Massachusetts Health & Hospital Association

Budget Priorities for FY2024

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> MHA Budget Priorities
> Markey on Workforce
> “Returning Citizens”
> FOCUS ON WORKFORCE: Boston Medical Center
> Brockton Hospital


MHA’s Budget Priorities in FY2024

Governor Maura Healey announced last week that her administration is on track to release its FY2024 budget proposal on March 1 and that in conjunction with that filing she’ll also introduce tax reform legislation to make “life more affordable for folks.” Governors usually release their “House 1” budgets in January, but new administrations are allowed the extra time to file their first spending proposal.

Last week, MHA sent Administration & Finance Secretary Mathew Gorzkowicz a letter outlining the hospital and healthcare community’s priorities that MHA hopes are reflected in the governor’s budget.

“The last several years have presented our members with unprecedented difficulties, yet they continue to do a remarkable job adapting and responding heroically to any and all challenges that threaten the ability of our healthcare delivery system to meet the needs of patients and communities,” MHA President & CEO Steve Walsh wrote to Gorzkowicz. “Our members have received critically needed financial relief from federal and state government during the pandemic, but the majority continue to fare worse financially compared to pre COVID-19. They are still grappling with unprecedented costs relative to labor, inflation, an ongoing behavioral health boarding crisis, difficulty in moving patients across the care continuum, and other spending and operational pressures.”

Among MHA budget priorities are building the healthcare workforce, codifying telehealth payment parity in state law, and increasing long-term bed capacity to address the situation of 800 to 1,000 patients a month being unable to transition from acute care hospitals to post-acute facilities.

Additional budget requests relate to inflation updates to MassHealth hospital reimbursement rates; full funding of the state’s share of the Health Safety Net ($30 million); shifting more of the funding for the Health Policy Commission and Center for Health Information and Analysis away from providers and insurers and towards the state itself; and additional resources to care for behavioral health patients and “stuck” pediatric patients in hospitals.

“We appreciate the administration’s support as we work together to ensure that our health system continues to provide the highest quality of care and that patients have access to the services they need,” Walsh wrote.

Markey Cites MHA Report in Advocating for Action on Workforce

The Senate Health, Education, Labor, and Pensions (HELP) Committee held a hearing last Thursday entitled “Examining Healthcare Workforce Shortages: Where Do We Go from Here?” The shrinking healthcare workforce combined with increasing patient volumes at hospitals is causing an unprecedented capacity crisis coupled with worker burnout.

The HELP Committee is chaired by Bernie Sanders (I-Vt.), and its ranking member is Bill Cassidy, M.D. (R-La.). Ed Markey (D-Mass.) last week was named chair of the HELP Subcommittee on Primary Health and Retirement Security.

At the workforce hearing last week, Markey cited MHA’s report that shows there are an estimated 19,000 full-time job vacancies across Massachusetts hospitals, which has led to the curtailment of hospital beds and services, steep financial losses for facilities, and access challenges for patients.

Markey focused on the problem of children waiting in hospital for behavioral health services – an issue that is prevalent across the U.S. In response, James Herbert, PhD, the president of University of New England in Biddeford, Maine, said that a major problem is the critical shortage of psychiatrists, adding, “But we’re never going to train enough psychiatrists to meet the psychiatric needs of underserved areas.” Instead, he said, hospitals and health systems are attempting to train more behavioral health nurse practitioners, and, in some areas, are working to credential undergraduates to help fill entry-level positions in nursing homes, schools, and other care locations.

Re-Entry Workforce Development Demonstration Program

To address the workforce problem afflicting nearly all economic sectors, the Commonwealth Corporation is seeking applications from groups that have demonstrated experience, success, and current capacity in providing occupationally focused training and placement programs for previously incarcerated people. Eligible “returning citizens” are those who will be released within 60 days of a program start date or individuals who were released no earlier than 12 months prior to enrolling in a program or a combination or both. Budget forms, applications, and other resources are here. A bidders’ webinar will take place on Wednesday, February 22, from 10 to 11:30 a.m. Attend the session through this link. The program is funded through the Executive Office of Labor and Workforce Development.

Boston Medical Center Providing a Pathway for Future, Diverse Leaders

Boston Medical Center’s Pathways Program was created to help its Black, Indigenous, and people of color (BIPOC) personnel move into leadership positions as part of the health system’s larger economic mobility work.

“This came about as a means of accelerating and advancing the careers of BIPOC employees, part of our overall approach to DEI [diversity, equity, and inclusion] initiative,” says Breannah Conward-Lewis, BMC’s program manager in the Human Resources Department. “Pathways is a way of recognizing the fact that folks from underrepresented backgrounds – specifically BIPOC employees – are often overlooked when it comes to promotion opportunities or of just getting into leadership roles.”

When the program first began, it required a manager to nominate a high-potential BIPOC employee, who demonstrated an interest in leadership/management, received high performance reviews, and was generally assessed as ready for significantly expanded responsibilities. Conward-Lewis said BMC realized that sometimes managers were not aware of the program, or that some employees felt overlooked, which led to BMC allowing employees to nominate themselves.

“With the most recent cohort – the fifth – we received 47 applications for only 20 seats,” Conward-Lewis said. “So we go through the applications, read them thoroughly, understanding the needs of each applicant, the needs of the department, and if this program will support individuals in getting to that next step.”

Those accepted participate in a six-month program consisting of one-on-one coaching, “mentor circles” where four-to-five enrollees meet once a month with 2-3 mentors, career development plans, 360-degree feedback assessment from peers and managers, and more.

“We want them to lean into their leadership skills and learn about what it means to be a leader in general, what it means to be a leader at BMC, and how to lead across cultural differences,” Conward-Lewis said. “Our hospital is diverse and through leadership development, Pathways intends to create a leadership team that reflects our diverse patient population … ”

Read the rest of the story about Boston Medical Center’s workforce strategy, as well as workplace stories from other providers throughout the state, by visiting MHA’s Workforce Toolkit.

Signature Brockton Hospital’s Re-Opening Plan

The recent closure of Signature Healthcare Brockton Hospital demonstrates once again how hospitals are essential, central components of communities. When they face difficulties, those difficulties reverberate quickly throughout the state.

The hospital has been closed since a 10-alarm fire broke out on February 7. Last week the hospital released its three-phase plan for a limited re-opening in three months.

First, it has expanded access and hours at Signature Medical Group ambulatory locations and will open two new urgent care centers. Phase 2 involves the limited re-opening of inpatient services in an estimated three months, following assessments and evaluations of damage and reliance on supply chain delivery of materials. Phase 3 will be the full re-opening.

“Brockton Hospital has been a long-standing institution in the City of Champions for over 125 years,” the hospital wrote. “We plan to be here for the next 125 years, fulfilling the same mission to care for our community.”

Hospital across the state, particularly in Southeastern Mass., worked to coordinate the relocation of patients who were at Brockton. The state’s Executive Office of Health and Human Services has coordinated daily discussions with the hospital community to assist mitigation efforts.

“This a tremendous undertaking for a system already under significant pressure,” said MHA President & CEO Steve Walsh. “It is not easy for anyone involved, especially patients and caregivers. But just as they did throughout the peaks of the pandemic, hospitals are stepping up to make it work. We are grateful for the leaders at Signature Healthcare, the Healey Administration, and hospitals and nursing facilities throughout Massachusetts for their tireless work over the past week.”

Nearly 200 patients have been moved. Due to the dedication of staff and first responders, there were no injuries due to the fire and relocation.

John LoDico, Editor