Petrosky had picked up a dangerous new strain of an old bug: Clostridium difficile. The bacteria, which produces toxins in the intestine, is common--when people on antibiotics end up with diarrhea, C. difficile is often to blame. Generally, once they've finished taking the drugs, the diarrhea clears up on its own. But the new strain is much nastier than normal. It churns out 20 times the colon-damaging toxins as the older version, causing severe intestinal inflammation, or colitis, and is resistant to several important antibiotics. When Petrosky got sick, Canadian hospitals had already reported more than 200 deaths from C. difficile--toxins had eaten right through the walls of patients' colons. Many American hospitals were experiencing similar outbreaks, and the hypervirulent strain had begun to infect people in the general community. Since then, the situation has only gotten worse.

Experts have long warned against the overuse of antibiotics because of the possibility that bacteria would develop resistance to the drugs we use to kill them. Now, researchers say, some of their fears have come to pass. The CDC estimates that of the approximately 2 million bacterial infections Americans acquire in hospitals each year, 70% are resistant to at least one of the drugs commonly used against them. Why that's scaring the experts: If standard drugs don't work, doctors sometimes have to turn to more potent--and more toxic--alternatives. In some cases, those last-resort antibiotics have caused irreversible liver or kidney problems or lasting pain from nerve damage. In others, people have died for lack of an effective treatment. The CDC says that drug resistance kills 70,000 Americans each year--more than car accidents and homicides combined.

"The superbugs are here," says Martin J. Blaser, MD, president of the Infectious Diseases Society of America and the chair of New York University Medical School's department of medicine. "And it doesn't take a crystal ball to see that even more problems are coming."

Scientists are trying to develop new bacteria-fighting drugs, but that process takes decades. In the meantime, we have to defend ourselves. It's crucial to be able to recognize the warning signs of a superbug infection, or, even better, prevent one. Here are four of the most dangerous of these germs and how leading experts say you can protect yourself.

Where is your toothbrush? Perched on the bathroom sink? Then let's hope you don't mind brushing your teeth with toilet water. Not to gross you out, but in the May issue of Prevention, we reported on 16 alarming, germ-breeding spots that are a whole lot nastier that you might have imagined. Take your commode: There are 3.2 million microbes per square inch in the average toilet bowl, according to germ expert Chuck Gerba, PhD, a professor of environmental microbiology at University of Arizona. When you flush, aerosolized toilet funk is propelled as far as 6 FEET, settling on the floor, the sink, and yes, your toothbrush. Shutting the lid, of course, is probably a smart move, but at the very least, put anything that goes inside your mouth behind closed doors (your medicine cabinet will do just fine). Here are a few more little known germ hot spots:

The worst place for your flip-flops and sneakers: The bedroom closet
Your comfiest shoes are on intimate terms with the sidewalk, the grass at the park, the track at your gym, the locker room... So everything they come in contact with (use your imagination) can end up all over your house, including your closet floor. In fact, a study found that chemicals clung to shoes and were tracked inside even a week after they were sprayed on a lawn. Shoes are also a magnet for pollen and other allergens, so if you're sniffle prone, you'll want to keep rough-and-tumble footwear far, far away from your bedroom. Store them in a basket by the front door or under an entryway bench--and for heaven's sake, make sure everyone does the same, even guests.

The worst place to set your handbag: The kitchen counter
Your Rafe bag is a major tote for microbes: When Gerba and his team swabbed purse bottoms (whatta job, right?), they found up to 10,000 bacteria per square inch-and a third of the bags tested positive for, ahem, fecal bacteria. It makes sense though; your carryall gets parked in some nasty spots: on the floor of the bus, beneath the restaurant table-maybe even on the floor of a public bathroom. Put your bag in a drawer or on a chair-anywhere except where food is prepared or eaten-and try not to drop it willy-nilly throughout the day. Ladies, this is what hooks are for!

The worst stall to pick in a public restroom: The middle one
Your instinct is probably to head to the middle stall. Problem is, it's everyone else's, too. The center stall has more bacteria than those on either end, according to unpublished data collected by Gerba. No, you won't catch an STD from a toilet seat. But you can contract all matter of ills if you touch a germy toilet handle and then neglect to wash your hands thoroughly.

Come clean: Do you have a particular germ phobia? How do you handle it?

Consider this: A $30,000 pay hike can be viewed as an annual return on a capital investment, like earning a continuous yield of $6% on $500,000 of savings. You know how hard it is to save up $500,000. Maybe that $30,000 boost in salary is easier to achieve.

Key 2: Protect yourself and your loved ones
Before you acquire any financial assets, make sure you have enough insurance against life's big risks -- serious illness, disability and early death. Most people, young families in particular, are woefully underinsured, especially for disability. When an emergency arises, you and your family will never regret having "wasted" all those annual premiums on insurance you "don't need." (See The Basics of Insurance to learn more.)

Key 3: Borrow sparingly
Use credit only to purchase things of lasting value: a home, education, maybe a car. Pay cash for everything else such as clothing, travel, entertainment and furniture. Even better, take advantage of the credit card company's free 30-day loan by charging responsibly and paying off the bill in full every month. Do you know anyone who got into big financial trouble because they didn't borrow enough money? I don't.

Key 4: Pay yourself first
If you feel you never have any money "left over" for investing after you pay all your bills, try reversing the bill-paying process. Make the first check you write each month a deposit to your mutual fund, money market or brokerage account. Then pay all your regular monthly bills, finishing up with the credit card bill. If you're having trouble paying that last bill, trim your discretionary spending -- but keep paying yourself first.

Key 5: Don't go for the home run
In investing, as in baseball, those who swing for the fences do hit the occasional home run. But they strike out a lot too, and their lifetime batting average -- average annual total return -- suffers accordingly. So shy away from highly volatile stocks, Initial Public Offerings (IPOs), buying on margin and commodity trading. Don't try to time markets, because no one does it consistently well. Use dollar-cost averaging to invest regularly in markets good, bad and lackluster. Have the patience to wait out the occasional (and inevitable) bear markets.

Key 6: Diversify, diversify, diversify
When tech stocks were flying high in the late '90s, safer investments like bonds, CDs and less-volatile blue-chip stocks were derided as sissy stuff. Diversification was considered boring. But successful investors have always known that any one class of assets -- stocks, real estate, bonds, cash -- will have its day in the doghouse and its day in the sun. That's why you've got to own all of them, in a mix that's right for your age, income, family responsibilities and tolerance for risk.

Key 7: Live simply today for a more comfortable tomorrow
Deferred gratification is no fun, but it's the only way I know to fund your long-term goals -- college for your kids or grandkids, that vacation home you've always wanted, early retirement, a generous bequest to your alma mater. Take a close look at your current lifestyle, and if you see a lot of spending that is dispensable, consider it found money for the bigger dreams in your life (see The Invisible Rich).

Key 8: Give generously to create a better world
Your own financial security depends far more than you may think on the financial, physical and spiritual health of others in your community, our nation, our world. When you share your good fortune by donating your money, time and talent to charity, you help create a stronger economy and a healthier, safer world.

So give generously to education, your church, social-service agencies, the arts, medical research -- whatever you value most. It feels wonderful, it's the ultimate in enlightened self-interest and it's the right thing to do (see Philanthropy Made Easy).

Knight Kiplinger is the editor in chief of Kiplinger's Personal Finance magazine, The Kiplinger Letter and Kiplinger.com.

5 Surprising Symptoms of Infidelity

Trim Expenses While You Trim the Tree

The holidays are typically a time we think about spending money, not cutting expenses. But let's face it, you're going to have to pay for all those shiny new packages under the tree (or whatever holiday icon you choose to celebrate).

You've heard all the standard ways to cut costs: don't buy Starbucks, take a bag lunch, and so forth. But you can get a lot more creative with slicing and dicing the way you divvy up your financial pie. Some of these trimming tips may be familiar to you and some may be new, but if you follow through on them, you're sure to shake loose a few more dollars that can be spent on whatever you value the most.

1. Watch out for shipping costs when buying via the Internet. Use the Internet to comparison shop, then pick up the item locally.

2. If you see something in a catalog that you want to buy, wait a week before ordering to see if you still really want it. (But don't wait too long or your holiday gift may not make it under the tree in time.)

3. When traveling, look online for ideas and/or coupons before you go. Once on site, ask the locals for low-cost favorite spots, a la Rachael Ray.

4. Try a vacation at home. See and do the things you've always meant to do and save on hotel costs. The holidays are a perfect time to enjoy local festivities.

5. Send free e-cards and save on postage.

6. Give your time or services instead of "things" for gifts.

7. Go gray. If you hate sitting with gloppy color on your head and paying an arm and a leg for the privilege, you should know that as the baby boomers age, gray is "in."

8. If you own a house, shift your higher-rate credit card debt to a lower-rate line of credit. Deduct the interest on your tax return.

9. If you own a house, use a home equity loan to pay off auto loans. The interest is tax-deductible.

10. Pay your mortgage payment biweekly instead of monthly--you'll save on interest costs and pay off your mortgage sooner.

11. Pay extra premium payments when paying your mortgage. As above, you'll save interest payments and be able to pay off your mortgage sooner.

12. Pay cash when possible--psychologically it's harder to spend cash than using credit cards, and you'll save on interest charges.

13. Set up one checking account for regular recurring expenses and another for bigger-ticket items. (Only buy if you've saved enough.)

14. Check with state or federal governments to see if you have money owed to you. To find out more about claims in your state, go to the National Association of Unclaimed Property Administrators' Web site.

15. If you've inherited an IRA, understand how to stretch out the tax deferral by taking the correct minimum required distribution.

16. Don't get divorced.

17. Quit smoking.

18. Save all your change and use it to buy gifts next year.

19. Go to matinee movies instead of movies at night.

20. Stop buying clothes that are "dry clean only." Learn to iron.

21. Plan parties where everyone brings something.

22. Have cocktails at home and then go out; have dessert at home.

23. Order vegetarian when you're out.

24. Look up phone numbers in the phone book instead of paying for directory assistance.

25. Sell stuff you don't need or use anymore on eBay.

26. Shop resale shops or estate sales.

27. Shop the clearance racks.

28. Make your own greeting cards on a computer.

29. Fill prescriptions with the generic form of the drug.

30. Plan your purchases--avoid impulse buying.

31. Use public transportation.

32. Track your spending. If you write it all down, you'll probably spend less. And you'll know exactly where your money goes.

33. Use your senior discount (if eligible). Go to www.AARP.org for information about member discounts and services.

34. Skip paying cab fare now and then. Walk or take the bus.

35. Don't buy mutual funds just before capital gains distributions.

36. Use a budget--especially for items like gifts.

37. Compare rates for cable and satellite. Go with the less expensive option. Only sign up for the channels you know you'll watch.

38. Consider buying a certified preowned car instead of a new one.

39. Don't renew subscriptions to publications you don't have time to read.

40. Don't watch so much TV. You won't see all the ads and be as tempted to buy. Take a walk instead or play with your kids.

41. Make IRA contributions early in the year to take advantage of additional months of tax deferral.

42. Lock in a fixed mortgage rate so your interest rate can't increase to a point you can no longer make your house payments.

43. Only use ATMs where you won't be charged service fees.

44. Use the public library to check out movies or books for free.

45. Consider dropping your land line phone at home. Your cell phone may be all you need and some come with free long distance services.

46. Give up expensive health club memberships. Learn to exercise outdoors, at home, or through the park district. Or join the YMCA.

47. With the high cost of oil, those hybrid cars are looking more attractive all the time. Check out Hybrid Car Guide for more.

48. Wait a little longer between manicures (try doing one yourself!), massages, or highlights, and try a local training school.

49. Play golf less often, look for tee times when rates are reduced, or play at lower-cost public courses.

50. Pay off your credit cards monthly and avoid paying interest.

51. If you must charge, switch to a no-fee or low-fee credit card.

52. If your house down payment was less than 20%, cancel your private mortgage insurance once your mortgage balance is 80% or less of your home's value.

53. Check your credit history. Go to AnnualCreditReport.com and make sure everything is accurate. Good credit may mean lower interest charges.

54. If you have a tendency to "bounce" checks, deduct a "cushion" from your balance. Then if you accidentally let your balance go below zero, you'll hit that cushion instead of paying fees for insufficient funds.

55. Participate in company retirement plans to save on taxes. Your taxable income will go down and you'll defer taxes to the future.

56. Take advantage of your employer match in your 401(k) or other retirement plan.

57. Don't take a loan from your 401(k) plan--you'll save on double taxation of that repaid interest.

58. Take advantage of company-sponsored reimbursement plans. If your company sponsors free retirement advice, take advantage of it.

59. Talk to financial planners at no cost. Look for newspaper money shows or local events where this service may be offered.

60. Take advantage of free health screenings at work (if offered).

61. Switch to an HMO from a PPO for health insurance.

62. If self-employed, consider switching health insurance plans to high-deductible plans to take advantage of HSAs.

63. Take advantage of medical prescription drug cards.

64. Get multiple quotes on insurance. It pays to shop around.

65. Raise the deductible on your homeowners insurance and car insurance policies.

66. Increase the waiting period to six months or longer on your long-term care insurance.

67. Review life insurance premiums. Can the dividends pay the premium instead of purchasing more coverage?

68. Buy term instead of whole life or universal life insurance.

69. If considering moving or retirement, look into places where the cost of living and/or state tax rates are cheaper.

70. Keep track of your cost basis on investments to save money on taxes when you sell an investment.

71. If you have a loss on your Roth IRA (the current balance is less than what you contributed), consider taking out the balance and claiming a deduction for the loss on Schedule A of your tax return.

72. Avoid paying penalties on retirement distributions by waiting until you're over age 59 1/2 to make withdrawals. Start required minimum distributions from traditional IRAs when you're age 70 1/2.

73. Do a 1035 annuity exchange to a company with lower expenses.

74. Put investments that generate ordinary income in tax-deferred accounts.

75. Use tax-exempt bonds in taxable accounts.

76. Put investments that generate capital gains or dividends (both generally taxed at lower rates than ordinary income) in taxable accounts.

77. Pay attention to the expense ratios on mutual funds you buy.

78. Consider using exchange-traded funds.

79. Pay attention to mutual fund brokerage fees.

80. Use prior-year capital-loss carryforwards to net out realized capital gains. You'll pay less tax.

81. If you have stock options, consider holding the shares after exercise for at least one year. You'll pay capital gains tax on the appreciation when you sell.

82. Cook in bulk and freeze.

83. Turn down your home thermostat a couple of degrees in the winter.

84. Only do full loads of laundry and fill the dishwasher before running it.

85. Get a roommate and share expenses.

86. Investigate phone service via the Internet.

87. Use regular gas instead of premium.

88. Cut back on eating out.

89. Be a smart grocery shopper--cut coupons, shop at discount stores, and stock up on sale items. Check out Costco or Sam's Club.

90. Buy energy-efficient appliances. They're cheaper in the long run.

91. Get rid of "add on" services with phone, TV, etc.

92. Keep up maintenance on cars. It may prevent costly future problems.

93. Get annual physicals to prevent costly future problems.

94. Wash your car at home and skip the car wash.

95. Pay bills online. Save postage.

96. Trade in your car with high insurance premiums for a car with lower insurance premiums.

97. Buy an I-PASS and save on highway tolls (in Illinois).

98. Sign up for a Upromise credit card. A percentage of your purchases will go into a college savings fund for your children.

99. Do your own home improvements. Home Depot and Lowe's employees can walk you through what you need to know.

100. Bring your lunch to work or scout out the inexpensive places to buy lunch. Look for inexpensive items on the menu, like soup.

101. Cut back trips to Starbucks or other premium coffee shops.

Sources: Morningstar.com

Some Experts Say Risks Outweigh Benefits

Our culture's cleanliness obsession has been fed by a booming business in household products that promise the virtue of sterility. According to estimates by the Environmental Protection Agency, our antimicrobial crusade has us spending almost $1 billion annually on soaps and detergents, toys and cutting boards, bedsheets and toothbrushes, all of them treated with chemical compounds designed to kill the germs that cling to them. At the forefront of this product niche is the antimicrobial hand wash, commonly fortified with the bug-battling chemical triclosan.

It may be a dangerous, germ-filled world out there, but with your little bottle of -- choose one: Dial, Safeguard, Palmolive -- you can stroll worry-free through it.

Or so you may think

The problem about our obsession with killing germs, some scientists and public health advocates warn, is that it may ultimately do us more harm than good.

Chief among those skeptics is microbiologist Stuart Levy of Tufts University School of Medicine, president of the Alliance for the Prudent Use of Antibiotics (APUA). Levy's research has led him to question why "antibacterial ingredients, once successfully used to prevent transmission of disease-causing microorganisms among patients, particularly in hospitals . . . are now being added to products used in healthy households . . . even though an added health benefit has not been demonstrated."

That's happening, Levy says, despite several "potential negative consequences" of these products, including weakening the immune system, which could lead to a greater chance of allergies in children, and their possible link to the emergence of antibiotic resistance -- the very problem that is making some diseases, such as methicillin-resistant Staphylococcus aureus, or MRSA, so difficult to treat.

Members of the manufacturing industry, meanwhile, including Brian Sansoni, vice president of communications at the Soap and Detergent Association, contend that consumers can use these products "with confidence" because "they reduce or kill germs on the skin that can make us sick."

Are Antimicrobial Soaps Breeding Tougher Bugs?

And that message has found a following. According to Mintel GNPD, a market research firm based in Chicago, 71 percent of adults who do some or all of the household cleaning "prefer [to use] antibacterial and germ-killing cleaning products."

Moving Beyond Soap

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The first mass-marketed antimicrobial product was put out in 1948 by the Dial Corp. "Aren't you glad you use Dial?" the marketing campaign asked: "Don't you wish everybody did?" The implied biology lesson -- a correct one, as it happens -- was that bacteria are partly responsible for body odor. The new deodorant was a hit; Liquid Dial followed in 1987, and a waterless hand-sanitizing gel in 1998.

(Jupiter Images/¿ Royalty-free/corbis)       .

Major marketing breakthroughs came when companies figured out how to put the antimicrobial compounds into more than just soap. Hand sanitizers were swiftly followed by germ-killing plastics and synthetic fibers, and suddenly nearly every product in your house -- from air filters to wallpaper, bathroom appliances, door frames, food storage containers and the kitchen sink -- could be part of the fight against bugs. Check your computer keyboard; chances are it was treated with a film of Microban, one of the leading trade names for triclosan.

In the wake of such scares as the bird flu, E. coli in food and MRSA, Mintel says the germ-killing marketplace has become even more fertile. In one recent three-year period, new product launches increased by more than 700 percent, from 200 products introduced in 2003 to more than 1,600 in 2006.

For many Americans, soap -- the plain old soap your grandmother used -- is simply not enough.

New and Improved?

---

Plain old soap relied for its chemistry primarily on animal and vegetable fat, and its cleaning power came essentially from its ability to create suds and lather, as the soap molecules formed a thin film around dirt, allowing it to be washed away under running water. Down the drain go not only bacteria but also viruses, such as those that cause the common cold. Compounds like chlorine, alcohol and peroxide (which kill immediately and at random rather than inhibiting the growth of bacteria) were often added to give soap extra cleansing kick. Those products are also commonly found in travel wipes and towelettes.

Adding specifically antibacterial agents seemed a natural next step. And although Levy and other scientists don't dispute that these chemicals can kill bacteria, they argue there's no evidence they do any good. "No study has shown that," Levy says. What's more, many illnesses such as flu and the common cold, which prompt people to wipe down telephone handsets and doorknobs, are caused not by bacteria but by viruses -- and antibacterials can't slow a virus at all.

Levy cites several studies, among them a 2004 study in the Annals of Internal Medicine, in which 228 New York households were divided randomly into two groups: One used regular soap and water; the other antimicrobial soap. There were just as many instances of vomiting, diarrhea, fever, sore throat, cough, runny nose and pinkeye among the antimicrobial users.

"For general use, antibacterial soaps are not superior to cleansing with regular soap and water," says Shmuel Shoham, an infectious disease specialist at Washington Hospital Center. His view is backed by the conclusions of an advisory panel to the Food and Drug Administration, which voted 11 to 1 in 2005 that, when it comes to keeping us healthy, antibacterial soaps and washes are no more effective.

But the New York study's lead author, Elaine Larson of Columbia University concedes that antibacterial soaps may offer benefits when there are medically vulnerable people in the house: someone who is "ill, immunocompromised, a neonate [newborn], or elder." A point that Sansoni emphasizes: Health care is not just in the hospital anymore, he says, it is in our homes.

Hazardous to Your Health?

---

While the arguments continue over whether antibacterial soap does any good, there's a second concern over whether it may actually do harm.

"Evidence is accumulating," Shoham says, "that chemicals used in antimicrobial soaps may be causing bacteria to become more resistant to commonly used antibiotics."

Are Antimicrobial Soaps Breeding Tougher Bugs?

Levy lays out this theory in his book "The Antibiotic Paradox": Antibacterial products leave residues on the surfaces where they are used. The active ingredients linger and continue to kill the bacteria, but not effectively or randomly. The naturally stronger bacteria that survived the initial assault develop new defense mechanisms against the chemicals. This selection process gives rise to a new generation that is resistant to the offending compounds.

Certain bacteria also develop "cross-resistance" -- transferring their new and improved defenses to bacteria fighting other types of antibiotics.

This is essentially the same scenario as the emergence of drug resistance from the overuse of antibiotic medications.

But Sansoni says that transferring the drug resistance phenomenon to hand cleaners is one of the "greatest suburban myths," for which, he says, there is no scientific evidence. Indeed, scientists looking for the emerging resistance have found it only in their own labs, in Petri dishes. Triclosan, for example, has been shown to make bacteria undergo mutations and create resistance -- but only in the laboratory setting. Not on your kitchen counter.

Levy is cautious: "Clearly, this is not a leading cause or a major cause of the resistance problem," he says. "But it is a potential." Given that it can happen in the laboratory, he is concerned that with increasing use, "these additives will contribute to the problem of resistance."

According to Allison Aiello, an epidemiologist at the University of Michigan School of Public Health, the specific way that triclosan works could cause problems. Triclosan targets a biochemical pathway in the bacteria, so any mutations at that site could mean that the chemical no longer gets to the target to kill the bacteria.

Beyond the drug-resistance worries, some scientists are concerned that antimicrobial soap is an indiscriminate killer.

Some bacteria are bad for us, but some are good. The antimicrobials kill both. And when the good bacteria are gone, there's more room for the bad bacteria to grow, raising our risk of becoming sick.

Besides, a germ-free environment may actually weaken our immune systems, some critics say. They are referring to the Hygiene Hypothesis -- the theory that children build their immune systems from infancy by putting in their mouths all those dirty objects they find lying around.

A number of studies have linked the development of allergies, asthma and skin problems in children to their having been raised in environments that are too sterile. "You need a little dirt," Levy says, "to train your immune system correctly."

Altering the Environment

---

Scientists have discovered high levels of triclosan and triclocarban -- two of the common compounds found in soaps and detergents -- in our ecosystem. According to a U.S. Geological Survey report from 2002, the substances can be found in nearly 60 percent of our streams and rivers.

Kristopher McNeill, a University of Minnesota chemist studying the effect of triclosan on the ecosystem, says it might be a source of certain types of dioxins.

The chlorine that is routinely added to wastewater, McNeill says, reacts with triclosan. The chlorinated triclosan, in the presence of sunlight, is transformed yet again in a reaction that forms dioxin -- not the most toxic type of dioxin, but one that may be harmful to aquatic life and, as a result, the food chain.

"We, as a society, did everything wrong with triclosan," McNeill says. "We took an antimicrobial compound and put it into all kinds of products and thus into just about every household, workplace and public restroom. . . . Amazingly, we haven't had outbreaks of triclosan-resistant bacteria, but it's not for lack of trying on our part."

The takeaway message: If you are worried about MRSA, E. coli, SARS, influenza or simply the common cold, you already know you should wash your hands.

Thoroughly.

Regular soap and water will do.

Ranit Mishori is a family medicine resident at Georgetown University/Providence Hospital. Comments:health@washpost.com.

By Brigitte Yuille

The turbulent economy and tougher lending environment appears to have shut the door on credit opportunities for those with a dubious credit history.

However, in many instances, poor credit doesn't necessarily knock you out of the credit pool. But it does mean you'll need to be well prepared and informed when you go looking for a loan. In any case, you're probably going to get less-desirable terms, and you'll pay a little more than the average consumer because the lender is taking on a greater risk, thanks to your shaky financial record.

Here's a chance to learn how lenders evaluate you and better understand a few of the tools they use to make their choices, such as your credit reports and credit scores; how to deal with lenders so you don't get tricked into losing even more money; and how you can bypass some conventional routes to receiving credit.

Bankrate has selected seven areas where your credit history can have a big impact, explaining how bad credit can affect you and what you can do to make things better.

More From Bankrate.com: • Alternative Fuels: Is Help on the Way? • Is Early Retirement Possible? • Early Retirement Is Possible for Couple

Some of the guidance provided, as well as the wise use of the credit you might ultimately receive, will create improvements to your history and boost your credit scores from bad to good. That means easier credit at a better price.

Beat the bad credit blues

• Don't let bad credit impact your job
  You may have aced the job interview, but you have one more hurdle: your credit. A few fixes to your history can help your first impression go a long way.
  
  
• Don't let bad credit impact your credit card use
  Out of cash? A few restrictive credit card replacements can help you get by in an emergency.
  
  
• Don't let bad credit impact your car loan
  It may not be the car that you desired, but it will be the transportation that you need.
  
  
• Don't let bad credit impact your insurance
  Better to have some protection than none at all. Rest assured; your credit isn't necessarily the main focus.
  
  
• Don't let bad credit impact your rent
  Most likely, you won't be homeless, but be prepared to pay more in certain areas.
  
  
• Don't let bad credit impact your mortgage
  A house is a large investment. That's why your credit plays a critical role. You won't be shut out of a house, but your options to pay for it will be limited.
  
  
• Don't let bad credit impact your student loan
  Your education is important, and the ability to get a student loan is one area where your credit is less likely to play a critical role.
  

A: There are three types of aging – chronological age (which is your age according to your date of birth), biological age (which is measured by looking at certain bio markers), and psychological age (which is dependent on your attitude.)

Top 5 "Be Your Own Boss" Careers

A growing number of Americans have discovered the joys of working for themselves. By developing a marketable skill, you can work directly for customers and clients without having to worry about middle managers or boring company presentations. In today's increasingly flexible job market, medical careers no longer require working in hospitals, and technology degree holders can find lucrative work from their home offices.

According to government data, these five careers offer some of the easiest ways to get started with self-employment. In many cases, you can usually start earning money while completing your formal training.

1. Home Health Aide

While most home health aides spend their time working from clients' homes, this fast-growing profession combines many of the benefits of a nursing career with the flexibility of self-employment. Earning $20,000 per year or more by working part-time, a typical home health aide assists clients when he or she is not caring for family members or completing a nursing degree program.

Many states require a prospective home health aide to hold an associate medical degree, as well as a personal bond. Though some home health aids are truly self-employed, the vast majority of professionals book clients through a professional agency. Agencies provide tax withholding, bookkeeping, and business support for home health aides. Some larger agencies even provide tuition reimbursement for online health degrees.

2. Private Investigator

A criminal justice degree and a love for working unusual hours are two of the most important ingredients for a job as a private investigator. Private eyes often transition to this career during or after a similar career in law enforcement. Retired or injured police officers who cannot return to active duty often take on P.I. work to supplement pension or insurance payments.

Hard work in the field pays very well, since skip tracing and other collection activities frequently offer larger, immediate bonuses. Many private investigators earn over $32,000 per year working full-time. However, the flexibility of P.I. work allows many professionals to spend time attending law school or completing other degree programs.

3. Freelance Database Administrator

Nearly every business in America relies on a database, yet few small businesses can afford to hire a full time staff member with a technology degree. Therefore, the market for freelance database administrators has blossomed over the past ten years.

Many online technical degree programs now offer elective courses on business management and marketing for freelance professionals. Meanwhile, online technology courses help freelancers earn and maintain industry certifications. Working full time from home, some freelance database administrators earn $60,000 or more per year.

4. Personal Chef

Don't confuse today's personal chef with a nanny or housekeeper. Professional personal chefs spend their afternoons bouncing between two, three, or four home kitchens, putting their culinary degrees to work for clients. Many personal chefs earn $33,000 or more per year, without the long hours or the stress of working in a commercial kitchen.

Personal chefs are also part of another interesting trend in larger cities: personal dinner preparation centers. Customers can book time at these open, professional kitchens where chefs help prepare ingredients that can be completed quickly at home. Personal chefs often round out their schedules by teaching group culinary courses at the homes of clients or at catering facilities.

5. Graphic Designer

Thanks to new technology, a growing number of graphic designers prefer to work from home studios and keep their own hours. Some modern graphic design degree training is done on software that can run on home computers. Working from home allows many creative people the chance to complete online graphic design degrees while still earning an income of $38,000 per year or more.

Although working from home requires more discipline than working at an agency, many graphic design schools offer time management and business courses that help students prepare for the freelance life. Local graphic design colleges also sponsor exhibitions, seminars, and other social events that help professionals make valuable, personal connections.

Transitioning to Self-Employment

Many career experts recommend testing the waters before making a major career change that involves being your own boss. For example, taking a few culinary courses can help you decide whether you really have the patience and the skill to become a personal chef. Likewise, an introductory online technology course can determine whether you've got the passion to make databases your full time job.

While working independently can hold tremendous personal rewards, self-employment carries some burdens and risks. Experts encourage self-employed professionals to save at least a third of their income in a high-interest savings fund to cover emergency expenses, unexpected sick days, and income tax withholding. On the flip side, small business owners can often take tax deductions on work-related equipment and professional development programs. Enrolling in online career training courses today can help you start your own career transition.

(Oprah.com) -- You can become a part of the fight against global warming. Former Vice President Al Gore shares the five things you can buy now that will help solve the climate crisis -- and save you a few bucks! Plus, more of his easy going green tips!

Former Vice President Al Gore speaks onstage during Live Earth New York at Giants Stadium on July 7.

Five things you can buy

1. Compact fluorescent lightbulbs

These energy-efficient bulbs cost less than $4 and are produced by major corporations like GE. If every household in America switched five regular light bulbs for five fluorescent bulbs, it would be the equivalent of taking 1 million cars off the highways for a full year.

2. Outdoor solar lighting

These yard or patio lights cost less than $20, and they don't burn any electricity or produce any CO2.

3. Programmable thermostats

Though these thermostats cost from $50 to $100, they can actually cut your heating and cooling costs. Set the setting so it's a little bit cooler in the winter and warmer in the summer when you're not in the house. A difference of 2 degrees can reduce a home's CO2 emissions by up to 9 percent over the course of a year.

4. Air filters

Changing the air filters in your heating and cooling systems regularly can knock 2 percent off of your CO2 output each year.

Water heaters use a lot of energy and generate a lot of CO2. A blanket costs less than $18 and can cut your home's CO2 emissions by almost 4½ percent.

Keep green in mind!

Gore says that when you're shopping for major home appliances, look for the Energy Star label. "This is a signal that you're getting an environmentally efficient appliance that's going to save you money at the same time," he says.

During a simple trip to the grocery store, you make hundreds of decisions that can have real environmental impacts. With just a few easy changes, you can make a positive difference in the world.

Instead of regular aluminum foil or plastic wrap, buy recycled aluminum foil. It uses just 1/20th of the energy needed to produce regular foil.

Look for items without extensive packaging. Most food packaging material uses some petroleum-based plastic. There are several ways to cut down on the energy and waste this produces. Look for minimally or unpackaged items instead. Experiment with bringing your own packaging or buying in bulk. Purchase brands that use bio-based instead of petroleum-based plastic. Recycle or reuse packaging materials you end up having to buy.

Bring a cloth bag to the grocery store instead of using its plastic bags. An estimated 500 billion to 1 trillion plastic bags are consumed worldwide each year. That's 1 million bags used per minute.

And, according to the EPA, more than 380 billion of those are discarded in the United States. Less than 1 percent of those are actually recycled. Instead, these bags will clog landfills, create litter, choke streams and harm marine wildlife, like whales, seals and sea turtles.

Buy local and organic. Buying seasonal, locally produced food helps in a number of ways. Most food travels 1,500 miles from "farm to fork." But buying local food drastically reduces the energy spent on food shipping. Local goods also tend to use minimal packaging, are fresher and come in more varieties.

The best place to track down local food is at your local farmers' markets or through the Community Supported Agriculture Department. Farmers who grow produce organically use less fossil fuel and release fewer greenhouse gasses into the atmosphere. Organic farming is better for the land, for the farmers and for the consumers.

Sources: TM & © 2007 Harpo Productions, Inc.

I've spent a lot of time teaching Americans how to get out debt. From television appearances to books to speeches, I've tried to proactively address how to fight the credit card companies at their own game.

CardTrak.com reports that the median amount of credit card debt carried by a typical American is about $6,600. But 13 percent of participants in a recent online poll reported balances higher than a staggering $25,000.

Many of these families now have over nine credit cards per household. That's not hard to believe considering that the average college student now graduates with three credit cards.

Kill Off Your Credit Card Debt

The question for many of these people is, "How do I know which of these cards to pay off first?"

To that end, I developed a system that helps consumers prioritize their debt payment plans for my book "The Finish Rich Workbook." It's called DOLP, which stands for Dead On Last Payment, and DOLPing your way out of debt is all about building momentum as you systematically pay off each card, one by one.

Back in a February column, I introduced you to Dan and Sally Eggleston, with whom I've been working over the past two years. We met on "Oprah" while taping the Debt Diet series, and the Egglestons have made amazing progress toward wiping out their debt.

Using the DOLP method, they've gone from 13 credit cards down to 4; in 90 days they'll be down to 3. They've reduced their $72,000 in credit card debt by over $25,000 so far, and by doing so they've also increased their credit score by over 100 points.

Do the DOLP

This same system can help you, too. Like Dan and Sally, you can get a true handle on how much you owe and how to put a payment plan into action in a matter of minutes. Here's what you need to do get DOLPing:

1. Make a list of the current outstanding balances on each of your credit card accounts.

2. Divide each balance by the minimum payment that particular card company wants you to make. The result is that account's DOLP number.

For example, say your outstanding Visa balance is $500 and the minimum payment due is $50. Dividing the total debt ($500) by the minimum payment ($50) gives you a DOLP number of 10.

3. Once you've figured out the DOLP number for each account, rank them in reverse order, putting the account with the lowest number first, the one with the second-lowest number second, and so on.

You now know the most efficient order in which you should pay off your various credit card balances.

4. Pay as much as you can each month toward the card with the lowest DOLP number. For each of your other cards, make only the minimum payment.

5. Once a card is paid off, cut it up -- but don't close the account! Leave the account open so you have credit you aren't using, which will help improve your credit score.

Now move the next card up on your list and repeat the process until all your cards are paid off.

Track Your Progress

I had Dan and Sally create a DOLP chart that was big enough to hang in their kitchen. This is a great way for the whole family to keep track of where they are in the process of wiping out their debt, and it serves as a reminder of their ultimate goal and helps them stay focused.

Tracking which cards have been paid off is a huge emotional boost, and propels you toward future progress. Here's a template you can use to create your own DOLP chart:

Negotiate Interest Rates

Other experts will suggest that you pay off your cards in an order based on the interest rate each card charges. I disagree with this method simply because you should be negotiating a lower interest rate with each credit card company from the very beginning. (See my column "Credit Card Hazards and How to Avoid Them" for details.)

Once you've asked for a lower rate, you may end up with pretty much the same interest rate on all your accounts. In Dan and Sally's case, they were able to lower most of their cards below a 5 percent interest rate -- and many of them had been as high as 29 percent.

Breaking a Vicious Circle

Being in debt can be depressing and overwhelming. The more credit cards you have the more bills you have to worry about paying on time, and just trying to stay on top of all those bills inevitably leads to mistakes like late payments.

Late payments can cost you upward of $30 a month, higher interest rates of up to 30 percent, over-limit fees of up to $35 a month -- and more stress. DOLPing your debt helps you break this cycle.

For instance, Dan and Sally went from 13 cards to 6 in less than 6 months. It was a huge relief for them, and also a huge motivator because they could see the progress they made so fast.

Patience, Persistence, and Progress

Although the DOLP method is simple, getting out of debt isn't. It may take months or even years to pay off all your credit card debt. My experience is that it can take twice as long to get out of debt as it took to get in it. But you can do it, and it's worth the effort.

Today, Dan and Sally's DOLP chart still hangs in their kitchen, serving as a constant reminder of their progress as well as the work they still have left to do. I'm really proud of what they've accomplished to date, and they serve as a great example of how patience and persistence can pay off on the road to financial freedom.

I hope this tool helps you. If you have other debt-management methods you'd like to share, please leave a comment below.

by David Bach

Many older Americans routinely engage in vaginal intercourse, oral sex and masturbation, a landmark study into a long-taboo subject reported Wednesday.

"From a societal perspective, I would say that old people are young people later in life," said Dr. Stacy Tesler Lindau, lead author of the federally funded study, which was published in the New England Journal of Medicine.

Sexual activity reported among the 3,005 men and women who participated in the survey did decrease with age, particularly among the oldest participants -- from 73 percent among those 57 to 64 years of age to 53 percent among those 65 to 74 years of age to 26 percent among those 75 to 85 years of age.

Discussion of the sex habits of American seniors has received little attention, even from scientists.

"Hopefully, this opens the door for conversation that might counter stereotypes," Lindau told reporters in a conference call. "If we regard older people as asexual, particularly as physicians, we really miss an opportunity to do important counseling and interventions for people who may benefit from them."

Among the survey's many discoveries was that about half of those 57 to 75 years of age who remained sexually active reported engaging in oral sex.

More than half of men and a quarter of women said they had masturbated during the previous year, a figure that remained constant whether they were sexually active or not.

The figure on masturbation "reflects a level of sexual need, even among men at very advanced ages, and speaks to the fact that sexuality is a lifelong proposition," said Edward O. Laumann, a study co-author and a sociologist at the University of Chicago.

But not for everybody. Thirty-five percent of women versus 13 percent of men rated sex as "not at all important."

That sentiment increased with age: 41 percent of the oldest age group said they felt that way, versus 25 percent of the middle group and 15 percent of the youngest group.

Across all age groups, women were less likely than men to report having engaged in sexual activity during the previous year. The disparity was attributed to the fact that women typically outlive men. Though 78 percent of men ages 75 to 85 had a spouse or other intimate relationship, the figure for women of the same age range was 40 percent.

Among those who said they were sexually active, about half of men and women reported at least one sexual problem that bothered them, including low desire (43 percent), difficulty with vaginal lubrication (39 percent) and inability to climax (34 percent).

The most common problem reported by men was difficulty gaining or maintaining an erection (37 percent).

About one in seven men (14 percent) said they were using drugs to improve their performance.

About one in four sexually active adults with a sexual problem said it led them to avoid sex.

Despite the high prevalence of sexual problems, few respondents -- 38 percent of men and 22 percent of women -- said they had discussed them with their doctors.

"Most felt sexuality is an important part of life, but feel physicians need to initiate discussion" about it, Lindau said.

Only a small minority -- 3.5 percent for men and 1.5 percent for women -- said they had had more than one sex partner during the previous year. Though the authors asked about prostitution, they said they had not yet reviewed those data.

Study author: 'Data are a gold mine'

The survey elicited an unusually high response rate of about 75 percent. Participants were paid $100 to submit to a two-hour interview and half-hour physical exam about a topic that has rarely been studied in detail, the authors said.

"These data are a gold mine," said co-author Linda Waite, a sociologist at the University of Chicago, and will be particularly useful to baby boomers about to become seniors.

But the study had limitations: Only sexually active individuals were asked about problems, meaning the findings likely underestimate the true incidence of sexual problems.

And much of the data were self-reported, meaning the results assume the subjects were truthful.

That may not always have been the case: The study found eight people who said their sex partner was of the same gender, a figure lower than commonly accepted estimates and one that Laumann acknowledged raises questions about the veracity of the respondents.

"I think you have to ask these questions, and I think they are very valid worries," Laumann said.

In an accompanying editorial, Dr. John H.J. Bancroft, the former director of the Kinsey Institute for Research in Sex, Gender and Reproduction, noted the survey gave little attention to those who said they were sexually inactive.

"Unfortunately, the present study did not assess the proportion of respondents in a relationship who had become sexually inactive because of sexual problems, whether men or women had these sexual problems, and how the respondents felt about their relationship," he said.

Laumann responded that the survey was able to cover only so much material. "It's a question of what you can cover in the amount of time we had," he said.

Sources: CNN.com

Commonwealth Care Plans 2, 3, and 4:  January 2007 Roll-Out

What Advocates Need to Know

Review of Commonwealth Care Plan Types

Who CAN get Commonwealth Care health insurance?

You may qualify if you:

Ø      Are 19 years old or older, and

Ø      Are a United States legal resident or citizen, and

Ø      Earn less than three times the federal poverty level.  For one person, this means earning no more than $29,412 a year.  For a family of 4, this means earning no more than $60,012 a year

Ø      Are insured under COBRA or Massachusetts mini-COBRA

Ø      Are paying a full premium in the non-group (individual) insurance commercial market

Ø      Are in a waiting period prior to receiving coverage for an employer-provided health plan, where the employer covers at least 20% of the annual cost of the premium for a family health plan or 33% of an individual plan

Ø      Are employed by an employer that does not cover at least 20% of the annual cost of the premium for a family health plan or 33% of an individual plan

Who CANNOT get Commonwealth Care health insurance?

You do not qualify if:

Ø      Your employer or a family member’s current employer offered health insurance coverage in the last 6 months, and the coverage covered at least 20% of the annual cost of the premium for a family health plan or 33% of an individual plan

Ø      You are a student and can get student health insurance  through your university or college

Ø      You qualify for these programs:

·         MassHealth, Children’s Medical Security Plan, and Healthy Start

·         Medicare

·         TRICARE (for individuals in the military)

·         Massachusetts Fisherman’s Partnership, Inc.

·         Massachusetts Division of Unemployment Assistance Medical Security Program

Uncompensated Care Pool & Commonwealth Care

Until October 2007, individuals who are eligible for Commonwealth Care Plans 1, 2, 3, or 4, are able to opt out of coverage and remain in the Uncompensated Care Pool.  Pool regulations after October 2007 have not yet been set.

Until October 2007, the Uncompensated Care Pool will continue to wrap services that are not covered by Commonwealth Care, including dental coverage and co-payments.

Conversion Process from Uncompensated Care Pool to Commonwealth Care

Ø      50% of eligible individuals under Plan 1 have been auto-assigned to a Commonwealth Care health plan

Ø      On January 2, 2007, the number of customer service representatives in the call centers doubled

Ø      Callers are encouraged to avoid contacting the call center on Mondays, which experience the highest volumes of calls as compared with other days of the week

Ø      Any person who has applied for, or have children who are enrolled in, MassHealth or the Children’s Medical Security Plan in the past year, should not complete a new Medical Benefits Request form, as they are already in the system and will be automatically converted if they are eligible for Commonwealth Care

Ø      They can contact 877-MA-ENROLL to verify that they will be receiving a packet; however, they cannot confirm when they will receive the packet, as the conversion process is random throughout the beginning of March

Ø      The enrollment process for individuals under 100% of the poverty level who were in the state’s system was completed by December 31, 2006

Ø      As of February 1, 2007, 40,000 individuals are expected to be enrolled in Commonwealth Care

Ø      The conversion process will involve roughly 73,000 eligible individuals from the Pool, and proceed with a randomized conversion rate of 8000 individuals a week.  After 4 weeks, the process will pause to assess its status (sometime in early to mid February); if there are no glitches, the conversions will continue for a total of nine weeks

Notices to Individuals who Qualify for Commonwealth Care

For Plans 2, 3, and 4, individuals who are in the state’s system and qualify for Commonwealth Care will receive information in the following order to notify them of the necessary steps they need to take to officially enroll:

1.      MA21 notice

2.      Postcard (with directions to call, visit website, or mail back)

3.      Individualized enrollment packet with plan(s) available in the individual’s area, with corresponding monthly premiums

Once a plan has been selected and payment received (the check does not need to have cleared yet), the individual is officially enrolled in the program by the 1^st of the following month.  There is no auto-assignment for individuals above 100% of poverty.

Premium Billing for Individuals in Plans 2, 3, and 4

Ø      Once an enrollment selection is made, an invoice is sent out within 5 business days

Ø      The first premium payment is due on the 20^th of the month for enrollment to begin on the 1^st of the following month

Ø      Invoices for subsequent months are generated on the 22^nd of the month for delivery on or by the 1^st of the month

Days Matter:  2 Scenarios

Individuals have less than 3 weeks to make a payment in order to ensure enrollment by the following month.  Failing to pay a monthly premium bill by the 20^th of the month can delay an individual’s coverage for an additional month.  See below for two comparative scenarios:

Disenrollment Notices

Ø      Payments must be received by the 20^th of the month

Ø      A member will be disenrolled due to nonpayment of premium after a 60-day period of non-payment

Ø      Prior to disenrollment, the member will receive an initial bill, a bill for 2 months with a late message, and a cancellation warning letter

Ø      A member will need to pay back arrears in order to re-enroll, although they will never have to pay more than 2 months worth of premiums

Premium Waivers and Payment Plans

Commonwealth Care will provide options for members in efforts to avoid disenrollment due to non-payment of premiums.  These include:

Ø      3, 6, and 9-month payment plans

Ø      Hardship waivers, which can be requested via Maximus and are processed by the Connector

Hardship waivers will be considered if a member has had a sudden change in circumstances that prevents them from being able to pay the premium.  These include a major life event or loss of income.  Requests for waivers will be approved right away, and the Connector Authority will follow-up with the necessary paperwork.  Full details can be found in the regulations.

Payment Options Continued

Throughout January, the following options will be available:

Ø      Check or money order

Ø      Option to print statement or bill from web portal

After January, more options will be available for members, including phone payment, direct deduction from checking account and debit payments.

Commonwealth Care Web Portal

Ø      www.macommonwealthcare.com

Ø      Commonwealth Care Customer Service Center:  1-877-MA-ENROLL (1-877-623-6765); TTY: 1-877-623-7773

Ø      Portal will feature self-service functions:  request of address or phone number change, selection of MCO, selection of a PCP, and premium payments (available in phases)

IMMIGRANT SERVICES

Refugee & Immigrant Assistance Center

Description: helps refugees and other immigrants with basic needs, legal advice, and counseling and training

Services:

• Tutoring
• Connection with Community Resources
• Hands on assistance applying for community resources such as Transitional Assistance, Food Stamps, etc.
• Case management and counseling
• Information and referrals for housing, food assistance, health care, etc.
• Translations and legal assistance
• English language instruction
• Family reunification
• Other immigrant services

Contact Information:

340 Main St
Worcester, MA 01608
(508) 756-7557

Catholic Charities

Description: helps refugees and other immigrants with basic needs, legal advice, and counseling and training

Services:

• Refugee Resettlement Program
• Legal counseling on immigration for low-income clients 
• English as a second language (ESL) classes
• Employment training and counseling
• Case management and counseling
• Information and referrals for housing, food assistance, health care, etc.
• Interpreter and translation services in Latino, African and other groups
• Citizenship preparation
• Computer training
• Other immigrant services

Contact Information:

• Catholic Charities of Worcester County
  Refugee Resettlement Program
  10 Hammond Street
  Worcester, MA 01610              
• Phone: 508-798-0191
  Fax: 508-797-5659
   

Lutheran Social Services of New England (LSSNE)

Description: provides resettlement and support services to help refugees and other immigrants

Services:

• Refugee Resettlement Program
• Unaccompanied Refugee Minor Program
• Sponsorship
• Refugee Employment and Training Program
• Case management and counseling
• Information and referrals for housing, food assistance, health care, etc.
• Translations and legal assistance
• English language instruction
• Family reunification
• Other immigrant services

Contact Information:

• Lutheran Social Services of New England
  Refugee and Immigrant Services
  30 Harvard Street
  Worcester, MA 01609              
  Phone: 508-754-1121
  Fax: 508-754-1393
   

Refugee Apostolate, Inc.

Description: assists refugees, immigrants and other families with food, clothing, and furnishings; advocacy; language and work skills; citizenship assistance; and other needs.

Services:

• The Little Store (thrift store)
• Christmas Giving Program
• Our Lady of Hope Center food pantry
• Employment program
• Citizenship and immigration assistance
• Information and referrals for housing, food assistance, health care, etc.
• Computer-based English language instruction
• Computer instruction

Contact Information:

• Refugee Apostolate, Inc.
  731 Main Street
  Worcester, MA 01610              
• Phone: 508-831-7455
  Fax: 508-831-1104

Centros Las Americas

Description: provides resettlement and support services to help refugees and other immigrants become self-sufficient and productive citizens of the United States.

Services:

• Case management and counseling
• Information and referrals for housing, food assistance, health care, etc.
• Interpreter and translation services in Spanish
• Citizenship preparation

·         Monday – Fridays, 9-5

Contact:

Centros Las Americas

11 Sycamore Street

Worcester, MA 

508-798-1900

Friendly House

Description: provides support services to help refugees and other immigrants

Services:

• Translations and legal assistance
• Case management and counseling
• Information and referrals for housing, food assistance, health care, etc.
• Interpreter and translation services in Spanish & Albanian
• Legal Assistance 1 x month
• Citizenship preparation

·         Monday – Fridays 9-5

Contact:

Friendly House

36 Wall Street

Worcester, MA  01604

508-755-4362

MIRA:

Program Description: Legislative Advocacy.   MIRA is the only statewide organization that unites community organizations, human service providers, civic and religious leaders, state and local agencies, and legal and labor groups to work together to uphold the rights and opportunities of newcomers.  We also work to connect local activists with national policy debates that impact immigrants' lives.

Contact Information:

Massachusetts Immigrant and Refugee Advocacy Coalition

105 Chauncy Street, #901

Boston, MA 02111

Phone: 617-350-5480

Fax: 617-350-5499

Web: www.miracoalition.org

Non Citizen Eligibility for Assistance Programs

Most assistance programs offer help to noncitizens as well as U.S. citizens. Your eligibility for these programs may depend on your immigration status, the date you entered the United States, how long you have lived here, and other factors. Some programs offer help to undocumented non-citizens, but many do not.  For details about non-citizen eligibility requirements,

HOW DO I….?

How do I get a Massachusetts driver's license?

If you plan to drive and you are a resident of Massachusetts, you must get a Massachusetts driver's license within 30 days of your arrival. You can get information about Massachusetts driver's licenses at the Massachusetts Registry of Motor Vehicles (RMV) office or online:

• Worcester RMV
  611 Main Street
  Worcester, MA 01608          Hours: Monday through Friday, 8:30 AM to 5 PM, Thursdays until 7 PM
  Web site: Worcester RMV
  Customer service: 1-800-858-3926 (9 AM to 5 PM)

If you are a nonimmigrant (for example, a student or visitor) and you have a valid driver's license from another country, you are usually allowed to drive in Massachusetts for up to a year from your date of arrival.

How do I get a Social Security number (SSN)?

If you are a noncitizen with permission to work in the United States, you will need a Social Security number. You may also need a Social Security number to get certain government benefits or services, whether or not you have permission to work.

To apply for a Social Security number,

• visit the Worcester Social Security office, OR
• print a copy of the SSN application from the Social Security web site and mail it to the Worcester Social Security office

The Worcester Social Security office address is:

• Social Security Administration Office
  51 Myrtle Street
  Worcester, Mass 01608         
  Telephone: 508-753-4105
  Hours: Monday through Friday 9 AM to 4 PM

To print a copy of the SSN application:

You will need to bring or send two original documents (or certified copies) proving your age, identify, and citizenship or immigration status. In addition:

How do I get a work permit?

All U.S. employers are required by law to make sure that their employees have permission to work in the United States. Therefore, new employees must show proof of their authorization to work.

U.S. citizens and legal permanent residents (LPRs) are allowed to work in the U.S. without restriction, at any job and for any length of time.

Other noncitizens may need to apply for an Employment Authorization Document (EAD), giving them permission to work in the U.S. An EAD may be general, allowing a noncitizen to work at any job, or it may be job-specific. Most EADs are valid for a limited time, but can usually be renewed.

To apply for a work permit, you must file Form I-765, Application for Employment Authorization. There are two ways you can do this:

Send the completed form to:

U.S. Department of Homeland Security
U.S. Citizenship and Immigration Services
Vermont Service Center
75 Lower Welden St.
Saint Albans, Vermont 05479

Tourists, business visitors, and certain other noncitizens may not be eligible for work permits.

How do I get a green card?

A green card shows that you are a legal permanent resident (LPR) of the United States, and allows you to live and work in the United States for as long as you choose. To get a green card, you must file an application with the United States Citizenship and Immigration Services (USCIS).

you may call the National Customer Service Center:

• USCIS National Customer Service Center
  Phone: 1-800-375-5283
  TTY: 1-800-767-1833
  Live assistance hours: Monday through Friday, 8 AM to 6 PM
  Automated assistance hours: 24 hours a day, 7 days a week

HEALTH CARE

Mass Health

MassHealth is a public health insurance program for people living in Worcester and other parts of Massachusetts.

To be eligible for MassHealth, you must be a low to medium-income resident of Massachusetts and meet certain general and financial eligibility requirements.

What benefits will I get?

The MassHealth program pays for all or some of a member’s health insurance and health care services. Services and costs vary depending on your type of coverage.

How do I apply?

To apply for MassHealth, you should call the MassHealth Enrollment Center at 1-888-665-9993 (TTY: 1-888-665-9997) to request an application. You can also download an application from the MassHealth Applications and Member Forms on the MassHealth web site, or visit a community health center.

How do I enroll?

Once you have been approved for MassHealth, you will receive an enrollment package explaining how to choose a health plan and a primary care doctor. You will also receive your MassHealth card which you must show whenever you need medical care.

MassHealth HMO Managed Care Health Plans

MassHealth members who want to enroll in an HMO managed care plan can choose from four plans: BMC HealthNet, Fallon Community Health Plan, Neighborhood Health Plan, and Network Health. All of the HMOs offer all MassHealth benefits, plus extras.

How do I use my benefits?

You can call MassHealth Customer Service at 1-800-841-2900 (TTY: 1-800-497-4648) or a community health center to find a doctor, dentist, or other health care provider in your area. Most MassHealth HMOs have online provider search tools.

Coverage types

MassHealth includes several coverage types with different rules for each coverage. The coverage types are:

·         MassHealth Standard: comprehensive health insurance, including long-term-care, for low-income Massachusetts residents including eligible parents with children under 19 years of age, pregnant women, children up to 19 years of age, the elderly, and disabled individuals.

·         CommonHealth: complete coverage similar to MassHealth Standard, for eligible disabled adults and disabled children through age 18 who cannot get MassHealth Standard because their incomes are too high.

·         MassHealth Family Assistance: health insurance with most of the services of MassHealth Standard, for children under 19 and people with HIV who are not eligible for MassHealth Standard or CommonHealth; also health insurance premium assistance for certain employed adults.

·         MassHealth Basic: a full range of health care benefits or premium assistance for EAEDC recipients and low-income Department of Mental Health clients who are long-term unemployed. (Note: Due to state budget cuts, immigrants with special status are no longer eligible for MassHealth Basic.)

·         MassHealth Limited: emergency medical coverage for undocumented noncitizens whose immigration status makes them ineligible for other MassHealth programs.

·         Medicare Buy-In programs: programs that pay all or part of Medicare health insurance expenses for eligible low-income Medicare recipients.

·         MassHealth Prenatal: short-term outpatient prenatal care (does not include labor and delivery) for low-income pregnant women.

·         MassHealth Essential: a wide range of health care benefits for the long-term unemployed who do not meet the eligibility requirements for MassHealth Basic. Coverage is similar to MassHealth Basic, but more limited.

Medicare

Medicare is a national health insurance program for people who are 65 or older, certain people under 65 with disabilities, and people with end-stage renal disease (permanent kidney failure). Medicare is basic protection, and does not cover all medical expenses or most long-term care.

Most people age 65 or older are eligible for Medicare. You may also be eligible if you or your spouse worked in Medicare-covered employment and you are under 65 and disabled, or you have end-stage renal disease (permanent kidney failure). Your income and assets do not affect your eligibility. For more information, call Medicare at 1-800-MEDICARE (TTY: 1-877-486-2048).

Children's Medical Security Plan (CMSP)

The Children’s Medical Security Plan (CMSP) is a basic health insurance program for Massachusetts children and teens under the age of 19 years who are not eligible for MassHealth. Primary and preventive medical and dental care services are included. Eligibility does not depend on immigration status or income.

What benefits will I get?

The Children’s Medical Security Plan (CMSP) covers preventive and non-preventive outpatient care, dental services, family planning, and prescription drugs and medical equipment. It does not cover hospitalization. Depending on income, some families pay a monthly premium for CMSP coverage, while others pay no premium. Most services require a small co-payment.

How do I apply?

To apply for the Children’s Medical Security Plan (CMSP), you must fill out the Medical Benefit Request (MBR) form, which is a joint application for MassHealth and the CMSP. You can get this application online from the MassHealth Applications and Member Forms; or by calling the MassHealth Enrollment Center at 1-888-665-9993; or by going to one of Worcester's community health care centers.

How do I use my CMSP benefits?

You will get a Children’s Medical Security Plan ID card which you must show when you bring your children for medical or dental care, or when you buy medical supplies or prescription medicines at the pharmacy. Certain community health centers and hospitals are CMSP network providers and accept CMSP insurance.

Commonwealth Care

Commonwealth Care is for adult Massachusetts residents who are uninsured, do not qualify for MassHealth or Medicare, and meet the income limits. Undocumented noncitizens are not eligible.

Members get comprehensive health coverage. The cost depends on household income. You can get more information and an application from the Commonwealth Care Customer Service line at 1-877-MA-ENROLL (1-877-623-6765) (TTY: 1-877-623-7773), or from any community health center.

Uncompensated Care (formerly called free care)

What is Uncompensated Care?

The Uncompensated Care Pool (UCP) is a health care "safety net" to make sure that all low income residents of Massachusetts can get health care when they need it, even if they don't have insurance. Free Care members can get free or reduced cost health services at community health centers and hospitals in Massachusetts. The cost depends on family income.

Am I eligible?

To be eligible for the Uncompensated Care Pool, you and other members of your family must have low or moderate income, and little or no health insurance. People of any income with extraordinary medical bills that they cannot pay are also eligible. Your citizenship or immigration status does not affect your eligibility. You must be a resident of Massachusetts to get Free Care.

What benefits will I get?

The Uncompensated Care Pool pays for medically necessary services at Massachusetts community health centers (CHCs) and hospitals. Free Care pays all of the cost, or part of the cost, depending on your income. Free Care does not cover fees from private doctors or specialists, independent labs, retail pharmacies, etc., or any other health services you get outside of community health centers or hospitals. Check for availability of benefits.

How do I apply?

Most people must file a MassHealth application to get UCP. You can file your application at a community health center (CHC) or hospital, or you can send your application directly to MassHealth. If you are applying for medical hardship, you must file a UCP application at a CHC or hospital. In Worcester, you may apply at the Family Health Center of Worcester (508-860-7720), Great Brook Valley Health Center (508-852-1805), St. Vincent Hospital (508-363-5000), or UMass Memorial Medical Center (508-334-1000). You will get a written notice within 45 days letting you know if you are eligible for Free Care. You may call the Free Care Help Line at 1-877-910-2100 for more information.

How do I use my benefits?

You will be approved for the Uncompensated Care Pool for one year from your eligibility date. In most cases, you must go to a community health center for non-urgent health care. If there is no CHC within 5 miles, if you need specialty care, or if you have a medical emergency, you may go to a hospital. You must report any changes that might affect your eligibility.

FREE WALK IN HEALTH CLINICS

Green Island Free Medical Services

Description: This clinic provides health care for adults, teens, children and infants who do not have health insurance. There are two volunteer doctors on staff, a pediatrician and an internist.

Services:

·         Medical services include immunizations for children and adults; developmental assessments; blood pressure and blood glucose screening; flu clinics; referrals for testing and follow-up services; and pharmacy assistance.

·         Interpreters are available if you call ahead of time.

·         There is a walk-in clinic for adults on the 2nd and 4th Monday of the month from 9:30 AM to 11:30 AM. There is a children's clinic every Thursday from 9:30 AM to 11:30 AM. Appointments are preferred, but you will not be turned away if you do not call first.

Contact information:

Green Island Free Medical Services
50 Canton St. (in Crompton Park)
Worcester, MA 01610          Map of this location
Telephone: 508-753-4661

Green Island Health Awareness Clinic

Description: This clinic offers family planning and other health services on a sliding scale. No one is turned away for inability to pay. The staff includes a nurse practitioner, bilingual counselors (Spanish-English), and an on-call physician.

Services:

·         Health services include family planning, HIV testing and counseling, cancer screenings, and various health education programs.

·         Bilingual (Spanish-English) interpreters are available at the clinic.

·         Clinic hours are from 2:00 to 4:30 on Tuesdays.

Contact information:

Health Awareness Clinic
Green Island Community Center
50 Canton St. (in Crompton Park)
Worcester, MA 01610          Map of this location
Telephone: 508-753-0800 or 1-800-637-5466

Guild of Our Lady of Providence Free Medical Program

Description: This free health clinic, at St. Bernard's Church in Worcester, offers medical care to children and adults who are uninsured or underinsured.

Services:

·         Services include immunizations, adult and pediatric medical care, pharmacy assistance, social services, and referrals.

·         Hours are Thursday evenings, from 6 PM to 8 PM. You do not need an appointment.

Contact information:

Guild of Our Lady of Providence Free Medical Program
St. Bernard's Church
228 Lincoln Street
Worcester, MA 01605          Map of this location
Telephone: 508-798-6818

Health Awareness Services of Central Mass.

Description: Health Awareness Services is a non-profit health care organization with family planning clinics and HIV counseling/testing sites in Worcester and other central Massachusetts locations.

Family planning clinic services:

·         Services include pap smears and breast exams; screening for high cholesterol, high blood pressure, anemia; blood tests for marriage license applicants; birth control; pregnancy tests; emergency contraception; referrals.

·         Charges for services are based on a sliding fee scale. No one is turned away because of inability to pay.

·         Hours are Mondays, 1:30 to 7:30 PM; Wednesdays, 11:30 AM to 4:30 PM; and Fridays, 9:30 AM to 2:30 PM. You should call for an appointment.

HIV testing/counseling services:

·         Services include confidential HIV testing; HIV counseling; and referrals.

·         These services are free.

·         Hours are Monday through Friday, 10 AM to 4 PM; and Tuesday evenings, 4:30 to 7:30 PM. This is a walk-in clinic. You do not need an appointment for these services.

Contact information:

Health Awareness Services of Central Mass., Inc.
405 Grove Street
Worcester, MA 01605          Map of this location
Telephone: 1-800-637-5466 or 508-753-0800  

Web site: Health Awareness Services of Central Mass.

St. Anne's Free Medical Program

Description: This program provides medical services free of charge for children and adults with no insurance or very little insurance. It serves Shrewsbury and surrounding towns, including Worcester.

Services:

·         This clinic offers medical care for adults and children, including physicals, diagnostic testing, obstetrics and gynecology, immunizations, medical equipment, pharmacy assistance, and referrals for urgent care.

·         Clinic hours are Tuesdays from 6 PM to 8 PM. You do not need an appointment.

Contact Information:

St. Anne's Church
130 Boston Turnpike (Rte. 9, across from Spag’s)
Shrewsbury, MA 01545          Map of this location
Telephone: 508-757-5154

UMass Memorial Ronald McDonald Care Mobile

Description: The Ronald McDonald Care Mobile is a mobile health care unit that makes scheduled stops at various locations in Worcester. It offers free health care to children and young adults who do not have health care because of financial problems, language barriers, or transportation issues. The Care Mobile is staffed by family doctors, nurse practitioners, dental hygienists, lab technicians, and outreach workers, and is equipped with medical and dental exam rooms and a lab.

Services:

·         Medical services include physicals, treatment of illnesses, immunizations, well-child care, lab tests, blood pressure tests, health education, vision referrals, hearing tests, and mental health counseling.

·         Dental services include dental exams, dental cleaning, dental x-rays, fluoride applications, sealants, and referrals.

·         The Care Mobile helps eligible families enroll in MassHealth, Free Care, and other low-cost or free health care programs.

·         The Care Mobile makes scheduled stops at community schools and various other locations in Worcester on weekdays between 9 AM and 6 PM. Call for a schedule. If possible, make an appointment ahead of time. However, walk-ins are always welcome.

Contact information:

UMass Memorial Ronald McDonald Care Mobile
Voice Mail: 508-334-6073

For appointments, call Nardy Vega: 508-334-7642 (office) or 508-341-9416 (mobile)

The Care Mobile stops at these locations:

·         Becker College, corner of West Street and William Street

·         Bell Pond, Belmont Street

·         Lakeside Apartments, 28 Lakeside Avenue

·         Upland Garden Apartments, 7–2 Upland Gardens Drive

·         South Worcester Neighborhood Center, 47 Camp Street

·         Worcester Youth Center, 27 Chandler Street

·         YMCA of Greater Worcester, Central Branch, 766 Main Street

·         community schools throughout Worcester

Web site: Health Care on Wheels

Worcester Evening Free Medical Service Program (WEFMSP)

Description: The Worcester Evening Free Medical Service Program (WEFMSP) has two walk-in clinics for adults and children with little or no health insurance. The clinic at Epworth United Methodist Church offers free general medical care, and the clinic at Wesley United Methodist Church offers eye care and hearing evaluations. Services are provided by volunteers from the Worcester area.

Services at Epworth United Methodist Church:

·         Services include physicals, lab tests, treatment of illnesses, medications, referrals to specialists, physical therapy, nutritional counseling, social services information, and other referrals

·         Hours are Mondays, 6 PM to 8 PM. This is a walk-in clinic. You do not need an appointment.

Services at Wesley United Methodist Church:

·         Services include eye exams; free or low cost eyeglasses; glaucoma and diabetic retinopathy exams; hearing tests; and low cost hearing aids

·         Hours are Mondays, 6 PM to 8 PM. This is a walk-in clinic. You do not need an appointment.

·         Glaucoma and diabetic retinopathy exams are given on the 1st Monday of the month only. Hearing tests are given on the 2nd and 4th Mondays of the month only.

Contact information:

Web site: Worcester Evening Free Medical Service Program

Other Walk-In Clinics

Health Awareness Services (see above) also has clinics in Framingham, Marlborough, Milford, and Southbridge. Call 1-800-637-5466 for more information.

St. Camillus Health Center hosts the Blackstone Valley Free Medical Program on the 2nd and 4th Mondays of every month in Whitinsville. Hours are 6 PM to 8 PM. Call 508-234-7306.

MEDICATIONS

Prescription Advantage

Prescription Advantage is a state-sponsored prescription drug insurance plan for Massachusetts seniors and disabled residents who meet eligibility requirements.

To be eligible for Prescription Advantage, you must be a Massachusetts resident who is 65 years or older; or a Massachusetts resident under 65 who is disabled and meets the income and employment guidelines. You cannot join Prescription Advantage if you get prescription drug benefits through MassHealth. Your immigration status and your current state of health do not affect your eligibility.

To apply for Prescription Advantage, you should call 1-800-AGE-INFO to get an application. You may also write to Prescription Advantage, P.O. Box 15153, Worcester, MA 01615-0153, or visit the Worcester Senior Center at 128 Providence St.

What is MassMedLine?

MassMedLine is a free prescription drug information and referral service for Massachusetts residents. The service is a partnership between the Massachusetts Executive Office of Elder Affairs, and the Massachusetts College of Pharmacy and Health Sciences.

By calling the MassMedLine toll-free Helpline at 1-866-633-1617, people can get medication counseling, prescription drug plan referrals, and information about ways to get free or discounted drugs.

Am I eligible?

All residents of Massachusetts are eligible to use MassMedLine. There are no income limits or other eligibility requirements.

What benefits will I get?

MassMedLine services include:

·         Medication counseling

If you have questions about the medications you are taking, lower cost alternatives, drug interactions, etc., licensed pharmacists will help you.

·         Prescription drug plan counseling

Trained staff members will answer your questions about Medicare Prescription Drug Plans, Prescription Advantage, MassHealth drug benefits, and other prescription drug insurance options.

·         Referrals for free and discount drug programs

If you cannot afford your medications, MassMedLine staff members will try to find drug company programs or private agency programs to help you. You may be eligible for free or discounted medications through one of these programs.

All MassMedLine services are free.

How do I apply?

All Massachusetts residents are eligible for MassMedLine. There is no application. However, in order for MassMedLine to help you, you must fill out a questionnaire with information about your medications, your income, and your health insurance coverage.

You can get a copy of this questionnaire by calling MassMedLine at 1-866-633-1617, or by downloading it from the MassMedLine web site:

• MassMedLine Patient Profile Form (requires Adobe Reader)

All information you give to MassMedLine is confidential. Your privacy rights are explained on the questionnaire.

HIV/AIDS

Although AIDS is a global epidemic, we cannot help but notice its disproportionate impact on Africa and the African people.  According to the World Health Organization (WHO), 10% of the World’s population lives in Sub-Saharan Africa and that region contains 60% of the World’s HIV/AIDS cases.  The number of African people infected, estimated at over 25 million people, is staggering.  In 2004, over 2 million died and another 3 million became infected.  The rates of infection in China, Russia and India are also increasing at an alarming rate.

As fellow citizens of the world who may also have families, friends and roots in these nations, we cannot look away.  And, if only because of where and when we were born, it continues to affect us here.  Recent immigrants from African nations are in great need of HIV/AIDS services--at high risk for HIV infection, or HIV-positive--due to the devastating scale of the AIDS epidemic in their homelands.

Many recent immigrants to the United States are reluctant to seek HIV testing and treatment.  Because they are more familiar with medical care in their countries of origin, they may not be aware of the life-saving treatment available here.  Not knowing or learning the facts about the HIV virus and how it is transmitted can be fatal.  Not being tested could mean passing the virus to someone you love or your unborn baby.  Not getting medical care while in the early stages of the disease can prevent people from living long and healthy lives. 

HIV does not discriminate, and neither should we.  This disease does not care about age, gender, religion or skin color.  It does not care how much money we have or how often we go to church.  HIV is a medical condition—like cancer, diabetes, or asthma--that can be controlled with proper medical care.  We are fortunate to live in a country that has so many resources to help people with almost any medical condition:  knowledgeable doctors, effective medications, and great health facilities.  The State of Massachusetts is well-known for its commitment of offering easily accessible programs to people with HIV and AIDS.

Here are a few things that you should know:

Ø   Free, anonymous or confidential HIV testing is available throughout Massachusetts.  Call 1-800-235-1672 for days, times and locations, or just to get answers to your questions.  The call is free and you do not have to give your name.

Ø   With proper pre-natal care, a pregnant woman who has HIV can drastically reduce the chances of passing the virus onto her baby.  By taking the right medication during pregnancy and not breast-feeding, the baby’s chances of contracting HIV from its mother can decrease from 20-25% to less than 2%.

Ø   People who test positive for HIV/AIDS can get medical care and financial help to get their medications.  Massachusetts has special programs to help people with HIV/AIDS get the care they need.  You do NOT have to be a citizen to use many of these programs, and the information is NOT reported to immigration officials.  People with HIV can get help from HDAP (HIV Drug Assistance Program); HDAP can help pay for medications, co-pays, and enrollment in a health insurance program.  If you have HIV and could use help with these things, call HDAP at 1-800-228-2714. 

Twenty years ago, when HIV/AIDS first emerged in the U.S., everyone was afraid.  We did not know how the disease was transmitted, how to prevent it, or how to treat it.  Science and medicine have changed those things.  Like cancer and many other diseases, early detection and treatment can make an enormous difference in the both the length and quality of life of a person with HIV disease.  And, even more than other medical conditions, records of HIV status and treatment are –by law--held in strictest confidence.

Although some people are fearful of being stigmatized within their own communities, the long-term health benefits of knowing their HIV status may far outweigh those fears.  Denial will not make HIV go away---and neither will medicine.  There is still no cure for HIV/AIDS, but it is not a death sentence.  By getting good medical care and taking the right medications, people with HIV or AIDS can live and be healthy for many, many years.

Knowledge is power.  To get answers to your questions about HIV/AIDS, you can call the State (1-800-235-2331) or Federal (1-800-232-4636) Hotlines.  Both numbers are free and confidential.

Sources: Sandi Carlson - UMMASS Medical School

Referring Worcester Families to Child Care Programs

Families Who Receive DTA Benefits	Low Income Working Families with toddlers  up to 2.9 years old & school age children up to 12 years old	Childcare For Teen Parents	Preschool Child Care (ages 2.9 - kindergarten)	Private Pay
First: Ask your DTA worker for a Child Care referral to take to Child Care Resources at least a week before start of work / job training. Then:  Make appointment at Child Care Resources: 90 Madison Street, Worcester, MA 01608	§     Visit and/or phone Child Care Resources to get on income eligible waiting lists:  90 Madison Street, Worcester, MA 01608 / 508-798-8112 Vouchers provided for children ages infant to age 12 (Call to check on income eligibility requirements)   Start this process as early as possible!!!  As soon as you know your baby’s due date, if possible.	§     Visit and/or phone Child Care Resources to get on income eligible waiting lists:  90 Madison Street, Worcester, MA 01608 / 508-798-8112 And Apply for DTA Benefits!! : ·          DTA Office at 9 Walnut St., Worcester. / (508)767-3100 ·          For families with children (under the age of 19) or pregnant women at or below 125% of the federal poverty level. The asset limit = $2500	Contact: §     Worcester Head Start, 770 Main Street,: a free pre-school program for 3-5 year-old children from low-income families (see eligibility below) Or §     Worcester Public Schools Preschool Program:  Apply at the James L. Garvey Parent Information Center, 768 Main Street, Worcester, MA 01610, telephone 508-799-3194. For Worcester residents/ children 4 years of age by December 31st. Selection is done through a lottery system. You should apply before the announced lottery date.   Or §     Worcester Community Partnerships for Children  Worcester Public Schools- James L. Garvey  Parent Information Center 768 Main Street Worcester, MA 508-799-3642. (Financial assistance for eligible families with children ages 2.9 – 4.9 years old).	§     Visit/contact Child Care Connection for information on private pay providers:  100 Grove Street, Suite 102 Worcester/ 508-757-3880   §     Get listing of in-home licensed family child care providers in your neighborhood (Through Child Care Connection or www.eec.state.ma.us/fe. These providers sometimes offer flexible schedules

Important!  Bring all documentation to your appointment at Child Care Resources or your voucher will not be issued!!!

Call Child Care Resources before you go to find out what to bring:  508-798-8112

____________________________________________________

General Information & Referral

Child Care Resources

90 Madison Street, Worcester, MA 01608.

Before you go, make an appointment with a counselor by calling 508-798-8112 or 800-952-9183.

Provides referrals to licensed day care providers for parents enrolled in Department of Transitional Assistance.  Also assists families who do not receive DTA benefits but need help paying for child care services.  These families can apply to be on waiting list to receive child care financial assistance. Maintains statewide waiting list.

Child Care Connection

A program of Family Services of Central MA

100 Grove Street, Suite 102

Worcester, MA  01605

508-757-3880

Provides child care resource and referral services for parents on selecting child care programs including family child care, day care centers, school age programs, nursery schools, summer camps and in-home care.  Also provides information and referral to day care for special needs children

Worcester Community Partnerships for Children

A program that helps make quality preschool programs more affordable for eligible families in Worcester.

Worcester Public Schools – James L. Garvey Parent Information Center

768 Main Street

Worcester, MA  01610

508-799-3642.

Contact: Madeleine Gentile, Coordinator / Early Childhood Program Specialist

Eligibility: You must be a working or in school (up to undergraduate level), living in Worcester and have a preschool child between the ages of 2.9 and 4.9. Your income must be within the program limits.

Benefits: Eligible families get financial help to pay for early childhood programs for their preschool children. Families pay a fee based on their income and family size, according to the Massachusetts sliding fee scale for child care.

_________________________________________________________________________________________

Tips For Parents:

Eligible for Subsidized Slots (Low income or receiving DTA benefits	Private Pay
Apply at Child Care Resources to get on statewide waiting list. CCR alone has ability to update info in the statewide system.	Get on waiting list early (there is one statewide waiting list) at Child Care Resources.  CCR alone has ability to update info in the statewide system. Get on waiting list as soon as you know your baby’s due date – no matter how long the list is!!
Even if you or your childcare provider goes on vacation – many childcare providers will still require payment.	For listing of local private providers visit www.eec.state.ma.us -Then sort by zip code—to narrow down list, call or visit Child Care Connections. These may have more flexibility of  hours of operation.
DTA clients can apply for travel time to allow additional time to drop children off at childcare if they are working or are in job training – depends on circumstances.  Ask Child Care Resources worker.	Even if you or your childcare provider goes on vacation – many childcare providers will still require payment.
Watch out for Renewal letter from Child Care Resources that will be sent out 6 months after family is placed on waiting list for slot.  Family must contact CCR within ten days of the letter to inform them that they wish to remain on the list – or they will be removed.	Most centers charge a parent/caregiver if he/she is late in picking up his/her child.  Child Care Voucher does not cover late fees—parent is responsible for late fee.
Keep the DTA and/or Child Care Resources aware of any address changes!! – Contact with these agencies is mostly through the mail!!  Reply to all correspondence!	Keep Child Care Resources aware of any address changes!! – Contact with these agencies is mostly through the mail!!  Reply to all correspondence!
Most centers charge a parent/caregiver if he/she is late in picking up his/her child.  Child Care Voucher does not cover late fees—parent is responsible for late fee.	Watch out for Renewal letter from Child Care Resources that will be sent out 6 months after family is placed on waiting list for slot.  Family must contact CCR within ten days of the letter to inform them that they wish to remain on the list – or they will be removed.
If your voucher is due to expire, call CCR at least two weeks before.  When you call, make sure you leave the date that your voucher will expire.	If your voucher is due to expire, call CCR at least two weeks before.  When you call, make sure you leave the date that your voucher will expire.
·        Be on time for appointments. Child Care Resources runs on a tight schedule and may have to reschedule your appointment otherwise.

How to Choose a Childcare Provider:

Family Child Care offers care in the provider’s home.  You should be sure that the home is licensed and inspected on a regular basis. 

• When visiting the home look at the environment. 
• Is it childproof? 
• Are outlets covered? 
• Are cleaning products and electrical cords out of reach? 
• Are the toys and materials age appropriate? 
• Is the television on?  (If the TV is always on, the children may not be getting enough stimulation.)  Ask about the daily schedule.  Children thrive on routine.  There should be a regular schedule for naptime, snack and meal time, story time etc.
• Ask about who else will be in contact with your child.  Will the caregiver’s husband be home?  What about a teenage child and his or her friends? 
• Be sure to look at the outside play equipment as well.  Make sure it is in good condition.

When touring a childcare center, the same rules apply. 

• The center should have a current license from the Mass. Dept. of Early Education and Care.  National Association for the Education of Young Children (NAEYC) accreditation is a good measure of childcare quality. 
• The center should be clean and free from safety hazards.
• You will want to know that you can “drop-in” at any time.
• Ask about staff turnover.  Consistency in caregivers helps children to develop a sense of security.  Adjusting to new caregivers is difficult for young children. 
• Ask about the educational background of staff.  Have they completed courses in Early Childhood Education?  When you visit, are the children engaged in activities?
• Is the staff taking care of crying or upset children in a sensitive and nurturing manner?  Is conflict between children handled in a positive manner? 

The most important question you can ask yourself is, “Am I comfortable leaving my child here?”  If you have a bad feeling about the caregiver or the center, listen to your instincts.

Head Start

Worcester Child Development Head Start Program - Worcester Public Schools

A federally funded pre-school program. Services include: Education, Social Service, Health, Nutrition/Dental, Special Needs Services, and Family Involvement support.

·         Acceptance is based on Federal Income Guidelines.

·         Children with special needs are given special consideration.

·         For children ages 3 and 4 year.

·         Must be a resident of Worcester.  (Documentation required, such as a utility bill)

·         Must provide up to date immunization record and physical exam &

             Birth Certificate

·         Offer both Half Day and Full Day Programs.

·         Half-day programs operate 5 days per week from 9:00 a.m. to 12:30 p.m. 

·        Full day programs operate 5 days per week from 8:00 a.m. – 3:00 p.m. for parents who work at least 20 hours a week, who are going to school, or are in job training programs.  Documentation is required.

·        Limited transportation may be available.

Size of Family Unit	Income Limit
1	$9,800
2	13,200
3	16,600
4	20,000
5	23,400
6	26,800
7	30,200
8	33,600
For each additional person add