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Winter 2013 HCAP

MRC Home Care Assistance Program Resource Newsletter, 2013 Edition
Massachusetts Rehabilitation Commission
Home Care Assistance Program



Betty Maher, Director

Angela Cipriano, Supervisor
Felix Jordan, Supervisor

Christine Rinaldi, Administrative Assistant
Lilly Lau, Accountant
Lianna Marcinec, Support Case Worker
Kathy Stimpson, Support Case Worker
Barbara McPherson, Support Case Worker


WEST: Liz Mahoney and April Anderson
NORTH: Jim Cockerham and Chris O’Brien
SOUTH: Jodi Watson and Katherine Chesebro
BOSTON: Eloise Cruz

Newsletter Editor: Katherine Chesebro

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

As I sat down to write this considering what to highlight in this issue, I kept going back to not what is in here, but what is NOT—an article by Walter King. Walter, a consumer of the Home Care Assistance Program and regular contributor to the newsletter, passed away in February 2012.

Having had the opportunity to get to know Walter through his participation on the Home Care Advisory Committee, I was an eye witness to the effect of consumer involvement on the empowerment of an individual with a disability. Walter attended his first Advisory Committee meeting years ago after being encouraged to attend by his case manager who felt he had a lot to offer. Initially he was tentative, listening carefully to the dialogue, but thinking he had nothing to add. But as he learned that his thoughts and opinions about how services were going, what worked as well as what did not, were in fact helpful both to HCAP staff and to the providers, and that they helped to drive program improvements, we saw Walter open up more and more. Soon he was a regular attendee who could be counted on for well thought out feedback and ideas. We also watched as he became an advocate both for the program and for himself—writing to his representatives at the State House to advocate for continued financial support for this and other programs upon which he and others with disabilities rely. He also became more connected to his community. He set a goal for himself to learn to use the Internet and made use of the resources at his local library to set up an email account and surf the Internet for news and information that helped him feel less isolated and more connected to the world. He attended the MRC Consumer Conference and he began writing articles for this newsletter in hopes that by sharing his experiences he could help others.

While Walter’s experiences demonstrate several ways consumer involvement is integrated into our program, there are many other ways in which our consumers’ voices help to shape the program and how services are delivered. Over the course of a year, you may have heard from a case manager or a student intern, asking for your feedback about how services are going, or asking a series of questions about how YOU are doing. Your responses to these surveys help us identify trends that might point to gaps in services, provider performance issues, or larger systems issues that our partner agencies may be able to address. Some specific projects currently underway in our program—revising our application materials, developing a fact sheet for those preparing to begin to use homemaker services, and revising our provider contract specifications—are being done as a result of consumer feedback and with the involvement of consumers throughout the project. For example, in revising the application materials, several focus groups were held in which consumers had an opportunity to review and make recommendations on drafts before a recommendation was made to the Advisory Committee. If you are interested in getting involved in these projects, attending Advisory Committee meetings, or offering your voice in any other way, give us a call. There’s more than one way to let your voice be heard.

As you read through the pages before you, take note of the variety of contributors, which include not only program staff, but a student from McGill University in Montreal, Meaghan Kennedy, who spent the summer volunteering to develop a guide to Peer Supports, from Brenda Rogers, RN, the president and CEO of Abbey Road Home Care, from June Hailer, HCAP Consumer and dedicated chair of our Advisory Committee, and from John Bruinsma, HCAP consumer, and one of the newest members of our Advisory Committee.

Finally, I want to welcome some new members to the team. Barbara McPherson will be working part time, joining Lianna Marciniec and Kathy Stimpson to support our case managers by taking applications, collecting eligibility documents, assisting in locating resources and collecting and following up on Provider Quality Assurance information, among other things. Cathi Halloran, an Independent Consumer Consultant has been helping out in the office two to three days a week, answering phones, distributing mail and helping with billing activities. You may hear her voice if you call our main line on a Monday or Wednesday afternoon.

Also joining our program, from September 2012 through May 2013, are four student interns from the Wheelock College School of Social Work. Kara Farrington will be supporting the North Region, Tamami Katoaka, West, Michael Wood, Boston and Boney DaSent-Jones in the South Region. They will take on increasing responsibilities throughout the year. If you do hear from them, we hope you’ll find their assistance helpful. They, like all of us in HCAP are as excited to be able to support you in your goals as we are to learn from you and your experiences.

“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 easier for someone else”.
~Walter King, MRC-HCAP Consumer and Advisory Member
In Memorium (1962-2012)

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

As you may already know, MRC has moved their administrative offices to 600 Washington Street, Second Floor Boston, MA 02111. For those who have their own Home Care Assistants (HCAs) and send in the required time sheets at the end of each month in the provided, pre-addressed envelopes; please remember to change the street address and zip code on any old envelopes you still have or just ask MRC for new ones.

The Home Care Assistance Program has had 1157 referrals since the intake process was re-opened about one year ago. This averages 96 monthly. Around 937 individuals have not returned necessary paperwork, are waiting for medical verification or the results of in-home assessments, have been referred to home care agencies and are waiting for services to begin or are now receiving services. There are also 4 people who requested to be “on-hold” and 216 people who have exited the program or were off the wait-list as a result of aging out or for other reasons.

This year the Home Care Assistance Program is lucky to be level-funded for FY ’13, it looks like it will basically remain intact thanks to the strong advocacy of the consumers of the Home Care Assistance Program and members of the Home Care Advisory Committee. This program was lucky enough to have interns from Wheelock College and we look forward to having four new ones during the upcoming fall semester.

We welcomed Kathy Stimpson until September 30, 2012, she had a position as a Home Care Assistance Program-Vocational Rehabilitation (HCAP-VR) Liaison. Her task was to coordinate services for a specialized group of consumers who are receiving both home care and Vocational rehabilitation services. She worked with consumers who receive home care services and have a high level of interest in working, but have not yet applied for VR services. In this position, Kathy was responsible for all aspects of home care coordination. She collaborated with the consumer, the VR office and other VR contractors that consumers are involved with.

The purpose of the position was to use an interdisciplinary approach addressing health issues, mental health management, independent living skills and services directly related to a consumer’s employment goals. Another objective was to identify obstacles to employment and share responsibility for assisting consumers in addressing them, whether they be physical, emotional or educational (pre-vocational program referral). Finally, the role of the liaison was to serve as a resource to HCAP staff to determine how best VR can assist consumers of the Home Care Assistance Program to successfully access VR services, and to identify and address obstacles to employment prior to referral. This may include getting consumers connected with community mental health services, Adult Basic Education and ESL programs, or accessing Career Center pre-employment, computer training, and “job placement” skills workshops.

Kathy’s job was to also speak with consumers who used the VR system successfully and unsuccessfully to see if there are any common factors which pre-dispose a consumer to successfully getting and maintaining a job. Conversely, this helped Kathy learn if there are other factors (health, motivational, emotional) that make it inappropriate to refer consumers to the VR system at a given time. This information was shared with the appropriate HCAP-VR staff.

Kathy prepared a report on the lessons learned from her work. This includes providing information on; the types of obstacles to employment encountered by HCAP consumers, best practices for reducing obstacles to VR participation and employment, the impact of interventions on employment outcomes, and recommendations for continued coordination between HCAP and VR. This report is expected to bring some very positive results.

Lastly, and as a reminder, I wish to share that the Home Care Assistance Program has a “Home Care Advisory Committee” that meets quarterly. Its members are made up of HCAP staff, consumers of the Home Care Assistance Program, representatives from Home Care agencies who are MRC vendors and representatives from Elder Services and DPH. The committee is very involved in improving services and the continuation of this necessary program: it keeps consumers out of medical institutions and living within their communities and able to consider employment goals. Hence, I would like to invite all interested parties to attend these meetings. For more information, you are welcome to contact Betty Maher at Betty.Maher@state.ma.us.


“Best Practices for Providing Homecare Services”
Submitted by Felix Jordan, MRC-HCAP Supervisor

Since 1986 the Massachusetts Rehabilitation Commission has provided homecare services to individuals 18-59 years of age in need of cooking, cleaning, shopping, and preparing meals. Throughout this time, consumers informed the MRC how these services have functioned to improve their overall quality of life, enhanced their independence and prevented institutionalization.

This desired outcome is possible only through the hard work and dedication of the homecare agencies and the homecare workers who provide this needed service every day. The following article highlights four homecare vendors who scored highest in our statistical measures. It outlines their mission, philosophy, processes and procedures. Our goal in writing this article is to formulate a summary of best practices for providing homecare services.

From a list of 161 vendors that includes satellite offices, four vendors were selected that scored highest in our analysis. The four agencies were: 1.) Family Services of Central MA, 31 Harvard Street, Worcester, MA 2.) Habilitation Assistance Corporation, 10 Water Street, Plymouth, MA 3.) Geriatric Assistance Corporation, 4 Punchard Avenue, Andover, MA 4.) Supportive Care with offices in Malden and Lawrence, MA

Statistical Methodology
The statistical measures utilized in this analysis were derived through the use of the Massachusetts Rehabilitation Commission’s Provider Reports Database. This database calculates responses from consumers that measure the following areas: quality of cooking, light housekeeping, cleaning, shopping, laundry, communication, quantity of services, new placement transfer and safety. These areas are each graded using a scale of: excellent, good, fair and poor to form a record. Each vendor record is then joined to other records to produce the vendor’s final average. Since the needs of the consumers vary, mean averages are not weighed. A decision to use un-weighed averages was made to account for consumers who receive less than the full complement of services that are offered.

Three criteria were used to distinguish these vendors:
1. A vendor average of 90% or better.
2. A record entry rate greater than 100% of the total number of consumers served.
3. An active list of 25 or more consumers being served. To avoid skewed data the information gathered in this analysis spans a four year period.

The full article outlining the strengths of these vendors is due late 2012.


“Amazing Technology At Our Fingertips”
Submitted By Laurel Bancroft, Wheelock Intern, MSW Program

Recently I attended the Universal Design and Assistive Technologies Expo at the Hynes Convention Center in Boston, MA. As a first time attendee, I was eager to see what information I could use to help our consumers. As I wandered through aisles of happy faces and impressive advances in adaptive technology, I was overwhelmed with organizations and services being represented.

Amongst the home, work, life-long learning, athletic and recreation booths, I happened upon the Perkins School for the Blind who were there representing their Braille and Talking Book Library. Since most of our consumers do not list blindness as a concern, I almost didn’t linger at this booth, but then a lovely lady asked me what organization I was with. When I told her about the services that we offer in the MRC’s Home Care Assistance Program she quickly handed me information about their services. She pointed out that many people don’t think of the other disabilities that might make simply reading a book difficult. Arthritis or the complications with many neuromuscular disorders can make holding a book very uncomfortable.
This library provides many services, including FREE delivery of playback equipment for auditory books and magazines to Massachusetts residents of any age who are unable to read traditional print materials due to a visual or physical disability. They offer public access computers equipped with assistive technology. So please don’t hesitate to contact them, request an application if you feel this may benefit you and enrich your life!

To contact the Library, call 617-972-7240, 1-800-852-3133, TTY617-972-7690 or email Library@Perkins.org. http://www.perkins.org/community-programs/btbl/
Braille & Talking Book Library, Perkins School for the Blind
175 North Beacon Street, Watertown, MA 02472-2790

“The Transformation Center: Massachusetts Peer-Operated Training, Education, and Support”
Submitted by Meaghan Kennedy, College Intern

Based in a small building on Magazine Street in Roxbury, right off Massachusetts Avenue, the Transformation Center still manages to offer an outstanding wealth of information, referrals, and trainings for all Massachusetts residents with a lived experience of a mental health diagnosis, trauma, and/or extreme emotional state. The center also provides education and support for those who provide and fund services for state residents with a mental health condition. Created in 2004, when the Massachusetts Department of Mental Health procured funding to establish a statewide, peer-operated center that supported recovery communities, the Transformation Center became a driving force behind the expansion of the recovery model in mental health treatment practice.

The center’s staff consists entirely of “peers,” or those with a lived experience of mental health diagnosis and treatment who have “been there” and are available to assist in the wellness and recovery process of others with a mental health condition. The peer-to-peer relationship is based on key principles of respect, shared responsibility, and mutual agreement, and aims to provide an improved quality of life. This kind of relationship has proven to be beneficial over traditional mental health treatment, including a connection based on shared perspective and advice regarding the recovery process based on first-hand experience.

While providing information and support, peers at the center also avoid language in keeping with the traditional medical model, preferring “lived experience” over “mental illness.” Their mission is to “promote the growth and voices of people with lived experience, individually, in communities, and in organizations” and to “facilitate these diverse voices to impact and transform policy and practice.”

In order to carry out this mission, the center offers various activities and training opportunities. Latinos En Acción is a group of Latinos meeting monthly to learn leadership skills and inform policy development. Deaf Journey in Recovery is for leaders who are deaf, deaf/blind, and hard of hearing to explore and expand the recovery community. Black Voices in Recovery is for diverse black voices in the recovery movement to share leader skills as an affinity group. Training opportunities at the Transformation Center are even more numerous. Peer Specialist Training and Certification prepares people with a mental health diagnosis for paid positions in mental health treatment. Leadership Academy Training teaches multicultural leadership and advocacy skills, allowing one to choose a role in either peer support, paid peer roles, or grassroots activism within the recovery movement. Peer Advocacy Training prepares “self-advocacy coaches” to help peers with housing, benefits, employment, peer support networking, treatment planning, and more. Provider Trainings educate mental health providers on how they may best offer help and integrate the role of Certified Peer Specialists into their model.

In addition to these activities, the Transformation Center also hosts an annual Race/Walk/Gentle Movement Celebration in October as part of their peer support services for health and wellness. The center works with other statewide communities including the Young Adult Leadership Council and Massachusetts’ six Recovery Learning Communities (RLCs).

RLCs are consumer-run networks of self help/peer support, information and referral, advocacy and training activities. RLCs create significant culture change that shifts the focus on symptom management to a focus on promoting recovery, resilience and wellness. RLCs also support consumers to take charge of their own recovery process. A list of the state’s six RLCs, by region, is provided below.

Recovery Learning Communities in Massachusetts:

  • Western Mass RLC
    (413) 539-5941
    Toll-Free: (866) 641-2853
  • Central Mass RLC
    (508) 751-9600
  • Metropolitan Boston RLC
    (617) 305-9976 www.metrobostonrlc.org
  • Metro Suburban RLC
    (617) 472-3237
  • Southeastern RLC
    (508) 880-8527
  • Northeastern RLC
    (978) 687-4288

Although the Transformation Center primarily supports people living with a mental health diagnosis, there are other excellent statewide resources that are cross-disability. A good place to start is your region’s Independent Living Center (ILC). ILC’s are private, non-profit, consumer-controlled, community-based organizations that assist individuals with disabilities to achieve their self-defined goals through peer counseling, skills training, advocacy, and information & referral. ILC's may also provide a range of other services such as housing referral, communication assistance, support groups, transportation, health information, and much more. A complete list of Massachusetts ILC’s by region is provided. For more cross-disability peer support by telephone, call the Boston Self Help Center at (617) 277-0080.


“Ban On Needles in Landfills: What It Means To You”
Submitted by Betty Maher, MRC-HCAP DIrector

Did you know that about 2 million hypodermic needles are used in Massachusetts each week? A large portion of these are used at home and were disposed of in regular household trash. This practice has put those who handle our trash at risk of infection. And because they don’t know where a particular needle, lancet or other medical sharp items came from, a trash-handler who gets a needle stick wound must undergo months of testing and counseling in the event an infectious disease was transmitted.
But beginning July 1, 2012, home sharps, as well as unopened packages of hypodermic needles and lancets, cannot be disposed of in solid municipal waste, including household waste, and must be collected and disposed of in accordance with the requirements outlined in the amended state regulations.
What does this mean for you? If you use sharps at home, you should continue to place used items in a solid plastic container, such as a laundry detergent container. Do not use glass containers or plastic bags. Once your container is full, it will need to be brought to the nearest collection site. Every city and town in Massachusetts is required to have a collection site. Check with your town’s health department, or you can go to Massachusetts Department of Public Health’s website for a full listing of sites in the state: www.mass.gov/dph.

If you need assistance in bringing your used sharps to a collection site, we may be able to have your homemaker help with this. Before contacting your HCAP Case Manager to request assistance, think about how often you would need to make a drop-off? How far is the site from your home? Could a trip to the drop-off site be combined with, or alternate with other trips your homemaker makes during the week, such as to the grocery store, pharmacy or laundromat? This will help determine whether more time is needed or whether we need to simply ensure this task is added to your authorized services.

Alternatively, there are several companies that, for a monthly fee, provide for sharps to be turned in through the mail. All provide a variety of container sizes and prepaid mailing cartons:
• Medasend 1-800-200-3581
• Stericycle 1-800-355-8773
• MWDC 1-866-810-3000

Finally, you can talk with your doctor about whether their office is planning to offer any collection service, as this is a newly implemented regulation and plans are evolving.


“Happiness comes out of the capacity to feel deeply, to enjoy simply, to think freely, to risk life, to be needed”.
~Storm Jameson


“Saving Money”
Submitted by Brenda Rogers, RN, Abbey Road Home Care

Saving money can take place in your choices of daily living in numerous areas like grocery shopping, utility bills, personal products/choices and entertainment. This brief article will highlight some ideas to consider.

Let’s start with grocery shopping. If possible, choose stores that give you discounts with rewards cards – like Shaw's, Stop and Shop, CVS, and Rite Aide. Many stores offer bonus points and coupons. For example, if you have a CVS card you can scan this at the kiosk which dispenses coupons. But don’t just scan it once – do it twice for more variety and savings.

Purchase only items you want and consider using generic or store brands for savings. Compare prices and similar products. Use coupons! Identify ingredients that are important for you like low salt/low fat and check the prices and calories. When you compare products and pricing, the right choice will be there for you to clearly see. Once you have developed your list of products and choices it is very easy to continue the habit of saving money for groceries while preserving food quality and health.

Consider joining a food pantry in your neighborhood. You can use your library resources to search on the Internet for pantries near you. Do not hesitate to ask a librarian for assistance with this, or you can ask your human service providers for help locating a food pantry. Many pantries require identification and a utility bill to validate your address. At the pantry you can stock up on canned/packaged goods as well as paper goods. Each pantry has its own rules to follow – some are open twice/month while others are available more frequently. You may also join a couple of them in your area.

If you are low-income, look into receiving an EBT food benefit or SNAP benefit card. You can apply for this online – again, ask your librarian or human service provider for assistance. Search for “EBT application in MA.” The EBT card can be used for food items but does not cover paper items– you can supplement your purchase with the food pantry.

To save money on utility bills, turn off lights that are not in use. Motion lights can be installed that will automatically turn on when movement is detected. The drawback though is they will go off if you are sitting still for a period of time. Use these in hallways and avoid them in bathrooms for safety. Solar lights that plug in are quite useful for lighting at night and are low cost.

You can reduce the cost of cable/Internet/phone by bundling the utilities together. Contact your provider and ask “how can I save money? Am I in the best savings plan?” Sometimes the company representative transfers you to the cancellation department – this is where the big savings are offered so don’t hang up – negotiate!

If you have a cell phone you may not need your landline – unless you have a Personal Emergency Response System (PERS). If you subscribe to HBO/STARZ and similar movie channels you could save money by joining Netflix – you can stream movies with a computer line to your TV and also receive regular DVD’s for about $8.00/month. And remember to contact your cell phone carrier and ask for guidance “on the best plan for you.” They have new programs regularly and can move you into a cost savings one if you are qualified.

For living well on a budget, first identify the things that are important to you. Then maximize your benefits and get an EBT card or join a food pantry.

Compare prices on groceries and personal products and utility service plans. Be ready to negotiate – simply state to your cable/cell phone carriers “I need to save money!” They want to retain your business and they are ready to meet your needs. Go on – ask and be ready to receive some savings!

  • HCAP NOTE: If grocery shopping is part of your service plan, you can use that time for your homemaker to go to a food pantry instead.
  • HCAP NOTE: Consider contacting utility companies requesting a reduced rate.
  • HCAP NOTE: Local libraries are often a good source for music and movies.

“When you find peace within yourself, you become the kind of person who can live at peace with others”
~Peace Pilgrim

Home Care Recipe
Basil Crusted Chicken with Tomato Pesto Pasta
Submitted by John Bruinsma, MRC-HCAP Consumer

• 4 or 6 ounces chicken breast
• 1 ounce fresh basil
• 1/4 cup Olive oil
• 1 Roma tomato
• 2 cloves fresh garlic, peeled (place knife flat side on top of garlic and press down hard; peel will come off easily)
• 4 Tablespoons grated Parmesan or Romano cheese
• 4 ounces cooked pasta (I prefer Penne: it holds the basil the best– not so much sauce gets left behind)
• Salt and pepper (to taste)

• Pre-heat oven to 425 degrees.
• Remove basil leaves from stems, discard stems (save 2 nice leaves for garnish) and place leaves in blender or food processor. Add garlic and cheese to blender. Remove center piece on blender lid and turn on machine to full power. Slowly pour in olive oil from opening on top until mixture becomes a smooth paste. Pour mixture into a bowl and set aside.
• Cook pasta according to package directions.
• Place rinsed chicken breast on flat baking sheet. Spread 2 tablespoons of basil mix on top of chicken and salt and pepper if desired. Place chicken in pre-heated oven on top rack. Bake for 20-25 minutes until internal temperature reaches 165 degrees. Cut tomato in half and discard seeds. Dice tomato into 1/4 inch pieces. Add tomatoes to basil mix. Drain pasta and place in bowl. Pour basil mix over pasta to coat. Placed cooked chicken alongside pasta on a plate. Place reserved basil garnish on top. Enjoy!

“How To Eat Healthy”
Submitted by Katherine Chesebro, MRC-HCAP Case Manager

Eating healthy is something we all know we need to do but a lot of us have difficulty doing it on a daily basis. The U.S. Department of Agriculture provides an easy guide on what we need to do to ensure healthy eating with a simple diagram from Choose My Plate (www.choosemyplate.gov). I am sharing with you several of their easy tips that we can all try to get healthy and reduce our risk of diet-related conditions and disabilities.

1. Build a healthy plate
• Make half your plate fruits and vegetables
• Switch to skim milk for less fat and calories
• Choose mostly whole grains for your cereal, rice, pasta and bread
• Vary your protein choosing fish twice a week, beans and lean meat and poultry

2. Reduce added sugars, salt and foods high in solid fats
• Choose water over sugary drinks
• Watch the salt: read food labels especially on soups and frozen meals
• Add fresh herbs or spices to reduce salt intake
• Eat fruit for dessert
• Save cakes, pizza, ice cream and hot dogs for occasions rather than every day choices

3. Eat the correct amount of calories for you
• Get your personal calorie limit on www.choosemyplate.gov
• Use a smaller plate, glass or bowl for adequate serving size
• Eat until you are satisfied, not until you are full
• Control your eating more by cooking at home
• Choose to share a meal with a friend when eating out

4. Be active your way

• Start small: plan an activity you enjoy for at least 10 minutes

5. Read food labels to make the best choices
• Check calories, saturated fat, trans fat, added sugar, and sodium

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

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!

Home Care Assistance Program
600 Washington St. 2nd. Fl.
Boston, MA 02111
1-800-223-2559 / TTY: 617-204-3819

Deval Patrick

Timothy Murray
Lieutenant Governor

Dr. JudyAnn Bigby

Charles Carr

Kasper Goshgarian
Deputy Commissioner

Debra Kamen
Assistant Commissioner of Community Living

This information is provided by the Massachusetts Rehabilitation Commission.