February 26, 2018
Disability Policy Consortium Weekly Update

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This is the week that MassHealth moves to Accountable Care Organizations.  As our editorial notes, the process is a marathon and not a sprint.  We want to make sure to provide you the most current information you will need.

Opps!  Did you spot my mistake last week?  If you noted that House 620 affects Title III of the ADA and not Title II as I said, you are correct.  Either way, it is still a pile of stinky poop.

Our job postings that I promised for this week have been delayed while we finalize our contract. 

Also the Budget Hearing at Gardner Auditorium has been moved to March 16th.

We have a couple of informative news articles for you.
Until next week,  good reading.

John Winske
Disability Policy Consortium
Editorial:  MassHealth Moves to ACO's this Week!

On Thursday, March 1, Massachusetts will be following the lead of other states by enrolling people on MassHealth into new Accountable Care Organizations (ACOs) and other new managed care entities. The change will impact up to 1.2 million MassHealth members. A significant percentage of this population are people with complex medical, behavioral, cognitive health care needs and other chronic conditions, including 80,000 people with disabilities.

Disability Advocates Advancing our Health Care Rights (DAAHR), a joint effort of the DPC and BCIL, is supportive of the state's efforts to build a more integrated and cost-efficient healthcare delivery system for MassHealth members. The system currently is a challenge for many; we ask MassHealth members to embrace new opportunities that may be available to them. At the same time, it is important that we point out some concerns, particularly as they pertain to the start of this new initiative.

The new system is complex and may be confusing for providers and consumers alike. There are 17 ACOs and some will offer access to the full array of MassHealth providers and others will have narrower networks. Primary care providers are permitted to contract with a single plan. Some specialists, acting as primary care providers, may not be recognized as a primary care provider by a plan.

For MassHealth members with stable health conditions or limited behavioral health or medical needs, these changes may be frustrating, but not lead to medical harm. But for consumers with thin margins of health and complex needs, who have knitted together very fragile networks of care, disruptions to these networks could be a big problem. A personalized network may be unraveled as you discover that your new plan's hospital or the specialist you rely on is not in the plan's network.

Do you stay with those few specialists with expertise in treating your particular condition or do you choose your primary care provider who has been successfully acting in partnership with these specialists to keep you healthy?

Do you forfeit a specialist who no longer has admitting privileges at a hospital in order to continue receiving care at the hospital?

MassHealth is aware of these concerns and at a February 23 meeting with advocates, EOHHS Secretary Marylou Sudders said, "Our top priority are our members," while MassHealth Director Dan Tsai said, "We really want seamless transitions for our members."

Program elements that should reduce problems include a minimum 30-day continuity of care requirements that enables members to see and receive care from their current providers through March 30. This requirement will protect most prior authorizations for home care,, durable medical equipment, and other services, including prescriptions. Coupled with this are requirements that plans actively assist members during the transition. This includes actively doing outreach to MassHealth members with more complex needs and working with these members to establish single case agreements with out-of-network specialists to support continuity of care.

Additionally, MassHealth has also put in place what they are calling an "escalation protocol." The protocol is for members who may have trouble understanding the changes or facing new or urgent medical situations to get more hands-on support. There's also unwritten understanding that many plans will go beyond the 30 days during the initial months of this initiative.

One thing people will want to pay attention to is the so-called 90-day lock-in. This is a requirement that will prevent people from changing from one plan to another after three months, though there are exceptions. If it's getting close to June 1 and a plan is not working for you, you may want to switch.

One concern we have comes from the experience with One Care, the plan for those on both MassHealth and Medicare. When it started in 2013, many people with the most complex needs, those who are homeless, have a mental health diagnosis, or a combination of needs, were not able to be reached in the first 90 days of enrollment. It will be important that those in similar situations with ACOs in 2018 have flexibility to switch plans if necessary to ensure quality services and care.

While there are real concerns about keeping your medical team, and new rules, terms and names to learn, we do wish to emphasize why ACOs can be a big plus. Not everyone has been able to create coordinated networks of care, and a key part of ACOs are coordinated care teams that are supposed to emphasize community-based services. This can really help people, if it's all clicking, to live healthier, independent lives.

Healthcare innovation is a marathon, it's no sprint. A key to making this work will be MassHealth members with disabilities speaking to their health care plans, to MassHealth, to advocates, to DAAHR. Your voice is absolutely the most important one!

Dennis Heaphy, DPC and DAAHR co-chair
Bill Henning, BCIL and DAAHR co-chair
Advocacy Information:  ACO Informational Flyer

BCIL, DPC and DAAHR want you to have the latest information at your fingertips, a s the ACO process begins in earnest this week.  Here is the latest flyer.  Please keep in touch with us so we can track the process and pass on your feedback.  Get the flyer here.
Net News:  How to Design for Everyone in Three Easy Steps

DeAnn Elliott pointed us to this great article in Fast Company.  The article on inclusive design lends some hope that maybe, just maybe, companies are starting to understand that we all matter.  You can read it here.
Net News:  Discharged From a Nursing Home to A Homeless Shelter

Nursing home evictions are on the rise according to this story from the New York Times.   It appears to be occurring when a persons Medicare payment is ending and lower paying Medicaid is about to begin.  You can read about it here.  
Calendar:  Joint Committee on Ways and Means Hearing Schedule Released

Th Joint Committee on Ways and Means has released their hearing schedule for this year.  You can access the schedule here.

Human Services testimony will be heard March 2nd at Roxbury Community College and March 12th at Berkshire Community College.

The hearing on March 16th at Gardner Auditorium will also be an open session where testimony is open to any line-item.
Calendar:  Disability and Public Service: Advocating When Everything is at Stake 

When:  Wednesday, February 28, 2018, 1:00 P.M. - 2:00 P.M.

Where:  Land Hall, Beifer Building, 4th Floor, Kennedy School of Government, 79 JFK Street, Cambridge 02138

From the current protests to protect the ADA to last year's successful defense of Medicaid, many disabled Americans believe, with good reason, that they must continually speak up to ensure the public programs that help them stay healthy, stay housed, and often stay alive remain funded.  It is no wonder then that there are many exemplary people with disabilities in the field of public service. Join a distinguished panel including: 

Clyde Terry, Chair of the National Council on Disability, 

Tom Sannicandro, Director of the Institute for Community Inclusion and former MA State 
Representative,and 

Colleen Flanagan, co-Executive Director of Disability Action for America (the Nation's only disability rights political action committee)

Join us, for a passionate discussion of what it means to be an advocate for disability rights in the public sphere. 
Moderated by Colin Killick, chair of the Kennedy School's student Disability Justice Caucus.

Free and open to the public
Light Refreshments Provided

This event is wheelchair accessible. 
For other reasonable accommodations, please contact:  colin_killick@hks18.harvard.edu.
Calendar:  One Care TeleTown Hall

When:  Tuesday March 27, 2018, 1:00 P.M. - 2:00 P.M.

Join us on the phone.

Tell the Implementation Council:

What is working?

What needs to be fixed?

Call Toll Free 1 (877) 300-1240.

Calendar: Architectural Access Board Public Hearing Dates 521 CMR

Below you will find the dates and locations for the public hearings on the proposed changes to 521 CMR. They are also on the AAB website.

The proposed updates are online at 

We have been advocating for these changes for a long time. Compliance with these regulations should make more housing accessible and remove barriers for employment for people with disabilities. Please attend a hearing, and let the AAB know that we support these changes.

March 22, 2018 8:30 a.m. - 12:30 p.m.
Fall River Government Center
The Atrium
1 Government Center (if this address doesn't come up on GPS use 30 Third Street, building is across the street)
Fall River, MA
Parking: Third Street Parking Garage, 157 Third St, Fall River, MA 02721
1 Government Center Fall River MA

March 29, 2018 8:30 a.m. - 12:30 p.m.
UMass Amherst
Lincoln Campus Center
1 Campus Center Way Room 163C
Amherst, MA
Parking: The parking garage is located next to the Campus Center
UMass Campus Maps

April 5, 2018 12:30 p.m. - 4:30 p.m.
One Ashburton Place
21st Floor, Conference Rooms 1 and 2
Boston, MA

April 12, 2018 8:30 a.m. -12:30 p.m.
Worcester State University
May Street Auditorium
May Street Building
280 May StreetWorcester, MA
Parking: There is on-street parking located around the May St. Building

April 26, 2018 8:30 a.m. - 12:30 p.m.
Salem State University
Petrowski Room
Marsh Hall #210
71B Loring Ave, Salem
Parking: Follow signs for Enterprise Center parking
Salem State University Campus Map

May 24, 2018 8:30 - 12:30
Cape Cod Community College
Science Lecture Hall C
2240 Iyannough RoadWest Barnstable, MA
Parking: Lots 8 and 9
Cape Cod Community College Campus Map

Reasonable accommodations for people with disabilities are available upon request (note that CART and ASL services have been requested from MCDHH). Include a description of the accommodation you will need,
including as much detail as you can. Also include a way we can contact you if we need more information. 

Please allow at least two weeks (14 days) advance notice. Last minute requests will be accepted, but may be impossible to fill. Send an e-mail to Thomas Hopkins at Thomas.hopkins@state.ma.us or contact him by telephone at 617-727-0660.

Our thanks to MetroWest Center for Independent Living for sharing this with us.
Calendar: Our Space, Our Place

We have two upcoming workshops about which we would like to let you know:

1.       Be.You.tiful

Empowering Girls, Breaking Barriers and Building friendships.

Date:  April 17, 18  and 19

Location: The Nonprofit Center, 89 south Street, Boston MA.

A workshop for girls in middle and high school.

2.       Coding Camp

A workshop for students curious about coding.

Date:  July 9 - 13

Best,

Cheryl

www.ourspaceourplace.org
In This Issue
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Disability Policy Consortium
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Malden, MA 02148
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