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MGH Community News |
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MGH Community News |
| June 2015 | Volume 19 • Issue 6 |
Highlights
Sections
Social Service staff may direct resource questions to the Community Resource Center, Lindsey Streahle, x6-8182. Questions, comments about the newsletter? Contact Ellen Forman, x6-5807. |
MBHP Accepting New RAFT (Residential Assistance for Families in Transition) Applications – Guide for Providers As you probably are aware, funding for the state’s homelessness prevention program, Residential Assistance for Families in Transition (RAFT), is typically exhausted well before the end of the fiscal year. With the start of the new fiscal year upon us, Metropolitan Boston Housing Partnership (MBHP) is again accepting RAFT applications. MBHP is the greater Boston Housing Consumer Education Center (HCEC); to find other local HCECs visit www.masshousinginfo.org or call 800-224-5124. To apply for RAFT through MBHP review the guidance below and complete the Housing Supports FY16 Referral Form. Send the completed form to Amy Mullen, RAFT Manager, by e-mail at amy.mullen@mbhp.org or by fax at (617) 532-7509. RAFT can assist families who have: 1) At least one child under the age of 21 (or a pregnant individual) IF the family meets the above criteria, MBHP staff will then screen the family to determine RAFT eligibility. Families must undergo a RAFT screen by our staff and demonstrate risk factors for homelessness to be considered for RAFT assistance. RAFT is limited to $4,000 per year, starting with the date of the participant’s first RAFT payment.
Income Chart (Annual)
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Eligible Housing Crises
If a family is seeking assistance with start-up or relocation costs, they should apply for RAFT AFTER they have identified their new unit, but BEFORE they move in. Risk Factors Funds are approved for those families who demonstrate high risk factors for homelessness, as determined by screening questions provided by DHCD. DHCD looks the following for the head of household: current employment, level of education, prior or current DCF involvement, history of shelter stays, and demonstrated unstable housing in the past year. RAFT eligibility depends in part on how the applicant answers these questions. Required Documentation
Additional Requirements for Tenants with Housing Subsidies
Some Same Sex Married Couples Newly Eligible for Social Security Benefits and Should Apply ASAP Under the U.S. Supreme Court’s historic ruling in, some people whose earlier marriage to a person of the same sex is now recognized may now be eligible for social security spousal or widow’s benefits and should apply as soon as possible, to maximize benefits. Benefits under Medicare and Medicaid may also be newly available. Those impacted are couples who live in states that previously did not recognize their marriages.Immediate impact of the Obergefell Marriage Rights Decision: Some married persons may be eligible immediately for previously inaccessible Social Security, Medicare, and/or Medicaid benefits.
Here are some situations in which status as a married person might be particularly important for determination of benefits:
What do I need to do? For Social Security and Medicare, contact Social Security ASAP and preferably by Tuesday, July 31:
Medicaid eligibility is handled by local Medicaid offices or MGH patients can apply through Patient Financial Services. Again, application should be made ASAP, and preferably by July 31.. -Adapted from Marriage Equality Decision: Some Should Take Immediate Action to Apply for Federal Benefits, Justice In Aging, June 29, 2015.
State Officials Tackling SNAP Mess with a 10-point Plan Over the past year nearly 90,000 Massachusetts residents, 10 percent of the total number of people receiving Supplemental Nutrition Assistance Program benefits, were cut from the program, largely as a result of an expanded caseload and business model changes that produced incorrect eligibility data and computer and phone system breakdowns. State Secretary of Health and Human Services Marylou Sudders and Jeffrey McCue, commissioner of the Department of Transitional Assistance were taken to task in late April by 12 Central Massachusetts legislators who had learned from constituents about clients not being able to reach the DTA by phone; confusing letters and repetitive requests for documents that clients had already submitted; and finding out at the supermarket check-out that their SNAP benefits had been terminated. Kurt Messner, acting regional administrator for the USDA's Northeast Regional Office, sent a letter to Ms. Sudders date-stamped May 5, requesting a detailed corrective action plan within 30 days. A USDA spokesman did not reply to a request on June 5 for that corrective action plan. Ms Sudders outlined in a letter of April 27 to USDA regional officials a 10-point plan to address the issues, including: Restructuring DTA; adding and training SNAP case managers immediately; using overtime on weekends to catch up with backlogs; strengthening the ombudsman's office to resolve complaints; hiring a consultant to assess program delivery and customer service; expanding simplified reporting for eligible clients; conducting follow-up surveys with clients whose cases had closed; creating an agency scorecard; enhancing telephone assistance lines; and exchanging modernization best practices with other states. In an interview in early June, Mr. McCue said 73 additional case managers had been hired in May and were scheduled to graduate from training within two weeks. Another class of case managers is expected to start at the end of June. And, DTA expanded its training unit to improve consistency and performance. Staff have worked overtime through May and will continue through June to process eligibility certifications. "That has allowed us to make a pretty substantial bite into our processing backlog," Mr. McCue said. A significant upgrade to the telephone assistance line is expected this month. The department has established a "pretty robust" Office of the Ombudsman, directed by Sara Craven, which is tied closely to the department's policy and training units. "If a case comes through the cracks, it allows us the chance to look at it promptly," Mr. McCue said. Public Consulting Group, a consulting firm that worked with EOHHS and an internal DTA team to develop the 2013 business model, has been hired to assess the department's structure and processes. Mr. McCue said also that DTA is working with its federal partners to make it easier for a majority of SNAP clients, particularly the elderly, to file for recertification. They would follow "simplified reporting" rules in which they'd have to report any changes in living costs or income every year or two instead of every six months to a year. What Happened? The business model blamed for much of the mess was put in place in 2014 to address a claim from the federal government that the state overpaid $30 million in SNAP benefits between 2009 and 2011 by not properly reviewing client eligibility. The "Plan to Strengthen Service Delivery and Program Integrity" presented by state human services officials two years ago highlighted a new model that changed how clients interacted with DTA (including a move to a “first available worker” model rather than a designated case-manager for SNAP-only clients), moved a lot of transactions online and ultimately proved to befuddle many elderly, disabled and low-income SNAP clients as well as overwhelmed staff. Further, the SNAP system changes were to be integrated with technology being built to implement the Affordable Care Act, meshing nutrition benefits with MassHealth, the state's Medicaid program, according to the plan summary. The state spent more than $250 million, most of it covered by federal grants, to rebuild its Health Connector website after massive system failures in 2013. -See the full Telegram.com article. Previous MGH Community News Coverage:
Protect Your SNAP Benefits – Step-by-Step Instructions Including Audio and Translated Versions As reported previously and in the accompanying story, many SNAP recipients have been facing erroneous benefit termination and difficulty in correcting errors and reinstating benefits. Greater Boston Legal Services and Massachusetts Law Reform Institute have created detailed self-advocacy tips that are posted on MassLegalHelp.org, a Mass Legal Services website for consumers. It provides step-by-step instructions and includes an audio version and written versions in English, Spanish, Portuguese and Haitian Creole. Here are links to sections of that page and selected tips:
Call DTA's Assistance Line (877-382-2363)How do I get through to a live DTA worker?You do not need to enter your personal information to get to a worker. When you call the Assistance Line:
Note: If you do not follow the steps above, the DTA phone system may ask you to enter 4 things: EBT card number; SSN; year of birth; and zip code. You do not have to do this to reach a worker.What should I ask for if I reach a DTA worker?
What if DTA says it needs other documents I do not have?
Important: The SNAP rules say DTA workers must help you get verifications if you need help. DTA should not cut off your SNAP if you ask for help by signing and sending in one of these forms.
Call the DTA Ombudsman or the local DTA Office DirectorWhen should I call the DTA Ombudsman?
When should I call the Director?
Where can I find phone numbers for the Ombudsman or local Director?See the DTA Ombudsman and Directors Contact List for both the DTA Ombudsman Sara Craven and the Director’s phone.
DTA Implements New Americans with Disabilities Act Accommodations DTA recently implemented key portions of the Settlement Agreement in Harper v. DTA. Harper is a federal disability discrimination class action lawsuit that Greater Boston Legal Services (GBLS) settled in 2013. The changes described below are to improve the DTA’s process for providing “reasonable accommodations” to persons with disabilities. Under the law, DTA is required to accommodate people with disabilities who need extra help, or need a rule changed, in order to have access to DTA’s services. DTA will now screen clients to discuss the need for reasonable accommodations. GBLS also urges advocates to ask clients with disabilities that affect their ability to deal with DTA if they need an accommodation from DTA, and monitor if DTA actually offers accommodations. Accommodations can include getting DTA help to get verifications, coming into the local DTA office, keeping appointments, understanding written notices, and more. Here’s a summary of recent changes:
For More Information:
Questions or Concerns? If you have questions or concerns about any of the Harper-related changes as you seen them implemented, please contact Sarah Levy (617)-603-1619, slevy@gbls.org) or Lizbeth Ginsburg (617)-603-1624, lginsburg@gbls.org). Given the magnitude of the changes DTA has rolled out, we anticipate that some problems and/or technical glitches may arise. GBLS is working with DTA on Harper implementation and have gotten some fixes by raising specific issues. If you have concerns with how these new accommodation procedures work, please contact us. (For example, we have concerns with the notices that DTA has created for the accommodation process and are addressing these with DTA.) -The information above adapted from a summary by Lizbeth Ginsberg of GBLS forwarded by Patricia Baker, Mass Law Reform Institute.
Shelter for Homeless Displaced from Long Island Expands Eight months after abruptly closing the city’s largest homeless shelter on Long Island, on June 22nd city officials opened a nearly complete new shelter in the Newmarket area of Boston, ending a purgatory for hundreds of men who slept in cramped quarters in a South End gym and at other shelters. The new refuge on Southampton Street, which opened to about 100 men in January, can now house more than 400 in a refurbished city building. The shelter was initially scheduled to open in April, but city officials ran into construction delays and were forced to keep about 250 men sleeping on cots and mats beneath the bright lights of a basketball court at the South End Fitness Center. In a statement, Mayor Martin J. Walsh said the new shelter will offer “more abundant and better integrated” support services than the homeless received at their former refuge on Boston Harbor, which was closed in October after city officials condemned the old, rickety bridge leading to Long Island. When all its offices open, the shelter will offer services including mental health and addiction counseling, health checkups, case management, and help finding housing, Walsh said.
The nearby Woods Mullen Shelter will be reserved for homeless women. “It’s about time,” said David Carpenter, 50, who has been homeless for the past three years and lived on Long Island when city officials closed the bridge. He and others said it was tough living at the South End Fitness Center, where cots and mats were arranged within a few feet of each other, it was often too hot, and some complained of an insufficient number of toilets. “It’s been hard,” said Carpenter, as he waited outside the new shelter. “We’re hoping this will be better.” Others said they worried about fights over beds as the men adjusted to the new space and questioned some rules of the new shelter, such as lights being left on in dormitories all night. The final phase of the project, which city officials said would be complete this year, will add space for a clinic and a large kitchen. Over the next few days, the city will close the fitness center as a homeless shelter and stop paying to house others at the Boston Rescue Mission and Boston’s Health Care for the Homeless. -See the full Boston Globe article.
City Plan to fight Homelessness Would Use Triage System Eight months after the Long Island shelter abruptly closed, the Walsh administration is unveiling an ambitious multimillion-dollar plan to end homelessness among veterans this year and to end chronic homelessness by 2018. “I think we’re going to look back on it as a turning point,” Mayor Martin J. Walsh said about the closure of the 450-bed Long Island facility, which set off a scramble to house the city’s homeless as winter approached. “It’s a bold plan.” The plan aims to improve emergency and street outreach; coordinate access to resources; and increase rapid rehousing and permanent housing. Although Walsh plans to raise $12.7 million from state, city, and private sources for additional support, the basic strategy uses existing institutions. The first part of the program, dubbed a “triage system,” will identify the needs of each person and provides specialized services to groups such as youths, women, disabled individuals, and addicts. In particular, the report from the mayor’s office will mention LGBTQ youths and young adults of color. The triage approach tries to fix solvable problems instead of sending people immediately to an emergency shelter. A centralized system — the first in Boston to handle homelessness, according to officials — will soon match people with the best housing service. Without such a system, the city struggles to find available housing for those in need, said Chief of Housing Sheila Dillon. The new system is “very thoughtful” and “very coordinated,” Dillon said. For those on the brink of chronic homelessness, the city hopes to provide pathways to employment and rapid rehousing. A little monetary boost or a bit of guidance can prevent many in temporary — or “crisis” — homelessness from slipping into a chronic homelessness, the report states. By using existing buildings and developing about 200 new housing units, Walsh and his team believe all chronically homeless individuals will be permanently housed in three years. Chronically homeless individuals are defined as those who have disabling conditions, who have been continuously homeless for a year or more, or who have had at least four episodes of homelessness in the past three years. The number of chronically homeless people in Boston has plummeted since 2004, but in the past two years, that number has inched upward this year by more than 100, to the current 600, according to the report. Veteran homelessness is still a problem in Boston, but Walsh believes he can solve it. In 2014, Walsh joined a coalition of mayors pledging to end veteran homelessness. Of the 414 homeless veterans at the time of Walsh’s announcement, only 80 remained homeless a year later. However, more veterans frequently become homeless. The announcement of the new plan to aid the homeless coincides with the opening of 150 more beds in the Southampton Street Shelter. -See the full Boston Globe article.
SSI Temporarily Halts Overpayment Notices to SSI Recipients Married to Person of the Same Sex In March, Justice in Aging, along with GLAD (Gay & Lesbian Advocates & Defenders), and Foley Hoag LLP filed the class action lawsuit, Held v. Colvin to stop the SSA from collecting overpayments from elderly and disabled recipients of SSI who were married to someone of the same sex and receiving SSI in June 2013 or before. The suit charges that SSA discriminated against these individuals for months, and in some cases more than a year, after that discrimination was held unlawful by the Supreme Court when it struck down the Defense of Marriage Act (DOMA) in June 2013. SSA failed to recognize the marriages of same sex couples on SSI even after they’d informed the agency of their status. Because benefits for two unmarried individuals are higher than for a married couple, almost all were overpaid. And the agency was demanding the recipients pay back the overpayments caused by the agency’s tardy and negligent response, resulting in bills of sometimes thousands of dollars that they could ill afford. SSA recently issued a temporary emergency order to stop agency workers from issuing any new overpayment notices to SSI recipients married to a person of the same sex. SSA field office personnel are not to place any more SSI recipients in overpayment status as a result of a change in recognition of the recipient’s same-sex marital status. The order is only in effect from May 6, 2015-October 30, 2015. Watch for updates. Class Members May be Unaware Those who were receiving SSI in June, 2013 and were married to a person of the same sex at the time, are likely class members even if they have not yet received an overpayment notice. They are encouraged to contact Justice in Aging Litigation Director, Anna Rich at arich@justiceinaging.org. -Adapted from the Justice in Aging blog.
Keep Your Advance Directive Safe but Accessible Many people understandably want to keep their living will and health care power of attorney forms in a secure place. But if these documents are locked away in a safe deposit box, they won't be much help if you're unexpectedly hospitalized. Here are some people who should have copies of your advance directives and some other places where they should be filed.
-From HEALTHbeat, Harvard Medical School, June 06, 2015.
State Lawmakers Send Governor Baker One-Month Budget Extension As talks between the House and Senate over a fiscal 2016 state budget continued, on June 22nd House leaders turned a two-week interim budget filed by Governor Charlie Baker into a one-month spending bill intended to keep government running beyond July 1. The Senate ultimately went along, enacting the bill and sending it to Baker’s desk. While it was unclear whether the House was sending a message about the status of negotiations or simply trying to avoid the possibility of having to pass another interim budget in a few weeks, it is now unlikely the fiscal year will start with a full budget in place. Baker filed the $2.7 billion interim budget bill in an effort to give negotiators a small cushion until July 14 to reach a compromise on the larger $38.1 billion spending plan for fiscal 2016, and give himself the allowable 10 days to review and sign a bill. The bill funds state agencies and programs for one month based on fiscal 2015 appropriation levels. -See the full Boston Globe article.
Money Follows the Person- Helping SNF and Long-Term Hospital Residents Return to the Community If you are in a nursing facility or “long-stay” hospital and want to move back to the community, Money Follows the Person (MFP) can give you the freedom to choose where you live and get services in the community. What kind of help can I get? A designated person, called a transition coordinator, will help you plan and organize the services you will need. You will learn about your choices of available home- and community-based services. You will learn about state agency programs you can use. You also will be linked with a case manager. Your case manager will make sure you get the services you need when you are in the community. What kind of services can I get? Money Follows the Person can help you find a place to live; pay security and utility deposits; and provide moving costs, home modifications, furnishings, dishes, pots, pans, and other household goods. Your transition coordinator will help you get the items, services, and supports needed for your new home. Supports may include peer support, assistive technology devices, orientation and mobility services. Am I eligible? To qualify, you must be
Where can I live? You can choose from many places to live. This may include: returning to your home; a home owned or leased by you or a family member; an apartment; a community-based home setting in which no more than four unrelated people live; or an assisted-living apartment with separate living, sleeping, bathing, and cooking areas; lockable doors; and other requirements. How do I learn more?
To learn more about the services you can get through Money Follows the Person, call 1-800-841-2900 (TTY: 1-800-497-4648, for people who are deaf, hard of hearing, or speech disabled) or visit www.mass.gov/masshealth/MFP. Not eligible for MFP? Boston Center for Independent Living (BCIL) may be able provide similar services to some who are not eligible for MFP for various reasons such as being over-income for MassHealth, subject to an immigration status bar, or have not lived long enough in a facility to qualify. Call BCIL and ask about their Nursing Home Transitions program: 617-338-6665, or TTY: 617-338-6662.
Immediate Openings at Summer House - a shared living alternative to nursing home care for frail elders Note: this information was e-mailed to the Department on 6/22/15. Eligibility Criteria
Applications are Now Being Accepted for Single Room Occupancy Waitlist at Newton Corner Place NCP, a 28 unit SRO located at the West Suburban YMCA in Newton Corner, is accepting applications for the waiting list for its Section 8 Moderate Rehabilitation program. Applications are available at the Newton Housing Authority (NHA), 82 Lincoln Street, Newton Highlands, MA 02461 or call 617-552-5501 to request an application. Completed applications should be returned to the NHA for processing. Eligible applicants will be added to an existing waiting list with an estimated waiting time of 3 months. Eligible applicants will be placed in accordance with the Newton Housing Authority Section 8 Existing Housing Administrative Plan, Appendix A, Single Room Occupancy (SRO) Moderate Rehabilitation, West Suburban YMCA SRO, and with the provisions of the U.S. Housing Act of 1937, as amended. You may qualify for this program if you are a homeless or about to be homeless male with a gross income which is $34,500.00 or less. Due to the structural design of the facility it is necessary that placement be restricted to males. If you have a disability and require an accommodation, please call. (617) 552-5501 and ask for Alycia Auchterlonie. Only applications from homeless individuals or about to be homeless individuals will be accepted. Homeless individual:
Market-rate rooms currently available - $651/per month. Contact Dina Troiani at NCDF for more information. 617-244-4035 x 25
Children with Loved Ones Fighting Cancer Find Support in Norwell Group Support groups for adults with cancer are prevalent. And some hospitals offer ill parents counseling on how to help their kids. There are bereavement groups for kids whose family members have died. But sick parents have little emotional support for their children other than private counseling, even though a 2010 study estimated 562,000 children are living with a parent in the early phases of cancer treatment and recovery. Enter the Kid Support Program at Cancer Support Community in Norwell, a rare support group for kids whose parents or grandparents have cancer, and one of the first of its kind in New England. Although the first group officially ended — the next group starts in the fall — the members have grown so close that the program will host reunions and the families themselves plan to continue gathering socially. Seven kids between the ages of 9 and 16 joined the program, which is free. Grants from several foundations and businesses paid for the program, which the staff hopes to expand in the future. The Cancer Support Community — Massachusetts South Shore is an affiliate of the national group, and a division of the Norwell Visiting Nurse Association. -See the full Boston Globe article.
Human Services Employment Ladder Program (HELP) The Human Services Employment Ladder Program (HELP) is an eight week Human Services training program provided by Morgan Memorial Goodwill Industries. HELP prepares participants to become entry-level direct support professionals in the field of Human Services. Students learn the essentials of the field while gaining experience in personal interaction with disadvantaged populations. Students learn the nuts and bolts of direct care including terminology and methods, motivating and managing client behaviors, maintaining boundaries and identifying career paths. Students are challenged and encouraged to apply themselves on a daily basis through individual and group assignments. Through the HELP program, graduates become qualified to fill the increasing need for caring, professional workers in community residences, shelters, day programs and other Human Services settings. Graduates can become a:
Program Requirements
The next session begins July 6, 2015. For more information call the HELP Line at 617-541-1499. Applications are available at the Security Desk Morgan Memorial Goodwill Industries, 1010 Harrison Avenue, Boston, MA 02119.
City Program Gives Job Opportunities to Those Needing a Second Chance Operation Exit recently graduated a class of 15 who completed the 3½-week program for people who have been in the criminal justice system or are considered to be at high risk. The program provides training in the building trades, and participants received certifications in workplace safety, first aid, and CPR. They also visited building trades unions, learned how to weld, worked on basic job skills, and completed several projects with sheet metal union instructors, such as making tool boxes, trash cans, and tin flower pots. Their next step is to interview for a job with unions in the building trades. The interviews are being organized by Brian Doherty, general agent for the Building and Construction Trades Council of the Metropolitan District, a program organizer said. The program was established last year by Mayor Martin J. Walsh of Boston, a former union organizer who approached representatives of the building trades in hopes of combatting violence by giving “opportunities to people who don’t have opportunities.” This is the second class of graduates, after 16 people completed the program last year, the city said. Boston spent an estimated $60,000 to $70,000 in grants and private funds to train the most recent class, said Kimberly Pelletreau, deputy director of Youth Options Unlimited Boston, the city agency that runs the program. Graduates who get a job with one of the unions have the potential to earn $50,000 to $100,000 annually, she said. As union members, they also enjoy health benefits, training, and retirement income, Doherty said. -See the full Boston Globe article. Update: In November 2015 Mayor Walsh announced the expansion of the program to include opportunities in the technology industry through a partnership with Resilient Coders. Operation Exit currently includes apprenticeship opportunities in the building trades, culinary arts and now technology. The program is based out of MassChallenge. More information: see the press release.
Wish Upon a Wedding- Weddings and Vow Renewals for Couples Facing Serious Illness or Life-Altering Circumstances Wish Upon a Wedding is a nonprofit organization granting weddings and vow renewals for couples facing serious illness or a life-altering circumstance and has helped dozens of couples say “I DO” since its launch in January 2010. While their core mission is to grant weddings to couples facing terminal illness, a limited number of “Special Circumstances” wishes are also granted to those who have endured serious life-altering circumstances (e.g., severely injured military veterans and those facing extreme hardships). These types of wishes are granted based on current resources and availability. Basic Requirements For All Wish Recipients
Please note: Not all applications are approved for Wishes. They do not grant Wishes for financial hardship, job loss or for any person who has been convicted of a felony. The “Classic Wish” Wedding typically includes
More information and application: http://wishuponawedding.org/ or 877-305-WISH -Thanks to Lynn Mazur for sharing this resource.
Health Connector Bugs Remain Software defects that have dogged the Massachusetts Health Connector are significantly more severe than expected, forcing the agency to scale back its ambitions for the upcoming fall open-enrollment period, state officials revealed this month. The problems extend to the one function the Connector’s website was thought to be performing well: determining eligibility for coverage. Nearly 6,000 people ended up enrolled in both MassHealth (the state’s Medicaid program for the poor) and in private insurance bought through the Connector. Fixing the defects and adding functions in time for enrollment in 2016 plans will cost $47.2 million, which the Connector will share with MassHealth. The glitches that led to double enrollments involve two separate issues. Some 5,000 people who have disabilities but are not low-income were enrolled in MassHealth and also told to sign up for a Connector plan; the state is still trying to sort out where each belongs. An additional 756 people who submitted multiple applications with slightly different information were enrolled in both programs. Because these problems consume the staff’s attention, the website will not be able to replace the Connector’s malfunctioning payment system, a major source of consumer complaints, in time for the Nov. 1 start of open enrollment. Instead, the Connector is working to repair the existing system and seeking a contractor to replace the payment system later. And there are diminished hopes that consumers will be able to instantly find out whether their doctors are in the coverage network of the plan they are considering. Gutierrez took charge of the Connector a few months after it launched a new website to replace software that failed disastrously the previous year. The rebuilt website performed better than its predecessor, enrolling tens of thousands of subscribers, but was still plagued by problems. Consumers endured hours on hold with the call center, encountered misinformed or unhelpful customer service agents, discovered payments had been lost, and found they could not access insurance they had paid for. Gutierrez said that improving customer service has been his main focus since arriving in February. He is requiring Dell, the technology company that runs the call center and the payment portal, to start measuring customer satisfaction as people call in. Vicki Coates, the Connector’s new chief operating officer, said that beefed-up staffing and training had improved the call center’s performance, with wait times down to a minute or less. The Connector has resolved all but 383 of the 1,591 serious complaints brought to its attention. And a backlog of nearly 11,000 requested account changes — such as adding a newborn or a change of address — has been cleared, with new requests handled promptly, she said. Additionally, the Connector has paid refunds to about 900 members who requested them, often because they paid for insurance but were not enrolled in a plan. Checks were to be in the mail by June 19 to all remaining customers owed refunds, Coates said. Some 810 members whose payments went into the wrong account have had the money properly redirected. Coates said those problems will not recur because the defects that caused them have been fixed. But Kathy Butterworth, a patient advocate at Nantucket Cottage Hospital, said that problems with the Connector are far from resolved. “Now, the Connector is answering the phone, which is great, but then nothing really happens,” she said. Butterworth has found, in some cases, that it was faster to submit paper applications than cope with the Connector website. Many of her clients, she said, received confusing mailings, missed the enrollment deadline, and found out they were uninsured when they went to the doctor. On Monday, she called on behalf of three clients trying to enroll. “The phone call ended with we were referred to a supervisor who will call you,” Butterworth said. “When I said, ‘When will that be?’ there is no answer.” -See the full Boston Globe article.
Medicare Reminder: How Do I Enroll and Avoid Penalties? The steps you should take to enroll in Medicare on time will depend upon whether or not you already collect Social Security retirement benefits when you turn 65. If you already receive Social Security when you turn 65, the federal government will automatically enroll you in Medicare A & B. Your Medicare will start on the first of the month you turn 65. You do not need to sign up for Medicare. On the other hand, if you do not receive Social Security when you turn 65, you must take action to apply for Medicare. To avoid higher costs down the line, you must enroll during your Initial Enrollment Period (IEP). Your IEP includes the three months before, the month of, and the three months following your 65th birthday. If you enroll in Medicare during this seven month period, you will avoid late enrollment penalties and gaps in health insurance coverage. The date your Medicare coverage begins depends on when you enroll during your IEP. For your coverage to begin as soon as possible, it is best to enroll in the first three months of your IEP (the three months before the month you turn 65). Your Medicare coverage will then go into effect starting the first day of the month you turn 65. If you enroll during the month you turn 65, your Medicare coverage will go into effect the following month. If you enroll during the fifth month of your IEP, your Medicare coverage begins two months after you enroll. If you enroll during the sixth or seventh month of your IEP, your coverage begins three months after you enroll. If you enroll in Medicare at any point during your IEP, your enrollment will be considered timely. You will not face any late enrollment penalties. To enroll in Medicare, you can call the Social Security Administration at 800-772-1213 or you can visit your local Social Security office. When you enroll in Medicare (either actively during your IEP or automatically), you receive Medicare Parts A and B. Most people do not pay a premium for Part A, but almost all people owe a premium for Part B. You will have the option to turn down Part B, but you should use great caution before declining Part B coverage as delaying could lead to a permanent premium penalty. You should only consider delaying Part B if you confirm two essential things.
-Adapted from Dear Marci, e-newsletter, June 01, 2015 and June 15, 2015, The Medicare Rights Center.
Approximately 1 Million Unemployed Childless Adults Will Lose SNAP Benefits in 2016 as State Waivers Expire Roughly 1 million of the nation's poorest people will be cut off SNAP (formerly known as the Food Stamp Program) over the course of 2016, due to the return in many areas of a three-month limit on SNAP benefits for unemployed adults aged 18-50 who aren't disabled or raising minor children. These individuals will lose their food assistance benefits after three months regardless of how hard they are looking for work. One of the harshest pieces of the 1996 welfare law, this provision limits such individuals to three months of SNAP benefits in any 36-month period when they aren't employed or in a work or training program for at least 20 hours a week. Even SNAP recipients whose state operates few or no employment programs for them and fails to offer them a spot in a work or training program -- which is the case in most states -- have their benefits cut off after three months irrespective of whether they are searching diligently for a job. Because this provision denies basic food assistance to people who want to work and will accept any job or work program slot offered, it is effectively a severe time limit rather than a work requirement, as such requirements are commonly understood. Work requirements in public assistance programs typically require people to look for work and accept any job or employment program slot that is offered but do not cut off people who are willing to work and looking for a job simply because they can't find one. In the past few years, the three-month limit hasn't been in effect in most states. The 1996 welfare law allows states to suspend the three-month limit in areas with high and sustained unemployment; many states qualified due to the Great Recession and its aftermath and waived the time limit throughout the state. But as unemployment rates fall, fewer and fewer areas will qualify for waivers. We estimate that the number of states qualifying for state-wide waivers will fall to just a few states by 2016 and that approximately 1 million SNAP recipients nationally (or roughly 46,000 in Massachusetts according to one estimate) will have their benefits cut off due to the time limit in fiscal year 2016. The loss of this food assistance, which averages approximately $150 to $200 per person per month for this group, will likely cause serious hardship among many. Agriculture Department (USDA) data show that the individuals subject to the three-month limit have average monthly income of approximately 19 percent of the poverty line, and they typically qualify for no other income support. The indigent individuals at risk are diverse. About 40 percent are women. Close to one-third are over age 40. Among those who report their race, about half are white, a third are African American, and a tenth are Hispanic. Half have only a high school diploma or GED. Many in this population, which generally has limited education and skills and limited job prospects, struggle to find employment even in normal economic times. And although the overall unemployment rate is slowly falling, other labor market data indicate that many people who want to work still cannot find jobs, while others who want to work full time can find only part-time employment. Cutting off food assistance to poor unemployed and underemployed workers doesn't enable them to find employment or secure more hours of work. -Adapted from, and more information at: http://www.cbpp.org/research/food-assistance/approximately-1-million-unemployed-childless-adults-will-lose-snap-benefits
Opioid Task Force Recommendations The opioid crisis task force created by Gov. Charlie Baker this month released a total of 65 recommendations in the areas of prevention, education, intervention, and treatment and recovery, after holding a series of meetings around the state in recent months. The task force wants tighter controls on prescription painkillers, more funds for substance abuse prevention and education and a shift in focus from incarceration to treatment of addicts.
Proposals made by the panel focus on prevention, education, intervention, treatment and recovery. They will cost about $35 million to implement and include steps that Baker may take himself and some that require the Legislature's approval. Secretary of Health and Human Services Marylou Sudders said addiction must be treated as a chronic medical disease no different than diabetes, heart disease or others. Among the Task Force’s recommendations:
Sources and for More Information
State Revises Count of Impoverished Students in Schools Massachusetts has scrapped a decades-old method for defining low-income students in public schools, resulting in a dramatic decline in the number considered to be living in poverty, according to a Globe review of state data. Now, less than half of Boston school students are regarded as being from impoverished homes, compared with the previous figure of about three-quarters. Chelsea, Lawrence, and other cities also saw big drops. Statewide rates dropped, but less dramatically. The new approach deems students “economically disadvantaged” if their families receive food stamps or other welfare benefits. Previously, the state used income reported by families on applications for free school lunches to identify “low-income” students. The new calculations are expected to lead to major changes by the Legislature in the way state aid for needy students is distributed to local schools. But some educators question whether the state Department of Elementary and Secondary Education has come up with the best methodology to identify poor students. Paul Dakin, superintendent of Revere public schools, said he worries that relying only on data from welfare programs could overlook the large number of poor immigrant families who are not tapping those programs, either out of pride or because they are here illegally and fear deportation. ‘These folks live under the radar, but we are still legally responsible to educate them.’ Only 37.4 percent of students in Revere have been designated economically disadvantaged, down from 77.8 percent of students who were deemed low income. Across the state, 26.3 percent of the 400,000 students enrolled in public schools are considered economically disadvantaged, compared with 38.3 percent who had been previously deemed low income. For decades, Massachusetts and other states considered families who qualified for free or reduced-price lunches as the standard for measuring poverty. But many school systems, such as Boston and more than a dozen others in Massachusetts, no longer ask families to fill out applications to receive the perk because they are participating in a special federal program that allows them to offer free meals to all students, regardless of income. The intention of the universal free meal program is to increase participation and eliminate the stigma, but it has caused Massachusetts and other states to grapple with finding a new way to measure student poverty. Privacy concerns deterred Massachusetts education officials from tapping state Department of Revenue data. -See the full Boston Globe article. Opinion: Poor in America- It's Not All About Bad Choices Whenever I write about people who are struggling, I hear from readers who say something like: Folks need to stop whining and get a job. It's all about personal responsibility. In a 2014 poll, Republicans were twice as likely to say that people are poor because of individual failings as to say the reason is lack of opportunity (Democrats thought the opposite). I decided to ask some of the poor what they think. Here in Baltimore, I consulted Andrew Jackson Phillips Jr., 28, who's been homeless for the last eight years or so, and he thinks that there is something to the personal responsibility narrative. "I had multiple chances," he acknowledged. "I made some bad choices" – although he added that he thought "the system" had failed him as well. I asked about his childhood. Phillips said that his mother had been a drug addict and that he may have been born with drugs in his system. His siblings had had acute lead poisoning, and he may have had toxic lead levels as well, with lifelong cognitive and behavioral consequences. At age 3, Phillips said he saw his brother shot dead. At age 5, he himself was shot in the head by a drug dealer (he showed me the scar). In the eighth grade, he dropped out of school. Sure, he made bad choices. Who among us, after going through his traumatic childhood, could be sure of making optimal choices? Too often, I believe, liberals deny that poverty is linked to bad choices. As Phillips and many other poor people acknowledge, of course, it is. Self-destructive behaviors – dropping out of school, joining a gang, taking drugs, bearing children when one isn't ready – compound poverty. Researchers have often found that very poor families worldwide spend more of their income on alcohol than on educating their children. And, in central Kenya, a government study published a few years ago found that men there, on average, spent more of their salaries on alcohol than on food. Yet scholars are also learning to understand the roots of these behaviors, and they're far more complicated than the conservative narrative of human weakness. For starters, there is growing evidence that poverty and mental health problems are linked in complex, reinforcing ways. In the United States, a Gallup poll a few years ago found that people living in poverty were twice as likely to have been diagnosed with depression as other Americans. One study in 2010 found that 55 percent of American babies living in poverty in 2001 were raised by mothers showing signs of depression. The journal JAMA Psychiatry last year estimated that millions of low-income Americans suffer from parasitic infections such as toxocariasis and toxoplasmosis that, in turn, are associated with cognitive impairment or mental health disorders. "I estimate 12 million Americans living in poverty suffer from at least one neglected parasitic or tropical disease," says Dr. Peter Hotez, the author of that study. "The media places so much emphasis on imaginary infectious disease threats, when millions of people in poverty, mostly people of color, have neglected infections that are almost completely ignored." If you're battling mental health problems, or grow up with traumas like domestic violence (or seeing your brother shot dead), you're more likely to have trouble in school, to self-medicate with drugs or alcohol, to have trouble in relationships. "There's a strong association between poverty and low mental health," notes Johannes Haushofer, a psychologist at Princeton University. A second line of research has shown that economic stress robs us of cognitive bandwidth. Worrying about bills, food or other problems, leaves less capacity to think ahead or to exert self-discipline. So, poverty imposes a mental tax. Sendhil Mullainathan of Harvard and Eldar Shafir of Princeton explored this research in their important book "Scarcity." They note that Indian farmers test about 10 points lower on IQ tests before the harvest (when they're stretched economically) than afterward (when they're flush). Indeed, even asking poor people in psychology experiments to imagine a $1,500 car bill leads them to perform significantly lower on IQ tests. It turns out that when people have elevated levels of cortisol, a stress hormone, they are less willing to delay gratification. Researchers have raised cortisol levels in research subjects – who then became more impatient for immediate rewards, and thus more prone to "bad choices." "This is a really difficult conversation," notes Haushofer, "because you very quickly can end up in the corner of blaming the poor for poverty, and that's not the message I've been telling. Rather, it's circumstances that can land you in a situation where it's really hard to make a good decision because you're so stressed out. And the ones you get wrong matter much more, because there's less slack to play with." -See the full Nicolas Kristof opinion piece on masslive.com.
Some Insured Patients Still Skipping Care Due to Cost A key goal of the Affordable Care Act is to help people get health insurance who may have not been able to pay for it before. But the most popular plans – those with low monthly premiums – also have high deductibles and copays. And that can leave medical care still out of reach for some.
A recent study released by the nonprofit Families USA shows that a lot of folks with such coverage feel a high financial burden, and a poll from the Kaiser Family Foundation finds the same thing. The majority of people who buy insurance on state or federal exchanges pick silver-level plans, which often carry a lower monthly premium, but have a high annual deductible – $1,500 or more. Many people in that situation skip follow-up care and don't fill prescriptions. Mitts says that only adds to long-term complications and costs. But it doesn't have to be that way, she says. Plans in some states, including Pennsylvania, Texas, Florida and Arizona, have recently done away with deductibles on some silver-level insurance plans. And for certain basic services, including doctors' visits and generic prescriptions, other states are requiring only a small copay. -See the full NPR story.
Commonwealth Care Alliance Mental Health Respite Care Home Opens in Brighton On any given day, dozens of Commonwealth Care Alliance’s patients, struggling with depression, anxiety, or some other mental illness, can be found in psychiatric hospital beds. But fewer than half of them really need expensive hospital care. The others end up in hospitals because they have no other options for treatment, according to Commonwealth Care, a nonprofit health care organization that serves seniors, the poor, and people with disabilities. This prompted the organization to open a 14-bed respite center - a residential facility for people who need 24-hour care for mental illness but who are not considered to be a danger to themselves or to others. They do not need the restrictive setting of a psychiatric hospital unit. The organization has a similar respite program with a dozen beds in Dorchester, which has been full since it opened last fall. The Brighton facility will treat patients at about half the cost of a psychiatric hospital. It is opening when mental health services are in short supply, even though demand is growing, according to industry specialists. “So many people have been going to the most expensive and restrictive psychiatric hospitals who could be better served elsewhere — except the ‘elsewhere’ didn’t exist,” said Dr. Robert J. Master, the chief executive of Commonwealth Care Alliance. The respite center, called Marie’s Place, is across the street from St. Elizabeth’s Medical Center, and resembles a dorm more than a hospital. It will house patients diagnosed with illnesses such as depression, bipolar disorder, schizophrenia, posttraumatic stress disorder, anxiety disorder, and mild dementia. The services will include counseling, addiction treatment, and nonmedical services such as housing assistance. The respite program is an important cost-control measure for Commonwealth Care, which is both a provider and an insurer for people on Medicare and Medicaid. A psychiatric inpatient hospital stay costs the organization about $1,100 per patient per day, while the respite program will cost closer to $600. “There are many, many services that are needed for people with mental illness,” said Laurie Martinelli, executive director of the Massachusetts chapter of the National Alliance on Mental Illness. This includes inpatient hospital beds, outpatient counseling, and services that fall somewhere in between, such as respite programs, she said. David Matteodo, executive director of the Massachusetts Association of Behavioral Health Systems, a trade group that represents psychiatric hospitals, said he welcomes the respite facility — as long as it is used for the right patients. “If this is an appropriate setting for people, and this is what they need, it’s wonderful,” Matteodo said. “My concern is they’re not diverting people who need inpatient care to alternative facilities to save money. This is something the oversight agencies need to watch.” -See the full Boston Globe article.
Opinion: Why Too Many Health Insurance Choices Are Costing You Money It’s time for health insurance plans to take a page out of 401(k) playbooks. Consumers are bewildered by dozens of health plan options—and they're making expensive mistakes. Insurers could learn from 401(k) plans. People need simpler choices, as well as guidance that will nudge them toward the best plan for their needs. That’s what 401(k)s are designed to do—though it took years for plans to evolve. As the traditional employer-managed defined benefit pension began to disappear, the early generations of 401(k)s and other defined contribution plans presented workers with new and complicated sets of investment choices. Employees were so overwhelmed that many did nothing, leading Congress to pass reform laws to simplify 401(k) decisions, including providing default plan choices and using auto-enrollment—putting employees into plans unless they opt out. Today many employers are going a step further by turning 401(k)s into pension-like plans, removing the need for decisions unless workers choose to make them. But health insurance is still stuck in an old-school 401(k) world. Obamacare exchanges have created extensive menus of plan choices that many consumers don’t understand. The exchange concept has also become popular among employer plans for both current workers and retirees. Exchange providers, led by big employee-benefits firms, are signing up lots of health insurers to offer employers and their workers extensive sets of plan choices. The confusion extends to Medicare, as consumers are often required to choose among 30, 40 or more Medicare Advantage plans or Part D prescription drug plans. They are simply overmatched by the task, research shows. As with 401(k)s, the primary problem consumers face with health insurance choices is that they don’t understand how the policies work, studies show. Nor do they understand the industry jargon—in the case of health insurance, that may mean even basic terms like deductibles and co-payments. Consider this alarming study: A Fortune 100 company offered 48 new health insurance plans to more than 50,000 employees. All of the plans were offered by the same health insurer and offered identical coverage. They differed only by premiums, deductibles and other cost-sharing variables. In roughly 80% of their selections, workers made bad decisions—opting for the low-deductible but high-premium plans that cost them more money yet provided no additional insurance protection. Lower-income and female employees made particularly bad choices. The amounts of wasted money often equaled 40% or more of the employee’s annual premium expenses. Employees who chose low-deductible plans paid $631 more on average in premiums, but saved only $259 a year in out-of-pocket costs compared with available higher-deductible plans. Even more discouraging, when researchers went back and told employees about their mistakes, it had very little effect. More than 70% of employees did not understand insurance well enough to make an informed choice. Further, it had never occurred to the workers that their employer would include lousy choices in its plan offerings, the researchers found. Improving insurance literacy is crucial in helping employees understand how to make better choices. But as behavioral research with 401(k)s has shown, the most effective solution is to reduce the number of plan choices and their complexity. -See the full Time.com article.
CBT Feasible, Effective for Anxiety in Dementia Cognitive-behavioral therapy (CBT) is a feasible and effective intervention for the treatment of anxiety in dementia patients, results of a new pilot study suggest.
Investigators, led by Aimee Spector, PhD, DClinPsy, from University College London, United Kingdom, found that CBT improved anxiety symptoms and significantly improved depression. Moreover, the intervention was cost neutral. "This study helps to confirm that, despite cognitive impairments, people with dementia are able to learn new skills and engage in CBT, despite it previously being disregarded by many as a treatment for the 'cognitively intact,' " Dr Spector told Medscape Medical News. "The study also shows change in attitudes and feelings about their diagnosis and maintenance over time, suggesting the integration of new ideas and management strategies. Ultimately, I would hope that it would increase independence and reduce stigma ― something that is much harder to achieve with drugs," she added. The research is published in the June issue of the British Journal of Psychiatry. -See the full Medscape summary article.
Social Anxiety? Fermented Foods May Help A diet rich in fermented foods and beverages likely to contain probiotics may help curb social anxiety in young adults, especially those who are highly neurotic, new research suggests. "While our study cannot definitely determine a causal relationship between fermented food consumption and social anxiety, in combination with the preclinical and clinical studies, our findings suggest that eating more fermented foods can decrease social anxiety," Matthew Hilimire, PhD, an assistant professor in the Department of Psychology, College of William and Mary, Williamsburg, Virginia, told Medscape Medical News. "Future studies could test potential applications, such as supplementing drug or cognitive-behavioral therapy with fermented foods," he said. The study was published in the August 15 issue of Psychiatry Research and is available online. -See the full Medscape summary article.
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