CityLine: Massachusetts health check-up

THE PROGRAMS AT RISK, AND THE EFFORTS TO BREAK DOWN BARRIERS TO ACCESSING CARE. PLUS, A BREAKTHROUGH TREATMENT FOR A PAINFUL AND DEBILITATING DISEASE. GOOD MORNING. I’M KAREN HOLMES WARD, AND WELCOME TO CITYLINE AT OUR NEW TIME. NOW, SUNDAYS AT 11:30 A.M. MASSACHUSETTS IS NOTED FOR ITS WORLD CLASS HOSPITALS AND MEDICAL RESEARCH. IT RANKS FIRST IN THE NATION WHEN IT COMES TO HEALTH CARE, ACCORDING TO THE LATEST COMMONWEALTH FUND REPORT, THE ANNUAL SCORE CARD FINDS MASSACHUSETTS LEADS IN HEALTH INSURANCE COVERAGE AND ACCESS TO CARE. IT’S ALSO A TOP PERFORMING STATE WHEN IT COMES TO HEALTH CARE QUALITY AND CHILDHOOD VACCINATION RATES, BUT THE STATE IS STILL FACING CHALLENGES FROM FEDERAL GOVERNMENT CUTS TO COMMUNITY HEALTH. JOINING US NOW IS MASSACHUSETTS NEW HEALTH AND HUMAN SERVICES SECRETARY, DOCTOR KIM MAHONEY. HOW ARE YOU? I’M DOING VERY WELL. THANK YOU FOR HAVING ME HERE TODAY. THANK YOU. SO YOU’VE BEEN ON THE JOB FOR JUST OVER A MONTH, MAYBE CLOSE TO TWO MONTHS NOW. THAT IS CORRECT. OKAY. WHAT DO YOU SEE AS SOME OF THE STATE’S BIGGEST HEALTH CARE CHALLENGES? AND WHAT ISSUES ARE YOU. PRIORITIZING? I THINK THERE ARE DIFFERENT LEVELS OF CHALLENGES THAT THE ADMINISTRATION AND THE STATE IS FACING. THERE ARE SOME LONG RUNNING CHALLENGES THAT WE’VE HAD IN OUR STATES AROUND AND OUR STATE AROUND AFFORDABILITY. AROUND ACCESS, AROUND MAKING SURE WE CAN MAINTAIN ALL THE GAINS THAT WE’VE MADE AROUND QUALITY OF CARE. AND THEN THERE ARE MORE IMMEDIATE CHALLENGES THAT WE’RE HAVING, MOSTLY STEMMING FROM THE CHANGES THAT ARE HAPPENING AT THE FEDERAL LEVEL. LET’S GET INTO SOME OF THE SPECIFICS. MANY MASSACHUSETTS HOSPITALS ARE FACING FINANCIAL DIFFICULTIES, AS YOU KNOW. ARE ANY AT RISK OF FAILING DUE TO FEDERAL FUNDING CUTS? I WOULD SAY THAT. OVER THE LAST PROBABLY TEN YEARS HAS BEEN A DIFFICULT TIME FOR MASSACHUSETTS HOSPITALS, PARTICULARLY FOR THE HOSPITALS THAT ARE COMMUNITY HOSPITALS ARE NOT AFFILIATED WITH ANY SYSTEM. AND SO ANY KIND OF SHOCK OR CHANGE IS OBVIOUSLY A STRAIN FOR THEM. AND HAVING THE PROSPECT OF MEDICAID CUTS SORT OF ROLL THROUGH THEIR COMMUNITY IS OBVIOUSLY SOMETHING THAT IS GOING TO CHALLENGE THEM. I DON’T KNOW THAT I WOULD SAY THAT THEY ARE AT FAULT. THEY ARE AT RISK OF DEFAULTING AND GOING BANKRUPT. BUT I DO THINK THAT THE NEXT FEW YEARS ARE GOING TO BE VERY DIFFICULT FOR HOSPITALS IN MASSACHUSETTS. WELL, EVERYONE RECALLS THE COLLAPSE OF STEWARD HEALTH CARE THAT LED TO THE LOSS OF THE CARNEY HOSPITAL AND THE NASHOBA VALLEY MEDICAL CENTER. HOW IS THE STATE MANAGED THE FALLOUT AND THE IMPACTS ON THOSE COMMUNITIES? I WOULD SAY THAT WE ARE VERY PROUD AS AN ADMINISTRATION THAT WE WERE ABLE FOR SIX OF THOSE HOSPITALS TO FIND OPERATORS AND KEEP THEM OPEN. THOSE HOSPITALS ARE ESSENTIAL TO PROVIDING CARE. A LOT OF THEM ARE IN UNDERSERVED COMMUNITIES. AND SO WE’RE REALLY WE’RE REALLY EXCITED THAT WE’RE ABLE TO KEEP THEM OPEN. I WOULD SAY THAT IT WAS A WARNING BELL FOR OUR SYSTEM, THAT WE DO HAVE TO PAY PARTICULAR ATTENTION, ESPECIALLY WHEN IT COMES TO PRIVATE EQUITY AND DISTRESS, BECAUSE THE STRESS IS THAT PRIVATE EQUITY OWNED INSTITUTIONS ARE A LITTLE BIT DIFFERENT THAN IF YOU’RE A NONPROFIT. AND WE JUST HAVE TO PAY MORE ATTENTION TO THAT. I WOULD SAY THAT THE FALLOUT FROM THE STEWARD BANKRUPTCY IS REALLY BEEN THAT WE HAVE TO PAY MUCH, MUCH CLOSER ATTENTION TO HEALTH EQUITY, TO HEALTH ACCESS, AND TO WHAT DOES IT MEAN TO BE A COMMUNITY HOSPITAL, AND WHAT DOES IT TAKE IN TERMS OF SUPPORT AND GOVERNMENT POLICIES FOR A COMMUNITY HOSPITAL TO SURVIVE? MASSACHUSETTS HAS LONG BEEN A NATIONAL LEADER IN PROTECTING ACCESS TO CARE. ABOUT 28% OF RESIDENTS ARE ENROLLED IN MASSHEALTH. WHAT DO THE FEDERAL CUTS MEAN TO THOSE WHO USE MASSHEALTH? SO CURRENTLY, OUR BEST ESTIMATES ARE THAT OUT OF THE 2 MILLION PEOPLE WHO RELY ON MASSHEALTH TODAY, THAT OVER THE NEXT 2 TO 3 YEARS, WE’RE GOING TO SEE A LOSS OF ABOUT 300,000 PEOPLE ARE GOING TO BE LOSING MASSHEALTH BENEFITS. SO WE’RE TALKING, YOU KNOW, BETWEEN 10 AND 15% OF OUR FOLKS WHO ARE GOING TO BE WHO ARE NOT GOING TO QUALIFY ANYMORE FOR MEDICAID. AND SO THAT’S A LOT THAT’S A LOT. THAT IS A LOT. THAT’S A BIG IMPACT. AND SO PART OF OUR JOB IS TO FIGURE OUT HOW CAN WE MITIGATE THAT. WHAT WHAT CAN WE PUT IN PLACE AT ESSENTIALLY ONLY STATE DOLLARS. BECAUSE THE FEDERAL THERE WILL BE NO FEDERAL PARTICIPATION. SO FOR THOSE 300,000 PEOPLE, WHAT CAN WE DO AT THE STATE LEVEL TO MITIGATE SOME OF THE PAIN THAT THEY WILL BE FEELING? WHAT ARE YOU THINKING? WHAT ARE YOU PLANNING? WELL, FORTUNATELY, YOU KNOW, ONE OF THE GREAT THINGS THAT WE HAVE IN MASSACHUSETTS IS THAT WE DO HAVE A PROGRAM THAT’S MADE, THAT’S REALLY BUILT, THAT SITS BELOW MEDICAID AND THAT IS DESIGNED TO PROVIDE PEOPLE WITH EMERGENCY CARE, ACCESS TO EMERGENCY ROOMS, ACCESS TO COMMUNITY HEALTH CENTERS FOR THEIR PRIMARY CARE. SO OUR DESIRE IS REALLY TO MAKE SURE THAT THOSE PROGRAMS ARE SOLID, WELL FUNDED SO THAT THOSE PATIENTS WILL STILL HAVE ACCESS TO SOME BASIC CARE. WELL, THOSE 300,000 PEOPLE NEED TO REAPPLY. WILL THEY BE ROLLED OVER INTO THESE PROGRAMS? I MEAN, IN GENERAL, IN ANY, ANY GOVERNMENT PROGRAM, THERE’S A PERIOD THROUGH WHICH YOU HAVE TO REAPPLY AND RECERTIFY. BUT AS THEY DO SO, THEY WILL BE POINTED IN THE DIRECTION OF THESE PROGRAMS. OKAY. THE HEALTH CARE FIELD IN IN BOSTON, ACROSS THE STATE IS REALLY DEPENDENT ON IMMIGRANTS. AS YOU KNOW, MANY PERSONAL CARE ATTENDANTS, PCAS ARE FOREIGN BORN. IS THE WASHINGTON ADMINISTRATION’S CRACKDOWN ON IMMIGRATION IMPACTING STAFFING IN OUR CITY AND STATE? YES, OBVIOUSLY, BECAUSE OF THE NATURE OF THE ISSUE, IT’S DIFFICULT FOR US TO GET A GLOBAL PICTURE ON IT BECAUSE, YOU KNOW, I CAN’T JUST CALL A NURSING HOME AND SAY, HEY, YOU KNOW, WHAT’S BEEN THE IMPACT? THEY DON’T THEY DON’T NECESSARILY WANT TO TALK TO ME ABOUT, LIKE WHAT’S REALLY GOING ON, WHAT’S REALLY GOING ON. RIGHT. YEAH. BUT CERTAINLY AND I WOULD SAY PARTICULARLY IN OUR DIRECT CARE SERVICES, WHEN YOU’RE THINKING ABOUT GROUP HOMES, WHEN YOU’RE THINKING ABOUT NURSING HOMES, THOSE ARE THE SUPPORT STAFF IN HOSPITALS AND HOSPITALS. YES. AND I WAS RECENTLY TRAVELING. AND IF YOU’RE TRAVELING AT LOGAN AIRPORT, THERE’S A TREMENDOUS AMOUNT OF PEOPLE OF IMMIGRANT BACKGROUND WHO ARE WHO WHO ARE ESSENTIALLY THE BACKBONE OF THAT INSTITUTION, BEING ABLE TO WORK. SO, YES, THE IMPACT IS IS TREMENDOUS. AND I WOULD SAY THAT EVEN FOR THOSE WHO ARE LEGALLY HERE AND HAVE ARE LEGALLY REGISTERED AND ARE WAITING BECAUSE THE FEDERAL GOVERNMENT HAS THIS FIVE YEAR WASHOUT PERIOD DURING WHICH YOU DON’T QUALIFY FOR BENEFITS, THERE’S STILL A LOT OF TENSION FOR THOSE PEOPLE. FOR THOSE PEOPLE, THERE’S STILL A LOT OF TENSION. SO EVEN THOUGH THEY WILL STAY HERE AND WORK, THEY DON’T QUALIFY FOR HEALTH INSURANCE ANYMORE. THEY DON’T QUALIFY, QUALIFY FOR CERTAIN BENEFITS. AND THERE’S ALSO THE FEAR THAT IF THEY WERE TO APPLY FOR GOVERNMENT PROGRAMS, THAT THEY WOULD QUALIFY FOR THAT SOMEHOW IT WOULD NEGATIVELY IMPACT WHEN THEY APPLY FOR A GREEN CARD OR TO BE A CITIZEN. AND SO THERE’S ALSO I WOULD SAY THAT THE IMPACT ON OUR IMMIGRANT COMMUNITY IS MASSIVE, NOT JUST ECONOMICALLY. I MEAN, YOU’RE ASKING ABOUT THE ECONOMIC IMPACT. THE ECONOMIC IMPACT WILL BE MASSIVE, BUT THE PERSONAL IMPACT, THE HUMAN IMPACT ON THESE FAMILIES WILL BE WILL BE INCREDIBLE. FOLKS GOING BACK TO SCHOOL, FAMILIES GOING BACK TO SCHOOL, THINKING ABOUT VACCINES, FEDERAL VACCINE POLICY GUIDELINES HAVE DRASTICALLY CHANGED. THAT’S AN UNDERSTATEMENT. NOW, FEWER PEOPLE HAVE BEEN SIGNING UP FOR FLU SHOTS, COVID VACCINES. IN FACT, LESS THAN HALF OF ALL ADULTS IN THE U.S. GOT A FLU SHOT LAST YEAR, GOVERNOR HEALEY IS PROPOSING A BREAK WITH FEDERAL IMMUNIZATION RECOMMENDATIONS. WHAT WOULD THAT LOOK LIKE AND WHY WOULD THAT MATTER? WELL, I THINK THAT AND MY COLLEAGUE, COMMISSIONER GOLDSTEIN, HAS BEEN LEADING THE EFFORT AROUND THE VACCINE INITIATIVE. WHAT WE REALLY ARE THINKING OF IS HOW DO WE SAFEGUARD ACCESS TO VACCINES IN THE WAY THAT WE KNOW HAS BEEN PROVEN BY SCIENCE. WE KNOW SAVES LIVES, AND THAT PARENTS HAVE COME TO RELY ON. AND SO THAT WOULD THAT WOULD LIKELY MEAN THAT WE WOULD RELY ON GUIDANCE IN TERMS OF VACCINE AND WE WOULD SEPARATE. SO UP TO NOW, OUR GUIDANCE HAS ALWAYS BEEN MATCHED WITH WHAT’S HAPPENING AT THE FEDERAL LEVEL WITH THE CDC. AND IT WOULD THIS WOULD PROBABLY MEAN THAT WE NEED TO FIND ANOTHER SOURCE THAT IS MORE IN LINE WITH OUR SENSE OF VALUES AND OUR INTERPRETATION OF THE SCIENCE IN TERMS OF WHAT IS VALUABLE, WHAT SAVES LIVES, AND WHAT DO KIDS NEED IN ORDER TO BE SAFE. AND THE GOVERNOR HAS BEEN VERY CLEAR THAT WE AS A STATE, WILL PROVIDE THE PROTECTIONS THAT THE FEDERAL GOVERNMENT IS STEPPING AWAY FROM WHEN IT COMES TO VACCINES. DOCTOR, THERE’S SO MUCH TO TALK ABOUT. WE HOPE YOU’LL COME BACK AND JOIN US AGAIN. KEEP US UPDATED ANYTIME. ALL RIGHT. THANK YOU TO DOCTOR FOR BEING WITH US TODAY. HELPING PEOPLE OUT OF ADDICTION. RIGHT. IN THE COMMUNITIES THEY CALL HOME. WE’RE GOING INSIDE A RECOVERY CENTER IN ROXBURY THAT’S GETTING NEW HELP TO BATTLE THE OVERDOSE