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Shine volunteers work on the cutting
Edge of health care policy
By Margaret Johnson Ware, Regional SHINE Coordinator
The SHINE (Serving Health Information Needs of Elders) Program trains counselors to provide information, counseling and assistance to people with questions about Medicare, "Medigap" supplemental insurance, MassHealth programs, insurance claims and appeals, quality issues and other health insurance-related issues.
The work that SHINE Counselors do in Berkshire County is particularly complicated because of the lack of the availability of Medicare HMO’s in the County. The result of this is that often counselors have "no good choices" to present to clients. Programs that supplement services for lower income individuals do not have "sliding scales;" therefore, if someone fails to qualify for MassHealth, or the Pharmacy Program or a Medicare "buy in" it is an "all or nothing" proposition. These are the most difficult cases for counselors to deal with, because public systems can be very inflexible for individuals with few resources and an inability to advocate for themselves.
What really keeps SHINE counselors on their toes is the "dynamic" nature of the health care sector. As this is being written, Congress is debating the possible inclusion of a prescription drug program as part of Medicare; the two plans being debated take very different approaches. On the state level, the legislature is debating yet two other prescription drug programs, one of which may replace the present Pharmacy and Pharmacy Plus programs, or, there may be no change at all!
Whenever any aspect of our healthcare network changes, SHINE counselors have to be ready to learn new information and communicate it quickly and effectively to healthcare consumers. It is a daunting task. It also should give us pause that so much of this information system is dependent upon a system of well-trained volunteers. Once more it makes those of us interested in human services ask what value society places on services to those most in need.
In Berkshire County, counselors work in senior centers in Williamstown, North Adams, Pittsfield, Dalton, Lenox, Lee, Otis and Great Barrington. Several counselors are available to make home visits if necessary, and we have also begun an outreach program to elderly housing developments, with our first location being the Berkshiretown Apartments on Columbus Avenue. We hope soon to have a presence in the Providence Court facility to complement other services provided by Elder Services at that site.