Public Benefits Task Force

2012 Maryland Health Disparities Chartbook

From DHMH:

Dear Health Disparities Partner:

The Maryland Department of Health and Mental Hygiene and its Office of Minority Health and Health Disparities have placed priority on the elimination of health disparities among the State’s population.   We are pleased to provide you with a copy of the third “Maryland Chartbook of Minority Health Disparities Data”.  The attached Chartbook provides essential information for identifying and measuring disparities, determining the causes of disparities, planning interventions that work, and tracking progress.  This document is also accessible on our website at 

 Use this Chartbook like a dictionary, search for diseases, population groups, and local communities to answer your questions.  There is some information on most disparities data-related subjects as well as recent website references that lead to other sources and further information. 

Having done all that, let us know how this document helps you, what questions remain to be answered, and suggestions for future publications.  Send comments to:


Maryland Health Disparities Data Chartbook 2012 021413.pdf3.62 MB

Mass Shootings and Mental Disability Rights in the United States

Mon, 02/25/2013 - 12:00pm - 1:30pm

The recent tragedies in Connecticut, Colorado and Arizona have sparked debate over the link between mass shootings, gun control, and persons with psychological and psychosocial disabilities.  A panel of experts will examine new trends in gun control legislation from a human rights perspective, discussing whether this type of policy is necessary to prevent tragic shootings and how to ensure protection of the rights of persons with mental disabilities to liberty, equality and nondiscrimination.  Speakers include:

Prof. Robert Dinerstein, Professor of Law and Director of the Disabilty Rights Law Clinic, WCL

Ira Burnim, Bazelon Center for Mental Health Law

Sherry Trafford, Mental Health Division of the Public Defender Service for the District of Columbia

Moderator: Lauren E. Bartlett, Project Director, Center for Human Rights and Humanitarian Law

Lunch will be served!

This event will be live webcast at Questions for discussion may be submitted during the event to  For more information, visit

Location Name: 
Center for Human Rights and Humanitarian Law
4801 Massachusetts Ave. NW Room 603
WCL Center for Human Rights and Humanitarian Law

Webinar: Managed Long-Term Services and Supports: Measuring Outcomes

Tue, 02/26/2013 - 3:00pm - 4:30pm

Managed Long-Term Services and Supports: Measuring Outcomes  


Tuesday, February 26, 3:00-4:30 PM Eastern
Outcomes measurement is critical to the implementation of state managed long-term services and supports systems to ensure that the needs of older adults and individuals with disabilities are being met. This webinar sponsored by the Administration for Community Living will examine core principles and criteria for selecting measures, possible data sources, and methods for building infrastructure capacity to monitor the quality of managed long-term services and supports.

Mary Lou Breslin, Senior Policy Advisor, Disability Rights, Education and Defense Fund
Eric Carlson, Directing Attorney, National Senior Citizens Law Center
H. Stephen Kaye, Director, Center for Personal Assistance Services, University of California San Francisco
To register for the online event
1. Go to
2. Click "Register".
3. On the registration form, enter your information and then click "Submit".

Once your registration is approved, you will receive a confirmation email message with instructions on how to join the event.
Please note: Space is limited, so please register as early as possible. This webinar will also be recorded and posted on our web site ( ) soon after the webinar.

Administration for Community Living

Webinar: What's in Store for Older Adults (50-64) Under Health Care Reform

Wed, 03/13/2013 - 2:00pm - 3:30pm

Title: What's in Store for Older Adults (50-64) Under Health Care Reform

Date: Wednesday, March 13, 2013

Time: 2:00 PM - 3:30 PM EDT

Space is limited.
Reserve your Webinar seat now at:
2014 marks a new era for health insurance in the United States. The establishment of health insurance exchanges, or marketplaces, and the expansion of Medicaid eligibility in many states will enable millions of people to access affordable insurance. Prior to health reform, older adults, between 50 and 64, faced significant challenges accessing insurance, including limited coverage in Medicaid, unaffordable premiums on the private insurance market, and policies on pre-existing conditions that render many effectively "uninsurable." This webinar will focus on how key provisions of the Affordable Care Act, colloquially known as "Obamacare," can help older adults access the insurance and benefits they need, such as:

- Expanded Medicaid eligibility to 138% Federal Poverty Limit (FPL) for adults under 65;
- Access to federal subsidies to help pay for insurance premiums for individuals and families up to 400% FPL;
- Required Essential Health Benefits, including no cost sharing preventive screening and annual wellness visits;
- Limitations on how much extra a plan can charge for premiums based on the beneficiary's age;
- Guaranteed issue insurance that forbids health plans from denying coverage or charging extra for pre-existing conditions;
- Delivery system innovations, including initiatives to coordinate care like the health homes

Presenters are: David Machledt, Ph.D., policy analyst at NHeLP; and Leonardo Cuello, J.D., Director of Health Reform at NHeLP

Additional sponsorship for this Webinar is provided by a grant from the Administration on Aging/Administration for Community Living . This webinar is part of a series of National Elder Rights Training Project webinars for the National Legal Resource Center.

There is no charge for this webinar.
All time listings are in Eastern Standard Time.
If you have any questions email

National Legal Resource Center

HHS Releases Proposed Rule on Medicaid, CHIP and Health Insurance Marketplaces

See below for the HHS announcement of the proposed Rule on Medicaid, CHIP, and Health Insurance Marketplace.  The fact sheet can be found at along with a link to the proposed rule.

HHS Intergovernmental and External Affairs Notification

January 14, 2012

From:  Paul Dioguardi

Director, Office of Intergovernmental and External Affairs

U.S. Department of Health and Human Services

RE:     HHS Releases Proposed Rule on Medicaid, CHIP and Health Insurance Marketplaces

Today, the Department of Health and Human Services (HHS) released a proposed rule implementing key Affordable Care Act provisions relating to Medicaid and the Exchanges. This proposed rule codifies statutory eligibility provisions, lays out a structure and options for coordinating Medicaid, the Children’s Health Insurance Program (CHIP), and Exchange eligibility notices and appeals. It also proposes to modify existing benchmark benefits regulations for low-income adults, and codify several of the provisions included in the Children’s Health Insurance Program Reauthorization Act (CHIPRA).

This proposed rule includes information on how consumers will receive coordinated communications on eligibility determinations and can appeal eligibility determinations.  It gives states flexibility in designing benefits and determining cost sharing in the Medicaid program.  The proposed rule also provides flexibility to state-based Exchanges by allowing them to opt to rely on HHS for verifying whether an individual has employer-sponsored coverage and conducting some types of appeals.

The NPRM is available on display at the Federal Register here:

A fact sheet with additional information regarding the changes made through this proposed rule will be available on and later today.

Please direct questions to

MD gets $36.5 million for improving children's access to health insurance

From the Baltimore Sun:

MD gets $36.5 million for improving children's access to health insurance

By Andrea K. Walker

December 19 2012, 5:49 PM EST

The federal government has awarded Maryland $36.5 million for its success at getting children enrolled in government subsidized health programs.

The complete article can be viewed at:,0,731458.story

Save the dates! 2013 PBTF Meetings


Meeting Dates for 2013

First Thursday of alternate months

9:30 am – 12:30 pm

2nd Floor conference room in Baltimore City office and GoToMeeting

Tuesday, January 8

March 7

May 2

Tuesday, July 9

September 5

November 7

REMINDER: Tuesday, January 8, 2013 PBTF Meeting


Hello All,

On  Tuesday, January 8, 2013, we will be having our next Public Benefits Task Force meeting in the second floor conference room in the Baltimore City office of the Legal Aid Bureau and via GoToMeeting. Please contact me at by close of business on Wednesday, January 2, 2012 if you have any agenda items you'd like to add for the meeting. I'll circulate an agenda on Thursday, January 3rd in advance of the meeting.

Happy holidays and look forward to seeing everyone in the new year!

Abena Y. Williams

Public Poll: “Silver and Blue – The Unfinished Business of Mental Health Care for Older Adults”

From the John A. Hartford Foundation:

“It was as if I were falling into a deep dark well and I could not climb out of it.” - Poll Respondent

Large majorities of older Americans with depression, anxiety, or other mental health disorders are receiving treatment that does not meet evidence-based standards, and many do not know that depression can put their health at increased risk, according to a national survey, “Silver and Blue: The Unfinished Business of Mental Health Care for Older Adults,” released on December 13, 2012 by the John A. Hartford Foundation.

The survey focused on 1,318 Americans age 65 and older. Key findings include: 

  • 46% of people currently receiving treatment say their provider did not follow up with them within a few weeks of starting treatment to see how they were doing – a critical component of effective care.


  • Among all respondents, very few understood the health risks of depression: only one out of five (21%) had heard that depression is believed to double an individual’s risk of developing dementia and only one in three (34%) knew it can double the risk of heart disease.


The poll revealed serious shortfalls in the quality of mental health care related to patient engagement and treatment follow-up and modification.  Older adults also reported that team-based depression care, known to increase effectiveness, is appealing.  In their own words, respondents shared what it feels like to live with depression or other mental illness.

Depression is a common and serious medical condition second only to heart disease in causing disability as well as harm to people’s health and quality of life. Mental health problems affect nearly one in five older adults, according to the Institute of Medicine. Depression is not a natural part of the aging process, but almost one in three people surveyed (27%) believed it was.

“It is a needless tragedy that so many older people are still receiving mental health care that does not measure up,” said Christopher Langston, PhD, program director for the John A. Hartford Foundation, which funded and directed the survey.

For more details on the poll findings, the below supporting materials are available for download and key findings are also listed at the bottom of this page.


For assistance and resources in communicating these findings to a variety of audiences, please contact Elliott Walker at Strategic Communications & Planning (; 610-687-5495) or Marcus Escobedo at the John A. Hartford Foundation (; 212-832-7788).

Mental Health and the Older AdultFor more information about this topic, see the John A. Hartford Foundation 2011 Annual Report, “Mental Health and the Older Adult,”  the Health AGEnda mental health blog series featuring videos of older adults and caregivers, and learn about the highly effective, evidence-based IMPACT depression care model being spread in the rural northwest through the Foundation’s Social Innovation Fund project.

U.N. Votes In Favor Of Universal Health Coverage


Obamacare everywhere: U.N. votes in favor of universal health coverage

Posted by Olga Khazan on December 12, 2012 at 2:46 pm

The United Nations General Assembly voted in favor of a draft resolution supporting universal health coverage, signaling the importance of universal healthcare to the international development agenda.

The resolution, which is backed by the United States, encourages governments to come up with systems that avoid direct payments at the point of delivery, include a way to prepay for financial contributions toward health care and a mechanism to pool risks among the population in order to avoid catastrophic expenses. Essentially, this amounts to a system where health insurance is either attainable and affordable for all, or the federal government picks up the tab for health care costs.

The U.N. also urged governments to “promote the inclusion of universal health coverage in the implementation of the internationally agreed development goals…as a means of promoting sustained, inclusive and equitable growth, social cohesion and well-being of the population.”

Universal healthcare is widely seen as a hallmark of a developed nation, with nearly all high- and many middle-income countries having some form of universal coverage in place.

Here’s a map my colleague Max Fisher once made depicting all the countries in the world that have universal healthcare coverage (in green); it also very nearly delineates the developed countries from the developing ones.

Health experts say 40 percent of the world’s population – about 2.8 billion people – have some form of risk-pooled health insurance. Opinions vary as to whether the United States’ Affordable Care Act actually counts as universal health care (this map excludes the United States, for example), but others say its mandate provision means it comes close enough.

Over the past few years, rich and poor countries alike have been moving toward universal coverage.

Following the WHO’s 2010 report, Health systems financing: the path to universal coverage, more than 60 middle- and low-income countries requested technical assistance and advice to implement universal health coverage.

Countries that were once considered universal-health “blind spots,” such as India and South Africa, are developing systems that provide access to medical care for nearly all of their citizens.

China, for example, is now attempting to reconcile its patchwork of health plans and it’s close to completing a $124 billion project that aims to insure 90 percent of the nation’s residents. In India, a system started in 2008 has provided hospital access to 100 million people who live below the poverty line.

Of course, U.N. resolutions are generally non-binding, so the resolution may not lead to meaningful change in the member nations or elsewhere. (There have been multiple resolutions calling for a moratorium on the death penalty, for example). But the U.N. has been pressured for a declaration on universal health care before and it does show an interesting consensus among countries about the importance of health access to broader development goals.

Briefs Examine CMS Rules Governing Changes to Medicaid Eligibility And Enrollment Under the Affordable Care Act

From the Kaiser Family Foundation:

Two new briefs from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured examine changes to Medicaid eligibility and enrollment rules under the Affordable Care Act, and how such changes are expected to affect those covered by the program, including people with disabilities.

One brief provides a summary of the Centers for Medicare and Medicaid Services’ (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan. 1, 2014, lays out procedures for states to implement the Medicaid expansion and the streamlined and integrated eligibility and enrollment system created under the ACA. Achieving this goal will require substantial process and system changes among state Medicaid agencies and close coordination between Medicaid, the new health insurance Exchanges and other insurance affordability programs.

A companion brief provides a short summary of Medicaid eligibility and benefits for people with disabilities today and explains how they will be affected by the ACA in light of CMS’s new regulations. Provisions of the new Exchange regulations are discussed briefly to the extent that they related to Medicaid eligibility determinations for people with disabilities.

Final MOLST Regulations and Form

From OHCQ and the Ombudsman:

The final Maryland MOLST regulations and form will be printed in the Maryland Register on December 14, 2012, with an effective date of January 1, 2013. Beginning July 1, 2013, certain facilities will be mandated to complete the form for certain patients, including nursing homes, assisted living facilities, home health agencies, hospices, dialysis centers, and hospitals. The current version of the MOLST form will never expire and will continue to be honored. The new version of the MOLST form will be posted on the website on January 1, 2013. For further information, contact


Join the Maryland MOLST group on LinkedIn for announcements, updates, and discussions.




The End of Social Security Checks: The 2013 Transition to Electronic Payments

Wed, 12/05/2012 - 2:00pm - 3:30pm


The End of Social Security Checks: The 2013 Transition to Electronic Payments


Wednesday, December 5, 2012


2:00 PM - 3:30 PM EST

Space is limited.
Reserve your Webinar seat now at:


In March 2013, most individuals who are currently receiving Social Security, veterans' benefits, and other federal payments by paper check will be required to change to electronic payment. This webinar will address what will happen next year, what options seniors have, and how you can help them make the transition.  We will also discuss new protections for bank accounts, the Direct Express prepaid card, and privately purchased prepaid cards.


Walt Henderson, Director, EFT Strategy Division, U.S. Department of the Treasury
Margot Saunders, Of Counsel, National Consumer Law Center
Lauren Saunders, Managing Attorney, National Consumer Law Center

Additional sponsorship for this Webinar is provided by a grant from the Administration on Aging.  This webinar is part of a series of National Elder Rights Training Project webinars for the National Legal Resource Center.

There is no charge for this webinar.
All time listings are in Eastern Standard Time.

If you have any questions email

National Consumer Law Center

Introduction to Quality Measures in Managed Long-Term Services and Supports

Fri, 11/30/2012 - 2:00pm - 3:30pm

Friday Morning Collaborative Webinar Series:

Introduction to Quality Measures in Managed Long-Term Services and Supports

States are increasingly establishing or expanding Medicaid managed long-term services and supports (MLTSS) programs.
LTSS quality measures and monitoring activities are essential tools for consumers and states to ensure protections, enhance choice and plan performance, and align incentives to meet desired goals such as rebalancing or promoting options for self-direction.

This webinar is the first in a series that will promote learning and discussion to build the capacity of stakeholders on these issues.


  • Sarah Scholle, National Committee on Quality Assurance
  • Alice Lind, Center for Health Care Strategies

Space is limited, so please register early and share lines when possible. The webinar will be recorded and posted online.


The Friday Morning Collaborative is a coalition of national aging and disability organizations working together to protect and strengthen Medicaid home and community-based services. With support from The SCAN Foundation, the coalition is hosting ongoing webinars to provide information and resources to state advocates.

Learn More: Join Our HCBS Online Community!

A special group on the NCOA Crossroads online community unites state advocates in the aging and disability fields working to strengthen and protect Medicaid HCBS:

  • Share what's happening in your state. 
  • Communicate with advocates in other states and nationally. 
  • Get information and resources related to Medicaid HCBS.

Join us now—and after the webinar to discuss what you heard!

Thank you

A big thank you to Sandra Brushart and Sara Wilkinson for their suggestions of substantive changes.  We will be submitting the final copy for the printer's first draft this week.


Disaster Unemployment Assistance in Wake of Hurricane Sandy

Workers who lost their jobs as a result of Hurricane Sandy -- and who aren't eligible for regular state unemployment insurance, e.g., the self-employed -- may be eligible for Disaster Unemployment  Assistance, a federal program that provides up to 26 weeks of jobless aid.

To qualify, individuals must have lost their jobs as a result of a major disaster in an area so declared by the president.  To date, a number of counties in NY, NJ, and CT have been declared major disaster areas.  Check out our fact  sheet at for more info.

And be sure to visit NELP's Immigrant Worker Justice Blog at to read about how the storm has impacted immigrant worker communities on the East Coast.

Agenda for November 1 Public Benefits Task Force meeting

Please join us on Thursday, November 1 at 9:30 am for our next Public Benefits Task Force meeting in the second floor conference room in the Baltimore City office of the Legal Aid Bureau and via GoToMeeting. Below is the agenda for the meeting:


  1. Welcome and Introductions
  2. 2013 Meeting Dates
  3. 2013 MD Legislative session
  4. COMAR “authorized representative” regulation
  5. Problems with DHMH Board of Review
  6. Medicaid Advisory Committee update
  7. Language Access issues – recent meeting with DHR
  8. Human Rights discussion
  9. Sept-Oct Clearinghouse Review issue on hunger/food access issues
  10. conferences and trainings
    1. Social Security training in conjunction with DC NLS
  11. case staffings


Medicaid Hearings

At the last PBTF we discussed how the MA fair hearing regulations are being interpreted by OAH to mean that legal counsel must enter an affirmative statement entering their appearance at the time the appeal is filed or face exclusion from the case for its duration.  Paralegals are being asked for a power of attorney or something in writing from the client naming the paralegal as the authorized representative.  Now, we need your stories if you have been affected by this practice.  The stories will be included in letters to DHMH and OAH advocating for changes in the regulations and in how the regulation is being interpreted.  

Please email a synopsis of your experience to Francine Hahn at no later than Wednesday, October 24.

Thank you!


Public Benefits Task Force meeting on Thursday, November 1

On Thursday, November 1 at 9:30 am, we will be having our next Public Benefits Task Force meeting in the second floor conference room in the Baltimore City office of the Legal Aid Bureau and via GoToMeeting. Please contact me at by close of business on Wednesday, October 24 if you have any agenda items you'd like to add for the meeting. I'll circulate an agenda on Thursday, October 25 in advance of the meeting.

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We welcome your comments and suggestions