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Massachusetts Falling Behind Rest of the Nation in Health Care Access, Efficiency

Massachusetts Falling Behind Rest of the Nation in Health Care Access, Efficiency

While Massachusetts has led the nation with health care reform, residents of the Commonwealth continue to lack basic access to primary and specialty care across the state. Poor patient access to care, an uncontrolled opioid epidemic and rising healthcare costs together present a perfect storm.  Many states however, have been proactive about removing practice barriers to increase access to NP driven care.

While other states have taken steps to position the NP workforce to meet rising needs, antiquated and unnecessarily restrictive laws and licensing requirements leave Massachusetts as one of only 13 states in the nation – and the only state in New England – that continues to maintain a such a restrictive nurse practice act. The unintended consequence of health reform is access to healthcare coverage without the same level of access to health care.  Without intervention for those patients seeking health care in Massachusetts, it is not likely to improve.

There are 9,500 qualified, educated Nurse Practitioners available to meet the healthcare challenges facing the Commonwealth. NPs are licensed, board certified and have achieved a master’s or doctoral degree.  With documented high quality outcomes, they are equipped to fill the gaps, enhance access to care, provide life-saving treatment for opioid use disorder and deliver a much-needed cost savings to the Commonwealth – and to patients. In failing to use NPs to the full extent of their education and training to optimize the state’s healthcare delivery system, Massachusetts is missing an opportunity to best serve patients.

For patients seeking access to basic healthcare services in Massachusetts, including both primary and specialty care, restricted NP practice contributes to longer wait times.  Research supports that for those patients seeking a new family medicine appointment, access delays in the Commonwealth are amongst the worst in the nation. Faced with longer wait times for appointments and contending with significant delays in care, patients may risk adverse health outcomes or rely on more costly care delivery settings, such as emergency rooms, for treatment.

Like the rest of the nation, the Commonwealth is experiencing an escalating number of opioid related deaths. According to the MA Department of Public Health, in 2016 there were 2,155 reported opioid related deaths in Massachusetts. Heartbreaking stories of neighbors, friends, coworkers, and family members dying from overdoses have become too familiar.  All available resources must be leveraged to combat this public health crisis, including access to Medication Assisted Treatment (MAT), which has proven to be lifesaving. Nationally, NPs have contributed significantly to treating this disease. However, in Massachusetts, antiquated and unnecessarily restrictive laws and regulations mandating physician supervision for NP prescriptive practice are limiting the ability of NPs to respond to the epidemic. For those patients with opioid use disorder, such delays in receiving care can be life-threatening.

In 2009, a study by the Rand Corporation evaluating access and cost of care estimated Massachusetts could save millions of dollars through increased utilization of NPs.  Despite these recommendations, the state has still not acted. Office visits with an NP are 20 – 35 percent lower in cost than physician driven visits, without compromise in quality outcomes.  Medicare, Medicaid and private insurers presently reimburse NPs at rates that are 75-85 percent of the physician rate. As Healthcare costs continue to increase, utilization of NPs in care is a viable and responsible way to help bring costs down.

Presently, there is legislation pending on Beacon Hill, which will remove barriers impeding Nurse Practitioners’ ability to practice to the full extent of their training and education. H.2451/S.1257, An Act to Contain Health Care Costs and Improve Access to Value Based Nurse Practitioner Care as Recommended by the IOM and FTC, will modernize Massachusetts licensure laws and grant Full Practice Authority to Nurse Practitioners in Massachusetts, thus removing the requirement for physician oversight for NP prescriptive practice. In doing so, NPs will be better positioned to respond to the evolving care delivery needs of the Commonwealth.  Increased access to basic healthcare, specialty services and opioid use disorder treatment all mean significant cost savings for the Commonwealth.

As registered nurses with advanced master’s or doctoral level education and national certification in advanced practice nursing specialties, Nurse Practitioners have the knowledge and experience needed to deliver high-quality, cost-effective healthcare to patients.

Stephanie Ahmed, DNP, FNP-BC

Chair of the Massachusetts Coalition of Nurse Practitioners’ Legislative Committee and Former MCNP President

Donna Hanson, MS ANP, BC, MGH Emergency Medicine

Resident, Wintrhop, MA

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Is This Really America?

Is This Really America?

The national disgrace that is occurring at our southern border is something that we never could have imagined happening in the United States of America.

The images of children separated from their parents and locked behind chain link fences evokes the worst horrors of the 20th century —  the concentration camps and gulags to which millions of people were consigned by the very worst dictatorial regimes.

For almost 250 years, America has been not merely a place, but an ideal for the proposition that all men are created equally and that every person has a right to life, liberty, and the pursuit of happiness.

In less than a few days’ time however, the principles that Thomas Jefferson and the Founding Fathers so eloquently, yet simply, put into words in the Declaration of Independence have been destroyed.

The justification for what, by any standards of decency, amounts to an inhumane policy resembles a classic case of reductio ad absurdum.

The New York Times columnist David Brooks (who is a conservative writer) put it this way in his analysis of the language that is being used when they talk about the situation:

“This is what George Orwell noticed about the authoritarian brutalists: They don’t use words to illuminate the complexity of reality; they use words to eradicate the complexity of reality.”

If we say nothing then basically we are telling these families and their children that they are getting what they deserve. If separating people into metal cages is okay, then what does that say about our society and ourselves.

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Sports 06-21-2018

Sports 06-21-2018

Bruins Beat

by Bob Morello

Bruins’ Blades coming to Chelsea

The Boston Bruins will be returning to Massachusetts and New Hampshire libraries this summer to continue their “When You Read, You Score!” reading programs, presented by Velcro Companies. They will be at the Chelsea Public Library (569 Broadway), on Tuesday, July 10th from 2 – 3 p.m.. On Wednesday, June 27, the Bruins will host a kick-off event pairing Bruins Development Camp prospects and local students for games and other reading activities at the Waltham Public Library (735 Main St., Waltham).

2018 marks the ninth year the Bruins will partner with the Massachusetts Board of Library Commissioners and the Massachusetts Library System, and the third year partnering with the Children’s Librarians of New Hampshire to support literacy programs and encourage reading among youth across the two states.

Throughout the summer, Bruins Mascot Blades and members of the Bruins promo team will visit libraries across Massachusetts and New Hampshire in an effort to promote youth literacy. At each “When You Read, You Score!” library visit, children and teens will be able to meet and interact with Blades, participate in Bruins arts and crafts, fun backyard games, and have the chance to win official Bruins prizes by competing in hockey trivia.

“Literacy is one of the most important abilities for students to develop and builds a strong foundation for success in life; so we are proud to be working with the Bruins to bring educational and literacy programs to the kids,” said Fraser Cameron, CEO, Velcro Companies. “‘When You Read, You Score!’ is an innovative way to connect with kids and sharpen their reading skills by making learning engaging, exciting and fun outside the classroom.”

To help inspire children and teens to keep reading over the summer, Bruins players, including Patrice Bergeron, ZdenoChara, Brad Marchand and Tuukka Rask have helped libraries develop a summer reading list that also includes librarian picks for the best hockey books. To see the “Favorite Books of the Boston Bruins” list, visit BostonBruins.com/SummerReading.

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A Large and Successful Class Graduates from CHS

A Large and Successful Class Graduates from CHS

Some 344 students walked across the stage at Chelsea High School on Sunday, June 10, as part of commencement exercises – becoming one of the largest classes to graduate in decades.

The Class of 2018 followed an unusually large class in 2017 as well.

At Sunday’s commencement, Supt. Mary Bourque said the class had distinguished itself by not only its overall numbers, but also its successes.

“All of you standing here are the living and breathing reason why we say our mission is to ‘We Welcome and Educate,’” she said. “No matter when you entered the Chelsea Public Schools, we wrapped our arms around you and moved you along the road to graduation. Class of 2018, I want you to know that we are so very proud of you and your accomplishments.”

Of the graduates, 64 percent are attending a two- or four-year college next year. Bourque listed off 79 colleges where students have been accepted, including Wellesley College, Williams College, Tufts University, UMass-Amherst, University of Maine, Hamilton College, Drexel University, Denison University, Bryn Mawr College, Boston University and Boston College – to name a few.

Scholarship awards from those schools totaled $4.4 million, the largest amount ever at Chelsea High.

The rest of the class plans include:

  • 4% are entering a certificate program.
  • 2% are entering a Trade School.
  • 6% are taking a Gap Year.
  • 2% are entering the Military.
  • 20% are going directly into the work force.
  • 2%, are still working on their plans.

The Class of 2018 was also special in that 180 of its students enrolled in the dual enrollment/early college program with Bunker Hill Community College.

“Together you earned 1,374 college credits equaling approximately 458

courses,” she said. “You saved over $250,000 on tuition and fees and saved another $40,000 on books.”

The average numbers of credits earned was eight, but Bourque said on student, Samir Zemmouri had earned 33 credits, the equivalent of a full year of college.

“Most impressive is that 69 students completed English 111 College Writing I course, a required course that often acts as a prerequisite for college coursework; and 15 students of the 69 entered our country and began their educational career at CHS as an English Language Learner,” she stated.

There were also seven members entering the military, including:  Pedro  Barrientos, Krishell Chacon-Aldana, Adrian Diaz, Nelson Hernandez Jr., Denis Martinez Pineda, Carla Romero and Melinen Urizar Perez.

Bourque closed out her comments about the Class of 2018 on Sunday with five points of wisdom. More than any achievement, she advised to live a life of purpose.

“Choose to live a life of purpose,” she said. “A life of giving back. Knowing our purpose in life empowers us, strengthens us, grounds us. It gives us the courage and conviction to fight the good fight and for the good reasons. A life of purpose is a successful life.”

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Community Preservation Committee Announced

Community Preservation Committee Announced

The newly established Community Preservation Committee will lead Chelsea’s use of funds provided by the Community Preservation Act (CPA).

Chelsea voters approved the adoption of the CPA in November 2016.  It will provide hundreds of thousands of dollars each year to be used for the creation and acquisition of affordable housing, historic preservation, open space and recreation.

Nine members appointed to the Community Preservation Committee are: Bea Cravatta, Judith Dyer, Caroline Ellenbird, Jose Iraheta, Michelle Lopez, Yahya Noor, Ron Robinson, Juan Vega, and Tuck Willis. Five members, by statute, represent City boards and commissions. The remaining four members are appointed by the Chelsea City Manager with the following requirements for each of the seats: one seat requires expertise in open spaces, housing and/or historical preservation; one seat requires expertise in development, business, finance, and/or construction; and the two remaining seats will be for individuals with a history of community involvement.

Community Preservation Committee (CPC) members serve a three-year term in a volunteer capacity, and must be residents of Chelsea. The CPC’s primary responsibilities include: approving an administrative budget for the City’s Community Preservation program; developing an annual Community Preservation Plan; reviewing project applications and making recommendations for funding approval. Further, CPC members are required to meet with regularity and engage with community groups throughout the City as needed.

The Committee is organized by John DePriest, AICP, Director, City of Chelsea Department of Planning and Development. An RFP has been prepared to hire a Professional Planning consultant services to develop the Community Preservation Plan. The Community Preservation Committee solicits and reviews proposals for use of the Community Preservation Act funds and  makes recommendations on how funds should be used. The funding of any project requires a recommendation from the committee.

For more information go to:  https://www.chelseama.gov/community-preservation-committee.

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Albanese Upset Over Council’s Cut

Albanese Upset Over Council’s Cut

Saying he is disappointed with the Council’s posture toward the Fire Department during last week’s successful $100,000 budget cut to his department, Chief Len Albanese said the Council missed an opportunity to help bring the Department forward.

The Council, particularly Council President Damali Vidot, called for the cut and said the Fire Department overtime budget had requested an increase. She and others felt like that number – which in the past has been described as being abused – should be doing down.

Albanese said it wasn’t fair, and he said he Council hasn’t listened to his calls for an appropriate percentage of funding and more staffing.

“I’m disappointed with the cut that was made and the comments made by Council President Vidot,” he said. “This year we made budget. I told the Council that if they properly funded the Fire Department we would do our best to live within that range, and we delivered. We require no supplemental funding to finish the year.

“I have advocated for more staffing since my first month on the job,” he continued. “We have acquired both the staffing and apparatus to make that happen. Now, we need this additional staffing to translate into more boots on the ground daily. If the recent fire on John Street is not indication enough of that, I’m not sure what is. These major fires in our densely populated neighborhoods are a significant threat to our community. We need as much help as possible in the first 10 minutes of these fires to protect our neighborhoods.”

He said the John Street fire was one where they lucked out because had other calls been going, the staffing might not have been there to respond correctly.

“We are lucky that all of our apparatus was available at the time of that alarm and not tied up on other calls,” he said. “I assure you, the devastation would have been much worse. Twenty homeless could have been 100. We cannot count on luck. We need to be prepared with a reasonable amount of protection based on the threat that we face.”

In 2016, Albanese presented to the Council that the Fire Department budget is around 6.25 percent of the overall budget, and national standard indicate it should be between 6.5-7 percent based on the call volumes.

This year, they would be 6.25 percent and that represents less percentage-wise than in 2016.

“Our overall budget represents only 6.25 percent of the overall City Budget which is actually less percentage wise than we received in 2016,” he said. “Even when you consider that we will eventually take over the new hire salaries in full, we will still be between 6.5 and 6.75 percent of total budget, well within a reasonable and acceptable range.”

For his overtime request, he said he requested a 4 percent increase to the current year’s $1.25 million overtime budget. That, he said, is because salaries increased by 4 percent and so there would be less overtime coverage.

“It’s one thing to hold the line, but to cut our entire request, plus an additional $50,000 that we had this year makes no sense,” he said. “It’s like saying thanks but no thanks.”

City Manager Tom Ambrosino said he believes the chief can make things work despite the cut.

“I was opposed to that cut,” he said. “I think the chief can make his overtime and salaries work. He has some open positions. There are three now…Hopefully he’ll make it and if he can’t, I’ll have to come to the council in the spring and ask for more money.”

Albanese said the cut won’t stop them from carrying out their plan, but it does no one any favors.

“The $100,000 cut will not keep us from continuing on our plan to increase daily staffing, but it doesn’t help,” he said. “With the amount of information we have provided the council, I think those members who voted to support this cut missed an opportunity to show their commitment to protecting our neighborhoods. The $100,000 is literally one-half of 1 percent of the City Budget, but it can translate into having an extra firefighter searching for a trapped occupant. To me, that’s money well spent.”

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Public Library Featured on Gateway Trail

Public Library Featured on Gateway Trail

Recognizing the integral role that public libraries play in their communities, Massachusetts Center for the Book (MCB) has added a Gateway City Library Trail to its live app, MassBook Trails.

Chelsea Public Library is celebrated on the trail for providing democratic access to reading and 21st century gateways to opportunity for their patrons through digital connectivity and programming that enhances life-long learning and cultural assimilation.

“This trail underscores the unique history, architecture, and attributes of each Gateway City library,” explains Sharon Shaloo, Executive Director of Mass Center for the Book. “Some are ‘Carnegie Libraries,’ built through the generosity of philanthropist and industrialist Andrew Carnegie; others had humble beginnings as a shelf of books to loan at the local general store.  But this trail also reflects the common mission of these public institutions that is as important today as it ever was: our public libraries are centerpieces of civic engagement and advancement and benefit from the local, state and federal support they receive to further their objectives.”

Available on the web and as a free download, Mass Book Trails was launched in 2017 with two literary walking tours in Boston and two statewide trails:  Literary Museums of Massachusetts, and African American Writers Heritage Trail.  Additional tours are being added as libraries have accepted MCB’s invitation to develop their own local literary, cultural, and historic tours.

The Massachusetts Center for the Book, chartered as the Commonwealth Affiliate of the Center for the Book in the Library of Congress, is a public-private partnership charged with developing, supporting and promoting cultural programming that advances the cause of books and reading and enhances the outreach potential of Massachusetts public libraries.

For more information, contact info@massbook.org.  MassBook Trails may be found in the app store and through Google Play.  It is also available on the web at https://massbooktrails.oncell.com/en/index.html.

Cutline –

The Chelsea Public Library has been added to the MassBook Trail App for Gateway City Libraries.

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Gerrish Street Gang Member Sentenced on Racketeering and Drug Trafficking

Gerrish Street Gang Member Sentenced on Racketeering and Drug Trafficking

An East Side Money Gang (ES$G) member was sentenced last week in federal court in Boston on racketeering and drug trafficking charges.

Henry Del Rio, a/k/a “Junior,” a/k/a “JR,” 21, of Chelsea, was sentenced by U.S. District Court Judge Richard G. Stearns to five years in prison and four years of supervised release. In February 2018, Del Rio pleaded guilty to one count of conspiracy to conduct enterprise affairs through a pattern of racketeering activity, commonly known as RICO, one count of conspiracy to distribute cocaine and cocaine base, one count of conspiracy to distribute heroin, and one count of possession of a firearm with an obliterated serial number.

Del Rio is a self-admitted member of the ES$G, a Chelsea-based street gang, which uses violence to further its criminal activities and enforce its internal rules. Specifically, ES$G uses violence to protect its members/associates, target rival gang members/associates and intimidate potential witnesses. The ES$G is also involved in drug trafficking, including cocaine, cocaine base (a/k/a crack) and heroin in Chelsea and surrounding communities.

Del Rio conspired with other gang members and associates to distribute heroin and other drugs in Chelsea. Additionally, Del Rio sold a confidential informant a .45 caliber semi-automatic handgun with an obliterated serial number and a 30-round, high-capacity magazine from Del Rio’s residence on Gerrish Street in Chelsea.   Del Rio is one of 53 defendants indicted in June 2016 on federal firearms and drug charges following an investigation into a network of street gangs that had created alliances to traffic weapons and drugs throughout Massachusetts and to generate violence against rival gang members. According to court documents, the defendants, who are leaders, members, and associates of the 18th Street Gang, East Side Money Gang and the Boylston Street Gang, were responsible for fueling a gun and drug pipeline across a number of cities and towns in eastern Massachusetts.

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Avellaneda, Traffic Commission Move to Protect Silver Line Stations

Avellaneda, Traffic Commission Move to Protect Silver Line Stations

The City has moved to protect the resident parking around the new Silver Line Stations and busy 111 bus stops, anticipating a rush of commuters that will look to capitalize on easy parking in the day and a fast bus into Boston.

The Traffic Commission in late May approved the plan to enforce the existing resident parking program during the day hours of 8 a.m. to 6 p.m. Typically, in most parts of Chelsea, the resident parking program is enforced at night from midnight to 5 a.m.

Some exceptions are near the Commuter Rail and near the Chelsea Court.

The City Council approved the plan last week, on June 4.

The idea came from Councilor Roy Avellaneda, who first began talking about it at Council in December.

He said this week that he was glad to see proactive action.

“We don’t want to see commuters coming from Everett, Malden and Revere driving over to Chelsea and parking all day long so they can take the Silver Line into Boston and park for free,” he said. “I’m glad they also decided to take the extra step of protecting the busier 111 bus routes too. This is a win for Chelsea residents.”

After suggested by Avellaneda, Planner Alex Train worked up the proposal and sent it to the Traffic Commission.

City Manager Tom Ambrosino said they will begin enforcing the ordinance soon after they relay information to residents, as residents will need to have information in the areas affected. Most residents already have resident stickers, but they may need to be aware to get placards for their visitors during the day hours.

That’s a major change from what is currently in effect.

Ambrosino said they plan to have a public meeting on June 21 to explain the program and give out information to those effected. He said he wants to make sure people have a chance to digest the information as there were no public meetings beyond the Traffic Commission.

The meeting will take place at Chelsea City Hall in the City Council Chambers at 6 p.m. on Thursday, June 21.

The areas effected for the Silver Line include:

  • Gerrish Avenue from Broadway to Highland;
  • Library Street, from Broadway to Highland;
  • Highland Street, from Marlborough to Box District Station;
  • Marlborough Street, from Broadway to Willow.

Those areas affected by the 111 bus stop protections are:

  • Washington Avenue, Bloomingdale to Heard St.;
  • Washington Avenue, Spruce to Jefferson;
  • Franklin Avenue – all;
  • County Road, from Washington to Basset;
  • Forsyth Street, from Washington to Franklin;
  • Gardner Street, from Washington to Parker Street.

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