Bridging the Divide: Symposium RecapDear all,

Thank you for your participation in the Bridging the Divide Symposium on May 5th, 2017. In this document, I have summarized some of the main ideas that we generated and included your specific suggestions in your own words. We hope that this event is a first step toward bringing together a diverse group of people with a shared commitment to promoting equity in cancer care for people affected by mental illness and their caregivers.

Key outcomes from our work together include:

Promoting increased communication and awareness of the broader stakeholder community invested in this issue

Building a patient/stakeholder advisory council Submitting a grant proposal to develop a community network Raising funds for an annual symposium on mental health and cancer Educating psychiatry/psychology residents and trainees (400 plus state-wide),

community mental health clinicians, and departments of radiation oncology

Each topic area includes my summary followed by participants’ own words. Please share your thoughts and distribute this document widely! Your feedback is crucial to addressing these issues. Please add your comments directly to this document and send it to we.bridge.the.divide@gmail.com, or follow the link to comment on the Google document: https://docs.google.com/document/d/1NhklQk4P-t133P2Q2u_a0MNYlEl0KOiJeECagcine6U/edit?usp=sharing

We promise to collect your comments and update the community in 3 months. Both documents will remain open until July 28th and we look forward to receiving your feedback. Thank you.

Sincerely,Kelly Irwin on behalf of the symposium planning team

Thank you to our symposium participants!

Alacrita Consulting, LLC.American Cancer SocietyBayCove Human ServicesBeacon Health StrategiesBeth-Israel Deaconess Medical CenterBoston College School of Social WorkBrigham and Women's HospitalChildren's Hospital BostonCommonwealth Care AllianceCommonwealth Community CareDana-Farber Cancer Institute

Depression and Bipolar Support AllianceFreedom Trail ClinicGreater Boston Psychiatric ServicesLahey Health Behavioral ServicesLahey Oncology at Parkland MedicalLemuel Shattuck HospitalMassachusetts College of Pharmacy and Health SciencesMassachusetts Department of Mental Health Massachusetts General Cancer Center

Massachusetts General PsychiatryMcLean HospitalNational Alliance on Mental Illness – MassachusettsNewton-Wellesley HospitalNorth Suffolk Mental Health AssociationSouth End Community Health CenterUMass BostonVinfen CorpWinchester Hospital

EXECUTIVE SUMMARY 1

The need, priorities for change, and proposed solutions How can stakeholders do more?

PART 1: THEMES EMERGING FROM PATIENT NARRATIVES 2

Kelly’s Summary 2

Next steps 2

PART 2: CREATING OUR SHARED AGENDA FOR CHANGE 6

Group 1: Barriers to Care 6

Group 2: Caregiver Resilience 7

Group 3: End-of-Life Care and Serious Mental Illness 9

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Bridging the Divide: Mental Health and Cancer Care

May 5, 2017Feedback and Major

Themes

Table of Contents

Group 4: Building Trust: Person-Centered Care 10

PART 3: IMPACT ON PARTICIPANTS 13 Next steps: How to Learn More, Upcoming Events, Ways to Contribute

Appendix: Symposium Agenda 17

EXECUTIVE SUMMARY

The Unmet Need: Individuals with serious mental illness die 15-30 years earlier than the general population, and cancer is the second leading cause of death. Patients with schizophrenia are more than twice as likely to die from many common cancers and less likely to receive timely, high quality cancer care. This disparity is understudied, and this group of patients is marginalized and voiceless. Our healthcare system separates cancer care from mental health care and the academic medical center from the community. To change the outcome, we need to do things differently. We need to bridge the divide.

Purpose: The symposium brought together diverse stakeholders: oncology and mental health clinicians, researchers, patients, families and community-based caregivers, advocates, and policy-makers, including >30 organizations and 150 participants: all invested in achieving equity in cancer care for people with mental illness.

Priorities for Change: Symposium participants identified core challenges at the human, patient, clinician, systems, and policy levels including mental health stigma, complex, patient needs, lack of education about mental health, barriers to communication, and anticipated challenges with dissemination. Work Groups included: barriers to care, caregiver resilience, end-of-life care, and person-centered care.

Proposed Solutions: Attendees shared that the dialogue changed due to the diverse participants and perspectives. Participants emphasized the need to continue to include patients and families and build a stakeholder community

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Target education about mental health to decrease stigma and improve communication

Redefine multidisciplinary teams to engage community health workers, peers, and caregivers and integrate them in cancer care delivery

Develop a healthcare system that is integrated, proactive, flexible and person-centered

Decrease barriers to prevention and hospice care Conduct research that demonstrates the benefits of innovative care models Share the message widely with policy leaders

What Can Stakeholders Do?

Read on, let us know what you think, and share this document Join the community network and let us know how you want to be involved

How? Email Kelly Irwin at kirwin1@partners.org or Amy Corveleyn at acorveleyn@partners.org

Participate in educational trainings for mental health and oncology clinicians

Thank you to our sponsors:The Massachusetts General Hospital Cancer Center and the Dana-Faber/Harvard Cancer Center

PART 1: THEMES EMERGING FROM PATIENT AND CAREGIVER STORIES

We began the afternoon by listening to a panel presentation of two patients who have been affected by mental illness and cancer, which included the voices of parents, oncologists, and community mental health clinicians.

We then asked you to reflect on your own experience and advise us:

What are the challenges that we need to discuss today to improve cancer care for patients affected by mental illness and their caregivers?

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Kelly’s Summary

In addition to identifying key challenges, many participants highlighted potential solutions. We discussed what we need to do as individuals and as a community to promote equity in cancer care for people with mental illness. These action steps span our different roles as patients, caregivers, clinicians, and researchers. Individuals highlighted the value of coming together and sharing diverse perspectives.

We need to:

1) Be advocates2) Name mental health stigma and be aware of our own biases 3) Educate widely about mental health4) Engage a diverse community5) Decrease barriers to communication across a fragmented system6) Design, study, and disseminate new models of care with a broad

multidisciplinary team including peers and caregivers7) Influence policy8) Promote sustainability

WE NEED TO BE ADVOCATES

A panelist and mental health clinician summarized her perspective with words about her patient with schizophrenia and lung cancer:

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”Our patients’ lives matter. Even when they don’t have a family, their lives matter. This person and patient who initially declined treatment expected to be dead. She was amazed that she could receive care and it would help. In her words, “They made me feel like I mattered. Like I had a choice. I feel so lucky that my group home staff came, that they cared.” We might be our patients’ families. We are the people advocating for our patients. And then patients seek treatment. She comes independently after being out of care for 15 years. All these things we thought she wouldn’t do. Being cared about is essential.”

WE NEED TO NAME STIGMA OUT LOUD

Be aware of our own biases How do we treat each other with kindness and respect? “Take more opportunity to name it out loud, and the fear that engenders

in ourselves and our medical colleagues. That fear can alter what we know how to do.”- Mental health clinician

Be integrative: Don’t separate mental health from physical health, it’s both. Name out loud why someone could be afraid to seek treatment to increase

our understanding. Self-Determination: Patient wishes vs. right to treatment

WE NEED TO EDUCATE ABOUT MENTAL HEALTH

Should there be a mandate to have mental health training when treating patients with cancer?

Without education, we can misinterpret behavior as threatening, when it’s a symptom.

Base-level of Education of the care team on the frontlines.o There is a spectrum of mental illnesso We need basic education of all the caregivers regardless of disciplineo Education about palliative care

WE NEED TO DECREASE BARRIERS TO COMMUNICATION

Barriers between institutions and impact on communication Danger of HIPAA (barrier to communication) Fragmentation of system leads to losing the patient voice To address complex patient needs: Substance use, homelessness Barriers between institutions make it difficult for outside agencies to

communicate

For Families and Legal Guardians (and Caregivers): We didn’t have the say we needed to have. The need for families to have rights.

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“I have a friend who wants to learn what is happening for her son, “I’m sorry I cannot speak to you.” What can parents do? It’s a real problem.” – Parent of young adult affected by cancer and mental illness

WE NEED TO ENGAGE A DIVERSE COMMUNITY

Engage families and caregivers Value of diversity of perspectives How to support group home staff and community with rising incidence of

cancer and mortality gap in people with serious mental illness? Be attentive to listening collaboratively within and beyond the hospital Communication and patience as critical skills.

WE NEED A NEW MODEL

Broaden the multidisciplinary team: We need clinical and “non-clinical”- peer support specialists and a family

support specialist---who can become supports to family and patient. Involve patients in meetings with support Support for guardianship to decrease financial barriers for lawyers

“Psychiatry the bedrock and foundation to be able to make decisions and support his wishes and best interests with cancer care” - Father and guardian speaking about son with bipolar disorder and rectal cancer

WE NEED POLICY CHANGE AND SUSTAINABILITY

The mandate for behavioral health integration. Need for disciplined research to drive practice change Workforce: The need for more “Kellys” (More psychiatrists and researchers

dedicated to this work) Coordinating, listening to all supporters. And fundraising. Informed by disciplined research

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PART 2: CREATING OUR SHARED AGENDA FOR CHANGE

Next, we divided into workgroups dedicated to 4 key topic areas co-led by facilitators with expertise in cancer care and mental health care. We were charged with identifying the key challenges within these topic areas and generating next steps. We were struck by the richness of the conversation, the innovative ideas, and the feedback that we can do more to include the perspectives of patients and community members. Ideas included individual change, clinician education (including focused teaching about our own implicit biases), and strategies to change the healthcare system and disseminate this work.

GROUP 1 │ BARRIERS TO CARE8

CHALLENGES:

“Don’t like” to care for these patients (think about why) “It’s hard to take care of these patients. We don’t like it. You feel terrible. Sometimes

they smell.” Care takes more time. Lack of resources on site, challenges of accessing services at different sites Lack of funding for navigation

STRATEGIES:

Plan longer visits proactivelyo Plan longer visits ahead of time o Proactive review of case by psychiatry/social work

Engage mental health earlyo Plan join visit with oncologyo Engage the multidisciplinary team early, an anticipatory process

Connect to someone who can come to the appointment (identify caregiver)o Learn from the Department of Developmental Services model which emphasizes

that each patient be accompanied to appointments Reinstate patient care navigator to MGH North Shore Partner with community organizations Telephone follow-up supporting anticipatory guidance Practical provider education: teach communication and how to connect to patient “Magic App:” Know all members of the care team, document contact information/role Identify patients early (flagging or screening electronic health record

PRIORITIES FOR CHANGE AND ACTION:

1. Educate clinicians to recognize biases and strengthen relationship building with patients with mental illness

a. Include patients and caregivers b. Focus on communication

2. Change the system to better address complex needs and logistical barriers. Work against experience of patients as challenging or difficult by modifying the system.

a. Proactively allocate more time for visits in the clinic scheduleb. Fund navigators & community health workers (the multi-disciplinary team)

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“Find something you treasure in the patient that isn’t related to their mental illness.”— Guidance from clinician

c. Use technology proactively: an app with key members of the care and support team, identifying patients at cancer diagnosis

GROUP 2 │ CAREGIVER RESILIENCE

CHALLENGES:

Who is the caregiver? o Roles and needs may be differento Unique needs of children and parents with cancero Family involvement can be fracturedo Important to recognize community mental health and group home staff as

caregivers HIPAA and how to talk to caregivers (barriers to communication) Increased caregiver burden with change in treatment types from infusion (IV

medication) to oral medications in homeo Caregivers have more responsibility for adherence

When the team doesn’t know what’s happening at home Access to providers/communication Separating caregiving from guardianship Lack of resources for caregivers with practical help: home health, transportation,

equipment Caregiver burnout (high burden) Sad to uproot patients at the end of life if cannot stay in group home, loss of family at

highly vulnerable time (link to EOL Group) Need to address anticipatory grief and loss

STRATEGIES:

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Kelly’s Summary

Group participants felt more hopeful after the session, appreciated diverse perspectives, and generated ideas they had not previously considered. Key ideas included broadening our definition of the caregiver, independently assessing caregiver needs, and developing targeted interventions. Participants emphasized integrating the caregiver into cancer care delivery, improving communication, and providing practical tools.

Create system of peer cross training to help remove siloed aspects of careo Peer-to-peer support groupso Support groups for caregivers (grouped with similar needs)

Give caregivers templates for leaves of absence Help caregivers feel heard- by oncology and mental health teams Target caregiver burnout: develop programs to identify and address diverse caregiver

needso Mental health screening for caregiverso Give caregivers permission/directive to practice self-careo Separate check-in with caregivers at appointments, opportunity to ask questionso Support groups for caregivers o Provide written material for caregivers to review outside appointments

Ask about barriers to care at 1st visit with caregiver Education

o Clear training, access to informational protocolso Include other families/caregiverso Use video models of how caregivers coped effectively with cancer care

Communicationo Train caregivers in digestible chunks about what to expect (phases of treatment)o Email access to clinicians/providerso Talk to patient vs. exclusively talking to caregiver o Be aware of complexities of familieso Try weekly NP/RN call for caregivers o Team meetings

Practical tools: E.G. Sample letters to employers for family leave Community outreach Integrate caregivers into the patient’s care team

o Caregivers present and part of careo Have caregivers at appointments, caregivers know patient best

Need for earlier palliative careo Utilize VNA or bridge palliative care nurses in the home or group homeo Palliative care early for patients with serious mental illness

PRIORITIES FOR CHANGE AND ACTION

1. Screen caregivers for mental health needs, as they may need mental health treatmenta. Systematically identify caregivers early b. Broaden our definition of caregiver for this populationc. Learn more about caregivers’ needs related to end-of-life care

2. Improve communication and integrate caregivers into cancer care deliverya. Consider resource-based barriers b. Use flexible approaches tailored to caregiver’s needs and capacity

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GROUP 3 │ END OF LIFE CARE and SERIOUS MENTAL ILLNESS

CHALLENGES:

Lack of control Lack of practical supports Social isolation, may not live with family and need a dedicated place Cognitive challenges with comprehension “capacity” Guilt Grief support for the family Addiction Barriers to home hospice Barriers to inpatient hospice Time constraints Safety: Treatment toxicity Addressing fears Paranoia leads to avoiding services/care Importance of Relationships/Connections Transitions in care settings (hospital to rehab)

STRATEGIES

Advocate and refer for open access hospice Increase access and financial support for inpatient hospice Integration and collaboration

o Foster collaboration with residential/group home/mental health staff and clinicians

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Kelly’s Summary

The diverse panel including an oncologist and psychologists with expertise in palliative care, a community mental health nurse practitioner, and a group home program coordinator led to a rich conversation about how to better care for patients with mental illness and cancer at the end of life and how to support each other as caregivers. Key messages including decreasing barriers to participation in hospice in the community and hospital, redefining and broadening our definition of the multidisciplinary team, and educating clinicians about how to tailor communication.

o Foster multi and interdisciplinary care teamso Identify solutions for patients, caregivers, and systems and make care less

fragmented Create relationships to diffuse fear, establish trusting relationships early to build trust

and be ready to have difficult conversations at EOL. Tailor conversations to cognitive deficits Think broadly and thoughtfully about who to include in the conversation Consider the site of death and end of life: Can patients stay at home? Where is home?

What about cost and access?

PRIORITIES FOR CHANGE AND ACTION

1. Develop pilot programs with local hospice agencies re: open access for this population, engage hospice staff earlier to be part of care team/reimbursement

2. Redefine multidisciplinary teams -Include group home staff at appointments to help the psychiatrist and oncologist feel confident in patients staying in group home- Include caregivers and advocates- Potential strategy to mitigate Increasing burden on caregivers

3. Educate clinicians, patients, and caregivers: how to tailor the conversation

GROUP 4│ BUILDING TRUST: PERSON-CENTERED CARE

CHALLENGES:

Time (lack of time) Is it paternalism or our responsibility as clinicians? Obtaining and reviewing social history frequently Silos between different parts of the healthcare system Bureaucratic barriers to supportive long-term care relationships with providers

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Kelly’s Summary

Facilitators and participants began discussing the challenge of being person-centered when patients initially decline treatment. The discussion highlighted best practices that have reached patients in the community that are flexible and targeted. To sustain this work, we need to build teams, to inform healthcare systems change and to conduct innovative research examining care models that can be disseminated to the community.

Not enough inpatient beds Challenges accessing healthcare Patients not following through with appointments Challenging to stay in touch with a person with SMI and communicate in a way that is

helpful Financial barriers/transportation How can we make this model standard? Increased support of peer relationships-- to allow patients to go to day programs from

rehab or nursing facilities---patients may not have families What happens when team approach doesn’t work? Getting referrals quickly enough to keep reluctant patients engaged in care Need for research: Define the outcome for person-centered care Not prioritized (the patient population) “We’ve always done it this way” (resistance to new models) Difficult to measure Lack of teamwork/collaboration Not being patient-centered

- Patient may not be able to do outpatient treatment, may need to be hospitalized

Not sustainable to do after hours, during overtime, to rely on going above and beyond- Lack of time for providers to do “extra”

People on “care and comfort meds” (i.e. comfort measures only)- deserve psychiatric care

STRATEGIES:

Listen first Ask why not Flexibility with timing, structure, and location of visits

o After hours visitso Change of appointment time can help families who can then be able to meet

with doctors later in the day (8pm)o Have a “window of time”o Not everyone on the team needs/wants to work 9-5pmo House calls

Community-based approach to establish trust with providers to increase agreement with care

Add community health workers to the team Ability to bill for dual (joint) appointments Team approach: Person-centered: team, team, team A better call system Integrated care models

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Increased access to hospital systems (for admission) Integrate family and support and flexibility and individual solutions More collaboration with nursing who become very close to many of their patients. They

might be able to offer ideas! Facilitate communication between providers through billing incentives: Pay for Phone

Calls Reemerging ethos (training) re: the ethos of good practice for physicians (clinicians) Listen to patients: What helps? What hurts? Determine who takes the lead on what is person-centered: If not the patient, then,

who? Research Funding, Creative funding! Education to counteract stigma: Educate entire team on mental health/sensitivity

(implicit bias) training More beds Process of learning to trust, takes multiple steps, tries Technology may help in the future

o Care academy.com and care.com: developing apps that inform all stakeholders of a patient’s care (leverage model in geriatrics)

o Learn from best practices Increase time for appointments Adopt team approach in oncology based on community model Outreach between medical center and community programs Establish team and specific roles Families and patients meeting with doctors and others with similar experiences Have patients who have been through it before talk through procedures with patients Create system for patients with undiagnosed mental illness in a crisis/how to engage a

team Measure the cost offset Train healthcare providers Communication and reaching out to caregivers (communication among clinicians)

PRIORITIES FOR CHANGE AND ACTION

1. Build multidisciplinary teams: Add group home staff, peers/families, community health workers, caregivers and integrate into care delivery

2. Educate everyone on the team at being patient-centered, how to connect with the patient to engage them (Cross-Education)

3. Connect to policy makers and use research and personal stories to advocate and disseminate work

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PART 3: THE IMPACT ON PARTICIPANTS

What We Learned, Attendee Feedback on the Symposium:

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Kelly’s Summary

Many participants emphasized that having diverse perspectives in speakers and participants generated richer conversation and new ideas. There was a new awareness of a community of people from different backgrounds with a shared commitment to advocate for people affected by mental illness and cancer and their caregivers---which was restorative.

“It brought the community and MGH Providers together.”

“I am not alone in this fight for quality care, so don’t stop advocating and doing what I feel is right.”

“Need attention at the system level—to recognize the extent of the impact of these issues on the health system—those working in it and those who need care in it.”

“That the mortality for people with SMI has not improved, the 30 year gap, The Cancer Disparity.”

“Interdisciplinary communication is key to patient outcomes,” “Communication between providers is a problem that needs solving.”

“Not being passive with providers and ask why not?” The need to be aware and challenge our own biases

“Going the extra mile to support and coordinate care with caregivers- in the community and family.”

“There is a model here and therefore hope for other centers without one: The critical nature of integrated, team-based care.”

“Community: Colleagues full of spirit and resilience that we can always turn to.”

NEXT STEPS:

Creating stakeholder advisory council Partnering to create 2018 symposium Education, training, and community engagement

A quarterly newsletter will provide updates about the collaborative care and community engagement program and research, clinical initiatives, education , and advocacy for people affected by cancer and mental illness

HOW TO LEARN MORE:

Contact the Collaborative Care and Community Engagement Program Center for Psychiatric Oncology and Behavioral SciencesMassachusetts General Hospital - Cancer Center55 Fruit Street – Yawkey 10BBoston, MA 02114

Director: Kelly IrwinEmail: kirwin1@partners.orgTel: 617-643-4453

Associate Director: Amy Corveleyn Email: acorveleyn@partners.orgTel: 617-726-2344

Click here to visit MGH Cancer Outcomes Research Program (CORe) website

Click here to view a recap of the Symposium

To access video content from the Symposium and add your feedback to the Symposium Google document:

Click here to visit Kelly Irwin’s CORe page

Click here to visit MGH Psychiatric Oncology and Behavioral Services

SAVE THE DATE: May 2018 Symposium, details to come

WAYS TO CONTRIBUTE: For more information about supporting the MGH Collaborative Care and Community Engagement Program, please visit

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giving.massgeneral.org/donate/support-psychiatric-oncology/ or contact Molly McCarthy at 617-643-8827 or mmccarthy50@partners.org.

https://giving.massgeneral.org/donate/support-psychiatric-oncology/

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Bridging the Divide: Mental Health and Cancer Care

AGENDA

12:00 PM WELCOME AND INTRODUCTIONSDavid Ryan, MD │ Clinical Director, Mass General Cancer CenterKelly Irwin, MD │ Director of Collaborative Care & Community Engagement, Mass

General Cancer Center

12:15 PM LUNCH PANELModeratorsDavid Ryan, MD │ Clinical Director, Mass General Cancer CenterIlana Braun, MD │ Director of Psychosocial Oncology, Dana-Farber Cancer

Institute

Narrative 1: Joan and Henry Archibald, Lipika Goyal, MD, Keri Brenner, MDNarrative 2: Caryn Metzger, NP, Anna Farago, MD

1:15 PM PLENARY: BRIDGING THE DIVIDESpeakerKelly Irwin, MD │ Director of Collaborative Care & Community Engagement, Mass

General Cancer Center

1:45 PM LEADERS IN MENTAL HEALTH AND CANCER CAREModeratorJerrold Rosenbaum, MD │ Chief of Psychiatry, Mass General HospitalPanelistsEmma Stanton, MD │ Beacon Health OptionsInga Lennes, MD │ SVP, Mass General Physicians Organization, SVP of Service

Excellence and Practice ImprovementRepresentative Christopher Markey, JD │ Chairman of the House Ethics

Committee and State representative from Dartmouth and New Bedford

Kathy Sanders, MD │ Deputy Commissioner, Department of Mental Health

2:15 PM BREAK2:30 PM WORKGROUPS (see next page for selections)3:30 PM BREAK3:45 PM COMING TOGETHER

Creating our Shared AgendaElyse Park, PhD, MPH │ Associate Director of Survivorship Research &

Psychosocial Services, Mass General Cancer Center

4:15 PM Award Presentation: Angels in the System

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4:30 PM Call to Action – “Why I Am Hopeful”Oliver Freudenreich, MD │ Co-Director, Mass General Schizophrenia

Program

4:50 PM CLOSING REMARKS & NETWORKING

1BARRIERS TO CARE

Facilitators: Drs. Beverly Moy and Becca BrendelSpeakers: Lisa Lovett, MSW, LICSW Emily Doerr, MSW, LICSW Gail Levine, MD Giselle Perez-Lougee, PhD

2CAREGIVER RESILIENCEFacilitators: Amy Corveleyn, MSW, LICSW and Rhaea Photopoulos, NPSpeakers: Jamie Jacobs, PhD Elyse Park, PhD Kriya Brown

3END-OF-LIFE CAREFacilitators: Drs. Jennifer Temel and Joseph GreerSpeakers: Eric Hanson, MSW, LICSW Angela Sousa, NP Ben Macri, NP

4PATIENT AND CAREGIVER CENTERED CARE:BUILDING TRUST IN CLINICAL CARE AND RESEARCHFacilitators: Drs. Kelly Irwin and Michelle SpechtSpeakers: Joan Archibald Jeff Peppercorn, MD Sally Reyering, MD

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1st Annual Recipients of the Bridge Award: Promoting Equity in Cancer Care for People with Mental

IllnessThese clinicians and caregivers were recognized by their colleagues this year for

their innovation, persistence, and creativity in improving care for people with cancer and mental illness and their caregivers:

Shukriyah BrownSenior Program Coordinator, North Suffolk Mental Health

Eileen Keenan, MSW, LICSWSocial Worker, Mass General Hospital Cancer Center

Fremonta Meyer, MDPsychiatrist, Dana-Farber Cancer Institute

Jennifer Shin, MDMedical Oncologist and Palliative Care Clinician,

Mass General Hospital Cancer Center

Thank YouWe would like to thank the following institutions and individuals:

Dana-Farber/Harvard Cancer CenterMassachusetts General Hospital Cancer Center

For their work as the planning committee:

David Ryan, Mara Bloom, Ilana Braun, Oliver Freudenreich, Sarah MacLaurin, Amy Corveleyn, Steve Herskovitz, Joe Greer, and Joan Archibald

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For their support and collaboration:

Rep. Christopher Markey, Debbie Goff, Erin O’Leary, Mary Nunes, Devon Punch, Jenna Gilberti, Cameron Ware, and Lauren Fields

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