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-litigation-hutchinson-v-patrick)

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 community-based services.

DDS operates all 24/7 staffed Residential Programs associated with the ABI and MFP waivers. The following models are as follows:

o 2-4 person group homes (most common)

o Shared Living Services

o Assisted Living

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)*;

meet the clinical requirements and need of the waiver services available; and

meet the financial requirements to qualify for MassHealth. Special financial rules exist for waiver participants.

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.

Day service

Supported employment

Transportation

Occupational therapy

Physical therapy

Speech therapy

Specialized medical equipment

Transitional assistance

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.

Day Services

Occupational Therapy

Peer Support

Physical Therapy

Prevocational Services

Specialized Medical Equipment

Speech Therapy

Supported Employment

Transportation

Transitional Assistance

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:

o Who will I live with?

o Who will help me with my care?

o Who will give my medications?

o Who will order my medical equipment?

o What if my family doesn’t want me to move?

o What if my doctor doesn’t want me to move?

o What if I’m not happy after I move?

Social Worker

o First point of contact

o Tends to know the person well

o Organizes the rest of the nursing home team

Nursing Staff

o Knows the person’s medical needs

o Knows the person’s personal care needs

Rehabilitation Department

o Includes Physical, Speech, and Occupational Therapies

o Have knowledge of equipment needs

o Can order equipment through Masshealth

Service Coordinator

o Organizes all transition meetings

o Serves as liaison between the Nursing Home, Provider, Participant, and Family

Nurse

o Consults with team about health concerns and how they will be managed in the future residential placement

Risk Manager

o Consults with team about present risk issues and risk issues that may arise post-placement

Program Directors

o Consistent presence in the home

o Can serve as liaison between staff, participants, and DDS Service Coordinator

Nursing Staff

o Ensures that staff are trained on necessary medical protocols

o Monitor overall physical well-being of participants

Clinical Staff

o Ensures that staff are trained on the mental health needs of participants

o Develops and implements Positive Behavior Support (PBS) plans

Participant

Family

Legal Guardian

Friends

The Waiting Game

o It takes an average of 354 days from enrollment to placement for Provider Based Residential Placements

o Weather, building permits, and other unforeseen circumstances can delay a move

Equipment

o Depending on the needs of a participant, proper medical equipment can take some time to order

Finding new medical providers

Medications

Adapting to Community Living o Relationships

o Lifestyle considerations

o Receiving help from other people

o Communal Living

(play video)

• http://www.mass.gov/eohhs/consumer/insurance/more-programs/acquired-brain-injury-waivers.html

• http://www.centerforpublicrep.org/litigation-and-major-cases/brain-injury

• http://www.mass.gov/eohhs/consumer/insurance/more-programs/mfp-demo-and-waivers/money-follows-the-person-waivers.html

• http://www.mass.gov/eohhs/consumer/disability-services/living-supports/community-first/money-follows-the-person-rebalancing-grant.html

• http://www.biama.org/