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Hutchinson Agreement
Hutchinson v. Patrick is a federal class action lawsuit brought on behalf
of over 9,000 persons with brain injuries who are unnecessarily
confined to nursing facilities in Massachusetts.
The agreement was initiated in 2008 and updated in 2013.
(Taken from Center for Public Representation; http://www.centerforpublicrep.org/litigation-and-major-cases/brain-injury/the-litigationhutchinson-v-patrick)
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As a result of Hutchinson Agreement, The Massachusetts
Rehabilitation Commission and MassHealth, in conjunction with
UMass Medical School and the Department of Developmental
Services, offer two home- and community-based services waivers to
help Medicaid-eligible persons with acquired brain injury (ABI) move
to the community and obtain community-based services.
In addition, MassHealth offers two Home- and Community-Based
Services (HCBS) waivers called the Money Follows the Person Waivers
(MFP Waivers), which helps Medicaid-eligible persons with a
qualifying disability move to the community and obtain communitybased services.
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DDS operates all 24/7 staffed Residential Programs associated with
the ABI and MFP waivers. The following models are as follows:
2-4 person group homes (most common)
Shared Living Services
Assisted Living
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Must be living in a nursing facility or a chronic or rehabilitation hospital and
have resided there for at least 90 days;
have experienced an acquired brain injury at age 22 or older. An acquired
brain injury can result from a stroke, brain trauma, infection of the brain
(such as encephalitis), brain tumor, or anoxia (lack of oxygen)*;
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meet the clinical requirements and need of the waiver services available; and
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meet the financial requirements to qualify for MassHealth. Special financial
rules exist for waiver participants.
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Must be able to be safely served and is defined as the ability to remain in the
community without risk of significant harm to self or others.
*See “What is an Acquired Brain Injury,” MFP Transition Entity Training—April 2014.
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Day service
Supported employment
Transportation
Occupational therapy
Physical therapy
Speech therapy
Specialized medical equipment
Transitional assistance
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Must be living in a nursing home or long-stay hospital for at least 90
consecutive days, excluding Medicare rehabilitation days
be 18 years old or older and have a disability, or be age 65 or older;
meet the clinical requirements for and be in need of MFP waiver services;
be able to be safely served* in the community within the terms of the MFP
waivers;
meet the financial requirements to qualify for MassHealth. Special financial
rules exist for waivers participants;
In addition to the above, to qualify for the MFP-RS waiver, you as an
applicant must need residential support services with staff supervision 24
hours a day, seven days a week.
*Safely served is defined as the ability to remain in the community without risk
of significant harm to self or others.
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Day Services
Occupational Therapy
Peer Support
Physical Therapy
Prevocational Services
Specialized Medical Equipment
Speech Therapy
Supported Employment
Transportation
Transitional Assistance
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A Transition Meeting is scheduled roughly 2-3 months in advance of
a person moving and is intended to make plans and troubleshoot
any issues in preparation for a participant’s move to the community.
There are typically 2 or 3 meetings depending on the needs of a
person. Common topics of discussion include:
Who will I live with?
Who will help me with my care?
Who will give my medications?
Who will order my medical equipment?
What if my family doesn’t want me to move?
What if my doctor doesn’t want me to move?
What if I’m not happy after I move?
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Social Worker
First point of contact
Tends to know the person well
Organizes the rest of the nursing home team
Nursing Staff
Knows the person’s medical needs
Knows the person’s personal care needs
Rehabilitation Department
Includes Physical, Speech, and Occupational Therapies
Have knowledge of equipment needs
Can order equipment through Masshealth
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Service Coordinator
Organizes all transition meetings
Serves as liaison between the Nursing Home, Provider, Participant,
and Family
Nurse
Consults with team about health concerns and how they will be
managed in the future residential placement
Risk Manager
Consults with team about present risk issues and risk issues that
may arise post-placement
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Program Directors
Consistent presence in the home
Can serve as liaison between staff, participants, and DDS Service
Coordinator
Nursing Staff
Ensures that staff are trained on necessary medical protocols
Monitor overall physical well-being of participants
Clinical Staff
Ensures that staff are trained on the mental health needs of
participants
Develops and implements Positive Behavior Support (PBS) plans
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Participant
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Family
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Legal Guardian
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Friends
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The Waiting Game
It takes an average of 354 days from enrollment to placement for
Provider Based Residential Placements
Weather, building permits, and other unforeseen circumstances
can delay a move
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Equipment
Depending on the needs of a participant, proper medical
equipment can take some time to order
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Finding new medical providers
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Medications
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Adapting to Community Living
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Relationships
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Lifestyle considerations
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Receiving help from other people
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Communal Living
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(play video)
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http://www.mass.gov/eohhs/consumer/insurance/moreprograms/acquired-brain-injury-waivers.html
http://www.centerforpublicrep.org/litigation-and-major-cases/braininjury
http://www.mass.gov/eohhs/consumer/insurance/moreprograms/mfp-demo-and-waivers/money-follows-the-personwaivers.html
http://www.mass.gov/eohhs/consumer/disability-services/livingsupports/community-first/money-follows-the-person-rebalancinggrant.html
http://www.biama.org/