Tag: health care

  • MA health panel delays vote on proton beam therapy center. Here’s why

    MA health panel delays vote on proton beam therapy center. Here’s why

    The Massachusetts Public Health Council has delayed a vote on a proposal from the Dana-Farber Cancer Institute to build a new proton beam therapy center in Boston, citing concerns about equity and access.

    Proton beam therapy is a highly precise form of radiation treatment for cancerous tumors that spares more of the healthy tissue around the tumor from radiation, according to Johns Hopkins Medicine.

    Massachusetts General Hospital is currently the only hospital offering proton beam therapy in the state. UMass Memorial Health in Worcester received approval in December to bring a $54 million proton beam center to Marlborough Hospital.

    Dana-Farber wants to construct an approximately 4,500-square-foot proton beam therapy center at 35 Binney St. in Boston. The project is valued at approximately $50.5 million, with a $2.5 million contribution from the Community Health Initiative, according to the proposal presented by Torey McNamara, senior policy adviser at the Massachusetts Department of Public Health.

    A proton beam system in Peoria, Illinois, is shown in this 2024 file photo. The Dana-Farber Cancer Institute in Boston is proposing to build a $50 million proton beam therapy center.

    Mass General owns two proton beam therapy systems, one of which is operational. Dana-Farber maintains that even with the approved center at the UMass Memorial Marlborough Hospital campus, additional capacity is needed in the state.

    The Dana-Farber presentation suggested it had seen “widespread difficulty among its patients seeking access to proton beam therapy,” based on clinical and patient reports. According to approximate data, 24% of Dana-Farber patients in “group one”  those who medically require proton beam therapy  reside near the proposed center, which is anticipated to be operational by December 2027.

    Public Health Council says equity, access are issues

    But Dr. Ramnath Subbaraman, a Public Health Council member, said there are “a few problems across both payer mix, race and ethnicity, and geographic location in terms of equity.”

    According to information packets presented to the council, “the proportion of patients in group one, those most likely to benefit from PBT, is only 4.4% MassHealth overall, 2% for children,” Subbaraman said.

    Other council members raised similar concerns about the center’s geographic location and the patient population it’s expected to treat.

    The health council, chaired by Department of Public Health Commissioner Robbie Goldstein, advises the DPH on major policy decisions at the discretion of the commissioner, and grants the commissioner authority to take necessary actions to protect public health upon a declaration of a public health emergency by the governor.

    The Dana Farber proposal said the center would treat approximately 216 patients per year, based on historical data, but does not account for expected increases in need for PBT treatment.

    Dana-Farber cites access to Boston Children’s Hospital

    Dana-Farber plans to use the proton beam clinic to collect more data on their patient profiles to inform broader research on proton beam therapy centers.

    “This is an opportunity to bring this therapy to patients that may have had barriers to accessing them,” said Magnolia Contreras, vice president of community health at Dana-Farber.

    Susan Chi, a Dana Farber pediatric neuro-oncologist, addressed concerns about the center’s location  inside a building connected to Boston Children’s Hospital, where her patients most often receive treatment. Currently, children must travel to other proton beam therapy facilities to receive treatment.

    “This is stressful for children and families who are already undergoing treatment at Dana-Farber, Boston Children’s, which often leads to treatment delays and puts patients at risk for communication errors, and transferring care for very sick children is just not feasible,” Chi said.

    The council is expected to revisit the proposal next month, according to a Dana Farber spokesperson.

  • McGovern leads bipartisan effort to support, expand ‘food is medicine’ initiatives

    Repeating the mantra that “food is medicine,” U.S. Rep. Jim McGovern is leading a bipartisan effort urging congressional appropriators to make healthy food and good nutrition a core pillar of the nation’s health care system.

    “I believe that food is a human right. And I also believe that the United States has kind of lagged behind other countries in terms of making the connection between good nutrition and better health outcomes,” said McGovern in an interview with the Gazette.

    He continued, “Bad diets result in heart disease, bad diets can result in diabetes, bad diets can result in high blood pressure and I can go right down the list. We have senior citizens who are in the emergency room because they’re taking their medication on an empty stomach, because they can’t afford their medicine and their food.”

    That’s why McGovern recently drafted a letter, signed by 46 House members from both sides of the aisle, asking appropriators to “provide essential resources and timely guidance to better integrate nutrition into our health care system” as part of the fiscal year 2027 Labor, Health and Human Services, Education, and Related Agencies funding bill.

    “Good nutrition is fundamental for restoring and maintaining health,” the legislators wrote. “The costs of treating diet-related disease are crushing healthcare systems, federal and state budgets, private employers, and our economy… The combined healthcare spending and lost productivity from suboptimal diets and food insecurity are estimated to exceed $1.1 trillion each year.”

    The Department of Health and Human Services (HHS) developed a Food is Medicine (FiM) initiative in 2023 to create a strategy to “reduce nutrition-related chronic diseases and food insecurity to improve health in the United States,” including “diet-related research” and efforts that will increase access to Food is Medicine initiatives, according to the HHS.

    In the March 26 letter, legislators called for around $3.5 billion in additional funding to be directed to various FiM programs, including medically-tailored meals, groceries and produce prescriptions, which are customized for people with severe, complex or chronic conditions, and the Ryan White HIV/AIDS program, which provides FiM programs and HIV primary care to people living with HIV/AIDS.

    “What this letter is about is us putting some money on the table so we can move ahead on some of these initiatives,” said McGovern. “The bottom line is, we’ve got to put some money on the table here, and we have to make this a priority.”

    In addition to providing potentially life-saving nutritional supplements, expanding and supporting FiM initiatives could save the country, and individual states, money on unnecessary health care spending.

    “If we do this right, we’re going to save a boatload of money in avoidable health care costs,” McGovern said. “Health care costs are skyrocketing, and rather than going to people and telling them that ‘in order to get good health care, you got to pay more,’ how about we find ways to control costs through getting them access to better nutrition?”

    Healthy food initiatives have been one of McGovern’s primary political focuses for more than two decades; in 2001, he introduced legislation creating the George McGovern-Robert Dole International Food for Education and Child Nutrition Program, which has “provided lifesaving food” for “over 31 million of the world’s most vulnerable children in 48 different countries,” according to McGovern’s office.

    In 2008, McGovern launched the bipartisan House Hunger Caucus, and in 2018 he created the bipartisan Food is Medicine Working Group to “highlight the costs related to hunger and promote health-focused research into access to fresh fruits and vegetables.”

  • Haitian TPS uncertainty puts pressure on Mass health care sector

    Dr. Hans Patrick Domercant has been getting more phone calls than usual.

    As president of the U.S. Haitian Chamber of Commerce, he works to assist and advise local business owners and workers of Haitian background. 

    In early February, a federal judge temporarily blocked the Trump administration’s termination of Temporary Protective Status for Haitian immigrants, which had been set to take effect Feb. 3. The ruling allowed Haitian TPS holders to keep their legal work authorization and protection from deportation while the case moves forward. 

    For now, the status remains in legal limbo as the administration pursues an appeal to the Supreme Court.

    “People are thankful that the recent court decision provided a pause,” Domercant said, “But no one feels fully secure. The conversations I’m having are very real and very personal — people asking, ‘Am I going to be able to keep working?’ ‘Is my family going to be OK?’”

    The Trump administration has pursued an aggressive effort to scale back TPS protections for several countries as part of a broader push to narrow humanitarian immigration programs. Since taking office, the administration has moved to terminate TPS designations for countries including Haiti, Honduras, Nicaragua, Afghanistan, Cameroon and Nepal, arguing that conditions in those nations have improved enough to no longer justify the protections. 

    TPS, allows migrants from countries experiencing armed conflict, environmental disaster or other extraordinary conditions to live and work legally in the United States. Haiti was designated for TPS after the devastating 2010 earthquake that killed an estimated 300,000 people and displaced millions more.

    Massachusetts is among the states with the largest Haitian immigrant populations, according to the Migration Policy Institute. The community makes up a significant share of the workforce in Greater Boston and across the commonwealth, particularly in the health care sector, where many work in nursing homes, home health care agencies and long-term care facilities.

    “They are essential,” Domercant said. “These are people who have been here for years. They’ve built lives. They’ve built careers. They’re not temporary in the way the word sounds.”

    Doug Howgate, president of the Massachusetts Taxpayers Foundation, said the potential loss of TPS workers would add pressure to a state economy already struggling with labor shortages. Massachusetts has faced slow workforce growth and domestic outmigration for years, he said, making international immigration an increasingly important source of labor and economic stability.

    “Our labor force has grown since the pandemic, and some of the biggest increases in our labor force in two decades are entirely driven by international immigration,” Howgate said. “International immigration has been what has enabled Massachusetts to have a growing population and to have a growing economy.”

    Howgate said the dynamic is especially important in health care. Any change that reduces the number of available workers could worsen staffing shortages in hospitals, long-term care facilities and home health settings.

    If employers are competing for fewer workers, Howgate said, labor costs could rise, adding strain to providers already operating under pressure while trying to maintain patient care.

    “There’s going to be dollars chasing fewer people, which means it could potentially drive up some personnel costs as well.”

    More broadly, Howgate said uncertainty around immigration status can slow economic growth by making it harder for businesses to plan and expand.

    For many Haitian immigrants in Massachusetts, TPS has functioned as more than a temporary administrative status. It has been the legal framework that has allowed them to buy homes and start businesses. The possibility of losing that framework — even if not immediate — creates what Domercant describes as “emotional and economic whiplash.”

    He worries that prolonged uncertainty could stall economic mobility and community investment.

    While the federal court decision has temporarily preserved protections, immigration advocates say the uncertainty itself is already having consequences.

    Elizabeth Sweet, executive director of the Massachusetts Immigrant and Refugee Advocacy Coalition, said Haitian TPS holders remain legally authorized to live and work in the United States while the case proceeds. But she said confusion, and in some cases misinformation, have already created instability in workplaces across the state.

    “At the moment, individuals with Haitian TPS have a continuing legal status and a continuing work authorization,” Sweet said. 

    Sweet said her organization has received reports of workers being let go prematurely because employers believed TPS protections were ending immediately.

    “That’s not a valid reason to lay someone off,” she said. 

    Three Haitian TPS holders were laid off by Tribute Home Care, based on their status expiring later that week. Even through the federal ruling extended work authorization, GBH reported

    Several Haitian-born residents contacted for this story declined interview requests, saying they feared being identified while their status remains uncertain. 

    Their reluctance to speak publicly reflects the anxiety and instability that advocates and community leaders say have intensified in recent weeks. Even with the court’s temporary block in place, some workers remain wary that public exposure could carry professional or personal consequences.

    For health care providers already navigating chronic staffing shortages, even small disruptions can ripple quickly through patient care systems.

    Since the COVID-19 pandemic, recruitment pipelines have thinned while burnout has increased. Losing experienced staff would likely compound those pressures.

    Sweet argued that the underlying conditions that justified the status remain.

    “The conditions in Haiti are truly the type of conditions that temporary protected status was meant to address,” she said. 

    While state officials in Massachusetts have issued guidance to employers about navigating immigration-related uncertainty, immigration status itself is determined at the federal level.

    In the meantime, prolonged instability carries broader economic implications. Small business lending decisions, expansion plans and hiring strategies often depend on predictability. If thousands of workers face potential loss of work authorization, employers may hesitate to invest.

    Domercant said that hesitancy is already creeping into conversations.

    “When people feel secure, they build,” Domercant said. “They buy homes. They start businesses. They pursue education. That benefits everyone — not just the Haitian community, but the entire state.”

    This uncertainty places workers in a difficult position even before any formal change takes effect. Some may hesitate to pursue jobs, apply for promotions or make major financial commitments while their status remains under review. 

    Others may find themselves having to repeatedly explain their legal status to employers unfamiliar with TPS protections and court rulings. That confusion can deepen anxiety for workers who are still legally authorized to remain employed.

    “It’s not just about jobs,” Domercant said. “It’s about the ability to plan a life.”

    If TPS were ultimately terminated and work authorization revoked, the impact would be felt beyond the Haitian community.

    Health care facilities would scramble to fill gaps, small businesses owned by TPS holders might close or scale back operations, affecting landlords, suppliers and local tax bases.

    The potential effects on the health care sector also reflect broader risks for other industries in Massachusetts that rely on TPS workers. While the consequences may be especially visible in health care, the disruption would not stop there. 

    Employers across multiple sectors depend on TPS holders to fill essential roles, and any loss of work authorization could shrink the labor pool at a time when many businesses are already facing hiring challenges, according to Bloomberg Law.

    For now, the court’s temporary block has bought time.