Massachusetts drafts retail clinic regulations

Drug Store News, August 13, 2007 by Antoinette Alexander

BOSTON -- State health officials in Massachusetts are proposing new retail health clinic regulations that they say, "may promote convenience and greater access to basic care." The move, announced in July, is in response to CVS' recent application to open in-store health clinics in the state, and it delays the decision whether to allow the pharmacy reatailer to open me first or 20 to 30 MinuteClinics here.

As previously reported, CVS executives hope to open the first in-store health clinic in a CVS store in Weymouth, Mass. The retailer had submitted an application for the Weymouth location, which it hopes to use as a template that can be applied to additional locations. In the 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.

In-store health clinics, which are open for extended hours and weekends, are typically staffed with certified nurse practitioners who provide diagnosis and treatment of common family illnesses, administer vaccinations, perform diagnostic screenings and conduct physical exams. The menu of services generally ranges in price from about $30 to $100, and many major health plans cover the services. Most visits take about 15 minutes and require no appointment.

"It became clear from our review that the current Department of Public Health regulations governing medical clinics don't address the operation of medical clinics with limited scopes of services," stated Secretary of Health and Human Services Judy Ann Bigby in a statement issued by state health officials. "Rather than considering applications that require numerous waivers, we believe we should consider an alternative set of regulations that, if approved, will make the application process for operating limited service medical clinics transparent to any entity that feels they have a role in their community."

The proposed regulations were brought before the Massachusetts Public Health Council during its Aug. 8 meeting. The rules will then be released for public comment and a public hearing will be scheduled. Health officials have stated that this approach will have the added benefit of allowing other entities, such as not-for-profit hospitals or community health centers, to operate such clinics. Responding to the state's decision, Chris Bodine, president of CVS/Caremark Health Care Services, said, "MinuteClinic looks forward to working with the Massachusetts Department of Public Health as it develops regulations regarding retail health care clinics. Secretary Bigby, Commissioner Auerbach and the Department of Public Health officials have taken a thoughtful and innovative approach to developing regulations, which we believe will ultimately expand access to quality health care and which we fully support. MinuteClinic can serve a critical health care need by providing convenient, affordable access to quality health care for common medical conditions. As Massachusetts expands access to health insurance to hundreds of thousands of people, we know that demand for basic health care services will increase. MinuteClinic stands ready to help meet that need."

Added Tine Hansen-Turton, executive director of the Convenient Care Association, "We hope that the Department of Public Health's proposed regulations will reflect the value of convenient care clinics and encourage the growth and sustainability of this innovative model of care. The CCA looks forward to participating in the rule-making process, and making basic healthcare services more accessible and affordable for individuals throughout Massachusetts."

John Auerbach, commissioner of the Department of Public Health, called the move a "win-win" situation as it could help expand access to health care to "very vulnerable populations." He noted that one example of such increased access under the proposed regulations is that a community health center could opt to open a satellite clinic at a homeless shelter.

The Department of Public Health's Bureau of Health Care Quality is developing the proposed regulations. The bureau is charged with licensing all inpatient healthcare facilities in the state, and also must approve the construction of all healthcare clinics in Massachusetts. The bureau provides licensure or certification to approximately 6,000 healthcare facilities in the Commonwealth.