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Thirteen the people's Channel joining us today hopefully will have to guess but
right now we have. Russ morrow Breslau right that's right she's the
coordinator for of media advisory for tobacco free mass which is
a Health Coalition we're going to learn about that and also the Mass Health tobacco
situation benefit that's coming up soon so we're going to get some details about
that and why it's so important to. About this issue so thanks for being here now
you're welcome. We will looking forwards who perhaps are you sure
for joining us and it's you know us it was for go right Camaro right clearance Yes
that's for Social be good but maybe you could say we'll start with you sure because
I know she's driving is your last few. Minutes of. Tell me
a little bit about what what is this what's the back or sensation cessation of well
it's see
a pilot program that lasts for two years it was passed by the legislature signed
into law by Governor Romney last April it started in July of two thousand and six
was passed as I say as
a pilot program and it ends in July of two thousand and eight it basically allows
anyone who is virtually anybody who is on mass healthy subscribes to Medicaid and
who smokes and wants to quit to be able to access counseling face to face
counseling telephone counseling patches and any sort of F.D.A.
Approved medication. To allow them to help quit to allow them to to try to quit
smoking so it provides resources exactly and tools to use exactly that's exactly
right so were the resources and tools that access those where they can go for you
have to if they come and talk to their doctor and ask for
a prescription for the patch or like I say any sort of F.D.A.
Approved medication like Chantix has been in the news lately and then they are able
to literally take that prescription to their pharmacy and and and get the
medication for for themselves for either free or usually
a very low cost co-pay so that So those so those tobacco solution
program. Actually helps cover some of the cost exactly covers it covers like I
say pretty much everything and this is certainly something that
a lot of people who have wanted to quit and their subscribers have not been able to
access in the past because let's face it the cost of
a pack of cigarettes is about five fifty but the cost of
a box of patches is more like fifty dollars and that's really hard for
a lot of people to afford and so this this you know for
a dollar or two co-pay they're able to afford
a whole box of patches or pills or whatever they need to whatever they need to do
to quit smoking is excellent so yeah so how is that funded where does the funding
those go to resources as part of the passage of the pilot program back last spring
the legislator legislature allotted seven million dollars each year for the next
for two years so for
a total of fourteen million dollars to help pay for this benefit so it's something
that the state is picking up and really makes
a lot more sense to help people quit smoking now than treat six milkers in the
future where the cost to Medicaid would be close to maybe even three you know
million dollars Yeah mention all the pain exactly well for of its employees and
economic and emotional health costs Yeah you know I were boarding
a lot of that by helping people now. So if the state give him money from tobacco
penalties and fees are from taxes from the tobacco sales right now it's coming out
of the general finds that is. So now this benefit is to help raise additional funds
is that what this is about is it is it is it's not of benefit event we are at it
now if it's an event that's taking place we just call it
a benefit because it's not that's because it's
a benefit to people to quit. OK we're. Going to point so the back of the
station benefit is this program isn't exactly how it's. So so why is this why is
this so important well really. People who are on again people who smoke and want to
be able to quit and who subscribed to Mass Health in the past have not had any sort
of way to to access. To access prescriptions or to access any kind of help to
access counseling and you've had to pay for it out of your pocket if you want to
quit and it's really hard to do that so for somebody to be able to give the
pharmacy a dollar and get all of this health in return I think is
a really valuable thing and I know that one of the things that sound tobacco free
mass which is an advocacy organization is working on is making sure that this C.
Program becomes a permanent benefit because if I'm
a smoker and I'm not ready to quit now but I'm ready to quit in September of two
thousand and eight I want to be able to do that and I think it's only fair to allow
people to be able to do that whenever they want to as opposed to having this car in
July of two thousand and eight so. There is global warming or there's
a little bit of
a timeline and like you say one of the things that some tobacco free mass is
working on is making this a permanent benefit. Through the Massachusetts
a Comprehensive Cancer Coalition we've done some outreach to local organizations
that work with myself subscribers just kind of let them know about it in the first
place our hope is that if if
a lot of people use this benefits that the state will see that it's
a really valuable thing and want to make it permanent We've also worked with state
representative and state senator to file
a bill that would do the same thing that would make this benefit
a permanent benefit so we've gone about it at
a couple of different angles in terms of making sure that this is around for the
long term she would think that that would be. Better for the beginning like we
would we would yeah we were certainly hoping for something like that and I think
that it was there are some challenges somewhere along the way that I mean I'm not
really sure to tell you the truth other than this is something that Massachusetts
was one of the few states I think there were close to forty other states that have
a benefit like this in place already and Massachusetts is one of the few states
that didn't have it and so. So I think that maybe they were testing the waters
a little bit there so you know
a concern that anything things cost money and I think there was
a little bit of hesitation to make it worth per minute if they put this money aside
and people weren't going to be to be using it well certainly again that's one of
the things that we want to make sure happens is that people know about it and then
use it as well yeah I mean it doesn't encouraging for them OK just to be more
expensive than the actual cigarettes or Exactly it's so much incentive you know I
mean well there's all those other if you go you're going to die from smoking or
rate but it's so tough to quit your rate you know rate and it's I mean it's tough
for me to just throw out fifty dollars for any young enough for so for somebody
who's on
a fixed income certainly it's even more difficult and hopefully this will really
encourage people. To make
a go of it you're good to go to work as I have there been any statistics too far as
how many people who actually took advantage of the. Tobacco cessation benefit I
think that I think that the Department of Public Health is very encouraged you'd
have to ask Are you sure to get some more specifics part of the. The concern or the
issues that we're having is that
a lot of people don't know that it's even in place in the first place I know that.
Mass Health has been working with doctors who provide the services. But there are
but there are
a lot of people don't know it even exists and so you know you're trying to quit
smoking and your doctor doesn't always ask How can I help or you know you should
really stop smoking we have you know you need to you need to ask your doctor about
it I think. We've run into some situations where there are people asking for the
benefit the doctors aren't even aware of it in the first place so we've got some
work to do we've got some work ahead of us if we if we hope to get to get people to
use the benefit in the first place yeah so no other medical model the doctor is
people where this program great great I know as I say mass house Mass Health System
some outreach with the doctors but I think it takes kind of
a couple of tries. And make sure and making sure that you get to the right person
within each physicians practice to make sure that they're aware of it but what
brought you to describe the business is me personally tobacco free mass honestly I
had to jab help wanted ad but didn't know it's
a terrific organization it was. It was started were
a fifteen member advocacy organization and we work on tobacco prevention and
secession policies and our members range from you know the smallest community
center in western Massachusetts to American Cancer Society to American Heart
Association so you really are organizations run the gamut and American Cancer
Society actually started that coalition back in one thousand ninety one around the
question one ballot initiative to raise the tobacco excise tax by twenty five cents
and kind of just kept going from Ban And so we've done things like work on getting
some additional funding for the states tobacco prevention and suspicion program
that's been slashed in the budget itself for the program has been slashed in the
last couple of years and we also worked on I'm sure you're very familiar with the
state wide smoke free workplace why that was passed in two thousand and four we
were an advocacy organization behind them and so kind of whatever you think of
tobacco control and you know we're trying to do things around and again this is one
of the things we've been working on for
a couple of years is trying to get this. This Medicaid suspicion benefit passed and
you know like I say we've kind of gone one step with it where it's at least it's at
least in place for a couple of years and we need to go
a little bit further with it so. As we've been successful other people take you
know we've heard I mean anecdotally we certainly have heard that there are
a number of people who have who have used it. Which we're very encouraged by now.
We are coming in to join us and so we're going to keep the camera views that are so
much so there so there is there has been some people utilize that yes program yes
certainly we've heard that hopefully people are getting there getting them out
there getting the message here. Is what we do to get more word out for the for the
for the most all of this you for the doctors and pharmacies I think it's
a matter of again Mass Health both working on continuing its outreach and also our
organization as an advocacy organization doing some more public outreach making
sure that we're that we're hitting the right areas and not just sending
a press release out here in there but actually touching the organizations and
physicians' offices that work with the population here so this is No Longer term
share you know yeah issue or something that needs to be had
a lot of attention on it one of the things that we've been doing is we have
targeted
a couple of community health centers and I think they're mostly in eastern Massachusetts
. To really work with the staff to make them understand that this benefit is
available and try to get them to do some of their own outreach rather than just our
organization doing outreach but do their own outreach amongst their clients and
within their community so we're hoping to do
a little bit more of that also over the next year year what can we do tell people
to. Look at what can our viewers do out there. I'd say the word here if you're
interested in in this benefits and in letting people know how important it is I'd
say certainly call your state representative call your state senator tell them that
this is
a very important benefits. I'd also encourage you to visit our website it's
tobacco free mass dot org and sign up to become an E.T.A.
At the end you'll get some updates from us about what's going on in the world of
tobacco prevention in suspicion and you'll get some more information about this
benefit and how she can help share groups who are good we go you sure commercial
camera you know thank you for joining us so you should. Go to the
traffic deal with sometimes
a little glad you didn't see this new you know West or so your nice little
invention you know you're sitting in. Your M.B.A.
Your health problems your health policy analyst that's correct and you're the from
the Executive Office of Health and Human Services. Well what are we we begin
because you coming into the show we were
a little bit about the back and say should benefit but you had your perspective too
you could tell us about you know how this benefit was designed to you know so
before you Opposition I've been the project manager on the Mass Health tobacco
cessation benefit project since the mandate went into place and it's been
a very strong collaborative effort with the Department of Public Health and their
tobacco control program because as recent was saying they've had
a lot of experience and
a great deal of breath in this work offering services across the state so you know
Mass Health is a portion of our state obviously in
a back community so we really want to learn from them and their experience to be
able to design
a benefit that would really be the best for our members and so bad design process
involved working with subject matter experts in the community we have some of the
best experts in tobacco control and smoking station in the nation some of the best
researchers out of Mass General Hospital and we all know the amazing medical
community we have here in Massachusetts so I won't go on but in this case we're
very fortunate to have some experts who could really help inform our decision
making process around the design of the benefit and we were. As well as some of the
community you masked men school they also work in collaboration with the Department
of Public Health Tobacco Control Program and work
a lot with providers and training people to become tobacco suspension counselors so
we worked with them to make sure that we had
a sense of what the providers needed as well as what the members needed in order to
make sure the benefit would really work so this is
a real this is available for everyone this is available for all Mass Health members
no. Access to the program at all Rosso
you talk
a little bit about it maybe you can in the primary way that the benefit was designed
especially in lieu of the fact that the benefit initially. Was designed and
mandated as
a pilot benefit so it wasn't as it was speaking about we really want to work to
make sure that it is most effective so that it will become
a permanent benefit and as the project manager I really
a very strong believer of making sure that this continues and so we're working to
to do that when we designed the benefit we designed it so that the source of
services would be the primary care clinician so that really means that
a mouse health member hopefully already has a primary care provider and
a doctor that they go to for their primary care for their regular checkups for all
of their routine care as well as if they have you know the flu or something and and
so they would go to that doctor and say you know hopefully I'm interested in
quitting smoking I heard that there are new services what more can you do you and
the good thing about the benefit is it's designed to be very flexible the
counseling portion of the benefit is. Up to sixteen sessions over the course of
a twelve month cycle. And we know from research that most people when they're
utilizing counselling to help them quit smoking they only use three or four
sessions usually on average but we really wanted to make sure that if they tried to
quit and had
a relapse and needed to come back for more counseling that they wouldn't have any
problems with access we also made sure that we didn't require counseling in order
for people to get the medication so so that's that's
a fairly controversial element of the benefit different programs do different
things around that but initially we wanted to make sure that we would be able to
offer the most open access to these services so that we could really evaluate what
works best and then over time see how we might potentially read just the policy to
see if there are other ways that we want to give people access to the search for
media she was right we want
a person to be able to go to their doctor and say I want help quitting and for the
doc to say OK you know hopefully I've got
a counsellor in my office down the hall who you can go and see or if at the time
the provider isn't that knowledgeable they might already know about the Department
of Public Health quick works program which is
a phone counselling support system so they could also say you know I don't have
a counsellor right now but you can get phone counselling through quite works and
many providers might know about it because it works and the Department of Public
Health Program was promoting their phone counseling service statewide to hospitals
all across the state primary prior to the implementation of this benefit so there's
already
a little bit of groundwork that's been done on some level of counseling services
for health members and people all over Massachusetts in the Commonwealth and then
also for the provider to be able to say even if you don't want counselling or
however you want to go about accessing that if if they don't have it in their
office at the time. Of the medications we have this is the information about
medications that might help. You know the benefit covers over the counter
medications like the patch the lozenge and that's fairly unique not everybody
covers over the counter medications those are usually very expensive if you just
buy them at the drug store so we want to facilitate people's process and allow them
to potentially access that medication but there are also. Prescription medications
that can assist people in quitting smoking and we also cover those as part of the
benefit and so it's really don't want to encourage people when they're working on
quitting to partner with their provider to have
a dialogue about what's going to work best for them and to work with their doctor
to make the best decisions in their quit process hopefully they would combine
counseling and medication we know from
a lot of research that that is the most effective way to quit smoking you should
have
a combination of both the rates of quitting increased by fifty percent when people
combine both. For those who are the actual providers for the service what should
what would you advise them as far as to take to get involved revivers for the
counseling service. Could be
a range of medical professions you could have primary care physicians if there
really champions of tobacco cessation they may choose to provide the counseling we
think though it's more likely because primary care clinicians tend to be very busy
and have fairly. Fast moving practices that they might
facilitate having registered nurse or one of their physicians assistants or
possibly
a nurse practitioner in their practice provide the counseling service so that
person would become the counselor in the office if they didn't have one of those
clinically registered stuff available to provide the counseling then
a physician could potentially hire tobacco suspicion counselor and back person
simply means to have a basic level of certification which means to be at
a minimum. Eight hours of training we kept the training minimum low and so that
people could. Go ahead and get the certification I will become counselors I make it
as long as they're under their physician. Supervision and then they can provide
the counseling and the physician is the one who would do the billing and that's the
same in
a community health center or an outpatient department hospital you could hire these
people or you can use people with clinical licenses and then bill for the
counseling under community health center or the or the physician's office medical
here in which there is actually one of. The only police that's doing
a lot of training Yes exactly we are and like I said we partnered with them and so
we knew that they had excellent resources for the training of tobacco cessation
specialists and they actually did that prior to the benefit in training people and
working with Ph And so the counseling is
a major component to this isn't it seems. We really value the
service and we have
a great deal of desire to really encourage people to utilize counseling and we know
that it is
a very effective means of quitting smoking in combination with medication and. So
in that sense it's very unique and it makes this benefit more of.
More and more of a model in comparison to some other status that there's
a whole different range of ways in which states can cover tobacco solution services
they can simply cover the medications they could cover the medications and rely on
. Other counseling but not cover it or reimburse the providers for delivering it
which is more of a comprehensive approach on home yet. Can you discuss
a little bit about what you doing to reach this program for those who are members
will. Consider being members. While we've been working still in collaboration with
the Department of Public Health through the whole project and they have
a great deal of experience also in public health campaigns and so we partnered with
them they recently did. A statewide mass media campaign that included transit and
radio ads they specifically marketed to women in this campaign.
And what they did was they found real people who had had success with quitting
smoking and had their stories and then they had sort of billboards and they made
flyers that
a company of the images and everything and then there was secondary language that
spoke about if you're amounts health member you can get support ask your provider
call this number and so that outreach campaign happened at the beginning of this
year back in summer January. We are currently working on developing an outreach
programme which would probably have
a similar touch and feel we don't want people to be confused about. Smoking
cessation to getting different messages from all sorts of different sources and so
one of the real benefits of working in collaboration with really the other primary
state agency into liver and tobacco cessation services and support is that we can
make sure we have similar messages so the basic message is that we want to
encourage people to quit smoking the fact that mass health numbers have
a service that's available is something we want them to know about and in telling
them they will also hopefully speak to their providers and vice versa providers
will be able to see the mass media information and really you know my myself
members have this new resource but the bottom line is we want to help people quit
smoking and that's really
a major focus so we'll be working on implementing our own campaign to encourage
people to continuously learn about the benefit we also update our website send out
probably looking at redistributing messages to providers and members we have
possible through our system we have
a number of different ways that communicate we can communicate with our providers
there's Rowsley It was discussing earlier the school and need to to move
a solution to making this more of
a permanent longer term program that's correct. Look hopeful yeah it looks
very hopeful I think I think both both the legislature and and myself and D.P.
Each have been pretty encouraged in terms of the numbers that they seem so far.
People utilizing this benefit and we can say that the higher numbers that we can
share with people you do using this the more likely it is to pass you and I think
that there's
a real understanding in the last year or so. The fact that preventive preventive
programs are the way to go help somebody quit smoking now exercising now and in the
long run it's going to cost a lot to treat them and I think there's
a real awareness of that how can people who are interest of the working of this
issue which is to be hopeful. Certainly you may have something to sing about. If
they're interested you mean in terms of making this permanent or any way or in any
way might say call your state legislator and let them now it's easy to reach the
state has
a number six one seven seventy two two thousand to ask for your State Senator Steve
representative let him know that you know about this benefit you know how important
it is and you want them to understand how important it is and certainly if you
contact us tobacco free mass we've got some ideas as well and. That's our website
address it's very good with the time you should Any final comments to wrap up
today's program well I think that you know something that's really important to be
aware of as far as making the benefit permanent as we are looking at evaluating the
success that we've had to date we know that over ten thousand members have used the
benefit which is fairly good news today through one of the things that we've just
to give you
a sense of what that number really means in Mass Health about thirty five percent
of the members smoke that's about twice as much as the state smoking rate however
in an average smoking cessation program that you run you're usually fortunate if
you get
a five percent participation rate and real involvement in the benefits so we feel
pretty confident that we're actually doing
a little bit more than that and giving the members utilizing the benefit of those
numbers are continuing to increase actually each month it goes up anywhere from ten
to fifteen percent right now so the rate is really building and part of that I
think cost to do with the fact that we have been working to outreach and to tell
people about the benefit and to really encourage people something else we'll be
doing is mouse health is going to be encouraging and supporting Mousehole for
members to be involved with overall wellness and part of wellness and having
a healthy lifestyle is being smoke free so if you don't start to smoke don't start
if you smoke see if whatever you can do taking small steps that you. Really
successfully take and so that you can get on the road to quitting and ultimately
that's what we want to encourage people to do and we'll continue to work with
advocacy organizations in the Department of Public Health to really make sure that
we can show through our evaluation on our report that this benefit will hopefully
become permanent and we wish you much success and we're talking
a quality of life or more that voters want the White thank you for joining us we
have. Russell joining us. Regarding the mass health records issues benefits
a Till next time I'm all good as well you know before the seeing you is
a new species has written the big question. For.
The.