Federal Funding, ACA Saved (Again), and more ...

Governor Lays Out Plan for Use of Federal Funds

Governor Baker on Thursday outlined his plan to spend the $5.3 billion Massachusetts received through the American Rescue Plan Act (ARPA). The legislature earlier in June had passed a bill – H.3827, An Act Relative to Transferring Federal Funds to the Federal COVID-19 Response Fund – that directs the state to transfer the money into a trust fund. The governor’s action last week is an amendment to that bill which puts $2.815 billion of the total to immediate use. 
“If the Legislature approves this spending, the other $2.3 billion in direct federal aid that is not allocated through my proposal will remain in the Federal COVID-19 Response Fund, to be appropriated by the Legislature,” the governor wrote.
The governor’s plan proposes funding for home ownership initiatives, downtown revitalization plans, workforce programs, environmental infrastructure, water and sewer infrastructure, and more.
The main healthcare-related expenditures under the governor’s proposal are $175 million for behavioral health and addiction services, and $50 million for fiscally strained hospitals in municipalities disproportionately impacted by the pandemic.
MHA said it is grateful for the administration’s attention to these areas of need, but that this proposed funding falls short of what is needed to stabilize the hospitals that stayed open throughout the peaks of the pandemic and whose financial pressures are continuing to intensify. These economic challenges have been well documented, as hospitals had already lost $5 billion by last July. 
“Through the darkest hours of the pandemic, our hospitals never closed their doors and spared no cost to deliver lifesaving care under extraordinary circumstances,” MHA President & CEO Steve Walsh said. “Now, many are feeling the full weight of these financial pressures. We are grateful for the relief funding to date, but it has not bridged the gap for many hospitals, including numerous community and safety net providers across the state. Additional funding must be devoted to these providers so they can stabilize and remain accessible to the millions who rely on their services. The American Rescue Plan Act may be the last opportunity to do so, which is why this proposal is so vital to the future of our healthcare system.
“It is important to remember that hospitals do more than just deliver world-class care. They are often the largest employer, charitable partner, and economic engine in their area. When they are not at full strength, their communities are not at full strength.
“We look forward to working with the administration and the legislature to ensure all providers can make a full recovery, and that new behavioral health funding can be used to address inpatient settings, workforce obstacles, and rate challenges.”

Affordable Care Act Survives Challenge In Supreme Court

The Affordable Care Act has survived yet another challenge in the U.S. Supreme Court. Last Thursday, the court voted 7-2 that 18 states and two individuals challenging the act did not have standing because they could not prove how they were injured by the requirement that they buy health insurance. Congress in 2017 removed the financial penalty against those who fail to enroll in insurance coverage.
Justice Stephen Breyer, writing for the majority, first addressed the complaints of the two individual plaintiffs, who, he wrote, “point to the statutory language, which, they say, commands them to buy health insurance … Their problem lies in the fact that the statutory provision, while it tells them to obtain that coverage, has no means of enforcement. With the penalty zeroed out, the IRS can no longer seek a penalty from those who fail to comply.”
As for the states that complained about the increased number of people who would seek coverage through public programs, and who would therefore increase costs to the state, Breyer wrote, “the States have not demonstrated that an unenforceable mandate will cause their residents to enroll in valuable benefits programs that they would otherwise forgo.” That is, state programs offer enrollees numerous benefits over and above minimal credible coverage mandates of the ACA. “Given these benefits, neither logic nor intuition suggests that the presence of the minimum essential coverage requirement would lead an individual to enroll in one of those programs that its absence would lead them to ignore,” Breyer wrote. 
Because the plaintiffs could not prove they were injured by the ACA, the court ruled “they have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision.”
This is the third suit against the ACA the U.S. Supreme Court has heard, the others being National Federation of Independent Business v. Sebelius in 2012 that challenged the individual mandate, and King v. Burwell in 2015 that challenged the concept of persons purchasing insurance through federal exchanges.
MHA has consistently defended the ACA, most recently in 2020 when it joined with 35 other hospital associations to file an amicus brief in support of the act in the current case.

First Extension Steps Taken; More Expected

The Massachusetts House and Senate agreed upon a COVID-19 policy extensions bill last week and Governor Baker signed it into law on Wednesday.
The bill focuses mainly on restaurant service, eviction protection, and remote public meetings, but does contain some healthcare-related measures for which MHA advocated. For example, the final bill allows medical assistants, phlebotomists, podiatrists, and Massachusetts Military Division staff to administer COVID-19 vaccines. It also authorizes a licensed nurse employed by an assisted living facility and who is certified by the Executive Office of Elder Affairs to provide skilled nursing care in accordance with valid medical orders. In addition, an unlicensed graduate student from a registered nursing or practical nursing program, or senior nursing students attending their last semester, will continue to be able to practice nursing in specific settings, and another expansion allows pharmacists and pharmacy interns to administer opioid use disorder treatment.
The legislature’s and administration’s work on extension is not finished, however. All sides indicated that they continue to negotiate on measures that would extend some version of the emergency orders implemented during the pandemic into the post-pandemic world. An MHA priority in that regard is extending the orders that made the increased use of telehealth available.

Critical Blood Shortage Facing New England States

Hospitals and health systems across New England are facing a critical shortage of all blood types and are seeking volunteer donors and host sites. 
Blood supplies have historically dipped during summer months, but the recent pandemic has put even more strain on an already scarce resource.
“People in communities across Massachusetts continue to ask what they can do to support our healthcare providers as they recover from the pandemic. Right now, the answer is simply to donate blood,” said Steve Walsh, MHA president and CEO. “Giving blood is a simple but powerful way to help your local healthcare organizations continue serving every patient in need.” 
“The need for life-saving blood knows no geographical border and we must work together to meet this critical need,” said Devon Green, Vice President of Government Relations at the Vermont Association of Hospitals and Health Systems. “If you are able, please give blood as soon as you can.”
Schedule an appointment to donate blood today by clicking here. To learn more about ways to donate blood and host blood drives, visit the American Red Cross of Northern New England online here

Congratulations to ONL Awards Recipients

The Organization of Nurse Leaders, MA, RI, NH, CT, VT (ONL) last week presented its annual awards. The following awards went to MHA members:
Joanne Fucile, R.N., the Vice President of Operations, Director of Nursing at Spaulding Hospital Cambridge, was presented the Mary B. Conceison Award for Excellence in Nursing Leadership. Conceison was Director of Professional Relations at the Massachusetts Hospital Association for 12 years before her death in 1981.
Madelyn “Maddy” Pearson, R.N., the Chief Nursing Officer and Senior Vice President, Patient Care Services at Brigham Health, shared the Janet Madigan Award with Joan Meunier-Sham, the Director of the Massachusetts Sexual Assault Nurse Examiner (SANE) Program. The late Janet Madigan served in a number of roles at ONL (and its predecessor organization MONE), including as president and chair of the Government Affairs Committee. The award is given to an ONL member who demonstrates excellence as a community advocate, or political leader committed to supporting and advocating for the nursing profession and patient care.
ONL’s Elaine K. Sherwood Award was presented to Tammy Retalic, R.N., Chief Nursing Officer and Vice President, Patient Care Services at Hebrew Rehabilitation Center. The award recognizes outstanding commitment and contribution to the work of ONL and is named for one of its first recipients, Sherwood, who worked at then-Deaconess Hospital, Boston.
ONL's President's Award went to a trio of Brigham Health nurses, who in partnership with ONL and the New England Regional Black Nurses Association were instrumental in creating the Nurse's Pledge to Champion Diversity, Equity, and Inclusivity. The three Brigham nurses are Nadia Raymond, R.N., Sasha DuBois, R.N., and Cassandra Mombrun, R.N.

Hospital Deals: Tenet, Steward, Joslin, BILH

Tenet Healthcare, which operates three hospitals in Massachusetts (Saint Vincent, Framingham Union, and Leonard Morse hospitals) will sell four of its hospitals in Florida to Steward Health Care, which operates 10 hospitals in Massachusetts (Carney Hospital, Good Samaritan Medical Center, Holy Family Hospital – Haverhill, Holy Family Hospital – Methuen, Morton Hospital, Nashoba Valley Medical Center, New England Sinai Hospital, Norwood Hospital, Saint Anne’s Hospital, and St. Elizabeth’s Medical Center.)
If the deal is approved, Steward will acquire Coral Gables Hospital, Florida Medical Center, Hialeah Hospital, North Shore Medical Center (Miami), and Palmetto General Hospital for $1.1 billion, Steward announced last week.
Beth Israel Lahey Health (BILH) and Joslin Diabetes Center have signed a definitive agreement under which Joslin will join BILH. The two entities signed a letter of intent to explore the transaction in November 2020. The regulatory review process is expected to take several months.,
Joslin has had a decades-old clinical affiliation with Beth Israel Deaconess Medical Center (BIDMC). A media release indicated that by joining BILH, Joslin “would expand that expertise across the spectrum of primary care, preventive care, acute care, and population health management.”

Mark Your Calendars: June 29 Primary Care Webinar

Mass. Health Quality Partners (MHQP) is holding a free webinar on Tuesday, June 29 from 4:30 to 6 p.m. entitled, “Primary Care Is at a Crossroads: What's Next for Massachusetts After the National Academy of Medicine Report?”
When the COVID-19 pandemic hit, many primary care practices found themselves struggling to survive amid substantial uncertainty. Yet, last month, when the National Academy of Medicine issued its new report, Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care, it received very little attention.
The webinar’s keynote speaker will be Chris Koller, president of the Milbank Memorial Fund and a member of the advisory committee that produced the report. He will be joined by an impressive group of Massachusetts healthcare leaders, including:
Marylou Sudders, Secretary of Health and Human Services 
Cindy Friedman, Massachusetts State Senator and Chair of Joint Committee on Health Care Financing
Carole Allen, M.D., president, Massachusetts Medical Society
Barbara Spivak, M.D., president and CEO, Mount Auburn Cambridge Independent Practice Association 
Jean Yang, president of Public Plans, Tufts Health Plan
Julita Mir, M.D., Chief Medical Officer, Community Care Cooperative
Paul Pirraglia, M.D., division chief, General Medicine and Community Health, Baystate Health
Lucilia Prates, director, MA Senior Medicare Patrol Program, Elder Services of Merrimack Valley
Bonnie Thompson, Family-Centered Child Healthcare Advocate

Please click here to register.


Helen Boucher, M.D., the chief of the Division of Geographic Medicine and Infectious Diseases at Tufts Medical Center and professor of medicine at Tufts University School of Medicine, has been named to a new joint position as interim dean for Tufts University School of Medicine and chief academic officer for Wellforce, beginning July 1. She will report both to the president of Tufts University and to the president and CEO of Tufts Medical Center, Michael Tarnoff, M.D., and will also join the senior leadership teams of both Tufts University and Wellforce. She will be the first woman to lead the Tufts School of Medicine in its 128-year history. Boucher earned an undergraduate degree in English from College of the Holy Cross and a medical degree from the University of Texas Medical School at Houston. 

Caring for the Caregiver Webinar Series-- Session 2: Workforce Safety

Thursday, June 24, 1:30-2 p.m.

In a first-of-its-kind examination of workforce challenges, leaders from across the Massachusetts healthcare community recently joined together to form the Caring for the Caregiver Task Force, convened by the Massachusetts Health & Hospital Association. 
This webinar series will follow key pillars of the taskforce's areas of focus. In this webinar, local experts will provide recommendations and best practices around workforce safety and violence prevention. The presenters will share challenges and lessons learned across their organizations. Register here.

John LoDico, Editor