INSIDE THE ISSUE
Priority Legislation Advances on Joint Rule 10 Day
Last Wednesday was an important day for a number of bills that are still pending in the State House.
The first Wednesday of February in what is known as the Second Annual Session of the Legislature is the “Joint Rule 10” deadline, which is the last day for reports to be made from joint committees. If a committee reports a bill favorably by Joint Rule 10 day, then the measure is still alive and could be passed and signed into law by the formal end of the legislative session this July. Committees can still choose to file extension orders to allow for further review of legislative measures, but try to send out as many bills as possible to increase their likelihood of passage. (The Joint Committee on Health Care Financing is not bound by the Joint Rule 10 deadline and has more time to report out bills, as it often is referred measures from other committees for a secondary review.)
Last Wednesday saw joint committees report favorably on several MHA priority bills, including the Joint Committee on Financial Services’ action on H.1143, An Act to Improve the Health Insurance Prior Authorization Process, which healthcare providers believe is an essential measure in helping to resolve the capacity crisis, expand access to patient care, and increase efficiency in the system. H.1143 is backed not only by the hospital community, but by doctors and patients, represented by the Massachusetts Medical Society and Health Care For All, respectively.
Importantly, the bill does not erase prior authorization (PA) entirely, but rather streamlines or eliminates PAs for generic medications and treatments that currently have low denial rates. It also requires PAs to be valid through the course of a patient’s treatment, meaning a patient’s treating provider doesn’t have to seek insurers’ okays for the same thing every few months. And if a patient switches plans during the course of a treatment, the PA from one insurer must be honored by the new insurer. Those and other elements of the prior auth bill that Financial Services reported favorably on will remove care roadblocks that even the Health Policy Commission has noted are gumming up the system and making it hard to transfer patients from one care setting to another.
Another bill that MHA, the Organization of Nurse Leaders, and the Massachusetts Senior Care Association, among others, are throwing their strong support behind is H.3613, An Act to Improve Health Care Workforce Development Through Graduate Nursing Practice, which the Joint Committee on Public Health reported favorably last Wednesday. That bill would allow a graduate of a nursing program or nursing students in their last semester of study to work at the bedside under direct supervision of licensed nurses, prior to passing their NCLEX exam. The flexibility allowing the nurse graduates to work immediately was put in place during the pandemic and extended by the legislature and both Governors Charlie Baker and Maura Healey through appropriations bills. But without legislation to provide for another extension, graduate nursing practice will expire this March 31. Since the flexibility was first allowed, nurse leaders have cited the innovative approach to professional development as being an especially beneficial workforce and patient care tool. It has led to high retention levels of these staff post-graduation, and the support hospitals and licensed nurses provide to the nurse grads ensures they pass their NCLEX exam.
MHA’s Vice President of Government Advocacy and Public Policy Emily Dulong said of this year’s Joint Rule 10 deadline, “MHA and our members were excited to see the legislature advance so many proposals designed to improve patient access to care and support providers in delivery innovation. Many of these bills had been put forth for numerous sessions and were never acted upon. This level of action and resolve to get things done, and to get them done on behalf of patients, is refreshing and recognizes the importance of healthcare to the commonwealth’s communities.”
MHA also lauded Financial Services’ action on several other bills, including:
- H.986/S.655 – An Act Relative to Telehealth and Digital Equity for Patients
- H.1145 – An Act Removing Barriers to Behavioral Health Services
- H.1156 – An Act Relative to Opioid Use Disorder Treatment and Rehabilitation
- H.1007/S.718 – An Act Relative to Insurance Coverage of Mobile Integrated Health
- H.4058 – An Act Expanding Access to Mental Health Services; and
- H.959/S.704 – An Act Prohibiting Discrimination Against 340b Drug Discount Program Participants.
Good News From Brockton: Hospital Reopening Slated for Spring
Signature Healthcare Brockton Hospital says it could be up and running by “late spring” and that’s very good news to the Southeastern Massachusetts communities that rely on care delivered at the 216-bed facility.
Since Brockton Hospital was forced to close in February 2023 following a fire that damaged the facility, other hospitals have stepped in to take on the additional care demand. Brockton normally sees more than 60,000 emergency department visits, 11,000 discharges, and more than 175,000 outpatient visits annually, according to the state’s Center for Health Information and Analysis – and all of that care had to be absorbed by surrounding facilities. With workforce shortages and capacity challenges throughout the entire system, the loss of Brockton Hospital has been especially troubling.
“Every day since the fire, one of our three paramount goals has been to safely reopen as soon as possible,” said Robert Haffey, Signature’s president and CEO. “Our construction partners and local, state, and federal officials share this goal and have been tireless in pursuing it. Now, we have entered the final phases of work to continue renovating the damaged electrical and other infrastructure and are announcing this spring, Brockton Hospital will welcome back its valued staff, patients, and the community.”
“For the past year, we have seen Signature Healthcare work around the clock to restore its facility, temporarily place caregivers in other local settings, and maintain access to as many care services as possible – all while keeping community members engaged and informed,” said MHA’s Vice President of Clinical Affairs Patricia Noga, R.N. “Signature’s reopening announcement is fantastic news for patients in the greater Brockton area. And it is equally welcome news for the southeast region, where the hospital capacity crunch has been especially pronounced in recent years. We congratulate the organization’s leaders, caregivers, and community members on this important step.”
The 250,000-square-foot hospital had to be completely rewired following the fire that began in an electrical equipment room. Remodeling and renovations that were underway pre-fire were incorporated into the recovery effort; the hospital will have a renovated ED, a new 12-bed behavioral health triage unit, and an outpatient surgical center when the reopening occurs this spring.
FOCUS ON WORKFORCE
Mass General Brigham’s Online College Prep Program
It’s not unusual for hospitals and health systems of any size to offer employees continuing education opportunities – such as brush-up classes to keep workers up to date in their fields, or full degree-granting courses.
And in most cases, many schools, colleges, and universities offer their courses online – either live, known as “synchronous” with students participating in real-time with their professors, or “asynchronous” where students learn on their own schedules, within a certain time frame, with the support guidance and access to subject matter experts as needed
Potential students familiar with traditional in-person classes, or those new to the education system may wonder if online learning is for them. Will they be able to handle the technology? Do they have the discipline to pursue a class at their own speed?
Mass General Brigham (MGB) helps potential students answer those questions with the Online College Preparation Program (OCPP) it created almost 14 years ago.
“We help you figure out if going back to school online is the right move for you,” says Dena Lerra, MGB’s senior workforce development manager, human resources. “The OCPP allows employees to complete an assessment of their own strengths before diving into further education, and then offers a simulation of actual online courses.” (Read more by clicking link below.)
Learn more about MGB’s free OCPP program that is open to all employees, as well as about other workforce initiatives throughout the state, by visiting MHA’s Workforce Toolkit. Do you have a workforce program that you would like featured in the toolkit? Contact MHA’s Kim Stevenson at email@example.com.
More Loan Repay Funding Available for Healthcare Workers
In round three of the MA Repay program announced last week, the Healey Administration is making funding available to direct care professionals, and supervisors of direct care professionals, “who provide treatment, support, or services to clients or their families in a home-based or community-based human service organization.” For the first time, early education, childcare, home health, and other home- and community-based workers are eligible to apply for MA Repay funding.
The first round of MA Repay was awarded in August 2023 and provided $140.9 million in student loan repayments to primary care and behavioral health providers. Round 2 launched in September and provided loan repayment to RNs and LPNs providing skilled nursing care to MassHealth members, and to Department of Mental Health direct care workers.
Qualifying professionals for the new round include care coordinators, peer specialists, social workers, nurses, personal care attendants, certified nursing assistants, developmental specialists, educator assistants, and family childcare assistants working in eligible settings. Awards range from $3,000 to $30,000 depending on academic degree level attained and whether the individual works part- or full-time. Priority will be given to those who can communicate and provide care in a language other than English; who can “support access and delivery of services in a culturally competent manner;” and who either live or work in one of 20 communities identified in the COVID-19 Vaccine Equity Initiative.
Applications close on February 26 at 11:59 p.m. MA Repay is funded through the American Rescue Plan Act with funding appropriated by the legislature. Three additional rounds of this program will be made available in 2024.
ACHE of MA Virtual Seminar: Staying Nimble Through the Staffing Crisis
On Tuesday, February 27, from 5 to 6:30 p.m., ACHE of MA is holding its second annual program dedicated exclusively to the topic of staffing. The program is timely in that the speakers have analyzed the data they collected from the recently ended calendar year 2023, so their assessments, projections, and predictions for 2024 are well sourced. Post-pandemic challenges, demographic shifts, and other broader economic trends continue to create a healthcare staffing shortage of large proportions. Labor costs are rising and people to fill the necessary roles are shrinking. The 2024 program will be designed to look at these staffing challenges.
Panelists include moderator Carmen Kenrich, AMN Leadership Solutions, Merritt Hawkins; Patricia Noga, R.N., MHA’s VP of Clinical Affairs; Jackie Larson, AYA Healthcare; and Therese Fitzpatrick, R.N., Kaufman Hall. Register here.
Black History Month: Incremental, Continual Progress
As the nation continues its recognition of Black History Month, it’s worth examining some recent developments in Massachusetts that move the celebration beyond merely a calendar event and closer to the goal of creating an equitable society.
In the commonwealth, the hospital community has entered the second year of the historic five-year Section 1115 MassHealth waiver. At its core, the waiver is built on the knowledge that while certain genetic conditions encoded within you may determine your health fate, many health disparities between one segment of a population as opposed to another are due to purely preventable circumstances.
And once certain groups are properly supported to overcome these “social determinants of health” and access good care, they often may face language barriers, cultural differences between caregivers and patients, misunderstandings or prejudice about sexual orientations, among other things that sometimes have been part of fraught interactions between patients and those caring for them.
But in Massachusetts over the next five years, in what is truly a first-of-its-kind commitment, the state’s entire healthcare system has been reengineered to cut through the inequities and improve care for historically affected communities. Under the Section 1115 waiver, the care system is altering how caregivers must interact with patients, the questions they ask at the bedside, the tests they offer and the protocols they follow – all with the intent of improving health outcomes. Reimbursement to providers is tied to their ability to improve care.
Throughout the state, hospital Chief Diversity Officers are helping lead the data collection, staff education, and community outreach necessary for the waiver to work. They’re assisted by IT pros, caregiving staff, and finance officers, among others throughout the entire hospital tasked with the massive undertaking. Last month at its Annual Meeting, MHA held a special recognition for its members’ diversity and equity officers.
MHA’s V.P. of Health Equity Izzy Lopes said the ongoing waiver effort affords an opportunity to “do more than reflect on the past, which has often been the focus of Black History Month. Rather, it’s an invitation to reimagine and envision a future where every individual, irrespective of their background, can realize optimal health and wellbeing. It has been said that a society that is healthy, and a society that is just, are two inseparable concepts. These words should serve as a clarion call to action in our pursuit of health equity and challenge us to confront – each and every month – the inequities that persist and the destructive ideologies which undergird them.”