Workers’ Compensation Insurance Workers’ Compensation Insurance Coverage in theCoverage in the

Massachusetts Personal Care Attendant Massachusetts Personal Care Attendant (PCA) Program(PCA) Program

US DHHS/ASPE sponsored Government US DHHS/ASPE sponsored Government and Vendor F/EA Workshopand Vendor F/EA Workshop

November 1, 2007November 1, 2007Presented by Lois Aldrich, MS, LCSWPresented by Lois Aldrich, MS, LCSWDirector of Community Services, Director of Community Services, MassHealth Office of Long Term CareMassHealth Office of Long Term CareExecutive Office of Elder AffairsExecutive Office of Elder Affairs

22

Today’s PresentationToday’s Presentation

Overview of the MassHealth PCA programOverview of the MassHealth PCA program

-- Fiscal Intermediary (FI) Services (Vendor F/EA Fiscal Intermediary (FI) Services (Vendor F/EA services)services)

Provision of Workers’ Compensation Insurance in the Provision of Workers’ Compensation Insurance in the MassHealth PCA ProgramMassHealth PCA Program

Lessons LearnedLessons Learned Contact InformationContact Information

33

Overview of the MassHealth PCA Overview of the MassHealth PCA ProgramProgram

Massachusetts Medicaid state plan serviceMassachusetts Medicaid state plan service Consumer- directed since inception in 1970’sConsumer- directed since inception in 1970’s

-- Surrogates allowed since 1980’sSurrogates allowed since 1980’s 28 Personal Care Management (PCM) Agencies28 Personal Care Management (PCM) Agencies

-- Performance based contracts with MassHealth Performance based contracts with MassHealth

-- PCMs provide assessment and evaluation; intake and PCMs provide assessment and evaluation; intake and orientation; functional skills trainingorientation; functional skills training

3 Fiscal Intermediaries (FI) 3 Fiscal Intermediaries (FI) -- Performance based contracts with MassHealthPerformance based contracts with MassHealth

-- FIs provide PCA payroll services on behalf of all “Option FIs provide PCA payroll services on behalf of all “Option One” PCA consumersOne” PCA consumers

44

FY 2000FY 2000 FY 2007FY 2007 % % IncreaseIncrease

ConsumersConsumers 5,4015,401 15,08415,084 179%179%

PCM AgenciesPCM Agencies 1212 2828 131%131%

FIsFIs 44 33 -25%-25%

PCAsPCAs 10,40210,402 21,824 21,824

( July 1, 2007)( July 1, 2007)

69%69%

PCA payrollPCA payroll $98,297,017$98,297,017 $265,092,508$265,092,508 169%169%

FI admin costsFI admin costs $3,379,285$3,379,285 $8,106,178$8,106,178 133%133%

PCM agency costsPCM agency costs $3,800,798$3,800,798 $10,754,785$10,754,785 178%178%

PCA hourly wagePCA hourly wage $8.87$8.87 $10.84$10.84 22%22%

PCA hourly ratePCA hourly rate $10.03$10.03 $12.28$12.28 22%22%

55

Overview Overview (continued)(continued)

19% of consumers are under 22 years old19% of consumers are under 22 years old 55% are between the age of 22 and 64 55% are between the age of 22 and 64 26% are 65 years old or older (fastest growing 26% are 65 years old or older (fastest growing

population)population) 62% of consumers have surrogates62% of consumers have surrogates 3,314 new consumers began receiving services in FY 3,314 new consumers began receiving services in FY

20072007 PCA regulations amended March 1, 2006 to allow PCA regulations amended March 1, 2006 to allow

family members, except legally responsible relatives, family members, except legally responsible relatives, to be paid as PCAs. 2,000 family members hired as to be paid as PCAs. 2,000 family members hired as PCAs since September, 2006.PCAs since September, 2006.

66

Fiscal Intermediary (FI) ServicesFiscal Intermediary (FI) Services

PayrollSub-

Contractor

InvestigativeAuthorities

Workers’Compensation

State &Federal taxAuthorities

MassHealth

PCM Agency

PCAs

Surrogate

Consumer

Fiscal Intermediary

77

Fiscal Intermediary ServicesFiscal Intermediary Services (continued)(continued)

The FIs operate as Vendor Fiscal/Employer Agents The FIs operate as Vendor Fiscal/Employer Agents under Section 3504 of the IRS code and IRS Revenue under Section 3504 of the IRS code and IRS Revenue Procedure 70-6 and as modified by Proposed Notice Procedure 70-6 and as modified by Proposed Notice 2003-702003-70

FI model began with 4 FIs in 1999, 3 now operatingFI model began with 4 FIs in 1999, 3 now operating Performance based contracts with MassHealthPerformance based contracts with MassHealth FI services include:FI services include:

-- Customer ServiceCustomer Service- Administrative functionsAdministrative functions- PayrollPayroll-- Contract ManagementContract Management-- Financial ManagementFinancial Management

* FIs subcontract with a reporting age* FIs subcontract with a reporting agent to peform these tasksnt to peform these tasks

Fiscal Intermediary ServicesFiscal Intermediary Services (continued)(continued)

FI payroll functionsFI payroll functions-- Receiving, reviewing and processing PCA Receiving, reviewing and processing PCA

timesheets timesheets • Pay period is every two weeksPay period is every two weeks• Over 10,000 timesheets processed weeklyOver 10,000 timesheets processed weekly

-- Withholding, filing and paying federal and Withholding, filing and paying federal and state income tax withholding and employment state income tax withholding and employment taxes and issuing IRS Forms W-2* taxes and issuing IRS Forms W-2*

-- Facilitating resolution of tax issues Facilitating resolution of tax issues

* FIs subcontract with a reporting age* FIs subcontract with a reporting agent to perform these tasksnt to perform these tasks

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Fiscal Intermediary Services Fiscal Intermediary Services (continued)(continued)

Issuing PCA checks to consumers, including Issuing PCA checks to consumers, including providing a “check stub” identifying hours worked providing a “check stub” identifying hours worked and rate of pay *and rate of pay *

-- Direct deposit available for PCAsDirect deposit available for PCAs

Purchasing workers’ compensation insurancePurchasing workers’ compensation insurance

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Workers’ Compensation (WC)Workers’ Compensation (WC)

BackgroundBackground Key Players and Their RolesKey Players and Their Roles Challenges in Securing WC CoverageChallenges in Securing WC Coverage MA-specific 0918 Classification CodeMA-specific 0918 Classification Code Workers’ Compensation Insurance DataWorkers’ Compensation Insurance Data Lessons LearnedLessons Learned Contact InformationContact Information

1111

BackgroundBackground

Massachusetts General Laws c. 152 requires all Massachusetts General Laws c. 152 requires all employers to provide workers’ compensation (WC) employers to provide workers’ compensation (WC) insurance coverage to employees. insurance coverage to employees.

- Workers are covered by WC insurance if they are injured Workers are covered by WC insurance if they are injured

on the job or contract a work-related illness. on the job or contract a work-related illness.

-- Workers’ compensation insurance pays for any necessary Workers’ compensation insurance pays for any necessary medical treatment related to the injury, and also pays medical treatment related to the injury, and also pays partial compensation for lost wages, after the first five days partial compensation for lost wages, after the first five days of disability.of disability.

1212

Background Background (continued)(continued)

MassHealth FI contract requires FIs to purchase WC MassHealth FI contract requires FIs to purchase WC coverage for each PCA consumer.coverage for each PCA consumer.

PCA consumers are the common law employers of PCA consumers are the common law employers of their workerstheir workers

FIs purchase WC for all “Option One” consumers FIs purchase WC for all “Option One” consumers

through single insurance broker and insurance carrierthrough single insurance broker and insurance carrier

1313

BackgroundBackground (continued)(continued)

All Option One consumers are covered immediately upon All Option One consumers are covered immediately upon enrollment with FI.enrollment with FI.

WC rate is based on per $100 of payroll and applies to WC rate is based on per $100 of payroll and applies to payroll for whole program during coverage period (Feb.1- payroll for whole program during coverage period (Feb.1- Jan. 31).Jan. 31).

Payroll estimates are provided by FIs at beginning of Payroll estimates are provided by FIs at beginning of coverage year; audit is conducted at end of coverage year coverage year; audit is conducted at end of coverage year to reconcile any differences.to reconcile any differences.

Premium paid 2/1/06-2/1/07: $3,849,000 (averages $286 Premium paid 2/1/06-2/1/07: $3,849,000 (averages $286 per policy)per policy)

1414

Key PlayersKey Players

Workers’ Compensation Rating and Inspection Workers’ Compensation Rating and Inspection Bureau of Massachusetts (WCRIB)Bureau of Massachusetts (WCRIB)

Division of Insurance (DOI)Division of Insurance (DOI) Division of Industrial Accidents (DIA)Division of Industrial Accidents (DIA) Hub International New England, LLC ( insurance Hub International New England, LLC ( insurance

broker)broker) Atlantic Charter (insurance carrier)Atlantic Charter (insurance carrier) 3 Fiscal Intermediaries3 Fiscal Intermediaries

1515

Key PlayersKey Players (continued)(continued)

Workers’ Compensation Rating and Inspection Workers’ Compensation Rating and Inspection Bureau of Massachusetts (WCRIB)Bureau of Massachusetts (WCRIB)

Private, non-profit association of insurers that is Private, non-profit association of insurers that is licensed by the Massachusetts Division of licensed by the Massachusetts Division of Insurance as a rating organization for workers’ Insurance as a rating organization for workers’ compensation insurance in Massachusetts (since compensation insurance in Massachusetts (since 1915).1915).

Collects policy, claims and financial data from all Collects policy, claims and financial data from all carriers licensed to sell WC insurance in Mass.carriers licensed to sell WC insurance in Mass.

1616

Key PlayersKey Players (continued)(continued)

Files rates, classifications, and rating plans with Files rates, classifications, and rating plans with the Division of Insurance on behalf of member the Division of Insurance on behalf of member insurers.insurers.

Acts as WC statistical agent and Assigned Pool Acts as WC statistical agent and Assigned Pool Risk Administrator for the Division of Insurance.Risk Administrator for the Division of Insurance.

Acts as coverage verification entity for the Acts as coverage verification entity for the Department of Industrial Accidents.Department of Industrial Accidents.

Issues experience modifications and classification Issues experience modifications and classification

rulings for employersrulings for employers..

1717

Key PlayersKey Players (continued)(continued)

Massachusetts Division of Insurance (DOI)Massachusetts Division of Insurance (DOI)-- Oversees insurance market in MassachusettsOversees insurance market in Massachusetts

-- Serves as consumer representative in hearings on the Serves as consumer representative in hearings on the appropriateness of rates filed by insurance industry appropriateness of rates filed by insurance industry

-- Collects and analyzes data Collects and analyzes data

-- Reviews rates filed by the WCRIB and other insurance Reviews rates filed by the WCRIB and other insurance entitiesentities

-- Approves, disapproves or limits rate filings and Approves, disapproves or limits rate filings and classificationsclassifications

1818

Key PlayersKey Players (continued)(continued)

Division of Industrial Accidents (DIA)Division of Industrial Accidents (DIA)-- Administers Massachusetts’ WC systemAdministers Massachusetts’ WC system

-- Ensures employers meet the requirements of M.G.L. c. 152Ensures employers meet the requirements of M.G.L. c. 152

-- Ensures prompt and fair compensation to victims of Ensures prompt and fair compensation to victims of occupational injuries and illnessoccupational injuries and illness

-- Provides dispute resolution of workers’ compensation Provides dispute resolution of workers’ compensation cases through due process and adjudicationcases through due process and adjudication

1919

Key PlayersKey Players (continued)(continued)

Hub International New England, LLCHub International New England, LLC-- Broker for all Option One PCA consumers in the Broker for all Option One PCA consumers in the

MassHealth PCA ProgramMassHealth PCA Program

-- Secured a voluntary WC insurance carrier for programSecured a voluntary WC insurance carrier for program

-- Represents the buyer (MassHealth, FIs, and each PCA Represents the buyer (MassHealth, FIs, and each PCA consumer) in coordinating all aspects of services for the consumer) in coordinating all aspects of services for the programprogram

-- Calculates pricing of WC in PCA program based on data Calculates pricing of WC in PCA program based on data supplied by FIssupplied by FIs

2020

Key PlayersKey Players (continued)(continued)

-- Processes enrollments and disenrollmentsProcesses enrollments and disenrollments

-- Coordinates audit at end of each coverage period Coordinates audit at end of each coverage period

-- Attends claims reviews with Atlantic Charter on open Attends claims reviews with Atlantic Charter on open active claimsactive claims

-- Supplies MassHealth with rate information and summary Supplies MassHealth with rate information and summary reports for overall programreports for overall program

-- Monitors any changes coming out of the WCRIB and Monitors any changes coming out of the WCRIB and informs MassHealth of such changesinforms MassHealth of such changes

2121

Key PlayersKey Players (continued)(continued)

Atlantic Charter Atlantic Charter -- Voluntary workers’ compensation insurance carrier for all Voluntary workers’ compensation insurance carrier for all

Option One PCA consumers in the MassHealth PCA Option One PCA consumers in the MassHealth PCA programprogram

-- Writes WC insurance policies for consumers policyholdersWrites WC insurance policies for consumers policyholders

-- Pays WC claims for consumer policyholdersPays WC claims for consumer policyholders

-- -- Provides data to WCRIBProvides data to WCRIB• Massachusetts specific code 0918 is currently used solely by MA Massachusetts specific code 0918 is currently used solely by MA

Medicaid PCA programMedicaid PCA program

2222

Key PlayersKey Players (continued)(continued)

Fiscal IntermediariesFiscal Intermediaries Inform Hub when consumers enroll or disenrollInform Hub when consumers enroll or disenroll Provide Hub and Atlantic Charter with historical payroll Provide Hub and Atlantic Charter with historical payroll

information as neededinformation as needed Provide Hub with annual estimates of payroll at beginning Provide Hub with annual estimates of payroll at beginning

of coverage periodof coverage period Provide Hub with final payroll figures at end of coverage Provide Hub with final payroll figures at end of coverage

period to complete and reconcile WC auditperiod to complete and reconcile WC audit Provide feedback on individual cases as neededProvide feedback on individual cases as needed Pay WC premiums as calculated by Hub on monthly basisPay WC premiums as calculated by Hub on monthly basis

2323

Challenges in Securing WC CoverageChallenges in Securing WC Coverage

Exposure and risks unknownExposure and risks unknown No experience historyNo experience history No applicable job classification codeNo applicable job classification code Qualifications, training, knowledge, skills and Qualifications, training, knowledge, skills and

proficiency of PCAs not knownproficiency of PCAs not known Hiring practices not clearly definedHiring practices not clearly defined Insurer cannot physically look at risk involved (such Insurer cannot physically look at risk involved (such

as stairs in home, whether or not consumer is on 2as stairs in home, whether or not consumer is on 2ndnd floor, equipment used, etc.)floor, equipment used, etc.)

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Mass-Specific 0918 Classification CodeMass-Specific 0918 Classification Code

Developed by WCRIB in 1999Developed by WCRIB in 1999

- Rate is per $100 of payroll, subject to manual ratesRate is per $100 of payroll, subject to manual rates

Division of Medical Assistance (MassHealth) and Division of Medical Assistance (MassHealth) and Executive Office of Health and Human Services Executive Office of Health and Human Services advocated with WCRIB and DOI to assign a new advocated with WCRIB and DOI to assign a new code specific to work performed by PCAscode specific to work performed by PCAs

-- Government administered program providing consumer-Government administered program providing consumer-directed services to disabled population and distinct from directed services to disabled population and distinct from home healthhome health

2525

Mass-Specific 0918 Classification Code Mass-Specific 0918 Classification Code (continued)(continued)

-- Needed to collect data and establish experience ratings Needed to collect data and establish experience ratings specific to PCA programspecific to PCA program

-- Size of exposure was considerable (over 6,000 workers)Size of exposure was considerable (over 6,000 workers)- Needed to ensure that all PCAs were coveredNeeded to ensure that all PCAs were covered

Concerned about the potential of 5,000 applications Concerned about the potential of 5,000 applications being submitted to the risk pool (WCRIB administers being submitted to the risk pool (WCRIB administers risk pool)risk pool)

2626

Mass-Specific 0918 Classification Code Mass-Specific 0918 Classification Code (continued)(continued)

FIs agreed one insurance broker for whole program FIs agreed one insurance broker for whole program would work most efficiently.would work most efficiently.

FIs contacted C.J. McCarthy Insurance (now Hub FIs contacted C.J. McCarthy Insurance (now Hub International) to find the best carrier(s) for the PCA International) to find the best carrier(s) for the PCA program.program.

-- C.J. McCarthy successfully marketed to First Return, then C.J. McCarthy successfully marketed to First Return, then to Atlantic Charter when First Return went out of business.to Atlantic Charter when First Return went out of business.

* WCRIB Circular letter # 1824 issue* WCRIB Circular letter # 1824 issued July 13,1999d July 13,1999

2727

Mass-Specific 0918 Classification Code Mass-Specific 0918 Classification Code (continued)(continued)

Domestic Workers—Inside—Physical AssistanceDomestic Workers—Inside—Physical Assistance Applies to Applies to domesticdomestic workers who workers who provide physical assistanceprovide physical assistance

in activities of daily living in activities of daily living to the elderly or to persons who are to the elderly or to persons who are convalescent, acutely or chronically ill, or physically or convalescent, acutely or chronically ill, or physically or mentally disabledmentally disabled. For purposes of assigning code 0918, . For purposes of assigning code 0918, physical assistance in activities of daily living shall mean the physical assistance in activities of daily living shall mean the performance of one or more of the following functions: performance of one or more of the following functions: physically assisting a household member with…… In physically assisting a household member with…… In addition to providing physical assistance with activities of addition to providing physical assistance with activities of daily living, a domestic worker properly assignable to this daily living, a domestic worker properly assignable to this new classification may also perform functions such as new classification may also perform functions such as cooking, laundry, shopping, housekeeping, providing cooking, laundry, shopping, housekeeping, providing transportation or assistance with paperwork or reading.*transportation or assistance with paperwork or reading.*

2828

Mass PCA Program Workers’ Mass PCA Program Workers’ Compensation Insurance DataCompensation Insurance Data

Premium DevelopmentPremium Development Historic RatesHistoric Rates Claims HistoryClaims History Ad hoc ReportsAd hoc Reports

2929

WC Data: Premium Development WC Data: Premium Development

The WC premium is calculated by Hub International The WC premium is calculated by Hub International prior to beginning of new coverage period, based on prior to beginning of new coverage period, based on estimated payrolls provided by the FIs for the coming estimated payrolls provided by the FIs for the coming year.year.

3030

WC Data: Premium DevelopmentWC Data: Premium Development (continued)(continued)

Example (2006-2007) Example (2006-2007)

Estimated payroll: Estimated payroll: $216,500,000$216,500,000 Total policies:Total policies: 12,90012,900 Average payroll per policy: Average payroll per policy: $16,783$16,783 $16,783 X .76 (WCRIB rate) $16,783 X .76 (WCRIB rate) $128 per policy$128 per policy + additional WC costs ($158) + additional WC costs ($158) $286 per policy$286 per policy $286 X 12,900 $286 X 12,900 $3,689,400$3,689,400

total annual total annual premiumpremium

3131

WC Data: Premium DevelopmentWC Data: Premium Development (continued)(continued)

PCA program rate = $1.704 per $100 payrollPCA program rate = $1.704 per $100 payroll

-- Total annual / premium total payrollTotal annual / premium total payroll

-- Incorporated into the MassHealth PCA hourly rate Incorporated into the MassHealth PCA hourly rate paid to the FIspaid to the FIs

3232

WC Data: Historic RatesWC Data: Historic Rates

YearYear Cost Cost per per PolicyPolicy

WCRIB WCRIB RateRate

Program Program RateRate

PCA PayrollPCA Payroll Audited Audited PremiumPremium

99-99-20002000

$378$378 $2.000$2.000 $74,300,000$74,300,000 $1,485,000$1,485,000

00-0100-01 $445$445 .94.94 $2.000$2.000 $96,400,000$96,400,000 $1,928,000$1,928,000

01-0201-02 $455$455 .94.94 $2.000$2.000 $119,385,000$119,385,000 $2,387,000$2,387,000

02-0302-03 $281$281 .79.79 $1.740$1.740 $145,270,000$145,270,000 $2,527,000$2,527,000

03-0403-04 $278$278 .79.79 $1.690$1.690 $173,000,000$173,000,000 $2,923,000$2,923,000

04-0504-05 $328$328 .89.89 $1.777$1.777 $192,345,000$192,345,000 $3,417,000$3,417,000

05-0605-06 $307$307 .89.89 $1.696$1.696 $213,654,000$213,654,000 $3,623,000$3,623,000

06-0706-07 $286$286 .76.76 $1.704$1.704 $225,878,000$225,878,000 $3,849,000$3,849,000

3333

WC Data: Claims HistoryWC Data: Claims History

YearYear Claims Claims # PCAs # PCAs CoveredCovered

IncurredIncurred

1999-20001999-2000 7070 $340,015$340,015

2000-20012000-2001 5151 10,40210,402 $330,779$330,779

2001-20022001-2002 6868 12,47612,476 $401,332$401,332

2002-20032002-2003 8282 12,67012,670 $738,100$738,100

2003-20042003-2004 6969 16,41816,418 $349,622$349,622

2004-20052004-2005 7474 17,13517,135 $796,287$796,287

2005-20062005-2006 6969 19,11619,116 $788,329$788,329

2006-20072006-2007 7373 21,82421,824 $882,421$882,421

TOTALTOTAL 556556 $4,626,885$4,626,885

3434

WC Data: Ad hoc ReportsWC Data: Ad hoc Reports

Ad hoc reports are provided upon request.Ad hoc reports are provided upon request. Multiple claims filed by PCAs for same consumerMultiple claims filed by PCAs for same consumer

-- Possible training issuePossible training issue

-- Possible need for skills trainingPossible need for skills training Multiple claims filed by PCA for different Multiple claims filed by PCA for different

consumersconsumers Common reasons for filing claimCommon reasons for filing claim

-- Car accidents, liftingCar accidents, lifting

-- Pre-existing medical condition of PCAPre-existing medical condition of PCA

3535

Lessons LearnedLessons Learned Assign a specific job classification code for work Assign a specific job classification code for work

performed by PCAsperformed by PCAs-- Establishes ratings based solely on experience for work performed Establishes ratings based solely on experience for work performed

by PCAsby PCAs-- Loss ratios are easily documented Loss ratios are easily documented - Premium basis per payroll, not per capitaPremium basis per payroll, not per capita

Use one insurance broker and one carrier to provide Use one insurance broker and one carrier to provide WC coverage for the whole programWC coverage for the whole program

-- Regular accountability to MassHealth and to rating bureau on all Regular accountability to MassHealth and to rating bureau on all WC dataWC data

-- All consumers have coverage for their PCAs immediately upon All consumers have coverage for their PCAs immediately upon enrollment in PCA programenrollment in PCA program

-- Carrier tracks claims activity; identifies trends/patterns/issuesCarrier tracks claims activity; identifies trends/patterns/issues

3636

Lessons Learned Lessons Learned (continued)(continued)

Calculate annual premium based on estimated payroll Calculate annual premium based on estimated payroll for whole program, not individual employersfor whole program, not individual employers-- Streamlines payment and billing of WCStreamlines payment and billing of WC

-- Annual audit ensures premiums paid accurately reflect Annual audit ensures premiums paid accurately reflect payrollpayroll

-- Ensures timely WC coverage for all consumersEnsures timely WC coverage for all consumers

-- Facilitates establishment of MassHealth hourly rate for Facilitates establishment of MassHealth hourly rate for PCAPCA

Incorporate FI WC responsibilities into FI contractIncorporate FI WC responsibilities into FI contract

3737

Contact InformationContact Information

Workers’ Compensation Rating and Inspection Workers’ Compensation Rating and Inspection Bureau (WCRIB)Bureau (WCRIB)

101 Arch St.101 Arch St.

Boston MA 02110Boston MA 02110

617-439-9030617-439-9030

www.wcribma.org/masswww.wcribma.org/mass

3838

Contact Information Contact Information (continued)(continued)

Massachusetts Division of InsuranceMassachusetts Division of Insurance

One South Station, 5One South Station, 5thth floor floor

Boston MA 02110-2208Boston MA 02110-2208

617-521-7794617-521-7794

www.mass.govwww.mass.gov

3939

Contact Information Contact Information (continued)(continued)

Massachusetts Department of Industrial AccidentsMassachusetts Department of Industrial Accidents

600 Washington St. 7600 Washington St. 7thth floor floor

Boston MA 02111Boston MA 02111

617-727-4900617-727-4900

www.mass.gov/diawww.mass.gov/dia

4040

Contact Information Contact Information (continued)(continued)

Hub International New England, LLCHub International New England, LLC

299 Ballardvale St.299 Ballardvale St.

Wilmington MA 01887Wilmington MA 01887

John Riley, Sr. Vice PresidentJohn Riley, Sr. Vice President

978-661-6648978-661-6648

john.riley@hubinternational.comjohn.riley@hubinternational.com

4141

Contact InformationContact Information Fiscal IntermediariesFiscal Intermediaries

-- Cerebral Palsy of Massachusetts (CPMA)Cerebral Palsy of Massachusetts (CPMA)43 Old Colony Ave.43 Old Colony Ave.Quincy MA 02170Quincy MA 02170Larry Spencer, FI Manager Larry Spencer, FI Manager 617-479-7443 X 111 617-479-7443 X 111

-- Stavros Center for Independent LivingStavros Center for Independent Living210 Old Farm Rd.210 Old Farm Rd.Amherst MA 01002Amherst MA 01002Seren Derin, FI Manager Seren Derin, FI Manager 413-253-4236 413-253-4236

-- North Shore ARC (NSARC)North Shore ARC (NSARC)6 Southside Rd.6 Southside Rd.Danvers MA 01923 Danvers MA 01923 Vade Mohammed, FI Manager Vade Mohammed, FI Manager 978-762-8307 978-762-8307

4242

Contact Information Contact Information (continued)(continued)

MassHealth Office of Long Term Care (OLTC)MassHealth Office of Long Term Care (OLTC)

1 Ashburton Place1 Ashburton Place

Boston MA 02108Boston MA 02108 Lois Aldrich, Director of Community ServicesLois Aldrich, Director of Community Services

617-222-7440617-222-7440

LLois.Aldrich@state.ma.usois.Aldrich@state.ma.us Judith Nest-Pasierb, Program ManagerJudith Nest-Pasierb, Program Manager

617-222-7431617-222-7431

JJudith.Nest-Pasierb@state.ma.usudith.Nest-Pasierb@state.ma.us