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Research Report

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The state of Massachusetts, like the rest of the United States, is facing an approaching crisis in long-term care. Over the next few decades the number of Massachusetts residents age 65 and older will soar. As these numbers increase, so will the need for long-term care.

Massachusetts is ill prepared to provide the services that will be needed. Our current system of health care benefits leaves many elders with gaps in coverage. Those individuals who need long-term services often impoverish themselves and their spouses before the state pays for their care. Others languish on waiting lists to receive services. Our current provider supply and direct care workforce is inadequate to meet the needs of today's elders, let alone cope with an increase in care needs. Although the state currently spends hundreds of millions of dollars on long-term care services provided by the MassHealth Program and the Home Care Program, providers are often reimbursed at below cost. We must reassess and plan for our future needs before the current problems in long-term care become a crisis.

Following is a list of recommendations to improve our long-term care system and to address the coming surge in elder demographics. The recommendations are grouped by subject area and address a wide range of systemic issues. The one overriding concern of the authors is the need for better public education about long-term care and the programs and services that are available to those in need. Until elders and their families have a better understanding of the system and its alternatives, it will not be possible for individuals to plan thoughtfully for their care needs.


The genesis of this paper was a course taught at the University of Massachusetts Boston over the 2003-2004 academic sessions. The class, taught by attorneys Deborah Thomson and John J. Ford, was in partial fulfillment of the requirements for the Gerontological Social Policy Certificate, College of Public and Community Service. The class examined current issues in long-term care and developed recommendations to address the needs of the Baby Boom generation as its members approach retirement.

Students who contributed to this report are Sybil Baer, Janet Benkert, Darleen Blood, Jeanne Bragg, Helen Buckley, Cathy Callahan, Loretta Epeneter, Kathryn Erat, Suzanne Gnospelius and Edna Staub. The recommendations in this report are those of the students. All of them have had direct experience with our current system, either on a personal level or a professional one. The report was enriched by this store of knowledge. It is the hope of the students and the instructors that the report will help legislative leaders and policy makers in Massachusetts develop concrete proposals that will move us toward a comprehensive, affordable, and high quality continuum of long-term care services and supports.



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