March 2014

March 31, 2014

AP photo
(AP photo)

Here's a thought experiment prompted by the closing of North Adams Regional Hospital:

What if there was an objective, independent inventory of all the health care resources in the state, matched with an evaluation of the needs for the next 5 years? The project could look at the distribution of acute and non-acute care units, like surgery, coronary care, obstetrics, behavioral health, primary care and dental care. It could also look at expensive new technologies, and inexpensive services like health screening and family planning. It could then assess how the distribution of these resources meets the expected needs in each region, allowing the public and state policymakers to make decisions based on upholding ideal standards of care, reducing disparities, and avoiding unnecesary duplication.

What if?

Of course, Chapter 224 included this, a provision establishing a state "Health Planning Council" to do exactly that. The Council (HCFA is a member of its advisory board) includes key state officials and several experts in the field of health planning, analysis and economics. They are producing a detailed, comprehensive inventory of the state's behavioral health resources, which will prove invaluable for state policymakers working with behavioral health and substance abuse.

And then, they are planning to pretty much stop. No health planning for acute hospitals, no planning for any other services. No recommendations, no guidelines, no looking at undersupply or excess capacity.

The FY14 funding approved for health planning was way below what the administration requested. For FY15, there are no funds forthcoming, so DPH is looking to scrounge small money in other accounts. But basically, it will be over.

Obviously the chapter 224 health planning initiative would not been finished in time to have helped guide our responses to the closing of North Adams Regional Hospital. But there will be other closings, and other requests for permission to acquite the latest high-tech gadgets. We hope the tragic closing of NARH will spur the legislature and administration to make planning a priority.

One other thing on North Adams: The closing of the hospital means that hundreds of workers are losing their health coverage. Our friends at Ecu-Health Care, the ACA Navigator for Northern Berkshire County, is overwhelmed with the need for help. Ecu-Health, members of the AFL-CIO,  SEIU, and the Health Connector worked throughout the weekend to ensure former hospital employees do not experience a gap in health insurance coverage. Tomorrow, 6 members of the HCFA HelpLine team will travel to North Adams Regional Hospital to help former employees secure coverage via the Health Connector and MassHealth.  


The Berkshire Eagle provides a flavor of the aftermath of hospital closing:

Ecu-Health Care, state rush to help cover NARH jobless


NORTH ADAMS -- A statewide effort by multiple organizations aims to sign up former North Adams Regional Hospital employees for health insurance and provide temporary coverage, said Charles "Chip" Joffe-Halpern, executive director of Ecu-Health Care.

"The best number we have is at least 300 people have lost their health insurance, probably many more," he said. "This is very painful for the employees of the hospital."

... "We've had people weeping in the waiting room," he said. "People who are losing their jobs who have mortgages, families, and need important medications."

What has been heartening for Joffe-Halpern and the four other Ecu-Health Care employees, he said, is the responsiveness from the Massachusetts Health Connector.

"Knowing that we're going to get people coverage, and how they've organized a statewide response for Northern Berkshire County, that's been moving," he said.

"They sent four staff to us to coordinate efforts to help employees get health coverage quickly," he said. "They moved so quickly and with such passion and commitment."

Ecu-Health Care staff volunteered to put in hours over the weekend, Joffee-Halpern said, and provided health coverage counseling to former employees. And that work will continue on Tuesday and Wednesday.

As a result of the coordinated efforts, 14 representatives from the following organizations will be on site Tuesday and Wednesday: Health Care for All of Boston, Hilltown Community Health Center of Huntington, Caring Health Center of Springfield, Advocacy for Access of Pittsfield, and Community Health Programs of Great Barrington.


     -Brian Rosman

March 28, 2014

Chris Hayes of MSNBC tried to have a rational conversation about health care policy and politics. Oh well. Watch here, or click above.

Connector Dashboard shows progress in eliminating backlog, expanding coverage
March 27, 2014

Today the Connector Board met to discuss the continued progress on the short-term and long-term enrollment and IT goals, and to prepare for the 2015 health plan offerings, called the Seal of Approval (SoA) process. Headlines include the elimination of the backlog in paper applications, another 32,000 people added to transitional MassHealth coverage, and progress in figuring out a plan for resolving the website and IT issues that have blocked the online eligibility and enrollment system.  The Connector materals include an "Open Enrollment Check-in," a presentation on the Seal of Approval issues, and the weekly progress dashboard.

Our full report on the meeting is coming up in just one click:

March 27, 2014

HCFA would like to applaud the Governor on his action today regarding opiate abuse (see story: Opiate Abuse Stirs Gov. Patrick To Declare Public Health Emergency). The Commonwealth has long struggled with the public health issue of opioid addiction and Governor Patrick’s declaration implements much needed interventions.

In Massachusetts we are losing hundreds of our citizen to a public health epidemic that shows no signs of slowing. Instead with the influx of a higher grade of heroin in larger supply, it will only increase.  The heroin has become cheaper, a stronger “high,” and more plentiful on our streets.  With experimentation of narcotics happening at a younger age, not only is it important we find ways to treat the rising tide of addiction but it is a necessity to secure the future health of the next generation.

By treating opiate addiction we are not only thinking in terms of a humanitarian public health response but also that of a fiscal response. If opiate addiction is treated in the early stages in becomes more manageable system-wide.  Public services like police, e.m.t., emergency rooms, shelters will benefit from less strain to their already limited resources.

How does one treat opiate addiction if it is so prevalent and widespread? The most crucial aspect is educating both the public and the abuser that addiction is a clinical issue. This is a medical condition to be treated as we treat any progressive and life threatening illness. Does this mean we condone the actions of the addict? No. We must recognize that some behaviors however are symptoms of the underlying illness, and by treating that illness we will in fact alleviate some, if not all of those symptoms.  The other key to treating this addiction is having the resources from a public health sector available to both identify the substance use and have adequate resources in place to treat. This means publically funding programs that not only detoxify the person but teach them to live without the drug in their life.

The Governor set out two major policy steps today:

  • Permission for first responders to carry and administer Naloxone, known as Narcan, a so-called opioid antagonist that can prevent deaths in overdose cases. State officials also announced Narcan will be made available through prescriptions in pharmacies so it will be available to individuals who fear a loved one might overdose.
  • A Department of Public Health mandate that physicians and pharmacies use prescription monitoring to guard against abuse or misuse of prescriptions. The program has been voluntary.

We applaud our Governor's bold steps today. 
     -Paul Williams

March 23, 2014

Two important bills each passed one branch of the state legislature last week. Now it's up to the other branch to finish the job.

First is legislation addressing racial and ethnic health disparities. On March 20, H. 3888 passed the House and was sent to the Senate.

Health Care For All has long supported this legislation, working with a broad coalition of disparities advocates in the Disparities Action Network to draft the bill back in 2009. In addition to creating a permanent Office of Health Equity in state government focused on health disparities, the bill would create a framework for a comprehensive approach to health disparities. The approach encompasses all the activities of state government, such as housing, transportation, education and economic development. It requires that each state budget submission identify major state initiatives that affect health and health care, and their impact on health disparities. It also calls for an annual report card on progress in reducing disparities.

On the same day, the Senate passed S. 2063, "An Act to prevent shackling and promote safe pregnancies for female inmates." Shackling pregnant women is unsafe, unnecessary, and inhumane. HCFA has worked closely with the Massachusetts Anti-Shackling Coalition, led by NARAL Pro-Choice Massachusetts and other groups to put an end to the practice of a woman from being shackled during pregnancy, childbirth, and post-delivery recuperation unless she presents a specific safety or flight risk. While Governor Patrick issued regulations in February, he and the coalition have supported legislation to codify the standard into permanent law. 

The statement by HCFA's Executive Director Amy Whitcomb Slemmer was cited by the State House News Service in their report on the passage of the bill by the Senate:

“Women in prison are more likely to have high-risk pregnancies, as they are less likely to have access to regular health care prior to being incarcerated,” says Health Care For All Executive Director Amy Whitcomb Slemmer. “The Anti-Shackling Bill would reduce the risks and associated costs for pregnant women in our jails and prison by requiring basic medical standards like prenatal and postpartum care, access to health-related information, counseling and dietary needs.”

We urge the House to move quickly on the anti-shackling bill, and the Senate to move quickly on the disparities proposal.
   - Brian Rosman


March 22, 2014

This week, a real-life cartoon story instead of a video. The first panel is below. Click on the cartoon or here to see the rest.

How Obamacare's individual mandate works -- in two minutes

March 19, 2014

We love that former Washington Post and friend-of-the-HCFA-blog blogger Ezra Klein's first explainer video for his new venture,, is about health care reform. We're even happier that his 2-minute piece on the indiviudal mandate includes this graphic, highlighting Massachusetts' success in expanding coverage through reform:

Map of Massachusetts showing "95%" covered

You can watch the whole thing above.


March 19, 2014

Safety is Personal Report coverThe National Patient Safety Foundation’s Lucian Leape Institute (link to: today released a new report titled Safety is Personal: Partnering with Patients and Families for the Safest Care (link to:

HCFA was one of the participants in roundtables convened by the Lucian Leape Institute to look at consumer engagement in patient safety. This white paper summarizes the discussions and the recommendations that came out of those convenings. The report looks at three levels of engagement in care: direct care, at the level of a health system, and at the policy level. The target audience for the report is those working within the system, and therefore it focuses its recommendations on the associated change agents for each care level-clinicians and staff, health care system leaders, and policy makers. The report looks at possible barriers to consumer engagement and then makes recommendations, summarized in the report, for how to work to overcome those barriers to effectively engage patients and families in improving care.  Recommendations include involving patients and families in decision-making processes both when it comes to their own care and to system-wide changes, training staff in how to partner with patients and families, partnering with community organizations, supporting patients and families when something goes wrong with their care, and developing and implementing safety metrics (and engaging patients in that process).

The Lucian Leape Institute will hold a webinar on April 29, 11-12, to discuss the paper and the recommendations. Registration is free and you can register here.  

As hospitals in Massachusetts come to see the value of having patients and families at the table through Patient and Family Advisory Councils and in other ways, we encourage them and all other health care settings to look closely at this report and think about ways in which you can begin and/or deepen consumer engagement.
    -Deb Wachenheim

March 18, 2014

Patient Safety Forum





The MA Coalition for the Prevention of Medical Errors, Masspro, and the Betsy Lehman Center for Patient Safety and Medical Error Reduction  are hosting a patient safety forum in Burlington, MA the afternoon of April 7. Learn more and register here. The fee to attend is $75. Among other things, you will hear about some important initiatives that include patients and family members.

Senator Richard Moore is giving the opening remarks. The keynote address is being given by Dr. Jeff Brady, the director of the AHRQ Center for Quality Improvement and Patient Safety.
     -Deb Wachenheim

March 17, 2014

Connector slide shows progress in several areas

The Connector Board met today to discuss progress in addressing short- and long-term issues related to the website and eligibility system; vote to approve the extension of Commonwealth Care through June 30th; and vote to approve the final calendar year 2014 affordability schedule. Materials from the meeting, including the updated "dashboard," are posted on the Connector's website. Our full report takes just a click:

March 14, 2014

Colbert Report video on Obama's appearance on the "Between Two Ferns" video


We'll try to do this every Friday, OK? Click to view.

Sally knocking on door
March 13, 2014

No March Deadline for Getting Help Paying for Health Insurance in Massachusetts!

You may have heard that the last day to enroll into a Health Connector health plan is March 24th. That is the case only if you are seeking a health plan from the Health Connector without getting help to pay for it and/or if you want your coverage to start for April 1st. BUT - if you are seeking help paying for a Health Connector Qualified Health Plan or qualify for MassHealth – you do not have a deadline for getting help. People that need help paying for health insurance in Massachusetts can apply anytime during the year and get free or lower-cost health insurance coverage!  Please contact our free HelpLine at 800-272-4232 if you have questions about getting health insurance in Massachusetts.

Março não é o prazo final para obter ajuda para pagar por um seguro de saúde em Massachusetts!

Você pode ter ouvido que o último dia para se inscrever em um plano de saúde do Health Connector é 24 de março. Esse é o caso somente se você está procurando um plano de saúde do Health Connector sem receber ajuda para pagar por esse plano e/ou se você quer que a sua cobertura começe no dia 1 de Abril. Porém - se você está procurando ajuda para pagar por um plano de saúde do Health Connector ou se você se qualifica para MassHealth - você não tem um prazo para obter ajuda. As pessoas que precisam de ajuda para pagar por um seguro de saúde em Massachusetts podem aplicar a qualquer momento durante o ano e obter uma cobertura de seguro de saúde grátis ou de baixo custo! Entre em contato com a nossa Linha de Ajuda gratuita no 1-800-272-4232 se você tiver dúvidas sobre como obter um  seguro de saúde em Massachusetts.

¡No hay una fecha límite en Massachusetts para obtener ayuda para pagar por el Seguro Médico!

Quizá usted ha oído que el último día para registrarse en los seguros médicos del Health Connector es el 24 de marzo. Eso se aplica solamente si usted está buscando por un seguro medico del Health Connector sin que le den ayuda para pagar por él y/o si usted quiere que su cobertura empiece el 1o. de abril. PERO – si usted está buscando ayuda para pagar por un Seguro de Salud Calificado por el Health Connector o si califica para MassHealth – usted no tiene una fecha límite para obtener ayuda. Las personas que necesitan ayuda para pagar por su seguro médico en Massachusetts puede solicitarlo en cualquier momento durante el año y obtener una cobertura medica gratis o a bajo costo! Por favor llame a nuestra Línea de Ayuda gratis al 1-800-272-4232 si usted tiene preguntas acerca de cómo obtener seguro medico en Massachusetts.

-Kate Bicego