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MGH Community News |
| May 2012 | Volume 16 • Issue 5 |
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MGH Community News |
| May 2012 | Volume 16 • Issue 5 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Ellen Forman, x6-5807. Questions, comments about the newsletter? Contact Ellen Forman, x6-5807. |
The RIDE In-Person Assessment To Start 7/1 As reported previously, (September 2011, October 2011), as of July 1, The RIDE is scheduled to begin in-person assessments. New applicants will be screened in person by a rehabilitation specialist to determine if he or she can use regular public transportation, perhaps with training, and therefore would not be eligible for The RIDE. Existing users will be screened as well starting in September. Those with visual disabilities, mental health disabilities and seizure disorders will be exempt from in-person assessment. There are specific medical verification forms for these groups that are in the The RIDE application that was rolled out earlier this year. The RIDE will provide free transportation to the assessment. Eligibility determinations will be made within 21 days of the assessment. For more information see The RIDE In-Person Assessment - Update, MGH Community News, October 2011. Fare Increases Fares will increase to $4 each way for most rides, $5 for "premium" rides, including same day and "will call" trips. For more information see: MBTA Revised Fare and Service Plan- Major Fare Increase for The RIDE, MGH Community News, March 2012. New Rules Define Unsafe Drivers More than two years after a string of high-profile accidents by older drivers, Massachusetts health regulators voted unanimously recently to approve new rules that, for the first time, define what it means to be too physically or cognitively impaired to drive safely. The rules make clear that age and illness are not by themselves disqualifying. Instead, the decision will be based on ‘‘observations or evidence of the actual effect’’ that an impairment may have on a person’s ability to safely drive, according to the rules, developed after months of public hearings and advice from medical specialists. The rules define cognitive impairment as an impediment that ‘‘limits a person’s ability to sustain attention, avoid distraction, understand the immediate driving context, and refrain from impulsive responding.’’ |
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The regulations also detail what constitutes functional impairments. The list includes an ‘‘inability or diminished capacity to consistently maintain a firm grasp on or manipulate a steering wheel or driving hand controls.’’ It also stipulates that ‘‘weakness or paralysis of muscles affecting ability to consistently maintain sitting balance’’ be considered an impairment. -See the full Boston Globe article… New Broadband Internet Discounts for School Children (and their families) According to the Pew Research center, only 45% of those with annual household income under $30,000 have broadband at home. In our increasingly wired world, children without internet access at home run the risk of falling behind their wired peers. Enter a new pilot program to offer low-cost computers and discounted broadband to help address the digital divide. For those in the Comcast service area: Comcast Internet Essentials
For those outside Comcast’s Service Area- this program will be expanding its service area in the fall: Connect to Compete (C2C)
-Information adapted from: Lifeline and Strategies for Maintaining Affordable Telecommunications Services, webinar from the National Elder Rights Training Project for the National Legal Resource Center. This and past webinars available at: http://www.nclc.org/conferences-training/national-elder-rights-training-project.html. The Obama administration and the National Institutes of Health launched their new one-stop website for information on Alzheimer's treatment Tuesday, May 15. The site, www.alzheimers.gov, is part of the government's new National Alzheimer's Plan. The plan aims to find new effective treatments or a cure for Alzheimer's disease by 2025. The new site will provide resources for Alzheimer's caregivers and patients including places they can go to get treatment in their communities. "These actions are the cornerstones of an historic effort to fight Alzheimer's disease," HHS Secretary Kathleen Sebelius said in a statement. "This is a national plan — not a federal one, because reducing the burden of Alzheimer's will require the active engagement of both the public and private sectors." The new plan will additionally provide millions of dollars for Alzheimer's research including a study on an insulin nasal-spray that has shown promise in slowing the disease -Thanks to Barbara Moscowitz for forwarding. Physician Assisted Suicide on November Ballot Patient’s rights advocates are pushing a ballot initiative to legalize the practice they call Death with Dignity, more commonly known as physician-assisted suicide. Voters will almost certainly decide at the polls this November whether it should be allowed here, as in Oregon and Washington, the only two states where voters have explicitly authorized it. Under the Massachusetts proposal, which is virtually identical to the laws in Oregon and Washington, terminally ill, mentally competent adults would have the freedom to obtain a fatal prescription. They could qualify only after going through a process designed to ensure that they are not being coerced and that they fully understand what they’re doing. They would administer the drugs themselves. Any doctor opposed to the practice could opt out of writing the prescription. -See the full Boston Globe article for case examples and pro and con arguments… -See the full accompanying Boston Globe article for details on how the law would work… Secure Communities- Federal Immigration Checks Start 5/12 Federal officials notified state 0fficials this month that they are expanding a controversial program targeting illegal immigrants, particularly criminals, despite longstanding opposition from Governor Deval Patrick and advocates. Local police routinely send the fingerprints of people they arrest to the FBI for criminal background checks. Now, through Secure Communities, the FBI will share those fingerprints with immigration officials to identify illegal immigrants for deportation, especially criminals and repeat violators of federal immigration law. Advocates expressed concern that immigrants fearful of deportation will refuse to turn to police for help - or to aid them in their investigations. Advocates have said that victims of domestic violence and other crimes are already afraid to turn to police for fear of deportation, even though police say they will not target crime victims. Some advocates have also said that the program nets too many without criminal convictions. Spokesman Ross Feinstein said immigration enforcement officials have improved the program to focus more intensively on serious criminals and other priorities, which also include immigrants who have reentered the country after having been deported and those with deportation orders. -See the full Boston Globe article… Six Questions to Ask Before Choosing a Nursing Home The Boston Globe asked Susan Rowlett, manager of care consultation at the Alzheimer’s Association’s Massachusetts/New Hampshire Chapter, to provide some important questions to ask when looking for a nursing home for a loved-one.
-See what kind of answers you are looking for in the full Boston Globe article…
Peabody Resident Services GAFC - MassHealth Personal Care, Homemaker and Case Management for Those Under 65 Most of us are familiar with the state’s Group Adult Foster Care (GAFC) program related to Adult Foster Care placements and as a subsidy in assisted living. But did you know it also can be used to get personal care, homemaker and case management services at home for adults of any age (22 and up)? This is particularly useful to know as homemaker services through Mass. Rehab. Commission have at times run long waiting lists and home-based case management can be difficult to obtain at any age. Peabody Resident Services, Inc. (PRSI) Home Care (GAFC) program is one such program. They have been providing personal care and homemaking services with case management and RN well visits since 1995 to eligible residents of affordable housing. They serve approximately 1900 clients statewide. They directly employ case managers and social workers and contract with 13 agencies to provide care throughout Massachusetts. Both direct hire and contracted agency staff are CORI checked prior to hire, and direct hire staff are subject to a CORI annually. Eligibility Program participants must meet all of the following criteria. There is no direct cost to the participant; the program is third-party paid by Medicaid via their GAFC program.
Services
Partnering with Other Services
Application Process
More Information: http://www.peabodyproperties.com/peabody-resident-services/prsi-home-care/group-adult-foster-care-gafc/ Contact: Jennifer Adamczyk, RN BSN, Program Development Manager, Peabody Resident Services, Inc., (781) 794-1022. Other similar programs: To find other GAFC programs, call 1-800-AGE-INFO or find the local Area Agency on Aging/Age Info Center online: http://contactus.800ageinfo.com/FindAgency.aspx. The Cancer Legal Resource Center (CLRC) The Cancer Legal Resource Center (CLRC) is a national, joint program of the Disability Rights Legal Center and Loyola Law School Los Angeles. The CLRC provides free information and resources on cancer-related legal issues to cancer survivors, caregivers, health care professionals, employers, and others coping with cancer. A cancer diagnosis may carry with it a variety of legal issues, including insurance coverage, employment and taking time off work, access to health care and government benefits, and estate planning. These legal issues can cause people unnecessary worry, confusion, and stress, and can be overwhelming. When these legal issues are not addressed, people may find that although they have gotten through treatment, they have lost their homes, jobs, or insurance coverage. Legal Resource Manual
Telephone Assistance Line
-Above from http://www.disabilityrightslegalcenter.org/about/cancerlegalresource.cfm -Thanks to Lourdes Barros for the lead about this program. For over 10 years, Mom’s Meals has been providing home-delivered, microwavable meals to seniors and patients nationwide. Meals are delivered fresh- not frozen- and are packaged in a way that allows them to remain fresh in the refrigerator for up to two weeks. Choices include low sodium, heart-healthy, diabetic-friendly, gluten-free and vegetarian menus. A new menu for renal patients will be available in June. Mom’s Meals can be delivered to any location within the continental United States, including remote locations via FedEx. Mom’s Meals cost $5.99 each and can be ordered in packages of 10, 14 or 21 meals with a flat shipping charge of $14.95 for any of those options. One can place a one-time order or can schedule ongoing weekly, or every other week, service. In some areas of Vermont and Rhode Island, elders may be able to access a subsidy to reduce their cost for these meals. They would need to contact their local Area on Aging or Elder service agency to find out if they qualify. For more information: call 877-434-8850 or visit http://www.momsmeals.com.
MassHealth Disability Accommodation Ombudsman There is an entry below on the MassHealth Ombudsman wh0 has been available to people with disabilities needing assistance for some months. MassHealth held a public meeting on May 4 in part to help raise public awareness of this service. MassHealth staff should make every reasonable effort to assist members, and potential members, with disabilities who need accommodations with MassHealth eligibility or services. For assistance beyond what is immediately available to MEC staff, EOHHS has designated a person – the MassHealth Disability Accommodation Ombudsman - to assist. For example, when deaf and hard-of-hearing individuals request an in-person appointment that requires an American Sign Language (ASL) interpreter, or Communication Access Real Time Translation (CART) services, MassHealth staff must immediately forward the requests to the Ombudsman by e-mail. The Ombudsman will schedule the appointment with the individual and arrange for an ASL interpreter or CART services by contacting the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH). The MassHealth Disability Accommodation Ombudsman office will provide personal assistance explaining the application processes and understanding requirements and will give hands-on assistance filling out forms over the telephone.
MassHealth Disability Accommodation Ombudsman -Adapted from Weekly Update from Disability Policy Consortium,Bill Allan, May 29, 2012 and MassHealth Eligibility Operations Memo 12-04, April 23, 2012, http://www.mass.gov/eohhs/docs/masshealth/eom2012/eom-12-04.pdf. Commonwealth Care Open Enrollment June 1- 22 This year's Commonwealth Care Open Enrollment period is from June 1-22, 2012. During Open Enrollment members can change their health plan. During the rest of the year they must experience a “qualifying event” to make such changes. (Commonwealth Care accepts new applications throughout the year; this Open Enrollment only relates to current members desiring to change plans.) Members should know that:
What do members need to do? Members should review their Open Enrollment packet carefully to learn more about the health plan changes to take effect July 1, 2012. If they are happy with the health plan that they currently have, they do not need to do anything. There are two ways to make a health plan change:
Remember, the deadline to make a health plan change is June 22, 2012. Please note: All Commonwealth Care members enrolled with an effective date of June 1, 2012 or prior, including former Bridge members and other newly enrolled AWSS (Aliens with Special Status) members, will be able to switch to any available health plan in their service area for any reason during Open Enrollment. Review the details about this year's Open Enrollment at MAhealthconnector.org. -From Important Information about Commonwealth Care's Open Enrollment, MA Health Care Training Forum, May 18, 2012. MA Announces Plans for New Basic Health PlanRecently, officials from the MA EOHHS, MassHealth, and the Connector publicly announced their recommendation to implement a Basic Health Plan (BHP) in Massachusetts, to be administered by MassHealth, beginning in January 2014. The Affordable Care Act (ACA) gives States the option to administer a Basic Health Plan for individuals just above Medicaid-eligible income levels, between 134-200% FPL (about $14,900-$22,300/year), and legal immigrants under the “5 year bar” who can’t access MassHealth with income up to 200% FPL. From their analysis, EOHHS and the Connector concluded that the Massachusetts BHP could be financed with federal-only dollars. In essence, the State will purchase benefits on behalf of enrollees similar to MassHealth MCOs and CommCare. The goals of implementing a BHP, as laid out by MassHealth:
In addition, the BHP protects consumers from having to pay back subsidies to the federal government if their income goes up during the year. The Administration also plans to seek authority from the Legislature to maintain State subsidy levels for residents between 200-300% FPL, who in 2014 will buy commercial insurance through the Connector. The Legislature needs to pass legislation by the end of this session to authorize MassHealth and the Connector to implement a BHP and a subsidy “wrap” for residents 200-300% FPL. Then, the details of each program will be worked out. EOHHS has a website that includes a lot of information about the Commonwealth’s efforts to implement the ACA: http://www.mass.gov/nationalhealthreform. In a statement, Health Care For All and the ACT!! Coalition supported the state’s effort. -From Health Care For All May News, Amy Whitcomb Slemmer, May 14, 2012. Medicare Reminder – Hospice Benefits Medicare will help pay for hospice care if you meet all of the following criteria:
The hospice benefit is always covered under Original Medicare. If you are enrolled in a Medicare private health plan, also known as a Medicare Advantage plan, and you elect hospice, your hospice care will be paid for by Original Medicare. You can get hospice care for as long as your doctor and the hospice medical director certify that you are terminally ill. On day 180 of hospice care, you are required to have a face-to-face meeting with a hospice doctor or nurse practitioner. After that, you must continue to have these meetings before the start of each following 60-day benefit period. Learn more about Medicare coverage of hospice care at www.medicareinteractive.org. - From Medicare Watch, Volume 3, Issue 18, Medicare Rights Center, May 11, 2012 Medicare Reminder – Non-Emergent Ambulance CoverageUnder non-emergency situations, Medicare coverage of ambulance services is very limited. Medicare may cover non-emergency ambulance services if:
Medicare may cover scheduled, regular trips if your doctor sends the ambulance supplier a written order ahead of time to show that your health requires ambulance transport. Note: If you are receiving SNF care under Part A, any ambulance transport should be paid for by the SNF. The SNF should not bill Medicare for this service. Note: Lack of access to alternative transportation alone will not justify Medicare coverage. Medicare will never pay for ambulette services. An ambulette is a wheelchair-accessible van that provides non-emergency transportation for people with disabilities. If an ambulance service is covered, Medicare will pay 80% of its approved amount for the service. You or your supplemental insurance policy will be responsible for the remaining 20%. Learn more about Medicare coverage of ambulance services at www.medicareinteractive.org - Adapted from Medicare Watch, Volume 3, Issue 19 , Medicare Rights Center, May 17, 2012 and http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=1246. Medicare Reminder – When to Take Part BWhen you turn 65, whether you should take Part B depends on if you have primary insurance from a current employer or from a spouse’s current employer. You should talk to your employer when you become eligible for Medicare to see how your employer insurance will coordinate with Medicare.
In either case, if you have insurance from a current employer, you qualify for a Special Enrollment Period that allows you to enroll in Part B at any time while you or your spouse is still working, and for up to eight months after you lose your employer coverage or stop working. -From Medicare Watch , Volume 3, Issue 20, May 24, 2012, Medicare Rights Center.
Junk Food Linked to Depression Eating too much junk food may increase risk for depression, a large study suggests. In a cohort study of almost 9000 adults in Spain, those who consistently consumed "fast food," such as hamburgers and pizza, were 40% more likely to develop depression than the participants who consumed little to none of these types of food. In addition, investigators found that the depression risk rose steadily as more fast food was consumed. Participants who often ate commercial baked goods, such as croissants and doughnuts, were also at significant risk of developing this disorder. The study is published in the March issue of Public Health Nutrition. -See the full article summary on Medscape…
Experts Unconvinced by Changes to DSM 5 Many psychiatrists believe a new edition of a manual designed to help diagnose mental illness should be shelved for at least a year for further revisions, despite some modifications which eliminated two controversial diagnoses. More than 13,000 health professionals from around the world have signed an open letter petition (at dsm5-reform.com) calling for the DSM 5 to be halted and re-thought. The American Psychiatric Association (APA), which produces the DSM, said it had decided to drop two proposed diagnoses, for "attenuated psychosis syndrome" and "mixed anxiety depressive disorder." The former, intended to help identify people at risk of full-blown psychosis, and the latter, which suggested a blend of anxiety and depression, had been criticized as too ill-defined. One of the proposed changes that has survived in the draft DSM 5 -- despite fierce public outcry -- is in autism. The new edition eliminates the milder diagnosis of Asperger syndrome in favor of the umbrella diagnosis of autism spectrum disorder. -See the full discussion on Medscape… Proposed Diagnosis for Bipolar Disorder Divides Psychiatrists The American Psychiatric Association appointed a panel to address the debate over whether a glaring 40-fold increase within a decade in bipolar diagnoses in children is genuine or the result of routine misdiagnoses. The panel is urging that a new, potentially more transient and less-stigmatizing diagnosis - “disruptive mood dysregulation disorder’’ - be added to the DSM5. The new condition would apply to children who have chronic irritability, as well as recurrent temper outbursts - three or more times a week, on average - that are “grossly out of proportion’’ to the situation the child confronts. The proposal to add the new diagnosis has renewed scrutiny of a psychiatric unit at Massachusetts General Hospital, which has been credited - and berated in some quarters - for its role in the nation’s more aggressive diagnosis and medication of children with bipolar disorder. Critics accuse the Mass. General unit of driving the sharp increase in bipolar diagnoses. Some top mental health specialists, while critical of this surge in diagnoses of bipolar disorder in young people, do not see the proposed new disorder as the answer. One prominent psychiatrist said both conditions are part of the profession’s tendency to rely on limited research to oversimplify, pathologize, and medicate stormy but potentially normal passages through childhood. -See the full Boston Globe article… Antidepressants Work, and Depression Severity Does not Matter Effects are greatest in children, but are significant for all, in a study examining patient-level data from 41 studies focusing on two antidepressants. This analysis of more than 9000 patients shows that antidepressants work regardless of the severity of the depression. Moreover, antidepressant response often takes more than the 6 weeks analyzed here, suggesting that these effects may be underestimated. Finally, these results add to concerns that meta-analyses summarizing effects across studies with different designs and outcomes, while sometimes useful, can lead to erroneous conclusions. -See the article summary on Medscape…
Speed, Ecstasy Use in Teens Linked to Subsequent Depression Use of MDMA (ecstasy) and either amphetamines or the more potent methamphetamine in adolescents is associated with subsequent depression, new research shows. A large, longitudinal study of 3880 high school students found that those who took either drug were between 60% and 70% more likely to exhibit heightened depressive symptoms than their counterparts who used neither drug. These findings were independent of previous bouts of depressive symptoms or other drug use. The study is published online April 18 in the Journal of Epidemiology and Community Health. -See the full Medscape article summary… Brief ED Intervention Cuts Alcohol Consumption in Risky Drinkers A brief intervention performed by emergency department staff reduced alcohol consumption, episodes of binge drinking, and episodes of impaired driving in problem drinkers over the next six to 12 months in a randomized study conducted at Yale New Haven Hospital in Connecticut (n=889). "This intervention uses motivational interviewing techniques to change behavior," Dr. Gail D'Onofrio of the department of emergency medicine, Yale University School of Medicine in New Haven, Connecticut, told Reuters Health. The "Brief Negotiation Interview," taught during a two-hour training program, includes raising the subject of alcohol use with the ED patient, asking about changing his or her drinking behavior, negotiating a drinking goal with the patient, and asking them to sign a drinking agreement. The whole intervention takes about seven minutes to complete. The US Preventive Services Task Force recommends screening and brief intervention for at-risk drinkers, but studies in ED settings have been inconclusive, Dr. D'Onofrio and colleagues point out in a report online March 30 in the Annals of Emergency Medicine. -See the full article summary on Medscape.com… Emergency Therapy May Prevent PTSD in Trauma Victims Immediate psychiatric therapy for trauma patients in the emergency department (ED) may decrease the emergence of posttraumatic stress disorder (PTSD) and appears to be most effective in sexual assault victims, new research shows. Presented at the Anxiety Disorders Association of America (ADAA) 32nd Annual Conference, a study by investigators from Emory University in Atlanta, Georgia, showed that trauma patients who received emergency psychiatric treatment had fewer PTSD symptoms at 3 months than their counterparts who received a basic assessment. "This is something we want to be able to transport and use wherever traumas occur and before people sleep on it" said Barbara Olasov Rothbaum, PhD, director of the Trauma and Anxiety Recovery Program and professor of psychiatry at Emory University School of Medicine. "We know that memories are consolidated when you sleep, so we wanted to try and catch people before" she explained. 3-Part Therapy In the study, 137 trauma patients who presented at a level 1 trauma center were randomly assigned to receive either basic assessment of injuries (n = 68) or assessment plus a psychiatric intervention aimed at preventing the development of PTSD (n = 69). The intervention consisted of what Dr. Rothbaum called 3 modified exposure therapies: the first one when they came into the ED, the second one 1 week later, and the final one another week later. In the initial session, "we asked people to go back to the traumatic event, to go through it in their mind's eye and recount it out loud over and over. We tape-recorded it, and we gave them that tape to listen to. All of this happened very quickly, in about an hour, because they had already been in the ER [emergency room] for a long time and just want to go home," she said. At this session, participants were also given an exercise to help them to process the information. "We tried to identify some unhelpful thoughts that they might be having and work on correcting those. We helped them anticipate any avoidance — for example, if they were in a motor vehicle collision, maybe they don't want to drive again." Home exercises were assigned and were repeated during sessions 2 and 3. Novel Approach In light of the debate over potential risks of trauma debriefing, the findings are reassuring, said Dr. Rothbaum. "In some of the studies looking at psychological debriefing, it looks like some of the folks that got it have been doing worse at follow-up, so I think it scared everybody off early interventions." However, she added, there are differences between her study's intervention and traditional debriefings. "It's individual, and usually debriefing is in the group setting. Sometimes in debriefings they make everybody talk even if they don't want to, and usually debriefing is once, and ours is 3 sessions with a lot of homework in between. Hopefully, it's the difference between a therapeutic exposure and something that might not be." Anxiety Disorders Association of America (ADAA) 32nd Annual Conference. Session 318R, presented April 13, 2012. |