Weekly Update - January 30, 2012

Reaction to Governor Deval Patrick's State of the Commonwealth Speech

Mass Home Care, Jan 24, 2012

contact: Al Norman, 978-502-3794

Where Have All The Elders Gone?

For the sixth year in a row, Governor Deval Patrick has said little or nothing about his vision of how to improve the lot of older and disabled individuals living in the Commonwealth.

Since his first Inaugural Address in January of 2007, the Governor has barely mentioned this population group---remarkable because the 60+ population in Massachusetts today is now almost one in five (19.4%), and is the most rapidly growing segment of the state's population.

Older people have not historically made much of an appearance in the Governor's annual message to citizens:           

• In his Jan, 2007 Inaugural speech the Governor told an anecdote about an 82 year old woman in Worcester who was recovering from cancer and a broken hip. The narration described how this elderly woman was determined to get down 6 flights of stairs to vote. "That frail 82-year-old did not walk down six flights of stairs for us to conduct the business of government the same old way," the Governor concluded. "It is time for a change."
• In his January, 2008 State of the Commonwealth, there was no reference to seniors.
• In his January, 2009 State of the Commonwealth, the Governor noted that home health aides, "who deliver vital services," were working "without a contract or adequate pay." He also added later in the speech: "We are going to have to learn to lean on each other, to live as members of a community. That means check in on your elderly neighbor when it's cold to make sure the heat is on."
• In January, 2010, the Governor recalled that he met a grandmother in Lynn "who told me about moving her son and daughter and their kids, 9 of them strong, into her home because they're out of work and strapped for cash." The Governor explained that this woman had lost her job, and said: "She's not asking for much, just a chance to work to provide for her family, and a little help holding on until she can make her own way."
• In January of 2011, in his Second Inaugural Address, the Governor made a passing reference to "the service and sacrifice of our parents and grandparents."
• In his January, 2012 State of the Commonwealth, the Governor returned to a common theme of generational responsibility and noted: "there are parents across our state who wonder tonight whether they will be able to do as well for their children as their parents did for them." He mentioned putting an end to the "fee-for-service" health care payment model---which will affect over 1 million Medicare beneficiaries, who by federal law have a right to Original Medicare fee-for-service. Finally, the Governor said that "people in their thirties or forties or fifties, don't have the proper training for those jobs," but he said nothing about people in the 60s and older who still have to work to survive in this weak economy, with little or no pension income.

Over the years, the Governor has given older citizens little by way of an 'elder vision' to shape his public policy initiatives. Elderly people are burdened by the high cost of health care, and general living expenses. They want to remain living in their homes independently, yet find waiting lists for home care. There is much that the Governor could have spoken about, but his State of the Commonwealth speech was silent on the needs of older residents.

The record on senior issues in the Commonwealth over the past few years has been spotty:

• In September 2005, Massachusetts was awarded a multi-million dollar Systems Transformation grant from the feds to transform the state's long-term support system for elders and people with disabilities. But very little transformation actually took place.
• In August of 2006, the equal choice law guaranteed adults on MassHealth a choice of care in "the least restrictive setting appropriate to their needs." But today, the MassHealth state plan and regulations only guarantees nursing facility care, and 64% of our long term care spending still goes to nursing facilities.
• On July 1, 2008, the Administration's 1115 waiver was supposed to begin, promising expanded home and community based services. After two years of state planning, a waiver was submitted to the federal government---but ultimately was abandoned.
• In September of 2008, the Governor's Olmstead Plan was released, with the mission of creating a "community first" long-term care policy," and "the deliberate development of more accessible and effective long-term supports in local communities." The Olmstead Plan promised to shift the "focus of long-term care financing from institutions to the community." But, as noted above, only 36% to community first care, and the home care program has a waiting list.
• In 2009 and 2010 advocates fought the Administration to get $2.5 million in state funds released for the Equal Choice "Options Counseling" that manages the front door of nursing facilities, to inform people of their options in the community before they decide on a nursing facility. This program is woefully underfunded, as is the program that funds diversion efforts targeted to people already in nursing facilities.
• In 2009, elder advocates beat back a plan from the Administration to do an Article 87 reorganization that would have diminished the role and responsibility of the Executive Office of Elder Affairs. The Administration went ahead with its plan anyway without formal response from the General Court.
• Two months ago a national report from AARP said that Massachusetts ranked 40th in the nation for Medicaid LTSS users first receiving services in the community. According to this report, if Massachusetts improved its performance to the level of the highest-performing state,10,203 more new users of Medicaid LTSS would first receive services in home and community based settings instead of nursing homes;3,945 nursing home residents with low care needs would instead be able to receive LTSS in the community.
• In 2011, the state submitted an 'Integrated Care Organization" grant for federal funding that would turn over total control of LTSS for people on MassHealth to large hospital and physician networks-despite the fact that these managed care entities have no experience in managing LTSS, and if anything have demonstrated an institutional bias in their referral patterns.

The Governor's State of the Commonwealth speeches often return to the themes of hope, and generational responsibility. But in terms of tangible actions and policy initiatives to address the needs and hopes of seniors---these speeches leave little to hold onto---leaving advocates to ask: Where have all the elders gone?

Editorial:  "...not by Accident" 

Anyone who watched Governor Deval Patrick's State of the Commonwealth address last Monday night heard the phrase "not by accident" repeatedly as the governor ticked off the accomplishments of his administration.  

It wasn't too many years ago that Dr. JudyAnn Bigby would hold briefing sessions for agencies and advocates to assure every one that the budget cuts being suggested were "values-based".   In today's issue under FY13 budget, we publish Dr.  Bigby's list of budget cuts.  No briefing this year (unless of course there was one I didn't get invited to). No talk this year about values.  

Let's highlight couple recommendations from Governor Community Next-to-Last.  

Deaf-Blind Community Access Network:  DBCAN is a success of the DPC from the late 90's.  This program provides Deaf-Blind citizens in eastern Massachusetts with Service Support Providers to help them get out of their homes for doctor's visits, shopping, church and social events.  They get a whopping 16 hours a month!  

Can you imagine staying in your house the other 704 hours a month.  A functional assessment of Deaf-Blind people would find parallels with many people in other state-supported systems with 24/7 coverage.  This would be  an excellent case to test the theory of "equity within the class".

Elder Nutrition:  250,000 meals are being cut from 

Elder Affairs.  "Let them eat cake" because "its not by accident".  

I will be sure to use the phrase repeatedly during the next few months.  It as such a nice ring to it.  

On the Calendar: Duals Meeting

MassHealth has scheduled another Open Meeting:

February 6, 2012, 10:30 AM -12:30 PM 

• State Transportation Building, Conference Rooms 2 & 3
  10 Park Plaza, Boston

The purpose of this open meeting will be to discuss changes MassHealth is making to the draft Demonstration Proposal on Integrated Medicare and Medicaid for Dual Eligible Individuals in response to input received through the public comment and public hearing process. 

We welcome attendance from all stakeholders and members of the public with interest in this proposed Demonstration. Reasonable accommodations will be made for participants who need assistance.  Please send your request for accommodations or RSVP to Donna Kymalainen at  Donna.Kymalainen@state.ma.us.

On the Calendar: T Hearing 

On the Calendar: Film Festival

Six films from around the world about people with disabilities will comprise the first REELAbilitiesBoston Film Festival being presented Feb. 2-8 by The Boston Jewish Film Festival. Boston becomes only  the fifth city to stage a REELAbilities festival.

The films are My Spectacular Theater, War Eagle, Arkansas, Shooting Beauty, Snow Cake, Warrior Champions and Anita.

Tickets are $10 general admission, $9 for students, seniors, BJFF, Coolidge Corner Theatre, MFA and WGBH members and $6 for groups of 10 people or more for the same movie. Those with disabilities can attend for free. Please contact us in advance for more information at info@bjff.org.

On the Calendar:  MFP Meeting

Money Follows the Person

Thank you for being part of the MFP process and participating in the Topical Discussion and Stakeholder meetings. We hope you will join us for our next meeting on Thursday, February 2, 2012 at the Worcester Public Library (Saxe Room) from 2:00 to 3:30 pm.   

In an effort to include people who have not attended past Stakeholder Meetings, we will have a pre-meeting from 1:30-2:00 that will provide an overview of MFP so please invite others who want to be involved.

Calendar:  Consumer Conference

 Save the Date!!!!  2012 Consumer Conference  

The Massachusetts Rehabilitation Commission (MRC) has an ongoing need for the short term services of qualified consumers from various fields of public vocational rehabilitation, and related areas including Independent Living Program and Services, Disability Determination Services and Statewide Programs such as Disabled Persons Protection Services, Statewide Employment Services, Home Care Assistance Program and services for Brain Injury and Statewide Specialized Community Services Program (BISSCS).