Massachusetts Affiliate leads fight for $60 million state health trust fund (The Nation’s Health)

THE NATION’S HEALTH
APRIL 23, 2013

Massachusetts Affiliate leads fight for $60 million state health trust fund

By Natalie McGill

After two years of building alliances with local elected officials and writing letters, the Massachusetts Public Health Association is enjoying the fruits of its labor: a pot of $60 million aimed at starting health and wellness programs across the state.

The state’s lawmakers created the Massachusetts Prevention and Wellness Trust Fund Aug. 6 after the Massachusetts Public Health Association spearheaded a two-year campaign for money that state-based municipalities and nonprofits could apply for to create programs that reduce preventable diseases such as diabetes and hypertension. The first round of trust money, made available from state hospital surcharge fees, will be available in the summer.

A total of 75 percent of the state’s health care costs are spent on preventable conditions such as diabetes, heart disease and hypertension, according to the MPHA. As a result, MPHA formed a Prevention Trust Coalition with five other groups, including the Boston Public Health Commission, asking state legislators to include the trust in an existing state health care cost reform bill. The coalition’s stance was that if there were interventions that reduced preventable diseases such as hypertension by as little as 5 percent, such as adding bike lanes to streets and creating youth tobacco prevention programs, it could save the state more than $450 million in health care costs annually, MPHA said.

Figure

Massachusetts Gov. Deval Patrick signs legislation creating the state’s Prevention and Wellness Trust Fund in August.

Photo by Eric Haynes, courtesy Massachusetts governor’s office

“Everyone at least here liked the idea of investment in prevention as long as someone else funded it,” said Toby Fisher, executive director of MPHA. “We were able to attach this to a larger piece of legislation on health care cost containment, and argued if the state is going to be serious about that, they have to think about prevention, too.”

The coalition wrote the bill to show the need for a trust in the fall of 2010, said Lisa Conley, the Boston Public Health Commission’s director of intergovernmental relations. The first key strategy was showing data that supported the need for a prevention and wellness trust. Massachusetts spends $4.3 billion annually in diabetes treatment and $3.5 billion annually in hospital treatment for cardiovascular disease, according to MPHA.

“We always came from the angle that prevention saves money and here’s what Massachusetts could save,” Conley told The Nation’s Health. “I think having good data is important. I think developing a strong coalition was important.”

To lay the groundwork for support, the coalition contacted mayors and council members of municipalities across the state asking for their support of a trust and telling them how a slice of that money could benefit residents in their respective cities. One of those was Thomas Menino, Boston’s mayor, who co-authored an April 5, 2012, op-ed piece in The Boston Globe with Paula Johnson, MD, MPH, chair of the Boston Public Health Commission, on the importance of preventive care.

“We know mayors are highly visible and highly respected leaders and to have them carry the prevention and wellness message was just one part of an effective strategy,” Fisher said.

In September 2011, the coalition sent an open letter to Massachusetts state Sen. Therese Murray, D-Plymouth, Senate president and Rep. Robert DeLeo, D-Winthrop, state House speaker, that amassed 300 signatures supporting a prevention and wellness trust. Those signatures included elected officials such as Menino, leaders of the state’s local health departments, nonprofits and residents. The trust was officially voted on and approved July 31 and signed into law by Massachusetts Gov. Deval Patrick on Aug. 6.

An advisory board will be formed to oversee how the money will be distributed over the next four years, Fisher said.

Conley said the Boston Public Health Commission is interested in applying for funds but is waiting on the state government to see what the money will be designated for. Chronic disease, obesity and tobacco are problems statewide, but Conley said she would like to see a public health focus on violence prevention in city centers where minorities die from gun or stabbing violence at a higher rate than whites.

“It’s not like it’s not addressed, it’s just that it’s not something that the state is focusing on,” Conley said. “They have to pay attention to problems across the state.”

To access the original article, APHA members can enter their username and password at the following address: http://thenationshealth.aphapublications.org/content/43/1/19.1.full

For more information on the new fund, visit: www.mphaweb.org/Prevention_in_Payment_Reform.htm.