Bay State balks on clinic decision

BOSTON The state Public Health Council on Wednesday decided to table its vote on proposed retail health clinic regulations until January, according to a spokesperson for the Department of Public Health.

“The Public Health Council decided to table its consideration of the limited service regulations until January,” Donna Rheaume, spokesperson for the Department of Public Health, told Drug Store News. “They [the Council] raised a number of concerns in the meeting and asked for clarifying language to be included on some issues.”

During the well-attended meeting, the motion to table the vote passed unanimously. According to Rheaume, some of the issues or concerns raised included a potential conflict of interest in clinics that both diagnose and prescribe medications; a need for clarifying language with regard to the location of the waiting areas for patient privacy; a concern about the sale of tobacco products at a clinic site; and a need for new language that would require the use of hand sanitizers.

“We are going to go back and address the comments and concerns and will bring an improved regulation back before the Council next month,” said Rheaume.

As previously reported by Drug Store News, in August, the Department of Public Health unveiled the proposed regulations that call for, among other things, clinics to maintain rosters of primary care providers accepting new patients, clinics automatically sending patient records to their primary care physician and limiting the number of times a patient can visit a clinic each year.

Looking to receive feedback on the proposed rules, state officials held public hearings in September, during which the Convenient Care Association urged state health officials to make amendments on the proposed regulations. CCA believes that the rules, if adopted as proposed, would create barriers to operating in-store health clinics within the state.

Sparking the issue was CVS’ application to open a MinuteClinic in one of its stores in Weymouth, Mass.—which would mark the first of its kind for the state. State health officials took a step back and decided it made more sense to draft retail clinic regulations. The move delayed the decision whether to allow CVS to open the first of the 20 to 30 planned clinics in the state.

In its application, CVS reportedly asked the Department of Public Health to waive some of the state’s requirements for licensing clinics. For example, because none of the conditions treated require blood tests, CVS reportedly is seeking approval to waive the requirement for blood collection equipment and facilities.

Responding to the Council’s decision to table the vote until January, MinuteClinic chief executive officer Michael Howe issued a statement that read: “Today, members of the Public Health Council and staff discussed additional refinements to the language of proposed regulations to guide the practice of limited service clinics in the state. We support the thorough and thoughtful approach the Massachusetts Department of Public Health is taking in developing these regulations. MinuteClinic already demonstrates best practices in many of the areas discussed at today’s hearing. We look forward to continuing to work with the Department as they refine these regulations which we believe will ultimately expand access to quality health care in the state.”

In an interview prior to Wednesday’s meeting, Tine Hansen-Turton, executive director of the CCA, said that the association has been hard at work educating officials on the in-store health clinic model and its desire to collaborate with the health care community. “Part of what we need to do is educate more on how we are not a primary care home. That is something we are working hard on, is to educate policymakers, consumers and providers that we are not to be a medical home. We are here to provide a continuum of care,” said Hansen-Turton. “We follow the same laws as others and we are always subject to a wide range of existing laws applicable to traditional health care providers. We want to be subject to that [the laws] but to single us out because of location certainly is a concern.”

While many support the in-store clinic model, it is no secret that some, including policymakers and physicians, have expressed concern over a lack of continuity of care and a risk that the clinics will replace a doctor-patient relationship. However, clinic operators have long pointed to sophisticated treatment protocols and electronic medication record systems, as well as physician referral programs—all of which are generally accepted standards among virtually every retail clinic operator nationwide. 

“To me, it is inconceivable that anybody in Massachusetts would oppose the convenient care clinics that are providing easier access to affordable health care in the face of what is widely acknowledged to be a significant and growing physician shortage. There are tremendous problems, in Massachusetts in particular, with access to health care,” said Web Golinkin, president and chief executive officer of in-store clinic operator RediClinic and president of the CCA, prior to Wednesday’s meeting. “The issue of continuity of care is important and is being addressed by convenient care providers today. Virtually all convenient care providers, by state regulation, work in collaboration with local physicians and, in some cases, health care systems. In some cases, they are actually owned by major integrated health care systems so there is continuity of care and integration of care today.”