MGH Community News

April 2018
Volume 22 • Issue 4

Highlights (Links)

Sections


Social Service staff may direct resource questions to the Community Resource Center, Elena Chace, x6-8182.

Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807.

 

Baker Signs Law Improving Patient Privacy in Health Insurance

Massachusetts Gov. Charlie Baker this month signed a bill providing people with more privacy from their health insurance companies.

The new law, the so-called PATCH Act, seeks to ensure that patients can request that a summary of payment form for their health insurance be sent directly to them, not to the policyholder of their insurance.

The acronym stands for Protecting Access to Confidential Health Care.

Summary of payment forms typically describe the type and cost of care. The legislation could help an adult who is on their parent's or spouse's health insurance, but does not want their parent or spouse to know what kind of health care they received. For example, a person might not want a family member to know about their reproductive health care or mental health treatment. Today, some people may pay out of pocket for health care even if they have insurance to avoid having paperwork sent to the insurance policyholder.

According to the new law, an Act to Protect Access to Confidential Healthcare (PATCH):

  • Insurers must allow patients to choose their preferred method of receiving EOBs, including at an alternate address or through HIPAA-compliant electronic means
  • EOBs will provide generic information only, such as “office visit” or “medical care,” rather than more explicit descriptions that could violate confidentiality
  • Patients can opt out of receiving an EOB when no remaining balance exists on a claim
  • Patients would be informed of their options to request confidential means of receiving EOBs
  • The state Division of Insurance and Department of Public Health are required to educate providers and patients on these protections

 

"Patient confidentiality is a foundational element of the patient-provider relationship," said Sen. Karen Spilka, D-Ashland, the lead sponsor of the bill, after the Senate passed the bill in February. "Unfortunately, young adults, minors or victims of abuse are often reluctant to seek certain types of treatment, fearing that their personal health information will be disclosed to a parent or spouse."

Amy Rosenthal, executive director of Health Care for All, said that without the new law, confidential health information may be inadvertently disclosed on a summary of benefits, "violating the basic right to privacy for anyone enrolled as a dependent on another's policy."

-See the full Mass Live article.

-Additional information from, and more information at Health IT Security.

 

 

MART Rolling-Out New Online Booking for PT-1 Transport

MART transportation, the broker used by most of our patients for MassHealth PT-1 transportation, is debuting a new online member portal for patients to book or cancel their PT-1 trips. Patients and staff have long reported extended telephone wait times to schedule trips or ask questions. If it works as planned this online option should facilitate booking rides. The new portal is scheduled to begin on May 1, 2018.

Member Portal Quick Guide
Member Portal
MART MassHealth website

- Thanks to Jennifer Kubic Knight for sharing this resource.

 

 

Advocating for Nursing Facility Residents under the Revised Federal Requirements

The Centers for Medicare and Medicaid Services (CMS) revised the federal nursing facility regulations in late 2016 for the first time in 25 years. Many of the provisions went into effect in 2016 and 2017, but enforcement for some has been put on a moratorium by the Trump administration.

What does this mean for advocates? Last month, Justice in Aging attorney Eric Carlson co-authored an article for the National Association for Elder Law Attorneys (NAELA), along with Lori Smetanka of the National Consumer Voice for Quality Long-Term Care and elder law attorney Nancy Stone.

The article, Advocating for Nursing Facility Residents under the Revised Federal Requirements aims to help advocates navigate the revised nursing facility regulations, hold nursing facilities accountable, and assert residents’ rights.

Topics include

  • rules prohibiting nursing facilities from requiring a third party (friend or relative) to guarantee payment as a condition of admission
  • prohibition on requiring applicants to sign predispute arbitration agreements; however, this is likely to be rescinded by the Trump administration.
  • chemical restraints
  • residents’ rights in cases of transfer and discharge, including bed hold rules, and involuntary discharges (including clarifying that resident rights continue to apply when the patient has been hospitalized).

See the article: Advocating for Nursing Facility Residents Under the Revised Federal Requirements.

-Adapted from Focus on Poverty, SSI, Justice, Justice in Aging, April 14, 2018.

 

 

New DTA SNAP Online Application

Earlier this month DTA rolled-out a new online SNAP application and some new ways for clients and advocates to learn information about a DTA benefits case. 

DTA's new website, www.DTAConnect.com should be used for online SNAP applications. The Virtual Gateway SNAP online application was planned to be deactivated. As always, clients have a right to apply online, in person, or by faxing or mailing in a paper application. 

This website includes:

  • an updated, simplified, and interactive online SNAP application. In addition to using the online application on a desktop computer, the application will be smart phone and tablet friendly and can be completed on a smart phone or tablet by going to www.DTAConnect.com!
  • a client portal to access case information: This portal includes case information going back further than the 3 months shown in the DTA Connect mobile app
  • a provider portal for SNAP outreach providers 

Mass Law Reform Institute (MLRI) and other community partners were involved in the development of this online application, and hope the new online application will be much more simple and clear then the Virtual Gateway application. 

Non-Citizen Advocacy Note

The online application currently does not tell people about their right not to include a Social Security Number or non-citizen information. Federal rules are clear that applicants do not need to give DTA the Social Security Number or status information for non-citizens who are not applying for SNAP, even if they live together. Income of the person opting out will still be counted, but their SSN or non-citizen information does not have to be included. Let MLRI know if this is an issue or concern for your client.  See Question 54 of the SNAP Advocacy Guide for more information on what it means if a non citizen opts out of the SNAP application.  

- From Monday, April 9: DTA change to SNAP Online Application and DTA Connect client portal!, Food/SNAP Coalition listserv on behalf of Victoria Negus, MLRI, April 06, 2018.

Addendum:

For more information: MLRI has updated Masslegalservices.org/DTAConnect to include more information about the application and client portal, along with DTA Connect fliers from DTA. Also see the differences between the DTA Connect mobile app and the DTA Connect online portal- mobile app vs. online portal comparison chart.

 

 

HIP Suspension Flyers and Maximizing SNAP Benefits

As you may know, the Healthy Incentives Program (HIP) has been so phenomenally successful that it ran out of matching money much sooner than first anticipated and was suspended as of April 15, 2018 (SNAP Healthy Incentives Program (HIP) Program to Be Suspended, MGH Community News, February 2018). 

SNAP recipients can still use their SNAP benefits at farmer’s markets, mobile markets, farm stands and through Community Supported Agriculture (CSA) programs, but will not receive the matching benefits. 

DTA has developed 15 "HIP Suspension" fliers - in English and 14 other languages (see left navigation bar).

Maximizing Benefits

The flyers above also include information about expenses that may be deducted from countable income thereby increasing benefits. Recipients may get credit for these expenses even if they are currently not paying for them in full.

Deductible Expenses:

  • Shelter Costs: Rent, Mortgage (Principal, Interest, Taxes, & Insurance), Condo Fees, etc.
  • Utility Costs: Heating, Cooling, Electricity, Trash Collection, Water & Sewerage, Phone
  • Dependent Care Costs: childcare or adult dependent care costs
  • DOR Child Support Payments: paying court ordered child support
  • Medical Costs: Elderly or disabled clients may claim Co-pays, Prescriptions, Over-the-Counter Medications, Health Insurance costs

Program Benefits

“The program was designed to improve health outcomes for some of the Commonwealth’s most vulnerable communities, people who don’t traditionally have access to fresh fruits and vegetables,” said Winton Pitcoff, director of the Massachusetts Food Systems Collaborative, a nonprofit that promotes the development of sustainable food systems in the state. “At the same time it increases sales to Massachusetts farmers. That keeps money in the local economy.”

Because most HIP recipients are also on MassHealth, supporters note that the fresh food initiative could help lower health care costs for the state. The program, however, has not been running long enough to gather enough data to confirm that theory.

There have been less tangible effects as well. HIP’s success has disproven old stereotypes that low-income families do not care about the quality and nutrition of their food, Pitcoff said.

“The reality is that they do,” he said. “They just need help accessing that food.”

For fiscal 2019, Governor Charlie Baker has requested $1.35 million for the program. HIP advocates say that sum is nowhere near enough. Based on this year’s performance, Pitcoff said, the program really needs $6.2 million next year — less than 1 percent of DTA’s expected budget.

Supporters say they have not yet encountered anyone who objects to the program. Still, they acknowledge that the budget process involves a lot of priorities competing for a limited sum of money.

Legislative Advocacy

The state budget campaign to urge both FY18 supplemental funding to reopen HIP as well as the FY19 budget to adequately fund HIP next year are underway. Interested clients can call their State Rep and Senator and share how important HIP is to them and why they should support funding for HIP. Check out action steps with MA Food System Collaborative's Campaign for HIP Funding. 

- From: DTA filers on 4/15 HIP suspension; Campaign to fund HIP; Farm Bill Defense Marathon, Food/SNAP Coalition listserv, on behalf of Pat Baker, MLRI, April 13, 2018. Additional material from The Boston Globe

 

 

SNAP- College Student Self Declaration of Financial Aid and Expenses

Financial aid offices have been directed to not complete any documents that request financial aid information, even with student consent. Recent federal privacy guidance from the US Department of Education guidance appears to be making it harder for students to get DTA forms filled out, specifically the DTA Educational Income and Expense Form (EDUC-1) form that students are sent with the Verification Checklist notice after they apply for SNAP.

The federal and state SNAP rules do not allow DTA to deny SNAP benefits if information about income cannot be secured due to non-cooperation of a third party - such as a financial aid office or a non-cooperating employer. Students have the right to provide a self-declaration of the financial aid information requested as the "best evidence available", along with a copy of the financial aid award letter they received. DTA is aware of this SNAP self-attestation policy as well.

MLRI has created a sample self-declaration statement for students to use when the financial aid office declines to fill out the DTA forms. Students can also hand write a statement that says the same and include it with a print-out of their financial aid award letter.

Please note, under the SNAP and cash assistance rules, federal financial aid does not count as income for determining benefits. State or private financial aid monies may count when earmarked or designed for basic living expenses (vs. educational expenses) in determining SNAP eligibility.  If the student’s financial aid is so designated, they need to state how much is being used for room and board.

Here's MLRI's resource page on SNAP and college students, with client fliers and DTA forms:  https://www.masslegalservices.org/food4students

MLRI is interested in hearing from any students who are having difficulty getting SNAP benefits due to lack of verification.

-Adapted from Sample self-declaration statement to help students applying for SNAP; Voices of Hunger on Campus Conference in Worcester, May 11th, Food/SNAP coalition listserv, on behalf of Victoria Negus, MLRI, April 06, 2018.

 

 

Immigrant Access to Health Care

Health Care for All’s Immigrant Healthcare Access Coalition has created Know Your Healthcare Rights flyers available in English, Spanish and Portuguese. Excerpts:

  • EVERYONE in MA can access some health services regardless of immigration status
  • It is safe to see a doctor in a health clinic or go to the hospital, including if you have a medical emergency
  • Your doctor, health center, and hospital cannot give your personal information, including information about your immigration status, to the government unless you agree to share that information
  • It is safe to apply for MassHealth, the Health Connector or Health Safety Net. Those programs to not share personal information, including your immigration status, with immigration authorities (ICE).
  • Enrolling in health insurance does not make you a “public charge.” Being a public charge can prevent people from getting a better immigration status or being admitted in the US.
    • Note while this is true about public charge as of this writing, the Trump Administration has floated a draft Executive Order that would change this. So it would be important to monitor this issue going forward.


Anyone can call the Health Care for All Helpline at 800-272-4232 with questions (help is available in English, Spanish and Portuguese).

Download the flyers: Know Your Healthcare Rights

-Adapted from Immigrant Health Care Access Training this Sat, April 14th + fliers on health care & immigrant rights, SNAP resources, Food/SNAP Coalition listserv on behalf of Victoria Negus, April 11, 2018.

 

 

New Immigrant Rights Videos from the ACLU

The ACLU has created animated videos to inform the immigrant community about their rights when interacting with ICE. The “We Have Rights” campaign videos are available in multiple languages (English, Spanish, Urdu, Arabic, Haitian Creole, Russian and Mandarin), and provide real life action points for how to handle interactions with ICE in various settings. 

Videos (each is 3-4 minutes in length):

  • We Have Rights: When ICE is Outside our Doors
  • We Have Rights: Inside Our Homes
  • We Have Rights: In Our Communities, In Our Streets
  • We Have Rights: If ICE Arrest Us

Videos are available on the ACLU website.

Social Service Department staff can find related materials and resources on our website under Undocumented Immigrants.

 

 

New SSI Basics Guide

In March, Justice in Aging released a new guide to help beginning advocates, lay advocates, and low-income seniors understand the basics of the Supplemental Security Income (SSI) program. The new guide, Supplemental Security Income 101: A Guide for Advocates, introduces the SSI program by delving into the basics for those age 65 and older. The guide includes a description of the SSI program and its benefits, an overview of the application and appeals processes, and a discussion of key eligibility criteria, including multiple case examples. 

Download the guide    

-Adapted from Focus on Poverty, SSI, Justice, Justice in Aging, April 14, 2018.

 

 

SSI Advocacy Guide – In-Kind Support and Maintenance

Why do some individuals receiving Supplemental Security Income (SSI) benefits only receive $500 a month instead of $750? In many cases, the reason is “in-kind support and maintenance” (ISM).

As SSI is a means-tested program, applicants and recipients must meet several financial eligibility criteria on an ongoing basis. If an SSI recipient is receiving “in-kind support and maintenance” in the form of free or subsidized food and/or shelter from others, the Social Security Administration (SSA) will treat that support as unearned income and reduce the individual’s benefits by as much as one-third. ISM determinations are made on a monthly basis.

The income and resource rules, including in-kind support and maintenance, are particularly complicated. These rules can cause significant hardship for low-income people trying to survive on SSI.

This new guide, In-Kind Support and Maintenance in the SSI Program, gives advocates tools to successfully navigate ISM on behalf of their clients. They can make a big difference by making sure that clients can maximize their SSI benefits to better meet their needs for shelter, food, health care, and other necessities.

Read the guide, and watch the recording or download the PowerPoint of the In-Kind Support and Maintenance webinar.

-Adapted from In-Kind Support and Maintenance in the SSI Program, Justice in Aging, April 11, 2018.

 

 

New Changes to ABLE Programs for 2018

In May 2017, the MA Educational Financing Authority (MEFA) became the state sponsor of the  Attainable Savings PlanSM. Attainable allows individuals with disabilities and their families to save for disability-related expenses in a tax-advantaged savings account. The program represents Massachusetts’ response to the Achieving a Better Life Experience (ABLE) Act, which allows for the creation of these important plans.

Recent new legislation brought revision to ABLE regulations, which affect all Attainable accounts. It’s important for Attainable account owners and their families to understand what’s been updated.

Annual Contribution Limit

Contributions into a single Attainable account are now limited to $15,000, up from $14,000 in 2017. This dollar limit applies to the sum of contributions from all sources into each Attainable account. The contribution limit does not reset or increase if the beneficiary spends down the contribution in the same year.

ABLE Financial Planning Act

Provided that the beneficiary is the same individual on both accounts (or one beneficiary is a family member of the other), it is now allowable to transfer funds from a 529 college savings plan into an ABLE account without incurring any tax or penalty. The funds rolled over from the 529 plan are subject to the annual contribution limit of $15,000 into an ABLE account. The rollover may originate from any state’s 529 plan.

ABLE to Work Act

The ABLE to Work legislation specifies that ABLE account beneficiaries who work and earn income may now contribute over the annual limit of $15,000 into their ABLE account. The additional permissible contribution amount equals the lesser of the individual’s gross income or the amount equal to the federal poverty line set for one person, currently $12,060. This additional contribution over $15,000 is only permitted if the beneficiary is not participating in his or her employer’s work retirement plan.

For more information about ABLE and to find additional resources, including articles, videos, and webinars, visit the ABLE National Resource Center online at ablenrc.org.

- Adapted from New Changes to ABLE programs for 2018

 

 

North Shore Elder Services Announces Online Referral Form

North Shore Elder Services, which serves the communities of Marblehead, Salem, Peabody, Danvers and Middleton, now offers an online referral form as an option for routine homecare assistance referrals for those to those who prefer to complete a form or for use outside of regular business hours.

North Shore Elder Services will continue to accept referrals by phone as well (978-750-4540). The referral form has been added to our website.

Please note that this form should not be used for protective services referrals – elder abuse reports should continue to go to the Massachusetts Elder Abuse Hotline at (800) 922-2275.

-Thanks to Gabrielle Haseotes for sharing this information.

 

 

Terminating Competitive Energy Supply Contracts

As reported last month, (AG Healey Calls for Shut Down of Individual Residential Competitive Supply Industry to Protect Electric Customers, MGH Community News, March 2018) citing aggressive sales tactics, false promises of cheaper electric bills and the targeting of low-income, elderly, and minority residents, Attorney General Maura Healey has issued a report calling for an end to the competitive electricity supply market for individual residential customers in Massachusetts.

This month the National Consumer Law Center (NCLC) released a new report: Competing to Overcharge Customers: The Competitive Energy Supplier Market in Massachusetts, that urges Massachusetts to take immediate action to protect consumers from abusive and deceptive marketing practices, high prices, and unfair contracts. NCLC recommends that customers stick with their utility company in most cases.  A small percentage of customers have saved money with competitive supply companies, but the savings tend to be small.

Customers who have signed up with competitive supply companies and want to change back to utility service can take these steps:

  • Start by contacting the competitive supply company. Ask the company to terminate the contract and to switch the account back to basic service with the utility company.
  • If the customer doesn't know who the competitive supply company is, look at a recent bill, or call the utility company and ask.
  • If the customer contacts the competitive supply company and is not able to end the contract, one option is to contact the Consumer Division at the Department of Public Utilities.  The DPU has mediators who help with these customer problems. The DPU could help find out if there is a way to end the contract, and if it cannot be ended immediately then they could help the customer find out when the contract could be ended. You can call the DPU Consumer Division at 877-886-5066 or email them at DPUConsumer.Complaints@state.ma.us or complete the online form: https://www.mass.gov/how-to/file-a-complaint-involving-a-gas-electric-or-water-company
  • You can also complain to the Attorney General's office. A large number of complaints about a company could lead to enforcement action in some cases, which could help a large number of consumers. You can call the Attorney General's office at 617-727-8400, and online complaints can be filed here.

-From NCLC Energy: Mass. Attorney General's report on competitive electric supply, Utility Network Listserv on behalf of Jenifer Bosco, NCLC, April 11, 2018.

 

 

Nepali Immigrants Lose Their Protected Status

The Department of Homeland Security has announced that it is terminating the status of a group of federally protected immigrants — this time Nepali — is the latest move by the Trump administration to expel foreigners living in the United States who have some form of provisional status.

Nepal is the fifth country whose citizens have lost Temporary Protected Status since President Trump took office, meaning about 250,000 immigrants have been told they must leave the country next year, seek an alternative immigration status, or face deportation.

The humanitarian program has given refuge to about 9,000 people from Nepal, including about 500 in Massachusetts, since June 2015. A devastating 7.8 magnitude earthquake near the country’s capital killed thousands and triggered a deadly avalanche on Mount Everest.

TPS protects immigrants from certain countries affected by crisis or natural disaster from deportation, allowing them to live and work in the United States legally. But it is not a track to permanent residency or citizenship.

Nepal’s TPS designation expires June 24, 2019, giving families 12 months to get their affairs in order and “time for Nepal to prepare for the return and reintegration of its citizens,” said a statement Thursday from Homeland Security Secretary Kirstjen Nielsen, announcing the termination of the South Asian country’s status.

Advocates for the Nepali community disagree, saying the current conditions of the country render it incapable of re-absorbing its citizens.

Immigration advocates have heavily criticized the administration’s decisions to rescind TPS, particularly for people from Haiti and El Salvador, arguing that racial animus has been the deciding factor, not disaster recovery. A country’s designation lasts six to 18 months and is renewed at the discretion of the executive branch.

The administration has extended the status of three countries — Syria, South Sudan, and Honduras, though Hondurans were put on notice in November that “it is possible” their protections could end in six months. The deadline to determine whether nearly 60,000 Hondurans will have their status renewed is scheduled for early next month.

-See the full Boston Globe article.  

 

 

Mass. General to Partner with Maine Health System

Massachusetts General Hospital has signed an agreement to partner with one of Maine’s largest health care systems, the latest move by the Boston hospital and its parent company, Partners HealthCare, to expand across New England.

Mass. General officials said that they will form a clinical affiliation with Eastern Maine Healthcare Systems, or EMHS. The organization operates nine hospitals and is based in Brewer, Maine, nearly 250 miles from the Mass. General campus in Boston.

Because EMHS’s facilities are several hours away, Mass. General physicians will work with their Maine colleagues virtually more often than they will travel to that state. The collaboration will focus on specialties including cardiovascular, neuroscience, pediatrics, orthopedics, and transplant medicine. Mass. General physicians plan to provide advice to EMHS physicians in these areas.

In addition, the patients at the Maine health system with the most complex ailments may be referred to Mass. General for specialty care.

In 2017, Mass. General acquired Wentworth-Douglass Hospital in Dover, N.H., its first out-of-state acquisition.

Mass. General’s parent company, Partners HealthCare, is planning to acquire Care New England Health System of Providence, and is discussing a partnership with the Lifespan health system, also in Providence.

-See the full Boston Globe article.

 

Program Highlights

 

MA Office on Disability

MA Office on Disability staff recently presented about their services to a group of Department of Psychiatry social workers.

MOD provides information, technical assistance, training, and advocacy. MOD does not provide disability benefits or emergency services. 

The MA Office on Disability (MOD) provides training to employers, businesses, state and local government agencies, and others on a variety of topics, including:

  • Architectural access
  • Emergency preparedness
  • Americans with Disabilities Act
  • Disability rights & nondiscrimination
  • Service animals

Though not primarily a direct service provider, MOD provides advocacy and technical assistance to the public through:

  • Information & referral on resources
  • Technical assistance on reasonable accommodations, architectural access codes, etc.
  • Assistance with disability-related discrimination
  • Civil rights information

The Client Assistance Program (CAP) is client facing, and provides independent advocacy for and information to people who seek and receive services from

  • the Massachusetts Rehabilitation Commission (MRC)
  • the Massachusetts Commission for the Blind (MCB) and
  • the Independent Living Centers (ILCs) in Massachusetts
  • More CAP information

Contact MOD:
(617)727-7440 or (800)322-2020
Massachusetts Office on Disability
One Ashburton Place, Room 1305
Boston, MA 02108
Or online: www.mass.gov/mod

They also make a number of publications available to the public. Selected publications include:

MOD’s blog also addresses a number of disability related topics in more depth. Search for topics at:http://blog.mass.gov/mod/

-Thanks to Jennifer DeSouza for inviting Community Resource Center staff to attend this presentation.

 

 

Job Corps - Intensive Job Training for Low-Income Youth and Young Adults

Job Corps is a FREE education and vocational training program administered by the U.S. Department of Labor that helps young people ages 16-24 improve the quality of their lives by empowering them to get jobs and become independent. Job corps offers hands-on career technical training in high-growth industries and can also help participants get a GED or high school diploma if they don't already have one.

Job Corps also offers career planning, on-the-job training, job placement, residential housing, food service, driver's education, health and dental care, a bi-weekly basic living allowance, and a clothing allowance. The program can last up to two years.

Most Job Corps students live on campus. Students will likely be assigned to live and train at the center closest to home. Some centers have a non-residential option that allows students to live at home during training. Search for centers.

Approximately 90% of Job Corps graduates go on to careers in the private sector, enlist in the military, or move on to higher education or advanced training programs. Graduates receive transitional support services, including help locating housing, child care, and transportation, for up to 21 months after they leave the program.

Eligible candidates:

  • Are between the ages of 16 and 24 (The maximum age limit may be waived if the applicant is a person with a documented disability. For minors, a parent or guardian must sign a consent form.)
  • Receive public assistance, earn poverty-level income, are homeless, are a foster child, or qualify for free or reduced-price lunch 
  • Face one or more barriers to employment like needing additional career technical training, education, counseling, and/or assistance to complete regular schoolwork or to secure and maintain employment
  • Are a U.S. citizen, a legal U.S. resident, or are a resident of a U.S. territory and/or are authorized to work in the United States
  • Meet other eligibility requirements

Certain criminal convictions or court supervision requirements are a bar to participation.

Above excerpted from: https://www.jobcorps.gov/citizens
Above excerpted from: https://www.jobcorps.gov/questions

More at: https://www.jobcorps.gov/

-Thanks to Mia Concordia for sharing this resource.

 

 

Campus Career Connect (C3) Prepares College Students with Disabilities for Career Success

Campus Career Connect (C3) is an online program created to aid young adults with disabilities transitioning from school to work and to connect them to mentors within their desired career field. By promoting job readiness, inclusion, and advocacy trainings and advice, C3 mentors help make the transition from school to employment a positive one. Mentoring on C3 can be found through the platform’s use of online events, local job listings, networking, resume building, soft and hard skill coaching, and an interactive forum space for questions and advice.

One year ago with funding from Mitsubishi Electric America Foundation, Partners for Youth with Disabilities (PYD) announced that it would partner with UMass Medical School’s Work Without Limits initiative to launch a new online group mentoring program to support community college students with disabilities with the goal of improving employment outcomes. Additional funding from The Milbank Foundation enabled PYD to expand beyond community college students in Massachusetts to include students with disabilities in any type of higher education institution across the nation.

The site is designed to be user-friendly and accommodating to any specific needs a mentee or mentor may have. C3 members participate in monthly webinars geared toward discussing pertinent employment-related topics such as financial literacy, resume building, and interview skills. Users also have access to disability-friendly employers through a partnership with Work Without Limit’s job board, and can seek advice and support from one another through private messages or group discussions.

Mentors come from companies such as:

  • Alira Health
  • Carroll Center for the Blind
  • CVS Health
  • Department of Children and Families
  • Gillette
  • Haircuts Ltd
  • John Hancock
  • MAPFRE Insurance;
  • MA Commission for the Blind;
  • Metrowest Regional Transit Authority
  • National Ability Center
  • Partners for Youth with Disabilities
  • Sikorsky Aircraft
  • UMass Medical School
  • US Department of Transportation
  • Work Without Limits

Learn more: See http://www.workwithoutlimits.org/blog/c3-prepares-college-students-disabilities-career-success or contact C3 Coordinator Deep Chinappa.

 

 

Detailed Manual on Protecting Assets and Child Custody in the Face of Deportation - Available in Spanish

The Appleseed Network’s detailed advocacy guide “Protecting Assets and Child Custody in the Face of Deportation: A Guide for Practitioners and Immigrants.” Is now available in Spanish. Or read individual chapters in English and Spanish versions. The Spanish translation of the Manual incorporates the latest updates made to the full English version of the Manual that was published earlier this year.

Last month we reported on the availability of a similar guide (Planning for Child Custody if a Parent is Deported, MGH Community News, March 2018.) The Appleseed guide offers a more in-depth reference and guidance.

-Adapted from Now Available in Spanish! 2018 Updates to the "Protecting Assets" (Deportation) Manual, on behalf of Elisa Ortiz, Appleseed Network, April 04, 2018.

 

 

2 Sisters Senior Living Advisors

2Sisters Senior Living Advisors offers FREE help to families to find elder supportive living options for their loved-ones. 2Sisters currently works with families in Massachusetts’ Plymouth, Bristol, Norfolk, Barnstable, and Middlesex Counties. They help elders and their families understand the different types of senior living options available and can assist with transition logistics and referrals to other senior care resources.

Note of caution: They are able to offer free services to elders and their families because they are compensated by providers when clients move in or choose their services. If engaging this service, keep in mind that it is in their financial interest to recommend participating providers.

For more information see their website: https://2sisters-sla.com/

To learn about other options see the Aging Life Care Association (formerly the National Association of Professional Geriatric Care Managers) Find an Aging Life Care Expert Search.

-Thanks to Mia Concordia for sharing this resource.

 

Health Care Coverage

 

MassHealth ACO – Continuity of Care Period and Member Lock-In Dates Extended

This is a revised version of an email sent to the Social Service Department earlier this month.

Earlier this month MassHealth released new guidance extending the Accountable Care Organization (ACO) Continuity of Care Period and member “lock-in” dates.

Please keep in mind that Patient Financial Services staff have been trained and are the role group primarily responsible for helping patients navigate these changes.

Here are the key take-ways from the guidance:

  • Continuity of Care period is now extended to May 31st.  The original period for continuity of care was March 1 – 31, but the state is now extending that through May. What does that mean?
    • Through May 31st, any patients who have shifted to new plans out of our network, but who have not yet transitioned to in-network providers, may continue to see their existing providers in our system.  If these patients are on non-contracted plans, we must seek prior authorizations from the new plan, the same way we did in March.  You should not book subsequent appointments for these patients unless you have made longer term arrangements with the plan; these patients must begin to shift care to their plan’s network. 

  • Patients will now be able to switch their plans through June 30th.  The original date for patients to be locked into their plans was June 1st, but the state is now extending that to July 1st. What does that mean?
    • Our patients who discover that we are not in network with their new plan now have until the end of June to explore switching plans if they prefer to keep seeing us. 

  • If you read the state’s guidance, you will see that it also contains new information on Service Area Exceptions.  Please note that information does not pertain to us.  The Partners HealthCare Choice ACO is a “Primary Care ACO” that runs on the MassHealth network.  This update is for “Accountable Care Partnership Plans” which run on MCO plan networks, which have geographic service areas.  The rule for our ACO, and the others that run on MassHealth’s network, is that patients must live within 25 miles of their assigned primary care site.  That is not changing.    

Contracting Reminders

As of this writing, contracts with BMC’s MCO, BMC’s Community Alliance ACO, Tufts Children’s ACO, and Tufts CHA ACO (for children going to MGHfC – MGH for Children) are in process.  In the interim practices can see these patients with the guidance below. 

  • You can see BMC MCO and BMC Community Alliance ACO members now, but still need a prior auth from BMC HealthNet for every service.
  • You can see Tufts Children’s ACO and Tufts CHA ACO (only pedi members going to MGHfC) members now, but still need a prior auth from Tufts Public Plans for every service.
  • Remember, these contracts are for hospital, specialty, and post acute care across the Partners system; primary care providers in our ACO can see only Partners HealthCare Choice ACO members, not members from these other plans. 

More Information

Please visit our Medicaid ACO Sharepoint Site for all ACO related resources.

See the full MassHealth guidance document.

-This section adapted from email correspondence from Kim Simonian, MPH,  Director, Public Payer Patient Access, April 7, 2018.

ACO Changes Do NOT Impact Connector Plans

As a reminder: MassHealth health plan changes, including ACO plans, do not impact Health Connector members.

Here are some helpful reminders.

  • The Health Connector is a separate entity from MassHealth, with different types of commercial health plan options (subsidized and unsubsidized) for individuals, families, and small businesses
  • Applicants seeking health coverage through the Health Connector or MassHealth can apply for coverage online through MAhealthconnector.org, but these are two different programs with different eligibility and enrollment requirements and processes
  • The Health Connector maintains separate contracts with the commercial health insurance carriers for the plans that are available to Health Connector eligible members
  • Health Connector members continue to have access to their same provider networks and are not impacted by the new MassHealth health plan or ACO plan changes
  • Health Connector coverage will be unchanged through the calendar year. Health Connector members can consider shopping for a new plan when Open Enrollment begins November 1, 2018

Unsure? Ask to see the member's health plan card:

  • All MassHealth members receive a MassHealth card that shows the member's name and their 12-digit member identification number. Members enrolled in a Managed Care Organization (MCO) or ACO health plan, will also have a card from their health plan. Members are asked to carry both cards at all times. To view sample MassHealth health plan cards go to:  MassHealth Contact Matrix 2018 Managed Care Health Plans
  • Health Connector membership is displayed on each member's health plan card.

And, again, please keep in mind that Patient Financial Services staff have been trained and are the role group primarily responsible for helping patients navigate these changes.
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- This section adapted from Health Connector Reminders - Please Share, MA Health Care Training Forum, April 06, 2018

 

 

Medicare Reminder- The Five-Star Special Enrollment Period

Generally, you can only change your plan or enroll in a new one during specific times. Special Enrollment Periods are periods of time outside normal enrollment periods, triggered by specific circumstances. If you want to enroll in a plan or change plans, you can take advantage of an SEP to join or switch to a five-star Medicare Advantage or Part D plan. This means that you can enroll in a Medicare Advantage Plan or stand-alone Part D plan in your service area that has an overall plan performance rating of five stars. You may only use this SEP once per calendar year.

  • This SEP begins December 8 of the year before the plan is considered a five-star plan (remember that ratings come out in October) and lasts through November 30 of the year the plan is a five-star plan.
  • Enrollments in December are effective January 1.
  • Enrollments from January to November are effective the month following the enrollment request.

To use the five-star SEP, contact Medicare at 1-800-633-4227.

Visit Medicare Interactive to learn how to compare plans using the Medicare Star Rating System.

-From Medicare Rights Outlines Concerns with Short-Term Insurance Plans, Medicare Watch, The Medicare Rights Center April 26, 2018.

 

Policy & Social Issues

 

New Massachusetts Criminal Justice Law

The Massachusetts legislature has passed, and Governor Baker signed, an extensive overhaul of Massachusetts’ criminal procedures, proposing changes in nearly every aspect of a justice system criticized by many for focusing too much on punishment and too little on rehabilitation.

The 121-page bill seeks reform in everything from the state’s bail system to the use of solitary confinement in prisons. It calls for greater use of programs that divert some youthful offenders and people struggling with mental health issues or drug addiction away from involvement with the courts. And for the first time in Massachusetts, it would allow certain prior offenses to be expunged from a person’s record including those that are no longer crimes, such as possession of small amounts of marijuana. The law shortens the period of time that must have passed before certain records can be sealed from employers from 10 years on felonies to 7 years as well as 5 years on misdemeanors to 3 years. This makes it easier for the formerly incarcerated to get more access to affordable housing and occupational licenses.

The legislation repeals several mandatory minimum sentences for low-level drug offenses, but also adds new mandatory sentences for trafficking in fentanyl and carfentanil, synthetic opioids blamed for escalating the deadly opioid abuse crisis.

Senate Republican Leader Bruce Tarr of Gloucester, who participated in negotiations that led to the compromise pointed to provisions that would increase prison time for people caught driving drunk five or more times, and stiffen penalties for corporations convicted of manslaughter.

The measure changes the threshold for which theft is considered a larceny from the current $250. Currently, people convicted of stealing cash or goods worth more than $250 — say, a smartphone — are felons, subject to up to five years in state prison and diminished education and job prospects once they’ve done their time. That’s a lower monetary bar than almost every other state. The bill changes the threshold to $1,200, meaning that thefts of less-expensive items will not draw a felony charge.  A lesser charge, with a lesser penalty, means those found guilty will have a better chance of getting back on their feet more quickly, advocates say. But retailers insist it would incentivize theft.

And while a Senate proposal to raise the age of juvenile jurisdiction from 18 to 19 was dropped from the compromise, the minimum age for criminal responsibility would be raised from 7 to 12. It is estimated that several dozen children under the age of 12 are arrested each year in Massachusetts, though fewer cases actually reach the court system.

And the bill would forbid parents from testifying against their minor children even if they want to. (The only exception would be when the victim is a family member and resides in the household.)

And the legislation would mandate that a judge setting bail must consider, to the extent practicable, the defendant’s financial resources.

If bail is set at a level that is likely to be unaffordable and therefore means that a defendant would have to stay in jail while awaiting trial, judges would have to explain why. They’d have to state how the state’s interest in keeping someone who has not yet faced a trial locked up outweighs the potential adverse impact on the defendant and his or her family.

The package would also mandate that the state notify people about their upcoming court dates — via text and e-mail, for example — a provision intended to ensure they don’t fall into a spiral of accumulating penalties for not showing up.

Additional Provisions include:

  • Solitary Confinement: Many changes made including periodic reviews, allowing visits, more humane alternatives and time in solitary reduced. This has been a priority of NASW-MA for several legislative sessions and we are very pleased with this outcome.
  • Convicted Caregivers: Provisions included to lessen sentencing primary parents to prison and encourages community-based treatment as an alternative to incarceration if caring for a child.
  • Bail Reform: Allowing individuals to demonstrate financial hardship to make bail so less people will be imprisoned solely due to financial insecurity.
  • Compassionate Medical Release: Those who are incarcerated and are also terminally ill or severely disabled is made more available.
  • Police Training: Encourages police departments to train officers in implicit bias and in deescalation.

Sources and for More Information:

Reentry Programs Missing from Debate

Ironically, crucial reentry services have been cut during the same time leaders on Beacon Hill have been debating criminal justice reform and wrestling with ways to reduce incarceration rates, which are roughly four times higher than they were in the 1970s. The new law contains no funding for community programs designed to help offenders after they’re released with housing, mental health services, employment, or other things that can increase their chances of success outside prison.

Last May, CommonWealth reported that Boston’s widely acclaimed inmate reentry programs had been quietly shut down months earlier when efforts to renew a federal grant failed. It meant the end of a program called the Boston Reentry Initiative, which assigned case managers to work with inmates returning to Boston neighborhoods from the Suffolk County House of Correction, as well as a parallel program called Overcoming the Odds that worked with those returning to the city from state prisons.

The city and nonprofit partners cobbled together funding to restore some staff dealing with those leaving the county jail, but the program has not been returned to full strength. The program working with state prisons remains shuttered.
It makes for a huge disconnect, said John Larivee, president and CEO of Community Resources for Justice, the nonprofit that provided case managers for Overcoming the Odds.

Another program run by his agency, a residential program in Boston for women returning from incarceration, was shut down this month because funding dried up.

More than a third of those leaving Massachusetts state prisons are convicted of a new crime within three years. Larivee said community-based residential reentry programs can cut recidivism rates by up to 25 percent.

Community Resources for Justice is calling on the Legislature to allocate $5 million in the upcoming budget for community-based residential reentry programs.

Last year, Boston opened a new Office of Returning Citizens to work with the 3,000 people who return to Boston each year from federal, state, and county correctional facilities. Its three-person staff helps former inmates find their way to existing programs, but the office doesn’t provide the actual case management services offered by reentry programs.

-See the full Commonwealth article.
-See related Boston Globe Opinion piece.

 

 

US Farm Bill Would Further Limit SNAP

The House Republican Farm Bill was released on April 13th. 

In summary, if passed without changes, the House Republican Farm Bill would limit access and eligibility to SNAP in three key ways:

  • It takes food from working families with children by rolling back Categorical Eligibility. This is a critical state option Massachusetts elected allowing low-wage working families with gross income above 130% FPL but below 200% FPL to still qualify for some SNAP benefits if they have high expenses for basic necessities like housing and child care. For example, a family of 2 with one parent working full time and earning even $10 an hour (less than the MA min wage) would be SNAP ineligible! This change will take food from their dinner tables and jeopardize eligibility for automatic free school meals for their children. It could also harm school districts that have elected the “community eligibility provision” or CEP under which they provide meals for all students. 
  • It severely limits the Heat and Eat state option that boosts SNAP benefits for households who get Fuel Assistance, especially persons with disabilities and many low wage working households (the bill proposes to exempt elders). This cut primarily dings working households, forcing them to decide between missing meals or having utilities shut off.
  • It limits SNAP eligibility and access for unemployed and underemployed adults, including seniors up to age 60. This change takes food away from these individuals if they aren't working a minimum of 20 hours per week. This harms people who are facing significant barriers to work -- and punishes people who are working but are only given limited hours or do not have work available year-round. In Massachusetts, many rely on the fishing, agricultural, home health care, restaurant and tourism/service industries for jobs that ebb and flow with the seasons. This change would deepen hunger during off seasons.

“These cuts assume the worst about struggling individuals and families, the people we serve, and the people we care about-our program participants. These cuts also shift more of the work of feeding our neighbors to us and the charitable hunger relief system.” said Pat Baker, Mass Law Reform Institute in an emailed statement.

For More Information

-Adapted from Tell Congress #HandsOffSNAP in Farm Bill - Please take action this week!, Food/SNAP Coalition listserv, on behalf of Pat Baker, MLRI, April 17, 2018.

 

 

Trump Turns Attention to Welfare Programs

President Trump quietly signed an executive order this month directing federal agencies to strengthen the work requirements for various welfare programs. The move could eventually affect recipients of Medicaid, food stamps, housing assistance and cash welfare.

The administration argues that despite low unemployment — just 4.1 percent last month — enrollment in various government assistance programs remains high, years into the economic recovery.

Advocates for the poor note that many recipients of government assistance already work, but often earn too little income to pay for rent, groceries and health care on their own.

"Evidence shows that such [work] requirements have few long-term positive effects on employment and often result in families losing help they need to afford the basics," said Sharon Parrott, a senior fellow at the left-leaning Center on Budget and Policy Priorities.

The administration has been trying to reduce the rolls of people on government assistance since Trump took office — both in an effort to reduce federal spending and to drive more people into the workforce.

Most able-bodied adults already are required to work at least 20 hours a week to participate in the food stamp program, formally known as SNAP.

More than 40 million Americans benefited from food stamps last year, down from a peak of 47.6 million in 2013.

-See the full NPR story.

 

 

Is it Time to Stop Saying “the Safety Net?”

For decades, politicians, the media and the public have used a simple phrase to describe government programs that help people afford necessities like food, housing and health care: “the safety net.” Now, three national groups that represent public agencies and nonprofits that administer those benefit programs say it’s time to retire the phrase.

The American Public Human Services Association stopped using the term several years ago. Now the Alliance for Strong Families and Communities and the National Human Services Assembly, which both represent nonprofits in human services, have also dropped the phrase from their communications. 

Dropping the term safety net is part of the human services groups' broader strategy to get the public and policymakers to think of human services as investments in the community that boost the economy, reduce crime and improve public health. For example, child participation in the food stamps program has been linked to better health in adulthood, such as reduced incidence of obesity, high blood pressure and diabetes. And some evidence suggests that Head Start reduces the likelihood that children will be arrested or charged with a crime as adults.

“We know we need to do a better job as a sector in telling the story of what our work does, why it’s important to society, why people benefit even if they don’t see themselves as direct recipients of services,” says Bridget Gavaghan of the National Human Services Assembly, who's working on a project to change the way people talk and think about human services. “Because we haven’t done such a great job of that in the past, people have really entrenched in unhelpful views about the work that we do.”

Instead of talking about the safety net, the groups want people to think about access to employment, housing, education and health care as “building blocks” necessary for a metaphorical "house," or community's well-being. They emphasize that communities are interconnected, so services that help one household or neighborhood succeed ultimately benefits everyone.

“Well-being is something that is built, just like a house is built,” says Gavaghan. “When we talk about constructing well-being over the course of a life, we are able to talk about things like prevention, we’re able to talk about things like ongoing maintenance, and we’re able to talk about things like why that might need to be restored or repaired over time.”

-See the full Governing article.