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MGH Community News |
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MGH Community News |
| December 2011 | Volume 15 • Issue 11 |
Highlights
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. |
Mass Rehab Homecare Assistance Program Waitlist Reopens The Massachusetts Rehabilitation Commission’s Homecare Assistance Program provides homemaker services to eligible disabled adults under age 60 who are unable to do these tasks themselves. Due to funding cuts, in June 2009 the program’s waiting list was closed. The waiting list reopened as of June 2011 (with little fanfare) and they are currently taking new referrals. Homemaking services include:
Income eligibility limit is 300% FPG. If there are any other adults in the home, they also must be unable to do homemaking tasks. There are no citizenship or immigration status requirements for this program. More information |
Home Affordable Refinance Program (HARP) On October 24, 2011, the federal government announced changes to the Home Affordable Refinance Program (HARP) that will make it easier for homeowners with at-risk mortgages to refinance their loans. This program allows those with little equity in their homes, including some of those who are “under water” (who owe more than their home’s currently value), to take advantage of historically low interest rates to refinance their mortgages. Homeowners must be current with their mortgage, however, so it is not a foreclosure intervention program. An important element of these changes is the encouragement, through elimination of certain risk-based fees, for borrowers to utilize HARP to refinance into shorter-term mortgages. Borrowers who owe more on their house than the house is worth will be able to reduce the balance owed much faster if they take advantage of today’s low interest rates by shortening the term of their mortgage. These changes extend the program through December 31, 2013 (previously scheduled to sunset on June 30, 2012). Adapted from FHFA News Release: HARP Changes to Reach More Borrowers More Information Funding for Lead Poisoning Prevention May be CutPrograms to fight lead poisoning in Massachusetts have been slashed during the past two years because of squeezed state and federal budgets, and now Congress is poised to eliminate the remaining federal aid - even as scientists last month concluded that the toxic metal can harm children at half the levels previously thought. The new cuts would hit Massachusetts especially hard because the state has some of the nation’s oldest housing, much of it with dangerous levels of deteriorating lead paint. Children here are more likely to suffer lead poisoning than in all but five other states, according to the latest federal data. See the full article on BostonGlobe.com… Study Finds Top Nursing Home Chains' Focus on Low Labor Costs Reduces Care Quality Nursing homes are notoriously understaffed, but a new analysis reveals that the largest for-profit facilities typically maintain staffing levels nearly one-third lower than non-profit and government-owned nursing homes, resulting in a significantly lower quality of care. -See full article on ElderLawAnswers.com… A Letter of Instruction Can Spare Heirs Great Stress There is a lot of information that your heirs should know that doesn't necessarily fit into a will. The solution is a letter of instruction, which can provide your heirs with guidance if you die or become incapacitated. Without such a letter, it can be easy for heirs to miss important items or become overwhelmed trying to sort through all the documents you left behind. Some examples of information one might include:
-See the full article on elderlawanswers.com Warning on Senior Advisor Credentials Thousands of financial advisors market themselves as trained to provide investment advice to seniors, using authoritative-sounding titles like "certified senior advisor" or "certified retirement counselor." But often these designations are nothing more than what are called "weekend" designations, obtained by attending a hotel seminar, and some don't even require a high school or college diploma. (See "When Getting Financial Advice, Don't Be Fooled by Impressive-Sounding Credentials.") The use of these misleading designations has become so widespread that now the brokerage industry's largest regulator has issued a warning regarding their use. If you are looking for qualified financial advice, look for a "certified financial planner," "chartered financial consultant," or a "master of science in financial services (MSFS)." -See the full article on elderlawanswers.com BBA Publishes Updated Children's Mental Health Guide The Boston Bar Association has just published a new edition of its Parents' How-To Guide to Children's Mental Health Services in Massachusetts. This is useful booklet covers both legal and non-legal issues, including diagnosis of mental illness, the availability of public services, payment sources, and legal issues, including commitment and school discipline issues. -From “News from Margolis & Bloom, LLP - December 19, 2011”, Margolis & Bloom, LLP
Center for Hoarding Intervention (formerly MBHP Hoarding and Sanitation Initiative) Once thought to be simply an eccentricity, hoarding affects 3 to 5 percent (approximately 15 million people) of the U.S. population, according to a 2008 study from Johns Hopkins University (Samuels, et al., 2008). Without intervention, tenants who hoard almost inevitably face eviction. In fact, hoarding/clutter is one of the leading causes of eviction in Massachusetts. Center for Hoarding Intervention of Metro Housing|Boston (formerly Metropolitan Boston Housing Partnership or MBHP) has experience in addressing issues of hoarding that can endanger housing stability. Case managers work hands-on to bring apartments into health and safety compliance, teach skills to maintain compliance, and support tenants in obtaining mental health services to ensure sustained behavioral changes. Its success is attributed in large part to interagency cooperation and coordination of services. Intervention begins with an Metro Housing|Boston staff member visiting the home for an assessment, followed by the development of an individualized action plan. The plan tailors resources for home decluttering; education and skill-building regarding shopping, organization, and sanitation; and counseling and support using cognitive and behavioral techniques. Metro Housing|Boston also provides training and technical assistance to communities and agencies to help them assist individuals affected by hoarding and sanitation issues. To learn more about the program contact Jesse Edsell-Vetter at (617) 425-6658. Did you know that those who hoard may be protected under the ADA? See their Hoarding Fair Housing Fact Sheet to learn more. Allsup Educates and Advocates for Social Security Disability Benefits Nearly 1.7 million applicants nationwide are waiting for their SSDI claim to be determined according to Allsup, a private Social Security disability claims services company. Nearly 10,000 Massachusetts residents with disabilities are waiting an average of 346 days to receive a hearing for their Social Security Disability Insurance (SSDI) benefits after already waiting an additional 10 months on average at earlier levels of the process. Many also face lost savings and bankruptcy. With early SSDI representation, many people could receive their benefits more quickly, often avoiding multiple appeals that lengthen wait times. How can Allsup help? Allsup provides several services, SSDI literacy materials and resources to your and your patients. This includes free SSDI screenings to help patients determine if they are eligible to apply.
What Does Social Security Disability Representation Cost? The SSA determines the fee that any organization, such as Allsup, or an attorney, can charge for SSDI representation . Currently this amount is 25 percent of the retroactive dollar amount awarded, not to exceed $6,000 (as of June 22, 2009). Those who are approved quickly at the application level and receive no retroactive award typically pay much less.
To Refer or for More Information You refer online by going to AllsupCares.com and clicking “Refer a Patient.” Or, call (866)-606-8812. For more information or questions, contact Karen Hercules-Doerr at (800)-854-1418, ext. 65770 or k.hercules-doerr@allsupinc.com. Some Other Professional Advocacy Services These charge a fee:
These are free or low-cost (at least at some stages) to those who qualify:
“Disability Answers” Smartphone App The Advocator Group, an organization that helps Americans obtain disability benefits for a fee, has released a new smartphone app, “Disability Answers,” to help people with debilitating health conditions and their families navigate Social Security Disability Insurance and Medicare eligibility. Available for both iPhone and Android devices, it offers answers from “What is disability insurance?” to “Tips for filing taxes for a lump sum retroactive award.” The “My Answers” menu walks users through a step-by-step survey to determine the likelihood of coverage. Get more information on the itunes app download page: http://itunes.apple.com/us/app/disability-answers/id458210207?mt=8 -Adapted from: Disability Issues, Vol. 31, No. 4 , Winter 2011 , Center for Health Policy and Research, University of Massachusetts Medical School, www.workwithoutlimits.org/DisabilityIssues Highland Kids Initiative -From: http://www.mahomeless.org/programs/highland-kids-initiative
Partners a “Pioneer” Accountable Care Organization Massachusetts is set once again to become a testing ground for a major federal effort to overhaul the health care industry. Five of the 32 hospital systems and physician groups that will become “pioneers” in a program to change how doctors are paid for the care they provide Medicare patients are from eastern Massachusetts. Starting Jan. 1, the federal program will give them a budget to care for their more than 150,000 patients, rather than a payment for each test or treatment. Called accountable care organizations, among the participants are the state’s two largest hospital systems, Partners HealthCare and Steward Health Care System. Proponents say such systems provide financial incentives for health care providers to give better care at lower cost by improving communication between specialists and primary care doctors, reducing unnecessary tests, and focusing on preventive care. -See the full article on Boston.com… US Extends Medicaid Waiver for Massachusetts; Deal changes how safety-next hospitals are paid The federal government approved a plan on December 19, 2011 that extends Medicaid funding for the state’s health insurance law through mid-2014 and shifts the way hospitals that treat a large portion of poor patients are paid. The $26.75-billion deal includes $120 million in new federal funding to shift “safety-net” hospitals toward global payments for Medicaid patients. Hospitals eligible for the program are Boston Medical Center, Cambridge Health Alliance, Brockton Hospital, Lawrence General Hospital, Holyoke Medical Center, and Mercy Medical Center in Springfield. Other provisions for specific programs include:
-See the full article on the BostonGlobe.com… Medical Security Program Direct Coverage Switches to Non-Partners Contracted Plan The state’s Medical Security Program (MSP) is Massachusetts’ health coverage for income-eligible Unemployment Compensation recipients. Those who have MSP Direct Coverage as of January 1, 2012, will automatically be transferred from Blue Cross Blue Shield to Network Health, the new MSP Direct Coverage health insurance provider. This product is called Network Health Extend. Partners Healthcare sites, with the exception of the Island Hospitals, are not contracted with Network Health Extend. About 23,000 individuals statewide are currently enrolled in MSP Direct Coverage. We do not know how many of these individuals come to our sites for care. Unfortunately, we have no way to identify our patients who may be on this plan ahead of time. Patients who are transferred to Network Health Extend will no longer be able to come to us for primary or specialty care. They must call Network Health at 1-888-257-1985 for help finding new doctors. There are some exceptions, but they require that the provider first get a Prior Authorization (PA) from Network Health. Exceptions:
Providers should follow the instructions for obtaining a PA at www.network-health.org under the provider section. Children on this plan may be eligible for MassHealth and you may direct families with children to a patient financial counselor for assistance. Handouts: -Adapted from “UPDATE: New insurance plan for unemployed - we are not contracted” Kim Simonian, MPH, Associate Director, Patient Access, Partners HealthCare - Community Health, December 15, 2011
Medicare Covers Screening and Counseling for Obesity The Centers for Medicare & Medicaid Services (CMS) recently announced that Medicare is adding coverage for preventive services to reduce obesity. This adds to Medicare’s existing portfolio of preventive services that are now available without cost sharing under the Affordable Care Act. Covered under this new benefit are screening for obesity and counseling for eligible beneficiaries by primary care providers in settings such as physicians’ offices. For a beneficiary who screens positive for obesity with a body mass index (BMI) ≥ 30 kg/m2, the benefit would include one face-to-face counseling visit each week for one month and one face-to-face counseling visit every other week for an additional five months. If the beneficiary achieves a weight reduction of at least 6.6 pounds (or 3 kilograms) during the first six months of counseling he or she may receive one face-to-face counseling visit every month for an additional six months (for a total of 12 months of counseling). For beneficiaries who do not achieve a weight loss of at least 3kg during the first six months of intensive therapy, a reassessment of their readiness to change and BMI is appropriate after an additional six month period. This benefit is limited to primary care practitioners and primary care settings. Emergency departments, inpatient hospital settings, ambulatory surgical centers, independent diagnostic testing facilities, skilled nursing facilities, inpatient rehabilitation facilities and hospices are not considered primary care settings for this benefit. Read CMS’ final decision on the new national coverage determination. -Cited in: http://www.medscape.com/viewarticle/754531 Medicare Reminder – Home Health Care If you qualify for the home health benefit, Medicare covers the following types of care:
Learn more about home health care coverage at www.medicareinteractive.org. - From “ Act Now to Preserve Access”, Medicare Watch, Medicare Rights Center, December 08, 2011. Tiered Health Plans Cutting Costs, Restricting OptionsMore Massachusetts employers and consumers are embracing “tiered network’’ and other “limited network” health insurance plans. Tiered network plans rank hospitals and doctors by cost and quality measures and assign patients’ payments with costs in mind. “Limited network” plans restrict members to certain providers and require them to pay higher rates for out-of-network care. Tiered and limited network plans are not new, but last year the Legislature passed an amendment to the state’s 2006 health care overhaul that requires insurers to offer them, with premiums that are priced at least 12 percent below their standard plans. They now make up as much as 15 percent of the Massachusetts health insurance market, industry leaders estimate. Insurance that ties premium prices to where patients get care received an added boost in the spring, when the Group Insurance Commission, which administers health plans for state employees and some municipal workers, made a strong push for limited network options. -See the full article on the BostonGlobe.com…
Upcoming Program: Money Follows the Person- Helping People Move Out of LTC Massachusetts is in the process of developing a very exciting and positive new opportunity for people in long term care facilities to move into the community. The Money Follows the Person (MFP) Demonstration Grant was funded by the Centers for Medicare and Medicaid Services (CMS) in July 2011. The grant is focused on “re-balancing” the state’s long term supports and services (LTSS) funding from medical facilities (e.g., nursing homes, rehabilitation facilities, etc.) to community-based, person-centered services and supports. The grant will enable people with disabilities age 18 and older to make choices with respect to where they live and will provide case management and additional community based services. This community living alternative will support participants to find housing including apartments, family homes, or small group homes, and will include provision of a variety of support and services that enable participants to live as independently as possible. For many years, Massachusetts has provided community-based services and supports to certain populations through Medicaid Home and Community-Based Services Waivers. These waivers allow the state to “waive” certain Medicaid requirements to provide expanded LTSS to individuals who would otherwise require care in a medical facility. The commonwealth currently operates waivers to serve people with intellectual disabilities, elders, traumatic brain injury, autism, and, most recently, acquired brain injury. This new MFP initiative will make waiver programs available for additional people with disabilities and elders who are interested in moving to a community setting. The commonwealth anticipates having these waivers available in mid-2012. People must meet certain qualifications in order to enroll in the demonstration (must have resided in a long term care facility for at least 90 days, be MassHealth eligible, and have at least the last day in the facility paid by Medicaid). Once qualified, the person will work with a case manager or transition coordinator and will receive assistance to locate housing and prepare for community living. As a result of the MFP Demonstration grant, Massachusetts hopes to support over 2,000 people to move from long term care facilities to the community over the next 5 years. The bottom line is that more people will live in communities of their choice. For further information about the MFP project see: Money Follows the Person Demonstration and Money Follows the Person Waivers -Adapted from Money Follows the Person By Barry Schwartz, Project Director for the Money Follows the Person initiative at EHS/MassHealth, Disability Issues , Vol. 31, No. 4 , Winter 2011 , Center for Health Policy and Research University of Massachusetts Medical School, www.workwithoutlimits.org/DisabilityIssues. No Supercommittee Agreement; What Comes Next Last month the Joint Select Committee on Deficit Reduction, also known as the supercommittee, announced that its members were unable to agree on a package that would reduce the deficit by at least $1.2 trillion. With Medicare and Medicaid at the center of the supercommittee’s discussions, both programs would likely have faced difficult cuts had an agreement been reached. -Adapted from “ No Deal on the Deficit”, Medicare Watch, Medicare Rights Center, December 01, 2011
Issues in Healthcare of Sexual Minority Populations A literature review of 20 years of research found that LGBT issues were addressed in only 0.1% of Medline articles. Additionally, most of that research was in the area of sexually transmitted disease, with attention to other topics important to this community lacking. The researchers concluded that a new research framework focused on sociocultural issues that encompassed the racial-ethnic and socioeconomic diversity of the LGBT community was needed. The full article debunks some common assumptions about health risks and protective factors, including a suggestion that lesbians were disproportionately affected by some cancers. Another example, while gay men had a lifetime prevalence of any mood and anxiety disorder of 42.3% compared with 19.8% among heterosexual men, lesbian women had a reduced odds ratio (0.6) for any lifetime mood disorder compared with heterosexual women. See the full article on Medscape.com... Study: Bright Light Treatment is Effective in Treating Older Patients With Non-seasonal Major Depression Treatment for major depression is unsuccessful in a large proportion of patients, and newer treatment modalities are thus welcomed. Bright light treatment has now been used for three decades and has been shown to be effective for non-seasonal depression, but specific evidence for efficacy in older people is still sparse. This small study was a double-blind randomised placebo-controlled trial of 89 non-seasonally depressed patients aged 60 years and above. The results showed that pale blue bright light treatment was effective in the treatment of older patients with major depression. Effect sizes are comparable to those found with antidepressant treatment. The hormonal outcome measures saw elevated cortisol levels approaching normal and positive changes in the circadian rhythm of sleep and melatonin. -Full summary at Medscape.com… Happy Holidays, and a healthy and joyous New Year to you and yours! |