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Blaze a Trail to Wellness

By |May 5th, 2016|

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May is Older Americans Month.  The 2016 theme, “Blaze a Trail,” emphasizes the ways older adults are reinventing themselves through new work and passions, engaging their communities, and blazing a trail of positive impact on the lives of people of all ages.

It’s never too late to get more active or revamp your diet.  Small changes can lead to huge differences in the way you feel and the way your body works.  Although you should always consult with your doctor before making changes, there are easy steps you can take toward overall wellness-regardless of your age.  Important things to keep in mind:

  1. Start slowly – If you have not been exercising, choose something low-impact that you can do a little at a time.
  2. Exercising is less of a chore when you do it with other people you enjoy – Gather a group of friends or join a class that offers what you are looking for.
  3. Activity is important, but nutrition is equally vital – Try keeping an honest record of what you eat to see how you are doing.

4. Wellness is a matter of body and mind – Eating healthy foods and staying active may reduce risks to your brain’s health.  Do even more by learning new things and exercising your mind.  Try reading, playing games, taking a class, or simply being social.

 

Preparing Yourself for Medicare

By |May 4th, 2016|

Eldercare Q&A:  Preparing Yourself For Medicare

Q: I am turning 65, how should I get ready for Medicare?

A: Between 2011 and 2030, 10,000 people a day will turn 65. That’s 73 million Americans who will be exploring Medicare health insurance for the first time. Medicare has several primary parts:

  • Part A: is often called hospital insurance because it pays for your care while you are in the hospital. Part A also pays some of the costs if you stay in a skilled nursing facility or if you get health care at home. Part A also covers hospice care for people who are terminally ill.
  • Part B: covers doctor visits, plus screenings, lab tests, outpatient hospital care and home healthcare which is not covered by Part A.

These two Parts A & B are known as “Original” Medicare, or “fee for service” Medicare. With Original Medicare, you can go to any doctor, hospital, skilled nursing facility or outpatient treatment clinic that accepts Medicare assignment.

  • Part C: refers to private health care plans known as Medicare Advantage plans, which have contracts with Medicare. When you join one, you get your Medicare-covered healthcare services—all the same things as Medicare Part A and B. But Part C plans also may cover services that Original Medicare does not—like eye exams, a pair of eyeglasses, or a hearing exam.once a year. They may charge different amounts than you would pay through Original Medicare. Medicare Advantage plans may also cover prescription drugs. If they do, you cannot buy a separate Medicare prescription drug plan.
  • Part D: provides prescription drug coverage to everyone with Medicare. To get Part D, you must join a plan run by an insurance company or other private company approved by Medicare. Each plan will vary in cost and the drugs covered, and plans can change from year to year. A plan that covers your prescriptions this year might change and not cover them next year. If you take drugs now, or if you do not. and your health changes or you need more medicines, this insurance will help pay for your drugs and protect you from very high drug costs.

When you approach 6 months before your 65th birthday, here are some ways to prepare:

  • Research the ABCD’s of Medicare by going to the website: MyMedicareMatters.org.
  • Find out if you are eligible: Most people are eligible to get Medicare when they reach the age of 65, or younger if they have certain disabilities that prevent them from working. To read the eligibility rules go to: : https://www.mymedicarematters.org/
  •  Learn when you can enroll: There are several times when you can enroll in Medicare, The Initial Enrollment Period is the first time you can sign up for Medicare. You can join Medicare Parts A, B, C and D during this time: The 3 months before your 65th birthday, the month of your birthday, and the 3 months after your birthday. If you were working for an employer and waited to sign up for Medicare, there is a Special Enrollment Period for Parts A & B any time you are working, or within 8 months following the month your employer health plan coverage ends, or when your employment ends (whichever is first). There is also a Special Enrollment Period for Part C & D, which is 63 days after the loss of employer healthcare coverage. If you miss your Initial or Special Enrollment Period, you can sign up for Medicare Parts A & B during the General Enrollment Period from January 1 and March 31 of each year. If you need to buy Part A, you must also enroll in Part B at this time. Finally, there is an Open Enrollment Period from October 15 to December 7th, when anyone with Parts A & B can switch to a Part C, or vice versa, and anyone can join, drop or switch a Part D plan, or change Part C plans.

To help sort all this out, call HESSCO to speak to a SHINE counselor (781) 784-4944.SHINE logo.

Mass Home Care April 16 Press Release on MassHealth “Restructuring” Plan

By |April 21st, 2016|

MASSHEALTH RELEASES “RESTRUCTURING” PLAN: TEARING DOWN SILOES

PRESS RELEASE: APRIL 16, 2016

Contact: Al Norman/978-502-3794/info@masshomecare.org

MASSHEALTH “RESTRUCTURES” : TEARING DOWN THE SILOES

On April 14, 2016, the $15.4 billion MassHealth program announced a major “restructuring” campaign designed to create “a sustainable, robust” health care program for its 1.8 million members. This process is the culmination of roughly a year of “intensive design and stakeholder engagement,” according to state officials.

MassHealth accounts for almost 40% of the Commonwealth’s budget. The Administration of Governor Charles Baker has made overt moves to swap out the current fee-for-service payment model, which they says results in “fragmented, siloed care,” and replace it with a managed care delivery system experiment which places large hospital and physician networks, known as “Accountable Care Organizations,” in control of funding.

The instrument to make this change is a large federal 1115 waiver to support MassHealth restructuring. Financing for the current waiver ends June 30, 2017 with $1 billion in federal support. State law (Chapter 224) requires MassHealth to adopt alternative payment methodologies for promotion of more coordinated and efficient care. ACOs would represent for MassHealth a more “integrated” model of care. In ACO models, the health care providers are accountable for the cost and quality of care. MassHealth also has a number of existing managed care organizations (MCOs) already providing care for the low-income population. In most cases, these MCOs will  remain the insurer, pay claims and will work with ACO providers to improve care delivery. Integrated care  means bringing behavioral health (BH) and long term services and support (LTSS ) under the control of the ACO, and strengthening links with social services.

MassHealth is finishing up work on a 5-year Delivery System Reform Investment Program (DSRIP) funding request to the federal government. To access the DSRIP funding, the Feds require the state to come up with matching funds for the new DSRIP investment, which will be financed through a $250 million increase in the existing assessments on hospitals. The hospitals will receive a $250 million annual increase in MassHealth payments, resulting in no net impact to hospitals as a class

The DSRIP proposal will include investments to support providers who sign on for ACO model; funding for BH and LTSS Community Partner (CP) organizations; formal partnerships between ACOs and CPs; funds for more flexible services;  investments in health care workforce development, improved accommodations for members with disabilities; and a major expansion of the treatment for Substance Use Disorder for addressing the opioid crisis

At the center of the “restructuring” plan are the ACOs. To be an ACO, providers must show they can coordinate care and partner with Community Partners, including primary, specialty, behavioral, acute, and community-based care. The ACO must have relationships with other providers to coordinate/ integrate care effectively. ACOs will be able to choose to create an integrated ACO/MCO entity or enter into ACO contracts with other MCOs; some ACOs may choose to contract directly with MassHealth.

MassHealth has also been working to improve program integrity, especially for LTSS, like  home health service. Home health spending grew last year by $170M, or 41%, and over 80% of growth was driven by providers new to the Commonwealth since 2013. As part of its increased oversight of the home health industry, MassHealth has referred 12 home health providers to the Attorney General’s office for fraud, and imposed a  moratorium on new home health providers,  and added clinical prior authorizations for home health services.

In addition, MassHealth is attempting to “passively enroll” its members into managed and accountable care models. In its FY 17 budget, the Baker Administration sought authority to involuntarily enroll seniors in FFS into Senior Care Options (SCO) plans. But the House thus far refused to grant this power. The SCO plan by statute must provide for voluntary enrollment.

MassHealth’s timeline calls for pilot ACOs to launch by the end of calendar 2016, with a full roll out of ACOs, BH/LTSS Community Partners and DSRIP by October 2017.

In the LTSS field, the focus is on the relationships between the new ACOs and the new “Community Partners.” (CPs). The ACO plan calls for increased LTSS integration and linkages to social services in ACO models through “explicit requirements for partnering with LTSS Community Partners.” The state will encourage ACOs to “buy” LTSS care management expertise from existing community-based organizations, like the 26 statewide Aging Services Access Points (ASAPs) vs. “building” their own assessment and care coordination capacity. MassHealth plans to invest in infrastructure and capacity to overcome fragmentation amongst community-based organizations.

The State will certify who becomes  a LTSS CP. The ACOs will refer to BH, LTSS and social service providers, to help assess “social determinants of health,” ranging from housing stabilization, income supports, nutrition and utility assistance. These new certified CP will have to demonstrate expertise in care coordination and assessments and infrastructure/ capacity. MassHealth says that the CPs “can be providers but self-referrals monitored.” This process is not defined yet, but the goal is presumably to mitigate any conflict of interest between the assessment process and the direct service providers. ACOs themselves will not be allowed to have any direct or indirect financial ownership interest in a CP. In addition, LTSS CPs must demonstrate expertise across multiple populations with disabilities, such as those with physical disabilities, developmental or intellectual disabilities, brain injuries, the elderly, etc.

Certified CPs and ACOs will both be able to get direct DSRIP funding. Social service providers will receive DSRIP funding from funds given to ACO designated for flexible services to address social determinants of health. The funding for both is contingent on ACOs and CPs formalizing arrangements for how they work together. MassHealth is not requiring ACOs to partner with CPs, but instead trying to use financial incentives to make this happen. But advocates for LTSS have pushed for a formal requirement that ACOs use LTSS CPs to provide an “independent agent” for members as a consumer protection against health providers self-referring to the services they own. Such a formal relationship has been available for years by statute in the Senior Care Options (SCO) plan, and the One Care plan—the state’s first two integrated managed care experiments.

The stated goals of the Community Partners initiative are as follows:

  • Create explicit opportunity for ACOs and MCOs to leverage existing community-based expertise and capabilities to best serve consumers with LTSS and BH
  • Break down existing silos in the care delivery system across BH, LTSS and physical health
  • Ensure care is person-centered, and avoid over-medicalization of care for LTSS
  • Preserve conflict-free principles including consideration of care options for consumers and limitations on self-referrals
  • Make explicit and scalable investments in community-based infrastructure within an overall framework of performance accountability
  • Create a certification process for BH and LTSS Community Partners
  • Encourage ACOs/MCOs and Community Partners to formalize how they work together, especially for care coordination and performance management

A CP must be a community-based organization with extensive and broad expertise in BH and/or LTSS in a geographic region. A CP can be a direct service provider but will have a limit on self-referrals. A LTSS CP must have competencies to work with at least 3 subpopulations with disabilities, and meet other criteria, such as strong relationships with social service organizations, IT infrastructure for data capture and maintenance, quality measurement and reporting, electronic encounter/billing capacity. MassHealth will encouraging formation of new entities and partnerships to be CPs, with the explicit goal of overcoming fragmentation and siloes that hinder care integration. The state will promotes entities to come together to serve the continuum of members, such as elders, adults and children with physical disabilities, and members with brain injury, ID/DD, mental illness, and SUD. LTSS CPs may receive DSRIP funding for MCO members if formal arrangements in place.

Certified Community Partners (CPs) must be certified by EOHHS, will be expected to develop infrastructure and meet performance requirements, and a  portion of their DSRIP funding will be contingent on meeting quality/process metrics and ACO/MCO review of performance. At the consumer level, the “Certified” LTSS Community Partners will offer LTSS expertise across multiple populations, conduct independent assessments, advise members on their care options, provide LTSS care coordination, and offer linkages to social services. The CPs will refer to/partner with Adult Foster Care, Personal Care Attendant, Adult Day Health,  and other providers, as well as social service providers.

“This is a very ambitious restructuring,” said Dan O’Leary, President of Mass Home Care . “The key for us will be the role of the ‘conflict free agent’ in conducting assessments and care planning. Since this is a program being managed by large health care providers, we need to ensure that the consumer’s long term supports needs are fully recognized and addressed , and that they have an independent agent on their team to preserve open choice of services and providers.”

“Ensuring the consumer’s needs are met with the right care and services in the right place will be a major challenge,” O’Leary said.

 

–END–

Memory Cafes

By |April 12th, 2016|

MEMORY CAFÉ NORMS AND STANDARDS

Developed by the Greater Boston Memory Café Percolator, September 2015  (Adapted from the work of Jytte Lokvig and Susan McFadden)

What a memory café is:

  •  A meeting place for individuals living with changes in their thinking or memory, mild cognitive impairment (MCI) or dementia due to Alzheimer’s disease or a related disorder. It’s a place to relax, have fun, and meet others.  A diagnosis of dementia is not required to attend.
  • A meeting place for care partners, who can enjoy a change of scene and routine, meet other care partners to exchange ideas and learn about resources, and experience respite and renewal in their relationship with the person in their life who has dementia.
  • Structured to support and engage individuals with a range of cognitive needs, including those with cognitive changes, and family, friends, and other care partners.
  • Managed by community advocates and/or volunteers with experience or training in working with individuals with cognitive impairment. Guests who require personal care or assistance participating in the café must have a care partner stay with them.
  • A time to focus on socializing, exploration and respite from disease and disability.
  • An opportunity to learn where to find support and services for those who are looking for this type of information.
  • Free of charge or open to those who cannot afford a fee.
  • A program that strives for inclusion. This includes physical accessibility, respect for and inclusiveness of different cultures, and freedom from stigma.
  • Unique in character, based on the interests and style of the community where it is located and/or the individuals whom it serves.

What a memory café is NOT:

  •  A workshop, seminar or lecture about dementia.
  • A facilitated support group.
  • A drop-off respite program.
  • Primarily a marketing opportunity for a commercial enterprise.

For town listings/dates/times of a Memory Cafe near you, visit  www.jfcsboston.org/MemoryCafeDirectory

 

2016 MM5K for HESSCO a Success!

By |March 25th, 2016|

Congratulations to our 5 Year Race Veterans sporting their commemorative Race Caps with Pat Patriot.

 

5YEARVETS

Caring for the Caregiver Fashion Show a Success

By |January 29th, 2016|

CGFSS2016 CGFSH CGFS2016 CGFashionShowE2016 CGFashionShowD2016 CGFashionShowC2016 CGFashionShowB2016 CGFASH2016 CGF2016

HESSCO Experts Present “Caring for the Caregiver” At Sharon Public Library

By |January 26th, 2016|

On Thurs, Jan 28, join HESSCO speakers Patricia Gavin and Terry Tomasello for, “Caring for the Caregiver,” at SPL.

http://patch.com/massachusetts/sharon/hessco-experts-present-caring-caregiver-sharon-public-library-jan-28-0

 

HESSCO Highlights and Happenings Winter 2015

By |December 9th, 2015|

Winter Newsletter 2015

MA Meals on Wheels Association Recipient of Grant

By |December 7th, 2015|

The MA Meals on Wheels Association is the recipient of this year’s NANASP/ Pfizer Vaccine Awareness Campaign grant.  The grant award is $3,500.  This money will be used to help offset costs associated with production and dissemination of materials used to raise awareness and motivate older adults to get vaccines including flu, pneumococcal, shingles, and tetanus boosters.

About NANASP (National Association of Nutrition and Aging Services Program):  NANASP is a leading organization advocating for community-based senior nutrition programs and their staff. With members from across the United States, they are able to impact local, state and national public policy to maintain and improve the health and well-being of all older persons.

About the Massachusetts Meals on Wheels Association: MAMOW is an advocacy organization made up of twenty-six Nutrition Program Directors who are part of the Aging Services Access Point network in MA. The group shares best practices, keeps an eye on current political issues affecting nutrition, and develops plans to support legislative action.

10 TIPS FOR CAREGIVERS DURING THE HOLIDAY SEASON

By |December 1st, 2015|

free-wallpaper-2 holiday starHolidays bring added commitments, obligations, increased demand on finances, increased visits with family/friends, and other additional stressors which can cause caregivers to experience feelings of being overwhelmed and burnt out.  Here are 10 tips to help you not only survive, but thrive this holiday season, as a means to minimize the added stress of the holiday season.

 Plan – Individuals who experience the most difficulty with the holiday season are those who have given little though to the challenges they will encounter.  Consider yours and others expectations of you, both socially and emotionally.  Discuss holiday celebration plans with relatives and loved ones in advance.  Plan to maintain a regular routine as much as possible while trying to provide an enjoyable, meaningful, and calm holiday event.  If possible, explore celebrating the holidays earlier in the day, rather than a late dinner, as this allows for “down time” at the end of an evening.  Planning can avoid holiday stressors.  Allow yourself extra time to be ahead of schedule in terms of gift shopping, meal prepping, and event planning.  Start early.

  1. Prioritize/Self-Care – As a caregiver, you should keep in mind that the holidays are an opportunity to spend time with your loved ones.  Concentrate on enjoying your time with your loved ones.  Prioritizing involves setting limits by communicating with your family and friends that you intend to reduce your stress this holiday season by opting to say “no” to certain things.  It could be as simple as not taking the time to send out family holiday cards or to skip cooking for the family one night a week and go out to dinner instead.  As a caregiver, maintaining a positive mental attitude will go a long way in terms of self-care.  Lean on family, friends, and professional supports as a means to reduce stress by asking for help when you need it.  Arrange for respite care for your loved one when you are feeling burnt out as a caregiver.  It is also important to build a “toolbox” that pertains to managing your own self-care and coping skills.  Coping skills can be anything from deep breathing exercises, stopping to smell a scent that makes you smile, listening to music, spending time with others outside of your caregiving role, or even just taking a walk.  Seek counseling if you feel you require additional therapeutic interventions as well.
  2. Simplify – Holidays can cause feelings of being overwhelmed with the demands of family traditions.  A caregiver should simplify things by setting limits for the care recipient.  Preparing the care recipient for the family gathering allows both of you to enjoy the holiday traditions together.  Talk with the care recipient about and show photos of family members and friends who will be visiting in order to reduce their feelings of anxiety, stress, and being overwhelmed.  Having a “quiet” room for the care recipient is helpful in the event that the celebration gets to be overwhelming for the care recipient.  Playing familiar music and serving favorite family traditional foods will help ease the stress on the care recipient.  Scheduling naps for yourself and the care recipient can be beneficial for rejuvenation.
  3. Prepare – Prepare family and friends by communicating with them about your role of a caregiver and what that entails, as well as what is to be expected in terms of the care recipient’s needs.  Lean on others for additional support.  Involve everyone when selecting activities including the care recipient.   Communicate with success by being calm and supportive to each other.
  4. Adapt Gift-Giving – Encourage family and friends who want to give gifts to purchase something useful for both the caregiver and the care recipient.  Ideas such as comfortable easy to remove clothing, favorite music cd, magazines, photo albums, or videos of family members.  Warn people about unsafe gifts such as power tools, pets, challenging board games, etc.  Allow the care recipient to participate in gift-giving.  For example, someone who enjoyed cooking may utilize this strength by baking cookies and packaging them for others.  Remember not to neglect your own needs during the gift giving process.  If asked what you would like for a gift, remember to go back to simplifying things.  You might consider a gift card to a carry-out restaurant to alleviate having to cook one night.
  5. Connect – Remember to stay connected to supports whether they are formal professional supports who can provide respite care for your loved one, or whether it be a family or a friend who may be able to do some shopping for you, get creative and utilize your support system to your advantage.
  1. Give Yourself Permission to Say No – You are not obligated to attend every social holiday gathering nor host events in your home during the holiday season. Remember that each time you agree to host or attend a holiday party; you have to put something else on the back burner.  For example, relaxation time for yourself, time to prepare for the upcoming holiday, and time to spend with loved ones.  Committing to too much will increase stress levels and get you off track.
  2. Manageable – Remind yourself to keep your holiday parties manageable. For instance, keep the number of guests to a manageable amount of people.  Often times, noise and hectic activity can be difficult for a care recipient who may be frail or confused.   Schedule a time for other family/friends to visit before or after your traditional holiday celebrations.  A suggestion of a pot luck dinner could be helpful for the caregiver, so that you do not have to cook and prepare a whole meal by yourself.  Use paper plates and plastic utensils so that you do not have a lot of dishes to do.  This makes your time more manageable and again coincides with keeping things simple.
  3. Realistic – Try not to be a perfectionist, as there is no such thing as perfection. Forego having to be sure that all of your Christmas decorations are put up in the exact spot or that you are trying to portray the perfect family in Christmas cards.  No one is perfect, no family is perfect.  Be realistic about your situation and take notice that you do not have to present your home or family as being perfect to anyone.  Love and accept yourself and others for who they are.  Simplify your expectations in order to avoid feelings of not measuring up to standards you have previously set for yourself.
  4. Accept – Admitting that your loved one is in need of continued care is often difficult. As a caregiver, you should make adjustments for your loved ones needs.  For example, a care recipient may have been diagnosed with Alzheimer’s, who used to be able to complete simple tasks independently such as placing a drinking glass on a TV tray.  The confused care recipient then attempt to balance the TV tray on his/her lap and spills the tray of food and drink on the floor.  Accepting the fact that your loved one would never do such a balancing act if they were not confused is par for the course.  Pretending that your loved ones condition has not changed is not doing anyone any favors.  Accept your loved ones impairments and help support them with their needs.  Acceptance will allow the caregiver to also face reality from a social-emotional perspective.

 

 

References:

(Alzheimers Association, 2015)