2021-09-21 00:00:00 - Joint Committee on Ways and Means
2021-09-21 00:00:00 - Joint Committee on Ways and Means
(Part 3 of 4)
[PART 3]
SHOW NON-ESSENTIAL DIALOGUE
mhm.
Um Pat Kelleher,
you were just
Pat, you are a muted
thank you that I a muted
[PAT KELLEHER(HOME CARE ALLIANCE MASS):] Thank you, Chair Friedman, Chair Hunt. I am the executive director of the Home Care of Massachusetts. We represent about 180 home health and home care agencies and I'll just say35 you've heard a lot of this already, but if the past year has revealed anything, it has revealed to heighten awareness of how much consumers43 in our commonwealth dependent on the home care workforce and how critical the home care workforce is to ensure patient flow through our hospitals, our emergency rooms in our nursing homes. Home care first became the preferred solution for many families this past year and I remember agencies stepped up and took care of thousands of covid patients in their home, covid positive and covid exposed.
And not only did they address their health needs, but they were often confronted with those social determinants75 of health issues like food security, other members in the home that we also were trying to address. As the home care alliance comes before you today. Congress has entrusted our state with an absolutely unprecedented opportunity to improve our approach and access to home and community services in massachusetts. We can make long term changes that will strengthen and ensure access for generations to come. We already heard the problems, the Council Home Care Aid Council testified that we have 5000 people waiting for home care services in the Commonwealth.
That is the highest, it's been in my 20 years in this industry. I would also add that we provide home health services to medically complex children and there are more than 100 families waiting for complex continuous scale nursing services right now through Mass health, again, the highest I've ever seen it. Home Care Alliance Masses, several recommendations that we have laid out in longer testimony, I'll just quickly summarize them; first, as was previously testified to by141 the home care aide council, we support immediately annualizing the six months rate increases that secretary studies reference has been put in place from July to December.
We definitely appreciate the six-month increases, but I think the committee can appreciate that the temporary nature of these funds makes it really difficult for our agencies to make substantive progress in recruiting a permanent workforce. They do allow us to provide bonuses or temporary wage increases but only as long as these rate increases are in effect. We believe we need permanent year-round increases to be able to offer higher starting salaries and permanent salaries, not just temporary bonuses. Second, we believe we cannot stop at June 22 with these rate increases. We must build192 again on this generational opportunity. We had to come to the legislature every year and you have acted and provided us temporary rate add ons.
We would like to see as the ARPA funds are allowed to be spent through 2026 that we believe we have an opportunity to implement a multi-year rate investment program in-home and community-based services. That we would have predictability over the next four years, what our rates would be, what we would be able to pay? Again, we have numbers for what those costs are in our written testimony. Third, we need to look long term as we just heard,231 we must look at attracting people into the home care workforce and keeping them in the home care workforce. That requires things beyond provider reimbursement rates. For instance, we believe we must do more to prepare newly graduating nurses to go from school into the home care setting, which the current nursing school curricula do not provide.
This means funding graduate residencies and precepts opportunities. We must think, as others have said creatively about the259 issue of student law relief for those who choose to go into long term care services and support, tuition reimbursement or training and mentorship programs for new hires. We urge the legislature to commit $100 million dollars into the reserve funds for these efforts that will build and retain a permanent and appreciated home care workforce. We have in our testimony included a list of programs and services that we think would be eligible for providers to apply to fund through this fund, including student loan replacement and tuition nurse preceptorships new graduate programs.
As I said, nurses come from schools unable to work independently. Select agencies have had success in creating their own perceptive programs, but they're expensive and we'd like to see a statewide approach. The grants could be used for childcare vouchers. This was a huge issue for us when schools were closed last year. Mentorship programs for home care aides, we find that we bring people into the field but they don't stay, it's difficult. They have to turn to your boss if you have a problem if you have a mentor that's paid to be your mentor while you're new in the field.
We have seen that work in other states, we would like to see something like that here. We can reduce the turnover of these aides and make them feel more supported while creating a career ladder for those aides who become mentors. Home care aide training programs are dwindling, the number of programs in the state, many close during the pandemic and haven't reopened. We would like to see investments through this fund and creating training programs using some sort of economies of scale to create more training programs for home health aides. Our state has a great online Peake cast program to train homemakers but we don't have a program to get. So with that, you'll see the rest of our ideas in my testimony. I just remind you that home care is the most cost-effective preferred setting for long term services and support. Thank you.
SHOW NON-ESSENTIAL DIALOGUE
and I apologize if I went over. No worries. There's I know there's a lot and three minutes sometimes doesn't quite cover it. But thank you. Thanks so much for your testimony. Uh rep hunt any questions
I couldn't mute myself. Thank you for your testimony. Thank you. Okay. Um Mhm
lisa Gorgan E. Okay. Hi, can you hear me? Hi everyone.
[LISA GURGONE(MASS HOME CARE):] Thank you. Good morning or Good afternoon. My name is Lisa Gurgone, I am the executive director of Mass Home Care. We are the trade association representing the commonwealth Network of ageing service access points and area agencies on ageing. I want to thank the committee and the administration for all the attention and time you have taken to listen to stakeholders like myself talk about how best to use the ARPA funds to really reimagine how we provide care in the community of people who need services. Mass Home Care will be submitting very detailed testimony with lots of information but I did want448 to just touch upon really two priorities for what our association think about ARPA.
One, is really to address the immediate challenges that are faced by our ageing network in all human service providers and others as we think about461 how we have cared for people during covid, on the front lines, day in day out, our frontline workers, the direct care workers at agencies, all473 of us trying to do what we can to make sure that individuals receive the care they need in such a difficult time. Then two, what are the ways that as a commonwealth we can enhance and modernize our home and community-based service network. Again, I won't read everything, I did want to speak to represent tons of questions about sustainability beyond the ARPA dollars.
Note that Governor Baker included two outside sections, sections 79 and 82 his recent Fy21 closeout budget. What those sections do are actually establish a new home and community-based services, Federal Investment Trust fund where the commonwealth can take some of the financial federal participation they received from the government for enhanced home and community services and invest in a trust they can use in the out years to continue to enhance and expand home and community-based care. So it's a very unique opportunity we have here, we will be getting an enhanced map at a higher amount from the federal government.
And instead of using that immediately, we can invest it for future uses. And so a lot of our testimony that we wrote and we will share talk about different things the commonwealth can do like expanding residential options for people, expanding technology, trying to understand options of services. We talk about older behavioural health options on investments in our workforce, all those things could be addressed if we were to take some of the funding invested568 in the long term. So we certainly want to think about how to do that and I think that we also just want to say that these ARPA dollars are really an opportunity of a lifetime I have to say um for our country and our commonwealth to invest in our home and communities network.
We've done a lot over the years but so much more can be done. And we really want to use the opportunity to make sure that we have the services that all of us will need as we age to remain where we want to be which598 is primarily in the home. Thank you.
SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you very much
rep hunt. You have any. Not as the time. Thank you. Thanks lisa. Thank you. Um Para gregorio. Mhm. Hello. Good afternoon. Hello.
[TARA GREGORIO(MASS SENIOR CARE ASSOCIATION):] Thank you, Madam Chair, Mr. Chairman and members of623 the committee. As stated, my name is Tara Gregorio, and on behalf of the Massachusetts Senior Care Association, I thank you for the opportunity to present testimony on what we are calling the nursing facility638 recovery and sustainability proposal. With the640 strong support of the legislature and Baker administration, nursing facilities continue to make meaningful progress in our fight against covid 19. Massachusetts facilities continue to lead the nation in the number of residents and staff vaccination rates with 92% of staff having received at least one dose of vaccine and 90% of our residents fully vaccinated.
As a result of these high vaccination rates and our ongoing infection prevention efforts including the wearing of PPE and at least weekly surveillance testing, we have made a significant and sustained decrease in the rate of COVID-19 infections among nursing facility residents to 0.09 or currently 28 breakthrough infections out of 32,000 residents. However, as we continue to remain vigilant against the unpredictable nature of the COVID-19 virus and demand for our services increases, nursing facilities across the state are faced with an immediate and urgent workforce crisis of 6000 or one in five direct care positions720 unfilled due to what many have described as the worst staffing crisis in history and has led to over half of nursing facilities intermittently closing admissions for new residents and hospital referrals.
Since 70% of our residents have their care or 22,000 residents have their care paid for by Mass health, there is a particular imperative for the commonwealth and provider community to continue to work together to address these mounting challenges by allocating a portion of the ARPA funds to continue to support nursing facility residents, their families and caregivers. Specifically, the recovery and sustainability proposal, totalling $461 million would enable the Commonwealth and nursing facilities over the next several years to make investments in three fundamental areas. The first is workforce, we propose781 285.5 million to fund several retentions and recruitment initiatives, including first and foremost, a $2500 heroes, a thank you bonus for our dedicated 45,000 staff who showed up to work each day during the height of the pandemic.
We also are asking for an804 international nurse805 placement program to offset the cost of hiring 2000810 overseas nurses who are expected to begin arriving, fingers crossed in Massachusetts nursing facilities later this winter. We are also asking for grants for front line821 staff to help offset childcare, eldercare and transportation costs. We ask for a CNA training scholarship program of $2000 for 4000 individuals to be trained and certified as certified nursing assistants. Then we also ask for a nursing student clinical rotation program and finally a leadership training program for our nursing facility administrators. We are also asking for our residents that invest in timely training for our staff and ongoing training for our staff and in an end of life what matters to me programs so that we859 have dignity at the end of our life.
As well as an annual residents satisfaction and experience survey so that we can hear directly from residents as to their care needs in the facility. Finally, an infrastructure fund that proposes $150 million dollars to modernize and update nursing facilities to enhance care, delivery and resident privacy by creating more home-like settings of care. I'm going to stop right there, but887 I have extensive written comments, as you can imagine, but really want to thank the committee and all of your colleagues for your great work and support on behalf of the residents, their families and caregivers in the state. So thank you.
SHOW NON-ESSENTIAL DIALOGUE
Thank you, Tarr Good job, good job. We look forward to your testimony. So greatly appreciated. Um and uh I know it's been a long haul for you all and Um I appreciate all of the work you did over the last 20 months. Um uh Report. Ditto thank you if All right. Good to see you. Um The next uh Senate is the panel um
get this right OK, Phoebe walker. Tess Curran Damon chaplain and Tierney flaherty. Hi Phoebe, good afternoon Senator. Great to see you. I great to see you to Representative Hunt. Um
[PHOEBE WALKER(WESTERN MASS PUBLIC HEALTH ASSOCIATION):] Thank you for having us here. I am the first speaker of a group of people who are representing the coalition for local public health, which is a coalition of thousands of health agents, Health inspectors, health directors, public health nurses and others, board of health members and the mass Public Health Association. We're here to go over in detail our proposal for a one-time transformative Investment in changing the local public health infrastructure in Massachusetts. I know we've heard some really great support of that from our other legislative champions earlier today and I want to thank them for all their work on that. It's about $250.9 million dollars we're talking about, I know that you have been provided with very specific details on what that is, so I won't waste a lot of time knowing how many people are still waiting to talk, but just want to briefly highlight a little bit of that myself and then my colleagues will each highlight another little part of the ask.
I'm here from the Franklin Regional Council of Governments, I'm representing the1029 Western Mass Public Health Association and basically the rural parts of this state. I've worked in local public health for about 27 years and that has given me some real perspective on how urgent the need is for investment in changing the structure in Massachusetts as others have already said today so I won't waste your time on that. My charge here today is to make it clear why we need investment in local public health data systems. On the Special Commission, I was the chair of the Data committee and it was quite eye-opening to in that role call together everybody in the State Department of1066 Public Health who collects data from local Public health and looks around and sees just how few people that was through no fault of1072 their own, of course.
You know, we don't have a system in this state that collects much of anything1077 about local public health. For example, we know now better than ever how important a determinant of health housing is, especially during covid. We don't collect any data on housing code complaints, we don't collect any data on housing safety, housing code enforcement outcomes, who does lead inspections, who doesn't, we don't know what kind of food safety violations are happening1101 in what towns in Massachusetts in what kinds of restaurants, we don't know whose private wells are near whose septic systems, we don't know how old that septic system is, whether it's working and whether it's polluting that private well, these are just one of the many of the things we don't know about how our local public health system works.
Our $118 million five-year funding proposal for the data infrastructure includes three chunks; one, is permitting systems, one is inspection systems and one is a uniform state reporting system. So briefly, in terms of permitting, every local health department needs to have online permitting software because small business owners deserve to not have to wait for a town hall to be open on the third Thursday of the night to go in and get a permit, they need to be able to log on from their home. It's the 21st century, they should be able to do that and file and pay online, this is something we need to be able to have. In terms of inspection software, every community needs to have a health inspection software that collects information when they're in restaurants, when they're in housing complaint investigations, when they are at summer camps, right, in order to tell what are the hazards they're seeing and that is so that they know what do they need to do, what do we need to do at the local level, what kind of policy change do we need, what kind of programming should we be doing, what kind of education could we be doing.
If we have the data, we can figure that out and we can report it to the state. Finally, the third chunk is we need a 21st-century state reporting system, right? You need to be able as legislators, you've got to be able to have a report, you can pull off a shelf, pull up on your computer and see how are we doing and you don't have that right now and none of us has it. So that would be the third thing, is really how can we build a system that works, that collects the data from these1218 other pieces. It gives us an overarching sense of how our local public health system works in this state. I know other colleagues are going to be addressing other aspects of the proposal and I'm sorry Dimon Chaplain, New Bedford's health director had to leave already, so he won't be here to talk about in particular the disparity focus of our ask, but I know that that's in the written testimony that we're submitting to you. So1240 I thank you so much for your time and I'll pass it on to1244 my colleagues unless anyone has questions
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well. So why don't you keep going?
[TESS CURRAN(HEALTH AND HUMAN SERVICES FALL RIVER):] Thank you, this is Tess Curran. Thank you for inviting me here today to discuss the need for prioritizing local public health in Massachusetts to be provided with funds from the American Rescue Plan Act, an act that has1269 resulted from the largest public health crisis of1271 our times. Again, my name is Tess Curran and I am the director of health and human services for the city of Fall River when1278 I think of this proposal, the saying that a team is only as strong as your weakest player comes to mind. In order to strengthen our collective local board of health team, your support by extending this ARPA funding to local public health would ensure that as a commonwealth we can provide all Massachusetts residents with an effective comprehensive and equitable public health system.
As Phoebe has mentioned a lack of accessible and timely data not only impacts our work but also impacts our workforce. As a city, we're fortunate to have a dedicated team of inspectors, two public health nurses and a recipient of a number of grants. However, even with the staffing, we still have our challenges in addressing a full range of public health issues. This includes connecting with community members through outreach and addressing health equity. Fortunately,1331 in our recently formed partnership with two other communities, Fall River is a recipient of the public health excellence grants. This new shared service model will increase access to1340 public health nursing and provide our three communities with an outreach worker and an epidemiologist.
These are positions that have either remained vacant or have been non-existent within our departments. This will strengthen our communities in our region, it will improve health outcomes for our residents and it will begin to transform the public health system in Bristol County. As we know and as the last two years have shown like a virus public health concerns know no municipal bonds. The fragmented system that we have currently left our communities vulnerable. We have the blueprint1375 from the Special Commission and we know and love the communities that we serve, what we need is the resources to ensure that our collective local board of health team across the region and the commonwealth are more united and are able to protect all Massachusetts residents. I thank you for your time and consideration on this issue.
SHOW NON-ESSENTIAL DIALOGUE
Mhm. Uh huh.
[TIERNEY FLAHERTY(BOSTON PUBLIC HEALTH COMMISSION):] Good afternoon everyone. My name is Tierney Flaherty and I'm the Director of Intergovernmental Relations for the Boston Public Health Commission. I'm very proud to join my local public health colleagues here today to advocate for substantial and substandard investment in local public health across the commonwealth. Boston is a vibrant, thriving, dynamic city, but it's also a city where we see dramatic and persistent health inequities, inequities that have only been highlighted and exacerbated by the COVID-19 pandemic. In June 2020, racism was declared a public1438 health crisis in Boston, and the Boston Public Health Commission was charged with combating racism and the resulting health inequities. Local public health departments like the Boston Public Health Commission are powerful tools when it comes to combating these health inequities.
We're eager to continue our work on racial justice and health equity and we know that the legislature shares our commitment to this1464 issue, but we do need additional investment from the state level to support this work. I'd like to further point out that public health issues, particularly infectious diseases do not recognize municipal boundaries. While Boston's residential population stands at about 694,000, it's estimated that about 1.2 million people are in the city during work hours. In order to ensure the health and welfare of all these people, Boston depends on a strong, sustainable statewide public health system. Similarly, and particularly during the covid, neighbouring municipalities depend on Boston having a robust infectious disease surveillance and response system. Thank you for your time.
SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you very much. It's good to hear from you all and thanks for the amazing work you did over the past 20 months, um, plenty of any questions.
Just a parochial statement is that um I see dorchester heights behind you tyranny, but you know, we need some savin hill representation in your back.
Yeah. Really know your audience, you know? Um Okay, thank you all. We appreciate it. Um Mr Foley. Are you here?
Jim? There you are. Yeah, I see you. Are you doing.
So I'll just start. Uh
[TIM FULEY(1199 SEIU):] Thank you to the chairs of the committee and all the other members here today. It's a great opportunity to testify before this committee and also just a great public process that you have here and I just want to appreciate that and all the testimony that preceded me, I don't envy the position you're all in to make these decisions. For the record, my name is Tim Fuley, I'm the executive vice president. 1199 SEIU, state's largest healthcare workers union representing more than 75,000 essential caregivers and home care, nursing homes, community health centres and hospitals throughout the commonwealth. I know the time is limited today and you have the power of mute as well.
So I just wanted to focus on a few critical areas that are really informed by the healthcare workers' experiences during the pandemic, before the pandemic and after the pandemic and as Massachusetts residents living in communities disproportionately impacted by this pandemic. There are three major critical investment areas that our members have identified again shaped by their experiences where they work and where they live first and foremost is pandemic pay for front line health care workers. Secondly, community and safety net provider investments to address the disproportionate impact that COVID-19 has had.
Thirdly, investments in health care, workforce training and recruitment to address, which many of the speakers before we have identified as the staffing crisis we are facing throughout our health care delivery system. Again, importantly these investment areas that we are highlighting today seek to centre an equity framework that prioritizes spending to help address the continued disparities made only worse by the pandemic. First and foremost, is pandemic pay is a key priority for 1199 SEIU. I hope that you have heard from our members from across the commonwealth. I know I certainly have that they've identified pandemic pay as their top priority. This we believe would be one concrete way to recognize the heroic role that healthcare workers played during the pandemic and continue to play today, but also just to give a little bit of financial relief and some of them take some pressure off this workforce that has only increased during the pandemic.
We know that in the enabling statute for this funding, that premium pay was a clear priority and the stated purpose of the American rescue plan, but I think, more importantly, we just think it's simply the right thing to do for this amazing group of workers who have continued to care for us during these critical times. The healthcare workers of 1199 SEIU not only work for community and Safety net providers, but they also receive care at1720 these critical health care providers. These community and Safety net providers as well as our long term care providers, much like the 1199 workforces, are under stress and require immediate support. We believe through enhanced rates and our1733 investment, community and safety-net hospitals in particular experienced unprecedented revenue loss and require additional funding to begin to stabilize, rebalance and just continue to provide the quality care that we know we all want to the state's most vulnerable population.
I think that the CHIO report was identified earlier, but seven out of the eight providers with negative margins in the fy 20 report from CHIO, where community-based systems, we also know the same systems treated a1766 large volume of Covid 19 patients and lost significant volume compared to their counterparts in the industry. So we believe making these investments and targeted investments to support these providers impacted the most by Covid who have been struggling1780 during and prior to the pandemic and have continued to exacerbate those, particularly under our current hospital financing structure that we've all talked about in the past. Finally, it's been mentioned many times before the workforce issues are just at a critical level here so we believe the American rescue plan1798 gives us an opportunity to make investments in workforce training, education programs to help address the critical staffing needs of our health care, home care and nursing home industry.
We need to ensure that we're upskilling career ladder programs, training recruitment and retaining a qualified and committed health care workforce so that we can continue to provide high-quality care to the residents of Massachusetts. Again, as has been mentioned before. I think we are at a critical level here where the pressure and the stress of these workers are at the highest I've seen and staffing is of a critical nature. So addressing the workforce issue is incredibly important. So I thank you for your time and consideration and continue to work with this committee like we have in the past to address these important issues thanks again for the opportunity and for the great process you put on here today and I know you will continue to do that. Thank you.
Thank you to all the people that you represent for all that they've done. It's not gone unnoticed. Where's that for punt. Do you have any questions? Thank you tim. Thank you. Good to see you. Um brian Doherty
Yes,
[BRIAN DOHERTY(MASS ASSISTED LIVING ASSOCIATION):] Thank you, Chairman Friedman, members of the committee. Good to see you and thanks for the opportunity to testify today. I'm Brian Doherty President Ceo of Massachusetts assisted living association and we represent the vast majority of the 270 certified assisted living residences in the commonwealth which are regulated by the executive office of elder affairs, which has provided very helpful and appropriate guidance both prior to and during the pandemic versus of living providers. And as you know, assisted living providers have been on the front lines of providing care since the start of the pandemic and we've really ramped up our standards of infection control and safety during that time.
Through that process, We've incurred estimated losses of 464 million from the beginning of the pandemic through the second quarter of this year. Today, I just wanted to call your attention to a few programs that are very helpful to provide more access to assisted living for older adults. One of those that have been helpful in the pandemic in keeping older adults and staff safe has been a point of care testing, which we really appreciate administration, it1943 has provided free access to point of care tests throughout this year, they expanded the access of the number of test kits per month that providers can request and that's been extended through October.
We would ask for that to be extended further so that we can continue to be proactive with covid testing communities. Also, I'm often asked how can we make assisted living more affordable and we have longer-term bigger policy proposals. I'm happy1971 to discuss in another forum but the three most pragmatic ways to do that are through GAFC, the group adult foster care program, AIC, the program of all-inclusive care for the elderly and SCO, senior care options. We greatly appreciate that there have been short term funding increases through the home and community-based services through the administration thus far. But those are scheduled to end especially for the group at All Foster Care, which provides reimbursement for about 500 older adults and assisted living in Massachusetts and is the primary affordable source for assisted living in Massachusetts.
That 10% funding bump is set to end at the end of December. We would appreciate any consideration you could give to expanding the home and community-based services funding or extending it further as the longer-term increase in group adult foster care which is being pursued is now delayed until later in 2022 at the earliest. Thank you.
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Thank you. Thanks very much for your testimony. Um any questions, yep. No. Okay, thanks2045 so much Harriet brand, Big
Harriet, are you here hurry up?
Hi, yes, I am here. Uh my name is Harriet branding. Um, I am blind a little short on the uh interaction with the technology. Sorry, okay,
[HARRIOTE RANVIG( MASS ADAPT):] I am 75 years old. I am blind and I have been a professional and now a volunteer disability2090 advocate with Mass adapt, a chapter member from the national adapt movement. And ostensibly I am here, unfortunately fairly singly so far to raise up the issue of home and community-based services and durable medical equipment. Several years ago, I had to go into a nursing home for rehab services after hip replacements, two of them in one year and what was astounding to me was that my physical therapy care was excellent, however, the staffing of the nursing care facility was meagre and I was even housed with one of the long term residents.
So I was able to observe how infrequently her needs were met and also to what degree the food care was very poor. So I'm here primarily to point out that home-based community services served people with a wide range of disabilities and most particularly remember anyone who has severe orthopaedic problems will probably end up in a nursing home. What is really understood about this is that unless there's outside support for that person to come out and live back in the community no matter their age, if they don't have the financial or family wherewithal, they will be stuck in a nursing home.
I don't have to tell all of you that a third to a half of the deaths in this country have occurred in congregate and nursing home settings. The appalling another aspect I want to bring up and I just bring it up for your consideration, there's a huge amount of money for nursing home Medicaid and2213 has always been, however, it is much cheaper for state and city and federal governments to support us in-home independence for a living in quality of life. And just look at your budget layout so far. Just to keep everyone aware, there are 91,000 people who are wheelchair users in the Commonwealth, and perhaps about 25% of them use power chairs. Power chairs are costing really anywhere from $20,000 to 70,000.
Accommodating a quadriplegic, for example, to continue working in their full-time jobs and not to leave out the critical need of personal care attendants and the same problem that has been spoken about over and over here and I admire every2268 speaker, I've learned a lot. There are not enough well trained and sustainable personal care attendants. So if2277 you lose your personal care attendant and your chair is not repaired in time, you will end up in a nursing home and during covid, this has just been so exacerbated. So for you, I don't have all the figures here. I'll get unfinished. Thank you.
Thank you. Thanks so much for your advocacy. We really2300 appreciate it. Um And I'm glad that you joined us and I'm glad2306 that um you were able to listen to the other speakers. So thank you so much. Really appreciate it. Okay, excuse me. Oh, when you and she
shit. Yeah, I'm here. Okay. Hi, just a second. I can't. I just want um uh Miss rand it. Could you, would you for us please do that. Great, thank you. Go ahead. Ok,
[WEN(HARVARD AFFILIATED DENTAL HOSPITAL):] Honourable Chair and committee members, thank you for the opportunity to speak to you. My name is Wen, I'm the president and Ceo of Harvard affiliated dental hospital and a2353 research organization called2355 the Forces Institute. I'm here to talk about the proposal to enhance oral health services to underserved children. Starting with a bus donated by the Kennedy family2367 back in 190, four sites have been providing free mobile dental care in the past 100 years to hundreds of thousands of underserved children from various communities such as Lynn, Cambridge and the Cape.
We are proud to be the only mobile dental program to stay open throughout the COVID-19 pandemic. For most of the kids we served in the past 20 months, we were the only dental care resource they have had access to. The problem we are addressing today is2399 that oral health is still a huge public health issue, to date, it remained the most common chronic disease in children. While Mass health provided dental coverage access to care2410 remain to be a huge problem for an underserved population. According to a state report before the pandemic, up to 300,000 children in the state of travel have access to the needed dental care. The pandemic has certainly made the issue much more difficult.
So the four sites mobile dental program is really still one of the best approaches to address the issue. Currently, our mobile program is delivered by small vents and can only provide limited preventive dental care such as cleaning and fluoride treatment. So I'm here today on seeking state support of $2.4 million to purchase a fully equipped modern mobile dental units that will allow us to bring a higher level of special treatment such as oral surgery and economics to our children. Those units can last 15 to 20 years so this one-time investment would have a long-lasting effect and we will work with the state to use this, adding the mobile capacity to support and complement the existing dental care infrastructure like community health if they only have a general identity, we really lack specialists and those mobile2491 units will allow us to actually bring especially dental care to them and those mobile units also allow us to expand our service to central and western Massachusetts.
I was actually very moved by the testimony by Representative Farley-Bouvier and that is something that could actually help with such a mobile program. Faucets have extremely dedicated team who can implement this plan immediately if we'll be able to have you know to be able to purchase in those units. So this approach will allow the state to become the leader in oral health equity to our children and thank you in advance2531 for your support to bring the kids another reason to smile. Thank you.
SHOW NON-ESSENTIAL DIALOGUE
Thank you very much and thanks for bringing2539 that to our attention. That's really actually interesting information that I didn't didn't know about before. So thank you. Um, okay, uh, anna eaves
and uh,
yes
Zana here.
Okay. Um, the next testify, Ayers are Micah Shalev Ron well ski on jennifer Cook and I apologize for any names I did not that I mispronounced. Yeah,
yeah. Ryan Podolski here. Thank you for
[RONALD PAWELSKI(MARCH):] Thank you for allowing me to submit this testimony. My name is Ronald Pawelski, president of the Massachusetts Association of Residential Care Homes, MARCH. MARCH is the Trade Association representing 72 rest homes in the Commonwealth rest2601 homes, providing medical management, medication, management address psychosocial needs and providing room and board in the community-based palm setting. Rest homes care for over 2000 agents and firm and indigent residents, many of whom were previously homeless and employ over 2700 healthcare professionals.
On behalf of all rest homes, their staff and residents, we come before you today seeking $54 million dollars in ARPA funding. The2628 survival of rest homes is threatened. Since 1998, 106 rest homes have closed due primarily to financial reasons brought on by inadequate reimbursement. Over 4000 residents lost their homes, many were transferred to more expensive nursing home settings or became homeless, some died due to the trauma of relocation. The onset of COVID-192652 of the pandemic has exacerbated an already dire situation. Prior to the pandemic, rest homes were not required to have had experience with infectious diseases like covid.
Battling covid has resulted in rest homes experiencing significantly increased costs, protesting PPE infectious disease can control, staff recruitment and retainment, sanitization and lost revenue from admission freezes and census loss, these additional costs have not been reimbursed by the commonwealth. In June 2020, 25 Senators and representatives led by2693 Senator Gobi sent a letter to Governor Baker detailing the covid challenges rest homes faced and requested that rest homes received $30 million in incremental funding. This amount would have been commensurate with incremental funding received by skilled nursing facilities which received over $300 million.
The letter did not elicit a response from the Governor. In April of 2021, a letter sent to the Secretary of administration and finance requested $54 million in incremental funding based on the ever-increasing ongoing covid expenses incurred by rest homes. Again, this request did not elicit any response. Simply stated, ARPA funds are needed to prevent rest homes from closing and residents losing their homes. On behalf of all Massachusetts rest homes, their staff and the residents we collectively serve, I thank you for your consideration of this request. I now turn to MARCH members who will share their covid experiences with you. I'm also pleased to report that rest homes have the highest percentage of staff and resident vaccinations and the fewest deaths of any long term care setting.
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and hopefully, either Jennifer cook or Mr Shalev are on the line. Yes, I'm online.
Go ahead Michelle
Hi, this is Mirra Shalev. You guys hear me?
Yes. Hi.
[MICHA2797 SHAKEV(DODGE PARK REST HOMES IN WORCESTER):] Thank you for allowing me to submit this testimony. My name is Micha Shalev, I'm the co-owner administrator of Dodge Park Rest Homes in Worcester Massachusetts. As the pandemic eaters with full force in early March 2020, we realized how severe the situation is. We spend a huge sum of the2819 money on PPE, infection control enhancement program and started sprayer equipment, employee overtime, employee covid break and more. As has happened with many employers, we lost quite a bit of our stuff because many of them were worried about working with Covid or the finite is easier to stay home and collect all the federal money.
Our operation during the pandemic was the same as a skilled nursing facility, no difference2849 and it is still in the same mode almost 20 months later. We had to adjust to the mode of operation that we never experienced before nor trained for. The dollar amount that was allocated to a rest home as incremental funding compared to a nursing home which was over $300 million dollars is un proportionally low by any means of comparison which causes a big financial strain on the operation of all providers and myself. Rest homes should be reimbursed based on the actual cost. The key point made at the nursing facility task force. This will help us for long term survival.
In addition, rest homes should be reimbursed for all across associate with fighting the COVID-19 since March 2020. I come before you today supporting the 54 million in ARPA funding on behalf of all the rest homes and mine specifically. We've done our share with maintaining the highest staff and resident vaccination rate and keeping our residents safe and now we need the state's help to survive. We need the ARPA funds to reimburse all providers for all costs and expenses creating a meaningful profession2924 that not only call it a job by supporting the front line living hourly wages support special thank you bonus to all staff, but we would also like to get the stand financial support nursing home are getting in supporting their employee program and structure.
Our starting reimbursement rate to the EADC is not being adjusted in near to take into consideration the labour costs increased as well as the food and energy costs increase. Inflation is already taken a high toll on the cross of operation. We know that if this not will be done our facility will be one of many casualties of this inaction by the state. I'm grateful for the opportunity to testify in front of you. Thank you for giving me the opportunity and thank you for supporting the rest home in the state.
Thank you Jennifer
[JENNIFER COOK(MARILLAC RESIDENCE):] Good afternoon. My name is Jennifer Cook, I am the controller for Marillac residence, a level four rest home 76-bed facility and Elizabeth Seton, a skilled nursing facility located in Welsley. I can speak first hand to the financial impact that covid had on our campus and the disparity between the2999 covid relief funds allocated and dispersed between skilled nursing facilities versus rest homes. As we know, Covid didn't discriminate as the first cases became evident in the commonwealth last winter. Infection control guidance was issued, testing and reporting requirements were mandated, facility quarantines3018 were required of all long term care facilities even the rest homes were included.
In order for Marillac to meet the requirements, we had to make drastic changes to our3028 dining program, we3029 required additional staff to be able to care for our residents, we had to purchase special infection control equipment, we conducted ongoing employee testing, surveillance testing. As an organization, from March 2020 until July of 2021, Marillac incurred $246,000 and unreimbursed COVID-related expenses. This included PPE expense, increased employee compensation, infection control education and3057 ongoing auditing. Unlike any, we did have some unreimbursed testing expenses and then also due to the long period of not being able to admit in order to protect our vulnerable population, we calculated potential lost revenues of over $270,000.
So we desperately need the support of additional funding for the rest homes in order for us to be able to survive. Our infection control efforts continue, our staffing shortages are starting to seem dire again. We need to be able to offer competitive wages to attract candidates from this already small diminished candidate pool that we have available to us. We're trying to retain our current staff by offering market adjustments to them. We're trying to figure out where to rob Peter to pay Paul to be able to give staff increases so we don't lose them to our competitors, even our sister facility but we are losing them and we're also losing staff due to the covid mandates so unfortunately, it's not looking very positive and we need that additional funding to be able to increase those wages to them to our staff members.
Just as a point of reference, in terms of state funding that we received, Elizabeth Seaton receive their funds and Marillac received 55% and the amount of funding from the rest homes side. So I thank you for your time and consideration and support of the rest home industry and to allow us to continue to provide care for our residents now in the future.
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Thank you. Thank you to the panel for your testimony.3150
Um Next testifier is Tanya Del Rio
Tanya.
Mhm
I'm here just turning on my camera 1/2. Okay You should see me. Yes. Yes. Thank you.
[TANIA DEL RIO(YWCA CAMBRIDGE):] Thank you, the Chairs and the members for the time and the opportunity to testify and I'm here to testify on behalf...
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of Won't let me talk to you either. Can you hear me?3193 Yes.
Excuse me? Please? Excuse me, please. You OK? Peter Macy, could you please mute your phone? Thank you.
Everybody. Could. Could you make sure you're muted?
Okay. Um I'm sorry Tanya, why don't you3219 start over? Okay. Yeah, no problem. And I'm actually supposed to be part of a panel. I'm not sure if Gail for Tucson, but if she isn't, I'm happy to just kind of read through
Gail. Are you here?
Yeah, I don't think so.
That's fine. So I'm happy to do it. And I'm actually testifying on behalf.
[RIO:] I am the executive director of YWCA Cambridge and I am happy to testify on behalf of the alliance of YWCA of Massachusetts. We have nine member organisations in different parts of the state and our common mission is to eliminate racism and empower women. As I said, I was meant to be joined by Gilford who is the ED, in Southeastern Massachusetts in New Bedford. We want to say that across Massachusetts, you know, city councils, elected officials and boards of health have been declaring racism a public health crisis that has a number of effects. The effects of systemic racism are obviously very far-reaching, reducing access to employment, housing, education and just adverse emotional loads due to the current and inherited trauma of oppression and increased exposure to risk factors such as avoidable contact with police, environmental hazards and increased engagement with unhealthy behaviours.
This is all part of our written testimony, so I won't read it directly. What we want to advocate for in terms of investing the ARPA funds would be twofold; one would be increase support for behavioural health support and the other would be looking at childcare and especially the child care workforce, which a number of YWCS in Massachusetts provide. So I will start with behavioural3336 health and we'll speak specifically to what we do at YWCA Cambridge. So right now, in YWCA Cambridge, where we have a family shelter for homeless families who are always in need of childcare, whether they have a voucher or not, the rates are going from about 150 a day to around which means $700 a week, many of these programs are funded through the state.3371
They currently have waitlists of up to two years. We have seen closures in terms of classrooms closing or understaffing3378 from child care programs, for example, we work really closely with naturally early education and they have closed a few classrooms which are really impacting our homeless families who live in our shelter in moving forward, right? They can't look for jobs, they can't really move forward at all if they don't have the childcare um to kind of spend time on that. So that's one thing that we want to advocate for is providing funding for the programs that provide this child care so that they can stay open.
Obviously in addition to child care needs, housing and homelessness programs, we are in desperate need of funding. In Cambridge, only 128 emergency3421 housing vouchers were received from Hud, even though our homeless population was estimated to be above 400 in 2019 and it's been rising. So within Cambridge, the way we would use this funding if you were to provide more funding for mental health support would be to support our resident services managers and only other members of our housing team and shelter team to provide expanded essential case management service as well3454 as hiring on-site clinicians to promote resident physical and behavioural wellbeing.
Through covid, we have seen just increased conflict between tenants in our housing, between tenants and staff in our housing because everybody is really just undergoing an amount of stress that is just even more than what they have been undergoing in the past. In addition, I think the YWCA alliance would increase the support for programs just like the YWCA Newburyport roof overhead collaborative in the case of YWCA and Central Mass and in Worcester, they would increase their child care slots and then for YWCA southeastern Massachusetts, they would use it for residential services, health and wellness and adult service programs which would be strengthened and would have additional capacity across the state.
I'll just wrap it up by saying we are advocating for additional funding for child care providers and mental health support for those of us who provide housing for homeless families and women and so on behalf of the YWCA of Massachusetts, we3523 thank you for the time.
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and um yeah and I'll wrap it up like that. Okay, so
[SEN FRIEDMAN:] Are you in your testimony asking for money directly for the YWCA or are you just asking for overall that childcare and behavioural health that funds be appropriated for more childcare and health?
[RIO:] Both, yes. So we did talk amongst the Alliance of YWCA about what a budget might look like3546 and so if possible, we were thinking a figure of about $1 million for the nine YWCAs would be appropriate. Some of us would use it for childcare, some of us would use it for mental health support for the people in our homeless shelters, in Cambridge's case, we would use it for mental health, and we will provide that in our written testimony.
[FRIEDMAN:] Great, thank you for that clarification.
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Of course, thank you. Okay and I'm sorry for the mix up with I think you were on the3582 on the list twice so no 11 so I'm just glad I got to speak. We'll catch gail on the other end. Thank you. All right take care the
next
person is Alexis Levitt.
Hi got minor. Hi
hi thank you for the opportunity. I'm with mass Malia Okay
[ALEXIS LEVILL(MASSNAELA):] Thank you, committee chairs and members. I'm with the mass chapter of the National Academy of Elder Law attorneys and we're the state bar of elderly and special needs planning attorneys. So every single day, we see families struggling to stay at home and together. Like many others today, I come with the goal of helping more elders and more disabled people to stay at home and out of a nursing home. So as you know, there are many puzzle pieces both private market and government that will all need to be worked out simultaneously to achieve that goal of helping more people stay at home and out of a nursing home.
Today, I'm here to focus on one very particular mass health program and its inequitable impact on Mass health members and of course, there are all sorts of details in our written testimony, the particulars. But the summary is that Mass health has some excellent programs to help elders and disabled people remain in the community. And one of the very best of these programs is called frail elder waiver. So if you're on the frail elder, you have home health aides, durable medical equipment, a lifeline, it's fantastic. To be accepted into a frail elder, one needs to be medically frail, below an asset cap and below an income cap. This year's income cap is to $2,382 per month.
So if your income is at or below 2382, you qualify for frail elderly at the home health aides and you keep the entire 2382 for your living expenses, rent, key groceries et cetera. So guess what happens if instead of having your income of 2382 a month, your income is 2383 a month. Well now Mass health requires you to spend down until all you have left is $544 per month and can you imagine trying to live at home on only $544 a month. So if we have people with the same home care needs, one has an income of 2382, the other has 2383, one gets to keep her full 2382, the other one has to figure out how to live on 544 a month, this is just inequitable treatment.
Our proposal is that rather than making people reduce down to 544, instead, if you're over 2382, you can take that little bit that's over and send it directly to Mass health as a premium. This would even the playing field allowing all of our seniors and disabled to retain monthly income up to the same dollar figure as everybody else in the program.
[FRIEDMAN:] So let me just stop you there. I'm not sure this is an AARP issue, I think this is a Mass health issue and I believe that there is actually legislation that is pending to address this issue, which I agree there's something not right about that. Okay so we would definitely, I know this is being looked at but I think just, for now, I'm not sure we would you know include that in an ARPA funding.
[LEVILL:] Well, what we like about the ARPA vehicle is it allows a pilot program essentially if we do a one or two-year pilot program then we collect our data and see did we really succeed in keeping more people home? Did we level the playing field? Do we reduce costs altogether overall? Okay. Thank you.
[FRIEDMAN:] Okay. I would argue I am not sure we need a pilot program to prove this, but brilliant, good try. I appreciate it.
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Thank you for your support of the legislation. Thank you very much. Okay, thank you. Take care of me. Um, dr Anderson. Yes. Hello, Vice chairwoman Friedman How are you doing? Vice Chairman Hunt and members of the committee.
[CHARLES ANDERSON(DIMOCK COMMUNITY HEALTH CENTRE):] Thank you for the opportunity to speak on behalf of the Dimock Community Health centre. My name is Dr Charles Anderson. I'm the chief executive officer at the Dimock centre. It is unique among community health centres that we provide the full continuum of substance use disorder treatment on our nine-acre campus in the middle of Roxbury. These programs include 40-bed inpatient detox, four residential recovery programs serving over 80 men and women for up to one year and outpatient addiction recovery services. We treat a diverse population of men and women from the Roxbury neighbourhood and other areas of the city and state.
Even as we have been faced with the unprecedented challenges of3933 the COVID-19 pandemic, the opioid epidemic continues in our community and across the state and country. It is particularly alarming that there has been a 69% increase in overdose in black men in the Commonwealth in the past year alone. To respond to the critical need for treatment for people struggling with substance use disorder, Dimock plans to expand our capacity by creating a new 16 bed men's clinical stabilization service or CSS program in our Dr. Marie shelf sceptical building. The new men CSS will provide 14 to 28 days of intensive treatment immediately following inpatient detox and proceeding longer-term residential recovery, addiction counsellors and recovery specialists will support the men connecting them to our health centre for primary care, dental eye care and behavioural health.
During this critical period of clinical stabilization, we also enrol them in health coverage and engage them in planning for the next steps in their recovery journey, including planning for family and community reunification. Without this stabilization component, inpatient detox is more likely to be a revolving door and we know that being able to literally walk someone across the street from detox to this next level of care with the same team of trusted providers will have a4017 greater chance of getting them onto a road that will be one of successful recovery given the unprecedented opportunity presented by ARPA funds coupled with the increasing need for clinical stabilization to help address the behavioural health and substance use crisis that has been exacerbated by the pandemic.
Dimock is requesting that $5 million dollars be appropriated to the renovation and construction of our Z building. This generous and critical support will be a critical and significant part of our plan, a comprehensive capital campaign to build this man CSS. This funding would allow for 16 beds, kitchen dining space, exam rooms, meeting spaces and wellness space that includes a small gym. There will also be outside garden access for patients. The Z building is located in the4070 centre of our campus, again directly across the street from our Dr lucy Sewell's Center for acute treatment services, which is our detox. So we're generous support of this by the city.
We've already started a fair amount of the work in restoring the outside. The Boston community preservation fund has been a big part of that, we have been working on the exterior of the building for the past two years. We've also received a generous grant from Boston's Resiliency Fund last year which allowed us to create a 16 bed covid 19 positive treatment unit in the building for men and women in recovery, just the second such program of its kind of the state. The new men CSS would complement our comprehensive model and make a tremendous need in our community not only for substance use disorder treatment but also4120 create new jobs for Roxbury residents. So I'd like to thank you for your thoughtful consideration of this life-saving4126 support and4127 I welcome any questions you might have.
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Thank you. Thank you very much. Um We are well aware of the important role that the the Dimmick center plays. So it's nice to hear from you. Thank you for testifying and we will take a very close look at this. Very good. Thank you. Okay, thank you. Um The next uh Mhm. The next set of testifies as a panel ruth, Zakarin Juanita Bachelor, Greg Jackson Michelle caldera.
Every
thank you. Chairs
actually was I just
did you all hear me when I called your names? Yeah, sorry, sorry, Chair. This is Greg Croteau from you talk and actually ruth got called away. And so she asked me to uh, go in her stead and pinch hit. That's okay, That's fine. Absolutely. Go ahead. All right, so
[GREGG COATEAU(MASS COALITION FOR GUN VIOLENCE):] Chairs, thank you again. Again, Ruth is the executive director of the Mass Coalition for Gun Violence Prevention and we wanted to join in, we have today's panel and a group of us really wanted to first start by saying, thank you, thank you for the state for all your past and very support. Massachusetts has long been a leader in addressing gun violence prevention through legislation as well as the continued investment in community-based programs. And we want to start by saying thank you, thank you for leading. As folks know with the pandemic, the inequities around gun violence have been further exacerbated and we know that we have a unique opportunity with the American rescue plan to deepen that investment and further move the needle on addressing gun violence prevention.
We have a coalition of over 40 organizations that over the past few months have been working collectively to respectfully particular proposal as you may have already had before you requesting 5% of ARPA funds to be allocated for gun violence prevention through the creation of a new4264 one-time grant program that would possibly be through health and human services. And so I'll let others talk about it but the funds we hope will target programs in the community-based community-led support communities most impacted by the trauma around gun violence and have got into oversight provided survivors members of those impacted by gun violence in the communities.
As part of this work, we respectfully put together draft language for your consideration as well. So on the panel today, we'll be hearing from frontline workers, survivors will tell you a bit more about the critical need that they see in our communities.
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And I want to now introduce uh someone who's been at the forefront of the national conversations. Uh my fellow Greg on the panel, Greg Jackson, thank you again. All right, thank you and thank you again for having me. Can you guys hear me? Okay, thumbs up? Okay, awesome.
[GREG JACKSON(COMMUNITY JUSTICE ACTION FUND):] Thank you again leadership for having me here. As mother Gregg said, we've been working on this issue at the national level for a long time. I think everyone should be aware of how huge this crisis is, but every year, over 100,000 people are shot or killed and it costs our economy over $280 billion. And so I come as one of those 100,000, I was shot in April of 2013 and since I was shot, nearly a million people have either been injured or victimized4345 or lost of this crisis, but also serve as the executive director for the Community Justice Action Fund and we've been advocating and working directly with federal leaders about the importance of this issue and seeing this as more than just law enforcement or crime challenge.
The president in December of4361 2020 acknowledge this as a public health crisis and at his rose garden remarks4366 on April 8th acknowledged the proven strategies that our community violence intervention programs and their efficacy nationwide. In a4373 direct response to that, the attorney general, Merrick Garland stated that gun violence is a problem that not that law enforcement alone cannot solve and that we need community partners to be leaders, but also to help us implement solutions that we know work. Since then, the White House Domestic Policy Council, the Department of Treasury and the Department of Education have all released guidance that funding for American funding of community violence intervention programs that target those4402 most at risk should be a priority usage of the American rescue plan dollars.
With that said, we've been advocating understanding that Covid has directly intensified the root causes that fuel violence and frankly is most responsible for the huge spikes that we're seeing all over the country, most major cities are seeing violence reach levels, it was that in the 90s including places in Massachusetts. And so we know that if there is that big surge of violence um we also need to have surgeon resources to support that. I also wanted to share that, you know, these strategies4440 not only work but they focus on serving victims, intervening in conflicts, providing cognitive behavioural therapy programs for those who are most at risk and also include targeted youth workforce strategies.
And so there are a lot of folks who presented today that I think4456 their programs intersect with what we're fighting for and definitely could complement it. Secondly, I'll share that a lot of states have already stepped up and committed dollars; Connecticut, New York, New Jersey, Virginia. North Carolina is North Korea hasn't yet, but certain cities North Carolina, Illinois and even Tennessee, we've seen them all step up and figure out what allocation or what percentage of their dollars can they bring forward to invest in these solutions that we know work and can proactively address the violence in our community.
Lastly, I'll share that, you know, these community violence intervention programs that are referred to in the simplest form, apply proven evidence-based scientific and health-based strategies to engage those who are most at risk and in certain cities, we've seen violence to be reduced upwards of 60% even in places like Baltimore despite covid 19 and despite this past year, neighbourhoods that have successfully funded CVI programs have been able to hold the line and keep the crisis of violence fairly steady while other major cities have kind of spiked and seen a huge, huge jump.
And so, you know, we know this work, we know these programs are effective, what we also know is that they're underfunded and4527 under-resourced and every day that we refuse to fund and resource, we're not only hurting our economy, we're hurting our communities and we're losing valuable people in our neighbourhoods. Like Lewis Brown was a 73-year-old grandmother who was shot by stray bullets and lost. 16-year-old Lee Montero who has killed not only a few days ago and then a nine-year-old Darell Moore who was shot blocks away from where his father was killed in the shooting four years before.
And so I really want to emphasize that this is more than a policy priority, this is more than strengthening our government or solving a problem, this is literally life or death. Gun violence is the number one cause of death for black men and black youth in America right now. And so if we don't prioritize this was frankly given up on folks who are literally fighting for their lives out there. So thank you so much for having us, I'm definitely excited4576 to pass it to folks who are doing this work and who are deeper into the weeds, of how it can be implemented and why it's so important but we hope you'll acknowledge this, the leadership of the White House and the federal government, but also the urgency of the crisis in our own neighbourhoods.
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Um, so I'll pass it to, I believe,
uh, oh, I might have to order on, but maybe Kathy, it's not feel free to jump in.
We're going to go to Dennis 1st.
[DENNIS EVERETT(UTEC DOR):] Thank you, Chair and members of the committee. My4620 name is Dennis Everett, I'm the director of the re-entry for Utech, a youth-serving agency that is committed to removing barriers for the justice involved young adults we serve4630 in the Merrimack Valley and beyond. We have continued to learn that the solutions we seek are most frequently found within the communities we serve. It is the overcoming spirit and resiliency of the people we engage that continue to teach us and inspire us to widen our circle and invite others in because together is the only way we can accomplish our collective goal of a community free of gun violence.
That is why this proposal, shaped by over 40 different organizations working together will ensure that Massachusetts remains at the forefront of leading our nation in the work of reducing gun violence. As a young man who pled guilty to three counts of armed assault with intent to murder, I can only say that I truly believe that what I was doing on that day was the best option I had. I often wondered what my life would be like if Utech workers would4680 have been around back then. The work that we are navigating day to day is layered and complex. This funding would give us the freedom to target and address the underlying issues identified by the people who live and work in these communities directly.
Economic inclusion for people of colour, capital, infrastructure, human infrastructure policy, grassroots organizing, restorative justice, education and continued coalition building. We're deeply proud of the local state and federal government officials that have fought and supported the work of recognizing gun violence as a public health crisis. We invite anyone that desires to see the impact of this work is having to come and meet some of the amazing young adults we are honoured to work with. To us as Utech, the return on this 5% investment is worth every penny. We thank you for your consideration of this proposal and remain4730 committed to the work that lies ahead.
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Hi um we have three people that were slated to testify but we're going to ask if Juanita can go um first and if there's time for anything else will go from there. Thank you.
Hello,
[JUANITA BATCHELOR(DARYLE4754 JENKINS JUNIOR FAMILIES OF THE HOMICIDE RESOURCE CENTRE):] Thank you, Chairs and members of the committee. Thank you for having me here today to testify. My name is Juanita Batchelor, I am the founder of the Daryle Jenkins Junior Families of the homicide resource centre. It was formerly called, MORE, mother overlooked reaching out and reaching out for empowerment. I am also a volunteer with the Massachusetts chapter of Moms demand action. Gun violence has been a horrific tragedy, I know all too well. I lost my4793 23-year-old son, Darryl Jenkins jr, to gun violence on June 4th 2014 when he was killed right4800 in front of our home, I lost my firstborn and only son who left behind two daughters ages seven & one.
They are now 14 and eight. Just when I thought things could not get any worse, my niece in law to Tameer Clark was gunned down in a drive-by shooting, coming out of a convenience store on June 26, 2020. Then on April 28 of this year, my son in law Reginal Deshaw fought for his life as two men tried to rob him, they ended up shooting him and killing him. This funding is so very4829 needed to fight the root causes of gun violence, poverty and racism, help relocate families who are survivors or witnesses and create places for low-income families to send their children and know that they are safe off the street.
Gun violence increased in the city of Springfield in 2020 during the COVID pandemic and continues to plague our city today. So I am hopeful that these funds will be used to help families and communities so they will not have to endure the pain of losing a loved one. It's a pain you never get over. Thank you for giving me and my loved ones a voice. SHOW NON-ESSENTIAL DIALOGUE
Thank you.
very much. Um,
very important stories for us to hear. I really appreciate it. Kathy, I'm sorry. I think I didn't acknowledge you when I called the panel and I'm sorry, but it's nice. Quite alright madam Chair. No worries. Good to see you. Nice to see you. Um,
thank you. Um,4893
yeah, are there any questions from the committee?
I don't see anything. Thank you Juanita. And thank you Dennis really appreciate you coming madam. Chair. Uh, thank you rip Vargas had a question. Oh, I'm sorry. That's all right. Thank you madam Chair and thank you mr. Chairman. Uh
[REP VARGAS:] Thank you to the panel for the wonderful presentation. I just wanted4926 to quickly just follow up and make sure I am understanding correctly, you guys have come together through a broad sector of organizations from moms demand to Utech, to ROCA to different organizations across the state. Are you asking for a new grant program to be created or is this adding to existing programming? If you could just talk a little bit about that, that would be great but thank you for the very powerful testimony.
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I just want because I'd like to have Kathy from brokers here and Michelle from boston and Connolly as well. So if time allows for Kathy, I'll definitely let you jump and take it. Thank you. Um, and, and thank you to chair Friedman and Hunt and Ferrante And and
[KATHI REINSTEIN(ROCA):] Thank you, Representative Vargas, for your question. This is a coalition of over 40 organizations that are both within Massachusetts and national and ROCA has been very, very proud to be a member of the coalition to advocate for in craft the proposed language provides ARPA funding for non-profit community-based gun violence prevention organizations such as the one that I represent here today, which is ROCA. This is a new grant and its unrestricted funds proposing this grant can be tailored to what each organization needs. So whether it's capital projects, emergency funding, impact studies, evaluations, the proposed grant would allow each organization to continue to focus on the people that we serve by increasing access to the funding that we all need. And we're happy to answer any other questions. I hope5018 that that answers part of your question, Representative.
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Thank you.
[MICHELLE CALDERIA:] Thank you, Kathi. I would just add, this is Michelle, this request; a new grant program like Kathi said is a one-time investment that will help these community organizations build capacity to continue the work that they're doing that's already having success. So I just want to make that point.
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That's all great. Thank you, Madam Chair. No further5045 questions. Thank you. Decker question Yes, thank you.
[REP DECKER:] Thank you to all the panellists and to of course former colleague Kathi, it's great to see you. I guess the question that I would have is one if I haven't seen the written testimony yet and I'll be asking for all of that but do you list all the organizations that have access? Right? Because there are some really powerful voices here and then I think of other groups like the Lewis D. Brown Peace Institute that are also doing this important work and then also with this grant also allow groups like ROCA, I know Kathi you guys have been trying to do some really groundbreaking work on offering various kinds of cognitive behavioural therapy, like at the very grassroots level, is that the kind of stuff also when I think about the work around trying to eliminate and reduce gun violence, so much of that is about meeting the needs of people where they're at, both victims and perpetrators, you know, which is a separate although related silo to like gun control laws.
This other work is really for me the highest impact work and so could you just tell me a little bit more about what the scope of the, of grant, would allow people to do and then maybe I can also just see who would5128 be included, who would have the ability to apply for that.
[REINSTEIN:] Sure, thank you very much, Madam Chair and thank you for your work on all of this too. You know, Michelle actually said it, you know, all these organizations that are within Massachusetts are doing this incredible work and you know, we have over 40 people that have signed on to the proposal that we've put together and they ask that we put before all of you. I think that we're still soliciting for other people to um, to basically sound and if they like, but the way that we've written it if it's approved by all of you would be that the funding would go to non-profit community-based gun violence prevention organizations to be able to access this grant program.
I don't know if there was another part of5173 that question I need to5175 answer, but again, it's providing the services as you said, we're all meeting people where they're at were doing different things and then covid to was really tough on all of us, for example, you know, at ROCA, you know, none of our doors closed. I don't think any of our organizations, you know, closed. And then we had to also pivot to what, what are the other things that are organizations need? They needed rental assistance, they needed diapers, they needed toiletries, they needed, you know, so we were doing all that and then we, we actually got Chromebooks to everyone so we could continue the CBT lessons and high set lessons. I know that a lot of my, my brothers and sisters in their different organizations5210 have been doing the same. So thank you.
[EVERETT:] I just wanted to say really quick5215 that it's very difficult when we have the ability to stop two young adults from getting into a dangerous situation, but we can't allocate the funds5225 to separate. You know, most of the funds that we have are very specific, so we have a relationship with our outreach where we could say, hey, get in this car, we're going to put you in a different community, it's just we are not able to actually do that right now.
SHOW NON-ESSENTIAL DIALOGUE
Mhm. Yeah. This really quickly,
[JACKSON:] You mentioned the CBT programmes and those are one of the main programs that are uplifted in a lot of the federal guidance to, So CBT, community-based intervention programs, reentry Services, hospital-based intervention programs and healing and victim service programs. So all of those are in the federal guidance and I know they are being reinforced and advocated for here too.
[FRIEDMAN:] Thank you.5280 I guess one other question that I have is so I have not seen the written proposal, but I would expect or imagine that the written proposal has some boundaries around it, about what kind of services or what kind of programs this money would go to and so that we could sort of ensuring that this was going to the right place and the right people. Um, so if that isn't part of it, that would be something that I think we would all be looking for because it is a very worthy cause, I know a number of your organizations, they do incredible work and we just want to make sure that if we can get a part of the money that it goes really directly to the right, um, you know, to the right services.
[CROTEAU:] Thank you, Madam Chair, we give credit to the coalition for organizations for the past three months, weekly coming together and trying to make sure that you didn't have, you know, 19 different proposals around this and be able to have that. And so we did put together language, broken it down and, and we do, you know, a lot of us has worked with health and human health human services and did a great job and I think it was important for us to have support for, you know, ranges of organizations, organizations that grassroots and just starting out to those that are no longer in really prioritizing the workaround racial equity work as well. And so that's another kind of platform that folks really wanted to raise up. So thank you and happy to talk to you more.
SHOW NON-ESSENTIAL DIALOGUE
Okay, thank you. Thanks to you all. Um take care, stay safe, stay healthy. Um Okay, heather, Sullivan
heather are you here?
Mhm.
Okay. Ah Ellen taverna. Oh hi, this is this is more a Sullivan from the arc of Mass um pinch hitting for Ellen today. Okay, thank you much. It's great to see you all.
[MAURA SULLIVAN(ARC OF MASS):] Thank you, Chairs and members of the committee for your time today and for the extraordinary work over the past 19 months. My name is Maura Sullivan and I'm the director of Government Affairs for the Arc of Mass and the mother of two young adults with severe autism. My testimony is centred on the use of the ARPA and state funds for addressing essential services and supports to constituents with intellectual and developmental disabilities including autism and their families. And we greatly appreciate the commonwealth's commitment to strengthen home and community-based services using those short term ARPA funds.
This 500 million is vital given Massachusetts is facing as you know, the workforce shortage crisis for direct support workers, which has been compounded by as you know, the covid pandemic. Covid has exacerbated both the need for services for individuals with disabilities with a variety of behavioural, social, medical and other issues and the difficulties that providers face filling the staff positions. In addition to the ARPA funding, we appreciate the administration's further investment in the human services rates of approximately 39 million to increase the rates to $16.79 for direct care workers, one.
While these are important steps in the right direction toward reflecting5495 the high quality work of the direct support workforce, there continue to be very serious gaps in support and service coverage for people with disabilities and their families. Some provider agencies have started offering $17 per hour for direct support, which is above the 1679 benchmark and it is still not5516 enough to find qualified workers. As you might know, the utilization of day services has hovered at 50-60% capacity, which means people with disabilities are not adequately served while agencies are struggling to hire qualified staff. Personally, I can tell you that the past year and a half has been especially difficult for families.
One parent recently shared about their autistic son who turned 22 in July of 21 but must wait to start his adult programming until at least March of 2022 and even that is tentative based on staffing. We hear about stories of isolation, challenging behaviours, emergency department visits and all due to programs not being opened in services being delayed. A family shared about their son's self-injurious behaviour and regression of social skills related to the inability to find any in-home support services. The lack of services means the responsibility of care often falls to the unpaid family caregiver.
In June 2021, the CDC study found that 70% of parents and unpaid caregivers suffered mental health issues during the pandemic, including anxiety, depression, trauma and suicidal thoughts. Family caregivers are eight times more likely to contemplate suicide than others and we must do better to help these families. We advocate using ARPA funds for an immediate bump to $19 per hour as a baseline minimum for the approximate 29,000 DSPs serving the IDD autism community. As we laid out in previous testimony and reports regarding the DSP workforce crisis, DSP wages5625 need to be based on market-based reimbursement rates consistent with health and education sectors in order to be competitive, as well as an increase in the compensation for the front line managers, clinical positions and program directors to avoid compression.
In addition to the wage boost, we recommend using the ARPA funds5647 in the following ways; we need more options and flexibility for individuals with disabilities to obtain stipends and choose their caregivers. If a spouse5657 or a guardian parent fulfils the eligibility requirements to be a Mass health adult foster care provider or an APCA, they should be considered for that position, they've often been doing it anyway. In addition, more options for long term support service packages for families to avoid 24/7 congregate care. Funding for administrative responsibilities of covid surveillance testing should be expanded, immediate funding should be provided for significant hazard pay and providing additional funding for Covid and5692 post Covid enhancements to day services include CBDs employment in Dahab.
SHOW NON-ESSENTIAL DIALOGUE
Okay, thank you. Thank you so much mara, thanks for testifying and you did a great job pinch hitting. Thank you. Thank you. Thank you for everything. Absolutely. Thank you for joining us. Yeah. Mhm. Um Paula Collins Yes. Hi, I'm here. Hi,
[PAULA COLLINS(HUMAN SERVICE AGENCY):] Good afternoon. My name is Paula Collins, I'm here today wearing two hats; the mom of a young man with a disability and also an employer of5729 a human services agency serving families in the community. I want to address the impact covid has had on families with adult dependence with disabilities. For me personally, I have a son who has down syndrome ADHD and an anxiety disorder who is 23 years old, he turned 22 just two months before the country shut down for Covid. For those of you who are unaware, the 22nd birthday is a huge transition for people with disabilities.
They end school on their 22nd birthday and then they move to the adult system. For Tucker5759 that meant going to a day program near a house which was a huge adjustment from the high-quality education program that he previously attended. He had not yet adjusted when we had to pull him home due to the closure. My husband and me both working parents, we had meant adjusting our schedules to have him home with us. We're lucky we both have jobs that allowed us to work from home during that time and then hybrid to a few days a week in the office. But for Tucker, it meant a loss of social connection routine which are critical to his retention of skills and needed to maintain work and be active in the community as well, deterioration of his mental health.
Although I had that work flexibility, it has been extremely difficult. I simply can't offer him the effective programming that he would have while I'm trying to work. So his therapies also went virtual, which also removed any short breaks we might5813 have had. He did go back to work a little bit this summer, but we're back to trying to do one on one programming for him. Many families are looking to self-direction programs, but due to lack of funding, that means fewer hours of services,5829 we need to fund high-quality services full time. So families can work the lack of services makes it impossible to return to work5836 if you work in a setting that requires you to be somewhere full time and not have that. That has a direct impact on the economy.
Our story is not unique. Most young adults I know also have families that are struggling to make it work. We're limited to where we can work to because we have to be flexible. This bill did put in a child care credit but it did not accommodate those who have adult dependants. I respectfully ask this committee to include some assistance for5866 families who are caring for adult dependents. These adult dependants also left off the tax credit because although they were working, they should have been eligible. They are dependent. So they were not because they are over 18. We as parents also did not get that additional money.
The burden for families extends because of agencies can't find help. Our families rely on DDS and these programs are short-staffed due to wages that are not livable wage as a provider, I've had numerous changes in staff due to the limits on wages. These are tough jobs, caring for our most vulnerable. I'd like to see livable wages because right5902 now most of our staff worked two jobs, which5905 means they're not giving everything to our job and our clients because they're trying to just pay their bills and have to do second jobs.
So if we could please, again, I'm just reiterating what5920 many people have said about that sustainable wage and then under the small business section, I'd like to see some additional funding to offer incentives for hiring people with disabilities in this job market employees are hard to find and expanding the job pool significantly if we were able to add incentives for people with disabilities and also provide maybe possibly some education to those employers on what having an employee with a disability would mean in this direction. There are studies that this does directly affect their profit margins for companies who have people with disabilities and also directly affect the GMP.
SHOW NON-ESSENTIAL DIALOGUE
Great, thank you, Thank you.5952 Thanks so much for coming. Um The Sarah Patricia, Hearn
Sarah,
5958 Okay,
chris staples,
good afternoon madam Madam Chair. It's nice to see you and thank you for this long day, I feel like I know you much better now after today, I
I am here, my name is Christi staples and I lead the statewide campaign to end homelessness and create housing justice at the United Way uh and [CHRISTI STAPLES(SUPPORTIVE HOUSING):] Thank you so much for this opportunity to testify today on the importance of making clear and intentional connections between substance use disorder, physical behavioural health, public health and housing stability. As you've heard from many of my colleagues on today's hearing, housing is a social determinant of health and I'd like to make some intentional connections today in my ask. Specifically here to urge you to allocate at least three million for supportive housing and leverage a portion of6048 these funds at least 25 million to pilot the Massachusetts flexible housing subsidy pool, which is a nimble pot of public-private funding to help meet the complex health and housing needs of our most vulnerable residents.
So why am I here asking for this today? As you've heard throughout the entire day, the pandemic has laid bare the inadequacy of the safety net system in Massachusetts as a public health response for our seniors, our adults or youth and families experiencing homelessness. COVID-19 has pushed our crisis response systems to the limit as you've heard, further straining the state's patchwork of critical services and supports that keep households experiencing severe persistent and complex behavioural health issues stable. Now, as a once in a lifetime opportunity to take coordinated comprehensive action, an approach to ensure these resources are leveraged effectively and equitably.
Again, housing is health care. So I just want to talk a little bit and I'm going to keep this brief because it's been a long day and I have submitted written testimony, but supportive housing has been proven through many, many national trials to be a highly effective cost-effective strategy and for those of you who don't know on this call, supportive housing combines affordable housing with intensive, coordinated supportive services to help people struggling with substance use disorders, chronic, physical and behavioural health issues maintain stable housing. I just want to give a couple of numbers and figures for you about what we've been able to see across the country, this model saves an average of over 6000 a year per person in health care costs. Then furthermore, according to our Massachusetts pay for success initiative Which served more6152 than 1000 vulnerable individuals, there was a cost-saving to health care in the amount of $5,257 per person per year. Of those, 1,064 individuals served by the pay for success initiative. Important to note that 84% of them experienced chronic homelessness and remained housed within a year. So again, I have more details in my written testimony and I get very specific about what we're asking for but I really did just want you to consider thinking about coordinating and aligning a portion of the ARPA funds towards supportive housing, which is the deeply affordable housing with supportive services. It's proven, it's effective, housing is health care and thank you so much, Madam Chair for your time, if you have any questions please do ask.
SHOW NON-ESSENTIAL DIALOGUE
Thank you, Christine. Yeah, I am aware of a number of these programs and the success of housing is can't get6207 stable if you don't6208 have housing. So thank you Chair Hunt. I didn't see you there before. Nice to see you. Thank you for your testimony. Um liam Lowney.
Good afternoon. Thank you.
Yes, you have to the
[LIAM LOWNEY(MASS OFFICE FOR VICTIM ASSISTANCE):] Chair6232 Friedman, Hunt and members of the committee. I'm Liam Lowney, I'm the executive director of the Massachusetts Office for victim assistance. We are an independent state agency established to serve crime victims in Massachusetts. I'm respectfully asking this committee to stabilize victim service programming in Massachusetts as an organization scrapple with the devastating impacts of covid 19 on victims of crime as well as survivor populations and underserved and marginalized communities. I want to thank District Attorney Harrington for testifying earlier today and supporting this proposal and the many victim's service programs and statewide coalitions that are either here today or have submitted written testimony.
We're asking for one-time bridge funding in the amount of 70 million from ARPA to stabilize victim services in Massachusetts. MOVA is the sole administrator of federal victims of Crime Act funding here in Massachusetts. BOCA as we call it is not funded by taxpayers but rather originates from monetary penalties associated with federal criminal convictions and it serves as the largest funding source for victims' services here in Mass. We6296 use this funding to support 161 unique programs across the state and served over 96,000 victims last year. It was the highest in our agency's history. The crime victims fund that provides this funding to all the states that a 10 year low due to changes in prosecution settlement strategies at6313 the Department of justice and this historic depletion and the crime victims fund has led to three years of decreased funding awards to BOCA in Massachusetts at this6323 time.
And our programs are struggling to meet the increased demands of6329 services brought on by Covid and this is the worst possible time for us to be receiving less federal funding. Our most recent award is 35% less than it was last year and over 50% less than the year before that. So this means that there's going to be reduced funding available for our child advocacy centres, domestic violence shelters and programs, rape crisis centres, victims, legal services, homicide bereavement and human trafficking programs. All of these programs had to switch their service models to offer services during the pandemic.
Although our country has opened up, some of these programs will still struggle to support survivors in a remote environment and do more with less philanthropic and volunteer support. As District Attorney Harrington told you, we worked hard to achieve passage of a federal law that will fix the issues of the crime victims fund and while that's great, it doesn't change the three years of decrease awards we received. So last April, we told our programs that next July they're going to be facing reductions and that will remain through the state fiscal years 23, and 25. So without ARPA funding, we risk losing services and programming for those 100,000 survivors and equally importantly is about 72% of our funding support personnel and staff who are at risk of losing their jobs.
So in addition to maintaining currently funded services, we know that communities that are disproportionately impacted by violence were also disproportionately impacted by Covid. And we see this as an opportunity to support by and for programming that is accessible to communities of6424 colour here in Massachusetts. So Mass MOVA were set up with partnerships and contracts to get these dollars out to programs now. We already have contracts, we already have monitoring and compliance and we already have the ability to report to you on its success to meet the identified goals. It's a one-time investment, we will not be back here again because we do believe that6445 the fund is going to fix itself.
So this investment is going to allow us to address these funding gaps and stabilize services. So with that, I'll stop because I think my time is up. So thank you for your time today and I'm available to answer any of your questions.
SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you very much. I was very thorough, appreciate it. Of course. Okay, thanks for your testimony.
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