FAQs

Updated 6/25/2020

Re:  AARP tax assistance program   Many COA’s in our region are scheduling make-up tax assistance appointments with their AARP volunteers.  For those of us whose volunteers have contacted us to say they will not be providing appointments, what does AARP want us to tell seniors with cancelled appointments?  One of the regional AARP volunteer coordinators recommended referring them to neighboring towns whose AARP volunteers are offering appointments.  However, those towns are already full or near capacity.  Our Center has 30 seniors with cancelled appointments, the vast majority of whom have said they cannot afford to pay privately or don’t have the device or knowledge to use a free online service.  Referring them to other towns with waitlists is extremely frustrating for them and we anticipate they will call us again as the deadline nears. Where can we refer them?  Thank you.   This is a case where there aren’t any good answers – at least in the short term.

However, many people are worrying unnecessarily.  It’s important to note that the IRS and DOR typically do NOT penalize taxpayers who file late unless they owe or buy insurance from the health care marketplace. Very few of our seniors fall into the category.

So there are really three options: prepare your own return (or have a friend/family member do it), go to a paid preparer, or wait.

Fortunately, the tax law has not changed significantly from last year to this. If you look at our typical population – that is, seniors with social security, pensions, IRAs, interest/dividends, and on Medicare – IF (big if) their income has not changed significantly – their return will likely we very similar to last year – and their refund or amount owed will be about the same.

So taxpayers need to look at their individual situation.  First – check their last year’s return…..what was their income and did they owe or get a refund?   Did their income change significantly (cost of living increases aren’t really significant) from last year?  If it’s comparable to last year and they got a refund – most likely they’ll get one this year and it’s not big deal to file late.

The people who really need to really make a decision are those who a) have significant changes in income, b) have investment income and consolidated statements from their investment firm, and c) typically owe.

I know it’s not the answer anybody wants. One of the issues this whole shutdown has highlighted is the face that so few people have a fundamental understanding of basic tax law and what it means to them [I am a huge proponent of everyone understand the basics – especially their own financial situation – and that applies to both spouses in a couple.  One of the saddest things ever is when a recent widow/widower comes in and has not idea what his/her situation is.]

 

Whatever AARP decides re: running a tax aide program this year, please put the details in writing so we know how to answer seniors’ questions.  If their plan is to go totally remote,

  1. Will they be able to handle returns for seniors who do not have computers or smart phones? 
  2. Will they be relying on COA’s in any way, e.g. delivery, pick up of forms?
  3. Will they pay for and use phone interpretation services?
  4. Cybersecurity issues?
  5. If they intend to provide services in senior centers, will AARP provide appropriate PPE?  Social distancing will require limiting numbers of clients seen concurrently.
  6. If the senior center is not yet open to the public, will they find another space for face to face meetings?
  7. Will their capacity be reduced?  Certainly, if they are depending on COA’s as “runners” it must be reduced.
  8. I believe this program is run differently in different regions.  For Worcester, it is not unusual for 400-500 clients to be served.  The Tax Aide volunteers do all the scheduling/rescheduling and we’d hope that would continue this year if started up again.

We are concerned that if our Centers aren’t allowed to host programs and activities until July 1st, this leaves very little time for all those who still need help with their tax filing and had appointments cancelled due the crisis, and would likely leave many unserved.  Should there be consideration for allowing this program to resume earlier, perhaps in June, in order to meet the need?  Will each community be receiving communication from a local coordinator about when and how the program will move forward?

National guidelines to reopen site are in progress and will be shared once finalized. Intent to reopen those we possible as well as volunteers, safety protocols. Will consider alternate location that meet all the criteria of parking, online access, accessible, etc. Minimum of two certified preparers per site. Volunteers are looking to procure their own PPE. May need to ask COA for help acquiring those. Since space is important, we may have change in workflow resulting in fewer returns. Unsure how many taxpayers in need right now. Scheduling via volunteers is expected to continue. Can’t commit every site will reopen. Talk to tax aid site leader for coordination.

Over 600 volunteers statewide ready to assist. The commitment is there. The practical challenges are the barrier where solutions are being reviewed. If centers are not going to be open through the tax season, what would MCOA want as messaging and completion of the tax returns ~70% of tax aid filings last year completed them this year before closing, assume others went elsewhere but what is the hope/expectation AARP’s program can look like if centers aren’t open. If members have thoughts/questions please send them in to coronavirus@mcoaonline.com. Please connect with town administrators and BOH regarding the needs of AARP to reopen this program for individuals (not the general public). If centers are not available, can other locations be identified? Sprint to meet July 15 deadline.

2020 Census 

On June 25th, MCOA was joined by  Uriel (Uri) Molina, Census Specialist, for the Information Technology Division of the Office of the Secretary of the Commonwealth of Massachusetts, and Lisa Moore, Assistant Regional Census Manager of the New York Regional Census Center, who provided an update on Census activity in Massachusetts. The hotline for any Census questions about information, avoiding scams, etc. is 833-621-2020. Todays information can be seen here.

David reminded everyone that COAs should post Census information on their social media sites, and that the next 90 days are critical to impact the final count. Whatever count is completed by the end of this year, will govern the count through the FY32 budget.

 

GENERAL

We’ve been getting a lot of calls from Seniors this week and they are asking why our lunch program isn’t open because restaurants are open for “inside  dining”? Can you please share your thoughts and ideas on how best to respond to these inquiries?  Verbal guidance EOEA has provided on this matter includes: if the COAs or your agency wants to open, and has the permission of the LBOH, the meals should be individually packed (HDM format), and operate like a lunch club. Outdoors is the best.  The nutrition program recommends operating at 30% of the capacity for dining in. If you are planning to operate dine-in, please follow and modify the restaurant guidelines (https://www.mass.gov/info-details/safety-standards-and-checklist-restaurants) to suit your operation.  The Governor’s Reopening plans also requires all businesses to have a COVID-19 control plan in place. These plans do not need to be submitted but need to walk through the process internally.​Restaurant patrons can sit regularly at tables that are spaced 6’ apart but this may not be the same at centers. David reminded everyone that they can contact tara@mcoaonline.com for nutrition questions as well.

Currently there is a State of Emergency that has been declared on a National and State level (to the best of my knowledge).  Is there any insight as to how long this will be the case.  If Massachusetts enters Phase 4 – will that mean the state of emergency has been lifted?  Any insight on the federal level’s lifting of the state of emergency?  The State of Emergency was issued by Governor Baker on March 10 in response to the COVID-19 virus.  The response was very quick and the State need to ramp up very quickly.  Although EOEA is not privy to the State and Federal decision making, we know that the Governor has said that this process is not a sprint and that we are in this for the long haul.  The data changes daily with the virus and that we are in the 1st part of Phase 2.  The Governor will go forward or scale back according to the data.  The whole State has responded to the precautions: wearing masks, handwashing, small groups, staying at home, etc.  This guidance has gotten us to where we are today.  As this is the first time we are facing something like this, we have to stay the course.  Regarding reopening Senior Centers, EOEA advises keeping a Contact Tracing log, sanitize, sanitize, sanitize, and keep in the forefront of our minds that we need to support each other put the brakes on when needed, proceed cautiously and embrace positivity.

 

FUNDING/FORMULA GRANT RELATED

Is anyone at MCOA or EOEA working with the governor or the federal government regarding the financial impact on the COA’s, with the costs associated to keep high risk seniors safe in their centers. Will there be more than Formula Grant funds available for cleaning supplies (etc.), will there be additional reimbursement to ASAP’s and the COA’s they contract with for SDP and transportation services. How will this impact intergenerational programs?  At EOEA we are looking at formula funding for FY21 and we’ve shared that we won’t know the final Formula grant funding level until the final General Appropriations Act (GAA) for FY21.  There is no information available at this time about providing additional funding for supplies for local communities but no doubt this is on the radar of the task force looking at reopening efforts of businesses and programs across the Commonwealth. Regarding Supportive Day Programs (SDPs), EOEA is aware that MCOA has created a task force on SDPs and we look forward to learning more from that group.  In addition, EOEA is working with MCOA to schedule a meeting over the next couple of weeks to learn more from MCOA about SDP and what future programming in this area will look like as senior centers re-open later in the year through a phased in approach.  Moreover, agencies are encouraged to continue working with local leaders in your cities/towns on what planning may be going on now in your communities to support municipal agencies with the supplies they may need to re-open. Everyone should keep a ledger of additional COVID19 costs. We don’t know if anything will be reimbursed but include additional cleaning costs, station at entrance to dispense mask/gloves, etc. Include disposable goods for grab-and-go, keep receipts. We want to have a cost projection of what the network has incurred and be prepared to share it with local government when the time comes.

Can we keep Formula grant at $12.00 for FY21? This will help us to keep staff employed (as we have been told we will undergo municipal cuts to our budget).   EOEA does not know the answer to this question until the final General Appropriations Act. Communities should plan as they have in the past and base formula grant funding on the prior year amount. All funding needs to be spent by June 30th. Please continue to submit questions relative to formula grant to Adam Frank and Emmett Schmarsow for review. Keeping a list of requests and uses as an opportunity to learn and future planning.

Would there be a willingness for EOEA to work with COAs to restructure supportive day care reimbursements should it be possible to offer individualized or small group respite services instead of larger scale supportive day care services?  EOEA would like to learn more from the COAs on this matter and will reach out to MCOA to set up a time to discuss further.

Will COA’s still need to spend down our 2020 formula grant by June 30th?  Yes, all funding needs to be spent by June 30th.

Most of my formula grant money is used for part-time staff salaries.  Can EOEA provide any information on the fate of the formula grant?  Will there even be a grant in FY21?  If so, can you ballpark a per elder amount?  I need some guidance and sense of potential funding (or not) as we are quickly approaching the July 1 date.  We do not know the answer to this question until the final GAA.  Communities should plan as they have in the past and base formula grant funding on the prior year amount.

Can formula grant money be used to purchase account with Zoom Meeting or other virtual platforms?  Yes, however please continue to submit questions relative to formula grant to Adam Frank and Emmett Schmarsow for review.

RE-OPENING SENIOR CENTERS

Has been any talk about cooling centers and senior centers’ role in them this year.  Our Library usually serves as the cooling center. They are not open, and they are a bigger operation to staff up if they did need to open.  So we are being asked our thoughts on the senior center functioning as the cooling center until such time the demand grows beyond our space and then they would open up a bigger building if needed.  I am concerned that once we open our center like this, that there is no turning back from the seniors point of view. I am afraid we would have seniors coming to be with others and not so much to cool off. I am worried about optics of opening for this and then needing to close the door again and the emotional impact that could have. COAs and senior centers should work with their local town officials and LBOH in determining if centers should open as cooling centers.

The Governor’s and the state’s language about “safer at home” is clear for the population served by Councils on Aging, and it provides clear guidance for older adults to use in making personal decisions. However, there is a great deal of frustration for Councils on Aging because there is no language about our facilities in the state’s reopening report. We all serve the very population most at risk from this pandemic, yet there is a complete lack of clear, consistent guidelines for us to plan around. Public libraries knew they would begin to reopen in Phase 2, fitness centers know they will reopen in Phase 3, bars know they can’t reopen until Phase 4, but COAs facilities and senior centers aren’t even mentioned Governor’s Order Clarifying the Progression of the Commonwealth’s Phased Workplace Re-opening Plan. It feels very much like we’ve been left to figure it out for ourselves, and without clear and consistent guidelines, it is fair to assume some COAs may consider hosting activities that others consider inappropriate or risky, while some will be judged for playing it “too safe”. Will the state provide clearer guidelines for COA’s?  Why or Why not?   EOEA understands that COAs and senior centers are not the first out of the gate and all your thoughts and concerns are being shared with the Secretary and also with EOHHS leadership as we work together to ensure a safe opening across community programs for older adults across the Commonwealth. There is much to learn from other sectors who are  at the beginning stages of reopening; including, child and youth programs (guidance released last week). As the Governor’s May 18th “Safer At Home Advisory” continues as one of the guiding principles for COAs and senior centers, it is important to think about the populations served through senior centers (consider the differences of all – programming, services, space, staffing, etc..) and what reopening looks like in assessing risk. It is safe to say that some COAs may consider hosting activities based on their readiness and others may not be at that same point to resume certain activities. Readiness is based on your unique communities and overall assessment of what is needed to safely reopen programs. There is no judgement. This specific question was raised with the Secretary about providing guidance for COAs. EOEA will share with MCOA as information is made available. Your voices are heard and there is no oversight by the administration. The challenges still exist for us and we want you to open safely.

There are some concerns in the field that MCOA wants to share. Language needs to be very concise. Ensure the information you have is first-hand and accurate. MCOA is asking EOEA to take this back to their leadership, to please mention COAs specifically in the next announcement as many other industries were noted explicitly (libraries, bars, restaurants, etc.). It would be helpful to hear where in the Governor’s plan, COAs fit  and it would be helpful for our communities to be mentioned and to decrease stress levels. MCOA does not regulate what the COAs do. COAs differ dramatically and this must be considered with as recommendations are loosened. It is clear that older adults and those with pre-existing conditions should remain safer at home at this point. Scaling up Operations guidance will be posted shortly and will include Operations Plans and Communications Plan for; Transportation, Senior Centers and  Remote Programming.

Do you expect that centers will be asked to temporarily relocate upholstered furniture to discourage people sitting closer than 6’ apart during the first months of operations?   Identify your spaces, activities, walk through with your public health partner. Do this before you open the doors for even a small number of visitors. Prepare your center over the next 6-18 weeks as ‘partially opened’. All surfaces are of concern and we ask you rely on your public health partners as well as take the questions back to DPH leadership.

Will it be safe to have people use the MySeniorCenter touch screens as long as they sanitize their hands first? Some COA’s have more than one solution in place. For example, cover with plastic AND use sanitizer. Swipe card but don’t touch the screen indicating the program. Can the card be reprogrammed for contact tracing? We don’t want to damage the equipment by cleaning it. Sanitizing stations at front door for those in need. Can also use hand-held scanner.

I am curious if anyone has addressed covid-19 testing for COA’s. To your knowledge, is this possibility being explored? Governor Baker spoke to expanded testing today. Universal testing will not be in place for opening the state. But as we expand there may be more requirements for employers such as those with close contact with confirmed cases. Check DPH and Governor’s website for more information including the testing facilities and their phone numbers. Need to determine who will need testing by priority.

We  are planning to purchase now, the supplies needed to reopen; supplies that will be needed to keep seniors and staff safe, could EOEA advise us what supplies we should be purchasing? Cleaning/sanitizing equipment plus LBOH recommendations. Confirm the correct items with your LBOH and governing body since other municipal buildings will have similar needs.

I would like to know where Councils on Aging fall, in the Four Phases of Reopening that the Governor released on Monday. Unlikely that the COAs are part of the early group. Reopening will be slow and deliberate, acknowledging this is a difficult time. Do not want to put Older Adults at risk. Remember every time there is a phase in place, there is a pause to review any changes/confirm we can move forward.

My town administrator is somewhat relying on me  to provide guidance about what to do with our center, so it would be really helpful to have more guidance from EOEA on reopening.  Glad the administrator recognizes the director as a leader and looking for guidance. Take the checklist and reopening plan (discussed next week) to develop your own local plan. Each center is unique in every way.

Do you expect that centers will be asked to temporarily relocate upholstered furniture to discourage people sitting closer than 6’ apart during the first months of operations?  This question triggered my checklist for formal and informal gatherings and touchpoints. Identify your spaces, activities, walk through with your public health partner. Do this before you open the doors for even a small number of visitors. Prepare your center over the next 6-18 weeks in preparation for becoming ‘partially opened’. All surfaces are of concern and we ask you rely on your public health partners as well as take the questions back to DPH leadership.

Will it be safe to have people use the MySeniorCenter touch screens as long as they sanitize their hands first?  Consider reaching out to MySeniorCenter for feedback on the monitor cleaning and/or covering and review again with BOH, also some situations have more than one solution in place. For example, cover with plastic AND use sanitizer. Consider having participants’ swipe card but not touch the screen indicating the program. We don’t want to damage the equipment by cleaning it. Sanitizing stations at front door for those in need. Can also use hand-held scanner (Melrose COA recommendation – approximately $800)

I am curious if anyone has addressed covid-19 testing for COA’s. I think it is too late to ask the question today – and maybe it has already come up. To your knowledge, is this possibility being explored?  Governor Baker spoke to expanded testing today. Universal testing will not be in place for opening the state. But as we expand there may be more requirements for employers such as those with close contact with confirmed cases. Check DPH and Governor’s website for more information including the testing facilities and their phone numbers.  There has been a lot of discussion around Thermal scanners ($3K) however this should reminding us that many don’t show symptoms and one can be negative one day and positive the next. Tests are different between if you have the virus or the antibodies. Need to determine who will need testing by priority. Can send guidelines and testing facilities to everyone.

We are planning to purchase now, the supplies needed to reopen; supplies that will be needed to keep seniors and staff safe, could EOEA advise us what supplies we should be purchasing? Cleaning/sanitizing equipment plus LBOH recommendations. Confirm the correct items with your LBOH and governing body since other municipal buildings will have similar needs.

I would like to know where Councils on Aging fall, in the Four Phases of Reopening that the Governor released on Monday.  It’s unlikely that the COAs are part of the early group. Reopening will be slow and deliberate, we acknowledge this is a difficult time and do not want to put Older Adults at risk.  Remember every time there is a phase in place, there is a pause to review any changes and then confirm that we can move forward.

My town administrator is somewhat relying on me to provide guidance about what to do with our center, so it would be really helpful to have more guidance from EOEA on reopening.  Glad the town administrator recognizes the director as a leader and looking for guidance. Take the checklist and reopening plan (discussed next week) to develop your own local plan. Each center is unique in every way.

My question is whether there are guidelines for senior centers in phasing re-openings of public spaces.   ​To follow up from past calls on this topic, the Governor has formed a task force to look at re-opening Massachusetts and look forward to the guidance that will come from that group’s work.  I think we should expect that there will be guidance from the task force, DPH, local boards of health and town officials.  EOEA will provide what we learn to MCOA as the work evolves around planning to re-open Massachusetts. ​ The Secretary also met with the MCOA Board yesterday and she talked about re-opening and what that might look like.  She shared a slow reopening of the economy in keeping with the public health principles and that we will be looking for your (MCOA) recommendations and do not want to jeopardize the health and safety of seniors.  Dave Stevens shared that you are all also looking at being “back to normal” in 12-24-month timeframe, and the availability of a vaccine is helpful in decision making. Dave also reminds us COAs are part of the community and operating even though centers are physically closed. David noted as we open, we’ll phase in different programs as they are appropriate/allowed. We may open and need to closed again if there’s a need.

Some of the most recent language states that decisions are to be made by municipal governing bodies, which we fully understand.  However, many of our communities are actively creating reopening plans which must be finalized in the coming week, pending the release of the Governor’s plan, and administrators are actively seeking COA input now.  We recall hearing that the state, MCOA and NCOA would be having discussions.  Will there be guidelines or recommendations released in the near future regarding what should and should not be allowed at senior centers for the safety of those we serve?  And if so, what will the release date be for this information?  Remind folks to err on the side of caution, slow openings, small groups, less physical exertion, etc. We are taking a slower approach than some municipalities. COAs may be one of the last departments to open due to the population served. Would be concerned if senior centers are opening before July 4 considering schools are closed through June. Expect mid- late- summer. Be cautious since you’re putting at-risk people together in a closed environment.

Would MCOA or Elder Affairs be able to make available cohesive information on the new “fogging” sanitization systems for senior centers, particularly for those who operate vehicles for transportation services?  Is there a purchasing collaborative which could be harnessed for COAs?  Are there safety concerns regarding the chemicals for the driver or riders?  Are there recommended sanitization products which we should be using?   COAs should work with their local boards of health on fogging sanitation systems in senior centers. Governor set up a task force and more will come.

I am not sure if you will be able to answer this or if this is the correct forum. I was just wondering that the State recommendation is now for Senior Centers re opening. We closed down as soon as the schools did, so now them not returning this year, I am curious what the means for the Centers.   At this time, the state is focusing on the coronavirus surge and staying the course each day as the situation evolves.  It is safe to assume that state and local governments will work together in a thoughtful and smart way with planning to return to work and the re-opening of COAs and senior centers.  ​

I am writing to ask about re-opening our Centers in our new normal. It is obvious to me that planning large events is not prudent in the near future. I am concerned about managing small events such as meals and exercise.  The Coronavirus has effected about peoples mental health;  loosely my concerns are people who fall one of two extreme camps, those that are  terrified of Covid-19 and those that still think this is a hoax. This divide could be difficult. In short how to program to respect differences, and maintain a safe environment  and function efficiently on a small scale.   At this time, the state is focusing on the coronavirus surge and staying the course each day as the situation evolves.  It is safe to assume that state and local governments will work together in a thoughtful and smart way with planning to return to work and the re-opening of COAs and senior centers.

When can we could expect even some preliminary guidelines for COAs moving forward from MCOA, EOEA, and NCOA?  When can we expect that decisions will be made to provide us with guidelines regarding what might be allowed, what shouldn’t be allowed, etc.?  David Stevens Responded for MCOA: Expect not to be open for the rest of fiscal year and COA’s should operate as you have over next few weeks. We will watch public health indicators going forward. Many task forces working on this as NCOA is looking at what criteria should be used for reopening. Expect to have some recommendations over the next 4-6 weeks. Reopening will remain a local decision and may be more of a regional approach, we doubt the entire state will open all at once. MCOA will work with administration to help create guidance and guardrails regarding reopening. It may take a few weeks to figure out. Meanwhile, we are asking members to look at the full curriculum of their programming and decide what can/can’t go online, small v. large groups. It is not going to be an easy answer and there are many different ways to execute.

PROGRAMMATIC INFORMATION

Are there any ideas for best practices to get the card games & mahjong games at 4 ft tables going again at some point.  Any games like that have multiple times that people are touching the same items.  Even before Covid19 I had seen people blow their noses and then touch the tiles.  I don’t see it being much different as far as habits they have.  Current guidance for social distancing would not include 4’ tables. Materials being used for this and these types of programs, which require sharing  of materials are probably not  appropriate at this time. This is being worked on at casinos. Look into those guidelines. Look at electronic gaming such as those done in Agawam. Look at online games as an option. Can you assist setting up OA at home? While this will not meet the needs of everyone, it will help some. Also mahjongg players can continue to play without being with people or using tiles. You play on your computer and play with yourself, join a table that is already set up with other people or set up a private table and have your friends play with you. The site is: www.Myjongg.net  You do need to register. This is a free site. That being said, it gets very busy and you might have some connectivity issues. There is a premium site which costs 4.99/mo. www.myjonggpremium.net

Are folks requesting a liability waiver when transporting clients to either medical, shopping,    personal or travel (Liability for taking part in the transportation service)   EOEA is not requesting these waivers. EOEA recommends that COAs work with their local city/town solicitor on this matter. Make sure your town solicitor or administrator is involved in this if this is the route you go.

We are trying to figure out how to use Tax Work-Off starting in July..   Susan Carp is gathering information from those who use it and what’s allowed – wellness check, grab-n-go, etc. She will report out. Please share if you have alternatives: susanc@mcoaonline.com

Is there any collaborations happening regionally among COA’s?   Weekly regional calls to share ideas solving difficult problems. Collecting these best practices as well as others you are working on so we can share.

Zoom concern:  Some of my seniors do not have internet access but WOULD participate by dialing the phone number, i.e. I would like to set up a Party Line/conference phone call for my Daycare participants, many of whom do not have internet but who could participate over the phone. The free version of zoom doesn’t provide a call in number and other versions of Zoom generate call-in numbers but they are out of state and thereby toll calls, I have no way of knowing if our Daycare participants have long distance service and don’t want them to be charged for the call. There is a “Toll Free” option for Zoom but there is an additional charge of about $100. So (1) How can COA’s purchase a Zoom Account with all the bells and whistles when our municipalities don’t provide many of us with a credit card?, and (2) Can MCOA intervene somehow to allow for these purchases and bill COA’s who may be interested?  We are actively trying to find solutions such as the Comcast Essentials programs. Will get them out as we find them but as you know, it is difficult. Lynn Wolf will investigate and report on this next week.

Is there anything EOEA/MCOA can do to help us make our legislators realize that what we’re being asked to do is unrealistic, especially this year? Assuming that doesn’t happen, what advise/suggestions do you have for us going forward?  The Administration is aware of the extraordinary efforts of COAs. MCOA is making the case to the legislators in a June letter outlining the change in services, challenges, impact, etc. and hope to find remedies as we move forward. EOEA is in tune and knows there is more to do and be concerned about. We need to look at things more creatively while remaining sensitive to ongoing asks, questions and concerns. Our legislature supports older adults overall and we should take comfort in that. Trying to market those talking points which show what COAs are doing. We need to show our services and employees are essential and need to be fully funded. Send me your front-line talking points to reinforce this. The anecdotes are needed: david@mcoaonline.com. This will strengthen the June letter.

If we will be dealing with another round of COVID in the fall, I have a great deal of concern about how we as SHINE Counsellors will continue to provide assistance during Open Enrollment in a way that is safe to our seniors and for our staff and volunteers (many of whom are seniors themselves). Part D drug forms and other documentation must pass through our hands back and forth and I have concerns about contamination both ways. With many of us expecting budget cuts, we may be losing SHINE staff.  The SHINE Program Regional Directors (RDs) and some paid staff are handling the bulk of the calls now and the safety of the counselor and the consumer are priorities. The SHINE team at EOEA is not anticipating a huge rush during Open Enrollment (OE) but are seeing a lot of people now who lost their jobs, are going on unemployment and need Medicare information. Our concern about counseling capacity during OE resulted in development of a counselor survey to determine who feels comfortable going forward, if they want technology training and in what capacity they would like to work on during OE. These surveys are sent by the SHINE RDs and at different times based on the RDs ability to get them out. Results should be coming in within the next month.

In addition, SHINE expects services to be via phone and email counseling with face-to-face only in special circumstances and with protection in place. Due to the loss of the type of counseling they enjoyed or due to their own risk factors,  some programs are anticipating a loss of 50% of their counselor teams while others are confident they will retain most of them. In spite of the new on-line training protocol, we are continuing to train new counselors in several regions so we are feeling there is reason to be optimistic about counselor availability.

Regarding the handling of documents, we would expect more guidance from LBOH, DPH and the CDC as part of the reopening phases. In years past, the regions sent a pre-enrollment sheet to previous consumers to complete and return to the counselor, who would do the drug plan search and return the top recommendations to the consumer – we may need to rethink this. Gloves should also be available for the consumer and counselor when handling documents. We have more to learn about handling materials and the exposure and risk of the virus on different surfaces.

At this time, SHINE is not aware of any potential cuts from the federal level. The program is funded through the end of the fiscal year and EOEA is prepared to issue contracts to sustain funding in FY21. There is always a risk with any state or federally funded program but at this time, we are not aware of a risk to SHINE.

Moreover, it is understandable that there may be counselors worried about the short OE time frame but the state office feels certain that the SHIP Steering Committee and Directors, along with other organizations will encourage CMS to extend the current Disaster Special Enrollment periods for people who missed an enrollment period or made errors to sign up for B, C and D as long as possible, and for consumers to have the ability to change plans through early 2021.

My question for this week is more of a follow-up from one of the issues discussed last week. We are also trying to figure out how to use Tax Work-Off starting in July. Given the need to continue to social distance, we certainly are going to continue to use volunteers for wellness checks. Would like to see MCOA continue to discuss creative options.  Go back to three steps outlined above to determine when you reopen portions of senior center and which components you can pull off. Susan Carp is gathering information from those who use it and what’s allowed – wellness check, grab-n-go, etc. She will report out next week on this. Please share if you have alternatives: susanc@mcoaonline.com

Is there any collaborations happening regionally among COA’s?  Weekly regional calls to share ideas solving difficult problems. Collecting these best practices as well as others you are working on so we can share.

Zoom concern:  Some of my seniors do not have internet access but WOULD participate by dialing the phone number, i.e. I’d like to set up aconference phone call for my Daycare participants The free version of zoom doesn’t provide a call in number and other versions of Zoom generate call-in numbers but they are out of state and thereby toll calls, I have no way of knowing if our Daycare participants have long distance service and don’t want them to be charged for the call. There is a “Toll Free” option for Zoom but there is an additional charge of about $100. So (1) How can COA’s purchase a Zoom Account with all the bells and whistles when our municipalities don’t provide many of us with a credit card?, and (2) Can MCOA intervene somehow to allow for these purchases and bill COA’s who may be interested?  We are actively trying to find solutions such as the Comcast Essentials programs. Will get them out as we find them but as you know, it is difficult. Lynn Wolf will investigate and report on this next week

Is there anything EOEA/MCOA can do to help us make our legislators realize that what we’re being asked to do is unrealistic, especially this year? Assuming that doesn’t happen, what advise/suggestions do you have for us going forward?  The Administration is aware of the extraordinary efforts of COAs. Making the case to the legislators in a June letter outlining the change in services, challenges, impact, etc. and hope to find remedies as we move forward. EOEA is in tune and knows there is more to do and be concerned about. We need to look at things more creatively while remaining sensitive to ongoing asks, questions and concerns. Our legislature supports older adults overall and we should take comfort in that. Trying to market those talking points which show what COAs are doing. We need to show our services and employees are essential and need to be fully funded. Send me your front-line talking points to reinforce this. The anecdotes are needed: david@mcoaonline.com. This will strengthen the June letter.

I continue to provide telephone counseling for SHINE calls that continue to come into the office.  The Open Enrollment timeline is already extremely difficult because of the growing number of seniors that need to be seen, SHINE Counsellors (both paid staff and volunteers) have been struggling to meet demand for SHINE Counselling during Open Enrollment. We barely have time to get it done now, If we will be dealing with another round of COVID in the fall, I have a great deal of concern about how we as SHINE Counsellors will continue to provide assistance during Open Enrollment in a way that is safe to our seniors and for our staff and volunteers (many of whom are seniors themselves). Part D drug forms and other documentation must pass through our hands back and forth and I have concerns about contamination both ways. With many of us expecting budget cuts, we may be losing SHINE staff. Previous discussions to change and/or extend the timeline for Open Enrollment to allow more time to make sure everyone has access to counselling have fallen on deaf ears.  The SHINE Program Regional Directors (RDs) and some paid staff are handling the bulk of the calls now and the safety of the counselor and the consumer are priorities. The SHINE team at EOEA is not anticipating a huge rush during Open Enrollment (OE) but are seeing a lot of people now who lost their jobs, are going on unemployment and need Medicare information. Our concern about counseling capacity during OE resulted in development of a counselor survey to determine who feels comfortable going forward, if they want technology training and in what capacity they would like to work on during OE. These surveys are sent by the SHINE RDs and at different times based on the RDs ability to get them out. Results should be coming in within the next month.

In addition, SHINE expects services to be via phone and email counseling with face-to-face only in special circumstances and with protection in place. Due to the loss of the type of counseling they enjoyed or due to their own risk factors, some programs are anticipating a loss of 50% of their counselor teams while others are confident they will retain most of them. In spite of the new on-line training protocol, we are continuing to train new counselors in several regions so we are feeling there is reason to be optimistic about counselor availability.

Regarding the handling of documents, we would expect more guidance from LBOH, DPH and the CDC as part of the reopening phases. In years past, the regions sent a pre-enrollment sheet to previous consumers to complete and return to the counselor, who would do the drug plan search and return the top recommendations to the consumer – we may need to rethink this. Gloves should also be available for the consumer and counselor when handling documents. We have more to learn about handling materials and the exposure and risk of the virus on different surfaces.

At this time, SHINE is not aware of any potential cuts from the federal level. The program is funded through the end of the fiscal year and EOEA is prepared to issue contracts to sustain funding in FY21. There is always a risk with any state or federally funded program but at this time, we are not aware of a risk to SHINE.

Moreover, it is understandable that there may be counselors worried about the short OE time frame but the state office feels certain that the SHIP Steering Committee and Directors, along with other organizations will encourage CMS to extend the current Disaster Special Enrollment periods for people who missed an enrollment period or made errors to sign up for B, C and D as long as possible, and for consumers to have the ability to change plans through early 2021.

We have learned that our local Healthy Living program laid off their coordinator, which leaves us without anyone to coordinate the evidenced based programming in our region.  What is the status of the Healthy Living programs in other areas of the state?  We are wondering what will happen to all the Title III funding designated for evidence based programs, could it be redistributed?  Will there be efforts to move any of the evidence based programs to online formats which the COAs may then publicize and/or host?  The following is from Ted Zimmerman, AAA Planner at EOEA:  The funding provided to the AAAs via the Title III Funding Formula will not be redistributed in relation to underspending by particular AAAs or in particular areas.  Unspent Title III-D funding for evidence-based (EVB) programs that remains unspent in FFY2020 (through 9.30.2020) will be carried over into FFY2021 (at the AAA level). EOEA also spoke with Jen Raymond, of the Healthy Living Center of Excellence, who shared that many of the community partners who deliver programs are pivoting to virtual delivery:  Telephonic CDSMP, Zoom CDSMP, Zoom Tai Chi, Telephonic Healthy IDEAS for example. In order to do this, the delivery orgs (like the COAs) have to follow the guidance from the program developer.  They’ve shared that to all their partners on the HLCE listserve but here it is now:  http://www.eblcprograms.org/about-us/news/.  The key is that folks can’t just run off on their own and do the programs anyway they like.    They are pulling together a “workgroup” of CBOS to discuss and problem solve implementation challenges.  There will be more info about this in the coming days.  If any of the COA folks are interested in participating, they can reach out to Jen Raymond.  HLCE will be adapting their reimbursement to CBOs to allow them to be “paid” for remotely delivery.  ACL has shared that they will allow remote delivery of approved programs until September 2021 (not 2020).

What are other towns doing with their Tax Work Off program during this time of Covid 19. We are currently not allowing any participants to work in their placements nor are we creating different placements. We are thinking about how to make use of these participants in the long term but have not determined how and when this might be possible exactly but my hope is that they may be able to help with remote work if we can arrange this.  If you have data or even an idea about how other communities are managing tax work off programs now can you let me know?  Susan Carp will look into this and ask members to report back on how you’re using your Work Off programs. We will compile a list of suggestions and share it with members, likely on resource page list. Membership, please respond.

We would like to see a standard on line waiver for all fitness classes throughout MA.  Can EOEA can create a standardize waiver that we can implement?  This falls outside of EOEA’s oversight. COAs should work with local town officials and their city solicitor within their city/town.

Could EOEA develop a campaign/marketing for elders to complete census?  The census is overseen by the Secretary of State in Massachusetts and there is a campaign underway to educate and inform citizens of the Commonwealth to complete the census.  There are brochures that can be downloaded from the Secretary of State website to share with communities.  https://www.sec.state.ma.us/census2020/index.html

Could we please have an official update from the state AARP Tax Aide Program regarding plans moving forward.  We are continuing to receive calls from the public wondering if they will have an opportunity to have their taxes completed at the beginning of July, or should make alternative plans.  Some COAs have received informal communication from their volunteer counselors, but releasing this information to the public cannot wait much longer as we need to give people time to make informed decisions about what they should do regarding filing their taxes.  The AARP Foundation who oversees this program, is developing a plan and hoping for a Jun 1 date. But how it looks is still TBD. Privacy rights, online information and physical distancing are still issues. AARP will join us Thursday May 7th, at the top of the hour to hear for an update. Briefs will carry subsequent updates.

Would EOEA or MCOA consider making a video for older adults regarding the COVID crisis which we could link to from our respective COA websites?  COAs are encouraged to review information and guidance on the mass.gov/covid19 website and to share information with older adults in their communities. The MA Department of Public Health and the CDC oversee information and guidance on COVID19. https://www.mass.gov/info-details/covid-19-updates-and-information

Would MCOA ever consider making some canned but professionally done programming available to COAs for viewing on local cable access stations or as links on social media or websites?  Yes, a task force is working on this as we speak. Looking at programming to meet needs of older adults in the community, online programming and how to access and download and offer and use on cable as well. Lynn and others looking at zoom tutorials and to transfer programming online. We will get more tools and subject matter to you when it is ready.

Our center will continue to be closed to the public until July 1st.  We are looking to bring back staff/volunteers (especially in our Daycare programs) sometime in June but realize life in a senior center as they knew it, is no more.  We will need to do a significant amount of training prior to reopening.  Many of us are at different levels with staffing/volunteers so training required for one center may/may not be required at another.  We will continue to follow the guidance of our Governor, DPH, CDC, Elder Affairs, EMA, Board of Health etc., but training will be MCOA has talked about increasing trainings.  I think it would be a good idea for COA’s and Supportive Day programs to start compiling a list of trainings being offered and who/where we can obtain the trainings.  (e.g. MCOA, EMA, Fire Department, Town Nurse, Alzheimer’s Association etc.).

    1. Is MCOA planning to include COA Staff/Volunteers?
    2. Will it include:
      1. COVID-19 Training – prescreening; maintaining contact list; taking temps, symptoms to watch for; immediate and long-term steps required etc.
      2. Alzheimer’s Training – Perhaps by Alzheimer’s Association.  This is especially important to those of us with Day programs; COVID along with the time in isolation WILL have had an impact.
      3. Crisis Management/Techniques Training – This could help us HELP our seniors
      4. Depression/Isolation Training – Important for staff/volunteers AND help them better serve our seniors.
      5. Transportation – We usually run full vans for Daycare, medical appointments, grocery shopping etc.  Full vans are probably not a good idea right now.
      6. Training Materials – Could we get trainings in PowerPoint presentations so we can do/review trainings?

This gives us a great agenda for both online training task forces. It gives them information what’s needed to create/do. Will get final versions. Laurie Pimentel and Patty Sullivan are working on supportive day programs. Looking for members to help us think them through. Many answers will be found locally in the field. If we can’t do supportive day, what else is available in community, what else can help families? Please continue to share and to the list of questions, concerns, best practices. Transportation is looking at partners for best practices especially around sanitation.

SUPPORTIVE DAY

We have learned that EOEA has created a reimbursement structure for Adult Day Health vendors who are making regular phone calls to clients and families.  Many COA Supportive Day Care programs have been doing the same, is there any consideration to creating a reimbursement structure for Supportive Day Care vendors?  Regarding Supportive Day Programs (SDPs), EOEA is aware that MCOA has created a task force on SDPs and we look forward to learning more from that group.  In addition, EOEA is working with MCOA to schedule a meeting over the next couple of weeks to learn more from MCOA about SDP and what future programming may look like in this area. This is an extremely valuable program and we need to provide respite. We need to figure out how to provide the service given the new reality.

Will the state be providing COAs with Supportive Day Care guidelines, and if so, when could we expect them?  The loss of these programs in many communities is having a significant impact on caregivers as well as COAs.  Families are asking for information about when and if the programs will resume.  COAs are concerned about whether/how services could be provided in a safe way.  To date, CDC and state guidelines have been specific to Adult Day Health programs, and/or child day care programs.  EOEA is aware that MCOA has created a task force on SDPs and we look forward to learning more from that group.  In addition, EOEA is working with MCOA to schedule a meeting over the next couple of weeks to learn more from MCOA about SDP and what future programming in this area will look like as senior centers re-open later in the year through a phased in approach.  Moreover, agencies are encouraged to continue working with local leaders in your cities/towns on what planning may be going on now in your communities to support municipal agencies with the supplies they may need to re-open.  What would the 30+ providers running these programs recommend? We want to hear from the front-line workers. What are the concerns, resources, etc. to have a comprehensive plan for EOEA, MCOA, MHC of solutions to meet the needs of the older adults and caregivers in the communities? Any information you’d like to share on SDP is welcome. Patty Sullivan is leading this workgroup and you can send information directly to her at Patty@mcoaonline.com

COA BOARDS

We had a question this week about working with your boards during this pandemic, David do you have any recommendations on this?  Use them as a sounding board, they are advisory boards to help you make decisions. Bring them in on phone calls, Zoom on any issues, great to do as a group.

TRANSPORTATION 

The CTAA (community transportation assoc. of America) has provided a document for recommendations for keeping both drivers and passengers safe. Currently our fleet is off the road but would like to think that we could re-open our transportation service sooner than some of our other programs.  Is there any guidance about how to retrofit the vans and get the necessary PPE for drivers and passengers?  Including how to pay for adaptations and supplies.  The CTAA guidance came to us through our regional transportation services MARtap.   EOEA has learned from some COAs that have already started installing shields in their vans to practice safety and social distancing and this may be because they have funding to do so.  EOEA is looking into the question further with EHS/MassMobility,  MassDOT and CTAA to learn more and will share what we learn.   The PPE issue falls again under the category of what supplies will COAs have access to and how will those supplies be provided and is in line with the planning around reopening and working with local town officials and LBOH in accessing supplies.   In addition, EOEA has reached out to learn more about two recent Volunteer Drive Network conference calls, a list of community transportation funding opportunities and an invitation to the Central Transportation Planning Staff forum this Tuesday for local transportation providers.  We learned that the EHS Human Service Transportation Office is currently revising guidelines and we hope to get those soon and will share what we learn.  Anecdotally, the field is only just starting to look into this.  Most of their precautions, other than shutting down completely have been things like limiting rides to one rider at a time, only allowing drivers aged 59 or under, and utilizing their largest vans to maximize space between riders.  EOEA is working on a one page document with links to the funding opportunities, HST and CTAA guidance, and the invitation to the forum on Tuesday.  We will send to MCOA to share with all of you once completed.  The Community Transportation Provider forum is just 3 business days away,  interested listeners can go to: http://www.ctps.org to register.  There is information about the forum right there on the main page.

GENERAL HEALTH & SAFETY

We have lent out most of the equipment in our medical closet and have not been accepting any equipment back at this time.  Are there any guidelines or recommendations on whether we should be accepting back durable medical equipment?   (As we all know most times equipment is returned dirty.)  We only have custodial services for 4 hours after the building is closed, therefore the hour by hour cleaning and sanitizing that must happen when the building reopens will have to be taken on by the staff.   Do you have any suggestions on how to handle this?  Would it be best just to simply say we are not accepting back equipment?  COAs and senior centers should work with their LBOH on guidance re accepting, cleaning and storing equipment at this time. EOEA does not have jurisdiction.

Talk to your municipal department heads who may be able to help. But if there’s assistance within your town through other departments, hospitals, etc. it may be manageable. However, we may need to decide not to provide equipment at this time.

I am curious about if the timing is right to offer a senior group exercise class outdoors. I have doubts because I am unclear as to the appropriate combination of distance and mask. Is it 6’ AND a mask? Or is it 6’ OR a mask? The answer is relevant, as distance AND a mask means exercise outdoors is not yet appropriate. But if 6’ of space makes it possible to exercise without a mask then a small group class seems feasible.   People should wear a mask if they are unable to maintain 6’ of distance. The DPH and  CDC websites provides guidance on social distancing. Guidance continues to cite maintaining 6 feet or more.​ Be mindful of the number of people to attend even if classes are held outside.

  • There is also guidance on the Wearing a Mask video
  • Check with you LBOH agents.

Helpful Websites:

https://www.mass.gov/info-details/covid-19-updates-and-information

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.mass.gov/news/wear-a-mask-in-public#:~:text=Governor%20Baker%20has%20issued%20an,both%20indoor%20and%20oudoor%20spaces.

What is the guidance surrounding placement of senior volunteers (obviously in the at-risk demographic due to age, plus many have health factors as well) in the Tax Work Off Program in public buildings?   Need to maintain sufficient safety distance for all face-to-face activities. COAs/senior centers should work with their LBOH agents. PTWOP staff are hired to be in these roles and are governed by your municipality.

Question from a client receiving home services about her home health aide(HHA) that works nights in a nursing home and does home care during the day. Client was concerned about testing, if the home health aides were tested occasionally. If they might bring the virus from the nursing home to her.  Client is concerned because she lives in housing in a high rise. Her question was Do the home health aides have to report that they also work in a nursing home at other times?  HHA’s have access to testing if they are in contact with someone who has COVID regardless if the HHA is symptomatic or asymptomatic (access to testing even if you are asymptomatic is newly released this week, EOEA was a BIG advocate for this). DPH and CDC have released guidance on types of personal protective equipment to where and also work restrictions based on exposure and the HHA wearing PPE. https://www.mass.gov/info-details/covid-19-testing#should-i-be-tested?-

The HHA is not required to report their other places of work. However, HHAs within and outside of nursing homes are required to use certain levels of PPE depending on the consumer. Additionally  HHA have been trained in the proper use of PPE. If anyone has any concerns please don’t hesitate to reach out to your local ASAP to discuss their personal situation.

As the conversations turn from essential services to the process for re-opening, what guidance can you provide now or in the future regarding contact tracing and the role of COAs with regard to providing the names and contact information to the appropriate agency (BOH or DPH) about seniors who have been diagnosed with COVID19 after we have had some type of opening within the Senior Centers?  Example: we keep records of almost every senior (and person) who comes through our doors and could be a vital tool for contact tracing in the event it becomes necessary. However with MGL making this information confidential, what might our role be or can it be with providing information to help with ensuring that our seniors who may be exposed in the future are taking proper next steps. EOEA will share the contact tracing one pager for your use. At this moment in time- EOEA would see the contact tracers reaching out to a COA only if a COVID+ person visited the COA or a COVID+ person mentioned they came in contact with a COA/center employee while sick.

Close contact is defined as within 6ft for more than 10 minutes​. So as for the way things are now that is how EOEA sees COAs being connected with the contact tracers.  In the future when things start to open up more and in-person programming takes place, there will still be guidance around social distancing until there is a vaccine. More information is to come regarding re-opening and what each phase will include. That is a great point about the wealth of information the COAs have, I will share with the Secretary and leadership team and take that back to consider as we all discuss what re-opening looks like. As a network, we need to get this right. MCOA to ask EOEA to have someone from DPH regarding contact tracing at the next meeting. At MCOA, keeping a log in the office to know who has been in and out of the space if necessary for tracing. Need to do the same at senior centers in addition to MySeniorCenter to capture all the interactions.

Question from a client receiving home services about her home health aide that works nights in a nursing home and does home care during the day. Client was concerned about testing, if the home health aides were tested occasionally. If they might bring the virus from the nursing home to her.  Client is concerned because she lives in housing in a high rise. Her question was Do the home health aides have to report that they also work in a nursing home at other times?  HHA’s have access to testing if they are in contact with someone who has COVID regardless if the HHA is symptomatic or asymptomatic (access to testing even if you are asymptomatic is newly released this week, EOEA was a BIG advocate for this). See https://www.mass.gov/info-details/covid-19-testing#should-i-be-tested?-

DPH and CDC have released guidance on types of personal protective equipment to where and also work restrictions based on exposure and the HHA wearing PPE. The HHA is not required to report their other places of work. However, HHAs within and outside of nursing homes are required to use certain levels of PPE depending on the consumer. Additionally HHA’s have been trained in the proper use of PPE. If anyone has any concerns please don’t hesitate to reach out to your local ASAP to discuss their personal situation.

As the conversations turn from essential services to the process for re-opening, what guidance can you provide now or in the future regarding contact tracing and the role of COAs with regard to providing the names and contact information to the appropriate agency (BOH or DPH) about seniors who have been diagnosed with COVID19 after we have had some type of opening within the Senior Centers?  Example: we keep records of almost every senior (and person) who comes through our doors and could be a vital tool for contact tracing in the event it becomes necessary. However with MGL making this information confidential, what might our role be or can it be with providing information to help with ensuring that our seniors who may be exposed in the future are taking proper next steps.  EOEA will send Contact Tracing Media Packet for COA use, and will share the contact tracing one pager. At this moment in time- EOEA would see the contact tracers reaching out to a COA only if a COVID+ person visited the COA or a COVID+ person mentioned they came in contact with a COA/center employee while sick.

Close contact is defined as within 6ft, for more than 10 minutes. So as for the way things are now that is how EOEA sees COAs being connected with the contact tracers.  In the future when things start to open up more and in-person programming takes place, there will still be guidance around social distancing until there is a vaccine. More information is to come regarding re-opening and what each phase will include. That is a great point about the wealth of information the COAs have, I will share with the Secretary and leadership team and take that back to consider as we all discuss what re-opening looks like. As a network, we need to get this right. At MCOA, keeping a log in the office to know who has been in and out of the space if necessary for tracing. Need to do the same at senior centers in addition to MySeniorCenter to capture all the interactions.

Could you please clarify, are staff members who provide direct care in skilled nursing facilities and assisted living required to participate in COVID testing or is it optional?  COVID testing is for all employees of an assisted living residence is dependent on the circumstances at the particular residence. We have found that certain ALRs have arranged to have all their employees tested at the same time as their residents. Additionally, we have found that when the National Guard performs testing of residents at the request of the ALR, it also tests the employees, provided that the appropriate medical orders have been obtained. Lastly, we have also experienced that a local board of health may arrange for all employees (and residents) to be tested. Note that testing is different than screening and it’s our belief and understanding that all ALRs are screening their employees at the beginning of their shift(s) to ensure that they are symptom-free.

In nursing home and rest homes all residents and employees, symptomatic or asymptomatic, are eligible to be tested. The rate of participation varies from facility to facility.  Some employees and residents are refusing to be tested. New MassHealth funding has identified full testing of staff to be an eligibility requirement.

STATISTIC INFORMATION

Will the state be releasing information about specific case numbers of COVID by individual skilled nursing and assisted living facilities?  There are many rumors circulating about what is happening at different residential facilities for older adults, and some COAs are receiving inquiries.  While we know to refer to public health officials, COVID numbers are now being listed by the state by individual hospital.  Given tragic recent history regarding COVID mortality in residential facilities, wouldn’t it be a natural progression of this release of information, and a measure of protection for older adults, to proactively release COVID numbers for residential facilities whether regulated by DPH or not?  Please see mass.gov/covid19 for numbers re SNFs and hospitals.  ALRs are not health care facilities and are not subject to the same reporting requirements as SNFs.  The state is working through with ALRs on what can be shared and will be sure to share with MCOA as information is made available.

I want to know where I can find who died where and why by age group. If COVID19 was the cause of death, were there pre-existing conditions that contributed? For example-in the DPH dashboard of April 21st, it lists 1237 deaths in the 80+ group and 1059 in nursing homes. Were the 80+ all institutionalized? If so then only 187 of 80+ died in the community- And were the 1059 in nursing homes all in the 80+ group? I am trying to understand the vulnerability for the seniors in our community?   This level of detail of readily available data is unprecedented.  MA is truly leading the way in transparency. The information you are seeking regarding the number of persons who died from COVID who had a pre-existing condition – can be found on page 13 of the daily COVID-19 dashboard , which can be found daily here  – https://www.mass.gov/info-details/covid-19-response-reporting

DPH is unfortunately unable to provide the level of further detailed information you are seeking regarding whether  the “1237 deaths in the 80+  group” were institutionalized or not. However, on page 19 of the COVID dashboard you can find data regarding Nursing Homes, Rest Homes, and Skilled Nursing Facilities with 2+ Known COVID Cases. Additionally you can find data by city and town in  here https://www.mass.gov/info- details/covid-19-response-reporting

RESOURCE INFORMATION

I am very concerned about the mental health impact of this pandemic and want to be sure people are trained to understand warning signs and appropriate actions. Do you have any suggestions for online free suicide prevention trainings? I am curious about other ways that MCOA is working to address the mental health impact of this pandemic on seniors Are there any current approaches to connect seniors to needed technology and teletherapy. Is there current messaging about factors that build resilience and creative and/or successful approaches in the community to address resiliency factors? I am particularly worried about seniors without families or social connections.   There are some free trainings available through other states Depts of Health, which you can search on the internet. There is also Mental Health First Aid.com, which conducts trainings (there is a cost) and have a Mental Health First Aid for Older Adult curriculum covering how to identify, understand and respond to signs of mental illnesses and substance use disorders. They recently announced that they are preparing to release a virtual Mental Health First Aid course, again that website is Mental Health First Aid.com)

The EMHOTs are utilizing virtual platforms to provide behavioral health services to their clients, in addition to that one EMHOT has just created a ‘Phone –Pal program’ matching -people who’ve reached out asking how they can help during this crisis, with isolated clients, and they created a training for these volunteers. Another EMHOT has started a support group conducted by phone/conference call- no video for their behavioral health clients and seniors called “Be Safe, Feel Safe”. Lastly – there is a free webinar training next Tuesday, April 28th sponsored by the MA Department of Mental Health, MA Aging and Mental Health Coalition, and MA Association for Mental Health., on Working with Older Adult Trauma Survivors, the link to register for this is on the “Resources” page of the MCOA Coronavirus Webpage, under the Mental Health Resources/Trainings section. Please check this section as we will be adding to it regularly

Could you describe some of the innovative programming developed and implemented by some ASAPs in the state, in response to the pandemic? Is there any discussion of conducting these successful programs or services at all the ASAPs statewide?  COAs should be working directly with their local ASAPs regarding programming and access to services and supports –  ASAPs and COAs are integral partners in the  “no wrong door” ADRC network in Massachusetts regarding programs, services and supports for older adults and people with disabilities. EOEA encourages ADRC partners to reach out to one another on a regular basis especially during these uncertain times.  One story EOEA has received from ASAP program managers this week is that a few are trying to create conference call support groups of consumers.  Think of group friendly visiting if you will – or telephone COVID concern support group.  People wanting to reach out and talk with others, share some concerns about these uncertain times. There have been small groups of people, not a large response, but the conversation and desire were welcomed.

HESSCO has also shared some information about what they are doing to stay connected with community partners during this pandemic.  The community update is shared weekly with  COA’s, meal sites, SCO partners, housing authorities and local emergency services.  This is in addition to daily calls with councils on aging directors, providers and meal sites.  In addition, HESSCO has decided to put together two videos to share with their community.  One video is a thank you to everyone involved in supporting their agency/ consumers and the other is a video used to train HDM volunteers around proper use of PPE when delivering.  See links below to the videos.

Thank you video: https://www.youtube.com/watch?v=71QwXPX2rCU&t=4s

Meals on Wheels Training Video: https://www.youtube.com/watch?v=5-bB1h4rTdc

ASAPs have also asked what COAs are doing that is creative and innovative during these times? Maybe COAs could share with their local ASAPs, how they are educating consumers, providers and staff on COVID19 and what different methods they are utilizing to communicate with their partners.

The ACL announced on 4/21 Nearly $1 Billion in CARES Act Grants to Support Older Adults and People with Disabilities in the Community During the COVID-19 Emergency.  The majority of these additional funds ($905 million) are being awarded today to states, territories, and tribes for subsequent allocation to local service providers. Grant amounts are determined based on the formulas defined under the program authorizing statutes. The remaining $50 million will be awarded by the close of April.  Can EOEA explain what these funds will be used for and who/ what agencies will have access to it?   EOEA has received a total of $16.7M in federal awards under the CARES Act. This includes funding for EOEA’s Older Americans Act activities under Title III-B Supportive Services, Title III-C Nutrition Services, Tithe III-E Family Caregiver Support Program, and Title VII Ombudsman. These funds will be distributed in accordance with EOEA’s approved funding formula. These are the only awards EOEA has received thus far under the CARES Act. If additional formula grant awards are received, those will also be distributed in accordance with EOEA’s approved funding formula. If additional competitive grants are made available, EOEA will evaluate each opportunity and engage stakeholders as appropriate based on the mission, terms and conditions, award criteria, and other relevant factors of the grant.

GENERAL HEALTH & SAFETY

I have had several calls from clients asking if there are any State Policies for Home Care agencies to ensure the company is following CDC or State regulations when making home visits.   One Home Care agency told a client that the client had to sign a waiver that they wouldn’t sue the agency if they got COVID.  The caregiver refused to sign because they had no existing policy that the employees were following CDC or State policies and procedures.  The Home Care agency suspended their services.  The caregiver said most of the employees not only go to other homes to provide home health services but many also work in nursing homes.  Are there any State Policies that are specific to COVID-19?   There are directives and guidance in this area however more particulars on the question are needed to address it fully, such as who is providing care and what type of agency it is; also if the person receiving care has COVID-19 and where the care is being provided.  There is different guidance for different care providers. You can consult Mass.gov to get more information and guidance.

 

Is it safe for seniors to receive handmade cards from the community? I’ve heard that COVID-19 can live on paper for up to 24 hours. Any guidance you could offer would be appreciated.  Recommend checking with your LBOH and the CDC website.  https://www.cdc.gov/coronavirus/2019-ncov/index.html

Will there be supplemental funding for MOW?  So far, the only funding made available is through the ACL Family First Funding   grant and it is funded through the AAA under Title IIIC of the Older Americans Act

Is there any way EOEA can inform us of the types of requests they have approved for re-purposing formula grants?  EOEA wants to learn from this by talking to everyone as their situation arises. Please continue to consult the Green Guide which Emmett Schmarsow has provided to the network and can resend if needed. COAs should continue to consult with EOEA directly (Carole, Emmet, Adam) relating to any expenses incurred as a result of COVID19 as this also helps EOEA in learning about the impact the pandemic is having on our community agencies and access to services for older adults.

Can the formula grant be used to purchase gift cards/grocery store gift cards to be given and or used for seniors in need? Please continue to send your requests to EOEA (Carole, Emmet, Adam) to seek guidance on formula grant spending through EOEA.

If no vaccine is available for upwards of a year it may be necessary to limit the open hours at our center, or delay opening until such a time that testing, confirmation of immunity and or a vaccine can be made widely available. Is this scenario, where there continue to be higher concerns and need for precautions for seniors, are plans for advising senior centers on when to reopen being discussed on a statewide level or will this be left to individual towns/cities working with their boards of health?  This is top of mind for everyone; What is our next step? The Governor is very clear with daily press briefings, and we are now in the surge of the virus. The Governor has said we need to continue practicing social distancing. There is much to do before reopening. Massachusetts is working with neighboring states on a task force. Together, state and local governments will work in thoughtful and smart way. Cities and towns will be pulled into this conversation.  David Stevens added: This is a local issue. It will take time and will include planning, coordination and guidance from EOEA, NCOA, other players and insight from what is happening around the country.

What changes are advised or mandated by the state regarding how assisted living facilities in Massachusetts can operate, as a result of the pandemic?  EOEA in partnership with DPH and EOHHS has issued orders to ALRs regarding visitation, staffing and training requirements, and the provision of skilled care during the pandemic.  Additionally, EOEA has provided guidance to ALRs to manage scenarios that may arise during this challenging time.  Guidance for ALRs can also be found at http://www.mass.gov/COVID19

Has there been any initial projection in terms of the number of seniors age 60 and over in Massachusetts who will be significantly financially impacted by the job losses caused by the pandemic?   I am thinking of the seniors who may not be able to pay their rent or mortgage and/or meet their basic needs such as food and medications.  We learned that there are 5,862 MOSES participants who are 60+ and who have lost their job on or after March 9. To be clear we can only assume that the reason for job loss is COVID-19. Also this is only MOSES data and does not include all claimants, who would come from DUA.  MOSES  is a database that keeps track of all job seekers entering Masshire system. Most are there because of a recent unemployment, but there could be people who just decided to look for a job and needed help. So it is safe to assume that a large percentage of people is there due to loss of employment during COVID19.

We are trying to determine what COVID related expenses would be allowable to submit under the FEMA reimbursement program. Do you know if we purchased food items to give to our seniors for a “go bag”, would this be an allowable expense? Thank you for your help in getting an answer to this question. Municipalities should continue to track all COVID19 related expenses for FEMA reimbursement and direct questions on this matter to their local city/town budget offices.

I was just listening to the governor’s daily update, and in the discussion heard something about adult day programs being part of the 30 million funds to recoup for expenses, if you have any information regarding this either this week or next week, it would be great. There is funding for Adult Day Health programs that is being made available through the Governor’s provider relief package.

Other than the issued guidelines we have followed, are there any other resources we should be tapping into that speak directly to Supportive Day programs?  See below re: formula grant funds.

Who decides if and when Supportive Day programs should be open/closed? (i.e. the COA, the city/town, the ASAP etc.)  The Governor and DPH will provide guidance.

Do we expect there to be any assistance as to what the roll out to re-open will look like not just for COA’s but for Supportive Day programs as well?  Guidance is not available at this time. EOEA will forward any guidance that is provided to MCOA as it is made available.

Can we use Formula Funds to offset costs in Supportive Day?  (i.e. Salary of SDC Staff and technology equipment etc.) EOEA approves the use of formula funds for these expenses at this time.

Do we anticipate needing to take the temperatures of participants when we reopen to the public, to ensure no one is running a fever?  EOEA is not aware of any guidance from DPH at this time.​

If the salary of an employee is being paid either entirely, or in part utilizing Formula Grant funds, and the town’s policy is to pay employees during the crisis their regular salary regardless of how many hours they are able to work during the crisis, are we still able to utilize Formula Grant funds to pay those employees if it was in the submitted Formula Grant budget? You can still use formula grant to pay employees in accordance with the original budget.

If we want to revise and reallocate our FY20 Formula Grant budget, do we need to submit a revised budget to EOEA before we are allowed to transition to a new budget?  If so, who would we submit the budget to and how quickly could we expect it to be approved?  If the revision to the budget is simple–just two or three items, you can send it to Adam Frank adam.frank@state.ma.us , with a couple sentences describing the changes.  If it is more complex, you can send EOEA the whole budget with the changes highlighted.  Or if submitting a revised budget would be excessive given everything else going on, a short written request.  EOEA should be able to get you a decision within one or two business days.

What if I have questions for EOEA?  COAs should contact Adam Frank, or Assistant Secretary, Carole Malone at:

Adam Frank
Grants and Council on Aging Coordinator
Phone:  (617) 222-7428
Cell:  ​(617) 767-1475
adam.frank@state.ma.us
adfrank@rcn.com

Carole L. Malone
Assistant Secretary
Executive Office of Elder Affairs
One Ashburton Place, 5th floor
Boston, MA  02108
Phone:  617-222-7568
Cell: 857-294-0085
carole.malone@state.ma.us

Can we, the Senior Center staff, help people respond to the Census online, using their ID and with the client on the phone providing their information directly?  Communities should weigh in with their city or town solicitor.

Update: 4/8/2020:  Paper surveys are coming to those who have not responded.  Read the press release from the Secretary of State’s Office.  Please contact Uriel Molina with any questions regarding census.

We have people offering to deliver food or Rx or other necessities – how can we be sure they’re not passing the virus on to our vulnerable population?  Follow the guidance provided by the CDC and the Massachusetts Dept. of Public Health, here: https://www.mass.gov/info-details/covid-19-guidance-and-directives

Should COA’s continue to accept donations of durable medical equipment?  COAs with concerns about taking in medical equipment as donations at this time should check with their local boards of health.

Can I continue to refer seniors to SHINE?  Yes, SHINE Counselors are working remotely and you can still refer seniors to the SHINE Program.

Are there guidelines for remote meetings? Yes.  MMA has provided the following for remote meetings:

Remote Meeting Script (00022231xA050C)

Remote Participation Checklist for COVID-19 Emergency (00022229xA050C)

 

What should we do to prepare for COVID-19 impacts to our Senior Center? Follow the Guidance for community day program settings (e.g. Adult Day Health, Day Habilitation, Clubhouses, Councils on Aging, etc.): issued by mass.gov here: https://www.mass.gov/info-details/covid-19-guidance-and-recommendations#for-community-day-programs-

 

What are other centers doing? MCOA is in the process of collecting this information; Please ensure you complete this form: https://mcoaonline.com/coronavirus/coa-status/

Once MCOA has received initial reporting, we will start to provide informational updates on COA’s across the Commonwealth our main Coronavirus webpage here: https://mcoaonline.com/coronavirus/

 

What is the status of MCOA events and trainings, etc.? MCOA will be regularly updating this information, so please check this link for updates: https://mcoaonline.com/training/event-schedule/

 

What other things should we be thinking about? Depending upon the actions your community takes regarding your centers activities, you may need to consider assessing how your COA can assist seniors outside of the center. Seniors may need assistance with:

  • Accessing Food, Medications & other supplies: if they are not able to shop for themselves. Meals on Wheels, food banks or store and/or pharmacy deliveries may need to be arranged to provide sufficient nutrition. Involve available family members or neighbors if necessary.
  • Social Connections:Social isolation may be experienced by seniors who depend on the center to interact with friends and your staff. Consider collaborating with social service agencies to provide telecommunication options (Face time, Phone calls, etc.)
  • Welfare Checks:Consider contacting other agency service providers such as community paramedics or neighborhood watch groups to collaborate on checking on the welfare of seniors in your community.

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Massachusetts Councils
on Aging

116 Pleasant Street, Suite 306
Easthampton, MA 01027
Telephone: 413-527-6425
Fax: 413-527-7138