Commonwealth Conversations: Health and Human Services

State plan for managing Alzheimer’s advances

By Elder Affairs’ Secretary Ann Hartstein

Last week the Massachusetts Alzheimer’s Disease and Related Disorders State Plan was released by the Executive Office of Elder Affairs (EOEA) and the Alzheimer’s Association Massachusetts /New Hampshire chapter. The plan provides recommendations, resources, goals and strategies to improve the lives of individuals affected by Alzheimer’s. The report was developed over the past two years by a statewide Advisory Committee that convened advocates, caregivers, participants with early stage Alzheimer's, stage agency representatives, and institutional and community agencies working with men and women with this difficult disease.  The recommendations reflect enduring concerns as well as priorities that were developed out of four listening sessions and seven focus groups convened throughout the state, collectively involving more than 400 participants.  “Alzheimer’s is the most common type of dementia-causing illness and the sixth leading cause of death in the United States,” said Health and Human Services Secretary Dr. JudyAnn Bigby. “Massachusetts alone has 120,000 seniors who suffer from Alzheimer’s disease which doesn’t include the many thousands with younger-onset Alzheimer’s or other related dementias.” 

The Advisory Committee identified five major areas of concern and ways that Elder Affairs and the Alzheimer’s Association will work with state wide and local agencies,  medical groups and advocacy groups  as well as and interested citizens to implement recommendations in those areas. The Advisory Committee recommendations are designed to address these concerns and include strategies to accomplish these goals. The key recommendations from the State Plan are:

• Improve access to services and information for people with Alzheimer’s;
• Improve and expand support and education for family caregivers;
• Develop an infrastructure for enhanced quality of services within the medical community;
• Improve public awareness surrounding risk factors and risk reduction for Alzheimer’s disease;
• Create a set of statewide recommendations, guidelines and minimum standards surrounding quality of care in all care settings.

I very am pleased about this report and invite you to read it in its entirety. The recommendations provide a framework for the entire Massachusetts plan around Alzheimer’s and the future for all of us as we work together to meet the needs of  the increasing number of people affected by this disease.

 

To read the full report visit: http://www.mass.gov/elders/

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Making resolutions you can really keep

By Executive Office of Elder Affairs Secretary Ann Hartstein

 

It’s the start of the New Year, and many of us are being inundated by an avalanche of New Year’s resolutions. We are warned to start exercising regularly; address weight concerns; stop smoking; give up carbohydrates; give up sugar; give up fried food.  It’s hard not to equate resolutions with depriving yourself of many of life’s pleasures.  At the same time, we know that taking charge of one’s life and habits will give us a major dividend: better health and longer life. 

 

There is another way to greet the beginning of the New Year. Perhaps we could think about empowering ourselves to make good choices that will make us feel and look a lot better.  In other words, New Year’s resolutions should be a gift to ourselves – and to our families for whom we are setting a healthy example and who will have the pleasure of having us with them for many more years.

 

A recent article in the Boston Globe cited a Stanford University study that revealed making resolutions has a negative impact because 80% of them are doomed to fail according to B.J. Fogg, director of the Persuasive Technology Lab at Stanford University.  And, Susan Lehmann, a John Hopkins University School of Medicine psychiatrist recommends working on focusing on specific issues rather than on everything (Washington Post, 1/2/12)  Both suggest that developing healthier habits rather than setting oneself unrealistic goals will yield better results.

 

Two years ago, Governor Patrick and the Massachusetts Executive Office of Elder Affairs (EOEA) launched the Aging Agenda, based in part on the premise that developing lifelong healthy habits generally yields a longer, healthier life.  But these habits – regular exercise, sensible nutrition, regular bedtimes, social activities, lifelong learning – are always there for you.

 

Most people prefer company as they embark on a life-changing activity.  First, we need the support of people taking the same journey. Second, it’s more fun to have company.  I’m not going to say “misery loves company” because I am not talking about inflicting misery.  Rather, I’m suggesting that we all have the opportunity to make some easy choices.  For example, check out your local Council on Aging, available on our website or by calling us at 1-800-AGE-INFO (1-800-243-4636), and ask about the range of exercise, diet/nutrition counseling (starving yourself for a week or two isn’t going to give you the long-term benefits of  reasonable sustained food choices) and chronic disease self management programs they offer.  Many COAs also have programs such as walking clubs – a pleasant way to initiate an important change. You can even invite a friend or two to form your own walking club – in a local mall when the weather is bad. And most Councils on Aging have healthy meals available every weekday.

 

Begin by thinking of empowering and rewarding yourself.  Seize the opportunity to work with people who can give you tools you want to give yourself: A New Years gift of a better, longer and healthier life.

 

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Flu Season is Here – Get Vaccinated Today.

Posted by Donna Lazorik, RN, MS. Donna is the Immunization Coordinator in the Division of Epidemiology and Immunization at the Massachusetts Department of Public Health.

 

The best way to protect yourself and your family from getting sick this flu season is to get vaccinated.  This is true even if you were vaccinated last season.  Health experts at the Centers for Disease Control and Prevention (CDC) recommend that everyone 6 months of age and older receive a flu vaccine every year.  That’s because flu can be very serious – every year in Massachusetts, an average of 5,000 residents are hospitalized due to complications from the flu, resulting in up to 800 deaths.  The good news is that many of these hospitalizations and deaths are preventable. 

Getting a flu vaccine is especially important if you or someone in your family: 

• Is pregnant
• Has a chronic health condition like asthma, diabetes, or heart, lung, liver, or kidney disease
• Is immuno-suppressed
• Is very overweight
• Is 50 years of age or older.

 Flu vaccination is important for children younger than 5 years of age, who are at higher risk of serious flu complications if they get the flu.  For the same reason, if you’re a caregiver or household contact of children less than five years old it’s important that you get vaccinated as well.  

 The flu vaccine is safe, effective, and widely available.  There is more vaccine available this year than ever before! 

 To find out where to get the flu vaccine: 

• Call your health care provider;
• Contact your local health department;
• Check with your local pharmacy; or 
• Visit the Massachusetts Flu Clinic website for a list of flu clinics near you. 

 For more information, please visit www.mass.gov/flu or call the Department of Public Health Immunization Program at (617) 983-6800.

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Strengthening support services for Massachusetts seniors and people with disabilities

 By Dr. JudyAnn Bigby

A recent report released by the AARP Policy Institute, the Commonwealth Fund and the SCAN Foundation ranked Massachusetts 30^th in the nation for long-term care. The report highlights areas where Massachusetts can improve upon its ability to provide long-term for some of its most vulnerable residents, The report ranked Massachusetts 40th in its ability to provide home and community-based supports to residents without channeling them to a nursing home first and states that Massachusetts, unlike many of the states that ranked much higher, does not allow registered nurses to delegate some tasks (administering medication, for example) to other home health workers—an issue the co-author of this report said would ease burdens on families who end up having to hire nurses to do these tasks, adding more costs to families and to Medicaid. There is clearly room for improvement and the need to improve is compelling.

This year in the United States, 10,000 people will turn 65 every day.  With Baby Boomers coming of age, the Commonwealth’s senior population will increase from 20% today to more than 26% by 2030.  Since 2007, the Patrick-Murray Administration has been developing and implementing programs for this growing population based on the principle of “Community First,” which seeks to ensure that elders and people with disabilities have access to community-living opportunities and supports that address each individual's diverse needs, abilities and backgrounds.  By promoting a wide range of accessible community-based support services, the Commonwealth can offer elders and people with disabilities the supports they need to live safely, independently and with dignity.

Surveys indicate that most people prefer to remain in their homes or communities receiving medical care and assistance with daily living needs, rather than moving to a long-term care facility.  These are some of the supports the Commonwealth provides to accommodate that preference:

• The Massachusetts Home Care Program, overseen by the Executive Office of Elder Affairs (EOEA), currently serves approximately 40,000 elders in need of support services. Slightly more than 5,000 of these consumers have been found to be “nursing facility-eligible” remain in the setting of their choice through the Commonwealth’s Enhanced Community Options Program (ECOP) with expanded support services.  Trained caregivers provide personal care, homemaking, transportation, and grocery shopping and are supported by visiting nurses, physical therapists and other healthcare professionals. 

 

• Locally-based community agencies are essential to effective service delivery throughout the Commonwealth. Over the past five years, EOEA has established 11 Aging and Disability Resource Consortia (ADRC) to provide a well-organized, coordinated, seamless information system dedicated to community-based long-term care support.  In fact, we employ a ‘No Wrong Door’ policy, meaning that consumers can access comprehensive options information from any point and at any stage in their care.  ADRC’s offer Options Counseling is available whenever and wherever a consumer wants information about service choices, even if he/she is in a nursing facility and wishes to return to a community setting.  By the end of last year, Options Counselors had served more than 2,300 people.

 

• In September 2010, Massachusetts was awarded a grant under the Affordable Care Act (ACA) to develop core competency training curricula for personal and home care aides providing long term care services and supports to community-based residents.  This program, the Personal and Home Care Aide State Training (PHCAST) program, is a national demonstration project and is expected to set the standard for nationwide training programs.  Front-line home-based direct care workers often require intensive training to meet the challenges of geriatric, mentally ill and disabled people who choose home-based care. By the end of the year, the pilot PHCAST program will have trained 20 personal care attendants and 150 home care aides throughout the Commonwealth.

Similarly, under the MassHealth Office of Long-Term Support Services, eligible MassHealth consumers have access to a system of extensive community-based service choices.   For example, MassHealth consumers may choose home health services, among them nursing, home health aides, physical therapy, occupational therapy and speech language therapy.  A consumer’s physician establishes the care plan for the patient.  People requiring continuous nursing services may also receive care under the MassHealth Home Health program. Individuals 55 and older who are clinically eligible for nursing facility admission, may also be eligible for a variety of clinical, day health and social services under the joint Medicare/Medicaid-funded Program for All-Inclusive Care. This program is a critical component to providing essential daily services to individuals who choose to live in the community. Additional supports from MassHealth include:

• Senior Care Options (SCOs) - Last year, 15,891 Medicare/Medicaid consumers 65 and older were enrolled in a SCO, or comprehensive health care provider organization. Consumers in a SCO plan have a primary care provider who coordinates the delivery of acute, behavioral and long-term care services and supports.  Studies show that people who are part of a health care plan and have a primary care provider are less likely to require emergency room care, have fewer hospitalizations are able to stay in a community setting for a longer time.

 

• Adult Foster Care - If a MassHealth consumer prefers caregiver supports in a home setting, the Adult Foster Care program can provide a suitable caregiver who lives with the individual. In the Adult Foster Care program, individuals receive assistance with daily activities (such as dressing, bathing, nutrition); medication management; and health monitoring. Group Adult Foster Care services administered by MassHealth’s Office of Long Term Support Services combines assisted living services with personal care assistance.

 

• Individuals, 55 and older, who are clinically eligible for nursing facility admission, may also be eligible for all of their clinical, day health and social services under the joint Medicare/Medicaid funded Program for All-Inclusive Care for the Elderly (PACE).  For many, PACE is the most critical component in providing essential daily services to individuals who wish to remain living in their communities. 

 

• Massachusetts received the largest Money Follows the Person (MFP) grant award under the federal Affordable Care Act (ACA) to help elders and individuals with disabilities live in their own communities. Massachusetts will receive $110 million in federal funds over five years as part of the MFP program, which supports seniors and individuals with disabilities so they may live in their own homes or in community settings successfully. Massachusetts is one of just 13 states to receive federal Affordable Care Act (ACA) funding for the program and will receive $13.5 million in the first year.

 

• Support for Dual-Eligible Individuals - Earlier this year, MassHealth was awarded a $1 million design contract with the nation’s Center for Medicare and Medicaid Innovation and the Federal Coordinated Health Care Office (FCHCO) to develop a demonstration proposal to integrate care for dual-eligible individuals (individuals who are eligible for both Medicare and Medicaid). The demonstration will serve dual eligible adults ages 21-64 who currently receive full MassHealth benefits. It will promote an unprecedented level of care integration which will contribute to better health outcomes for the dual-eligible population through the delivery of higher-quality, person-centered care. Dual- eligible adults will experience their coverage through a single, integrated care program that will promote healthy outcomes and offer dual-eligible individuals the opportunity to live with dignity and independence in their communities.

 

• Consistent with the Patrick-Murray Administration’s commitment to ‘Community First,’ the Commonwealth’s Supportive Housing program offers income-eligible seniors the opportunity to “age in place” in public housing, with access to twenty-four hour on call assistance; housekeeping; daily meals; transportation; grocery shopping; laundry; social activities; and personal care assistance.  The Executive Office of Elder Affairs and the state’s Department of Housing and Community Development (DHCD) bring “assisted-living” services to residents of state-aided or federally funded elderly housing.  There are 32 public housing buildings with Supportive Housing clients, accommodating approximately 4,630 seniors who might otherwise be in long-term care facilities.

The Patrick-Murray Administration is committed to making significant strides in these areas in the years ahead.  Massachusetts now spends 40% of long-term care funding on community-based services, up from 30% since 2007. This funding has helped ensure that seniors and people with disabilities who want to live in their own homes and communities have the support they need to do so successfully. But there is a lot more to do.

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Assistive technology is changing the accessibility landscape and daily life for us all

By Assistant Secretary for Disability Policies and Programs Christine Griffin

Over the past 25 years, we have witnessed the advent of innovative assistive technology–everything from “kneeling buses” to software for computers that speak to blind or visually-impaired individuals to video phones that allow individuals who are Deaf to sign to each other.  These and other devices have made significant strides in simplifying life for elders and people with disabilities. Simply put, “assistive technology” (AT) includes products and systems that expand the capabilities for those with functional limitations.  Each and every day, AT changes people’s lives.

As someone who has had a disability for more than 30 years and has spent many of those years advocating for increased employment opportunities for all people with disabilities, it is access to affordable assistive technology that will allow more people with disabilities to obtain and retain competitive employment.

Many AT products are designed for people with functional limitations but offer benefits to the public at large, making their design benefits truly universal. Who with a stroller or bicycle hasn’t benefited from a curb cut that’s designed to accommodate people using wheelchairs? Or voice activation software that is designed for people who are not able to use their hands? This innovation is now commercially available to the busy executive, teacher, student or even grandma. By modeling and designing products, policies and environments that are simple and accessible to the broadest possible range of  users, the thought leaders in this arena are truly creating what has become known as universal design (UD).

More than 34% of the population over the age of 65 in Massachusetts is identified as having a disability; 5.9% of residents between the ages of 5 and 17 are identified with a disability, and 8.9% of individuals between 18 and 64 are identified as having a disability. These numbers illustrate the need to adopt universal design and assistive technology within local communities across the Commonwealth.

In this interest, Governor Deval Patrick and the Executive Offices of Health and Human Services, Education, and Housing & Economic Development are co-hosting  a conference and free expo on “Products & Technologies that Change People’s Lives: Universal Design and Assistive Technology in Massachusetts” this Friday, September 23at the Hynes Convention Center in Boston. The Institute for Human Centered Design is partnering with the Commonwealth to convene this event. For more information about the more than 75 assistive technology exhibitors who will participate, or to register: visit: www.changepeopleslives.org.

I hope you’ll join us for a day of thought-provoking discussion, an exchange of ideas and vision, and access to information about products that are improving the quality of all of our lives.

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Innovative technology offers more than creature comforts: critical tools for independent living

By Emma Morrison, communications fellow at the Executive Office of Health and Human Services

You know when you leave your house without your Blackberry or iPhone and you get that sinking feeling?  We have all been there: the panic sets in and without your ‘smart’ phone, you feel like you are not really whole all day.  Or what about when you leave your iPod at home when you go to the gym?  I hate running without my music!  These are everyday occurrences that highlight just how much we depend on technology.  But consider for a moment you are an individual with a disability and you really do rely on assistive technology (AT) every day to make your life more independent and manageable.  Forgetting your phone for a day seems trivial doesn’t it? 

You may be surprised to find out just how many individuals in the Commonwealth live with a disability or are elders, and rely on some form of assistive technology on a daily basis.  According to the 2009 American Community Survey from the U.S. Census Bureau:

• 5.9% of Massachusetts residents ages 5-17 have a disability
• 8.9% of Massachusetts residents ages 18-64 have a disability
• 34% of Massachusetts residents ages 65 and over have a disability

As all forms of technology continue to evolve, assistive technology (AT) is rapidly developing and impacts a growing number of people living with disabilities in the Commonwealth. 

Assistive or adaptive technology refers to what the U.S. Assistive Technology Act of 1998 outlines as "products, devices or equipment, whether acquired commercially, modified or customized, that are used to maintain, increase or improve the functional capabilities of individuals with disabilities."   

AT change people’s lives for the better and helps individuals live more independently.  Keith Jones and Joe McCormick are two such residents; their lives have changed considerably thanks to AT and they cannot imagine their lives without it. Keith is the President and CEO of Soul Touchin’ Experiences; Joe is a sophomore at Harvard.

Without the use of his arms, Keith uses his feet for virtually everything requiring manual dexterity. He stresses “the role of technology” and how it’s ”bridging the gap between what the American dream is for American people and what the actual American reality is for people with disabilities.”  As a result of AT innovation, Keith works from home using his iPhone, iPad and iMac – and his feet.  Keith reminds us that there’s no such thing as “we can’t do it” for people living with disabilities and elders, because, he says, the technological solutions available today have truly changed the way Keith lives and works every day.

Joe is a student at Harvard University who is legally blind.  Advents in AT have provided Joe with invaluable technological tools to study.  For example, Joe uses a Zoom-EX (a portable book scanner) to read texts and assignments and to write papers.  Joe says devices like the Zoom-EX “make me more independent, they let me do everything that anyone else can do at the same rate as them.”  Maybe I don’t rely on my iPod as much as Joe relies on his Zoom EX.

To help recognize and celebrate September as Universal Design and Assistive Technology Awareness Month, on September 23, 2011, Governor Patrick and the Executive Offices of Health and Human Services, Housing and Economic Development and Education will co-host “Products & Technologies that Change People’s Lives,” a daylong conference and exhibition of the latest developments in assistive technology, at the Hynes Convention Center in Boston.  Check out the event’s website to learn more: www.changepeopleslives.org.  Everyone depends on technology, some people just a little more!

To learn more about Keith and Joe’s stories and how AT has changed their lives’ visit:

 Keith Jones: AT at work

http://www.youtube.com/watch?v=8P42x3yJfOo&feature=related

 Joe McCormick: Learning with AT

http://www.youtube.com/watch?v=FduCZESJXVY&feature=related

 

SHINE counselors to help guide open enrollment for Medicare benificiaries later this year

By Director of the SHINE Program for the Executive Office of Elder Affairs Cynthia Phillips

Most Medicare beneficiaries have just one opportunity a year to evaluate and change their coverage—and this year it's coming earlier, from October 15^th to December 7th.  Every year, the “open-enrollment” period allows seniors and others on Medicare to change their part D (prescription-drug) coverage, enroll or change enrollment in a Medicare Advantage program, such as an HMO or PPO plan, and generally reevaluate their healthcare package. Many seniors disregard this opportunity and enroll in the same plans they did the year before, assuming that as long as a plan has not changed dramatically, there is no need to switch.  People should review their plans, however, because even if their plans have not changed, their needs may have. If a Medicare beneficiary has been prescribed new medications or dropped old ones, there may be a new (and perhaps less expensive) part D plan that suits him or her better.

           While the open enrollment period offers an opportunity for reevaluation, it can also be a confusing time for beneficiaries. Plans inundate seniors with information and those who don’t know the system can end up drowning in a sea of questions and paper.  That’s why the Serving Health Information Needs of Elders (SHINE) program will be training “Part D Enrollment Counselors” to help seniors make informed enrollment decisions. The counselors will have a role similar to that of SHINE counselors, who are state-certified guides to health insurance options, but they are focused specifically on Part D. Volunteer SHINE counselors and Part D counselors can sit down with beneficiaries to explain their benefits giving them the options they need to make the choice that works for them. SHINE counselors are conversant in the in the language of the enrollment process, which means they can help find solutions to complex problems by drawing on diverse resources within the healthcare finance network. Anyone interested in becoming a SHINE counselor or Part D Specialist should contact the SHINE program via EOEA’s hotline, 1-800-AGE-INFO (1-800-243-4636; press #3).

 

 

Event at the State House celebrates 20 years of connecting urban youth to individuals with intellectual disabilities

By DDS Commissioner Elin Howe

Through the UYCP, I learned that human services promote each unique individual. We as staff in this field can bring out the qualities and abilities in all of the individuals we support. Through that, we can all live a life of beauty through diversity. – Jeff Hammond, 18, from Brockton

Today officials from the Patrick-Murray Administration honored participants in the 2011 Urban Youth Collaborative Program (UYCP) at an awards ceremony at the State House. Youth were awarded and thanked for their commitment and dedication to caring for individuals with developmental disabilities at state-operated and community programs throughout the state. Interns from each program shared their experiences.

In 1992 the Department of Developmental Services (formerly known as the Department of Mental Retardation) began an eight-week summer pilot program called the Urban Youth Collaborative Program (UYCP). The program’s creation is based on four principles: 1) expand the social and recreational activities for people with intellectual disabilities 2) foster an interest among a diverse group of high-school students who reside in urban areas to work in the human service field 3) develop an ongoing collaboration with different high schools, colleges and human service providers throughout the state and 4) train and potentially provide a talented, multi-cultural pool of individuals who can meet the needs of an increasingly diverse population in human services.

One 2011 participant, Jeff Hammond, interned at DDS provider Road to Responsibility and reflected on his experience:

After participating in this year’s Urban Youth Collaborative, my perspective about people with disabilities has changed dramatically. Before UYCP, there were only a small number of individuals who I had been exposed to with disabilities, so there was a lot I didn’t understand. I had only focused on what the individual couldn’t do. Road to Responsibility promotes the concept that each individual is that; an individual and although there are limitations to what each person can do there are many things that each person can do.

Though I have had many great moments this summer with the UYCP, the ones that stand out the most is time spent with Carl. Carl is an individual who can simply walk into a room and instantly brighten it with his huge smile, and his many requests for lunch -- I saw myself in him on that one! Every day Carl has shown me that there is no limit to what he can learn. The fact that he knew sign language (something I have tried to learn but still only know how to sign water and music), made me think about his abilities … not disabilities. 

What I took from this experience was the strengthening of the idea that everyone is different in their own way. I gathered this from the individuals and also from the staff at my program site. I saw that everyone had a unique quality about them. Whether it was Tommy, who played piano but REQUIRED a cushioned chair for seating; to Ricky who could mirror anything you did perfectly; I saw that no one was the same. I also saw how differently staff members dealt with every day situations, which helped me develop my own workplace skills.

I definitely see myself in human services because to know that I’m in a field that is devoted to increasing the quality of life for individuals with disabilities (or rather, abilities) is so rewarding.

Now that UYCP has ended for me I can honestly say that there was a change in myself. I met wonderful people who helped change my life. I can walk into a workplace with confidence. Most importantly, I am now a firm believer that each individual is unique to the world. We are all different with our own abilities and skills. I understand that this is something that is taught to us at a young age but it takes living to truly believe.

Through the UYCP, I learned that human services promote each unique individual. We as staff in this field can bring out the qualities and abilities in all of the individuals we support. Through that, we can all live a life of beauty through diversity.

-          Jeffrey Hammond, UYCP participant

Twenty successful years later, this summer the UYCP collaborated with 19 program sites from across the Commonwealth to work with 194 students who were recruited from 85 towns. Since its inception, nearly 3,000 interns have participated in the UYCP, with almost half continuing on to pursue careers in human services. In keeping with the Patrick-Murray Administration’s ongoing commitment to promoting dignity and independence for people with disabilities, the UYCP also addresses a key focus of the administration by providing jobs in this arena, particularly to this young workforce.

As Commissioner of DDS, I am very proud of the UYCP and its impact on both the student participants and the individuals we support and serve.  We at DDS hope that the dedication of young adults like Jeff will carry on throughout their careers, and they will consider working with people with intellectual disabilities.

Commissioner Howe with 2011 UYC participants at today's awards ceremony at the
State House

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Managing “Mi Vida, Mi Salud”: A culturally-adapted approach to chronic disease management

By Ana Karchmer, American Reinvestment and Recovery Act (ARRA) program coordinator at the Executive Office of Elder Affairs

I recently had the privilege of co-facilitating the “Mi Vida, Mi Salud” program, a Spanish language initiative to help seniors with chronic conditions take control of managing their illnesses, along with Edwin Morales, site coordinator for the Foster Grandparents Program at Action for Boston’s Community Development (ABCD). The six-week program, held in Boston, has been culturally adapted to the Latino population and includes tips on healthy eating and exercise. ”Mi Vida” also helps participants formulate action plans, brainstorm and problem solve as part of their health maintenance.

Workshop participants in “Mi Vida” are Spanish-speaking foster grandparents who volunteer in the Boston public schools. The group – 16 women and one man from several different Latin American countries - met every Friday morning for six weeks. Ranging in age from 57 to 89, participants live alone and suffer from at least one chronic illness. Many suffer from two or more illnesses, including: diabetes, arthritis, hypertension, lung disease, osteoporosis and depression.

Two peer leaders (one of whom has a chronic illness herself) facilitated the workshops that comprise the “Mi Vida” program. After the second week, participants report back to the group about their action plans and collaborate to formulate new plans. The action plans are based on something each person wants to change about his/her lifestyle and health.

One of the workshops focused on diet and nutrition. As they learned more about guidelines for healthy eating, their individual action plans focused more on improving their diets. Some wanted to limit the amount of rice or tortillas they ate; others wanted to eat fewer sweets; and others wanted to try to eat breakfast. One participant, who never ate breakfast, found it challenging to follow her action plan of eating breakfast a few mornings per week. Other members of the group offered strategies for eating in the morning, giving their fellow participant some dining options.  After selecting one of the group’s ideas, the participant reported that after six weeks, she was in the habit of eating a small breakfast every day.

In the sixth and final session of “Mi Vida,” all participants shared their successes.  One had started to eat salads regularly; another better understood the concept of portions and how to limit intake of carbohydrates. A few began reading food labels and learned to check the sodium content of the foods they eat.

The educational impact of “Mi Vida” was readily apparent when one participant, Maria^*, discovered how much sodium was in the packaged noodle soups she ate every day – the look on her face was priceless! Another member of the group, Lucy^*, commented that she had previously taken a nutrition class, but she now understood how to put together a menu following the formula for healthy eating presented in the program. A participant reported that she felt proud that she had kept to her weekly action plans.  And an initially reticent participant slowly warmed up to the group and gradually began to share reports with the others.

As co-facilitators, Edwin and I were likewise responsible for forming action plans and reported on them to the group. One week, for example, I decided to cut back on my coffee intake -- to one cup per day. Every afternoon I came home and prepared myself a cup of tea instead, thinking about the “abuelitas” (grandmothers) in the group and how they were helping me keep my goal.

Although a couple of program participants knew each other well, most knew each other only from participating in the program’s mandatory meetings. They all arrived at the first session anxious to learn but not sure what to expect. After the first couple of sessions, the group participants began opening up and supporting one another.  Although many had hard lives, they came to each session with a smile, a hug and a willingness to work and learn something new that would improve their health.

As part of the program, participants also talked about the impact of APCD’s Foster Grandparents Program on their lives. Many noted that the program gave them a reason to wake up in the morning because they “loved their foster grandchildren.”

“Mi Vida, Mi Salud” or “My Life, My Health” is the Stanford University Chronic Disease Self Management Program and is available in Spanish, English, Chinese and Portuguese. The program is supported by an American Recovery and Reinvestment Act (ARRA) grant and through collaboration between the Department of Public Health and the Executive Office of Elder Affairs. The program is being offered at various community sites such as public libraries, community health centers, senior centers, hospitals and at Councils on Aging (COAs).

For more information about “Mi Vida,” contact Ana Karchmer – at the Executive Office of Elder Affairs (ana.karchmer@state.ma.us).

 *participant names have been changed

 Ana Karchmer is American Reinvestment and Recovery Act (ARRA) program coordinator at the Executive Office of Elder Affairs

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Executive Office of Elder Affairs teams up with HHS Regional Director to explain the Affordable Care Act (ACA) to Commonwealth seniors

By Secretary of Elder Affairs Ann L. Hartstein

Over the last five months, I’ve been traveling the Commonwealth with Christie Hager, regional director of the U.S. Department of Health and Human Services (HHS) to help explain how the Affordable Care Act (ACA) – known to most as federal health care reform -- will impact Medicare beneficiaries. We’ve been hosting forums for seniors across Massachusetts to dispel common misconceptions about the new federal health care reform law and educate people about Medicare fraud, abuse and exploitation.  We’ve already traveled to Norwood, Burlington, Chicopee, New Bedford and Boston, with more to come.  These forums reflect the Executive Office of Elder Affairs’ mission to ensure that Massachusetts seniors are well-informed consumers.  

People are worried about changes in their Medicare coverage.  They hear descriptions of what federal health care reform means for them, which are sometimes sensational and often inaccurate.  Seniors benefit from reform in some very significant ways. Since President Obama signed the ACA into law in March 2010, seniors with high prescription drug expenses have received a one-time $250 rebate check from the federal government.  This year, they will be able to go to their health care provider for a free wellness check-up and screenings for a variety of conditions, including breast and colon cancers.  Over the next three years, additional changes will offer more patient-centered care, with payments to doctors and hospitals based on outcomes.

In addition to our discussion about the ACA, we describe some of the ways scam artists target seniors and how best to avoid Medicare fraud and abuse.  Along the way, we’ve had a number of people tell us about the kinds of scams they have encountered since the Act became law.  For example, people have reported getting telephone calls from “the Medicare office” asking for personal financial information.  We assure them that Medicare does not call its beneficiaries.   Educating people about what’s legitimate and what is a scam is just as important as telling them about programs and services available to them.  Sharing stories about the kinds of scams and abuse help people to recognize them if they become a target of unscrupulous people. 

As part of my office’s efforts to ensure that seniors are well-informed consumers, I’m delighted to host these forums along with Regional Administrator Hager and hope that Massachusetts seniors continue to join the discussion and share their stories.

I invite you to visit the elder affairs website for more information about upcoming forums about the ACA and its impact on seniors.

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