INSIDE THE ISSUE

> NLC Background Check Backlog
> Glide Path for Foreign Doctors in Mass.
> Senate Passes Workplace Violence Bill
> Hospital Tiering
> Blood Shortage!
> Transition: Matteodo

MONDAY REPORT

Why the Nurse Licensure Compact is Not Up and Running

The Nurse Licensure Compact (NLC) in Massachusetts, which was enacted in November 2024 after years of advocacy from the hospital community, is not yet up and running in the state, due mainly to roadblocks in mandated criminal background checks by the FBI.

Last week, MHA joined the Organization of Nurse Leaders – New England (ONL) in drafting a letter to the state’s congressional delegation, asking them to support legislation to make the federal criminal background check process more efficient.

The NLC allows qualified nurses to hold one multistate license with the ability to practice in all other “compact states,” eliminating the arduous re-licensure process and easing workforce shortages. About a year after its passage in Massachusetts, the legislature passed required legislation allowing federal background checks to go through. Since then, however, the background checks have been held up by backlogs at the FBI.

“As a result, multistate licenses cannot be issued in Massachusetts, and the compact cannot be implemented until FBI approval for these federal background checks is obtained,” MHA and ONL wrote to the delegation.

The States Handling Access to Reciprocity Employment Act (SHARE – H.R. H.R. 2332/S.1101) would provide state nursing boards consistent access to FBI criminal background checks, enabling better eligibility decisions for individuals seeking licensure under an interstate compact. It would also ensure that state licensing boards have the tools necessary to make informed nurse licensure decisions, allowing nurses access to job opportunities in nearby states and enabling them to provide care – in person or via telehealth – wherever and whenever patients need it.

“Hospitals across the commonwealth continue to face workforce shortages and rely on traveling and float-pool nurses to maintain safe staffing, particularly during seasonal surges and public health emergencies,” MHA and ONL wrote. “Without full NLC implementation, Massachusetts hospitals face slower time-to-hire for out-of-state RNs, added administrative burden, and barriers to delivering telehealth nursing across state lines.”

Workforce Shortages: Easing the Path for Foreign-Trained Doctors

The persistent and coordinated push to attract more professionals into the healthcare field in Massachusetts continues with the renewed focus on easing the pathway for physicians who are already licensed and practicing in another country to practice in the commonwealth.

The Physician Pathway Act (PPA) that Governor Maura Healey signed into law in November 2024 allows full Massachusetts licensure for internationally trained physicians in exchange for at least three years of medical practice in an underserved community. The act focuses on physicians practicing in the primary care and psychiatric fields, which are experiencing the greatest shortages.

Because the education and training standards for physicians vary by country and because there are non-clinical skills that vary by location, the PPA outlines a glide path for licensing foreign physicians. Before applicants can be accepted, approved participating healthcare facilities (health centers, hospitals, etc.) must establish programs that develop, assess, and evaluate the applicant’s familiarity with non-clinical skills and standards appropriate for medical practice in the commonwealth. International physicians can get a renewable one-year license in which they practice under the mentorship of an approved facility. Upon successful completion, the physician will be eligible for a renewable two-year restricted license to practice in a shortage area or specialty. The internationally trained physician is then eligible to apply for a full unrestricted license to practice medicine anywhere in the state.

In short, the Physician Pathway Act removes the requirement to complete a U.S.-based medical residency for physician licensure and substitutes an assessment and evaluation program at a participating healthcare facility.

The Massachusetts Immigrant and Refugee Advocacy Coalition and the Massachusetts League of Community Health Centers are working with the Board of Registration in Medicine, Department of Public Health, Massachusetts Medical Society, the African Bridge Network, and other stakeholders, including individual healthcare institutions, on implementation.

Workplace Violence Legislation Moves One Step Closer to Completion

The Massachusetts State Senate passed its version of a workplace violence prevention bill last Thursday. The House passed a similar bill last year. The two bills are now expected to go to conference committee.

Under new legislative rules, if the conference committee is formed before the end of the session on July 31, it will have until the end of the year to create compromise legislation to send to Governor Healey. Previously, if that compromise was not ready by July 31, the bill all but expired until the next legislative session.

The Senate passed the bill without a roll call.

The main difference between the House and Senate bills involve the penalties for those who commit violence. The Senate bill does not include the felony language the House had passed, but makes the misdemeanor charge that it included an arrestable offense regardless of whether it was witnessed by law enforcement. This would allow for immediate removal of the offending party from a healthcare facility.

“We’re grateful for the House and Senate for passage of the bills, which have been a priority of the Massachusetts hospital community and its workforce for many years,” said MHA’s Vice President of Government Advocacy & Public Policy Emily Dulong. “We hope a conference committee will be formed quickly and begin the work of crafting a much-needed, long-awaited law to protect healthcare workers.”

DPH Adjusts Regional Hospital Tiering

The Department of Public Health, noting “overall improvements in acute care occupancy and capacity,” on Friday moved state Regions 3, 4, and 5 from Tier 2 to Tier 1. Regions 1 and 2 were already at Tier 1. The tiering of regions originally began in 2020 during the pandemic and mainly influences how often regional coordinating calls between acute care hospitals are held. Tier 1 means regional coordinating calls are paused. Hospital occupancy data, disease metrics, direct and indirect feedback from hospitals, and other capacity factors will continue to be monitored, and the tiers will be re-evaluated as necessary. This Capacity Planning and Response Guidance provides further details of the tiering.

Blood Shortage in Massachusetts and in U.S.

The American Red Cross has declared an emergency blood shortage. The blood supply fell nearly 25% in June, and blood and platelet donations are needed ASAP. The Massachusetts Department of Public Health encourages people to call 1-800-RED-CROSS or to visit www.redcrossblood.org to find out where to donate. Many Massachusetts hospitals also have blood donation centers.

Transition – MABHS’ Matteodo to Step Down

David Matteodo, who has served as executive director of the Massachusetts Association of Behavioral Health Systems since 1990, announced last week that he is stepping down from the position, effective upon the hiring of his replacement. During his tenure, MABHS expanded its influence on Beacon Hill, becoming the essential voice for freestanding psychiatric hospitals, general hospital psychiatric units, and substance use disorder treatment facilities in Massachusetts. MABHS grew from eight facilities to 53 during Matteodo’s tenure. MHA relied on his behavioral healthcare perspective and expertise on a variety of issues over the years important to hospitals and the patients and communities they serve. His friends and colleagues at MHA wish him the best in his retirement.

John LoDico, Editor