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December 19, 2006...As the legislature wraps up the 2005-2006 session, lawmakers are busy preparing their legislative agendas for the new session that begins on Jan. 3, 2007. Today, Sen. Richard T. Moore, Senate Chair of the Health Care Financing Committee, highlighted his health care priorities for 2007-2008. He said he intends to file legislation in January to address each of the goals and will be seeking the support of his colleagues.

“While this year’s health care reform law has received much attention and praise both here at home and across the nation, this was just the first step toward creating a world-class health care system for everyone in our Commonwealth,” said Moore. “The initiatives that I have laid out today will bring us even closer to the goal of quality, affordable health care for all and will also help to grow and stimulate the critical health care sector of our state’s economy.” 

Senator Moore’s health care legislative priorities in no special order are:

• Strengthening Health Care Reform - In 2006, Massachusetts enacted landmark health care access, cost and quality legislation that has become a catalyst among the states to address health reform. However, much more needs to take place for implementation of health reform to be successful. We cannot be satisfied until our health care is the best in the nation. Legislation is needed to move Massachusetts into the next phases in health care reform: to make affordable, quality health care accessible to all residents of Massachusetts and to build on the momentum of the provisions currently being implemented. 

• Focusing Leadership in Health Policy - Legislation will be filed to establish an Executive Office of Health and a Secretary of Health who will be the Governor’s point person to lead the implementation of the state’s landmark health care access, cost and quality legislation. With health care among the top concerns of Massachusetts residents, the state needs focused leadership during this crucial implementation phase and in the years to come. 

• Promoting Quality Measurement in Health Care - The Baldridge National Quality Program, administered through the National Institute of Standards and Technology has developed the Baldridge Health Care Criteria for Performance Excellence. Legislation will be filed to utilize this nationally accepted format for measuring performance excellence in health care as part of the work of the Commonwealth’s new Cost and Quality Council.

• Ensuring Consumer Health Care Quality - Legislation will be filed to monitor hospital infection policies and practices and hold facilities accountable for outcomes.

• Reducing Cost/Improving Quality through Chronic Care Management - If Massachusetts is to contain costs of Medicaid and of the new Health Care Access Reform law without sacrificing quality of care, improved management of individuals with chronic health conditions is essential. The best management of chronic care relies on linkage with technology systems. Legislation will be filed in this area for consideration in the new session.

• Strengthening the Mental Health Safety Net - Major reform of the state’s mental health care system for children must be a priority over the next several years. The “system” has been described as “a complicated maze of fractured care, inadequate insurance coverage, programs too few and far between, and access defined by limitations in covered diagnoses and services.” An estimated 100,000 children in Massachusetts do not receive the mental health care they need because of lack of attention to prevention, timely diagnosis, and appropriate intervention. The centerpiece of this priority must be passage of a comprehensive mental health parity law with a focus on services to children including comprehensive insurance coverage for mental health care.

• Continuing Progress of the Massachusetts e-Health Initiative - The Massachusetts e-Health Initiative has set a goal of implementing Computerized Physician Order Entry (CPOE) in all Massachusetts acute care hospitals within four years. A budget request will be made for $25 million in FY 2008 to support physician training, subsidize technology acquisition, and promote leadership efforts.

• Continuing Progress of Prevention Initiatives – This will be a major initiative to prevent hip fractures through fall prevention. Legislation will be filed to create a special commission on falls prevention and to establish a pilot program to conduct home-based fall risk assessments and implement prevention strategies including teaching physical activity and exercise, medication review and management, and environmental modifications. The bill will also seek to raise awareness of falls prevention practices through public education for older adults, family members and caregivers. 

• Expanding the State Vaccination Program - There are three new vaccines that, if effectively deployed, will significantly reduce the cost of health care and improve health outcomes for Massachusetts residents.

• Addressing the Health Care Workforce Shortage – Critical shortages of health care professionals exist and are growing at a time when the population is becoming older and more culturally diverse placing great stress on most health care providers. Currently, there are not enough primary care physicians or specialists in obstetrics, there is an insufficient supply of psychiatrists and other in the mental health professionals, and there is a significant shortage of nurses. Contributing to this problem is the high cost of education for medical and nursing students and, in nursing, a shortage of nursing faculty and clinical sites. Legislation will be filed to ease the financial burden on those who seek to enter health fields provided they agree to work in our state and in geographic areas and specialties where needs exists. 

• Reforming Medical Malpractice Laws - Medical malpractice premiums and the tendency of health care practitioners to practice defensive medicine are driving up the cost of health care without, necessarily, improving patient safety. The current system is too adversarial, fails to effectively compensate those injured, undermines trust in the system, and fails to provide information that could reduce the chance of recurrence of mistakes by the same parties or by others who could learn from the situation – possibly developing ways to avoid such mistakes. A specialized health court, where the presiding judge has both legal and medical background, who relies on expert testimony of his or her choosing rather than on either or both sides in dispute, and who can assign damages in proportion to liability involved would go a long way to improving the system. 

• Promoting Safe Health Care Work Schedules – Physicians-in-training and nurses routinely work long hours to care for patients. Recent studies have demonstrated that long work hours with insufficient recovery time – whether mandatory or voluntary – significantly increase risk of serious injury or death to patients and may even result in the health professional being injured or killed in an accident after their shift. Legislation will be filed to set parameters for work hours with reductions over time as workforce shortages are addressed and as technology can be employed to offset any shortage of personnel.

• Renewing the Foundation of Public Health - the Massachusetts Department of Public Health currently has no Office of Local Public Health and no regional health planners to work with local boards and departments of public health. This leaves local public health agencies without any support, resources, technical assistance or guidance for building healthy communities, let alone for planning for public health emergencies, like pandemic flu. Legislation will be filed to re-establish the Office of Local Public Health, provide regional health planners and establish a state grant program to build the local public health infrastructure.

• Restoring Trust in Health Care - Prescription medications have become an essential part of health care helping to manage disease and treating many illnesses. However, such medications are expensive and not always prescribed to provide maximum benefit for patients. Currently, physicians don’t get enough education in the burgeoning number of drugs and their side effects. They should be encouraged to work with in voluntary affiliations with pharmacists for Collaborative Drug Treatment Management of chronically ill patients. Legislation is needed to authorize this partnership. Research has demonstrated that pharmaceutical marketing has improperly influenced. Legislation is needed to protect patients and physicians by requiring pharmaceutical marketers to follow their own industry’s code of ethics and to require that results of clinical trials of medication be reported regardless of the outcome.

• Aging with Dignity - A report prepared in 2003 by the Massachusetts Technology Collaborative and the New England Health Care Institute reported that by monitoring diabetic patients and those with congestive heart failure using home monitoring devices would produce a net savings of $687 million per year – mostly in reduced hospitalizations and emergency room visits. Legislation will be filed to promote the use of Telemedicine to enhance the efficiency in the delivery of home health services. In support the “Equal Choice” concept for long term care, legislation will be filed to promote long term care insurance, including a requirement that everyone over age 35 have such insurance and the establishment of tax credit to offset the cost of purchasing the coverage.

To view Moore’s complete “Health Care Priorities for 2007-2008 Legislative Session,” visit www.senatormoore.com. Moore also noted that complete text and summary information for all bills he is filing for the upcoming session will also be available on his web site after January 1, 2007. 

• Senator Moore's Health Care Priorities for 2007-2008
• Health Care Issue Center

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