Page 10 THE EVERETT ADVOCATE – FRiDAy, July 26, 2024 REFORMS | FROM PAGE 8 Managing Costs and Improving Quality of Care. The bill updates several programs aimed at constraining health care costs and improving care quality, including the Determination of Need (DoN), Performance Improvement Plan (PIP), and Material Change Notice (MCN), and programs. Determination of Need. This bill increases coordination between state agencies involved in health care market review by clarifying that DPH should not act on a DoN application until HPC, CHIA, the Attorney General, or other relevant agencies have been given reasonable opportunity to supply required information. This change will ensure that DPH has all the information it needs to more fully asEVENTS | FROM PAGE 9 Room, Monday, July 29, from 3-5 p.m. Come to the Children’s Room on Mondays for some free Lego building fun. Open to all ages; children under six years old must be accompanied by an adult – no registration required. Storytime and Sing-along with Karen: Parlin Children’s Room, Wednesday, July 31, at 11 a.m. Join us for a fun-filled morning of singing and storytelling with Karen! Suggested ages: newborn to six. Drama Class: Parlin Children’s Room, Wednesday, July 31, at 3 p.m. Do you have a drama queen or king at home? Drama Class in the Parlin Children’s Department is the perfect opportunity for your child to put those acting skills to use with our drama coach! Sugsess a proposal’s potential impact on the provision of health care in the Commonwealth. Performance Improvement Plan. The PIP is a process by which HPC can require entities that have exceeded the cost growth benchmark to reduce their spending. The bill provides more flexibility for CHIA to refer health care entities with excessive spending to HPC, which can require the referred entity to file and implement a PIP. In addition, the HPC is given new authority to assess a civil penalty instead of requiring a PIP. Material Change Notice. A MCN is a requirement for providers and provider organizations to notify HPC of a proposed change to their operations or governance structure at least 60 days before the change gested ages: six to 14. Story Time Adventures with Mrs. McAuliffe: Parlin Children’s Room, August 1 & 2 at 11:00 a.m. Join us on Thursday and Friday with Mrs. McAuliffe for our enchanting Story Time! You will be whisked away on magical adventures through the pages of your favorite books. Bring a friend or make a new one in our circle of friends. Crafternoon: Parlin Children’s Room, Thursday, August 1, at 3 p.m. Mystery Craft! What kind of craft will you pick? All kids ages three and up are welcome; please come and join the fun! Registration is required. Sign up online or at the Parlin Children’s desk. Fluency Fun Fridays! Parlin Children’s Room, Friday, August 2, at 3 p.m. Level up your fluency game! Join Mrs. McAuis to go into effect. The bill adds new types of transactions that require a MCN, including significant new for-profit investment and acquisitions by for-profit entities, such as large for-profit physician organizations and private equity firms, as well as the sale of assets for the purposes of a lease-back arrangement. Crucially, the bill gives HPC new authority to require providers to address concerns that their proposed change will significantly increase consumer costs, reduce the quality of care, or reduce access to services. A previous version of this bill having passed the House of Representatives, the two branches will now reconcile the differences between the bills, before sending it to the Governor’s desk. liffe for an afternoon of fun board games like Scrabble and Bananagrams, word searches and crossword puzzles. Suggested ages: five to 12. Mixed-Media Crafts: Parlin Children’s Room, Saturday, August 3, at 10 a.m. Enjoy learning and develop your imagination! Recommended for ages four to 12. Registration is required; sign up online. This program is funded by the Everett Cultural Council. Shute Adult and Teens Crafty Conversations: Embroidery Edition: Shute Meeting Room, Tuesday, July 30, at 7 p.m. Whether you’re a seasoned stitcher or a complete beginner, all are welcome to join us for an evening of self-paced embroidery! All materials will be provided, so relax, exchange tips and share stories as we stitch together. This program is suitable for ages 18 and up. Space is limited and registration is required, so sign up today! This program is generously funded by the Friends of the Everett Public Libraries. Resume Writing: Shute Portal To Hope (“PTH”) serves people whose lives have been impacted by domestic violence and related assault crimes. Job Opportunities Available: PTH is seeking an Operations Assistant and a Licensed Social Worker to join our team! If you would like to join PTH’s award-winning team and share your leadership in the cause to end domestic violence, please call (781) 338-7678 for more information; or, email: nita@portaltohope.org. Adult Department. Book a one-on-one resume assistance appointment at the Shute Library and let a librarian help you craft a resume tailored to your strengths and aspirations. Sign up for a 30-minute session at the Shute Library; Fridays by appointment only. Computer Basics 101: Shute Adult Department. Tech Newbie? No Problem! Learn to power up, click around, type like a pro, explore the digital world and even send your first email. Book your Friday adventure with technology today! By appointment only on Fridays; please call the Shute Library to register for an appointment. The Home and the Medicaid Lien T he general rule is that the home and any adjacent land, if located in Massachusetts, is considered to be a “non-countable” asset for MassHealth eligibility purposes as long as the applicant checks off the box on the MassHealth application stating that he or she intends on returning home from a nursing home. This may or may not be likely to happen but by checking the box, the home will not be a countable asset. Assuming that for a single person the total of all other countable assets is $2,000 or less, the applicant will be eligible for MassHealth benefits. MassHealth’s estate recovery unit will, however, place a lien on the property. This is done so in order to seek repayment of Medicaid benefits paid to the nursing home upon the death of the MassHealth applicant. The home would have to be sold (or mortgaged) in order to pay back MassHealth. It is important to note, in 2024, the home will not be considered a “non-countable” asset if the equity in the home exceeds $1,071,000. There is an exception to this rule. The home will still be non-countable if a spouse is living there or a blind or permanently disabled child is living there, regardless of its value. The benefit of applying for MassHealth and keeping the home is that estate recovery will be based upon the “Medicaid” rate and not the private pay rate. Therefore, the ultimate recovery against the home will be much less. If the private pay rate for the average nursing home in Massachusetts is $15,000 per month, the “Medicaid” rate might be, for example, $7,000 per month. This may be one reason why not to sell the house. For example, if the home is sold for $750,000, at $15,000 per month for nursing home cost, the equity in the home would be entirely wiped out in approximately 50 months. However, if MassHealth is applied for and the house is not sold, and the application is approved, assuming the “Medicaid” rate is $7,000 per month, the equity in the home would not be wiped out until approximately 107 months. In other words, it would take twice as long to lose all of the value of the home. The Medicaid rate is what MassHealth actually pays to the nursing home each month. The daily rate paid is based upon the level of care provided to the applicant. In this example, if the MassHealth recipient died in the nursing home after 36 months, the payback to MassHealth would only be $252,000, leaving $498,000 in equity for the family members upon the applicant’s death. In this example, I am assuming the applicant is single. If married, the house can simply be transferred to the spouse who is still living at home. So it pays to at least look at your options when dealing with the home and MassHealth eligibility. It also makes a lot of sense to consider transferring your home to an irrevocable Medicaid-qualifying Trust. In that case, after the five year look-back period is over, the house will be protected. This would avoid probate and also any Estate Recovery Lien. MassHealth estate recovery only applies to the probate estate, not assets held in Trust. Joseph D. Cataldo is an estate planning/elder law attorney, Certified Public Accountant, Certified Financial Planner, AICPA Personal Financial Specialist and holds a masters degree in taxation.
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