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MGH Community News |
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MGH Community News |
| October 2015 | Volume 19 • Issue 10 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Lindsey Streahle, x6-8182. Questions, comments about the newsletter? Contact Ellen Forman, x6-5807. |
It’s Fuel Assistance Season Again November 1 marks the beginning of Fuel Assistance season as local community action programs begin accepting applications for the Low Income Home Energy Assistance Program (LIHEAP) as of that date. The 2015-2016 brochure with updated income limits and participating agencies is now available at: http://www.mass.gov/hed/docs/dhcd/cd/cold/coldrel.pdf. Consumers may also call the Cold Relief Heatline 800-632-8175 to find their local participating agency. Income Eligibility Chart
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Utility Discounts Fuel Assistance typically does not cover the full season-long cost of heat-related utilities. So this is also a good time to ensure that those eligible are receiving discounted utility rates where applicable. Investor-owned utility companies (gas, electric, local phone) in Massachusetts must offer reduced rates (about 25% discount) to certain low-income households. (Municipally-owned utilities are not required to do so.) The income guideline is the same as for Fuel Assistance (see chart above). One must also already receive some type of income-tested benefit. There are many low-income programs that can qualify a household for the utility discounts, including fuel assistance, TAFDC, SNAP (food stamps), school lunch, housing subsidies, and certain subsidized health care coverage programs. Those receiving Fuel Assistance should automatically be enrolled in their utility company’s discount program, but it doesn’t always happen. Consumers are encouraged to confirm that they are being charged the discounted rate. The Winter Moratorium - Shut-Off Protection In Massachusetts utilities are prohibited from shutting-off heat-related utilities between November 15 and March 15 each year (commonly extended a few weeks on an annual basis) for those with documented “financial hardship”. This protection applies only to gas and electric utilities, and not to “deliverables” such as oil, propane, kerosene and wood. It does apply to electricity in homes that heat with gas if electricity is required to operate the heating system. To qualify, one must document “financial hardship” by completing a utility-specific form and supplying required additional documentation. While the winter moratorium provides protection from shut-off during this time period, it does not erase the debt. Utilities are free to, and often will, proceed with shut-off at the end of the moratorium unless arrangements are made to address overdue bills. Social Service staff can find information on our website about other utility assistance programs and on additional shut-off protections and Arrearage Management Programs. There one can also find our Utilities Handout for Patients, a brief summary of assistance, shut-off protections and managing past-due bills.
State Agencies’ Power Outage on October 28 A previous version of the following was e-mailed to Social Service staff on 10/29/15. Anyone who submitted an application via the Virtual Gateway around that date should confirm it was received. Clients who may have missed a deadline on that date due to the outage should ask for assistance from their DTA or other agency worker. Clients may not realize that they were impacted until later, so please make a note of the date for future trouble-shooting. DTA clients needing additional assistance may contact the DTA Ombudsman: 617-348-5354. Advocates can contact Pat Baker of Mass Law Reform Institute if clients are having related difficulties and need additional assistance or to share successful advocacy tips. Her contact information is: Patricia Baker
New Victim Compensation Forms To comply with new federal performance measures reporting requirements, the Victim Compensation & Assistance Division of the Massachusetts Attorney General’s office has revised the applications for Victim Compensation. Old forms cannot be accepted and victims would need to resubmit using the new application. Please destroy any old copies you may have. Download the new Victim Compensation Application: English or in Spanish The pertinent links have been updated on our website. For more information about Victim Compensation see http://www.mass.gov/ago/public-safety/resources-for-victims/victims-of-violent-crime/victim-compensation.html. -Thanks to Rebecca Murphy and Kate Haskins (VIAP Coordinator) for forwarding this important update.
No Raise for 65 Million on Social Security For the first time in five years, there will be no annual raise for some 65 million retirees and other Social Security recipients in 2016. The reason? A decline in inflation caused by falling gas prices. The amount of money that Social Security pays out is adjusted each year to take into account the rate of inflation. This is known as the cost of living adjustment, or COLA. The inflation measure used by the Social Security Administration was down 0.6% for the 12 months that ended in September -- largely due to a nearly 30% drop in gas prices. The problem for seniors is that the way the government measures inflation simply doesn't reflect how people on Social Security spend. Seniors don't benefit as much from lower gas prices as the average American worker because most are no longer driving to and from work. Medical costs have also increased faster than overall inflation, and a greater percentage of seniors' spending is on health care. In 2015, Social Security benefits rose 1.7%, and they've climbed by less than 2% for three years in a row. Social Security benefits stayed flat in 2010 and 2011. A study by the Senior Citizens League found that Social Security benefits have lost about 22% of their buying power since 2000, despite the benefit increases due to the COLA. -See the full CNN Money story.
Year Since Long Island’s Closure Finds Safety Net Still Tattered A year after city officials abruptly closed Long Island, evacuating hundreds of homeless residents and recovering addicts because the rickety bridge to the island was no longer safe, gaping holes remain in the city’s social safety net. More than 100 recovery and detox beds, much in demand, have yet to be replaced. While the city has spent tens of millions of dollars to rebuild the services once on Long Island, officials have yet to replace the 47 residential addiction-treatment beds for women at the halfway house Joelyn’s Family Home. “There is nowhere to send people who are begging for help,” said Jonathan Scott, executive director of Victory Programs, a Boston-based nonprofit that spent more than $2 million renovating Joelyn’s shortly before it was closed. “Everyone is desperate for access to recovery home and detox beds.” After months of searching, Victory Programs recently secured two buildings and is raising more than $2 million to rebuild the program it had on Long Island, though it will have fewer beds. “It can take years to open up a small group home,” Scott said. Another program on Long Island, Andrew House, which provided detox treatment to about 100 people a week, has yet to find a new home for its 60 treatment beds, which accounted for more than 40 percent of the city’s detox spaces. The lack of detox services — an entry point for the city’s safety net — has had significant consequences and may have played a role in the deaths of at least four people who had frequently sought care from Andrew House, said James Laprade, senior vice president of operations at Bay Cove Human Services Inc., which ran the program for decades. Bay Cove has struggled to find a home for Andrew House. The costs in Boston are too steep, and few neighbors want to live beside a detox center, which became clear last year when residents protested a plan to move the program to the old Radius Hospital in Roxbury. So they’re now looking at potential properties outside the city. “It’s really disappointing,” Laprade said. “We have left no stone unturned to replace the space.” A report from the Blue Cross Blue Shield of Massachusetts Foundation, conducted for the city’s new Office of Recovery Services and released in May, found that the city indeed does not have enough substance abuse treatment beds, a problem that the report said was exacerbated by the closure of the Long Island bridge. “Compounding the existing challenges with addiction treatment and recovery services capacity, and diverting immediate attention from the larger issue of reforming Boston’s substance use recovery system, was the loss of 8 programs that were situated on Long Island,” the report said. According to the report, roughly 225 people receiving addiction treatment services on Long Island were forced to relocate when the bridge was deemed unsafe. Over the past year, the city has spent about $17 million to tear down Long Island Bridge, but Mayor Martin J. Walsh, in a telephone interview, acknowledged the toll from the closure of Long Island. “The fact that we haven’t relocated all the programs from Long Island certainly doesn’t make me happy,” he said in a telephone interview. “I know there are people struggling. We have to do a better job.” Walsh said he hasn’t had any conversations with other officials about whether to rebuild the bridge. As for the future of Long Island, a valuable, 225-acre stretch of vacant buildings and fallow farmland in the middle of Boston Harbor, Walsh said: “I haven’t really thought about it. Dollars are scarce.” -Sources and for more information:
Thanksgiving Food Baskets Believe it or not Thanksgiving is just around the corner. While we may still be in denial, families in need must move quickly if they want to get assistance with the fixings for the holiday meal. ABCD Many locations throughout ABCD’s network of neighborhood sites offer holiday meal assistance in the form of food baskets, turkeys, and food supplies that low-income families need to cook and serve holiday meals in their homes. Holiday Meal services are usually available during the Thanksgiving season and in December. Contact the sites listed below for specific information on availability and application.
-From http://bostonabcd.org/holiday-meals.aspx Salvation Army Every November, The Salvation Army provides Thanksgiving food baskets to individuals and families in need, which include traditional items: a turkey, stuffing, gravy and a roasting pan. BOSTON Thanksgiving Distribution - Boston Only. If you are in need of assistance in another Massachusetts community - find the location nearest you. Pre-Registration: Begins October 26 - while supplies last! Distribution: Saturday, Nov. 21, 2015 You will need to bring in the following information:
Quantities are limited and registration is on a first come, first served basis. PLEASE NOTE: REGISTRATION and pickup location is based upon your zip code. Qualifying families are also invited to pre-register for Christmas Assistance: -From http://massachusetts.salvationarmy.org/MA/Thanksgiving Local Food Pantries Many food pantries also offer Thanksgiving turkeys or food baskets for needy families. Families should apply as soon as possible. Contact Project Bread’s FoodSource Hotline to find a local food pantry. FoodSource Hotline: 800-645-8333, TTY 1-800-377-1292, Monday through Friday 8 a.m. - 7 p.m., and Saturday 10 a.m. - 2 p.m. -Thanks to Lindsey Streahle for her assistance with gathering these resources.
“Cake” End-of-life Planning App in Beta Testing After you are gone, should your Facebook profile be deleted? Do you have a health care proxy who will make medical decisions for you when you can’t? Burial or cremation? And what music should be played at your funeral? An emerging startup called Cake wants to make advance care and end-of-life planning a simpler process for all of us – a piece of cake, if you will. The Cake team was a finalist in this year’s MassChallenge startup accelerator. They are collaborating with Brigham Innovation Hub (iHub) the unit of Brigham & Women’s Hospital that helps innovators turn ideas into products and services. Cake is now signing up people for its second round of beta testing. “Right now end-of-life planning is complicated, over-legalized, full of medical jargon and seems like a chore few would want to get down to,” says the 34-year-old co-founder of Cake, Suelin Chen. “It is like doing taxes, except there is no deadline, and so this task can be put off indefinitely.” Cake’s free app, which can be used on smartphones, tablets, or computers, helps the user create a secure online document of instructions to share with loved ones, physicians and lawyers, either for themselves, or for someone they care about. Here is how Cake will make money: People may need help to accomplish their objectives and so the startup offers some of these services in-house, for others it will refer users to service providers such as estate attorneys or insurance companies. “We are also in discussions with HR managers who want to offer Cake as an employee benefit,” says Chen.
Some members of the medical community like the concept. “I think Cake is an excellent way to engage people in thinking about their end-of-life care decisions and choices. It encourages discussion with friends and families to ensure that one’s wishes are known and fulfilled,” says Dr. Kathy Selvaggi, the Division Chief-Palliative Care at the Butler Health System in Pennsylvania. -See the full BetaBoston.com (Boston Globe) article.
Health Connector 2016 Open Enrollment Begins November 1 Open Enrollment for 2016 Health Connector plans begins November 1 and runs through January 31, 2016. Open Enrollment allows individuals and families to enroll in non-group coverage or switch existing coverage for any reason, without needing a qualifying event. (Those seeking financial assistance for insurance coverage can apply at any time during the year.) A goal for Open Enrollment is to ensure that consumers who are happy with their plan and have no updates continue to get the same coverage. However, the Connector’s overall message to the market is to encourage people to update their applications with the most current information and to browse their plan options. The Connector will only be notifying and renewing individuals who are actively enrolled in a 2015 Qualified Health Plan (QHP) or Qualified Dental Plan (QDP). Members can remain in their same plan for 2016, if that plan is available, but if not, then members will be mapped into a similar plan. Unless a member checks out with a new plan, they will be auto-renewed into their mapped plan in late November. Members can always shop for a new plan until the end of Open Enrollment (until 12/23 for coverage starting 1/1, 1/23 for 2/1, and 1/31 for 3/1). Assistance Among other customer service improvements The Connector is launching a new “Assister Line” that aims to provide service to Navigators and Certified Application Counselors (CACs) who call requesting assistance with their clients. Ten agents will be trained to operate the special line during service hours, with five back up agents for high volume times. The Connector plans to extend operation hours at the call center during Open Enrollment beyond what was offered last year, and supplement current locations in Boston and Worcester with additional in-person customer service center areas. The Monday-Friday hours during Open Enrollment will be 8AM to 9PM and Saturday and Sunday hours are 9AM to 5PM. There are also contingency plans in place to involve extra staffing in the event that there are shortages during peak times. Customer Service Interaction Centers (CICs) will operate in areas with the largest concentration of members and uninsured individuals, including: More about the CICs can be found at: http://wwlp.com/2015/08/12/mass-health-connector-looks-to-add-walk-in-centers/. Outreach Strategy Current members will receive targeted messages throughout Open Enrollment, updating their renewal status and encouraging reviewing plan options for 2016. Although Massachusetts has reached a low of 3% uninsured, the Connector aims to lower this rate further by employing a mixture of targeted and broad-based strategies like direct-to-consumer contact, community awareness, and media/public education campaigns. The Connector has conducted research into reaching the remaining uninsured and is partnering with other agencies, such as the Department of Revenue (DOR) and the Department of Unemployment Assistance, as well as using social media, direct mail, and the new CICs to meet their goal. Specifically with the DOR, the Connector is sending letters to tax filers who, based on previous tax filings, do not carry health insurance that meets Minimum Creditable Coverage standards, which is estimated to be approximately 180,000 individuals as of the most recent year. -See the full Health Care for All blog post. Additional sources and for more information:
MassHealth CarePlus Members Now Have PCC Option Accepted Across Partners’ Sites This is one of a series of periodic updates related to state coverage programs and Affordable Care Act (ACA) implementation from Partners HealthCare - Community Health. Background The CarePlus category of MassHealth was created as part of ACA implementation in Massachusetts and has been around since January 2014. There are approximately 347,000 CarePlus members across the state. It is comprehensive coverage intended for low income adults who are not eligible for MassHealth Standard. Most of the individuals on CarePlus were formerly on a different MassHealth coverage type (Essential, Basic) or on Commonwealth Care – programs which were eliminated under the ACA. Health Plan Choices All CarePlus members also have a health plan. Until now, there have been 6 health plan options: NHP, Tufts Together (formerly Network Health), Fallon, BMC HealthNet, Health New England, and CeltiCare. Most Partners Healthcare sites have accepted only the NHP CarePlus plan (with the exception of North Shore and the Islands which are contracted with BMC HealthNet and Spaulding which is contracted with CeltiCare). Now, CarePlus members have another plan option: the MassHealth Primary Care Clinician (PCC) Plan is now available for MassHealth CarePlus members, which is accepted across Partners sites. A new plan code of MassHealth CarePlus PCC is being added to Epic. Why Does This Matter? This is important because it means that there are now at least two health plan options for all MassHealth coverage categories (CarePlus, Standard, Family Assistance, and CommonHealth) across Partners sites. CarePlus patients have another avenue to receive care from us. Why Might You See a Patient on MassHealth Careplus with No Health Plan?
Resources:
-Thanks to Kim Simonian, MPH, Director for Public Payer Patient Access, Partners HealthCare - Community Health for this update and related materials.
Baker Opioid Proposal Would Give Hospitals the Power to Hold Addicts Governor Charlie Baker, facing a deadly scourge of prescription drug and heroin abuse, proposed this month to place new limits on how many opioid painkillers doctors and dentists can prescribe to a patient. Looking to help stanch addiction where it often begins, the wide-ranging bill would limit practitioners to prescribing no more than a 72-hour supply of opioids to patients the first time they prescribe an opioid to them, with exceptions only for certain limited emergencies. The governor’s legislation would also strengthen a prescription monitoring program, requiring every practitioner to check a database before writing an opioid prescription; increase education about the drugs for athletic coaches, parents, and physicians; and give hospitals new power to force treatment on substance abusers who pose a danger to themselves or others. Family members, law enforcement, and some other parties can currently petition a court to involuntarily commit an addict to treatment if they are deemed a danger to themselves or the community. Baker's proposal would also allow physicians to petition a court to commit a substance-abuse patient. Legislative leaders reacted positively to the proposal, but the Baker plan immediately drew concern from the medical community in Massachusetts. The powerful American Medical Association also expressed worry. The group’s chairwoman-elect, Dr. Patrice A. Harris, said in a statement the AMA shares local doctors’ “concerns over sections of the bill, including universal mandates that may be well-intentioned, but may have unintentional consequences to the patient-physician relationship.” Hospitals worry that sending more people to treatment involuntarily -- a process known as civil commitment -- does not address the need for expanded voluntary treatment services and would further congest the facilities that hold civil committees. "Instead of getting to the point where these patients need to be civilly committed, let's make sure the system is integrated enough that they don't have to be committed," said Paul MacKinnon, chief operating officer of UMass Memorial-Health Alliance Hospital in Leominster. "The reason some of these patients come in (to the emergency department) is because there's nothing out in the community to help them." Barbara Herbert, president of the Massachusetts chapter of the American Society of Addiction Medicine, calls the proposal “an extremely provocative idea that might actually bring some people into care.” Too often, she said, hospitals treat addicts for overdoses with antidotes like Narcan, only to watch them walk out the door and onto the street hours later. “We’re saving more people [in Massachusetts] than anywhere else from death, from immediate overdose,” she said. “But we get these people, they come in — and then we lose them. The idea that we can hold them long enough to try to figure out what would be real care could be a really wonderful idea.” But it could backfire, Herbert was quick to add. Overdose victims could grow afraid to seek treatment, she said, if they fear they will be held for three days and possibly shuttled into a longer-term commitment. And if there are questions about the practical impacts of the policy, there are also ethical concerns about expanding a system that confines people against their will. Civil commitment, the Supreme Court declared in 1972, amounts to a “massive deprivation of liberty.” Christine Griffin, executive director of the Boston-based Disability Law Center, said the state too often takes that liberty without offering adequate substance abuse recovery services in exchange. “That’s the part where we fall down,” she said. “Everyone pays attention to the process — yes, that’s important — but then, what ultimately happens to these folks?” The Senate has already passed its own bill this fall, focused on steering people away from addiction through education and prevention. Baker’s bill, along with efforts by the House, may be melded into a single legislative package in the months ahead. Sources and for full articles:
SNAP Fraud Detected- Baker: State Must Crack Down Gov. Charlie Baker said it is crucial for the state “to be aggressive” in tracking down welfare fraud after a Worcester convenience store owner was accused of operating a $3.6 million food stamp fraud scheme. “Each time someone who is gaming the system and stealing from everyone here in the commonwealth gets arrested, that’s a good thing,” Baker said. “From my point of view, we need to be aggressive at making sure because the credibility of the commonwealth is at stake.” The governor said the state has a number of ways it ferrets out cases of welfare fraud. “We have secret shoppers and a whole series of mechanisms we use to make sure people aren’t gaming the system,” said Baker. He pointed to a massive raid in Lawrence in June that resulted in six arrests at four markets after a three-year investigation into an estimated $2.5 million in food stamp fraud. That raid was carried out by Lawrence police, state police and the USDA’s Office of the Inspector General under the direction of the Essex County District Attorney after investigators noticed that EBT sales were dramatically higher than the projected sales inside the small stores. In the Worcester case, Vida Ofori Causey owned J&W Aseda Plaza, a convenience store, and purchased SNAP benefits instead of exchanging them for food from April 2010 to October 2014, prosecutors said. Causey is accused of buying the benefits at 50 cents for every SNAP dollar. The USDA then electronically deposited the SNAP benefits into Causey’s bank account, according to authorities. She defrauded the USDA of approximately $3.6 million in SNAP funds, authorities said. -See the full Boston Herald article.
Homelessness Problem on Upswing in Posh Areas of Boston In Boston, as in most other major cities, homeless people dot the sidewalks, streets, and parks, but recently the problem has become more prevalent in several neighborhoods better known for tourists and high-end shoppers. This shift reflects a steady rise in homelessness in Boston — an increase of more than 15 percent between late 2011 and early 2015, including those staying in emergency shelters and temporary housing. And as more upscale stores and condominiums crop up, more people are taking note of the problem. “There’s some sort of a critical mass happening,” said Meg Mainzer-Cohen, president of the Back Bay Association. The uptick in homelessness, as well as panhandling, prompted the city to reach out to social service providers, police, and the business community last year to form a task force that tackles the issue from all angles. By getting a variety of groups to communicate what they are seeing and doing, the task force aims to more readily pinpoint hot spots and coordinate efforts. On the Greenway, for instance, newly hired park rangers are being directed to get to know, and help, the people sleeping on benches and under bushes. Shopkeepers and property owners near Boston Common have started meeting with the day shelter on Boylston Street. In the Back Bay, where the issue has recently come into stark relief, so many people are setting up cardboard-box shelters in front of lower-level shops on Newbury Street and camping out beside the Boston Public Library — some storing blankets and food in unlocked newspaper boxes — that the head of the business association requested a meeting with the police commissioner. The general manager of the Fairmont Copley Plaza said he has been seeing double the number of people on the street that he usually sees. It’s hard to tell why more homeless people and panhandlers have found their way to areas like the Waterfront and the Back Bay, but service providers say recent crackdowns on Boston Common and in South Station could be forcing people to migrate to surrounding areas. The reasons cited for the rise in homelessness, even in a strong economy, are many: high housing costs, the heroin epidemic, the loss of detox beds after the Long Island Bridge was condemned a year ago. Despite the overall increase, the number of unsheltered people living on the streets is lower in Boston than in many other cities (less than 2 percent of the total homeless population) and was down this past winter from the previous year, due in part perhaps to the massive snowfall. For private businesses, the balance is a delicate one: making their neighborhoods welcoming for customers without turning their backs on the poverty, mental illness, and addiction on their doorsteps. They aren’t simply trying to clear the sidewalks in front of their stores, although that is part of the motivation. They are reaching out to the people they see there, and to service providers, to help those in need get housing or treatment. One task force member that has much to offer is the Downtown Boston Business Improvement District, which represents commercial property owners in and around Downtown Crossing. For several years, its ambassadors have talked to people on the street every day to see if they can help — directing individuals to soup kitchens, taking them to fill out housing applications, storing extra belongings, even buying bus tickets home. This type of hands-on approach seems to be taking hold. On the Greenway, the rangers have become familiar with the people huddled under blankets and know many of them by name, said Jesse Brackenbury, executive director of the Rose Fitzgerald Kennedy Greenway Conservancy. “It is very much our goal not to just push this problem somewhere else but to actually try to address it,” he said. Paul Tormey, general manager at the Fairmont Copley Plaza, is hoping to do just that for the people struggling outside his storied hotel. “Everyone wants to help these people,” he said. “Winter’s coming.” -See the full Boston Globe article.
Walsh Seeks Rise in Construction Fees to Expand Housing The Walsh administration is poised to require real estate developers to do more to create affordable housing at a time when rent increases and a boom in luxury projects are pricing many people out of the city. Two top city officials disclosed this month that Walsh plans to ask developers of new apartment and condo buildings to add to the number of affordably priced units they build within their projects or, alternatively, fund added affordable units elsewhere. Developers of office buildings, meanwhile, will likely be required to pay a higher fee to finance housing and job training, so-called linkage payments. Developers are enjoying Boston’s biggest building boom in a generation. Advocates have been pressing City Hall to make those developers foot more of the bill to house lower- and middle-income Bostonians. “This is an issue of shared prosperity,” said Patricia Flaherty, executive director of Mission Hill Neighborhood Housing Services, said at a hearing on the issue Tuesday. “There needs to be an increase in linkage fees to make sure our neighborhoods remain diverse and affordable.” Walsh’s housing chief, Sheila Dillon, said the administration has been trying to negotiate a compromise between the advocates and developers. Dillon expects the mayor to unveil new targets by the end of the year. The new construction fees would most likely take effect late in 2016, three years after they were last increased, officials said. -See the full Boston Globe article.
Tax on So-Called Cadillac Health Plans May Impact Many The White House has launched a bid to preserve a tax on generous, employer-sponsored insurance plans that underpins President Obama’s health care law, trying to stem a political tide after Hillary Clinton broke with Obama and called for its repeal.Targeting the unpopular “Cadillac tax,’’ which begins in 2018, Clinton says consumers and their employers should not be saddled with new costs to achieve reductions in medical spending. Many health care economists contend generous insurance plans lead to wasteful, unnecessary care. Imposing the tax should encourage employers to make coverage less generous, which means workers will be hit with more costs in the form of deductibles and copayments. And that, in theory, will force those consumers to become more discerning, skip wasteful care and duplicative tests, and drive stronger competition in the medical marketplace. Jason Furman, chairman of Obama’s Council of Economic Advisers, calls the Cadillac tax one of the law’s most important tools for constraining the rising cost of health care. Scrapping or delaying the tax, he contends, would have “serious negative consequences.” “It is perhaps the single biggest leverage we have on health costs in the private sector,” Furman said in an interview with The Boston Globe. The tax would affect employer-sponsored plans whose total costs exceed $10,200 a year for individual coverage and $27,500 for families. Employers would be taxed 40 percent on the amount that exceeds those thresholds. The tax is expected to generate $87 billion in revenue over the first eight years to help pay for the insurance subsidies that low-income Americans receive under the Affordable Care Act, according to a June analysis by the Congressional Budget Office. Unions denounce the tax as punitive because it would erode the generous health benefits many members enjoy. Others say the tax is unfair because companies in regions with high health care costs, such as New England, are subject to the tax even if the benefits offered are just average. “These are not grandiose plans,” said Rich Gulla, president of the State Employees’ Association of New Hampshire/SEIU, who fears the cost of the tax will be passed on to employees. “You go into state service knowing that you’re going to be taken care of in health care and in retirement. What was once promised as fully paid health care now comes with deductibles and copays.” A dozen Democratic senators, including Bernie Sanders, Clinton’s closest rival for the party’s nomination, introduced a bill last month to repeal the tax. More than 100 House Republicans, lead by Representative Frank Guinta of New Hampshire, are also targeting the unpopular tax. The tax “punishes hard working Americans,” Sanders said in a statement, adding that it more resembles a Chevy tax than a Cadillac tax. “Workers have fought hard to negotiate decent healthcare benefits, often in exchange for lower pay.” Senator Ed Markey, who has endorsed Clinton, also supports repealing the tax because of the “large burden” it places on middle-class families, said his spokeswoman. The Congressional Research Service estimates 15.8 percent of employer-sponsored single plans and 8.2 percent of nonsingle plans in Massachusetts would be subject to the tax in 2018 — among the highest rates in the nation, according to an August analysis. The Pioneer Institute expects the impact to be even greater. The Boston think tank estimates that about half of Massachusetts workers with private insurance will be affected because of the state’s high insurance costs, especially for teachers, police, and other public workers with robust health benefits. “It’s called a Cadillac tax but it’s really a Buick tax. It affects a significant amount of firms,” said Drew Altman, chief executive of the nonpartisan Kaiser Family Foundation. “It’s easy to dismiss this as Secretary Clinton throwing a bone to labor groups, but it’s wrong to frame it as a debate between good policy and a sellout to easy politics.” The tax, Altman said, would hit low-income workers and the chronically ill the hardest because it encourages companies to increase deductibles and copays, which are already rising rapidly. Furthermore, predictions by economists that reducing generous insurance packages will lead to higher wages are unlikely to happen immediately and may not be distributed equally among workers, he said. -See the full Boston Globe article.
Why It’s so Hard to Find a Mental Health Professional The demand for mental health services is growing nationally, and comprehensive mental health legislation is gaining momentum in Congress for the first time in years. But both forces could run up against a counter-force: a shortage of psychiatrists, psychologists, counselors and therapists in much of the country. More than half of U.S. counties have no mental health professionals and so "don't have any access whatsoever," according to Thomas Insel, director of the National Institute of Mental Health. The implications are significant. Nearly one in five adults -- about 43 million people -- had a diagnosable mental disorder within the past year. For nearly 10 million, the condition was serious enough to affect their ability to function day to day. Millions of adolescents also struggle with a debilitating mental disorder. Many people have become eligible for mental health coverage under the 2010 Affordable Care Act. Yet finding the professionals to deliver that care is increasingly tough. Merritt Hawkins, a physician search firm, conducted more searches for psychiatrists this past year than at any time in its 27-year history, according to a recent report. Psychiatrists trailed only primary-care doctors on the list of the firm’s 20 most in-demand medical specialties. States with the highest rates of mental illness and the lowest rates of access to care are in the South and the West, according to the patient advocacy group Mental Health America. Rural areas face some of the biggest deficits. "It is a serious shortage, especially in certain parts of the country," said Renee Binder, president of the American Psychiatric Association. The lack of psychiatrists and other mental-health providers is part of an overall shortage of physicians in the United States. Earlier this year, a study by the Association of American Medical Colleges concluded that the nation will face a deficit of between 46,000 and 90,400 doctors within a decade. While primary care doctors will certainly be in short supply, it said, the biggest deficits may be among specialist physicians who care for the elderly, including psychiatrists. Experts cite inadequate reimbursement from government and private insurance plans as one factor. "A medical student leaves medical school and residency with the same amount of debt no matter their specialty, yet primary care and psychiatry are professions with some of the lowest annual salaries," said Chuck Ingoglia, senior vice president for public policy at the National Council for Behavioral Health. "Which one would a smart, ambitious young person choose?" Or put another way: "If you look at the valuation for an hour of therapy, you could say we pay plumbers, carpenters and handymen more than we pay for behavioral health," said Paul Gionfriddo, president of Mental Health America. -See the full Washington Post article. Cited in/Linked from: HEALTH CARE WEEKLY UPDATE, Barbara Roop & John Goodson, Health Care for Massachusetts, October 23, 2015.
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