Legislative Update
BBA relief: the waiting game continues… Both sides in Congress seem to want a resolution of the presidential race before they commit to action on any of the pending issues. Congress adopted another temporary spending resolution that extends funding until early December.
In Massachusetts:
• State task force turns to insurance access…
The state’s blue-ribbon health care task force convened recently to discuss health care insurance access. The preliminary report on access to insurance recommends incremental reform as the appropriate strategy to increase insurance access in Massachusetts. Among the options proposed by the working group were: (1) expanding MassHealth; (2) combining and streamlining state insurance programs; (3) redesigning insurance products; (4) subsidizing insurance purchase by employers and employees; (5) tax credits for insurance purchase; (6) mandating employer coverage; (7) mandating employee purchase; (8) reform of the insurance market; and (9) examining medical savings accounts and flexible spending accounts. For a copy of the report, please contact Tish McMullin at 278-0544 or pmcmullin@partners.org.
• “HealthNow” campaign begins in Massachusetts…
HealthNow, an initiative of the American Cancer Society, Health Care for All, and the Massachusetts Medical Society kicked off its campaign this week to raise the tobacco tax by 50 cents in Massachusetts. The funds would be used for several public health initiatives including: expansion of MassHealth to uninsured adults; addressing racial and ethnic health care disparities by increasing community health outreach; improving health services for low-income seniors and disabled adults while obtaining more federal reimbursement for the senior pharmacy program; reducing hospital
uncompensated care responsibility; and reducing tobacco use among youths and adults,
particularly in low-income and minority communities. HealthNow is part of a New
England-wide effort to raise tobacco taxes in order to expand access to health insurance and reduce tobacco use. The press conference announcing the initiative was held in the MGH Ether Dome.
• Mayor Menino's health care task force reports…
After several months of deliberation, the task force issued a report that identifies five areas where the Mayor's involvement and intervention could decisively improve Boston's health care system:
(1) addressing the current labor shortage crisis;
(2) creating a blue ribbon health care committee (consisting of health care providers, insurers, and local public health officials)
to serve as a forum for proposed changes in service delivery;
(3) advocating for fair payment by all payers to health care providers;
(4) mobilizing the U.S. Conference of Mayors to advocate on health care issues, including BBA relief and research funding; and
(5) supporting efforts to expand health care coverage and access to mental health,substance abuse, and dental services for the city’s most vulnerable citizens. For hospitals, the report advocated payment increases from Medicaid and Medicare, establishment of a public forum and planning process to discuss the impact of potential closures or changes in service, and movement of certain hospital outpatient care to community health centers and other locations.
BWPO News
Effective January 1, the 500 physicians converting from seven individual foundations will be eligible for a newly created BWPO benefits program. The new package was developed over a two year period by a committee of BWH physicians under the leadership of Thomas Thornhill, M.D., and approved by department chairs.
The new package closely resembles the departments’ former individual packages, while it establishes a consistent benefits platform for BWPO physicians as a whole. The program provides a range of benefits that are generally comparable to, and in some cases better than, current foundation benefits. Departments will continue to independently determine certain benefits, such as pension contribution levels.
Advantages available to physicians through the new benefits package include:
• A payroll system that will administer both BWH and BWPO salaries for those physicians who receive income from both sources;
• single paychecks to streamline tax deductions and consolidate pension deduction
potential to full salary;
• six options for health care insurance;
• dental and vision coverage for physicians and their families;
• a package that is externally competitive with other organizations, supporting recruitment and retention;
• minimal administrative costs due to increased purchasing power;
• increased supplemental coverage both for self and dependents; and
• long term disability coverage that is specifically tailored to physicians in academic medicine.
In tandem with these new developments, Virginia Rosales, manager of Professional Staff Benefits, has joined the BWPO and will be the key contact for physicians as they move forward with choosing their benefits. Rosales can be reached at 582-1207 or via email—vrosales@partners.org
In addition, a Benefits Guide for Professional Staff is currently being distributed to detail the new options included in the BWPO benefits package. Physicians who have not received a copy of the guide, can obtain one by contacting Rosales.
Policy Helps Patients with Limited Capacity
A new policy on medical decision making for patients with limited capacity has been presented by Lynn Peterson, MD, from the Ethics Service and Committee of BWH and approved by the Medical Staff Executive Committee. The focus of the policy is on respecting patients’ rights, to the extent provided by law. It addresses situations where the patient’s decision-making capacity is limited, but not completely absent, by a chronic mental illness, temporary delirium or an acute medical condition.
“This new policy was crafted to help caregivers know what to do in situations that involve patients with limited capacities but who are not completely incompetent,” said Dr. Peterson. “This is a fairly common problem—patients who suffer from a chronic illness like Alzheimer's disease or acutely injured in an accident can have the capacity to make some decisions, but not enough to make all decisions.”
Peterson explains that there are three steps in respecting the wishes of such patients as much as possible. The first step involves understanding the patient’s medical situation, and recognizing the extent to which the treatment decision he/she is making is critical or life-saving. The second step involves assessing the patient's current decisional capacity. This may involve an evaluation of the patient by a psychiatrist. The third step involves consultations with the patient’s family, friends, religious counselors and advance medical directives or living will. As much effort as possible should be made to find out how the patient's present wishes fit with other values or choices he or she made in the past.In complicated cases, especially those with conflict, an ethics consult can be helpful.
“By following these steps outlined in the new policy,
medical teams will be able to develop a better understanding of what these patients’ wishes are,” said Peterson. “Rather than ignoring their choices because of limited capacity they will be engaged in the decision-making process to the extent possible.”
The new policy can be found on BICS, under the “Patient Care Policies” section of the Administrative Policy Manual.
Relocation of Purchasing Office
Partners Corporate Purchasing, supporting the research community for all its corporate buying needs, has moved from 221 Longwood Ave. to 121 Innerbelt Road, Somerville. The Brigham and Women’s Research Community now occupies the offices on Longwood Avenue.
Bright Horizons is Open
The Bright Horizons day care facility at Landmark is open and has space for toddlers and preschoolers and a wait list available for infants. This center is an initiative of the Quality of Worklife Program.
Funding Opportunities found online
All BWH investigators are invited to search three online databases at http://research.bwh.harvard. edu/fundops.htm#search for funding opportunities. The databases—called GrantNet, SPIN and IRIS—give investigators the ability to search for research funding sources efficiently via a WWW interface, using keywords that best describe their area of study.
GrantNet is a free service, while BWH subscribes to SPIN and IRIS on behalf of its investigators. In addition, IRIS contains a programmable search feature that will e-mail the investigator if a funding opportunity that fits specified criteria becomes available. These databases were made available as a joint initiative of BWH Research Administration and the Career Development Committee of the BWH Research Council.
For more information on research at BWH, visit the web site http://research.bwh.harvard.edu
Winning Team
The University HealthSystem Consortium (UHC) recently presented BWH's Health Information Services (HIS) Department with an award for the department's performance on the Medical Records Benchmarking Survey. HIS had improved in many areas, including labor and outsourcing expense per adjusted record, coding completion time, loose filing per 100 records, record retrieval turnaround time and transcription turnaround time.
United Way/Tobin School Campaign Update
Thanks to the generosity of BWH employees, the United Way/Tobin School Campaign is proud to announce that the United Way Fund has reached approximately $45,300, while approximately $35,400 has been raised so far for the Tobin Fund.
This puts the United Way fund at 56 percent of its goal and the Tobin Fund at approximately $6,600 away from its goal. Donations will continue to be accepted until December 31, 2000 to reach both goals.
For more information, contact Maria Damiano at ext. 7250, Marlene Freeley at ext. 8501 or the campaign captain in your department. Any amount donated is appreciated.