UMass Hospital/Medical School

You asked for information on the University of Massachusetts Health Center (medical school and hospital), particularly its activities addressing the medically uninsured and underinsured.

UMass Memorial Health Care, Inc. (UMMHC) is the clinical partner of the University of Massachusetts Medical School (UMMS) and the largest health care system in central and western Massachusetts. UMMHC is a not-for-profit, integrated health care system designed to provide all levels of healthcare. It provides care through the UMass Memorial Medical Center (UMMMC) and its member hospitals (Clinton, Health Alliance, Marlborough, and Wing Memorial). Further health care services are provided by UMass Memorial Medical Group, University Commons Nursing Care Center, Fairlawn Nursing Home, Highlands Long-Term Care Facility, Community Healthlink, Diversified Visiting Nurses Association, and UMass Memorial Home Health and Hospice.

UMass Memorial Health Care is involved in a number of activities to improve the health status of all those it serves and to address the health problems of the poor and medically uninsured populations. In addition, it addresses nonmedical conditions affecting the health and wellness of the community. These activities, outlined and explained in its annual “Community Benefits” report (see attached), follow the community benefit guidelines for not-for-profit acute care hospitals, as outlined by the state attorney general’s office.

UMass Memorial Medical Center is comprised of the Memorial, University, and Hahnemann campuses, all located in Worcester. The Office of Emergency Medical Services accredits UMMC as the region’s only designated Level I Trauma Center. The University campus includes Life Flight, a hospital-based air ambulance. The Memorial campus houses the region’s only Level III Obstetrical and Newborn Intensive Care Unit.

UMMC has 761 licensed beds and 54 bassinets on the three campuses. It also operates a 26-bed mental health unit at Worcester State Hospital.

UMass Memorial Medical Group has more than 700 physicians, including the practices of over 175 employed physicians and nurse practitioners in 20 of the region’s cities and towns and more than 600 UMass Memorial-based physicians.

UMass Medical School, founded in 1962 by an act of the legislature, is the only public medical school in the state. Its first class was accepted in 1970 and today it has three schools—the Medical School, the Graduate School of Biomedical Sciences (1979) and the Graduate School of Nursing (1986). In 2003, a total of 407 medical students, 17 PhD/MD students, and 531 residents and fellows trained at the medical school. The residency programs, administered by the University, provide training in many specialties such as surgery, obstetrics, pediatrics, internal medicine, emergency medicine, psychiatry, and family medicine.

According to the “2003 UMass Memorial Health Care Community Benefits Report,” UMMS ranks high in training primary care physicians due in part to a curriculum emphasizing early exposure to community practice, beginning with the first year of medical school. Third-year students are required to complete a clerkship rotation program in which they spend six weeks at a time with community-based physicians.

The 2003 community benefits report also notes that “given the magnitude of the region’s crisis in oral health and dental care access, the University of Massachusetts Medical School is working with several academic, clinical and community programs to provide oral health care for populations in need of acute services” (see p. 16 of report). Also, the medical school’s Department of Family Medicine and Community Health is reviewing the possibility of establishing a program in oral health that will integrate oral health education into its teaching programs.

UMass Memorial Health Care’s community benefit mission statement states that it “is committed to improving the health status of all those it serves and to addressing the health problems of the poor and other medically underserved populations. In addition, nonmedical conditions that negatively impact the health and wellness of our community are addressed “ (p. 16).

The 2003 Community Benefit Plan focused on addressing health care issues affecting the underserved youth population, a group identified as most at risk by the Worcester Wellness Coalition. Critical issues identified for this population include high teen pregnancy and sexually transmitted disease rates, lack of violence prevention programs, lack of mental health services, access to higher education, access to public transportation, and reduction of substance abuse services. Also, three crucial areas were identified through the “Pathways to Progress Report”: child well-being (school readiness, mental health, and out-of-school time); workforce readiness (job training and transportation); and housing (neighborhood stabilization, affordable housing, and homelessness).

1. medical interpreter services;

2. mobile medical and dental services;

3. “Healthy Communities Initiatives”;

4. community-based and school health centers;

5. literacy initiatives;

6. teen and youth programs;

7. injury and violence prevention and awareness;

8. children’s health, protection, and wellness initiatives;

9. programs for uninsured, underinsured, indigent and homeless;

10. infant mortality reduction;

11. access to specialty care; and

12. elder care services.

The report defines a “healthy community” as one “that is safe with affordable housing and accessible transportation systems, work available for all who want to work, a healthy and safe environment with a sustainable ecosystem and a community that offers access to health care services which focuses on prevention and maintaining health” (pp. 19-20).

UMass Memorial works with other organizations “that know firsthand what the local health issues are and can provide UMass Memorial with insight into the needs and desires of the residents” (p. 20). UMass Memorial uses an outreach worker model, with staff developing relationships with residents in neighboring communities and incorporating the following goals and objectives:

1. develop programs to prevent root causes of disease,

2. assist residents with public health insurance enrollment and accessing primary care services,

3. educate residents to improve their access to services,

4. increase dental access by working with area dentists and health centers,

5. support literacy and mentoring programs at neighboring schools for at-risk families,

6. develop internship programs for job placement of youth and neighborhood residents, and

7. stabilize neighborhoods by involving residents in activities focused on neighborhood cleanup and crime watch programs.

(More detail on these activities can be found in the 2003 community benefits report attached. )

The Patient Access Services Department of UMass Memorial Medical Center has dedicated resources to help the uninsured/underinsured with the enrollment process and eligibility requirements to qualify for public insurance and assistance. The staff screens for MassHealth, Healthy Start, Social Security, pharmacy assistance, disability, and referrals to the Department of Transitional Assistance. Staff also coordinates services with social workers, case managers, drug assistance coordinators, community health center staff, and state agencies. (A comprehensive catalog of health care programs for uninsured and underinsured individuals in Massachusetts is attached. )

In fiscal year 2003, UMass Memorial Medical Center provided a total of $ 18. 5 million in free care and emergency bad debt. Physicians employed by UMMHC provided $ 15. 4 million of free care and bad debt.

The Medical Center’s Department of Social Work, Patient Care Fund, made available to patients home intravenous therapy, prescription medication vouchers, independent taxi vouchers, and adjunct medical services based on financial need.

Free prescription drugs and samples from pharmaceutical companies were dispensed to patients without sufficient resources. In addition, the pharmacy staffed a patient information telephone line and answered questions from the community concerning drug overdoses, side effects, and general information.


August 10, 2004		2004-R-0645
UMASS HEALTH CENTER

By: John Kasprak, Senior Attorney