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> Guardianships
> ARPA-H Investor Catalyst Hub
> Measure Set
> Children’s BH Summit
> PFAC Annual Report Reminder!
> New NIH Director
> 340B
> 40 Under 40 Awards

MONDAY REPORT

New Webpage Gives Guidance on Critical Guardianship Issue

It is a well-established fact that many patients in Massachusetts acute care hospitals are “stuck” in hospital beds as they await discharge to a post-acute care facility, such as a nursing home. A recent MHA report detailed how 15% of medical-surgical hospitals beds in the state are filled by patients who no longer need to be in them but are delayed in transferring out for a variety of reasons.

One such reason involves patients who lack healthcare proxies – that is, the form designating who can make care decisions for them. If a patient is unable to make a care decision for themselves, or does not have someone designated to do so for them, a hospital must then go through the courts to designate a guardian – which can take months. Also, many patients with cognitive or other impairments are unable to fill out a MassHealth application to receive long-term care benefits. This requires intervention by the courts – known as a conservatorship – that further delays the process.

Now, Honoring Choices Massachusetts has created a webpage with information, downloadable tools, and links to help people through the complicated guardianship process.

The webpage contains a five-question checklist that encourages people to first consider alternatives, an eight-point list of things to know about guardianships, and a list of other resources for all people as they consider medical treatment and services throughout their lives.

MHA’s Transitions to Post-Acute Care Workgroup works with Honoring Choices and other partners to develop resources for healthcare providers, patients, and families.

Earlier this year, a coalition of leading Massachusetts healthcare organizations issued a united message urging individuals to proactively protect their care choices and designate a healthcare agent they trust.

“Assigning a healthcare agent is about empowering patients and families to protect their care choices. But it’s also about supporting our local providers and caregivers who are striving to keep care accessible,” said MHA Vice President of Clinical Affairs, Patricia Noga, RN, as a part of the “Simple Step” effort. “For those wondering what they can do to help support our hospitals and health systems at this critical time, completing a health care proxy is something you can do today.”

ARPA-H Investor Catalyst Hub Announces Spokes

Last Thursday, Renee Wegrzyn, the director of ARPA-H, visited Cambridge for the announcement of the original spokes, which include MHA, and association members Beth Israel Lahey Health, and Boston Children’s Hospital, Boston Medical Center, Dana-Farber Cancer Institute, and Mass General Brigham. Many other Massachusetts-based and national organizations are among the spokes listed here, and the list is expected to expand greatly.

MHA was part of the coalition of hospitals, life sciences companies, education institutions, and elected officials that had recruited ARPA-H to Massachusetts over the past year-plus.

A Chance to Alter the Aligned Measure Set

The Massachusetts Quality Measure Alignment Taskforce invites members of the public to submit, by December 8, 2023, written recommendations for measures to include in the Aligned Measure Set, which providers and insurers use voluntarily in global budget-based risk contracts.

In January 2024, the taskforce will begin reviewing the measure set suggestions it receives and will make recommend changes to the Executive Office of Health and Human Services for adoption in contracts beginning in January 2025.

The updated version of the 2024 Aligned Measure Set is on the taskforce’s webpage. The public can suggest revisions to the measure set by sending comments to Quality.Alignment@chiamass.gov.

Children’s Summit Features AG Campbell, Experts from Across Continuum

MHA’s Children’s Behavioral Health Summit last Thursday, co-sponsored with Boston Children’s Hospital, drew more than 150 attendees, who heard from experts across the care continuum.

The Summit opened with keynote remarks from a youth advocate, Avery Toole, 19, who reflected on her mental health journey alongside her medical challenges, and stressed the importance of including youth in discussions around mental and behavioral healthcare.

In his opening remarks, Boston Children’s Hospital President and CEO Kevin Churchwell, M.D. reflected on the gains seen in the children’s behavioral health space in the past year, such as student loan forgiveness for workers, the spread of school-based supports, and pilot programs for young people whose needs are not being met within the current infrastructure of care.

He also acknowledged that those steps, while meaningful, are just a part of the journey toward a system that can adequately treat all pediatric patients. “We are still in the midst of a stubborn, ongoing crisis that demands our continued and collective commitment, collaboration, and creativity,” Churchwell said.

Massachusetts Attorney General Andrea Joy Campbell participated in a panel with Kevin Simon, M.D., chief behavioral health officer for the City of Boston. They discussed the importance of diverse workforce, social determinants of health, and equitable grantmaking to expand community-based capacity as it relates to promoting behavioral health.

Rep. Adrian Madaro (D-Boston) and Sen. John Velis (D-Westfield) closed out the day by discussing the goals and successes of the Joint Committee on Mental Health, Substance Use and Recovery.

Images from the Children’s summit (from top to bottom, left to right):

The “Health Equity and Behavioral Health” panel featuring Kevin Simon, M.D., Attorney General Campbell, and Moderator Amara Anosike from Boston Children’s Hospital.

Rep. Adrian Madaro and Sen. John Velis provided a legislative update.

MHA President & CEO Steve Walsh; Joseph Mitchell, M.D., president, Franciscan Children’s; and Boston Children’s Kevin Churchwell, M.D. at a panel entitled “Partnering for Excellence.”

A panel entitled “Caring for Children with Specialized Needs,” featured Sharmila Mehta, Cambridge Health Alliance; Tammy Mello, Key Program; Leslee Uhrich, Baystate Medical Center; and Moderator Nancy Allen-Scannell, executive director, Massachusetts Society for the Prevention of Cruelty to Children.

A Reminder to Submit PFAC Annual Report

Massachusetts passed a law in 2008 requiring all acute and rehabilitation hospitals in the state to establish a Patient and Family Advisory Council (PFAC). The legislation remains the only one of its kind in the country. In past years, Health Care For All collected and aggregated annual reports from each hospital to share publicly. As of 2023, the Betsy Lehman Center for Patient Safety assumed responsibility for collecting and sharing PFAC reports. If they have not done so already, hospitals are asked to use this template to submit their reports as soon as possible. The Betsy Lehman Center says it is planning to revitalize efforts to support PFAC work across the state and will have more information in the coming months on those efforts.

Bertagnolli Poised to Become NIH Director

The U.S. Senate’s Health, Education, Labor and Pensions (HELP) Committee, on which Massachusetts Democrat Ed Markey sits, last Wednesday voted 15-to-6 to advance the nomination of Dr. Monica Bertagnolli to be the next director of the National Institutes of Health (NIH). The full Senate is expected to vote on her appointment as early as this week.

Bertagnolli has been director of the National Cancer Institute since October 2022. She previously served as professor of surgical oncology at Harvard Medical School, a surgeon at Brigham and Women’s Hospital, and a member of the Gastrointestinal Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute.

Her confirmation hearing, which had been long delayed, was predicted to be contentious, not specifically because of Bertagnolli’s qualifications but due to ongoing, sometimes partisan disputes about the origins of COVID-19, fetal tissue studies, and prescription drug costs, among other topics.

MHA lent its support for Bertagnolli. MHA’s Senior V.P. of Government Advocacy and General Counsel Mike Sroczynski, in a letter to Sen. Markey, cited Bertagnolli’s distinguished career in Massachusetts, adding, “Managing healthcare research and the delivery of patient care is an extremely complex undertaking in today’s world and we believe Dr. Bertagnolli brings the expertise, experience, vision, and compassion that will be required of the next Director of the National Institutes of Health.”

HRSA Reminds 340B Facilities of Outpatient Offsite Requirements

On October 26, the Health Resources and Services Administration (HRSA) released a notice about the registration requirements for offsite, outpatient hospital facilities to participate in the 340B Drug Pricing Program. During the pandemic, HRSA allowed some flexibilities on 340B reporting for such offsite facilities, but these flexibilities ended with the end of the public health emergency. The notice clarifies that to continue purchasing 340B drugs, covered entities’ offsite, outpatient hospital facilities must be listed on the hospital’s most recently filed Medicare Cost Report and registered in the Office of Pharmacy Affairs Information System (OPAIS) or must notify HRSA within 90 days that they are in the process of doing so. HRSA is providing the 90-day grace period before non-compliant entities may be subject to audit and compliance action.

HRSA Reminds 340B Facilities of Outpatient Offsite Requirements

John LoDico, Editor