Senator Tackling Opioid Crisis, an Interview with Jen Flanagan (D-MA)

Senator Flanagan has been a leading proponent and champion in her state on issues that involve setting mental health policies and more recently in passing two key bills on the opioid crisis. The first, An Act to Increase Opportunities for Long-Term Substance Abuse Recovery, provides people with an opportunity to access treatment. As well as An Act Relative to Substance Use Prevention, which seeks to avert people away from substances.

Q.  Tell us a little bit about yourself and what has driven your passion around the issue of opioid use? Is there a personal connection that has inspired you to work on the opioid epidemic?

A.  There is no personal issue per se, I get asked that a lot. I actually came about it from a side door. Growing up, I am the daughter of an ER Nurse and witnessed first hand the impact of accidents involving drugs. I knew I couldn’t be a nurse, I just can’t handle blood and guts, but I wanted to be on the recovery side of mental health. I specifically recall a story of a 14-year-old cocaine addict. Her mom was her supplier, whereas my mom was a nurse helping people, what a contrast! I then thought about becoming an attorney, to learn more about the law and go after those that abuse children. I eventually graduated from college with a degree in political science and began as a legislative aide for the Massachusetts’s House of Representatives.   This was followed by my obtaining a master’s degree in mental health counseling while remaining in public service. It’s just my passion to help people!

Let’s move into some background on what’s happening in Massachusetts. Unintentional opioid-related deaths continue to increase. The estimated rate of 17.4 deaths per 100,000 residents for 2014 is the highest ever for unintentional opioid overdoses & represents a 228% increase from the rate of 5.3 deaths per 100K in 2000. Since 2004, 6600 members of your communities have died of an opioid overdose.

Q.  What is driving this trend from your perspective in MA? And do you view the issue within your state any different than neighboring states in this regard?

A.  Our state has had a Mental Health & Substance Abuse Committee in place for over 10 years. The problem is that it only addressed chronic disease. People that needed help with addiction and detox couldn’t get into treatment, many were dying. So in 2014, we made access easier.  Insurance did not want to cover 5 days of detox or post detox but the problem is that tolerance goes down after detox then overdose can happen when they go back to using drugs again.   So we began allocating money in our budget for more open beds for addiction treatment even though insurance was saying no way. The legislature basically walked over them, forcing them to understand we were talking pennies to make this work! By addressing addiction treatment head on, there are immediate savings in reduction of treatment costs associated with Hep C as an example. Yes, we do have 99% insured in our state and now insurance does cover some of the cost. But with more beds and treatment coverage, inpatient is much safer as the patient is under observation and assistance. We also have a $5M substance abuse trust to help cover costs, but individuals must apply for it.

Over $250M has been allocated toward opioid epidemic substance use disorders, education, prevention & treatment, increased bulk purchasing of Narcan and also changes to the PDMP including 24 hour reporting, not 7 days. 200 substance use treatment beds have been opened. We continue to invest in major programs, i.e. beds, treatment, expert training & screening for $1.4M per year. We gave a lot of attention and dollars for the treatment side of this epidemic. But we also now have prevention programs to assess risky behaviors for teens for example. Streamlining use for all of these programs is our next goal.

However, we are now faced with increasing use of heroin. What is more concerning is that heroin is being cut with fentanyl which is leading to higher rates of overdoses. Our first responders must wear gloves when treating overdosed patients because they could get sick from even minimal contact with the patient. Our police and firefighters carry Narcan as a matter of routine. Just when you think you have one spoke of the wheel fixed (making it harder to get opioids), you realize you need another spoke for something else (increased use of heroin).

In May 2016, Governor Baker signed landmark legislation to address the deadly opioid and heroin epidemic which was supported by a large contingency including HHS Secretary, Senate President, House Speaker, Attorney General, Auditor and members of the legislature, law enforcement, health care providers, community leaders, individuals in recovery and others. The bill, titled an Act relative to substance use, treatment, education and prevention passed with unanimous votes in both legislative chambers and included numerous recommendation from the Governor’s opioid working group as well as the first law in the nation to establish a 7 day limit on first time opioid prescriptions.

Q.  How was the legislature able to get on the same page and agree to the terms in the bill?

A.  The key word here is Honesty. We have a Republican Governor with a Democratic majority in the legislature. When the Governor began his term, it wasn’t part of his agenda to deal with the opioid crisis. That changed quickly, substance abuse impacts everyone no matter what side of the aisle you’re on. There was a lot of proactive work in the legislature with respect to the problem, the Governor supported our efforts, and all sides and stakeholders were included. Trust was also a big factor.

Back in June 2015, the Governor’s Opioid Working Group released its recommendations including 65 actionable recommendations with an Action Plan for the administration to consider for implementation.   I appreciate how the recommendations were broken down from short-term goals (0-6 months) with long terms goals (3+ years) by 4 categories: Prevention, Intervention, Treatment & Recovery. According to the Governor’s website, approximately 90% of the initiatives in the Governor’s Action Plan are complete or underway, impressive!

Q.  Was it important to develop the recommendations and action plan? How are you measuring its success?

A.  First we had to figure out how we could move around money and not increase taxes. Next, we needed a roadmap. I traveled from the corner of our state to the Cape. We brought in all stakeholders while working on the issue in the Senate and the Governor’s plan mirrored our plan. Absolutely it has been important to have these documents. We may not have gotten everything we wanted or asked for, but the roadmap sets the pathway for what we have agreed to work on together.

Use of data will be necessary to measure success; this is still new for us. Most likely our Department of Public Safety will be the ones that aggregate and create the metrics for quantitative and qualitative analysis of the impact of our roadmap’s initiatives.

In December 2016, the Governor joined Secretary of Labor & Workforce Development Ronald Walker, II and Secretary of HHS Marylou Sudders to announce a new 2 year voluntary workers compensation pilot for opioid-related cases to assist injured workers who have settled workers’ compensation claims get treatment for pain management, aimed at limiting the use of opioids or other narcotics. The program assigns a care coordinator to mediate treatment options between an injured worker and the insurance company paying for medical care.

Q.  May be too soon to tell, but what are your thoughts on this voluntary, work comp program for opioid-related cases?

A.  I was not involved with this latest initiative however I feel that people on opioids just want to find some sort of balance. So for example, how do we utilize alternative therapies (yoga or acupuncture) versus use of opioids? How can we do a better job of having a conversation on do you want to spend the next 60 years of your life on drugs or having a quality of life?   Education matters, let’s be open to trying other things. Doctors need to be part of the conversation in helping to change the disability mindset of patient. It has helped that younger doctors today are getting trained in school on addiction.

Q.  Last, what more needs to be done with respect to the opioid crisis? What are some of the items you’ll be working on?

A.  More transitional housing needs to be addressed. When addicts get out of detox, they are stuck…they have a record, background of drug use, they cannot get into public housing, “sober homes” aren’t always sober and most can’t go home. I want to encourage more public/private partnerships, dorm-style or apartment living to help with recovery and gainful employment.

Additionally, we need to educate employers that the best thing they can do for an addicted worker is to allow them to remain employed while seeking treatment. Employers can put posters in the bathroom on available resources for treatment help for example. Involving the Chamber of Commerce to support this issue would help. It doesn’t cost any money to educate workers on available resources and workers can’t pay taxes if they aren’t working!

Senator, thank you for taking time out of our busy schedule for our discussion on the opioid epidemic and for your tireless efforts to make a difference.



It Takes Grit! Becoming Business Insurance’s Women to Watch

Ever wonder what it takes to be nominated and recognized as a Business Insurance Women To Watch Honoree?  In its 11th year, this awards and leadership conference was recently held in New York and honored a diverse group of women from a variety of insurance industry backgrounds.  Honorees are selected based on criteria including recent professional accomplishments, expertise, leadership and future career prospects.

Congratulations to this year’s Honorees, you can read all about them by visiting Business Insurance’s website.

I wanted to write about the event from another vantage point, from that of the Nominator.  Someone who not only took time to write the nomination, but who was so inspired by the nominee to take the time to do so.  I went behind the scenes and spoke with Mary O’Donoghue, Chief Clinical Officer for MedRisk Inc on her nomination of Honoree Shelley Boyce, CEO/Founder for MedRisk.

Q.  What inspired you to nominate Shelley as a 2016 Woman To Watch?

Mary:    At the time, I was working for another company that has been a long-time customer of MedRisk.  I got to know Shelley through that lens.  Shelley started MedRisk over 20 years ago, the concept for her business sprang from a college thesis and is today a thriving business employing over 800 employees providing managed physical medicine and diagnostic services to the work comp industry.

There are two characteristics exhibited by Shelley that inspired me to nominate her.  The first is humbleness.  Shelley may be the CEO and founder of MedRisk, but she has never forgotten the people that helped her grow the business.  She is rooted in her community as well, constantly giving back to causes that are important to her.  The second characteristic is Shelley’s strategic mindset.  Shelley can turn an idea upside, engage her team in providing new ways at looking for a solution and allow them to play out.

Shelley is someone I trusted working with, so much so that she was the first person that came to mind when I was looking to make a career move.  And today I’m honored to be working with Shelley and the MedRisk team!

Q.  Do you see a theme or trend for women that rise to the top in their profession?

Mary:    Financial acumen is good, but equally important is knowing the business from every angle so you can think strategically on how to grow the business.   Shelley set out to solve a very specific problem in work comp, a lack of focus on the benefits of physical medicine.  She built a business based on her knowledge of the work comp delivery system, what was lacking at the time and how to create value for stakeholders while returning an injured worker to work more timely.

It’s important to deliberate about where you want the business to be in five years, what’s next, what are the problems we are going to solve for.  Strategizing, thinking big, not giving up…frankly true grit are important themes.  Also important are working on people skills, respect for others, embracing diversity, creating a culture where women and men can equally be successful.

Q.  What has been the biggest shift you’ve personally witnessed since you began your career?

Mary:    Flexibility in the workplace.  Not only where you work, home or office, but how you work.  More and more companies understand a need to focus on work/life balance.  So what if you need to leave work at noon to pick up your child from day care, or if you do your best work at midnight?  Today’s work environment affords employees the flexibility to decide when and how to get their work done, and have fun while doing so.

Q.  How can we get more women to nominate one another or receive more recognition at work?

Mary:    We underestimate the value of mentoring.  Find someone and mentor them!  There is so much a tenured person takes for granted because you’ve been in the business for a while, you just assume that everyone knows.  Encourage women to take risks in the workplace and allow them to fail without negative ramifications so they can learn from their mistakes and grow.  And promote them when it’s deserved.   Also, make sure co-workers are aware of each other’s successes to keep the momentum, visibility and recognition alive.

Q.  What is your company doing to promote women in the workplace?

Mary:    Shelley certainly leads by example, she is a supporter of anything that helps advance women in the work place.  She encourages her team to be on Boards or get involved in events that are supportive of women.  Our company offers employee recognition programs such as distinguishing an employee for when “they brightened someone’s day” or when he/she created an excellent customer service experience.  We support one another, which is not only limited to women, but offering equal pathways for whoever is the most qualified for a promotion.

Q.  What would be a takeaway or two to inspire younger women to get involved in our industry?

Mary:    We are the perfect industry for millennials, however we don’t do a good job of explaining why.  Millennials are motivated by having a purpose, they want to have an impact.  Think about what we, in workers’ compensation, do every day.  Our work impacts a person’s quality of life.  Our industry strives to provide the best quality medical care an injured worker can receive during a time of crisis.  Injured workers want to get back to work, they want to support their families and they want their pre-injury quality of life.  Our job is to help them do just that, which is something millennials can believe in.

Q.  Last question, did you attend the W2W event?

Mary:    Unfortunately, I was unable to attend due to work commitments.  However, Shelley drove a van full of MedRisk women to the occasion, who were representative of all levels of occupations within our organization!  They couldn’t stop talking about the event when they returned, all of them loved seeing Shelley honored and being a part of the conference.

About Mary and MedRisk:

Mary O’Donoghue is responsible for MedRisk’s new product and business line development as well as strategic leadership of all clinical programs and research. A Registered Nurse by trade, Mary has over 25 years of experience in the managed care, group health, disability and workers’ compensation industries having held senior leadership positions in strategic planning, operations management and product development with top carriers, third party administrators and managed care organizations.  Mary serves on the Board of The Alliance of Women in Workers’ Compensation.

MedRisk is a leading provider of managed physical medicine and diagnostic imaging services for the workers’ compensation industry and related market sectors.  MedRisk ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates, physical therapists, and radiologists are based in the U.S. MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. For more information, visit or call 800-225-9675.

Thinking Inside the Box to Save Lives

Texas Mutual thinks inside the box to save lives

David Wylie, Senior Technical Writer

Safety resonates loudest when we deliver the message where the work gets done – auto repair shops, manufacturing facilities, oil rigs. So I decided to ditch the comfort of my ergonomically correct office chair and walk a construction site this morning. The experience could have cost me my life.

Everything was fine until I got distracted by a text message and fell about 20 feet off the roof I was scrutinizing.

If you believe bad things happen in bunches, the ensuing events won’t surprise you.

In the span of five minutes, I managed to absorb the blow of a falling cinder block, get engulfed in a trench collapse and run head-on into a high-voltage wire. Talk about a shock.

Fortunately, my brushes with death were virtual, not literal, thanks to a new app developed by Texas Mutual. The app, aptly named Safety in a Box, empowers users to learn life-saving lessons without putting themselves in harm’s way. Here’s how it works.

Safety in a box walks users through four common construction site hazards.

The user downloads the Safety in a Box app onto their smartphone. Then, they slip their phone into a cardboard viewer also aptly named Google Cardboard. The app takes it from there, walking the user through a construction site, where they encounter the industry’s four deadliest workplace hazards: falls, electrocutions, struck-by incidents and trenching incidents.

Safety in a Box is a product of a new phenomenon that is changing the way we protect workers from on-the-job injuries. Of course, there will never be a substitute for time-tested safe work behaviors. But those behaviors are increasingly being supplemented by tech tools that remove human error from the equation.

The union between technology and safety has already been fruitful, and there’s certainly more to come. In case you haven’t been keeping score, here’s a quick review of where were are.

Millennials live life largely from their mobile devices. Safety professionals are meeting them on their terms with a host of powerful apps. Concerned your employees need hearing protection? There’s an app for that. Want to know what to do in case of a tornado, fire or other natural disaster? There’s an app for that, too.

Driver-assist safety tools
The wellness industry has been leveraging wearable technology for years to help people eat, exercise and sleep their way to better health. Technology and safety professionals built on the concept, designing wearable tools that gather data about us and our surroundings, and then nudge us toward safer behaviors.

Blind-spot warning systems, smart headlights and other driver-assist safety features are a priority for 76 percent of drivers who are at least 50 years old, according to a new survey. The survey suggests older drivers equate advanced technology with enhanced safety. Still, safe-driving principles will never go out of style. So buckle up, slow down, stay awake and focus on driving.

Autonomous vehicles
Driver-assist safety tools represent the half-way point toward technology’s ultimate destination: removing humans and our flaws from the act of driving. Google has been testing fully autonomous vehicles in select markets, including right here in Austin. With backing from the government, 10 million self-driving cars could be on the road by 2020. At that point, we’ll simply be along for the ride.

Stay tuned
Technology is revolutionizing safety at a dizzying pace. Today’s trendy tools could be tomorrow’s relics. Follow our blog and stay up-to-date on the latest developments.

About Texas Mutual Insurance Company

Austin-based Texas Mutual Insurance Company, a policyholder-owned company, is the state’s leading provider of workers’ compensation insurance. Texas Mutual provides coverage to 40 percent of the market, representing over 66,000 companies, many of which are small businesses. Since 1991, the company has provided a stable, competitively priced source of workers’ comp insurance for Texas employers. Helping employers prevent workplace accidents is an important part of Texas Mutual’s mission.