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MGH Community News |
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MGH Community News |
| August 2022 | Volume 26 • Issue 8 |
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. |
MassHealth and SNAP Common App and Coming Soon for All MA State Benefits
On July 27th, the Baker Administration implemented a portion of FY21 and FY22 budget language and began allowing low-income households applying for or renewing MassHealth online to apply for SNAP food benefits at the same time. This month, the Legislature officially re-enacted language from the FY23 budget that had been amended by the Governor and sent it back to his desk for his signature. This language directs the Administration to create a common application for SNAP, MassHealth, cash assistance, childcare and housing subsidies, fuel assistance, and other needs-tested benefits. For many years, Massachusetts had separate application processes for MassHealth and SNAP, as well as many other safety-net programs, that all asked for the same basic information. Burdensome and duplicative application processes have caused low-income families to fall through the cracks and connect to some but not all of the programs they are eligible for. For example, the separate application process for MassHealth and SNAP resulted in the “SNAP Gap” – approximately 700,000 MassHealth recipients who are likely income-eligible for, but not receiving, SNAP. “For too long, Massachusetts households in need have faced bureaucratic obstacles in order to access benefits they need to put food on the table or make their rent payments. Low-income people seeking assistance already face many challenges in their lives. We should be doing everything we can to ease the burden and to remove bureaucratic barriers that impede access to benefits. We applaud lawmakers and the administration for taking major steps in the right direction,” said Georgia Katsoulomitis, Executive Director of the Massachusetts Law Reform Institute (MLRI). The Common App Coalition is a coalition of more than 150 organizations across Massachusetts committed to reducing hunger and alleviating poverty and is led by the National Association of Social Workers - Massachusetts Chapter (NASW-MA) and the Massachusetts Law Reform Institute (MLRI). The Coalition has been advocating for a Common Application and looks forward to continuing to work on the implementation of this initiative with the next administration. It may well be expected to take years to implement. - From Breaking News: Major Advocacy Victory!, Massachusetts Law Reform Institute, August 4, 2022 |
EBT PIN Removal to Protect Benefits from Skimming – Members will Need to Re-PIN to Access Benefits As reported last month (Cash Assistance and SNAP Benefits May be Stolen with No Notice or Recourse – Encourage Members to Regularly re-PIN their EBT Cards) The Massachusetts Department of Transitional Assistance (DTA) is reporting that they are hearing of an alarming number of “skimming” cases among those who receive their public benefits payments (TAFDC, EAEDC and SNAP) on EBT cards. DTA has advised members to re-PIN their cards frequently, but only small numbers have. So DTA announced this month that to protect those who may have had their PINs compromised, they will be removing PINs from all EBT cards issued in the three main geographic areas with the greatest prevalence of compromised cards unless the PINs have been recently changed. Cards with PINs removed will not be usable until the user re-PINs. DTA had announced plans earlier this month to remove PINs this week (week of August 22nd) for those receiving benefits people receiving TAFDC, EAEDC and SNAP benefits who get their benefits through the Quincy, Brockton, and Boston DTA offices. How to re-PIN the Card
In Person Assistance The Brockton, Quincy and Nubian Square local DTA offices will be open tomorrow, Saturday, 8/27, from 9am to 1pm to help clients change their PIN. DTA is telling clients who live in these areas about this by text. These offices are NOT open for regular business such as interviews. Background Skimming is the use of an electronic device to steal card information from a card reader and create a fake card, known as cloning, to steal money or benefits. These scams are aimed at obtaining credit, debit and Electronic Benefit Transfer (EBT) card information and Personal Identification Numbers (PINs). Credit card companies typically monitor your usage to identify suspicious activity and notify you to ascertain if your card may have been compromised and typically your liability is limited to $50. Unfortunately, there is no such mechanism for Electronic Benefits Transfer (EBT) cards- cards that have public benefits such as TAFDC, EAEDC and/or SNAP benefits loaded on them. And, also unlike your credit card, if scammers steal your funds, while cash assistance benefits may be replaced, due to federal regulations, there is currently no mechanism to replace lost SNAP benefits. Recipients typically have no warning that something is wrong until they attempt to use their benefits and find no funds available. - Adapted from Updates on EBT Skimming; WH Conf on Food Security Special Session Monday 8/29; Lt Gov Candidates on Food Security - Recording from 8/17 Forum, Pat Baker, MLRI, August 26, 2022.
Coming Soon - a 10% Increase to MA Cash Assistance Grants Thanks to the advocacy of the Lift our Kids Coalition, co-led by MLRI and Greater Boston Legal Services, the Massachusetts FY2023 budget includes a 10% grant increase, starting October 2022, for cash assistance to families with children, people with disabilities, and the elderly (TAFDC and EAEDC). These crucial public benefits provide essential support to 67,000 people across the Commonwealth. This is the third increase in three years after decades of frozen benefit levels. The TAFDC grant for a family of three will go up from a maximum of $712 a month to a maximum of $783 a month - that’s an additional $852 a year in the pockets of struggling families. This is closer to, but still well below, half of the federal poverty level – known as the Deep Poverty level – of $960 a month. The pandemic and the current skyrocketing inflation have underscored the distressing inadequacy of our safety net. Families who struggled before to meet their basic needs now face even greater expenses for food, rent, household and cleaning supplies, internet access, and utilities. - From Support MLRI's High-Impact Advocacy, Mass Law Reform Institute, August 18, 2022 and https://www.mlri.org/2022/07/28/statement-on-cash-assistance-increases-in-the-fy-23-budget/
RAFT Changes as of August 1 As the Massachusetts Department of Housing and Community Development (DHCD) begins fiscal year 2023 (FY23) some new RAFT policy changes went into effect on August 1, 2022.
The chart below shows how the policy based on application submission and processing dates: The chart below shows how the policy based on application submission and processing dates:
As a reminder, since the launch of the Homeowner Assistance Fund (HAF) program, homeowners are no longer served by RAFT.
More information: DHDC’s RAFT overview guide. - From RAFT Program Summary FY23, Tyler Newhall (OCD), August 1, 2022, forwarded by Amy Mullen (OCD), August 4, 2022.
September TAFDC Clothing Allowance – and Benefit Increase In addition to an increase in cash assistance grants, the MA FY23 budget also increases the annual clothing allowance for each child receiving TAFDC from $350 to $400. The clothing allowance increase means that a family with two children will get $100 more in assistance in September than they got last year, allowing kids to have new clothes to start the school year. Background Families receiving TAFDC benefits automatically receive a clothing allowance for each eligible child in September. Additionally, TAFDC income limits increase each year just for the month of September, allowing many low-income working families who otherwise wouldn’t qualify for TAFDC to qualify for the September clothing allowance. As noted above, this year the amount is $400 per eligible child. Families who apply and qualify because of the clothing allowance, will NOT receive cash benefits in addition to the clothing allowance, but may be able to receive one year of MassHealth benefits and subsidized child care. More information: TAFDC September Clothing Allowance- Adapted in part from Support MLRI's High-Impact Advocacy, Mass Law Reform Institute, August 18, 2022.
MA Homeowner Assistance Fund Institutes New Benefit Cap As of September 1, 2022 Mass Homeowner Assistance Fund (HAF) program assistance will be capped at $50,000 per household. This applies to applications submitted on September 1 and after. This does not affect applications submitted prior to September 1, 2022. What does this mean? If a homeowner is eligible for the Mass HAF program, Mass HAF will pay up to $50,000 in assistance. The homeowner’s servicer may be able to offer a plan to help the homeowner with the remaining amount owed. If a homeowner owes more than $50,000, they are encouraged to still apply at massmortgagehelp.org. Why is this change being implemented? Through August 15th, over 1,466 homeowners have received over $27.6 million in HAF assistance. Learn more about Mass HAF program at mass.gov/haf About Mass HAF Mass HAF is a state program that provides mortgage relief funded through the federal American Rescue Plan Act. The assistance provided includes counseling and for eligible homeowners, financial assistance for delinquent mortgage payments. It is a grant not a loan; homeowners do not have to pay it back. Applicants must be at least three months behind on their mortgage payments because of financial hardships suffered during the pandemic. If you have questions about HAF, please email masshaf@mhp.net. Eligible homeowners:
Homeowners can check if they are eligible by completing a short online pre-screener. Applying for Mass HAF To apply, go to massmortgagehelp.org. Applicants will register for an account using an email address. The application is available in multiple languages. Application Help
From Mass HAF program changes effective September 1, 2022, Mass HAF, August 25, 2022.
Covid-19 Public Health Emergency Expected to Be Extended State and local public health officials are expecting the Biden administration to extend the Covid-19 public health emergency for another 90 days in mid-October. An extension would ensure expanded Medicaid coverage, telehealth services, boosted payments to hospitals and other pandemic measures remain in place beyond the midterm elections even as public health experts and lawmakers debate the merits of a PHE that was first declared in January 2020. Among other impacts, for SNAP benefits this would mean:
The administration has not notified groups that the PHE would end, a courtesy HHS has said it would issue 60 days before the Covid-19 declaration is terminated. The 60-day notice would have been issued in the middle of August under that pledge. “Silence from the administration means that the public health emergency will almost certainly be extended into January 2023,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. - See the full Politico article with additional material from the July MGH Community News.
Biden Announces Student Loan Forgiveness After more than a year of debates, protests, meetings, and deliberations, President Biden is fulfilling a campaign promise to cancel some of the federal student debt held by millions of Americans. Under the plan, borrowers can qualify for up to $10,000 in student loan forgiveness, and recipients of Pell Grants are eligible for an additional $10,000 in forgiveness. Only borrowers earning under $125,000 per year — or $250,000 per year, for a married couple filing taxes jointly — qualify. The Biden administration also announced that it is extending the current moratorium on payments until Dec. 31 and implementing a new cap on the maximum monthly payments of undergraduate borrowers, among other changes. The White House estimates roughly 43 million federal student loan borrowers are eligible for forgiveness, and about 20 million could have their debt completely wiped out, according to a senior administration official who briefed reporters on Wednesday. The policy will deliver the single largest discharge of education debt on record. Here is what you need to know about the cancellation plan: How do I get student loans forgiven? The Biden administration said Wednesday that most borrowers will be required to fill out a form with the Education Department to certify that they qualify under the new income guidelines. Education officials are expected to provide more information in the coming weeks about where borrowers can fill out the application. Administration officials also estimate that roughly 8 million borrowers have already provided their income to the Education Department and may not need to take any additional steps to see their debt reduced. Who qualifies for student loan forgiveness? The vast majority of Americans with federal student debt are below the income threshold and would qualify for Biden’s plan. Still, implementation challenges could mean many people who are eligible can’t take advantage of the policy. Some advocates worried that the Education Department forms will provide a barrier for forgiveness for lower-income borrowers, because many borrowers may not go through the process of applying. Will private loans be forgiven? No, education loans originated and held by private lenders are ineligible for cancellation. Are graduate student loans eligible for forgiveness? Yes. Under the new policy, graduate student loans are eligible for up to $10,000 in debt forgiveness. They are not eligible for the additional $10,000 offered to Pell Grant recipients. Roughly 1.6 million borrowers have Grad PLUS loans subsidized by the federal government, but millions of other graduate students have private unsubsidized loans, according to Huelsman. Are Parent Plus loans eligible? Yes. Parent Plus loans — federal loans taken out by parents to pay for their children’s education — are eligible for the $10,000 in cancellation under the White House plan, subject to the income thresholds. Roughly 3.6 million borrowers hold Parent Plus loans, according to Huelsman. Are current students eligible? Current students will qualify for loan forgiveness if their parents’ income is below the cap required to qualify, the senior administration official told reporters Wednesday. Loans must have been originated before July 1 to qualify. Does the plan cap what undergraduate borrowers have to pay? The Biden administration on Wednesday proposed creating a new repayment plan tied to borrowers’ earnings, capping monthly payments for undergraduate loans to 5 percent of a person’s discretionary income instead of 10 percent. It also would raise the amount of income that is considered non-discretionary and forgive balances after 10 years of payments, instead of 20 years. The new rule probably will take effect next summer. This policy significantly increases the cost of Biden’s reforms, but it will also provide long-term relief to future borrowers. Can I take out loans now and have them forgiven under this policy? No. Loans must have been originated before July 1 to qualify. How will the government determine my income for qualifying for forgiveness? Borrowers will qualify for loan forgiveness if they earned less than the income cap in either 2020 or 2021, according to the White House official. I owe more than $10,000. When do my payments restart? Biden said he will extend a pause on federal loan payments until Dec. 31 — which extends the moratorium beyond the midterm elections. That could give the Education Department enough time to recalculate borrowers’ monthly payments based on their new lower balances. More than 41 million federal student loan borrowers have not had to make payments or accrued interest on their debt since March 2020, under the pause initially implemented by President Donald Trump at the start of the pandemic and then continued by Biden. Will I have to pay taxes on forgiven student debt? No. The $1.9 trillion stimulus package Biden signed into law last year temporarily eliminated the tax burden many student loan borrowers would face if any portion of their debt was discharged. The tax relief is good only through January 2026, but that’s long enough to cover borrowers benefiting from this one-time cancellation. - See the full Boston Globe article.
New 2022 DACA Rule On August 25, 2022, the Biden Administration published a new rule enshrining the DACA program in federal regulations. The new rule is scheduled to take effect on October 31, 2022. What is DACA? Established by President Obama in 2012, DACA (Deferred Action for Childhood Arrivals) allowed hundreds of thousands of young undocumented immigrants to live and work legally in the U.S., subject to renewal every two years. To qualify, you had to be undocumented when the program was announced; have arrived in the U.S. prior to your 16th birthday; have lived continuously in the U.S. since June 15, 2007; be in school or have graduated, obtained a GED, or been honorably discharged from the military; and have no serious criminal record. What does the new rule say, and is it different from the DACA program that has been in place since 2012? The new rule keeps in place the same eligibility rules as the DACA program that has been in place since 2012. In order to be eligible, individuals must still meet the same presence, age, and education requirements. The new rule differs in small ways. For example, once the new rule takes effect, individuals can choose to apply for Deferred Action (protection from deportation) without also applying for a work permit. More Information- see the MIRA DACA Factsheet. - From DACA Update – FAQ, Estefany Pineda, MIRA Coalition, August 25, 2022, and the DACA Factsheet. Thanks to Fiona Danaher for sharing.
MGfC Pediatric Bereavement Pilot Program In January 2022, Mass General for Children (MGfC) launched the Pediatric Bereavement Program, a two-year pilot program to provide bereavement supports and resources for families who have experienced the death of a child who was cared for at MGfC, as well as for their clinical caregivers. The program aims to help families navigate the first two years of their grief. This includes helping families transition from hospital to community supports; coordinating funeral arrangements; guiding families in how to best support their other children; paying attention to family mental health and making referrals to mental health providers, if needed. The team also checks in with families by phone, virtual visit or in person on particular milestones after a child’s death. This can include birth and death dates, special holidays, Mother’s Day, Father’s Day and milestone anniversaries that are known to be challenging, such as one month, six months, one year and two years. The team connects families to resources that are personalized to them, based on preferred language, cultural beliefs, faith and nature of the child’s illness or death. Living with Grief“After a child dies at the hospital, the families must leave the place that holds so many memories for them, whether their child was here for an extended length of time or just a few hours. In the hospital, they have experienced the loving guidance of staff journeying with them as their child nears death,” said Mary Barber Bussiere, LICSW, a social worker and program coordinator for the Pediatric Bereavement Program.. “We help families maintain a connection to people and to a place that hold a lot of meaning.” Even when a child dies elsewhere, the clinical caregivers who have been part of the child’s medical care can remain a source of comfort and guidance. To contact the Pediatric Bereavement Program directly or to make a referral, email MGHFCBP@mgh.harvard.edu or call 617.724.5962. - See the full story on the Mass General website.
New MA Hate Crimes and Threat Report Hotline In response to an uptick in neo-Nazi activity in Massachusetts, US Attorney Rachael Rollins this month launched the “End Hate Now” hotline, her office announced. Residents who suspect white supremacist activity or any other form of hate crime can report it by calling 1-83-END-H8-NOW (1-833-634-8669). Massachusetts has experienced a spate of white supremacist demonstrations, including an anti-LGBTQ+ demonstration outside a children’s drag queen story hour in Jamaica Plain last month. Also in July, about 100 Patriot Front members marched through the city over the Independence Day weekend. Rollins also announced the leadership of a newly created criminal division known as the Civil Rights and Human Trafficking Unit. Assistant US Attorney Elizabeth Riley will serve as the unit chair and will supervise a staff of three assistant US attorneys, Rollins said. Rollins says her office's has gotten over 50 calls in its first two weeks. In an interview with Radio Boston, she said the response shows there's "an appetite for this type of assistance" from the government. - From Last-minute scrambling, WBUR Today, August 18, 2022.
A New Home for Recently Incarcerated Transgender People The house is run by Black and Pink Massachusetts, a prison abolition group that focuses on helping LGBTQ people who are incarcerated. “I really wanted to make a space that was different, to make a space where folks could really come and heal from the trauma of such a dehumanizing process as incarceration,” said house coordinator Erin McLaughlin. “I wanted it to be where you could grow and flourish and experience that warmth and life incarceration has tried to deny them.” The new house, which opened for applications August 15, has been carefully crafted to fill an unmet need by providing temporary housing to some of those individuals who find it hardest to find housing. It has four beds, with a fifth reserved for short-term emergency stays. McLaughlin, the house’s only full-time employee, said residents could start arriving within weeks. The organization got five applications just in the first couple of days. “Homelessness is just endemic in the trans community,” said Michael Cox, executive director of Black and Pink Massachusetts. “It really is a crisis.” In a survey of its incarcerated members, Black and Pink Massachusetts found that 52 percent of respondents reported they would be homeless upon release. The house is called the Alexia Norena House, named for a transgender woman and member of Black and Pink Massachusetts who was chronically homeless and fatally overdosed while living in a tent in Cambridge. McLaughlin, a transgender woman who is trained as a lawyer, spent time in law school doing legal work for people who are incarcerated. She plans to work with the residents to make referrals to whatever services they need – connecting them with transgender-focused health care services and helping them find job training and permanent housing. The organization will use its existing relationships with organizations that help transgender people like Fenway Health and the Massachusetts LGBT Chamber of Commerce. The housing will be free for the first couple of months, then residents will be asked to pay what they can afford. There is no time limit on how long residents can stay, which Cox said is due to the understanding that different people take different amounts of time to find a job, housing, and whatever they need to reenter the community. The emergency bed will be available if, for example, someone gets released on a Friday and can’t enter their housing until Monday, or if someone is unexpectedly bailed out or has a court case dismissed but has nowhere to go. It is open to anyone who was incarcerated regardless of offense type. While substance use will be discouraged, someone who uses alcohol or drugs will not be automatically kicked out. There is one other house in the state that provides emergency shelter to transgender people, run by the Transgender Emergency Fund of Massachusetts. That house opened in May in Dorchester and offers up to a year of housing for eight people who are transgender or gender nonconforming. Chastity Bowick, executive director of the Transgender Emergency Fund of Massachusetts, said she does not know of any other similar houses in New England, although the need for it is great. Bowick said transgender people are more likely to be discriminated against in employment, then end up on the streets. They may be kicked out of their family’s home at a young age. They are often excluded from or harassed in shelters. “It’s a cycle of oppression,” Bowick said. “The society system is not set up to help us become sustainable.” The Transgender Emergency Fund house offers services to help people sustain themselves, teaching life skills, referring them to job coaching or culturally appropriate health care services, and helping them find housing and employment. It is funded through a one-time grant from the state, which will end next month, and Bowick is fundraising, applying for additional grants, and hoping for more public support. The demand far outstrips supply: the organization has received 56 applications for eight spots. But Bowick said she cannot serve the same population the Black and Pink house can. Because the emergency fund’s house is located within a school district, it cannot accept sex offenders or people with open cases for certain criminal offenses. For people with those types of criminal records, the Black and Pink house will be a valuable option. - See the full CommonWealth Magazine article.
Inflation Reduction Act’s Medicare Prescription Drug Reforms The Inflation Reduction Act of 2022 (IRA), which Congress passed last week, includes sweeping Medicare prescription drug reforms and changes to the Part D program to protect people with Medicare from high out-of-pocket costs. Justice in Aging’s new fact sheet provides a summary of the IRA’s health provisions that will bring cost savings to low-income older adults. Here’s a list of the policies the Act will impact:
Read more detail in the Fact Sheet. - From New Fact Sheet: How New Medicare Prescription Drug Reforms Will Help Older Adults, Justice in Aging, August 17, 2022.
State to Expand Taxpayer-Subsidized Health Coverage The state’s subsidized health insurance system is slated for its largest expansion in nearly a decade after lawmakers brushed aside Gov. Charlie Baker’s objections to approve the plan. Approved by the Legislature in the final days of its two-year session, the plan calls for a two-year pilot program expanding eligibility for ConnectorCare, the state’s subsidized health insurance program. Once the program gets underway in June 2023, coverage would be offered to individuals and families earning up to 500% of the federal poverty level, or about $139,000 for a family of four. The current level is 300% of the poverty level. Advocates say the program would offer lower premiums and deductibles, as well as other subsidies to families, which offer ConnectorCare coverage to another 37,000 individuals who currently don’t qualify. The expansion targets middle-income individuals and households who make too much money to qualify for coverage from MassHealth, the state’s Medicaid program, but are still struggling to afford the cost of private health plans. But lawmakers overrode Baker’s objections less than a day later, restoring the expansion pilot to the budget. The move will cost $140 million to $150 million over the two-year period, according to estimates. But supporters say the state has accrued savings from enhanced federal subsidies for health insurance provided during the pandemic, which will more than cover the cost of the pilot program. The ConnectorCare program, which was created as part of the state’s landmark 2006 health care law, offers low-premium plans with no deductible and limited cost-sharing to about 150,000 members. The changes approved by lawmakers will be the largest expansion of state subsidized coverage since the implementation of the federal Affordable Care Act in 2014, advocates say. The move is backed by the Massachusetts Medical Society, which represents physicians. Dr. Theodore Calianos, the society’s president, said the changes will “allow more of our patients to have high-quality insurance while reducing out-of-pocket costs at a time in which so many individuals and families need help.” Massachusetts law requires people to have health coverage, and the state boasts one of the highest insurance coverage rates in the nation. But advocates said studies have shown at least a quarter of residents have “unmet health care needs” due to high costs, and more than half face challenges affording care. Still, critics say it would create a “cliff” when the two-year pilot project expires, forcing the state to either come up with funds to continue the subsidies or drop coverage for tens of thousands who received it as part of the expansion. - See the full Salem News article.
To Call or Not to Call 988? When the 988 Suicide & Crisis Lifeline launched last month, many mental health providers, researchers and advocates celebrated. Although a national suicide hotline had existed for years, finally there was an easy-to-remember three-digit number for people to call, they said. The shorter number would serve as an alternative to 911 for mental health emergencies. But not everyone felt the same way. Some advocates and people who had experiences with the mental health system took to social media to voice concerns about 988 and warn people not to call it. One Instagram post said, "988 is not friendly. Don't call it, don't post it, don't share it, without knowing the risks." The post, which had garnered nearly a quarter of a million likes as of early August, went on to list the risks as police involvement, involuntary treatment at emergency rooms or psychiatric hospitals, and the emotional and financial toll of those experiences. Why are some people saying not to call 988?Liz Winston, who authored the Instagram post calling 988 "not friendly," said she wanted people to understand all the potential outcomes of calling so they wouldn't be blindsided by the "traumatizing system" that she experienced. Last summer, Winston was having suicidal thoughts and visited a hospital in New York. She hoped to speak with a psychiatrist but instead was involuntarily detained in the psychiatric wing of the emergency room. She said that she did not receive any counseling during the 24 hours she spent there and that the experience was "extremely traumatic." Winston hadn't called the hotline, but she said those who do can end up in a similar situation. It's true that when police respond to calls about people in mental health crises, they often take them to an emergency room or psychiatric hospital. Research shows suicide rates increase drastically in the months after people are discharged from psychiatric hospitals. Those who were sent involuntarily are more likely to attempt suicide than those who chose to go, and involuntary commitments can make young people less likely to disclose their suicidal feelings in the future. Some people also get stuck with large bills for treatment they didn't want. Emily Krebs, a suicide researcher and assistant professor joining Fordham University this fall, said that involuntary treatment is viewed as a necessary part of suicide prevention in the U.S., but that other countries don't see it that way. The United Nations has called forced mental health treatment a human rights abuse and asked countries to ban it. Like Winston, Krebs wanted people to be fully informed before deciding to call 988. That's why she wrote on Twitter that 988 can and will "send police if they deem it necessary." Officials from 988 say they recognize the risks of having law enforcement officers involved in mental health emergencies. That's why 988 was created as an alternative to 911, said John Draper, executive director of the hotline and a vice president at Vibrant Emotional Health, the company tasked with administering it. "We know the best way for a person to remain safe from harm is for them to be empowered and to choose to be safe from harm," Draper said. Dispatching police is a last resort, he said. Counselors who answer the phones or respond to texts and online chats for 988 are supposed to be trained to actively listen, discuss the callers' concerns and wishes, and collaborate with them to find solutions. Most calls about suicide are de-escalated without law enforcement, Draper said. Instead, counselors talk through people's reasons for dying and reasons for living; have callers connect with supportive family, friends, religious leaders or others in their community; refer callers to outpatient treatment; or set up follow-up calls with 988. Only when the caller cannot or will not collaborate on a safety plan and the counselor feels the caller will harm themselves imminently should emergency services be called, according to the hotline's policy. At that point, Draper said, "we have the choice of just letting [harm] happen or doing whatever we can to keep them safe." In previous years, before the 988 number launched, emergency services were dispatched in 2% of the hotline's interactions, the service reported. With about 2.4 million calls a year, that means emergency services were initiated for roughly 48,000 calls. Those services can be mobile crisis teams, consisting of people trained in mental health and de-escalation, but in many rural and suburban communities, it is often police. Contrary to some information circulating on social media, 988 cannot geolocate callers, Draper said. When emergency services are called, 988 call centers share with 911 operators information they have about the location of the person who contacted the hotline — typically a caller's phone number, with area code, or a chat user's IP address — to help first responders find the individual. Starting this fall, Draper said, 988 will update its policies to require supervisors to review all calls that result in the use of emergency services. Counselors for 988 nationwide will also receive additional training on the alternatives to involving law enforcement and the consequences callers can face when police respond. So should I use 988 or not?We know it's not satisfying, but the honest answer is: It depends. Sonyia Richardson, a licensed clinical social worker who owns a counseling agency that serves mostly Black and brown clients in Charlotte, N.C., said she didn't immediately tell her clients about 988 when it launched. Even though she's a member of her state's 988 planning committee, she said she needed time to develop trust in the service herself. When she learned at a recent committee meeting that fewer than 5% of 988 calls in North Carolina led to a law enforcement response, she felt reassured. "There are going to be issues perhaps with 988, but it might be one of the safer options for us," Richardson said. With suicide rates increasing among Black Americans, the community needs more ways to save lives, she added. If I don't want to call 988, do I have other options?Although the U.S. doesn't have a national, government-run mental health hotline that pledges not to call police without callers' consent, several alternatives that are smaller than 988 aim to decrease law enforcement involvement. "Warm" lines are one option. They're typically staffed by "peers," people who have experienced mental health challenges. They focus less on crisis intervention and more on emotional support to prevent crises. You can find a directory of warm lines by state here. Below are other hotlines and resources. This is not a comprehensive list, and some resources may limit their services geographically.
- See the full WBUR story.
New MA Mental Health ABC Act: Addressing Barriers to Care Law The Mental Health ABC Act: Addressing Barriers to Care is now the law in Massachusetts! This landmark piece of legislation will expand access to mental health care and make important advances in ensuring that residents of the Commonwealth get the mental health care they need when they need it. The law makes vital investments in the behavioral health care workforce, including social workers. It also provides the state with the tools needed to enforce existing mental health parity laws designed to ensure that health care systems treat mental health with the same importance given to physical health. Below are selected highlights of the new law: Enforcing Mental Health Parity Laws. This law provides the state with better tools to implement and enforce parity laws by creating a clear structure for state agencies to receive and investigate parity complaints and ensure their timely resolution. Defines clinical social work practice by addressing the different facets of practice within the profession so they are not left to interpretation. Clearly defining clinical social work practice ensures that the licensing board or other entities cannot deny master’s level social workers from advancing to the LICSW level of licensure. Initiatives to Address Emergency Department Boarding. This law creates online portals that provide access to real-time data on youth and adults seeking mental health and substance use services and includes a search function that allows health care providers to easily search and find open beds using several criteria; requires the Health Policy Commission (HPC) to prepare and publish a report every three years on the status of pediatric behavioral health as the youth boarding crisis is particularly acute; requires the Center for Health Information and Analysis (CHIA) to report on behavioral health needs; updates the expedited psychiatric inpatient admissions (EPIA) protocol and creates an expedited evaluation and stabilization process for patients under 18. Red Flag Laws and Extreme Risk Protection Orders. This law initiates a public awareness campaign on red flag laws and extreme risk protection orders (ERPOs) that limit access to guns for people at risk of hurting themselves or others. Reimbursing Mental Health Providers Equitably. The law requires an equitable rate floor for evaluation and management services that is consistent with primary care. Reforming Medical Necessity and Prior Authorization Requirements. This law mandates coverage and eliminates prior authorization for mental health acute treatment and stabilization services for adults and children and ensures that if a health insurance company intends to change its medical necessity guidelines, the new guidelines must be easily accessible by consumers on the health insurance company’s website. Creating a Standard Release Form. This law directs the development of a standard release form for exchanging confidential mental health and substance use disorder information to facilitate access to treatment by patients with multiple health care providers. Increasing Access to Emergency Service Programs. The law requires health insurance companies to cover Emergency Service Programs (ESPs), community-based and recovery-oriented programs that provide behavioral health crisis assessment, intervention, and stabilization services for people with behavioral health needs. Establishing an Office of Behavioral Health Promotion. The law establishes an Office of Behavioral Health Promotion within the Executive Office of Health and Human Services (EOHHS) to coordinate all state initiatives that promote mental, emotional, and behavioral health and wellness for residents. Increasing Access to Care in Geographically Isolated Areas. This law directs the Department of Mental Health (DMH) to consider factors that may present barriers to care—such as travel distance and access to transportation— when contracting for services in geographically isolated and rural communities. Enhancing School-based Behavioral Health Services and Programming. This law enhances school-based behavioral health supports, increases access points for effective behavioral health treatment by limiting the use of suspension and expulsion in all licensed early education and care programs and public schools, and creates a statewide technical assistance program to help schools implement school-based behavioral health services. Expanding Insurance Coverage for Vulnerable Populations. This law ensures individuals over 26 years old who live with disabilities can remain on their parents’ health insurance. Creating a Roadmap on Access to Culturally Competent Care. Under this provision, an interagency health equity team under the Office of Health Equity, working with an advisory council, will make annual recommendations for the next three years to improve access to, and the quality of, culturally competent mental health services. Paired with the Legislature’s ARPA investment of $122 million in the behavioral health workforce through loan repayment assistance programs, this roadmap will make great strides toward building a robust workforce Expanding Mental Health Billing. This law allows clinicians practicing under the supervision of a licensed professional and working towards independent licensure to practice in a clinic setting. Updating the Board of Registration of Social Workers. The law updates the membership of the Board of Registration of Social Workers to clarify that designees from the Department of Children and Families (DCF) and Department of Mental Health (DMH) be licensed social workers. Additionally, in 2019, the state licensing board denied masters-level DCF social workers and hospital social workers the opportunity to sit for the LICSW exam because of their interpretation of what clinical social work practice entailed. This bill will ensure that the definition of clinical social work practice is not left to the discretion of others in the future. View the bill's Fact Sheet here for more information. - See the full NASWMA story with additional material from Mass Insider.
Hearing Aids Soon Available without Prescription Adults with perceived mild to moderate hearing impairment will be able to buy hearing aids directly from stores, pharmacies and online retailers — no prescription or doctor's appointment required — as soon as mid-October. That's thanks to a final rule issued by the U.S. Food and Drug Administration and set to take effect in two months, following years of campaigning by lawmakers and advocates. It creates a new category of over-the-counter hearing aids, which the Biden administration says will make the devices more accessible and affordable for millions of Americans. The new rule applies only to certain air-conduction hearing aids for people ages 18 and older who experience mild to moderate hearing impairment, meaning those that are intended for pediatric use or severe hearing impairment will remain prescription devices. It also does not apply to "personal sound amplification products," consumer products that help people with normal hearing amplify sounds. This rule is an important step to improve access to hearing aids. Currently, hearing aids are prescription-only devices that require exams and fittings by hearing health professionals, and the costs for these visits and devices can run well into the thousands of dollars. This price tag has put hearing aids out of reach for millions. OTC devices are not recommended for people with severe hearing loss or people under the age of 18. While they will not require a hearing exam, experts recommend that people have exams if they experience sudden or severe hearing loss, pain, tinnitus or ringing, or fluid in their ears. They also recommend that people choose their OTC devices carefully, including researching return policies, battery life, and volume, among other considerations. Untreated hearing loss can significantly reduce a person’s quality of life, making them feel isolated or frustrated, and leaving them potentially unable to follow important conversations like instructions from medical personnel. Hearing loss is also associated with depression and cognitive decline, increasing the urgency of getting help to those who need it. Medicare Rights welcomes this rule and the access it will create for many people with Medicare. But it does not eliminate the need for comprehensive Medicare coverage of hearing services. Currently, Traditional Medicare offers no hearing aid coverage. While some Medicare Advantage plans might, it is generally limited, leaving care unaffordable for too many. We will continue to urge Congress to expand Medicare Part B coverage to include comprehensive hearing benefits, as well as dental and vision, to better serve the older adults and people with disabilities who rely on the program. - See the full Medicare Rights article and the full WBUR story.
Baker Signs Bill Protecting Abortion Access A sweeping abortion bill designed to protect access to the procedure in Massachusetts at a time when many other states are restricting or outlawing abortions was signed into law late last month by Gov. Charlie Baker. The new law attempts in part to build a firewall around abortion services in the state after a U.S. Supreme Court ruling overturned Roe v. Wade last month. The bill also states that access to reproductive and gender-affirming health care services is a right protected by the Massachusetts Constitution; requires the state’s insurers, including the state’s Medicaid program, known as MassHealth, to cover abortions without copays; allows over-the-counter emergency contraception to be sold in vending machines; and requires public colleges and universities to create medication abortion readiness plans for students. A unique Texas law banning most abortions after about six weeks is enforceable through lawsuits filed by private citizens against doctors or anyone who helps a woman obtain an abortion. Many elements in the new law echo steps Baker took in an executive order he issued immediately after the Supreme Court handed down its ruling. The new law also addresses the question of permitting an abortion for a pregnancy that has lasted 24 weeks or longer. Under the bill, the abortion would be allowed if, in the best medical judgment of a physician, it is necessary to preserve the life of the patient, necessary to preserve the patient’s physical or mental health, warranted because of a lethal fetal anomaly or diagnosis or warranted because of “a grave fetal diagnosis that indicates that the fetus is incompatible with sustained life outside of the uterus without extraordinary medical interventions.” The vast majority of abortions occur before 20 to 21 weeks of pregnancy. In 2019, almost 93% of abortions occurred at or before 13 weeks’ gestation, while only 1% of abortions occurred at 21 weeks or later, according to data from the Centers for Disease Control and Prevention. Other portions of the bill would allow any licensed pharmacist to dispense emergency contraception and require the Public Health Department to identify areas in the state without access to abortion within a 50-mile (80-kilometer) radius and recommend ways to ensure access to abortion in those areas. Gender Affirming Care The new law also protects Massachusetts providers and patients in Massachusetts from legal repercussions for providing or accessing gender affirming care like hormone therapy or gender reassignment surgery for transgender individuals. - See the full WBUR story and the Commonwealth Magazine article.
Postponement of Out-of-Network Patient Protections in Massachusetts Act On July 5, 2022, the Commonwealth of Massachusetts re-extended the implementation and enforcement date for the “Patients First Act”, sometimes referred to as the Massachusetts No Surprises Act, to January 1, 2025. The law requires Massachusetts health care providers to disclose additional information to their patients about the cost of scheduled hospital stays, medical procedures, health care services, or referrals, based on the patient’s specific health insurance. The penalties in Massachusetts were originally set to start on January 1, 2022. The Massachusetts Department of Public Health first delayed these penalties until July 31, 2022, and recently re-extended the enforcement date to January 1, 2025. Many in the industry struggled with how to operationalize the new Massachusetts law while simultaneously addressing the Federal No Surprises Act and regulations that have overlapping obligations. This new delay in implementation reflects the Commonwealth’s appreciation of those challenges. We should also note that our reading of the statute is that not only are the penalties delayed, but the statute is not self-implementing and implementation is delayed as well, meaning that the requirements under this law are not effective until January 1, 2025. - See the full Foley.com blog post, shared in the August 5, 2022 MHA’s Weekly WRAP-UP.
Mass. Boosts Anti-Discrimination Funding to Help Clear Complaint Backlog The Massachusetts Commission Against Discrimination will receive an additional $3.3 million in funding in this year's state budget, following a WBUR report detailing wait times of well over a decade (and reported here last month). The money is in the new FY23 budget Gov. Charlie Baker signed this month. "It’s going to be a game changer," Chang-Díaz said. "I know it's going to take time for the MCAD to fill the staffing shortages that they've been experiencing in recent years, but this is a huge step forward." "These funds will directly impact the Commission’s ability to accept, investigate, adjudicate and resolve complaints of discrimination," said MCAD Chairwoman Sunila Thomas George in a statement. - See the full WBUR story. |
