Highlights

• Child Tax Credit Updates
• Haitian Immigrant Benefit Eligiblity
• Afghan Immigrant Benefit Eligibility
• New Limits on ICE Enforcement
• SNAP Replacement Benefits
• Boston Foreclosure Funds
• Anti Meal Shaming Law
• Public Service Loan Forgiveness Overhaul
• Homeless Intervention for Seniors
• Family Assist to Cover SNF and PCA

Sections

• Program Highlights
• Health Care Coverage
• Policy & Social Issues

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

A version of this article was emailed to the Social Service Department and the MGH Outreach and Resource Navigation distribution list earlier this month.

The MA legislature has overridden Governor Baker's veto of provisions eliminating asset limits for TAFDC and EAEDC.  TAFDC and EAEDC no longer have asset limits.

On October 1st the Department of Transitional Assistance (DTA) sent a staff advisory stating "effective immediately, assets must not be counted when determining eligibility for both TAFDC and EAEDC .... Any pending TAFDC or EAEDC case with outstanding verifications for assets must have the item for assets dispositioned as verified. No TAFDC or EAEDC cases are to be closed or denied due to assets."

This will have a big impact on eligibility for both programs; prior to this change EAEDC had particularly low asset limits: $250/individual and $500/couple.

Any recent applicants who had been denied due to excess assets or people who had been dissuaded from applying due to the asset limits should consider applying.

HUGE congratulations to the Lift Our Kids Campaign for their tireless advocacy to both boost cash benefits and eliminate barriers to cash benefits including eliminating the asset test!

- Adapted from MLRI Basic Benefits 2021/22 trainings announced including 10/5 training re assisting homeless families; VICTORY MA Senate Overrides Gov's veto on asset test !, Pat Baker, MLRI, October 1, 2021.

November 15 is the new 2021 deadline to sign up to get the Child Tax Credit for those who didn’t file 2019 or 2020 taxes and didn’t use the non-filer portal in 2020. Those who miss this deadline (unless extended further) will need to wait until they file their 2021 taxes to apply.

Free in-person help is available to residents of Boston, Lawrence and New Bedford; see: findyourfunds.org/apply-for-funds

Reminder that undocumented families or others without social security numbers can apply on behalf of their citizen children. The child must have an SSN, and the parent must have an Individual Taxpayer ID Number (ITIN). An ITIN is a tax processing number issued by the IRS regardless of immigration status. ITIN applicants and holders are protected by privacy requirements that limit the information the IRS can share with other agencies such as Immigration and Customs Enforcement (ICE). Learn more - The Facts About the Individual Taxpayer Identification Number (ITIN), American Immigration Council.  

Need help for immigrant families and/or those who want an ITIN?  Advocates can contact Angela Divaris at Greater Boston Legal Services's Low Income Taxpayer Clinic.  She is available to host clinics, Facebook Lives or to provide in-person or phone help.  Call 617-603-1629 or email adivaris@gbls.org. 

Learn more and share easy to understand information and flyers and other outreach information on the FindYourFunds.org website.

- Based on information shared by Naomi Meyer, GBLS, at the October 26, 2021, SNAP Coalition meeting; additional material from replacement SNAP + Nor'easter, 11/15 child tax credit deadline, SNAP outreach info, Victoria Negus, MLRI, October 28, 2021.

Certain recent Haitian immigrants may be eligible for benefits. There is a special immigration category “Cuban/Haitian immigrants” that applies to many, but perhaps not all, recent Haitian entrants. This category confers benefits eligibility with no 5-year bar. Benefits eligibility for this group is in the same category as those with refugee status or whom have been granted asylum. These benefits eligibility rules for Cuban/Haitian immigrants differ from those for other immigrant groups.

Cuban/Haitian immigrants

To qualify, Haitian immigrants must have been processed by USCIS (but not all who have been processed by USCIS will qualify). Some common statuses that many recent Haitian immigrants are presenting with would qualify if otherwise eligible:

• parole (a type of humanitarian release into the country; unrelated to the more familiar parole from prison)
• in removal proceedings, but don’t yet have a final order of deportation
• pending asylum application

As noted, not every Haitian who has been processed by USCIS qualifies as a Cuban-Haitian Entrant. For example, unfortunately, folks granted TS are not considered Cuban-Haitian Entrants on that basis alone (though they could be if they also have an asylum application pending).

This is not a complete list. Others may qualify; consult legal service with questions.

Benefits

Haitian entrants with these statuses, unlike other immigrant groups with the same status, are benefits eligible – meaning that if otherwise eligible they would qualify for full MassHealth, TAFDC and SNAP. Those without children, who therefore do not qualify for TAFDC, may qualify for refugee cash assistance for up to 8 months after receiving this status. (Note the 8 month clock starts with becoming a Cuban/Haitian immigrant; those who apply for refugee cash assistance later will only qualify for any remaining months’ worth of benefits.) The Mass Office for Refugees & Immigrants administers refugee cash assistance. They contract out direct services, but can direct you to the local refugee provider - call 617-727-7888.

Advocacy tip: also consider EAEDC for single adults with a disability. We know that many folks have been through trauma, so may qualify.

DTA has instructed staff to consult with central office before denying Haitian immigrant’s applications; if applicants are denied please refer them to legal services. For those living in the GBLS service area, advocates can fax or email a completed referral form to the GBLS Welfare Law Unit.

- Based on presentation by Naomi Meyer, Senior Attorney, GBLS, SNAP Coalition meeting, October 26, 2021. Thanks too for her assistance with this article.

Through a stopgap funding bill that President Biden recently signed into law, Congress made Afghan evacuees eligible for traditional refugee benefits, like Medicaid and direct assistance to purchase basic necessities like food and housing. Under this new development, Afghan evacuees in Massachusetts who have been granted Humanitarian Parole are eligible for full MassHealth, SNAP and TAFDC, if otherwise eligible, without being subject to the 5 year bar. Under the new rules, those who are not categorically eligible for TAFDC (e.g., not pregnant and no children) may qualify for refugee cash assistance for 8 months. The Mass Office for Refugees & Immigrants administers refugee cash assistance. They contract out direct services, but can direct you to the local refugee provider - call 617-727-7888. Resource contact for Afghan evacuees in the Worcester area only- Noreen Johnson at welcomeafghans@gmail.com.

MassHealth Coverage and Additional Detail

Afghan immigrant evacuees who apply for health coverage (MassHealth or Health Connector) and other public benefits will have the immigration status categories described in the attached Categories of Afghan Immigration Status document. These categories will vary based on several factors, such as whether the evacuee was assisting the United States while in Afghanistan; whether the evacuee filed for and completed paperwork before evacuation; or whether there is an urgent humanitarian need.

Please review the Categories of Afghan Immigration Status document which provides the different categories of Afghan Immigration Status, a brief description of how status was defined, the immigration status, and the type of documents they may be issued. At this time all Afghan immigrant evacuee statuses will be treated the same as a refugee under Section 2502(a) of the Afghan Supplemental Appropriations Act and 212(d)(5).

Reasonable-Opportunity

If an applicant’s immigration status cannot be verified by a data match or if a document is not provided, a request for information (RFI) may be generated. Applicants or members who have made a good-faith effort to resolve inconsistencies or obtain verification of immigration status during their initial 90-day RFI period may request a 90-day reasonable opportunity extension.

Requests for a reasonable opportunity extension must be made before the expiration of the initial 90-day verification period.

Path to Permanent Residency?

Tens of thousands of Afghan evacuees who are set to leave U.S. military sites in the next few weeks to start new lives in communities across America will face an unresolved question: what legal status will I have here?

Because they entered the U.S. under a temporary legal process known as parole — and not as traditional refugees or visa holders — many at-risk Afghans brought to America following the swift Taliban takeover of their homeland do not have a direct avenue to obtain permanent residency.

Since mid-August, more than 55,000 Afghans have been relocated to the U.S., according to Department of Homeland Security (DHS) figures provided Wednesday. The department said it determined that at least 40% of evacuees are eligible for special immigrant visas because they aided the U.S. war effort. 

Between July and September, nearly 5,400 Afghans entered the U.S. with special immigrant visas, which allow recipients and their spouses and children to become permanent residents, according to government data. DHS said other evacuees have pending special visa applications, but did not provide a number.

Unless Congress creates a legalization program for them, Afghan evacuees who are not eligible for special immigrant visas will likely have to request asylum, and join more than 400,000 asylum-seekers in the U.S. with pending applications, to gain permanent status. 

"We evacuated them here. We did that. It's not very equitable to force people to stay in this limbo state," said Meredith Owen, policy director at Church World Service, one of nine national refugee resettlement groups in the U.S.

While Congress made Afghan evacuees eligible for traditional refugee benefits, instead of allowing them to apply for permanent residency, as the Biden administration asked for, Congress created what is supposed to be an expedited asylum process.

Congress instructed the U.S. Citizenship and Immigration Services (USCIS) to interview Afghan evacuees no later than 45 days after they file an asylum petition and to generally issue a final decision within a 150-day timeframe. 

But refugee resettlement officials expressed concern that U.S. officials may not be able to meet the time limits, stranding Afghans in the backlogged asylum pipeline. Evacuees will also face difficulty finding lawyers to help them navigate the convoluted asylum application process and may not have the necessary documents to win their cases, the officials said.

"Some families destroyed paperwork based on U.S. Embassy instructions, knowing these documents could be a death warrant if found by the Taliban. And of course, these are the same papers that are required for seeking asylum," Krish O'Mara Vignarajah, president of the Lutheran Immigration and Refugee Service, told CBS News.

- Sources and for more information: MassHealth Benefits for Afghan Immigrant Evacuees, Supporting Afghan Immigrant Evacuees, Massachusetts Health Care Training Forum, October 22, 2021; Categories of Afghan Immigration Statuses; Afghan evacuees face uncertain legal status as they prepare to leave U.S. bases - CBS News October 7, 2021; with additional material presented by Naomi Meyer, Senior Attorney, GBLS, at SNAP coalition meeting, October 26, 2021.

Secretary of Homeland Security Alejandro Mayorkas has just released a new immigration enforcement policy for “protected areas,” including hospitals and other medical or mental health care facilities. Effective immediately, U.S. Immigration and Customs Enforcement and Customs and Border Protection “should not take an enforcement action in or near a location that would restrain people’s access to essential services or engagement in essential activities,” the policy states. Such a location, formerly called “sensitive locations” are now referred to as a “protected area.”

Frequently Asked Questions (Excerpted):
 

Q: What does the Department of Homeland Security mean by the term “protected area”?

• A “protected area” is a location that, based on the essential services or activities that occur there, is generally protected from enforcement actions by ICE and CBP. The policy provides a non-exhaustive list of protected areas based on the types of activities that take place there, the importance of those activities to the well-being of people and the communities of which they are a part, and the impact that an enforcement action by ICE or CBP would have on people’s willingness to be there and receive or engage in the essential services or activities that occur there.
• Some examples of protected areas include:
• A school, such as a pre-school, primary or secondary school, vocational or trade school, or college or university.
• A medical or mental healthcare facility, such as a hospital, doctor’s office, health clinic, vaccination or testing site, urgent care center, site that serves pregnant individuals, or community health center.
• A place of worship or religious study, whether in a structure dedicated to activities of faith (such as a church or religious school) or a temporary facility or location where such activities are taking place.
• A place where children gather, such as a playground, recreation center, childcare center, before- or after-school care center, foster care facility, group home for children, or school bus stop.
• A social services establishment, such as a crisis center, domestic violence shelter, victims services center, child advocacy center, supervised visitation center, family justice center, community-based organization, facility that serves disabled persons, homeless shelter, drug or alcohol counseling and treatment facility, or food bank or pantry or other establishment distributing food or other essentials of life to people in need.
• A place where disaster or emergency response and relief is being provided, such as along evacuation routes, where shelter or emergency supplies, food, or water are being distributed, or registration for disaster-related assistance or family reunification is underway.
• A place where a funeral, graveside ceremony, rosary, wedding, or other religious or civil ceremonies or observances occur.
• A place where there is an ongoing parade, demonstration, or rally.

Q: What is an enforcement action?

• Enforcement actions by ICE or CBP covered by this policy include, but are not limited to, arrests, civil apprehensions, searches, inspections, seizures, service of charging documents or subpoenas, interviews, and immigration enforcement surveillance.
• This guidance does not apply to matters in which enforcement activity is not contemplated.

Q: How is this different from previous sensitive location memos? What is new?

• For the first time, DHS will have one single coherent policy to guide enforcement actions by ICE and CBP in or near protected areas.
• The change in name, from “sensitive locations” to “protected areas,” is to provide a more precise understanding that certain areas are inherently in need of special consideration. Rather than only being “sensitive” they rise to a level of being protected because of the functions performed in such locations and the people those facilities serve, such as children, survivors of domestic violence, and worshippers.
• This memo provides greater clarity on what types of locations are protected areas and which kinds of enforcement actions should generally be avoided there and guides the workforce in the exercise of judgment to determine what additional areas should be protected.

Q: Will enforcement actions ever occur in or near protected areas?

• Enforcement actions may occur in or near protected areas in limited circumstances but will generally be avoided.
• The following are some examples of limited circumstances under which an enforcement action may need to be taken in or near a protected area:
• The enforcement action involves a national security threat.
• There is an imminent risk of death, violence, or physical harm to a person.
• The enforcement action involves the hot pursuit of an individual who poses a public safety threat.
• The enforcement action involves the hot pursuit of a personally observed border-crosser.
• There is an imminent risk that evidence material to a criminal case will be destroyed.
• A safe alternative location does not exist.

Q: When may an enforcement action be carried out in or near a protected area without prior approval?

• Absent exigent circumstances, an Agent or Officer must seek prior approval from their Agency’s headquarters, before taking an enforcement action in or near a protected area.
• Even when exigent circumstances exist, to the fullest extent possible, any enforcement action in or near a protected area should be taken in a non-public area, outside of public view, and be otherwise conducted to eliminate or at least minimize the chance that the enforcement action will restrain people from accessing the protected area.

Q: Are courthouses protected areas?

• Courthouses do not fall under ICE or CBP’s previous policies concerning enforcement actions at or focused on sensitive locations, nor do they fall within the protected areas memorandum issued today. However, the April 27, 2021, Memorandum from Tae Johnson, ICE Acting Director, and Troy Miller, CBP Acting Commissioner, entitled “Civil Immigration Enforcement Actions in or Near Courthouses” remains in effect. Enforcement actions at courthouses will only be executed in limited circumstances against individuals falling within the public safety priorities of DHS’s civil immigration enforcement priorities. Such enforcement actions will, absent exigent circumstances, not lead to arrest of non-targeted individuals and will, wherever practicable, take place outside of public areas of the courthouse.

Q: Where should I report a DHS enforcement action that I believe may be inconsistent with these policies?

• You may contact ICE Enforcement and Removal Operations (ERO) through the Detention Reporting and Information Line at (888) 351-4024 or through the ERO information email address at ERO.INFO@ice.dhs.gov, also available at www.ice.gov/webform/ero-contact-form.
• You may contact the CBP Information Center to file a complaint or compliment via phone at (877) 227-5511, or submit an email through the website at help.cbp.gov/.

• You may contact the Office of the Inspector General at www.oig.dhs.gov/ and (800) 323-8603 and the DHS Office for Civil Rights and Civil Liberties at CRCLCompliance@hq.dhs.gov or (866) 644-8360.

See the full policy and FAQs.

The MA Department of Family and Medical Leave (DFML) is now offering Spanish and Portuguese translations of the following handouts:

• PFML Information for Employees One Pager English Spanish Portuguese
• PFML Leave to Care for a Family Member English Spanish Portuguese
• PFML New and Expectant Parents One Pager English Spanish Portuguese

In another new change, employees can now check application status online.

Benefit Calculation and Maximum Benefits Changes for 2022

The amount of benefits you’re eligible to receive for PFML is based on your own average weekly wage when you apply for leave, and the average weekly wage for workers throughout Massachusetts. The individual benefit calculation:

• 80% of your average weekly wage, up to 50% of the average weekly wage for MA workers PLUS
• 50% of any of your average weekly wage that exceeds 50% of the average weekly wage for MA workers, up to the maximum allowed benefit amount

Calendar Year 2021

• The average weekly wage in Massachusetts for 2021 is $1,487.78. Fifty percent of $1,487.78 is $743.89.
• Currently, any amount of your own weekly wage that is less than or equal to $743.89 will be replaced at a rate of 80%. Any part of your average weekly wage that is greater than $743.89 will be replaced at a rate of 50%, up to the maximum allowed benefit amount.
• The maximum total amount that you can receive in PFML benefits right now is $850 per week. If you receive multiple benefit payments in the same week, one or more may be reduced so that your combined payments do not exceed the maximum.

Calendar Year 2022

• The new average weekly wage in Massachusetts as of October 1, 2021 is $1,694.24. It takes effect on January 1, 2022.
• The maximum total amount that you can receive in PFML benefits in 2022 is $1,084.31 per week. If you receive multiple benefit payments in the same week, one or more may be reduced so that your combined payments do not exceed the maximum.

- Adapted from PFML Update: What you need to know, Department of Family and Medical Leave, October 20, 2021 and https://www.mass.gov/info-details/paid-family-and-medical-leave-pfml-benefits-guide#benefit-amount-details-

SNAP rules provide for replacement of food lost by individual SNAP recipients due to "household misfortune." Household misfortune includes fire, flood, loss of electricity (4 hours or more), equipment (refrigerator/freezer) failure, an individual utility shut off (even for non-payment of an electricity bill) or similar misfortune. In light of the significant power outages due to this week’s Nor’easter, here’s a reminder.

Households who lose food bought with SNAP due to a power outage of 4 hours or more, may request replacement SNAP benefits - up to the value of one month of SNAP, including the Emergency Allotment! 

To request SNAP replacement benefits, the SNAP household needs to:

• Step 1: Report the loss within 10 days of the loss (i.e., when food was destroyed or became unsafe to eat). This can be done either over the phone or in writing. 
• Call the DTA Assistance Line at 877-382-2363 - after selecting a language, press 5 and then 1. 
• Note: if able to submit form or self-declaration with details of loss (see Step 2) within 10 days of the loss, no need to report first.

• Step 2: Complete the DTA Statement of Loss/ Request for Replacement of Food -- Form SNAP 9B English and Spanish OR write a self-declaration* and submit it to DTA within 10 days of when the loss of food was first reported.

*The self-declaration should include the following:

• head of household name, address and either their DTA Agency ID or date of birth;
• the reason for the replacement food request (fire, flooding, power outage, appliance failure, etc.) and the date the food was lost;
• the dollar value of the food lost that was bought with SNAP benefits; and
• the signature of the head of household along with the words that say "this statement is signed under the penalty of perjury".

Learn more about this process on MLRI's webpage on household misfortune SNAP here. 

- From replacement SNAP + Nor'easter, 11/15 child tax credit deadline, SNAP outreach info, Victoria Negus, MLRI, October 28, 2021; additional material from masslegalservices.org/content/snap-replacement-benefits-due-natural-disaster-power-loss-flooding-or-other-misfortune

Carlos Santiago, Commissioner of the MA Department of Higher Education (DHE) sent to 84K Massachusetts students earlier this month.

• The e-letters were sent to every MA student who gets a MassGrant, Pell grant, is eligible for work study (even if no job), or has an Estimated Family Contribution (EFC) of $0 (part of the financial aid calculation).
• When students apply for SNAP, this letter can be used as proof of their financial aid status.  

See the text the letter, including helpful explanations and rights: MA college students! Need help paying for groceries? (campaign-archive.com)

Advocates: please let MLRI know if you see students who run into problems accessing SNAP.  MLRI has a new AmeriCorps member, Lilydahn Stewart, who can help students get the benefits they are eligible to receive. Her email is lstewart@mlri.org 

- From Powerful testimony at Hunger Free Campus Hearing Yesterday; and DHE letter to 84K Low-Income MA College Students about SNAP! Pat Baker, MLRI, October 8, 2021.

The city of Boston has set aside $5 million in emergency funds to help local homeowners avoid foreclosure.

Eligible residents can apply for assistance under the program, which is open to local residents who are at least 90 days behind on payments and who meet income guidelines.

Boston Mayor Kim Janey announced the program Thursday, saying it was an effort to address pandemic-related job losses and the local residents who are now struggling to make ends meet.

The city is working with local non-profit agencies to oversee the fund. Homeowners can apply for the fund by contacting any one of three agencies who are administering the funds in partnership with the City: ESAC, Urban Edge, and ABCD Mattapan Family Services. Recipients will also be offered foreclosure counseling to help them learn how to avoid the risk of foreclosure in the future.

Boston is using federal pandemic relief funds to pay for the program.

Questions or to apply:

• ESAC: (617) 524-2555, ext 108 or sbennett@esacboston.org
• Urban Edge: (617) 989-9309 or fbowen@urbanedge.org
• ABCD - Mattapan: (617) 298-2045 or staff_mattapanfsc@bostonabcd.org

- See the full press release.

As many as 10,000 children in Massachusetts will be able to access school meals under a new state student nutrition law which will provide free lunches to more students by requiring more schools to participate in a federal reimbursement program.  

This year, under pandemic-related emergency laws, all schools can provide free meals to all students and be reimbursed by the federal government. But under normal circumstances, there are two ways students can get free meals. Low-income families can always apply for free or reduced priced meals in school. But communities with a high percentage of low-income families can also apply for the “community eligibility provision,” in which the school can offer free lunches to all students without processing individual applications, and the federal government will reimburse a percentage of the cost based on the number of low-income students in the district. 

The new law will require all districts where more than 50 percent of students are low-income to enroll in the community eligibility provision and provide free meals to all students, unless the school applies for a waiver and proves that it would cause the school financial hardship.

Meal Shaming Too Outlawed

The legislation Gov. Charlie Baker signed on this month also prohibits schools from a practice known as "lunch shaming," in which staff punish or publicly identify students who have unpaid debt for their meals.

The new law was the result of three years of advocacy by hunger prevention groups and the Massachusetts Law Reform Institute, which published a report in 2018 chronicling the disparate practices districts have for addressing meal debt. In some cases, cafeteria workers were instructed to throw away a hot meal and exchange it for a cold cheese sandwich. In others, students were prohibited from participating in sports, field trips, or graduation due to meal debt.  .

The new law prohibits schools from taking any action that would publicly identify a student whose family owes a meal debt, including providing them with an alternative meal that is not available to every student. Schools can no longer deny students the ability to participate in activities or receive their transcripts or grades due to meal debt.  

- See the full WBUR story and the full CommonWealth Magazine article.

The Social Security Administration announced that the2022 Cost of Living Adjustment (COLA) for people receiving Social Security and Supplemental Security Income (SSI) benefits will be 5.9%. This is the highest COLA adjustment beneficiaries have seen since 1982, and is in large part the result of rising prices triggered as the economy recovers from the COVID-19 pandemic. 

Advocacy group Justice In Aging, in an emailed statement said

While this is helpful for older adults who are facing rising costs in the economy, we also need Congress to work proactively to help struggling seniors meet their needs. This is particularly true for women, people of color, and people with disabilities who depend on Social Security and SSI for much of their total income and have lower benefits on average. 

Congress should expand base Social Security benefits to accurately reflect the income older adults need to live in dignity. They must also include updates to SSI, a program that has been neglected for too long, in their Build Back Better package in order to prevent very low-income older adults from being left behind. Until additional efforts are made to ensure that all seniors have enough income to meet their needs as they age, a COLA increase alone will not be sufficient.

- From Cost of Living Adjustment Insufficient to Keep Older Adults Out of Poverty, Justice in Aging, October 13, 2021.

The MA Health & Hospitals Association (MHA) Continuum of Care Council has created a 64-page After the Hospital: A Guide to Post-Acute Care to inform patients and their caregivers of their options for care after a major change in a patient’s health.

The guide is divided into three sections to: 1) give advice to patients and their families; 2) assist caregivers in understanding the post-acute process and choices; and 3) to provide both patients and caregivers with a wide range of resources.

You can download each section here:

• After the Hospital: A Guide to Post-Acute Care (full report, 64 pages)
• For Patients and Families (31 pages)
• For Providers and Clinicians (10 pages)
• Post-Acute Care Resources (25 pages)

- From After the Hospital: A Guide to Post-Acute Care, Patricia Noga, R.N., MHA, October 13, 2021.

U.S. Department of Education has announced it will use its authority to help borrowers and relax the rules of the troubled Public Service Loan Forgiveness (PSLF) program. "Borrowers who devote a decade of their lives to public service should be able to rely on the promise of Public Service Loan Forgiveness," said U.S. Secretary of Education Miguel Cardona in a press release announcing the changes. "The system has not delivered on that promise to date, but that is about to change for many borrowers who have served their communities and their country."

Up to this point, to qualify for PSLF, borrowers have had to meet a handful of requirements:

• Working in a public-sector job. 
• Making 120 on-time student loan payments. 
• Participating in a qualified repayment plan. 
• Having a specific type of loan, known as federal Direct Loans. 

Now, the department says, it will use its authority to give borrowers a time-limited waiver — essentially relaxing several of these rules retroactively, so that previously disqualified loan payments can now be counted toward forgiveness.

The department estimates that this waiver could have an enormous impact on borrowers, with roughly 22,000 immediately eligible to have their loans erased automatically. Another 27,000 borrowers could likewise see their debts disappear if they're able to prove they were working in public service at the time they made payments that had been declared ineligible. By comparison, 16,000 borrowers have had their loans forgiven under PSLF since the program was created.

Many disqualified payments will now count toward loan forgiveness

In the past, monthly loan payments were disqualified not only for being received late but also for being even slightly different from the amount required.

Now, the department says, past-due payments will be counted — as will payments that were disqualified for differing slightly, even by just a few cents, from the amount due.

Different repayment plans will also temporarily count toward forgiveness

The PSLF program requires that a borrower be enrolled in one of a few specific repayment plans, including the Income-Based Repayment Plan (IBR) and the Pay As You Earn Repayment Plan (PAYE). But because of complaints from borrowers about loan servicing companies misinforming them or automatically switching them to disqualified plans, the department says these past ineligible payments will now count toward forgiveness, at least temporarily.

Past FFEL loan payments will now count toward forgiveness

PSLF was designed to encourage borrowers to consolidate their old federal loans, known as Federal Family Education Loans (FFEL), into federal Direct Loans. But for myriad reasons — on a spectrum from mistakes to mismanagement to misconduct — loan servicing companies and the Education Department muddied this message to borrowers.

Many borrowers would express interest in Public Service Loan Forgiveness to their servicer only to make it years into repayment before realizing (or finally being told) that their FFEL loans didn't qualify. And while they could consolidate them into federal Direct Loans, none of those old FFEL payments counted toward the 120 total payments required for PSLF.

In perhaps the most consequential softening of the program's rigidity, the department is retroactively allowing borrowers to receive credit for all of those old payments they made toward ineligible FFEL and Federal Perkins Loans — going back to the beginning of the program, in 2007 — regardless of whether they consolidated those loans into Direct Loans.

In fact, for borrowers who were already certifying their public service employment, the department will attempt to automatically revise their count of PSLF-qualified payments.

There's extra help for military service members

There's also good news for service members in this PSLF reset. The department says it will now allow all months spent on active duty to count toward PSLF — that's even if the borrower's loans were in deferment or forbearance and not actively being repaid.

What has not changed

Public service is still non-negotiable, as are the 120 required payments — though what now qualifies as a payment has expanded dramatically.

The department says it also plans to use the rulemaking process to improve PSLF moving forward, so more changes may be on the way.

To benefit from the temporary changes the department is making, borrowers who have not yet applied for PSLF must do so before Oct. 31, 2022. For borrowers with FFEL or Perkins loans, the department says they must consolidate those loans and submit a PSLF form. The Department of Education says it will post more information about its PSLF waiver at StudentAid.gov/PSLFWaiver.

- See the full NPR story.

Here’s a chilling statistic from one of Boston’s most prominent medical institutions: On any given day, two to three nurses at Massachusetts General Hospital are assaulted. The incidents can range from a shove or a kick to verbal harassment and even threats by patients, according to hospital officials.

And that’s almost certainly an undercount, in part because there’s little mandatory reporting or tracking of assaults inside Massachusetts hospitals or to the state.

“We believe that the reporting is lower than what the reality is,” said Colleen Snydeman, executive director for quality and safety in nursing and patient care at MGH. The hospital started collecting data on staff assaults in 2019, she said. “It’s been something that we've been very concerned about. Everyone is — the entire hospital.”

Last year, the hospital provided safety training for some 30,000 employees, officials said. And there are additional pilot efforts underway to help staffers detect signs of potential trouble. The hospital is going to test panic buttons for nurses, too.

COVID-19 has only exacerbated the problems, according to health care executives and national nursing surveys. Hospitals have lost nurses and patient care assistants during the pandemic, leaving many institutions short-staffed. That can mean nurses or aides carrying a heavier patient load, and having to enter rooms alone when it would be better to have backup.

And then there’s added anxiety in the current environment. Nerves are frayed all around, among staff and patients. Some patients are arriving sicker after putting off treatment during the pandemic. In some hospitals, bed and staff shortages mean patients may wait longer for care.

A portion of the patients who lash out have dementia or untreated mental illness, or behave aggressively after coming off anesthesia. Bonnie Michelman, MGH’s director of police and security, estimated that assaults are roughly 40% “unintentional” and 60% “intentional.” Intentional assaults can involve people altered by drugs or alcohol, she said. The unintentional cases are often older patients with dementia or Alzheimer’s “who have changed from their normal personality to a personality that can be radically volatile. Those are really sad cases,” she said.

But the ramifications are the same, Michelman said. Nurses, aides, doctors and others can be injured or have traumatic experiences dealing with patient outbursts. At MGH, it’s the busy downtown emergency department that has the most frequent reports of violent patients, officials said. The inpatient psychiatric unit also carries a heavy load. But the issue is hospital-wide — and industrywide.

According to the U.S. Bureau of Labor Statistics, health care workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018.

The stresses of receiving and providing health care during the pandemic have surged, according to Katie Murphy, an ICU nurse at Brigham and Women’s Hospital in Boston and president of the Massachusetts Nurses Association union. And a shortage of psychiatric beds in the region has been a big contributor to the prevalence of patients lashing out.

“Patients are waiting for care and treatment” in some cases, she said. “When they’re in the hospital, they’re more vulnerable. They’re scared, they’re confused. And health care workers are right there, you know — often very, very close.”

Murphy recalled a fellow nurse being punched in the face a couple of months ago. But the incident likely went unreported, she said.

Both the Massachusetts Nurses Association and the Massachusetts Health & Hospital Association are supporting bills in the state Legislature targeting workplace safety for medical workers. Both would, among other things, require more rigorous reporting and tracking of assaults.

The hospital association in a statement called incidents of violence “rare.” But the group’s vice president of clinical affairs, Patricia Noga, also said, “We share the urgency of nurses, doctors, and other care professionals in putting an end to unacceptable acts of violence in all healthcare facilities.”

- See the full WBUR story.

JF&CS Bereavement Support Groups provide emotional and spiritual support for adults living with loss. In the past 18 months, interest in these drop-in groups – now offered via Zoom – has exploded. What used to be one twice-monthly group is now four weekly groups, driven by a need for connection during an isolating time. In addition to a general bereavement group, there are groups for people who lost their partners, lost their parents, or have lost someone to suicide. Groups are open to everyone, and also allow space for discussion of Jewish aspects of mourning, such as shiva or yizkor. 

Learn more at Grief & Bereavement Supports (jfcsboston.org).

This Boston Medical Center based program offers three programs to help elders transition and remain out of homelessness.

Homelessness Prevention

The Aging Right in Community Initiative is a collaboration of the Elders Living at Home program and the Medical-Legal Partnership. The program works to provide intensive case management to older adults at imminent risk of losing their housing and becoming homeless. Some examples of situations assisted with are rental arrearages, home safety concerns, inappropriate behaviors, etc.  Typically, clients have received a “notice to quit” or another legal notice from their landlord or housing court. Applicants need to be 55 or over, have a low income, and at imminent risk of losing their housing.

Stabilization Services

Provides support to elders with a history of homelessness and those with chronic disabilities that put them at risk of loosing their housing and becoming homeless. Services provided to newly housed elders and elders at risk of becoming homeless. Services include case management, medication management, nursing assessments, etc. Referrals are also made to other agencies as needed. Applicants must be at least 62 years old, formerly homeless or at risk of becoming homeless and willing to accept stabilization services.

Nutrition

The HERO program works to provide fresh nutritious foods free of charge. Home delivery is provided to individuals that are not able to shop for themselves. The program also offers nutrition education.

Additional Eligibility Notes

None of these programs require elders to be BMC patients. MGH staff can refer patients. Due to the number of referrals the program is receiving there may be a waitlist.

Unfortunately ELAHP cannot take referrals for registered sex offenders.

Elders Living at Home Referral Form.

For more information:  https://www.bmc.org/elders-living-home or email Kip.Langello@bmc.org

- Thanks to Lauren DeMarco for sharing this resource and Hannah Perry for submitting this article.

Smart from the Start’s school readiness program is a free program that supports kids up to age 5 and their families in Boston. See the graphic below and the smartfromthestart.org/boston/ website for more information.

- Thanks to Kristen Risley for sharing this resource.

Two sisters are running one of Wellesley's only black-owned businesses, and also creating a safe and all-inclusive play place for children of all abilities. Owners and sisters Melissa Defay and Sherley Brice opened the "We Rock the Spectrum - Wellesley" gym at 34 Central St., in Wellesley on Oct. 9.

The sensory safe gym is inclusive for children ages 0-12 of all mental and physical abilities. Included in the play area are a zip line, trampoline, and landing pit which allow children to engage with others while exercising and learning.

The sisters could not be more excited about the new fully functioning gym. Inspired by her youngest son, who is on the spectrum, Defay says she was fed up with how a parent at a local gym treated him, saying a parent of another child got physical with the boy.

She says poor treatment and lack of understanding left her completely traumatized and wanting to create a space where her son could feel welcomed and free to enjoy himself.

Defay says it was hard to find a space where both of her sons, one of who is neurotypical, could play and feel included. When she came across "We Rock The Spectrum," she says she ran to her sister and family saying, "We need to open this here!"

The recreation center is not a clinical-insurance-based center, meaning it is open to everyone insured or not. Starting at $25 for open play, the sisters offer discounts for siblings and monthly rates for children who frequent the space.

Beginning Nov. 3, "We Rock the Spectrum - Wellesley" will host birthday parties and classes through Dec. 15. Some of the classes include ABC dance, music therapy, and Zumbini (caretaker and me classes from ages 0-4).

There is even a calming room for children who get too overstimulated and need to relax for a little.

Open play is from 9 a.m. to 7 p.m. seven days a week. The sisters say to call or check social media for weekend hours, as they tend to vary.

Due to high demand, the sisters are looking for volunteers who may want to intern or just help out with some of the kids while staffing is on the difficult side.

More information: werockthespectrumwellesley.com

- See the full The Patch article.

A brief version of this article was previously emailed to the Social Service Department.

Effective November 1, 2021, MassHealth will expand coverage of skilled nursing facility stays and community-based services for individuals on MassHealth Family Assistance when the member meets a Nursing Facility Level of Care.

The Family Assistance coverage expansion will include:

• The expansion of short-term stay coverage from 100 days to six months
• For members who need care beyond six months in a facility or community-based long term care services and support facility, coverage includes a new option to enroll in (state-funded) MassHealth “Standard” or “CommonHealth”

• Covered community-based services include Personal Care Attendants (PCAs) for people with permanent disabilities.
  

Approximately 120,000 immigrants are insured under MassHealth Family Assistance the agency said.

How Family Assistance Members Can Access Benefits

To access these benefits, MassHealth members or their Authorized Representatives, including health care facilities, must notify MassHealth of a change in health care needs. This includes reporting disability status or need for long-term care in a facility. The notification starts the application process.

"I think there was a greater appreciation of disparities due to the COVID-19 pandemic — also because of the broader racial justice awakening," Andrew Cohen, of Health Law Advocates in Boston said. "And I think MassHealth leadership has realized that treating immigrants differently in terms of their access to long-term services and supports was ultimately a huge problem in terms of racial disparities."
The eligibility operations memo is still forthcoming which will include final details.

- Sources: MassHealth expands long-term care to thousands of immigrants | WBUR News, MassHealth Family Assistance Coverage Expansion Update, Brooke Alexander, MGB, October 18, 2021, and Updates from MassHealth: MassHealth Family Assistance Coverage Expansion Update, MAhealthconnectorUpdates , Oct 18, 2021.

Though it’s not unique to Massachusetts, the scarcity of therapy is a significant issue here, and not just in hospitals, which have been overwhelmed by patients needing psychiatric care. There are some obvious reasons for this supply and demand problem.

Of course, COVID-19 has meant a lot of us have been suffering at the same time, and many are struggling with the reality that, despite the vaccines, we’re not going to be done with the pandemic any time soon. We’re still dealing with trauma, big choices, and change amid a worldwide crisis.

COVID-19 also made some of the stigma attached to therapy go away, I think, swelling patient demand. There were people in my life who’d resisted therapy, or who’d stopped counseling long ago, who suddenly decided, “Well, it’s time to get help, and I don’t feel weird asking for it.”

For others, getting help became more manageable in the logistical sense. Most therapists switched to online appointments after COVID hit, and therapy is easier to fit in when you don’t have to figure in travel time.

It didn’t take long, though, before mental health professionals with openings reached their limit with caseloads. And even if they had openings, they didn’t necessarily take insurance, making them inaccessible to a large swath of people in need. (Why don’t those therapists take insurance? More on that later.)

Massachusetts Psychological Association president Martin R. Pierre said there are about 6,000 psychologists in the state, 1,700 of whom are MPA members. While he doesn’t have hard data, “Anecdotally I could say that an overwhelming majority of [psychologists] are full,” he says. “They’re stretched to the limit. The waiting lists are approximately 5 to 15 clients. This changed at the height of the pandemic.”

This summer, I called Danna Mauch, president and CEO of the Massachusetts Association for Mental Health, and told her I wasn’t sure what to advise people seeking therapy anymore. Mauch said people in the industry are asking the same question.

This problem is so big that her organization started a campaign called #JustAsk, which offers links to resources, including community health centers, support groups, hot lines, and private clinics, and also reminds people they can reach out to their friends and family for support. That’s better than nothing, I guess.

Limits on insurance coverage continue to play a big role in patients’ ability to access behavioral health care. Mauch said that even before the pandemic, a huge issue for mental health professionals has been that insurance companies often don’t reimburse them what they actually charge. A therapist may bill $200 an hour, for example, but only get paid $75 by a client’s insurer. That disconnect can drive practicing therapists to refuse insurance altogether and, according to Mauch, can even dissuade would-be therapists from pursuing the field.

A 2017 Blue Cross Blue Shield of Massachusetts Foundation-funded study, “Access to Outpatient Mental Health Services in Massachusetts,” found that 45 percent of outpatient mental health providers didn’t accept MassHealth, 38 percent did not accept Medicare, and 16 percent did not accept commercial insurance.

Responding to a 2018 BCBSM Foundation study, nearly 36 percent of adults in Massachusetts seeking treatment for mental health and/or substance use disorders said they were told a provider was not accepting their type of insurance; nearly 11 percent were told a provider wasn’t accepting insurance at all.

Mental health care providers — including licensed social workers, psychologists, and psychiatrists — are in a constant battle with insurers about how and how much they get paid and when the money is coming, multiple therapists told me. That means less time for clients.

And for a person already experiencing anxiety or depression, finding a therapist who is both affordable and accepting new patients can be exhausting. Many ask friends, family, colleagues — and people like me who talk about therapy a lot. They google. Psychology Today’s website has a pretty good list of therapists in all ZIP codes. But not every therapist is on it, and the directory doesn’t always tell you who’s taking new patients.

Sienna Hunter-Cuyjet, the clinical manager at And Still We Rise, said most therapists want to help as many people as possible, but that they have to set boundaries for themselves, too. Therapists in her group are seeing patients coping not just with the pandemic, but with racism and discrimination based on their gender or sexuality. The therapists are balancing those treatment needs with administrative work and with their own experiences during this time of crisis.

There are mental health professionals with And Still We Rise who are taking new patients, though, and the group plans to hire more new therapists, she said.

Help getting help

Can’t find a therapist? The therapists and experts I spoke with had a few suggestions.

1. Consider group work. Sometimes group therapy is easier to find than one-on-one. Call your primary care doctor, your insurance company, even local hospitals to find out what group therapy services are available.
2. Say yes to any wait list. Some used to say, “Well, ugh, I can’t wait six months.” But even wait lists can be hard to come by now. Get on all lists you can.
3. Seek a referral. Mauch advises asking your primary care physician if they’re affiliated with any behavioral health practitioners.
4. Pierre recommends asking someone you trust to help with making initial phone calls, so the process is less daunting.
5. Do not underestimate your immediate needs. If you need assistance now, treat it like any other emergency and get help, even if it means an emergency room.

- See the full Boston Globe story.

Anti-poverty advocates are making a push to expand welfare benefits as part of a campaign to lift tens of thousands of children out of “deep poverty.”

One proposal, backed by more than half of the 200-member state Legislature, would increase welfare benefits through the state’s primary cash assistance program, known as Transitional Aid to Families with Dependent Children (TAFDC), by 20% every year until the payments reach 50% of the federal poverty level.

That would raise benefits for an average family of three to $915 a month.

Last year, lawmakers approved a plan increasing child welfare benefits for the first time in two decades, but advocates say more help is needed.

Families living below 50% of the federal poverty level, which is currently $1,830 a month, are considered to be in “deep poverty,” according to advocates.

Under state law, a recipient is limited to getting benefits for two years in any five-year period. A family of three in the program now collects a maximum of $712 per month.

- See the full Gloucester Times article.

The State’s Largest hospital system says it intends to invest $50 million over the next five years in 20 community partners who can help address mental health care shortages, chronic disease, and food insecurity.

Mass General Brigham said the $50 million will be in addition to the $175 million it is already spending annually on community health. What sets the new money apart is that most of it is going to community partners outside the hospital system network.

The biggest chunk of money — $18 million – is going to address mental health shortages that are in plain view in hospital emergency rooms where patients are forced to endure long waits for treatment. Mass General Brigham is trying to tackle the problem two ways – by funding stipends, fellowships, scholarships, and salary supplements to increase the number of graduates going into the field and by supporting the delivery of more mental health services.

Its partners on the education front are Bridgewater State University, William James College, UMass Boston, Salem State University, Quincy College, and Boston College. Its partners on the care delivery front are the Massachusetts Association of Mental Health and the Corey Johnson Program for Post-Traumatic Healing at Roxbury Presbyterian Church.

Dr. Elsie Tavares, the hospital system’s health equity officer, said $14.3 million will be used to address chronic diseases, particularly hypertension. She said most of the money will go to community health centers and another $4 million will go to Mass General Brigham’s mobile health program, allowing it to do outreach in Lynn, Chelsea, Revere, Everett, and in Boston Charlestown, Dorchester, Roxbury, Mattapan, and Jamaica Plain.

The last area of focus is food insecurity. Tavares said $13.3 million would go to expanding capacity to deliver nutritious food to people who need it. The hospital system’s partners are Community Servings, About Fresh, La Colaborativa, GreenRoots, the Lynn Food Security Task Force, My Brother’s Table, and Greater Lynn Senior Services.

Tavares said the $50 million will be spent over five years, but 80 percent of the money is already contracted with the various partners.

- See the full Commonwealth Magazine article.

Only residents with lawful immigration status may apply for a Massachusetts driver’s license. Yet even immigrants who are lawfully present face problems verifying their immigration status to the satisfaction of the Massachusetts Registry of Motor Vehicles. The process the RMV uses to verify an applicant’s immigration status is fraught with frustration, delays, inconsistent results, multiple trips to RMV service centers, and gaps in license validity.

The RMV verifies status through web-based software called SAVE (Systemic Alien Verification for Entitlements), at a cost of thousands of dollars each month. In theory, SAVE is an efficient method of verifying the immigration status of large numbers of applicants. Administered by the Department of Homeland Security, SAVE allows RMV clerks to enter identifiable information about the applicant and learn instantly whether the applicant has the required immigration status. If the system cannot automatically verify the applicant’s status, the case can be escalated for manual review. As an interface between the RMV and DHS, SAVE should eliminate the need for RMV clerks to interpret complex immigration documents, but the program often falls short of its promise.

Even though SAVE is a product of DHS, it struggles to discern eligibility in complex cases. For example, the spouse of a US citizen with a pending green card application, or an individual fleeing persecution with a pending asylum application, will often face challenges. These individuals are allowed to be in the U.S. and are entitled to a driver’s license under state law, yet SAVE is often unable to confirm their status automatically. The prescribed resolution to this problem – SAVE manual review – cannot always be requested by RMV clerks. And when a request for review is successful, it can delay the application process by weeks. Because of confusion about who qualifies for licenses, some applicants are turned away from RMV service centers even before a SAVE check is initiated.

Under the agreement in place between the RMV and DHS, the RMV must provide applicants whose status cannot be verified with an information sheet explaining how their record can be corrected “in a timely manner.” This information sheet is another triumph of theory over practice, however.  Foreign nationals are instructed to call customer service for the United States Citizenship and Immigration Services or book an in-person appointment. However, for the majority of applicants in this predicament, there is no error to correct in the DHS system. Rather, the problem is systemic: SAVE is ineffective, and is not equipped to process complex or nuanced forms of immigration status and present them to the RMV.

- See the full CommonWealth Magazine opinion piece.