Vaccine Rollout; X-Waiver Waived

Vaccine Rollout Continues

Today the state continues its Phase 1 vaccine rollout by expanding vaccinations into congregate care settings, which includes residential treatment programs, corrections facilities, domestic violence and sexual assault shelters, and veterans’ shelters, among other sites. Approximately 94,000 people fall under this congregate care category. Next on the Phase 1 vaccine rollout in coming weeks will be home-based healthcare workers and non-COVID-facing healthcare workers.
Hospitals across the state are reporting strong demand for the vaccine and are fielding questions from their communities about when they can get the shots. Last week, the Beth Israel Lahey Health system sent e-mails to its patients to explain the state’s vaccine distribution. “We will be contacting our patients individually to let you know when it's your turn based on the state’s guidelines and vaccine availability,” the system wrote. “You do not need to call your doctor's office at this time.” Many other hospitals and health systems are conducting similar outreach and are encouraging people to check the mass.gov/COVIDvaccine webpage for the latest updates.
Phase 2, scheduled to begin in February, will first provide vaccines to individuals with 2-plus comorbidities, individuals age 75 and older, and residents and staff of public and private low income and affordable senior housing. Then a long list of essential workers, followed by residents over age 65, and then individuals with one co-morbid condition can get the vaccine. 
The entire vaccination timetable depends on the state receiving enough vaccine through the federal government. Last week, President-elect Joe Biden said he would ask Congress for $400 billion to expand vaccine distribution to meet his goal of inoculating 100 million Americans within the first 100 days of his administration. Also last week, U.S. Health & Human Services asked hospitals, beginning January 13, to add to their regular reporting requirements a new field showing how many healthcare personnel and patients have received the vaccine.

Eliminating the X-Waiver Improves Substance Use Disorder Treatment

The U.S. Department of Health and Human Services (HHS) last Thursday announced it is eliminating the so-called “X-waiver” requirement for physicians treating those with opioid use disorder. The revised guidelines mean more physicians will be able to provide buprenorphine to patients to help curb the steadily increasing opioid epidemic across the U.S. 
Buprenorphine is an FDA-approved medication that is used as part of a treatment plan for opioid use disorder that may also include counseling and behavioral therapies. To prescribe buprenorphine in an outpatient setting, a physician has to fulfill a series of requirements to receive a waiver from the Drug Enforcement Administration. In its revision of the guidelines last week, HHS said that the process of receiving the waiver “represents a significant perceived barrier” to prescribing buprenorphine and that its removal “would dramatically improve” access to the drug.
There are still limits to the exemption from the waiver. For example, it applies only to physicians and not “qualifying practitioners" such as nurse practitioners and physician assistants; physicians using the exemption can treat no more than 30 patients; and doctors cannot treat patients across state lines. The new HHS guidance will take effect immediately on its publication in the Federal Register.
"This is a promising step forward in the health system's ability to treat individuals struggling with substance use disorder," said Leigh Simons Youmans, MHA's senior director of healthcare policy. "It's clear that the COVID-19 pandemic has only exacerbated the opioid epidemic, and medication for opioid use disorder such as buprenorphine is one of the most powerful tools at a clinician's disposal. Breaking down the barriers for qualified clinicians to offer this treatment will undoubtably help save lives.”

Neal’s Ways & Means Agenda Focuses on Health & Economic Equity

The recent attack on the U.S. Capitol, the reasons for it and the response to it, once again pointed out for many the inequalities that persist in the United States. Last week, House Ways and Means Committee Chairman Richard E. Neal (D-Mass.) released a report that the Democratic staff of the committee prepared, entitled Something Must Change: Inequities in U.S. Policy and Society. It provides context for another report Ways & Means released, entitled A Bold Vision for a Legislative Path Toward Health and Economic Equity that discusses the policy priorities of the committee under Neal’s leadership.
“The framework we present here is Ways and Means Committee Democrats’ plan to make our nation a more just and equitable place,” Neal wrote in his introduction to the policy document. “Some actions we can pursue almost immediately. Other advancements may take longer to become law. But inaction is not an option. Complacency cannot be tolerated.”
While the healthcare sector’s focus has been primarily on COVID-19 throughout 2020, hospitals using their status as agents of change within communities have continued to address the issues of racial injustice. MHA’s Board of Trustees, for example, created a Standing Committee on Diversity, Health Equity & Inclusion – one of only five such committees within the organization. (The others focus on clinical affairs, public affairs, finance, and the continuum of care.) 

January 26: PICCK Program Addresses Implicit Bias

PICCK (Partners in Contraceptive Choice & Knowledge) is hosting a two-part training series on implicit bias in the healthcare setting. The second training session will be held virtually on January 26, from 12 to 1 p.m. (The first training session was held virtually on December 8, 2020, and is available here.) 
Boston University School of Medicine designates this live webinar for a maximum of 1.0 AMA PRA Category 1 Credit(s). For more information and to register, visit here.
PICCK is a clinical and public health program designed to promote contraceptive choice and counseling across Massachusetts. The five-year program is funded by the Executive Office of Health and Human Services and is housed at Boston Medical Center/Boston University School of Medicine. MHA is a member of its advisory committee and many of the state’s 44 birth hospitals partner with it.

Assisting Providers with Human Trafficking Education and Reporting

As part of the American Hospital Association’s Hospitals Against Violence initiative, the legal firm Jones Day has released a tool to help providers navigate the complex roadmap of their reporting and education obligations regarding human trafficking, particularly because of the increased role of telehealth and multistate practitioners.


Auditor Suzanne Bump last week appointed Patricia Houpt to serve on the Health Policy Commission, replacing Rick Lord, the former CEO of Associated Industries of Massachusetts. Houpt recently retired from the New England Employee Benefits Council (NEEBC) where she served as executive director for eight years. The seat Houpt will fill, one of three appointed by the state’s auditor, requires an individual with expertise as a purchaser of health insurance representing business management or health benefits administration.

Annual Design, Operations and Construction Conference

January 26, February 2, February 9, and February 16
Weekly on Tuesdays from 9 to 10 a.m. ET
4-Part Virtual Webinar Series

Registration is open for MHA’s Annual Design, Operation & Construction (DOC) Conference, always a timely and relevant program for facilities leaders, architects, builders, and those doing business in the healthcare design and construction business. The program for the conference has been revised to include the latest updates on COVID-19 as it relates to DOC. We will feature expert faculty on the topic and include opportunities for engagement and interaction. If you are unable to attend the live webinar sessions, all registrants will have access to the session recordings to view at your convenience. Don’t miss out!
Reminder: This virtual conference is FREE for MHFPS, NEHES, or other facility professionals working for a hospital or system. The event is supported by the vital consultant and vendor community in the healthcare A/E/C/RE industry. Through generous sponsorship and registrations, this event is made available to all facility professionals at all levels. Please encourage your staff to attend. Register early as this event fills up quickly!

John LoDico, Editor