A Focus on Equity, New RFA, and more...

Chase’s AdvancingCities Challenge Assists Hospitals’ Equity Efforts

A hospital-led initiative in Boston has received a $5 million grant from JP Morgan Chase to improve employment opportunities and housing in historically under-invested Boston neighborhoods, including Black and Latinx communities.
The AdvancingCities Challenge will be led by Boston Medical Center (BMC), joined by Boston Children’s Hospital, Brigham and Women’s Hospital, and Health Resources in Action, all of which will team up with the City of Boston and four community partners: the Dudley Street Neighborhood Initiative, BlueHub Loan Fund, Action for Equity, and JVS to form the BOS Collaborative.
That collaborative will deploy below-market-rate capital to create affordable and permanent housing, adopt new hiring and retention policies that connect residents to better-paying jobs at the anchor institutions, and promote state and federal policies that help residents, such as increased state rental vouchers for tenants of acquired properties, or expanded Medicaid funding.
Chase said the program will “help strengthen recovery efforts in Boston and address the needs of Black and Latinx communities, which have suffered disproportionately both from the COVID-19 pandemic and generations of disinvestment.”
The groundwork for the new effort had already been laid by the hospital community. In 2019, BMC, Boston Children’s, and the Brigham formed the Innovative Stable Housing Initiative (ISHI) – a $3 million effort to increase access to and maintain stable housing in Boston. The BOS Collaborative will leverage ISHI’s strong efforts, which were detailed in this MHA community benefits publication. Chase said the collaborative will create 100 affordable housing units and preserve 150 more beginning in 2021. The collaborative’s efforts will be concentrated in Boston’s neighborhoods of Roxbury, Dorchester and Mattapan.
Over the course of the three-year philanthropic commitment, the collaborative will invest in training 1,100 individuals, and place at least 500 of those individuals into full-time employment at living wages in the healthcare, tech, and biotech industries. 
“At Boston Medical Center, we see the consequences of unstable housing and a lack of economic opportunity reflected in the health of our patients on a daily basis,” said BMC President and CEO Kate Walsh. “The COVID-19 pandemic is only making these disparities worse. Through this collaboration between JPMorgan Chase, the City of Boston and community partners, we can bring new vitality to neighborhoods that have suffered through generations of inequity and disinvestment.”

MHA Disagrees with White House on Benefits of Equity Discussions

MHA has issued a strong statement denouncing a September 22 executive order from the White House that could limit the ability of organizations receiving federal funding, like hospitals, to hold anti-racism and anti-discrimination training. 
The president’s order terms discussions of equity in the workplace as part of a “destructive ideology.” The order states, “This ideology is rooted in the pernicious and false belief that America is an irredeemably racist and sexist country; that some people, simply on account of their race or sex, are oppressors; and that racial and sexual identities are more important than our common status as human beings and Americans."
MHA, which has a Board-level Health Diversity, Equity & Inclusion Committee, said in its statement that the association and its membership have “serious concerns” about the Trump order. It continues:
“Our hospitals have always been more than just places of healing. As we care for and interact with people from every walk of life, our healthcare organizations serve as forums to address some of the most pressing issues facing communities of color and disadvantaged populations. 
“The systemic inequities brought to light by the COVID-19 crisis and the events of the past six months have prompted our healthcare system to take a focused look at how our policies and practices reach people of color and other underrepresented communities. 
“We have a distinct role to play in being part of the solution, with education being the most powerful tool at our disposal. Hospitals have mounted anti-discrimination programming to ensure that every patient and employee is treated with dignity and without bias. These initiatives not only stand to improve the way our organizations run; they will support the health and wellbeing of our patients.
“The Executive Order handed down by the Trump Administration seeks to senselessly undercut our ability to maintain meaningful conversations on these issues, citing them as “divisive” and “anti-American.” The mandate fails to grasp the very mission of these trainings: to bridge the divides that are harming our communities and create a better version of what it means to be an American."
Read the full MHA statement here. 
Federal CARES Act payments improved profitability in April and May, but overall total margins remained mostly unfavorable compared to the base period,” CHIA found. Without CARES Act funding in April, community hospital total margins decreased 69%. With the CARES Act money, those community facilities experienced median total margins of negative 26.4%. 
While expenses rose, operating revenue decreased. CHIA found that in aggregate, total operating revenue was lower than total expenses for all three months. As a result, hospitals and hospitals systems have faced challenging decisions on services and personnel in order to remain financially stable.

COVID-19 Vaccine Preparations Begin

The Baker Administration last week announced creation of a vaccine advisory group to lay the groundwork for how a COVID-19 vaccine will be distributed once one becomes available, with a focus on equity issues.
Dr. Paul Biddinger of Mass General Brigham will chair the new panel, which is made up of medical professionals, public health experts, elected officials, community leaders and infectious disease specialists. Other advisory group members from MHA’s membership include: Dr. Vincent Chiang, Boston Children’s Hospital; Wanda McClain, Brigham and Women’s Hospital; Dr. David Twitchell, Boston Medical Center; Dr. Simone Wildes, South Shore Hospital; and Dr. Sharon Wright, Beth Israel Lahey Health.
MHA is also forming a working group to address issues and challenges related to the planning, rollout, and communications regarding a COVID-19 vaccine.
The rollout of a COVID vaccine – if and when one becomes available – is likely to be a highly complex endeavor as it is not yet known which vaccines will be available, at what time, with what efficacy, in what volumes, and with what cold storage, handling, or booster requirements. 

Webinar Focuses on Mass Delivery of Vaccines

Immunization Action Coalition – a Minnesota-based non-profit – is holding a webinar entitled Mass Vaccination Clinics: Challenges and Best Practices, this Thursday, October 15 from 1 to 2:30 p.m. A panel of providers will discuss successes and challenges in conducting mass-vaccination clinics, highlighting best practices. Mass vaccination clinics allow the rapid and efficient administration of vaccines to a large number of people over a relatively short period of time. The approach is helpful in delivering flu vaccines but will also be necessary when COVID-19 vaccines are released. Click here to register.

New MassHealth-Hospital Contract Released

The 2021 Request for Applications (RFA) – the main Medicaid contract between the state and acute hospitals – was released last week and will become effective on November 1.
The latest RFA is influenced in part by the emergency MassHealth changes the state made this year to assist hospitals during the pandemic. The RFA continues throughout the state emergency an enhanced rate for certain inpatient services related to COVID-19 care. Innovations such as remote patient monitoring of COVID-19 patients also continues.
There is also new supplemental funding dedicated to inpatient psychiatric services to assist hospitals in alleviating emergency department boarding that has increased significantly during the pandemic.
MassHealth inpatient and outpatient standard rates increase by 0.2% in the new RFA. Other important financing continues from RY2020, including added support for outpatient care provided by certain safety net hospitals. 

MHA Partnership Eases Staffing Issues for Member Hospitals

In preparation for a potential COVID-19 resurgence, MHA has entered into a partnership with Qualivis, which works with staffing agencies across the country to simplify the search process for supplementary staffing. Qualivis’ partnerships with staffing agencies helps hospitals save time, increase fill rates and retention, and simplify the temporary staffing process. The company currently works with more than 20 hospital associations.

Next MCSTAP Call-in Hour Scheduled

The Massachusetts Consultation Service for the Treatment of Addiction and Pain (MCSTAP) is holding its next case discussion call-in hour on Wednesday, October 21, from noon to 1 p.m. During the session, Dr. Christopher Shanahan, the MCSTAP medical director, will discuss a recent consultation about starting buprenorphine for a patient with opioid use disorder. The case discussion call-in hours are an opportunity for participants to hear about real, anonymized cases concerning management of chronic pain and substance use disorder, and to get input and best practices on the treatment of patients with chronic pain and/or SUD. Click here for more information and to register. CME credits are available.

New England Journal of Medicine’s Unprecedented Editorial

The New England Journal of Medicine, which is published by the Massachusetts Medical Society and has been in existence in various forms since 1812, last week issued one of its most pointed editorials ever, calling the national political leadership’s efforts in fighting COVID-19 “dangerously incompetent.”
“We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs,” the editors wrote.
“The response of our nation’s leaders has been consistently inadequate,” the editorial states. “The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them … Our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed ‘opinion leaders’ and charlatans who obscure the truth and facilitate the promulgation of outright lies.”
The editorial does not mention President Trump, nor does it explicitly endorse Joe Biden.

Mass HIway Attestation Forms are Due 

The Mass HIway that allows caregivers and healthcare organizations to transmit vital data securely and electronically announced last week that its regular attestation forms are available. Provider organizations subject to the HIway connection requirement must submit annual documentation attesting to their efforts to implement health information exchanges. Hospitals either have to fill out an attestation form if they fulfilled the Mass HIway connection requirement in 2019, or an exception form if they did not fulfill the requirement.

Excellence in the Emergency Department
Wednesday, October 14; 11 a.m. - 2:30 p.m. 
Virtual Conference

For many patients, the emergency department (ED) sets the tone for the entire patient experience. During the COVID-19 pandemic, emergency medicine leaders have faced unique challenges and developed innovative solutions. At this conference, we’ll hear from local experts on leading practices from healthcare organizations that are doing things differently in the ED and seeing positive outcomes as a result. Hear from clinical thought leaders on how they have transformed and led their EDs during the pandemic, as well as strategies for process improvement and innovation for the future of medicine. Register by clicking here.

John LoDico, Editor