Following Gov. Maura Healey’s unsuccessful attempt to make budget cuts that would have limited services for elderly and disabled people last year, advocates are contacting her office ahead of this year’s budget session to request full funding in fiscal year 2025. Under Healey’s fiscal 2025 budget, 6,000 people would have lost access to personal care assistants (PCAs), who provide seniors and disabled people with assistance with activities of daily living such as bathing, dressing, meal preparation, feeding, housekeeping, and grocery shopping.
To address a $950 million MassHealth budget gap, the administration sought to cut $57 million in state spending for the program — despite the fact that a federal match would have resulted in over $100 million in overall service cuts. Despite protests from people with disabilities, elderly people, personal care assistants, health care unions, and independent living center staff, the House and Senate did not agree to the financial cut.
“We haven’t gone away. The program’s as valuable as it always was, and we just want to say the coalition is still active, the program is vital — we hope you don’t cut it this year,” Boston Center for Independent Living Executive Director Bill Henning, who participated in the rallies last year, told the News Service on Monday.
Advocates planned deliver a letter to Healey and Health and Human Services Secretary Kate Walsh on Tuesday. They are requesting full support for the PCA program in the fiscal year 2026 budget, which is due on January 22. Nearly 30 organizations signed the letter, including the state’s independent living centers, the Disability Law Center, Arc Massachusetts, the Massachusetts Senior Action Council, Health Care for All, and others.
I am one of the thousands of Massachusetts residents who rely on the PCA program. I have received PCA services for over a decade. In 2020, I moved into my own apartment. My PCA provides around-the-clock support.
Independent living would not be possible without the PCA program. Without PCAs, many disabled people could be forced to live in nursing homes or other residential settings.
Lawmakers are warning about difficult decisions in the upcoming fiscal year. The PCA program is not cheap. 1199 SEIU, the union that represents personal care attendants, won a three-year deal with the state in 2023 that will increase PCA compensation from a flat $18 per hour to a wage scale that rises to $25 per hour based on experience by 2027.
According to state health officials, the cost of home care services has increased from $1.2 billion in fiscal 2020 to $1.6 billion in fiscal 2023. The program is projected to reach $2 billion by fiscal 2027. Thus, making it the highest per capita cost among states.
Advocates argue the state must invest in independent living programs as Massachusetts’s aging population grows and needs more support. In 2020, 14% of Massachusetts citizens were 65 and older. According to UMass Donahue Institute population projections, by 2050, that figure will rise to 27% above the retirement age of 65.
“These are people who could go to expensive nursing homes, or live at home in their communities with help,” Henning said. “… We know it’s a tough budget year. Word on the street is there might be cuts … It’s their job to look at the numbers. It’s our job to remind them of the people, the stories behind the numbers.”
Massachusetts has one of the highest monthly costs when it comes to nursing home care. In 2023 the average cost of a semi-private room was $13,688. It costs the state more than $160,000 annually to care for someone in a nursing home.
The PCA program plays a vital role in the lives of thousands of Massachusetts residents. For some people, budget cuts could be a matter of life or death.
Sources:
Drysdale, Sam. “PCA Program’s Cost, Importance on the Rise.” State House News Service, State House News Service, 7 Jan. 2025, http://www.statehousenews.com/news/healthcare/humanservices/pca-programs-cost-importance-on-the-rise/article_2c287c72-cc54-11ef-9bc7-37b287cc6a38.html.
Van Erdewyk , Kayla, and Niki Gewirtz. “How Much Does a Nursing Home Cost? (2024).” A Place for Mom, A Place for Mom, 26 Nov. 2024, http://www.aplaceformom.com/caregiver-resources/articles/nursing-homes-cost.