Opioid Forum at UMass Amherst: Introductions

Opioid Forum at UMass Amherst: Introductions

September 30, 2019 0 By Ronny Jaskolski


Today we will
focus on the extent of the problem of opioid
addiction, the cost, and the consequences, and
unique challenges to Western Massachusetts,
interventions– we’ll hear about what some important
and key clinicians in Western Massachusetts are
doing to intervene with folks who are
addicted– best practices, and recommendations. We’ve got some of the top
experts in the country from whom you will hear. And we thank them for being here
and speaking with us as well. We have no way to put
these forums together, whether in the eastern
part of the state or the Western
part of the state, without financial support. And for 21 years now, that
the forum has existed, we’ve had terrific support
from Blue Cross/Blue Shield of Massachusetts, which
was really the initial funder. The CEO at the time,
Bill Van Fossen, had this vision that we should
create a forum within which very seemingly intractable
health policy issues could be confronted and discussed. And so I want to thank
my very close friend Audrey Shelto, who is
the president of the Blue Cross/Blue Shield Foundation,
for the Foundation’s support, for this particular forum. Thank you, Audrey. And as an alum of UMass
Amherst myself, I’m proud to– I’m really proud and delighted
that the university has been so involved in this project. And so, I particularly
want to thank not only the university in its entirety,
but also, particularly the School of Public
Health and Health Sciences. And my other very close
friend, Julie Burns, who is an ex Blue Cross/Blue
Shield person and an ex Boston City Hall person, but she cares
about Western Massachusetts too, right Julie. She is the head of
the Rise Massachusetts Foundation, which specifically
deals with addiction. And so they helped to
fund this event as well. Julie, thank you so much. [APPLAUSE] And the key health provider– I’m biased a little
bit, because I’m close to this particular
medical center, but it’s one of the
top medical centers, not only in this state, but in
this country, Bay State Medical Center, thank you so much for
all the work that you’ve done and all the commitment
that you’ve given to this. I want to, also, just board
members that we have here. Audrey is on our board. Connie Horgan, from Brandeis
University, and Dr. Keroack, from whom you’ll
hear in a moment. And I’m particularly
delighted that there are several legislators
who are here. Senator Joanne Comerford,
Representative Michael Finn, Representative Lindsay Sabadosa,
and Representative Mindy Domb. And also Mayor Nicole LaChapelle
of East Hampton is here. So we have a good representation
from elected officials. I got a call this morning from
our very good friend Chancellor Subbaswamy, saying
that his wife’s had a bit of a medical
issue this morning. And so they had to
head over to the ER. I don’t think it’s anything to
be terribly concerned about. But they are worried
enough so that he said that he felt he needed
to put her in the car and get over to an ER. And I always say, proudly,
as well, I did 10 years on the board of UMass. And the thing I’m proudest
of in my 10 years of service there is that I chaired
the search committee that led to the appointment
of Chancellor Subbaswamy. He’s been a transformational
leader on this campus and in higher
education in general. And we’re very lucky
in the Commonwealth that we have someone
of his quality and his commitment
leading this campus. And representing him, I’d
like to, for a few words, introduce Risa Silverman, who’s
the Director of the Office of Public Health and Outreach
at the School of Public Health at UMass Amherst. Risa– [APPLAUSE] Good morning, everybody. This is truly off the cuff. And I’ve never done this
before, replaced the Chancellor. And so I am Risa Silverman. I am with the Office for
Public Health Practice and Outreach in the School
of Public Health and Health Sciences. And several months ago, or maybe
a year, the Mass Health Policy Forum, and Phil Johnston,
reached out to our school and asked to work on
this forum together. And that was so exciting. It’s been a pleasure to work
with the Mass Health Policy Forum. I hope we get to do it again. And this is such a critical
issue here in Western Mass. And what’s really amazing about
the 500 of you who signed up is just that you really
obviously care, but also collaborate, work together,
and are really smart. And so I think that the Health
Policy Forum and today’s event is really enriched by all of
you and your participation, in one aspect of this
crisis or another. Because I’m an
outreach person, I do want to say that I wish
I could say welcome to each and every one of you directly,
because I’m so happy to see people here from law
enforcement, and researchers, and practitioners, and students. Because we all need
to work together. And just a little
bit about the room. It was a minor miracle that
this room was available a couple months ago, when
we had to switch rooms. So I just hope everybody enjoys
the morning, and learns a lot, and makes connections. And welcome, thank you. [APPLAUSE] This is an issue that requires a
lot of governmental involvement and funding, in addition
to private commitments that I’ve discussed already. And we’re very fortunate that
we have two United States Senators representing
us in Washington, and House Members as well,
who are very involved with this issue, and are
leading the fight for more funding, more resources
for all of you who are out there on the
front lines working on this. And one of the key
leaders on this has been Senator Ed Markey. He was instrumental in obtaining
some significant federal funds a couple of years ago
for Massachusetts. And frankly, if you look
at the history of spending or appropriations over
the past several years, and this addiction
issue in general, and opioids in
particular, you’ll see that despite
all the craziness that’s going on in
Washington, it’s because of the fact that we have
a delegation here that’s really focused on this issue
that we’ve received significant federal money to,
as I say, to help all of you in your work. Senator Markey couldn’t
be here this morning, but he wanted to have
a presence, because he cared so much about this issue. So we’re going to run a video
right now from Senator Markey. [AUDIO OUT] [APPLAUSE] Well, that was a very
substantive summary of where we stand, I think. And I think we can tell
how committed he is. I well remember, being
an old social worker myself, that in the old days,
when someone was arrested for heroin addiction,
for instance, they’d be tossed into jail. That’d be the response. And I think over
the years, we’ve learned that tossing people
who are addicted and have a disease, what essentially
is a disease, into jail is self-defeating, not
only for the individual, but also for the community. And so treatment is our focus
now, should be our focus. And as Senator Markey said, if
you go into any of the jails, even today, however, you’ll
find that almost everyone in correctional
facilities is addicted to something or several things. And so it’s been an epidemic–
that has been at epidemic– the epidemic of addiction
has been out there for a long, long time. And this is just the latest,
really terribly tragic example of it. The clinicians, who are
really heroes in this effort to curb the increase in
the number of people who are addicted, in this
part of the state is Bay State Medical Center. And they have a presence
in the entire region. And as I said earlier,
I think it’s well recognized that Bay State
is among the top hospitals in the United States. And one of the top leaders
in the United States, hospital leaders,
is Dr. Marc Keroack, who has been our partner in
this and has been very involved in saying, listen, it’s
very important that Western Massachusetts and the
rural communities, the problems within these
communities, be addressed, as well as urban areas. Dr. Keroack provides
oversight for all services at Bay State Health and
its health plan, Health New England. Under his leadership,
Bay State Health has expanded its
clinical services and has been a national leader
in adopting population based approaches to organizing
and financing health care. He came to Bay State Health
from University Health System Consortium in Oak
Brook, Illinois, where he oversaw programs
in quality and safety as chief medical officer. Prior to his national
work, he served on the faculty of the University
of Massachusetts for 12 years, where he focused on
HIV and AIDS care. Beginning in 1995, Dr. Keroack
took on a more administrative role, serving as president
of the UMass Memorial Medical Group. He is a graduate of Amherst
College and Harvard Medical School. And he received his MPH
from Boston University. And if that isn’t
enough, he also trained– he trained in Internal Medicine
and Infectious Diseases at Brigham and Women’s
Hospital in Boston, Mass. Please welcome the CEO of Bay
State Medical Center, Dr. Mark Keroack. [APPLAUSE] Well, good morning everybody. Phil, thank you for
that kind introduction. And thank you for your
leadership of the forum. I want to thank the
Mass Health Policy Forum for holding this,
its first policy forum out in Western Massachusetts. And I can’t think of a more
important or timely topic to tackle. I also want to acknowledge
the Blue Cross and Blue Shield of Massachusetts
Foundation for its long-term
support of the forum, and our co-sponsors for
this event, UMass Amherst School of Public Health
and Rise Massachusetts. I also want to give
a special shout out to the Brandeis Harvard National
Institute of Drug Abuse Center to Improve System Performance
of Substance Use Disorder Treatment, along with the
Opioid Policy Research Collaborative, who are going to
be putting together the issue brief related to this forum,
which will be available to you all shortly. As Phil said, Bay State
Health is the largest provider of health care in Western Mass. We’re also the largest employer. And we certainly have felt
the impact of substance use disorder, both in
the inner cities and in the rural communities. While overdose deaths
have come down slightly across the state in 2018, here
in the communities we serve, they’ve gone up. In our ED in
Springfield alone, we treated over 1,500 patients with
opioid use disorder last year. We’ve done a lot to try
to tackle this epidemic, but as the Senator said,
there’s still a lot more to do. We’re pleased with the partners
that we’ve had in this fight. And many grassroots,
multidisciplinary organizations have really stepped up. Notably, the Opioid Task
Force of Franklin County in North Quabbin, led
by John Merrigan, who’s here today, and Sheriff Chris
Donelan, as well as the Hampden County Opioid Task Force, led
by District Attorney Anthony Gulluni. These have been a
wonderful groups for convening all
the key stakeholders and making coordinated plans. We’ve expanded
buprenorphine therapy, both at our community
health centers and our regional
hospitals, by increasing the number of
providers certified to provide this therapy. We’ve also done some
very unique work for moms and babies affected
by substance use disorder. Bay State Franklin Medical
Center, the only hospital in Franklin County,
pioneered a unique program, called the Empower Program,
to provide a coordinated care model for both pregnant
and parenting moms with opioid use disorder. That program was adopted
at our Springfield campus. And we’ve added to it a
unique rooming-in program for moms who are dependent
on opioids, who deliver, so that they can be with their
babies in the first few weeks after delivery. We’ve also implemented a
neonatal abstinence protocol that’s been replicated
across the country, something that I’m very proud
of our providers for stepping up and innovating. Medication assisted therapy
is also now offered, both at the Franklin and
Hampden County Houses of Correction, because of
the huge problem there. And we’re very proud to provide
medical liaison services, not only at the jail
in Hampden County, but also to coordinate
with our partners, like Behavioral Health
Network, to provide aftercare during that very fragile
time after release. On the research
front, we’ve really been very pleased
by the leadership of Dr. Peter
Friedman, who you’re going to be hearing from later. He’s helped us receive grants
from the Health Research Services Association, as well
as the National Institutes of Health, to enhance care
coordination in rural areas and to evaluate
effective treatments in the criminal justice system. But there is still more to do. In the next year or
two we’re planning to enhance our
medication treatment protocols in our
emergency departments across our health system. We’re adding an addictions
consultation team for people admitted for other
reasons to our hospitals. And we’ll continue to partner
with Behavioral Health Network to coordinate inpatient and
outpatient care so folks don’t fall through the cracks. We’re also working with
Tapestry Health, which has provided very
important harm reduction services for this population. You know, as a
physician, years ago, as my daughters would
say, back when I had hair, I worked for about
20 years taking care of people with HIV and AIDS. And two thirds of
them were current or former intravenous
drug users. I kind of thought I knew the
face of opioid use disorder. It was a familiar foe that we
always had to struggle with. But what I’m learning now is
that the face of the opioid use disorder today is
something very different. And it requires a very
different response. The links of this
current epidemic to a lack of
economic opportunity, difficulties in accessing
care, and social isolation in rural communities presents
all kinds of new challenges. And it requires new
partners and new solutions. It requires us to bridge many
gaps, not only health care, but mental health, law
enforcement, education, social services, first
responders, transportation providers. But I think in these
challenges lie our strengths. Because in small
rural communities, the leaders of all these
areas all know each other. They can come together
quickly and act as a team to really get things done. And we’re going to hear
some great examples of that later on this morning. To me, that’s our best hope
to turn this epidemic around. So I thank you for
the work you’re doing. And I thank you for continuing
to learn about this. And I’m convinced
that together we are going to get this
thing turned around. Thank you for attending. [APPLAUSE]