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The “Crafty Ladies” are “Blazing a Trail” and Doing What They Love

By |May 19th, 2016|

This year’s Older American’s Month theme, “Blazing 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.  HESSCO is celebrating OAM by recognizing older adults in our area who have embraced this philosophy and are using their skills to make a difference.  Millis seniors Natalie Bossie, Jackie Carroll, Carol Fetter, Carol Russo, Camille Saitta, Dottie Skag and Pam Wilkey are the aptly named “Crafty Ladies.”  This lovely group of women get together ever Tuesday to do what they love – craft!  Their group first formed as a one-stroke painting art group and evolved into a weekly crafting group.  Sometimes they work on a specific project and other times they bring their own individual projects to work on.  They are not only following their passion for the arts, but they’re using their skills and years of experience to serve others.  One craft a month is dedicated to be shared with the HESSCO “Meals on Wheels” consumers who receive home delivered meals through the Millis Meal Site at Millis Council on Aging.  The ladies pick a seasonally themed craft that they think will be enjoyed by the consumers.  “It’s a little something extra, in addition to their lunch, to put a smile on their faces,” said Carol Fetter, the founder of the Group.  They have crafted “bunny bags” for Easter, “turkey pins” at Thanksgiving and snowmen in the winter, to name a few.  The items are adorable and the ladies try to include items that would also be useful…such as tea bags with handmade notecards.  Much of the crafting supplies come from their own donations.  Many of the ladies attend other activities at the Senior Center – some participate in exercise class, scrabble, outings and luncheons.  They all agreed that the crafting group is largely a social outlet, but it makes them feel good to give back.  Although the ladies don’t get to see the recipients’ reactions, they sometimes get positive feedback from the volunteer drivers, so they know their donations are appreciated. Carol added, “Just knowing that we may have brightened their days makes us feel good.”  This is a perfect example that the effort doesn’t need to be a monumental one in order to make a difference.  These ladies are doing something they love, and making a difference, one craft project at a time.

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MASS HOME CARE Part of New End-of-Life Care Coalition

By |May 13th, 2016|

 Mass Home Care Part of New End-of-Life Care Coalition

BOSTON, May 12, 2016—Mass Home Care is one of the statewide groups that is participating in a new coalition to help people of all ages to make their wishes know about end of life care.

Eighty-five percent of Massachusetts residents believe that physicians and their patients should talk about end-of-life care – but only 15 percent have actually had such conversations, according to a new statewide survey by the Massachusetts Coalition for Serious Illness Care.

Strikingly, even those respondents facing serious illness are reluctant to plan ahead with their care team. Only 25 percent of respondents facing such afflictions reported talking with their physician about end-of-life care.

In addition, although the vast majority of people will eventually encounter medical situations in which they are unable to make decisions for themselves:

  • Almost half of the population (46 percent), including most men, people of color, and those without college education, have not discussed their wishes for serious illness care with others.
  • Most respondents (55 percent) have not named a health care agent (or proxy) to make such decisions.

“These findings are a wake-up call for all of us, clinicians and patients alike,” said Atul Gawande, M.D., M.P.H., co-chair of the Coalition, executive director of Ariadne Labs, a joint center of Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, and author of the New York Times bestseller, Being Mortal: Medicine and What Matters in the End.

“People have priorities in their lives besides just living longer,” said Dr. Gawande. “They have goals and aims for the quality of their life, too. This survey shines a light on the need to ask people about what those priorities are– and then to ensure that they are honored.

“This is about how you want to live, not just about how you want to die,” Gawande said. “When clinicians don’t talk to people about their priorities for serious illness care, care can become misaligned with what matters to them. And the result is suffering.”

The landmark survey’s findings were  shared at the Coalition’s inaugural Summit at the Kennedy Library in Boston.

The Coalition’s goal is “for everyone in Massachusetts to be cared for in accordance with their own goals and preferences, at every stage of health care and illness,” said Maureen Bisognano, co-chair of the Coalition and former President and CEO of the Institute for Healthcare Improvement. “We have to have the will to build a system where clinicians feel comfortable raising these conversations with their patients. And people feel comfortable raising it with their clinicians.”

But there is work to be done to achieve that goal, according to the survey. One-third of Massachusetts residents who had a loved one die in the past year said patient preferences were not fully followed. And one-fifth described the end-of-life care they witnessed as only fair or poor.

“None of us should be satisfied until people across the Commonwealth feel much more comfortable to express their wishes, and clinicians have the time and skills to really understand, so they can respect those wishes,” said Bisognano.

But the survey shines light on reasons for hopefulness, too. When respondents do name a health care agent, 85 percent talked to their agent about their wishes if faced with serious illness.

“There are people doing incredible work in this area in Massachusetts,” said Andrew Dreyfus, another Coalition founding member and President and CEO of Blue Cross Blue Shield of Massachusetts. “They are joining the Coalition to give these matters the focused attention they deserve. And to help make Massachusetts a national leader in serious illness care, just as we have been a national leader in so many other important areas of health care. This is the right time. And this is the right community in which to do it.”

“We want to make this conversation easier to have,” explained coalition member Al Norman of Mass Home Care. “People want their health care to be consistent with their values and wishes. The best way to do that is to tell family and practitioners what you want in advance—because when the time comes—you may not be able to have that conversation yourself.”SeriousIllnessPanel2016

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.

 

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Caring for the Caregiver Fashion Show a Success

By |January 29th, 2016|

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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