2021-10-15 00:00:00 - Joint Committee on Public Health
2021-10-15 00:00:00 - Joint Committee on Public Health
(Part 2 of 2)
[PART 2]
SHOW NON-ESSENTIAL DIALOGUE
Yeah. All right.
Mhm.
Mhm. Oh
I'm thank you so much.17 Thank you. Senator. Before I move on to the next one, I'm gonna go back to somebody else who signed up as an individual is Tracy lane. Um If you are here Tracy please come forward.
I am here. Okay welcome your three minutes high. Thank you.
TRACEY LANE - MASS CHIROPRACTIC SOCIETY - Thank you for39 having us today. I represent the Massachusetts chiropractic society and we're nonprofit representing the chiropractic profession in Massachusetts and the patients we serve. The reason that I'm coming on today is to talk about the continuing education requirements for chiropractors. The Massachusetts board has voluntarily relinquished the pre certification activity, leaving a vacuum of provider security and the courses that they consider as lawful satisfying requirements. By doing that, they have decided to retroactively, a program that complies with lawful requirements during a license audit. MCS Certification will provide surety to a license that a program taken meets a lawful requirement that is indeed meeting that requirement and hence not risking license suspension, sanctions, fines or fees in the aspect of maintaining their license.
Additionally, programs not meeting lawful aspect of maintaining their license, these programs not meeting falsely represent the program. Basically, what I'm asking is; there are so many levels of continuing education that chiropractors are utilizing in order to receive their education to receive their credits to renew their license and we see so many that are offering faults and not great quality health care education. By not having a regulation on that, it cuts down on what chiropractors are actually learning. So we would like for the continuing education requirements to be handed back to the MCS so that we can qualify those programs so that we can make sure that everyone in the state of Massachusetts is compliant and that they're not being duped by other entities of education that are coming into the state and offering programs, they're really not good education. Thank you. SHOW NON-ESSENTIAL DIALOGUE
thank you thank you for your time and your testimony. Um At this point we will move on to house 2342 an act creating an entry level licensing program to allow applicants to practice under supervision prior to becoming a licensed mental health counselor. This is a panel of four. So just reminding folks that panels people have asked for because they wanted people to be able to speak at the same time. Um And when you come on as a panel um the panel173 in total has six minutes. So I'm really hoping that people have worked out that time in order to give each other the time that you might have hoped to have. I'm gonna start with joseph Weeks joseph you can move it onto mid Williams mid Williams You can hand it over to Jamie Osborne and Jamie Osborne. You can hand it over to make O'Connor and that will be the end of the panel. Welcome.
Mhm.
Hi I think joe cannot be here194 will chime in later. He was called away to an emergency So he'll be allowed to chime in as long as the panel hasn't used six minutes. I206 will we will try we will try. So
MIDGE WILLIAMS - MASS MENTAL HEALTH COUNSELORS ASSOCIATION - HB 2342 - My name is Midge Williams, I'm an MMHC and I'm the executive director of the Massachusetts mental health counselors Association and we represent about almost 8000 MMHCs that provide behavioral health services to consumers in Massachusetts. I want to thank the committee Chairs, Senator Comerford and Moran and Representatives Decker and Murray and the committee members for this opportunity to testify on behalf of H 2342 an act to help ensure more efficient and streamlined consumer protection. I think I'm going to just switch the order of what I'm going to say because two minutes or three minutes is very short.
This bill seeks to address the critical issues and needs related to the allied mental health licensing board. In the past three years, we've seen huge disparities in successful workflow among license applicant types with an especially dramatic decrease in the MMHC application processing efficiency even before Covid with an almost 50% decline in the number of applications successfully approved over the last three years. This all occurs while MMHCs exceed the other for licensed discipline service by this board by anywhere between 2.5 times to almost 45 times. Approximately 1000 individuals yearly seek field placement in agencies for their postmasters work experience necessary for their licensure for the MMHC.
This disparity results in a direct negative impact on access to services as consumers are being denied access to a significant group of providers with a full scope of practice. MMHCs can provide services to all consumers with all diagnoses in all settings unlike the licensed providers regulated by this board. The MMHCs can provide more direct service to consumers in Moore settings across the commonwealth if their applications were being processed. We believe that this bill with an entry level license would help facilitate that. I'm going to speak about five direct and immediate benefits of an entry level license. One, it increases consumer protection by clarifying the aspiring MMHCs role within agencies, providing the clarity and transparency for this provider group.
It will provide financial assistance to agencies through the increased ease of billing and payment for those agencies employing the postmasters individuals who seek these hours for the MMHC license. Again, approximately 1000 individuals a year seek field placements in agencies for their postmasters work experience. Such a license would reinforce and support the very recent, very successful outcome of a suit brought by the Attorney General's division of Medicaid fraud against a statewide behavioral health agency that failed to provide adequate supervision to MA level clinicians obtaining their postmasters work experience. A clear MMHC entry level license will help prevent similar fraud and inadequate supervision going forward.
We also think this bill will promote workforce development because432 it will allow entry level mental health counselors to become eligible for state and federal loan reimbursement programs, for which you must have a license to be eligible. It will also ultimately facilitate the license, your workflow problems at the independent MMHC level because most of the licensing boards work will be done. So we're asking you very respectfully to please support H 2342 an act to help ensure more efficient and streamlined consumer protection and professional oversight and report this bill out472 of your committee with a positive recommendation. I want to thank you so much and I will turn this over to Jamie Osborne.
JAMIE OSBORNE - MMHCA - HB 2342 - Good afternoon everybody, I want to thank the committee Chairs, Senators, Comerford and Moran, Representatives, Decker and Murray, the committee members and representative LaNatra for supporting this bill. I speak to you as an MMHC, as a MMHCA staff member and as chair of the license applications support committee and I want to address507 or bring to your attention a little bit of a historical perspective. When I took over as chair of this committee back in about 2014, the license application process went very swiftly. Applications were being approved within two to six, maybe 8 weeks. As we approached 2017 and 2018, a lag occurred and at the end of 2018, MMHCA was deputized to help the licensing board review applications because they were so backlogged. 2019, a new application form was presented, which left the schools to support the pre master's work. Still left the applicants to document two years of postmasters work and with the advent of electronic records and Covid, things have come to a grinding halt. We believe this bill would create the entry level license on graduation, thereby expediting the boards work just reviewing the two years postmasters. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time. Um and I would just say that you should feel free to submit testimony to us. We are we are taking it, we are reading it so I appreciate that um at this time we're going to move on to house 23 43 Senate 13 80. I would ask uh if we we have a panel um of I and Guillem and Diane Miller
is an with us. Yes, I am.
ANNE GILLUM - NATIONAL HEALTH FREEDOM ACTION - SB 1380 - Good morning everyone, Chair Comerford and Decker, Vice chairs614 and members of the committee. My name is Anne Gillum. I'm an Attorney with National Health Freedom Action. Thank you for hearing this bill and for the opportunity to speak in favor of it today. We've had the privilege of working with Massachusetts residents on this bill after they reached out to us over five years ago for a solution to a problem in Massachusetts law. A problem that is not unique to Massachusetts law but a problem that leaves complementary and alternative health care practitioners vulnerable to civil and criminal charges for practicing medicine or another licensed health care profession without a license.
These potential charges arise from the broad definition of the practice of medicine in Massachusetts, which essentially states that a person is practicing medicine if he or she advises in the maintenance of human health by the prevention or alleviation of disease or for the other person's physical or mental well being, or if they provide treatment for the relief of adverse physical or mental conditions. It's good to have a broad definition. We want680 doctors to be able to use every tool in their toolbox to help people get well but the problem is that anyone who688 does anything within that broad definition without holding a license, even if it's not dangerous or harmful, can be put in jail or fined thousands of dollars.
So S 1380 doesn't seek to change that broad definition, but it asks Massachusetts law to acknowledge the impact that that broad definition has on complementary and alternative health care providers by providing them with an exemption under certain situations. Adherence with the disclosure requirements listed on page 2-3 in the bill and avoiding the list of prohibited acts outlined on page 3-4 of the bill. Massachusetts law already has a long list of exemptions at the end of each health care licensing law and S 1380 is asking you to add another exemption for these unlicensed complementary and alternative health care practitioners. An exemption for gentle common sense, noninvasive activities that, yes, do fit within the broad definition of754 the practice of medicine, but they are activities that should be allowed in the public domain because they don't rise to the level of the potential of harm that requires state regulation.
If a practitioner fails to adhere to the requirements766 in the bill, they could be shut down. A practitioner exemption law passed in 11 states so far and in Minnesota for the past 20 years will add transparency and consumer protection to Massachusetts laws while acknowledging what is happening in the culture already. Consumers have been increasingly searching for and benefiting from health care options that involve lifestyle and behavior modifications for decades, centuries even. Consumers want to use gentle healing therapies alongside of their more conventional pharmaceutical based options and they want access to practitioners who799 can help them navigate their holistic health options, such as herbalists, health coaches, aroma therapists and many more.
But finding a practitioner who can discuss these approaches with the consumer is challenging because they are working under the radar due to the814 potential of criminal charges for speaking honestly about what they know or for putting to use the education, training or credentials or other experience that they have invested time and money in pursuing and that is what S 1380 is here to change. NHFA respectfully ask you to support S 1380 and we are happy to answer any questions you have. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Should
835 I835 go ahead, yep, you're part of the Hill All right, Hello,
DIANE MILLER - NHFA - SB 1380 - HB 2343 - Good morning, Chairwoman839 Comerford and Chairman Decker. Thank you for the opportunity to provide testimony to the Joint Committee on Public Health in support of Senate 1380 House 2343. This bill provides consumer access to and the right to practice complementary alternative health care services. My name is Diane Miller, I'm an attorney and a director of law and public Policy for National Health Freedom Action. National Health Freedom Action is a 501 C4 nonprofit corporation working to protect maximum health care options for consumers. We responded to a call your own from individuals and groups throughout the country who wish to promote legal reform in occupational laws and regulations. Massachusetts citizens have contacted our office because they would like to have a safe harbor practitioner exemption law for unlicensed healers and practitioners who are providing noninvasive methods of healing and health care services in Massachusetts, similar to other states that we have been involved with across the country.
We support this bill because it will protect access to thousands of traditional complementary and alternative health care practitioners providing their services to health seekers in Massachusetts and who are not licensed under a medical healthcare occupation law.922 1380 and 2343 provides guidelines for the use of an exemption from state occupational licensing laws which Anne has already described to you. The use of complementary and alternative practitioners is prevalent in the United States.937 Based on February 2015 National Health Statistics report, the941 percentage of us adults aged 18 and over her use complementary health approaches according to the most recent statistics was 33%, thousands of Massachusetts citizens are using complementary alternative health care and spending millions of dollars out of pocket in the commonwealth.
We have observed in other states that safe harbor laws provide a practical way for states to ensure continued consumer access to the availability of wellness practitioners and banalities while also retain the avenues that state governments have to process complaints for unlicensed practice when the need arises. Currently, 11 states as Anne has said have passed safe harbor exemption laws including Minnesota, Rhode island, California, Louisiana, Idaho, Oklahoma, Arizona, New Mexico, Colorado, Nevada and most recently, Maine. NHFA992 believes that Senate Bill 1380 House Bill 2343 go a long way and protecting consumer access to broad domain of healing modalities practiced. Thank you for allowing us to testify today and wish you the very best. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you for your time and for your testimony. Um at this time I'm going to try to finish a couple more people who have signed up to speak on this bill and then we will move to um Senator O'Connor who I know has been able to join us. But I'm going to ask Hillary um Garibaldi's and fish and then Alexandra Girl to come forward.
Hi,
this is Hillary Garibaldi's. Hillary Welcome. You have three minutes. Thank you.
HILLARY GARIVALTIS - HEALTH FREEDOM ACTION MASS - HB 234 - SB 1380 - Thank you, Chairwoman Comerford and Chairwoman Decker and all the committee members. I'm currently the President of Health Freedom Action Massachusetts and founder and former Dean of the Crayola School of Garry Veda in Stockbridge and currently the executive director of the National Ayurveda Medical Association and as an Ayurveda practitioner and educator here in the commonwealth of Massachusetts. I'm here today to support H 2343 S 1380, an act providing for consumer access and disclosure of complementary and1076 alternative health services. Ayurveda is just one of the many modalities I'm here to represent today, among them are Tibetan medicine, herbalism, aromatherapy, yoga therapy, ricky, just to name a few.
Ayurveda is a 5000 year old traditional system of medicine from India. It's considered the oldest continuously practice system medicine in the world. Its focus is on maintaining health and preventing disease. It's practiced alongside Western al empathic medicine and hospitals throughout India and has now spread to almost every continent around the world. I'm also here as a consumer of complementary and alternative medicine and someone who's been profoundly impacted by exposure to one of these modalities. One out of three US citizens uses this bill will balance consumer protections and public safety with the rights of those who practice healing therapies, it will ensure that the citizens of Massachusetts have the freedom to choose and access all healing therapies and that the practitioners have the right to practice legally while guaranteeing consumer protections by requiring practices to provide informed disclosure and collect consent.
Massachusetts has long been a leader in establishing access to quality health care for all its citizens. This bill will serve to strengthen the commonwealth's commitment to its citizen's health and well being by expanding service options for consumers. Every citizen should have the right to access the practitioner treatment or information source that best suits his or her personal needs and preferences. By recognizing these services on a statewide level, consumers will be better able to make informed decisions about their health care1181 options. 11 other states, as has been mentioned, has passed this legislation and many more, working in similar efforts.
It's time for Massachusetts to do the same. While Massachusetts statutes and regulations governing the many conventional mainstream health care services, they do not require licensure for the vast array of complementary and alternative health care practitioners. As such, the law and the regulations are silent on these practitioners responsibilities, duties and best practices in connection with patient care. This bill will help address this void. This bill not only requires the cam professional to disclose their background education services offered. It also clearly states the types of activities prohibited by can professionals which are only to be performed by licensed health care professionals. Further, this legislation ties any violation of the notice and disclosure requirements to Mass General Laws 93A, the Consumer Protection Act. Therefore, this bill will have no financial1239 impact on because there will be no additional administrative1242 enforcement class of this country. I thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you for your time at this time. I would ask, I believe we worked with and fish. Thank you.
ANNE FISH - CONCERNED CITIZEN - HB 243 - SB 1380 - Thank you, Chairwoman Decker and thank you, Chairwoman Comerford for giving me the chance to testify. I wanted to let you know that this is something that's very near and dear to my heart, although I come from a long line of doctors when I had a frozen shoulder 30 years ago, no doctor could help me. Not my own doctor, not my sports medicine doctor, not a chiropractor, nutritionist, massage therapy, I made the rounds for two years until I finally found my way to a modality called Jin shin jitsu. Within three sessions, using extremely light touch, my frozen shoulder was released and I am now an active user of holistic health practices. I turned to holistic health practitioners primarily to maintain my health these days and I want to ensure that these holistic health practitioners are protected under the law so that the public can continue to use their services.
There's no need to license these non harming professionals, but we do want to protect them and guarantee public access to them. As you've heard, 11 other states offer this kind of safe harbor and it's time for Massachusetts to offer this kind of safe harbor for holistic healthcare workers as well. I urge you to pass House 2343 Senate 1380 out of committee so Massachusetts can be the 12th state with the safe harbor protection. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time. And at this time I would ask alexander girl to come forward.
1344
1344 ALEXANDRA1344 GURAL1344 -1344 CONCERNED1344 CITIZEN1344 -1344 HB1344 23431344 -1344 SB1344 13801344 -1344 Thank1344 you, Chair Decker, my fellow can to bridging and thank you also to Chair Comerford for facilitating. My name is Alexandra Gural and my health has benefited from having a greater option of choices in health care and different alternative treatments. For about 30 years, I've been able to share with my family as well and my dad just turned 94 and my mom is 88 and we're all thriving from having the access to alternative health. I just had my 60th birthday and I feel that I'm in the best health I've ever been. I'm in support of the bills, H 2343 S 1380. I believe they will enable and ensure consumer access to and the right to practice complementary and alternative health care. This is vital to our families and communities, while sometimes medical services are needed. However, we know there are growing financial constraints on traditional health care.
Alternative health care is vital because in the long run, it will lower health care costs for an individual. Its gentle and nurturing for a person with underlying conditions and procedures and it balances and grounds an individual and connects them to their best version of themselves. My family and I are so grateful to be able to use alternative health care for 30 years and our traditional health care doctors are very pleased with the results. We need more dialogue and discussion and case studies to increase our understanding of different perspectives. We need more information and access, not limitation. This is needed to help an individual navigate the options and the rights to a range of proven alternative health care1461 therapies. Bills 2343 and S 1380 will benefit more people just as my family has been helped by alternative therapies. Thank you very much for your time and for1477 listening. SHOW NON-ESSENTIAL DIALOGUE
thank you for your time and happy birthday. Um We have1482 a few other people who are going to speak on this bill before I bring them forward though it is um a courtesy, we provide our colleagues who are also juggling multiple um hearings to come on. Um and just to be clear that if you have your hand up, we actually don't call on people. Um1501 and so um that's why we're not responding to hands raised. I will tell you after. Um we hear from Senator O'Connor, we will then also hear from Donna messenger Margot roman and Julianne Otis. Um, but at this time I would welcome Senator O'Connor Senator O'Connor are you coming on alone or do you have somebody with you? I1522 have a constituent with me as well, madam. Chair, Okay, is that Katie Condo? It is. Okay. Welcome.
SEN O'CONNOR - SB 1502 - Chair Decker, Chair Comerford and through you to the members of the of1540 the committee, thank you for the opportunity to be here today and to be taken out of order. I'm here to testify in support of Senate bill 1502, which is an act relative to the reform of the personal care attendant system in Massachusetts. I was very proud to file this bill in partnership with my constituent, Katie Condo, who lives in Hall, who is also here to testify today. Katie will give you a first hand account and perspective of why this bill is important and necessary but I just wanted to say beforehand that Katie has been one of the strongest self advocates that I've ever met and I'm so proud to be working alongside1573 her to advance this important policy change.
Senate Bill 1502 aims to improve the commonwealth PCA system by making the program more user friendly efficient and reliable for the clients who depend on PCA services. Right now, the PCA system is often causing more problems than solving. The system should exist to take off the burden of the people who receive care. but as you'll hear from Katie, clients1599 carry the vast majority of this burden and there is little oversight to ensure that they're not being put at risk. You know, to reform the standard, the language in this bill requires the PCA quality home care workforce council which was established previously by the legislature, we require that to meet at least three times per year as well as to update the PCA referral directory every six months to account for changes in contact information to deliver these critical services.
Currently, there are no requirements for the frequency of PCA council meetings, nor is there any requirement for how frequently they update the referral directory. Rather than the client being responsible for training,1638 directing, hiring and supervising PCA,1641 this council would be responsible for these duties. When left up to the client, the task of recruiting and retaining PCA's often becomes a full time job, which in my opinion defeats the entire purpose of having a PCA, to help some of our most vulnerable people in our state achieve a more independent life. This bill also creates the position of a primary PCA which can serve up to any number of hours per week1667 that the client would want them to.
Right now, there's regulations1670 with a cap on PCAs and providing no more than 40 hours of service per week for an individual but if a PCA has a good relationship with the individual and they're willing to provide more than 40 hours of service, we as a state shouldn't be stopping them, especially with the serious workforce and labor shortages that we're1687 facing in human services. The risk associated with dependency on a single PCA, which was one of the things that we were pushed back on would be eliminated in this bill by the creation of a consistent well maintained PCA pool, which would be an online registry of PCAs for the specific purpose of replacing a primary or regularly PCA if they are unable to work at a scheduled time.
The language seeks to ensure that there will be PCAs available anytime in case of a PCA absence, which occurs all too often. We've heard stories, not just from Katie but from other constituents who are left on their own for hours and sometimes days when a PCA unfortunately is not able to make a scheduled time. This bill would also require that the council offer training services to PCA as well as conduct thorough performance reviews to make sure the PCA pool is effective and that it's responding to the actual needs of some of the state's most vulnerable. To conclude, this is a hefty bill and I, for one can tell you straight up that I don't have all the answers to what we need to do here in the commonwealth to fix the PCA system, all I know is that it needs to be fixed.
We right now are entering in a state of1760 what I would say critical human resource sector shortages and I think it's important that we advance legislation this session to address the needs1767 of some of the state's most vulnerable residents. This was only exacerbated by COVID-19 and the people who rely on the PCA program have been put at even greater risk. The Commonwealth having resumed responsibility for the PCA system needs to follow through and we need to ensure that providing acceptable services at a very bare minimum but there's so much more we can do in this space and there's so many opportunities that we have to make this system so much better. With that said, with your indulgence, Madam Chair, I'd like to pass it over to Katie. SHOW NON-ESSENTIAL DIALOGUE
Great! Thank you Katie, Welcome
up Katie, You're on mute. We all keep doing this.
So Katie, you're still1809 on mute. I'm trying1810 to see if I can on mute you. Um, but it's not letting me,
Can you hear me now? Yes, well, okay, thank you. I apologize for the technological issues. We all have them.
KATIE CONDO - CONCERNED CITIZEN - I was going to read from a speech today, but I think what I'm going to do is just describe a little bit about my situation. For the past 13 years, I have been almost single handedly overseeing my own PCA program. During that time, I would estimate that I have hired well over 75 different caregivers, some of which have been detrimental to my safety. As consumers, we are required to oversee our entire program which includes hiring, firing and maintaining staff as well as training and essentially, maintaining an advertising campaign. Over the 13 years that I've been a consumer of the program, I would estimate that I have spent well over $10,000 on advertising. This is all well on a fixed income.
I'm lucky as a consumer of the PCA program, I have family support, but because I have1910 family support, that means that when a PCA does not fulfil their duty, the duties fall on my mother and siblings who have had to sacrifice endless amounts of time because a PCA fail to fulfil required duties.1931 This is not to mention all of the times when I have been put at personal and physical risk because of lack of oversight from a PCA. I've had medication stolen, hours tampered with, I could go on forever. I've been also extremely lucky over the years, I've had some extraordinary PCAs and the extraordinary PCAs are not compensated for their extraordinary service.
All of these things have been exacerbated by Covid 19. For the past two years, I haven't been able to maintain any outside staff, which means I'm receiving care from my family members directly and they've had to give up jobs to maintain my care. This bill is so important to the consumers of Massachusetts, and, yes, it's important for me, but it's even more important for those consumers who don't have family supports because I don't even know where I would be if I did not have2020 the support of my family. I urge you to pass this bill to ensure the quality of life that the PCA program is supposed to provide for us. I thank you all for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time, Katie and thank you for your testimony and thank you for connecting with your state senator Often when we are looking at ways to ensure that our laws and our budgets and our regulations um empower and uplift our community. We really rely on our constituents to bring those issues to life for us. And um as you've said, you know, your testimony is really speaking to the needs of so many people who probably will never find their way um for a lot of reasons to a hearing like this. So um thank you for that. We will be looking at this bill carefully and um we appreciate your testimony. Thank you.
Thank you Sandra.
Thank you madam Chair. Um we're going to go back to um next in line were going to finish up House 232088 43 Senate 13 80 the order of next speakers are individual speakers are Donna Messenger, then Margo roman and then Julianne notice. Welcome.
Thank you. Hello everyone.
DONNA MESSENGER - CONCERNED CITIZEN - SB 180 - HB 2343 - Thank you for the opportunity to speak today. My name is Donna Messenger and I live in work in Massachusetts. I'm here to urge you to support S 1380 H 2343. It's a common sense solution that addresses the wishes of thousands of residents in Massachusetts who are using a wide variety of complementary and alternative health related services. I am a parent of a child with significant and complex disabilities and medical needs. My child has profoundly benefited from a wide variety of alternative and complementary approaches and modalities. This bill would be a great step forward toward protecting our rights to health care of our choice and for practitioners to be allowed to continue working and providing these services without fear of unfair and unreasonable restraint of trade due to overreaching and unsustainable licensing requirements.
My teenage child is now in the process of learning to walk using a walker. She communicates with some words, gestures, eye gazing, and facial expressions. While her developmental delays are significant, she has become a joyful and curious learner. Her skill levels in multiple areas continue to surpass the predictions and expectations of licensed medical and educational professionals. Thanks to many modalities that I hope will be preserved and supported by passage of this bill. This includes Ricky, classical homeopathy, energy, kinesiology, integrated movement modalities and many more, all of which have been providing my child a greater chance towards more independence and a higher quality of life. I seek alternative approaches such as these because the standard al empathic approaches were not helping my child and were even causing severe emotional trauma, withdrawal and regression.
This bill has essential protection for my family, for the disabled and those with complex medical challenges as well as anyone seeking improved health and well being. Many of professionals providing these services have been trained and are certified in their work through highly specialized and individualized manners. Many are derived from a wide variety of ancient spiritual, cultural and religious traditions and lineages. This bill allows these practitioners to be equally valued, preserved and included as part of Massachusetts rich diversity of health care options along with those that follow more traditional forms of education and training, all of which are valuable. This is a kind compassionate bill in that it offers dignity and inclusivity to those caring, dedicated, law abiding professionals and still offers some baseline tangible information and agreements between the practitioners and the commonwealth. Our commonwealth will be a better place to live for all with this bill in place. Thank you so much. SHOW NON-ESSENTIAL DIALOGUE
And I also wanted to mention that dr Martha Herbert would also like to speak. I don't know when she's in line to speak but she is only available between two and three o'clock today. If Thank you Donna, thank you. As you can imagine there's a lot of people in the commonwealth who have complicated schedules. So I just wanted to see if she's on the, when we call her. We will certainly be, I hope that she it aligns at this time. I would ask Margot roman to please join us.
Are you here Margo?
Okay. Um, I would ask who I can see on the screen, Julianne otis to please join us.
JULIE ANN OTIS - HEALTH CARE WORKER MEDFORD - HB 2343 - SB 1380 - Thank you so much for the opportunity to testify on H 2343 S 1380. My name is Julie Ann Otis, I'm a health care worker based in Medford Massachusetts and I've studied alternative healing methodologies in Bali Indonesia and in the United States with many holistic teachers over the past seven years. I myself practice several gentle, noninvasive healing practices, including energy work that's similar to Ricky and gentian, jutsu, a Japanese healing art that works with energy lines and nexus is in the body. I'm here today to request your support of H 2343 S 1380 known as the safe harbor bill to provide permanent safe harbor in Massachusetts for unlicensed holistic practitioners such as myself.
This bill would protect my livelihood, it would protect my work and it would protect my clients. It would also protect my personal ability to access natural health care practitioners who provide me with health care weekly. I thank my colleagues and the MMHA so much for their efforts over the last three years to bring this well crafted bill to the floor. This legislation establishes specific disclosure requirements for practitioners and specific prohibited acts while not preventing me from practicing my vocation and also allowing me to serve my clients. As Diane Miller mentioned, 11 other states have already passed similar legislation that protects alternative and complementary health care accessibility, Massachusetts bill will likewise clearly define the responsibilities that I have and that other practitioners have to our clients while providing an exemption to state occupational licensure for noninvasive complementary and alternative health care.
In the last session, the public hearing for this legislation, which I unfortunately was not able to attend was overwhelmingly positive. This bill advanced from the Joint Committee on Public Health, the Joint Committee on Ways and means but was unfortunately stalled as the pandemic hit. So2452 better late than silent, I am here today to enthusiastically ask that you take this opportunity to pass the safe harbor bill. Please do vote to support both my access to alternative healing modalities that I use for my own health and also for my right to practice my vocation as an alternative health care practitioner. Thank you so much for supporting this bill. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time and your testimony. Um at this time I would ask, looks like have a panel here. Clark Reddick and Deb Fox
um is clark Clark critics and Deb Fox. Are you on? This is Deb, can you hear me? Yeah. Um Devers clark here. I believe he is here. Um Okay, okay, great. So you guys are signed up as a panel just to give you a heads up. That meant that any panel has six minutes, individuals who2516 signed up have three minutes. I only remind us so that whoever the first speakers of the two of you probably2521 wants to unless you've agreed to otherwise stick to that three minutes of the other person also has three minutes but we would not stop you2528 um at2529 three minutes as we2530 would with individuals who signed up. Right2533
uh Welcome, go ahead first. However, the two of you would like to do that. Go ahead. Great,
DEBORAH FOX - CONCERNED CITIZEN - Thank you for the opportunity to speak today on these bills. My name is Deborah Fox. I'm a consumer of many, many holistic modalities as well as a licensed massage therapist and a business owner. My practice relies primarily on on license specialties namely biodynamic, cranial psychotherapy, polarity therapy and homeopathy. As you know, the practice of complementary and alternative health care is not a protected right in our state. The problem is that the act of providing wellness and prevention services is currently defined within the scope of the practice of medicine. However, medical schools provide little or no training in complementary care of any kind.
For example, a 2015 report in the Journal of biomedical Education States only 29% of US medical schools offer the students a mere 25 hours of recommended nutrition education. This article is linked in my testimony. This situation has created a demand for complementary and wellness services and it is the wellness industry that has the training and the skill and is providing these services. I have several articles linked in my testimony as well. One a 60 year old woman who turned to holistic medicine 20 years ago after being diagnosed with Osteoarthritis and told by her physician there was nothing that could be done for her and that she would be in a wheelchair by the time she was 55. She's now 60, healthy walking her dogs every day and very active.
May 2019, school sends kids to meditation instead of detention with amazing results. A Mindful moment program from in Baltimore helps students to focus and recalibrate. Since the program started, not a single student was suspended. The program teaches breathing techniques and yoga and helps them overcome trauma they may have faced, which causes them to act out and it is helping their home life as many share the tools with their parents. August 2016, 85 year old and a pesky suffered from excruciating back pain and hunchbacked posture until she started working with yoga based back care specialist, helping her regain her posture and alleviate the pain. She now says she feels wonderful, is driving again and doing other things she couldn't do before.
Imagine for a moment the medical cost savings in just these three cases, then multiply that by the impact that thousands of practitioners in the statewide are having. I ask each of you as a member of2705 the joint committee on Public Health to please recognize the importance of this industry by giving the acknowledgement, protection and respect that it deserves by taking the next step and making Massachusetts the next state in health care freedom. Please vote in favor of this bill.
CLARK REDDICK - CONCERNED CITIZEN - Hi, my name is Clark Reddick. As a child, I had bad allergies and was put on anti histamines that made me very unwell. I would also contracts throw often more than once a year, which was incredibly painful. I was prescribed antibiotics but the infection just kept returning. Cure, I mean I guess horrendous abdominal cramping, cramping by 24 I had to dig. Finally, someone referred me to a licensed health care. You never to return method impacted the cause2767 of my disease. Rather really time to turn off sensitive. Does that include, well like fatigue and like them? I and unlike practitioner gave me my life and his colleagues work in the future of the practice. Please fix this your time. SHOW NON-ESSENTIAL DIALOGUE
Mr. Erik your connectivity is not very strong. I'm getting most of what you're saying,2800 but just so you know,
REDDICK - Thank you. Can't do anything about it. I have used reflexology shiatsu between a homeowner apathy. You know, swimming thirties I spiraled into a major depression. I refused to see a doctor. I knew I was not sick because fish Prozac. My stream a real you're not a little time of artifacts and I found it in an I practice rears and myself became a practitioner helping many with the debilitating conditions, experience renewed health, sometimes verbal serious illness. Under CMR 2014 medicine is defined to include prevention, alleviation and cure disease. What is the making change medicine and that because of the wants to own healing, I could arbitrarily target the prosecutor fear is often mhm yes, the same time exams okay for speaking so and this is the come in here, how 1380 would be out of committee to the floor democratic process can function. Pathe News, thank you very much. SHOW NON-ESSENTIAL DIALOGUE
Yeah, thank you for your time. Mr Erik I know that you can't control the quality of connectivity. We did not hear a lot of what you said, I got the, I certainly understand what the point is that you're making. So I just say this to encourage you if you would like to please submit your testimony in writing, but I certainly understood the point that you were making um and appreciate your time.
Um at this time I'm going to call um the next several folks who are coming up as individuals are Stephen Brown then Carol Bedrosian, Stephen fisher erin Feldman and Ariana bain. So we will start with Stephen Brown, Welcome
Stephen are you here
Carol Bedrosian.
Hello, I'm here.
Can you hear me? Vieira Welcome, Welcome. Hello,
CAROL BEDROSIAN - SPIRIT OF CHANGE - SB 1380 - HB 2343 - My name is Carol Bedrosian. I thank the committee for taking this issue up. For 35 years, I2983 have been the publisher of spirit of change holistic magazine in New England and I've2988 used alternative and natural medicine for all of my health care needs except for dental optometry and receiving the COVID vaccine. A robust alternative health presence in this state is vital to my health as well as to my profession. I'm aware of many practitioners who are unable to promote their services publicly and expand their businesses in Massachusetts due to fear of being charged of practicing medicine without a license.
The human body is an organic life sustaining and self healing organism programmed to do everything within its power and intelligence to keep itself alive even when we can't explain how or why. For centuries, countless varieties of non medical, non licensed hailing professionals have provided essential, powerful, safe and effective services to assist others, both family members and the public in this natural healing process. Our present Massachusetts, commonwealth is no different. The complementary and alternative healing industry thrives in our state, in homes in private and group practices and in hospitals. Noninvasive holistic self care is at the forefront of the healthcare innovations today because it works and it reduces health care costs by billions in the process.
Now that3071 the costs of pharmaceutical surgical diagnostic healthcare model is spiraling out of control along with the recognition of its many dangerous side effects, the common sense effectiveness and affordability of natural medicine has become more apparent. The safe, non harming, healing professionals who provide these services such as Ricky cheong mindfulness training, energy medicine and hundreds of other unique modalities need a legislative safe harbor that ensures that they can continue to practice and provide their healing services without fear of retribution for practicing medicine without a license. Bill S 1380 and H 2343 provides the safe harbor for these unlicensed alternative and complementary practitioners, thereby ensuring their safety and confidence in setting up their3127 businesses and providing services to Massachusetts residents.
The bill upholds the right of non harming practitioners to practice their profession without a license and it provides the state with the oversight of these unlicensed practitioners and the public with protection through the establishment of prohibited acts. It ensures Massachusetts residents will3150 continue to enjoy access to the widest variety of natural healing practitioners in the state. Please support the3159 passage of this bill known as the safe amendment act. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you. At this time I would call Stephen fisher.
Mhm.
Okay. Um Aaron Feldman.
Arianna bain,
Brandon bouchar
dr Martha Herbert.
Gouveia news walled.
I think I see Gina on the list here as having is angie are you with us? Yes, can you hear me? I can welcome you have three minutes to share your testimony.
Hi,
GIA NESWALD - CONCERNED CITIZEN - Thank you very much and I appreciate the opportunity to speak with you all. I'd like to just add my personal story. I was trained in a modality called Quantum Touch in 2007, I've been practicing since then but although I'd like to make it a business and to make it part of my living, I have not chosen to do so although I've treated over 100 people. The feedback I've received from my clients or non paying clients has been entirely positive, I have not had one complaint and I always check in and follow up and if this bill were passed, I would feel secure in practicing this technique as part of my living. I'm getting older and some of what I do is not going to be so easy for me in the coming years but practicing Quantum Touch and the chakra alignment techniques that I do is something I can do presumably for the rest of my life and that makes a positive difference in the wellness of those I work with. So I just wanted3298 to share that piece. Thank you. SHOW NON-ESSENTIAL DIALOGUE
thanks for making the time to come on and sure3305 your testimony today, um I'm gonna be moving on to another bill but I would ask if if you've already testified, I'm sorry that we have to do this but we're asking you to please sign off as you probably saw earlier, we had somebody who's connectivity wasn't strong and we have just found that when more people sign off the connectivity seems stronger for some people than others and so you're welcome to follow the hearing, live streaming is happening, you can get it on the state House website service and we understand that this is really imperfect and I think like all of you are doing the best we can to make sure we can keep the democratic process moving forward even if we have to do with some of it virtually right now and that means hearing from all of you, so if you have testified, please sign off and come back on and watch3352 it as it's being live streamed, um I'm going to just do one more round of calls for people who were on this bill before I go on to the next one but Stephen Brown and I don't see them on the list but I'll call their names anyway uh Stephen fisher,
erin Feldman,
Arianna being
Brandon Bushehr
dr Martha Herbert, Laurie Maher,
okay, we're gonna move on to the next bill and um if you haven't logged on, don't feel startled if you are just unclogged by staff in the background because that's what's happening here but we'd rather you do it yourself so we don't have to do it. Um I'm now going to move on to house 2356 act relative to anesthesiologists assistance and the panel that I have before me is paul done Nichole cable, you have six minutes as a panel and I would just ask you to be mindful of each other in case you haven't actually coordinated ahead of time so that the first speaker doesn't maybe use up the time of what the second speaker on your panel is hoping for. But I leave that up to you paul done in Nichole cable. Please welcome.
Okay. Great.
NICOLE CABELL - CERTIFIED ANESTHESIOLOGIST - HB 2356 - Thank you, madam Chair. My name's Nicole Cabell and thank you for letting us speak today. I'll hand it over to call here in just a little while. I'm a certified anesthesiologist assistants that's currently practicing in Washington DC at George Washington University Hospital. I also work as an adjunct tobacco to member to teach current AA students enrolled in case Western masters of Science in anesthesia program. I'm here to testify in strong support of H 2356 legislation that would authorize licensure and regulation of certified anesthesiologist assistants also known as3458 [inaudible 0:57:52] of this legislation would provide the residents of Massachusetts. The state's on my own extended family members called home. Access to benefits that CAA is, currently provide benefits of patients in 19 jurisdictions already received today.
I along with my other CAA colleagues provide high quality and affordable are. As a CAA, I'm highly trained anesthesia provider with a master's degree from case Western reserve School of Medicine. I work alongside my physician and anesthesiologist colleagues under medical direction to implement anesthesia within the anesthesia care team, meaning patients will always have to people involved in their anesthetic care. Yes, I have no intention of practicing independently or practice model will always be that of the anesthesia care team. Working under the medical direction of a position anesthesiologists. All CAA is because it's a pre medical undergraduate background and complete a comprehensive didactic and clinical program at the Graduate school Master's Degree level.
The typical AA massive program is 24-28 months and includes an average of 2400 kornafel hours and 600 cases. We're doing extensively in the delivery and maintenance of quality anesthesia care as well as advanced patient monitoring techniques. As someone who has both completed training and currently works as an adjunct faculty member at an AA program, I can assure you that CAA has understand the disease states, pharmacology and all other factors that can influence an anesthetic and ensure we provide high quality care to our patients.3556 In multiple states, including my own, we've been utilized during the Covid pandemic to assist with the management, breathing device placement and my emplacement of critically ill patients.
My profession is an established profession that has been serving patients over four decades. CAA is recognized by the centers of Medicare and Medicaid Tricare and all major commercial insurance payers. MMHA recognizes the CAA as qualified non position and assume providers just like our CNA counterparts. CAA is our safe and effective visitors anesthetists and one of my hospitals, I worked alongside CNA as most people don't know who is the CAA or CNA without asking. We have the same job responsibilities and duties and work together cohesively. There3596 is no pure review. There are other credible evidence of any sort that the care provided by a certified anesthesiologist assistants is less safe than that of a nurse anesthetist.
In October 2018, there was a study published in the reputable journal anesthesiology, It concluded the specific composition of the anesthetic care team was not associated with any significant differences in mortality, length of stay or envision standing. I would like to again thank all of you for your time and allowing us to be here to speak with you today, I graciously ask for your support on H 2356 to allow the residents of Massachusetts access to the high quality care that CAAs can provide. I am happy to answer any questions that you3635 may have after you speak with Paul.
PAUL DUNN - CAA - HB 2356 - Good afternoon and thank you for the opportunity to speak to you. My name is Paul Dunn and I am a practicing3646 certified anesthesiologist assistants in the state of Vermont at the University of Vermont Medical Center and the current president of the Massachusetts Academy of Anesthesiologist assistance. I'm here to support the bill H 2356 an act relative to anesthesiologist, assistance. I am a native of the commonwealth of Massachusetts having grown up in Winthrop and Saugus and I am also3665 an alumnus of both Salem State University and the University of Massachusetts at home. Previously, I worked as a certified paramedic in the commonwealth of Massachusetts on the North shore for over a decade.
Upon becoming a certified anesthesiologist assistants, I was no longer able to live in Massachusetts, but I would love the opportunity to3683 come back home and take care of people in the commonwealth again. Additionally, there are many other certified anesthesiologist assistants that are Massachusetts natives or who have had ties to the commonwealth that would practice there if given the opportunity. At this time, I would also like to speak about the scope of practice of certified anesthesiologist assistants. Certified anesthesiologist assistants work to provide safe anesthesia care within the anesthesia3702 care team with physician anesthesiologists directing care.
While the specific job descriptions and duties of certified anesthesiologist assistants may differ among different practices, in general, a certified anesthesiologist assistants may make a pre anesthetic health history and physical examination for review by an anesthesiologist, establishment monitoring modalities as directed, assist in inducing maintaining and altering anesthesia levels, assist in providing care in the postoperative period and assist in the performance of lifesaving treatments such as CPR. Certified anesthesiologist assistants always provide care in the anesthesia care team under medical direction, physician anesthesiologists. I would also like to add that the scope of clinical practice of certified anesthesiologist assistants is generally the same as that of certified registered nurse anesthetists in the anesthesia team. Thank you for supporting H 2356, an act relative to anesthesiologist assistants. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you.3760 Um at this time I would call on Katie. No, no.
Okay. So I'm going to ask uh We're gonna move on to house 23 59 and I would ask Christopher Arnold to come forward.
I can see you on Christopher. There you are. Ok, okay,
CHRISTOPHER ARNOLD - DEPARTMENT OF DEFENSE - HB 2359 - Good afternoon, madam Chair. Thank you for having us. The Department of Defense is grateful for the opportunity to support the policies reflected in House Bill 2359. The physical therapy licensure compact. My name is Christopher Arnold, I am the Northeast region liaison at the United States Department of Defense, State liaison Office, operating under the direction of the Under Secretary of Defense for Personnel and readiness. I will endeavor not to repeat much of our written testimony, however, the compact will greatly assist military spouses pursuing physical therapy careers by reducing licensure barriers while also improving access to physical therapy services and maintaining a high level of public protection.
The department is especially grateful to Representative Madaro for sponsoring this legislation which is a continuation of the ongoing efforts in Massachusetts to advance the department's key priorities for military spouse licensure. The first lady has called these efforts a national security imperative. The Governor has taken multiple steps which make the process of transferring professional licenses simpler for military personnel and their spouses arriving in Massachusetts including executive order 93.3860 Pursuant to the order, the division of professional licensure recently delivered a report on the PT compact, which recommended the commonwealth join the 33 states which have already enacted the compact legislation. DOD has established3873 and is working on three lines of effort to improve licensed portability for military spouses.
These lines of efforts3880 seek to improve the state licensing laws to allow a military spouse to receive a license with minimal initial paperwork3886 within 30 days of an application. This includes approving profession specific licensure compacts a long term3899 solution for portability. In the interim, the department perceives individual state efforts to improve their ability to support portability, such as the valor acts as important. Individual state laws and policies provide options which provide varying degrees of reciprocity. That's part of the way forward will be compacts for license affordability. Section 283 of the FY 2020 National Defense authorization act required the military departments to assess licensure as part of their strategic basing criteria.
The Department of the Air3926 Force specifically examines the physical therapy occupation in its licensure portability evaluation. Their 2021 evaluation assessed the base state as Amber for physical therapy licensure. To3937 validate this assessment and to provide additional insight regarding time licensing boards in each state's take to adjudicate an application, DOD contracted the Pennsylvania state university clearinghouse for military family readiness to assess licensing practice and the possibility of these practices to military spouses. Their findings include that 66% of the boards they reviewed, adjudicated military spouse license occupations within 30 days. The results also showed that licensing boards were not consistent within states meeting these criteria.
Pursuant to the Governor's order, Massachusetts has since appointed a single point of contact deep occupations for military spouses to provide accessibility including meeting our 30 day window. For the long term desired end state, the department has found that licensure interstate compacts for individual professions provide true reciprocity by allowing the practice certain license. SHOW NON-ESSENTIAL DIALOGUE
Do you and I am happy to answer any3992 questions. No, I appreciate your time and um it's impressive to see the Department of Defense weighing in on this um, on behalf of military spouses so I just appreciate the testimony and we have it in writing I believe.
Is that correct? Okay thank you very much. We will be have any questions. We will circle back to you. Thank4013 you.
Okay at this time um we're going to go on to house 23 80 Senate4020 15 28. And the only person who signed up for this one is frank romano. Are you on frank?
Yes, I believe you are. I can see that you're on. Can you, are you um
frank, are you there?
Okay so I have frank romano on may have stepped away from the computer for a minute. I can hear you welcome. That's my fault. No worries. This is, this is all tricky for all of us.
Okay,
FRANK ROMANO - CONCERNED CITIZEN - SB 1528 - HB 2380 - Thank you very much for the presentation I'm about to make this afternoon. I am here to support Senate Bill 1528 and House Bill 2380 and I'd like to thank Senator Tarr and Representative Murray for sponsoring this important legislation. I have been in the healthcare business in the state of Massachusetts for the last 45 years and I run a family company of six skilled nursing homes, two assisted living, four adults Health Centers and a Home Care Company servicing 40 cities and towns in the state of Massachusetts. I am here to testify about the MedTech proposal that's in this bill. I'd like to start off by reviewing a letter dated4107 sept 1st 2021 by Doctor Ernest Grant, President, the American nursing Association to the Secretary of the Department of Health and Human Service.
Dr. Grant stated, on behalf of the American nurses association. I write to urge robust and immediate action to address the unsustainable nursing staffing shortage facing our country. According to the Bureau of Labor Statistics employment projected 2019 through 2029, there will be 175,900 openings for our ends each year through 2029. At least 36 states allow medication aides in skilled nursing facilities. In 2013, a report published in the gerontologist found that certified medication aides associated with lower4162 medication errors and lower drug related regulatory deficiencies. According to the National Council of State Board of Nursing in 22 states, utilize Mace, a national medication aid certification exam administered to nurse's aides who choose to receive additional training to become certified medical assistants.
According to the American Associated College of Nursing reported in 2019 through to 2020, enrollment in graduation graduate baccalaureate degrees programs in the US Nursing School turned away 80,407 qualified applicants because there were not sufficient faculty clinical sites, classroom space. The use of medication aides would provide a career path for certified nursing assistants, the backbone of every long term care facility, while it's taking steps to foster an environment of continued of care. I can only say that I have never seen a nursing shortage like we're experiencing today. We are eliminating admissions from homes because we just can't find nurses. More medication aides would be a wonderful help to the nursing shortage. Thank you very much. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time and your testimony. Um We have a number of people who are signed up to speak next on House 2382 Senate 1452. We heard earlier from the sponsors of this bill. O'Day senator Keenan this is an act relative to recovery coach. I'm going to start with Mary Anne frank, my friend. Velis um I've seen you on here. Good to see you again, Marianne,
you're not you're still muted.
Mhm. Mhm.
Let's see if I can help.4282
Uh I don't know what's worse is having to speak and undo a mute button not having one eventually, wow, we're going to see Welcome. Well yeah, wonderful to see you too because we're um teaming away here so
MARYANNE FRANGULES - MASS ORGANIZATION FOR ADDICTION - We want to just thank you, Chair Decker as well as Senator Comerford, it's great to be here. Massachusetts organization for addiction recovery facilitated and continues to facilitate an opportunity to have recovery coaches meet with us in regards to the licensing that stems back to the recovery coach commission. People wanted to have their voices heard and they really4338 did because when we were at this recovery coach commission café, they were like how do you get on one of those commissions? So we found a way for people to have their voices heard. So we took a lead in this process, had many, many meetings and watch this bill go through last year, the mental health substance use and recovery with its recommendations from the recovery coach Commission.
Very important to the coaches that met is that they wanted to have a board of registration that was mostly from the recovery coach field,4372 they wanted to have a4374 representing the six different public health regions as well as race, culture, diversity of workplace. I want to honor that peace, the rest, you're going to hear from everybody else and I thank you so much for this opportunity. SHOW NON-ESSENTIAL DIALOGUE
Thank you for all of your work.
Um and I know there's a lot of people who are doing good work, so if I don't know you personally, I'm not thanking you, I'm just thanking all of you now who are about to come forward? Um I'm going to invite Daniel um, john even, I'm sorry if I'm not saying this correctly,
I don't see Daniel on at this time, so I want to jump straight to Nicholas Alicia who I do see
Hello
NICOLAS ALICEA - RECOVERY COACH SPRINGFIELD - Madam Chair, thank you very much for this opportunity and everybody who has come before me working on this. My name is Nicholas Alicea, recovery coach from Springfield Massachusetts. I was part of the recovery coach commission and in that time, we went across state of Massachusetts that we heard from the people, consumers and the family members of consumers. What we have realized and we saw is that we needed this to happen. One of the greatest things that we've seen also is people not being able4465 to access recovery coaches because of the health insurances. A licensure will help bring that through, but across the board, the diversity that happens to Massachusetts, we have seen cultures, African American, Asian Hispanic communities and with the work that we do as recovery coaches are in the community, we help lower that recidivism rate to jails, institutions and hospitals by offering people a different way to live.
By doing that, we do that from the peer to peer model when we we have a question with somebody, we say I have been there and that breaks through further than a lot of medical techniques that were4501 used before. Now, I'm4502 not bringing that down, but I do realize that the culture that we represent is largely based upon the community that happens in everyday lives. The Hispanic community, the African American community, the Asian community as well as the religious community, because some religious communities do not believe in former medical help from addiction and recovery, we break that culture by doing that. Also, by creating a licensure, we create a board of registrations that will also oversee if people are not carrying ethical rights or if they cross boundaries, how can we revoke licenses and certifications.
By this all around, we can help that across the board of Massachusetts, we can help regulate that thing, we can help regulate that nobody's crossing boundaries. Also4544 we can oversee that the trainings are available across the board. At one point, recertification training was not available and now it is and with this board and with the licensure, we will help cover the things that are needed so we can help bring down this addiction across Massachusetts, but we can better help our people. Me myself as a person, I'm in recovery myself, if it wasn't of the work of the grassroots work of the people working at the bottom, I wouldn't be here in this moment talking to any of you all.
I am proof that this works and there are many people out there that don't have the chance of being heard. So as the recovery coach commission went across Massachusetts,4585 we may so that their voices were heard. We ask that this bill gets passed so4590 we can better help our community and our family members because addiction is a family disease. So when we help one, we help all. Thank you for the time. SHOW NON-ESSENTIAL DIALOGUE
Nicholas, thank you for your time and you know as frustrating as this virtual world is sometimes one of the upsides is that you didn't have to drive two hours to come and share this testimony with legislators which you may have done anyway, but I know that my co chair senator Comerford whose had to just step off ramon. It should have been very sad to have missed your testimony, but she certainly knows that you're on and thank you for the work that you do. Um I will now move to um kim crop, I'm sorry kim Krulewitz4630 uh always get it and
KIMBERLY KRAWCZYK - CONCERNED CITIZEN - Thank you, madam Chair for listening to us and members. I am a woman in long term recovery. My name is Kimberly Krawczyk and I suffered from active addiction for more than 30 years along with being harbored4648 in institutions and systems for most of my life. Since my journey and recovery started seven years ago, I've been blessed to help many people find solutions and hope. As a recovery coach and4658 recovery coach supervisor for more,4660 mass organization for addiction recovery, I've been able to help many folks out of situations where they felt hopeless and helpless. As a recovery coach with4670 a non clinical approach, I've seen many miracles happen to our clients whom we call recoveries.
These miracles happen because of the powerful connection of4679 one human to another with similar lived experiences. Recovery coaching is a unique model that allows a coach to share their lived experience along with assisting people in early recovery to overcome barriers that often trapped people in the deadly cycle of acute treatment and relapse. I believe that the mandatory licensure could help recovery coaching to become recognized as a legitimate valuable service. However, I urge caution. Recovery coaches are meant to be well trained peer supporters, not highly educated clinicians. We do not want to put undue burdens on coaches or enact requirements that could exclude people who could become great4723 coaches.
For instance, we do not want to put a college degree requirement on coaches but support folks that wish to further their education. Lastly, more facilitated a recovery coach Commission strategy committee, we reviewed all meetings, listening sessions and related services, we still need to review and plan for making license and enhance the growth of recovery coaches. The committee spent hours reviewing the licensing bill and proposed as much debate we came up with the following press4755 for that are now in the current bill, a 12 member like Marianne said a 12 member board, six of them, it should be in recovery who are employed4765 as a recovery coach, recovery coach supervisor, educator representing demographic diversity from region workplace gender identification,4770 culture, race.
A family member of someone with substance use disorder, a person with lived experience from substance use disorder who has received recovery coaching services. We also ask that good moral character, a recent history qualifications be in that bill as well as lived experience, licensed recovery coaches must demonstrate at least two years of sustained recovery and the life experience requirements may be waived for family members or other4804 allies who have been credentialed by the Massachusetts board of substance abuse counselling certification before the establishment of the board. We also are asking that folks get grandfathered in or or test exempt period, those who have already, because that's a certified addition recovery coach park certification shall be considered as already meeting the application requirements. I really thank you for the time in hearing this really important bill and4833 work. SHOW NON-ESSENTIAL DIALOGUE
Thank you kim. Um I have a few more people who I don't see, but I'm going to call their names Audrey, Claremont,
Katie O leary
Caitlin Gillespie,
Dennis Doris
Alex Fidalgo.
Doris cox
Rebecca is wicker. So what I will just say that that is who signed up for this bill. Um, the good news is I got to share this bill and I was in a previous committee that heard this bill, so I'm not sure how it got sent over to public health. But here we are again, I try to stay a little bit more neutral and when hearing bills before my committee, but since I've heard this one before and I have acted on this one before, I will just say that um, to those of you in recovery and working in the harm reduction community. I just have to say it has been one of4892 the greatest, unexpected inspirations of my political career has been to work with many of you and to be in support inspired and grateful for the work that all of you do. So, um, I'm going to step outside of that role is neutral Chair and just take this opportunity to just to say thank you. Okay, this is twice today I've been emotional. So I think it's get off the screen. Well, thank you Nicolas. Okay, now we're going to center come back and go back into calling on some4917 new bills we have before us. Thank you for your work. Thank you. Um, at this time we're going to do House 23 84 Senate 14 56 and act to define clinical social work and I'm going to call on first Alison Scobee carol followed by Rebecca Gurwitz. Alison,
ALLISON SCOBIE CARROLL - BOSTON CHILDREN'S HOSPITAL - HB 2384 - SB 1456 - Good afternoon. Thank you for the opportunity to speak with you today. My name is Alison Scobie Carroll and I am the senior director of social work and family services at boston Children's Hospital. I'm a board member for the NSW Massachusetts chapter and former president. Thank you for the opportunity to speak with you, I thought it was going to be this morning but this afternoon in support of an act to define clinical social work practice. In my view, this bill is essential to ensure that qualified social work practitioners are able to sit for their LSCSW exams and ultimately, to achieve the highest level of licensure, commensurate with their training and preparation.
As you know, the need for clinical social workers is only growing in the commonwealth. With the impacts of the pandemic, the mental health crisis, ongoing and widening socio economic disparities that impact so many. Here at Boston Children's, we have social work staff occupying critical roles in a wide variety of acute inpatient and ambulatory settings. They are providing care to patients and families as they confront the most frightening and devastating moments of their lives. Addressing issues of community and family violence, chronic and catastrophic illness, death, dying, bereavement, food insecurity and homelessness and I think you would likely agree that responding to all of these above, these clinical scenarios require the advanced clinical training and skill of a master's prepared clinician.
Yet, in the last year, our own licensing board unilaterally and erroneously determined that all of these functions among many others performed by critical agencies serving vulnerable populations all over the state were somehow not truly clinical social5063 work. As you know, while we're experiencing5066 multiple profound social conditions that are worsened by COVID-19 including these disparities and the alarming behavioral health crisis. So, additionally we're experiencing a workforce shortage which is becoming really quite dire and the vacancies that are presenting at the hospital are really placing quite a strain on this acute medical setting. So suffice it to say, there could not have been a worse time for our licensing board to arbitrarily determined that all clinical social work practice that falls outside of a narrowly and improperly defined psychiatrically oriented intervention is somehow not clinical5104 and to deny the applications of social work practitioners who fulfil their training supervisory practice and character requirements to sit for their LICSW exams.
But this is what they did, causing unnecessary hardship and delays, fear and uncertainty among LCSWs and those in the midst of their social work training. Without the LICSW, social workers are unable to practice independently to advance to positions of leadership in their careers, to build insurance for their services, to supervise other social workers and5134 all of the above. So I just want to say thank you so much for the time and I really ask for your your support of this act to define clinical social work practice. SHOW NON-ESSENTIAL DIALOGUE
Thank you thank you and I'm sorry that you, you thought it was earlier. I just want to remind people so right, this is some of the challenges that if we were in person which we will be in person someday. This is not an inevitable pause that we are at um we will be back together in person and it would be the same thing except you would not be able to be in your office to work or you might not be able to come. So just reminding people that um there's a lot of challenges to this virtual life but there will be something that we think we miss about it and we'll have to figure a way how to keep the best of both as we move forward. So thank you for your testimony. Thank you for your work And with that I want to invite um somebody who's no stranger to um to me or this work is Rebecca Gurwitz.
Well,
REBEKAH GEWIRTZ - NATIONAL ASSOCIATION OF SOCIAL WORKERS - Thank you so much, Chair Decker, Chair Comerford and thank you Alison for your testimony as always. So this bill an act to find clinical social work practice was filed by senator Lesser whose mother is a social worker and representative O'Day who you heard from earlier who is a longtime DCF social worker. We got involved in this from the National Association of Social workers because in 2019, we heard from many social workers across the state, particularly those in hospital settings as Alison described in a DCF that were being denied the opportunity to sit for the LICSW exam by the state's social work licensing board. You may think to yourself, wow, this sounds like kind of a dry topic, you know like it's about licensure, why does it matter that much? It matters a lot.
We need to have masters level social workers working in DCF and working in hospital settings and working in our schools, working in settings that aren't traditionally what you would think of as a private practice office. And that was what the licensing board was saying was that only people who are doing this strictly defined clinical work, were actually doing clinical social work. When we learned about this we hopped into action with our colleagues and friends at SEIU 509 and others to persuade the licensing board to not do this basically, their regulations stated that they should be recognizing the clinical work of social workers in these settings and allowing them to earn those hours and then be able to sit for the LICSW exam.
The consequences of not doing this, the consequences of saying that people who are in these5294 settings are not doing clinical5296 work, these masters level trained social workers is that people who are masters level trained social workers will no5302 longer want to work in these settings. We did see people who are leaving certain settings because they felt they were going to be able to advance in their career, they weren't going to be able to get the LICSW. So I guess the main thing I want to convey to you is that the pandemic has also exacerbated our mental health crisis and the behavioral health workforce shortage. Social workers are the US largest group of mental health providers and society cannot afford to have masters level licensed social workers arbitrarily denied the opportunity to advance in their careers and meet the growing demand for their services.
So this bill was crafted after 18 months of working with social workers in a wide variety of settings together at the NSW office back when we could be in person in the NSW office to think together what should the definition of clinical social worker bee in statute? So that never again could aboard say are defined for the profession, what it meant to be a clinical social worker. So we came to5361 the definition that you see laid out in this bill, it's comprehensive accurate and it creates a situation where will never again be in a position where a board says this is what it means to be a clinical social worker, it would be inspected. Thank you so much for your attention to this matter.
I want to thank you, especially Rep Decker, Senator Comerford for all of your advocacy over so many years together with us and with the social work profession on such a wide variety of issues that matter deeply to the profession. So we hope this bill can be moved as expeditiously as possible. SHOW NON-ESSENTIAL DIALOGUE
Uh, thank you Rebecca and the good news is I don't think either one of us think that licensing issues are addressed. So we are very engaged and interested and we appreciate all of the work that you do. Thank you for your testimony for being with us today. Thank you. Um, at5412 this time I'm going to welcome a panel. Um, so your panel, but there's only two of you. So reminder, the panels were really six minutes because it was for people who were coming on with 34 or five um, to be together. So you have six minutes as a panel were not timing you as a panel. So just to be clear that if one speaks longer than the three minutes, as long as that was worked out then great. Um, I'm going to welcome you john Lewis and Carole Bonner. Thank you for joining us.
YVONNE RUIZ SALEM STATE UNIVERSITY SCHOOL OF SOCIAL WORK - Thank you for the honor of being here today and testifying on behalf of this bill. I'm going to take a moment to introduce myself. I'm Dr. Yvonne Ruiz. I've been a professor of social work for over 20 years. I work at Salem State University School of Social Work. I also hold a licensed independent clinical social worker license and have supervised students as well as provide direct services. So I am here to attest that graduate social work education is rigorously based on clinical processes. These clinical processes include engagement on a deep level with5478 clients and client systems, assessment of the presenting problems that clients present with, on intervention methods and also evaluation.
Courses I teach on practice and theory and also on diversity and equity based practices require a great deal of study, a great deal of application of theories and interventions and students are well grounded in clinical social5505 work processes. So in short, students are trained both in the classroom and in their two required internships in the field to provide services based on a thorough and meaningful assessment of the clients presenting problem and challenges in living, students are trying to determine specific attainable and measurable goals and objectives and to implement interventions that lead to positive outcomes on behalf of clients.
So, in order to achieve these professional clinical responsibilities, students acquire and maintain knowledge of current psychological and developmental theories, they are trained in evidence informed practice and evaluation methods for both practice and program evaluation and not to mention research methods, policy diversity and equity approaches as well. So all of this is the foundation of the knowledge and skills that our students use in ongoing information gathering and decision making processes that help their clients5621 and they collaborate with their clients to identify the clients goals, strengths and challenges. So planning, implementing, monitoring and also amending individualized services that promote clients strengths, advanced client well being and help clients achieve their goals in living is what social work students at the graduate level are going to do. In some, licensure is the goal, students come to social programs at the graduate level with the goal of obtaining licenses. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Mr is that that was six minutes and it's really normally three minutes per individual and you were part of a panel. Um so um at this time I would just ask that if Miss Bonner has um testimony, she can submit it as well.
Um I would ask at this time Mark Giannino
is Mark Giannino with us.
Okay, our next panel, I want to be really clear so that we can get the voices of both panelists and especially since I know one of them personally and it could listen to her speak all day. Um we have Roxanne Meskel and Mary rule just to be sure because you're signed up as a panel, you're given six minutes, but if you had signed up it's individuals, it's three minutes. Um but5715 because there's only two of you equals up to what it be. So just be sure that as you speak, um you have worked out with each other what the time it is, if you're going to take more than three minutes, but I want to welcome Roxanne5727 Maskell, who I have had5728 the privilege of listening to many hours um and has helped inform me on how to be a a better legislator around many issues. So welcome.
Thank you so much. Can you hear me? I can hear you and I can see you all right. I'm going to make the short and sweet. So5745 my colleague mary has sufficient time.
ROXANN MASCOLL - SOCIAL WORKER - So I want to give you a perspective into my life and a career that I absolutely love. I'm a black social worker. I graduated from Simmons in 2015 and I spent 18 years at DCF and I just want to remember that in 2014, when I went to lead day at the state house, the former Governor Patrick said, Social Workers, you do God's work. So I carry on with that with that sentiment. I was denied in 2018 to be eligible with my clinical hours set because I worked at DCF and I was told that I would not be eligible to take an LI test. It was simply because I was at DCF. At DCF, I worked as a domestic violence specialist, has a social worker and as a representative of the commissioner's office and the ombudsman's office. In every single5794 role, I worked as a social worker, a clinical social worker, helping families navigate the mysteries of this system and at the worst time of their lives. So the impact of my personal life is what I want you to understand about this denial. I was denied to increase my earning power. I was kept in a low paying job which impacted my financial life. I was riddled with student debt. I ended up working seven days a week with5826 three jobs to survive and the worst part of all of this was being rendered powerless during a pandemic when my community needed me to be able to provide services to them and a system where we were, we all knew about the health disparities for black and brown communities, it's not unknown and that powerlessness has really affected my own mental health and so I hope that you understand what the impact has been for this one, Black social worker. Thank you so much. SHOW NON-ESSENTIAL DIALOGUE
mary, you're next, yep. So
MARY RUHL -SOCIAL WORKER - My name is Mary Ruhl and I'm a social worker at Ethos Elder services in Boston. For the past six years, I've been working with older adults as a social worker. When I graduated with my master of social work, my goal was to work as a clinical social worker and then take the LICSW exam. My first job was working as a geriatric case manager for Jewish family and Children's services in Waltham. In that position, I had a caseload of older adults, most of whom were struggling with mental health issues, housing and homelessness and food insecurity. On a daily basis, I was using my clinical social work skills to do psychosocial assessments and design interventions to help my clients. I was very surprised when in 2018 after I had completed enough work and supervision hours that5923 I had a difficult time getting approved to take the LICSW exam. My boss at Jewish family and Children's services, had written a recommendation about my work which was5935 rejected three times because what she wrote did not have enough clinical language.
After several attempts to write my job tasks in a different way, the board finally accepted the recommendation and I was approved to sit for the test. Also during that time, several of my class mates from social work school, were having a difficult time applying to take the test. My experience illustrates that the job tasks of a clinical social worker were too narrowly5963 defined by the licensing board. When I decided to become a social worker, I was attracted to the profession because of the flexibility in which social workers can apply their clinical skills to help people. The state needs a clear definition of what clinical social work practice entails so future master level social workers can sit for their LICSW exam and move forward with their careers. Please support and act to define clinical social work practice. Thank you. SHOW NON-ESSENTIAL DIALOGUE
thank you both for your testimony and thank you both for your work. Um At this time I have one more speaker on this bill and shaven culture who I do not6002 see as logged on. I'm6004 going to ask though in case Sullivan are you there?
Okay so we're going to move on to house 24 oh two. This is an act to ensure timely physician license. Singer and I have a panel of someone else who is very familiar to me and many members of this committee. David Mariano It's great to see you um And Rachel legend. I'm going to welcome you both. Um and you will together have six minutes.
DAVID MATTEODO - MASS ASSOCIATION OF BEHAVIORAL HEALTH SYSTEMS - HB 2402 - SB 210 - Thank you, madam Chair and members of the committee. I'll be very short because I want to have my colleague Rachel, the CEO of Barber fuller hospital in Attenborough do most of our talking. My name is David Matteodo and I'm the executive director of the Mass Association of behavioral Health Systems which consists of 47 inpatient mental health and substance use facilities throughout Massachusetts and we really appreciate this opportunity to testify. Congratulations, madam Chair on your award the other night, I was watching it virtually, I was kind of still a little nervous about the whole Covid thing so I didn't go but6058 I watched it, you gave a great speech, well deserved by the way. So we're supporting House 2402 and S 210 an act to ensure timely physician licensure.
I'll just summarize the bill and then Rachel can give you a little feel for what we're up against. We have severe staffing shortages in behavioral health as the committee well knows. Very, very significant to the point of having almost 700 beds empty on a given day while we also have over 600 people boarding an emergency room. So this is really very significant. What this bill would do is specifically two things, it would say, that a physician licensed in another state could get, should get approved by the board of registration in medicine within 90 days. Currently, we can wait months and months and months and we lose physicians. We had one an incident where a position6129 took the job and then didn't hear anything for eight months6150 and couldn't keep subsidizing their mortgage and everything, so6167 they ended up refusing it, this happens frequently.
The other piece the bill would do is act within 90 days for physician licensure renewals. These this issue has been a real problem for us getting psychiatrists to begin with to work in our hospitals as the committee knows is a problem. We're trying to recruit them from other states and it just doesn't seem to work. So I really appreciate Rachel joining, she's got her hands full as you can imagine, she's actually running two hospitals now. So really appreciate her joining for a couple minutes, and, of course, we're available at any time that the committees needs us. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Rachel. You want to give them a couple examples? Uh yes,
RACHEL LEGEND - ARBOUR FULLER HOSPITAL - Thank you, Representative Decker, nice to see you again, so thank you for being the advocate that you are. This problem is vast and well known nationally, which I don't think is what Massachusetts wants to be known for. So6225 we currently are in a behavioral health crisis that includes the opioid epidemic primarily to treat these patients in our community. We have to have psychiatrist. It is well known that Massachusetts in6238 the top two states most difficult to get licensed and us in Texas.6242 Knowing that to be true, I could give you 20 examples, but I'll give you kind of the two most egregious. I had a psychiatrist who came from another state, he had a blight on his record for being disrespectful6255 to a nurse one6257 time in his residency of which he was sanctioned for by his school.
As a result of that, it took 14 months and 10,000 and legal fees for us at the end of the day never to answer him and never to issue a license. While most certainly I would not condone being disrespectful to anyone, I don't think that not issuing a license also raises to that level. Secondly, I can tell you because we don't have enough providers and can't get them licensed in the state that we're forced to go to local providers to be able to provide us physicians. In doing so, I probably have contracts for 16 local companies throughout the United States. Every single one of them will say to me flat out, you have to know that it's going to take us eight months to one year to get licensed.
If there is an international doc, you can absolutely exacerbate that and multiply it times two. So we're in a crisis, don't have enough beds, but primarily as it starts now, I have tried everyone and their mother to figure out how do we hold Boerum accountable to any standard for our patients, for our state, for facilities for us and there's without them being accountable to anyone in the state, there's no ability and no way to move them in any way that allows us the very lowest barometer of a provider to treat our patients in this crisis. So I'm grateful to you again and thank you for listening to the testimony. SHOW NON-ESSENTIAL DIALOGUE
I want to thank both of you for your work6339 every day and your advocacy, David. I want to say that itunes still, you know, very cautious around Covid and I double masked and I did not take it off to eat or drink. Um and I think it's important that we continue to share publicly, how we all each6356 mitigate how to navigate this world.6358 That still this this pandemic is not over. Um And so but just to share that with you and say thank you.6364 Um And you know we also we worked together on also making it possible that we're going to now have more transparency about who is in how many people are on E. G. Rooms on a weekly basis. And so I feel really proud of that work. And um and what I'm hoping is that it makes it very clear that there are so many people who need help. And if we had more resources, more uh credential people providers and programmes they wouldn't be sitting in an E. D. Room waiting for the help that they would never have to6395 sit through if they had a broken leg. Um So I certainly appreciate the work that you both are doing and um here you and understand the issue very clearly. Great thank you. And we submitted written as well. Thanks very much, Madam. Chair members of the committee. Thank you. Thank you both. Thank you. Yeah. Okay. Um at this time I'm going to ask we only have a few more people here who are signed up. Um We're going to move to Senate 14 9 49. An act regulating surgical assistance. And I'm going to ask Greg, Greg. Salmon and David, Jeanette your individually signed up. So I'll ask you in that order. Greg I believe I see you on.
There you go. Welcome. Actually, I'm going to let David Go 1st. That's okay. Sure. All right, thank you. Greg. Uh
DAVID JEANETTE - NATIONAL SURGICAL ASSISTANT ASSOCIATION - Madam Chair, Comerford and Decker and members of the commonwealth of Massachusetts Joint Committee on Public Health, thank you for the opportunity to testify today. My name is David Jeanette6450 and I'm the chief administrative officer for the National Surgical Assistant Association. We are an organization with over 1600 nationally certified surgical assistant members. I'm an 1987 graduate of Eastern Virginia Medical School surgical assistant program and I've been practicing surgical assistant in Virginia and the Metro DC area for the past 34 years. I'm a licensed as a surgical assistant in both those jurisdictions. Even though some of you on this committee may have a background in health care, I feel it's important to briefly describe the evolution of the surgical assistant profession because I've seen firsthand, it's incredible transformation over the past several decades.
The surgical assistant is typically the individuals standing across the operating room table from the surgeon participating and actively assisting in completing the surgical operation safely, expeditiously and providing exposure, maintaining homeostasis and performing other invasive technical functions. The American College of surgeons, also known as ACS supports the concept that ideally the surgical assistant at the operating table should be a qualified surgeon or resident. If such residents6521 are not available, other physicians who are experienced in surgical assisting should participate. ACS recognizes that it may be necessary6529 to utilize non physicians as surgical assistance. As such, they recommend that these non physician surgical assistance meet national credentialing standards and be regulated by the appropriate state and local authorities.
The ACS guidance helps highlight the need to establish minimum training and education requirements for individuals entering the surgical assistant profession. Throughout my tenure in the health care arena, I can tell you that all the role of the surgical assistant has not changed over the years. The level of experience associated with individuals practicing the profession which of course can have a detrimental impact on patient care and can lead to adverse outcomes. The need for regulation ultimately comes down to enhancing patient safety, which is fundamental goal of ACS as well as our organizations, the NSA and helps guide the creation of their principles and overall philosophies.
The number of states that have begun to recognize and6618 regulate surgical assistance has also increased significantly over the past two decades. This has been expedited in the commonwealth of Massachusetts due to the recent passing of the Boerum regulation that Senator Keenan so eloquently explained earlier prohibiting physicians from delegating significant surgical tasks to individuals who are not licensed in the commonwealth. Please note that SB 1449 does not leave healthcare6644 professionals behind, it exempts physician assistants and registered nurses from this license requirement. It also addresses a loss of employment for a large number of Massachusetts. SHOW NON-ESSENTIAL DIALOGUE
Certain percentage of the staffing shortages.
Thank you. Thank you for your testimony. You are welcome to submit further testimony in writing. Um, at this time, Greg, I would ask you to come forward
Greg. You're6672 muted.
Always happened. Sorry about that. Um,
GREGORY SALMAN - NATIONAL SURGICAL ASSISTANT ASSOCIATION - SB 1449 - Chairwoman Comerford, Decker and members of the Joint Committee of the Public Health, my name is Gregory Salman, I'm the executive director of the Association of Surgical Assistants. We represent over 1600 actual members and well over 4500 other practicing surgical assistants within the country. The reason we're here today is because of the regulations passed by Boerum back in August of 2019. As of December 2019, many of our members in the state of Massachusetts have been either displaced, demoted or had to look for employment elsewhere because of this regulation. Sometimes the regulations are good and they take care of the issue at hand, but they have outlined ramifications that aren't really considered at the time and I think that's what happened here.
Surgical assistants are an integral part of the surgical procedures. The need for surgical assistants always become more apparent during the recent pandemic and staffing issues at the hospitals. In the state of Massachusetts up until recent regulatory changes by boring the surgical assistant profession was growing rapidly. With these changes in the regulations, hospitals have been forced to fortunately for them, I guess with the pandemic, you know, the surgical procedure account was down, but now it's coming back up, the surgical assistants are in much more need, especially in the rural outlying areas in the state of Massachusetts. As I said before, the profession was thriving in your rural hospitals before the regulation and Quincy College was actually preparing to establish a6785 program in order to meet the growing demand there, but they had to scrap that because they couldn't work there anymore. We've recently had more discussions with Quincy College and they've been very productive, but it all is dependent on the outcome of this bill.
The surgical assistant profession provides hospitals and surgical centers with highly trained and qualified personnel which provides patient safety and well being in your communities. Passage of this legislation would establish what was once a growing occupation only hindered by a regulation into a thriving occupation established within the state of Massachusetts. In conclusion, support of SB 1449 will not only benefit those professionals that were inadvertently affected by the changing regulation but will allow occupational growth and provide more opportunities for those in Massachusetts in the future. Thank you for your time and consideration of this legislation, will be happy to answer any questions the committee might have and I will submit written testimony as well. SHOW NON-ESSENTIAL DIALOGUE
Great, thank you very much for your time and your testimony at this time. I would ask Christine Madeira to please come forward blood. Can you hear me? We can hear you All right.
CHRISTINE MADEIRA - SURGICAL ASSISTANT - I'd like to first thank senator Keenan and this committee for giving our profession of surgical assistants the opportunity to be heard. My name is Christine Madeira. And as the saying goes, find a6884 job you love and you will never work a day in your life. I found that out as an occupation as a surgical assistants. after practicing as a certified surgical technologist for 20 years, I pursued an advanced certification for surgical assistant certified. In addition to the Bachelor of Science physiology, I have an associates of Science and surgical technology which led to my CSC, which is required permittal her enroll in the program for SSB. My advanced certification for surgical assistant certified required to complete a program which entailed over 40 credits of online college6913 level classes intensive on skills Lab and an extensive clinical of 135 cases which took hundreds of hours of my own time to complete.
2018, I accepted my dream job that I worked so hard for at St. Anne's Hospital in Fall River Massachusetts. Then one day, I was abruptly informed that my position was no longer viable with little explanation in December of 2019. I was essentially demoted to the specific role of CST at St. Anne's. This flow and future loss of revenue compelled me to find work closer to home. I live in Warwick Rhode Island and was commuting 50 miles a day and my certification as CST has been in jeopardy since my particular certification requires, I participate as a surgical assistant in 400 cases every two years, as part of maintaining my CST certification in addition to other continuing education benchmarks that I must meet.
I realized decisions that were made that led up to this event were necessary, but those decisions were made without regard to the potential effects, not only to the surgical assistant role, but the patients themselves. We are highly trained in a specific area6975 to help the surgeons provide the best possible outcome for our patients. We went to school specifically to learn how to properly assist in surgery, not learn those skills on jobs, as some other professions do. As surgical assistants, we do much more than hold retractors, fixtures, surgical incisions and of course makes the surgeons look good. We developed an extremely close rapport with our surgeons, they trust us to be their extra pair of eyes, to anticipate, there needs to prepare to avert any potential setbacks7000 at quickly in an emergency and meet the needs of the patient and the procedure, ensuring all equipment is available for the procedures, positioning the patient for surgery and supporting the operating room team with any other additional needs they may have.
All these points lead to a better patient outcome. I hope this board will consider the ramifications of past decisions and seriously consider reinstating our ability to practice and make fair living wages that we financially invested in with additional education. I believe reinstating the role of a surgical assistant in licensure of our occupation is the best way forward for our profession. The sooner this is achieved the better for our patients and for the sake of a surgical patient. I hope this can be expedited. Thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time and your testimony. Um at this time I would call on francine Moser to come forward. Welcome.
Hello. Uh
FRANCINE MOZER - PATIENT ADVOCATE - SB 1449 - Good afternoon, Representative Decker, Comerford, Howard and committee members. Thank you7077 for allowing me to speak today on behalf of Bill S 1449. Christine fully explains a lot of the details to you, so I'm just going to add to her testimony7090 that we are also patient advocates. SHOW NON-ESSENTIAL DIALOGUE
We are
mismos. I'm not sure what happened but all of a sudden got muted.
Yes, I'm okay. Can you hear me? No, I'm sorry? Yeah, there's some kind of connectivity issue. I'm sorry.
No, we can't hear you.
You can hear me at all now. I can hear you
hear me Okay, thank you. Um
MOZER - The restrictions placed upon the role of the certified surgical technologist has reduced the amount of patient care is experienced surgical staff is available but not utilized and I realized that these7138 regulations are very important and vital to define the scope of practice. During this time, I still continue to make efforts to continue my education. As soon as it was allowed with the Covid restrictions reduced, I obtained educational conference versus business meetings. I have enrolled myself in a bachelor's degree program at UMass Dartmouth pursuing a GBA and majoring in Spanish. I have not given up on my career goal to be a surgical assistant and I hope that in the future, we'll get new information so that we may apply to be licensed practitioners in the state of Massachusetts. I am a patient advocate and I'm going to do the best I can to meet all professional requirements to continue my career as a surgical assistant state of Mass. Thank you for your time and I appreciate the opportunity to speak on behalf of bill 1449. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time and for your testimony as well. Um at this time I have someone who I think had tried to sign up um but didn't make it onto my list, but I do see that you're on. So I have um Wendy a Rodrigues who I believe wanted to speak on and act relative to recovery coach license and you're so windy if you're on here. Um, please do come forward.
Hello. Hi, we can hear you. Hi,
WINDIA RODRIGUEZ - RECOVERY COACH - Thank you for allowing me to speak today. I would like to share some testimony on the recovery coach, an act to license recovery coaching and I am a certified recovery coach. I'm a woman in long term recovery and I worked for a major hospital here in boston. I'm currently a program manager for that hospital and I just have some concerns around this bill, I understand the impact that it can make and the positive impact that it can make, but I have concerns around the board, around having people who are on the board that are not in recovery and you know, this is the only board of licensure that the people are not made up of only recovery coaches. So that to me speaks to the concern about people's belief in recovery coaches and the professionalism.
A lot of people have said that this will legitimize our profession, but I also think it could also do some harm. We have had a lot of strides, you can't see me on camera because my camera doesn't work on this computer, but we have really had some trouble recruiting people of color and I just7296 think that we really need to, I'm a woman of color as well and I think we really need to make sure that this life is the7305 same, doesn't, you know, hold people back who may not speak the language, who may be deaf and hard of hearing and you know, there's just a lot of concerns that I have of this bill before we move forward. I think there needs to be more ironing out and more people, there are a lot of coaches that I know who did not know about this testimony today.
So there are a lot of people out there who had no clue that this was happening today, their voices haven't been heard and their concerns haven't been heard. So again, I think that we really need to look at this; I'm going to send you an email, Ms. Decker, that I I'm kind of on the fence about this bill, you know, as a coach as appear and as somebody who is in recovery. So I would just hope that this committee before moving forward would hear the concerns that people are bringing forward and actually we need to have a larger meeting about this licensing because people are not hearing about this. Thank you. SHOW NON-ESSENTIAL DIALOGUE
thank you for your time and for your testimony. And I will look forward to your email as well. I'm glad we were able to get you on today.
7378 Okay,7378 that is uh this is this is the conclusion of this hearing today. I'm looking at this list and actually um I'm just seeing someone else pop up here. Ellen. Have you spoken already? Uh No Ellen. So I think you've come on just a little I think you've just come on um Ellen I may not get your name correct. So Rims Z. Sorry Ellen are you there?
Hi I7406 can't hear you but I just noticed you were able to get on so perfect time. How bout now? Can you hear me now? We can hear you? Yeah. Oh great today thank you for letting me join.
So I missed a little bit of what's been going on but I have just wrote down a few things that I'd like to share as a testimony. Great. You have three minutes please go right ahead. Okay great.
ELLEN CARTER - SURGICAL ASSISTANT - I'd like to start today by just letting you7439 know, I was actually in some procedures when we had some surveyors from the DPH come in. There was a little lack of knowledge to what exactly our role was in the operating room, so I'd just like to let you know a little bit about what we do and why we are so important to the patient that comes for surgery. You know pre operatively intra operatively and post operatively. You know, preoperatively, as a first assist, we have advance knowledge of the surgical procedure. I ensure that all of the equipment and supplies that are necessary for every surgery are readily and available. You know, sure there's always preference cards that we try to go by, but not every detail can always be on that card. So, you know, I worked closely with each surgeon regularly, I know what specific likes and dislikes each surgeon has, which brings efficiency, you know, to the operation.
I'm able to anticipate and definitely helps with great patient outcomes. Intra operatively, there's also things that I'm able to do, like place a retractor, I'm able to tie assert suitor if the surgeon's hands are held up, I can cut tissue and he separates tissue planes with an instrument and these are just a few7509 examples of things that as a surgical technologist, I can do. Post operatively, I help the patient because I care about what that incision site looks like. I know that it's the one thing that a7523 patient season remembers is the incision and addressing and I have specialist training with plastic surgeons, ear nose and throat, doctors who specialize in plastic surgery7532 and so many other specialty surgeons that I've been able to take everything that I've learned from each one of them and it gives me a skill level that, you know, helps give this patients really good patient outcomes.7545
I always think about this like you know, who do you call when you need an important job done? You call a specialist and we're specialists were highly skilled and were well educated in the operating room to assist these surgeons. You know, PAs that we also work alongside. They are very well educated but they receive little to no training in school as to how to perform in the operating room as an assistant and an7569 RN, they're also well educated in patient care but they receive minimal training in the operating room. Every professional that we work with side by side every day, they're licensed, a PA is licensed, an RN is licensed, respiratory therapists are licensed, ultrasound technicians also licensed, radiology technicians also licensed, we also need to become licensed. Thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your time. I'm so glad you got in your the last speaker. Um So I'm glad we were able to hear your testimony. Um Thank you. Thank you have a good day you at this time this week. I will call on this hearing to a conclusion. But I want to welcome my co chair Senator Comerford. If there's anything that she would like to say. As we close out, thank you madam chair and to our committee members and members and everybody who testified. I'm very grateful for the7646 information we heard and all that we learned during today's hearing. And thanks madam. Chair for leading. Um And thanks to everybody for coming forward with really important testimony, Ellen. I love that you closed without. Um So that was terrific. Thank you so much. Thank you Senator Comerford. I share your thoughts. I actually sat here throughout this hearing and I keep thinking about what an incredible privilege it is to chair this committee. To hear from so many different people across the commonwealth about issues that they are advocating for that will help strengthen all of our community. So with that I'm going to move that we adjourn. I thank L. I. S. As usual, I want to7684 thank our committee staff who also want to thank kate, tain and Kathleen. I know that you have incredible staff that's been working. I think brian's been on on deck all day today. So just thanking all of our staff for their work and meeting is adjourned.
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