Commonwealth Conversations: Health and Human Services

The art of origami and its healing power: 1,000 paper cranes create community at Shattuck Hospital

By DMH Commissioner Barbara A. Leadholm, M.S., M.B.A.

From time to time I have the opportunity as DMH commissioner to share an experience that is in many ways mutually life-changing for the residents of Massachusetts whom we serve and for our hard-working DMH staff.

It all began with a humble proposal to teach a new skill to a small group of patients who comprise the Arts and Social Action Group at Lemuel Shattuck Hospital Metro Boston Mental Health Unit (MBMHU), operated by the Department of Mental Health. In January 2011, this distinct group, with the help and encouragement of Shattuck staff, embarked on the ancient Japanese art of origami, folding paper cranes. The meditative practice of folding paper to create objects blossomed among these budding paper artists: as they completed one, then two, then three, then more cranes, they were empowered and encouraged to reach higher than anyone in the group at Shattuck thought possible: making 1,000 folded paper cranes as a tribute to health and wellness.  

There is a deeper, more profound meaning in this ancient activity. The origin of the project at Shattuck is rooted in the Japanese tradition of entire communities making origami cranes. According to Japanese legend, anyone who folds a thousand origami cranes will be granted a wish, such as long life or recovery from illness or injury. In Japan, it is commonly said that folding one thousand origami cranes can make a person's wish come true – it has also become a symbol of world peace.

The dedicated members of Shattuck’s Arts and Social Action Group began folding cranes in the hospital chapel during the harsh winter days in January and February. Together the small group learned the 26 paper folding steps, slowly and diligently creating 80 paper cranes. During this process, members of the group made wishes for themselves and for the world at large. Some articulated hopes and visions that evolved into songs that the group sang together as they worked: a beautiful and heartwarming way to get through the punishing winter.

In March, it became increasingly clear to the group that in order to reach the goal of making 1,000 cranes, help was needed from a wider circle. Anyone and everyone from all corners of the Lemuel Shattuck Hospital community were invited to help in the quest to fold 1,000 cranes. Every Wednesday morning in March, the Arts and Social Action group set up tables in the hospital’s main lobby for crane making, wish writing and music making.  By showcasing this project into the main lobby, people’s curiosity was piqued and many joined in as they encountered the handful of origami artists working together. Dedication to the project was contagious, and the original group members who were the first students to learn crane folding in the hospital chapel became teachers to others new to origami. The experience was a great equalizer as patients taught doctors, unit staff, security staff, visitors and interns. A new community at Shattuck was born: together, the expanded group created 1,000 paper cranes, collectively made wishes and created beautiful music with people throughout the entire hospital. 

As the weeks passed and winter evolved into spring, the crane-folding community grew larger and stronger. The project, with its humble beginnings, grew as patients and staff learned how to fold cranes, work together, effectively interact with each other and communicate each individual’s unique skills and knowledge to others in the group.  Everyone who participated was touched by the magnitude and teamwork of this project and contributed to a scroll of good wishes, many of which are written inside individual cranes.

After nearly five months of this work by many dedicated hands, the goal of creating more than 1,000 cranes was achieved. To celebrate this community event, on May 11 the Arts and Social Action Group and the entire Shattuck Hospital community celebrated their achievement with a ceremony and installation in the hospital lobby of every paper crane created.

The community came together once again as they sang, made wishes together and hung more than 1,000 cranes, stringing them together with sparkling beads hanging from the ceiling: it’s now the first thing visitors, staff, patients and families see when entering the hospital. The cranes are an artful representation of wishes from the hearts and souls of many, and it is installed with the hope that it will bring joy, inspiration, health and wellness to everyone who passes by and witnesses its magnitude.  

I am very grateful to everyone who participated in this inspiring, beautiful project. To quote Joel Skolnick, chief operating officer of DMH’s MBMHU at Shattuck, “This amazing project could not have been done without the strength and unity of the entire Shattuck Hospital community and the people who came together to make it all happen, especially staff in the occupational therapy department Sharon Gaffney, Jenny Murphy and Caryl Beth Thomas.”

There are so many lessons to be learned here, and all of them are grounded in the simple act of folding paper to make a crane, to make a wish and to spread the hope of recovery.

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Health benefits of electronic medical records outweigh risks

By Dr. JudyAnn Bigby

This week a Boston Globe editorial urged readers not to lose sight of the need for electronic medical records, despite the recent demise of Google Health. The editorial noted that lack of consumer interest in the service as the reason Google Health failed.

There is growing momentum in Massachusetts and other states to migrate to a system of electronic health records. In February 2010, Massachusetts was awarded $24 million to develop a Regional Extension Center, designed to assist 2,500 priority primary care physicians to achieve ‘meaningful use’ of electronic health records and create a statewide Health Information Exchange. The exchange will ensure that clinical information is secure and accessible to providers and consumers.   In addition to offering financial assistance to physicians, Massachusetts also passed legislation requiring the adoption of EHRs by 2015 for all hospitals, health centers and physicians.

Massachusetts is also fortunate to be home to some of the world’s most advanced technology companies including those specializing in electronic health records.  Many of these companies and businesses participated in Governor Patrick’s second annual health information technology conference earlier this year.  Creating public/private partnerships is essential to a thorough migration to EHRs.

One of the keys to reigning in skyrocketing health care costs that continue to threaten the state’s economy, impede the ability for small businesses to create jobs and burden families, is to find innovative ways to change the existing model and tackle persistent costs. Electronic health records can play a significant role in reducing healthcare costs; migration to a universally electronic environment would also stimulate job growth.

While there have been challenges to the migration toward, and maintenance of, EHRs – witness Beth Israel Hospital’s recent security breach where more than 2,000 patient records may have been compromised (see Boston Globe story here) -- this transformative technology is critical to helping providers reduce paperwork, improve accuracy, and spend more time with patients. It’s essential that we update management of our health care system so it is aligned with the 21st century. Being able to coordinate services through electronic management and exchange of information would mean an ability to provide better care for patients and ultimately, lower costs to consumers for quality care.

Individuals with meaningful access to their personal health records will be better participants in decisions about their care. Personal health records must be accessible, understandable and easy to maintain and keep current. They also must remain private and secure. The demise of Google Health should not deter migration to electronic health records; it just means we need to keep trying until we get it right.

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Changing families’ lives, one child at a time

By DCF Commissioner Angelo McClain

Recently, the Winchester Star profiled a local foster family that has made a significant difference in the lives of children. Eight years ago, Neilani and Doug Simpson made the decision to serve their community, and the Commonwealth, by providing a safe and loving home to children in need. The Simpsons have significantly improved the lives of 16 children who they have welcomed into their home and into their hearts. We are all impacted, and our lives made better, by people like Neilani and Doug Simpson, for their generosity and commitment to helping others. I am grateful for their service to the children of Massachusetts.

To read the heartwarming profile of the Simpsons, click here.

There is an ongoing need for caring families to open their homes and hearts to foster children. To learn more about becoming a foster or adoptive parent, please call 1-800-KIDS-508 or visit www.mass.gov/dcf. If you think you may be interested, please call. Our foster care recruitment staff would be happy to talk to you about your interest and help you to determine if becoming a foster parent is right for you and your family.

On behalf of the Department of Children and Families, I want to express my sincere thanks to all the residents of Massachusetts who have shown their commitment to kids by becoming foster families.

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DYS clients discover the transformative effect of yoga

By Heather Wise

For the past year, boys involved with the Department of Youth Services (DYS) have experienced the transformative effect of yoga. A new yoga program has become an integral part of residential life at Casa Isla, one of DYS’ secure residences for adolescent boys located in Boston.  In just one year, the pilot yoga program has shown some very positive outcomes. After a month of the program’s inception, not a single incident of assault or restraint has occurred for any of the yoga participants. Testimonial from all DYS clients at Casa Isla reflect participants’ greater self-awareness and the belief that yoga practice has been beneficial and tremendously useful -- both on and off the yoga mat. They also indicated an interest in continuing their practice once they re-integrate into their communities.

According to Theresa Conti, Program Director at Casa Isla, DYS clients have noticed changes within themselves.  Many have shared that they have discovered an ability to slow themselves down, clear their minds and/or be able to calm themselves more readily.  More recently, Casa Isla residents practicing yoga have begun making a point of coming to yoga when angry or frustrated and found that when they do, they say they feel better and recognize the value and calming effect of yoga practice. Clients also report that after doing yoga stretches they experience a kind of release –  a positive feeling – and that they are using yoga more to alleviate bad moods.  They also say that the practice helps them feel that they can get through something difficult, ultimately building their self-confidence. Kids who participate regularly notice that there are days when they can do more and days when they can’t. Alluding to greater self-awareness they say they are, “noticing differences in themselves.”

Overall, the experience of offering yoga to boys at Casa Isla has been overwhelmingly successful. The program was made possible through a generous grant from the Romano Family Foundation DYS recently learned that this grant has been extended through 2012, and the agency looks forward to continuing to offer these opportunities to clients at Casa Isla.

Heather Wise recently completed a Communications fellowship at the Executive Office of Health and Human Services

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Health care reform’s impact: Massachusetts outpaces national rate of employers providing health coverage

By DHCFP Acting Commissioner Seena Perumal Carrington

Earlier today, we released the results of the Massachusetts Employer Survey 2010.  This report provides information on employer health insurance offer rates, employee take up rates, health insurance premiums, employer contribution amounts, and employee cost sharing requirements.  DHCFP has administered the survey on a biannual basis since 2001, and annually since 2009.

The findings reflect the vital role of Massachusetts employers in the state’s health care reform effort. In 2010, Massachusetts employers continued to offer health insurance to their employees at a higher rate than their counterparts nationwide (77% versus 69%).  It is worth noting that our employer offer rate has steadily increased since the implementation of Massachusetts health reform – it was 70% in 2005.  Although employee contributions toward health insurance have risen since 2001, the recent median monthly employer contribution for an individual health plan saw a reverse in this trend – increasing from 72% in 2009 to 75% in 2010.  About three-quarters of employees who were eligible for their employer’s health insurance coverage chose to enroll in the plan.  These results demonstrate the continued commitment of Massachusetts employers to ensuring access to coverage.

The report also highlights some of the challenges associated with rising health care costs.  Since 2001, the median monthly premium for individual health plans has nearly doubled.  Similarly, during that same time period, emergency room copayments have more than tripled, copayments for inpatient hospitalizations have risen six-fold, and co-payments for prescription drugs have doubled.   In February, Governor Patrick comprehensive health care cost containment legislation designed to help control costs and improve patient care by reforming the health care payment and delivery systems. 

To learn more about the Governor’s bill, click here.

As we all know, containing health care costs is important to ensuring the continued success and sustainability of health care reform, and such efforts rely upon the ongoing engagement and support of the employer community.

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Health resource planning and payment reform: taking steps to improve quality and control the costs of health care

By DPH Commissioner John Auerbach

Here in Massachusetts, we’re fortunate to have access to some of the best health care in the world, and more and more people have access to care due to the success of health care reform.  But the cost of health care remains too high and, too often, focused on expensive, high-tech or inpatient procedures rather than primary and preventive care delivered in a medical home.  To address these concerns, Governor Patrick filed a comprehensive health care cost containment bill last February.

The Governor’s proposed legislation includes a number of important provisions that will not only control unnecessary costs but also promote high quality care.  One area involves the establishment of a comprehensive health resource planning initiative.  

This particular initiative would provide more resources for state agencies to gather reliable data on how our health care system is meeting the needs of our population – and how that system can be better positioned to meet our needs in the future.

Currently, the Department of Public Health and the Division of Health Care Finance and Policy have only limited abilities to collect and analyze in-depth data on health care usage trends and future needs in Massachusetts. The Governor’s health care cost containment bill would change that.

Under the Governor’s plan, the state would have the ability to take a closer look at changes in specific demographics within the state’s population, for example, the total number of folks who are over 65. We’ll also be able to better analyze trends in illness and injury across the state, such as how many of us are living with diabetes. A health resources planning initiative would also help us keep more detailed track of the current availability of health care services and procedures – such as an MRI or dialysis – in our communities. And that’s just a sample.

But data is only as valuable as our ability to understand and act upon it. Towards that end, we’ll work in close partnership with health care experts and consumers across the state to produce regular reports that explain what we’re seeing, identify trends, and make recommendations for moving forward.

All this will help us make informed decisions about health care resources, so that the health care system will help keep Massachusetts healthy in the years ahead.

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In the wake of a federal disaster declaration, a rapid response to help thousands

By DTA Commissioner Julia Kehoe

On June 1, several tornadoes and severe thunderstorms devastated communities in Central and Western Massachusetts and left thousands of residents and businesses without power, surrounded by destroyed property, and homeless. Immediately after the storms, the Department of Transitional Assistance (DTA) took the lead in establishing three Storm Assistance Centers in Monson/Palmer, Southbridge, and Springfield.  These centers, open seven days a week, provided a variety of services, such as food assistance, housing, unemployment assistance, and mental health services.  More than 5,000 households received assistance at these centers through June 16.

On June 15, President Obama declared a federal emergency in Hampden and Worcester Counties.  As a result of this declaration, DTA could administer Disaster SNAP (D-SNAP), a one-time food assistance benefit from the U.S. Department of Agriculture that is provided through Electronic Benefits Transfer (EBT) cards.  These cards can be used in the same manner as a debit or ATM card to purchase food at a supermarket, grocer, or farmers’ market that accepts SNAP. 

To administer D-SNAP as quickly as possible, DTA transformed the three Storm Assistance Centers into Disaster SNAP sites, and added a second D-SNAP location in Springfield.  Working from tents pitched in the parking lots of the storm centers, DTA staff assisted more than 16,000 households in just seven days.

At all of the sites, I witnessed unparalleled teamwork and incredibly compassionate customer service.  Despite working nights and weekends for several weeks, DTA staff were energized and fully committed to assisting individuals and families affected by the storms.  Specifically, I would like to thank all of the Transitional Assistance Office (TAO) Directors and Assistant Directors; the Supervisors, Case Managers, Clerks and Human Service Assistants who worked on the front lines; the Regional Directors; Assistant Commissioners; and Deputy Commissioners. 

I would also like to thank all of the staff in the TAOs and Central Office Units who offered critical support throughout the D-SNAP effort, notably the Holyoke, Greenfield, Lowell, North Shore, Plymouth, Taunton and Worcester TAOs as well as Administration and Finance; Field Operations; Legal Division; Management Information Systems (MIS); Policy, Programs and External Relations (PPER); and Program Integrity.  The entire DTA staff across the Commonwealth worked together to ensure efficient and expedient intake and processing of D-SNAP.

I have always been impressed and humbled by my colleagues’ dedication.  They work every day to serve more than 810,000 people across the state – one out of every eight Massachusetts residents.  Their response to the storms has been truly remarkable.  DTA staff demonstrated incredible energy, grace, and compassion in the aftermath of the tornadoes and truly went above and beyond the call of duty to assist thousands of people in dire need. 

The last day the Department could accept Disaster SNAP applications was Friday, June 24.  Anyone seeking assistance regarding his or her pending application should call the DTA Hotline at 1-800-445-6604.

 

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Remembering veterans’ sacrifices to the nation this Independence Day

By Chelsea Soldiers' Home Commandant Michael Resca

“This nation will remain the land of the free only so long as it is the home of the brave.”

 -Elmer Davis, reporting on World War II

The Governor’s Advisory Council on Veterans’ Services recently held its annual regional meeting at the Chelsea Soldiers’ Home.  The Council works on programs for Veterans and the delivery of essential services to Veterans, including health care, education, housing, outreach through regular community meetings, and workforce training and retraining. The men and women on the Council are dedicated to ensuring that Veterans throughout the Commonwealth receive the resources they deserve. 

To kick off the annual meeting, Chelsea Soldiers’ Home Chief Operating Officer Betty Anne Ritcey welcomed Lieutenant Governor Timothy P. Murray, as well as the many distinguished Veterans and advocates in attendance.  

State Representative and Chairman of the Joint Committee on Veterans and Federal Affairs Jim Vallee (a Veteran himself) attended and spoke about the various bills currently before his committee and its efforts to support his fellow servicemen and women, “I fully recognize and acknowledge the selfless sacrifice of my fellow soldiers who have given and continue to give so much more than me," Representative Vallee said.

Department of Veterans’ Services Secretary Coleman Nee, a frequent visitor to the Home, spoke to the many familiar faces, stressing that he knew how incredibly hard staff at the Home work every day to ensure Veterans receive the care they need and the benefits they have distinctly earned.  Colonel Frances Magurn, chief of staff for the Massachusetts National Guard, reported to attendees on the Deployment Cycle Support Office and provided an update on the services available at the Military & Family Support Center.  Christine Croteau, acting director of the Bedford VA Medical Center, talked about realigning VA services so they are centralized in Boston for Veterans throughout the state. 

Brigadier General Paul Smith, the Assistant Adjunct General of the Massachusetts Army National Guard, talked about the devastating impact of the tornadoes in Western and Central Massachusetts earlier this month and heroic responses by so many. 

“As Chair of the Governor’s Advisory Council on Veterans’ Services, I appreciate the opportunity to meet Massachusetts Veterans and thank them for their service throughout the year,” said Lieutenant Governor Tim Murray. The Lieutenant Governor also pointed out that the recent heroic storm recovery efforts by the Massachusetts National Guard typified the dedication of the state’s armed forces. Lieutenant Governor Murray also acknowledged the great sacrifice of our military servicemen and women, and thanked all of the meeting’s attendees for raising awareness about resources and benefits available to Veterans and their families.

On behalf of the more than 450 men and women living at the Chelsea Soldiers’ Home and our entire staff, we look forward to sharing more in this blog space about the many projects, program and events happening at the Home.

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