Massachusetts Health & Hospital Association Many Beds, Not Enough Staff
INSIDE THE ISSUE
> 20% of Beds Offline
> Screening for Anxiety
> Tufts MC Magnet Designation
> Delmolino’s Telehealth Award
> Preparing for Flu Season
MONDAY REPORT
One-Fifth of Mental Health Beds Offline Due to Staff Shortages
In recent years and through the pandemic, Massachusetts hospitals, assisted by state government and the behavioral health community, have increased the number of inpatient psychiatric beds to meet the growing demand for mental health services. But while the number of beds has increased, nearly 20% of them across the state are offline, solely because there are not enough workers to staff them, according to a new survey from MHA and the Massachusetts Association of Behavioral Health Systems (MABHS).
According to the August survey of 56 facilities that represent 2,858 licensed inpatient psychiatric beds, 568 of those beds (19.9%) are offline due to staffing needs. That figure has been steadily increasing from 9% and 14% in February and October 2021, respectively.
The MHA survey found that while facilities need clinical staff at all levels, the greatest number of vacancies are among bachelor’s level mental health workers (504), registered nurses (472), and social workers.
“Between February 2021 and now, the number of full-time equivalent workers needed to staff offline beds in the commonwealth has doubled or more in nearly every category of worker, from R.N.s, to social workers, to sitters and personal care attendants,” said MHA’s Leigh Simons Youmans, senior director, Healthcare Policy.
In 2021, the Baker administration devoted $31 million from American Rescue Plan Act funding to the behavioral health workforce crisis. Hospitals used the temporary funds to increase wages and signing bonuses to incentivize and retain workers at the bedside, and for hiring temporary staff to keep current beds online. In the recent MHA survey, hospitals indicated more help is needed to, among other actions, compel insurers to reimburse more fairly for behavioral health services, to expand loan repayment programs and other workforce development programs, and to create employee well-being support to minimize the great strains of working in the behavioral health sector.
“Compounding the problem is the fact that settings across the continuum are stressed as well,” MHA’s Youmans said. “Patients ready for discharge from inpatient psychiatric beds can wait for weeks or months on inpatient floors while they wait for post-acute, community-based, and Department of Mental Health continuing care beds to become available, further limiting the number of available inpatient beds for those that need them.”
A COVID-19 recovery bill that the legislature passed in late 2021, and Governor Baker signed, contained $111 million for behavioral health workforce loan forgiveness. That forgiveness program is now being designed. The legislation also contained $198.6 million for a behavioral health trust fund that has yet to be allocated.
MHA and MABHS are advocating that the $198.6 million be used for behavioral health workforce recruitment, retention, and pipeline development programs, including expanding scholarship opportunities and loan forgiveness; training across the care continuum to expand capacity to care for and discharge patients with behavioral health needs to non-hospital settings; capital investments in hospital infrastructure to expand behavioral telehealth services; and treatment and diversion programs for incarcerated and/or formerly incarcerated people with mental illness.
National Group Says Adults Should be Screened for Anxiety
The U.S. Preventative Services Task Force(UPSTF) – an independent, but influential panel of medical advisors – has recommended for the first time the screening of anxiety in adults aged 65 and younger. The anxiety screening is in addition to the task force’s ongoing recommendation that all adults, including those who are pregnant and postpartum, be screened for depression. (The group said there is not enough evidence to show if there is a benefit on screening adults 65 or older for anxiety and screening all adults for suicide risk.)
“The Task Force recognizes that screening is only the first step in helping adults with anxiety and depression,” USTPF wrote. “People who screen positive need further evaluation to determine if they have anxiety or depression. After diagnosis, people should participate in shared decision making with their healthcare professionals to identify the treatment or combination of treatments that are right for them, and then be monitored on an ongoing basis to ensure that the chosen treatment is effective.”
People may comment on the group’s draft recommendations through October 17.
The national screening proposal follows a provision in the state’s Act Addressing Barriers to Care for Mental Health, otherwise known as the ABC Act, which was signed into law this past August. That law mandates insurance coverage for an annual mental health wellness exam comparable to an annual physical.
Tufts Medical Center Receives Prestigious Magnet Designation
The American Nurses Credentialing Center (a subsidiary of the American Nurses Association) has designated Tufts Medical Center as a “Magnet” facility, meaning the hospital has great nursing outcomes, high job satisfaction, low turnover rates, and a supportive culture.
Only about 9.4% of hospitals in the United States have received magnet designation status. The process to achieve Magnet designation is long and difficult.
“When we embarked on our Magnet journey years ago, we knew we had a long legacy of excellence in nursing. Nurses at Tufts MC are the very best —in skill, innovation and compassion,” said Terry Hudson-Jinks, R.N., chief nursing officer at Tufts Medical Center. “That’s why it is incredibly gratifying to receive this validation of the phenomenal work our nurses do every day.”
Of the approximately 591 Magnet hospital nationwide, 12 are in Massachusetts. In addition to Tufts Medical Center, the others are: Baystate Medical Center, Boston Children’s Hospital, Boston Medical Center, Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital, Dana-Farber Cancer Institute, Lowell General Hospital, Massachusetts General Hospital, South Shore Hospital, New England Baptist Hospital, and Winchester Hospital.
MHA’s Delmolino to Receive Northeast Telehealth Award
Congratulations to our own MHA Director, Virtual Care & Clinical Affairs Adam Delmolino, who this Friday will be presented the Michael Edwards Memorial Award from the Northeast Telehealth Resource Center (NETRC), in recognition of his work in leveraging telehealth to improve access to care.
NETRC helps to increase access to healthcare services through telehealth for rural and medically underserved populations in Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont.
The group is recognizing Delmolino for his work over the years, but especially during the pandemic, in leading MHA initiatives regarding telehealth, including convening the Massachusetts Telemedicine Coalition (tMED). “As a big picture thinker and fierce advocate in the telehealth policy space, Adam has made an impact on countless patients, hospitals, and behavioral health clinics,” NETRC stated in explaining its award.
As Flu Season Begins, AHA Launches Campaign
During flu season, which is generally thought to run from October through May, the Massachusetts Department of Public Health publishes its weekly flu report, and caregivers stress the importance of getting vaccinated. The best time to get vaccinated is in September and October. Each year, the American Hospital Association (AHA) also restarts its United Against the Flu campaign that provides the public with information, and providers with resources to help spread the message about the need for vaccinations. As has been the case the past two years, flu season coincides with an expected uptick in COVID-19 cases. The symptoms of the two ailments can be similar, and testing may be needed to confirm a diagnosis. Last season, more than 90,000 people in the U.S. were hospitalized because of the flu.