Former Elder Case Manager Launches Career on Beacon Hill

By Al Norman

Eight months ago, Barbara L’Italien of Andover was elected by the voters of the 18th Essex district to represent them in the House of Representatives on Beacon Hill. The elderly of this state can thank the voters in Essex County for sending them a new champion under the Golden Dome.

Every freshman representative gets one chance to make his or her ‘maiden speech’ on the floor of the House. It is a traditional welcoming ceremony, which the members extend to new colleagues who are joining the House. When a lawmaker gets up to deliver a maiden speech, the rest of the Chamber is respectfully silent, in deference to the launching of a new career. What a member chooses to speak about gives you some insight to who they are as a person, and what they consider important.

On Thursday, July 10th, while most senior citizens in the state were sitting down to dinner, Barbara L’Italien, who lists her profession as a social worker, got up in front of 150 other lawmakers, and made her maiden speech. Out of all the issues swirling about on Beacon Hill, Barbara L’Italien chose to deliver her first speech on the subject of home care.

She had literally only minutes to collect her thoughts, because the subject she wanted to discuss had come up for a vote earlier than expected. She knew the speech she wanted to give in her heart—because she had lived it first-hand.

The House was about to take a vote on whether or not to restore $2.4 million in home care services that had been vetoed the week before by Governor Mitt Romney. For the first time in her legislative career, L’Italien took the floor. “I am a mother of four young children,” she began, “and have been doing that for the last ten years. I was a home care worker prior to that. I understand this topic quite well.” In fact Barbara L’Italien is someone who not only understands home care quite well, she has done it. L’Italien worked as a case manager and as a supervisor for Elder Services of Merrimack Valley, and for Springwell. She lived this issue for several years of her life, working on what some people call the “front lines” of elderly home care, before she left to raise her own family.

“I was a case manager in Lowell,” L’Italien explained. “I had a caseload of 60 to 70 clients. It’s up to 100 now. That’s OK. We have limited dollars. We need to understand the economics of the situation. Twenty-eight hundred dollars a year keeps a senior at home…we have an opportunity to buy independence for some of our seniors. We need to understand what these dollars mean to seniors. We can maintain elders in their community, which is what they want. They want choice. It’s a common sense approach and a compassionate approach. Eliminating this (home care funding) amounts to 875 seniors taken off the rolls. It’s quite compelling.”

L’Italien noted, “That Massachusetts spends only 10% of its Medicaid long-term care budget on home care—the rest goes to institutions. Federal law requires disabled people to receive care in the least restrictive setting.”

“A recent Globe poll had a list of what people did not want to see cut.” L’Italien said. “Home care was at the top of the list, higher than Prescription Advantage. It ranked lowest in terms of services mentioned for cuts. The federal government weighed in on this with the Olmstead decision. They said people had the right to decide to live in the least restrictive environment. President Bush is also highlighting this. We really need to put money into community-based placement. This is the most caring and compassionate way to approach our seniors. In the words of the late elder advocate Frank Manning, putting an elder on a waiting list is like calling 911 and being put on hold.”

With that, L’Italien ended her maiden speech, to the applause of her colleagues. They then rewarded L’Italien with a remarkable 151-0 vote to override the Governor’s veto, and restore $2,400,000 to the home care services program. It was an affirmation of the work Barbara L’Italien had done for years, working with hundreds of senior citizens. And it was a unanimous vote of confidence in a program that buys independence—a rare purchase.

It was also a wonderful way to begin a new career on Beacon Hill.

Al Norman is the Executive Director of Mass Home Care. He can be reached at 413-773-5555, or