Elder, Health and Disability Impact Advocacy

The Elder, Health and Disability Unit engages in impact advocacy in the following areas:

Guardianship Reform

We work with the Probate and Family Court and other advocates to ensure full implementation of the landmark Guardianship Reform law, passed in 2009. The new law dramatically improved due process protections for the elderly and disabled, including a key goal — the right to counsel — in most cases.

GBLS, CPCS and the Center for Public Representation continue to monitor this issue. GBLS is one of the few, key representatives for elders invited by Probate Court Chief Justice Paula Carey to participate in the Court’s Work Group to discuss possible compromises. Through this advocacy, we were able to incorporate stronger right to counsel language in the consensus recommendation.

Advancing the Rights of People with Disabilities

Access to Hospital Services

In collaboration with the Boston Center for Independent Living (BCIL), the GBLS Elder, Health and Disability Unit is advocating to improve access to Boston-area health care facilities for people with disabilities. The project addresses three types of health care barriers:

architectural, such as small exam rooms and inpatient rooms without accessibility features;
medical equipment, including the lack of accessible scales and adjustable-height exam tables;
policies and procedures, such as ensuring that proper accommodations and properly trained staff are available for patients with disabilities.

In June 2009, BCIL and several individuals with disabilities — represented by GBLS — reached six-year agreements with Massachusetts General Hospital and Brigham and Women's Hospital to remove accessibility barriers and ensure compliance with the Americans with Disabilities Act. GBLS and BCIL are negotiating with another teaching hospital about accessibility agreements, as well as exploring potential statewide and national strategies to create long-term, effective solutions for overcoming health care barriers.

Access to Transportation Services

Ten years ago GBLS sued the MBTA in federal court in Daniels-Finegold v. MBTA, seeking compliance with state and federal laws governing access to mass transportation services for people with disabilities. Click here for more information.

ENSURING THE RIGHTS OF STUDENTS AND COMBATTING THE SCHOOL TO PRISON PIPELINE

In 2018, GBLS settled, on behalf of three child clients, a complaint against Boston Public Schools (BPS) regarding unlawful suspensions. In the S.A. et al. v. Boston Public Schools settlement agreement, BPS agreed to amend school discipline policies to: 1) no longer suspend kindergartners, first graders, or second graders; 2) to suspend third, fourth, and fifth graders only for very serious offenses, e.g., assaulting staff members; and 3) agreed to design, in collaboration with community groups, professional development trainings for all educational staff to increase the use of non-exclusionary, alternative discipline and emphasize the impact of exclusionary discipline, particularly on students of color and students with disabilities. Suspension and exclusions have devastating effects long into students’ futures (e.g. students are more likely to drop out, have to repeat a grade, and be incarcerated later in life) and the goal of the settlement is to ultimately prevent suspensions altogether.

During the 2022-2023 school year, GBLS – jointly with Massachusetts Advocates for Children (MAC) – represented five families of BPS students with disabilities to ensure reliable, legally-mandated transportation services. The Complaint filed with the Department of Elementary and Secondary Education Problem Resolution System Office resulted in a Letter of Finding, dated February 24, 2023, stating that BPS violated the rights of each complainant student and the rights of students with disabilities on a system-wide basis due to its failure to provide legally entitled transportation services. BPS was ordered to, among other things, (1) develop a step-by-step plan to provide transportation at no cost to caregivers when Transportation-eligible students are lacking a driver or monitor; (2) proactively identify and reimburse parents who transported their children because their special education transportation failed within the last year; (3) ensure reimbursement to parents is more readily accessible, and payments are made quickly, including for parents who do not have a social security number or tax identification number; (4) begin tracking special education transportation data for the first time. See full press release here.

Ensuring Access to Health Care Services

While Massachusetts has more insured children than any other state in the country, having a health insurance card doesn’t always mean that there are services available to low-income children. GBLS has recently concluded two class action law suits which expanded MassHealth services.
GBLS, co-counsel with Health Law Advocates, assured expanded access to dental services for over 400,000 children on Masshealth. This lawsuit, Health Care For All, et al. v. Patrick, filed in 2000, ended in February 2011. During this time period over 100,000 more children got the dental services they needed. Rates went up, more providers enrolled, and administrative red tape was drastically reduced.
GBLS — with co-counsel Disability Law Center and Massachusetts Legal Reform Institute (MLRI) — expanded access to home-based private duty nursing services for severely disabled children. The families of these children were often unable to fill all the private duty nursing hours that they had been given because the way the state set rates for private duty nurshing created major barrier to providers participating tin this program. Our legal suit, Sabbag v.Swift, was the catalyst for the state to change the way it set rates. A family advisory committee was established that met quarterly.
In collaboration with Health Care for All, the ACT!! Coalition, MLRI, DLC, Health Care for the Homeless, MIRA and other partners, we advocate for improvements in public health insurance programs. We seek to expand access, close coverage gaps and ensure program operations are fair and comply with due process. We engage in detailed comments/ negotiations when public health programs propose to change their eligibility criteria, scope of coverage or service delivery model.
When Medicare implemented a new prescription drug benefit, Part D, over two hundred thousand elders and people with disabilities in Massachusetts faced the chaotic and frightening transition from MassHealth prescription coverage to a profoundly flawed and unfamiliar system sponsored by multiple private companies. MAP helped these "duals" - those on MassHealth and Medicaid - as well as thousands of other Medicare beneficiaries, to navigate the complex program to access life saving and other drugs. Collaborating with MLRI, HLA, and Mass. Senior Action Council, MAP secured emergency coverage legislation to protect people caught beween the old and the new systems, while working with MassHealth, the Center for Medicare and Medicaid Services, and the Social Security Administration to advance the critical interests of statewide clients.
Medicare premiums, deductibles, and co-payments have become increasingly costly for beneficiaries. MAP works on several fronts to make Medicare more affordable. MAP successfully advocated with MassHealth to implement a lawful and more generous formula for determining financial eligibility for the Medicare Savings Program which provides cost-sharing assistance to low income Medicare beneficiaries.

Ensuring the Rights of Isolated Nursing Home Residents

Twelve years ago, GBLS organized a coalition (Coalition to Reform Eldercare, or CORE) of elders, and advocates to fight for better conditions for nursing home residents. Over the years, CORE has successfully advocated to prevent arbitrary evictions from nursing homes, and to mandate that nursing homes support family councils to help monitor the nursing homes. Very often, CORE is the only consumer voice in the state legislative and budget process, advocating for isolated, vulnerable elders and disabled in nursing homes. CORE has kept alive some of the most important benefits, such as funding for the small monthly personal needs allowance, and the bedhold protection, which ensures residents the stability of returning to their own bed if they are hospitalized. The personal needs allowance would not have been included in this year’s state budget without CORE’s advocacy, and the bedhold was slated to be eliminated completely November 1, 2011, for the first time ever, until CORE and others successfully advocated to save it.