2021-10-15 00:00:00 - Joint Committee on Public Health
2021-10-15 00:00:00 - Joint Committee on Public Health
(Part 1 of 2)
[PART 1]
SHOW NON-ESSENTIAL DIALOGUE
Yeah. All right.
Mhm.
Mhm. Oh and I would like to welcome all of you to this hearing the public health hearing we are joined today I'm going to first welcome my colleague Senator Comerford and give her a chance to introduce her colleagues and then I will welcome mine thanks so much madam chair and thank you for your work on this committee and your leadership on these issues. Um Good morning everybody I've39 been looking forward to this hearing. I'm joe Comerford I represent the Hampshire Franklin Worcester district and I have the honour to be the Senate co chair this committee and I'd like to thank um and welcome vice chair Senator Susan Moran and members senators Chandler around here and O'Connor um and I'm excited to hear the testimony on these bills. This is our uh complicated issues and if they're going to be made much clearer and um and we're going to see the depth of what these bills can do um or not do thanks to the people who have gathered today over to you madam chair and thank you thank you senator um want to welcome um Vice chair of the House committee brian Murray. Representative88 paul Schmidt Representative Jack Louis representative Andy Vargas93 Representative john Santiago Representative brian Ashe representative Kay khan representative Vanna Howard yeah she's at every one of these. Um and our ranking minority member Representative Hannah Kane and Representative Dooley um today we will hear testimony on bills pertaining to professional licensure the scope of practice and agencies and before we proceed just like to share a few sort of Housekeeping issues to help ensure that we have the best virtual hearing. Um even when it's sometimes a little challenging, um I will ask you please keep your mix muted if you are not talking. I will also ask you that if you are testifying that once you've actually given your testimony, if you could please sign off and then if you'd like to watch the hearing, please do come back. There's a link on the House and the Senate web page that allows you to watch this hearing as it's being live streamed. But what we found is that when multiple people are on this platform, it tends to compromise the quality of connectivity for people. So please do sign off but come back and watch. Um also you will note that at the moment, I think the chat section is open, which I'm not sure it should be. Um please, if you are not a member of the House or the Senate committee, please do not respond in the chat area. We will not respond. If we were in person, we would not be able to do that and it becomes um becomes a distraction. And also we don't want the expectation to be that we are ignoring you individually. We're ignoring everybody in the chat section, but we're paying attention to everybody who is here and signed up to testify. I would also just like to remind folks and explain to people a little bit,197 You know, the everyone who has signed up has three minutes. We do have a rule that we have been following and inspired by some of the other committees that if you are part of a panel, your panel is given is given six minutes in its entirety. So it is the expectation of your panel that you will have actually divided the time amongst yourselves. We will be automatically uh we will, my staff is texting back when I talk, we will be automatically commuting people after your three minute or your six minute panel and I just want to acknowledge upfront that can be really discharging and I apologize for that. But at the moment we have close to six hours of testimony before us and it's really important that we hear everyone who has signed up. If you have more to say, we want to hear it, please put it in writing if you haven't already and do submit to the committee, both the chair and I and our committee members. We actually,253 we actually do read through the testimony so it's not for want and please do send it. Um, the six minute panel rule for um is just so people understand and what the process looks like. It really has been an effort not to curb people from coming together to speak because everyone as well is welcome to sign up for three minutes but we have been concerned that those who are fortunate to have somebody whose job it is to organize them into panels sometimes can get a little bit more time and um in the queue then286 individuals who are just coming in on their own and want to be sure that they get heard. So if you sign291 up as an individual you will absolutely have your three minutes, but if somebody has organized you into a panel um it just means that you're only going one after the other. Um And but unfortunately your time has been compressed collectively to six minutes. So I just I think it's important people understand why the rules exist as they do but it really isn't trying to honor and make sure that there's time for every citizen. Um those who have some unfortunate to organize them and those who do not and I think with that said um we are ready to move forward and before we begin I want to just thank L. I. S. Who is on here with us, thank you for all of your incredible good work. You have been learning as we go along on how to better ensure a really high quality virtual hearing. So although we don't see you L. I. S. Um we do know that you're out there helping us and making this better. So we appreciate it with that said I would like to welcome it is tradition to try to take colleagues out of order many of them are also in other hearings at the same time So they're jumping in and at this time I would like to welcome my colleague Representative Tacky Chan
[REP CHAN:] [HB2245] Thank you chairs for taking me out of turn and thank you to the committee members for you work and hard and your patients on all of us. In this format, I'm here to testify on House bill 2245 relative to CNA training. Uh this was an issue is brought to us by South Cove Manor, which Bill Graves is on the call I see on the list who go into more detail. But the short of it is this the Red Cross have provided CNA training in the past which include Chinese language as part one of the tests. Obviously, a self called is the largest Asian assistant facility but Chinese is a large portion of their population. Uh so the403 whatever reason they stopped that test and they asked for legislation, we filed to mandate that chinese language be part of one of the tests for CNA.
And we also included spanish recognizing the416 huge changing demographics in the state, are aging, particularly those two ethnic groups. So now I understand that that the DPH has looking for a new tester and which will include this statutorily as a requirement uh for availability of a chinese language test as well as a spanish language test. Um something has been done in the past, particularly chinese and we feel that it's important to address that the administration has not That sums it up.
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thank you Representative. Are there any members on the committee um that have any questions for Representative Chan
Okay, thank you very much for your testimony and your time. Thank you very much. It is an asian cox party. You have a letter in your mailbox already. Thank you. Thank you. Um at this time I would like to welcome senator keenan.
[SEN KEENAN:] [HB2245] [HB2382] [SB1452] [SB1449] Good morning and thank you. Uh Chair Decker chair Comerford. I really appreciate this and just quickly I'm here to testify on on two bills but I would like to echo the comments of my my colleague from Quincy Representative Chan uh in support of the CNA legislation and he referenced South Cove Manor. I have to tell you the work that they have done down there during particularly during Covid has just been absolutely remarkable and very much appreciated. So I know this is important to them and I'm happy to lend my support
The other bills I'd like to testify on Senate 1452, which is an act relative to recovery coach licensure and also Senate 1449, which is an act regulating surgical assistance. I'll start first with the recovery coach licensure bill if there was a519 single thing that I heard from people during the month of September as I was out and about at the recovery month events. It was the need for recovery coaches. And so the purpose of this bill is to create a streamlined process for recovery coach recognition assuring pay reimbursement. It supports the ongoing efforts to to recognize recovery coaches as part of the behavioral health workforce and increase the availability of peer to peer recovery support services.
The legislation would create new guidelines and requirements for how an individual could become a certified recovery coach as well as a board559 of registration that would oversee issues of application and compliance among recovery coaches. So who are recovery coaches? Many of you know that they're, people with lived experience and they've combined that lived experience with education and training and an incredible willingness to support individuals with substance use disorder during their recovery. They have been needed through the opioid epidemic and but increases in substance use and overdoses during the pandemic have certainly highlighted the need for them going forward.
And we all know that recovery coaches improve rates of retention in long term recovery among clients that work with them. The past is the past history means that they have a personal passionate investment in helping individuals with their recoveries. We had a briefing this this past week Rep O'Day and Rep Malia who are responses of this bill in the House side two real strong champions uh for the treatment of substance use disorder. And one thing that came was so clear during the course of the, of the briefing was the passion of the recovery coaches, their willingness to help.
And I think if we are to make our way through this opioid epidemic, it's going to be on the strengths of those who have gone through um substance use and have have struggled with it but have put themselves on a path to recovery and expressed their willingness to help others. So this legislation would give more legitimacy to the role of recovery coaches and650 help ensure that the individuals are paid a decent living wage right now. There is no way to take away somebody's certification if they act unethically. And this is especially problematic given that we are dealing with such a vulnerable population. So consistencies, uh,667 best practices and accountability are lacking in the recovery coach field, those that are doing the work are anxious to have this bill passed to bring consistency and accountability to their profession.
So what this bill would establish a new definition of licensed recovery coach. It would establish a border registration of licensed recovery coaches that would do much of what other boards of registration do. Last session This bill was in the joint committee on mental health substance use and recovery and received a favorable report. There are two noteworthy changes from last session. Uh, one is that the representation of recovery coaches on the board would be increased from one to six members and that there would be a requirement that a licensed recovery coach um, is in good moral character language that it is typical of licensure bills. It's pretty much what you're used to in all the other uh boards and licensure bills.
So with that I I respectfully request a favorable report on Senate bill 1452 and729 the companion bill that was filed by rep Malia and rep O'Day House 2382 and thank you for that. And then the second bill is Senate 1449, which is an act regulating surgical assistance and similar to recovery coaches who want to professionalize themselves.746 Senate Bill This bill 1449 would748 license surgical assistance who have been facing barriers to protect to practicing in the field that they currently work in. Um surgical assistance, provide aid to a surgeon during operation. And they have currently two national pathways to certification.768 This is certified surgical first assistant certificate. And then there is the certified surgical assistant certificate.
And both require exam candidates to be graduates from a commission on accreditation of allied health education programs, um credited surgical assistant programs. So they have to go through accredited an accredited um surgical system program to get these certifications. And so then what happens here in Massachusetts as a result of a decision made by the Board of Registration in Medicine. Uh The board voted to approve regulatory changes to the licensing and practicing of medicine to require that the delegation of medical services can only be to individuals who are licensed to perform such services.
So even though we have818 a group of people who are certified who have gone through an accredited surgical assistant program in order to get that certification and done all the extra work to get that certification and were practicing in massachusetts. This change in regulation by BORIM results in them not being able to work to the full extent of their training. So838 you'll be hearing from individuals who have been directly impacted by the change. And so this requirement is preventing them from doing their job, the job that they would change trained to do.
And it's if851 they cannot practice their formal education, the time they spent on studying for the certification exam, going to an accredited program and the exposure in the operating room, the training that they got there over the years, All that would go to waste. And um, this is the time more than ever that we have more medical professionals, not fewer. And currently this group of professionals is being basically kicked off the field that they have been been trained in.
So this legislation is an important step to make sure that they are licensed and that they fulfil the role of supporting surgeons. And that's uh, really, really good for our health care system overall. And certainly it's good for patients, which is a primary concern. So I ask that the committee uh, look favorable favorably on this report and issue a favorable report out of the committee. And I'd be happy to answer any questions on either of these bills.
SHOW NON-ESSENTIAL DIALOGUE
Thank you very much. Thank you. Are there members of the committee who have any questions for the senator?
Okay. At this time, Senator, thank you for your work. Um and I'm always919 appreciative and inspired by the incredible work and due diligence that you do923 that is not obvious on social media. Um that the incredible due diligence that I know you do around um harm reduction and recovery, it's really appreciate it. Thank you. Thank you. Have a great day, folks, thank you to Okay, at this time, I believe start there seems to be some, I don't know that939 anyone else is screen, but mine is kind of moving around quite a bit right now. I'm not sure what's happening here. Um but we're gonna keep it moving anyway. Um I believe Senator O'Connor is not here at this time and will join us later,
so assuming that's still true, I'm going to move to Representative O'Day
[REP O'DAY:] [HB2382] [HB2384] Good morning, good morning madam, Chair Senator Comerford, uh members of the committee, I'm going to apologize in advance, something's happening with my, my voice here this morning, woke up with it, so um I'll try to be as painless to all of you as possible. Um You know, Senator Keenan did a tremendous job, I'm here speaking 2382 2384. 2382 is an act relative to recovery coaches. And, I certainly do not want to be repetitive of what you've heard from senator Keenan a couple of key points.
I just want folks who who have some familiarity with the world of recovery, you know that this position1015 is not something that is excuse me looking to replace a, you know, the traditional sponsor of someone who may be in recovery. This is a position of more of a professional involvement. I think the overall board to review these positions is quite extraordinary. We will have a good group of individuals on that board that really will have an understanding uh you know, what the needs are of individuals in recovery and how this will best serve those those those individuals who are seeking1054 uh you know, recovery from substance use disorder issues.
Um this bill has been around for a period of time as the Senator mentioned, pardon me, as the senator mentioned, uh there have been some additional changes made to it. I support those changes. I think it's a hugely important to have individuals with lived experience1081 and with the experience of having been in recovery to be members of the board. Presently, only those that are occupying are available who have who have MassHealth have the opportunity to take advantage of services provided by a recovery coach. We're hoping that this1104 bill will broaden that scope and and give, you know, commercial carriers uh and clients who have commercial insurance the opportunity to uh you know, take benefit of those same services that recovery coaches are providing now to individuals who are covered by MassHealth.
So I know you're going to hear from many, many, many um well uh individuals today from the recovery committee and as the senator mentioned himself and Representative Malia and I around I called earlier this week and their stories absolutely compelling. So again, I strongly support this piece of legislation and ask that it be given a favorable report. Just really quickly. 2384 I believe you will also be hearing from members of the NASW National Association of Social Workers today with regards to those individuals who have professional licensuire of a clinical social worker.
And I think what is interesting here that I think a lot of our colleagues and folks on this call when they hear about a clinical social worker might think about that, that professional who was providing therapy, you know, in an office setting. Um right now there are clinical social workers working in hospitals, there are clinical social workers working for DCF and they are not being looked upon as you know, like having the ability or the experience or the educational experience and these are master's levels, individuals who are not being allowed to take the exam for to be a to be a licensed clinical social worker because they're they're doing their social work in the field um not behind the desk in an office.
So, you know, I really believe that these are workers that have a tremendous amount of experience and opportunity to do the type of work that they have studied for. That they have chosen to be1238 in the field of DCF or in a hospital setting and they should not be um somehow denied the opportunity to take that same level of testing. So support both of those bills. I thank you all for the tremendous work that you're doing on this committee and for taking me1256 out of order here this morning and I apologize for this voice. Thank you.
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No apologies necessary. Um Your words are always powerful and important. So thank you. Representative O'Day Are there any questions before us?
Okay, hearing none. Representative Day thank you for this work. I recall it vividly as this was in the committee I chaired last year and really appreciate the leadership and the that you have continued to bring to the legislature um and more importantly to people in need of support services and recovery. So thank you. Thank you, madam. Chair appreciate those kind words. Thank you. That's the committee.
Um At this time I welcome Representative Dave Rogers if he's with us.
Okay, I don't see him on here but we'll ask again. Representative Rogers.
Okay, he may come back to us. Um Representative Donald Wong
[REP WONG:] [HB2343] [SB1380] [Um Thank you very much. Um I want to thank both the chairmen and the committee for having this hearing and allowing me to speak. Um I'm going to be speaking on House 2343 and Senate 1380. Um it's about holistic and alternative uh and compatible um people that teach. Um this is really, it's hard for me to say because it's, it involves a lot of different people of different cultures. It can be Asian, Indian South American and even Europe have people that come over with uh alternative and holistic practices.
Um I just think that if you have them all try to have licences, it's hard because you might have people coming from foreign countries and there's a language barrier.1398 Uh and it's hard for them to get a license to teach or even work on people. And who would give them licenses and certification and you know, you would have to have a tremendous big board to cover all this holistic and alternative1423 ways of health. Um even some of the hospitals have incorporated some of these holistic and alternative health at their hospitals and and if the hospitals are recognizing them, why shouldn't we?
Um, also a lot of people who learn a lot of the holistic and alternative, especially in Asia and South America. Um they get no certification from their teachers. I know a lot of people that learned like chi gung myself, I learned from a monk for 10 years with no certification after that, a Taoist Lady for three years with no certification and I think the main thing that is good is the reputation of the person that has the talent. I think people will come to them because of the reputation. Word of mouth. I have given seminars in Asia Bermuda, Canada and europe and it's all by word of mouth when they asked me to come. So um again I thank you for giving me the time to talk. Okay, thank you
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Representative Wong thank you. I I do know personally that you are an incredible healer and so it's always nice to hear from you and to see you. Um and I will open this up to my colleagues in the committee to see if there's any questions.
Okay. Hearing no questions. Thank you. Representative wang thank you.
Okay at this time we're going to move on to House 2214 Senate 1395. An act relative to receptor ship programs for students of chiropractic along with um an act relative to certainty of continuing education for chiropractic chiropractors and an act relative to continuing education requirement for chiropractors. I have two people signed up to speak. It will be1553 first dr Albert Coulter and then Tracy Lane dr colter. Are you with us? I am. I don't know if you can see me. Can you hear me? I can't I can see you and hear you so welcome you have three minutes.
[ALBERT KALTER (BRAINTREE CHIROPRACTIC):] [HB2214] [SB1395] Okay, thank you. Um Is there uh so that's 13951582 is the first bill Senate 1395 and House Bill 2214 which1587 deals with the preceptor programs for students of chiropractic. Um so the purpose of this bill is to attract the most talented doctors of chiropractic to the commonwealth currently, when the colleges post preceptor opportunities, um there's no incentive for them to come to Massachusetts because um
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uh it's just somewhere that's good.
[KALTER:] There's no incentive to come from massachusetts because of the absence of qualified uh um Law. Most states and other professions include the full scope of practice for interns under the supervision of licensed practitioners. This new law would simply permit the near graduate external chiropractor. Limited practice only under the direct supervision of a duly licensed Massachusetts doctor of chiropractic license says instructed by a legally chartered chiropractic college. The nearest colleges in Connecticut.
Having an effective preceptor program in the commonwealth would function as encouragement for new car practice to come to Massachusetts from chiropractic colleges both near and far to serve citizens experience the benefits of living in Massachusetts and contribute to the historically affordable care and effective outcomes1669 provided uniquely by the chiropractic profession. New doctors benefit our citizens by helping serve in office is often overflowing now as more people, regardless of geographic or economic situation. Seek quality outcomes without pain medication or the risk of addicted addictive opioids.
The Federation of Chiropractic Licensing Board has a model practice act. Um and these two bills would amend the existing general law Massachusetts to model universal guidelines inviting in uh and and being congruent with the existing chiropractic college requirements um for uh preceptorship participation. Um I really appreciate you giving me the opportunity to testify. Um and I will uh follow instructions I guess on emailing an attached letter of today's testimony to the1725 to the to the joint committee.
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So thank you. Thank you. Any questions? I'm happy to answer questions.
Thank you. Um at this time any questions for my colleagues as we move forward through the public comment? Uh colleagues want to speak, you know, they know to text us or quickly put their1742 hands up because we're going to keep moving through this. Um I would ask Tracey Lane. Thank you. Mr Thank you. Doctor culture appreciate your testimony. And I would call Tracy Lane to come forward.
Okay. Tracy Lane with us.
Okay. Not at this time. All right, thank you. We're going1764 to move on to house 20-25
Senate 1390. This is an act relative to facilitating the utilization of psychologist on the health care team. We have two people signed up in a panel um Dr. Shoshana Fagan and Dr.1781 Andrea Barnes. Welcome.
[SHOSHANA FAGEN (FRANCISCAN CHILDRENS):] [HB2225] [SB1390] Hi, I'm1793 Dr. Fagen. Um Thank you for having me. I am a psychologist who works on a pediatric rehabilitation unit. I um my job is to consult with patients when one of them is struggling to participate or engage with the medical interventions that are needed and designed for their recovery. Um as we all know, being in the hospital can be frightening for anyone and particularly so for children when they1828 have absolutely no control over the decisions that1830 are being made for their care. Um just as an example, I am working with a young man whose birthday happens to be today, who has made amazing progress despite having been truly traumatized by the interventions required to save his life after the discovery of a brain tumor and1849 subsequent stroke he suffered.
He's finally weaning off his ventilation support and will require having uh CPAP at night.1857 Now any of you out there who require the use of CPAP or have a partner who uses CPAP knows that it's uncomfortable device to wear and takes time to get used to. So for this young man who is very reactive to any new medical intervention. Um the idea of having to learn to deal with something new is extremely off putting. And so I was called in to help him get used to the process. In order to do that I need to help him get comfortable with it in a very slow and prescribed way before he's asked to start trying to wear it overnight while he sleeps. I can do this.
I can get him to wear the CPAP, but it's not going to be effective if the other people who are working with him in the hospital on the unit are not able to follow through with my plan of action. So, the problem we run into right now as psychologists is that the nurses who work with us are unable to follow through with any orders and we are not able to place any orders for the nurses about care that we want to prescribe. So if I come up with a plan to get him used to the CPAP, I can't place an order for him to1945 get used to this plan and they are not allowed to follow an order that I would place for a plan for him to get used to the CPAP. And so we are then stuck in this situation where no one can do what we want to get done in order to help him get ready for that next step in his recovery with regard to the aspects of his care that I'm being brought in for.
So, the whole goal of this nurses orders bill is to allow us as psychologist doctor level providers to place orders that the nurses are allowed to follow. And part of I think what people don't understand, they say, Okay, so why can't you just put a note somewhere. The way all the medical systems were is that if it doesn't go through the nurses or the order process, No one knows it exists. It's not seen. And so even just a little note somewhere else in the system, even if people wanted to follow it, they wouldn't know where to look for it. And the truth is some people want to follow it more than others.
And if we're creating plans that are designed to help a patient participate in their care and the nurses can't follow2024 it consistently, then the care doesn't get completed consistently and the patients aren't able to receive the treatment that they need. So that's just, you know, one story of an example of things that happen very specifically on multiple units in multiple locations. Um we provide a very specialized set of services that MDS are not trained to provide. And in many manners we are providing services and functioning as consultating2062 doctors, like many other MD specialties on the unit and really do need the same level of um access to the nurses that they have. So thank you very much for your time.
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Next on. Sorry. Next. On your panels dr Andrea Barnes.
Dr Barnes, you're muted.
[ANDREA BARNES (CONCERNED CITIZEN):] [HB2225] [SB1390] Thank you. We'll be submitting written testimony. So I'll just be very brief. Um Dr. Fagen I think did a beautiful job of describing just what we're running into. We're not asking for any any expansion of our scope of practice but just to remove some barriers to the practice that we already do. And as you can see we're throughout the health care system, we're not just in mental health and we work on teams and so in order for us to be able to implement what we do and for teams to feel uh legally safe following our orders.
We need to be able to have this bill passed that gives them permission to follow it and for us to people, right it in the form of orders. Um this is about consistency of care and making sure that that um everybody is seeing the same information. Currently nurses can follow orders from doctor level physicians and dentists, but also from Master's level providers. And so it seems logical that doctoral level psychologists will be on that list.
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Thank you. Please do submit the testimony if you have more that you'd like to share with us. Um I just want to remind the next panel the panel you've come on as a panel, which means that somebody has organized you so that you can go on back to back. The total for the panel is six minutes. So whoever is speaking in a panel, hopefully the person who has organized you um has helped you work with each other to make sure that people are getting the time and a panel that they want to deliver this. Um and so we are gonna just keep to this rule. So the next panel has2207 three people on it. Um and just to be clear, the one after that has four, so hopefully people have worked out what that time looks like for each other. Um and because the buzzer will not go off until six minutes but we're keeping time, we hope you're keeping time. Um I would like to welcome the next three speakers who will, who are on the panel who will be speaking on an act relative to removing barriers to care for physician assistants. This is House 20 to 29 it's Susan Schattman um dr Christopher at Kyoto and dr eric Blumen um Welcome2246
[SUSAN SCHAFFMAN (MOA):] [HB2229] [SB740] [HB2247] [SB1438] [HB2270] [SB1510] [HB2240] [HB2241] [HB2396] thank you so much. This is Sue Schaffman really appreciate the opportunity today to come before the Public Health Committee. I am the executive director of the Massachusetts Orthopedic Association And I'm representing more than 250 orthopedic surgeons in the Commonwealth. Um joining me today will be Dr. Chiodo and Dr. Blumen um and um going to address first of all, the HB 2229 an act relative to removing barriers to care for physician assistants. And then if the committee would allow I have a several other ones from today's public hearing that I'd like to address as well.
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You have six minutes as a panel, so you're welcome to do use it however you want. Okay. Super. Thank you. I really appreciate that.
[SCHAFFMAN:] So the MOA appreciate the opportunity to testify and opposition to this bill, HB 2229 and Senate bill 740. This bill seeks to expand the scope of physician assistance and eliminate physician oversight and supervision. So orthopedic surgeons work with physician assistance as part of a team approach to the care of patients. And this bill would expand the profession's scope without regard to the appropriate training to to support the expansion um and could possibly compromise patient safety without the physician supervision oversight. It is for these reasons2330 that the MOA also registers our opposition to HB 2247 and Senate Bill 14382336 an act relative to athletic training.
The MOA strongly opposes any expansion by legislation that is not reflected in education and training. And to this end the association also2348 opposes House Bill 2270 and Senate Bill 1510, which would both significantly expand the scope of podiatry without regard to the various training levels of podiatrists over the last several decades, which again could compromise patients' safety. Both Dr Chiodo and Dr. Blumen will address these bills. The other bills before the committee today include transparency and truth in advertising, which are important components for consumers to make informed healthcare decisions about who is caring for them and their loved ones.
Patients have the right to know the credentials and the level of training of those diagnosing treating and caring2382 for them. It is2384 for these reasons. The Massachusetts Orthopedic Association strongly supports truth in advertising and an act relative to the healthcare transparency. These two bills, combined will provide consumer protections for patients. And the association strongly supports the patient safety measures and the transparency proposed in House Bill 2396 an act enhancing the podiatric professions, registration and oversight. This bill proposes a robust oversight by the Board of Registration in Medicine of the podiatric profession and includes transparency for patients uh um and so without further ado I'd like to thank you for your time and consideration and I'll turn it over to Dr. Chiodo who will be discussing the bills related to podiatry.
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DR Kennedy I'm here. Can you hear me? We can hear you. Your panel has just under three minutes between you and the next speaker.
[CHRIS CHIODO (BRIGHAM AND WOMEN'S HOSPITAL):] [HB2229] [SB740] Good morning. Thank you for a time. I'm Chris Chiodo in charge of foot and ankle at Brigham. All I do is foot and ankle surgery. I've been doing it for 202442 years. The ankle is very complex because it's a moving joint and has so much weight on it so close to the ground. I still get nervous doing ankle surgery and if it goes wrong, the patient has to take2453 5000 painful steps a day. Regarding this legislation. With all due respect. It goes again too far year after year, it just goes too far it includes surgery on not just the ankle but the leg and allows any podiatrist to do ankle surgery regardless of training. Do some podiatrists and other ankle in other states to ankle surgery. Yes, but we now have scientific evidence from other states demonstrating increased complications and increased costs when the ankle is ankle surgery is performed out of podiatric scope.
I ask you for our patients and for the citizens of our commonwealth not to pass this legislation. My colleague Dr. Blumen can add a few more words within a minute or so. We have left Dr. Eric. Okay, he may be operating or in the clinic but I'll leave it at that I do want to thank you for your time and your consideration. This is about safety and patient outcomes. It's not a turf war, it's about outcomes and patient safety and now costs our increased costs as well. Thank you for your time and for2512 your consideration.
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Um Thank you. And do you feel free to submit any written testimony and if Dr Blumen also wants to submit written testimony we will take that if he hasn't already.
Okay so the next actually are for individual speakers who signed up, you each have three minutes as individuals. Um I have Coal Turno who has signed up 1st. Are you here? Hi Senator Marjorie. Um Representative Marjorie Decker Um I'm here. Um So can you guys hear me? Okay? Can um thank you.
[COLE TURNO (MAPA):] [HB2229] So thank you to Senate Chairwoman Comerford House Chairwoman Decker and remaining members of the committee for the opportunity to briefly speak in favour of H 2229. An act relative to removing barriers to care for physician assistants. My name is Cole Turno and I have been practicing PA In the commonwealth for five years with clinical experience in emergency medicine, transplant cardiology and critical care. I've also been a board member of the commonwealth's only state PA advocacy group. The Massachusetts Association of PAs for seven years. Starting as a student rep in graduate school. Now currently serving as president of the executive committee.
In short, H 2229 represents a step forward in modernizing modernizing our state regulations2587 and legislation to more accurately reflect the team based model of care that is practiced today. Still removes requirements for identifying specific supervisory positions for PAs at the state level and allows PAs to be responsible for the care that they provide,2599 allowing us to practice at the maximum of our scope and training. It would not change our scope of practice but simply remove current administrative barriers for PAs.
Interestingly, we've already seen this bill in action as this is a continuation of the emergency order that was approved by Governor Baker and DPH Commissioner Bharel in March 2020 in the midst of the initial Covid surge. And the temporary executive order allowed for PAs to practice without filing a supervising position with the commonwealth, thereby creating greater flexibility for PAs enabling PAs to be deployed more easily to areas of need, assisting health systems with capacity issues and providing patients access to care. PAs undergo extensive clinical training and are highly educated in their field and in order to practice PAs complete rigorous requirements, including obtaining a Master's degree from accredited Medical school or Centre of Medicine, earning at least 2000 clinical training hours and completing 100 hours of CMEs every two years.
PAs with this general medical education and background were able to serve in a variety of positions outside of their normal positions when things2659 close down with2660 Covid. PAs were utilized in staff medical Covid wards, ICUs testing centers and eventually vaccination clinics moreover,2667 there were no negative consequences reported from this change. Moreover, the physician assistants profession has been around since the 60s and we've been delivering high quality care throughout the US from hospitals. Primary care rural setting. Um Since the interception of the profession laws have changed um some have not um as quickly as we prefer.
Um The law right now, uh we don't PAs don't practice with a single supervising doctor anymore, but rather operate in teams. The law however, mandates that PAs have a single supervisory physician but often in rural settings, especially the supervising physician and the PA rarely interact. We've heard of cases out in Wester Mass where PAs and physicians share hospital or clinic shifts only once every six months. Despite this, the supervising physician is legally responsible for any2710 decisions made by the PA which is not reflected in the way the practice operates.
This outdated law remains means that the supervising physicians are held liable for the work of the PA simply because they have registered with the state in this capacity. PAs are highly educated and trained medical practitioners and we should be held liable for the care that we provide. While Massachusetts has been a leader in healthcare across the nation, There remain areas of the commonwealth, particularly2731 in Western parts of the state that are medically underserved and do not have access to adequate primary care services. And as we've already bared witness with the strain on the healthcare system, um thank you for your time and I really appreciate it.
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Yeah. And please do feel free to submit testimony to writing and I will remind people that if you've already given testimony, we are asking you to log out of this team's platform and log back on and watch it live stream. Um that's just to protect the integrity of the connectivity. Thank you. Our next speaker2765 will be Duncan Davia and I'm saying that correctly.
[DUNCAN DAVIAU (MAPA):] [HB2229] Hi Chairwoman Decker thank you. You are saying it correctly. Um so thank you, Chair Decker and chair Comerford and members of the committee. I'm Duncan Daviau I am the president elect of the Massachusetts Association of PAs and I'm a clinically practicing physician assistant emergency medicine for the past five years. I came today to speak in favor of H House Bill 2229. An act relative to removing barriers to care for physician assistants. This provision if enacted would allow, would modernize PA2802 practice by removing the specific requirement that a PA has to have a supervising physician to practice.
If enacted, it would reduce administrative burdens and reduce the amount of licensing paperwork needed to file in the state. Covid has brought significant destruction in the Commonwealth regarding the public health implications and the economic devastation and no one knows more than the committee here today, but I believe in looking at silver linings. In March of 2020, Governor Baker signed an executive order temporarily severing our relationships with um supervising physicians. It allowed the commonwealth to effectuate a better pandemic response by allowing PAs who were in surgical disciplines um during the moratorium of elective surgeries to go work in Covid testing centers.
Um It improved our ability to respond to the pandemic and there was no adverse outcomes. At Mercy Hospital in Springfield Massachusetts where I currently work um We had an entire Covid uh Covid testing site that was staffed entirely by surgical surgical physician assistants. Um And also on a personal note, I was previously an employee of a private practice ER group. That group unfortunately ended up folding due to the devastation brought by Covid. I ended up working for a new hospital group at the start of Covid. Um And they were actually new to hiring PAs.
Um They had never had a PA in the emergency department. And even though I was still at the same practice site I I needed to find a new supervising physician. Um I was an employee of the private practice2892 group on Friday and on Monday I was an employee of the hospital. Um I spent 30 days trying to track down a new supervising physician in order to become compliant with the law. So that way there was no adverse complaints against my license. Um additionally, there has been significant issues regarding The regulations issued by the Board of Registration in Medicine in August of 2019. They issued 243 CMR 2.00.
This regulation noted that a physician has the sole obligation to perform written informed consents for procedures in certain interventions. Um different hospital groups have taken different approaches to this regulation. Um there's a PA who works at Children's Hospital who has a pre signed stack of informed consents about putting tympanostomy tubes and kids. Um Some hospital groups have taken away PAs abilities to do blood transfusions due to these regulations, it's taken away PAs ability to care and issuing this passing this law forward um would help counter this regulation and improve PAs abilities to help care for patients in the commonwealth. Um that's pretty much it. Thank you so much for your time today.
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Thank you for your time and please do feel free to submit any additional testimony. Absolutely. Okay, this time I would call forward Loren Bates Row, are you here with us? I am thank you Decker
[LAUREN BATES-ROWE (AAPA):] [HB2229] Thank you. Chair Decker and Chair Comerford and members of the committee for the opportunity to speak with you today. My name is Lauren Bates-Rowe I'm here on behalf of the AAPA who represents the more than 150,000 PAs across the US. And I'm glad to be here with my colleagues from MAPA who represent the 4000 PAs here in the commonwealth. AAPA supports H 22293007 as this legislation would modernize PA practice and increase access to care. PAs are highly trained medical professionals educated at the master's level who diagnose illness, develop and manage treatment plans, prescribe medications3018 and often serve as a patient's main healthcare provider. PAs have more than 400 million patient interactions per year.
So it's no wonder that 93% of patients say they trust PAs as their health care provider3032 and 92% say having access to a PA makes it easier to get a medical appointment. H 2229 builds on the progress Massachusetts has3042 already made. As you've heard the temporary EO allowed PAs to practice with greater flexibility. 20 other states across the nation also took similar action and again, even under the most dire circumstances of the pandemic PAs continued to deliver high quality care without negative consequences. It's time to make this change permanent as this body did for our colleagues in nursing last year. Um and notably this bill3064 would remove outdated administrative requirements for PAs to provide care.
It would not allow for independent practice. It does not change scope of practice. The bill allows the health care team to decide how they can work best together based on the patient. And so for example, one day a PA may need to work with physician the next day they may need to work with a respiratory therapist. And so it allows the care team and the PA's employer to have the flexibility they need without the additional paperwork. Nationally and candidly PAs Um PA Laws are generally a bit outdated um which puts PAs at a disadvantage with employers such as hospital and health systems.
Thankfully we are seeing states correct this problem and grant PAs the needed flexibility to maximize patient care. Earlier this year, Utah and Wyoming enacted new laws similar to H 2229. Other states such as maine Minnesota Rhode island, North Dakota and many others have all enacted laws that have similar principles in modernizing practice Again. This bill only allows PAs to provide care they are trained to provide. It does not increase the PA's scope of practice. PA's will be held to the same legal standard as physicians and advanced practice nurses. And the bill makes PAs legally responsible for the care they deliver, which is the change we welcome and most importantly, this bill will increase patients' access to care. Thank you for your time. I'll submit written testimony and I'm happy to answer any questions you may have.
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Thank you. Um At this time I would welcome thank you for your testimony and we'll be sure to accept the written testimony. Um At this time I would welcome Adrian hopper to join us just
[AIDAN HOPPER (MAPA):] [HB2229] Hi everybody. Um Thank you so much for having me today. Thank you Chair Comerford and Chair3173 Decker and members of this committee again for allowing us to testify in support of House Bill 2229. I'm a proud new physician assistant. I joined a very busy emergency department here in Massachusetts just two months before the start of the pandemic and now act as the director at large for the Massachusetts Association of PAs. Uh in this time I have seen how important it is for PAs to be uh invaluable contributing members of3198 our health care workforce. Uh We are dedicated and we remain on the front lines to this day.
However, our healthcare system is changing and the stresses of this pandemic will have years of consequences in our long term ability3213 to provide health and health and wellness to this commonwealth. A patient of mine yesterday presented with pregnancy, chest pain, high blood pressure and gestational diabetes. She won't be able to see her primary care provider for three months. And so she became my patient. Another presented with two months of abdominal pain, Nausea, vomiting, rendering them unable3236 to work out of the workforce and unable to see a gastroenterologist. They disclosed that the gastroenterology department told him that there are 2500 colonoscopies behind. And so they became my patient in the emergency department.
Another lost care with the psychiatrist After moving across state lines, they presented with psychosis decompensated off their medications and while this is a very, very real disease, their condition is inflicted from a system that has failed them. Unfortunately. These are just three of the 20 patients that I saw on a shift yesterday and we've all certainly heard about the overcrowding that our department is facing. Our ability to modernize what physician assistants can do in a healthcare team allows for a more malleable health care system and our ability to respond to the changing needs of this healthcare infrastructure.
In short, I'm concerned about our representation of the past, a cohort of health are providers and heroes who have brought years of healthcare experience before even starting PA school who now compete with our3290 colleagues who have been granted the same full practice authority that we were given and revoked. I am concerned about the present amidst a global pandemic and the constant struggle for access to care. Something I see on a day to day in my department and I'm concerned about the future as the stresses continue to challenge our workforce to continue to challenge students who at one point are very excited to enter this workforce and to be a part of the solution.
At one point, I was one of them, I decided to become a PA as opposed to a physician because I saw a need for malleable important healthcare workers who can meet the demands of an ever changing healthcare society and healthcare infrastructure. I see this bill as part of a much larger solution in accessing care for those who need it most and appreciate your time and the ability to submit this testimony. I will also be writing uh entering some written testimony as well. Thank you so much for your time.
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Thank you for your time and we will take testimony at this time. I'm going to hand this hearing off for the next hour to my colleague and co chair Senator Comerford, thank you so much, madam. Chair happy um to facilitate this next leg, we're going to move now to hear testimony on H 2241 and act relative to healthcare transparency. We have two panels. Um so again the six minutes apply to the panels. The first panel is Christopher gill and Lynn read Christopher and Lynn are you here? I'm here. Chairwoman comfort but Lynn is not on yet, you will be joining after So may I use my three minutes now and then see three minutes to her. Absolutely, yep. Three to you and it's just an individual time limit. So please you're warmly welcome. Thank you very much.3397
[CHRISTOPHER GILL (ST. LUKE'S HOSPITAL):] [HB2241] [HB2242] [HB2356] I'd like to thank both you um and chairwoman Decker and the members of the joint Committee on Public Health for this opportunity to provide testimony regarding opposition to H 2241 an act relative to healthcare transparency. 2242 act to promote team based health care and 2356 act relative to anesthesiologists assistants. My name is Christopher Gill. I'm originally born and from Lowell Massachusetts. I've lived much of my life in the state. I'm a proud graduate of the Direct-Entry3432 Master's Nursing program from Salem State College, A program that was fortunate to receive Mass State grant money to uh further the program. I'm also a proud husky and pleased to have concluded recently concluded my Ph.D. program at Northeastern in May of 2021.
Um, it's important for me to acknowledge and thank you all for supporting certified registered nurses in the Commonwealth of Massachusetts. I can personally attest to how the removal of practice restrictions during the Covid-19 pandemic enhanced care provided to patients. I believe CRNAs possess the knowledge, skills and abilities to provide a force multiplier in all arenas where anesthesia, anesthesia related care is required. As practitioners, we maintain unique capabilities in airway management pharmacology and physiology that allows us and enables us to provide safe patient centered cost effective care.
During the height of the pandemic I was the chief CRNA at St Luke's Hospital in New Bedford Massachusetts. When the hospital system was faced with making difficult choices as to how to staff the providers. My3492 anesthesia department stepped up. We leverage relationships with our critical care colleagues, physicians, MPs, PAs and RNs to enhance the existent, provider compliment. I like many and staff rotated days and nights working to meet the demands of the community we serve. While stressful I can definitely tell you that without removal of practice restrictions Patient care and the ability to provide life saving treatment would have been negatively impacted.
I feel strongly in telling you that allowing CRNAs and other advanced practice providers to practice at the top of their license, improves quality of patient care. We are so fortunate to have highly regarded academic institutions that research healthcare systems and policy. Uh, those institutions tell us the data supports enhancing and allowing all current team members to contribute to the fullest extent of their knowledge and expertise. Adding a new provider type to a state that has not fully utilised its current provider workforce does not make sense for our health care system or our patient care. I would ask the question, has a cost benefit analysis been performed to justify the creation of a new license and subsequent administration of licensing programs.
I would propose that the most economical path is to decrease unnecessary regulatory barriers and license restrictions on existing licensed provider groups who have a long established record of performance in Massachusetts. Removal of practice research does not nullify team based care. I will close with saying given my background experiences and points made here today, I hope you will3588 strongly opposing house bills. I'll stop. Thank you.
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Thank you. Um The buzzer is of course indelicate, appreciate Mahoney questions from my colleagues.
Okay, hearing none. We'll catch Lynn when she comes on. Um Thank you. We have another panel please. Um three individuals six minutes Nathan Jones Kathie jones mary anne van is the panel ready?
Yes, very good. You're warmly welcome.
Hi, my name is Nathan Jones I'm the president of the Massachusetts Society of Anesthesiologists. Um I have Kathy Jones and materia shaw with me. I'm going to let them speak first
um and I can speak.
[CATHIE JONES (MSA):] [HB2241] [HB2240] I'm Cathie Jones I'm a pediatric anesthesiologist at Boston Children's Hospital and I'm president elect of3639 the Massachusetts Society of Anesthesiologists and I wanted to testify in support of the transparent transparency and truth and advertising bills. H 2241 H 2240. patients can easily become confused about the differences between various healthcare professionals. Often patients mistakenly believe that they are meeting with physicians when they are not. patients deserve to know who is taking, helping to take care of them and what the professional taking care of them is qualified and licensed to diagnose prescribe and treat. Often It is not known that some medical specialists are physicians. Many patients are reluctant to ask their health care professional about one's training and certification during a visit or when they're about to undergo anesthesia.
With a growing number of non physician healthcare providers. It is easy to mistake who is a physician and who is not, especially as other providers are obtaining doctoral degrees and present themselves to patients as doctors. Nurse anesthetists and other advanced practice nurses are changing their degrees from master's degrees to Doctor of Nursing practice degrees. And3698 recently in New Hampshire nurse anesthetists wanted to tell patients that they were anesthesiologists, but the New Hampshire Supreme Court upheld that only physicians who have specialty training in anesthesia are allowed to call themselves anesthesiologists.
Passage of these bills will help patients make more informed decisions about their health care by ensuring that the doctor who is caring for them is indeed a physician and also that3731 the anesthesiologist who's caring for them and providing3734 their anesthesia care is indeed a physician. So I would encourage the committee to support H 2240 and H 2241 to ensure that patients have clarity and transparency as to who is providing their health care.
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Thank you. Next person on the panel please.
Um not hearing dr shaw, I'll just start
[NATHAN JONES (MSA):]3754 [HB2241] [HB2356] Again Nathan Jones, president of the Massachusetts Society of Anesthesiologists. I uh echo Dr. Jone's comments on the transparency act. Um I'd also like to speak about House Bill 2356 act relative to anesthesiologists assistants. I've submitted written testimony on behalf of the society. I encourage you to look at for more details. But I'd just like to say in brief summary that anesthesiologist assistants practice across the country and the care team model. Um there's been no credible evidence showing any difference between nurse anesthetists and anesthesia assistance. Um So we'd encourage the House to support passage of3793 this bill.
Um as my colleague Mr Gill down3796 in the3797 South Shore was saying um you know basically we have a need for additional anesthesia providers in the state. There's only two CRNA Programs currently producing CRNAs in the state. Um And we have multiple openings across the state. So this would allow for us to have expansion of practice and making sure that all patients have access to physician led team care. Um Again I encourage you to support House Bill 2356 and I'm happy to answer any questions.
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Thank you so much. And is this the conclusion of your panel I'm going to assume. Yes. Uh Unless dr shaw can get on. I know I don't know if she's having technical problems. Yes. Okay. Okay. Very good. Um Thank you so much both of you for your testimony, really appreciate it. Um And thanks for sending in written remarks questions from my colleagues.
Okay seeing none. Thank you again for coming on and for your work. Are you friends? Thank you were moving on now to H. 2246.
This is an act relative to C. N. A. Training. We have three folks signed up after H. 2262246.
We're going to hear testimony on H. 2247 and S. 14 38. That's an act relative to athletic training. So folks speaking about those bills are on deck now. Um so the first individuals signed up to speak on H 2246 is William Graves.
Mr Graves. Are you with us? I can thank you your little faint. Um and I was on when Senator biden was speaking about your important work. So please you're warmly welcome. Thank you very much.
[WILLIAM GRAVES (SOUTH COVE MANOR AT QUINCY POINT):] [HB2246] Thank you. Senator Comerford, Representative Decker and the other members of this committee for allowing me to speak in support of House Bill 2246. My name is William Graves and I'm the president and chief exec of South Cove Manor Nursing and Rehabilitation Center in Quincy. In addition, I serve as a board member of the Massachusetts Senior Care Association and as the chairman of the Board of Registration of Nursing Home Administrators for the commonwealth of3934 Massachusetts.
I believe that there are two significant issues that this bill has the potential to address. I have provided written testimony that speak specifically to the broader issue Critical shortage of certified nursing assistants. So I will focus my time here today on the issue that affects my organization and several others like it. That issue is the need for culturally and linguistically competent care for those elders whose primary language is not english. That need is supported by current census data that indicates that over 23% of the population of Massachusetts speaks a language other than English in their own homes and that number will undoubtedly continue to rise.
As just one example of this pressing need. My organization is a nonprofit 141 bit long term care facility dedicated to3976 serving the Asian elderly. 92% of the elders that call this high quality organization home do not speak or understand English. It only makes sense that those that care for them are able to communicate in a language of the elder's choosing. In fact, the Department of Public Health through the American Red Cross previously offered the certified nursing assistant examination in Chinese Until this language option was dropped in 2018 without explanation.
At South Cove Manor there's a pressing need for our facility to employ bilingual caregivers who can address our residents' medical issues, diet, daily activities in order to provide the highest quality of care that has been the hallmark in the nursing home industry for decades. House Bill 2246 restores the language option for the CNA examined Chinese and also as translations for Spanish and potentially other languages. This is a matter of great importance not just for South Cove Manor but for all nursing facilities that depend on bilingual staff to provide optimal care for their non english speaking residents. For CNA exam applicants with limited English language fluency as well as for the greater community.
This hearing comes at an incredibly advantageous time to make this change a reality. On October 31st, the current CNA testing provider, the American Red Cross will cease to provide those services to the Commonwealth. A new testing provider. Prometric LLC has been chosen and will begin providing the same CNA testing services on November 1st. According to Prometric's website they already provide translated testing services in other states, so requiring them to do the same in Massachusetts should not be an arduous task. Please help to make nursing homes safer by supporting House bill 2246. Thank you for your time today and I'm available for any questions if anyone has any.
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Thank you so much. Mr Graves thank you for the testimony and your important work essential um questions from the committee. SHOW NON-ESSENTIAL DIALOGUE
Okay hearing none. Thank you. Um The next to folks signed up to speak on this bill um are manly key and then Tabatha Feinberg. Um Minicucci are you available? Yes warm, you're warmly welcome.
[MAN-LI CHI (SOUTH COVE MANOR AT QUINCY POINT):] [HB2246] Thank you thank you Senator Comeford and Representative Decker and the other members of this committee for allowing me to speak in support of the House bill 2246. My name is Man-Li Chi and I am the staff development coordinator and infection preventionist at South Cove Manor 141 bed skilled nursing facility located in Quincy/ My role as staff development coordinator I teach an approve nursing assistant training course to those that wish to become certified. Prior to the translated testing being removed as an option in 2018 I taught the curriculum To about 150 CNA candidates in Chinese.
Every student was able to pass both clinical uh skill portion of the exam as well as the written portion in Chinese. Since the translate translated version of the exam was eliminated. South Cove have not offered a course4144 in Chinese because we knew the candidates could not pass the4147 written portion of the exam. As a result of the current federal state of emergency uncertified staff are allowed to work as a nursing assistants if they complete a nursing assistant training course. This nursing assistant will be permitted to work for up to four months after the state of emergency has been declared over. Because of that accommodation, we began to offer the course in Chinese recently.
Our student has very limited English skills but have become wonderful caregiver. Recently, two of our students choose to taking the certification exam knowing that the test was only available in English. Both of4189 these students worked incredibly hard for months studying English medical terminology that would be used in the task. But unfortunately they failed written portion of the exam. When the federal State of emergency has ended these intelligent hardworking caregivers will no longer be able to pursue gainful employment as a nursing assistants if the Chinese translation of the trend of the certification exam isn't reinstated.
92% of the elder that currently live at South Cove Manor do not speak English. Having the caregiver that speak their language could only serve to improve their quality of life. So I am urging you to require that the translated version of the exam are available to those candidates that need them. This accommodation will provide the non english speaking elders the care they deserve as well as provide working opportunities for many people with limited English skills that they otherwise would not have. Thank you again for allowing me to share my point of view with you today. Thank you.
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Thank you so much. Did you say that you you offered the exam to 150? Yeah. Inside in the position. Um that's Herculean work. Thank you very, very much, really appreciate the dedication um questions from my colleagues.
Okay seeing none. Well thank you. Um The next speaker on this bill is Tabatha Feinberg please Tabatha.
[TABITHA FINEBERG (HEBREW SENIOR LIFE):] [HB2246] Good morning and thank you, Chairwoman Comerford and Decker and the committee members for letting me speak this morning. My name is Tabitha Fineberg and I'm the administrative director for academic programs at Hebrew Senior Life. Um Hebrew Senior Life's 2600 employees are committed to increasing access and providing high quality care,4314 Personalized and person-centered healthcare to over 3000 seniors every day, Many who are low income um seniors4322 across eight campuses. Our healthcare services include a continuum of care, including home care, community based short term rehab, long term chronic and palliative and hospice care.
Um We also do a4335 large number of teaching with Harvard Medical School and 40 other medical centers colleges, schools and we trained before Covid over 1000 different physicians, nurses and allied professionals. And4350 because of the Covid pandemic, we started doing CNA training as well. And with that we really do support Bill 2246 an act relative CNA training. This bill would require the Department of Public Health to provide translated versions of the state CNA training examination. Um as many of you are aware, the Covid-19 has taken a great toll on long-term care facilities across the state of Massachusetts.
And yet every day Hebrew Senior Life employees have come to work and supported our elders in so much more than just patient care, but being their families when the families couldn't come to actually be there with them. Um and so when we started our CNA training program, we did not just do a CNA training program, but we did a training program that took under or unemployed individuals and offered them a paid training program with a guaranteed job at the end of the program. As long as they completed our training. We have internally promoted our housekeepers and our culinary staff and successfully employed people who were underemployed or unemployed for many years who who have lost their jobs to unemployment. Um due to the pandemic.
Unfortunately not everyone has been successful in the classroom or working on our units or I'm sorry everyone who has been successful has been able to pass the certification exam. Um with the American Red Cross stepping out and Prometric coming in we have been concerned that there will be further people being unemployed or underemployed. The barrier has mostly been language and we have been able to get people to pass the clinical exam but not pass the written exam. An example of this is Lucy. Lucy was a long time Hebrew Senior Life housekeeper who wanted to take the CNA course with us and she tried elsewhere but could not get into the courses. We then took her into our course. She was offered a position in our first cohort. Mhm And I will I give you guys my written exam. Uh my written statement. Sorry, thank you for letting me testify.
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No, this is wonderful and again the buzzer is hard. Um I'd love to read that testimony as I'm sure chair Decker would as well. And our colleagues on the committee. Thank you for your important testimony. Questions from my colleagues.
Okay moving on. Um now we're moving on to the athletic trainer Bill that's H 2247 S 1438. After that we are going to hit these are the folks on deck now H 2266 and S 1381. An act relative to enact relative to the board of registration in natural apathy. Um so back to um an act relative to athletic training. Um here is a panel4536 um I have three individuals on the panel robert calandria Brett Winston and Mark Larson. Um, is the panel ready? We certainly are. There's going to be two of us Today will be myself and bob calandria. Wonderful, wonderful. So three minutes each then. Simple. All right, thank you so much.
[BRETT WINSTON (SPRINGFIELD COLLEGE):] [HB2247] [SB1438] Chair Comerford chair, Decker and members of the committee. Thank you for this opportunity to voice my support for Senate Bill 1438 and House Bill 2247. An act relative to athletic training. My name is Brett Winston. I'm a resident of the city of Springfield and I currently serves as a professor and clinical education coordinator for the Springfield College Athletic Training Program where I also remain clinically active as a licensed athletic trainer within the college's athletics programs. Aside from my daily role at the college also served as the president of the Athletic Trainers of Massachusetts.
The bill before you seeks to update the language in regard to the Practice Act or the practice of athletic training. The current Practice Act was enacted in 1983 and this exact same language still remains today despite decades of4599 attempts to provide updates. Now, I want you to let that sink in. A healthcare profession in the Commonwealth is still being held to language of 1983. I'm sure we can all see the issues here as healthcare has drastically changed over the past 38 years now as an AT educator and practicing clinician, I'm concerned that our restrictive Language is one of the primary reasons that ATs are leaving the state.
Across the nation Athletic trainers are being utilized in workplace settings such as the FBI performing arts, the military and other industrial settings Just to name a few. However, ATs are not able to seek these opportunities in the state of Massachusetts. This is a direct result of the workplace restrictions imposed4641 by our antiquated Practice Act. Additionally, this restriction makes ATs the only allied health profession with such restriction on our practice. Athletic trainers are highly educated healthcare providers who must obtain and maintain a national board certification through hours of continuing education courses throughout each year. The expertise4658 in injury prevention, acute care and management of musculoskeletal conditions Makes ATs highly qualified to provide health care beyond the traditional sports sector.
Preventative strategies and policies can lead to a decrease in work related injuries, thus lowering the cost of healthcare in the state. Our understanding of ergonomics, biomechanics, patient education and other preventative methods will certainly decrease the number of fatal injuries while also limiting the overall injury rate in both sport and occupational settings. The current bill is not seeking to expand the scope of practice for athletic training, but rather to provide language that is representative of athletic training In 2021.
The removal of workplace restrictions will open jobs, increase access to care for the healthcare,4699 consumer and lower the cost of occupational and sports-related injuries through prevention-based programming and immediate on site care of acute and chronic injuries. The antiquated terms pre conditioning, conditioning and reconditioning lead many to confuse our profession with fitness professionals such as strength and conditioning coaches. However, terms like preventative emergent and rehabilitative care provide the clarity as to our role as allied health professions in the commonwealth.
While athletic trainers do work under4725 the direction of a physician, we have chosen the term in consultation with physicians as it better reflects the day to day working relationship of our two fields. In closing, I'd like to acknowledge that we have collaborated with our allied health partners on this proposed language and I would respectfully request a favorable vote on this bill to provide clarity for the legal practice, the healthcare consumer choice we cared for by an AT. Thank you.
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Thank you so much. And just a clarifying question, Does your written testimony contained the list of folks that collaborated with you? It does. And I will be submitting that today. Perfect. If you could just highlight that, that would be that's an important addition. Thank you. Absolutely. Thank you. All right. Um next person.
[ROBERT COLANDREO (ATOM):] [HB2247] [SB1438] Okay, good morning Chair, Comerford chair, Decker members of the4776 committee. Like to thank you for the opportunity to speak in support of Senate Bill 1438 and House Bill 2247 act relative to athletic training. I'm Robert Colandreo.4785 I would associate professor and the program director for the athletic training program for Bridgewater State University and the current past president of the Athletic Trainers of Massachusetts. I've been licensed in the Commonwealth as an athletic trainer since 1995 and physical therapist since 2002. Senate4803 Bill 1438 is a cost neutral bill. This bill will expand access to athletic training services but will not expand the scope4810 of practice of an athletic trainer.
The same skill set we use today will be the same skill set we perform after its passage. It will allow us to serve a wider population and a patient. We'll now be able to treat an injury to a member of a golf team in the same injury, which may occur to a person who golfs. We're currently educating our new professionals with the skill set4834 they're unable to fully utilize within the commonwealth. As a result, our graduates and young professionals leave the state for better pay and better professional opportunities. In today's job market we cannot afford to lose these individuals.4849 Athletic trainer specialist in injury prevention. As a result, this bill will save money.
Public safety settings, as evidenced by the Fairfax County Virginia Sheriff's office and the San Antonio Texas Fire Department, which both utilized athletic trainers have clearly shown and been able to save hundreds of thousands of dollars in healt care and overtime costs. Quick history of our bill, um4872 December 31st 1982 on New Year's Eve. The Senate's final vote of the session resulted resulted in the establishment of the Board of Allied Health Professions and licensure for athletic trainers, occupational therapists, physical therapists. Governor King signed that bill on January 5th 1983. We did face some opposition for licensure during that time frame, and the only way to achieve licensure was to agree to restrictive language regarding workplace and patient population.
It was not ideal for us, but we did become the 5th state in the country to statutorily protect the profession of athletic training and the title of Athletic Trainer. We compromised knowing that we could come back before the legislature for updates as our profession evolved. We've made on4913 and off attempts over the past 38 years and today marks my4916 fifth consecutive session before this committee. Our bill's first two filings saw it favorably reported through the Senate Rules Committee. And in both of those filings, we basically ran out of time during the formal sessions and in the third session are bill was held in hopes that the Kolkata healthcare reform bill would address Practice Act and scope of practice matters and that will ultimately died in Conference Committee.
In 1982 rotary dial telephones were still a majority and the Commodore 64 Computer came to market. Today's virtual hearing would not be taking place if that technology has not evolved. Healthcare has changed in this past time frame and it's time for our Practice Act to reflect today's current practice. On behalf of the approximately 1500 licensed athletic trainers in Massachusetts. I respectfully request your support, your support for another favorable report and I thank you for your time today.
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Thank you so much. It's hard to, it's hard to believe it was just 1982 for the rotary phone. Remember these very well myself and thank you for recognizing chair coconuts, unbelievable health care leadership. He was my representative and he is dearly missed um questions.
Okay, seeing none will welcome your testimony and thank you so much for your time today. Thank you. The next bill again is the act an act relative to the board of registration and not Tripathi. But before we hear from these good folks, I want to say that the bill after that. So the two bills on deck now um, and we're doing this so that you can do a little time management for yourselves. The bill after the natural path. The bill is H 2269 and S. 15 11. That's an act to ensure safe medication administration and then um, H 2 to 7 oh and S 15 10 an act relative to the definition of podiatry. Okay, so we're going back up to an act relative to the board of registration and naturopathic and I should just say upfront that I'm very proud to have filed this legislation with representative Mindy Domb and we have two speakers. Dr AMY NEsh and dr5047 Amy Rothenberg. You're warmly welcome to testify as individuals. Hi, thank you. I think that was an error in uh sending my testimony and twice it's only going to me a me5058 Rothenberg, Thank you for having me. It's nice to see you, amy um and thank you for your work in leadership. Oh, you bet.
[AMY ROTHENBERG (MSND):] [HB2266] [SB1381] Uh thank you, Chairwoman Decker and Comerford The members of the committee, I'm a licensed naturopathic doctor and I'm5074 testifying today on behalf of the Massachusetts Society of Naturopathic Doctors of which I am the immediate past president in favor of House5082 Bill 2266 Senate Bill 1381 an act relative to the board of registration in naturopathy. Thank you. Senator Comerford for introducing this legislation which did pass favourably from this committee last session. Strictly speaking, this bill proposes two technical corrections5099 to Chapter5100 400 of the act of 2017, which created the Board of Registration in Naturopathy and licensure for naturopathic doctors in the state.
First, this legislation clarifies the eligibility for licensure in the state since 1987. The North American Board of Naturopathic Examiners has administered the NPLEX exam for naturopathic doctors who graduated from a four year in residents full time accredited Naturopathic medical school. Prior to 1987 states that licensed Naturopathic doctors administered their own state-based exams. It was the intent of the language in Chapter 400 to require passage of NPLEX or its equivalent for Massachusetts applicants. This bill is needed to make clear the5143 meaning of the term, it's equivalent That only app only will apply to applicants who were licensed through state-based exams before 1987.
This change would make clear that naturopathic doctors who took state based exams before 1987 are eligible for licensure under the new licensure laws in Massachusetts. Since 1987 state board exams have been replaced by the National NPLEX exam. All 23 states Washington DC, Puerto, Rico and the US Virgin Islands. Naturopathic doctors are licensed follow this rule. Secondly, this bill clarifies the non scheduled non controlled substance prescribing rights for naturopathic doctors. The legislation explicitly prohibits naturopathic doctors from prescribing Schedule 1 through 4 drugs and controlled substances.
However, the intent of the licensuire law was to allow licensed naturopathic doctors to continue to prescribe simple, non controlled, non addictive substances such as IV rehydration. The language of the licensing law needs to be changed to make this more clear. This5203 clarification is also consistent with the vast majority of other jurisdictions that regulate this profession. On behalf of5209 the MSND, I respectfully request that the committee does once again give this a favorable report. Thank you for your consideration and for allowing me the time to testify.
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Thank you so much and thank you so much for bringing the issue to light. It is not something that, as I think, you know, I understood before you brought it to my attention so I'm deeply grateful to5236 you questions from my colleagues.
Okay, seeing none.5241 Thank you, amy grandma. Great. Okay, next two bills. Remember this is an act to ensure safe medication administration H 2269 and 15 11. I have one person who signed up to testify. Uh, and it's Katy Murphy Katie are you here? I am.
[KATIE MURPHY (MNA):] [HB2269] [SB1511] [HB2332] [HB2323] [HB2324] Good morning chairs, Comerford and Decker My name is Katie Murphy and I'm an ICU nurse at the Brigham Women's Hospital where I've been all night and president of the Massachusetts Nurses Association representing over 23,000 nurses and health care professionals. I'm here today to testify in support of House 2269 Senate 1511, which would codify existing medication administration practices in statute and in opposition to House 2332 which would upend current medication administration practice and put both patients and nurses' licenses in jeopardy. And in opposition to House 23235300 and 2324 which call for study commissions to examine Massachusetts entry into the nurse licensure compact, something that is both unnecessary and harmful to both nurses and their patients.
House 2332 would change existing law to allow delegation to unlicensed personnel to dispense medications. This is a bad idea. Put simply this would allow individuals without the proper education training and experience to administer medications, putting both the patient and the nurse's license in jeopardy. As a licensed registered nurse, I'm held to specific standards and requirements. I'm licensed by the state of Massachusetts with oversight from the board of registration and nursing. I'm responsible for my patients and for fulfilling all of the obligations My license requires. I'm trained in pharmacology. In other words, I know how a medication works on the body and how the body works on the medication. Administering medication to a patient is an important component of5356 clinical care. As such it's something that should be undertaken only by a licensed professional that is for the protection of5363 both the patient and the nurse's license.
That's not because the other individual cannot hand someone a pill, but because they are not trained to properly assess whether the medication should be given and evaluate the individual After that medication has been administered. This observation. The observation and evaluation is one of the fundamental jobs of a nurse. These bills would help to protect5390 against allowing this practice in Massachusetts. Not only should we not change current practice and override existing regulations to permit delegation of medication administration to unlicensed personnel, but we should pass House 2269 and S 1511 to codify and statute what is already in our regulations.
Finally, I would like to note the MNA's opposition to House 2323 2324 which called for a commission to look at the introduction of the nurse licensure compact into Massachusetts. We have nearly two decades of experience to draw on when it comes to the nurse licensure compact and none of that points to compact as something that would benefit the patients or nurses of the commonwealth. It has not worked to reduce nurse vacancy rates.5432 It has not addressed nursing shortages. It has not helped states respond to emergencies and has never been something I have heard from our members as something they want. We are submitting written testimony and I thank you for your time.
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Well I thank you for your time and all night shift and president of the Mn. A. Um, you've taken time to come here and speak on these important pieces of legislation and share the views of the M. N. A. And the front line nurses you represent. Thank you very much for you appreciate it very much. Questions from the committee.
Okay, Katie. Um, thanks again. I hope you get some sleep later. Um, Okay, friends were moving on now. This is the H 2 to 7 oh and S 15 10 after um, this bill and we have four folks signed up on this bill. We're going to hear um, two pieces of legislation, H 2273. An act relative to dry Needling. And we're going to hear S 14 58 enact relative to the practice of acupuncture. Um, so those good folks are on deck and I see some of them here. Okay, going back up to an act relative to the definition of podiatry, we have a
massachusetts put an ankle society panel dR walter wolf wolf. Dr jennifer Buchanan and dr jake summers. I believe it's dr summers who could testify before one p.m. Today. You're warmly welcome.
[WALTER WOLF (MASSACHUSETTS FOOT AND ANKLE SOCIETY:] [HB2270] [SB1510] So chair, Comerford chair, Decker and members of the committee. Thank you for the opportunity to testify in strong support of House Bill 2270 Senate Bill 1510 an Act relative to the definition of podiatry. My name is Dr. Walter wolf. I am the past president The Massachusetts Foot and Ankle Society, a nonprofit association that represents podiatrists throughout5546 the commonwealth. I've had the pleasure and responsibility of caring for patients Throughout western Massachusetts for over 35 years. And think of my practice as part of a large extended family.
I'm here today to express concern for them and not myself. Our5565 profession has enjoyed great advances in our training and research since our practice law was written in Massachusetts over 60 years ago. As a result of this advanced training, 47 of 50 states in our country have chosen to update their statutes to reflect this and the modern well trained podiatrists are allowed to perform surgery on the ankle as well as amputations involving the foot in all of these other states. Unfortunately, a consequence of our state's antiquated scope of practice law for podiatry has resulted in a national reputation for being one of the worst states to practice for the recent podiatric medical graduate.
It is extremely challenging to recruit and attract these sorely needed specialists to our state's. Over the past 35 years, the Greater Springfield area has experienced a net loss of 10 podiatrists to serve this same community. This current trend has created limited access to care, particularly for those on MassHealth or those in rural communities. It has led to increased stress and burnout due to the inability to reach the demand for proper foot and ankle care. The city of Holyoke had four full time podiatrists when I first arrived and now they have zero the entirety of the Berkshires has only one retirement5649 age podiatrist to serve their entire population.
So as a result in our practice, we see many of those patients making those hour long drives each way to come get appropriate care. Passing this legislation which has received favorable reports from this committee many times before is a necessary step to improve access and affordability for all communities across the commonwealth. Chair Comerford chair, Decker and members of the committee, I respectfully ask that you release this legislation with a favorable report. My colleague Dr. Jennifer Buchanan will now address the training and experience of today's podiatrist. Thank you for allowing me to testify.
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Thank you. DR Wolf. DR Buchanan.
[JENNIFER BUCHANAN (CHA):] [HB2270] [SB1510] Thank you chair Comerford chair. Decker and members of the committee. My name is Jennifer Buchanan and I am5704 an attending podiatrist at Cambridge Health Alliance and involved in the podiatric residency training program there. And I am also a fellow of the American College of Foot and Ankle Surgeons. I myself complete completed my residency at this program here in Cambridge and chose to stay in Massachusetts to practice and help train the future of our profession. As we have sat before you countless times discussing this matter our profession continues to evolve and the educational training continues to excel and advance.
Our residents receive high quality education including four years of podiatric medical education which is highly integrated with MD And DO Degrees at all Schools across the country. Our state, has seven accredited residency programs here in the Boston and Metro West areas. And our residents are fully integrated within these hospital teaching institutions and receive training from podiatrists orthopedic surgeons and other medical specialties which is a requirement of their training. The Council on Podiatric Medical Education has national standardized minimum competencies for foot and ankle surgical training and all residents are required to meet these standards prior to graduation and licensing, there is no such equivalent standard for foot and ankle orthopedic surgeons.
Additionally, many of our residents now go5778 on to advance fellowship training that is highly specialized in limb deformity correction and limb salvage many of these techniques that they they learn offer incredible life changing surgical interventions to patients which unfortunately cannot be legally performed by podiatrists here in our state because of5793 an outdated law that continuously is put on the back table. We live in a state where we hold medical care to the highest level and our patients deserve the opportunity to have the best quality5803 treatment that is available to them.
This law would allow those podiatrists that are indeed qualified and5809 trained to treat the ankle to do so in our state, which will overcome overall improve access to high quality care and increase the quality of standard of care. It's no longer a question of whether our training as podiatrists is satisfactory enough to provide this top level care for our patients in foot and ankle surgery. It has been clearly demonstrated the podiatrists and foot and ankle orthopedic surgeons can provide the same level of high quality care and it's time to update our law to reflect the current standards across the country and allow those qualified and capable to provide the level of care that our patients deserve here in the commonwealth of Massachusetts. Thank you very much.
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Thank you so much. DR Buchanan um DR Wolf and Dr Buchanan. Do we have DR Summers here on the panel with you? Yes, I'm online. Okay, very good. Doctor
[JAKE SUMMERS (ELLIOT ORTHOPAEDIC SURGICAL SPECIALISTS):] [HB2270] [SB1510] Chair. Comerford chair. Decker and members of the committee. My5861 name is Dr. Jake Summers. I'd like to give you an overall picture of what Massachusetts is missing out on. I have practiced the last five years at5869 Dartmouth Hitchcock Medical center and I'm now the head of foot and ankle surgery at Elliott Orthopaedic Surgical Specialists in Manchester New Hampshire. I am board certified by the American Board of Foot and Ankle Surgery and I'm afellow of the American College of Foot and ankle Surgeons. I'm a graduate of the Podiatric Foot and Ankle Surgical Residency at Mount Auburn Hospital in Cambridge Massachusetts, where I was also a clinical fellow of surgery at Harvard Medical School.
I also completed an advanced surgical fellowship in reconstructive foot and ankle surgery and now operate a highly specialized practice in limb deformity correction, ankle joint replacements and complex limb salvage. Yet, unlike the majority of states in this country, I'm unable to practice to the full level of my training in the state of Massachusetts. If I were to drive 20 miles south of my current practice, my training and experience becomes null and void due to an outdated and backwards Massachusetts state law, one of the last states in the country to modernize.
Massachusetts is a state that supposedly holds education and medical care in the highest regard and supposedly provides the highest quality of health care in our nation and touts itself as a leader yet currently prohibits some of the nation's most well trained podiatrists and foot and ankle surgeons from practicing to the full extent of their training like myself. Many of my colleagues have left the state and the best and brightest are no longer coming to Massachusetts, Massachusetts to train and those that do are leaving for other states. Now is the5947 time for Massachusetts to update the state law reflect5950 the current standards and quit playing from behind and to step out from decades of ignoring this issue and returned to its place as a leader5958 in healthcare.
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Thank you so much to the panel. I want to especially thank Dr Wolfe, who took the time to meet with me personally lost session on this issue and make me smarter about it. Questions from my colleagues.
Um, and I just also want to acknowledge that many of the bills before us today have been before the legislature. Many I think Dr Buchanan, you said you referenced many times you've come to testify on this issue and I want to appreciate very much the tenacity of all the advocates here today on the scope bills. Okay. Questions from my colleagues seeing none. Thank you so much to the panel for your testimony on this. Um, okay. Next, we're moving to the Dry Needling and acupuncture bills. Um, and after these bills and there are numbers of folks signed up, we're going to move to enact relative to acupuncture detective detoxification specialists. That's H 2 to 8 foreign S 15 20. Um, and then after that we're going to hear testimony on an act relative to liability protection for disaster volunteers. Um, okay, so we're going now back to here on H 2273 and S 14 58. I have an individual signed up. Daphne. Judge nick please.
Daphne, are you here with us?
Okay I don't I don't hear or see Daphne. Daphne. So we will move on next. We have a panel um and this panel is three individuals from the acupuncture society of Massachusetts. Um Welcome to Dr Amy Major, Laura Hamel and Naomi Olson please you're warmly welcome to testify.
[AMY MAGER (ASA):] [SB1458] [HB2273] Thank you so much. Chair Comerford Thank you. Chair Decker and your colleagues in the Senate and representatives in the6098 house. So I am going to give you the 411 and I have submitted everything written that has all of the citations, all of the documentation because everybody is waiting and this is a long Day. My6113 name is Amy Mager. I hold a doctorate6116 in Acupuncture, Chinese Medicine and Integrative Medicine. I earned6120 my bachelor's in sociology from Brandeis in 1985. My Master of Science in Chinese medicine in 1989 from the American College of Traditional Chinese medicine.6130 My doctorate in 2017 a first Professional doctor from Pacific College of Health Sciences hold Massachusetts acupuncture license number 349. And we are here to ask for your support to see more patients for less money and more paperwork because health care is a right not a privilege.
CMS Medicare just covered acupuncture in January 2020 I have the privilege as being legislative co-chair in the Commonwealth Dry Needling chair in the commonwealth and Vice chair of public Policy6163 for the American Society of Acupuncture. Our National Professional Trade Association and I've been working with representative Judy6170 Chu and her staff. Ellen6174 Hamilton and the NCCAOM to get licensed acupuncturists to become providers under Medicare. So Medicare covered acupuncture. We are working to become providers and we're asking for your support for the holdout plans. Like GIC all state employees not only do not have acupuncture covered under their plans, it is actively6192 excluded which is a problem for the lawyers. I see the professors I treat.
And it would be much better for them to like my Medicaid patients have coverage for the treatment of pain. PTSD nausea and opiate addiction. Um I'm also here to testify in support of the ADS Bills, increase access to acupuncture to treat opiate addiction. And why do we want commercial coverage to decrease pain without the use of opioids evidence based non opioid treatments for pain. On that6228 vein. H 2273 is about Dry Needling. Why we heard MDs testify before about the knowledge skills and abilities necessary to expand scope of practice. We want to make sure that anyone inserting a needle has been vetted by didactic education clinical supervision and has been psychometricaly examined to both demonstrate competency and the ability not to harm.
The Board of Allied Health opened its Practice Act two years ago. I know because I attended many of their meetings. We encourage them to create a scope for dry needling. So it would be clear to patients. It's not, it's confusing. The board allows people to practice dry Needling with no vetting. There are advertisements for athletic trainers doing dry Needling. They have no master's degree no doctorate, no vetting. No standards for what dry Needling is. Which is why we need H 2273 for anyone practising orthopedic acupuncture or dry Needling. The CMS CPT code group has one code for one procedure.
The argument that they are not the same is out the window since 2018 when I had the privilege of attending that meeting and testifying before the CMS CPT code group. That trigger point acupuncture and dry Needling are the same. They've been given the same code. Therefore, we need to create a set of standards because just like an MD testified before, people don't know what they don't know. You don't know your professional is not trained or licensed or vetted unless we demonstrate that they are. I'm going to give the floor to Naomi Olson and I thank you so much for your help6342 in time and I'm available for any questions.
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Mr Olson.
Naomi. You're muted
Now. My young music. Yes. Um
[NAOMI ALSON (BERKSHIRE HEALING ARTS):] [SB1458] Hi, I'm Naomi Alson and um, this is probably the fifth time that I've testified about this6364 particular bill. I'm especially um, cognizant of bill 1458, which has to do with an insurance mandate, uh, covering acupuncture treatments for pain, nausea PTSD and opioid withdrawal treatment. And it would also set up a committee to supervise inclusion of acupuncture in the public health sector of Massachusetts. Um over the last 10 years we have really seen that acupuncture has become part of the public health system and some insurance companies are covering acupuncture um especially in light of the of the opioid epidemic and um our real success in treating pain which has been recognized by NIH since because of extensive studies since 1994.
Um So um right now the VA Covers treatments for acupuncture. MassHealth will be covering treatments for pain with acupuncture in the near future. Um Blue Cross Blueshield is starting to cover. Um We have brought um research studies to you for many years, many of you have seen them, your research staff has seen them um because of its robust research, positive effect on pain syndromes, cancer treatment,6448 side effects and pain syndromes. It's used in many, many hospitals in our state. And these treatments allow people to continue work and be working productive citizens. Um um Oh there goes my timer um that they will not end, so they will not end uh so they will not end up in emergency rooms costing extra money and that acupuncturist will have employment opportunities. Thank you for your time
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laura. Thank you. And I don't believe there is a third person on your panel is that correct? I'm here you are here laura. I am here. How much time do you have remaining? Um uh sure we're taking time for the panel. Um I thought that because we had gone to six minutes beyond six minutes. Um It's this is the tricky thing here. Um I think we should hear you at three minutes, just really respectfully remind everyone, testifying. The panels have six minutes each and so the panel has to figure out the timeshare6512 in their um and I know that can be difficult and I also want to just acknowledge that dr rocket, I skipped dr sean rocket relative to podiatry. So after this wonderful group of folks, I'm going back to dr rocket with my sincere apologies.
[LAURA HAMILL6531 (ASM):] [HB2284] [SB1520] [SB1458] Thank you. Senator Comerford. Um thank you. Co chair Senators and representatives for the privilege of addressing you today. I'm going to share a personal statement that I wrote related to these acupuncture bills. My name is Laura Hamill. Um I'm the student representative for the ASM and I'm also a second year acupuncture student at the New England School of Acupuncture. I'll graduate, I'll6554 graduate in May of 2024 with a doctorate of acupuncture and um herbal medicine. I came to acupuncture as a second career after acupuncture treatments helped me to manage migraines and chronic pain. Both acupuncture and Chinese herbal medicine have helped me to reach a place where I don't need to regularly take ibuprofen6571 or other NSAIDs.
Another course of events that led me to search for more holistic health care resources was standing by a loved one going through the process of recovering from an opioid addiction from personal experience. I know that we as a nation need mainstream options for pain relief that are not prescription based that empower individuals to take control of their mental and physical health that are affordable and that do not just replace one opioid with another. I also believe that there needs to be oversight as our field integrates into the current health care model in order to maximize access and patient experience.
Practitioners providing Needling treatments should be required to meet a standardized level of training and examination in the specific medium. For a frame of reference upon completion of my degree, I will have over 3000 class hours and 900 hours of clinical experience. What I've seen over 10 years of receiving acupuncture treatments on and off and more recently through a clinical observation in my program is that acupuncture has an important place in our medical system. It's well suited to working alongside western biomedicine and filling gaps in care. I hope you will support these bills an act relative to dry. Needling and act relative to the practice of acupuncture and the act relative to acupuncture detoxification specialists. Thank you so much.
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Thank you so much Miss hummel thank you to the panel and for your tenacious work over many years to get your practice. Yes Amy I see you um incorporated the way it6662 should be and recognize the way it should be questions from my colleagues on the committee.
Okay. Seeing none. Thank you again for coming to testify and make a smarter um, dr rocket. I'm very sorry I skipped you. So we're going to go back to, you know, not a problem. I'm happy to happy to testify here today. You're warmly welcome thank you.
[SEAN ROCKETT (ORTHOPEDICS NEW ENGLAND):] [HB2270] [SB1510] Um, I just wanted to give uh real lives examples of podiatrist and what I've seen. I'm a graduate of Tufts and Harvard University. I've been practicing Orthopedic surgery for 23 years. I'm the president of Orthopedics New England in the metro west area and we have three podiatrists in our group and I can't speak more highly of the level of care they provided the professionalism their. Follow-up care. I've seen their x rays pre op post up of scrubbed with them personally in the operating room and seeing how they have taken care of people and as well as taking care6731 of my family and all my friends. So I'm very happy with the care they provide and I would support the bill. Thank you for your time.
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Um thank you very much for offering your really important perspective here um, and for your forbearance questions for dr rocket.
Okay. Seeing none sir, thank you. Um friends, we're going back to acupuncture and we have a panel, three folks, six minutes carl Schwartz regina mason kristen6777 Morris
is the panel6780 with us.
Just testing for the panel.
Okay? Um So I6785 don't see the panel or hear the panel. Um So we are going to go
okay. Regina Welcome. I come. So that do you have karl and christian with you? I do not have anybody with me. I'm not sure. I'm not6798 sure about the system. Okay. No worries. Um No, it's a it's the strange virtual world. Ok, so you're warmly welcome as an individual then. I see you as part of the panel but that's fine. So, we're an individual three minutes. Thank you for sharing.
[REGINA MASON (CONCERNED CITIZEN):] [SB1458] All right, thank you so much. So, I am Regina Mason and I'm speaking in support6825 of bill um 1458 And I'm sharing a personal story that illuminates a significant reason why acupuncture needs to be covered by health insurance. In 2015 I was diagnosed with life threatening Stage 3 breast cancer. I required extensive treatment and during chemotherapy I had adverse reactions to all the usual palliative medications for nausea and vomiting. So severe that I ended up hospitalised. When I was released I continued chemotherapy with no access to anti nausea medications and the nausea and related symptoms were untenable. I deteriorated quickly.
My cancer physician sent me to an acupuncture program sponsored by the cancer center. It worked. So acupuncture was the one resource that I had at my disposal6875 to alleviate the devastating nausea, vomiting, head pain and exhaustion. And this program was not covered by insurance at that time, but was sponsored by community donations. So fast forward 5 and a half years to this past March. My cancer treatment medication generated health issues6890 that necessitated a medication change. Sorry. Um, once again I had a severe adverse medication reaction.
The reaction left me with neurological damage and I developed life changing tremors and stabbing neuropathic pain that have not yet resolved. Once again, due to my medication reactivities, I found myself with a lack of access to palliative care. I could not drive, type into a computer or sleep at night. So I reached out for acupuncture and discovered that the cancer center could not fit me into their free program at that time. Then I learned my medical insurance would cover 10 sessions. The acupuncture has been quality of life improving, providing physical stability that has allowed me to return6930 to work and care for my family.
I could not possibly afford to pay for that acupuncture on my own. And my dependence on acupuncture as a source of medical care is only possible because my health insurance at this time has allowed for it.6949 Um,6950 and yet I face the concern what happens when I've6953 used up my 10 allowed visits. So I encourage you all to make this medication source of palliative this non medication source of6961 palliative care available for people like me who can't use traditional medications and it really needs to be covered by insurance. So I thank you very much.
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Thank you so much. We've said it before. Both chair Decker and I on these hearings6974 that personal stories are among the best ways to illustrate um the need for a bill or the concern about the bill in this case. The need for the bill. So thank you so much. Regina for sharing personal6990 story and connecting that to legislation. Okay thank you so much. I'm going to ask now if Karl or Kristen carl Schwartz kristen Morris are you here?
Okay? Um uh We're going to move on. Um Okay friends were about a third of the way through the hearing. So we have about four more hours of testimony expected. I'm going to tell you now the bills we're going to hear in this next traunch of testimony. Uh It's H. 2284 and S. 15 20. An act relative to acupuncture detoxification specialists.7037 Um Then we're going to hear H. 2293 and S. 15 21 enact relative to liability protection for disaster volunteers. Then we're going to hear H2296
and act relative to medical physics. And finally in this short hotlist is H. 23 to 2 and S. 15 22 and act regulating central service technicians. Okay. Um Starting now with an act relative to acupuncture detoxification specialists. I have four individuals signed up. I'm going to read you in the order. I have you signed up um and then we'll hear from you with three minutes each. Peggy Rose um I have someone Haley, I don't have a last name. Susan Murphy And then or in pill injure Peggy, are you here? I am here. You're welcome.
[PEGGY ROSE (CONCERNED CITIZEN):] [HB2284] [SB1520] Hi um Chair Comerford Chair Decker and the committee. Thank you for the opportunity to speak today. I'm speaking in favour of S 1520 and H 2284 an act relative to acupuncture detoxification specialists. My name is Peggy Rose and I've been a registered nurse in Massachusetts since 1994. I've worked in various community health and primary care settings where people experiencing substance use disorders have received their healthcare. I speak on behalf of patients and families and also on behalf of staff in treatment facilities. We need to support families with every tool we possibly can. We need to make existing treatments more effective. We need to save more lives.
Substance use disorder consumes a huge number of healthcare dollars and in general treatment methods have success rates that are less than 40%. The proposed legislation would improve the efficacy of existing behavioral and substance use treatment. The five needle protocol has been shown to improve inpatient and outpatient completion rates. It can reduce drug cravings and early withdrawal symptoms. People report it facilitates calm self regulation, relaxation, focus and self reflection. The treatment can decrease symptoms of stress anxiety, depression, anger, aggression, agitation, irritability and insomnia. It is a simple, effective and safe treatment. It has no contra indications it has no negative side effects.
The beauty of the legislation as7194 proposed is that it is leveraging the resource of existing staff in substance use disorder treatment7201 programs to bring this treatment to patients. It does not require bringing additional practitioners into7208 a facility. It utilizes the skills and relationships that are already in place. The barrier of finding retaining and paying for licensed acupuncturists is a huge barrier for substance use programs7220 And severely limits how many people in Massachusetts can receive the 5 NP treatment. It is unwise for Massachusetts to continue to limit people's access to this treatment, nurses and other licensed professionals are ideally placed to learn and perform this treatment. I urge the committee to support this legislation to make our substance use disorder treatment more effective to conserve healthcare dollars and ultimately to help make this7261 tool more widely available to help bring the substance use disorder epidemic under control. I'm happy to answer any questions.
SHOW NON-ESSENTIAL DIALOGUE
Thank you so much Peggy um for that important testimony questions.
Okay, hearing none. Thank you very much. Um I'm now looking for Haley,
sorry, I don't know your last name.
Okay, I'm looking for Susan Murphy please. He is
[SUSAN MURPHY (CONCERNED CITIZEN):] [HB2284] [SB1520] Hi, good afternoon chair Decker and committee members. My name is Susan Murphy7296 I have a master's in education and counseling. I'm a licensed mental7302 health counselor and a license alcohol and drug counselor. I have worked for many years with people struggling with substance use disorders. I'm a Massachusetts resident. Um I'm here supporting the acupuncture detoxification specialist bill S 1520 H 2284. For 50 years The National Acupuncture Detoxification Associations, five needle point auricular acupuncture protocol, also known as 5 NP, has been being used around the world for addiction, recovery, trauma and other mental health issues by non acupuncturists.
And um 5 NP is very simple. It's easily administered. It's safe. It's very cost effective protocol that I believe that Massachusetts communities could um Use to help with the overwhelming drug crisis that we're experiencing. And since at least the 1990s this protocol has been being used in Massachusetts in various public settings, but getting access to it has been a problem. Um Certain programs that were set up to offer the protocol did not always continue services for financial or logistical reasons. Um it's really not feasible to have licensed acupuncturist travel to public health settings to administer the 5 NP. Um It makes sense to have qualified healthcare professionals already working in the facilities to be trained at a low cost and then have them be able to offer the protocol as an adjunct treatment.
I'm asking you respectfully to ponder why anyone would want to restrict access to a tool that literally would cost cents not dollars. That has been shown to help the retention rates in substance use disorder, treatment, withdrawal symptoms and other mental health benefits. A treatment scenario where 5 NP might be used could be when a person is impatient for detox and they're experiencing um a lot of withdrawals, but there7417 are being told that they cannot have more comfort medications due to medication restrictions. Um many times at this point, usually 24 to 48 hours into someone's detox, a person may7429 leave against medical advice.
Um a nurse would be able to offer 5 NP to that patient to help with their varying symptoms. Um and this can keep the person in treatment possibly save a life and not risk the most likely re-entering into treatment with great financial costs. 30 states now allow this protocol by non acupuncturists. Massachusetts is the only New England state that is not allowing this. Massachusetts, New Jersey and Florida are the only Eastern coast states not allowing this.
Um This is a tool recognized by substance abuse and mental health services administration and it has been used in collaboration with the Red Cross7469 at traumatic events like 911 Ground Zero and Hurricane Katrina. Um, as a person in long term recovery myself, I've experienced the benefits of this powerful tool and I respectfully ask that you vote for it in favor to be out of the committee. Thank you.
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Thank you so much. Especially for giving us a perspective of other states. Thank you. Welcome. I'm looking now for or in Pillinger
our and are you here? Yes, I'm here. Wonderful.
[OREN PILINGER (CONCERNED CITIZEN):] [HB2284] [SB1520] Thank you so much chairs, Comerford and Decker Um and thank you Susan and Peggy for all of your7514 work on this and7516 your great testimony. Um I don't have much to add about the efficacy and safety of the protocol. Um my name is Oren Pillinger, I'm a licensed acupuncturist and I've been practicing in7531 the Commonwealth of Massachusetts for five years. Um I'm a big supporter of creating AcuDetox specialists in Massachusetts um in order to have the people who are actually have the expertise in addiction and recovery being able to provide this tool.
Um while I provide acupuncture. I'm a very general practitioner, so I don't have special training or clinical experience with addiction or recovery. Um I do community acupuncture, which is more affordable for people and I have definitely treated people who use acupuncture regularly as a step down when they were getting acupuncture in their recovery programs. Um And the other7574 thing I'll share is a quick personal story. I was approached by a social worker who wanted to start an ear acupuncture program um in a mental health recovery uh hospital where he was working and he wanted to get an acupuncturist to come in and get this program off the ground and they wanted to start with, you know, maybe a couple hours, once or twice a week providing this for patients.
Um so I would have to travel all the way to the facility, be there for an hour or two, maybe we'd get people. Maybe not and then leave. Um and at the time, you know, I live in Boston. I don't own a car. It wasn't feasible for me to do that even though I'm like yeah, that would be a great program. I know you want to help your7626 patients. I can't do this for you and it's just they're not a lot of acupuncturists um in general and it is hard to find the staffing for this kind of position. So um That's basically why I support this bill. I would really want to respect the expertise of the nurses and all the other licensed professionals who would be able under this legislation to provide 5 NP. Thank you for your time.
SHOW NON-ESSENTIAL DIALOGUE
Thank you so much for your testimony or in um questions from the committee uh for Peggy or Susan or or in
Okay, hearing none. We're going to move on. I've been notified that a person who was unavailable earlier when they were called Lynne Reid who wanted to speak on H2-41, which is a health care transparency piece of legislation. Lynn. I believe you're here.
Am I right about that
Lynn Rio? I see you you're on mute Lynn If you could find a little microphone symbol. SHOW NON-ESSENTIAL DIALOGUE
I thought I had it double unclipped. Thank you for your warmly welcome to speak on the bill.
[LYNN REEDE (NORTHEASTERN UNIVERSITY):] [HB2241] [HB2242] [HB2356] Thank you so much. Chairwoman Comeford and Decker and the members of the joint Committee on Public Health for this opportunity to provide testimony in opposition to um 2241 which is the act relative to health care transparency.7695 Um 2242 which is7696 an act to promote team based health care And 2356 an Act relative to anesthesiologists assistants. I want to first thank you for you and the governor for supporting nurse anesthesia practice during Covid-19 to allow us to provide care at the top of our license and the full extent of our our experience so that patients could receive the care necessary for life and for best health.
Also healthcare facilities were able to utilize nurse anesthetists, which I am to the full set of their critical care skills including airway management, hands on patient care and anesthesia delivery skills. And to7739 increase the capacity and lead Covid intensive care units specifically using anesthesia machines to ventilate patients. In my clinical experience in in practice leadership I actually had opportunity to serve as an operations manager for a 500 bed community hospital. I've served as a 66 foxtrot in the Army7761 Nurse Corps um as a nurse anesthetist which was the thrill of a lifetime and opportunity and also I continue to serve in interprofessional and professional volunteer roles where I understand the importance of the team related to policy and direct care of our patients.
I now serve as faculty at Northeastern University's Doctor of Nursing Practice program and we currently have in Massachusetts 850 CR as wNAsell as two world class dr nursing practice nurse anesthesia education programs in the Boston area. At Boston College at Northeastern University. These hometown programs graduate about 50 CRNAs annually who may or may not remain in Massachusetts depending on the practice environment. Can they use their7812 education and their licensure to bring forth what they want to from their doctors and nursing practice to transform healthcare based on evidence. These proposed bills do not foster teamwork.
Anesthesia excellence. Excellences are welcoming climate for these um for nursing messages to remain in Massachusetts or to come here. Um these bills would increase the burden on physicians anesthesia practice by limiting the practice of advanced practice professionals such as CRNAs. So please continue to focus on policy for excellence and health care by removing unnecessary and unfounded barriers to advanced practice, registered nursing as well as to improve access to care, decrease cost of care, patient satisfaction and to retain the entire health care team. I thank you for your time.
SHOW NON-ESSENTIAL DIALOGUE
Thank you so much Lynn you were spot on the buzzer questions for this important testimony.
Okay. I don't see any thanks for coming by senator appreciate it very7878 much. Um I've also just been notified that Daphne, joe schnick and I'm sorry if I got that wrong is also now available. Um Japanese here to speak on H. 2273 and S. 14 58 I believe.7892 Around dry Needling and acupuncture. Daphne, are you here?
Um If you're, I can't hear you if you're not up, I see you but I can't hear you.
Stephanie
it.
Daphne, are you there?
Mhm. Okay. We might definitely might be having trouble up. There. You are. Is that can ewan mute your you're muted and I Okay, yep.
Uh let's see, yep, you're there, That's fine.7952 Okay thanks for uh bearing with me with my technological issues this morning. I'm just, can you hear me? We can. It's all good.
[DAPHNE JOCHNICK (NCCAOM):] [HB2273] [SB1458] Okay great. Um just another vote in favor of the AcuDetox bill. I've been in, since 1996. I've worked in recovery clinics, disaster areas, I've practiced the NADA technique for decades. It's simple, safe, powerful. Uh This this bill has been passed and as Susan pointed out a number of other states, it's got a great track record as a simple safe, efficient tool. So I just wanted to add my support.
SHOW NON-ESSENTIAL DIALOGUE
Thank you so much for coming back and and adding your support. It's really important. Um and I see your, you may be at work, so thank you for squeezing us in today
questions.8025
Okay, I don't hear any. Um Thank you and take good care. Okay friends there were moving on now to H. 2296.
and then we have testimony on H 22, nope sorry H 23 to 2 and S 15 22. Um And then I'm going to call a few bills again. This is the on deck list. After that we have H233 to that's an act relative to home health and hospice AIDS And then H 234 to enact, creating an entry level licensing program. It's a long building so I won't read it but that's 23 42. Um So going back up now um H 2296 and act relative to medical physics. Carla Bradford, are8079 you with us? I am. Can you, can you hear me? Yep, you're good to go.
[CARLA BRADFORD (UMASS MEMORIAL CARE):] [HB2296] Okay great thank you. Well, good afternoon chairpersons coming forward and Decker and members of the committee, thank you for allowing me this opportunity to speak and8099 support a bill H 2296 and act relative to the practice of medical physics. My name is Carla Bradford and I am a medical physicist. I currently work as a senior medical physicist at UMass Memorial Health Care at Marlborough Hospital. I grew up in the commonwealth and went to WPI Worcester from my undergraduate studies in Physics. After completing my graduate degrees in medical8121 physics at the University of Wisconsin. I returned to Massachusetts of work as a medical physicist.
I am certified by the American Board of Radiology and have over 20 years experience in this field. During that time I've grown to feel that all individuals working in the commonwealth. As medical physicists should be licensed to practice this profession. To become a qualified medical physicists8146 requires many years of education, both academically as well as in the clinic. This is a highly technical field that requires us to continue to learn new technologies Even beyond our schooling. In healthcare, radiation is used for both medical imaging, like X-rays and CAT scans, as well as therapy for cancer treatments.
One of our primary responsibilities as a medical physicist is to make sure that this radiation is delivered to the patient in a safe, accurate and effective manner. Many people do not completely understand how we provide this critical service or are aware that we're even part of the treatment team. As I tell my family medical physicists many times work behind the scenes. Because of this, it's difficult for folks outside our profession to fully understand what credentials, education and experience determine that an individual is a qualified medical physicists, just like many other health professionals, physicians, nurses, and many other allied health professionals. State licensure of medical physicists will explicitly define these standards.
Professional licensure will also protect the public by ensuring that the people delivering medical physics services are qualified. For example, a lack in understanding of how to calibrate the radiation devices used to treat cancer can result in severe consequences to the patient and proper testing of radiation imaging devices can result in the misdiagnosis of serious health conditions. Medical physicists play an integral role in the health care of the public and to maintain quality safety in our health care environment. I strongly endorse the passing of House Bill 2296 and urge your support for licensure of medical physicists. Thank you for your time and consideration.
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Thank you so much for your testimony questions.
Okay, I don't see any. Thank you very very much for taking the time to come in.8274 Um Okay, we're going to hear testimony now on H 2293 and S. 15 21. And I'm looking for Betty Sparks, please.
Betty are you with us?
See see the Betty's on and Betty, I believe that you're a mute.
No, I don't see Betty
technology is vexing sometimes, so Betty, we'll get Bette if Betty comes back. Um Okay. All right, friends, we are moving on now. Um Mhm. To Hear Testimony on H 28335 3 - two and s.
8337 Um And that's an act relative regulating Central service technicians. I have a panel of three folks. That means six minutes three folks. Karen, now's Michael or Michelle, forgive me Michelle McGee and josephine colucci. You were warmly welcome. Yes, Thank you. Thank you so much. Can you hear me? Perfect. Okay, perfect. So Michelle will not be testifying. So hopefully we will not take all of our time. Thank you so much.
[JOSEPHINE COLACCI (IAHCSMM):] [HB2322] [SB1522] Thank you so much for hearing our legislation today. My name is Josephine Colacci and I'm director8375 of government affairs for the International Association of Central Service Materiel Management otherwise known as IAHCSMM. Uh We support House Bill 2322 Senate Bill 1522 which would require new Central Service technicians entering the field to be certified. IAHCSMM represents approximately 38,000 central Service technicians in the United States and abroad. And according to the Bureau of Labor Statistics, there's approximately 1000, 270 of these technicians in Massachusetts hospitals in ambulatory surgery centers.
These techs are responsible for ensuring that equipment and instruments used during surgical procedures are properly decontaminated, cleaned, inspected and sterilized prior8421 to patient use. There are five states which currently require certification for these technicians. New York, New Jersey Connecticut Tennessee and Pennsylvania as recently as October of 2020. Uh this legislation received a favorable vote from this committee during the last legislative session and it's8444 been around since 2014 and has passed out of this committee three times. It's passed8447 the Senate twice and we made it all the way to third reading in the house and ran out of time. It's our hope that you will continue your support for this legislation and allow it to move through the process. Karen Nauss will give you a little bit more detail of what the text do for their during their for their job. Thank you so much. And we appreciate you hearing this today.
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Thanks josephine
Karen.
Just a new mute. If you could just a mute yourself. Sorry.
[KAREN NAUSS (MOUNT AUBURN HOSPITAL):] [HB2322] [SB1522] Hi my members of the committee. My name is Karen Nauss and I am the manager of sterile processing and supply chain at Mount Auburn Hospital. I am here to support House Bill 2322 and Senate Bill 1522. These technicians are responsible for ensuring that equipment instruments used during surgical procedures are8506 properly properly decontaminated, cleaned, inspected and sterilized. Prior to patient used during Covid. They are responsible for sterilizing all personal protective8516 equipment. PPE uh Uh N-95 respirators and Covid-198520 testing swaps.8521 Central service technicians are performing their jobs with only a high school diploma or those surgical instruments comes with uh sorry high school diploma or GED. And yet they are required to know 37,000 different instruments.
Each of those surgical instruments comes with an instruction for use. For example, a colonoscope may have 110 or more steps but they must be followed to be chemically disinfected or sterilized properly. A hospital8551 that has 15 operating rooms. An average of 13,0008556 cases per year. This translates to 1.2 million surgical instruments being disassembled, cleaned, inspected, sterilized and reassembled prior to patient use. Thank you for your time and I am happy to answer any questions.
8571 SHOW NON-ESSENTIAL DIALOGUE
Thank you so much for your testimony, both of you on this panel. I remember hearing this bill last session. Um, just you laid out in pretty stark8582 detail how8583 many times you've come back. I really appreciate the intensity with which you're advocating for the passage of this um, questions from the committee.
All right. Um, let's let's keep the momentum going. Thank you. Thank you. Thank you. They could care. I'm happy to say that Betty has returned. Um, so Betty, you're with us now on H 2293 and S 1521. An act relative to liability protection for disaster volunteers. Tell me you can hear me this time. I absolutely can. It's like I've been yelling, you can hear me. Okay?
[BETTY SPARKS (CONCERNED CITIZEN):] [HB2293] [SB1521] So my name is Betty Sparks and I've been a registered nurse for over 45 years and I have worked in intensive care units, emergency rooms. ICUs and um, I've worked all the way from Massachusetts to California and I just got off a plane yesterday from Alaska helping out with a hospital that's overwhelmed as all our hospitals in the United States and elsewhere are Today I'm here to support Senate Bill 1521 and House Bill 2293. An act relative to liability protection for disaster workers. And I want to tell you about my experience as a federal medical disaster team. Okay. It's also known as a DMAT.
Um, I have deployed with this team for many disasters to provide emergency medical care um, for hurricanes, earthquakes anywhere for again, Alaska California Haiti all over. And um, that makes me know exactly what is nurses need in order to volunteer for a8681 disaster. When I'm deployed, I become a temporary8683 federal employee. So I'm covered under the TOD Act and the USERRA. So these acts cover me so that my employer has to let me go and has to give me my job back when I come back. Um, It also covers me.8697 Um, because it's when you go into disaster the rules are not the same.
You know, sometimes you have supplies. So you can do, you know, help out a lot of people, sometimes you don't. So you have to make those incredible to serious decisions of like walking past the worst hurt people so I can help more people. Okay. And we saw what this happened in Hurricane Katrina and Hurricane Rita. The nurses and doctors had to make judgments on who8727 to save and who not to save. And that resulted in their license to practice being put in jeopardy because they did the best they could for an unstable situation also. Um, it's a dangerous situation. Um, the environment is incredible. There's so many safety concerns because the people you're helping and their family relatives are in panic. So often violence occurs because they want your supplies. They, because things are so limited. The resources become so limited. Water, anything becomes limited food.
And what about now, Covid-19 I'm exposed all the time, but I am really exposed now when I go out. So the last thing a nurse needs when she's8776 leaving her family, her job to help out the injured, the sick in a disaster situation is to come home sick and hurt herself. So with the right now, if I go out and help in Massachusetts, not with my federal team, but just to help my town of Norwood, um, the commonwealth of Massachusetts does not provide me with adequate protections under the current laws. Without these protections provided in Senate Bill 1521 and House Bill 2293, I am reluctant to volunteer my skills and knowledge at the state level.
I have repeatedly had to say no when asked to volunteer because of lack of these protections. I need to consider my family and the needs before risking my life and livelihood as I am not the only one. Also members of my team who you need out there in those situations because we know what we're doing. So I urge you to report this. Um, report legislation out favorably out of your committee. So thank you so much.
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I really appreciate you bringing your personal experience to this and thanks for your tenacity and battling through teams to get on and talk to us. Um, agree we need folks to be able to get out and do the work. You're saving lives questions from the committee. Okay. Um, hearing none Betty, we're going to say thank you and move on now. Um All right friends. We have uh numbers of people signed up on the the following um uh 23 bills, we're going to take a bill now H 2332
with one person8881 and then move on to H 234 to that has four folks and then H 2343 and S 13 80. Um That has a number of folks I think something like 18 folks8898 signed up to speak. So first looping back to H233 to enact relative to home health and hospice AIDS. I see. Um I want to warmly8906 welcome jake Krylov, which please
[JAKE KRILOVICH (HOMECARE ALLIANCE OF MASSACHUSETTS):] [HB2332] Thank you. Thank you and thank you to the chairs. My name is Jake Krilovich. I'm the director of legislative and public affairs for the Homecare Alliance of Massachusetts. We represent over 180 home care and home health agencies throughout the state that provides skilled and non medical support services to people in their8930 homes. H 2332 would amend the Nurse Practice Act and establish authority for the Board of Registered Nurses and Department of Public Health to develop delegation of medication administration model.8940 This is a8941 model that's been implemented in many other states and supported by the ANA. Delegation of bed administration allows a nurse to delegate a limited scope of medications to a trained home health aide or hospice aide.
The legislation specifically excludes the delegation of controlled substances and would only be limited to basic medications that are oral optic topical, pre filled injectable suppositories and inhalers. The legislation requires that the regulations establish comprehensive training requirements for the home health aide on medication, administration and training requirements for the nurse on documentation and protocol and appropriateness of delegation. It also requires that the regulations would protect nurses and the aides from being disciplined by their employer if they refused to participate in the delegation model.
Delegation8991 would not be mandatory and the nurses is the delegator, not their8995 employer. Um Lastly, I'll just note because it's been wrongly characteristic. This legislation explicitly prohibits a nurse from being disciplined by BON for the performance of a person who was delegated a task. In other words, if the nurse delegates to an aide and the aide were to make an error, that aide is accountable for their actions and the nurse as the supervisor would be acting well within their scope of their nursing license for this activity. The nurse may delegate components of care but does not delegate the nursing process itself.
There are9026 assessments, evaluations, planning responsibilities that require nursing skills and this bill does nothing to change that. I'll just close as we've all seen. The value of providing care in the home is more important than ever. People want to stay home. But like many provider types, home health providers are experiencing severe workforce shortages. As home health agencies are struggling to compete for nurses in facility settings this legislation would enable agencies to utilize their nurses as efficiently as possible. In turn, quality of care and safety would increase by allowing nurses to delegate the9058 most basic medication administration tasks to a trained and supervised aide while freeing up that nurse to tend to a patient with more acute needs. We believe that this legislation is critical to allowing nurses is to practice at the top of their license and increase the quality of services for people9074 in their homes. We appreciate the opportunity to speak and we will submit additional testimony to The committee. Thank you again.
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Thanks so much. Mr Karlovic. Actually, you answered a question I had in your testimony and I'm very grateful to you questions from our colleagues on the committee.
Okay, seeing none. Thank you so much for coming on. Uh, and I'm now going to turn this over to chair marjorie Decker9096
Yeah.
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