PCAs: a bridge to community living The Newsletter of the Personal Care Attendant Quality Home Care Workforce Council Volume 9, Spring 2015 PCA New Hire Orientation Classes Take Hold Program Becomes Mandatory for New Hire PCAs in 2015 Inside This Issue 2 2014 Paul Kahn Award Ceremony 4 A Personal Perspective on the PCA Program 5 PCAs Gain Sick Leave Benefits through Ballot Question 6 Council to Fund Health Care Outreach to PCAs 6 Supreme Court Limits Fee Collection by PCA Union 6 Emergency Preparedness 7 PCA Council and Union Work to Protect Consumers 7 Bulletin: New Federal Regulations Affect PCAs 8 Council Listening Tour a Success The PCA New Hire Orientation program, described in the last issue of The Bridge (Vol. 8, Winter 2014), began operating in a pilot phase in the cities of Boston, Worcester, and Springfield. Just before and during this period, Leanne Winchester, Director of the Orientation Project, and Jack Boesen, Council Director, began an outreach program to explain the new orientation system to consumers and those who support them. Seven consumer forums were held throughout the state. At these forums, Leanne and Jack emphasized that orientation sessions do not cover providing care to consumers. Training on personal care remains the consumer’s responsibility. The goal of the orientation is to insure that new PCAs receive information that is accurate, uniform, and comprehensive. During the forums, consumers, skills trainers, and others attending were asked for suggestions on strengthening the orientation program. The first part of the pilot phase ran from April through July 2014. The next phase, beginning in September, expanded the program to 15 additional cities and towns. As a result of observations from the first pilot phase, significant revisions were made to the curriculum. The second phase ran from September through the end of the year. Beginning in 2015, the orientation program will go state-wide and sanctions will be applied to PCAs not complying with the orientation requirement. For more details, contact your skills trainer or go to www.mass.gov/pca. The response among PCAs to the group sessions was very positive. Several hundred consumers—many more than anticipated—chose the consumer- taught option in which the consumer personally orients his or her PCA, using the curriculum developed by the project. Both the group- and the consumer- taught options will be reviewed and evaluated by Leanne and her staff. Only PCAs who are entirely new to the MassHealth system are required to complete orientation, through either a group session or through their consumer if the consumer-taught option is chosen by their employer. PCAs required to attend an orientation session, as well as their consumers, receive notices from the fiscal intermediary responsible for their payroll. (l to r) Clay Novak (1199SEIU staff) and Kelly Lupica (instructor) stand with seven PCAs after completing a group orientation session in Worcester. Para una versión en español, por favor llame a su Agencia de atención personal o al 617-348-5317. 2 Celebrating the 40th Anniversary of the PCA Program 2014 Paul Kahn award winners: (l to r) Wendy Whelan, Irina Ukrainets, Sherrie Booker, Hyacinth Edwards, and Jeremy Kawachi, standing in the Hall of Flags at the State House. 2014 Paul Kahn Award Ceremony PCA program’s 40th anniversary and consumer “pioneers” also honored On October 14, 2014, the 5th annual Paul Kahn awards for PCA Service were presented in front of the Grand Staircase at the State House. An overflow crowd of consumers, PCAs, friends, and family attended the hour-long ceremony. The event was co-hosted by Senator James T. Welch and Representative Jeffrey Sanchez. The Paul Kahn award winners this year were Sherrie Booker, Southeastern MA; Hyacinth Edwards, Greater Boston; Jeremy Kawachi, central MA; Irina Ukrainets, western MA; and Wendy Whelan, northeastern MA. Profiles of the award winners are on the next page. Ann L. Hartstein, Secretary of the Executive Office of Elder Affairs, was the featured speaker. In her remarks, Secretary Hartstein congratulated the five award winners and noted that they are representative of thousands of PCAs currently in the workforce. “You and the consumers you work for,” she said, “exemplify the Patrick Administration’s belief that people should have a choice about where they live and who provides the support they require.” 2014 marked the 40th anniversary of the PCA program, a fact noted by Secretary Hartstein. To recognize the PCA program’s success and longevity, the event also honored consumers/employers who have been in the program for 30 years or more. Known as “PCA Pioneers,” approximately 12 of these consumers were on hand to receive certificates from the Council. Included in the Pioneer group were MRC Commissioner Charles Carr; former Council member Liz Casey; and current Council members Kristen McCosh, Cindy Purcell, Paul Spooner, and Joseph Tringali. State Auditor Suzanne Bump presented the certificates. 3 Profiles of the 2014 Paul Kahn Award Winners Sherrie Booker—Southeastern MA Sherrie is a native of New Bedford. She has worked as a PCA on and off for about 27 years, and steadily for the past nine. Her consumer, Janice, is in her 70s and has severe cerebral palsy. In training new PCAs, Sherrie emphasizes the importance of listening to Janice, as she is the expert on her own needs. Sherrie is always on hand when new PCAs are hired, even if it is her day off, to see how they interact with Janice. Sherrie likes the friendships that form and grow with while doing PCA work. Hyacinth Edwards—Greater Boston When he nominated Hyacinth in June, consumer Robert Caruso wrote that she “demonstrated diligence, responsibility, and an exceptional amount of experience.” Hyacinth met Robert (Bob) in a nursing home where she worked; she then became a PCA attending to his needs for 25 years. Sadly, Robert passed away in July. Hyacinth and Bob had a close relationship that also included her family. She enjoyed watching sports and movies with Bob; often her son would visit and watch sporting events with him. Hyacinth’s children and grandchildren all grew up knowing Bob; she states that having that kind of relationship is the best part of PCA work. Wendy Whelan—Northeastern MA When asked why Wendy should receive an award, the consumer she works for, Conor Healy, said, “Her work ethic is exemplary. She just gets it!” When asked what it means to “get it” about PCA work, Wendy said that a lot of people can do the job, but that it’s not just about dressing and bathing and feeding. Her role allows Conor and his mother to have a normal mother-son relationship. Wendy feels that she is a part of a care team. A busy mother of three, Wendy is starting an RN program in a few weeks. She plans to continue with PCA work after she earns her degree. Irina Ukrainets—Western MA Born in Russia, Irina has worked as a PCA for almost 20 years. For Harriet, the consumer she has assisted for over three years, Irina’s work has included working extra hours without pay, providing homemade soup, and persuading her husband to repair Harriet’s car for free. When Irina saw another consumer being mistreated, she promptly reported the situation. Irina substitutes for PCAs who can’t work because of illness. She has recruited other PCAs, including her sister. Irina was a finalist for the 2013 Paul Kahn Award. Jeremy Kawachi—Central MA David, the consumer who nominated Jeremy, cited dedication, reliability, and flexibility as some of the outstanding qualities that Jeremy has displayed during the eight years that he has worked for David. During severe snowstorms, Jeremy has slept over to ensure that he is available in the morning to assist David. Jeremy has developed the physical strength he says is necessary to move a person carefully. When David’s wife, also working for David, could not turn him during the night, Jeremy dived in, adding evening shifts to his day shift. Jeremy is a member of the union and has advocated for better pay and benefits. LOOKING to hire a PCA? REMEMBER www.mass.gov/findpca Over 7,400 PCAs are listed along with their preferences and qualifications. A Personal Perspective on the PCA Program Charles Carr is Commissioner of the Massachusetts Rehabilitation Commission. Joseph Tringali is the Director of Community Services for Stavros Independent Living Center. Both Charlie and Joe were recently honored by the Council as PCA Pioneers. They have both been consumer/ employers in this program since its inception. To commemorate the PCA program’s 40th anniversary, The Bridge asked Charlie and Joe to share with readers their memories of the program’s origin. MRC Commissioner Charles Carr (left) and PCA Workforce Council member Joseph Tringali. Charlie: Prior to 1974, people with significant disabilities lived primarily in institutional settings like nursing homes and chronic care hospitals. If you were high-school age or younger, you would probably go to a residential institutional school like the Massachusetts Hospital School, where only students with disabilities could attend. There were no laws requiring public schools to mainstream children with disabilities. Joe: That was the year the Boston Center for Independent Living (BCIL) was founded on the fifth floor of the theology building on the Boston University (BU) campus. I was living there with people who came from institutions, homes, farms, and the street. Some of us studied at BU while others claimed to be “students of life.” The PCA program made it all possible. Charlie: All around us we saw demonstrations and activism improving the lives of people of color, women, and the cause of peace. People with disabilities were hungry for change, hungry for the right to live independently outside of institutions and to be mainstreamed into society. When the first Center for Independent Living (CIL) opened its doors in 1972 in Berkeley, California, the floodgates to independence opened. BCIL followed two short years later, but not without tremendous opposition from the state. BCIL was necessary principally to serve as a “third party” to get Medicaid funding for PCAs into the hands of consumers. Of course, having a place to live was also a critical component. The Personal Care Attendant program was born! The PCA program was a social experiment started by forward- thinking, driven, and fearless people with disabilities. Joe: The PCA program was a seminal departure from the traditional medical model. It enabled young people to transition into the community by creating a new program where our personal needs would be met on our terms: the hours we needed and the assistance from people we chose. We recruited PCAs from our surroundings that included mostly BU students, and we used them to get us up, to get to class, to help us in the bathroom, and to put us to bed. We didn't have bookkeepers, advocates, and skills trainers to complete a Consumer Service Agreement. Instead, we depended on each other to learn how to find PCAs, schedule them, and provide hands-on assistance. We even had our own backup PCA system. If one of our PCAs couldn't work, our roommate’s PCAs would cover. Everybody shared the same space and everyone, including the PCAs, was familiar with each other. continued on page 5 Charlie: BCIL was actually transitional living, which was an important phase on the road to true independence. I chose to live in an apartment in Medford. We received cash payments from Medicaid and we paid our PCAs directly. At the time, this was a far more open and unregulated program than what we have today. I am not saying it was better but it was a bracing, exciting time. Joe: We made plenty of mistakes as some of us dropped out of school, indulged in unhealthy lifestyles…and some people died. It was like the Wild West of the PCA Program. There might have been 15 to 20 people at first. As we look around today, we are joined by over 20,000 people with disabilities. PCA users now include children, adolescents, adults, and elders. We are spread all over the state, all sharing a common experience— the PCA Program. continued from page 4 PCAs Gain Sick Leave Benefits through Ballot Question In addition to electing candidates for statewide office, Massachusetts citizens voted on four ballot questions last November. One of these questions required certain employers to provide paid sick leave to their workers. At the request of 1199SEIU, the union representing PCAs, the following language was included in the text of the ballot question. …the PCA Quality Home Care Workforce Council shall be deemed the Employer of all Personal Care Attendants…for purposes of subsection (d)(4) of this section, the Department of Medical Assistance shall be deemed the Employer of said Personal Care Attendants for all other purposes under this section… Subsection (d)(4) is the section of the ballot question stating that paid sick leave would be required for all employers having 11 or more workers. As stated in the above excerpt, MassHealth has the responsibility for administering the paid sick leave program for PCAs. This ballot question was passed by the electorate and will take effect on July 1, 2015. MassHealth staff is currently working on the details of how this program will be administered. As details emerge, they will be published on the Council’s website at www.mass.gov/pca. The first review to see how many PCAs qualified for the paid-time-off benefit, negotiated as part of the current labor contract, was done in July 2014. The review showed 11,299 PCAs qualifying for this benefit, which allows five hours of paid time off. Results are forthcoming from a second review done in February 2015. Join the Council on Facebook! www.facebook.com/MassPCA Supreme Court Limits Fee Collection by PCA Union Council Funds Health Care Outreach to PCAs Union mailed, telephoned, and made personal contact In July 2014, the U.S. Supreme Court issued a decision in the case of Harris v. Quinn. That case, which originated in Illinois, centered on a PCA’s challenge to a mandatory union fee deducted from her paycheck. By a 5-to-4 vote, the Court ruled this practice unconstitutional for violating the First Amendment. Because Massachusetts had a similar system in place, after the ruling MassHealth officials sent out the following notice, from which we print an excerpt. Please be advised that as a result of the Supreme Court ruling on Harris v. Quinn, effective July 24, 2014, MassHealth Fiscal Intermediaries are no longer collecting any Agency or Objector fees from PCAs. Only those PCAs who have signed up as Union members will have union dues and their PAC deducted. Thank you, MassHealth Office of Long Term Services and Supports One Ashburton Place, 5th Floor Boston, MA. 02108 For several months during 2014, the Council and 1199SEIU negotiated the issue of health care coverage for PCAs. While the union sought a distinct health care benefit for PCAs who do not have current coverage, the Council wanted to explore coverage through the Connector, the agency established by Massachusetts to facilitate health care coverage. With enhancements provided by the federal Affordable Care Act (ACA), the Connector is now able to offer persons whose income is no higher than 400% of the federal poverty level either subsidized coverage or tax credits to lower the cost of coverage. For persons who have a higher income, Connector staff is skilled at finding the most affordable health care options in the market. The Council felt strongly that a committed outreach program would significantly increase health care coverage in the PCA workforce. Without relinquishing their right to bring up the issue of a separate benefit in the future, the union agreed to conduct an intensive outreach program between November 2014 and February 2015. Paid by funds from the Commonwealth, union staff knocked on the doors of thousands of PCAs in conjunction with both a mailing to all PCAs and telephone outreach. This program was conducted concurrently with the Connector’s outreach program to the broader Massachusetts population. Emergency Preparedness The Office of Preparedness and Emergency Management has created a simple, hands-on tool called “Show Me” to reduce communication barriers and better assist individuals who have access and functional needs with making their needs and concerns understood during an emergency. This tool is free to all residents of Massachusetts and can be downloaded to your mobile devices through the App Store and Google Play. You can also order a laminated booklet through the Massachusetts Health Promotion Clearinghouse found on the web page (www.mass.gov/dph/showme), where you can also find more information. This tool should be part of everyone’s emergency preparedness plan; include it in your “emergency kit.” PCA Council and Union Work to Protect Consumers Guidelines for Organizing Outreach Established The Labor Management Committee (LMC), created by the PCA Workforce Council and 1199SEIU in 2009, is a vehicle for resolving problems arising from the employer/ employee relationship between consumers and PCAs. The LMC has tackled numerous problems, including late paychecks to PCAs, issues of communication, and the establishment of training priorities. Membership in the LMC includes Council members, PCAs, and staff from the union and Council. Last year, several consumers complained to Council members on the LMC about the actions of some union organizers. Because some PCAs live at the same address as their consumer/employers, union organizers who are engaged in door-knocking outreach sometimes visit the homes of consumers. The complaint indicated that some organizers were very persistent, returning several times even after the consumer requested them to leave their materials for the consumer to give to their PCA. Council members, while supportive of union organizing efforts, take consumers’ concerns very seriously. The Council drew up a list of guidelines and presented it for discussion at an LMC meeting. A productive conversation followed, with the union agreeing that the guidelines be adopted and distributed in writing to all union organizers. This is an excellent example of group problem- solving. You can see a copy of the guidelines in the box below. PCA Workforce Council member Anne Johansen serves on the Labor Management Committee. Guidelines for Union-Organizing in the Homes of Consumers QQA consumer’s home is a place of work for a PCA. Organizing activities should not distract the PCA from meeting the needs of the consumer. QQWhen the consumer is at home, there should be only one visit to the home. QQA consumer’s refusal to admit or talk to an organizer is final and must be respected. QQThe purpose of an organizing visit to the home of a consumer should be limited to XXleaving written materials for the PCA(s); and XXasking the PCA(s) if there is a convenient time to reach them outside of work hours. QQThe consumer must always be treated in a polite and respectful manner. Council Listening Tour a Success The last edition of The Bridge (Vol. 8) included an article about outreach to consumers by PCA Workforce Council members and staff. Plans for a statewide listening tour, beginning with the Council’s December 2013 meeting at Worcester Public Library, were announced. During 2014 the Council added four more “stops” to its tour, giving presentations and holding conversations in Brockton (Independence Associates), Pittsfield (Ad-Lib Inc.), Boston (Commission for Persons with Disabilities), and Danvers (Northeast ARC). The Council met with audiences of consumers, surrogates, family members, and agency staff. All of the stops on the tour produced animated exchanges between the audience and Council representatives. There were numerous questions concerning the new PCA orientation program and comments about changes that should be made to the PCA program. Several people suggested that the Council make better use of social media as a method of reaching out to consumers. In response to these comments, the Council launched a Facebook page in August 2014. The Council's Facebook page, launched in August 2014. Contribute to How to Contact Us PCA Council 600 Washington Street, Room 7264 Boston, MA 02111 Telephone: 617-348-5317 Website: www.mass.gov/pca Facebook: www.facebook.com/MassPCA E-mail: pcacouncil@state.ma.us Staff Jack Boesen, Director Michelle Byrd, Sr. Executive Assistant Please share this publication with your PCA. The Bridge is a newsletter for MassHealth members who use PCA services. We are very interested in your letters, articles, and thoughts about the PCA program and about improving the PCA workforce. Please send your ideas to pcacouncil@state.ma.us. We can’t promise to print everything we receive, but all submissions will receive our serious attention. For consumers without e-mail, please call 617-348-5317 or forward your ideas to the address on the right.