At Vitra Health, we support families who care for their loved ones at home, especially spouses. Yet, under current Massachusetts law, paid spousal caregivers are not allowed through the MassHealth Adult Foster Care (AFC) program. This creates a financial and emotional burden for many families already doing the work.

That’s why we support H.D. 4524, “An Act relative to allowing spouses to serve as paid caregivers,” filed by Representative Adam Scanlon. If passed, it would formally recognize the role of spousal caregivers and allow them to receive compensation through MassHealth. This would be a major step forward for families across the state.

Why Legal Recognition of Spousal Caregivers Matters

Spousal caregiving isn’t just practical, it’s deeply personal. It grows out of decades of trust and shared life. However, when compensation isn’t available, families face impossible choices. As a result, many caregivers experience financial instability and emotional exhaustion. Clearly, the law must evolve to meet these real-world needs.

H.D. 4524 highlights a long-overlooked truth: Spouses are already caregiving full-time, and they should receive the same financial support offered to other family caregivers in Massachusetts.

A Real Family’s Story of Care and Strain

Navea, a Vitra Health client, lives with chronic pain and limited mobility. Her daughter currently serves as her paid caregiver. Meanwhile, her husband, who handles most of her care, cannot receive compensation due to outdated rules that exclude paid spousal caregivers in Massachusetts.

Recently, Navea injured her back. Her husband immediately stepped in to help:

“I hurt my back badly… If I didn’t have help from my daughter and my husband, how would I manage around the house in pain?”

He lifts her, drives her, and handles daily support tasks. Despite this, the system offers him no compensation. This places unnecessary pressure on their household, emotionally and financially.

“Yes, I feel supported. I have the care I need, but my daughter can only help part-time. If my husband could be part of the program, it would make a huge difference. He’s the one who’s with me the majority of the time.”

Their 35-year marriage is grounded in mutual care. Yet, policies still prevent her husband from being officially recognized. It’s time for the law to reflect the care that’s already happening in homes across Massachusetts.

What H.D. 4524 Could Change

H.D. 4524 offers a clear and fair solution. It instructs the state to update MassHealth regulations and finally allow spouses to qualify as paid adult foster care providers.

Here are just a few reasons this change matters:

• It compensates spousal caregivers for the work they already do daily
• It reduces caregiver burnout and long-term financial stress
• It improves care outcomes for people with disabilities and older adults
• It keeps families together in safe, trusted environments

Other states already support this model, and Massachusetts should too. For more details, see AARP’s breakdown on paid spousal caregivers. As the demand for home-based care rises, fair and inclusive policies like this are more important than ever.

How to Take Action in Massachusetts

If you believe spouses should be allowed to care for and be compensated for that care, here’s how to help:

• Contact your legislators and ask them to support H.D. 4524
• Share your story, whether you’re a caregiver or someone who relies on care
• Learn how Adult Foster Care works in Massachusetts at Mass.gov
• Spread awareness on social media using #CaregiversDeserveBetter and tag your representatives

“Look, there are real people who need this program and need their spouses to be caregivers.”
-Stephanie, caregiver advocate with Vitra Health

Ultimately, this is about giving families what they need: dignity, respect, and the ability to care without going broke. The current policy leaves too many behind. but H.D. 4524 can fix that.

Let’s make paid spousal caregivers in Massachusetts a reality.
Support H.D. 4524.
Stand with Vitra Health.