Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid www.mass.gov/masshealth Eligibility Operations Memo 13-02 March 1, 2013 TO: MassHealth Eligibility Operations Staff FROM: Amy Andrade, Director, Member and Provider Services RE: Updated Best Practices for Ensuring Effective Communication with Members and Applicants with Disabilities Introduction It is the policy of the Executive Office of Health and Human Services to support and comply with the requirements of Section 504 of the Rehabilitation Act of 1973 (Section 504), M.G.L. c. 151B, and the Americans with Disabilities Act to ensure that persons with disabilities are afforded equal access to its facilities, programs, and services. Whatever is written or spoken must be clear and understandable to applicants who self-indentify as persons with a disability and who may communicate in a range of different ways. This memo sets forth updated protocols required to be used by MassHealth staff to ensure effective communication with members and applicants who self-identify as persons with a disability. Updating Member and Applicant Records Since April 2012, disabilities and preferred accommodations of members and applicants have been tracked in MA21. When an applicant or member self-identifies as a person with a disability, MassHealth staff must consult Accommodations for People with a Disability or Injury (ACC Event) in MA21, to determine which accommodation, if any, the person prefers. If there is no disability or accommodation data in the ACC event, or if the applicant’s or member’s preference has changed, the staff must update the ACC event and document the disability and preferred accommodation in the notes to household (NTH) as well as the notes to person (NTP) events using the following categories. (continued on next page) Updating Member Records (cont.) Disability * Low vision * Blind * Deaf * Developmentally disabled * Intellectually disabled * Physically disabled * Hard of hearing * Other Accommodation Preferred (Indicate all that apply.) * Text telephone (TTY) * Large-print publication * Sign language interpreter or certified deaf interpreter (CDI) Video relay service (VRS) (An individual who is deaf or hard of hearing contacts MassHealth through a real-time American Sign Language (ASL) interpreter who is communicating with them by video device.) * Communication access real-time translation (CART) * Publications in Braille * Assistive listening device (ALD) * Publications in electronic format * Other E-mail and Cell Phone The following options have been added to the Head of Household section. * Cell phone number * E-mail address (maximum of 50 characters) Protocol MassHealth Enrollment Center (MEC) staff must make every reasonable effort to assist members and applicants with disabilities who need accommodations, with MassHealth eligibility or services. MassHealth staff must provide the following accommodations to members and applicants with communication disabilities when they are communicating with them by phone, in person, or by e-mail. For assistance not related to eligibility issues, MEC staff must immediately forward the inquiry to the disability accommodation ombudsman. * When individuals who are deaf or hard of hearing request an in-person appointment that requires the services of a sign language interpreter, Certified Deaf Interpreter, or CART, MassHealth staff must immediately forward the request for such services to the MassHealth disability accommodation ombudsman by e-mail. (See the MassHealth Disability Accommodation Ombudsman section below for contact information.) (continued on next page) Protocol (cont.) The ombudsman must schedule an appointment with the individual and arrange for a sign language interpreter or CART services, by contacting the Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH). For a detailed explanation of these services, please visit the MCDHH website at www.mass.gov/eohhs/gov/departments/mcdhh. * ALDs are available at all MassHealth Enrollment Centers (MECs). Signs advertising ALDs must be prominently posted in walk-in areas at each MEC. MEC staff must provide an ALD to a member or applicant (or someone assisting them) who requests this accommodation. * When an individual who is deaf or hard of hearing who requires sign language interpretation enters a MEC without an appointment, MassHealth staff must advise the person of the option to schedule an appointment and also inquire what their preference is between a sign language interpreter and CDI. If the individual who is deaf or hard of hearing asks to communicate in writing immediately rather than schedule an appointment, MassHealth staff must comply with the request either through handwriting, by typing on a computer, or texting by phone. * When individuals who are deaf or hard of hearing contact MassHealth staff through a sign language interpreter or through a relay service, MEC staff must provide access to information in the same manner and to the same extent as to all other language interpreters. * MEC staff must promptly answer TTY calls using MassHealth’s TTY application. * MEC staff must check TTY messages regularly and respond the same day to messages received before 3:00 P.M. MassHealth staff must respond no later than the next business day to all messages received after 3:00 P.M. MECs must program their TTY devices to specify that if calls are received after hours those calls will be answered the next business day. * If a TTY caller inquiring about a long-term-care intake application reaches a different MEC location from where the applicant resides, MEC staff must send the caller’s information to the appropriate MEC location, which in turn, must respond the same day on which the original call was received. If the call is received after 3 P.M., MEC staff must respond no later than the morning of the next business day following the call. MEC staff must inform people who call after 3 P.M. that the call may not be returned until the next business day. * For assistance not related to eligibility issues or otherwise described in this section, MEC staff must forward the TTY call to the disability accommodation ombudsman. (continued on next page) Protocol (cont.) * MassHealth staff must offer to read documents or portions of documents to members and applicants with disabilities who say that they have difficulty reading print, and must read any document if requested to do so. * Many MassHealth publications are available in Braille and in large print. MassHealth staff must offer to assist the applicant or member to read, and if necessary, fill out such forms. However, MassHealth input documents, like applications, are not available in Braille. * MassHealth staff must offer to provide documents to members and applicants by e-mail, attached in a format (such as Microsoft Word) that can be read by screen readers in a simple font, such as Arial or in print 20-point font or larger (large print). * MEC staff must offer to print or e-mail large-print forms to the individual. MassHealth Disability Accomodation Ombudsman MEC staff must make every reasonable effort to assist members and potential members with disabilities who need accommodations, with MassHealth eligibility review or services. For assistance beyond what is immediately available to MEC staff, EOHHS has designated a person to assist MassHealth members and applicants with disabilities. 100 Hancock Street, 6th Floor Quincy, MA 02171 617-847-3468 TTY: 617-847-3788 for people who are deaf, hard of hearing, or speech disabled masshealthhelp@ehs.state.ma.us Other Resources Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH) www.mass.gov/eohhs/gov/departments/mcdhh Massachusetts Commission for the Blind (MCB) www.mass.gov/eohhs/gov/departments/mcb Department of Developmental Services (DDS) www.mass.gov/eohhs/gov/departments/dds General information on American Sign Language interpreters and CART services from MCDHH by phone, online, fax, and Virtual Gateway: www.mass.gov/eohhs/gov/departments/mcdhh/request-an- interpreter.html Disability Handbook for the Executive Branch www.mass.gov/anf/docs/mod/executivebranchdisabilityhandbookfinal 2007.pdf (continued on next page) Other Resources (cont.) Information for MassHealth members and applicants with disabilities: www.mass.gov/eohhs/consumer/insurance/masshealth-member- info/masshealth-members-and-applicants-with-disabilitie.html ADA Best Practice Toolkit for Governments www.ada.gov/pcatoolkit/chap3toolkit.htm ADA Technical Assistance Manual www.ada.gov/taman2.html Questions If you have any questions about this memo please have your MEC designee contact the Policy Hotline.