The Resource Newsletter - 2010 Edition
Massachusetts Rehabilitation Commission
Home Care Assistance Program

In This Issue:



Director's Notes
Submitted by Betty Maher, MRC-HCAP Director

Welcome to another issue of "The Resource" newsletter. The theme of this issue, 'getting by with less' is one in which we are all familiar. The Home Care Assistance Program has a history of carefully managing its limited resources, providing the least amount of assistance an individual needs to maintain their independence. This is done by case managers and consumers working together to review all possible options for getting needs met (e.g., adaptations and assistive technology, community resources and natural supports), and homemakers and consumers working together to organize tasks to make the best use of limited time. That is why a few hours per week of assistance can make a world of difference. That is also why the recent reduction in hours, due to budget cuts, caused such pain and hardship for both consumers and homemakers. There was simply 'no fat to trim'.

It is important to understand that, as a program, we'd been handling previous budget constraints through other means, so as not to impact consumers receiving services. We did not fill staff vacancies and distributed the workload through the department instead; we did not increase rates paid to providers forcing them to economize as well, we did not move anyone off the wait list and ultimately stopped taking referrals, and we stopped using providers to do in-home assessments. We were also unable to increase anyone's service hours when their needs changed. As the economy worsened and the Governor was forced to make more cuts, we were left with no choice but to reduce the service hours authorized to those consumers receiving 3 or more hours per week. We understand how difficult this has been for both consumers and homemakers who worked so closely together to develop routines that worked. Pulling an hour away from your schedules threatened collapse of a very delicate system for many of you. We heard that loud and clear in the many phone calls, letters and emails we received.

While it may seem ironic to be mailing out a newsletter during such fiscally challenging times, it is in fact a very cost-effective way of getting the same information out to all our consumers and providers. In particular, the article "Getting by With Less" includes many ideas that have come from the conversations between case managers, consumers and providers responding to the hour reduction.

While we received many calls asking for direction on how to manage the cut, we felt strongly that each consumer has their own priorities in terms of tasks that must be done weekly and those that could be omitted or alternated, and we offer some guidance to you as you make those difficult decisions.

Finally, I feel I must state how, despite the hardship and difficulties faced by all of us over the past months, there has been an amazing level of positive energy and support, both for the program and for each other. The eloquence of the consumers, providers and community members who have spoken up at the Commissioner's Forums, our Advisory Committee, and budget hearings, has been a privilege to witness. Your willingness to share your stories has educated many people about the disability experience and the need for access, accommodation, adaptations and direct services. I encourage you all to continue to share your stories with us.



What's New with the HCAP?
Submitted by June Hailer, Consumer

As of June 3, 2009, MRC's Home Care Assistance Program has stopped taking intakes for the program and this is simply due to some serious state funding issues; meaning, there aren't enough dollars to meet the needs of the numbers of individuals already on the waitlist.

The program has continued to process applications that were taken before the above date totaling 381 applications. The consumer cases determined eligible will also be subject to the waitlist with the 152 that are currently on it. Those already on the waitlist will also remain on it indefinitely, until the numbers of consumers served are decreased from 1,500 to under 1,300. The program is trying to do this through attrition or by consumers transitioning to the Personal Care Attendant Program or Group Adult Foster Care Program, moving out of state, turning 60 years old or by improving their own ability to do home care tasks independently.

In addition, the Home Care Assistance Program (HCAP) has not been able to replace the staff who have left in the past year. Thus, the program is down 2 positions and Case Managers and supervisors are pitching in, doing extra work, to ensure that needed services are not interrupted. It is helpful to know that by mid-September the program will have at least one intern from the School of Social Work at Wheelock College to assist with the duties of the two vacant positions, case management and more.

So as not to be all negative, let me also mention some positive things the staff of the Home Care Assistance Program have accomplished…

Between May and July of 2009, the MRC-HCAP staff held 6 separate regional meetings in Andover, Boston, Brockton, Plymouth, Holyoke and Worcester. These were well attended by providers of home care services in the stated locales. The focus was to ensure that all involved in the field of Home Care (Provider Staff, Homemakers, HCAP Staff and Consumers) learn that the "team approach" is the most effective way to end up with the most positive results. Timely and objective communication is important, too, because it assures everyone's perspective is understood and problems are resolved in a comprehensive manner. Here, the providers were also informed about the existence of the HCAP's quality assurance methodology. The quality assurance measures allow consumers to give input into the quality and quantity of service delivered by the providers (thus, indicating to the latter some summarized avenues for improvement) and it was noted that these "report cards" have already been sent out.

Finally, the Home Care Assistance Program completed a provider training on "Suicide Prevention," because it has been found that there is a statistically high rate of suicides among people with disabilities. The MRC-HCAP staff hope to continue providing regional trainings to providers on varying topics to continue to improve the quality of relationships and services to consumers.



How to Find a Home Care Assistant (HCA)
Submitted by June Hailer, Consumer

A consumer who is a recipient of the MRC Home Care Assistance Program has the option to find and hire an individual to perform housekeeping duties instead of using a contracted homemaking provider. This option is similar to those using the Medicaid Personal Care Attendant program except the MRC HCAP program is for consumers who only need homemaking, not personal care and homemaking combined. However, there are differences…

A consumer can put an ad in the paper or on www.craigslist.com stating the tasks of the position, rate of pay and weekly hours. Of course, this should include a contact's first name and/or (at the very least) a telephone number. A consumer can also find an HCA by getting the word out through his/her social contacts, acquaintances or friends.

No matter how potential HCAs are found, all hopeful candidates should be interviewed by the consumer to insure the prospective HCAs are aware the consumer is the boss and both are feeling safe, secure and comfortable while the appropriate work is being done in the home environment. The personalities of each individual involved also have to be a good match.

From the very start the tasks of the job should be mentioned, including: meal preparation, food shopping, laundry, taking out the trash, dusting, vacuuming, mopping floors, changing sheets, making beds, folding clothes, washing dishes and cleaning counters. It is the consumer's responsibility to also mention: the approved hours, the rate of pay per hour ($9.50), that each check comes monthly and is direct-deposited, that each HCA is considered an independent contractor (taxes are not taken out of the checks) and that each HCA is asked to sign a contract with the MRC (that contains additional information) and have a CORI completed and passed and a Department of Public Health registry review.

Finding the right HCA to hire may take some time, but it is worth it for some consumers who live in rural areas and don't have a Home Care Agency near them or for those that need more flexibility with their (the consumer's) weekly hours because they work. Agencies may not be able to provide more flexibility than an HCA who can work evening or weekend hours (but remember consumers need to be home during service provision by an HCA). Lastly, the use of HCAs are more cost-effective to the MRC and its Home Care Assistance Program, but ultimately it is the consumer's choice as to what works best for them.



Getting By With Less
Submitted By Katherine Chesebro, MRC-HCAP Case Manager

As we start the new year and adapt to the many changes due to the poor economy, many consumers are having to adjust to reduced assistance. With the adjustment comes the need to plan and prioritize what needs to be done and what can get done later. But sometimes it is hard to choose what is priority and what is not when it comes to your homemaking service plan. Perhaps grocery shopping and laundry would be apriority for you and the cleaning can get done in spurts over the month. For example, have the homemaker focus on weekly grocery shopping, laundry and then have her/him do a few cleaning tasks each week that can get squeezed in. The reality is, your homemaker is not going to get all of the tasks done that he or she would have been able to complete in the past. It is time to start thinking creatively and plan ahead. Here are some ideas the case managers, consumers and providers brainstormed to help you and your homemaker cope with the reduction in services.

  1. Start a community meal program/pot luck supper with your friends and neighbors in your complex. Everyone can bring one meal and meet in your community room. Bring along a Tupperware container so you can pack up some leftovers to eat the next day. What a great way to lessen the time and energy of preparing a meal and you get to socialize at the same time!
  2. Take advantage of a congregate meal program that may be offered at your complex- check with your resident service coordinator to see if one is available to you.
  3. Invest in a crock pot- it takes less energy and preparation time and you will have a hot meal in a few hours. Plus, you will have extra portions to put in the fridge or freezer to eat at a later time.
  4. Ask family members to start helping out. Maybe they can commit to just bringing a hot meal to you or take your laundry. Whatever they cannot do to help, have your homemaker do with the time she/he has.
  5. Don't have a computer? Does a family member have one? See if they can put an order in for you with Stop and Shop Pea Pod (www.peapod.com) and have it delivered to your house. This is a good way for a family member to help out when they may not be able to get to your home on a frequent basis. Also, another great website is www.alice.com to buy your bulk dry goods at reasonable prices and no shipping charges.
  6. Invest in some handy equipment that makes it easier to clean and do laundry. For example, a long-handled duster to avoid reaching/standing; a long-handled duster pan so you don't need to bend down to the floor; vacuuming/sweeping sitting down in a Chair; a rolling cart for your laundry bag.
  7. Alternating tasks. For example, have the homemaker do a large grocery shop every other week and alternate with cleaning on the other weeks. Have the homemaker then do laundry and meal preparation each week. Mix and match to fit your needs.
  8. Participate in the task with your homemaker. For example, folding the laundry the homemaker washes. This activity can be done sitting down and for those with good hand strength and dexterity. Another example is making a meal together. Perhaps there is a part of the meal preparation that you can do safely- getting the pots and pans, chopping vegetables sitting down, or getting all the ingredients ready for the homemaker.
  9. Contact your local Independent Living Center for ideas on low-technology assistive devices to help you in the home; such as kitchen devices, built-up utensils for better gripping, timers to help stay on task. Contact your MRC-HCAP Case Manager for information about your local Independent Living Center.
  10. Multi-tasking: If you receive help with meal preparation, find recipes for casseroles or slow-cookers or food that can be baked and left while your homemaker does other tasks. Baked chicken can be put in the oven at the beginning of your homemaker visit and done in less than an hour while the homemaker does another task. Take out any frozen foods the night before your visit so the homemaker is ready to make a meal when he/she gets to your home. Having the homemaker bake meals may be a good alternative to a crock-pot for those who have safety concerns with heating elements.
  11. Barter with friends, family and/or neighbors. Perhaps someone could do a homemaking task for you and then you could do something for that person helping you. For example, a consumer may be able to cook but cannot do the grocery shopping. Perhaps a neighbor or friend could do the grocery shopping and the consumer could share a meal or two. The opportunities could be endless. Don't know anyone to barter with? Look at www.timebanks.org if you have Internet access at home or at the library.


Stress Management
Submitted by Susan Gruber, Consumer

Balance. It is something we all strive for in life but it is a complex process whether we are referring to walking or daily living. Having a disability can make it even more of an accomplishment.

I want to state up front that I am not writing from a position of perfect balance. On the contrary, stressors, anxiety and deep depression led to so much imbalance in my life this year that I needed to be hospitalized twice. I am still struggling; however, I want to tell you there is hope even if it is hard to grasp at times.

In times of stress some of us instinctively withdraw into ourselves but it is actually vitally important to reach out to people for support. I find that being with people with whom I can be myself in all my vulnerability comforts and strengthens me. If possible, I limit contact with those who would drag me down further. This is not the time to spend precious energy having to explain myself or fight others' negativity. So, having a good network of people around you is one way to help with stress management - for some this may be all they need.

For those so inclined, spiritual practices are another way to manage stress and find the peace within. Consider connecting with a place of worship, which in addition to offering the presence of a Higher Power in your life, is also a source of people to support you. My church has had a tremendous impact on my life. Learning meditation and other relaxation techniques such as Reiki may be helpful. There are plenty of books, classes and practitioners available to you.

For me, spending time outdoors in nature is a wonderful de-stressor. If it is possible for you, you might try finding and relaxing into the beauty and wonder of the natural world. Butterflies, wildflowers and sunsets await you. These things take me out of myself and my problems for a little while and often bring perspective, and therefore balance, back into my being. Gardening, even if you can only have a few containers or houseplants, is another way of connecting with nature.

Having a pet has been shown by many studies to reduce stress in measurable ways. For example, stroking an animal lowers both blood pressure and heart rate. My cat offers me unconditional love and acceptance of who I am with all my frailties. I offer this back to her. Forming this deep bond is a life-affirming act and life-affirming acts of any kind help restore balance.

Avoiding patterns of self-neglect is vital. Good rest is essential. Taking care of yourself helps the body deal with stress. When stressed I find doing normal, healthy things for myself daunting. You might find this to be true in your situation - think about what they might be and figure out ways to simplify in a healthy way. In my case, cooking is one of those so I try to keep meals simple but nutritious. For example, I might buy a package of three chicken breasts, place them in a pan lined with two layers of aluminum foil to avoid cleaning a messy pan, sprinkle some seasoning on top, and bake. This provides protein for six meals with little effort. Vegetables can be eaten raw if it seems like too much effort to cook them.

Another thing to not neglect, for those who are able to do so, is getting the exercise one is capable of doing. I am assuming that many of us cannot do workouts. I cannot, so I just do whatever activity I can tolerate. Talk to your healthcare providers about your abilities; perhaps they will help you come up with new ideas. For those receiving physical therapy, keep at it - it counts!

Exercise your mind also. Keep it active and occupied with good, pleasant things. Expose yourself to ideas and topics you enjoy. You might even try stretching your mind a bit by doing or learning something new - it can be refreshing.

Above all, do not engage in self-destructive behaviors. They will only serve to bring you down and they might be difficult to overcome. Balance then goes away completely.

Sometimes stress is deeper and more persistent and cannot be managed solely by the things mentioned above. Do not be afraid to seek professional help when you cannot handle your difficulties. This has been of enormous value to me. Professionals are there and ready, dedicated to helping you cope. Doctors and therapists are trained to not be judgmental so you do not need to fear opening up to them. Be sure you find ones with whom you feel comfortable.

If medication is suggested, accept the offer. When taken as prescribed it may help tremendously, otherwise it may not be as effective. Also with counseling, you have to go regularly to reap the benefits. Give the professionals honest feedback about your treatment. Patience and time are needed - so do not give up on these efforts.

Take care of yourself!



Food Resources
Submitted by Katherine Chesebro, MRC-HCAP Case Manager

While talking with MRC-HCAP Consumers on my caseload, an unmet need that is often discussed is acquiring adequate food resources or trying to defray the cost of food. This is quite a challenge for many who are on a fixed income, especially in our current economic conditions. There are several wonderful food resources available to individuals either in certain locations or statewide. Please consider these resources below. You may contact the resources on your own or we welcome your calls to discuss with your assigned MRC-HCAP Case Manager.

Department of Transitional Assistance (DTA) SNAP/Food Stamps Program (Statewide)

SNAP Benefits Hotline: 1-866-950-FOOD (3663)
www.mass.gov/dta or www.gettingfoodstamps.org
SNAP, the Supplemental Nutrition Assistance Program (formerly the Food Stamps Program), is provided by the federal government and administered by DTA. Residents of the Commonwealth who participate in SNAP are families with children and individuals who are elderly or disabled. You can complete an application online or through a local community agency (please visit www.mass.gov/dta or www.gettingfoodstamps.org for information on your local DTA office or community agency to complete an application. You can print the application and mail it or submit it online. You may also go to your local DTA office in person.

If you receive SSI, EAEDC or TAFDC, you will be automatically eligible, and, if newly disabled or receiving SSI this can be determined at your local Social Security Office.

When you apply for food stamp benefits, you will be asked to provide DTA with proof of certain income, expenses and other information. You only need to provide information that applies to your household. For more information about the documents you will need to bring to DTA, call the FoodSource Hotline at 800-645-8333 (TTY 800-377-1292).

DTA has changed its policy about face-to-face interviews. A person may request a waiver to waive a face-to-face interview after the initial application or whenever you may be requested to visit the office. With this waiver, you may conduct your interview over the phone with a caseworker. You must request a waiver each time you are asked to go to your local DTA office for an interview. It is strongly encouraged to request this in writing or on your initial application for food stamps.

Bay State CAP

Bay State CAP (Combined Application Project) is a special food stamp application process that certain people who receive or apply for Supplemental Security Income (SSI) can use.
Bay State CAP is for SSI recipients and applicants who:

  • are 18 or older
  • are unmarried (single, widowed, divorced, or separated)
  • are U.S. citizens or eligible non-citizens
  • live alone or with others, but do not live with a spouse or with children under age 22
  • buy and prepare food separately from others
  • have no earned income when they apply

Advantages to Bay State CAP:

  • Bay State CAP uses the information from your SSI application to determine eligibility for SNAP food stamps. You do not have to fill out a separate application or go to the DTA office.
  • It does not require any proofs other than the proofs needed for SSI. It does not require a separate interview. Your SSI interview is also your Bay State CAP interview.
  • It has a three-year certification period, so you don't have to re-apply as often.
  • It often provides more food stamp benefits than the regular food stamp application.

Disadvantages to Bay State CAP:

  • If you have high shelter costs, medical expenses, dependent care expenses, or child support payments, you might get higher benefits with regular SNAP food stamps.
  • You cannot get expedited (emergency) SNAP food stamps with Bay State CAP.
  • If you choose Bay State CAP when you apply for SSI, you will not get SNAP food stamps until your SSI application is approved. Since this may take some time, you may want to file a regular application for SNAP food stamps while your SSI application is pending.

Your Social Security worker will help you decide if Bay State CAP is best for you. You can apply for Bay State CAP at your local Social Security office when you file your application for SSI. You do not have to fill out a separate application for Bay State CAP. Your SSI application and proofs are all you need.
If you have questions, you should call the Social Security Administration toll free at 1-800-772-1213, or call the Department of Transitional Assistance (DTA) at 1-800-249-2007.

WIC (Statewide)

1-800-WIC-1007
The Massachusetts Women, Infants, and Children Supplemental Nutrition Program (WIC), is a health, nutrition and prevention program. WIC is for pregnant women, mothers with infants, and children under 5. WIC helps mothers and children get free, healthy foods.

Serve New England (Statewide)

1-888-742-7363
www.servenewengland.org
SERVE is a New England-wide food buying cooperative for people who volunteer at least 2 hours per month anywhere in their communities. Every month, people can get frozen meats, vegetarian items, and fresh fruits and vegetables, for a savings of one-third off the retail price. Please contact the phone number above for a chapter in your area.

Project Bread's Food Source Hotline (Statewide)

1-800-645-8333 or TTY: 1-800-377-1292
FoodSource Hotline counselors refer callers to food resources in their communities. Hotline counselors also give callers information on public programs*, meal sites for the elderly, Meals On Wheels programs, salvage food distribution sites and other programs that supply free or low-cost food.
*Such as SNAP/ food stamps, school breakfast, or WIC.

Angel Food Ministries (Statewide)

1-877-366-3646
www.angelfoodministries.com
Angel Food Ministries is a non-profit, non-denominational organization dedicated to providing food relief and financial support to communities throughout the United States. Angel Food is available in a quantity that can fit into a medium-sized box at $30 per unit-just about one month's worth of food per individual. Each month's menu is different than the previous month and consists of both fresh and frozen items with an average retail value of approximately $60. There are no qualifications, minimums, income restrictions, or applications and food stamps are accepted. Orders and distribution are handled by church host sites. To find a local host site nearest you, contact the phone number listed above.

Fair Foods, Inc. Dollar-a-Bag

617-288-6185
www.fairfoods.org
Fair Foods, Inc. and its partners run over 50 "Dollar-a-Bag" sites throughout Boston and Eastern Massachusetts. Each week, participants enjoy a wide selection of fresh fruits, vegetables, breads, and pastries for a donation of $2 per bag. To find a site nearest you, call the phone number listed above.

Community Servings

617-522-7777
www.servings.org
Community Servings provides medically-tailored meals and nutritional assistance for people with acute life-threatening illnesses, their dependents, and their caregivers in Boston and surrounding towns. You must complete an application including physician documents and laboratory results verifying that you are at a critical stage of a life-threatening illness to qualify for services. For more information, please call the phone number above or discuss application submission with your MRC-HCAP Case Manager.

Intercity Grocer - Intercity Home Care

781-333-3003
Intercity Grocer is a division of Intercity Home Care. The service provides grocery shopping and delivery to individuals in their homes in the North Shore area. Orders are placed over the phone on your assigned delivery day. Groceries are delivered in a refrigerated vehicle or stored with cold packs. Delivery drivers can assist with heavy and refrigerated items. Payment is collected at delivery time. A register receipt will be included with your order. Payment options include cash, check, EBT, pre-payment or automatic deduction from your bank account.



Tighten That Belt
Submitted by Duncan Arden, MRC-HCAP Case Manager

Here are a few tips for stretching your grocery and medication budget, etc. a little further in these tough economic times.

Clip Coupons
If you're like me, you get a ton of junk mail in your mail box every week. Ironically, no sooner than the trash is picked up, your mailbox is brimming with junk mail. Yes, a lot of it is worth discarding but don't throw it all away. If you look closer, you can often find a list of weekly specials advertised at the grocery store, across a range of categories. These include coupons, 2 for $5 deals, etc. Why not save this advertisement and use it to compile your grocery list for that week, buying only the items on sale.

Reusable Grocery Bags - They're green and they save money
Many grocery stores, such as Market Basket and Stop and Shop now sell re-usable canvas bags for about $1 for your grocery shopping. Alternatively, why not reuse the plastic bags you take home. If you bring these and/or the canvas bags back to the store clerk, you'll save 5 cents per bag on your shopping bill. It's not much, but it adds up over time, and as they say, every penny counts!

Pennies for a Rainy Day
When my wallet becomes laden with small change (pennies, dimes, nickels) I like to throw them into a canister (usually a couple of times a week). When the canister is full, I bring it to the grocery store to cash it in at the Coinstar machine and find I have amassed $20-40. I don't miss these pennies; I magically have a spare $20-40 when I need it, and my wallet is more organized, making me less stressed at the end of the day.

Buy in Bulk
If you have the storage space, consider buying in bulk. Especially with perishable items because you can break down, say a 6 pack of chicken breasts or 2 pounds of ground beef and freeze in individual portions. I like to buy 2 loaves of bread and put one in the freezer. Frozen veggies are also as nutritionally beneficial, cheaper than fresh ones, and come in large sizes. If you compare the cost of buying two items of the same weight with a large sized item of equivalent weight, the larger item is cheaper.

Rewarding Loyalty
Make sure you join your grocery or pharmacy's loyalty card program, which is free of cost... Shaws, Big Y and Stop and Shop all have them. Market Basket sells many items at below market-cost so doesn't have a loyalty program. It will enable you to take advantage of all the weekly deals on all advertised items. Some stores also reward you with free points redeemable for gas when you use your store card.

Medication savings
Wal-Mart now offers over 400 generic drugs at only $4 per prescription. Also, if you don't have prescription insurance, but have AAA membership, you can show your membership card at CVS or Walgreens to get the lower rate on your prescriptions. Whenever you are prescribed a medication, check with your pharmacist to see if there is a generic alternative. The generic is almost always cheaper than the brand name drug. Your pharmacist can tell you which drugs have a generic option and which don't.

Free Services
Here are some free services to try, if you're not already using them:

Transportation
Do you have MassHealth Standard or CommonHealth for health insurance? If so, did you know you can get free transportation to your doctor's appointments through MART - the transportation unit of MassHealth? In order to apply for transportation, get your doctor's office to complete a PT-1 form (also called Prescription for Transportation form). The form can now be completed and submitted online by provider agencies at: www.mass.gov/masshealth. A separate form for each doctor will need to be completed. The form is mailed, emailed or faxed to MassHealth and is processed within 10 days. Authorization is good for 6 months to 1 year before you need a renewal depending on your doctor's statement.

Durable Medical Equipment
If you need bathroom equipment such as a shower chair or bench, commode, raised toilet seat, or incontinence supplies, and you have MassHealth you should be able to get these items for free. Other covered items include some diabetic supplies and nutritional supplements such as Ensure. You will need a script from your PCP to authorize this. In some cases you may need advice on the best product for your needs. In this case, ask your PCP for an evaluation for a "homecare safety assessment", "occupational therapy assessment" or "nursing assessment". Talk to your PCP and ask him/her to write you a script for the item you need.

Phone Services
Safelink Wireless is a government sponsored program offering a free cell phone to people throughout most of MA who are on a limited income - To be eligible you must be receiving assistance from one of the following: MassHealth, SSI, EAEDC, TAFDC, Fuel Assistance, Food Stamps program, or the Low Income Energy assistance program. Only one free phone per household is allowed and you require a valid postal address not, PO Box carrier, to ship the phone to. The cell phone comes with 80 minutes of free airtime per month, and you can buy a Trac Phone card for additional minutes at any recognized pharmacy. Not all towns offer this program. To apply call: 1-800-977-3768 or go online at www.safelinkwireless.com.

Legal Services
Legal services can be extremely expensive but fortunately there are some agencies who can offer assistance at low cost or free of charge. The following is a list of legal agencies throughout the State who specialize in providing free legal advice. Whether your issue is one that concerns family law, estate planning, taxes, or social security, in each case, you should be provided with self help information or forms, be provided with a legal services lawyer to help you, or be connected with a private volunteer lawyer willing to help. (Source: Mass Resources).

  • Greater Boston Legal Services
    Toll-free: 1-800-323-3205
    Boston: 617-371-1234
  • Legal Assistance Corporation of Central Massachusetts
    Toll-free: 1-800-649-3718
    Worcester: 508-752-3718
  • Massachusetts Justice Project
    Holyoke: toll-free: 1-800-639-1209; local: 413-533-2660
    Worcester: toll-free: 1-888-427-8989; local: 508-831-9888
  • Merrimack Valley Legal Services
    Toll-free: 1-800-336-2262
    Lowell: 978-458-1465
  • South Coastal Counties Legal Services
    Toll-free: 1-800-244-8393
  • MetroWest Legal Services
    Toll-free: 1-800-696-1501
    Framingham: 508-620-1830
  • Western Massachusetts Legal Services
    Greenfield: 413-774-3747
    North Adams: 413-664-4531
    Northampton: toll-free: 1-800-639-1309; local: 413-584-4034
    Pittsfield: toll-free: 1-800-639-1509; local: 413-499-1950
    Springfield: toll-free: 1-800-639-1109; local: 413-781-7814


" If it is hard, it is because your goals are high. If it is very hard, it is because your work is great and a meaningful departure from convention. And seeing it through will take, perhaps is already taking, the full resources of your competence, your commitment and your love..."
-James Nehring

"Be yourself, everyone else is taken."
- Maya Angelou



Community Resources: YMCA Financial Assistance
Submitted by Elaine Dallaire, MRC-HCAP Consumer

Many members may not be aware of the YMCA Merrimack Valley's Financial Assistance Policy Rev. May 17, 2004. If you have been denied assistance in the past; I have successfully obtained financial assistance for YMCA membership and would like to share my strategy with you! Please note that most, if not all YMCAs offer this financial assistance to qualifying applicants!
First, the Merrimack Valley's Financial Assistance Program, is funded via monies raised at it's annual Reach Out for Youth Campaign. Second, you need to be aware that anyone can be awarded aid at the discretion of the branch executive director. Plead your case based solely upon:

  • The gravity of your financial need- give them all documents reflecting your financial hardships; attach all copies to your application.
  • A personal statement focused on all the benefits you will gain physically, emotionally and spiritually.
  • State your particular disability and the (activity), you seek that will maintain your ability to ambulate or whatever physical remedy you seek.

Your personal statement will be the determining factor in getting financial assistance.
You should phrase your statement as though you were writing to a dear friend!
Good Luck To All Of You!



Wheelock Interns Conduct Survey
Submitted by Lianna Marciniec and Emily de Guzman, Wheelock Interns

On October 26, 2009, we, the interns from Wheelock College, conducted a survey which determined whether the Massachusetts Rehabilitation Commission Home Care Assistance Program (MRC-HCAP) services resulted in fewer hospital visits and emergency room visits among its consumers. We collected data over the phone for a period of two months. From a pool of 348 eligible consumers, 178 consumers were needed to participate for a statistically valid sample size. Consumers who were eligible for the survey needed to be receiving the MRC-HCAP services for at least one year with no change in the homemaking vendor. Consumers were asked a list of standardized questions pertaining to:

  • Their willingness to participate in the survey
  • Whether or not they believed the MRC-HCAP has prevented further injury and/or hospitalization
  • The number of hospital and emergency room visits before and after the MRC-HCAP services
  • Comments regarding their services

According to the results of the survey, there were a reported 333 hospitalizations before services were in place; and 128 hospitalizations while receiving services. Emergency room visits totaled 396 before services which then reduced to 133 visits while receiving services.

Results of the survey varied, due to the length of time consumers have been involved in the program as well as their willingness to participate. Consumers emotionally expressed their concerns about losing hours, as well as their appreciation for the program and homemakers. Many consumers expressed that they would not be able to make it through a week without receiving homemaking services. They remarked that service was, "excellent, helpful, superb, consistent, and a God send." One consumer stated, "Without the program I would not be able to function or survive. It has saved my life."

Consumers sharing their stories left a lasting impression on us. The services provide companionship for consumers, regularity, as well as the motivation to keep working. Each story brought a different level of appreciation for not only the work they are doing but the MRC-HCAP program itself.

A consumer that has received the MRC-HCAP services for 6 years shared her thoughtful story. She commented:

I have a 9 year old autistic son as well as 2 other children. I would probably lose my children if I didn't have the service. I have no family, no support. My father passed away and my children's father passed away. Without this service, I would be high and dry. I have contacted my local legislator and the Governor's office. If I didn't receive this service, my children would have no parent, not even one. I appreciate this so much and it is needed. It is sad that I need to pay people to support me, but without it, I wouldn't be able to survive, and it would end up costing more to support me.

After hearing this, it was evident that the MRC-HCAP has made improvements on individual's lives that we didn't realize was possible.

The initial purpose of the survey was to gather statistical data about the MRC-HCAP in regard to hospitalization, but the information that was most influential came from the consumers' stories that were shared. Although it may seem insignificant, we realize just a few hours a week provides some consumers with enough help and energy to perform other necessary tasks and maintain independence. Services from the MRC-HCAP empower consumers to work, share their home with family and friends, and participate within their community.



Recipes: Economical Crock Pot Recipes
Submitted by Katherine Chesebro, MRC-HCAP Case Manager

A crock pot is a great investment! You can make multiple portioned meals that are easy and economical. A homemaker can quickly add ingredients and let the food simmer for several hours. By the end of the day, you have several hot meals that can be portioned into small containers and put in the fridge or freezer to eat at a later time. This is a great solution to get a hot meal despite the recent service hour reductions that impacted so many consumers. It is important to remember safety- always turn off your crock pot when you are finished cooking your meal. Here are some great recipes to try with your homemaker:

SLOW COOKER TURKEY BREAST
Ingredients: 1 (6 pound) bone-in turkey breast and 1 (1 ounce) envelope dry onion soup mix
Directions: Rinse the turkey breast and pat dry. Cut off any excess skin, but leave the skin covering the breast. Rub onion mix all over outside of the turkey and under the skin. Place in a slow cooker. Cover and cook on high for 1 hour, then set to low, and cook for 7 hours.

SLOW COOKER VEGETABLE CHILI
Ingredients:
1 (28 ounce) can whole peeled tomatoes with juice
1 red bell pepper, chopped
1 (15 ounce) can garbanzo beans, drained
1/3 cup chili powder
2 zucchinis, thinly sliced
1 (4 ounce) can chopped green
1 onion, chopped
chili peppers
2 carrots, sliced
2 cloves of garlic, minced
2 stalks of celery, sliced
1 tablespoon dried oregano
2 teaspoons ground cumin
1 teaspoon salt
Directions:
In a slow cooker, combine the tomatoes, beans, zucchini, onion, carrots, celery, red bell pepper, chili powder, green chile peppers, garlic, oregano, cumin and salt. Cover and cook on low for 6 to 8 hours OR on high for 3 to 4 hours.

SLOW COOKER MEATLOAF
Ingredients:
2 pounds of lean ground beef
3 tablespoons of dry onion soup mix
2 eggs, beaten
3 tablespoons steak seasoning
6 tablespoons ketchup, divided
Directions:
In a medium bowl, mix together the ground beef, eggs, 3 tablespoons ketchup, onion soup mix and steak seasoning using your hands. Pat lightly into the bottom of a slow cooker. Spread remaining 3 tablespoons of ketchup over the top. Cover and cook for 6 to 8 hours on low or 4 hours on high.



Consumer Recipe
Submitted by Robert Keller, MRC-HCAP Consumer

Easy Yogurt
Equipment: 3 quart covered stainless steel saucepan, meat thermometer (optional: dedicated yogurt maker).

Ingredients:Half-gallon 1%, 2%, or 4% milk, (optional: 1 cup nonfat dry milk), 6 ounce container "Chobani" (Greek), or "Stonyfield" (organic) plain yogurt (your starter.)
Procedure: Pour the milk into the saucepan. Thoroughly stir in nonfat dry milk (leave out the dry milk and you'll get a less cohesive yogurt). Heat milk to exactly 185°F. Cover and allow to cool to exactly 110°F. Thoroughly stir in (starter) yogurt. Place mixture on a warm stovetop (to keep your stovetop warm, try running the oven at 300-400°F, and use a potholder under the saucepan, if need be, to help modulate the heat) or use a dedicated yogurt maker (available at low cost on the Internet.) Maintain temperature between 106°F and 110°F for 3 to 4 hours. Do not stir. Do not add fruit, sugar, or preserves until after the yogurt is done. When mixture thickens, pour into covered food storage containers and refrigerate. Enjoy! Reserve 6 ounces of the (unsweetened) yogurt to make the next batch.
This is a great recipe if you're going to use the oven to bake while the yogurt is kept warm on the range top - a very efficient use of energy!



MRC-HCAP Quick Facts

  • The MRC-HCAP provides services to eligible consumers who live alone, with children under the age of 18 years or with adult(s) who also have a medically documented disability that prevent them from completing homemaking tasks. Children who turn 18 during the provision of services must also have a medically documented disability preventing them from completing homemaking tasks in order for the eligible consumer to continue receiving homemaking services.
  • The MRC-HCAP provides services to eligible consumers between the ages of 18-59. When a consumer turns 60, the MRC-HCAP Case Manager will contact the consumer one month before his/her birthday to make a referral to the local Elder Service agency in his/her area and discuss a transition plan.
  • The MRC-HCAP may provide long-term assistance to eligible consumers. Every 1 year to 18 months, your MRC-HCAP Case Manager will conduct an eligibility review on your case file to re-determine eligibility, re-assess homemaking service hours, assess quality of service and help you identify community resources if you are in need of assistance. The review will commence with a letter informing you of this process with a request for you to submit documents necessary to re-determine your eligibility within a certain time-frame.
  • Consumers must be home during service provision.

Did You Know?

Homecare services reduce the risk of hospitalization by 62%
Homecare services reduce the risk of emergency room visits by 68%
**data provided by MRC-HCAP survey of consumers receiving MRC-HCAP services.
64% of MRC-HCAP Consumers believe homecare service has prevented hospitalization
79% of MRC-HCAP Consumers believe that homecare service has prevented injury
**data provided by MRC-HCAP quality assurance outcomes report surveying consumers at the time of eligibility review.



The MRC-HCAP Staff

The MRC Home Care Assistance Program staff encourage consumers to call with questions or concerns regarding homemaking services.
MANAGEMENT
Betty Maher , Director
Angela Cipriano, Supervisor
Felix Jordan , Supervisor

SUPPORT STAFF
Christine Rinaldi, Administrative Assistant
Bonny Taforo, Clerk
Lilly Lau, Accountant
Edward Loring, Accountant

INTAKE
Vacant

CASE MANAGERS
April Anderson, South Worcester County and surrounding towns of Middlesex and Norfolk Counties
Duncan Arden, Essex County and surrounding towns of Middlesex County
Eloise Cruz, Boston I-M and surrounding towns of Middlesex and Norfolk Counties
Katherine Chesebro, Bristol County and surrounding towns of Norfolk County
Maria King-Bynoe, Boston N-Z and surrounding towns of Suffolk and Middlesex Counties
Paulina Mauras, Southwestern MA and surrounding towns of Worcester County
Liz Morin, Northwestern MA and surrounding towns of Worcester and Middlesex County
Chris O'Brien, Greater Worcester and Metrowest
Debra Visocchi, Middlesex County
Jodi Watson, Plymouth County, Cape and the Islands, and surrounding towns of Bristol and Norfolk County
Megan McNally Boston A-H, Brookline, and surrounding towns of Middlesex County

The Resource Newsletter
Massachusetts Rehabilitation Commission Home Care Assistance Program
27 Wormwood Street, Ste. 600
Boston, MA 02210-1616

Phone/TDD: 617-204-3853
Toll Free: 1-800-223-2559
www.mass.gov/mrc

Deval Patrick
Governor

Timothy Murray
Lieutenant Governor

Dr. JudyAnn Bigby
Secretary

Charles Carr
Commissioner





This information is provided by the Massachusetts Rehabilitation Commission.