The State Senate begins debate tomorrow on the Senate Ways & Means proposed state budget for FY2020 and the 1,100-plus amendments to it that have been filed.
Hospitals are hoping that the Senate approves much needed relief for disproportionate share hospitals and compels the state to contribute funding to the Health Safety Net. Hospitals are also aligned in supporting amendments that address MassHealth payments for the most complex and sickest patients; provide insurance coverage for nasal naloxone rescue kits given to patients in hospital emergency departments; ensure access to telebehavioral health services for all MassHealth patients; assist providers with additional case management and care navigation as they help patients access community-based treatment for opioid use disorder; and, finally, to ensure that MassHealth does not prevent safety net hospitals from getting the pharmaceutical manufacturer discounts to which they are entitled under the federal 340B program.
The hospital request for the disproportionate share hospitals is that they receive an additional $17 million, but because of the state-federal Medicaid match formula, the net cost to Massachusetts would only be an additional $6.8 million.
The Health Safety Net, which funds care for the uninsured and underinsured, is consistently underfunded and its budget shortfall is covered by hospitals alone. That means that in FY2019, hospitals are estimated d to absorb $69 million in unfunded care – and the shortfall is expected to grow in FY2020. This is in addition to the $165 million hospitals contribute to the Health Safety Net through an assessment for care provided to low-income patients. Hospitals are asking the state to clarify the $15 million state budget directive included in the Senate budget. For the past four years, the permissive language related to this transfer has resulted in no financial support from the state for this important program.
Of the many amendments filed, the hospital community will be joining with nursing organizations, physicians and many others to raise strong opposition to #435, put forth by the Massachusetts Nurses Association, the union representing less than 25% of nurses in the state. Under the guise of promoting multiple studies on nursing-related issues, it actually sets the stage for the imposition of government-mandated ratios in acute care hospitals.
“The premise of mandated nurse staffing ratios has been rightfully and definitively rejected by policymakers and the voters of Massachusetts,” said MHA’s Vice President of Clinical Affairs Patricia Noga, R.N., PhD. “Our collective focus should now be centered on meaningful workplace supports for the entire healthcare workforce. That’s why the hospital community is working collaboratively on numerous cross-sector initiatives focused on safety, engagement, professional development, and wellbeing, with the aim of identifying ways to improve our workplaces and support all members of the care team.”