The Resource - Winter 2004

The (M)assachusetts (R)ehabilitation (C)ommission's primary focus is to provide supportive services for people who have disabilities in order to maximize their independence and ability to be productive community members.

Massachusetts Rehabilitation Commission Home Care Assistance Program
27 Wormwood Street, Boston, MA 02210-1616
1-800-223-2559 or 617-204-3853

The Home Care Assistance Program staff encourages consumers to call with questions or concerns regarding homemaking services.

Home Care Assistance Program Staff
Kevin T. Farrell, Director
Georgette Deraney, Supervisor
Jerry Crowley, Supervisor

Case Managers
Marian Burns, Boston (A-H) and Brookline
Angela Cipriano, Northern Middlesex County & Cambridge
Eloise Cruz Boston (I-M), East Norfolk County and surrounding towns
Felix Jordan, Plymouth County and the Cape
Robin Kellett, Essex County
Thea Klofac, Berkshire, Franklin, Hampden, and Hampshire County
Betty Maher, Boston (N-Z), Chelsea, Winthrop, and Revere
Andrea Tull, Western MA, West Worcester County
Katherine Chesebro, West Norfolk County and South Middlesex County
Roberta Medal, RN Bristol County and surrounding towns and the Islands (Nantucket and Martha's Vineyard)
Debra Visocchi, East Worcester County, Northwest Middlesex County
Jodi Watson, Intake Coordinator

Support Staff
Lilly Lau, Accountant
Edward Loring, Accountant
Christine Rinaldi, Administrative Assistant

Submitted by Kevin T. Farrell, MRC-HCAP Director

I am looking back as MRC approaches 2004, and see the many accomplishments that MRC-HCAP has made in serving the needs of over 1,700 adults with disabilities who live alone and need homemaking services to stay in the community. These accomplishments could only happen with the cooperation of a dedicated MRC-HCAP staff, over 72 vendors and 80 Home Care Assistants located across the state who provide the actual homecare services.

Significant in the activities of the past few years include the widespread outreach efforts, spearheaded by Betty Maher and other case managers, to reach non- MRC-HCAP vendors who have been encouraged to sign on and help us cover unserved parts of the state. The results have been very successful: now giving consumers a real choice of vendors in many locations across the Commonwealth. The efforts of growth continue today.

Significant efforts have been realized since 1998 when MRC-HCAP set up a Medicaid reimbursement project for MRC-HCAP services which would bring in Federal reimbursements for state expenditures. The reimbursement project has been made possible with the continued cooperation of the MRC-HCAP staff, the efforts of Deputy Commissioner John A. Chappell, Jr. and the continuous support of Commissioner Elmer C. Bartels. The resulting efforts have helped in an era of tightening budgets.

MRC-HCAP seeks to provide the highest quality of services in these times of fiscal constraint and increasing needs. The rising number of applicants and the tightening of funding sources have made the determination of eligibility and the provision of services all the more important. Tough decisions have had to be made including freezing intakes for non-Medicaid eligible consumers beginning July l, 2003 (Fiscal Year 2004). The action, coupled with a careful review of each consumer's eligibility, will ensure that adequate funds are provided to existing MRC-HCAP consumers. The MRC-HCAP newsletter, The Resource, contains a number of pertinent informative points and stories that prove to be valuable resources to consumers and vendors.

On a personal note, I have enjoyed my past six years as Director of MRC- HCAP. With a recent opportunity to take full retirement offered by the Commonwealth on October 1, 2003, I applied and have retired from state service as of that date. Due to the pressing need to keep MRC-HCAP functioning until new leadership can be assembled, I am back working as Director three days a week for a few months. This will provide a smooth transition to new leadership, which should occur sometime near March 2004. Additionally, the two Unit Supervisors, Georgette Deraney and Jerry Crowley, also took early retirement and they likewise were called back to assist in running the unit until one of the supervisor positions get filled. Reflecting a continued restrictive budget, one of the supervisor positions will be eliminated and not back-filled. Direct services should be unaffected by these changes. As always, I am available for your questions and concerns. I wish you all the best.

What's New

Caseload Re-allocation submitted by Katherine Chesebro

In March of 2003, MRC-HCAP staff completed a caseload re-allocation, or transfer of cases, to other Case Managers. This caseload transfer was necessary to "even out" the number of consumers each Case Manager handles. Some Case Managers had very high numbers and others had very low caseload numbers for their designated areas. A caseload re-allocation was needed to ensure that each Case Manager had an average of between 170-180 cases. Therefore, some Case Managers are now managing new towns or areas while others are no longer managing specific towns or areas of the state. The caseload re-allocation was completed to allow the least disruption in homemaking services as possible. Not every consumer had a change in Case Manager. In fact, only a small number of consumers were affected by this change. If you are not sure who is now covering your case, please refer to the staff list to see which Case Manager covers your area. Please contact us if you have any further questions at 1-800-223-2559.

Welcome New Homemaking Agencies to MRC-HCAP

MRC-HCAP has added quite a few new homemaking agencies to provide services to consumers across the state. We are very pleased the following agencies are providing homemaking services:

Personal Touch in Chelmsford
Clinical One, with offices in Wakefield, Beverly, Braintree, Fall River, Worcester, West Springfield
Health Education Services in Haverhill
Ideal Home Care in Attleboro
Interim Health Care in Western MA in West Springfield
Living Innovations in Salem, NH providing services to the Merrimack Valley area
Optimum Home Care in Hyde Park
Right at Home in Beverly
Sunrise Health Care and Staffing in Randolph
Collective Home Care in South Deerfield
Hawthorn Services in Chicopee

MRC-HCAP staff look forward to working with all of you!

New Staff

MRC-HCAP would like to welcome two new members to the case management staff. Andrea Tull is the new case manager for Western Massachusetts and Debra Visocchi is now managing the Worcester County area. MRC-HCAP is very pleased to have acquired such wonderful talent. Welcome!

Getting to Know You submitted by Thea Klofac

APEX Healthcare Services, Inc., in Springfield, MA has been providing exemplary homemaking services to MRC-HCAP consumers since September 2002. I have had the pleasure of recently working closely with the President and CEO, Cheryl Rumley, who started this extremely successful company in 1999. With the assistance of the Massachusetts Small Business Association and Marie Bergeron, her Service Coordinator, Ms. Rumley built this business into a quality agency that "provides a safe, friendly, compassionate atmosphere to enable the client to enjoy and maximize the quality of life in the comfort of his/her home." Kathy Alves is a new Service Coordinator who, together with Ms. Bergeron, have done an excellent job coordinating service, problem-solving, and quickly and efficiently addressing any concerns to assure that homemaking services to MRC-HCAP consumers run smoothly.

In April 2003, another MRC-HCAP homemaking agency closed and APEX accepted and placed over thirty MRC-HCAP consumers in need of homemaking services within a very short time frame. Many of the home care staff from the agency that closed applied to be employed at APEX. Not only did APEX have many applicants for employment, they simultaneously had many people in need of services who were in transition from the agency that closed! Ms. Bergeron and Ms. Alves coordinated services in a steady, courteous manner and they jointly worked together as a team during this difficult transition. It is clear that Cheryl Rumley and the APEX staff should be recognized for all their hard work and dedication provided to MRC-HCAP consumers.

Well, guess what? You've got it! It just so happens that APEX Health Care Services, Inc. received Governor Mitt Romney's Exemplary Employer of the Year Award in October 2003. This award is given by the Governor's Commission on Employment of People with Disabilities to honor companies that have shown success in hiring people with disabilities. It is given yearly in October because October is National Disability Employment Awareness Month. APEX was nominated by Susan Smith at Forum House, for having an exemplary record in employing people with disabilities and for exceeding reasonable accommodation requirements under state and federal law. MRC-HCAP is extremely proud to have APEX providing homemaking services to our consumers, especially due to the fact that APEX conducts their business exactly in line with MRC's vision and purpose. That is providing "comprehensive services to people with disabilities that will maximize their quality of life and economic self-sufficiency in the community." APEX provides quality home care services to people with disabilities and helps people with disabilities become economically self-sufficient by hiring qualified successful candidates on their workforce. Our warmest congratulations to Cheryl Rumley and the staff at APEX for an award well deserved.

APEX is a comprehensive home care agency that provides certified and skilled services to people with physical and mental disabilities and people who are elderly, including homemaking, personal care, nursing, and a variety of other home care services. Children with special needs also can receive physical therapy, occupational therapy, speech therapy, social work services, and additional home care service. APEX is located at 1985 Main Street, Springfield, MA, 01103 and the telephone number is 413-746-4663 or toll free 1-877-260-HOME. Email: APEX@the-spa.com.

MassHealth/CommonHealth Medicaid and Home Care submitted by June Hailer

As we know, with the present status of the state's budget, many human service programs have been cut or eliminated. Even though many of our statewide senators, representatives, and advocates for elderly, disabled, and low-income individuals are doing what they can to help ease the pain, the MRC Home Care Assistance Program is not excluded from these cuts (MRC-HCAP experienced budget cuts that were deeper than anticipated).

As of July 1, 2003 anyone who applies for the services of the Home Care Assistance Program and does not have MassHealth/CommonHealth Medicaid will be put on a "wait list" until the state comes up with the necessary funding. However, if a person with disabilities applies for the Home Care Assistance Program, has MassHealth/CommonHealth Medicaid, and has an available Homemaking Agency or HCA (Home Care Assistant), the process does go much quicker (it takes four months to process an application for eligibility).

During the Fiscal Year 2003 (July 1, 2002-June 30, 2003), the Division of Medical Assistance (DMA) reimbursed the MRC Home Care Assistance Program some monies (based on DMA's own specific formula). These dollars (not otherwise recouped) helped MRC offset some budget cuts. Therefore, the reimbursement is very important in keeping Home Care Assistance Program services from experiencing even further devastating budget cuts. Medicaid reimbursement should occur each fiscal year and helps fund MRC-HCAP and other Community Services Programs.

The above reasons are why it is important that every person with a disability (who may be eligible) apply for MassHealth or CommonHealth Medicaid.

To apply for MassHealth (as of April 1, 2003) a household (with or without a person with a disability) must have a gross monthly income (before taxes and other deductions) of 200% of the Federal Poverty Level. In other words, a household's monthly gross income (proven by pay stubs or other forms of income verification) has to be below the following amounts: 1 person-$1,497; 2 people-$2,020; 3 people-$2,544; 4 people-$3,067; 5 people-$3,590; 6 people-$4,114; 7 people-$4,637; 8 people-$5,160 and for additional persons, add $524 for each. Also, if a person receives a weekly income, one must multiply the weekly income by 4.333 to get the monthly income figure. For more information on applying for MassHealth, please call MassHealth Customer Service Center at (voice) 1-800-841-2900; TTY: 1-800-497-4648 (for individuals with partial or total hearing loss).

To apply for CommonHealth Medicaid, a person must not be eligible for MassHealth, must have a disability (proven with documentation), and be working at least 40 hours per month. Assets are not considered in determining eligibility for CommonHealth Medicaid, but an eligible person may be required to pay a monthly premium that is based on income and family size. Also, some services and assistive technology devices may be provided on a sliding-scale basis to an eligible person who meets a certain standard of disability. For more information on applying for CommonHealth Medicaid, please call (voice) 1-800-841-2900; TTY: 1-800-497-4648 (for individuals with partial or total hearing loss).

If you think you may be eligible for MassHealth or CommonHealth Medicaid, call the appropriate phone number, ask for an application and apply! To check on the status of an application, please call the MassHealth Enrollment Center at 1-888-665-9993; TTY: 1-888-655-9997 (for individuals with partial or total hearing loss). You are taking one of the first steps towards making your "quality of life" better.

Self-Advocacy by Emeka Nwokeji, Director, MRC Consumer Involvement Program

An article on "self-advocacy" can be difficult to write in general terms because self-advocacy, by implication, can be translated to self-interest, group-interest, or self-glorification. In order not to lead the reader to any level of interpretation, I will explain the empirical applications of self-advocacy so the reader may arrive at his/her own interpretation.

First, what is "advocacy"? The Webster College dictionary defines "advocacy" as "the act of pleading for, supporting or recommending a course of action". If one takes the course of pleading for his/her human or civil rights, then one may label himself or herself as an "advocate". Thus, the advocate will support himself/herself or another person or population by means of education or argument.

Secondly, the word "self" is defined by the Webster College dictionary as "a person or thing referred to with respect to individuality". One can visualize "self" as personal interest or being of one piece with the same matter or material as the rest of the population. Most importantly, "self" can be viewed as a subject of a given positive act or being effective without assistance.

It is an enormous task to apply "self" to "advocacy", particularly to people with disabilities within the philosophy of the independent living movement in this nation. Nevertheless, I will discuss the relevance of "self-advocacy" as it relates to individuals with disabilities. One may recall that independent living for all is essentially the ability and opportunity to make decisions that affect one's human and civil rights. For example, independent living affects one's choices in regards to participating in social groups and team activities. The opportunity to make decisions is influenced by social norms, morals, and community policing. Historically, the ability to live independently is naturally challenging. However, the challenge becomes a jeopardy when it is amplified by a disabling condition occurring biologically in nature or acquired by trauma or disease.

In the mid-1960's, individuals with disabilities challenged the idea they should be guided and protected in society only through hospitalization or institutionalization. The civil rights challenge led individuals with disabilities to have the right and opportunity to pursue a self-determined course of action. The idea of a self-determined course of action was to get to know oneself, to accept one's abilities and inabilities, and to have the freedom to venture successes and failures.

Today, one may observe people with disabilities advocating loudly against barriers and unnecessary gaps in human service systems. The progress of advocacy is due to the formation of self-help groups and community-based independent living centers nationwide. One may remove the barriers of hospital settings, institutions, and cultural biases via self-advocacy and community education.

The acquisition of self-advocacy skills begins with a discussion with an individual with a disability who is isolated or excluded from the community. An environment must be created to allow individuals with disabilities to interact through role modeling, or peer-to-peer relationships. The practice of role modeling has led individuals with disabilities into an agreement to talk with peers. I have valued this practice when I had the opportunity to talk to individuals who had sustained a spinal cord injury. The interaction helped me understand and appreciate the abilities and disabilities of these individuals.
Accepting one's disability is a sure way of getting to know oneself and it promotes self-esteem. Knowing one's abilities and disabilities will help one make the best choices in regard to independent living.

One may agree that self-advocacy begins with communication, role modeling, socialization, and friendship. Positive peer groups and acceptance of oneself may help in many ways. The sharing of knowledge between each other can be empowering on the path to self-advocacy. Therefore in state agency programs, consumer advisory committees promote the invitation for other consumers to advocate for services. The MRC Consumer Involvement Program promotes program/service advocacy practices in various ways, such as the following: consumer participation in the business of the statewide rehabilitation council, statewide independent living council, statewide program advisory councils, and vocational rehabilitation advisory councils. For more information about self-advocacy, please contact me at 617-204-3851.

A Statement of Gratitude to Home Care Assistants submitted by June Hailer

As a member of MRC's Home Care Assistance Program Rehabilitation Advisory Committee (a sub-committee of the Rehabilitation Council), I want to express my deep and heart-felt gratitude to the 80 or so Home Care Assistants (HCA's) who provide homemaking services to eligible MRC-HCAP consumers with disabilities across the state.

Prospective HCAs are individuals who have been interviewed and hired by persons with disabilities who live mostly in rural areas of the state and who have already been approved for homemaking services by MRC-HCAP. However, these HCAs cannot start their employment until they have a signed contract with MRC, have been made aware that they have to pay their own taxes, have successfully passed a CORI (criminal records background check), and have been informed of a start date through a letter from MRC.

These HCAs tend to be dedicated, hard working, reliable, and responsible individuals who work as homemakers for MRC-HCAP consumers with disabilities. HCAs truly realize that the required basic tasks of daily living (grocery shopping, food preparation, dishes, counter wash-up, laundry, vacuuming, floor cleaning, bed changing, trash removal, and bathroom cleaning) would not otherwise get done and that these individuals with disabilities might otherwise end up in institutions if these services were not available. Institutions are more expensive for the state and individuals with disabilities don't deserve to be in them. They actually do care about what they do!

One such HCA, by the name of Bernadette, works for a person with a disability in Pittsfield, MA. Bernadette is a perfect example of what is stated above. She has worked in this capacity for the same person for 12 years and she will continue to do so for as long as she is able. As Bernadette states, "It is not like working as a maid for an able-bodied person. Here, the homemaking tasks are really needed in order for the disabled person to remain independent and living within their own community". Bernadette sees and feels the deep sense of appreciation for her work in the eyes of the person she works for and in the words of thanks she receives after each day is done.

Thank you so much to all those HCAs who are so necessary!

"Anyone Can Learn the Internet" submitted by Walter King

I can now offer myself as someone who's had a very pleasant and enjoyable Internet education. I learned this summer that if a person wants to use the Internet it could be done. I'm far from being a computer expert, but for someone who doesn't go out much, I thought this summer was a good time to start enjoying what the Internet has to offer. It's a great tool for learning about people, places, and organizations from Mass General to the Massachusetts Rehabilitation Commission.

Armed with two reference books I bought, I called my local library because a social worker had told me the library had received some computers through the "Bill and Melinda Gates Foundation". I figured that if the library had computers with Internet access then the library had a way to teach a novice like me how to use the darn thing.

When I called the library, I was told I could walk right in the first time. I received several pamphlets to read and I was taken to a computer that had a "mouse practice" program. The computer program can independently teach a student how to operate a computer mouse; it's like learning to use a computer while being entertained by a cartoon at the same time. When I completed the program, I could begin to use the Internet.

The librarians gave me some excellent one-on-one instruction on occasion over the summer, but most of the time I spent using the Internet was by myself. So when the time came to leave me in front of a computer screen, I knew the mobile arrow on the screen wasn't always going to go around in circles anymore. I followed my own "practice makes perfect" strategy: I concentrated on reading one of my favorite websites. I became comfortable with this site and the Internet in general by staying on the one subject until I became bored.

I gained the kind of experience and familiarity that actually made it easy to move on to other sites. I was learning by doing and I was never afraid to make mistakes of any kind. Since I did nothing but read the words inside the screen of a machine, I figured I was never hurting anybody.

I was also happy to take my time. I had no strict deadline for figuring out how the Internet worked, so I could relax and enjoy myself. I could increase my experience on a computer at the same time.

The librarians helped me whenever they could. They were great at all times when I needed to call someone over to my computer terminal to solve problems. We agreed that because of my regular practice learning to use the Internet and acquiring the proper computer skills, I could sign up for my first e-mail address on October 10, 2003.

I have gone from knowing nothing about using the Internet on June 10, 2003 to having my first e-mail address four months later; but, there is still a great deal I've got to learn, so I'm now putting together my own plan. I'm compiling a list of e-mail addresses in a notebook, so I'll be looking forward to reaching out and contacting several sites from now on. I'll never forget that there are always people at the other end of those websites, and I'll always be happy to use the telephone or send a letter through the post office in any appropriate situation: communication is what counts.

Resource for Eating Well on a Tight Budget

Looking for a great way to eat well despite a tight budget?
Serve New England may be the resource for you. Serve New England is a food cooperative with pick-up locations throughout Massachusetts. It offers low cost food in exchange for 2 hours per month of voluntary community service.

A regular food package includes 4-6 meat servings, 4-6 varieties of fresh vegetables, 2-4 varieties of fruits and staples such as rice or pasta, all for under $20. July's food package, for example, included: 19 oz. Marinated pork, 1 pound Kayem Kielbasa, 1 pound hamburger patties, 20 ounces chicken kabobs, potatoes, onions, corn on the cob, carrots, green peppers, apples bananas, pears, and cantaloupe. The cost was $18.00 and 2 hours of community service. Serve New England accepts Food Stamps/EBT card, cash or credit cards (if ordered on-line). Non-meat packages or meat only packages are also available.

Community Service can be "anything you do for someone outside of your family, without pay." It may be service provided directly to Serve New England, such as help sorting food, or could be service to any other individual or organization in your community. (For example, reading to a blind neighbor, speaking to school groups about disability, helping an organization with phone calls or mailings). If you feel you are unable to provide any kind of service to another, you could have a friend or family member provide the service on your behalf.

Serve New England provides a great way to help yourself and others at the same time. For more information about this very unique organization or to find the chapter closest to you, call Serve New England at 1-888-742-7363, or check out their web-site at www.servenewengland.org.

A Special Thanks submitted by Katherine Chesebro

I would like to extend a special thanks to Leslie Wish and Carol Nordblom of the Consumer Involvement Program. MRC-HCAP has contracted with Leslie Wish since the inception of The Resource to assist us with formatting the newsletter. Carol Nordblom has also assisted us since the newsletter began by folding and labeling The Resource for distribution to all eligible consumers of MRC-HCAP.

Thank you both for your kindness, patience, and knowledge. We all greatly appreciate your work and dedication. We hope to work with you both well into the future.

For more information…

Are you interested in learning more about the Home Care Assistance Program or other services offered by the Massachusetts Rehabilitation Commission? Do you have a computer with Internet access? Then check us out online at www.mass.gov/mrc. You can read the most current MRC-HCAP newsletter, The Resource, at the Home Care Assistance Program link on the home page.

Are you interested in learning more about Home Care's budget, program development, policies and regulations? Please consider joining the MRC-HCAP's Rehabilitation Advisory Committee (MRC-HCAP RAC). We meet every three months on Tuesday afternoons at our office on Wormwood Street in Boston. MRC-HCAP values the input of consumers who receive homemaking services. Please contact Betty Maher at 1-800-223-2559 if you would like your voice to be heard. Travel reimbursement is available. If you cannot attend the meetings, please contact your Case Manager and offer your thoughts.

Do you know of any community resources that may help other consumers who receive homemaking services? Please contact your Case Manager with the name and number of the resource and what the resource provides. Your Case Manager may submit the resource for the next newsletter.


Inspirational Thought submitted by June Hailer

Personhood is not a gift, but an inalienable right.
Leo Buscaglia

Mitt Romney
GOVERNOR

Kerry Healey
LIEUTENANT GOVERNOR

Ronald Preston
SECRETARY

Elmer C. Bartels
COMMISSIONER

John A. Chappell, Jr.
DEPUTY COMMISSIONER of COMMUNITY SERVICES


This information is provided by the Massachusetts Rehabilitation Commission.