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MGH Community News |
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MGH Community News |
| November 2011 | Volume 15 • Issue 10 |
Highlights
Sections
Social Service staff may direct resource questions to the Community Resource Center, Samantha Gallant, x6-8182. Questions, comments about the newsletter? Contact Ellen Forman, x6-5807. |
The “Winter Moratorium” In Effect As of November 15, the Massachusetts "winter moratorium" is in effect. Gas and electric companies are prohibited from terminating heat-related utility service to low-income households between the dates of November 15 and March 15. The March end date is often extended into or through April. Those who heat with gas may also have their electricity service protected if they pay for heat, since all boilers and furnaces need electricity to operate. Typically those whose heat is included in their rent do not have this protection because the heating systems are not under control of their apartment/unit, so wouldn’t be affected by electric termination. Please note this protection only applies to utility companies (both investor-owned and municipal); it does not cover “deliverables” such as oil, propane or wood. Also note, the moratorium does not eliminate debt owed, it just temporarily protects from termination. Demonstrating “Financial Hardship” via Fuel Assistance To qualify for this protection one needs to demonstrate “financial hardship”. One way of doing this is by applying and qualifying for fuel assistance. If one heats with gas or electricity the fact that one’s bills are paid by fuel assistance (LIHEAP) qualifies one for the protection (more on this below) and serves as notice to the utility that you should be protected. If one heats with oil and got fuel assistance, ask the fuel assistance agency to contact the electric company to establish financial hardship for protection of electricity. If your client got fuel assistance payments last year, and the company knew about it, it can't shut-off until January 1, 2012, to allow the customer enough time to apply again for LIHEAP. Once the client is approved by LIHEAP this year, and the company learns that your client has been approved, the client will be protected against termination through March 15 (or April, if the end date is extended). DPU regs, 220 CMR 25.03(3): "A company which received fuel assistance payments in the prior winter season on behalf of a customer shall presume that customer meets the financial hardship guidelines set out in 220 CMR 25.01(2) and shall protect the account from November 15 through January 1, in order to give the customer sufficient time to apply for fuel assistance for the current winter season." Demonstrating “Financial Hardship” for All Others If one does not qualify for fuel assistance, one may complete and submit the utility company’s “financial hardship” form. Those with incomes below 60% of the Massachusetts Median Income automatically qualify. Those with incomes above this amount may also qualify on a case by case basis. -Adapted from “ Winter moratorium on terminations began today” , fromowner-utilitynetwork@lists.nclc.org |
Fuel Assistance Cut Dramatically The federally-funded Low-Income Home Energy Assistance Program (LIHEAP) in Massachusetts is starting winter with less than half the money it got last year, forcing the state to slash benefits. The maximum subsidy for the poorest customers has fallen from $1,090 last year to $675, and from $790 to $285 for natural gas or electric heat. For people with oil furnaces, the upper-tier benefit will pay for less than a full tank and is unlikely to last beyond mid-December for many families, several agencies said. It is not at all unusual for fuel assistance programs to start winter with less money than they believe they need. In fact, agencies often appeal to Congress for more money, and lawmakers sometimes deliver later in the season. But fuel assistance directors said this year stands out from the usual back-and-forth with Washington by starting with unusually steep cuts. While the U.S. House and Senate each have discussed boosting the program, if approved, the proposals would still represent a 30 percent cut from last year. -See the full article from the Pembroke Mariner and Reporter… MassHealth Bed Hold Saved Through June As reported last month ( Patrick Vetoes MassHealth Bed-Hold Funding , MGH Community News, October, 2011), Governor Patrick had vetoed the funds for the MassHealth 10-day Bed-Hold. He has since signed a supplemental budget restoring MassHealth payments to nursing homes to hold the beds of nursing home residents for up to 10 days while they are hospitalized, or leave the facility for other reasons. The funding runs through June 30, 2012. The Patrick administration said that it found at least 4,000 empty nursing home beds in Massachusetts on any given day. It and key members of the legislature have indicated that there may be further efforts to identify cost-savings in this program while balancing the needs of patients and families. Federal law requires nursing homes to readmit a resident after a temporary leave to the first available bed in a shared room, but it does not guarantee the same room or bed. -Adapted from “News from Margolis & Bloom, LLP - November 14, 2011”, Margolis & Bloom, LLP, November 15, 2011 and “Patrick OK’s bed saving for nursing homes”, TheBostonGlobe.com. New DTA Rules Prohibits Use of Cash Assist for Alcohol, Tobacco, Lottery On July 28, 2011 the Legislature passed and the Governor signed a law which prohibits DTA cash clients (TAFDC and EAEDC recipients) from using any direct cash assistance received from the Department (whether on an electronic benefit card or in cash withdrawn from an electronic benefit card) to purchase alcoholic beverages, lottery tickets and tobacco products. If a client has been found to make such a purchase, he or she must reimburse DTA for the amount of the purchase of the prohibited items from their current and/or future benefits. This is effective July 28, 2011. The new law also bars stores from selling the alcoholic beverages, lottery tickets and tobacco products to DTA cash clients using electronic benefit cards for these purchases. Store owners caught making these sales are subject to fines. Depending upon the number of offenses, fine amounts can range from less than $500 to $1000. More Information
Transgender Equal Rights Now Law in MA In November, in an historic vote, the Massachusetts legislature passed An Act Relative to Transgender Equal Rights which was subsequently signed by Governor Patrick. The new law provides protections for the transgender community in the areas of employment, education, housing, and credit and amends existing hate crime laws to explicitly protect people targeted for violence and harassment. To allow passage, the law was stripped of protections related to “public accommodations”. The Transgender Equal Rights Law adds “gender identity and expression” to existing Massachusetts civil rights laws which currently prohibit discrimination on the basis of age, race, creed, color, national origin, sexual orientation, sex and marital status. The law defines “Gender Identity” as “a person's gender-related identity, appearance, or behavior, whether or not that gender-related identity, appearance or behavior is different from that traditionally associated with the person's physiology or assigned sex at birth. Gender-related identity may be shown by providing evidence including, but not limited to, medical history, care or treatment of the gender-related identity, consistent and uniform assertion of the gender-related identity or any other evidence that the gender -related identity is sincerely held, as part of that person's core identity; provided however, gender-related identity shall not be asserted for any improper purpose." Advocates have pledged to continue to fight to expand transgender protections to include public accommodations, such as hotels, restaurants, and clubs. Opponents had decried those proposals as “the bathroom bill,’’ arguing that they would enable biological men to demand access to women’s restrooms and locker rooms. - Adapted from: http://www.masstpc.org/legislation/legabout.shtml (Mass Transgender Political Coalition), http://www.masstpc.org/publications/legis/briefing2011a.pdf and Transgender Civil Rights Bill OK’d, on TheBostonGlobe.com. As we reported last month, and as Samantha Gallant explained in an Information Session after this month’s Staff Meeting, the HomeBASE program for homeless families is facing a serious financial shortfall and resulting cuts ( HomeBASE Funding Endangered, MGH Community News, October 2011). Due to these budgetary constraints the HomeBASE program’sRental Assistance benefits will now be limited to those already in the pipeline. New eligible families still will be able to receive emergency shelter, temporary accommodations, and/or HomeBASE Household Assistance (non-rental assistance). Some families still will be able to access HomeBASE rental assistance, depending on funding availability. These include:
Families receiving rental assistance pay up to 35% of their incomes towards rent and utilities for an approved rental unit, with the subsidy making up the difference between a family's contribution and the contracted rent (usually between 80% - 100% of the fair market rent.) The HomeBASE Household Assistance (or Non-Rental Asisstance) program is open to new referrals going forward. This program provides up to $4,000/year (for no more than three years) for rent or utility arrears, payments to allow a homeless family to stay with another household, first and last month’s rent and security deposit, moving expenses, extraordinary medical bills, and other costs that will allow a family to become or remain housed. The Supplemental Budget offers additional protections; new legislative language:
-Adapted from “Budget Update: Legislature Approves Supplemental Funding for the Emergency Assistance and HomeBASE Programs!”, Kelly Turley, Mass. Coalition for the Homeless, November 7, 2011. Pilot Program To House Pregnant WomenIn an effort to drive down the disproportionately large number of deaths among black and Latino infants in Boston, city leaders this month unveiled a campaign to provide housing, counseling, and other critical support for pregnant women who are homeless or living on the edge. Healthy Start in Housing is a new joint initiative of the Boston Housing Authority and the Boston Public Health Commission. BHA will initially make 75 housing units available for the program, while BPHC will provide case management to help these women manage the combined demands of tenancy and infant care while meeting their own health needs and those of their children. The program will provide counseling and support for the first 18 months after a woman gives birth, while the public housing placement will be permanent. This is believed to be the first coordinated initiative of its kind in the country. “Stable housing and quality perinatal care are vital to helping reduce birth disparities,” said BPHC Executive Director Dr. Barbara Ferrer. “Housing insecurity is the first thing women report as a source of worry and distress during pregnancy. That stress translates into higher rates of low birth weight and preterm birth, and ultimately into the disparities we see in infant health and survival. A safe, secure home is the best prescription a city can provide to assure healthy pregnancy.” Referrals reportedly are managed by the Metropolitan Boston Housing Partnership (MBHP) (617) 859-0400, though we were unable to confirm this by press time. Adapted from http://www.cityofboston.gov/news/Default.aspx?id=5354 -Also see Pilot program aims to reduce infant deaths, by Kay Lazar, The Boston Globe, November 4, 2011. Patients Turn to the Internet for Fund-RaisingOnline fund-raising- a common tactic for nonprofit groups and charity events- is starting to spread to the world of costly health care. Although some Web sites do not accept such personal appeals, dozens of health-oriented campaigns have appeared on IndieGoGo in recent months. They cover a wide range of needs, from small medical expenses to extensive cancer treatments and even organ transplants. Posting to IndieGoGo is free, but the site takes 4 percent of the money raised. (To encourage users to set reasonable goals, the site imposes a 9 percent fee if a campaign falls short of the fund-raising goal.) Slava Rubin, who helped found IndieGoGo in 2008, says successful health-oriented campaigns on the site now number in the “hundreds.” See the full article on NYTimes Well Blogs… Cited in/linked from HEALTH CARE WEEKLY UPDATE, Barbara Roop & John Goodson, Health Care for Massachusetts, November 23, 2011.
Respite Homes Program Reminder NOTE: This program is currently closed. MENTOR is unable to meet the need. Healthcare for the Homeless will notify us if the program is reinstated. (6/15) Boston Health Care for the Homeless offers limited special foster-care arrangements for children whose parent needs inpatient treatment (this can be medical, psychiatric, or substance abuse related). Families who are homeless or marginally housed may qualify. The program helps families where the parent requires inpatient medical treatment and there is no informal support system to provide safe child care. Health Care for the Homeless learned from parents that they were refusing inpatient treatment because the only existing alternative for childcare was to request foster placement through DCF. Involving DCF was a concern for these parents so the Respite Homes program places the children in temporary foster homes, generally without DCF involvement. The foster families are contracted through the MENTOR program, all have had CORI checks, and at least one parent in each family does this work as a full-time job. These placements are considered "specialized foster care"- the families are accustomed to the most difficult placements and receive a higher than average reimbursement level. Many are social workers by training and tend to be culturally diverse allowing culturally appropriate placements. Parents are given the foster parent's contact information; when there is a planned admission and time allows, they may be able to contact them by phone in advance. The program is committed to placing siblings together where possible. It is best to make referrals as far in advance as possible. Because of the limited number of foster families and limited funding the program may not be able to accommodate all requests. For more information or to make a referral contact Nancy Paladino 857-654-1300, or page at 781-221-6565. Referrals can only be accommodated during normal business hours. Wellesley Friendly Aid Association Founded in 1899, the Wellesley Friendly Aid Association is a non-profit that focuses on helping Wellesley families living at or near poverty levels. Although Wellesley has a reputation as an affluent town, reality can be quite different for some of its residents. The Association offers a range of services. Their programs include the Neighbor Brigade, Medical Equipment Loan program and Emergency Community Aid. Neighbor Brigade This is a new program in which the Wellesley Friendly Aid Association partners with Neighbor Brigade to help individuals and families facing a serious medical condition, catastrophic injury or tragic event (see also Program Highlight: Neighbor Brigade, MGH Community News, July 2011). Friendly Aid has a Wellesley-based network of volunteers who provide services that are non-medical and temporary in nature to Wellesley residents, regardless of income. These services are designed to help the individuals and families cope with their new circumstances for a limited period of time until they can get back on their feet. They include:
The Friendly Aid Neighbor Brigade chapter leader interviews each caregiver to determine their needs then uses the Lotsahelpinghands website to allow volunteers to match their skills and time to tasks identified by the patient or caregiver. Patient identifying information is only visible to registered volunteers. The program screens volunteers including reviewing references. There are currently 24 Neighborhood Brigade chapters in Massachusetts. To refer or volunteer please contact WellesleyMA@neighborbrigade.org or call Karen Mondell, Friendly Aid Program Administrator, at 781-235-3960. Medical Equipment Loans Walkers, commodes, shower chairs, wheelchairs and other specialty equipment are available to town residents upon request, at no charge to the user. Please contact the Wellesley Friendly Aid office at (781) 235-3960. Donations of wheelchairs, walkers, and shower seats/benches are welcome. Emergency Community Aid Friendly Aid receives numerous requests throughout the year for emergency financial assistance from Wellesley residents. Schools and other community organizations also contact them on behalf of individuals they have identified as needing help. Applications are reviewed on an individual basis. The Wellesley Friendly Aid Association
FCC Unveils Broadband Plan for the Poor The Federal Communications Commission and cable and computer firms recently announced a program to provide low-income homes with $10 monthly broadband Internet service and $150 computers. The price of high-speed Internet averages $40 a month and computers can cost several hundred dollars. Beginning next spring, cable Internet service providers will offer families who are eligible for federal school-lunch programs the discounted monthly service. The service will include free installation and modem rental for two years. Redemtech, a computer refurbishing firm, will offer those families laptops or desktops for $150 with free home shipping and 90 days of tech support. Microsoft will provide new computers for $250. Critics point out that the real winner is the service providers who will get new subscribers used to and “dependent” on internet service, some of whom will continue at full price after the 2-3 year discount ends. Eligibility requirements vary, but many require that the families are not current subscribers, or that they not have overdue bills or unreturned equipment. -Full article on the BostonGlobe.com… -Also see http://www.dslreports.com/shownews/FCC-Pushes-10-Broadband-Plan-Most-Wont-Qualify-For-11696 Suit Contests Hospitals Use of Observation Status Leading to Non-Coverage of SNF Seven Medicare patients have filed a class action lawsuit challenging a Medicare policy that allows hospitals to place patients under "observation" for days on end rather than actually admitting them. If these patients then move to a nursing home, they are not eligible for Medicare coverage of their nursing home stay, costing them or their families thousands of dollars. See full article on ElderLawAnswers.com… Where Can We Realize Real Health Care Savings (Opinion)Health care spending in the United States typically increases by about $100 billion per year. Cutting a billion here or there from something that large is undetectable. In health care, you have to be talking about tens of billions of dollars before you are talking about real money. A useful threshold for savings is 1 percent of costs, which comes to $26 billion a year. Anything less is simply not meaningful. Where can you find that kind of money? See series of articles by Ezekiel Emanuel (yes, Rahm’s brother) on The New York Times’ “Opinionator” blog: -Cited in/linked from: HEALTH CARE WEEKLY UPDATE, Barbara Roop & John Goodson, Health Care for Massachusetts, November 04, 2011. 5 Questions About GOP's Plan to Privatize Medicare (Opinion) GOP Presidential candidate Mitt Romney recently called for creation of a "premium support" option that would let seniors choose between traditional fee-for-service Medicare or a defined amount of money they could use to shop for a private plan in a federally-sponsored Medicare exchange marketplace. Romney's proposal is a cousin of the privatization plan proposed by Rep. Paul Ryan and endorsed by the House of Representatives earlier this year and was a key stumbling block in the SuperCommittee budget negotiations. How would privatization impact seniors? How would benefits change, and what would it mean for seniors' cost of healthcare? Here are answers to five key issues. Editorial: Medicaid Has a Problem, but Block Grants Won’t Solve It Currently, the federal government sets minimum Medicaid eligibility standards and reimburses states at least half the program costs. There is ample reason to fear that, should states instead receive fixed grants, many would limit costs not through greater efficiency but simply by denying medical services. See full editorial on BostonGlobe.com… Integrated Care Improves Mental Health Outcomes, Cuts Costs Integrating primary and mental healthcare in "health homes" can save lives, according to a leading mental health expert. "It turns out, it's actually a really great way to save money, too," said Joseph Parks, MD, director of the Missouri Institute of Mental Health in St. Louis. Through a health home initiative in Missouri that predates the Affordable Care Act's patient-centered medical home concept, community mental health centers (CMHCs) function as healthcare homes, or medical homes. A primary care provider is responsible for overall coordination of care. Case management is coordinated, people with serious mental illnesses have their medical diseases managed, and mental healthcare providers offer preventive healthcare screening and monitoring. Primary care nurses play an active role as agents of change at the CMHCs. -See full article on Medscape.com…
LGBT Cultural Competence- New Joint Commission Field GuideThe Joint Commission recently released a field guide (“Advancing Effective Communication, Cultural Competence and Patient- and Family-Centered Care for the LGBT Community: A Field Guide”) for hospitals and healthcare organizations to create a more welcoming, safe and inclusive environment that contributes to improved healthcare quality for Lesbian, Gay, Bisexual, Transgender (LGBT) patients and their families. The Field Guide offers strategies, practice examples, resources and testimonials designed to help improve communication and provide more patient-centered care to LGBT patients through the implementation of the Joint Commission's new hospital visitation and non-discrimination standards, which are inclusive of LGBT patients. Excerpts from the guide:
-Cited in/linked from "November Announcements from the Disparities Solutions Center", MGH Disparities Solutions , November 16, 2011. Behavior Therapy Effective for ADHD Psychosocial interventions for Attention deficit hyperactivity disorder (ADHD) are mentioned prominently in the American Academy of Child and Adolescent Psychiatry's Practice Parameters. Behavioral therapy is also mentioned quite frequently in the American Academy of Pediatrics' recently published clinical practice guidelines. Both of these documents from professional organizations note that psychosocial intervention with the most definitive evidence for application in children with ADHD is clearly behavioral therapy. The data demonstrate that behavioral therapy, whether administered as parent training, behavioral classroom management, or as a peer-based intervention, can be beneficial to children or teenagers with ADHD. Moreover, both the guidelines and the practice parameters articulate the putative benefits that are associated with combining behavioral therapy with pharmacotherapy in certain patients. -Full summary on Medscape.com… Conversion Disorder - A Problematic Diagnosis Since doctors have conceptually and practically differentiated the symptoms of Conversion Disorder from neurological ('organic') disease it has been presumed to be a psychological disorder, but the psychological mechanism, and how this differs from feigning (conscious simulation), has remained elusive. The diagnosis is anomalous in psychiatry in that current diagnostic systems require that feigning is excluded and that the symptoms can be explained psychologically. In practice, feigning is very difficult to either disprove or prove, and a psychological explanation cannot always be found. These problems highlight serious theoretical and practical issues not just for the current diagnostic systems but for the concept of the disorder itself. -Full article on Medscape.com… Damage of Online Bullying SevereHigh school students who are bullied online are more likely to report symptoms of depression and suicide attempts than students who were bullied only at school, according to a recent survey of students in communities west of Boston. The study, which appears on the website of the American Journal of Public Health, also found that girls are more likely than boys to report being victims of cyberbullying, and students who do not identify themselves as heterosexual are more likely to report being bullied online and at school. -See the full article on BostonGlobe.com… DSM-5 Petition Calls for Critical ChangesAfter initially refusing to respond to an online petition issued by several divisions within the American Psychological Association expressing "serious reservations" about the lowering of diagnostic criteria in the upcoming Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the American Psychiatric Association (APA) has answered its critics. As reported previously by Medscape Medical News, the petition was posted online October 22 in the form of an "Open Letter" to the DSM-5 Task Force of the APA. -See the full article on Medscape.com… The Relationship Between Grief and DepressionAcknowledging that the line between depression and grief is blurrier than once thought, psychiatrists are now reconsidering whether bereavement should exclude a diagnosis of major depression. According to Dr. Naomi Simon, a Mass General psychiatrist who specializes in treating grief and depression, the American Psychiatric Association is debating whether to delete the bereavement exclusion in the next edition of the DSM. Additionally, a new diagnosis of “complicated grief,’’ for those with acute grief symptoms persisting at least 6-to-12 months after a loss, might be included in the DSM-5, to be published in 2013. But diagnosing the bereaved as clinically depressed is controversial. Such a diagnosis risks rushing people through the grieving process, pathologizing normal human emotion, and even stigmatizing those who experience it. On the other hand, as Dr. Simon points out, grief can be as painful and disabling as any medical or psychiatric illness. -See full article on BostonGlobe.com…
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