From State House News Service
ON THE AGENDA
- State health boss backs Wellness Fund
- Baker talks MBTA technology
- Police excellence center proposed
- MassHealth overhaul in the offing
- 1,000 Words: Flag Day
- Lottery moving toward online gaming
TOP OF THE HILL
State health commissioner sees Prevention and Wellness Trust Fund as ‘future of health care’
About a year before funding is set to expire for a state trust fund aimed at preventing chronic health conditions, community health organizations and other stakeholders shared with lawmakers their success stories and concerns about what could happen when the program ends.
The Prevention and Wellness Trust Fund was established as part of a 2012 health care cost containment law and funded with $60 million over four years through an assessment on health insurers and large hospital systems. The fund allocated money to nine local partnerships that focus on pediatric asthma, hypertension, falls in older adults, and tobacco use.
“We will not successfully reach our goals of improving health outcomes and reducing costs, especially for those who are at risk of chronic disease, without building our public health capacity and linking it to our health care system in a coordinated way,” state Public Health Commissioner Monica Bharel told the Joint Committee on Public Health during an informational hearing Tuesday, June 14. “This is the future of health care, and this is why the Prevention and Wellness Trust Fund is so important.”
With partnerships in Barnstable County, Berkshire County, Boston, Holyoke, Lynn, the MetroWest region, Quincy and Weymouth, New Bedford and Worcester, the fund’s grantees cover about 15 percent of the population, according to the Department of Public Health.
Mosaic Cultural Complex was a grantee and one of 10 community partners in the Worcester-area cohort. The nonprofit social service agency came under fire for perceived mismanagement. After an audit the city suspended its payments to Mosaic and placed its 41 Piedmont St. headquarters up for auction in late April. Find full Sun coverage here:
- Sun exclusive: City halts Mosaic work under state health fund
- Mosaic, grant challenges present from start, city official says
- Mosaic held health workshops through 2015 and into January
Trust fund partnerships must have clinical, community-based and municipal components. The partnerships have resulted in more than 8,800 referrals from clinical sites to community organizations to address “needs of the whole person,” according to the DPH.
After a capacity building period, 2015 was the first full year of implementation for Prevention and Wellness Trust Fund programs, according to a DPH report to the Legislature in January of this year.
Funding is slated to end by June 2017. The legislative report concluded the four-year time frame “presented opportunities and challenges,” allowing a quick response to a public health need.
“However, the impact of the model of linking clinical and community care and focusing on ‘upstream’ prevention efforts to promote health will not be fully demonstrated by June of 2017, and the opportunity for deeper and more sustained impact is still in front of us,” the report said.
An independent evaluation of the Prevention and Wellness Trust Fund is due to the Legislature in January.
— Katie Lannan (SHNS)
“Most of our technology is not technology. It’s mechanical.”
Gov. Charlie Baker, on needed MBTA improvements
Improvements at the MBTA are moving the transit system “in the right direction,” Gov. Charlie Baker said Thursday, June 16, but an “enormously significant climb” remains ahead.
Speaking at a Massachusetts Taxpayers Foundation forum exploring the future needs of the state’s transportation infrastructure, Baker reiterated his call for a focus on the T’s “core system” to create a “reliable, predictable and dependable product” for riders.
Baker said his priorities for the MBTA are “reliability, modernization and expansion, in that order.”
“Now, there’s no question that there’s work to do, broadly speaking, and if you look at where a big part of the five-year capital plan on the T side is focused, it’s on the core systems, and it’s built off of those three measures — reliability, modernization and expansion,” Baker said. “Now in that context, we … are going to have to roll that thing out in a way that works on the premise that we’re going to chase projects and opportunities that we believe need to be done and that we believe we can do effectively.”
The taxpayers foundation on Thursday released a transportation-focused report that pegged “inferior” data quality in asset management systems, the inability to properly manage projects, and a lack of accountability on how money is spent as challenges to adequately addressing the capital needs of the transportation system.
The report recommended that officials focus on talent, leadership, and improvements to data and systems to prevent “future erosion of the infrastructure.”
As an example, Baker said it could be possible to increase MBTA capacity by upgrading its signaling and switching technology, which he said limits “how close the trains can get.” An upgrade could allow more trains to move through a station in shorter periods of time, he said. “Most of our technology is not technology. It’s mechanical.”
— Katie Lannan
IN THE NEWS
Excellence Center proposed to highlight police best practices
For Eliza Williamson, who was found clenching the broken end of a bottle near a Mansfield concert venue in the late 1990s, the responding police officer’s demeanor meant everything.
“What I remember is his voice. He said, ‘I’m Mike. What’s your name?’ I remembered that he squatted down instead of standing over me,” Williamson recalled in testimony before the Committee on Mental Health and Substance Abuse on Tuesday. She said, “He didn’t rush me. He didn’t touch me. He didn’t raise his voice. Eventually I came out of the bushes and went with Mike to the hospital.”
Williamson, a survivor of a sexual assault in college, had been set off by a stranger’s touch after stumbling at Lilith Fair, during a performance by Sheryl Crow, she told the News Service.
“I felt his hand on my arm. I smelled beer and sweat and too much cologne, and boom, gone. It’s jumbled. I heard my voice scream, ‘Don’t touch me,’ ” said Williamson, who was in her mid-20s at the time. She told committee members she suffered from mental disorders, including post-traumatic stress disorder.
The calm approach of the officer who shepherded her to treatment is a protocol Williamson and others want to see adopted across the state through a bill (S 2320) establishing a center of excellence in community policing and behavioral health.
“When we go to these calls, if we don’t slow things down they turn into crises very quickly,” Brookline Police Deputy Superintendent Michael Gropman told the committee. Gropman said he has a child with a mental health disorder and described an incident where police were able to calm down a child who wielded a knife and begged police to kill him.
The center established by the bill would serve as a “clearinghouse for best practices,” develop training curriculum for local police, help municipalities partner with treatment services and measure the success of the programs. The bill would first, subject to appropriation, develop a planning process for the center.
Annabel Lane, the criminal justice coordinator for the National Alliance on Mental Illness Massachusetts, said additional training could be done for about $1.5 million to $1.7 million annually.
— Andy Metzger (SHNS)
Federal waiver would overhaul insurance program covering 1 in 4 in Mass.
The MassHealth program, which has 1.8 million members in Massachusetts, would be restructured toward the accountable care model of service delivery under a five-year deal with the federal government proposed Wednesday, June 15, by the Baker administration.
Federal authorization and funding for key aspects of the state’s current MassHealth program, jointly funded by the state and federal governments, expire July 1, 2017, and the state is at risk of losing more than $1 billion a year if its waiver agreement is not renegotiated.
The Baker administration is seeking from President Barack Obama’s administration a new five-year waiver extension it hopes will lead to the first fundamental course shift in 20 years for MassHealth and more sustainable growth in a $15 billion program that consumes 40 percent of the state budget.
The waiver request calls for $1.8 billion in upfront investments in the accountable care organization (ACO) model, including funding for behavioral health and long-term care service providers.
State officials see the ACO model, which emphasizes integrated and coordinated care and holds providers accountable for care quality and cost, as in keeping with the 2012 health care quality and costs containment law that called for a move away from fee-for-service models and “fragmented care.”
Politics could come into play with the 92-page waiver request since the Baker administration is looking to strike a major new deal with the federal government just months before the White House changes hands and Obama leaves office after an eight-year run.
State officials have opened a one-month comment period on their waiver request, ending on July 15, with two public hearings scheduled to accept feedback. A 2:30 p.m. hearing is planned Friday, June 24, at One Ashburton Place, Boston, followed by a 2 p.m. hearing on Monday, June 27, at Fitchburg Public Library, 610 Main St., Fitchburg.
According to the Baker administration’s waiver summary, the ACO model under MassHealth would not be a one-size-fits-all approach, and managed care organizations could “remain the insurer, pay claims and will work with ACO providers to improve care delivery.”
The state share of funds under the waiver is supported by a $250 million increase in assessments on hospitals.
The new waiver calls for $1.2 billion a year worth of so-called health care safety net programs, which often cover the cost of care to individuals who are underinsured or uninsured, and features an expansion of services covered under MassHealth for substance use disorders “to include the full continuum of medically necessary 24-hour community-based rehabilitation services.” Four-hundred beds are scheduled to be added in fiscal 2017 and 450 more beds in fiscal 2018.
— Michael P. Norton (SHNS)
IN THE NEWS
Committee greenlights Lottery move to online gaming
The Massachusetts Lottery Commission would be authorized to offer its products online and on mobile applications, something the Lottery has said is essential to maintaining and growing its revenues, under a bill given approval last week by a legislative committee.
The Lottery has been looking for a “broad mandate” from the Legislature to move online, saying an internet presence will be essential if it is to continue to thrive and return hundreds of millions of dollars to cities and towns as online games attract young players and their money.
The Joint Committee on Consumer Protection and Professional Licensure gave a favorable report Wednesday, June 15, to an amended version of a bill (S.151) sponsored by Sen. Jennifer L. Flanagan, D-Leominster, that would allow the Lottery to “conduct a state lottery, including a lottery or lotteries conducted online, over the internet, or through the use of mobile applications.”
“Since millennials and other younger players have grown up with access to technology at their fingertips, they are less likely to purchase lottery tickets in the traditional marketplace and we need to find an alternative way to engage them,” committee co-chair Sen. Barbara L’Italien, D-Andover, said in a statement. “Massachusetts is highly reliant on Lottery revenues for local aid, and in order to sustain the high revenues to which we are accustomed, we need to diversify our offerings to engage younger players and continue to have one of the strongest lotteries in the [nation].”
In addition to requirements that the Lottery verify all online players are at least 18 years old and in Massachusetts at the time of purchase, the committee attached eight conditions to the Lottery’s online shift.
Any winnings between $200 and $599 would have to be claimed by the winner in person at a Lottery retailer, and winnings of $600 or more would have to be claimed in person at the Lottery’s office. The committee also gives the Lottery the ability to withhold payout until it has determined the winner does not have outstanding child or spousal support payments or other state debt.
— Colin A. Young (SHNS)