Page Reviewed / Updated – Nov. 20, 2022

Program Description

Massachusetts operates two programs that help elderly state residents remain living in their homes instead of moving into nursing homes. These are the Home Care Program (HCP) and the very similar, Enhanced Community Options Program (ECOP). Both programs offer care and non-medical supports to individuals in their homes. But ECOP is targeted toward individuals with a higher level of care needs.

Services are intended to help individuals to continue to live in their homes or to help families care for loved ones in their homes. Benefits range from adult day care to home delivered meals to chore services and medication assistance. A complete list is available in the Benefits section further down this page.

The Enhanced Community Options Program is intended to help people who meet the clinical eligibility for nursing homes but who are ineligible for MassHealth Standard. Service costs depend on the income of the care recipient. Services may be free of charge (voluntary co-payments) or may require co-payments. If a co-payment is required, families should rest assured that their portion will be well below what the services would otherwise cost if they were obtained on the open market. Monthly co-payments for most services range from $10 to $152, depending on the participant’s ability to pay.

HCP and ECOP allow most family members to work as paid caregivers for their aging loved ones.

Both the HCP and ECOP programs allow for consumer direction of some services. This means participating individuals are empowered to select from whom they receive care services instead of state administrators choosing the service providers on the beneficiary’s behalf. Under these changes, personal care, home care, and homemaker services can be self-directed. Family members can be hired (and paid) to provide these services so long as the hired individual is not also the participant’s legal guardian or surrogate.

Eligibility Guidelines

The Home Care Program requires that Massachusetts’ residents live at home or in the home of a caregiver. This means they cannot reside in an adult foster home, assisted living residence, or in a skilled nursing facility. They must be at least 60 years old or diagnosed with early onset Alzheimer’s (and in need of respite services) as well as require assistance with daily living activities. Care recipients must be assessed by a case manager and found to have a need for services. As of 2022, for financial assistance for home care services, a single adult must have an annual income of less than $28,865 and a couple, less than $40,842. As mentioned before, there may be monthly co-payments for services.

The Enhanced Community Options Program has the same financial eligibility requirements as the Home Care Program. However, individuals must have a greater functional need for services. Participants must be assessed and determined to need the level of care provided in a skilled nursing facility (or nursing home).

Meeting eligibility requirements does not guarantee services.  Waiting lists may exist.

Benefits and Services

Seniors, the disabled, and their caregivers can benefit from a very wide range of support services through these two programs. Final services are determined on a case-by-case basis and are written up in a care management plan. They may include any of the following: 

  • Adult day health care
  • Alzheimer’s / dementia care
  • Companion services
  • Food shopping
  • Home health aides / services
  • Homemaker services including laundry
  • Meal delivery
  • Meal planning and preparation
  • Medication assistance
  • Minor home repair and yard work
  • Nutritional counseling
  • Personal care services
  • Personal emergency response services
  • Respite care
  • Transitional assistance
  • Transportation assistance

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How to Apply / Learn More

Local Massachusetts Area Agencies on Aging manage both programs, including applications for respite care. To learn more and apply for these programs contact your local area agency on aging or call the helpline at 800-AGE-INFO (800-243-4636). Additional information is available on the Mass Resources website.

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