Massachusetts Pain Initiative ( Annual Report

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Massachusetts Pain Initiative (www.masspaininitiative.org) 2017 Annual Report 2018 MassPI Steering Council Members Ann Marie Harootunian, MS, RN, FNP Co Chair, Steering Council Acting Co-Chair, Education Council Claire Sampson, RN BC Co Chair, Steering Council Mary Jane Estrada Lyder, MSN, ANP BC Co Chair, Education Council Cyndie Rodman, MS Chair, Communication Council; Webmaster Cindy Steinberg, BA, BS Chair, Policy Council To Be Filled Chair, Membership Council Ellen McCabe, RN, CHPN HopeHealth Liaison Kathy DellaPenna, MSW Treasurer Peggy Flood, MS, RN BC Member-at-Large Betty Morgan, PhD, PMHCNS, BC Member-at-Large Ginger Newell Stokes, MS, RN Member at Large Terry Layden Administrative Assistant MassPI s Mission The Massachusetts Pain Initiative (MassPI) is a statewide, nonprofit, volunteer organization dedicated to ending needless suffering from persistent and acute pain and to improving the quality of life for all people affected by pain. Who We Are MassPI is a Division of HopeHealth, Hyannis, MA. Our members include healthcare professionals and community members, including doctors, nurses, social workers, people with pain, caregivers, and advocates who are interested in helping people with pain. - 1 -

2017 Retirements of Long-Standing Leaders from the MassPI Steering Council Three key former leaders of MassPI and valuable ongoing members of the Steering Council retired in 2017 after decades of service. They were instrumental in developing and building MassPI over the years and two were recognized by the former national organization, The Association of State Pain Initiatives (ASPI), for their exemplary efforts, dedication, and contributions to pain management. They brought their professional pain management experience (clinical, education, and consulting) and leadership skills to benefit the efforts of MassPI. Their expertise and contributions were instrumental in helping MassPI fulfill its mission to advocate for Massachusetts patients suffering with pain and educate health care providers about pain management. We thank them for their numerous invaluable contributions to MassPI and wish them the very best. Carol P. Curtiss, MSN, RN-BC MassPI Roles include: Founding Member of MassPI; Steering Council Chair; long standing Consulting Chair; Co-Webmaster Leader of the former national Association of State Pain Initiatives (ASPI) MassPI-Related Recognition: Association of State Pain Initiative Distinguished Service Award (top ASPI award for outstanding long-term contributions to the state pain initiatives and the national organization) Jeanne Connolly-Horrigan, MS MassPI Roles include: Steering Council Co-Chair; long time Webmaster Anne Marie Kelly, MSN, RN-BC, CHPN MassPI Roles include: Steering Council Co-Chair; Membership Chair MassPI-Related Recognition: Association of State Pain Initiatives State Champion Award Education Council Co-Chair: Mary Jane Estrada-Lyder, MSN, ANP-BC Acting Co-Chair: Ann Marie Harootunian, MS, RN, FNP Council Purpose: The primary purpose of the Education Council is to lead the development of pain education programs to inform health care professionals about relevant pain assessment and management topics. These programs feature expert speakers, provide professional continuing education credits, and are offered twice a year in the spring and fall. Additional activities led by the Education Council include: Updating the very popular Pain Management Pocket Tool for distribution to healthcare professionals. Over 5,000 tools have been distributed thus far. Updating the Pain Resource Guide of major pain clinics throughout Massachusetts for the benefit of people suffering from pain who are seeking a variety of treatments. Presentations and workshops are available by specially trained MassPI members in a variety of settings through MassPI s Power Over Pain ( POP ) Education Project and a consumer version for the general public. These programs can be offered throughout Massachusetts upon request. Activities: MassPI Pocket Tool: The MassPI pocket tool continues to be a very popular resource that is distributed throughout the country and internationally as well. - 2 -

Pain Resource Guide: The Pain Resource guide identifies clinics that specialize in treating pain In the state of Massachusetts and is available on the MassIPI website. Ginger Newell-Stokes lead a major update for this guide in 2017. The newly updated Pain Resource Guide was introduced in early January 2018 and is available for download from the MassPI website. Education Council Members: This Council is made up of members, in addition to the co-chairs, who are interested in helping to develop the content and select the speakers for the upcoming education conferences. We are always interested in having additional people join this council to be able to provide input and perspective on creating the strongest educational programs with relevant topics for healthcare providers. Education Programs: Spring Program 2017: Full day meeting presented by MassPI Title: Stop the Swing: Solutions for Confident Pain Management in 2017 Date: Wednesday, April 5, 2017 Location: Holiday Inn Hotel & Suites, Marlborough, MA Continuing Education Credits: 7 CME Physicians/7 CE Nurses, social workers, and psychologists Presenters: Daniel B. Carr, MD, Professor of Health and Community Medicine, Director of Pain Research, Education, and Policy ( PREP ) Program, Tufts University School of Medicine Pain in 2017: Standing Up to the Challenge (Keynote Address) Paul Arnstein, RN, PhD, FAAN. Director of MGH Cares about Pain Relief, Massachusetts General Hospital; Certified Family Nurse Practitioner, Clinical Nurse Specialist, and Pain Management Nurse Prudent Opioid-sparing Therapies: An Evidence-based, Strategic Approach Erica Beal, MD, MS, Director, Non-Surgical Spine Care, Dept. of Neurosurgery, Lahey Hospital and Medical Centers Practical Magic: Delivering Compassionate and Effective Care... Without Opioids Omar Allibhai, PharmD, RPh, FACA, FIACP, Registered Pharmacist, Johnson Compounding & Wellness. First pharmacist to complete a 2-year Post-doctoral fellowship in Pharmacy compounding in the nation. Compounded Transdermal Pain Therapy Kathryn Giblin, MD, Neurologist and Interventional Pain Specialist, Boston Headache Institute, Boston PainCare Center, and Jordan Backstrom, M.Div., PsyD, Clinical Psychologist, Boston Headache Clinic, Boston Headache Institute, Boston PainCare Center, Tufts School of Dental Medicine Co-Evaluation and Interdisciplinary Evaluation and Management of Persistent Headaches David Gilchrist, MD, MBA, FAAFP, CPE, Assistant Professor, Dept. of Family Medicine and Community Health, Umass Memorial Healthcare Weaning Off Opioids A panel discussion followed to share strategies. The program was well received by the participants. - 3 -

Fall Program 2017: Full day meeting presented by MassPI MassPI 2017 Annual Report Title: Managing Pain from the Inside and Out Date: Thursday, October 26, 2017 Location: Holiday Inn Hotel & Suites, Marlborough, MA Continuing Education Credits: 5.5 CME Physicians/5.5 CE Nurses, social workers, and psychologists Presenters: John Otis, PhD, Associate Professor and Director of Behavioral Medicine Program, Center for Anxiety and Related Disorders, Boston University. Managing Chronic Pain: A Cognitive Behavioral Therapy Approach Maurice Bernaiche, DO, Physical Medicine and Rehabilitation specialist, New England Sports, Orthopedics, Spine & Rehabilitation Jayne Pawasauskas, PharmD, BCPC, Clinical Pharmacy Specialist, Kent Hospital and Clinical Professor of Pharmacy, University of Rhode Island College of Pharmacy Pain Management: Clinical Pearls & Hospital-Specific Protocols Anne Lynch, APRN-BC, FNP, Nurse Practitioner, Board Certified in Pain Management, Newton-Wellesley Hospital Spine Center and Pain Management Services Department Managing Pain from the Inside and Out A question and answer session followed to address issues raised by the speakers presentations. The program was well received by the participants. Chair: Cindy Steinberg, BA, BS Policy Council Council Purpose: The Policy Council s primary goal is to advance pain management in the Commonwealth through public policy. We accomplish that by: Educating lawmakers on pain management issues Helping to advance legislation that will result in improvements in pain care Identifying legislative opportunities for and barriers to improving pain care and taking action on them Providing advice on pain management regulatory issues to public health officials by appointment to and participation on Commissions, Boards and Working Groups Legislative Activities This year marked the beginning of a new legislative session. The MassPI Policy Council reviewed approximately 60 relevant bills and decided to follow and take positions on about 10 priority bills categorized into the following topic areas: pain management-related; alternative therapy; opioid-related; and pharmacy benefit management-related. We worked with Representative Jay Kaufman to reintroduce our Patients Rights Bill H1181/S1183 which would amend the Commonwealth s Patient Rights Law (MGL Chapter 111, Section 70E) to ensure that every patient or resident of a healthcare facility would have the right to prompt assessment and treatment of his or her pain with subsequent reassessment to ensure the treatment plan s safety and efficacy. We were pleased that Senator Julian Cyr agreed to introduce the companion bill in the Senate. Three MassPI professionals Cindy Steinberg, Policy Council Chair, Dr. Paul Arnstein of Massachusetts General Hospital and Dr. Libby Bradshaw of Tufts University School of Medicine as well as two patients living with chronic pain testified in support of this bill at the hearing of the Joint Committee on Public Health in December, 2017. - 4 -

This year MassPI worked with Senator John Keenan and Representative Smitty Pignatelli and their staffs on modifications to S1100/H565, a pain management bill, which would, among other provisions, require public and private insurers to develop plans that provide adequate coverage and access to a broad spectrum of pain management services, including non-pharmacological therapies. In November, 2017, Governor Charles Baker introduced his new opioid-related bill, H4033, entitled the CARE Act for Combating Addiction, Accessing Treatment, Reducing Prescriptions and Enhancing Prevention. We are pleased that the bill proposes many measures to aid those with substance use disorder and improve addiction and recovery services but disappointed that the bill does not include any provisions to aid MA residents living with chronic pain. Many of these chronic pain sufferers have been stigmatized and some have even lost care providers regardless of whether they use opioids for pain relief. Many who have used opioids appropriately for pain relief and have benefitted from their use have been tapered or removed from these medications simply because their prescribers are fearful of sanctions for prescribing. MassPI would like to see provisions added to this bill to improve the care of people living with pain. For example, the Keenan/Pignatelli bill discussed above improving access to a broad spectrum of pain management services and the Chapter 52 Pain Access Commission recommendation to the legislature to pilot a program that would cover the cost of free pain management specialty consultation for Primary Care Providers (PCP s) to improve their care of people with pain would be laudable additions to this bill. MassPI plans to testify at the hearing for H4033 scheduled for early 2018 and to work with lawmakers during the second year of this legislative session to make improvements in this bill. The MassPI Policy Council will work towards passage of the bills we support during the remainder of this legislative session. Regulatory Activities Three Policy Council members, all appointed by Governor Baker, serve on the MA Drug Formulary Commission which is a permanent commission established by the legislature. They are Cindy Steinberg, Policy Council Chair, Dr. Dan Carr of Tufts University School of Medicine and Dr. Doug Brandoff of Dana Farber Cancer Institute. The MA Drug Formulary Commission meets monthly year-round and is charged with developing a formulary of abuse deterrent opioid medications which are substitutes for non abuse deterrent opioid medications. The commission is also charged with publishing and updating annually a list of non opioid medications that are appropriately used for pain management. During the first half of 2017, MassPI worked with the Bureau of Health Professions Licensure and the Board of Registration in Nursing on a revision to Advisory Ruling (AR) 0901 on the Management of Pain. AR 0901 guides the practice of nursing in promoting access to appropriate, effective assessment, diagnosis and management of acute and chronic pain and to improving communication about the benefits and risks of therapy. The final revised AR was issued in May, 2017. Policy Council Leadership Advisory Group The MassPI Policy Council Leadership Advisory Group (LAG) was established in 2016 to provide strategic advice to the Policy Council on pending legislative, regulatory and other pain policy matters that are within the purview of the Council. The Policy Council is pleased to have this exceptionally talented and knowledgeable team. Members include Dr. Dan Carr, Dr. Bob Cohen, Dr. Libby Bradshaw, Dr. Paul Arnstein, Dr. Doug Brandoff and Marybeth Singer MS, NP. - 5 -

Governor s Proclamation MassPI received a Proclamation from Governor Baker declaring September, 2017, Pain Awareness Month in Massachusetts. MassPI led 10 other pain organizations in a collaboration on the proclamation including: U.S. Pain Foundation Tufts University School of Medicine's Program on Pain Research, Education and Policy American Chronic Pain Association National Fibromyalgia and Chronic Pain Association Academy of Integrative Pain Management American Society for Pain Management Nursing American Academy of Pain Medicine American Cancer Society Cancer Action Network American Pain Society American Society for Pain Management Nursing Eastern Massachusetts Chapter Communications Council Chair: Cyndie Rodman, MS Webmaster and Social Media: Carol Curtiss, MSN, RN-BC and Jeanne Connolly-Horrigan, MS (until mid-2017); Cyndie Rodman (after mid- 2017) Council Purpose: To provide strategic expertise and implementation assistance with internet and external communication, PR and media efforts, website maintenance (webmaster), and development and maintenance of MassPI s presence at strategic opportunities in social media. Major Activities: Transitioned from MassPI s long-time co-webmasters, Jeanne Connolly-Horrigan and Carol Curtiss, to Cyndie Rodman. Made additional changes to the 2016 redesigned website that improved key communications of upcoming educational programs. Worked in collaboration with Ginger Newell-Stokes to complete and verify the updated Pain Resource Guide with new web links. Updated the MassPI Pocket Tool order form. Ongoing Activities Maintained the website with updated information needed to keep the site current with MassPI activities and important news about pain management in Massachusetts. www.masspaininitiative.org Maintained MassPI s presence in social media on Facebook and Twitter pages. This is used primarily to communicate about upcoming educational programs and news about MassPI and pain management issues. Facebook: Massachusetts Pain Initiative Twitter: @Mass_PI - 6 -

Membership Council (Volunteership) Chair: Anne Marie Kelly, MSN, RN-BC, CHPN (2017) To Be Filled (2018) Council Purpose: To recruit volunteers who are interested in actively participating on councils/committees and to increase membership of professionals in all areas related to providing effective and appropriate pain management to patients in need and education of health care professional education. Both volunteers and members are critical to facilitate the continued effectiveness of MassPI and its long term sustainability. Membership in the organization is free. Volunteer Opportunities MassPI has many volunteer opportunities for members who are seeking to help persons in Massachusetts suffering in pain, including, educating healthcare providers, raising community awareness about pain management working with state government officials to improve policies related to pain care, and communicating about pain management issues through the web site and social media. Any amount of time a volunteer can provide is most helpful and greatly appreciated. Specific volunteer opportunities are listed on the MassPI website. Please visit the website for more detailed information. Members who volunteer their time find it to be a very enriching and rewarding experience. If you are interested in volunteering, please email your name,contact information, and area of primary interest to info@masspaininitiative.org. Benefits of Membership: Online access to MassPI newsletters and annual report Email updates on pertinent legislative issues, education programs and more Website access to pain management resources in Massachusetts Access to MassPI pocket tool Continuing education credits offered at education programs Networking opportunities with leaders in pain management Opportunity to participate in MassPI councils and committees. Membership Application To increase efficiency, the application process to become a MassPI member has been simplified by providing a link to an electronic membership application which is available on the MassPI website. Respectfully submitted by, MassPI Steering Council Members April, 2018-7 -