On Friday, November 4, 2016, the Centers for Medicare and Medicaid Services (CMS) approved Massachusetts' application to restructure the MassHealth Medicaid program. It's called the "1115 waiver". Over the next five years, the 1115 waiver will bring $1.8 billion into the Commonwealth of Massachusetts to create a more integrated healthcare delivery system for MassHealth members. This new system, "Accountable Care Organizations" (ACOs), will be responsible for providing person centered coordinated care and will integrate behavioral health services at the start, and eventually integrate Long-Term Services and Supports (LTSS).

ACOs are not bad in concept, but managed care entities have narrower provider networks and without proper oversight, by advocates, could reduce control, choice and access to LTSS.

There are other issues, too many to list here, but let me toss several out as food for thought. These include:

• the one year, lock-in of members into ACOs
• variations in ACO models
• member cost-sharing policies

We will share more information about the positive and negative parts of the 1115 waiver in coming months.

Is it important to support the state and its new endeavor? Yes. The influx of dollars is desperately needed and so is reform to the system as it currently exists.

For now, we must be persistent as well as vigilant. There are too many unanswered questions about how the Commonwealth will protect MassHealth members, particularly people with disabilities, from being squeezed by competing market interests of insurers, hospitals and provider groups? High among these questions is how the Baker Administration will respond to concerns and proposed solutions put forward by the disability community?

We will keep you posted in the coming months.

Dennis Heaphy

Health Care Analyst, DPC

dheaphy@dpcma.org

The REquipment DME Reuse Program is looking for one or two people to work 10 hours per week performing research and data entry to assist in our marketing activities. The individual must be:

• proficient in the use of Excel
• detail oriented
• able to follow directions
• able to work independently with limited supervision

This position is ideal for a person with a disability looking to maintain their CommonHealth eligibility or to gain work experience. There are no benefits.

For more information or to apply, contact Karen Langley, Executive Director, REquipment DME Reuse Program at  langley@dmereuse.org. If you are applying, please send an email of interest and resume.

The Greater Boston Chapter, National Spinal Cord Injury Association has an exciting opportunity for a person who is passionate about working with people affected by a life altering spinal cord injury.

Position Summary

The Chapter Coordinator manages the day to day operations of the Greater Boston Chapter, NSCIA. This includes the Peer Program, member communications and administrative assistance to the Executive Director. The Peer Program is central to the Chapter's mission to serve all those affected by spinal cord injury including the newly injured, family members and the overall spinal cord injury (SCI) Community.

The Chapter Coordinator is based out of the Chapter's satellite office located at Spaulding Rehabilitation Hospital, Charlestown, MA. In conjunction with the Executive Director, the Chapter Coordinator is responsible for coordinating peer visits, peer training and education, weekly staff meetings, social media, and engagement with the spinal cord injury community including healthcare professionals. In addition, the Chapter Coordinator is responsible for working with the Executive Director and Board of Directors on fundraising and other programs as identified.

This is a part time, 5 hours/day, 5 days/week position. The position does not provide healthcare benefits.
The Greater Boston Chapter, National Spinal Cord Injury Association is a non-profit 501 (c) 3 organization founded nearly 25 years ago to assist people affected by a spinal cord injury to rebuild their lives and live to their fullest potential. The Chapter's provides peer mentoring, role modeling, education, resources, social activity, public awareness and advocacy. 

  Qualifications

• Personal experience with a spinal cord injury a plus
• Thorough knowledge about individuals affected by a spinal cord injury
• Minimum of two years of experience working with and advocating on behalf of individuals and their families
• Working knowledge of the phases of medical rehabilitation preferred
• Associate's Degree required, Bachelor's Degree preferred, or equivalent work experience

Application

The complete job description including a full list of qualifications and how to apply can be found at http://sciboston.com/careers 

Applications are due by Friday, November 18, 2016. However, applications will be accepted until the position is filled. Interested candidates should submit a letter expressing their interest in the position, and how they believe they can make a difference to those living with a spinal cord injury. To apply, please send the letter, a current resume and three references to: sciboston@aol.com.