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MGH Community News |
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MGH Community News |
| January 2012 | Volume 16• Issue 1 |
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. |
Fuel Assistance Funding Increased But Still Less than Last Year On January 4, 2012 The Patrick-Murray Administration announced an additional $21.8 million for the Low-Income Home Energy Assistance Program (LIHEAP), increasing the maximum benefit to help low-income residents in Massachusetts heat their homes this winter. The additional funding, bringing the total Massachusetts allocation to $99.5 million, follows continued advocacy by the Administration for maximum funding for the program this year. "As winter’s cold weather arrives, this additional funding is crucial to help many of our neighbors heat their homes," said Governor Deval Patrick. "I thank our Congressional delegation and the Obama Administration for their continued support." The Commonwealth is expected to receive an additional funding increase in the coming weeks that will bring the total Massachusetts allocation to $132.7 million. Given this expected increase, the Massachusetts Department of Housing and Community Development (DHCD) has increased benefit levels; the maximum benefit level for the most vulnerable has increased from $675 for heating oil or other deliverable fuels to $1,025; and from $275 for utilities to $525. The Patrick-Murray Administration has been actively engaged in urging Congress to provide the maximum funding possible for LIHEAP. Total funding levels are expected to represent an approximate 28% cut in funding from last year’s allocation, down from what was originally a 57% cut (as reported in November). Last year, DHCD served more than 210,000 Massachusetts households through the program and expects the need to be even greater this winter. |
MBTA Proposes Fare Increases (Including for The RIDE) and Service Cuts The MBTA would raise fares and dramatically cull bus routes, eliminate ferries, and end weekend commuter rail trains under a plan unveiled earlier this month to help erase a projected $161 million deficit. MBTA officials stressed that details could change after a string of public hearings through February. But after 5 1/2 years of staving off fare increases and maintaining or increasing services, they said change appears inevitable when the next budget year begins July 1. Scenario 1 has higher rate increases and eliminates fewer bus routes and Scenario 2 has lower rate increases, but higher service cuts, wiping out dozens of outlying bus routes . Both proposals would charge more for The RIDE. Currently The RIDE charges $2 per trip. Under scenario 1 the fare would increase 125% to $4.50 for the ADA service area. Areas that are not served by bus routes would be higher; fares in these “Premium Service Areas” would be $12 in this scenario. Under scenario 2 the standard The RIDE fare would be $3, but $5 for Premium Service Area riders. The proposals are currently open to public comment.
For More Information:
MassHealth 2012 Community Spouse Allowances As of January 1st the MassHealth community spouse resource allowance (CSRA) has been raised to $113,640 and the minimum monthly maintenance needs allowance (MMMNA) has been increased to $2,841. Both figures are part of the protections in the law for spouses of nursing home residents. The CSRA figure is the amount of countable assets the healthy spouse of a nursing home resident may keep when the nursing home spouse qualifies for MassHealth coverage. Since the nursing home spouse can keep up to $2,000, together couples can keep approximately $115,000 in countable assets. (The house, one car, prepaid funerals and personal belongings are not counted against this limit.) The MMMNA is the minimum amount of both spouse's income that the healthy spouse can keep. It determines the community spouse's supposed monthly income need through a complicated formula that now caps out at the $2,841 figure. If the community spouse's income is less than her MMMNA, the shortfall will be made up from the nursing home spouse's income, which otherwise would go to the nursing home. - From News from Margolis & Bloom, LLP - January 12, 2012, Margolis & Bloom, LLP, January 09, 2012HomeBASE "Household Assistance"- When One Might Not Want to Apply Household Assistance is part of the HomeBASE program for homeless families (as reported previously and presented in Staff Meeting,). To get Household Assistance, you need to apply for and be eligible for Emergency Assistance (EA) shelter. Household Assistance (also called Non-Rental Assistance) offers up to $4,000 to help obtain or keep short-term housing. Advocates caution that applicants should carefully consider if HomeBASE Household Assistance is right for them. Massachusetts Law Reform Institute has created a flyer that explains applicant’s rights and factors they should consider in making this decision: HomeBASE "Household Assistance": Top 6 Things to Think About. Things to think about include:
Foreclosure-Prevention Plans Being Extended Freddie Mac and Fannie Mae, the government-sponsored housing finance companies that represent approximately half of all mortgages, have announced plans to extend existing programs so that unemployed borrowers can defer part or all of their monthly payments for up to 12 months while they are out of work. -See the full Boston Globe article… Immigration: Administration Announces Improvements to Family Unity Waivers The Obama Administration recently announced that it will be making major regulatory changes to the processing of Family Unity Waivers. Currently many relatives of US Citizens must leave the country before they can get their “green card”. Once they leave the country, however, they are barred from returning for 3 or (more often) 10 years. They can apply for a hardship exemption waiver of the three or ten year bar while in their home country, but this process itself may take months or years. As a result, many people who are otherwise eligible for a family-based petition for permanent residency fail to apply and continue to live on the periphery of our society. In the coming months DHS will issue new regulations to revise the processing of these Family Unity Waivers, allowing family members to stay in the United States while their waiver applications are being processed. While family members will still have to leave the country to get their "green cards", this new process will allow them to do so with confidence that their waiver application has already been approved and that they will be able to immediately re-enter the country as Lawful Permanent Residents. Families who might benefit from this change should recognize that the rule will take months for full implementation, and to be wary of predatory, semi-legal agencies promising immediate relief. This announcement is the result of months of advocacy and negotiation between the White House and advocacy groups around the country (including MIRA). Once the draft regulations are published there will be a period of public comment before they become effective. In advance of the public comment period, MIRA is seeking stories of families who are kept apart or living in the shadows because of the current system. If you have any questions about the announcement or stories of families impacted, please contact Sarang Sekhavat at (617) 350-5480 x212 or ssekhavat@miracoalition.org. -From “ Announcement: Positive Immigration Change will help Thousands of Families”, MIRA Coalition, January 06, 2012. TPS for Salvadorans Extended – Must Re-Apply On January 10, USCIS announced that it would extend Temporary Protected Status (TPS) for nationals of El Salvador for an additional 18 months ending September 9, 2013. Applicants must currently have TPS status to apply; new applicants will not be eligible for TPS status. To maintain their status, Salvadorans who currently have TPS must file both a Form I-821 Application for Temporary Protected Status and Form I-765 Application for Employment Authorization with US Citizenship and Immigration Services (USCIS) by March 11, 2012. Current employment authorization cards with an expiration date of March 9, 2012 will be automatically extended through September 9, 2012 to ensure that TPS beneficiaries who receive their new cards after March 9 will be able to continue to work. Applicants 14 years old or older must either:
For more information, visit USCIS's website or call the MIRA Coalition at (617) 350-5480. - From TPS Extended for Salvadorans; Must Apply by March 11, MIRA Coalition, January 12, 2012.
Trying to quit smoking? Free patches available - through May 2012 For a limited time, the Boston Public Health Commission (BPHC) is offering a two-week supply of free nicotine patches to those who live or work in Boston and who smoke 10 or more cigarettes a day. This includes any MGH employee at the Main Campus or at a satellite site. This patch giveaway will be available through May 2012. Boston residents can have the patches delivered to their home. MGH employees who live outside the city can have them sent to MGH’s Occupational Health Services at: 165 Cambridge St., Suite 404 , Boston, MA 02114 . Call 1-800-QUIT-NOW to arrange for delivery of your free two-week supply of nicotine patches, which can help start you on the path to being smoke-free. -Adapted from PCS News You Can Use, January 20, 2012. State to Close Taunton Facility for Mentally Ill After more than 150 years of housing mentally ill patients, Taunton State Hospital will close, and its remaining patients will be sent to other facilities by the end of the year, state officials said this month. The closing will help pay for the new Worcester Recovery Center and Hospital for the mentally ill. Of the 169 patients still in Taunton, 124 will be transferred to the Worcester Recovery Center and Hospital and 25 will be moved to Tewksbury State Hospital. Other patients will move into their own apartments or the equivalent of group homes linked to an array of support services, under the state’s Community First program, the officials said. But advocates for the mentally ill and officials from the nurses union decried the closing of the hospital. They pointed out that it is one of six remaining state mental health hospitals and that the system would have a net loss of 125 beds since fiscal 2010, when the state closed Westborough State Hospital. -See the full Boston Globe article
Comfort Zone- Suicide Loss Camp For the second year, Comfort Zone Camp is partnering with Samaritans Suicide Prevention & Massachusetts Dept. of Public Health/Suicide Prevention to offer a free one-day program dedicated solely to children and teens who have experienced the loss of a parent, sibling, or primary caregiver by suicide. This camp provides a place for bereaved kids and teens to break the isolation, build lasting friendships, and learn coping skills for their daily lives.
Applications must be received no later than March 9th . To apply online: register a camper . Or to receive an application by email, please contact Heather at HLaCasse@comfortzonecamp.org. One teen who attended last year said, “Going here was the best thing that ever happened to me.” A camper parent also said, "The camp [last year] helped tremendously because she got to be with people who feel about as close to the way she feels as humanly possible." Restartliving.org- Learn to Live Better with a Chronic Condition More than 90% of U.S. adults aged 55+ have at least one chronic condition, and 73% have at least two. Living with a chronic health condition can be overwhelming. Pain, fatigue, and the stress of managing multiple medications and trips to the doctor can make day-to-day life a real struggle. Often, it can lead to anxiety and depression. Now there’s a free six-week workshop developed and tested by Stanford University that can help those with a chronic condition to find a path back to a healthier life. The workshop teaches self-management—or the skills and knowledge you need to take better care of yourself. It's available in hundreds of communities at through senior centers, libraries, and churches. And it's available online. Volunteer leaders, many of whom also have health problems, guide the workshops and provide support. Participants meet regularly and help each other learn how to:
Learn more and get started at a new website from the National Council on Aging (NCOA) - RestartLiving.org, and it's completely free and confidential.
-Cited in/linked from Aging in Stride e-news, January 2012, Commonwealth and VA Launch Pilot to Help End Veteran Homelessness The Patrick Murray Administration, the U.S. Department of Veterans Affairs (VA) and the U.S. Interagency Council on Housing and Homelessness recently announced a new report showing homelessness among veterans in Massachusetts has dropped 21 percent since January 2011, nearly twice the rate of reduction nationally. The Administration also launched a new federally funded pilot program that will serve 50 chronically homeless veterans in the Boston Metro area. The new pilot program will offer comprehensive, peer-to-peer services to 50 chronically homeless veterans receiving HUD-Veterans Affairs Supportive Housing (VASH) vouchers in the Boston area. The Statewide Housing Advocacy for Reintegration and Prevention (SHARP) initiative, to be administered by Massachusetts Department of Veterans Services (DVS), will offer peer support, mental health services, psychiatric evaluation and linkages to emergency shelter to veterans recently placed in supportive housing at a veteran-centric facility. The team will also identify and enroll new homeless veterans in the HUD-VASH program. Through a $323,000 grant from the VA, the initiative will rely on an existing network of veteran service providers dedicated to supporting homeless veterans. Using these new funds, DVS has contracted for four peer support specialists, one substance abuse counselor and one psychiatrist to provide care coordination services. The Commonwealth has also established working agreements with the Soldiers’ Home in Chelsea, HopeFound, the Lynn Housing Authority, the New England Center for Homeless Veterans, the Pine Street Inn, St. Francis House and Veterans’ Northeast Outreach Center in Haverhill to identify veterans and work with DVS to move the veterans toward supportive housing. More information: http://www.mass.gov/eohhs/gov/newsroom/press-releases/eohhs/21-decrease-in-veteran-homelessness-announced.html
Prescription Advantage 2012 Annual Out-of-Pocket Limits Prescription Advantage annual out-of-pocket limits increased January 1. - From New Year's Greetings from MassResources.org, MassResources.org, January 10, 2012. MassHealth Administrative Review Process Expansion State and federal laws require MassHealth to perform a continuing eligibility review of every member annually. MassHealth uses a streamlined eligibility review process, called administrative review, on certain MassHealth members residing in nursing facilities. Administrative review streamlines the process by using data matching rather than having the member need to supply verification. On December 19, 2011, MassHealth expanded the administrative review process to more members. Members who meet the criteria for an administrative annual review will not need to return the review form if they do not have changes to report. Their eligibility will continue for another year, assuming no changes occur throughout the year. (They are still required to report any changes in their circumstances within 10 days of the change.) Most children enrolled in the Kaileigh Mulligan Program will be eligible for administrative review. See details on other eligible groups: http://www.mass.gov/eohhs/docs/masshealth/bull-2011/adh-13.pdf. Members Should Carefully Read Review Letters Members who meet the criteria for administrative review will be sent a packet of information that includes an administrative review cover letter and streamlined administrative review form. The cover letter states across the top: GOOD NEWS FROM MASSHEALTH . It advises the member that his or her eligibility has been reviewed electronically and that, unless there are changes to report, no further action is needed by the member. If the member has changes in income, assets, household composition, or health insurance coverage, they are instructed to complete the portion of the enclosed review form that pertains to the changes they need to report and return it to the MassHealth Enrollment Center (MEC). Please note that only members who are sent an administrative review form should use this streamlined review form to report changes to MassHealth. All other members are still required to complete the regular annual eligibility review form. -Adapted from Administrative Review Process Expansion, MA Health Care Training Forum, December 22, 2011 and MassHealth Adult Day Health Bulletin 13, December 2011: http://www.mass.gov/eohhs/docs/masshealth/bull-2011/adh-13.pdf. Commonwealth Care Coverage - Court Rules for Legal Immigrant InclusionThe Massachusetts State Supreme Judicial Court ruled unanimously this month that the state cannot bar legal immigrants from accessing affordable health care coverage. In deciding that legal immigrants are entitled to equal protection under the state constitution, the ruling reinstates the ability of low-income legal immigrants to enroll in Commonwealth Care, the state’s subsidized health care program. The Commonwealth cannot use financial reasons to defend discrimination against legal immigrants, the Court said. Originally, Commonwealth Care offered legal immigrants benefits. But in 2009, the Legislature, taking its cue from federal law, excluded legal immigrants who have lived in the United States for less than five years. The move affected about 29,000 legal immigrants, the court said. At the same time, a stripped-down program, the Bridge program, was set up for those who were excluded. As a result of the ruling, the Massachusetts state legislature will likely need to allocate additional budgetary resources to the state’s Commonwealth Care program to meet its constitutional obligations. Once that occurs, legal immigrants will once again be afforded access to affordable health insurance. More information from Health Law Advocates Also see the related Boston Globe article… How Medicare Works with Employer-Based Health Insurance Toolkit The Medicare Rights Center and AgeOptions (on behalf of the Make Medicare Work Coalition) have released “How Medicare Works with Employer-Based Health Insurance,” a toolkit of educational materials designed for Medicare beneficiaries and the professionals who serve them. The toolkit, which aims to help individuals understand how to transition from employer-based health insurance to Medicare, comes at a time when millions of baby boomers are aging into Medicare, but still working past the age of 65. Read Medicare Rights and AgeOptions’ “How Medicare Works With Employer-Based Health Insurance: A Guide for Employers, Professionals and Consumers”. - From “ Congress Seeks Compromise”, Medicare Watch, The Medicare Rights Center, December 22, 2011.
Partners Revises Contract with Tufts, Includes Global PaymentsA new contract struck between Partners HealthCare System Inc. and Tufts Health Plan will help control health care costs in Massachusetts by limiting payment increases to Partners’ hospitals and doctors to the rate of inflation, both sides said recently. Partners tore up the last two years of its existing contract with the health insurer, replacing the pact with a new four-year agreement that, while still giving Partners more money each year, will lower Tufts’ reimbursements to the medical care provider by about $105 million from what they would have been under the former rate structure. Partners reached a similar agreement last October with the state’s biggest health insurer, Blue Cross Blue Shield of Massachusetts. As with the Blue Cross deal, the new Tufts contract requires Partners medical care providers to accept global payments. -See the full Boston Globe article... ObamaCare Is Winning the Fight on Fraud and Abuse Members of Congress of both parties often complain about fraud and abuse in Medicare and Medicaid, usually charging that the President is not doing enough to keep bad guys from stealing money from these vital programs. Well, thanks to provisions in the Affordable Care Act (ACA/ObamaCare) and to an unprecedented effort by the Obama Administration, more progress has been made in the past three years to combat health care fraud and abuse than ever before. There was a 68.9 percent increase in criminal health care fraud prosecutions from 2010 to 2011, and 2010 was already the highest ever. Part of the effort involves hyper-charged efforts to catch bad guys through the Health Care Fraud Prevention and Enforcement Action Team (HEAT) , and a bigger part involves re-engineering the system to keep them out. For example, prior to the ACA, if a bad guy got kicked out of one state Medicaid program for fraud, he got kicked out of one program; under the ACA, when he gets kicked out of one, and he gets kicked out of all them, including Medicare. That's smart, and that's just a tiny bit of what the ACA does on fraud & abuse. -See John McDonough’s full Health Stew blog entry on Boston.com -Cited in/linked from HEALTH CARE WEEKLY UPDATE, Barbara Roop & John Goodson, Health Care for Massachusetts, January 06, 2012. Understanding Accountable Health Care Organizations More than 150,000 seniors in Eastern Massachusetts who are enrolled in traditional Medicare plans have received a letter in the mail - or will soon - informing them that their doctors are part of an accountable care organization, or ACO. Partners HealthCare has begun fielding calls from seniors looking for help in deciphering their letters, which also explain how seniors can opt out. Some letter recipients are worried that the change marks the return of the managed care model of the 1990s, when primary care doctors were seen as gatekeepers who controlled their bottom line by restricting care. The ACO model does not restrict which doctors or hospitals a patient can visit. Instead, the ACO model shifts the payment system, rewarding doctors who keep their patients out of the hospital. “I think we’ll see people making house calls, going into nursing homes, calling patients in more regularly, at times, to make sure that their health is improving,’’ said Dr. Richard Gilfillan, director of the Innovation Center that oversees the 32 Medicare Pioneer ACOs. Doctors may start staying in closer contact with their patients via phone or e-mail. Or they may involve other staff members to help care for patients with chronic conditions. Staff pharmacists may explain patients’ medication schedule and watch for negative drug interactions, health coaches might teach people about their diseases or help them to lose weight, and nurse care managers may make sure a patient gets necessary lab work and follow-up care. Under the traditional health care model, Medicare won’t pay for most of the work they do. In ACOs, their role will grow, experts say. Partners has nurse care managers in about half of its doctor offices now and plans to put them in all offices within two years. -See the full Boston Globe article…
Opinion: Legal Aid is a Sound Investment for All of Us People who can’t afford to pay their own lawyers have a constitutional right to public defenders when they face criminal charges. There’s no such guarantee for tens of thousands of low-income people each year involved in civil cases such as seeking benefits they were unfairly denied or fighting unjust foreclosures and evictions or needing protection from battering spouses. And so there is the network of lawyers who take on civil cases like this at no or low-cost to the litigant. Legal Service agencies are funded by a combination of state money, funds from private law firms, and donations. They worked a whopping 28,000 cases in Massachusetts last fiscal year. Civil legal aid has always been underfunded. But over the past three years state appropriations have shrunk, and private donations have dwindled. The result? Legal aid programs have lost a third of their staff in the last three years. For every five people who come to legal aid attorneys for help navigating the court system, three are turned away, says Lonnie Powers, executive director of the Massachusetts Legal Assistance Corporation, the largest funding source for legal civil aid in the state. Those numbers have made an impression on Beacon Hill. Legislators and the Governor recently proposed upping the Legal Assistance Corporation’s appropriation. It’s not nearly enough, but it’s a start. And a very smart investment. -See Yvonne Abraham’s full Boston Globe Column.
“Culture-Bound Syndromes” and the DSM Revision The mental health field is now in the midst of a debate that galvanizes its members every 10 to 20 years as it seeks to revise the Diagnostic and Statistical Manual of Mental Disorders (DSM). If you turn to page 898 of the current edition — past the glossary and the alphabetical index of diagnoses — you’ll find a list of 25 little-known illnesses. These are the “culture-bound syndromes”: mental illnesses that psychiatrists officially acknowledge occur only within a particular society. Depending on whom you ask, the notion that some cultures have their own ways of going crazy is either the ultimate in cultural sensitivity or the ultimate in Western condescension. What to do with the appendix is proving a thorny problem to solve, because the whole debate turns on an issue that psychiatry itself has yet to agree on: how much mental illnesses are a manifestation of the cultures in which they arise. And whether, when it comes to how culture and human psychology intersect, it’s time to start seeing the West as a culture too. -See the full Boston Globe article… Intimate Partner Violence Common in the US Intimate partner violence is common in the United States, with more than 1 in 3 women (35.6%) and 1 in 4 men (28.5%) reporting that they experienced rape, physical violence, stalking, or all 3 by their significant other in their lifetime, according to a new survey from the Centers for Disease Control and Prevention (CDC). To get a better understanding of the effect of such violence, the CDC launched the National Intimate Partner and Sexual Violence Survey (NISVS), its newest public health surveillance system, in 2010 with the support of the National Institute of Justice and the Department of Defense. The National Intimate Partner and Sexual Violence Survey: 2010 Summary Report. Executive Summary, released Wednesday, December 14, 2011. -See the summary on Medscape.com…
Mindfulness Training Reduces Stress of Rheumatic Disease A small (67 patient) randomized pilot study has shown that a mindfulness-based group therapy intervention produced significant and durable relief for patients with inflammatory rheumatoid joint diseases including rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. The study was published online December 20 in the Annals of the Rheumatic Diseases -See the Medscape.com summary…
Randomized Trial of Yoga in Metastatic Breast Cancer The practice of yoga might reduce psychological distress and modulate abnormal cortisol levels and immune responses in patients with metastatic breast cancer, according to a small study presented at the 34th Annual San Antonio Breast Cancer Symposium. In a 3-month study, 45 patients were randomized to a daily yoga intervention and 46 to standard supportive counseling. The subjects, with an average age of 50.5 years, were assessed at baseline and after the intervention. The yoga intervention was resoundingly effective in improving psychosocial states. 34th Annual San Antonio Breast Cancer Symposium (SABCS): Abstract P3-08-01. Presented December 8, 2011. -See the summary on Medscape.com… The Impact of Culture and Religion on Truth Telling at the End of Life Truth telling, a cardinal rule in Western medicine, is not a globally shared moral stance. Honest disclosure of terminal prognosis and diagnosis are regarded as imperative in preparing for the end of life. Yet in many cultures, truth concealment is common practice. In collectivist Asian and Muslim cultures, illness is a shared family affair. Consequently, decision making is family centred and beneficence and non-malfeasance play a dominant role in their ethical model, in contrast to patient autonomy in Western cultures. The 'four principles' are prevalent throughout Eastern and Western cultures, however, the weight with which they are considered and their understanding differ. The belief that a grave diagnosis or prognosis will extinguish hope in patients leads families to protect ill members from the truth. This denial of the truth, however, is linked with not losing faith in a cure. Thus, aggressive futile treatment can be expected. The challenge is to provide a health care service that is equable for all individuals in a given country. -Full summary on Medscape.com… Recent Findings in the Treatment of Prolonged Grief Purpose of review: Treatment for prolonged grief has been controversial. However, recent studies have clarified several key issues, offering important guidance to clinicians. This review summarizes the most recent evidence on the efficacy of grief treatments, moderators of treatment response, and new treatment approaches. Recent findings: Recent research findings highlight that grief therapy is efficacious when targeted to adult and child grievers with persistent and elevated levels of distress. However, when grief therapy is applied as a universal intervention, it has minimal to no benefits, either for adults or for children. Earlier intervention for children is associated with greater efficacy. In recent studies, therapies employing cognitive–behavioral techniques, such as cognitive restructuring and exposure, have shown particularly robust effects in ameliorating grief symptoms. Other intervention approaches, including pharmacotherapy, internet-based, family-based, and preventive, have shown initial promise, but insufficient data exist to validate their efficacy to date. Curr Opin Psychiatry. 2012;25(1):46-51. -See review summary on Medscape.com… |