The President’s Budget Proposal for Fiscal Year 2018 Cuts $294 Million From National Institutes of Aging (NIA)

The Administration has released the President’s budget, now to be considered and modified by Congress. While the President’s budget — no matter who is President — is never the final budget, it does signal strategic intent and policy preferences by the Administration.

Cure Alzheimer’s Fund is deeply concerned about several provisions of this budget, specifically, the approximately 21% cut to the National Institutes of Health in general; and the approximately 36% cut to the National Institute on Aging.

The NIH is the primary funder of basic medical research in the United States. Neither pharmaceutical companies nor philanthropy comes close to the amount of funding provided by the NIH for the basic, necessary research from which virtually all therapies originate.

Progress has been made in recent years to improve funding for NIH and therefore for more high quality basic research into numerous diseases, including Alzheimer’s disease. Cure Alzheimer’s Fund has worked very closely with both Democrats and Republicans in Congress and other Alzheimer’s disease advocacy organizations to champion increases in Alzheimer’s disease research funding at NIH.  Working together, we have all been successful in more than doubling research funding in the last few years to more than $1.4 billion in Fiscal Year 2017 at NIH.  As we have repeatedly said, independent experts have called for $2 billion a year in funding and we are continuing to work with all partners to reach this goal.

The proposed cuts not only threaten this bipartisan progress, but will without a doubt set back and diminish the hard-earned pace of discovery.

Cure Alzheimer’s Fund will continue to work with allies in Congress from both parties to prevent these devastating cuts from becoming reality and ensure robust funding for Alzheimer’s disease research.

Outdoor Fun at Faneuil Hall Marketplace

It’s that time of year when Bostonians and others shake off the winter doldrums and get outside to enjoy everything that the city has to offer as soon as the weather turns nicer.   What better way to experience history, shopping and dining than over at Faneuil Hall Marketplace?  The historic festival marketplace is amping up its game this season with a full array of FREE outdoor activities that offer something for every member of the family.  From outdoor chess and ping pong, to historic walking tours of Quincy Market, to free fitness classes to get your heart rate going that include BollyX, Cardio Dance, Warrior Sculpt Yoga, and Pound® lead by the leading fitness instructors in Boston.  The outdoor programming is called “Summer Sampler” because there truly are a vast sample of programs and activities that will fit everyone’s style and abilities.  Take a class, then enjoy a beverage and bite to eat from one of the Marketplace’s pubs or restaurants. Bring your friends and make Faneuil Hall Marketplace your “go to” spot for get-togethers all summer long.

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Pride Day @ Faneuil Hall

On June 3, Pride Day @ Faneuil Hall returns for the 17th consecutive year from 10:00 am to 5:00pm to kick-off Boston Pride week. The day will be packed with FREE family-friendly entertainment including Zumba classes, music and dancing performances, drag queens and new this year, a High Heel Dash for Charity to benefit Boston Pride’s Community Fund that gives grants to LGBTQ grassroots organizations.

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Sail Boston 2017 – June 17-22

The 2017 Tall Ships Regatta will be sailing into Boston on June 17 with its Grand Parade of Sail and Faneuil Hall Marketplace is proud to be a partner in Sail Boston.  The Marketplace has many activities planned for the thousands of tourists and the 3,500 crew members who will be visiting the waterfront area.  In keeping with the nautical theme, on Saturday, June 17, Faneuil Hall Marketplace will feature a boat-building demonstration from Lowell’s Boat Shop in Amesbury, Mass.  They’re bringing an unfinished dory to South Market where spectators will have the opportunity to try their hand at riveting, planing and cutting a sample set of wood.  Representatives from Lowell’s Boat Shop will be there to assist and provide more information.

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Street Performer Program

Nowhere else in Boston can you see the talent and variety of street performers than at Faneuil Hall Marketplace. A tradition that began when the Marketplace reopened after renovations in 1976, the world-famous street performers razzle and dazzle crowds throughout the season. The Marketplace is the perfect location for outdoor performances with its pedestrian friendly, car-free venue that has everything you need for a fun day in the City with friends and family: live performances, shops featuring unique local items as well as well-known international brands, a plethora of dining options for quick bites from the vendors in the Quincy Market Food Colonnade or enjoy a leisurely meal while dining at an outdoor patio and have the best seat in the house to watch the street performers from your table. New performers have just been added to the roster of acrobats, jugglers, escape artists, magicians, and musicians. You can catch all the acts throughout the season, or attend the Street Performer Showcase which will be scheduled in July and will be announced on the Faneuil Hall Marketplace website.

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For more information: www.faneuilhallmarketplace.com

The Massachusetts Coalition of Nurse Practitioners’ Discusses Healthcare Challenges Facing Massachusetts

On April 5, the Massachusetts Coalition of Nurse Practitioners (MCNP) hosted its annual Health Policy Breakfast, inviting nurse practitioners from across the state to discuss current health care challenges facing the Commonwealth and the goals of their bill, H.2451/S. 1257, An Act to Contain Health Care Costs and Improve Access to Value Based Nurse Practitioner Care as Recommended by the IOM and FTC.

Nurse practitioners were joined by co-sponsors of the bill Senator Marc Pacheco, Representative Paul Donato, Representative Kay Kahn and Representative Pat Haddad as well as Senator Walter Timilty, Representative Joan Meschino, and Representative Solomon Goldstein-Rose. The offices of Senator Mike Brady, Senator Jason Lewis, Representative Paul Brodeur, Representative Jay Kaufman, and Representative Jerald Parisella also came out in support of the nurse practitioners.

H. 2351/S. 1257 will allow nurse practitioners in Massachusetts to practice to the full extent of their education and training and will update the Massachusetts Nurse Practice Act by removing antiquated and unnecessarily restrictive licensing requirements. Despite leading the nation’s healthcare reform initiatives, Massachusetts has among the most restrictive and antiquated licensing requirements and is the only New England state that has yet to remove them.

Nurse practitioners are registered nurses with advanced Master’s or doctoral level education and nationally certified in advanced practice nursing specialties. They provide comprehensive health care services including performing physical examinations, prescribing medications, ordering and interpreting diagnostic tests, and treating and managing acute, episodic, and chronic conditions.  Nurse practitioners work closely with physicians and other members of the healthcare team and like physicians, consult with specialists when needed.

Although MA nurse practitioners have legal authority to prescribe medications, current MA regulations require a supervising physician to oversee their prescribing practices. This requirement would be removed if H. 2351/S. 1257 passes.

Nurse Practitioners are well recognized for delivering high quality, cost effective healthcare. Passage of H.2451/S. 1257 would align the Massachusetts Nurse Practice Act with 22 states plus D.C, where Full Practice Authority legislation for Nurse Practitioners has already been advanced.  Such a change here in Massachusetts would ensure greater consistency in practice and better care for patients.

Increased reliance on nurse practitioners can be a more cost-effective approach to healthcare.  As the cost of care continues to rise – for both the Commonwealth and patients – shifting to a Full Practice Authority model would better position the state and employers to leverage the workforce of Nurse Practitioners to identify cost-savings.  The average cost of a visit with a nurse practitioner can be between 20 and 35 percent lower than the average cost of an office-based visit with a physician.

At 109 days, a recent Merritt Hawkins study reports that Boston has the longest wait times in the country for those patients seeking new appointments with a family medicine provider. Massachusetts boasts the greatest number of physicians per capita and spends the most dollars on care.  By positioning Nurse Practitioners to work to the full extent of their education and training, passage of H. 2351/S. 1257 will create cost effective access to care for the residents of the Commonwealth.

About Massachusetts Coalition of Nurse Practitioners

The Massachusetts Coalition of Nurse Practitioners (MCNP) represents the professional voice of the Commonwealth’s nearly 9,000 nurse practitioners.  Advancing a patient centered agenda, MCNP seeks to create recognition for the key role that NPs can play to improve and ensure access to high quality and cost-effective care for all.

Total Wine & More Opened Its Fourth Massachusetts Store in Danvers

Total Wine & More opened its fourth Massachusetts store in Danvers on Wednesday, April 26th. The evening preview party gave guests and members of the community the opportunity to meet the store team while enjoying beer and wine tastings along with hors d’oeuvres and live music. Total Wine & More prides itself on being a member of each store community. With each store opening, TWM partners with a local charitable organization and donates 10% of its opening weekend wine sales to the organization. In Danvers, TWM has partnered with Northeast ARC. The preview party is not only a welcome to guests but a “thank you” to the community. State Representative Ted Speliotis, Robert Bradford, President of the North Shore Chamber of Commerce, JoAnn Simon of Northeast ARC and Total Wine & More co-founder Robert Trone together with representatives of the regional and local TWM team were all in attendance.

CEDAC Commits $8.5 Million to Preserve Affordable Housing in Boston’s Fenway Neighborhood

Massachusetts notched another win this month in its continued efforts to preserve affordable housing.  On April 10th, the Community Economic Development Assistance Corporation (CEDAC) announced that it had committed over $8.5 million in financing to Fenway Community Development Corporation (Fenway CDC) to purchase and preserve Burbank Gardens, an existing affordable housing development located in the Fenway neighborhood of Boston. This residence is one of many 13A properties whose 40 year mortgage will reach maturity in March 2018, risking tenant displacement and loss of affordable housing. Fenway CDC closed on the purchase of the property on the same day.

In 2009, the Massachusetts legislature passed into law Chapter 40T. This law has given the state’s Department of Housing and Community Development (DHCD) and CEDAC tools to monitor and address the expiring use challenge. Among the most important provisions of Chapter 40T are purchase rights to allow DHCD or its designated agent to acquire and preserve these expiring affordable housing projects if an owner offers to sell a building.

When the seller of Burbank Gardens put the property on the market in early 2016, Fenway CDC was designated by DHCD through Chapter 40T to purchase and preserve the 52-unit residence. The seller accepted Fenway CDC’s offer in September 2016.

“Preserving Burbank Gardens is an important step in the Commonwealth’s ongoing efforts to maintaining affordable housing,” said CEDAC’s Executive Director Roger Herzog. “It demonstrates once again that the innovative Chapter 40T law remains an effective tool and is a national model for preserving quality affordable housing.”

Fenway CDC, established in 1973, is a membership organization that builds and preserves affordable housing and champions local projects to protect the neighborhood’s economic and racial diversity as well as its long term vibrancy. The organization also provides social services, workforce development programs, financial literacy assistance, health programs, and adult education. They have developed nearly 500 affordable homes that house about 1,500 people, including seniors, families, and people living with disabilities.

With the acquisition of Burbank Gardens, Fenway CDC plans to ensure that 51 of the 52 apartments remain affordable for low and moderate income households. The property currently consists of 52 studio, one- and two-bedroom apartments. CEDAC provided a $313,000 predevelopment loan and, with participation by Eastern Bank, an $8,268,525 acquisition loan to Fenway CDC for this important preservation effort.

“CEDAC was thrilled to work with a mission-driven non-profit to preserve this crucial affordable housing resource,” said Bill Brauner, CEDAC’s Director of Housing Preservation and Policy. “The involvement of public sector agencies, including MassHousing, the City of Boston’s Department of Neighborhood Development and DHCD, was crucial to this transaction.”

Click here to read more about the expiring use challenge and CEDAC’s work in producing and preserving affordable housing.

O’Neill and Associates’ Clients on the Move at the 2017 Boston Marathon

Marissa finish lineO’Neill and Associates is proud to recognize its clients and teams that ran the 2017 Boston Marathon: the Arredondo Family Foundation, HomeStart, National Braille Press, Project Hope, and St. Francis House.

HomeStart had a team of two, including our client Jennifer Sciamanna of RCN, and raised more than $20,000. Project Hope’s team of ten runners raised over $100,000; St. Francis House’s five runners raised over $63,000; and the Arredondo Family Foundation’s seven runners raised over $37,000.

National Braille Press raised over $20,000 with a team of two, including our own account executive Marissa Sullivan (shown in photo).

OA: Are there special reasons for your interest in supporting National Braille Press through the Boston Marathon?

MS: I have been working with National Braille Press for almost two years and am amazed by everything they do to promote the importance of braille literacy. Organizations like National Braille Press enabled my great grandmother, who lived more than 40 years of her life blind, to be on her own and navigate through each day. It is an honor to fundraise and run for National Braille Press.

OA: What was it like crossing the finish line?

MS: It’s hard to put into words that feeling when you turn left onto Boylston Street and finally have the finish line in sight. I remember thousands of onlookers screaming my name as I got closer to the finish line.  The best moment was probably that moment when I was just steps away from the finish line and I saw and heard my family screaming my name and vigorously waving their hands. I gave them a big wave and finished the last steps of those grueling 26.2 miles.

OA: You were able to raise over $10,000; how do you hope those funds help National Braille Press?

MS: I hope the funds I raised continue to help National Braille Press support a lifetime of opportunity for blind children and adults through braille, and provide access to information that empowers them to actively engage in work, family and community their surrounding community.

 

The Path to Tax Reform Will Go Through Massachusetts

By: Anthony DeMaio

Washington is working overtime this week to characterize the president’s first 100 days following the April 29th milestone. With the spotlight on the White House, it is easy to ignore Capitol Hill. As the 115th Congress reconvenes after a two-week recess, many Members will be smarting from tough town halls and other public appearances back in their districts. Pressure on Speaker Paul Ryan and Majority Leader Mitch McConnell to pass legislation is mounting. With the president having outlined his vision for tax reform, it looks like a much-anticipated tax bill will be the next policy item on Congress’ agenda.

If the goal of re-writing the federal tax code seems ambitious, it’s because it is. The last time a tax reform bill was enacted was 1986 – three days before the ball rolled through Buckner’s legs – a lifetime ago (in both politics and sport). Despite a divided government then, Washington was less polarized. Democrats in the House including Speaker Tip O’Neill and Ways and Means Chairman Dan Rostenkowski worked with Republicans like Senate Majority Leader Bob Dole, Finance Chairman Bob Packwood, and President Ronald Reagan to pass the first comprehensive changes to the tax bill code in 32 years.

There is no doubt that politics is more partisan today than during the Reagan-O’Neill era. And with Republicans in control of Congress and the White House, one would expect the Democrats’ role to be insignificant. But as we learned during the recent attempt to repeal and replace the Affordable Care Act, House Republicans are deeply divided. So if congressional leadership is serious about passing a tax bill, they will need rank and file Democrats to support it, especially Congressman Richard Neal of Massachusetts.

Mr. Neal has served on the House Ways and Means Committee, which has jurisdiction over the tax code, for over 20 years. He is now the top or Ranking Democrat on the panel. It will be up to Mr. Neal and Chairman Kevin Brady (R-Texas) to hash out the details of a viable tax bill.

Among President Trump’s campaign promises and early proposals was a border adjustment tax, or BAT, which would impose a steep tax on goods coming into the United States from abroad. In theory, the BAT would encourage corporate investment at home and create jobs in the manufacturing sector. But as the president found out, tax proposals often make strange bedfellows and while the BAT has some bipartisan support, it also has bipartisan opposition. It appears that the vocal opposition from key Republican senators prompted Trump to shelve the BAT proposal. As other suggestions are considered and tweaked, Mr. Neal will be responsible for determining their viability within his caucus.

In recent history, the medical device tax has been the key tax issue for Massachusetts, thanks to the booming medtech industry. But with a comprehensive bill up for consideration, and a critical seat at the table, Massachusetts interests will play a more central role. Changes to the corporate tax rate will not only affect the 13 Fortune 500 companies based in Massachusetts, but the thousands of small businesses and startups in bio, tech, and other sectors. Consolidating tax brackets and changing eligible deductions should get the attention of the state’s growing millionaire class and the thriving middle class alike. And if Congress is serious about paying for lower taxes by creating savings in the healthcare system, Massachusetts’ research facilities and its dominant healthcare sector will need to sit up and take notice.

While not the low-hanging legislative fruit that would count as an easy win, tax reform is certainly high on Speaker Ryan’s agenda. As the focus turns to legislative action, and the Speaker seeks a win after an early failure on healthcare, we expect to see a tax bill move. There is a narrow political path for the legislation to tread, and it goes right though the Commonwealth.

April Showers bring….government shutdown?

By: AmyClaire Brusch

The end of this week is not only the end of President Trump’s first 100 days in office (Saturday), but also a looming federal funding deadline (Friday).  While the current fiscal year ends on Sept. 30, due to the lack of agreement last fall on FY17 appropriations bills, the government has been under a short term Continuing Resolution (CR) that ends on Friday.  Without a new Continuing Resolution or approval of the FY2017 appropriations, the government will not be allowed to spend money and non-essential functions will be forced to shut down. Threats of a government shutdown have Washington and media outlets in a spin zone, transforming the news cycle to a traditional administration vs. Congress dispute.

Though the formal appropriations process doesn’t usually get the attention and appreciation it deserves from the media, when it comes to a funding deadline everyone pulls out some of their favorite phrases: “Shutdown Showdown”, “CROmnibus” (the CR combined with omnibus for one big funding bill), and disputed “riders” of the day (as in policy language “riders” attached every year to appropriations bills that become bargaining chips, or poison pills, in the days leading up to a deadline).

Without agreement, non-essential government functions (as determined by OMB) cease. Many non-essential federal employees will be furloughed and certain federal government locations such as national parks will be closed. Essential personnel can vary from administration to administration but typically active military, law enforcement/homeland security, medical personnel in federal hospitals, air traffic controllers remain on duty. Mail will still be delivered and social security checks will still be processed. The length of shutdown determines how quickly non-federal employees feel the impact on their daily lives. Politically, the White House and Congress will feel the impact immediately. Constituencies on all sides will be angry and let their elected officials hear it.

There are indications that an agreement is in sight. One of the high profile obstacles to agreement on the FY17 spending bills has been funding for a border wall with Mexico. In order to reach agreement, President Trump has indicated that he will not insist that it be part of the FY17 package and instead look to FY18 for funds. An agreement, or even a CR through September 30th, would free Congress and the Trump Administration to focus on FY18 funding and other large policy areas such as infrastructure. Though it looks at the moment like a shutdown will be avoided, that could change at any time. We have learned in the past 100 days that conventional wisdom rarely applies to the interactions between the Trump administration and Congress.

Is Your Crisis Plan Ready for 2017 Realities?

By Anthony DeMaio

Running a network enterprise is exceedingly complicated. The global network of an airline like United makes the business particularly fraught. Industry pressures exacerbate problems and translate to frustration for passengers. What happened two weeks ago in Chicago was an unmitigated reputational disaster. Given the nature of the airline business today, passengers are well aware that operational disruptions can happen. However, this incident was extreme in every way. Today’s media landscape dictates that carriers need to be prepared with much better protocols than those employed at O’Hare.

First things first – flying is more affordable and more popular than it has ever been. Since the federal government deregulated the airline industry in 1978, fares have fallen by nearly 50 percent and passenger traffic has tripled. As much as we the flying public like to complain about the flying experience, the fact that it is uniquely accessible in the United States today can’t be denied.

Among the factors that keep ticket prices down is the practice of “capacity discipline,” an industry buzzword which roughly translates to “fuller flights.” In order to keep costs down, airlines do their best not to have more seats on a route or frequency than the market demands. In the United case ORD > SDF, that was 70 seats, as evidenced by the full flight. And while full flights can sometimes lead to boarding denials, most passengers would rather have a lower fare and take a chance on getting bumped than subsidize a bunch of empty seats. In rare cases, passengers need to be “re-accommodated.”

Other, external factors further complicate matters. While much has been made about United’s overbooking procedures, the flight in question was not technically oversold. Rather, a crew of four needed to be repositioned at the last second in order to work another flight out of Louisville. Any number of factors could have necessitated the deadheading crew including weather, a mechanical failure, poor scheduling or a growing and soon-to-be cataclysmic shortage of pilots.

The airlines remain a mystique industry. There is a certain amount of magic involved in hurtling through the sky at 500 miles per hour and ending up on the other side of the continent, the ocean, or the world in a matter of hours. The airlines need to do a better job of explaining that it isn’t magic, but rather the product of tens of thousands of employees constantly solving a giant and color-changing Rubik’s cube which get passengers to their destinations quickly, safely, and affordably.

So, too, do the airlines need to improve their communications and protocols. In the aftermath of this disgraceful episode, consumer advocates are rushing to push for improved federal regulations and lawmakers in Congress are introducing legislation. But certain problems are never going to go away. That means all carriers, not just United, need to take a hard look not only at what they’re doing but how they’re explaining their decisions. Social media has transformed the media. United’s bad month (including the “leggings incident” before the infamous “re-accommodation”) was made terrible by the wall-to-wall coverage provided by Twitter, Facebook, YouTube, and other channels. Social Media means there’s a reporter in every seat today, and their content can go viral in minutes. Book-aways, a plunging share price, and irreparable brand damage can result. The once iconic “Fly the Friendly Skies” is now and forever a punch line to a bad joke. All carriers would be wise to examine their crisis plans and employee training manuals to ensure they are up to 2017’s standards.

Opioid Policy Issues Continue to be Center Stage at the State House

By: Chris Niles

The recent announcements of two major private initiatives, RIZE Massachusetts and the Grayken Center at Boston Medical Center, focused on the treatment and prevention of substance use disorders are welcome additions in the fight against opioid addiction in Massachusetts. The misuse of opioids continues to take lives at a frightening pace in the Commonwealth and presents a complicated challenge to elected officials and policy makers across the United States.

Early data from the Massachusetts Department of Public Health indicate that 2016 was another devastating year as opioid overdose fatalities will approach or exceed 2,000 deaths, the deadliest year thus far. As of now, 1,465 deaths are confirmed with another 469 to 562 estimated to be designated as an overdose fatality. Equally shocking is that these numbers would have been much worse if not for the availability of the drug naloxone, used to reverse an overdose, which was administered approximately 12,000 times in 2015 (the last year data was available). Most recently, a report by the US Office of Health and Human Services found that the Commonwealth had the highest rate of opioid related Emergency Room visits among 30 states included in the study.

The sheer scope of the opioid epidemic in Massachusetts will require a sustained effort over many more years to bring under control. For over a decade the Commonwealth has increased resources, made significant policy changes and raised awareness about stigma in an effort to curb the epidemic. The Legislature has passed a series of omnibus bills over the last several legislative sessions to address different but interrelated aspects of the epidemic. Laws and regulations have been strengthened to mandate prescriber education, to encourage regular queries of the Prescription Monitoring Program by prescribers, to provide education to students, to improve access to quality treatment and to supplement treatment capacity. The implementation of the Commonwealth’s 1115 Medicaid waiver will add new resources and capacity in critical areas of the continuum of care and the system of five Recovery High Schools offer students with substance use disorders a safe and supportive environment to continue their education.

The Legislature also authorized a study, the Chapter 55 report, by the Department of Public Health in cooperation with other state agencies that utilizes pooled state data to try to identify patterns and gain a more comprehensive understanding of the underpinning issues of opioid misuse in Massachusetts.  For many years, hard data about the opioid epidemic was hard to come by, either siloed in agencies across state government or simply not collected. The data and analysis in the Chapter 55 report confirms that we are not facing an epidemic of misuse of only one class of drug, rather an evolving epidemic of misuse of many substances. The surge of fentanyl use in particular, identified in 75% of overdose fatalities in one set of recent data, combined with the emergence of carfentanil and the presence of benzodiazepines in postmortem overdose reports all illustrate the dangerous mix of chemicals that are being misused and are a driving factor in these fatalities. The changing nature of the epidemic over time has made it a moving target for providers, regulators and law enforcement.

As the Legislature considers its next policy priorities on opioids, we’re likely to see an emphasis on adding tools to sustain a client’s long term recovery in their community, one of the more elusive and frustrating aspects of this chronic disease. In many ways, policy makers have worked through many of the immediate challenges but the buildout of a comprehensive response is not yet complete. While many of the pieces are in place or coming online, pulling all of the components of treatment together to create a streamlined continuum of care that will be evidenced based, efficient and effective for clients remains a work in progress. The workforce challenges faced by the provider community could also present a chilling effect to the state’s response. As new programs open or expand  the demand for qualified professionals in the field is a pressing need across the state and attracting significant numbers of new staff will be critical to building a sustainable network. Additionally, training more medical professionals in addiction medicine and training existing staff in the latest advances in the field will help improve provider capacity. While much was done through the STEP Act around prevention, research and policy continues to develop around how to best identify opioid misuse at the earliest stages. The use of data to target resources and analyze trends is a new and important resource and some hope the application of mobile technology could be part of the solution.

Many of the remaining opioid policy issues are also intertwined with other challenges we face in Massachusetts but are crucial to the opioid epidemic as well. Affordable housing and homelessness, gaps in education, lack of job skills or work experience, complicated family dynamics, criminal records, co-occurring disorders and collateral health issues can all face clients as they work to sustain recovery. With the additional attention and resources that have now been brought to bear, perhaps we’ve reached a critical mass and a more robust understanding of what it will take to treat this public health crisis.