In January of 2000, the Community Care Ombudsman Program joined the other two state ombudsman programs, Assisted Living and Long-Term Care (which was profiled in the 6/98 MGH Community News), in assisting elders and their family members with quality of care issues and concerns. Run out of the Massachusetts Executive Office of Elder Affairs (EOEA), the Community Care Ombudsman mediates disputes between Massachusetts elders and providers of health or social services they receive in their home or community, including home health care, homemaker services and adult day care.

The Ombudsman responds to inquiries from elders and their families. Complaints are investigated and mediated for resolution. The ombudsman collaborates with other state agencies to ensure quality of life is met (i.e., The Office of the Managed Care Ombudsman, The Office of the Attorney General, The Department of Medical Assistance-Adult Day Health Unit). They also partner with The Department of Public Health-Health Care Quality Division to assist in reinforcing the Patient and Resident Abuse Prevention, Reporting, Investigation, Penalties and Registry (105 CMR 155.000) statute.

MassHealth has several different programs with different eligibility criteria and benefits. Keep in mind that to be eligible one has to qualify not only financially, but also categorically. These two factors plus immigration status are what determine for which program one is eligible. The main programs are listed below (but there are additional smaller programs not listed).

The Office of Elder Affairs Consumers' Bill of Rights
Elders have a right to:

1. Live in a decent, safe, and habitable environment regardless of the outside services entering the home;
2. Be treated with consideration and respect and with due recognition of personal dignity, individuality, and the need for privacy;
3. Freedom to participate in and benefit from community services and activities and to achieve the highest possible level of independence, autonomy, and interaction with the community;
4. Directly engage or contract with any licensed health care provider to obtain necessary health care service;
5. Present grievances and recommended changes in policies, procedures, and services to the provider agencies and government officials without restraint, interference, coercion, discrimination, or reprisal.
6. Upon request, obtain from all service providers, the name of the Service Coordinator or any other persons responsible for his/her care or the coordination of his/her care;
7. Confidentiality of all records and communications to the extent provided by Elder Affairs' privacy and confidentiality laws.

Many cases seen by the Ombudsman evolve around the home care industry's lack of enough direct care staff members per client case load. Many consumers call because they are not able to receive in-home services due to the elder service agency's inability to staff the authorized need.

Calls are also taken regarding meals-on-wheels, transportation, day to day conflicts with consumers and providers (theft, scheduling, personality issues, etc.), hospital discharge plans, scams, etc.

The Community Care Ombudsman Program's consumer complaint line is 1-800-AGE-INFO (1-800-243-4636) or (617) 222-7535.
TTY: 1-800-872-0166

This program is listed in IRis under the keywords: Ombudsman Program, and Consumer Complaints.

-Thanks to Annette V. Peele, MSW, Director Community Care Ombudsman Program for writing this article and to Sue Fisher, RN for suggesting the topic.