct their services in partnership with a qualified provider agency or to hire and manage their support workers. This means that participants can choose who provides their services, including family members, friends, or neighbors. The waiver pays for the wages and benefits of these support workers through either the agency with choice model or the participant-directed program model.
In the agency with choice model, the participant selects a provider agency that acts as the employer of record for their support workers. The agency handles the payroll, taxes, insurance, training, and supervision of the workers. The participant can hire, fire, schedule, and direct their workers in collaboration with the agency.
In the participant-directed program model, the participant acts as the employer of their support workers. The participant is responsible for recruiting, hiring, training, scheduling, supervising, and firing their workers. The participant must also comply with the labor laws and regulations that apply to employers. The waiver provides a fiscal intermediary service that helps the participant with the payroll, taxes, insurance, and reporting of their workers.
Both models allow participants to pay their support workers at a competitive rate determined by the waiver. The rate varies depending on the type and level of service provided. For example, as of 2021, the hourly rate for a personal care attendant was $15.75. The waiver also covers the costs of worker’s compensation, unemployment insurance, and health insurance for support workers.
If you think you or your loved one may be eligible for this waiver, or if you want to learn more about other Medicaid waivers that may compensate family caregivers, please fill out this form, and we will get back to you as soon as possible. We are here to help you navigate the complex world of caregiving and find the best solutions for your situation.
