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MGH Community News |
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MGH Community News |
| July 2024 | Volume 28 • Issue 7 |
Highlights
Sections Social Service staff may direct resource questions to the Community Resource Center, Ellen Forman, 617-726-5807. Questions, comments about the newsletter? Contact Ellen Forman, 617-726-5807. |
Healey Announces Sweeping Changes to State’s Emergency Family Shelter System
See the state's newly released FAQ Governor Maura Healey announced significant changes to the state’s emergency housing system late this month that sharply limit assistance to those who use temporary shelters and prioritizes needy Massachusetts families over migrants for longer-term placements. As of Aug. 1, stays in so-called overflow shelters will be limited to just five days, and importantly, would require people to wait at least six months before they could qualify for placement at a longer-term facility. And for long-term shelter sites, which have long been at capacity, the state will expand its priority list to include families with veterans or who become unhoused by natural disasters. Under the new rules, families who become unhoused due to a no-fault eviction or a disaster such as a flood or fire will be prioritized for shelter, as will families who have at least one family member who is a veteran. The state already gave priority status to families with medical needs, newborn babies, or who are at risk of domestic violence. The announcement adds to previous restrictions put in place by the Healey administration in an effort to keep the strained system afloat. Since the crisis began, Healey has declared a state of emergency, capped shelter capacity at 7,500 families, limited stays in state-run overflow shelters to 30 days, and restricted shelter stays in long-term shelter sites to nine consecutive months. Moreover, the state now bars homeless and migrant families from sleeping at Logan Airport. The state’s “Reticketing Program” now covers travel expenses for families who have a safe, long-term place to stay outside of Massachusetts. But the new restrictions came as a shock to those who work with homeless families. With just a few days between the announcement and implementation, they expressed fears that families with children will be forced onto the streets. And, the shift in policy, they said, marks a stark departure from the state’s 1986 right-to-shelter law, which requires it to quickly provide shelter and other necessities to homeless parents with children and pregnant women. |
“Having the right to shelter is one of the things we are very proud of. In Massachusetts, we have a lot of problems but we don’t let children and babies sleep outside,” said Andrea Park, an advocacy director at the Massachusetts Law Reform Institute. “If we are going to turn our backs on that, it needs to be a very intentional decision. People need to be bold enough to say it out loud.” Until recently, homeless families were guaranteed a roof over their heads, with no limitations. Healey was adamant the state is not abandoning the decades-old law, the only statewide right-to-shelter requirement in the country, but rather sending a message to those outside the state that “we do not have room here in Massachusetts.” Currently, overflow shelter sites in Chelsea, Lexington, Cambridge, and Norfolk have capacity for 300 families and allow them to stay for 30 days with options to reapply. Now, they will be transitioned to “temporary respite centers” with a five-day limit and no option to stay longer. Those families will be eligible to be flown out of Massachusetts on the state’s tab or apply for a subsidy (HomeBASE) to help pay for rent. According to the Healey administration, no new overflow sites will be opened to accommodate the need, which is still overwhelming, though the numbers of new arrivals are starting to abate. In the first two weeks of July, 467 families applied for shelter, but only 128 families exited, according to the most recent information provided by the state. There are about 334 families staying in overflow shelter sites and 728 on a wait-list. Meanwhile, the average length of stay in a long-term shelter has climbed in recent weeks — to 369 days or slightly longer than a year. The Law Reform Institute’s Park and Jeffrey Thielman, who works to resettle migrants as the executive director of the International Institute of New England, both said the new policy targets migrants in a way the administration’s previous policies have not. “Five days in a shelter is not enough time,” said Thielman, noting it can take three to four months for migrants to obtain authorizations that allow them to work and pay for their own housing. “It does feel like an effort to not be as welcoming as we can be to people who are trying to escape poverty, violence, and persecution.” School Limbo for New Arrivals New restrictions on access to the Massachusetts shelter system for homeless families raise the prospect that hundreds of migrant children may not have access to a public school this fall despite a federal law that guarantees them a right to an education. The five-day limit at the temporary shelters, followed by a six-month cooling off period to apply for new shelter, will likely complicate efforts by numerous families to settle on a school district for their children if their living arrangements are constantly changing. The state also has a nine-month limit on stays in longer term shelters, with some eligible for extensions, meaning another cohort of homeless families could be forced to relocate during the school year. “We are extremely concerned that the changes to the shelter system will impact the enrollment of children in public schools across the state,” said Iván Espinoza-Madrigal, executive director of Lawyers for Civil Rights. ”Any effort to stop eligible families from enrolling in their corresponding schools is a violation of fundamental educational rights that are well established under both federal and state law.” Espinoza-Madrigal’s said his group had already sent a letter to Attorney General Andrea Campbell asking her to direct school districts to enroll migrant children. Federal law requires states and local school systems to provide all children, regardless of immigration status, with access to public education. The federal McKinney-Vento Homeless Education Assistance Act also requires public school districts to immediately enroll any homeless student “actually living” in the district, unless it’s in their best interest to remain in their “school of origin.” State guidance says to presume students are best off in their home district, but “students who chose to enroll in school where they are temporarily residing must be enrolled immediately.” A spokesperson for the Massachusetts Executive Office of Education affirmed Wednesday that families have the right to enroll children in a district where they are living, including if they are staying in a temporary shelter. Districts cannot deny enrollment because a family is living in a respite center, the official said. The official added the state is working with local schools to ensure they are aware of state policy, including that they cannot deny enrollment solely because students are staying in the temporary shelters — however short that stay will be under the administration’s new restrictions. See the state's newly released FAQ - See the full Boston Globe articles:
Healey Signs Budget Bill Expanding Free Community College and Child Care Subsidies Gov. Maura Healey gave her OK to sweeping statewide policy changes as part of the overdue fiscal year 2025 budget. But she also potentially created more work for the Legislature by trimming $317 million from 60 separate line items in the spending plan with her veto pen just more than 48 hours before formal sessions are set to conclude, leaving the House and Senate little time to take the votes necessary if they choose to overrule the governor. Legislators packed the budget with policy provisions, including authorizing free community college. The Senate initiative to make community college permanently free for all will cost $117.5 million, covering tuition and fees for students. Another section of the budget aims to prevent so-called home equity theft, which refers to a municipality taking more of a property owner's earned equity than is owed in unpaid taxes and other expenses. The fiscal 2025 budget is supported by $1.3 billion in revenue generated from the state's 4% surtax on household income above $1 million, on top of the general state revenue foundation of $40.2 billion that lawmakers and the administration agreed to months ago. The surtax revenue — which is restricted by law to education and transportation uses — is being deployed in the budget to cover tuition-free community college, free RTA rides, the costs of providing universal free school meals in K-12 schools, enhanced minimum aid funding to local schools, additional financial aid for Massachusetts public college and university students, local road and bridge funding, and more. Lawmakers and budget managers in the Healey administration are also likely to have to work on funding for the state's overburdened emergency family shelter system in fiscal year 2025. The budget Healey signed Monday includes $326 million to contribute to the state’s ongoing shelter response, but the actual costs of providing shelter to homeless families swelled to roughly $1 billion last budget year, though Healey has since changed the program's terms in an attempt to control costs. Additional Detail
- See the full WBUR story. Additional material from WBUR Today, July 30, 2024, and from the Arc of MA.
Changes to Past Relevant Work and Disability Determinations In fiscal year 2023, more than 1.8 million people applied for disability benefits through Social Security’s two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Until recently, Social Security required adult applicants to provide their work history going back 15 years. That’s because the inability to work is key to Social Security’s definition of disability. But recalling the details of 15 years of employment – job titles, duties, dates, etc. – can be a major challenge. Effective June 22, 2024, Social Security began considering work going back 5 years, not 15. In addition, work is no longer relevant if the job lasted less than 30 calendar days. You can read more about changes in the disability evaluation process in Social Security’s press release. Decreasing the relevant work period from 15 to 5 years will make it easier for people to accurately report their work history. The reduction also makes sense given Social Security’s recent efforts to modernize the vocational policy that is used to make disability decisions. Research indicates that certain types of skills – namely, “manual” skills – can significantly deteriorate in 5 years. The PRW changes will reduce the time it takes for applicants to fill out Social Security’s work history forms. This is a small step to simplifying the disability application process. Social Security also benefits by receiving better quality information earlier in the evaluation process. Ultimately, millions of people applying for disability should see a reduction in processing times. - See the full SSA blog post.
Homeland Security Extends TPS for Haiti On June 28, 2024, Secretary of Homeland Security Alejandro N. Mayorkas announced the extension and redesignation of Haiti for TPS for 18 months, from Aug. 4, 2024, through Feb. 3, 2026. For additional information, please see the Federal Register notice. Individuals who currently do not have TPS may submit an initial application during the initial registration period that runs from July 1, 2024, through the full length of the redesignation period ending February 3, 2026. If you are currently a TPS beneficiary under the Haiti designation and you have not yet re-registered for TPS under the most recent extension, you must submit Form I-821, Application for Temporary Protected Status, by Aug. 30, 2024, to keep your TPS benefits. It is important to timely re-register during the re-registration period and not to wait until your EAD expires. Delaying re-registration could result in gaps in your employment authorization documentation. For additional information, please see the Federal Register notice. USCIS will issue new EADs with a February 3, 2026 expiration date to eligible beneficiaries granted TPS under Haiti's designation who timely re-register and apply for EADs. Given the time frames involved with processing TPS re-registration applications, DHS recognizes that not all re-registrants may receive a new EAD before their current EAD expires. Accordingly, through this Federal Register notice, DHS automatically extends through August 3, 2025, the validity of certain EADs previously issued under the TPS designation of Haiti. See the Federal Register notice as proof of extension. - See the USCIS website for the full announcement.
Federal Judge Blocks HHS Rule Protecting LGBTQ+ Patients from Discrimination Anti-discrimination protections for LGBTQ+ patients in the healthcare setting cannot be enforced, a federal judge in Mississippi ruled this month. In a preliminary injunction, the judge cited the Supreme Court's recent overturning of Chevron deference, a landmark ruling that weakened the power of federal agencies. The judge also argued that the Department of Health and Human Services (HHS) was wrong to rely on a previous SCOTUS decision to apply protections on the basis of sex to gender identity. Earlier this year, HHS finalized the rule that aimed to expand Section 1557 of the Affordable Care Act by codifying protections against discrimination based on sex to include sexual orientation and gender identity. This was clarified in an Obama-era rule, which was later rolled back by the Trump administration. In 2022, the Supreme Court held in Bostock v. Clayton County that the prohibition of sex discrimination in the workplace includes sexual orientation and gender identity. Based on that ruling, the Biden administration directed agencies to interpret Bostock to apply not just to Title VII, which deals with the workplace, but to other areas of law like healthcare where sex discrimination is prohibited. The judge on Wednesday ruled that HHS had wrongly conflated protections on the basis of sex with gender identity and wrongly extended Bostock protections to Title IX, which prohibits discrimination based on sex in federally funded programs. The judge acknowledged that some circuit courts have applied Bostock in Title IX cases. In a statement, the Human Rights Campaign condemned the injunction, warning that the decision may encourage discrimination, potential denial of coverage and denial of care in emergencies. “The discrimination LGBTQ+ people will continue to experience under this injunction is indefensible,” the campaign's president, Kelley Robinson, said in a statement. “This ruling is not only morally wrong, it's also bad policy. Everyone deserves access to the medical care they need to be healthy and thrive.” - See the full Fierce Healthcare story.
N.H. Governor Signs Bills Restricting Trans Health Care and Sports Participation New Hampshire Gov. Chris Sununu has signed two anti-trans measures into law that will limit transition-related care for transgender minors and bar some trans students from competing on school sports teams that match their gender identities. The health care measure, H.B. 619, will prevent trans minors from receiving transition-related surgery and bar physicians from referring patients for out-of-state procedures. It does not ban other forms of gender-affirming care, such as puberty blockers and hormone replacement therapy. The law takes effect at the start of next year. Supporters of the legislation argue that children are not mature enough to authorize life-altering surgery. He also vetoed legislation the same day that would have effectively prohibited trans people from using bathrooms and locker rooms that correspond with their gender identities. In total, 26 states now have laws limiting or banning such care, according to the Movement Advancement Project, an LGBTQ rights think tank. “There’s been a really strong push nationwide to block access to medical care for transgender people and to pass other laws that will impact the rights of transgender people to live publicly, to access health care, to go to school like anyone else,” Chris Erchull, a staff attorney at the Massachusetts-based LGBTQ advocacy group GLBTQ Legal Advocates & Defenders, or GLAD, said in an interview before Sununu signed his state’s bills into law. “That political movement has been impacting New Hampshire politics for years, but the swell has just gotten to the point where now, for the first time, legislation is actually passing in New Hampshire.” Zach and Sara Tirrell live with their trans daughter, Parker, in Plymouth, New Hampshire. Parker, 15, came out two years ago and began slowly receiving gender-affirming care — first puberty blockers and more recently hormone replacement therapy — at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. Parker and her parents said that the teen is not currently seeking transition-related surgery before becoming an adult, as the procedures are exceedingly rare for minors globally. However, the family worries that the state’s new health care law will make it easier for lawmakers to rationalize enacting wider limits on transition-related care. “This particular bill seems to us that it’s a little bit of them getting a win on the scoreboard against this marginalized population rather than enacting legislation that truly has any meaningful effect,” Zach Tirrell said in a phone call before the legislation was signed. “Oftentimes, if you’re intentionally targeting a marginalized group, if you can get a series of small victories, it’s easier to start eroding those broader freedoms. For us that’s what it feels like.” It is unclear if the New Hampshire laws will result in litigation. Last month, the Supreme Court agreed to hear a Biden administration appeal of a court ruling that upheld Tennessee’s measure prohibiting all gender-affirming care for the state’s minors. The court’s ruling on the Tennessee law, which is expected during the court’s next term, which begins in October, will affect similar laws in other states. The White House told media outlets recently that while it believes gender-affirming surgery should be “reserved for adults,” it opposes “attempts to limit healthcare for transgender individuals in the courts or through legislation.” - See the full NBC News story.
Governor Healey Signs Gun Safety Legislation Expanding Red Flag Rules Governor Maura T. Healey has signed into law An Act Modernizing Firearms Laws (H.4885), the state’s most significant gun safety legislation in a decade. The bill was passed by the Legislature as a result of the Supreme Court’s decision in New York State Rifle & Pistol Association v. Bruen, which sought to weaken states’ ability to protect their residents through gun safety laws. The bill modernizes Massachusetts’ existing firearms laws to address issues such as untraceable “ghost guns” and 3-D printed guns, enhance the “Red Flag Law,” further protect safety in public spaces and increase violence prevention programming in the state. “This legislation is the most significant gun safety reform package that Massachusetts has seen in a decade. It’s the culmination of a multi-year process that began once the Supreme Court’s conservative supermajority issued their disastrous Bruen decision, a ruling that undermined our laws and threatened the safety of our residents. After that decision was announced, the House began a comprehensive review of how that ruling would impact Massachusetts, and of the Commonwealth’s gun laws generally, a process that resulted in the historic bill that the House passed last October," said House Speaker Ronald J. Mariano (D-Quincy). The legislation cracks down on ghost guns, which are homemade weapons that do not have a serial number and thus are untraceable, and 3-D guns, which are made with a 3-D printer. The legislation enhances the firearms statute to combat ghost guns by requiring the Department of Criminal Justice Information Services (DCJIS) to develop and maintain a real time electronic firearms registration system and requiring that all firearms manufactured or assembled in Massachusetts be registered. It also requires all firearms to be serialized and registered and prohibits unlicensed individuals from using 3-D printers to manufacture firearms. The legislation also adds new language criminalizing the creation, sale or transfer of untraceable firearms and imposes a sentence of 1 – 1.5 years. The legislation also strengthens the state’s “Extreme Risk Protective Order” (ERPO) statute, or “Red Flag Law,” and takes additional steps to prevent guns from falling into the wrong hands. It clarifies that, under the Red Flag Law, a person who has had their firearm license revoked cannot obtain any new firearm licenses or identification cards while the ERPO is still in place. It also expands who can seek an ERPO to include licensing authorities, law enforcement agencies, and health care providers, in addition to a family or household member. To better protect Massachusetts communities from dangerous weapons, the legislation updates the state’s assault weapons ban by expanding the definition of “assault weapons” to include known assault weapons and other weapons that function like them with respect to certain features. It also prohibits possession, transfer, or sale of “assault-style” firearms or a large capacity feeding devices. Additionally, the legislation prohibits the issuance of a license to carry a machine gun except for firearms instructors and bona fide collectors and criminalizes the possession of parts that are intended to make weapons more lethal by adding them to the machine gun statute. This includes automatic parts, bump stocks, rapid-fire trigger activators, and trigger modifiers. The legislation also seeks to further enhance safety in public spaces by criminalizing possession of a firearm in government buildings, courts, and election/polling areas. Understanding that early intervention and community programming can be effective in stopping gun violence before it happens, the legislation creates a Violence Prevention Federal Reinvestment Trust Fund operated by the Executive Office of Health and Human Services that will fund violence prevention and intervention services. The legislation also takes significant action to update the state’s firearm registration, licensing and possession laws, as well as enhancing firearm data collection, analysis and publication. - See the full press release.
DREAMH Mobile Postpartum Care Unit: Now Accepting Patient Referrals The Kraft Center for Community Health has launched a new initiative, the Driving Equity and Maternal Health Initiative (DREAMH). The program aims to provide accessible care by addressing the health care disparities and maternal health needs in the Greater Boston area. Part of the initiative is a 3-year pilot of a Mobile Postpartum Care Unit (MPCU). The MPCU van offers postpartum care in a time and location that works for patients, whether this be at their home or in the community. The DPH-licensed mobile clinic will include providers to address all needs such as Certified Nurse Midwives (from BWH and MGH), Community Health Workers (CHWs), and Licensed Independent Clinical Social Workers (LICSWs). The goal is to use a holistic approach to address all needs in the postpartum period, including both physical and mental health, lactation support, and care coordination for support within local communities. Enrolled patients will work with a team for up to 6 months. There is no cost to patients or insurance coverage required to be enrolled in this program. Program costs during the pilot phase are covered by foundation funding. Eligibility Patients must
To Refer MPCU is currently open for referrals! Patients may self-refer, be referred by their care team, or by external providers such as a doula. Patients can be referred beginning in their third trimester or up to post-delivery. MGH staff may send an email to mpcu@mgb.org with “Send secure: patient referral” as the subject line. Send secure in the subject line will encrypt the email content and protect sensitive patient information. In your email, include the following details:
The MPCU staff will review the information and contact the patient directly for enrollment based on availability. If you have further questions about the program or would like more information to be shared with your team, contact Lyv Norris at anorris3@mgb.org. - By Caroline Rohnstock. Thanks to Lyv Norris for her assistance with this article.
Somerville-Cambridge Elder Service Announces New Technology Access Program (TAP) Somerville-Cambridge Elder Service’s new Technology Access Program (TAP) launched on July 1 with the goal of helping older adults use technology to find information, services and social connections easily and quickly. Somerville and Cambridge residents will benefit from free drop-in sessions, open labs and skills workshops. Home visits will be available by appointment. TAP will hold drop-in help sessions every Tuesday from 9:30-10:30 a.m. and skills workshops every Monday from 1-2 p.m. at the Somerville Council on Aging located at 167 Holland Street in Somerville. Other events will be scheduled on an ongoing basis. For more information, call SCES at 617-628-2601 or email info@eldercare.org. If your organization is interested in hosting a workshop or partnering with TAP, please contact TAP Manager Colin Barr at colin.barr@eldercare.org or 617-628-2601 x 1007. - From The Latest from SCES, Somerville-Cambridge Elder Services, July 30, 2024. Our former resource specialist Hannah Perry, who many of you know, is now the TAP Technology Access Coordinator.
MassHealth Transportation for Families of Inpatient Children and for Wheelchair Repair MassHealth has issued guidance that clarifies coverage of transportation for loved-ones of inpatient children and also for wheelchair repair. Transportation for the Direct Benefit of Children Under 21The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program provides comprehensive and preventive health care services to MassHealth Standard and CommonHealth members under 21 years old. MassHealth may cover transportation for the parent, family member or caregiver of a patient under 21 who has MassHealth Standard or CommonHealth coverage and is receiving residential or facility-based care in certain circumstances. “Under the EPSDT requirements…MassHealth covers transportation of a child’s parent, family member, or caregiver that is necessary to the child’s care, so long as that child is otherwise eligible for transportation. For example, if an eligible child is receiving residential or facility-based care (in an inpatient hospital, neonatal intensive care unit [NICU], intensive residential treatment program [IRTP], nursing facility, etc.) and the presence of the parent, family member, or caregiver is needed for them to actively participate in treatment or intervention for the direct benefit of the child, MassHealth will pay for transportation for the parent, family member, or caregiver to ensure the child’s medically necessary services are provided. Examples of necessary services include breastfeeding or providing breast milk, participating in family therapy, making medical decisions, consenting to surgery, and other similar activities.” (Emphasis added.) Please note however, that except as described above, the transportation of parents, family members, or other caregivers to visit members who are hospitalized or otherwise receiving residential or facility-based treatment is not considered necessary and is therefore not covered. This transportation is through the PT-1 process. To complete the PT-1 request, providers should list the child as the member receiving services and then indicate that this request is “for the medically necessary care of an EPSDT-eligible member.” Transportation for Wheelchair Repair MassHealth members otherwise eligible for non-emergency transportation (PT-1) may receive transportation with their wheelchair to obtain its evaluation or repair. Durable Medical Equipment (DME) providers will be considered “Authorized Providers” who can submit a PT-1 request on behalf of the member for such transportation. This type of transportation is only possible if the member can be safely transported with the equipment (for example, the wheelchair is operational enough to safely transport the member). The evaluation or the repair must also be expected to be completed on the same day as the transport. DME providers must continue to make home repairs, especially if the member cannot be safely transported to the DME provider, or if the DME to be assessed or repaired is anything other than a wheelchair. - See the full MassHealth Transportation Bulletin 21
MassHealth Now Covers Personal Emergency Response Systems for Those Without a Landline MassHealth has announced that, effective July 1, 2024, providers may bill for members who connect to a Personal Emergency Response System (PERS) either through a landline or a cellular network. Durable Medical Equipment Bulletin 37 also notes that members are not required to obtain an individual cellular plan when using a cellular PERS. Prior to this change, MassHealth regulations required that a patient have a landline to qualify for MassHealth PERS coverage. We had been advised that the only way around this was via a waiver requested by the patient's local Aging Services Access Point/Elder Service agency and that this could be a lengthy process. The new policy is welcome news and should help make PERS a more readily accessible option for MassHealth members. - See the full DME Equipment Bulletin 37
State Mandates Insurance Coverage at Urgent Cares to Relieve Overwhelmed ERs Faced with crushing numbers of patients at hospitals in Eastern Massachusetts, the state Department of Public Health launched an initiative Wednesday to relieve pressure on overwhelmed emergency departments by diverting patients to urgent care centers. Through the end of September, the state’s health insurers will cover treatment at urgent care centers even if the facility is outside their coverage network, according to a DPH memo. Urgent care providers, who treat patients with non-life-threatening conditions, also agreed not to bill patients for the remaining balance after insurance reimbursement. “What the DPH has done is unprecedented,” said Jim Brennan, president of the Massachusetts Urgent Care Association, an industry group. “The Department of Health is preemptively trying to make sure all patients are aware of resources they have above and beyond the emergency room.” The move comes amid extraordinary strain on the region’s hospitals, with summer also the busiest time for ERs. Meanwhile, providers are still reeling from pandemic-era workforce shortages and, this year, must also contend with difficulties at Steward Health Care, the largest for-profit hospital system in the country, which operates seven active hospitals in Massachusetts. Steward declared bankruptcy in May and has curtailed some services. Urgent care centers are equipped to handle less-dire medical emergencies than ERs, Brennan said. “For your everyday cough, cold, fever, sutures, we can handle that,” he said. Insurers will pay 135 percent of the Medicare reimbursement rate for out-of-network care at urgent care centers in nine Eastern Massachusetts counties, said Caljouw. The roughly 200 urgent care centers in Massachusetts have an average turnaround time of one hour, Brennan said, and cost one-fifth as much as a visit to a hospital emergency room. An estimated 13 to 27 percent of emergency department visits could be handled elsewhere, including at doctors’ offices, clinics, or urgent cares, according to the federal Department of Health and Human Services. Patients are spending much longer, on average, at emergency departments in Massachusetts. Six years ago, the average length of an emergency room visit was just over four hours, CHIA reported. That peaked at close to six hours at the beginning of 2023, edging down to 5½ hours at the end of last year — before Steward’s problems became acute. Patients languishing in emergency departments while waiting for a transfer to another department or facility, called boarders, are increasingly common in Massachusetts hospitals, said Dr. Joseph Kopp, chairman of the Massachusetts College of Emergency Physicians’ government advocacy committee and an emergency physician at Brigham and Women’s Hospital and Faulkner Hospital. At times, they occupy more than half the emergency department beds in the state. Those waits can be deadly. Boarding patients have worse outcomes, are more likely to fall victim to medical errors, and are more likely to die from avoidable complications, Kopp said. - See the full Boston Globe article.
New Pilot Seeks to Smooth Benefits Cliff Ariela Reynoso spends many nights scrolling on LinkedIn, browsing job postings that dangle the prospect of a better life for her and her 4-year-old son. Then she snaps back to reality. The East Boston single mother already works three jobs, but a higher income would make her ineligible for thousands of dollars in public benefits she receives each month in food subsidies, child care vouchers, and rental assistance. Reynoso does not want to depend on that money forever. And at 30 years old, she has no plans to stop working. But earning even a little bit more could mean losing the government support abruptly. It could leave her family hungry, or perhaps homeless again. Therein lies the trap. Make too little money for too long, and many families become reliant on public aid to survive. But make a smidge too much, and people are kicked off benefits entirely, often with no savings to soften the blow. A two-person household in Massachusetts earning $3,407 each month, for example, qualifies for up to $535 a month to cover groceries. But if they bring home even $1 more, that benefit disappears. Their food budget falls dramatically. Now a new program, dubbed “Bridge to Prosperity,” launching in the state’s three largest cities hopes to steer people away from the cliff. With $1 million of federal COVID relief funds and another $75,000 in philanthropic backing, the pilot will provide two years of “transitional assistance” to 100 families who would otherwise be at risk of losing government benefits if their income grew. Participants in Boston, Springfield, and Worcester will be eligible for monthly payments of up to $500 to make up for diminishing public assistance tied to taking a higher-paying job. There are no restrictions on how the money can be used, and the leaders of the pilot are negotiating with the Legislature to ensure the payments will not be counted toward participants’ taxable income or eligibility for benefits. If all goes to plan, program director Hannah Reuter envisions mothers climbing the economic ladder without the risk of losing public support. More parents may work their way out of low-paying jobs, or stay in the workforce, she said. Their labor could help ease shortages in fields such as health care and education. “What we are seeing is people doing everything right. They want to work more. They want to get off their benefits. But it’s hard to jump that cliff in one go,” said Reuter, who also represents Springfield WORKS, the Western Massachusetts nonprofit spearheading the effort. “We cannot tweak these assistance programs individually, because that may have unintended consequences somewhere else. But this is an opportunity to learn and change the whole system.” Reynoso now bears all the costs of raising a child alone. Her three jobs are as a family advocate at Head Start in Chelsea, a personal care assistant, and a shopping floor worker at Macy’s in South Bay. She pays for afterschool care for Zion with a monthly voucher and cuts costs wherever possible. Combined, Reynoso now earns below $4,000 a month before taxes; last year, she made less than $60,000. Her income is not enough to live on. But if her earnings rise, Reynoso is in danger of losing the public assistance she receives — a possibility caseworkers have repeatedly warned her about. It keeps her from pursuing a new job or a promotion. She is also scrupulous about reporting her earnings in full, knowing any mistake or omission risks losing her Section 8 benefit. Public assistance programs were first created decades ago “as a poverty-management system,” said Kamatara Johnson, executive director of Circles USA, a national nonprofit that has studied cliff effects. But little attention was paid to how one benefit affected another. Instead, she said, “the government created a one-size-fits-all program that often overlaps with itself, hurting families, employers, and the agencies put in charge of distributing this money to people in need.” A few states, including Tennessee, Louisiana, Vermont, and now Massachusetts, are trying to smoothen the transition off public benefits. Maine, too, recently let families who receive Temporary Assistance for Needy Families maintain their current benefits for up to six months after their income increases. The goal is to make it easier for people to leave benefits behind, said Keith Barnes, senior director of the nationwide Beyond the Cliff coalition. Reuter plans to roll out the pilot here by October. The Center for Social Policy at the University of Massachusetts Boston will track the 100 participating families, measuring their wages, job retention, financial stability, and psychological wellness. - See the full Boston Globe article.
$400 a Month in No-Strings-Attached Money For Chelsea Residents Improved Health Outcomes Chelsea residents who received a no-strings-attached cash benefit early in the pandemic saw vastly better health outcomes than those who didn’t, a new study found. Researchers found that the Chelsea Eats guaranteed income program reduced emergency visits among participants by 27 percent, simply by doling out $400 each month to families between November 2020 and August 2021. The cash recipients in the low-income, predominantly Latino city also saw an 87 percent decline in ER visits for substance abuse and behavioral health, as well as a drop in hospitalizations, according to the study published Monday in the Journal of the American Medical Association. Conversely, participants were more likely to visit outpatient sub-specialists, which are important for managing health conditions, but usually located further from Chelsea, more costly to see, and less amenable to residents’ work schedules. In the results lies a glimmer of hope that could help support guaranteed income programs in the future, advocates for such initiatives said. Direct cash assistance has proved effective in fighting hunger and poverty in Chelsea, Cambridge, and beyond since COVID-19 struck. But the programs remain expensive to fund, especially as federal pandemic relief funds run dry. The new study shows that reductions in health care spending could offset as much as half the costs of the Chelsea Eats program, said Sumit Agrawal, lead author of the paper and a physician at Mass General Brigham. (The randomized study was conducted by analyzing the medical records of 2,880 participants from Mass General Brigham, the Cambridge Health Alliance, and East Boston Neighborhood Health Center.) “There’s this prevailing belief that if you give low-income people cash, they’re going to spend it on drugs and alcohol,” he added. “The research shows this is not true. People need less acute care. They may not need to go to the emergency room for mental health crises — depression, anxiety, suicidal ideation — or substance abuse as much.” The findings embolden earlier studies that showed that low-income participants used the cash assistance responsibly. A 2022 paper from the Rappaport Institute for Greater Boston at the Harvard Kennedy School found that much of the guaranteed income money in Chelsea funneled to nearby food stores and restaurants, reduced food insecurity, decreased missed rent payments, and generally caused “lower levels of financial distress.” There was no evidence, that report said, that receiving the cash cards decreased employment or hours of work among participants, a common criticism of welfare. Lourdes Alvarez, a City of Chelsea employee who helped roll out the initiative in 2020, said the new study adds to the evidence that officials should find ways for basic income programs to continue, especially as the cost of living ratchets up in Massachusetts. “This research shows this is working, but there is no Chelsea Eats anymore,” Alvarez said. “We’re talking about a benefit of a program that no longer exists.” She added that hardworking Chelsea residents are struggling to stay in their homes in the face of rising rents and cost of living. “It’s so hard right now to live in the US that we need to have policies to support residents to stay in the place that they live,” Alvarez said. “If we don’t start considering these policies, we are opening the door for gentrification of communities like Chelsea.” - See the full Boston Globe article.
Boston Gets $10 Million to Help Close Life Expectancy Gap Between Neighborhoods Last year, a Boston Public Health Commission analysis shared a startling data point: the life expectancy for those living in Back Bay was 23 more years than those living in Roxbury's Nubian Square. Now, Atrius Health Equity Foundation is spending $10 million to help close the life expectancy gap across much of Boston. “Being able to live a long and healthy life shouldn’t depend on your wallet or where you live,” said the foundation's president Dr. Ann Hwang. At a press conference Wednesday, Boston Mayor Michelle Wu pointed to the factors affecting life expectancy: "It’s income, it’s parks and green spaces, it’s access to healthy and affordable food, education and opportunity. And so our health equity agenda is designed to take these gaps on directly." Boston will focus initially on reducing heart disease and diabetes. A report shows Black residents of the city die from diabetes at a 220% greater rate as compared to white residents and have a 37% higher rate of death from heart disease. For residents classified as Latinx in the report, the death rate from diabetes is 80% higher than for white residents. The $10 million will support better financial well-being for residents in neighborhoods with some of the worst cardiometabolic disease rates. The foundation, in partnership with the Boston Public Health Commission and the Boston Community Health Collaborative, will request proposals on how to execute this goal from community groups this fall. The first awards are expected in the first six months of next year. Boston is looking for more private funding partners to address other diseases that contribute to shorter life expectancy: overdose deaths and cancer. “We have to have a reality check,” said Boston Public Health Commissioner Dr. Bisola Ojikutu. “We know that this amount of money is wonderful but it isn’t sufficient to address the gaps that are present in our city.” - Source: WBUR
Concierge Medicine - Better Access for a Few Patients Disrupts Care for Many "You had to pay the fee, or the doctor wasn't going to see you anymore." That was the takeaway for Terri Marroquin of Midland, Texas, when her longtime physician began charging a membership fee in 2019. She found out about the change when someone at the physician's front desk pointed to a posted notice. With the national shortage of primary care physicians reaching 17,637 in 2023 and projected to worsen, more Americans are paying for the privilege of seeing a doctor — on top of insurance premiums that cover most services a doctor might provide or order. Many people seeking a new doctor are calling a long list of primary care practices only to be told they're not taking new patients. "Concierge medicine potentially leads to disproportionately richer people being able to pay for the scarce resource of physician time and crowding out people who have lower incomes and are sicker," said Adam Leive, lead author of a 2023 study on concierge medicine and researcher at University of California-Berkeley's Goldman School of Public Policy. Leive's research showed no decrease in mortality for concierge patients compared with similar patients who saw non-concierge physicians,suggesting concierge care may not notably improve some health outcomes. A 2005 study showed concierge physicians had smaller proportions of patients with diabetes than their non-concierge counterparts and provided care for fewer Black and Hispanic patients. The concierge pitch is simple: More time with your doctor, in-person or remotely, promptly and at your convenience. With many primary care physicians caring for thousands of patients each in appointments of 15 minutes or less, some people who can afford the fee say they feel forced to pay it just to maintain adequate access to their doctor. As primary care providers convert to concierge medicine, many patients could face the financial and health consequences of a potentially lengthy search for a new provider. With fewer physicians in non-concierge practices, the pool available to people who can't or won't pay is smaller. For them, it is harder to find a doctor. Concierge care models vary widely, but all involve paying a periodic fee to be a patient of the practice. These fees are generally not covered by insurance nor payable with a tax-advantaged flexible spending account or health savings account. Annual fees range from $199 for Amazon's One Medical (with a discount available for Prime members) to low four figures for companies like MDVIP and SignatureMD that partner with physicians, to $10,000 or more for top-branded practices like Massachusetts General Hospital's. Many patients are exasperated with the prospect of pay-to-play primary care. For one thing, under the Affordable Care Act, insurers are required to cover a variety of preventive services without a patient paying out-of-pocket. "Your annual physical should be free," said Caitlin Donovan, a spokesperson for the National Patient Advocate Foundation. "Why are you paying $2000 for it?" What happens to patients who find themselves at loose ends when a physician transitions to concierge practice? Patients who lose their doctors often give up on having an ongoing relationship with a primary care clinician. They may rely solely on a pharmacy-based clinic or urgent care center or even a hospital emergency department for primary care. Some patients find themselves turning to physician assistants and other midlevel providers. But those clinicians have much less training than physicians with board certification in family medicine or internal medicine and so may not be fully qualified to treat patients with complex health problems. "The expertise of physician assistants and nurse practitioners can really vary widely," said Russell Phillips, director of the Harvard Medical School Center for Primary Care. - See the full Medscape article.
How to Be There for a Dying Friend For purposes of my response, I’m going to assume this is a close friend, not simply an acquaintance. If your relationship is weak, they may find stress rather than comfort in your presumption of intimacy. But if they feel safe with you, if you’ve earned their trust, you should assume nothing less than that. This is when true friends show up. Here are some thoughts about how to show up. First, you ask: Can you say anything useful? I don’t know. But what I do know is that they probably want your companionship more than your advice. They are unlikely to want someone who attempts to beguile them from their obvious predicament with magical homilies. Don’t pressure yourself by assuming you need to fix something. What they will want most from you is for you to sit with them in their predicament. Experience it with them. Love them in it. Second, my experience is that in situations like this, we fault more often on being too tentative than on being too intrusive. It is often the case that more intimate is more appropriate. We often act as though we believe not talking about the fire-breathing dragon in the room is safer/kinder/better than taking a person’s hand, sitting beside them, and staring at the dragon together. Third, spend less time telling them how you feel about their impending death and more time asking them how they feel. Ask about their beliefs. Ask about fears. Ask about regrets. Ask about their legacy. Ask about their proudest life moments. These are perspective questions—ones that invite connection around larger issues of life. Beginnings and endings are moments of perspective. These are the kinds of thoughts that are naturally occurring to them anyway. So, go there with them. If they inquire, feel free to share your perspective on these questions, but don’t cross the line into coercion. Never take advantage of your psychological advantage of being the healthy one to impose your nostrums. Finally, relieve their stress. My father taught me once that stress is like arithmetic. Everyone has a certain tolerance threshold. Mine might be 40. Yours might be 45. But we all have a number. The amount of stress we feel at any time is equal to the sum of all the stressors acting on us. Some might be 3s (I have a chip in my windshield that might spread). Some are 5s (my water heater is leaking now). And some are 10s (I’m dying). Thinking about stress this way helps point out two things: 1. Everyone has a tolerance limit. Everyone begins to crumble when the sum of all their current stressors exceeds their tolerance limit. Everyone. Even if your tolerance level is 327. If your stress sum is 600, you will break down. 2. You don’t have to remove the big stressors to help someone get below their limit. If your friend is dying, you can’t fix that. You can’t take away the 10. You may not even be able to do much with their 9s and 8s. But if you take away enough 2s, 3s and 4s, you might help them get back to manageability. Once I learned this, it changed the way I talk with loved ones who are suffering. I no longer make vague offers like, “Please let me know if there is anything I can do to help.” This is a worthless offer. Basically, it says, “Here’s one more thing for you to think about—think about helping me feel helpful!” Instead, I teach them about the arithmetic of stress, then I hand them a pen and paper, and I say, “Write down EVERYTHING that’s on your stress list right now.” I sit with them and encourage them to work all the way down to the nit-picky 1s and 2s. When the list seems complete, I go to work. I don’t ask for permission. I take charge of all the fixable things on the list. I hope these ideas help. And I hope the sacred last moments you share with your friend are filled with the real intimacy. - See the full Crucial Learning blog post.
My Elderly Father Had Dementia, Anger Issues, and Many Guns. What Were We to Do? A few years ago, my 87-year-old father came into crisp focus one morning when I woke to his scratching at something in the step well of my parents’ motor home in Billings, Mont. From where I slept on the short, narrow couch in the living room of the old custom bus, he was just a barely visible, hunched figure up to his hips in the well at the RV door. I didn’t think much of it. I’d only barely been asleep anyway, because he’d been wandering around naked most of the night, turning stuff on and off, digging in sacks, opening the refrigerator. Unbeknownst to me at the time, my father, standing in that step well, was looking for one of his guns. Guns in the hands of people like him are a growing problem in America, one recently declared a public health crisis by US Surgeon General Vivek Murthy: firearm violence. Jake Berry Ellison Sr. was old, demented, and, quite often, armed. My father was one of some 60-plus million Americans over 65, an age demographic on track to make up nearly a quarter of the US population by 2054. Of this population, it is estimated that nearly 7 million currently suffer from Alzheimer’s or related dementias, and in 30 years, that number will grow to more than 13 million. Of those elderly with dementia, as many as half of them will live in a home with a gun. When the Surgeon General made his public health declaration about gun violence last month, his accompanying report twice identified people with dementia as being among those who could get unauthorized access to unlocked guns. The report states that roughly 13 out of 100,000 people over 65 committed suicide with a firearm in 2022, a rate 15 percent higher than it was a decade earlier. Researchers, physicians, and public health experts have been working hard to get information and tips about firearms and dementia to the general public. Dr. Emmy Betz, professor of emergency medicine at the University of Colorado, says progress is being made, albeit slowly, with the help of firearms enthusiasts, sellers, and associated groups who are raising awareness. “The more we share these stories,” says Betz, an emergency room doctor with deep expertise in firearm injury prevention and dementia, “the more people will realize how unfortunately common it is. For some families, maybe it’s about taking away the car keys . . . but obviously when [the conversation] is around firearms, the potential lethality is just so much higher.” There are a lot of “confusing legal questions” around firearms in these situations, Betz says. To help families deal with dementia, she says, the best thing is to have a conversation about what to do with the guns before a parent is too far gone to have it. Betz and other experts have developed the Firearm Life Plan to help families have that conversation. My family, including my mother, just hadn’t thought to have any conversation about firearms when my father first started showing signs of dementia. And once we did realize the danger, it was too late for a conversation about it. We just had to act. “He’s down by the river and he’s got that .45 on his hip,” my mother called to tell me. “Maybe it’s not loaded.” “No,” I said, “if he’s carrying it, it’s loaded.” This was a couple of days after I had scoured their bus for ammunition and gathered a bagful. Somehow, since then my father had found or bought more. People with dementia can still be effective problem solvers, and my father was one of them, even though he was experiencing full hallucinations and was increasingly agitated. My parents’ neighbors, whose land they were parked on, were worried about his access to guns, too. Especially since he had been telling them about “John,” a man he believed to be having an affair with his wife. I didn’t know for sure he was a safety risk, but I also didn’t know he wasn’t, because dementia is profoundly disorienting for everyone. Even when he seemed as if he knew what was happening around him, he would say something that showed he wasn’t connected to the world, such as calling me “John.” I realized to my shock and horror that my father thought that I was his wife’s paramour, the guy sleeping on their couch. No good legal options“If you are not in your right mind, and you have a delusion that the kid knocking on the door is the devil or a robber, of course it’s dangerous,” says Fredrick Vars, a professor at the University of Alabama law school and author of the 2017 paper “Not Young Guns Anymore: Dementia and the Second Amendment.” And without an advance directive, he says, one can take a gun away “surreptitiously,” but that is problematic. “You are violating the autonomy of someone who at least some of the time, maybe, has decision-making capacity or would be safe with a gun. Even if the person doesn’t have decision-making capacity, that’s not good enough. They have to be dangerous in the moment” for a judge to want to take the gun. Because of these strict legal constraints, Vars has been working to get states to adopt Donna’s Law for Suicide Prevention, which would establish a legal way for people to give advance permission to have their guns taken from them when they cannot be trusted with them. One of the most comprehensive reports about guns and people with dementia, by Kaiser Health News and PBS, found over a four-month investigation more than 100 cases across the United States “in which people with dementia used guns to kill or injure themselves or others.” Surveys of caregivers of people with dementia also make clear that they have a preoccupation with firearms, particularly unintentional firings. Such accidents were a top concern among those interviewed, but fear of instigating a battle with the gun owner often meant inaction. As Murthy’s advisory about gun violence makes clear, one thing compounding the problem of an epidemic of firearm deaths in America is that data about how guns are used and misused in America has not been collected for decades. Funding for research has been severely lacking. The NRA works hard to make sure such data is not collected. Consequently, we don’t really know how much of a danger gun holders with dementia are. “Historical underfunding for firearm violence prevention research has created challenges for expanding the evidence-base and implementing life-saving policies,” the Surgeon General’s advisory states. The dearth of data is rooted in the political firestorms that flare any time guns and regulation are mentioned in the same sentence. One legal tool available to family members of people with dementia is the Extreme Risk Protection Order, known colloquially as a “Red Flag” law. Unfortunately, ERPOs are very hard to obtain. Massachusetts, one of 21 states that have ERPO laws, adopted its version in 2018. Since that time, only 66 petitions have been filed, with mixed outcomes. A 2020 study of ERPO actions in Washington state found that of 237 filed, nine were for gun owners with dementia, and of those, only six were granted for the removal of firearms, and then only for one year. Another potential but difficult-to-get tool for taking firearms out of the home of a loved one with dementia is a custodial appointment. “This is where a part of me wants to yell at lawmakers,” Betz said after hearing my story. “It’s time for us to be grownups and have a conversation, and it might be that we have to find some compromises. But there are families out there who are facing these tough situations, and I don’t think it’s fair to just be paralyzed.” - See the full Boston Globe story.
What is Project 2025? 8 Healthcare Notes Project 2025 is a package of sweeping federal policy proposals from the Heritage Foundation, intended for the next Republican presidential administration. The conservative Washington, D.C.-based think tank proposed the 922-page initiative in 2022. On its website, Project 2025 notes that it "does not speak for any candidate or campaign, in any capacity." Project 2025 offers detailed policy proposals across specific topics and federal agencies, including major reforms at HHS, CMS, the CDC and NIH. Former President Donald Trump publicly disavowed the package in July. According to CNN, 140 former Trump administration officials have contributed to Project 2025, and Mr. Trump’s vice presidential candidate, Sen. JD Vance, wrote the introduction of an upcoming book from the Heritage Foundation's president, Kevin Roberts. Eight key healthcare proposals in Project 2025: 1. HHS reform. The department should be reformed to promote work, traditional marriage and nuclear families, not abortion as a healthcare service and LGBTQ equity efforts. Terms such as "sexual orientation, "gender identity" and "reproductive health" should be removed from all federal rules and regulations. States would be the ultimate regulators of the medical profession. HHS would also not be able to declare indefinite public health emergencies. 2. Medicare. Medicare Advantage would become the default enrollment option for older adults, and beneficiaries would be given "direct control" of spending. A "competitive bidding model" would be introduced and the current risk adjustment model would be reconfigured. Site-neutral payment policies would be promoted, with Medicare payments being the same across all healthcare settings. Medicare would be banned from negotiating drug prices, and 340B subsidies restructured "toward beneficiaries rather than hospitals." 3. Medicaid. Federal Medicaid funding would be reduced and lifetime caps on benefits would be introduced "to disincentivize permanent dependence." States could impose work requirements to receive benefits and providers would be able to "make payment reforms" without state or federal approval where possible. Other proposals include block grants, stricter eligibility determinations, the establishment of a voucher system to purchase private insurance with Medicaid funding, and more oversight and reform of managed care organizations. Medicaid funds would be banned from going to Planned Parenthood, and elective abortion providers would not be covered through state Medicaid programs. 4. Abortion. Abortion would not be considered a healthcare service and no federal funding should be allocated toward facilities that provide those services, including for active military personnel. Reporting and surveillance of those seeking or obtaining abortion services would become more strict in every state. Healthcare workers, particularly those in hospitals, would be required to report abortion pill complications. Medical schools that offer abortion-related training should do so under an opt-in basis. The FDA's approval of abortion pills such as mifepristone would be revoked, and mailing abortion medications or obtaining them virtually would be banned. The ACA insurance mandate to cover the "week-after" contraceptive pill Ella would also be rescinded. Any federally-funded research using human embryonic stem cells should not occur, and "abortion and embryo destructive related research, cell lines, and other testing methods become both fully obsolete." "Miscarriage management or standard ectopic pregnancy treatments should never be conflated with abortion," the proposal says. 5. Affordable Care Act/Insurance. The ACA should be reformed to better promote direct primary care policies, and CMS should promote more shared savings and reference pricing models. Health plan choices such as association plans, short-term plans, and ICHRAs should all be expanded, and the subsidized ACA exchange market should be separated from the non-subsidized insurance market. The independent dispute resolution process established under the No Surprises Act should be dissolved. Restrictions on physician-owned hospitals would be removed, and hospital price transparency regulations should be strengthened. 6. Gender-affirming care. A Biden administration policy asserting that transgender minors have a right to gender-affirming care should be reconsidered. CMS would not issue any national coverage determinations regarding gender reassignment surgery for Medicare beneficiaries. Discrimination laws on the basis of sexual orientation, gender identity, and transgender status would be rescinded. Transgender people would be banned from serving in the military, and no federal funding would be allocated for gender-affirming services for military personnel. 7. CDC reform. The agency should be split into two entities: an epidemiological agency responsible for publishing data, and an agency responsible for public health but with a "severely confined ability to make policy recommendations." 8. Corporate consolidation. The next administration should focus on preventing "the regulatory capture of our public health agencies by pharmaceutical companies, insurers, hospital conglomerates…" The FTC should work more closely with state attorneys general on antitrust enforcement policy, including proposed hospital mergers. - See the full Becker’s Hospital Review Article.
Victims of Drink Spiking Share Struggle to Get Drug Testing in Massachusetts People who have had their drinks spiked at various venues in Massachusetts are speaking out about the dangers and roadblocks they faced at hospitals when they tried to ask for drug testing. Ilana Katz Katz said her advocacy began in 2022 after she was drugged at The Sinclair, a music venue in Cambridge. "I had a drink, which I thought I was watching," said Katz. "I put it in the corner, and I was dancing, and my friend was a few feet away." Katz said she had "two small sips," and then she started to "feel really, really drunk." "I knew something was wrong, and I was holding onto the handrail and I collapsed," described Katz. Katz said she was taken to the emergency room, and her husband repeatedly asked doctors for a drug test. "They did finally take a urine sample at my husband's absolute insistence," she said. According to Katz Katz, the results showed the presence of "common date rape drugs." Ella Macduff said she had a similar experience at a bar in Boston. Macduff said she and her friends ordered beers, but later that night, she ended up with a cocktail in her hand. "I don't know how I got that drink," Macduff said. The first night Macduff was in the hospital, she said her mom asked doctors to drug test her, but they didn't. "The first doctor, from what I understand, was just saying that I was drunk and that I needed to sleep it off, but I was very agitated," said Macduff. "I was in and out of consciousness, and my mom was fighting back and forth with them saying that, 'This is not my daughter. She was drugged. Give her a drug test, something's wrong, she's not okay.'" According to Macduff, she was only given a drug test the next day when she was checked back into the hospital after having a seizure. "The second doctor looked at my chart and then examined me and took one look and said that I was drugged," she said. Currently, Massachusetts hospitals are not required to give victims a drug test unless they've also been sexually assaulted. A bill being considered right now on Beacon Hill would change that and would require "all hospitals to issue a urine sample or relevant drug test to identify the presence of a date rape drug if the patient requests it." "Why won't some hospitals provide these tests?" 5 Investigates reporter Brittany Johnson asked Sen. Paul Feeney, D-Foxboro, who is the bill's sponsor. "That's a great question, and I haven't gotten a satisfactory answer on Massachusetts yet from many of the different providers," Feeney replied. "We know that the health care system, especially here in Massachusetts, is struggling right now. We have some of the best providers in the world, the best hospitals in the world right here in Massachusetts. But there's always a game of, 'How do you code it for insurance? If somebody shows up and they say that they've been drugged, what do you test them for?'" Both Feeney and Sen. Patrick O'Connor, R-Weymouth, who is the co-sponsor of the bill, said that drink spiking is rampant in Massachusetts and it's a crime even if the victim isn't sexually abused. "There are people that are drink-spiking people to steal their credit cards or get their biometric information to unlock their phone and to Venmo money," O'Connor said. 5 Investigates reached out to the Massachusetts Health & Hospital Association for comment on the dangers of drink spiking. MHA emailed a statement that reads in part: "Our hospitals are proud to have their doors open 24/7 for anyone in need of immediate medical care. Given the EMTALA restrictions and complexities that come with providing these type of specialized drug tests through emergency departments, our members are fully on board to work with legislators and insurers to ensure testing is as widely available as possible, to alleviate restrictions on what constitutes an emergency service, and to protect victims from any surprise bills from their health plans." "Regardless of any state or federal law changes, MHA has committed to offering educational training and best practices to our member hospitals so that frontline workers are able to even better identify patients who may have been involuntarily drugged, abused, or are in need of refuge." - See the full WCVB story.
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