Opioid Mortality and Grant, Post-Acute Care

Opioids: BMC’s Shocking Mortality Study; AG Healey’s Grant Opportunity

Researchers at Boston Medical Center’s Grayken Center for Addiction have completed a study that finds that over a 10-year period infective endocarditis (heart valve infection) will cause 20% of those who inject opioids to die. The modeling estimates that 257,800 people are expected to die from infective endocarditis by 2030, which translates to 7,260,000 years of potential life lost. The study was published in Clinical Infectious Diseases.
“The expected burden of [infective endocarditis] among people who inject opioids in the U.S. is large,” wrote the researchers, led by Joshua Barocas, M.D., an infectious diseases physician at BMC’s Grayken Center. “Adopting a harm reduction approach, including expansion of syringe service programs, to address injection behaviors could have a major impact on decreasing the mortality associated with the opioid epidemic.”
Last Thursday, Massachusetts Attorney General Maura Healey announced a $1.5 million grant program that aims to promote equity among treatment programs for opioid use disorder in Massachusetts. Promoting Cultural Humility in Opioid Use Disorder Treatment is funded by a settlement that the AG’s Office reached with Injured Workers Pharmacy for unlawful and dangerous prescription drug dispensing practices. The grant program will support recovery programs committed to standards that serve racially, ethnically, and socioeconomically
diverse communities in Massachusetts. Priority will be given to organizations based in the communities they serve.
Applicants can include municipalities, non-profit organizations and quasi-public entities in Massachusetts that will be able to request up to $100,000 over a two-year period to supplement or create opioid use disorder treatment programs that incorporate cultural humility in Massachusetts. Interested applicants can visit here for more information and for application instructions. Applications must be received by 7 p.m. on October 23, 2020.

CHRTF Funding Announced

The Executive Office of Health and Human Services (EOHHS) announced last week that 42 acute care hospitals are eligible to receive a total of $10.16 million through the Community Hospital Reinvestment Trust Fund (CHRTF). CHRTF was established through Chapter 115 of the Acts of 2016, which required the Center for Health Information and Analysis (CHIA) to transfer $5 million to the trust fund in FY2017 and $10 million annually through FY2021. (The extra $160,000 available this year is left over from the previous year.) Hospitals are deemed eligible for trust fund payments through a CHIA-calculated formula that determines a hospital’s relative prices against a state median. All hospitals fund CHIA through annual assessments; the return of money to hospitals through CHRTF is, in part, a transfer of funding from hospitals with higher prices to those with relatively lower prices.

Post-Acute Care in the Time of COVID-19

COVID-19 put a focus on hospitals – both in terms of care provided and their capacity to accept patient surges. Also receiving attention is the post-acute aspect of care – that is, the care patients receive once they are discharged from an acute care hospital. During COVID-19, post-acute care has become especially important because transitioning recovering patients once they are healthy enough to do so is a necessary way of keeping hospital beds open for the sickest patients.
To learn more about post-acute care, visit the COVID-19: The Post-Acute Story blog on MHA’s website, which includes both written commentary and a video. In the posting, Lou Woolf, president & CEO of Hebrew SeniorLife, and Robin Hynds, R.N., senior VP of Network & Strategic Operations and Chief Clinical Integration Officer at Lawrence General Hospital, discuss the challenges such caregivers face. The two, with assistance from MHA, put together the Post-Acute Care Transitions Workgroup in late March to deal with the special issues arising from COVID-19 outbreak.
“Throughout this crisis, post-acute caregivers have done absolutely heroic work in making sure every patient in need of care – whether for COVID-19 or not – is treated in an effective, safe, and timely manner,” Woolf and Hynds write. “Home care workers enter patient homes where the ability to mitigate their exposure to COVID-19 is much less within their control. Those working in assisted living, long-term acute care, and skilled nursing facilities feel the pressures of treating large volumes of at-risk individuals. And yet, they continue to show up, make their patients comfortable, and provide world-class care.”

Get a Flu Shot … 

It can’t be stressed enough – a flu shot this year as the healthcare system prepares for a second surge of COVID-19 is imperative. Flu season usually begins in October and can last through March. MHA beginning this week will assist hospitals through a “flu toolkit” to get the message out to communities about the need for flu vaccinations. The goal is to keep people out of the hospital for the flu so that beds can remain open if needed for COVID-19.
Last week, The American Academy of Pediatrics said that everyone over six-months old should receive a vaccine either through a flu shot or nasal spray flu vaccine. The Academy said children should receive the flu vaccine as soon as it is available in their community and complete their vaccinations ideally by the end of October. 

… And Attend an Immunization Conference

Registration is now open for the Massachusetts Immunization Action Partnership (MIAP) Conference, a full-day virtual pediatric gathering. There will be an overview of the current pediatric immunization recommendations, plus general immunization updates and the current state of immunization in Massachusetts. The MIAP Conference is for vaccine coordinators, physicians, nurses, NPs, PAs, medical assistants, and anyone who works in pediatric healthcare or public health. The registration fee is $50. Click here to register, learn about available CMEs, see bios of presenters, and more.

MHA Supports Equity, Inclusion Efforts

The legislature’s Health Equity Task Force is holding a virtual public hearing on Wednesday, September 16 from 1 to 4 p.m., to hear testimony on health disparities for underserved or underrepresented populations during the COVID-19 pandemic. The group was created through legislation Governor Baker signed in June and is tasked with recommending to the legislature ways to, among other things, improve safety for populations at increased risk for COVID-19 and remove barriers and increase access to equitable healthcare services. The task force is co-chaired by Dr. Assaad Sayah, the CEO of Cambridge Health Alliance (who was appointed by House Speaker Robert DeLeo) and Michael Curry, the deputy CEO & general counsel of the Massachusetts League of Community Health Centers (appointed by Senate President Karen Spilka).
A June report from DPH’s Health Equity Advisory Group found that Blacks and Hispanics have a three-times-higher positive COVID-19 case rate than White non-Hispanics. They also have higher rates of hospitalizations and higher age-adjusted mortality rates from COVID-19. Nine of the 10 cities and towns with the highest rates of COVID infection are also communities where more than half the residents identify as people of color, according to the DPH report.
MHA supports pursuing policy and other initiatives to address social determinants of health and ensure equity in healthcare delivery across all patients. This spring, MHA created a Board-level Standing Committee on Diversity, Health Equity and Inclusion. That mission of the committee, chaired by Boston Children’s Hospital President & COO Dr. Kevin Churchwell, is to advise the Board of Trustees and staff on strategies, initiatives, data, and partnerships that will advance diversity, cultural competency, health equity and inclusion, and eliminate structural racism among the healthcare workforce and institutions.

Transition: Children’s Fenwick

Sandra Fenwick, the CEO of Boston Children’s Hospital since 2013, has announced she will retire from the post effective March 2021. Fenwick joined Children's in 1999, was promoted to COO later that year, and became President and COO in 2008. Children’s is consistently ranked as the top pediatric hospital in the U.S. 

3 Reasons You Can't Miss This Year's
MHA Annual Leadership Forum: Healthcare Reimagined!

Thursday, September 24; 9 to 11:30 a.m. Virtual Webcast; #MHALeaders

1) Healthcare’s thought-provoking Dr. Atul Gawande will deliver a keynote address on the future of healthcare
2) Noted PBS correspondent Yamiche Alcindor will provide her insights on "Healthcare and the 2020 Election"
3) Health equity will be a focus, featuring some of Massachusetts’ own trailblazers 
Just a year ago, no one could have predicted the course of global events leading to the worst pandemic in more than 100 years. Hospitals mobilized and met the challenge, but the battle is not yet over. Join us at MHA’s Annual Leadership Forum where local and national thought leaders will discuss what the future holds for innovative breakthroughs, health equity, and the 2020 elections. This year’s virtual conference will feature Dr. Mallika Marshall as emcee, engaging panel discussions, and enlightening educational sessions. Register today! 

John LoDico, Editor