Massachusetts Medical Society: Letter to House Speaker on investment of federal funds received via the American Rescue Plan Act

Letter to House Speaker on investment of federal funds received via the American Rescue Plan Act

The Honorable Ronald Mariano
Speaker, Massachusetts House of Representatives
State House, Room 356
Boston, MA 02133

Dear Mr. Speaker:

The Massachusetts Medical Society appreciates the thoughtful and inclusive process that the legislature has undertaken as it deliberates on the best way to invest federal funds received via the American Rescue Plan Act (ARPA.) The Medical Society supports several existing funding proposals, as detailed below, that will help ensure this funding is allocated to the areas of most acute need in the health care system so that patients across the Commonwealth receive maximal benefit from this unique opportunity.

The Medical Society wishes to underscore the urgent need to invest sufficiently in the behavioral health system to make a substantial improvement in access to care. The MMS has long engaged in advocacy to improve behavioral health in Massachusetts, but we have never heard greater and more widespread concern regarding the dire need to improve access to behavioral health in Massachusetts than now. Physicians from varying specialties and practice settings and across geographic regions in the Commonwealth are expressing increasing concern on this issue. As MMS has engaged with physician-experts in the behavioral health space and with many peer stakeholder organizations, workforce and reimbursement dilemmas are emerging as root causes of so many of the challenges in the behavioral health care space. Issues such as behavioral health boarding, while multifactorial in nature, could be most swiftly addressed by shoring up the behavioral health workforce to allow more licensed inpatient beds to accept patients as well as improved access to outpatient and day treatments for patients not requiring hospitalization. On the preventive and outpatient side, while there are evidence-based models to effectively integrate behavioral health into primary care settings, workforce shortages and inadequate reimbursement models undermine the establishment and sustainability of this collaborative care model.

MMS supports proposals by the Massachusetts Health and Hospital Association and the Association for Behavioral Health Systems to use budget surplus and ARPA funding to create a comprehensive behavioral health workforce investment plan that combines tuition reimbursement, loan forgiveness, and training to create a sustainable pipeline of behavioral health care professionals, from mental health workers to psychiatrists, who can meet the pressing demand in our Commonwealth.

As you know, workforce challenges extend throughout all of health care and across many other industry sectors. While the behavioral health workforce shortage is critical in nature, MMS wishes to underscore other workforce challenges that will need urgent attention as well. Primary care physicians are having significant challenges recruiting and retaining staff, from nurses to medical assistants and front office staff. MMS thus supports the expansion of the size and scope of the Massachusetts Loan Repayment Program (MLRP) for Health Professionals to ensure a robust pipeline of primary care physicians and other health care professionals.

In addition, specialty practices such as radiology clinics have had significant challenges recruiting technical personnel necessary for mammograms and colonoscopies. In these critical preventive services, there are sufficient imaging machines and enough physicians to perform and read the tests but without enough supplementary medical professionals, significant limitations on services lead to longer wait times for patients, which ultimately leads to delayed diagnoses and poorer health outcomes. We urge consideration of broad-based workforce initiatives in the health care space. ARPA investments also present an important opportunity to address racial equity. The Medical Society urges the legislature to ensure that funds dedicated to workforce development in the health care system focus on diversifying our health care workforce. This is consistent with robust data linking diverse medical workforce with improved health outcomes for communities of color.

In addition to prioritizing our behavioral health care system, the Medical Society also supports the proposal from a coalition of public health, municipal, regional, state and academic leaders spearheaded by the Massachusetts Public Health Association calling for investment of ARPA funds in our local public health system. The group is calling on the Legislature to invest funds to: establish integrated, 21st century data systems; invest in workforce development to ensure that every community benefits from the expertise of trained professionals; and eliminate the significant inequities in public health services and capacity between municipalities. This funding is critical to build a local public health system that is equitable, efficient and effective.

The Medical Society appreciates the opportunity to raise these critical issues and looks forward to engaging with the legislature to find areas of investment that will be most effective at creating positive change and most beneficial for our patients.


Carole E. Allen, MD, MBA, FAAP

View a PDF version of this letter here.

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