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MGH Community News |
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MGH Community News |
| April 2024 | Volume 28 • Issue 4 |
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. |
Family Shelter Time Limits Likely Massachusetts legislative leaders have unveiled a long-debated spending package that proposes to limit how long homeless and migrant families can stay in the state’s emergency shelter system while pumping hundreds of millions more dollars into the overwhelmed program. The announcement of an agreement follows weeks of closed-door talks between the House and Senate budget chiefs and as officials warn the system is nearly out of money. House Speaker Ronald Mariano and House budget chief Aaron Michlewitz said in a joint statement the plan will “ensure that the system can remain financially viable long term by limiting the maximum length of stay, and by taking significant steps to help folks in the shelter system to successfully enter the workforce.” It would dedicate $251 million in surplus money to fund the emergency shelter system through the end of the fiscal year and clear the state comptroller to transfer another $175 million for the next fiscal year. Lawmakers also propose limiting the maximum stay for most homeless families to nine consecutive months. (There is no current limit on stays in state-run shelters.) The plan allowed certain individuals to receive up to two 90-day extensions. They include veterans, single parents, parents of children with a disability, or people who have made progress toward receiving a permit to work. It also builds in the option for those facing certain hardship to apply for waivers for “additional extensions.” It also sets aside money for job training, a tax credit for companies that provide training to people in the shelter system, and money for those providing services in the shelters. The total funding included in the proposal amounts to about half of what Healey’s administration says the shelter program will need next fiscal year to stay afloat. The proposal marks the second time in less than six months that lawmakers raced to keep the shelter system funded. The Legislature included a $250 million infusion for the program in a separate spending bill it passed in December only after dozens of Democrats showed up for an informal session to break a GOP logjam. The compromise legislation will go before both chambers for another vote before it can be sent to the governor’s desk for her signature or veto pen. Beacon Hill leaders have for months grappled with how to cover the system’s exploding costs. The House this month released a state budget plan that dedicates $500 million to the state’s strained emergency shelter system, including using $175 million from the state surplus account.
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But even that total accounts for roughly half of the $915 million the Healey administration has said the program will need next fiscal year to stay afloat. Healey has already imposed some limits on the shelter system, last year capping capacity at 7,500 families. And on May 1, state officials will begin to limit stays in state-run overflow shelters to 30 days, requiring people to reapply monthly and show they are also seeking work authorization, pursuing new housing, or taking other steps to stay in the rapidly expanding program. Overflow shelters are separate from the state-run emergency shelter system, serving to temporarily house families on the waitlist to get into the larger system. State officials said Wednesday that 730 families were on the waitlist. Some advocates balk at the idea of putting time limits on shelter stays and worry about the added bureaucracy that would come with applying for an extension. Kelly Turley, associate director of the Massachusetts Coalition for the Homeless, said creating “artificial time limits” without additional resources won’t help families exit shelters faster. “We’re concerned that the blame will be on families for not succeeding,” she said. “There are 730 families on the waiting list today. We already know that the current system isn’t meeting all of the families’ needs.” An analysis obtained by MassLive details how the money in the compromise funding plan, if enacted, will be spent, and the conditions the state will impose on those in the system. The plan spends:
That includes:
The conditions:
The bill further requires the Healey administration to “complete an individual rehousing plan and case management for all families and pregnant women receiving benefits through the [Emergency Assistance] program.” In addition, the state’s Executive Office of Housing and Livable Communities also must “ensure, every 60 days, that all [EA] recipients who have been in the system for at least 2 months are compliant with rehousing plans and case management. If they’re not, beneficiaries will lose their eligibility to stay in the in the EA program, the analysis indicated. The compromise plan also establishes a “hardship waiver” for additional extensions, based on “written certification of hardship” by the state’s housing secretary. It further gives Gov. Maura Healey until May 15 to seek the U.S. Department of Homeland Security’s approval for a waiver that would speed up work authorizations for “newly arriving migrants, refugees, and asylum seekers to create a pathway to work and to alle - See the full Boston Globe article and the full MassLive article.
State SNAP Benefits for Certain Legal Immigrants Ending Unless Additional Funding Approved The MA Department of Transitional Assistance (DTA) has announced that MA state-funded SNAP benefits for certain legally-present non-citizens is nearing to exhausting allotted funding, and, unless the MA Legislature authorizes additional funding, the payments sent in early April are likely the last full payments these members will receive. This is expected to impact about 4,000 immigrant-headed households who will lose roughly $200 per person per month in SNAP benefits. Roughly 4,000 immigrant-headed households currently receive state-funded SNAP benefits. Federal SNAP will continue for US citizens and eligible immigrants in "mixed status" SNAP households - but the state SNAP will end (roughly $200/person/month in many of these households.) The Governor also did not include in her FY25 Proposed Budget (released in Jan) any request for state-funded SNAP this coming year (nor funding for any TAFDC or EAEDC grant increases). Background State funded-SNAP temporarily offered SNAP benefits to certain legally-present non-citizens who do not qualify for federal SNAP due to immigration status. Groups who were eligible for this program (if they met other eligibility criteria such as residency and financial limits) include Battered Immigrants/VAWA recipients, those with PENDING asylum applications, TPS, Deferred Action, U visas, Special Immigrant Juveniles, Humanitarian Parole and others “known to USCIS”. Advocacy Individual/family advocacy- Screen for eligibility for federal benefits. The rules for non-citizens are complex and DTA doesn’t always make the correct eligibility determination and status can change over time. Immigrants may also hold more than one immigration status with different associated benefits eligibility. Immigrants from certain countries also may have different eligibility rules – particularly folks from Afghanistan or Iraq and most recent arrivals from Cuba or Haiti.
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MA Child and Dependent Tax Credit – Including for Undocumented Kids and Those Who Don't Owe Taxes La Colaborativa has been working on the Child Tax Credit campaign, and we have an update we believe would be beneficial for our families with children enrolled. The Department of Revenue (DOR) will now issue temporary tax identification numbers for undocumented children who cannot obtain Individual Taxpayer Identification Numbers (ITINs) but are eligible for the Massachusetts Child and Family Tax Credit. What this means:
Why this is important: Previously, undocumented children faced challenges receiving the credit because the IRS wouldn't issue ITINs solely for state benefits. Thanks to DOR's decision, these children can now access the financial support they deserve. How to take advantage of this credit: Parents/guardians of eligible children must file a Massachusetts tax return to claim the credit. There is no deadline to claim the Child Tax Credit for 2023 on your tax return. You can still file and claim the credit even if it's past the standard filing deadline of April 15th, 2024.
The IRS doesn't check your immigration status when you apply for the Child Tax Credit. If you meet the eligibility requirements and file an accurate tax return, you can claim the credit regardless of your income source. For More Information For more details on the Child and Family Tax Credit, please visit the Mass.gov website. - From Child Tax Credit: Temporary Tax Identification numbers for undocumented children, Lina Tabar, La Collaborativa, April 26, 2024; additional material adapted from further email correspondence.
The Blue Envelope May Make Traffic Stops Safer for People with Autism State police in Massachusetts have begun implementing a program to improve interactions with people on the autism spectrum, building upon legislation that won Senate approval in January and remains before a House committee. Participating drivers can choose to place copies of their license, registration and insurance cards inside a blue envelope, which acts as a visual cue for police and other public safety officials during stressful and potentially dangerous traffic stops. The envelope would notify police that the driver is on the spectrum and provide guidance for how to handle certain behaviors, such as stimming. Drivers can also share emergency contact information on the envelope. Sample reverse side of CONNECTICUT's blue envelope
People on the spectrum can request the envelopes at state police barracks or online, according to a new state webpage. The envelopes are free, and people can request multiple envelopes if they have more than one car. Lt. Gov. Kim Driscoll touted the initiative, which state police developed with the Massachusetts Chiefs of Police Association and advocacy groups, during an event hosted by the Advocates for Autism of Massachusetts (AFAM) organization. "This is an initiative that reflects our administration's deep commitment to support programs that strengthen inclusivity and support law enforcement's ability to more effectively meet the needs of every single community member," Driscoll said. The Senate in early January passed legislation to also create a voluntary blue envelope program, directing the envelopes to be made available at Registry of Motor Vehicle offices. The bill, filed by Sen. Jo Comerford and now in the House Ways and Means Committee, did not carve out a specific responsibility for state police to use the envelopes, Comerford aides said. With the bill's fate in the House unclear, law enforcement and advocates have moved forward with their own program, which the Healey administration announced as it marked Autism Acceptance Month in April. State police implemented the initiative "with the cooperation of Senator Comerford," spokesman Dave Procopio said. Autism advocates warn that police, without training, can misinterpret the behavior of individuals on the spectrum — such as hand-flapping, body rocking or repeating certain phrases — and use force when it could have been avoided. State police are rolling out the blue envelopes to their barracks and working to share information with municipal police departments in the coming days, said Agawam Police Chief Eric Gillis, president of the police chiefs association. Blue envelopes "will soon be available at local police departments," the Executive Office of Public Safety said. "Our officers receive training in dealing with persons with autism and the different communication styles that are necessary for those interactions," Gillis told the News Service. "But to open the conduit right out of the gate with the blue envelopes lets our officers know across the commonwealth who're they dealing with, and that they need to kind of shift gears a little bit when dealing with that type of individual." For police officers, the envelope states the driver "may display repetitive body movements or fidgeting and may have unusual eye contact" and "may exhibit signs of high anxiety especially due to bright lights and noises such as your radio." Police are asked to "allow driver extra time to respond to your questions; they may have difficulty interpreting and processing your directions"; "use the most simplistic explanations possible, speak clearly, and limit unnecessary details or jargon"; "please clearly tell the driver when the stop is over and that they may leave"; and "if the driver becomes upset, ask and/or consider contacting the person listed on the reverse of this envelope." Drivers are given instructions that tell them to keep their hands on the steering wheel until they are told otherwise by police, provide the blue envelope to the officer, and ask the officer to consider calling their emergency contact. Drivers are warned "the officer may shine a flashlight in your car, may have a loud radio, and may have flashing lights on their car." The envelopes also contain QR codes, which out-of-state law enforcement can scan if they are unfamiliar with the program. - See the full WBUR story
Governor’s Council Approves Blanket Pardon for Cannabis Possession Charges The Governor's Council has unanimously approved Gov. Maura Healey's mass pardon that grants official forgiveness to anyone convicted of simple cannabis possession in Massachusetts. The courts must still work to identify people to whom the pardon applies and update their records, which one councilor called "an enormous task" that could require a shot of funding from the Legislature. "Massachusetts changed state laws around marijuana possession and this proposal is based on the simple premise of fairness and equity that a person should not bear the mark of conviction for an offense that is no longer a state crime," Suffolk County District Attorney Kevin Hayden told the council, referring to the 2016 ballot initiative that legalized adult-use cannabis. Councilor Terrence Kennedy of Lynnfield asked Hayden about the actual number of pardon recipients covered under the blanket action, noting that he heard the number "between 69,000 and 100,000" tossed around, and that Trial Court Chief Justice Heidi Brieger referred in a letter this week to "approximately 22,000 adult cases" contained in "electronic records." "Don't you think we should be making more of an effort to find those other people, and who they are? Most people that have a marijuana conviction don't know what's going on in this room today, and never will," Kennedy said. "... They're not going to get on a portal and fill out a form to get a pardon document. They're not going to be writing on a job application that they've been pardoned. Because they're never going to know it unless we reach out somehow. Don't you think we should be doing more?" "We should be doing as much as possible, I think," Hayden replied. "And I don't mean to be glib, but thankfully that's a problem I don't have to worry about. That's for the governor and probation office to worry about. ... We expressed this concern at the time that the issue was raised. It should be as automatic as possible." Healey and Driscoll have been clear that no action is needed on the part of recipients to receive their pardon, though they may apply for an optional pardon certificate if they wish to. "The exciting thing is, no one is required to take any additional action," Driscoll said after the assembly. "They are pardoned, effective at the Governor's Council vote." "The Governor's Office will use the list in two ways: (1) to review individual cases and make eligibility determinations for pardons; and (2) to verify information submitted to the Governor's Office by individuals requesting a pardon certificate. In both instances, the Governor's Office will provide to the Trial Court and [Massachusetts Probation Service], on a reasonably-paced and ongoing basis, the information pertaining to the individuals the Governor's Office has determined are eligible for a pardon. MPS and Trial Court Clerks will update their records accordingly," Brieger wrote. Kennedy struck a different tone about the newly-created administrative burden. He told the News Service that he "think[s] it's going to take some money" to accomplish. Some councilors underscored that a pardon alone does not remove the cannabis possession conviction from a person's criminal record, though would note on the record that it had been forgiven. Councilor Tara Jacobs said she recently learned the distinction between a pardon and expungement, a process which individuals would need to apply for that scrubs the record clean. As far as "really trying to get it really off people's records," Kennedy told Gonzalez it could be an area for future legislation. To request a pardon certificate: https://www.mass.gov/marijuana-pardons About the Marijuana Pardon Certificate You don’t need to request a marijuana pardon certificate to receive a pardon or for your records to be updated. State agencies will start automatically updating many records for those who are eligible for a pardon. Limitations in electronic court records will mean that not everyone will have their record updated that way. The certificate is proof of the pardon and may help remove civil or legal restrictions because of the conviction. Why would I need a Marijuana Pardon Certificate?
What offenses does this pardon cover?
The pardon does NOT apply to:
Will this pardon seal my criminal records?
- See the full WBUR story. Additional material from Marijuana Pardons Frequently Asked Questions | Mass.gov
USCIS Extends Work Permits United States Citizenship and Immigration Services (USCIS) is publishing a temporary final rule in the Federal Register to automatically extend the validity of Employment Authorization Documents (EADs) from 180 to 540 days. That means eligible immigrants whose EADs have expired since Oct. 27 will remain eligible to work for at least another 360 days, while their EAD renewals are processed.
“Over the last year, the USCIS workforce reduced processing times for most EAD categories, supporting an overall goal to improve work access to eligible individuals,” USCIS Director Ur Jaddou said. “However, we also received a record number of employment authorization applications, impacting our renewal mechanisms.” “Temporarily lengthening the existing automatic extension up to 540 days will avoid lapses in employment authorizations,” Jaddou added. “At the same time, this rule provides DHS with an additional window to consider long-term solutions by soliciting public comments, and identifying new strategies to ensure those noncitizens eligible for employment authorization can maintain that benefit.” USCIS will also benefit from the change: It has been aggressively rebuilding its processing capacity after the Trump administration refocused the agency away from processing applications, degrading its ability to deliver quick decisions. That reconstruction also came as asylum applications ballooned, adding to the agency’s historic backlog, though USCIS managed in fiscal 2023 to reduce that backlog for the first time in a decade. It’s the second time the Biden administration has announced an extension to 540 days. The first extension, announced in 2022, had a sunset on Oct. 27, 2023, when automatic extensions reverted to 180 days. All categories of immigrants covered by the 2022 extension will be covered by the new one as well. The implementation of 540-day extensions now also means the problem is unlikely to reoccur. Since September, USCIS has been granting five-year EADs to eligible immigrants, rather than the two-year EADs that were standard before. That gives USCIS a bigger cushion to prepare for any future potential mass expiration of EADs. Today, the Department of Homeland Security announced a temporary final rule will be published on Monday, April 8, 2024, extending work permits for 540 days for immigrants whose work permit renewal applications are stuck in processing backlogs. - See the full The Hill article. Additional material from MIRA Weekly Update –Celebrating Arab American Heritage Month, Action Alert - Safe Communities Act, MIRA Coalition, April 4, 2024.
Immigration Advocate Legal Helpline (for Providers) The MIRA Coalition, supported by a grant from the Massachusetts Attorney General’s office, launched an immigration helpline for service providers in Massachusetts on March 27th, 2024. This helpline number is open to all Massachusetts-based providers serving immigrants and refugees and accepts voicemails 24/7 at (508) 293-1871. Through this helpline, MIRA aims to provide community-based organizations with answers to the most commonly asked legal questions. By building on the community knowledge, providers will be able to better serve the immigrant and refugee population. Legal immigration organizations are facing increasing demands, while many immigrants face long wait times. This helpline will expand the capacity of the immigration legal services community by offering a channel for calls that would otherwise be routed to them. This will help free attorneys to focus on more complicated matters. How does it work?
- See the announcement on the MIRA website.
Mass Legal Help Website Relaunch The Massachusetts Law Reform Institute (MLRI) proudly announced the official relaunch of MassLegalHelp.org. MassLegalHelp.org offers free, practical legal information and resources to help members of the public learn about their legal rights in Massachusetts and take actionable steps to solve civil legal problems. The refreshed site features a modern, streamlined look that contains over 800 articles, e-books, and videos reviewed by substantive legal experts. MassLegalHelp.org is committed to enhancing access to justice for vulnerable people struggling with critical legal issues related to unemployment; housing; public benefits; family law; health care; domestic violence; money and debt; immigration; education; and more. MassLegalHelp has information for Massachusetts residents who are facing legal issues such as...
These are just a few of many examples! Explore more at MassLegalHelp.org. Note: MassLegalHelp does not offer legal advice or answer individual legal questions. We have a page on the site about options for finding a lawyer. Our team also runs the Massachusetts Legal Resource Finder, which gives Massachusetts residents targeted referrals to free and low cost legal sources of legal help, and Mass Legal Answers Online, an online legal advice website. “Over a million people each year use the MassLegalHelp website, often in moments of crisis. By providing information that folks can trust and presenting it in an understandable format, we hope to help make stressful situations less overwhelming and make the legal system more navigable,” said Marlena Idrobo, MassLegalHelp Website Project Manager at MLRI. “MassLegalHelp is committed to offering accessible legal self-help resources.” “Most people facing serious civil legal problems are not eligible for a free lawyer. Although Massachusetts’ civil legal programs provide free legal help to tens of thousands of people each year, they don’t have the capacity to help everyone who can’t afford a lawyer,” said Rochelle Hahn, Director, Massachusetts Legal Aid Websites Project. “MassLegalHelp leverages both technology and the substantive expertise of civil legal aid practitioners to fill this justice gap.” Over the past year, the MassLegalHelp team partnered with more than 60 subject matter experts, including legal aid staff, attorneys, and community partners to update the site’s content. The team incorporated user feedback through multiple rounds of user testing, including one with Spanish speakers. MassLegalHelp.org meets Web Content Accessibility Guidelines (WCAG), the industry standard for measuring accessibility for people with disabilities, with features like text-to-speech, stark color contrasts, and navigable pages for users of screen readers and keyboards. The team is in the process of translating content into Spanish, the second most common language spoken in Massachusetts. MassLegalHelp.org will continue to be regularly updated to ensure the most accessible and accurate information is presented to users. Learn more by visiting masslegalhelp.org and share it with others who may have civil legal questions. - See the full press release. Additional material from Do your clients need legal information? MassLegalHelp.org can help!, Rochelle Hahn, MLRI, April 29, 2024.
Free Online Publication – Surviving Debt The National Consumer Law Center’s (NCLC) publication Surviving Debt was recently named "the best all around guide to navigating debt" by Business Insider. It is a resource for consumers, counselors and other non-attorneys and is available for free download Surviving Debt | NCLC Digital Library - Free on-line publication from NCLC, "Surviving Debt", Jenifer Bosco, April 18, 2024.
Norfolk County Sheriff Opens Center to Help People Build Stable Lives After Incarceration The Norfolk County Sheriff's Office on Friday will open a center to offer support services to men who are transitioning out of the county jail, to help them re-enter society and rebuild their lives. The HOPE Center in Braintree will provide services including substance use treatment, 12-step recovery meetings, peer support and mental health support groups, and food, housing and employment assistance. The name stands for "healing, opportunity, purpose and engagement," according to Sheriff Patrick McDermott. He said the goal of the program is to reduce recidivism by focusing on issues that lead people into criminal behavior. "It's things like food insecurity. It's things like not having a job, not having a place to sleep at night. These men are leaving our facility, and they're very much unsure of what their next day, 10 days, month is going to look like," McDermott said. "If you can stabilize a job for these men, if you can stabilize their housing and get their mental health and substance use issues resolved, or at least in check, that actually puts people on the right path toward success." John Keegan is preparing for his release from jail and will utilize the new center. "When I walk out the door, everything's going to be prepared for me," Keegan said. "Not like I'm walking out the door and here's the world and I have to get all this stuff done and I get overwhelmed, you know what I mean? And then I just give up." "I walked out the door several times before, and just the world just hits me right in the face, you know?" Keegan said. "When I get out there, and that's when I relapse, because my head starts thinking — I get scared, to be honest with you. ... And then when I get scared, that's when I turn to drugs." Keegan started receiving help from HOPE Center staff a couple of months ago, during the center's soft launch. "These people really bend backwards to help me," he said. Through the assistance he's receiving, he plans to move into a halfway house, get a job and work to pay off all of his court fines in order to "take responsibility" for his actions, he said. The program is modeled on one that opened more than 25 years ago in Hampden County. McDermott said when he toured that program's center, he "fell in love with the concept." Three staff members have been hired for the HOPE Center so far. Support meetings and other programming will be held on site, and the program is also building partnerships with nonprofit organizations in the community to provide certain services. Members of the general public who are struggling will also be able to get assistance at the center, according to McDermott. The sheriff's department has identified more than 300 employers that are willing to hire formerly incarcerated people referred by the center. And it's built a partnership with the New England Carpenters Union for people to take part in its apprenticeship program after leaving incarceration, McDermott said. - See the full WBUR story.
CMS Approves MassHealth Demonstration Projects Expand Connector Subsidies, Increase Retroactive Eligibility and More The Healey-Driscoll Administration has received federal approval for MassHealth, and the state’s Children’s Health Insurance Program (CHIP), to amend its Section 1115 Demonstration (“1115 waiver”). The new federal authority will make health care more accessible, equitable, and affordable for hundreds of thousands of Massachusetts residents. The extension amendment is effective April 19, 2024 through current demonstration expiration date of December 31, 2027. The 1115 waiver provides federal authority for Massachusetts to expand health insurance subsidies to individuals who are not otherwise Medicaid or CHIP eligible, offer services that are not typically covered by Medicaid, and use innovative service delivery systems that improve care, increase efficiency, and reduce costs. MassHealth has received federal authority to cover a wide range of health services for eligible incarcerated individuals, including youth in Department of Youth Services (DYS) facilities, up to 90 days prior to release. The amendment also provides federal funding to support the Massachusetts Health Connector’s extension of health insurance subsidies to more low- and middle-income Massachusetts residents, making health insurance more affordable and advancing the Healey-Driscoll Administration’s goal of universal coverage. Through the newly approved amendment, CMS authorized MassHealth to:
Further information is available online:
New Medicaid Rule Aims to Simplify Enrollment Enrolling in Medicaid and staying on the program's rolls is about to get easier under a streamlined process the Biden administration finalized this month. The changes are expected to increase Medicaid enrollment by about 1.3 million people when fully implemented in 2028. Biden administration officials say removing barriers to Medicaid coverage will ultimately reduce states' administrative costs and keep patients healthier. Applying for Medicaid will involve less paperwork, and most enrollees who are eligible because they're 65 or older or disabled will now get 12 months of uninterrupted coverage without the state initiating a renewal. The rules also establish guidelines for states to check available data before cutting off an enrollee's coverage. And for the first time since 1986, the Centers for Medicare and Medicaid Services is updating record-keeping requirements for state Medicaid agencies. The policies will begin to take effect in early June. The rule also makes it easier for kids to benefit from Medicaid's sister program, the Children's Health Insurance Program. States will no longer have the option of imposing a waiting period before kids can enroll in CHIP or placing annual and lifetime limits on CHIP benefits. - See the full Axios story.
MassHealth Language Access Plan MassHealth’s Language Access Plan can be a useful source of rights and protections offered to those with Limited English Proficiency. Excerpts from the January 2024 – December 2025 plan: The Office of Medicaid within the Executive Office of Health and Human Services (MassHealth or the Agency) has prepared this Language Access Plan (LAP or Plan), which defines the actions the Agency will take to ensure meaningful access to services, programs, information, and activities on the part of persons who have limited English proficiency (LEP). The Agency will review and update this Plan every two years. The purpose of this plan is to ensure that MassHealth applicants and members have meaningful access to services, programs, information, and activities even if they may be limited in their English language proficiency or require accommodations related to a disability. The Plan will be fully implemented subject to the availability of fiscal resources to implement it. Applications MassHealth has an online application for applicants who are under 65 and are eligible for benefits because of their income, which is available on a system called the Health Information Exchange (or HIX). Income-eligible MassHealth applicants under 65 can apply online for benefits in English, Spanish, and Brazilian Portuguese. The paper application for the under 65 population is available in English, Spanish, Traditional Chinese, and Vietnamese. Eligibility notices for those applicants are available in English, Spanish, Haitian Creole, Brazilian Portuguese, Simplified Chinese, Vietnamese, braille, and large print. MassHealth has a different application platform for applicants who are 65 and over or who are under 65 and apply for benefits due to a disability (known as MA21). An online application is available in English, but paper applications are available in English, Spanish, Brazilian Portuguese, and Simplified Chinese. Currently, all eligibility notices are mailed to these applicants in English and Spanish. However, over the coming year, these notices will be migrated to a new system, and will become available in the six most common languages as well as braille and large print on a rolling basis between October 2023 and January 2025. Other Notices MassHealth is making long-term updates to its other, non-eligibility system that generates certain notices to members, such as prior authorizations, enrollment information, admission and discharge notifications, and other types of decision or medical notices. These changes will enable notices generated through MassHealth’s Medicaid Management Information System (known as “MMIS”) to be automatically converted into the six most common languages, and accessible formats, such as large print and braille. MassHealth is in the process of making notices available online on a new platform that launched in April 2023 called MyServices. MyServices is a mobile app and web portal that allows members to view current MassHealth or Health Connector eligibility, and MassHealth enrollment information, documents, and notices. Currently, HIX-eligibility notices are available electronically on MyServices. Eligibility notices for applicants with a disability and applicants 65 and over will be available electronically in the next year. Certain notices related to medical benefits and plan enrollment will be available electronically by 2026. The MyServices screens are screen reader accessible, and notices are available electronically in six languages: English, Spanish, Haitian Creole, Brazilian Portuguese, Simplified Chinese, and Vietnamese. All MassHealth mailings include an insert with multilanguage taglines in 16 languages that indicates the notice is important, offers translation services of notices free of charge and outlines a nondiscrimination statement. Taglines are short statements written in non-English languages that indicate the availability of language assistance services. The multilanguage taglines can be found on the MassHealth website at MassHealth Language Assistance. It provides the statement included in Figure 1 in English, Spanish, Arabic, Brazilian Portuguese, Khmer, Chinese, French, Greek, Gujarati, Haitian Creole, Hindi, Italian, Korean, Lao, Polish, Russian, Cape Verdean Creole, and Vietnamese. In-Person at Offices The Agency operates seven MassHealth Enrollment Centers (MECs) located in Charlestown, Chelsea, Quincy, Springfield, Taunton, Tewksbury, and Worcester. Each MEC is set up to serve walk-in members. At all walk-in sites, the Agency has contracted with Lionbridge to provide scheduled and unscheduled interpretation services for LEP individuals over the phone in 150 languages and various dialects. Each walk-in center also has one Virtual Remote Interpreter (VRI) for applicants or members who speak in American Sign Language (ASL). The VRI is a standalone video conferencing service for members who need ASL interpretation. MassHealth encourages members and applicants to schedule either virtual or telephonic appointments using MassHealth Scheduler, which is currently only available in English, but is expected to be available in Spanish in Spring 2024. The MassHealth Customer Service Center (CSC) has staff who can speak Spanish and English and are available to handle calls from LEP members and applicants. A more limited number of available staff can also speak Haitian Creole and Portuguese. In instances where there is no available bilingual staff, CSC’s language vendor, Language Line Solutions, can be used for interpretation by telephone. Members or applicants who are deaf or hard of hearing can access a variety of interpretation services through MassRelay or a standalone TTY phone line. In-Person Interpretation -For walk-in applicants and members, language interpretation in 150 languages and various dialects is provided upon request at the Agency’s local offices through the Agency’s vendor, Lionbridge. Staff at MassHealth Enrollment Centers can contact Lionbridge at (855) 759-1421 to access a third-party interpreter when requested by an applicant or member. For administrative hearings, in-person interpreters are provided upon request under a contract with ITI Inc. Staff coordinating administrative hearings through the Board of Hearings can contact a third-party interpreter at ITI Inc. when requested at (855) 275-0788. ASL interpretation is available for walk-in applicants and members which is provided through Video Relay Services (VRS). The MassHealth Scheduler webpage allows applicants and members to schedule an appointment with a MassHealth representative. The MassHealth Scheduler offers phone and video appointments and options for language preference which includes ASL interpretation. Phone Interpretation - MassHealth Customer Service Center provides phone interpretation services to callers, through the use of the language line service provided by Language Line Solutions and MassRelay, which is a Massachusetts-wide service for members who are deaf and hard of hearing. MassHealth Customer Service Representatives have an internal process to access interpreter services through Language Line Solutions at (800) 874-9426. If staff need assistance connecting an applicant or member with MassRelay services, they can contact the MassHealth disability ombudsman at (617) 847-3468. When a MassHealth member or applicant first calls customer service, an automated message allows members to select a language preference. This message has always played in English and Spanish but was recently updated to include the top five requested languages after English (Spanish, Portuguese, Haitian Creole, Arabic, Russian). English and Spanish speaking callers proceed through the call menu in their preferred languages, but callers who request another preferred language are automatically connected with a Customer Service Representative (CSR) who can grant access to free interpreter services through a language line. CSRs are trained to inform members up front that they are entitled to receive free interpreter services and to grant access. During a call, if a CSR determines that a caller with limited English proficiency would be better served by using the telephone interpreter service, the CSR will take steps to provide “real-time” access to the telephone interpreter service. Additionally, CSRs are trained in using Telecommunications Relay Services (TRS) and Video Relay Services (VRS). Individuals requesting an ASL interpreter can also contact the MassHealth Disability Accommodation Ombudsman for assistance. Individuals accompanying LEP persons, such as family, are generally not used as interpreters except in cases of emergency or at the specific request of an LEP person that an accompanying adult act as their interpreter. Fair Hearings MassHealth applicants and members may ask for a fair hearing to appeal a MassHealth decision. The Fair Hearing request form is available in English, Spanish, Brazilian Portuguese, Simplified Chinese, Haitian Creole, and Vietnamese and in large print. All members who request fair hearings are offered the opportunity to request an interpreter for their preferred language, including sign language interpretation or Communication Access Realtime Translation (CART) service, whether the hearing is on site or by phone. The Agency contracts with Interpreters & Translators ITI Inc. (ITI) for language interpreter services. Complaints - Language Access Complaint Procedure To file a complaint with the MassHealth Language Access Coordinator, submit the written complaint to: Camille Pearson, To file a complaint with the Office of Access and Opportunity, please submit the written complaint to the attention of: Office of Access and Opportunity - See the full MassHealth Language Access Plan
MassHealth DME Power Wheelchair Benefit MassHealth has a Durable Medical Equipment (DME) benefit for members with complex power wheelchairs. MassHealth will cover minor repairs to serviceable retired power wheelchairs so that members have a usable backup power wheelchair to use if their current power wheelchair is being fixed. Key points:
Call the My Ombudsman Program for more information at (855) 781-9898, videophone (VP) at (339) 224-6831, Monday-Friday, 9 a.m. to 4 p.m. - From Keep speaking up about the budget, Disability Policy Consortium Weekly Update, April 19, 2024.
Last Day to Apply for MassHealth Mitigating the Costs of Housing (MATCH) Program is May 10 The MassHealth Mitigating the Costs of Housing (MATCH) program helps MassHealth members pay for move-in costs and buy the items they may need to make a new home livable and comfortable. MassHealth members can apply for MATCH assistance if they are moving from a place where they do not need to pay for housing costs and related expenses (for example people living in a homeless shelter, nursing home, group home or jail) into community-based housing where they do need to pay for housing costs and expenses. Applications must be initiated by the member’s MassHealth managed care plan. (Note that the MGB ACO had already elected, as of the start of 2024, to not to participate in the program due to administrative burden. See participating health plans and contact information at How to apply for the MATCH program | Mass.gov) The MATCH program is funded by federal dollars from the American Rescue Plan Act (ARPA). ARPA funds are considered emergency funding and were delivered to states as a one-time, single payment. As such, the MATCH program was designed to run for a limited time, until March 2025 OR until funds run out. Due to high demand for the MATCH program and limited remaining funds, the last day to begin new applications for the MATCH program is May 10, 2024. Any applications initiated after May 10, 2024 will not be approved.
For more information on MATCH eligibility, assistance, and how to apply, please visit https://www.mass.gov/masshealth-match-program - Adapted from Important Mitigating the Costs of Housing (MATCH) Program Updates, Emily Cooper, Special Advisor on Housing, MassHealth, April 5, 2024, and MassHealth MATCH Program | Mass.gov. Additional material from Vicki Pulos, MLRI, and special thanks to Kristen Risley for MGB-specific information.
Postal Service Health Benefits are Changing U.S. Postal Service employee health benefits will change in 2025. A new program called the Postal Service Health Benefits (PSHB) program will be offering health insurance to eligible Postal Service employees, retirees, and their eligible family members. PSHB will replace the current Federal Employees Health Benefits (FEHB) coverage beginning January 1, 2025. It'll be the only health benefits program available through the Postal Service to employees, retirees, and their eligible family members. Some eligible members will have to enroll in Medicare to keep their PSHB:
Note: Those who are enrolled in Medicare Part B as of 1/1/2025 must remain enrolled in order to continue participating in the PSHB program. Some eligible members do not have to enroll in Medicare:
Some retirees eligible for PSHB might still wish to enroll in Medicare as they transition from FEHB to PSHB.
You can learn more about the upcoming changes in the USPS’s fact sheets on the Special Enrollment period and their document for retirees.
Advocates Say MA Needs a Right to Representation in Eviction Cases When the doors to Boston’s Edward W. Brooke Courthouse open at 8:30 a.m., many of the people who pass through the doors, through the metal detectors, and then to the courtrooms beyond, are residential rental tenants struggling to afford to stay in their homes. For the vast majority of these tenants, who are not guaranteed legal counsel in housing court, the odds are stacked against them in the high-stakes eviction proceedings they are facing. On a typical day, more than 100 people may appear in court to plead their cases before a housing judge or participate in mediation. According to the state court system, while about 90% of landlords have legal representation in these cases, only about 3% of tenants do. “The way the system is supposed to work is that it’s an adversarial system where both sides have advocates and both sides would therefore have equal bargaining power when they get to the court, but that’s not actually the reality,” Eloise Lawrence, deputy faculty director of the Harvard Legal Aid Bureau, one of the organizations that staffs the Lawyer for the Day program, told MassLive. “The reality is that one side has an advocate. One side knows the rules. One side knows how to navigate the process,” Lawrence continued. “One side is able to make the process work for them. The other side does not.” Pattie Whiting, a clinical instructor with the Harvard Legal Aid Bureau who has worked with the Lawyer for the Day program since she was a law student in 2006, explained that because of the high cost of property ownership in Boston, many of the landlords in housing court are corporations that already have legal counsel. In contrast, most tenants are individuals or families, often with low incomes. “In that mix, you have people who are disabled. You have people for whom English is a second language. You have people with mental health disabilities or physical disabilities that impact their ability to engage with the court or understand the process,” Whiting said. According to Georgetown Law School professor Nicole Summers, who testified at the Boston City Council hearing in March, more than half, about 57%, of eviction cases in the Eastern Housing Court of Massachusetts end in settlements. Fifteen percent end in a default judgment, where a tenant automatically loses because they did not show up in court, and 24% are voluntarily dismissed, often because the landlord decides not to go forward with the eviction or the tenant has already moved out. Only about 4% of cases go to trial, and of those, landlords win about 83% of cases. In contrast, in New York City, where tenants have had the right to legal counsel in eviction cases since 2017, about 78% of tenants with legal representation were able to remain in their homes, according to the city’s Office of Civil Justice. The city saw a 41% decrease in evictions in 2019 compared to 2013. From the moment they walk in the door of the courthouse, many tenants have no idea what is expected of them. It may be their first time interacting with the court system, which can feel like a maze of bureaucracy for the uninitiated without an experienced guide. Some show up to the Lawyer for the Day table thinking it’s where they need to check in for their hearing. That confusion can be dangerous and jeopardize case outcomes. Tenants who accidentally sit in the wrong courtroom or arrive late, missing when their name is called, can end up with a default judgment, and the case is over before it started. Lawrence explained that once those default judgments have been entered, it is very difficult to get them reversed. “In almost every other context, the court of the law disfavors default judgments because that means that the case has not been decided on its merits. It simply means that one side has not shown up,” Lawrence said. “In any other civil case, the court strongly disfavors and will be very liberal about lifting those default judgments. That is not the case in summary process [eviction] courts.” Agreeing to dangerous conditionsBefore a tenant ever speaks to a judge, however, they are encouraged to try mediation, a process which is meant to divert some of the flood of cases out of the courtroom, and give tenants a chance to come to an agreement with their landlord. The court staffs four mediators who may have as many as 100 cases scheduled on any given day. Because of the backlog, which could result in tenants, landlords and attorneys alike waiting for hours, most mediations end up happening not through the official process but out in the hallway. That Thursday morning, a MassLive reporter counted no less than six tenants at a time engaged in one-on-one conversations with attorneys representing their landlords. Many of these attorneys come prepared with pre-printed agreements, with terms such as extra monthly payments to repay debt or a date by which the tenant must move out. Once a tenant signs an agreement and it is filed with the court, it is legally enforceable, whether the terms are fair to the tenant or not. At that point, there is little the Lawyer for the Day attorneys can do for a tenant facing a post-agreement eviction. Lawrence explained that these agreements are often heavily weighted toward the landlord, and tenants will feel pressured to sign even if the payments are more than they can afford because they believe it will stave off an eviction. She said that while she and her team try to help tenants before they enter mediation, when they go up against the slick-looking attorney, they can lose their nerve. One woman she spoke with, who lived in subsidized housing making little to no income, owed just over $200 to her landlord. Even after talking to Lawrence she went to speak with her landlord’s attorney and ended up signing an agreement to pay over $500. If a tenant signs such an agreement and misses a payment, they are almost guaranteed to be evicted without a trial. With an eviction on their record, they will have even more trouble finding new housing, and can lose their eligibility for their housing voucher or the family shelter system. “Sometimes when the person says, ‘I’m the attorney,’ (tenants) think, ‘Oh, you’re my attorney.’ They don’t realize that that person is solely representing the landlord and the landlord’s interests,” Lawrence said. “They don’t know because they’ve never been through it before that they’re supposed to wait and go in with a court-appointed mediator who’s supposed to be neutral. That’s all just basic process, before you even get to any of what your legal claims might be.” According to Summers, the Georgetown Law professor, about one-third of these agreements require the tenant to move out, with the remaining two-thirds establishing a probationary period during which the tenant must repay what they owe or abide by other conditions. For about one-third of those agreements, the case ends up back in court after the landlord says one of those conditions is broken. Of those, a judge allows the eviction about 96% of the time. Before the start of the COVID-19 pandemic, all eviction cases were heard on Thursdays, meaning the court and the volunteer lawyers were inundated with as many as 300 cases in one day, handled by the same number of judges and mediators. However, since then, the court has changed its schedule to hear eviction cases on Tuesdays, Wednesdays and Thursdays. This has made it easier to spend more time on each case. But it also means the Lawyer for the Day program is stretched thin. While before, they only had to worry about staffing the table on Thursdays, they now offer their services on Tuesdays and Thursdays. The program is not held on Wednesdays. When the summer comes and there are fewer law students around, Whiting said they may not even be able to do it every Thursday. There are also more eviction cases in general. Since the end of the federal moratorium on evictions that was put in place during the pandemic in July 2021, the number of evictions filed each month has steadily increased, according to the Massachusetts Housing Partnership’s Housing Stability Monitor. Between August 2022 and October 2023, there were more than 3,000 eviction filings every month, above pre-pandemic levels. Of those, the Harvard Legal Aid Bureau team serves only the Boston location of the Housing Court. Lawyer for the Day programs run by other legal aid organizations exist at housing court locations in Brockton, Canton, Hadley, Greenfield, Lawrence, Lowell, Lynn, Pittsfield, Salem, Springfield, Woburn and Worcester, but tenants facing eviction cases in other court sessions are on their own. Even on the best days, the Boston team is hard-pressed to handle all of the demand. To make the housing court system function fairly for all tenants, she said, they need to have the right to legal counsel, in the same way defendants in criminal cases are guaranteed an attorney. “Telling someone their rights in a 10-minute conversation is just not the same,” Lawrence said. For this reason, Boston City Councilor Ben Weber filed a hearing order earlier this year to consider a pilot program for right to counsel in eviction cases. “People are so familiar with public attorneys in our criminal legal system, that it just doesn’t occur to them that this kind of court case can limit when someone has the right to an attorney,” Councilor Henry Santana said during the March 21 hearing on the proposal. “This is one of those issues that as soon as you hear the problem, it seems very obvious to fix it.” - See the full MassLive article.
Even with Work Permits, Migrants in Shelters Struggle to Find Self-Sustaining Jobs The Healey administration has focused on helping migrants obtain work authorization as a way to support their efforts for self-sufficiency and relieve the state’s overwhelmed shelter system. In the last six months, the state has helped over 2,700 migrants obtain working papers and is waiting on confirmation of another 750 people from the federal government. But migrants say that even with the coveted documents, finding a way out is harder than they thought. They struggle to find jobs, face significant language barriers and lack transportation or skills to get them the jobs they need, according to interviews with migrants and their advocates. This occurs even when many companies say they are seeking to fill vacancies in a state with low unemployment. “Getting an employer authorization document does not automatically lead to you getting a job right away,” said Jeff Thielman, president of International Institute of New England, a refugee agency that helps families in emergency shelters. “You may not have the language skills required for the workplace, and you may not understand exactly where and how to look for a job.” State officials say the administration has been successful in helping new arrivals obtain work permits and connect with job training. But they acknowledge that providing the tools to get employed can be a steep challenge. “Work authorization is critical to gaining a job. But we also know for any individual, whether they are a newly-arrived migrant, or someone who has been hard at work looking for a job, for a time, there's work supports that are needed,” said Lauren Jones, secretary of the state’s Executive Office of Labor and Workforce Development. Even with a job, affording housing is a challenge Immigration advocates know that having a job alone, especially one that pays near minimum wage, will not be enough to ensure full independence in high-cost Massachusetts. A minimum wage job at 40 hours a week generates about $31,000 annually. The median asking price for an apartment in the Boston area is $3,450 for a two-bedroom apartment, according to Apartment Advisor, and moving in usually costs multiple months rent. In Worcester, it’s significantly cheaper at $2,000 a month, but there’s the added cost of a car in central Massachusetts where there’s less public transportation. “Folks are going to need some subsidies and some help from the state government or elsewhere to afford an apartment,” said Thielman of the International Institute of New England. And even for those who find jobs, there's the possibility of having to move again. Families in overflow shelters could be moved to emergency shelters, and those already there, transitioned to subsidized housing. They may not even be in the same area of the state. “Shelters shift and shelters move. Sometimes people are moved with very short notice,” said Stephanie Rosario Rodriguez, senior director of programs at Massachusetts Immigrant and Advocacy Coalition, or MIRA. The state is trying to find migrants work opportunities close to shelters, but it can be difficult juggling so many competing factors. “We also recognize that there may be situations where employment, may not be in close proximity to housing, but hopefully we can still ensure, employment as well as housing stability,” Jones from the Executive Office of Labor and Workforce Development said. Getting ready to work Beyond La Colaborativa in Chelsea, many organizations are offering employment training. Among them, the Jewish Vocational Services of Downtown Boston operates a local MassHire office, one of 41 career centers and workforce boards statewide. JVS has helped migrants in their classes get jobs at Shake Shack, local medical facilities, retailers and restaurants. Hannah Odaa, senior director of refugee employment services at JVS, said it can take anywhere from one to six months to find someone a job. “That’s quite a big range. It’s because there’s so many different levels of English — of skills, and so many barriers to employment that we’re looking at,” she said. If a person is single with an open schedule and advanced English, she says, it’s an easy job placement. But if they’re a single parent, with less English proficiency, limited formal work experience and time restraints, getting the right placement takes longer. - See the full WGBH story.
Analysis - Dollars, Cents and the Migrant Story You Aren’t Reading For Sasha Chanoff, making sure the refugees and immigrants who seek shelter and a new home in the Greater Boston area isn’t just a humanitarian mandate. With both Boston and Massachusetts as a whole bleeding tax revenues, Chanoff, the founder of Boston-based RefugePoint, argued these newcomers should be greeted for who and what they are: A badly needed spark to Massachusetts’ economic engine. “The bottom line is that refugees and immigrants contribute immensely to the economy of the Greater Boston area,” Chanoff told MassLive earlier this week. And while the dominant public image of Massachusetts’ costly and still unfolding migrant crisis is one of people sleeping rough on the floor at Boston Logan International Airport, or of the dormitory-style housing at the Melnea J. Cass Recreational Complex in Roxbury, Chanoff said there’s another, less-told story. And that’s of the communities across Massachusetts who have willingly opened their doors to refugees fleeing violence and chaos in such nations as Haiti and Afghanistan, providing them with the tools and support they need to successfully start over in the United States. That nuance often has been lost in the debate over how to meet the towering cost of Massachusetts’ emergency shelter system. First, the numbers about the economic impact that newcomers are having on Greater Boston’s economy. And they’re tough to deny. A recent study, co-authored by Boston Indicators, the research wing of the Boston Foundation, and the nonprofit Immigration Research Initiative, provides the hard numbers to back up that assertion. Immigrants, both documented and undocumented, annually contribute $103 billion, or 21% of the Greater Boston region’s GDP, which is equivalent to their share of the population, the two groups’ research showed. At the same, those immigrants are “disproportionately likely to be in low-wage jobs, with 38% of all immigrants in jobs paying less than $49,000 a year, compared to 24% of native-born citizens, the data show. Even so, these newcomers also own and operate the “Main Street” businesses that many Bay State residents frequent and depend on every day — from nail salons and car washes to convenience stores and restaurants. In fact, four in 10 such businesses are immigrant owned in the Bay State, the research showed. The two groups’ research also shows that immigrants have helped offset population loss, as rising costs and a lack of affordable housing have prompted other Massachusetts residents to leave the state. - See the full MassLive opinion piece.
Biden Administration Restores Health Protections for Gay and Transgender People The Biden administration recently announced expansive new protections for gay and transgender medical patients, prohibiting federally funded health providers and insurers from discriminating on the basis of sexual orientation and gender identity. “Today’s rule is a giant step forward for this country toward a more equitable and inclusive health care system, and means that Americans across the country now have a clear way to act on their rights against discrimination when they go to the doctor, talk with their health plan or engage with health programs run by H.H.S.,” Xavier Becerra, the health and human services secretary, said in a statement. The rule overhauls federal policy in an area that has become a political flashpoint, with more than 20 Republican-led states banning or restricting gender-affirming care for minors in recent years, and it is likely to draw legal challenges. Even the history of the rule illustrates the political sensitivities at play: It has now taken three different forms under three successive presidents. The Affordable Care Act, passed in 2010, established a sweeping set of civil rights protections in the U.S. health system through what is known as Section 1557. It prohibits discrimination against patients based on race, color, national origin, sex, age or disability in “any health program or activity” that receives federal funds, covering a broad swath of the U.S. health system. In 2016, the Obama administration issued a less expansive version of the rule the Biden administration finalized on Friday, requiring health providers to provide medically appropriate treatment for transgender patients. Officials at the time argued that the Affordable Care Act’s protections against discrimination included gender identity. The Obama rule became tied up in litigation, and the Trump administration declined to enforce it. Conservative opponents of the rule have argued that the policy could effectively coerce doctors into performing medical services that they might have objected to, including on religious grounds. The Trump administration in 2020 formally narrowed the legal definition of sex discrimination to not include protections for transgender people. The rule finalized by the Biden administration on Friday states that it preserves religious exemptions and “does not require or mandate the provision of any particular medical service.” “Section 1557 prohibits discrimination on certain prohibited bases, and does not interfere with individualized clinical judgment about the appropriate course of care for a patient,” the rule says. After the Supreme Court ruled in 2020 that the Civil Rights Act of 1964’s prohibition on discrimination based on sex also applied to discrimination based on sexual orientation and gender identity, the Biden administration began to reverse the Trump administration policy. Republican officials continued to work to preserve the Trump-era rule. In 2022, after the Biden administration issued a proposed version of the rule it finalized on Friday, a group of Republican attorneys general wrote to Mr. Becerra, suggesting they could sue if the Health and Human Services Department pursued the policy. - See the full The New York Times article.
State Ends Housing Programs for Those in 'Mass. and Cass' Encampment With federal COVID funding running out, Massachusetts health officials are closing two housing programs designed to shelter those who were living in a large tent encampment removed by Boston officials late last year. The programs had seemed to help reduce the numbers of people living on the streets while facing mental health and substance use disorders, and address problems such as increasing violence in the encampment. Neighbors and area business owners had urged the city to dismantle the tents. State officials said they will stop admitting new residents to 18 cottages on the grounds of Lemuel Shattuck Hospital as of Monday. They plan to shutter the cottages this summer. Since 2022, the cottages have provided temporary homes for people receiving mental health care, treatment for substance use and other services while seeking stable, longer-term housing, a type of program known as "transitional housing." The state is also preparing to end a transitional housing program at the EnVision Hotel in Boston by the end of the year. State Department of Public Health officials said they're phasing out the programs as federal American Rescue Plan Act funds, put in place during the COVID pandemic, have run out. They said they have increased other transitional housing space in Suffolk and Middlesex counties to continue providing services to those struggling with homelessness, mental health issues and addiction. "We have been working on this plan, knowing that this initiative was temporary," said Deirdre Calvert, director of the Department of Public Health's Bureau of Substance Addiction Services. "We've been laser focused on making sure over the last few months to increase permanent capacity to ensure that we were ready to make the move." Twenty-two people currently live in the cottages at Shattuck Hospital, according to state officials. They are staying in temporary structures as part a program that also offers security and wraparound services such as counseling and addiction treatment. State officials said workers will help the cottage residents find other housing. The program at the EnVision Hotel, run by the nonprofit organization Victory Programs, provides temporary housing for up to 50 people in hotel rooms, while staff works to help secure permanent housing for the residents. The program is considered "low-threshold housing," meaning there are fewer barriers to admission such as being sober or having certain mental health conditions. "Victory Programs is working with all parties to find the best solution that guarantees uninterrupted services for all residents," said the organization's Chief Program Officer Melinda Giovengo in an emailed statement. "Our strategic planning is focused on ensuring every resident has access to secure, healthy, and safe housing without any disruptions. Calvert said the state is adding 48 new transitional housing units, for a total of 586 permanent low-threshold housing spaces across Massachusetts. - See the full WBUR story
New Federal Rules on Minimum Nursing Home Staffing Standards The federal government is for the first time requiring nursing homes to have minimum staffing levels after the COVID-19 pandemic exposed grim realities in poorly staffed facilities for older and disabled Americans. Current law only requires that nursing homes have “sufficient” staffing, leaving it up to states for interpretation. The new rules implement a minimum number of hours that staff members spend with residents. They also require a registered nurse to be available around the clock at the facilities, which are home to about 1.2 million people. The rules dictate that 80 percent of Medicaid payments for home care providers go to workers’ wages. The new rules call for staffing equivalent to 3.48 hours per resident per day, just over half an hour of it coming from registered nurses. The government said that means a facility with 100 residents would need two or three registered nurses and 10 or 11 nurse aides as well as two additional nurse staff per shift to meet the new standards. The average U.S. nursing home already has overall caregiver staffing of about 3.6 hours per resident per day, including RN staffing just above the half-hour mark, but the government said a majority of the country’s roughly 15,000 nursing homes would have to add staff under the new regulation. The new thresholds are still lower than those that had long been eyed by advocates after a landmark 2001 study funded by the Centers for Medicare and Medicaid Services, or CMS, recommended an average of 4.1 hours of nursing care per resident daily. The government will allow the rules to be introduced in phases with longer timeframes for nursing homes in rural communities and temporary exemptions for places with workforce shortages. - See the full PBS News Hour story.
Hospitals Forced to Revamp Business Models or Risk Losing Patients Hospitals' business models are being upended by fundamental changes within the health care system, including one that presents a pretty existential challenge: People have far more options to get their care elsewhere these days. Why it matters: Health systems' responses to major demographic, social and technological change have been controversial among policymakers and economists concerned about the impact on costs and competition.
The big picture: Many hospitals have recovered from the sector's post-pandemic financial slump, which was driven primarily by staffing costs and inflation. But systemic, long-term trends will continue to challenge their traditional business model.
And hospitals have long claimed that much higher commercial insurance rates make up for what they say are inadequate government rates.
By the numbers: Consulting firms are projecting a bleak decade for health systems.
Between the lines: This is the lens through which to view health systems' spree of mergers and acquisitions, which have increasingly drawn criticism from policymakers, regulators and economists as being anticompetitive.
Yes, but: A big bonus of outpatient care is that it's supposed to be cheaper. But when hospitals charge more for care than an independent physician's office would have, or they tack on facility fees, costs don't go down.
The other side: Hospitals are typically on the losing end of negotiations with insurers right now, thanks to how large insurers have become, and are "in an extremely difficult competitive position," said Ken Kaufman, co-founder of consulting agency Kaufman Hall.
Reality check: Hospitals account for 30% of the country's massive health spending tab, and they'll have to be at the forefront of any real efforts to contain costs.
- From Axios. |
