In a February 10 opinion piece in Generations, published by the American Society on Aging, author Margaret Morganroth Gullette warns that reductions to Massachusetts’ Enhanced Community Options Program (ECOP) could force vulnerable older adults out of their homes and into nursing facilities. Her argument is direct: home care is not only what people prefer — it is often safer, more dignified, and less costly than institutional placement.

The column details how the Executive Office of Aging & Independence reduced the number of ECOP participants by roughly 2,000 over the past year, returning capacity to levels not seen in more than a decade. ECOP serves low-income older adults who meet nursing home level-of-care criteria but can remain safely at home with limited assistance — capped at 7.5 hours per week.

Gullette notes that Massachusetts has historically taken a bipartisan approach to keeping elders in the community, aligning policy with the Olmstead decision’s mandate against unnecessary institutionalization. With federal Medicaid pressures looming and waiting lists already common nationwide, she questions whether scaling back home care access could increase nursing home admissions — citing analysis that individuals who qualify for nursing-level care but do not receive home services are significantly more likely to enter facilities.

For home care providers across the Commonwealth, the issue is more than policy. It is about patient choice, system capacity, and whether aging in place remains a realistic option for low-income elders in Massachusetts.