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“Caring Commonwealth” health policy wins 
plaudits in Western Massachusetts

SPRINGFIELD -- Health care and business leaders from Western Massachusetts who appeared at a hearing by the Legislature’s Health Care Committee said they were enthusiastically in support of the proposed comprehensive state health policy. The hearing at Springfield Technical Community College was the third of three field hearings to gain suggestions for improving “Massachusetts: A Caring Commonwealth, The Health Care Policy of Massachusetts".

Dr. Dennis Gordon, past president of the Hampden District Medical Society, representing the Massachusetts Medical Society, expressed “strong support for the policy objectives and the establishment of a coordinating council to ensure implementation.”

He was joined by Dr. John Fromson, Vice President for Professional Development at the Medical Society, who testified on behalf of the Commission on End of Life Care, who said, “the commission is delighted that the ‘Caring Commonwealth,’ recognizes compassionate end of life care as one of the ten top health care priorities facing Massachusetts.” However, he said the commission was concerned that the issue needs to be understood and articulated in the broadest and most consensus enhancing way and that the policy needs to express greater urgency in the need for public and provider education of the range of end of life care options.

Elliot Stone, Executive Director of the Massachusetts Health Data Consortium, noted that Massachusetts hasn’t had a statewide health policy in 25 years and commended the Health Care Committee for developing such a comprehensive document. Mr. Stone spoke of the critical need for investment and development of the health system’s information technology infrastructure to monitor progress in the implementation of the policy and to support the policy’s objectives.

“Hospitals are a prime engine of economic growth,” explained Allan Blair, President of the Western Massachusetts Economic Development Corporation. He noted that they employ over 440,000 people in Massachusetts, including 350,000 in direct care. In Western Massachusetts, Mr. Blair stated that hospitals have a slightly larger workforce and nearly as large a payroll as the manufacturing sector of the economy. “Government need to nurture health care as a major part of the state’s economy and one that employs a large number of women and minorities.

Among the specific suggestions offered were:

• Provide patients and their families need information for informed choices on end of life care.
  
• People need to be encouraged to appoint a health care proxy and discuss their preferences and values for end of life care with their proxy, health provider, and family members.
  
• People need to have confidence that their wishes, such as for Do Not Resuscitate order, will be understood and honored.
  
• The Betsy Lehman Center for Patient Safety needs to be activated.
  
• The Patient Care Assessment program that reviews cases of medical errors and attempts to educate hospitals and doctors to avoid future mistakes ought to be separate from the Board of Registration in Medicine that has disciplinary functions.
  
• There needs to be a confidential, non-punitive Center for Physician Remediation to help physicians whose clinical skills are less than desirable, and the Medical Society’s Physician Health Services need to be expanded from substance abuse issued to include all physical and mental health issues that harm physician competence.
  
• Medicaid rates for physicians and hospitals should be made equivalent to Medicare rates. This would only cost $30 million state dollars that would attract another $30 million in federal funds.
  
• Cost-effective recycling of prescription drugs in long term care settings and greater support for elders living in the community are needed.
  
• The quality of care in nursing homes, especially for elders with Alzheimer’s Disease, is rapidly deteriorating to the warehouse style level of care that was found in state mental institutions in the nineteen seventies. Direct care workers are underpaid and have no career ladder to encourage them into nursing.
  
• Support for family caregivers is critical. Tax credits for those who care for others at home should be enacted. The hospice model should be used in other areas of health care besides end of life care.
  
• Medicaid rules that prevent families of terminally ill children from using both hospice services and life extending health treatment need to be revised to allow both.
  
• Hospice for elderly can reduce emergency room visits and overcrowding of emergency departments.
  
• Pain management is not sufficiently understood. There is need for more education of providers.

In addition to Drs. Gordon and Fromson, Messrs Stone and Blair, others providing testimony were: Rigney Cunningham, Executive Director of the Hospice and Palliative Care Federation of Massachusetts; Brian Quigley, legislative counsel for the Massachusetts Association of Health Plans; Carla Braveman, Executive Director of the VNA/Hospice Alliance of Northampton; Carol Rodriques, Executive Director of Hospice of Western New England in Greenfield; Steve Bradley, Vice President for Government Relations at Bay State Medical Center; and Amy Goldstein of the Massachusetts Pain Initiative.

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