Interagency Task Force on Newborns with Neonatal Abstinence Syndrome
Monday, November 7th from 2-4pm
One Ashburton Place, Boston, MA 02108
Meeting Minutes
Task Force Attendees
Secretary of Health and Human Services, Secretary Sudders (co-chair)
Attorney General designee, Judge Gail Garinger (co-chair)
Commissioner of the Department of Children and Families designee, Kim Bishop- Stevens
Commissioner of Mental Health designee, Beverly Presson
Commissioner of Public Health designee, Ron Benham
Executive Director of the Health Policy Commission, Director Seltz
Other Meeting Attendees
Katherine Record
Erika L. Scibelli
Michael Kelleher
Vivian Pham
Shannon Moore
Abigail Taylor
Introduction and Opening Remarks
Review First Task Force Meeting Presentation
Secretary Sudders outlined Outside Section 171 establishing that establishes the interagency task force on newborns with neonatal abstinence syndrome and substance-exposed newborns to develop a unified statewide plan to collect data, develop outcome goals, and ensure quality service is delivered to those newborns.
The statewide plan shall ensure that, to the extent possible, all executive agencies work in coordination to address the needs of newborns, infants, and young children impacted by exposure to substances.
The task force shall file a report of its findings and the recommended statewide plan, along with any proposed legislation or regulatory amendments necessary to implement the statewide plan, not later than March 1, 2017.
The Task Force co-chairs reviewed the five components of the final report:
1. State plan for the coordination of care and services for newborns with neonatal abstinence syndrome and substance exposed newborns including, but not limited to, those related to early intervention, substance use disorders and healthcare access issues;
2. An inventory of the services and programs available in the Commonwealth to serve newborns with neonatal abstinence syndrome and substance-exposed newborns;
3. Identify gaps in available services and programs;
4. Formulate a plan to address identified gaps; and,
5. Develop an interagency plan for collecting data, developing outcome goals and ensuring quality service is delivered
The Task Force members agreed that these five components are the appropriate elements to include in the final report.
The Secretary stated the co-chairs will establish an Advisory Council to assist in developing a unified statewide plan. The Council may include representatives from hospitals, non-profit entities and community-based organizations with demonstrated expertise in the health, care and treatment of mothers with substance use disorders, newborns with Neonatal Abstinence Syndrome or substance-exposed newborns, infants and children. The Task Force will seek input from other experts in the field to develop a unified statewide plan.
It is anticipated that the Advisory Council will meet face-to-face at least once with the Task Force. This joint meeting is set for January 18th.
The Secretary asked David Seltz to describe the process the Health Policy Commission utilizes to ensure diversity across the care continuum and Commonwealth for their advisory council.
Judge Garinger stated that given the limited membership of the Task Force, we may want to consider a larger Advisory Council to ensure we are able to get information and feedback from a wider spectrum of perspectives. She raised the concern that the March 1st report date may be a challenge given our desire to select Advisory Council members and bring them together with sufficient time for meaningful engagement on the issues.
The Secretary asked Michael Kelleher to look into how MassHealth procured members for its various health reform advisory councils. She recalled that they utilized a more formal RFR process that worked quite well. Michael will report back on the process MassHealth employed. Secretary Sudders continued that even if we use the RFR process, we will still need to get the word out to make sure folks are aware of the opportunity to apply for the Advisory Council.
Judge Garinger stated we need to make sure we reach out to experts in the field, i.e. to the people who are working directly with folks on the ground. Secretary Sudders agreed and added we need to ensure we are not limiting ourselves to too many “policy insiders” but are able to hear from folks across the state and along the full care continuum.
Abigail Taylor agreed and stated we will need a cross-section of representatives to sit on the Advisory Council in order to help identify gaps across a number of measures; demographic, geographic, care continuum, patient age at intervention, etc.
Secretary Sudders stated the Advisory Council should reflect and react to analysis, content and recommendations made by the Task Force. David Seltz agreed with the Secretary and stated it will be important for the Task Force to set the appropriate expectations for the Advisory Council at the first meeting.
Kim Bishop-Stevens asked if the group could review the mandate and responsibilities of the Task Force by reviewing the establishing statute.
Judge Garinger stated the language in the statute is fairly narrow in its definition and charges. Secretary Sudders stated that we should stick as close to the language of the statute for the final report as we can.
The Task Force did note the pending application to the 2017 Policy Academy that may impact the work of the Task Force. A funding decision will be announced on December 2nd and we will update the Task Force, accordingly.
Judge Garinger stated that if we are selected, participation in the Policy Academy could complement the work of the Task Force.
Secretary Sudders agreed but emphasized her view that the work of the Task Force should remain consistent with the language in Outside Section 171.
Schedule of Task Force
Meeting/Activity / Date/Time / OtherTask Force meeting #1 / November 7th 2-4pm / Meeting Occurred
Advisory Council RFR released / November 15 / RFR Released
Advisory Council RFR due / November 28th at 5pm / NA
Task Force meeting #2 / December 19th 10-12pm / Presentation of recommendations for Advisory Council; review of existing data collection; report on inventory exercise
Task Force meeting #3 (including Advisory Council) / January 18th 1-3pm / Presentation of gaps in available services, capacity or programs in MA; initial recommendations to address identified gaps
Task Force meeting #4 / February 15th 1-3pm (final meeting) / Review draft interagency plan for collecting data, developing outcome goals and ensuring quality service; Review draft proposed legislation or regulatory amendments
Report of Task Force findings due to General Court / March 1, 2017 / Submit final statewide plan to the General Court pursuant to legislative charge
The Task Force reviewed several slides providing an overview of NAS and SEN in the Commonwealth. A discussion took place regarding the level, detail and timing of data collected on the topic of NAS and/or SEN in the Commonwealth.
Secretary Sudders asked folks around the room what data is gathered from NICUs, the Early Intervention program (DPH), CHIA, and other data sources. She asked what data is out there that we can collect and review.
Secretary Sudders asked DPH to review and overlay their overdose maps against the NAS Incidence Map.
David Seltz stated the data provided today is on the older spectrum of what HPC has been able to collect and HPC would be more than happy to provide updated data (particularly hospital-specific data) to the Task Force prior to the next meeting. In addition HPC will provide the Task Force with an overview of their data sources, timing, and known limitations.
David Seltz echoed the importance of understanding the topic, starting with what the data tells us. The first chapter of the report may very well be what data is collected and what it tells us.
The Task Force agreed that at the December we should review data collected as well as the data collection process and known data limitations across the following data sources:
· DPH
· HPC
· CHIA
· DCF
The Task Force discussed the need to review the current state of NAS/SEN services in the Commonwealth. The Task Force will be collecting information on the services, programs and initiatives available in the Commonwealth in order to identify gaps in available services and programs.
Key components of data collection will include:
· Organization
· Geographic Region
· Description/Operational Approach
· Type of Intervention (e.g., training, treatment, quality improvement, etc.)
· Intervention Stage (e.g., prenatal, neonatal, postnatal, etc.)
· Target Population (e.g., infants, providers, at-risk parents, etc.)
· Funding Source (e.g., state appropriation, grant, private funds, etc.)
· Data Collection/Data Sharing
Judge Garinger stated we need to be aware of what point on the age/service need continuum the specific program is focused and whether the program is geared towards NAS, SEN or both.
Secretary Sudders stated we need to be clear about what we are asking, in other words, what do we mean by "prenatal care"? Are we asking if they have established protocols or use standardized screenings?
Ron Benham stated in reviewing the capacity question, it will be important to get at any workforce issues and challenges that may be limiting a program’s ability to provide services to all those who could benefit.
Abigail Taylor stated it will be important to recognize and capture different ways of measuring gaps (workforce, screenings, trainings, service gaps for specific ages or geographies, etc.).
She emphasized that we need to add a “capacity” question in the identification of programs and services.
Beverly Presson stated that in collecting this information we need to be clear about specific definitions or varied interpretations of terms. For example, a screening could mean many different things to different programs or services. Do we want to reference national, peer-reviewed definitions and ask how a program operates in terms of those standards? By doing that we may more narrowly key in on apparent gaps across the Commonwealth or care continuum.
David Seltz stated HPC is currently funding four hospitals that are developing and operationalizing treatment protocols for NAS and SEN impacted patients. Several hospitals are quite sophisticated in the inpatient setting in screening and treating these patients. HPC will provide a more detailed update on these four hospitals at the next Task Force meeting.
David Seltz stated HPC is working in partnership with DPH to develop a set of “best practice” protocols that we would want to see other hospitals adopt.
Kim Bishop-Stevens stated we should also review all the screening tools utilized to gauge whether we want to adopt and promote a standardized screening and assessment tool across the Commonwealth.
Secretary Sudders asked Michael Kelleher to review the National Governors Association Compact to Fight Opioid Addiction to review the blueprint for any specific policies on NAS or SEN.
The meeting concluded.
Next Meeting
Next meeting date: Monday, December 19th at 10am