The Resource Newsletter Edition 2011
Massachusetts Rehabilitation Commission
Home Care Assistance Program
Betty Maher, MRC-HCAP Director
When undergoing change, it is tempting to fall back on old practices or habits, whether we are talking about a personal change, or an organizational one, such as that which the MRC Home Care Assistance Program has undergone over the past year and a half. However, with a smaller staff and smaller budget, we no longer could go back to our ‘norm’, but instead have had to define a ‘new normal’.
For the Home Care Assistance Program, this has meant a need for self-evaluation. First, we looked at our values, re-examining our program’s mission and vision statements* and an analysis of our regulations.
Next we took an inventory of our assets. Rather than focus on what we lost, we took a closer look at what we still had: a diligent and committed staff, a team of dedicated provider agencies and their hard-working homemakers, a solid fiscal management system, a system for data collection and data management, a partnership with Wheelock College including a strong internship program, excellent working relationships with many external partners, a very active and involved advisory committee, and support from the MRC administration.
We then worked on a plan for continuing to accomplish our mission and provide services to our consumers with fewer staff and fewer financial resources. To that end, we have:
- re-organized our staff so we now have one full-time and one part-time Case Manager and one student intern covering a region of the state. Our newest addition is full-time Case Manager, Jim Cockerham,
- revised our eligibility review process to focus more on maintaining communication with providers and consumers, to monitor quality of services and address needs and eligibility issues in a timely fashion,
- established new guidelines for Case Managers to meet consumers in person when they begin services to better anticipate service-delivery issues and assist with other independent living goals (as we begin to move people off the wait list for the first time in 2 years!),
- developed surveys to collect data on a consistent basis that will be used to measure outcomes, highlight successes and identify areas where change is needed,
- began working with our providers to develop systems of mutual support as we work to ensure maximum positive outcomes for our consumers despite reduced staffing.
Besides many a staff meeting focused on the issues, we have also incorporated input from consumers and providers at our advisory committee meetings (where we reviewed our program’s regulations and developed the survey for data collection, among other activities), as well as an incorporation of the feedback we received from consumers through the surveys sent out in October. It was that survey, meant to determine how to go about restoring the hour that had been cut due to fiscal constraints, that helped to clarify not just how important the homemaker services are, but how we need to provide the right amount of service to meet the needs. This has helped to clarify our vision of “individualized homemaking supports” as we move forward in determining how we best utilize our resources; being able to provide the right amount of assistance does indeed make a positive difference in people’s lives, just as providing inadequate time has a negative impact on our ability to meet our mission. As one respondent said:
I am writing to you as a recipient of this Home Care Assistance Program. Since my hours have been cut, I have been running out of food, my laundry is backed up and I have been hospitalized more. It wouldn’t seem like one hour would make all that difference but it does to me. (My homemaker) is longstanding over 10 years and cannot do all that I need her to do for me…thus my health deteriorates and I suffer more from all the diseases I am fighting.
Ensuring accurate and timely assessments of consumers’ needs continues to be our priority. Through utilization of survey data and communication with our consumers’ providers we began the process of restoring the hour that was cut to those who needed it in January.
While it has not been an easy process, it has been a productive one. To paraphrase Maya Angelou, “We can be changed by what happens to us, but we refuse to be reduced by it.”
OUR VISION: The Home Care Assistance Program empowers adults with disabilities and chronic health conditions to live to their optimal level of independence and engagement in their homes and communities, through the provision of individualized homemaking services and case management supports.
OUR MISSION: Our goal is to assist consumers with addressing homemaking tasks they are unable to perform independently. Quality services are provided through a collaborative effort among consumers, HCAP staff and service providers. Independence is further enhanced by staff who are:
- Sensitive to the unique needs of each individual,
- Knowledgeable about available resources,
- Creative in partnering with consumers and others to find solutions to challenges, and
- Dedicated to empowering consumers by ensuring opportunities for informed choice, self-direction and personal growth.
Did You Know?
In addition to our ongoing general MRC-HCAP informational trainings, the MRC-HCAP Staff conducts training workshops geared to our contracted vendors on certain topics. This year we are focusing on the training, “Empowered Change” which will be held across the state throughout the year!
In August of 2010, 4 case managers and 1 clerk left the Home Care Assistance Program. This leaves 4 full-time and 3 part-time case managers to cover the entire state; making referrals, doing eligibility reviews and insuring that the needs of 1360 consumers are met.
Four interns from Wheelock College School of Social Work (Amy Cooper, Angie Tweah, Kirsten Scharr and Katie Dalo) arrived in September 2010 and effectively assisted the existing case managers and staff with any needed tasks. As we approach Fall 2011, we are welcoming four new interns from Wheelock College: Virgenmina Cosme, Smirne Belot, Laurel Bancroft and Tia Forlizzi!
Consumers have left the program because they aged out and turned 60 years old. Home Care hours have been cut from remaining consumers and staff have been let go.
All of this has happened, yet there are still budgetary concerns and the only thing left to do is look at restructuring the department. This is exactly what the Home Care Assistance Program is in the middle of doing, but be assured that (if this occurs) the needs of the consumers are our first priority and staff will keep you informed and as always will ask for your valuable input.
On a brighter note, a survey was sent out to Home Care consumers who recently had an hour or more reduction in service. Feedback was requested on how this affected each person, individually. Many responses were received and they were greatly appreciated. The result is a positive one.
Even though there are currently no additional dollars, there is money saved from the hours not used by the consumers who have aged out of the program. Therefore, the Home Care Assistance Program implemented the process of fairly returning some hours back to the consumers who most need it and has lifted everyone off the wait list that was maintained since 2009. Most recently, on June 13th, MRC-HCAP began taking new applications once again.
There is even more news! The Home Care Assistance Program continues to work with the Department of Public Health to help case managers better inform their consumers (who wish to know) about how to quit smoking and about the “My Life My Health” groups that have formed around the state.
Also, Home Care is working with MRC’s Consumer Involvement Program’s new District Advocacy Councils. These will not replace the existing advisory committees. Instead, they will provide additional opportunities for consumers to be involved in agency operations, decisions and actual advocacy for needed resources; whether this be dollars, providers or anything else beneficial to the agency and those it serves.
Hawthorne Services of Chicopee, MA, merged with the Center for Human Development (CHD) on July 1, 2010. Hawthorne has been providing Homemaker Services through a contract with MRC-HCAP since 2004. As a multi-service agency, Hawthorne has been a provider of residential and day services in the community since 1979.
The Center for Human Development is a large, wide-ranging social service agency headquartered in Springfield. Hawthorne’s Board of Directors voted almost two years ago to begin exploring a merger with CHD. One year and many conversations later, we decided that, for the good of at-risk elders and adults with disabilities in our community, it makes sense to merge with an agency that is equipped for the restructuring that lies ahead. There will be no immediate changes in our name or our programs and I will serve as Vice President of the Elder Division of CHD.
As Hawthorne takes this step, it marks the end of one era and the beginning of a new one. This is both sad and hopeful at the same time. Great changes are coming to all human services. Public support has continually shrunk for social service agencies, especially in the provision of mental health services.
Elders and people with disabilities have taken the biggest hit. The trouble is the need for elder mental health care and support services for those with disabilities has grown and not shrunk. Families and communities will be given even less support and be burdened with more responsibilities. Services will need to change. It is an opportunity for providers to streamline the delivery of care and form stronger partnerships with the community and with one another.
Writing this article is thorny (as in Hawthorne). There is just too much to say and limited space to say it. What shouldn’t be lost at a time like this is the proud legacy that is part of our history. So many great individuals have been part of who we are. Families, clients, staff and partners have made this experiment memorable. We all can feel great pride in getting it right. People came first, the whole person. We never saw the disability but instead saw the potential.
Another surprising thing happened. Many of us who hadn’t worked with elders or people with disabilities in the past found out how addictive it is to work with them. They are real, in your face and above all, appreciative. In many cases, we needed to be a surrogate family for those whose family connections had been lost over the years. The great families that were able to keep their relationship intact allowed us to be extended members of their families. Disabilities that could have been devastating began to have silver linings. Working at Hawthorne has been a privilege. Hopefully families and clients feel the same.
We are at a turning point, one that requires this fond look back.
The new path we are heading down isn’t without risk and new adventures. Yet we all have a responsibility to step up to the plate and assist leadership in aging and disability services. As a community we need to say that elders and people with disabilities shouldn’t be poor, isolated or without comprehensive services that include mental health and substance abuse treatment. We believe that through a collaborative effort, we can improve diagnosis and treatment for those most at risk. Taking all the best ideas from our thirty one years working in the community is an exciting exercise. We need CHD to take the next step and help put it all together. We are bringing energy and excitement into this partnership, and hope the community will lend its support. Thanks.
“A Little Help Goes a Long Way”
Walter King, MRC-HCAP Consumer
Being an epileptic with only one good leg, I am an MRC-HCAP consumer who had been getting only 2 (instead of 3) hours of assistance each week because of cuts in the last state budget. Thankfully, the hour was restored in January 2011. This is the only real regular help I get so I can keep living by myself. That is not easy to do with my health history though (I have had 17 surgeries with a good chance for more in 2011).
My homemaker helps me with my most important tasks when she comes over such as food shopping and picking up my prescription medicine and she helps me with my weekly routine of housework so I can have a better quality of life.
I do my best to help my homemaker help me. Every week she comes over on Tuesday morning, which is bad for me because of my health, but helpful for her because of her work schedule. She can take care of more people in my neighborhood in one day; thus save on time and gasoline for her car.
I am always happy to help someone who helps me when I can, but sometimes it is hard. Because of my assorted illnesses and seizure problems, it can be tough to have a good night’s sleep. I just try to improve my health and keep adjusting how to care for myself in my apartment as well as possible.
I am a person who lives in a remote area of the state, so it feels all the better to have someone I have always thought of as a good, dear friend come to visit. She is the kind of person who makes a wonderfully positive difference.
There was one time in early October when I was exhausted, sleepy, and a mental wreck- thanks to the events of the previous weekend (someone tried to break into my apartment). At first I was feeling so “blah,” I just had to stay in bed. When my homemaker called to say she was coming, I knew I had to get moving - and so I did. I got up, finished my shopping list, got dressed (and made myself more presentable) and there she was. I felt so much better. She really cheered me up and brightened my day! I told her about the attempted apartment break-in while she was doing some light housework in my kitchen. She then did my grocery shopping. She is the only person in my life who can help me with that!
I’m the first person to agree that 2 hours a week was better than nothing. But governments on all levels should realize you cannot make an economic silk purse out of a sow’s ear. I am still able to get good, practical help which I am very grateful for, but I am relieved that MRC-HCAP was able to restore the lost hour back!
There was no wiggle room left for cutbacks in a case like mine. There has to be a certain amount of means left in the state budget; otherwise, how can people like me be helped? The budget is at the bottom of the barrel for programs like the MRC-HCAP. If the hours were cut even more in the future, what would there be left for someone to do at my home? All the state can cut now is bone, not flesh, so the substance of the program will vanish completely.
Because I believe this is very important, I want to bring up a quotation on kindness from one of my favorite books, “Giving. A Moment to Reflect…Meditations on Spirituality”: Aesop wrote, “No act of kindness, however small, is ever wasted.” Every benevolent action blesses all humanity and returns to us. Kind actions grow from kind thoughts and attitudes. When we take responsibility for our own happiness, we can afford to be kind toward others.
Performing acts of kindness in our daily lives does not require money, power, or any special skills. It only requires empathy: the recognition of our humanity and the desire to make things a little easier for someone else. Thoughtfulness, helpfulness, compassion, understanding, and gentleness are the hallmarks of human kindness.
“There is a time for everything, and a season for every activity under heaven”– Ecclesiastes 3:1
The proverb above speaks in part to there being a distinct season for change in one’s life. Metaphorically, it can be compared to the time when a tree bears its fruit. In like manner, prior to embarking on a new activity such as losing weight, becoming a non-smoker, returning to work or getting married there is often a time of preparation filled with inward thought and decision making.
Two researchers named Prochaska and Diclemente studied this internal process and documented four distinct stages that mark any lasting change. They called their theory “The Stages of Change.” Two of these stages are non-visible. They are: Pre-contemplation (when an individual is not thinking about change) and Contemplation (when an individual is weighing out the pro’s and cons of making a change in their life).
It is when the pros outweigh the cons that the individual moves toward a visible behavioral change. Prochaska and Diclemente called this the Action Stage. The new behavior in this stage is started and tested out. If the person is satisfied with the new behavior for three or more months the individual enters the final stage of Maintenance in which he or she no longer has to be convinced of the merits of the new behavior, it is now part of the person’s new identity.
A conclusion one can draw from the theory is that lasting change does not occur overnight, it takes time. If you’re in the position of being a helper or wanting to help others, such an approach can enhance your sense of patience, rapport and understanding of others as they seek to make better decisions in their life.
As you know, the MRC-HCAP provides services to eligible consumers ages 18-59 years old. So what happens when you turn 60 years old? About 1-2 months before you turn 60, you should expect a call from your MRC-HCAP Case Manager reminding you of your upcoming 60th birthday and the MRC-HCAP guidelines of the age group we service. With your permission, the MRC-HCAP Case Manager will make a referral to your local elder service office, known as ASAP (Aging Service Access Points). From there, your information will be screened to determine if you meet the criteria of eligibility for elder services. As you reach your 60th birthday, a Case Manager from your local ASAP will make a visit to your home to help determine your needs and eligibility. This information will be shared with your MRC-HCAP Case Manager to help plan your transition from MRC-HCAP to Elder Services.
Eligibility for Elder Services is based on the need for assistance with activities of daily living (bathing, dressing, eating, toileting, continence, transferring, and/or mobility) and instrumental activities of daily living (meal preparation, shopping, laundry, managing money, housework, transportation, use of telephone, outdoor mobility, and taking medicine). Eligibility is also based on priority levels: the highest priority is given to those who have several needs for activities of daily living and the lowest priority is given to those who need help with minimal instrumental activities of daily living.
Last year Elder Services had a wait-list due budget cuts. Since then, Elder Services has been doing its best to service as many consumers as possible without a wait-list requirement. We have found that consumers are being placed close to their 60th birthday offering a smooth transition.
If you are determined eligible and the ASAP is able to place you immediately once you turn 60, the MRC-HCAP Case Manager will work with you and your service provider. Most service providers also have a contract with the ASAPs so you may not even need to change vendors or homemakers! If your service provider does not have a contract with your ASAP, the ASAP will assign one. The MRC-HCAP Case Manager will ensure a smooth transition, trying to avoid any gaps in service from MRC to Elder Services.
If you are determined eligible and your local ASAP has a wait-list, your MRC-HCAP Case Manager may extend your homemaking services through MRC-HCAP for a maximum of one month after your 60th birthday. If you have been determined ineligible for Elder Services, the MRC-HCAP will need to close your case file on your 60th birthday but will have a discussion with you on finding resources to help meet your homemaking needs such as paying privately, use of low-tech assistive technology devices and/or family assistance.
Whatever the outcome may be, the MRC-HCAP Case Manager will be sure to inform you of your options for continued care and help advocate for your needs.
“My Life My Health Groups Succeed in Massachusetts”
Betty Maher, MRC-HCAP Director and Kirsten Scharr, MRC-HCAP Student Intern
The “My Life My Health” workshops run by the Department of Public Health and various community organizations throughout Massachusetts follow a curriculum developed by Stanford University. Though the curriculum is standard, the groups themselves are unique; each workshop brings together a group of people of varying ages and backgrounds, different health conditions, disabilities and abilities, and each with their own personal stories, and their own level of willingness to participate in the group.
In the spring of 2010, staff from MRC-HCAP and the Department of Public Health’s Healthy Aging and Disability Unit collaborated to hold a “My Life My Health” group in Jamaica Plain. The group met for 6 two and a half hour sessions, led by people with chronic conditions themselves. These workshops proved to be informative, motivating and supportive all at once.
Beginning with an explanation of the symptom cycle—how pain impacts stress which impacts fatigue which impacts emotions, etc., the goal of “My Life My Health” is to assist each participant in developing their own set of ‘tools’ to break the symptom cycle and turn the downward spiral around. The workshop content includes: dealing with difficult emotions, physical activity and exercise, muscle relaxation and guided imagery, pain and fatigue management, healthy eating, ways to talk with your doctor, your family and your friends about your health, making informed choices about your treatment, and medication usage. The information provided is general, not disease-specific, but each member takes the information and develops their own action plan.
Each session ends with participants setting a weekly action plan. These are goals that are practical and “do-able.” For instance, one participant wanted to be able to swim a few laps, but in discussing the goal with the group, started with an action plan of locating a pool with a lift and within easy transportation for her. By managing goals one small step at a time, success was within reach. Each following session would begin with participants reporting back to the group on their action plan. While this may sound threatening, participants rated this activity highly because: they were motivated by each others’ success, they were more likely to complete their own action plan because they had to report back, and because they were able to help each other in problem-solving when action plans didn’t work as well as anticipated. Participants reported that it felt good to be able to help others.
While the Jamaica Plain group is planning a reunion, other groups continue to meet long after the formal sessions ended and the leaders moved on. As MR of Brookline stated, “It gave me a lot of great tips and helped me to help myself.”
If you are interested in participating in a “My Life My Health” Workshop near you, there are many ways to find out about them: look for flyers or posters in your neighborhood—many groups are held at local Senior Centers; check the Department of Public Health website: www.mass.gov/dph (go to Healthy Aging and Disability Unit, Healthy Aging Topics, Programs and Workshops), or call the Healthy Aging and Disability Unit at (617)624-5070.
A variation of the program is also being offered on-line at: https://selfmanage.org/BetterHealth/SignUp
I am of an age now when the sight deteriorates. My decreasing vision was interfering with my ability to read my cookbooks and my mail.
I had been given a lighted, articulated magnifier lamp but it was sitting in my attic and not where I could use it or for it to be of any use at all. I searched the Internet for an electronic document reader but the prices were in the thousands of dollars! So I started to think of some low tech ways to solve my problem. Then I remembered the lamp! The only problem I had now was that the lamp was missing a mounting bracket.
When I was a teenager, I built “standards and brackets” style shelving in Manhattan where I grew up so I have the tools and experience to use them. I then realized I would have to build a counter with a half-inch hole inside to accept and support the lamp to sit on my countertop in the kitchen.
I bought a 2x4 foot sheet of plywood. I rounded the front edge with my saber saw, applied edge tape, drilled a hole and applied polyurethane to the whole thing. For added stability, I screwed the base down to the existing Formica countertop. I used scrap plywood to make a backsplash.
Now, I am very happy with my new reading station in my kitchen. If anyone wants to build something like this or needs help, I would be happy to advise. Email me at email@example.com or call 508-238-1333.
Thanks Bob for your contribution on how you managed a specific barrier in your home and how you went about solving it. This goes to show that you may have something in your home right now that could act as a low tech piece of adaptive equipment. It is important to note that Bob has experience using building tools and a project like this may require the expertise and construction of a professional builder. ~ The MRC-HCAP Staff
Assistive Technology Resources
MassMATCH– 1-866-682-9955; (TDD) 617-204-3815; www.massmatch.org
getATstuff– a free AT device exchange program. Call toll-free: 1-866-682-9955; www.getATstuff.org
Easter Seals– 1-800-224-2756; www.eastersealsma.org
“If nothing ever changed, there’d be no butterflies!”
~ Author Unknown
“Give what you have. To someone, it may be better than you dare to think.”
~ Henry Wadsworth Longfellow
“You cannot control what happens to you, but you can control your attitude toward what happens to you, and in that, you will be mastering change rather than allowing it to master you.”
~ Sri Ram
Home Care Assistance Program (HCAP)
Year in Review FYS 2010 (July 1, 2009 to June 30, 2010)
- Number of Consumers Served: 1,528
- Total HCAP Budget: $5,106,707
- Average Annual Cost of Purchased Services per Consumer: $2,615
- Unmet Need for HCAP Services: 100 individuals on waiting list; the HCAP Program stopped accepting new applications June 3, 2009
Who Are HCAP Consumers?
African American: 12.1%
What HCAP Consumers Have to Say:
"My home care assistant has been invaluable. My quality of life has risen, and my fear of going to a nursing home before I am a senior citizen has greatly lessened.”
“Before I discovered the Home Care Program, my situation was dire. The program provides me with assistance in doing tasks that I cannot complete. I have been able to stay in my home and live a life as independent as possible.”
“It isn’t just prevention from being injured; it’s keeping me in my home and assisting me in retaining my independence, preventing my eviction and ending up in a nursing home.”
– HCAP Consumer
“I am impressed with my case manager’s ability to advocate on my behalf. Thanks so much for helping me with feelings of self-worth and for consistent support with all the changes and assistance I need.”
– HCAP Consumer
“The goal of our services is to promote dignity through employment and community living, one person at a time. We hope that all citizens with disabilities in Massachusetts will have the opportunity to contribute as a productive member of their community and family as a result of services provided by the MRC.”
Charles Carr, Commissioner
The HCAP Program provides a vital community living service which assists people with disabilities to remain independent in the community and to have a higher quality of life. A recent survey of HCAP consumers indicated the need for home care services far outweighs services provided to HCAP consumers based on current funding levels, highlighting the importance of the program to consumers. HCAP Case Managers provide ongoing service coordination, leveraging resources from other programs and agencies to support consumers in living independently. Listed below is the number of HCAP consumers referred by Case Managers to a wide range of additional supports.
- ER Systems: 50
- ASAP: 28
- AT: 39
- Food Assistance: 32
- PCA: 85
- Nursing/OT: 30
- Transportation: 73
- Other: 129
- ILC: 110
- Counseling: 68
- SHIP: 44
- DMH: 21
- GAFC: 67
- VR: 117
Here are some great recipes you can try at home with your homemaker. The recipes require very little preparation time and few ingredients making them fast, easy and economical! Since they are large portions, they are perfect for dividing into single portions and then freezing them to enjoy another time.
Butternut Squash Soup
~recipe courtesy of Food Network, Claire Robinson, 2010
1 (3 pound) Butternut Squash (you may be able to find pre-cut squash in the produce aisle of your grocery store)
Extra-virgin olive oil for roasting, plus 2 tablespoons
Kosher salt and freshly cracked pepper
2 shallots, chopped
1 quart low-sodium chicken stock
2 teaspoons curry powder (mild or spicy)
Preheat the oven to 375 degrees F.
Cut the squash in half through the stem and remove the seeds. Drizzle the cut edges with oil, season with salt and pepper, and put it cut side down on a baking sheet. Roast until very soft, about 1 hour. Remove the squash from the oven, turn the halves over and let them stand until cool enough to handle. Scoop the flesh from the shell into a bowl and discard the shell.
In a large saucepan or Dutch oven with a lid, heat 2 tablespoons of oil over medium heat. Add the shallots and cook until softened, about 6 minutes. Add the squash, chicken stock and curry powder and bring to a boil. Reduce the heat to a simmer, cover and cook until the squash is broken down, about 10 minutes.
Cool the squash mixture for about 5 minutes before adding it to a blender. Working in batches, puree the soup in blender until smooth, transferring puree to a saucepan as you work. Season with salt and pepper to taste and let simmer for a few minutes. Serve.
Beef Taco Bake
~Courtesy of Campbell’s Kitchen
1 pound of ground beef
1 can (10 3/4 oz.) Campbell’s Condensed Tomato Soup
1 cup salsa
1/2 cup milk
6 flour tortillas cut into 1 inch strips
1 cup shredded cheddar cheese
Pre-heat oven to 400 degrees F. Cook the beef in a 10-inch skillet over medium-high heat until well browned, stirring often. Pour off any fat. Stir the soup, salsa, milk, tortillas and half the cheese in the skillet. Spoon the beef mixture into a 2 quart shallow baking dish. Cover the baking dish. Bake at 400 degrees for 30 minutes or until the beef mixture is hot and bubbling. Sprinkle with remaining cheese.
~ Courtesy of www.myrecipes.com
1 24-oz. jar of pasta sauce
2 18-20-oz. refrigerated large cheese ravioli (or if using frozen ravioli-cook first)
1 10-oz. box frozen chopped spinach, thawed and excess water squeezed out
1 8-oz. bag shredded mozzarella cheese
1/2 cup (2 oz.) grated parmesan cheese
Pre-heat oven to 375 degrees F.
Spoon a thin layer of sauce over the bottom of a 9x13-inch baking dish. Cover with a single layer of ravioli. Top with spinach, half the Mozzarella, and 1/3 of the sauce. Repeat with another layer of ravioli, spinach, Mozzarella, and sauce. Top with another layer of ravioli and the remaining sauce. Sprinkle with Parmesan. Cover with foil and bake for 30 minutes. Uncover and bake until bubbly, 5-10 minutes more.
Easy Tuna Casserole
~Courtesy of Allrecipes.com
3 cups cooked macaroni
1 (6 ounce) can tuna, drained
1 (10.75 ounce) can condensed Cream of Chicken soup
1 cup of shredded cheddar cheese
1 1/2 cups French Fried Onions
1. Preheat oven to 350 degrees F.
In a 9x13 inch baking dish, combine the macaroni, tuna, and soup. Mix well and then top with cheese.
Bake at 350 degrees F for about 25 minutes, or until bubbly. Sprinkle with fried onions and bake for another 5 minutes. Serve hot.
“The future depends on what we do in the present”
~ Mahatma Gandhi
Have You Recently Moved? Or changed your phone number? If so, please give your MRC-HCAP Case Manager a call so we can update your case information. Thank You!
The MRC Home Care Assistance Program staff encourage consumers to call with questions or concerns regarding homemaking services.
- Betty Maher, Director
- Angela Cipriano, Supervisor
- Felix Jordan, Supervisor
- Christine Rinaldi, Administrative Assistant
- Lilly Lau, Accountant
CASE MANAGERS BY REGION
- WEST Liz Mahoney and April Anderson
- NORTH Jim Cockerham and Chris O’Brien
- SOUTH Jodi Watson and Katherine Chesebro
- BOSTON Eloise Cruz
The Resource Newsletter
MRC Home Care Assistance Program
27 Wormwood Street, Suite 600
Boston, MA 02210
Toll Free: 1-800-223-2559
Dr. JudyAnn Bigby
Assistant Commissioner for Community Living