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MGH Community News |
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MGH Community News |
| November 2017 | Volume 21 • Issue 11 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Diana Tran, x6-8182. Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807. |
Able Bodied Adults without Dependents May be Eligible for a Fresh 3 Months SNAP Benefits This coming January, there will be TWO SNAP changes that will impact "Able Bodied Adults Without Dependents" or ABAWDs. There’s both good news and bad news. Good news: At least 3 months of SNAP for ABAWDs who lost SNAP in the past As of January 1, 2018, DTA will start a new "3-year clock" for individuals subject to the ABAWD work rules. This means that starting January 1, 2018, any ABAWD who lost SNAP since April 2016 can reapply at any time and get at least 3 months of SNAP. Reminders
If the ABAWD meets an exemption, there is NO time limit. If the ABAWD meets the work rules, their SNAP continues.
It is very important to screen for exemptions! For those who are not exempt, ABAWDs can meet the work rules in a few different ways. DTA has expanded the SNAP education and training programs available to ABAWDs - which means DTA will pay for the training!. Check out DTA's "SNAP Path to Work" website here. |
Bad news: Many Massachusetts ABAWDs living in cities and towns that were previously exempt will have to meet the work rules to keep their SNAP Many cities and towns that used to be "waived" from the ABAWD time limit because of high unemployment will not be waived as of January 1. This includes cities and towns where you might think there is still high unemployment, such as many areas of Hampden and Berkshire Counties, Gloucester and Taunton. DTA must follow federal rules to determine waived and non-waived areas - and the list of waived towns has dropped. About 6,000-7,000 ABAWDs may be impacted.Mass Law Reform Institute (MLRI) will post a map of the 2018 waived cities and towns soon. You May Get Questions- Advocacy Assist DTA will be doing outreach to these ABAWDs. ABAWDs may call you because they get a letter from DTA that they now have to meet the ABAWD work rules- or they will lose SNAP. It is important to screen these individuals for exemptions and, if not exempt, help them find ways to meet the work rules. Advocates may call Vicky Negus 617-357-0700 x 315 or Pat Baker x 328 at MLRI if you have an ABAWD client who is about to lose or has lost SNAP. - From SNAP Update - Changes coming in January 2018 both good and bad for 18-50 year olds, foodsnapcoalition listserve on behalf of Pat Baker, MLRI, November 02, 2017.
SNAP Advocacy- Foster Care and Dependent Care Foster Care Families and SNAP
Low income families who provide foster care to children or to adults through the Adult Foster Care (AFC) program may be entitled to higher SNAP benefits. Families have the choice to include or exclude the foster child or AFC adult in the SNAP case. This is true For more information, see Mass Legal Services for foster care families and Adult Foster Care. The SNAP Dependent Care Deduction MA SNAP policy allows households to self-declare the costs of child care or adult dependent care - unless the information provided by the household appears questionable. Declaring these costs can have a big impact on a family's SNAP! Every $3 you spend on childcare may increase your SNAP benefits by $1 – up to the maximum SNAP amount for your household. You can claim child care costs OR adult care costs if you need the care because:
Allowable costs:
This deduction can be claimed on the SNAP application form or at any time with a separate signed and dated statement. -Adapted from: Updated SNAP Know Your Rights fliers - Foster Care and Dependent Care Deduction, foodsnapcoalition listserv on behalf of Victoria Negus, Mass Law Reform Institute, November 15, 2017.
SNAP Reminder: Replacement Benefits Due to Natural Disaster or Household Misfortune (Including Power Loss, Appliance Failure, Fire, etc.) Looking ahead towards winter weather and likely power-outages here’s a reminder about replacement SNAP benefits. Federal and state SNAP rules provide for replacement of food lost by individual SNAP recipients due to "household misfortune." Household misfortune includes fire, flood, loss of electricity, equipment (refrigerator/freezer) failure or other disaster. To request SNAP replacement benefits:
DTA will confirm what happened by contacting a third party or visiting the client's home. Advocacy notes
Additional materials
-Source Mass Legal Services.org
SNAP- Massachusetts Tries to Enroll More Seniors in Food Stamps with New Holyoke Unit and Outreach For an elderly person, applying for food stamps can be difficult. The application is complex, calls to customer service involve new case managers every time, and documents must be organized and submitted. Seniors may not know about deductions and may think applying is not worth the hassle. In January, the state will open a statewide senior assistance office at its location on Front Street in Holyoke, which will be dedicated to helping seniors sign up for the benefits they are eligible for. State officials are also making a renewed effort to track down seniors who are eligible for food stamps but have not enrolled. Advocates for seniors and low-income individuals say the outreach is necessary, as many seniors who are eligible for public assistance find it hard to apply. Some lost benefits due to problems with the state's modernization of its food stamp system. According to data compiled by the Massachusetts Law Reform Institute, which focuses on poverty law, there are 106,000 adults over age 60 who are on MassHealth and are likely eligible for food stamps but have not signed up. Another approximately 125,000 seniors are not eligible for MassHealth, based on their income, but may be eligible for food stamps. Advocates refer to this as the "SNAP gap" -- the gap between the people eligible for the Supplemental Nutrition Assistance Program and those who actually obtain benefits. The senior assistance office in Holyoke will employ up to 20 case managers and three supervisors focused exclusively on seniors. There will also be a client assistance coordinator to help seniors with disabilities. The Department of Transitional Assistance already published a new application for seniors with more relevant questions and a larger font size. The senior assistance office will staff a phone line dedicated to seniors. Seniors will not have to go through an automated phone tree to reach a person, and staff will be trained in the particular needs of seniors. State officials will also begin an outreach campaign to contact seniors who appear eligible for food stamps due to their participation in MassHealth and ask them if they want to apply. Additionally, the state has always worked with community partner agencies, which are social service agencies that help people fill out food stamp applications. Agency staff are trained to ensure people submit the proper paperwork and claim the maximum benefits they are eligible for. The agencies are partly reimbursed by the federal government. On Oct. 1, the state added 14 Councils on Aging, which work with seniors, to its community partners. Donna Popkin, director of member services for Massachusetts Councils on Aging said the process of applying for benefits is cumbersome, and many seniors do not understand how to get maximum benefits. For example, seniors might not know they can deduct medical expenses when reporting income. Pat Baker, senior policy analyst at the Massachusetts Law Reform Institute said another problem is the caseload drop that occurred after Massachusetts modernized its SNAP system. The state instituted a data matching system that kicked people off SNAP based on an online check with Department of Revenue data. However, many people were unenrolled who were actually eligible. A modernization of the phone system made it harder to reach customer service. The department took steps to fix the problems, but many people lost benefits. Carolyn Villers, executive director of the Massachusetts Senior Action Council said ideally, there would be a common application for all welfare programs. State officials have been discussing that for years. -See the full MassLive article.
RAFT Veto Overridden The Massachusetts Senate this month completed the override of the Governor's Residential Assistance for Families in Transition Program (RAFT) budget veto (previously approved by the House). This override restores the proposed $2 million increase to RAFT, and restores language that will allow the program to continue serving the expanded population including unaccompanied youth, elders, people with disabilities, and other households without minor children. During FY'17, 3,980 households were served by RAFT. This included 124 households who previously were ineligible under the more limited definition of family, 56% of which were households with disabilities. With $15 million in FY'18 (including the earmark of $2 million for households without minor children), we anticipate that the state would be able to prevent homelessness for an estimated 4,878 households, based on the average FY'16 RAFT expenditure of $3,075/household. According to the 2015-2016 RAFT report published by the Regional Housing Network of Massachusetts, the state's FY'16 RAFT investment of $12.5 million saved the Commonwealth an estimated $137 million. As of this writing, however, the Baker Administration has not released funds for RAFT households without children. According to the MA Coalition for the homeless, the funds are being held back to possibly be taken back in mid-year 9c budget cuts. -From email correspondence, Kelly Turley, MA Coalition for the Homeless, November 07, 2017.
Reminder: Veterans’ Benefits and Services In honor of Veteran’s day, New England INDEX’s monthly Mass Network of Information Providers (MNIP) e-newsletter focused on services for veterans. Veterans’ BenefitsThe US Department of Veterans Benefits offers programs and services providing financial, medical and other assistance to veterans. Here is information about some of the most often used programs: Information for Spouses and Families VA Survivors Pension Information The Survivors Pension benefit, which may also be referred to as Death Pension, is a tax-free monetary benefit payable to a low-income, un-remarried surviving spouse and/or unmarried child(ren) of a deceased Veteran with wartime service. See MNIP's Veterans’ Benefits Fact Sheet for more information. Veterans’ Services Massachusetts Resources for Veterans Massachusetts Department of Veterans Services (DVS) – Web site provides resources on benefits, employment, training, education benefits, housing, outreach and counseling and more for veterans and their dependents. Local Veterans’ Service Officer (VSO) – Every Massachusetts city and town has a local veterans’ service officer to assist veterans applying for receiving state and federal benefits. Brain InjuryAccording to Stars and Stripes, the military newsletter, “as many as 60% of soldiers who survive external injuries from bomb blasts may have a brain injury. “Symptoms include headaches, memory problems, irritability, trouble organizing thoughts and difficulty finding words. Phone: 617-204-3662, 800-223-2559 ext. 2 (toll-free) Emotional SupportVeterans Crisis Line – Confidential toll-free hotline, online chat, or text options. The Women’s Veterans’ Network – The Women Veterans’ Network of the Department of Veterans’ Services is the central resource for women veterans in Massachusetts. - From Veterans’ Benefits and Services, MNIP News, November 09, 2017.
Three Conditions Added to SSA Compassionate Allowances List The Social Security Administration (SSA) recently announced three new Compassionate Allowances conditions were added to the list:
A recent SSA blog post included some background for context. Here’s an excerpt:
Reminder: The Compassionate Allowances list expedites the disability determination process. It does NOT eliminate the SSDI 5 month waiting period. Under the SSDI 5 month waiting period, those approved for SSDI are due benefits starting the 6th full month after the disability onset date (as determined by the SSA). The disability onset date may be before the date of application. -See the full Social Security blog post.
This month the U.S. Department of Homeland Security announced that it will extend Temporary Protected Status (TPS) for Haitians, which was set to end on Jan. 23, until July 2019, but then end it permanently.
More than 321,000 people from countries affected by violent conflict or disasters – including at least 8,000 in Massachusetts – depend on TPS to live and work legally in the U.S. Without action to renew TPS, Nicaraguans and Hondurans would lose their work permits and be subject to deportation on Jan. 5 and Salvadorans on March 9. MIRA Executive Director Eva Millona said in an email statement: Given the imminent threat that Haitians faced, we’re relieved that TPS has been extended until July 2019. That said, we strongly object to any suggestion that conditions in Haiti no longer warrant TPS. Indeed, the fact that this administration has now terminated TPS for three countries within three months – Sudan, Nicaragua and Haiti – makes it clear that decisions are being made not based on the facts, but on the administration’s desire to push immigrants out of this country. We know what conditions are like in Haiti. They’re still rebuilding basic infrastructure. They’ve just recently contained a major cholera epidemic. And the economy is in tatters. There is simply no way that Haiti can absorb 58,000 people and their families if they are expelled from the U.S. There’s not enough housing. There are not enough jobs. And without the money that Haitians abroad are sending back, which accounts for an astonishing 29% of GDP, how will people even subsist? Hopefully within 18 months, things will be better, but at the rate that Haiti is progressing, it could take many more years before it’s a safe and fully functioning country. -Adapted from TPS for Haiti extended for 18 months, then terminated: Next steps and ‘We are facing a humanitarian crisis’: Rising concerns about TPS, Eva Millona – MIRA Coalition, November 21, 2017 and November 3, 2017 respectively.
New Home Care Workers’ Registry Raises Privacy and Safety Concerns Gov. Charlie Baker this month signed a bill establishing a registry for home care workers. The bill was introduced as a consumer protection measure, to help ensure that seniors or people with disabilities know who is coming into their homes. It requires home care workers who work for state-contracted agencies to include in a database their name, home and mailing addresses, gender, job title, and training or certifications. The information could be reported to labor unions, home care worker agencies and private organizations that have state contracts to connect people with elder services. The bill includes exemptions for home care workers who are victims of domestic violence, sexual assault or harassment. The bill caused controversy over whether it had adequate protections for home care workers. Associations representing the Massachusetts home care industry opposed the bill. They said workers should be able to opt out of having their information included. Otherwise, it could jeopardize workers' safety. The home care industry instead proposed a licensing process with a database that included information about a worker's education and training, but not personal information like addresses. Industry leaders said exemptions are not sufficient since some victims of domestic violence might not want to tell their employers that they are victims. But the union representing home care workers came out in support of the bill, arguing that it is a step toward providing more oversight and making the home care industry more professional. The exemptions were added to the bill after Baker vetoed an earlier version, which was included in the fiscal 2018 budget, citing the privacy concerns. -See the full MassLive article.
Disability Disclosure and Self-Identification: What’s the difference?! Disclosure Disclosing a disability to an employer for the purpose of requesting an accommodation is a complex decision that bears with it both benefits and risks to the individual. On one hand, telling an employer about a disability is the only way to protect an individual’s legal right to any accommodations they might need to get or keep a job. On the other hand, revealing a disability may subject someone to misperception and discrimination which could limit opportunities for employment and advancement. Disclosing a disability to an employer is a very personal decision and not an easy one to make – when and to whom should someone disclose? If they do disclose, will they be looked at or treated differently? Will they be passed over for promotions, or interesting projects? Worse yet, will they be fired? Is the employer aware of, sensitive to and educated about disabilities? Self-Identification A person may self-identify informally when they feel confident in doing so and as part of their core beliefs in overall identity sharing. They feel comfortable in sharing this information as a part of who they are as a person. This is a personal decision and a totally voluntary action. A person may also self-identify formally in response to a self-identification survey at work.
Recent amendments to the ADA have put pressure on employers to ‘do better’ regarding recruiting, hiring and retaining veterans and employees with disabilities.
Self-Identification Surveys It’s important that employers communicate to their employees and candidates that self-identification surveys are:
Employers should also communicate that self-identification surveys are NOT:
Information obtained through self-identification surveys helps companies to:
For more information on self-identification and Section 503 of the Rehabilitation Act, visit OFCCP’s [Office of Federal Contract Compliance Programs (OFCCP)] web site at https://www.dol.gov/ofccp/regs/compliance/section503.htm. -From Work Without Limits Blog: 'Disclosure and Self-Identification What’s the Difference?!', Nicole Henry, UMass Medical School, November 20, 2017.
Earned Income Tax Credit- Now an Option for Those Who Have Left their Abusers The Earned Income Tax Credit (EITC) is a “refundable tax credit” for working, low-income individuals and families. The EITC lifts more low-income families out of poverty than any other benefit program. Even workers whose earnings are too small to owe income tax can get the EITC. To get it, one must file a federal tax return with the IRS. Massachusetts also has an Earned Income tax credit (EIC). To get the credit, you need to file a state tax return and send it to the Massachusetts Department of Revenue. The amount of the credit is based on the amount received on the federal EITC. If one qualifies for the federal credit the Massachusetts credit will be 23% of the federal credit. (The tax credit was expanded from 15% to 23%.) A provision in a bill allowing married individuals who have left their batterer to file their taxes, and now claim the EITC, was adopted in this year's budget and signed into law. MA is the first state in the nation to adopt this new policy. More information available at: www.taxcreditsforworkersandfamilies.org/news/massachusetts-takes-action-connect-domestic-violence-survivors-eitc/ -Adapted in part from November 15th Fundraiser and Legislative Highlights email, Friends of Marjorie Decker, November 8, 2017. -Thanks to Melanie Cohn-Hopwood for forwarding this information.
New Mass. Law Cracks Down on Handicapped Parking Abuse A new Massachusetts law is intended to crack down on people who fraudulently use handicapped license plates or placards to snag choice parking spaces. State Sen. Eileen Donoghue, a Lowell Democrat who sponsored the bill said the goals was to stop abuse "so that people who need the placard, who need the space, can get it." The measure imposes tougher fines for using a handicapped license plate or placard that was issued to a person who has since died - $500 for the first offense and $1,000 for each subsequent offense. License suspensions imposed upon people who fraudulently display a handicapped plate or placard would be extended from 30 days to 60 days for the first offense, and from 90 to 120 days if it happens again. The law also calls for a $50 fine on any driver who obstructs the expiration date or number of a handicapped placard. The law also seeks to strengthen the authority of the Registrar of Motor Vehicles to ask for more medical information about why the driver needs a handicapped plate or placard and to investigate allegations that an individual has falsely obtained a plate or placard. -See the full WBUR story.
Scam Victims May Claim Against Western Union The Federal Trade Commission (FTC) is informing consumers they may file a claim to retrieve money lost to scammers who used Western Union. Files must be submitted by February 12, 2018 through this form: FTC.gov/WU. In January 2017, the Western Union Company entered an agreement with the FTC and the US Department of Justice, admitting to criminal violations, including willfully failing to maintain an effective anti-money laundering program and aiding and abetting wire fraud. As part of the settlement, Western Union will pay $586 million to redress victims. Victims who lost money to scammers who told them to pay via Western Union’s money transfer system between January 1, 2004 and January 19, 2017 are eligible to file a claim to get their money back. More information from the FTC Consumer Alert:
- From Elder Justice: Victims of Western Union Fraud May File Claims with FTC, National Center on Law & Elder Rights (NCLER), November 20, 2017.
CancerandCareers.org Cancerandcareers.org (Spanish version: Cancerandcareers.org/espanol) is an interactive website with articles, a blog, an events calendar, a resource directory, a collective diary, videos, downloadable tools, and a newsfeed with recent articles and research on issues related to work and cancer. Much of the information and advice on their site and publications is applicable to those with any type of illness or injury that interferes with one’s ability to work. The site includes the following features:
-Thanks to Lauren DeMarco for sharing this resource.
Transportation to Boston- NH and ME Medicaid Members of the Community Resource Center’s Advisory Committee reported that they’ve been hearing of some New Hampshire and Maine Medicaid patients who were able to get transportation to Boston for treatment. They asked us to investigate and here’s what we learned. New Hampshire Medicaid Members of NH Medicaid’s Fee-for-Service (FFS), Premium Assistance (PAP), and Managed Care Organization (MCOs) may arrange transportation for medical appointments (not limited to cancer care) with prior authorization. More Information and contacts: Guide on How to Request Transportation for NH Medicaid Recipients MaineCare Services LogistiCare, MidCoast Connector and Penquis CAP provide transportation to Boston for all medical appointments with prior authorization and at least 2-3 business days notice. More Information and contacts: http://www.maine.gov/dhhs/oms/nemt/nemt_index.html
Boston Opens Day Center For Drug Users By some accounts, there are more heroin users clustered near the Mass. Ave. exit off Interstate-93 in Boston than anywhere else in the state. Within about a few blocks, there are two shelters, at least three recovery homes, two methadone clinics, doctors who specialize in care for people who are homeless and the city’s largest safety net hospital. But between appointments, clients spend much of their time in parking lots, along sidewalks or on a front stoop. Now in Boston something is happening. But community leaders, business owners, drug users and the city are divided over whether a new engagement center is the right something — whether it will relieve congestion, help people get off the streets, stay safe, and get into recovery. The center isn't all that easy to find. Look for a gate in a fence behind the Southampton Street men's shelter. An asphalt path winds around to a patch of AstroTurf and a line of porta potties. Men and women lounge at picnic tables in front of a domed tent, roughly half the size of an Olympic pool, that glistens in the sun. Inside, there are no walls. The space is loosely divided into 10 areas. A fridge and folding table with coffee urns, snack bars and instant oatmeal is right up front. "We always have water and coffee flowing all day, that's really important," laughs Devin Larkin as she begins a tour. Larkin oversees the center as director of the Bureau of Recovery Services at the Boston Public Health Commission (BPHC). Beyond the coffee, there’s an office of sorts with computers, a small library of books and magazines, and a nurse’s station staffed by the Boston Health Care for the Homeless Program. As many as 600 guests visit the center between 7 a.m. and 7 p.m. daily.
The center has 12 employees, five on at any given time. They help guests with job applications, organize domino games, and chat. "We place up to 50 people a day in treatment all over the state," Larkin says. "We didn’t feel the need to duplicate those services here." Some community activists, argue the city's investment in the center as a way to address the opioid epidemic is misguided."This is not a community, this is just a band-aid," says the Rev. June Cooper, executive director at the anti-poverty group City Mission. "It's an air-conditioned warehouse," says Jim Stewart, with the First Church shelter in Cambridge, jumping in. "You can AC a warehouse, but you'll still have a warehouse." "If they can find $800,000 to herd some people up and keep them in an air-conditioned warehouse, why can't they find $800,000 to increase access to treatment?" Stewart asks. Actually, the cost of setting up and running the engagement center as a six-month pilot project will be just over $1 million. It opened at the beginning of August. There's no decision yet about whether to keep the center open beyond February. -Listen to or read the full WBUR story.
Boston Launches Office of Returning Citizens for Those Previously Incarcerated Building on Boston's commitment to creating opportunities for all residents, Mayor Martin J. Walsh recently launched the Office of Returning Citizens, a newly formed office that will support the nearly 3,000 individuals who return to Boston after being released from state, federal and county facilities each year, as well as others who were previously incarcerated. The Office of Returning Citizens will be part of the Office of Public Safety, which was created in 2014. "No one should be defined by the hardest time in their lives. Everyone deserves a second chance and a fair opportunity at success. That's why we've created the Office of Public Safety, and continued our commitment to opportunity with the Office of Returning Citizens," said Mayor Walsh. "For those who have been incarcerated, accessing things like housing, jobs and healthcare can be difficult. The Office of Returning Citizens will connect returning residents to resources throughout the City, making Boston safer and stronger -- a better Boston for everyone." The Office aims to help individuals who have taken healthy steps and prepared themselves to move past the consequences of their past actions, and coordinate the work done by Boston's social service and law enforce partners. This office will incorporate best practices from local, state, and federal partners and include a review of similar offices in Washington D.C. and Philadelphia. According to The Boston Reentry Study from Harvard University, individuals reentering society need assistance accessing resources to help them find permanent housing and employment. Previous successful programs the City has established for those leaving incarceration include Operation Exit, Boston's reentry program. Mayor Walsh established Operation Exit in 2014 to help at-risk residents, or those with a criminal background, by providing the knowledge and skills required for entry into an apprenticeship program. Through career readiness and occupational skills training, the intensive training program provides hands-on learning experiences with peer-to-peer mentorship to prepare participants for good careers. The Office of Returning Citizens will be located at 22 Drydock Ave. in Boston's Seaport District, a neutral location designed to be accessible for all residents. For more information on the Office of Public Safety Initiatives see www.boston.gov/departments/public-safety. -See the full press release.
CVS Plans to Launch Same-Day Delivery in Boston CVS Pharmacy has announced plans to launch free same-day delivery from CVS Pharmacy locations in Boston beginning early next year. Nationwide, the company will offer next-day delivery starting early 2018. The move comes as Amazon reportedly is making moves into the pharmaceutical delivery business. Axios reported in September that Amazon may be talking with some pharmacy benefit managers in an attempt to potentially deliver drugs to customers. “Our goal is to meet the needs of our all of our customers wherever, however and whenever they want," said Helena Foulkes, executive vice president of CVS Health and president of CVS Pharmacy, in a statement. "Providing same and next-day options for delivery of medications is just another way we can help our patients get and stay healthy." The company said it will ship prescriptions and a “curated selection of over-the-counter products” in tamper-proof packaging. The company said it plans to offer the service at no added cost. CVS already offers shipping with Instacart for delivery of front-store products and the company's curbside service allows customers to shop online or in the CVS app to pick up prescriptions at the store in an hour. CVS has 357 retail stores in Massachusetts, and another 39 pharmacies within Target stores in Massachusetts, according to a regulatory filing. -See the full Boston Business Journal article.
Planning Guides for LGBT Caregivers
SAGE partnered with AARP to create a Prepare to Care Guide: A Planning Guide for Caregivers in the LGBT Community. This practical tool is filled with information, resources, and checklists to help caregivers get organized so they can do what's best for their loved ones.
If you provide programming for older LGBT people, be sure to download Caregiving in the LGBT Community: A Guide to Engaging and Supporting LGBT Caregivers Through Programming. This user-friendly publication provides ideas, lessons learned, and best practices for expanding programs to support LGBT caregivers and those caring for LGBT older adults. -Adapted from 'Tis the Season to Battle Loneliness, SAGE email, November 21, 2017.
Year Up Offers Job Training for Low-Income and Under-Served Year Up is a nonprofit whose mission is to train young adults who lack opportunities for professional careers. They tend to come from low-income and underserved communities. It's free and students even get a stipend. They’re offered classes in sales, finance, project management, quality assurance or IT. Students also take classes in communications and workplace readiness, learning essential skills like how to write a resume or build a network. Classes go for six months, then students do an internship for an additional six months.
Many of the classes at Year Up aim to prepare students for jobs that are expected to see major growth in the future. Garrick Rodrigues, a senior IT manager at Partners, said it's a challenge to fill entry-level IT jobs. "If we don't fill those positions, we're going to struggle to be effective," he said. "We're going to struggle to deliver the technology and the services that we need to deliver in this revolving world of digital and technology." Partners has hired 30 Year Up grads in recent years. Rodrigues said his greatest need is for workers with both professional skills and technical expertise. "We need them to be able to translate the use and support of that technology to how they speak with and interact with our users," he said. Year Up attempts to fill that divide with its mix of classes. About 90 percent of the program's grads are in full-time jobs or enrolled in college. Year Up Executive Director Bob Dame said there's a lot of overlooked talent, and those people can be trained to fill jobs. "Often some of these entry-level positions require a two- or a four-year degree. What we've demonstrated is that for a number of these entry-level positions you don't need a two- or four-year degree," Dame said. "You can come through a program like this or other programs, develop the skills specific to an industry and then continue to develop from there." That outcome is also backed up by research. A recent Harvard Business School study found workers with relevant professional experience were equally or more productive than college graduates. Students at Year Up say the training program is rigorous. In Massachusetts, there are 17 jobs for every computer science grad, according to a report by the Massachusetts Technology Leadership Council. And many jobs in science, technology, engineering and math are projected to grow by double digits by 2024. -See the full WBUR/Bostonomix article.
MLRI Flyers Explain ConnectorCare and NonGroup Open Enrollment and Coverage Open enrollment for ConnectorCare and other nongroup coverage in Massachusetts, Nov 1, 2017 to Jan 23, 2018. A new MLRI flyer explains the basics, includes links to 2018 ConnectorCare premiums and plan information, and flags three groups who need to take action to attain or retain affordable ConnectorCare in 2018. Excerpts follow. ConnectorCare All the insurance carriers offering ConnectorCare plans include the same benefits and charge the same copayments. However, different carriers include different doctors and hospitals and charge different premiums for their ConnectorCare plans. See the ConnectorCare Shopping Guide These are the ConnectorCare plans from the five insurance carriers available in 2018:
2017 ConnectorCare Members No Longer Eligible in 2018 Almost 50,000 ConnectorCare members were notified that they will not be eligible for ConnectorCare in 2018. They will be automatically enrolled into Health Connector plans at full price with no subsidy for 2018 unless they take action.
2017 ConnectorCare Members with a Carrier that is no longer the lowest cost ConnectorCare plan for 2018 In 3 regions of the state including Worcester and Cape Cod (regions B1, G1 and G3) the lowest cost carrier is no longer BMC Health Net Plan. To remain in the lowest cost plan in 2018, people in these regions who are enrolled in BMC will need to change to a different carrier. ConnectorCare eligible individuals who did not enroll in 2017 In 2017 over 25,000 people were found eligible for ConnectorCare Plan Types 1 and 2A with no premium contribution, but did not take the next step of selecting a plan and enrolling in coverage by the deadline. These people remained uninsured in 2017 and even lost access to the Health Safety Net (except for dental which ConnectorCare does not cover). Open enrollment is an opportunity for them to update their eligibility, and enroll in ConnectorCare coverage for 2018. -From Health Care Updates on MassHealth Managed Care & Open Enrollment, Health Announcement listserv, Vicky Pulos, MLRI, November 15, 2017.
MassHealth ACO- Updates and Outreach, Including Partners Handouts As part of the MassHealth Payment and Care Delivery Innovation (PCDI) initiative, MassHealth will be introducing new Accountable Care Organizations (ACOs) to its 1.3 million managed care eligible members. These health plans are designed to emphasize care coordination and member-centric care, as well as align financial incentives. ACOs are provider-led organizations that coordinate care, have an enhanced role for primary care, and are accountable for the quality and total cost of care. Reimbursement arrangements with ACOs will provide incentives to improve care coordination and achieve performance standards across multiple measures of quality, including prevention and wellness, chronic disease management, and member experience. Affected Members MassHealth managed care eligible members are:
PCDI does NOT affect members who receive MassHealth coverage through:
It is also not an option for those who are not on MassHealth (such as on CMSP, Health Safety Net, Medicare, etc.) Automatic Enrollment Today these members are in one of six Managed Care Organizations (MCOs) or the Primary Care Clinician Plan (PCCP). Starting March 1, 2018, they will be in one of two MCOs, the PCCP, or one of 16 new Accountable Care Organizations (ACOs). To prepare for this massive change in plans, MassHealth identified each member’s primary care provider (PCP) and will prospectively enroll members whose PCP joined an ACO into that ACO on March 1. PCPs who join an ACO are exclusive to that ACO. They cannot be PCPs in any other ACO, an MCO or the PCCP. (Exclusivity does not apply to other programs, such as Senior Care Options [SCO], One Care, the Program of All-inclusive Care for the Elderly [PACE] or MassHealth fee-for-service. PCPs can continue to provide services to members in the above-mentioned plans and fee-for-service members regardless of their contracts with ACOs.) Mass General and MGPO PCPs will be members of the Partners HealthCare Choice ACO. Their patients will be auto-assigned to the Partners HealthCare Choice ACO unless the member makes another choice. Notification On Nov 24, MassHealth began sending notices to about 815,000 members whose PCP joined an ACO telling them they will be enrolled in that ACO on March 1, 2018 unless the member makes another choice. About 100,000 people are in MCOs that will not continue after March 1 and have a PCP who did not join an ACO or have a PCP who joined an ACO that does not cover the member’s zip code. They will be told to select a new plan by March 1, 2018 or MassHealth will auto-assign them to one of the available options. It is particularly important that this group look into their options and select the best-suited plan for them in advance of March 1. Selecting and Changing Plans All 1.2 million members will be told that they can select from any available option for coverage starting March 1, 2018. All will be told they can freely change plans for 90 days after March 1, 2018, but will only be able to change plans for cause from June 1, 2018 to Feb. 28, 2019. A new website MassHealthChoices.com contains information on plan choices, explains ACOs, the importance of selecting a PCP and has links to provider directories and an online enrollment form. Fact Sheets from MassHealth To assist providers in their understanding of how these changes affect them and their members, MassHealth has developed four specific Fact Sheets: Specialists, Primary Care Providers (PCPs), Hospitals, and Behavioral Health Providers. For continuity purposes, and ease of understanding, each of these Fact Sheets includes sections titled: Eligible Members, Available Health Plans, and Who is Not Affected by These Changes. In addition, they include detail on the Provider Networks, Prior Authorizations/Medical and Pharmacy Claims, and give more information on Member Eligibility, Referrals and Referral Circles, Community Partners, and Member Assignments and Noticing. In the upcoming month MassHealth will be launching a dedicated “PCDI for Providers” webpage. The MassHealth PCDI for Providers webpage will be updated regularly with information, notices and relevant tools. Until that webpage is developed, please see the main provider page on the newly redesigned MassHealth website at www.mass.gov/masshealth-for-providers. To view these fact sheets, go to the "What you need to know" section and click "PCDI information for MassHealth Providers".
If you have any questions, please contact the MassHealth Customer Service Center at 1-800-841-2900 or e-mail providersupport@mahealth.net.
Partners-Specific Information Primary Care: Only MassHealth members in the Partners Healthcare Choice ACO will be able to see Partners Primary Care Providers (PCPs). To ensure continuity of care, MassHealth members currently assigned to a Partners PCP will be automatically mapped to the Partners ACO. Specialty care: The MassHealth health plans that allow you to see Partners specialty providers are:
How do MassHealth members enroll in the Partners HealthCare Choice ACO? Where can members of the Partners HealthCare Choice ACO go for behavioral health services? Learn more on the Partners Medicaid ACO SharePoint site. Sources and for More Information
-Thanks to Marie Elena Gioiella for forwarding some of this content and to Kim Simonian and her team for the SharePoint site.
For Many with Medicare Part D, There’s No Limit to What You May Need to Spend on Prescriptions According to a new issue brief by the Kaiser Family Foundation (KFF), one million people with Medicare Part D had drug costs above the catastrophic limit in 2015. On average, they spent $1,251 after they hit the catastrophic limit and more than $3,000 total on their prescriptions for the year. While Part D helps bring down the drug costs for people with Part D, many are still exposed to high drug costs. This is because Part D does not place a cap on how much people can spend out of pocket on their drugs. Under Part D, catastrophic coverage is meant to protect people with Medicare from paying very high costs once they pay a certain amount out-of-pocket. However, people with Part D are still required to pay up to 5% of the cost of their drug once they hit catastrophic coverage unless they qualify for the low-income subsidy, known as Extra Help, that helps pay for Part D costs. More people are affected every year. According to KFF, the number of people with Part D without Extra Help who had drug costs after reaching catastrophic coverage more than doubled between 2008 and 2015. Those who had drug costs beyond the catastrophic limit in 2015 made up just 2% of total Part D enrollees; however, these costs accounted for 20% ($3 billion) of total out-of-pocket drug costs for all enrollees ($15 billion) that year. -From Medicare Rights Center blog.
Why So Many People Choose the Wrong Health Plans Because people tend to keep the older, low-deductible plans they already have — and because they are often frightened by high deductibles — large numbers of workers and their families are spending more than they need to on health care. In most cases, if employees do not take direct action during the annual open enrollment period, they automatically continue with the previous year’s choice. But even if that was the right choice then, it often is not now. According to the Kaiser Family Foundation, 49 percent of the United States population receives health insurance through an employer-supplied plan. And several studies indicate that a sizable fraction of employees choose needlessly expensive plans with low deductibles when high-deductible versions are available. (High deductibles are still unusual for health maintenance organizations, which limit consumers to a single provider.) Simply providing consumers with good options doesn’t ensure that they will choose wisely. Three economists, Saurabh Bhargava and George Loewenstein of Carnegie Mellon University and Justin Sydnor of the University of Wisconsin, examined the problem in a 2017 paper. They studied an anonymous, large company that gave employees many choices. The company’s workers could choose from among 48 different combinations of deductibles, prescription-drug co-payments, co-insurance rates and maximum out-of-pocket costs. (Each version offered the same network of doctors and hospitals.) The results were troubling: A majority of employees selected financially dominated plans — generally, those with low deductibles, which were worse in every spending scenario. The employees who picked plans with a deductible of $750 rather than $1,000, for example, were essentially paying $528 to reduce their deductible by $250. That is not smart. But the authors showed that people often do not understand the choices they are making when it comes to health insurance. Counterintuitively, the “no-brainer” high-deductible plans were not only cheaper. They were less risky for consumers because they capped out-of-pocket costs at a lower level. People make exorbitant health care choices for reasons that include:
There are, however, many financial incentives for going the high-deductible route. Some are embodied in health savings accounts, of H.S.A.s, which provide tax breaks and are only offered in combination with high-deductible plans. It is easy to confuse H.S.A.s with the older flexible savings accounts, or F.S.A.s. Both types of account allow people to pay out-of-pocket health costs with pre-tax dollars, but F.S.A.s have a reputation for being annoying on two counts:
In contrast, no approvals are required with an H.S.A. When you incur a cost that insurance does not cover, just swipe a debit card and you are done. Moreover, any money unspent in a given year remains yours. You can use it to pay future medical costs or as an investment for retirement. -See the full New York Times article. Which Health Plan Is Cheaper?Doing a thorough comparison of health care plans is difficult. But there is an imperfect, yet fairly, simple way to check whether a high-deductible plan might qualify for “no-brainer” status, meaning, it enables you to save on health care no matter how often you go to the doctor. Here’s how to do it: Start with your premiumsFigure out how much you would have to pay in total annual premiums for low- and high-deductible plans. Do this by multiplying the cost of the plan per paycheck by the number of paychecks you get per year: 12 if paid monthly, 26 if biweekly, 52 if weekly. Do a zero-expense testThen turn to the high-deductible plan. If your employer contributes to a Health Savings Account for you, subtract that amount — say, $1,000 — from the cost of the premiums. Compare the result for the two plans. The high-deductible plan is bound to be cheaper. The difference is how much you would save if you have zero health care expenses. Clear the high-deductible hurdleNext, try a test that is more difficult for high-deductible health plans: Consider what happens if your expenses are exactly equal to the deductible for each plan.
By comparison, the high-deductible plan has an annual premium of $2,000 and a deductible of $3,250. You would spend $5,250 if you hit the deductible, except for one important thing: Your employer contributes $1,000 to your H.S.A., so your total costs only come to $4,250. Finally, repeat these steps, using the maximum-out-of-pocket limit for each plan in place of the deductible. If the high-deductible plan is still cheaper, it may be a “no-brainer. That’s it. You’re done with the simple test. A note of cautionRemember, these calculations are not perfect because there are complicating factors, such as how prescription drugs are covered in the two plans. Still, this is a good starting place for your comparisons. Your employer’s website may provide a plan comparison tool. See what it says. But, most important, consider your options instead of automatically taking a version of last year’s plan. -From The New York Times.
Balance Billing by Health Care Providers: Assessing Consumer Protections Across States Privately insured consumers expect that if they pay premiums and use in-network providers, their insurer will cover the cost of medically necessary care beyond their cost-sharing. However, when obtaining care at emergency departments and in-network hospitals, patients treated by an out-of-network provider may receive an unexpected “balance bill” or “surprise bill” for an amount beyond what the insurer paid. Even if enrollees research which providers are in network before seeking care, they may face balance billing in certain situations that are beyond their control, such as when they are treated by an out-of-network provider at an in-network emergency department (ED), hospital, or other facility. Indeed, many consumers who received unexpected bills report being surprised both by the bill and the fact that the provider who cared for them was not in network. With no explicit federal protections against balance billing, some states have stepped in to protect consumers from this costly and confusing practice. Of the 21 states offering protections, only six have a comprehensive approach to safeguarding consumers in both settings, and gaps remain even in these states. For more information see the Commonwealth Fund’s Issue Brief.
For Millions of Insured Americans, State Health Laws Don’t Apply Let’s say you have health insurance through your employer and live in one of 21 states with laws protecting consumers against surprise medical bills from out-of-network providers (see previous story). Should one of those unwanted bills land in your mailbox, you can turn to your state law and regulators for help, right? Not necessarily. Plus, if you have an issue with your coverage, you must go through a different appeals process than other state residents with private insurance. You must seek help from a federal regulator that may - or may not - be responsive. If you’re among the millions of Americans with a category of job-based health coverage known as self-funded insurance, most state health care laws do not apply to you. Businesses that opt for self-funded plans - also called self-insured plans - generally pay the medical bills of their employees directly. Under a fully insured plan, on the other hand, the employer - or an individual or family - buys coverage from a state-regulated insurance company, which assumes the financial risk. It might not be obvious that you’re covered by a self-funded plan. Most businesses contract with health insurance companies to administer them, pay claims and provide access to their provider networks. That means your insurance card will likely have a Cigna, Blue Shield or other familiar logo on it even if your plan is self-funded. If you’re not sure whether your plan is self-insured, ask your human resources department. “We have unequal consumer protections for a big chunk of our population,” says Tam Ma, legal and policy director for the advocacy group Health Access California. Nationally, 61 percent of covered workers were in self-funded plans last year, according to the Kaiser Family Foundation. Large companies are more likely to self-insure. Among companies with 5,000 or more employees, 94 percent of covered workers were in self-funded plans last year, KFF data show. More businesses — including smaller ones — are self-insuring because they can save money, says Dean Hoffman, an employee benefits consultant based in Wisconsin who specializes in self-insured plans. One way they save is by avoiding the cost of complying with state-mandated benefits. For example, Hoffman says, for every premium dollar spent on fully insured plans in Wisconsin, about 11 cents goes toward state-mandated requirements. Consider state laws relating to surprise medical bills. Among the states that have adopted various protections against such bills, Connecticut, Illinois, New York, Florida, Maryland and California have the strongest and most comprehensive measures. But even if you live in one of these states, “you still might get hit by large medical bills” if you’re in a self-funded plan, Pollitz says. Some self-insured businesses, however, voluntarily provide many of the same protections as state law, says Lauren Vela, a senior director at the Pacific Business Group on Health, which represents about 75 companies that self-insure nationwide. -See the full Kaiser Health News article.
MassHealth Provider Self-Service Resources- Including Online PT-1 MassHealth offers several different online resources for Providers. Here’s a round-up- including where to submit an online PT-1 (through the Customer Web Portal). Provider Self-Service Resources Providers are reminded and encouraged to utilize the variety of electronic self-service resources available through MassHealth. Regularly accessing the many online tools available to providers can improve your efficiency when completing the business transactions you need to conduct with MassHealth. The MassHealth website (www.mass.gov) allows providers to obtain publications and required enrollment documents, review regulatory requirements, and obtain more information on MassHealth's new initiatives. The Provider Online Service Center (POSC) allows providers to complete a variety of business transactions, including provider information updates, electronic claims transactions, direct data entry claims submissions, member eligibility verification, and obtaining member referrals. To access the POSC, go to https://www.mass.gov/masshealth-for-providers and click "Access the Provider Online Service Center (POSC)". The Customer Web Portal (CWP) allows providers to place bulk order mailing requests as well as to submit PT-1 Transportation forms. The CWP can be accessed at https://masshealth.ehs.state.ma.us/cwp/login.aspx.
The Learning Management System (www.masshealthtraining.com) allows providers to register for MassHealth trainings, as well as to download supporting training materials and resources. Providers with questions about any of these resources may contact the MassHealth Customer Service Center at 1-800-841-2900 or e-mail -Adapted from: 4 Customer Service, Manage Claims and Payment Notices - Monday, 11/27/17, MA Health Care Training Forum.
Republican Tax Plan Trojan Horse While much has been written about the tax plan being considered in Congress, and the content of the bills under consideration are shifting, here’s the bottom line: Republicans have made clear that, after passing tax cuts that drive up the deficit, they plan to point to that deficit as a justification to cut Medicaid, Medicare and other programs that help older adults meet their basic needs. It is really a two-step process. Step one is to cut taxes for the wealthy and corporations. Step two is to cut programs that older adults and their families rely on. -Adapted from Talking Taxes Over Turkey, Justice in Aging, November 22, 2017.
MBTA Plan to Go Cashless May Leave Low-Income and Elderly Stranded The MBTA announced this month a plan to institute cashless fare payments that is good news for the harried commuter tired of waiting for the person in front to search for change to get on board. But what about riders — mainly low-income and the elderly — who don’t have credit cards or aren’t comfortable with smartphones? There is growing concern that the new system could be inaccessible for them. Under the system, due to be in place by 2020, riders will not be allowed to pay with cash on board buses, trolleys, or commuter trains. Instead, the T will have vending machines at bus stops and outdoor trolley stops, where riders can use cash to load rides onto a new type of CharlieCard that’s being developed. The authority also plans to increase the number of retailers that sell and reload the cards. David Block-Schachter, the MBTA’s chief technology officer, said the authority will ensure that vending machines are installed at key bus stops and will make CharlieCards available for purchase and loading through “a greatly expanded retail network” that includes big-box chain stores and mom-and-pop businesses, such as bodegas and barbershops. The machines will also have multiple language options. However, many of the bus lines that have a high number of cash-paying riders have dozens of stops, and the T has acknowledged it will not be able to place vending machines at each one. The T wants to eliminate on-board cash payments because they can slow boarding and cause delays. Buses overall have the worst on-time performance records among the T’s transit modes, and on some bus routes 20 percent of the riders pay cash when they board. So the MBTA will install electronic readers that can scan CharlieCards, as well as credit cards and smartphone payment apps. Buses and trolleys will have the devices at the front and rear doors, which should also speed up boarding and improve on-time performance. Overall, only 7 percent of MBTA bus and trolley riders pay with cash, but many are low-income and immigrants, who, for a variety of reasons, do not or cannot have a bank account or a credit card, said Kimberly Barzola, an organizer for the T Riders Union, an advocacy group.
To encourage riders to keep track of their CharlieCards and reduce the cost of replacements, the T also plans to charge for the new cards, probably about $5. In a spring survey, the T found that about 4 percent of passengers don’t have a debit or credit card or a smartphone. Of those, half are minorities, and more than three-quarters pay in cash or get passes from an employer or school. Ultimately, the new system should save money for cash customers and those who use the paper CharlieTicket; they now pay a premium of 50 cents more per subway ride and 30 cents more on the bus. The new system will do away with that penalty, said Monica Tibbits-Nutt, of the MBTA’s Fiscal and Management Control Board. “Right now the options are limited if you don’t live near a station where you can add that cash to the CharlieCard; you really actually have no choice but to pay with cash on the bus itself,” Tibbits-Nutt said. “What we’re trying to do is take that out and make that network so vast that you can add that cash to the card and be able to go on the bus at that lower rate.” The MBTA has had limited success with arrangements with retailers to reload passes. Many dropped out because they earned just 1.8 percent as a commission. Currently, 160 retailers still provide that service for the T, mostly around commuter rail stations. Block-Schachter said the new fare vendor, California-based Cubic Corp., will negotiate with retailers and will have to meet certain performance standards, including ensuring that the vast majority of T riders have ready access to a vending machine or a retailer. For riders, it will be as simple as buying “a phone card at your local bodega and putting $20 into it,” Block-Schachter said. Proximity to vendors and kiosks will be key, said Carolyn Villers, executive director of the Massachusetts Senior Action Council, which works with low-income seniors. “People at the end or start of bus lines might have more access to vendors, retailers, or the machines, but a bus system travels a lot of ground that people wouldn’t have access” to payment systems, Villers said. “When you’re working with very limited income, you can’t always plan ahead and put money on the card because you may need that for something else,’’ she said. “To take the drivers out of that situation of having to collect fares and things of that sort, I think it’s going to continue to cause challenges for people.” -See the full Boston Globe article.
Law Enforcement Violence as a Public Health Issue The American Public Health Association released a policy statement on November 1 categorizing law enforcement violence as a public health issue. Abstract Harassment and violence by law enforcement officers result in deaths, injuries, trauma, and stress, which disproportionately affect people of color and other marginalized populations such as immigrants, individuals experiencing homelessness, members of the LGBTQ (lesbian, gay, bisexual, transgender, queer) community, and individuals with mental illness. Officers are rarely held accountable for acts of violence and harassment for several reasons, including an insular police culture, laws that interfere with investigation and prosecution around misconduct (e.g., the Law Enforcement Officers’ Bill of Rights), and insufficient civilian oversight. Numerous laws and policies have the effect of promoting and intensifying harassment and violence toward specific populations by police, including anti-immigrant legislation, policies associated with the “war on drugs,” the criminalization of sex work, and the criminalization of behaviors associated with homelessness. While some argue that rates of violence and harassment can be reduced by implementing strategies such as community-oriented policing or increasing the use of technological tools such as body- or dashboard-mounted cameras and conducted electrical weapons, limited evidence supports the effectiveness of these approaches. Instead, a public health strategy for preventing police violence and harassment should incorporate four main elements: decriminalization, robust police accountability measures, increased investment in policies promoting racial and economic equity, and community-based alternatives for addressing harms and preventing violence and crime, such as community-run restorative justice and violence intervention programs. -See the full APHA policy statement.
Unnatural Disaster: Seniors Hit Hardest in Floods and Fires The heartbreaking stories from our recent spate of natural disasters just keep coming. The hurricanes in Houston, Florida and Puerto Rico; the wildfires in Northern California. Stories of destruction, panic, fear and – sadly – death. And there is one disturbing through line: the victims of these disasters, especially those who lose their lives, are overwhelmingly older adults. As demonstrated in an issue brief from Grantmakers in Aging: older adults are more likely to die in a disaster than any other group. We are not able to stop natural disasters from occurring, but we can certainly be prepared to limit their impact, particularly upon older adults. Specifically, we need clear rules and regulations that dictate how nursing homes and assisted living facilities are to prepare to care for and protect their residents in emergency situations. This idea should not be controversial, but somehow it is – at least among those who put the needs and concerns of the nursing home industry over those of the seniors they serve. The example of the deaths in a Florida nursing home is instructive here. The deaths resulted from high temperatures inside the nursing home, which had lost electricity (and air conditioning) as a result of Hurricane Irma. In response, Florida has issued emergency regulations. Within sixty days, all Florida nursing homes and assisted living facilities must have emergency generators capable of maintaining safe temperatures. Had these regulations been in place—and enforced—before the hurricane, the lives of those twelve elders likely would have been saved. Given the horror of the situation, you would think that nursing homes and assisted living facilities would embrace taking further steps to ensure the safety of the seniors they serve. You would think that these new regulations would not be controversial. Instead, the nursing home industry has actually sued the state of Florida to prevent the new regulations from taking effect. The nursing home industry’s lawsuit reflects a broader trend in our current political environment – a reflexive hostility towards standards and regulations. This is a trend that is currently playing out in the context of nursing home consumer protections at the federal level, leaving the seniors that live in these settings even more vulnerable. In multiple recent pronouncements, for example, the Centers for Medicare & Medicaid Services (CMS) has indicated its willingness—bordering on eagerness—to eliminate or waive existing regulations that protect nursing home residents. The first casualty could be a federal rule that prohibits a nursing home from seeking an arbitration agreement from a resident during admission. CMS (under the Obama Administration) issued a rule to limit the use of arbitration agreements in nursing homes to prevent nursing home residents from being compelled during a vulnerable time to forfeit their rights by signing arbitration agreements. The nursing home industry promptly filed suit to stop these new protections. In June of this year, CMS (now under the Trump Administration) indicated that it would side with the nursing home industry and weaken the rule. -See the full Justice in Aging blog post and the companion issue brief.
Study Names Top Apps for Patients to Manage Illnesses Healthcare apps for patients are growing not only in number but also in their ability to improve clinical outcomes and reduce costs, according to a new report by the IQVIA Institute for Human Data Science that describes the maturation of digital health. The evidence for the usefulness of this technology also has grown, stated the IQVIA Institute, formerly the IMS Institute. While it may still take 10 years for digital health to become mainstream for most provider organizations, the direction is clear, and the pace of adoption of these tools is accelerating," said Murray Aitken, the IQVIA Institute's executive director, in a news briefing last week. Top clinically rated apps for patients to manage their conditions include those for cancer, diabetes, hypertension, and asthma, according to IQVIA. IQVIA is one of several companies that rate healthcare apps to help clinicians prescribe the right one. Other companies in this space include SocialWellth, iMedicalApps, and iGetBetter. IQVIA scores apps with a proprietary system that reflects patient ratings; endorsements or approvals by healthcare providers, regulators, and health content publishers; software features and updates; recommendations by clinicians through the company's AppScript mobile app; and a clinical rating of all peer-reviewed articles about an app's value in patient care. The firm calculated an AppScript score for all free and publicly available health apps and determined the top 12. It also scored apps solely on the basis of their clinical rating and produced a top 15 list for wellness and prevention, condition management, and prescription management (2 of the 15 overlapped with the other list). Roughly half of the apps in this clinically rated group are not sold directly to the public but are available to patients only through a third-party payer or healthcare provider. Table 1. Top Clinically Rated Apps for Wellness and Prevention
Table 2. Top Clinically Rated Apps for Condition Management
Table 3. Top Clinically Rated Apps for Prescription Filling and Compliance
More ratings and the full IQVIA report is available on the company website. -See the full Medscape article Study Names Top Apps for Patients to Manage Illnesses, Nov 07, 2017.
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