|The Dementia Friendly Massachusetts Initiative (DFMI) is a statewide effort to spark and support dementia friendly systems and grassroots programs across Massachusetts. A "dementia friendly community" is informed, safe, and respectful and enables people living with Alzheimer's or a related neurocognitive disorder, and those who care about them, to live full, engaged lives. Our goal is to help all communities in the Commonwealth to become more dementia friendly.
The Connection Newsletter
|Welcome to the second issue of the Connection! In this issue, we continue to offer resources and celebrate your efforts to grow dementia friendly communities throughout Massachusetts.
We are grateful to Tufts Health Plan Foundation for its support of the Dementia Friendly Massachusetts Initiative from its inception and for granting funding for our work to continue through 2017.
Below you will find news and resources from around Massachusetts. Please forward this newsletter to your colleagues and lists. We encourage you to share your ideas and learn from each other. To help you navigate the plentitude of resources and events, we have added some new sections including Media, Memory Cafés, and News from Around the World. We welcome your feedback and suggestions for further developing the newsletter, including examples of how it has impacted your work. Going forward, one-time events will be listed as a single line item in an Upcoming Events section to manage page length.
The deadline for submissions for the next issue of the Connection is Friday, March 31. Click here to submit your news today.
Music & Memory Certified
Somerville-Cambridge Elder Services became a Music & Memory certified facility in September 2016. Since certification, they have been bringing personalized music to their clients with Alzheimer's and dementia as a unique intervention to help reduce isolation, depression, and the behavioral symptoms of dementia. Each participant receives an iPod, headphones, and a personalized playlist. This program is free of cost for any client of Somerville-Cambridge Elder Services.
For more information, contact Rory Silvia, Somerville-Cambridge Elder Services at firstname.lastname@example.org or 617-628-2601 x3211.
Dementia Friendly Meets Age-Friendly in Berkshire Kick-Off
The Berkshires Dementia Friendly Initiative held a very exciting summit in November bringing together more than 60 diverse community stakeholders from across sectors to learn about the Dementia Friendly Massachusetts Initiative, develop a shared vision, and begin to plan how to move forward. DFMI Coordinator Emily Kearns presented about DFMI and facilitated a strategic visioning and planning process using the Appreciative Inquiry (AI) process. View an article related to the event published by the Berkshire Eagle.
For more information, contact Rhonda Serre, Outreach & Advancement Supervisor, Elder Services of Berkshire County, Inc. at email@example.com or 413-499-0524 x728.
Spotlight on Training and Community Education
Alzheimer's Disease and Dementia Training for Community First Responders
SeniorCare Inc., an Aging Services Access Point for the North Shore, will be offering Alzheimer's disease and dementia training for community first responders. The training is specifically designed to better prepare EMTs, fire, police, COA outreach workers, mail carriers, and other front lines staff to respond to incidents and emergencies involving individuals with dementia, both in their homes and in the community at large. The training is a 4-hour presentation that can be given as a whole or in shorter increments.
To schedule training dates, contact SeniorCare Inc. at 978-281-1750, x525.
Senior Living Residences' Dementia Experience
Senior Living Residences' Dementia Experience uses immersive learning techniques, role playing, and discussion groups to help participants better understand dementia and learn practical tools to assist with communicating and interacting with those with dementia. This program is easily replicable and was built for families, caregivers, students, elder care professionals, municipal workers, and emergency services workers and is a free program with a train-the-trainer component.
Learn more at dementiafriendlymass.org or email firstname.lastname@example.org for more information.
The Power of Music - Training Workshops for Family Caregivers
Music provides one of the greatest potential resources for connecting with people with dementia at any stage, compounding the psychological and physiological benefits for all involved. Recent research has revealed that music memories are likely to be among the last to be lost, providing an invaluable bridge for social connection. Jan Maier, RN, MPH leads creative training workshops for family caregivers, staff, and others who work with people with dementia on how to utilize that bridge by incorporating music into daily life with particular emphasis on fun, simple interactive methods. A singer and choral conductor/former health researcher, she bases her techniques on the latest research in music and the brain (with and without dementia) and is passionate about spreading the word about the power of music to help people with dementia and those who care for them.
For more information, contact Jan Maier at email@example.com or 781-301-1821.
Methuen and Emerson Hospital Receive Dementia Friendly Training
Amazing results from Dementia Friendly Trainings conducted with the City of Methuen and Emerson Hospital Wellness Center indicate that participants craved more and more information. A participant shared, "We can never get enough information on this topic."
For more information about this training and its findings, contact Maryellen King, Senior Living Residences at firstname.lastname@example.org or 781-749-6429.
Alzheimer's Association's First Responder Dementia Training Program
Alzheimer's Association has rolled out an evidence-informed First Responder dementia training program to a number of fire districts and EMS agencies in Massachusetts. This training is offered in a variety of formats including train-the-trainer, direct classroom, and online versions. Programs offered in the coming months will be provided in Gardner, Boston, and Pittsfield with collaboration from community champions, including Gardner Fire Chief Richard Ares, Patricia McCormack of Boston Alzheimer's Initiative, and Bobbie Orsi of Home Instead.
Contact Ronda Randazzo at email@example.com for more information.
Alzheimer's Association's Customer Service Training Program
The Alzheimer's Association has developed a customer service training program: Care, Cause, and our Customers, which teaches helpful strategies for working successfully with customers or clientele who have memory impairment.
Contact Ronda Randazzo at firstname.lastname@example.org for more information.
Dementia Education/Clinical Experience Offered to Vocational High School Students
Cornerstone at Milford has partnered with Tri County Vocational High School (TCVHS) in Franklin to provide ongoing dementia education and clinical experience to their medical career students. Students participate in Cornerstone's interactive dementia education program (part of Senior Living Residences Dementia Friendly Massachusetts Initiative) before working alongside Cornerstone's CNAs and nurses to support their residents with daily care. The program aims to provide a better understanding of dementia and the challenges it presents to those living with dementia and their caregivers.
For more information, contact Beth Patras, Cornerstone at Milford, at email@example.com or 508-473-0035.
Wingate Residences Offer Memory Loss Lunch and Learn Series
Wingate Residences, 235 Gould Street, Needham, is excited to offer monthly Memory Loss Lunch & Learn Series. Director of Memory Care Services, A.J. Plummer, MSPT, CDP, DCT, will be offering information on the following topics at noon on the first Thursday of every month. There is free parking, 5-star dining, and invaluable information.
- February 2: Creating Moments of Joy
- March 2: What's Happening to Grandma? How to Talk to Young Children About Memory Loss
Gerontology Certificate Series Offered on Cape Cod
The Center for Corporate and Professional Education is accepting registrations for the 2017 Gerontology Intensive Certificate. This is a 10-session certificate series for professionals currently working with older adults or exploring gerontology as a career choice. Course material covers the major topic areas in gerontology and teaches practical approaches to understanding, assessing, and intervening with a variety of service concerns affecting older adults.
Contact Patty Watson, Project Specialist, at firstname.lastname@example.org for more information.
REST Training Offered by Massachusetts Lifespan Respite Coalition (MLRC)
Respite Education and Support Tools (REST) is a national, evidence-supported program to provide training for respite providers (volunteer and paid) and respite, a "short break" for the caregivers. REST is an eight-hour training (one full day or two four-hour sessions) that teaches the role of respite provider, confidentiality, communication tips, interview or first visit form, planning and adapting activities for care recipient, valuing differences, crisis intervention and understanding behaviors. This active-learning training includes discussion, group exercises, and interactive and experiential learning. It can also be customized to your community needs.
The Boston University Alzheimer's Disease Center's Community Events & Programs
The Boston University Alzheimer's Disease Center holds many educational events and programs for community members and its faculty speak at a variety of community education events throughout Massachusetts and southern New Hampshire. They also conduct numerous educational activities for health care professionals and young researchers.
To request a speaker for a community education event or for more information, contact JoinADC@bu.edu or call 857-364-2140.
Alzheimer's Care Management Training
Hope Dementia & Alzheimer's Services offers a popular Alzheimer's Care Management training designed for professionals to gain confidence and knowledge to effectively work with individuals and families in the community and facility setting. This 16-hour program includes the 8-hour dementia certification, fulfilling Massachusetts state regulations. Trainings will be held at Old Colony Elder Services in Brockton.
Cheerful Spirit™: A Spiritual Support Program
Cheerful Spirit is designed for adults living in memory care communities and recognizes the challenges of aging in the experience of dementia. Programs incorporated under the umbrella Cheerful Spirit™ identify and uphold the still viable spirit of each person and rely on the strength of individual attributes that promote confidence in the individual's sense of agency, as well as the enjoyment of tangible successes accomplished through teamwork. Furthermore, aging adults may be concerned with self-worth, reconciliation, repeated losses (both physical and social) and subsequent grief and meaning-making, and their ultimate concerns and legacy. In this context, spiritual support is woven into meaningful activities that anticipate the realities of aging while adapting to the dynamics put forth by the effects of dementia. Facilitated by Annette Moyer Nicolas, Chaplain, M.Div.
Opening Minds Through Art Pilot at Goddard House
Goddard House is piloting a mini-version of Opening Minds through Art out of the Scripps Gerontology Center at Miami University. With the help of interns and four artists with dementia from their memory support program, they are creating abstract art and planning an exhibit for the month of March at the Goddard House. They are also looking to expand the program in Fall 2017.
Savvy Caregiver Practitioners' Training
On December 6, 20 staff members from different Aging Services Access Points (ASAP) agencies completed the Savvy Caregiver Practitioners' Training conducted by Ann O'Sullivan OTR/L, LSW, FAOTA, Family Caregiver Support Manager from the Southern Maine Area Agency on Aging. The training was sponsored by the Healthy Living Center of Excellence/Elder Services of the Merrimack Valley in collaboration with the MA Executive Office of Elder Affairs. Funding for this project was provided by an Administration for Community Living Alzheimer Disease Supportive Services Program (ADSSP) Grant.
The new practitioners will be able to implement Savvy Caregiver trainings in their respective communities. Savvy Caregiver is a training geared to informal caregivers of people living with Alzheimer's and related dementias. The new practitioners are planning to implement their first Savvy Caregivers trainings in the spring of 2017. Those interested in participating or referring caregivers should check the state-wide calendar of workshops on their
For more information, contact Ana Karchmer, MA Executive Office of Elder Affairs, at email@example.com or 617-222-7490.
Rest.Stop.Ranch in Topfield Offers Year-Round and Seasonal Programs in 2017
Year-round programs include one-on-one spiritual-care sessions, and a twice monthly support group for caregivers under age 65 caring for a loved one under 65 (young onset). Seasonal programs (April - October) include a monthly Sunday Stroll through wheelchair-accessible gardens (0.1 mile), and a Memory Café most Saturdays, for friends with dementia, with care-partners.
All programs are free-of-charge; contributions are graciously accepted. The MargFMac Front Garden Loop (0.1 mile) was built in 2011 in honor of founder Mary E. MacDonald's mother, Margaret, who passed from frontotemporal degeneration (FTD). Visit the activism website at
and the online respite website at
Spotlight on Collaboration and Inclusion
Research and Treatment Collaborators Reaching Out
The Center for Alzheimer Research and Treatment (CART/BWH) focuses on preventative and symptomatic clinical trials and the Massachusetts Alzheimer's Disease Research Center (MADRC/MGH) focuses on observational studies. Together, they are actively engaged in outreach in all communities in MetroWest, North Shore, South Shore, and Boston's many neighborhoods. They also have a speakers' bureau of neurologists and neuropsychologists and would be happy to speak at your events.
For more information, contact Nancy Coppelman and Miriam Olken at firstname.lastname@example.org and email@example.com or 617-278-0383.
Tools and Resources
DFMI Trainings Inventory
DFMI recognizes training and education about dementia to be a cornerstone of more dementia friendly communities. As a public service, we have compiled an inventory to help communities find training resources.
Organizations or individuals that offer trainings and would like to be added should contact Beth Soltzberg, DFMI/JF&CS, at firstname.lastname@example.org or 781-693-5628.
Framingham's Continuing Connections
The Continuing Connections program at the Callahan Senior Center in Framingham is a no cost social program for up to eight couples from Greater MetroWest with early stage Alzheimer's or other forms of dementia and their care partners to participate in together. The program involves a variety of beneficial activities including expressive therapies, reminiscence, speakers/entertainers, peer lunches, outings, and holiday/themed celebrations.
Running weekly for four hours on Fridays for the past five years, it encourages camaraderie and reminiscence between peers both in and outside of the program. Over time, it has served 20 couples facing Alzheimer's, all of whom have continued connections around the skills they still have and have formed new connections which are now continued with others facing the same challenges. The program receives support from the Town of Framingham, Friends of Callahan, and donations.
Contact Jamie Donchin, MSW, LICSW, Program Coordinator, at email@example.com for more information.
Dementia Friends is a global movement that is changing the way people think, talk, and act about dementia. Dementia Friendly America has recently licensed it for use in the United States. Visit their website for details.
DFMI is in the process of making Dementia Friends available in Massachusetts so that in-person community awareness sessions can be offered using a train-the-trainer model. Stay tuned for updates!
For more information, contact Beth Soltzberg, DFMI/JF&CS, at firstname.lastname@example.org or 781-693-5628.
Memory Café Toolkit
The number of memory cafés in Massachusetts continues to grow! Massachusetts and Wisconsin now have the most cafés of any states. View the statewide Memory Café Directory.
Those considering starting a café can download the free
Memory Café Toolkit
. A Spanish version of the Toolkit will be added to the website in the coming weeks.
For more information, contact Beth Soltzberg, DFMI/JF&CS, at email@example.com or 781-693-5628.
Making the Pitch: A Guide for Advocating with Your Policymakers
Speaking with constituents and customers is a major part of what leaders do. They want to know their customers' or constituents' concerns and what they can do to help. Many community organizations and individuals are seeking to engage their community leaders and elected officials in a dementia friendly community process. This document will give you pointers on how to get a meeting with a community leader, how to prepare, and how to get the most out of it. Available through DFMI.
Contact Emily Kearns, DFMI Coordinator, at firstname.lastname@example.org for more information.
Honoring Choices Massachusetts
No matter what age or phase of health, every adult has the right to receive person-centered care that honors their care goals, values, choices, and preferences. Honoring Choices provides downloadable tools and discussion guides to help you and your loved ones make a personal health care plan and work in partnership with your doctors and care providers to match care to your choices and preferences. The Honoring Choices Community Partners can help individuals and families start a discussion and connect to care in their community. You can access the free information and tools on their website.
For more information, contact Ellen DiPaola, Esq., President and CEO, at email@example.com or 781-642-0454.
Barnstable Offers Online Tools to Grow DF Communities
Barnstable County Department of Human Services' goal is to create a healthy, connected Cape Cod. Their online resources connect individuals, families, and organizations to the health and human services information they need. Their public health and wellness website is a resource for those seeking information in health and human services. The site provides data and information about community services, laws, related news, and a local service directory that includes resources on aging, disability, mental health, substance use, housing, and basic needs. Their behavioral health website focuses on behavioral/mental health information and includes a local service directory, current legislation, and key health topics, including medication, symptoms, and supports.
Contact Patty Watson, Project Specialist at firstname.lastname@example.org for more information.
New Book Coming Soon
Education Core Directors Andrew Budson, MD, and Maureen O'Connor, PsyD, have written a book for the public, Seven Steps to Managing Your Memory: What's Normal, What's Not, and What to Do About It. The book helps the older adult understand whether the changes in memory they are experiencing are normal or not, how to work with their doctor during an evaluation, what diets and exercises can help, which memory aids and strategies are useful, and how they can proactively plan their future. You can pre-order the book on Amazon.
For more information, contact Christina DiTerlizzi, Boston University Alzheimer's Disease Center, at email@example.com or 857-364-2140.
New Guide: Tips and Techniques for Supporting Residents with Alzheimer's Disease Using the Habilitation Model: A Guide for Staff in Independent Senior Housing
For a person living with Alzheimer's disease, interactions and surroundings are critically important. Caren Silverlieb, JCHE's Director of Strategic Planning and Partnerships, and Dr. Paul Raia, creator of the Habilitation Model, co-authored Tips and Techniques for Supporting Residents with Alzheimer's Disease Using the Habilitation Model: A Guide for Staff in Independent Senior Housing. This guide has been used by hundreds of organizations, individuals, family members, and professionals to learn what is happening in the brain, effective communication, the importance of purposeful engagement, the physical environment, and behavior as the person's way of communicating. Visit their website to access the free guide.
For more information, contact Caren Silverlieb, MMHS, at firstname.lastname@example.org or 617-912-8403.
Program for People Living with Newly Diagnosed or Early Dementia and Care Partners
Living Your Best is a program for people with newly diagnosed mild cognitive impairment (MCI) or early stage Alzheimer's disease or other dementias, and their care partners. This free 5-week program includes education, support, and engagement and begins on January 17 at Home Instead Senior Care in Pittsfield. The program is supported through a grant from the Berkshire Life Foundation and is offered in partnership with the Fenn Street Development Corporation, the Alzheimer's Association, and Home Instead Senior Care.
Dementia Friendly America Webinar - Getting Involved
Interested in learning about how you can organize a dementia friendly effort in your community? Begin by watching the DFA Overview and Toolkit Webinar on their website.
Please email DFA at email@example.com if you have questions that the webinar didn't answer. If you would like to inquire about organizing your community to begin working toward dementia friendliness, please contact Emily Kearns, DFMI Coordinator at firstname.lastname@example.org or 978-604-0830.
Dementia Friendly America Video - Produced by Connected Living
Connected Living, a Massachusetts-based social impact company, produced an in-kind video for Dementia Friendly America. Connected Living is part of the Dementia Friendly America National Committee with involvement from Neil Sullivan (Chief Operations Officer) and Sarah Hoit (Chief Executive Officer). The video tells the story of what a dementia friendly community looks like and how we can progress as a group toward bringing light to this initiative. Utilizing beautiful scenery and a serene atmosphere, the video works to portray this movement and its partners as confident, effective, and ready to make a significant impact in the lives of those affected by this disease. View the video today.
For more information, contact Matt Johnson, Connected Living, at email@example.com or 781-206-9328.
Blogging Living with Early-Onset Alzheimer's
Since August 2015, two months after Mitch was diagnosed with early-onset Alzheimer's, he has written a weekly blog about Alzheimer's and related topics. Visit his blog, which appears regularly on Fridays.
Contact Mitch Evich, Alzheimer's Association, at firstname.lastname@example.org for more information.
Video of Play: "iloveyouiloveyouiloveyoutoo"
"iloveyouiloveyouiloveyoutoo" honors the journey of people and their families affected by Alzheimer's disease and the related issues of dementia. The heart of this play was inspired several years ago by the daily greeting of a compassionate resident in a Massachusetts nursing home who taught everyone that she met about the gift of love through this greeting. She continually reminded the creators to see the same love that resides in each person and to celebrate their lives. You can view a filmed version of the play on YouTube.
For more information, contact Alan O'Hare, Author and Director, at email@example.com or 508-386-1076.
PBS Documentary: "Alzheimer's: Every Minute Counts"
Dementia Friendly America, our national partner, announced the premiere of a new PBS documentary about Alzheimer's disease called "Alzheimer's: Every Minute Counts." It will be available for streaming on the
for free starting on January 26. This powerful film emphasizes the impact Alzheimer's disease has on individuals and families and the urgent need to fund research and make support available. There is also an engagement guide, social media toolkit, and press materials on their
Email firstname.lastname@example.org for more information.
News from the Dementia Friendly MA Initiative
Learning Communities Help to Spread Ideas
The Dementia Friendly Massachusetts Initiative is continuing its Learning Communities, which meet periodically by conference call to help those doing related work share ideas, resources, and best practices. Learning Communities already in place include: two Eastern Massachusetts groups, Cape and the Islands, and a Faith Leaders Group. Central Massachusetts and Music and Memory Learning Communities are emerging. Already we've learned a great deal from one another!
Contact Emily Kearns, DFMI Coordinator, email@example.com for more information or to join a Learning Community.
Synagogue Becoming Dementia-Inclusive
Temple Shir Tikvah in Winchester has formed a dementia action group that has been meeting for more than a year. In December, they held their first synagogue-wide event, a meeting attended by 45 people, including people living with dementia, family members/care partners, and people whose professional work is related to dementia. They are now conducting a survey of the entire congregation to get input on this topic.
Contact Marcie Kaplan, Temple Shir Tikvah, at firstname.lastname@example.org or Beth Soltzberg, DFMI/JF&CS, at email@example.com or 781-693-5628 for more information.
Spotlight on Memory Café
Memory Café Directory
A directory of memory cafés listing all cafés in Massachusetts can be found online. For more information, contact Beth Soltzberg: DFMI/JF&CS, firstname.lastname@example.org, 781-693-5628.
Lexington Senior Center Program Dances and Cooperative Elder Services' Memory Cafés
On the third Wednesday in November, 14 seniors and caregivers gathered with adult-day-health professionals at the Lexington Senior Center to dance, laugh, learn, and enjoy a couple of uniquely care-free hours. Salsa music filled the senior center as dance instructor, Evens Joseph, led his audience through dance routines designed to stimulate creativity and highlight successes and strengths. At Cooperative Elder Services, Inc.'s (CESI) monthly Memory Cafés - held in Groton and in Lexington - individuals impacted by memory impairment are gaining much-needed support, stimulation, and education. CESI's Memory Cafés gather individuals living with Alzheimer's or other forms of dementia - along with their care partners - in a relaxed, stigma-free environment to experience a sense of community and enjoy activities tailored to their interests and abilities. In the words of a care partner who recently attend a CESI Memory Café, "It was a great opportunity to get out in a social fashion - a break from all of the doctor's appointments. I feel really good about giving [my parents] the chance to just have fun and socialize."
Ethos/AgeWell Memory Café
Guests can share conversation over a cup of coffee in a relaxed atmosphere that sometimes includes music, art, or other forms of entertainment and provides families who are living with dementia or Alzheimer's a support group to lean on and resources to share. Attend for free the first Tuesday of every month at the BCYF Roche Family Community Center, 1716 Centre St. in West Roxbury from 1:00 - 3:00 p.m. Anyone from any neighborhood can attend.
Contact Ann at email@example.com or 617-477-6616 for more information or to reserve a spot.
Sharon Community Center's Memory Café
The Sharon Memory Café is free and typically meets the second Monday of each month from 2:00 - 3:30 p.m. at the lower level of the Sharon Community Center.
For more information, contact Becky Bast, Sharon Adult Center, at firstname.lastname@example.org or 781-771-3517.
Middleboro Council on Aging's Memory Café - Music and Creative Therapies
The Middleboro Council on Aging offers an ongoing Memory Café with creative and engaging programs. In January, for example, it had Music Therapist and Director of Creative Arts Therapies, South Shore Conservatory, Eve D. Monatague, MSM, MT-BC, present a musical activity! Everyone was very excited to be a part of this program made available through the Old Colony Elder Services Memory Café Grant. The next cafe is Tuesday, February 14 from 11:30 a.m. - 1:00 p.m.
For more information, contact Susan Adams, Supportive Day Program Director, Middleboro Council on Aging, at email@example.com or 508-946-2490.
New Café Opened - Coffee Talk Café
The Berkley COA opened its Coffee Talk Café on December 6. A small group of attendees enjoyed themselves, and café leaders are working to spread the word to reach more people for upcoming cafés.
For more information, contact Donna L. Benoit, Chair, Berkley Council on Aging, at firstname.lastname@example.org or 508-821-3105.
News from Around the Nation and Beyond
Let us know what exciting programs you've discovered in your travels at home and abroad!
Brookline has introduced programming informed by an amazing program from Seattle, Momentia! Explore its website to find a wide array of offerings including a camp for people living with dementia, park adventures, and more!
UK's Dementia Friends
Dementia Friends UK's website
to discover where Dementia Friends originated and how it has changed the landscape growing awareness and community-wide responsiveness, supporting those living with dementia and their families.
- Tufts Health Plan Foundation for funding the Dementia Friendly Massachusetts Initiative as well as supporting the age-friendly movement throughout the Commonwealth
- The Executive Office of Elder Affairs, Jewish Family & Children's Service, the Alzheimer's Association MA/NH Chapter, LeadingAge Massachusetts, the Massachusetts Association of Councils on Aging, the Massachusetts Healthy Aging Collaborative, and the Multicultural Coalition on Aging
- The 40 + organizations that form the Dementia Friendly Massachusetts Initiative Advisory Group
- Everyone who contributed to this newsletter and are working to make Massachusetts more dementia friendly!
The Dementia Friendly Massachusetts Initiative is co-convened by the Executive Office of Elder Affairs (EOEA) and Jewish Family and Children's Service (JF&CS) and managed by representatives from the Alzheimer's Association MA/NH Chapter, LeadingAge Massachusetts, the Massachusetts Association of Councils on Aging, and the Multicultural Coalition on Aging. The Advisory Committee includes more than 40 organizations statewide. DFMI is generously supported by Tufts Health Plan Foundation.