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MGH Community News |
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MGH Community News |
| February 2021 | Volume 25 • Issue 2 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Hannah Perry, 617-726-8182. Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807. |
Vaccine Transportation for All MassHealth and HSN Members Massachusetts is offering all MassHealth members and those with Health Safety Net (HSN) rides to and from their COVID-19 vaccine appointments. Companions who can’t drive patients to a vaccine appointment can also get a ride if they’re helping patients who have a disability or helped get an appointment at a mass vaccination site and are seeking a shot at the same time. Some MassHealth plans already cover transportation costs, such as MassHealth Standard, CommonHealth and CarePlus. Last week’s bulletin expands coverage to members in Family Assistance, the Children’s Medical Security Plan and MassHealth Limited and Health Safety Net who can’t get to their vaccine appointments. Note that those enrolled in a Senior Care Options, a One Care plan or in a Program of All-Inclusive Care for the Elderly (PACE) should continue to contact their health plan or PACE provider to request transportation. The bulletin took effect Feb. 17. The state plans to work with Human Services Transportation brokers, which include six regional transit authorities, to schedule rides to and from vaccine appointments. Here’s how it works: MassHealth members who normally get transportation to doctor’s appointments can ask their doctor to submit a transportation request (PT-1) on their behalf. Those who don’t can call the MassHealth Customer Service Center at 800-841-2900 and follow the prompts for “transportation to a vaccine appointment” until a representative responds. MassHealth members requesting a ride will need to provide a MassHealth ID number, the location, date and time of the vaccine appointment, the pickup spot and a phone number or email address where the driver can reach the patient. Once making the request, MassHealth members should be able to call a regional transportation broker to schedule an appointment as soon as the next day, though state officials recommend scheduling transportation appointments at least three days in advance if possible.
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More Information Details for patients: FAQ Details for staff: MassHealth All Provider Bulletin 310 - See the full Mass Live article.. Additional material from the FAQ and the MassHealth All Provider Bulletin 310
Federal Foreclosure Moratorium and Forbearance Protections Extended The Biden Administration has extended the homeowner foreclosure moratorium and forbearance protections through June 30, 2021. These critical protections were due to expire in March, leaving many at risk of falling further into debt and losing their homes. This action builds on steps the President took on Day One to extend foreclosure moratoriums for federally guaranteed mortgages. The new actions will:
Previously the Federal Housing Finance Agency, the independent agency that oversees Fannie Mae and Freddie Mac, extended forbearance by three months for borrowers coming to the end of their forbearance period. These coordinated actions will cover 70 percent of existing single-family home mortgages. To bolster these efforts, it is critical that Congress pass the American Rescue Plan to deliver more aid to struggling homeowners. The rescue plan creates a Homeowners Assistance Fund which will provide states with $10 billion to help struggling homeowners catch up on their mortgage payments and utility costs. This relief is critical for homeowners with mortgages in the private market who are not able to take advantage of today’s actions and may face longer term challenges. Homeowners and renters can visit consumerfinance.gov/housing for up-to-date information on their relief options, protections, and key deadlines. As federal agencies continue working to implement housing assistance for American families, the Consumer Financial Protection Bureau offers this website as a one-stop shop for both homeowners and renters to learn about programs and resources that can help them stay in their homes by reducing the risk of eviction and foreclosure. - See the full White House press release
PFML – New Emerging Details We reported last month about basics of and resources about the state’s new Patient and Family Medical Leave (PFML) law (Paid Family and Medical Leave Website and FAQs). While the law is mostly in effect, some aspects are still a work in progress. The MA Department of Family and Medical Leave (DFML) recently held a town hall for employees to explain this new benefit and program director William Alpine shared some additional details at various levels of implementation largely in response to audience questions. Application Timeline: How long does it take for approval and to get paid?
Seven Day Waiting Period
Parental and Bonding Leave May be Available for Children Born or Placed in 2020 Parents of children born during 2020 may be eligible for Family Leave to bond with their new child in 2021, regardless of the duration or type of leave taken in 2020. Leave may be taken until the child’s first birthday. Parents of children adopted or placed in foster care during 2020 may be eligible for Family Leave to bond with their new child in 2021, regardless of the duration or type of leave taken in 2020. Leave may be taken until the child’s first anniversary of their adoption or foster care placement. One can apply up to 26 weeks after termination of employment. At the time of the training, DFML reported it is as yet unclear how this applies if one has changed employers and may vary depending on whether new employer uses the state fund or is privately-funding PFML. Are PFML Benefits Taxable? - Additional material from the PFML website, https://www.metlife.com/content/dam/metlifecom/us/homepage/insurance/disability-insurance/pfml/pdf/MA_PFML_Employee_FAQ.pdf and https://www.beckreedriden.com/massachusetts-paid-family-and-medical-leave-benefits-start-january-1-2021/
Emergency Broadband Benefit Coming Soon Congress has tasked the FCC with developing a new $3.2 billion program to help U.S. households that are struggling to pay for internet service during the pandemic. With this new benefit, eligible households can get or stay connected in order to work remotely or find jobs, access critical healthcare services, and keep students connected to the classroom. About the Emergency Broadband Benefit The Emergency Broadband Benefit provides a discount of up to $50 per month towards broadband service for eligible households and up to $75 per month for those on Tribal lands. Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop, or tablet from participating providers if they contribute $10-$50 toward the purchase price. Program eligibility details and participating providers will be announced in the coming weeks. - Sources: https://www.fcc.gov/broadbandbenefit and Information about FCC Emergency Broadband benefit, Jenifer Bosco, National Consumer Law Center, February 25, 2021.
All programs licensed and contracted by the state’s Bureau of Substance Addiction Services (BSAS) cannot mandate that a person seeking admission to a facility first produce a negative COVID-19 test or proof of vaccination for COVID-19.
- From COVID-19 Relief? Equity. Removing SUD Treatment Barrier. COVID-19 Update -- Patricia Noga, R.N., Mass Health & Hospital Association, February 23, 2021
Beginning this month, certain children with disabilities who qualify for Medicaid because they receive Supplemental Security Income (SSI) can be directly certified for free and reduced-price meals through the United States Department of Agriculture’s National School Lunch Program (NSLP). This policy change will connect approximately 2,600 children who are disabled and living with a relative caregiver to additional nutritional supports. These children will then also automatically meet one of the eligibility criteria to receive Pandemic EBT (P-EBT). P-EBT provides additional emergency food benefits during the COVID-19 pandemic to cover the cost of missed school meals for more than 500,000 students in remote or hybrid learning environments and supports local grocery and corner stores and farmers. Under standard rules, Medicaid programs are allowed to provide “Direct Certification” for children to qualify for free or reduced-price meals without the need for a household application based on their income-based Medicaid eligibility. However, due to different program rules, children who qualify for Medicaid because they receive Supplemental Security Income (SSI) and live with a relative caregiver, such as a grandparent, were not eligible to be directly certified for free or reduced-price meals. The Commonwealth has been pursuing federal approval to allow these thousands of vulnerable children to immediately be eligible for this important nutritional benefit for several years.
"These grandparents and all the kinship families are the true heroes here: raising their disabled grandkids, nieces and nephews at home, especially during the pandemic. Kinship families in Massachusetts and across the country need access to all available benefits to raise the next generation, including free school breakfast, lunch and Pandemic EBT benefits. No one in the Commonwealth should feel food insecure but unfortunately, we are dealing with record levels of hunger as the COVID-19 crisis continues on. We're glad we could assist the Baker Administration in advocating for this critical policy clarification under the National School Lunch Program and we are ready to assist in implementation,” said Patricia Baker, Senior Policy Advocate, Mass Law Reform Institute MassHealth and the Department of Elementary and Secondary Education (DESE) are setting up system changes so that, when schools begin to operate school lunches again in the future, these children are directly certified through the eligibility systems. During the federal public health emergency, all school aged children are able to receive free grab and go school meals through the summer meals program instead of NSLP. Families can find a school meal site near them at https://meals4kids.org/. Many households eligible for these supports may also be eligible for the Supplemental Nutrition Assistance Program (SNAP) and are encouraged to apply. - See the full Mass.gov press release.
In light of the state of emergency declared in the Commonwealth due to COVID-19, the Executive Office of Health and Human Services (EOHHS), which administers MassHealth, is providing guidance to adult day health (ADH) programs that ADH services do not have to be provided in a congregate setting. During the state of emergency, MassHealth ADH services may be provided in a residential setting and may be community-based rather than site-based. ADH providers may deploy a staff person to a member’s residence to assist the member with incidental ADLs and ADH services related to the member’s care plan. ADH services provided in the member’s home must not overlap or duplicate any other services the member is receiving that provide assistance with ADLs or therapies (e.g., residential, personal care attendant, or home health services). More information: see MassHealth Adult Day Health Bulletin 21: Guidance for Adult Day Health Providers Delivering Multi-Model Hybrid Services during the COVID-19 Public Health Emergencyfor additional guidance regarding in-person remote service provision. - From MassHealth, Adult Day Health Bulletin 21 January 2021
In a December MGH Community News article on the state’s new health care law we included erroneous reporting that cancer patients seeking to participate in a clinical trial would have to have their travel and hotel expenses covered by their insurance provider. After a sharp-eyed reader asked for more information we contacted to the American Cancer Society for clarification. The law, signed by Governor Baker on January 1 does NOT require insurers to cover travel and lodging for patients participating in clinical trials. What the new law does is allow organizations such as foundations, study sponsors, corporations, individuals and some others to provide financial support to cancer clinical trials participants for their travel and lodging costs related to the clinical trial. It also applies to their caregivers. Prior to passage of the law, this reimbursement was potentially considered an “inducement” (offering something of value to receive care from certain providers) under Massachusetts law. - Thanks to Lauren DeMarco for her inquiry that led to this correction and ACS’s Lindsay Nicholson and Marc Hymovitz for setting the record straight.
Heading Home Shelter EOHHS and MEMA have contracted with Heading Home to open a temporary winter overflow site at Bunker Hill Community College from December 1 – April 15. Basic details
Woods Mullen vs. Heading Home
The transportation plan (for current guests)
- Thanks to Lindsey Krenzel for sharing this information.
The MGH Workplace Well-Being Collaborative has recently launched a one-stop centralized resource Apollo site for the hospital’s many well-being initiatives for all employees. The site – created by a collaboration of a number of groups including the Employee Assistance Program, Patient Care Services, MGPO, Center for Faculty Development, and the Center for Physician Well-Being – aims to address the need for having one main landing page for all staff to easily find the well-being resources, programs, courses, departments or contacts they may need. - Broadcast MGH 2/12/21
(A version of this article was previously sent to the MGH Outreach and Resource Navigation email list.) Millions of immigrants are working on the front lines of the COVID-19 crisis, risking their health and well-being every day to keep our society going. And yet, many immigrants were excluded from federal stimulus aid. The COVID-19 Rapid Response Fund is providing financial support to immigrant families who have been left out of the federal government’s relief efforts. Immigrants may be eligible to receive a $500 grant to help cover whatever is most pressing in their lives. IMPORTANT NOTE: Due to limited funding and the high level of need, MAF can only provide one grant per individual (two grants per household). If you have received a MAF grant during the pandemic, please do not submit another application as we are unable to offer additional assistance at this time. We appreciate your understanding and encourage you to check out MAF’s COVID-19 Resources Finder. Eligibility
*Currently, due to an extremely large volume of interest, we are only able to approve applicants with online banking. Process
- See the Immigrant Families Grant website - Thanks to Manuella Anorga for sharing this important resource
McLean Psychotic Division- First Episode Resources and Groups Program McLean OnTrack offers treatment and support for first-episode psychosis and related symptoms. This outpatient program specializes in early recognition and treatment for young adults ages 18 to 30 who have had their first episode of psychosis during the previous year. The years immediately following the onset of psychosis represent a critical period, and early intervention during this time is important for good long-term results. Our program is best suited to individuals who are:
“Unlike some first episode outpatient programs On Track accepts patients… even if there is not diagnostic clarity or a thought disorder is not present” said Dawn Parker, LICSW There is also groups program that is part of McLean's Psychotic Division and is free, no insurance required. the program offers about 10 groups per week and is drop-in, to lower barriers to attendance. Apply - OnTrack Patients can fill out the Patient Referral Form. Alternatively, family members, friends, or clinicians can submit the Community/Clinician Referral Form. Once one of these forms is received, we will respond by mail within 5-7 business days. Apply – Well Space (Groups program): Well-Space Referral form Patients do not need to be a McLean Hospital patient or connected to OnTrack in any way to attend Well-Space. Groups are expected to remain virtual and in person post-pandemic. CostMcLean OnTrack is covered by most insurance providers. There is also a self-pay fee of $1,000 per year for services that are not covered by insurance. This out-of-pocket expense should not be a barrier to treatment, and therefore we provide financial aid on a sliding scale for those who qualify. For more information about McLean OnTrack or to make a referral, please call 617.855.3445 or email mcleanontrack@partners.org. - Thanks to Dawn Parker for sharing these resources.
Health Connector Open Enrollment Extended Until May 23rd The Health Connector recently announced it is continuing Open Enrollment until May 23rd, providing additional time for residents to access affordable, quality health insurance, particularly those hurt by the economic impacts of COVID-19.
Review the new administrative bulletin. You can always visit the Health Connector's website to see any past bulletin or regulation: https://www.mahealthconnector.org/about/policy-center/rules-regulations. Review the related bulletin from the Division of Insurance (DOI). - From Update - Health Connector Open Enrollment 2021 extending through 5/23, MA Health Care Training Forum, February 11, 2021
New FAQ on MassHealth Family Assistance Coverage of SNF and Chronic Hospital A new EOHHS FAQ focuses on the Family Assistance benefits that were expanded last summer to include 100 days of post-acute hospital care and 100 days of skilled nursing facility care. Despite the benefit expansion, there have been questions of coverage for these particular MassHealth patients, which in turn has led to transition challenges across the care continuum. The FAQ helps to address these questions and promotes awareness of the benefits so patients can receive the care for which they are eligible. Excerpts:
Will Family Assistance cover 100 days at both a nursing facility (NF) and a chronic disease and rehabilitation hospital (CDRH) for the same MassHealth member? Is there a maximum number of times a MassHealth member can receive the Family Assistance 100-day benefit at a nursing facility or a CDRH? Will Family Assistance cover Medical Leave of Absence (MLOA) days in a NF? For more information see the FAQ. - From: COVID-19 Update -- Patricia Noga, R.N., MA Health & Hospital Association, January 29, 2021 with additional material from the FAQ.
Unpaid Unemployment Leaves Many in Dire Straits Unemployed workers in Massachusetts who haven’t received benefits since the end of December are pleading with the state to tell them where their money is — and worrying about how they’re going to cover February’s rent. Some who have been waiting more than a month for a new round of unemployment benefits to kick in said that state employees are telling them the system is being updated; others have heard that a raft of fraudulent claims is causing delays. Employees answering the phones either don’t seem to know what’s going on or can’t assure callers the money will be there soon, unemployed residents say — and that’s only when calls get through at all. This is on top of software glitches that crop up occasionally, including one that temporarily reduced people’s accounts to zero and set off a new round of panic. On Facebook groups, people swap tips about how to game the unemployment system. One trick: When calling the state Department of Unemployment Assistance, pressing “6″ to change a password will get a live person on the phone — though that person probably won’t be able to help with an unpaid claim. The DUA has been plagued by problems since the early days of the pandemic, when a deluge of claims and an outdated computer system led to long waits for benefits. In the fall, fraudulent claims generated by autonomous software programs also contributed to significant delays as more stringent identification protocols were put in place to weed out fraud. Governor Charlie Baker recently said there were a number of issues with the extended benefits, including the fact the government had to design and implement new programs to keep the money flowing. There are also new rules in place based on previous fraud and identification problems, he said, and in many cases people have to submit more information and reapply for the extra benefits. Baker said he wasn’t aware of any software glitches. Before benefits were cut off at the end of December, more than half a million people were getting federal unemployment assistance. - See the full Boston Globe article
Unemployment Glitch Resolved for those with Temporary Protected Status The state’s Department of Unemployment Assistance has cleared up a paperwork Catch-22 for immigrants with temporary protected status that was preventing them from receiving or extending their unemployment benefits. The state agency required applicants to submit a page from the federal register showing that temporary protected status for their countries, primarily El Salvador, Haiti, Honduras, Nepal, and Nicaragua, had been extended. But the Trump administration did not update the federal register until late December, making it almost impossible for the immigrants to prove their status. The result was a logjam in claims. Lawyers for Civil Rights pressed the Baker administration last month in an open letter to address the problem, after being contacted by dozens of immigrants with temporary protected status. The Baker administration responded. “They have agreed to update their system to make sure TPS recipients are not denied benefits.” said Ivan Espinoza-Madrigal, the executive director of Lawyers for Civil Rights. Temporary protected status recipients can now file applications online the same way as any other unemployment assistance applicant –by submitting a Social Security number, an employment authorization document, and a Massachusetts driver’s license. Those who qualify will be eligible for all retroactive payments to their account, said a Department of Unemployment Assistance media representative in an emailed statement, adding that the agency “remains committed to ensuring that those who are eligible for unemployment benefits have access to the resources and benefits they need.” - See the full Commonwealth Magazine article
Unpaid utility bills are piling up in the aftermath of the coronavirus, with hundreds of thousands of homeowners and businesses in Massachusetts racking up record levels of debt, according to a new report. The report, released Wednesday by the Boston-based National Consumer Law Center, found that the number residential, commercial and industrial customers who've fallen 90 days behind on their utility bills more than doubled from November 2019 to November 2020, with their collective debt now totaling more than $735 million. Residential arrearages increased 80% from $194 million to $351 million, with the average customer owing at least $214. "The level of debt has reached a crisis level," said Charlie Harak, a senior attorney at the law center and co-author of the report. "The pandemic has created a major burden on small business owners and residential customers who are unable to pay their energy bills, which is of grave concern." Harak said the report's findings suggest the pandemic has created "a new class of struggling customers." "These are the people who were previously able to pay their bills, but due to job losses and other factors during the pandemic are no longer able to make their payments," he said. "They've fallen into a debt hole and can't get out." Last March, the state Department of Public Utilities issued an order banning electric, natural gas and water companies from disconnecting service during the state of emergency. The order included commercial and industrial utility customers, as well as small businesses, which fall behind on their bills because of the economic fallout. Utilities are also prohibited from threatening to shut off gas, electric or water service to customers for failure to pay. The state regulatory agency reminded consumers to "make payments during the moratorium to avoid the accumulation of large arrearages." But hundreds of thousands of customers who are behind by 90 days or more will have to pay those unpaid debts after the ban expires on April 1, Harak said. "The number of customers who are likely to find themselves facing shut off when the moratoriums ends is of great concern," he said. The report recommends additional federal funding and changes in public policy to prevent consumers and businesses from "falling off a cliff" when the bills eventually become due. - See the full Gloucester Times article
People who survive COVID-19, but have symptoms — sometimes debilitating symptoms — many months later are often called “long-haulers”. As scientists scramble to explain what is going on and figure out how to help, disability advocates are also scrambling: They are trying to figure out whether long-haulers will qualify for disability benefits. Disability advocates and lawmakers are calling on the Social Security Administration (SSA) to study the issue, update their policies and offer guidance for applicants. "If we end up with a million people with ongoing symptoms that are debilitating, that is a tremendous burden for each of those individuals, but also for our health care system and our society," says Dr. Steven Martin, a physician and professor of family medicine and community health at UMass Medical School. "We know what's coming. So, we have to make sure that we're on top of this," says U.S. Rep John Larson, a Democrat from Connecticut, who joined with another member of Congress to write a letter asking the SSA to work with scientists to understand what support long-haulers might need. Applying for benefits COVID-19 survivors are the newest group to approach the federal government for disability coverage, and it's unclear whether they will be considered eligible. "I do think it's still an open question. It's still a little iffy about whether [long-haulers] will be able to qualify," says Linda Landry, an attorney at the Disability Law Center in Massachusetts. She says it seems clear that long-haulers qualify for protections under the Americans with Disability Act, which would afford them accommodations for things like housing and accessing government services. But the question of whether long-haulers will be eligible for federal disability benefits is still being debated. Landry says there are three things, in general, that you need to qualify for benefits: First, a medical diagnosis. Second, evidence that the condition affects your ability to work. And third, the disability has to last for a while. The requirement is that "you have to have had or are likely to have a condition that affects your ability to work for 12 consecutive months," Landry says. Since COVID-19 has scarcely existed as a recognized disease for that long, this may be hard to prove, Landry says. She would like to see the SSA put out specialized guidance about COVID-19, similar to guidance the agency has released in the past for applicants suffering from debilitating headaches or fibromyalgia. In a statement, the SSA told NPR that the current disability policy rules should be sufficient for evaluating COVID-related applicants, though the agency did not rule out taking additional action in the future. "Researchers are still learning about the disease and we will continue to look at our policies as research evolves," the statement said. A lot of unknowns Larson serves on the congressional subcommittee that handles Social Security issues. He says it is challenging for the SSA to prepare for the situation because a number of important facts about long-haulers are still unknown. For example, scientists are still studying how to treat the debilitating symptoms of long-haulers, and it is unclear whether treatment will enable some individuals to eventually return to work. Researchers are also still trying to define the most common symptoms, establish roughly how many long-haulers there are, and determine how many of them have symptoms that are truly debilitating. Some estimate that as many as 10% of COVID-19 survivors will have persistent symptoms, while others think it's lower. Dr. Zeina Chemali, who runs a clinic for long-haulers at Massachusetts General Hospital, says early studies from Europe suggest it may be between 3% and 5%. Larson points out that even if only a small percentage of COVID-19 patients end up as long haulers there could still end up being a lot of them, given that more than 25 million people in the U.S. have been infected with the coronavirus. Chemali says the problem reminds her of the long-lasting consequences that can come from lyme disease or encephalitis. Chemali's clinic is looking into whether COVID-19 puts your brain at long-term risk for things such as strokes and neurodegenerative disease. She says they don't yet know the answer. - See the full NPR story.
Mayor Martin J. Walsh has announced the formal launch of the City of Boston Voucher Program (CBVP). The CBVP is a rental voucher program similar to Section 8, funded by the City of Boston's operating budget and administered by the Boston Housing Authority (BHA). Mayor Walsh included $2.5 million in the fiscal year 2021 budget to create the program. The program is expected to house hundreds of Boston families over the coming years. Responding to community input, the City of Boston Voucher Program will focus on Project Based Vouchers-tied to a particular site or development-and will further fair housing through equitable neighborhood planning. According to a statement, the “City of Boston Voucher Program will efficiently leverage city resources by deepening the affordability of both existing and in-development income-restricted housing, making such housing available to very- and extremely- low-income residents, homeless Boston Public Schools families, households facing displacement and other vulnerable populations.” Since June, the Boston Housing Authority has convened a stakeholder group of low-income renters, nonprofits and service providers to inform program design and priorities, while the Department of Neighborhood Development has consulted with property owners and developers to ensure the success of the program. The Boston Housing Authority will formally launch the program by issuing a Request for Proposals from housing operators and developers interested in incorporating Project Based Vouchers into their developments. Similar to Section 8, vouchers are funded by annual appropriation while the commitment to stable affordable housing is secured through long-term contracts between the Boston Housing Authority and the property owner. To efficiently deploy resources to serve vulnerable residents, the BHA will use three existing referral partnerships while incorporating a new partnership with the city's Office of Housing Stability. These partnerships will serve households in shelter, homeless and doubled-up families (multiple families sharing one primary residence) with children in Boston Public Schools, and families facing displacement. For more information on the City of Boston's work to create more housing, please visit Housing A Changing City: Boston 2030. - See the full Boston Globe article
SUDs Treatment Shortages Still Lead to Commitment to Jail for Some Men National groups have rated the Commonwealth’s civil commitment apparatus one of the worst in the country. Mass is currently defending itself against multiple lawsuits alleging everything from neglect to physical abuse of civil commitment patients. Under pressure, some elected leaders are calling for reform. Compelled by the horror of addiction and the desperation that follows repeated relapses, Bay State families filed roughly 11,000 commitment petitions in 2018 alone, according to data first accessed by WBUR. That’s a nearly 100% increase compared to data from 2010, just eight years earlier. With their children in crisis, parents have few options. As a result, they’re forced to struggle with the decision to commit a loved one to a system that has proven dysfunctional and morally ambiguous. Today, civil commitment is a checkerboard of rules and regulations, varying from state to state. Notably, while every US state allows some form of civil commitment, 13 currently exclude patients with substance use disorder from their laws. Of those that do allow substance use disorder as a valid reason for commitment, Illinois and Utah have statutes in place, but never use them. Places like Hawaii and Texas, meanwhile, only commit around 100 patients per year, according to a 2019 WBUR report. Others, like Florida and Massachusetts, process high numbers of involuntary civil commitments annually. While the state phased out jailhouse confinement for women in 2016, male overflow cases still end up in the care of either the Massachusetts Department of Correction, or the Hampden County Sheriff’s Department, which, together, offer an additional 240 beds. Advocates and experts say those jails and prisons are simply not equipped to handle drug withdrawal symptoms. A broken systemParents want their children a safe place. Often, they feel civil commitment facilities are the solution. But as lawsuits and outside condemnation pile up, a grisly picture has emerged, suggesting that’s often not the case.
“Massachusetts is the only state that places people in prison for treatment of alcohol and substance use disorders,” one lawsuit in 2019 read. “Other states recognize what public health experts know: these disorders are medical conditions for which people need treatment, not punishment.” The state has only 287 clinical beds, though. And an average commitment lasts at least 20 days according to a state study in 2019. That makes it impossible to keep every civilly committed person in a hospital. From the insideCivil commitment patients themselves say they suffer abuse and neglect behind bars. In 2017, 11 men sued the Commonwealth over their treatment while committed to a facility in Bridgewater. They had been housed at the Massachusetts Treatment Center in Bridgewater, a prison that the state itself describes as a “facility separately housing criminally sentenced male inmates identified as sex offenders and those who have been civilly committed as sexually dangerous persons.” This facility exists expressly for the state’s most threatening sex offenders. It’s not for people committed to addiction treatment. Yet the state dumped patients there, nonetheless. - See the full Dig Boston article.
The Centers for Medicare & Medicaid Services (CMS) has rescinded the Trump Administration’s January 2018 guidance encouraging states to implement work requirements in their Medicaid programs. CMS also sent letters to states with approved work requirement waivers to initiate the process to unwind those approvals, citing the public health emergency and the Administration’s position that work requirements do not promote the objectives of Medicaid. Meanwhile, the litigation of the work requirement waivers in Arkansas and New Hampshire is ongoing. The Trump Administration appealed the decisions striking down those states’ waivers to the Supreme Court and submitted its brief prior to Biden taking office. The Supreme Court is scheduled to hear oral arguments on March 29th. Read Justice in Aging’s resources about why work requirements harm older adults and family caregivers. - From From DC: COVID Relief Bill Includes Housing Assistance, CMS Rescinds Medicaid Work Requirements Guidance, and more, Justice in Aging, February 19, 2021.
The COVID-19 relief bill that Congress is currently working on would provide critical housing assistance for millions struggling to pay rent and avoid eviction, as well as funding to address homelessness. The House Financial Services Committee housing-related provisions include:
- From: From DC: COVID Relief Bill Includes Housing Assistance, CMS Rescinds Medicaid Work Requirements Guidance, and more, Justice in Aging, February 19, 2021
As part of an Executive Order to remove barriers to the legal immigration system, President Biden has directed an immediate review of the Trump-era public charge regulations. The announcement came just weeks after 500 nonprofit organizations affiliated with the Protecting Immigrant Families coalition sent a letter urging the President to act quickly in dismantling the wealth test created by the last Administration. The Executive Order means that the administrative process of reversing Trump’s public charge regulations has now begun. We anticipate that federal agencies will soon take action leading to reversal of the regulations. In the meantime, here’s what we know now:
- This section adapted from: BREAKING NEWS: Public Charge Executive Order Signed, Eddie Carmona, National Immigration Law Center (NILC), February 2, 2021. For more information visit PIF at https://protectingimmigrantfamilies.org/ Summary Executive Orders – Week of Feb 1, 2021 On February 2, 2021, President Biden signed three Executive Orders on immigration. Here are some highlights: Legal immigration and integration:
Asylum and the border:
Task Force on Reunification:
On February 5, 2021, President Biden announced a goal of 125,000 refugee admissions for the next full fiscal year (starting October 1, 2021). President Biden also signed an Executive Order on refugee resettlement, which, among other things:
- See the full MIRA Coalition summary, February 9, 2021
Senator Menendez and Representative Sánchez this month introduced the House and Senate versions of the U.S. Citizenship Act of 2021. This bill builds on President Biden’s plans to build a more just and welcoming immigration system, including creating a path to citizenship for millions of immigrants. The bill creates a pathway to citizenship for qualifying undocumented immigrants, by establishing a transitional “Lawful Prospective Immigrant” (LPI) status giving them work authorization and making them eligible to apply for a “green card,” and then for United States citizenship. While there is much to applaud in the bill, Protecting Immigrant Families (PIF) is disappointed that the bill denies immigrants holding LPI status access to health care and human services programs, including subsidies under the ACA, and most would remain subject to the five year waiting period after getting their green cards. While we all share the disappointment that the bill falls short in providing access to critical benefits, we know that organizations may differ in how they balance this disappointment against the benefits of the bill. PIF’s full statement is available here. NILC’s statement is available here. CLASP’s statement is available here.
Moving forward, advocacy groups plan to work with congressional leadership to strengthen the bill or any future bills creating pathways to status to ensure that all immigrants and their families have access to the support and services they need. - From: Our Thoughts on Biden’s Immigration Bill, Renato Rocha, CLASP for PIF, February 19, 2021
The Department of Justice has withdrawn its support for California v. Texas, the lawsuit challenging the constitutionality of the ACA brought by Texas and 17 other Republican-led states. The Trump Administration had joined Texas and argued in front of the Supreme Court last November that the entire ACA should be struck down because Congress had made the tax penalty for not complying with the individual mandate $0. Justice in Aging joined AARP and the Center for Medicare Advocacy on an amicus brief defending the ACA to demonstrate the vast harm overturning the law would have on older adults’ access to health care, Medicare, Medicaid, and the entire health care system. - From: From DC: COVID Relief and HCBS Funding, Justice in Aging Files Lawsuit to Restore Language Access Protections, and more, Justice in Aging, February 12, 2021
Poverty, bias, language all cited as factors Latino children are more likely than white children to have an open DCF case and more likely to be removed from their homes. In fact, according to the national research organization Child Trends, Latinos were more overrepresented in foster care in Massachusetts than in any other state. Advocates for families say the disparities cannot be attributed to higher rates of abuse and neglect in the Latino community. They say the overrepresentation of Latinos is tied to a range of factors, including poverty and cultural bias. And once Latino families are involved in the system, they can face additional barriers that white children do not, like language difficulties. This disparity has long been recognized by those within the child welfare system. But amid a national reckoning on race, advocates for children say there needs to be a broader conversation on why racial disparities exist in the system and how to address them. In Massachusetts, 19 percent of children are Latino or Hispanic, but 33.7 percent of children in the child welfare system are Latino or Hispanic, as are 31.9 percent of children taken from their families, according to DCF’s fiscal 2020 annual report. There are 13,800 Latino children with open DCF cases and 2,600 Latinos in out-of-home placements (living in foster care, a group home, or with a relative). Latino kids are 2.9 times more likely than white kids to have an open case with DCF, and 2.6 times more likely to have an out-of-home placement. While black children are also disproportionately represented in the system, the disparity is less. Black children, who are 8.8 percent of the child population, comprise 13.6 percent of those with open DCF caseloads and 14.3 percent of out-of-home placements. DCF spokesperson Andrea Grossman acknowledged the disparity. “Hispanic/Latinx, Black, and other families of color have been historically overrepresented on child welfare agency caseloads nationwide,” Grossman said in a statement. She said the agency has been taking steps to address the disparities. Last summer, DCF established a racial equity workgroup and steering committee focused on the agency’s policies, practices, work environment, and training opportunities. DCF is also involved with a commission exploring issues, including those tied to bias, surrounding mandated reporters. Mandated reporters are teachers, health care workers, law enforcement, and others who are required to report suspected abuse and neglect. Around 80 percent of DCF’s cases come through mandated reporters. There are many factors that contribute to families coming to the attention of DCF – abuse and neglect, but also poverty and, potentially, bias. Federal data on child maltreatment for Massachusetts over the last four years finds Hispanic children are more likely to be victimized than children of other races. But the vast majority of maltreated children – nearly 90 percent – are victims of neglect, rather than abuse, a classification often driven by poverty. DCF data show that Hispanic children who are removed from their homes are reunited with their parents at rates slightly higher than white children. Advocates say this may suggest that Hispanic children are removed more easily, but after a more thorough court review, their homes are deemed safe to return to. The state-appointed Massachusetts child advocate, Maria Mossaides, said unconscious bias around race and poverty also likely plays a role. For example, Mossaides said, if a child falls out of a tree, breaks their arm, and goes to the emergency room, white parents from Weston are unlikely to be questioned about why the child was in the tree and not properly supervised. A black or Latino parent from Worcester or a non-English speaking parent is more likely to be questioned, and potentially reported for neglect. Mossaides, who leads a commission is examining the system of mandated reporters, said the commission is looking at things like standardizing training for educators that could address unconscious bias. It is considering developing ways a mandated reporter can contact an agency other than DCF – for example, sending a family whose child is hungry to an organization that can help them get food. One major problem identified in a recent report by the Massachusetts Appleseed Center for Law and Justice, a Boston advocacy organization, is that DCF has often not provided adequate language services to non-English speaking families. Documents are not always translated, and visits and meetings are not always conducted with an interpreter. Nelly Medina, a former foster child who is now an organizer for Jobs With Justice, said Latino families today are reluctant to call DCF even in cases when someone knows of abuse. “There’s no support for families, and the fear of having families ripped apart causes more trauma,” Medina said. Medina, who has assisted DCF-involved families, said DCF may not help a family find money for food or clothing and might impose conditions without support to meet those conditions. For example, she said DCF recently gave a jobless woman 30 days to buy two beds for her kids – and it was Medina, not the DCF caseworker, who connected the woman to a program that gives a free bed to any family with a DCF referral. - See the full Commonwealth Magazine article.
State Drags its Feet on Nursing Home Medicaid Terminations On August 3, 2020 the Baker administration sent letters to three nursing homes informing them that a series of care violations had precipitated their ouster from the state’s Medicaid program, the financial lifeline of nearly every nursing home in Massachusetts. The letters made it sound as if residents of the three homes were in physical danger. Each letter asserted that the nursing home is “unable to safely and adequately care for MassHealth members residing at your facility, particularly in the midst of the COVID-19 global pandemic and considering the facility’s historic low-quality indicators.” Residents of the three facilities were notified of the decision. But since that stern warning, the state has not moved swiftly to remove two of the three nursing homes from Medicaid, which would likely precipitate their closure since Medicaid typically accounts for nearly 70 percent of a nursing home’s revenues. All three nursing homes – Hermitage Healthcare in Worcester, Wareham Healthcare, and Town and Country Health Care Center in Lowell – responded within the required 30 days to the August 3 termination letter, challenging the decision. The state rejected Town and Country’s response and that case is headed for a hearing, but the state has not even responded to the appeals of the other two nursing homes. A six-month delay is a long time for a nursing home and its residents to live under a cloud. Officials with the Executive Office of Health and Human Services, headed by cabinet secretary Marylou Sudders, declined to comment on the cases and the delay. They also refused to release the responses of the three nursing homes or even reveal when the Town and Country hearing is being held. In response to a public records request, officials said the agency was unable to respond within the required time frame because “doing so would interfere with its other responsibilities.” The officials said a response would be forthcoming this coming Monday. The nursing homes also declined comment. - See the full Commonwealth Magazine article. |
