By Senator Therese Murray
With the life expectancy of the Commonwealth's residents continuing to reach new heights, it has become increasingly critical that we address the health care needs of our state's senior population. This legislative session, we have continued these efforts by focusing on long-term care options and expanding prescription drug coverage for seniors.
Many of our seniors are faced with long-term health care issues, but their condition does not require them to be in a nursing home or a care facility. We all know that nursing homes are not always the best answer, but unfortunately for seniors on MassHealth, only a certain number of home care slots were available under the old long-term care structure.
This year the Legislature passed the Equal Choice Long-Term Care Law that gives senior citizens and disabled residents on MassHealth the ability to choose where they receive that care. Individuals who meet MassHealth financial and clinical eligibility requirements now are able to make their own decisions. The funding necessary to meet the needs of each client then would follow that person to the location of choice.
This means that eligible seniors will be able to stay in their homes and communities and near their loved ones while still receiving the care they need.
To further enhance the Commonwealth's long-term care efforts, we also passed legislation that focuses on the personal care attendants tasked with providing care. This bill creates a Council to oversee the recruiting and training of personal care attendants in order to stabilize the workforce. In addition to the Council, the legislation also creates a statewide directory of in-home care givers. This directory will act as a resource for residents to find assistance when their primary assistant is not available.
Another significant component of seniors' health is the ability to get the prescription drugs they need. Once the federal government launched its prescription drug program, it became clear that finding the right plan that covers all of their medications at best was a daunting task. And, because what the plans covered was so difficult to decipher, many seniors made inappropriate choices.
Seeing this difficulty and the gap in coverage that seniors would be facing, we retooled the state's prescription drug coverage plan, Prescription Advantage, to work as a wrap-around program for our seniors.
This wrap-around program will ensure that Prescription Advantage enrollees will not have higher out-of-pocket costs for any drug covered by their Medicare prescription drug plan than they would have had under the Prescription Advantage program if they were not eligible for Medicare prescription drug coverage.
In addition, if the enrollee's Medicare prescription drug plan does not cover a medication that would have been covered under Prescription Advantage, the program provides coverage for a one-time, 30-day supply of the prescribed medication during 2006. It also provides an additional emergency 72-hour supply of medication for uncovered prescription drugs after the initial 30-day supply.
The Commonwealth saw an incredible response with the first open enrollment for the program this past spring. The Legislature continued to open the plan to enrollees by authorizing a second two-month enrollment period ending November 15. If you have any questions about the Prescription Advantage program, please contact the Commonwealth's Office of Elder Affairs at 1-800-AGE-INFO.
As we live longer, programs like these are going to become even more critical to give seniors the ability to live their lives on their terms and not be worried about making ends meet or having to leave their homes.
(Senator Murray, D-Plymouth/Upper Cape, chairs the Senate Committee on Ways and Means.)
By Representative Cleon H. Turner
With the high cost of just about everything today, it's heartening to know that your legislators are doing something to lighten the load. We certainly can't make all of the cost burdens go away overnight. But we pick our battles and try to be the most cost-effective possible. In my first term in office, I am proud to have been part of an overhaul of the state of health care in Massachusetts.
Some say that we ought to roll back the income tax immediately, before economic triggers have been met. I disagree. What's an average $100 back in your pocket if you're shelling out thousands on overpriced health care and high property taxes? It's all interlinked in state government. Our job is to connect the dots and get you, the consumer/taxpayer, the most bang for your buck. This session we went about that by tackling the mammoth crisis in health care.
Nationwide, average citizens cannot afford health insurance. Those lucky enough to get it can barely afford to keep it. The time has come to change that. The reason you have to be treated in a hospital, regardless of insurance status, is the social contract we have that says you don't leave a sick man on the side of the road; you help him back to health. What's more basic than making sure our friends, neighbors and colleagues don't go without basic health care? What could make more sense to the economy of the Commonwealth, than a workforce that stays well and working?
To that end, the Massachusetts Legislature embarked on an untested path. Since our federal counterparts haven't shown an interest, we will not sit by as our fellows go without. Health Care Reform in Massachusetts isn't perfect; there are a lot of kinks to work out of this brand new system. To do that, we need your help.
As of October 1, the newly created Commonwealth Connector began enrolling people at or below 100 percent of the Federal Poverty Level (FPL-individual income $817/month; family of four $1,667/month) in the Commonwealth Care plans. In January, the Connector will start taking on people 100-300 percent of the FPL. Four plan options already have been approved and a fifth is in the works. Premiums will range from $18 to $106 per month for individuals and $36 to $240 per month for families.
As residents of the Commonwealth test the new plans, we legislators will need to hear back from you about how well the Connector is working. Where should we be making improvements? This is a work in progress, but it's a progressive working partnership between all the citizens of Massachusetts. This year, we all sent a loud message to the health care industry, to Washington, and to each other: a society as great as ours can do better.
To find out if you are eligible for one of the Commonwealth Care plans, visit the new Connector website: www.mass.gov/connector. I encourage you to call my office at 617-722-2090 to let me know how Healthcare reform is working for you.
(Representative Turner, D-Dennis, is a member of the Legislature’s Joint Public Health Committee.)
By Representative Shirley Gomes
This recent legislative session saw the passage of our new budget for FY07, which funds a number of important measures regarding health care for Massachusetts, including the programs contained in the new Health Care Reform Law.
The budget includes:
I was pleased to see the bipartisan efforts to address community health care needs. While more work needs to be done, important steps were taken this legislative session to ensure anyone who needs care, receives it.
(Representative Gomes, R-Harwich, is ranking member of the Legislature' Joint Committee on Public Health, 617-722-2803.)
By Senator Robert A. O’Leary
Recent medical studies have confirmed that there is a significant connection between oral health and physical well-being. For this reason investments in oral health must be an important piece of our health care strategy and investments. For every dollar spent on oral health prevention, $25 is saved in future medical costs.
Unfortunately, each year, millions of children and adults go without the prevention and treatment that would allow them to maintain good oral health. The implications of untreated dental disease are not just cosmetic; they are serious and can be permanent: Tooth decay is the leading cause for school absence in the United States.
In order to maintain good oral health, children and adults need access to such preventive measures as dental sealants, fluoride, and regular visits to an oral health professional for exams and cleanings. They also need access to treatment services in order to treat and stop the progression of decay.
Yet these services are not available for millions of Massachusetts residents. While 460,000 Massachusetts residents lack medical insurance, 2.3 million lack dental insurance.
In the spring of 2002 Massachusetts, under Acting-Governor Jane Swift, eliminated comprehensive dental care for most of the 600,000 adults enrolled in MassHealth. These cuts have forced beneficiaries to go without needed preventive and restorative care and treatment, often leading to advanced dental decay and complicating disease. Governor Mitt Romney's position has been to continue the denial of these important health services.
Fortunately, however, both the House and Senate had the good sense to include the restoration of MassHealth dental benefits for all adults enrolled in the program in the recently passed comprehensive health reform package. Over the veto of the Governor, the Legislature ensured that our most vulnerable citizens have access to the preventive oral health services necessary to maintain overall health security.
This year's state budget also included a number of important provisions and programs to address the dental health care needs of the people of the Cape and Islands.
In a supplemental appropriations bill, the Legislature stepped up and provided $750,000 for an innovative school-based health program in Hyannis. School-based exams are one way to improve children's access to oral health. The Forsyth Institute is testing a new model of care by setting up clinics in schools, and bringing in its own dentists. Currently, the Forsyth Institute's School-Based Oral Health program is working at Hyannis East and Hyannis West elementary schools. The data have been impressive. At the inception of the program 66 percent of the children had untreated cavities and 13 percent had acute and painful infections or abscesses that required immediate attention. In the three years of programming the children in Hyannis have had cavity reductions of 50 percent.
The inability to pay fees and afford care is a potential barrier to dental care for many of our young people on the Cape. One-in-12 of Cape Cod's young people live in poverty. Only one dentist in all of Cape Cod accepts Medicaid. As a part of the solution, for the first time, this year's state budget allocated $90,000 to help with the operation of a dental care program called Cape Cod Dentists Care. Under this a program dentists in private practice are recruited to provide low-cost care in their own offices or as volunteers at a community dental center. Patients served in dental offices make a small payment to the dentist in an amount scaled to their income. The program serves low-income adults residing in Barnstable County who are uninsured or on MassHealth.
Access to dental care is a major issue particularly on the Outer Cape. This allocation not only will help ameliorate the lack of accessibility, but it will support an innovative public-private partnership that is a potential model for the rest of the Commonwealth.
(Senator O’Leary, D-Cummaquid, who represents the Mid and Lower Cape, is a member of the Legislature’s Joint Public Health Committee.)