Representing the best interest of nursing professionals and their patients, the American Nurses Association (ANA) Massachusetts has joined the Coalition to Protect Patient Safety in opposition to a ballot question that mandates rigid nurse staffing ratios. The initiative petition has been proposed by the Massachusetts Nurses Association (MNA) union, which represents less than 25% of nurses in the Commonwealth.

“This is the wrong path for Massachusetts, for patients and for nurses,” said Diane Hanley, president of the ANA Massachusetts Board of Directors. “This proposal undermines the flexibility and decision-making authority of nurses and puts rigid mandates above patient safety, clinical nurse input, nurse manager's discretion, and every other consideration in a hospital.” 

ANA Massachusetts is the local chapter of the American Nurses Association, the premier organization representing the interests of the nation's 3.6 million registered nurses. ANA advances the nursing profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA Massachusetts joins the Organization of Nurse Leaders (ONL) in representing tens of thousands of nurses who want to protect the state’s healthcare system and its patients from the costs and consequences of rigid, government-mandated nurse staffing ratios. The petition is expected to be placed before voters on the November 2018 state ballot. 

“This proposal threatens the high quality of care we provide patients,” said Amanda Stefancyk Oberlies, CEO of ONL. “It will prevent nurses and doctors from being able to use their best judgment in times of crisis, and the cost pressures will negatively impact other commitments that support nurses, including professional development, research support, nurse residency programs and other funding for nurse time away from the bedside.”

In addition to ANA Massachusetts and ONL, the Coalition to Protect Patient Safety includes the Massachusetts Health & Hospital Association, the Massachusetts Council of Community Hospitals, the Conference of Boston Teaching Hospitals, and other healthcare leaders.
Learn more about the Coalition to Protect Patient Safety at www.facebook.com/ProtectPatientSafety and twitter.com/MAPatientSafety.

Last Tuesday, Governor Charlie Baker and Health & Human Services Secretary Marylou Sudders testified at length before the Joint Committee on Mental Health, Substance Use and Recovery on the governor’s second major bill to stem the opioid epidemic in the state.

MHA strongly supports the governor’s legislation – HB4033, “An Act Relative to Combatting Addiction, Accessing Treatment, Reducing Prescriptions, and Enhancing Prevention”. 

Recent data indicates that overdose deaths are declining and there has been a 29% reduction in opioid prescriptions since the governor enacted Chapter 52 of the Acts of 2016 (the STEP Act); but there are still people struggling with opioid addiction in the state, which tragically has resulted in many deaths.

In written testimony, MHA said HB4033 takes the next needed steps by improving access to treatment, preventing opioid misuse, and expanding care coordination between acute and community-based services.

“The hospital community stands as a committed partner to Governor Baker and the legislature in doing whatever it can to stem this persistent epidemic, including the development of more effective operational policies, clinical standards, and care coordination measures,” MHA wrote. “MHA looks forward to working with this committee, the administration and the full legislature to ensure the enactment of these and other evidence-based tools.”

MHA and its members have worked closely with the Baker Administration to develop policies and best practices to address the opiate epidemic, including: limiting opioid prescriptions to a seven-day supply; using prescriber reports from the state’s prescription monitoring program (MassPAT) to monitor inappropriate prescriptions; developing non-opiate pain management alternatives; and implementing standards for substance use disorder evaluations within emergency departments.

Last Wednesday, the new MHA-MMS Joint Task Force on Physician Burnout held its first meeting.

While representatives from MHA and the Mass. Medical Society have for many years sat on task forces together, the physician burnout group is perhaps the first task force that the two groups have chaired jointly.

Drs. Alain Chaoui, MMS president elect, and Steve Defossez, MHA’s VP of Clinical Integration, lead the task force.

According to various studies over the years, 54% of doctors say they are burned out, 88% report moderate to severe stress, and 59% of doctors wouldn’t recommend a career in medicine to their children.  It is commonly estimated that approximately 300 to 400 M.D.s commit suicide each year.

The goal of the task force is to identify and prioritize effective strategies to combat physician burnout and advocate for statewide adoption of identified strategies and practices. The task force will ultimately present its findings to the governing boards of MHA and MMS.

MHA’s Defossez said, “I’m hopeful we can make real progress on this long-standing problem and come up with a series of meaningful steps that not only will address physician burnout in the commonwealth, but could be used as a template for change across the U.S.  Alain and I also believe that while our focus is on physicians, we hope that our learnings and strategies may also be transferable to combat burnout of other types of clinicians.”

Senators Edward J. Markey (D-Mass.), Rand Paul (R-Ky.), Maggie Hassan (D-N.H.), and Susan Collins (R-Maine) last week introduced the “Addiction Treatment Access Improvement Act” that will expand access to medication-assisted therapies for opioid addiction. The legislation codifies a 2016 regulation that expanded the number of patients – from 100 to 275 – that qualified physicians could treat with life-saving medication-assisted therapies such as buprenorphine (also called Suboxone).

The legislation also builds upon a pilot program established in the Comprehensive Addiction and Recovery Act (CARA), signed into law in 2016, allowing non-physician qualified health practitioners to prescribe buprenorphine, making this authorization permanent and expanding the types of professionals who qualify.

Senators Markey and Paul are the original authors of the provision in CARA, modified for inclusion in the law, that for the first time allowed trained nurse practitioners and physicians assistants to provide life-saving medication-assisted therapies to those suffering from opioid use disorders. More than 42,000 Americans died of an opioid overdose in 2016; more than 2,000 of those deaths were in Massachusetts.

The new opioid legislation is supported by the American Society of Addiction Medicine, the American Nurses Association, American Association of Nurse Practitioners, American Academy of Physician Assistants, the American College of Nurse-Midwives, and the American Association of Nurse Anesthetists.

As of Monday Report’s deadline last Friday, bipartisan talks on the FY2018 federal spending bill remained contentious.  If the issue has not been resolved by the time you read this on Monday, here are some items of which to be aware.

Since 1976 there have been 17 federal government shutdowns.  Most were remedied within two weeks, and often sooner. The longest lasted 21 days, beginning in 1995 and ending in 1996.

During previous short-term government shutdowns, the Centers for Medicare and Medicaid Services (CMS) indicated that claims processing would not cease. A longer-term shutdown would require further guidance from CMS regarding whether claims processing would continue; in 1995 the fiscal intermediaries held claims until the shutdown’s conclusion.

Other healthcare programs administered through the Department of Health and Human Services would be affected by a shutdown. These include payments for Children’s Hospital graduate medical education, Centers for Disease Control and Prevention grants for seasonal influenza and other public health assistance, and nearly all other federal grants and program administration.

Here is public guidance that HHS issued last Friday.

MHA's 51st Annual Mid-Winter Leadership Forum

Friday, January 26, 2018; 9 a.m. to 2:45 p.m.

Sheraton Framingham Hotel

Don't miss MHA's most informative leadership meeting of the year. The atmosphere on Beacon Hill and in Washington, D.C. continues to be volatile, creating daily challenges for hospital and healthcare leaders. At this year’s Mid-Winter Leadership Forum, we will take a deep dive into the most pressing legal and regulatory issues for hospital leaders, including Medicaid, healthcare costs, opioids, and current legislative initiatives. We’ll also discuss how telemedicine will change the Massachusetts care delivery landscape and reimbursement system — and how it’s already affected care in other states. Speaker of the Massachusetts House Robert DeLeo is the Forum’s special guest speaker. We’ll conclude with a session with local commentators Jim Braude and Margery Eagan — always cogent and incisive — speaking about how to keep today’s headlines in perspective. It’s a don’t-miss program. Click here now to register.