2021-11-15 00:00:00 - Joint Committee on Public Health
2021-11-15 00:00:00 - Joint Committee on Public Health
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Yeah
all right she Ramos it's great to go live. SHOW NON-ESSENTIAL DIALOGUE
Perfect good morning everyone warm welcome to you. The joint committee on public health will come to order. Welcome to this remote public hearing of the committee. My name is joe Comerford I am the state senator for the Hampshire Franklin Worcester district. I'm honored to be the senate co chair of this committee with me today is House Chair, my esteemed House chair Representative marjorie Decker from the city of Cambridge. I'd like to take a moment to welcome my Senate committee members. Vice chair Senator Susan Moran and senators Harriette Chandler becquerel Julian Sear and Patrick O'Connor I'd like to invite the House Vice56 chair, Representative Murray you really are quite something always at these hearings to welcome house colleagues, SHOW NON-ESSENTIAL DIALOGUE
madam Chair. Thank you very much and I'd like to thank my House chair for allowing me the opportunity to recognize and introduce my72 colleagues on the house side of the public health committee. There is of course House chair uh marjorie Decker Representative paul Schmidt Representative Jack Patrick Lewis Representative Andrew Vargas Representative john Santiago Representative brian Ashe Representative Kay khan representative Vanna Howard ranking minority member97 Representative Hannah Kane and Representative Sean Dooley madam chair thank you mr Vice chair thank you.
[SEN COMERFORD:] Um Okay friends who have gathered, we're going to hear testimony on 30 bills pertaining to several topics uh in front of the committee including116 emergency medical services disposition of remains119 for those who are deceased and various other concerns This is our 14th bill hearing and it will be our last hearing for the year. Unless we get new bills in front of the committee Following today's hearing, we will have heard every single one of the 382 bills referred to this committee.
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Um and again, we will of course here late filed bills as necessary before we proceed. I would like to remind folks to to really mute your teams up during the hearing. If you're not148 speaking, it just helps everyone and for our colleagues, the vice chair and I would like to remind us all that156 will happily recognize committee colleagues for questions after each speaker or each panel in the case of testimony by panel, we'd asked that members hold all questions until the entire panel has concluded the testimony. And I'll certainly look as as the chair facilitating today. I'll certainly look for raised hands but in the event that I miss someone, please feel free to a180 mute and jump in181 uh, so that we can make sure to hear from you for those in attendance today other than committee members, please do remember that this committee asks that you limit your testimony to no more than three minutes. You're going to hear some sort of gentle beep or chime, sometimes not so gentle. Um, and we apologize for that, but that is our attempt to hold everyone to the same standards. Um, if you are corporate flying is that might have been it, that might have been the strange, strange noise that you'll hear. Um If you're testifying as part of a panel, please remember that this committee asks That panel testimony is limited to no more than six minutes and it's up to you to decide how you would like to divide that. So it's three people two minutes apiece, et cetera. I'd like to thank so much. L I s who have been intrepid throughout covid233 allowing us to have these public hearings in a virtual setting. Of course our staff, both mine and chair deckers and of course public health fellows and interns who are all chipping in to make sure that we run well today and listen to the testimony before us on these really important bills. If there is addition written written testimony that254 you'd like the committee to consider, we'd love it. Please submitted by email. The instructions are on the hearing notice on the legislature dot gov. Website for264 the Public Health Committee under the hearing tab. Um It is the committee's um pleasure to take our colleagues out of order. It is custom in this committee and276 that's because our colleagues are coming and going to other hearings on other bills they've filed. So this is a professional courtesy. We extend to our colleagues. I'm going to do my best to give folks notice ahead of time. Uh so that you have time to prepare both our colleagues and then uh those from the public following your testimony. If you would leave the team site, you can absolutely follow the hearing on livestream on Emma legislature dot gov. Getting folks to leave the team site helps reduce the load on teams, helps make the hearing technically run a bit easier. So again, um it is my pleasure to start with members of the legislature today. Um and so I have legislators before us in this order. Um Representative Dooley followed by senator lovely followed by Representative Philips followed by Senator Moore followed by Representative Denise Garlick Um so I am now looking for Representative Dooley on your bill.
[REP DOOLEY:] [HB2274] Uh Good morning madam chair, can you hear me? I can Representative Wonderful. I I apologize, I'm driving to another meeting so I apologize for not being on camera. Um I'll be, I'll be very brief, I'm here to speak on 2274 act uh359 to put forth trauma kits in public buildings. Um This is a joint effort that I've done with the um american Academy of surgeons as well as boston Children's Hospital. This is their priority legislation for for this term are one of the pieces of priority legislation and I believe they will both be testifying separately later on in the morning. Um what this bill does is simply like we did with AIDS, You know, 15, 20 years ago, this puts trauma kits which are you know and stop the bleeding kitchens as they're more commonly known uh in public buildings. So if someone has a life threatening bleed whether it's from an accident, a slip and fall or406 something more horrific, um, like a violent act, a shooter or someone stabbing or things along those lines.
It has the resources there to be able to put on a tourniquet and save their life. Um, you know, we're very, very fortunate in boston. When you look at the situation like at the boston bombing because of the training and the facilities that were there, um, none433 of the people that were uh, injured from the blast that would have been uh, in normal search of circumstances, would it would have442 passed away. Um, they were all saved due to intervention by um, uh, good Samaritans by standards. Um, public safety personnel who knew how to put on uh, put on tourniquets by having these in public buildings are relatively inexpensive. I actually provided all of my public schools with them. Um, it's roughly about $50 per per, per trauma kit and the training is relatively minimal.
Um, It can be done. I've done training with boston City House, uh, Children's hospital to most of my schools. Um, and it's only about an hour and a half long training. What we're able to do is prevent any sort of preventable. This, you know, lead out, uh, that would, would normally take place if we're waiting 567 minutes for an ambulance and going forward. What this also does is by having this incorporated, a lot of schools have begun to incorporate this in their health initiative in their health training within their classes. Is it teaches people in the population how to deal with this if there is a trauma on the road in a car accident at a restaurant wherever. Um So it's just good public policy. It's a relatively inexpensive measure. Um and I hope the committee is able to put this forward this year. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much Representative. Um I appreciate your testimony and your leadership on this issue. Questions for rep Dooley
Okay, I'm seeing none and mindful of your time. Will be back to back with you as you go. Thank you. Thank you so much. Safe travels. Um Friends, Disney, someone is unused and uh fellas can help me amuse them. That would be helpful or staff that would be helpful.
This is okay, we're going to move on now to senator, lovely
senator, lovely, are you with us?
Okay? I don't see the senator at present. We'll catch her if she comes in.581 I'm looking now for Representative Philips
[REP PHILLIPS:] [HB2386] [SB1489] Good morning madam. Chair Welcome. Thank you so much, madam. Chair Chair Decker and593 members of the committee. It is a privilege to be back in front of you596 this morning to talk about my bill, House 2386 and its companion Bills Senate 1489. An act relative to improving the outcomes for sudden cardiac arrest in the commonwealth. Um This bill simply is designed to increase607 the chances. uh that bystander CpR or CpR that is administered by non emergency medical personnel. It started before they get on scene. Currently most people in the commonwealth now dial 911 from their cell phones that activates a phone tree where the call can get past from location to location until it gets to the proper local fire or emergency medical dispatch. That time is crucial in making sure that CpR get started. And so not everyone in that phone tree is required to be trained up on state of the art CpR. And so this bill rectifies that by requiring by requiring said training. We think it's very solid bill that I filed with my friends at the American Heart Association when you will hear from later. Um and I respectfully ask for a favorable report and very much appreciate your consideration. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. Representative Philips Um And this issue has been brought to the committee and you have made us smarter about it and we're grateful for your leadership and that of course of the advocates questions for the representatives. Mhm. Okay, seeing none. Um We'll move on now to Senator Moore on the same topic.
[SEN MOORE:] [SB1491] [SB1489] Good morning madam. Chairman. Good morning. I hope you have a nice weekend and also chairman Decker and members of the committee. Today I speak in favour of two bills that aim to reduce inefficiencies in the commonwealth's emergency medical system by701 streamlining how we deliver key to massachusetts residents. In these scenarios, we can drastically improve medical outcomes for patients. Both bills are endorsed by experts in the medical field and have proven to save lives and other communities. The First Bill was Senate 1491. An act relative to stroke protocols. 34, of Massachusetts residents over 35 have reported having a stroke, and these incidents are among leading causes of disability and even death. In massachusetts, strokes are a sudden interruption of blood to the brain and require immediate treatment. The length of time between a stroke in proper treatment is directly correlated with the severity of744 the medical outcomes for patients. Currently, all massachusetts residents when experiencing a stroke brought to the closest hospital.
While this was the best practice in the past, medical technology has developed new procedures for certain types of strokes that can759 make significant differences in treatment of certain strokes, emergent, emergent, large vessel occlusion or elbow strokes represent a large majority of strike. Excuse me, strokes that occur every day. Certain hospitals are able to perform a treatment that uses a catheter to remove the blood clot blocking the vessel, a life saving and life reclaiming procedure. However, our system of care does not allow emergency medical technicians to bring a stroke patient directly to these hospitals. Instead, many patients have to pass through the closer hospital before transferred to the hospital, capable capable of the necessary treatment. This805 bill would require E. M. S. Council to establish points of entry tests and allow re routing to qualified hospitals in the case of an elbow stroke.
This procedure has already been adopted with staggering success in Rhode island in other states, it is time to upgrade our own system of care. The second bill I would like to testify on today is Senate 1489. An act relative to improving outcomes for sudden cardiac arrest. Again, this bill deals with getting the best possible treatment to our residents in a time of need. Unfortunately, only one of 10 individuals is likely to survive a sudden cardiac arrest outside of a hospital. However, quick access to emergency services into CPR are the to uh the first two factors and improve CPR, the first two factors and how to improve these outcomes. While 911 is frequently called quickly. The lack of CPR in the those intervening moments or minutes can mean life or death for the patient in question. This bill would capitalize on the expertise of our 911 operators to help identify when cardiac arrest is occurring and lead a bystander through CPR on the patient, instituting telephone CpR training for our operators is a cost efficient and effective approach to saving lives.
T CPR Is associated with a 51% greater likelihood of survival, largely by doubling the number of patients903 who receive early CPR. The training requires only a few questions to the caller. As keeping the protocol simple is essential during emergency situations every day that goes by without instituting protocols creates greater risk for our residents, greater strainer, greater strain on our medical system, in greater stress on the families and loved ones who must deal with with these consequences. I ask for your support for both Senate 1489 and Senate 1491 so that they may be favorably reported out of this committee and continue their way through the legislative process. And again, um I'm the bill for any questions. Uh and again, thank you to our chairs and the committee for taking us out of order.
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Thank you so much.946 Senator for your leadership on both of these bills. Um I know that your testimony over my first two terms in the Senate has made me smarter on both of these issues and I'm very grateful. Thank you.959 Thank you very much questions from uh my colleagues.
Okay, I see none. Um and so after Senator Moore will be Representative Garlick and then I'm delighted to also add Representative Jack Patrick, Lewis and Natalie Higgins who are testimony testifying as a group and then followed by Representative um Carmine Gentile So I'm so delighted that you three are here as well, but I'm going to go986 first to Representative Denise Garlick Welcome madam chair, You were warmly welcome.
[REP GARLICK:] [HB2300] Thank you good morning to the committee. Um on I would like to testify on H 2300 and act relative to emergency medical services oversight. The committee has worked long and hard this second in understanding the problems that were illuminated and exacerbated by Covid. This is a major example. The emergency medical services oversight is a fractured system in our commonwealth. This bill does not call for funding but calls for and establishment of a council to better coordinate the information we have about emergency medical services and certainly to talk about accountability. We know that um what we need most as we move into a more safe and healthy commonwealth in the future is coordinated systems um, and particularly to deal with the emergency medical services, some of which are handled by private industry, some of which is handled by local municipal government. Um it is the kind of work the committee has given incredible attention to in this session and I believe this is one more building block we need for the commonwealth. We are submitting written testimony and as always I am available to work with committee leaders and members.
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Thank you so much. And last session again you dug in on this issue even during Covid and we were pleased to report this out favorably. I do think it's a necessary piece of work and thank you for leading. Thank you Chan questions from the committee.
Okay, seeing none. We'll move on. Good morning representatives. Higgins and Lewis You're welcome.
[REP LEWIS:] [HB4036] Good morning. Thank you so much. Chair Comerford and chair Decker for taking us out of turn. Uh as Benjamin franklin is famous for writing in this world. Nothing can be said to be certain except death and taxes based on current federal tax policy. The tax piece isn't entirely true if you're super rich, but the death part that applies to all of us. It's an honor to have filed H 4036 act relative to environmentally friendly burial alternatives with rep Natalie Higgins This legislation would expand the number of burial options in the commonwealth to include two additional more cost effective environmentally friendly choices. The first option, Alkaline Hydraulic Sys, which is currently legal in 20 states uses water and an Alkali solution and 1/10 of the energy of traditional cremation.
The second option natural organic reduction which is currently legal in Washington state Oregon and colorado gently reduces human remains to soil. Think of instead of scattering a loved ones ashes, your instead given soil and from a public health perspective this option allows families and individuals to ensure1177 that their final resting place is one that benefits their environments. These burial options may not be everyone's cup of tea. They might not be a personal choice that anyone of us may explore. But if this bill were to be passed, it would expand consumer choices to include more cost effective greener options,
Natalie,
[REP HIGGINS:] thank you rep Lewis Shell Comerford Chair Decker I am thrilled to be working on age 40 36 with rep Jack patrick Lewis and as rep louis give some of the background and what this law would do. I just want to stress that this brings all good things to massachusetts residents1221 and gives them and their families better choices, more choices. Um, in end of life after death care. And and as Jack mentioned, it actually does Bring both environmental benefits. When a family chooses natural organic reduction, it saves one metric tonne of carbon dioxide from entering the environment uh equivalent to 40 backyard propane tanks or 113 gallons of gasoline. And on top of this, It is more affordable for our families making the environmental choice doesn't come with an additional cost on an average alkaline hydraulics is costs around $3,000 per burial. And natural organic reduction averages around 50 500 um per burial rep Lewis and I have had the opportunity actually to go out to Seattle and see the recon proposed facility with Katrina spade. Um and it only makes sense that massachusetts be the fourth state to adopt natural organic reduction. Senator Comerford. The idea actually was sparked in your district Katrina spade was the student U mass. Uh Amherst and while she was in graduate school she came up with the idea for natural organic reduction and and Seattle was lucky enough to have her executed but we should be bringing this practice back to1294 massachusetts. Uh and we look forward to working with you and your staff1298 answering any questions and we know many advocates have sent in written testimony. We're hoping some were able to join this hearing later today.
[COMERFORD:] Thank you, thank you so much. And I remember rep Lewis saying that you two were flying out to Seattle and I was quite frankly so impressed with your hardy due diligence. This is customary for both of you on all of your bills, but I thank you for bringing this idea to the commonwealth um questions from the committee. SHOW NON-ESSENTIAL DIALOGUE
Okay, seeing none, I'm sure we'll hear from other folks testifying. I believe they are on the list represented. Higgins and and we'll certainly be back in touch with you as the committee considers this.
Thank you both. Um Representative Gentile you're welcome.
[REP GENTILE:] [SB1389] [HB4214] Thank you Chair Comerford Chair, Decker and members of the committee thank you for the opportunity to speak today and for taking me out of turn. I'm here to testify in support of House 4214 and1364 Senate 1389 which had been filed by Senator Creem and heard previously an act to improve food allergy awareness. This legislation seeks to build on existing law by requiring restaurants designate an individual with knowledge about food allergies to coordinate service for customers who identify as having specific food allergies. I'm proud that massachusetts was one of the first states to adopt protections for individuals with allergies by requiring that restaurants display of food allergy awareness, poster, including a notice on menus that customers should inform their server of an allergy and have on staff of food protection manager who has been certified by the Department of Public Health.
These rules have successfully changed the culture around allergy awareness and made restaurants much safer for people with allergies. Unfortunately, the existing laws have been insufficient in a1419 number of cases to protect residents of the commonwealth from dangerous allergen exposure. I filed this bill in consultation with constituent who nearly lost her son trip at a restaurant after he was served a pastry that staff had explicitly said did not contain peanut. This legislation builds on the existing rules to help protect people like trip who can follow all the existing rules but still get hurt or die because their server did not have someone with expertise and allergies to help coordinate service. Those with serious allergies can sometimes feel as if they live in a parallel world from the rest of society. This is a world in which restaurant visits are anxiety inducing rather than a joy where individuals call restaurants ahead of time, comb the menu for the dishes that seemed safest and often must labor1470 to ensure their servant makes their allergy takes their allergy seriously.
This exhausting level of work means that people with serious allergies often only dine at one or two restaurants where they have built up trust I believe that House 4 to 14 and Senate 1389 would not only prevent potentially fatal accidents, but in the process help individuals with allergies trust their experience eating out will be enjoyable and safe crucially, this policy would impose no additional cost to restaurants during1502 the pandemic. The additional requirement is free and relatively easy for the industry to implement. One and 13 Children is diagnosed with food allergies now, meaning that when families feel safe, safe for eating out, the restaurant industry will benefit from their business. Thank you again for the opportunity to speak out of turn today and for considering my request that the committee report this legislation favorably happy to answer any questions. Thank you.
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Thank you so much. Representative. I remember the senators testimony at an earlier hearing as you said. And that of many people as you also said, who are affected by this a critical issue. So I really appreciate you calling us all to attend uh and make ourselves smarter and help protect our constituents.1551 Thank you. Um questions from the committee.
Okay, seeing none, I thank you for coming in and for your leadership.
[COMERFORD:] [HB2253] [HB2386] [SB1439] [SB1477] All right, friends, we're transitioning now to public testimony. We're going to hear 16 individuals Fiona not 16 5 individual speakers on three bills. Um So the bills are H.1581 2253. An act to create a timely stroke system of care. H. 2386 and s.1589 1489 An act relative to improving outcomes for sudden cardiac arrest and then s. 1477 An act to prevent death and disability from stroke.
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Um So the the speakers in this block are dr Lester uh young um Alison Peron, drag, Jessica, diaz Christina, Hill Janet Rojansky, jerry ward um Dr Jr um and then john brick it. So I'm going to go back up and welcome dr leon. Mhm.
[LESTER LEUNG:] Thank you. Chair Comerford Chair, Decker and the rest of the Joint Committee on Public Health. My name is Lesser Lawn and I'm a stroke neurology specialist. I have leadership roles as the director of the comprehensive stroke center at Tufts Medical Center, the director of the stroke service at Metro West Medical Center in Framingham. And as co chair for the american stroke Association massachusetts systems of care work group as a physician. My core mission is to work tirelessly to help my patients have the best outcomes, especially when afflicted by disease. As impactful as stroke as such. I would submit that if the well being of people with stroke our parents, our friends, our Children, our communities is the highest priority. There's no constable reason to argue against building a1657 system that enhances the ability of people to get the right health care they need in the most desperate our as you know or have heard stroke as one of the most disabling and lethal diseases.
This is a disease that can affect anyone at any age at any time. Many people think of stroke as a fate worse than death. Nonetheless, emergency treatments for1674 stroke have advanced dramatically in the past several years. In essence. This is our space age. As recently as a few years ago, people with devastating strokes causing them to be mute and paralyzed would nine times out of 10 be destined to live in a nursing home forever dependent on 24 7 care. Now, more than half of those people literally walk out of the hospital with minimal or no long term disability from their strokes. This change is due to the arrival of an incredibly effective and proven surgical treatments1698 called thrown back to me, which is now the standard of care for people severe strokes. Also known as LBO strokes. This treatment can only be done at comprehensive stroke centers with highly trained surgeons and the right infrastructure. Currently this is one of the most if not the most effective treatment and all of medicine and surgery.
However, this disease is a race against time. Every minute that passes millions of brain cells are irreversibly destroyed. If a patient with an LBO stroke is brought to the nearest community hospital in massachusetts, there is usually delay in evaluating the patient and mobilizing transfer to a comprehensive stroke center. We have the data to show that massachusetts hospitals are underperforming and are far from the national benchmark. The delay makes the difference. I see this difference every day as a stroke specialist. The successes with direct transport of an LBO patient by an ambulance and the failures when there is delay of hours at a community hospital before patients identified as having a severe stroke and transferred. In some cases, the person having a severe stroke may never get transferred and never have1748 the opportunity to receive the right treatment at all. This proposal however, is not just1752 about the people of the most of your strokes and the specialist centres that can treat them.
The majority of people with strokes and brain injuries that are mild and can be treated with the best medical treatments at community hospitals. These patients can and should be cared for in their communities close to home. This proposal is about getting people to the right treatment at the right place at the right time. So on a personal note, I want my patients in Framingham who are having mild strokes strokes to stay in Framingham. I do not want the beds at Tufts to be filled up with patients who could have been treated just as well in their own communities. On a final note, I'd like to emphasise the importance of empowering M. S. Providers. I worked with them over the past six years. They're incredibly dedicated and capable healthcare professionals. They can be trusted with this new responsibility to choose the right side of care for patients. This piece is crucial because creating this new decision point in the care1794 of patients is the stimulus to bring M. S. Community hospitals and comprehensive stroke centers together to collaborate and share this mission of getting people to the right treatment at the right place at the right time. Thank you again for your time. I would be happy to answer any questions.
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Thank you dr so much for your expertise and your call to action questions.
Okay, seeing none and mindful of your appointment which we knew about. I will say thank you and we'll look forward to your written testimony. Um I'm looking now for Alison please. SHOW NON-ESSENTIAL DIALOGUE
Hi senator. I good time you.
[ALLYSON PERRON DRAG (AMERICAN HEART ASSOCIATION):] [HB2386] [SB1489] [HB2253] [SB1477] Thank you. Chair Comerford chair, Decker and committee members. My name is Alison, parent drag and I'm testifying on behalf of the american Heart american stroke association in support of House Bill 2386, Senate Bill 1489 House Bill 2253 and Senate bill 1477. Both that will live to improve our system of care for anyone suffering a cardiac arrest or1854 stroke. And both her time is the most critical factor. Sudden cardiac death can happen any place1860 at any time1861 if you suffer sudden cardiac arrest, your best chance of survival is receiving by standard CpR until the MTs arrived. But bystander CpR is not always available, dispatches and emergency call takers are the true first responders and a critical link in the chain of survival. Working with the nine Roman collar. Telecommunications have the first opportunity to identify a victim in cardiac arrest and provide initial care by delivering CpR instructions while quickly dispatching emergency medical services In mass. Are telecommunications are required to give hands only CPR. But the current system can take critical minutes for college to get that lifesaving step with 80% of cardiac arrest happening at home.
This could mean that would take 3-4 minutes for you to be able to give the instructions to save your loved one. Updating the protocols can make the difference between life and death. In addition to streamlining the 91 system, this bill would ensure that we have critical medical expertise in the 911 Commission that we make sudden cardiac arrest a reportable disease and sure that we have better1915 understanding of where are a DSR plays. Lastly, we know that when someone suffers a stroke, they would should be1921 central hospital that can share properly trained staff, equipment and neurological services are there to treat them quick and intensive care of stroke victims are the key to determine the quality of the rest of their life. This bill would establish a system of care to address the whole stroke continuum. Hospitals can choose to seek designation by nationally recognized organizations that provide center certification for stroke care. This bill does not mandate a hospital to select a specific designation, would only encourage them to participate.
Once a tiered system of care was put in place, the office of emergency services would establish based on what's best for the region protocols for a point of entry plan that would complain include plans for triage and transport of acute stroke patients, pre hospital care protocols and routing currently exists in our place for both trauma and heart attacks1967 and AMS would work to further determine how to triage patients to the appropriate hospital based on the type of stroke, It should be noted that at least 80% of strokes would be able to stay in their own community hospital. These bills would be able to create a system that provide the best and most efficient services available to patients, the biggest driver of outcomes for stroke or time to treatment. And unfortunately, the current system creates delays and right now because of covid those delays have only worsened. It is taking hours to transfer patients to the most appropriate level of care. We believe you can't wait to act. Thank you for your time and consideration and I'm happy to answer any questions.
[COMERFORD:] Thank you so much for your advocacy and expertise. Question for you. Uh So as you know, there are numbers of related bills, different ideas of of solving what you're talking about and what the other speakers are here to talk about right delays and um less effective service than our commonwealth residents need. Do you believe it would be useful for the committee to consider a package um of the proposals that are more coordinated. Would that be a useful index committee?
[DRAG:] I would say the six bills have a lot of similarities. Um and so the bills that we testified on our kind of three pieces right, creates a tiered system of care E. M. S. Protocols and then collects data. Um The set of representative Golden and senator Moore tackle kind of just that E. M. S. Peace and so that's a piece of that2055 bill. And then the bills by representative Lawn and Senator Crighton really look at how does the department regulate this? So I think we can take I'm hopeful that we you know as you know we've been working on this for a very long time, feels like my lifetime um and we could take those six bills and really come out with something um that I'm hopeful that everyone can be supportive of and move forward. Um I really feel like it is time um to really address this issue so I appreciate that. I am more than happy to work with the committee. I have already reached out to the staff about that so we can put something down and hopefully move this quickly.
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Thank you. Please do put something down. I'm sure chair Decker would be interested in that as well. Um so terrific. And one of our volunteers that is testifying Jessica. Diaz is just running a little bit late so she'll be on shortly so we can just skip over her and go to the next credit. Well we'll get Jessica when she is ready. Thank you so much. Okay thanks Alison. Um Okay next up please Christina Hill
Hello, how are you?
[KRISTINA HILL:] So I am testifying on behalf of the bill that Alison was just talking about because I was one of the patients that were directly affected. Um I am 26 years old but I had to stop her2133 from a stroke and I was actually 14 years old. Um I had the classic signs and symptoms of stroke but due to my age um I did not get as you like the proper systems of care just because why would they think someone at 14 years old is suffering from a stroke? Um So time was not necessarily on my side which um in the long term my disabilities that was directly affected with, with not being able to walk um my right hand because that's the side that it affected. Um I really don't have much more ability and to write that much anymore. So moral of the story is, sorry, when I have my stroke I did not, when I got to the hospital um they, because of my age, they did not give me the proper systems of care. And then when I went to Children's hospital because first I went to my local hospital um and Milton, they just they weren't giving me the practices and care.
Finally, my mom being a nurse advocated for me to push to go to the boston, which I went to Children's Hospital, I got the Children's hospital? They still stroke was2192 the last thing they came to mind. Finally, they said they ran some tests. They said mr and mrs Hill Your daughter suffered from a stroke at 14 years old. And we're, my mom's first reaction was like, why couldn't we diagnose this sooner?2205 She had uh, and I keep saying it because they were the classic signs and symptoms of stroke. And I was lucky enough that due to my age I was able to recover and I wouldn't say I've made a full recovery. But um, compared to where I was with having to relearn again how to walk, talk and do simple things like brush my hair. Um, I was lucky enough that the rehab that I had helped me really progress everything that was going on. But I do believe that my symptoms would have been not as my disabilities would not have been as bad if I was treated a right when I came into the hospital with those classic signs and symptoms. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much for sharing your story. Chair Decker says this all the time. I due to the personal stories are, you know, ways that the committee hears
different than facts, right? Different than empirical data. Are people's personal accounts, which are so very critical to help underscore the imperative. Thank you so much. Christina. I appreciate your testimony the committee appreciates it. Thank you so much. I'm very powerful And next up I have Janet Rojansky please
Janet are you with us?
[JANET WRONSKI:] I am perfect. Okay, thank you everyone. Um, I'm happy to be here in more ways than one. Um, I had suffered a2297 stroke on July 12 of 2011 at age 53. I had no symptoms. I worked out every day. I was totally healthy. I got up one morning and um I just didn't feel right. I yelled2310 and my son came in the room immediately called 911 because he called my husband also and just said mum doesn't look right and called 911. So the Ems services got here and one of the and said this woman is suffering a stroke. So they got me in the stretches, started to put me in the ambulance and he said to my son, we're taking her to Winchester Hospital. My son said no, please take her to lady, that's where her doctors are. So they took me to Leahy. I was totally coherent through the whole thing. I knew everything that was2340 going on. I was trying to talk. I knew what I was saying, but no one else knew what I was saying.
They got me to leahy and put me immediately in cat scan because they were ready for me when I got there. Had I gone to Winchester, I don't know what the outcome would have been. I would have said an emergency. They probably would have ended up transferring me to leahy after. I don't know how much time and by then it could have been too late. So when I was in um I got back after the cat scan, they administered the TP A. Which is a clot busting drug. I was one of the first people to have gotten that. They weren't really sure what was going to happen. They won my husband and son, you know this may not work. We're giving it our best. She's young. It'll probably work on her. So all of a sudden my husband noticed that the needle had fallen out of my arm that they were administering the TP A. With.
So now they decided they needed to do brain surgery to remove the clot, they left not knowing what I was going to be like the next day I ended up coming through. I called them the next day. I was totally fine and it was all because I got to the place where they were ready for me and like I said I think about it all the time. If I had gone to the wrong hospital, I don't know where I'd be right now. Um I I know the doctors were all for it. One of them was an internet. He just say in my age, I know she's healthy, let's do this. So I'm thankful that they decided to do that and I every day I think about what could have happened if my son didn't make that quick decision the way he did. I don't know if I would have been dancing with him at his wedding last weekend. Sorry, thank you everyone and I appreciate it. And I hope these bills pass and other people can be as fortunate as me.
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Thank you mrs Linsky2444 Thank you so much for this powerful testimony. I'm glad your son such a good decision as well. And I'm really glad you were able to be with him at his wedding. How beautiful. Um so thank God. Um, and thank you for your powerful call to action. Thank you.
Uh, tear jerker. Uh,
thank you. Uh now next up please Gerry ward,
Carey are you with us?
[JERI WARD:] [HB2253] [HB2307] I am good morning. All right, madam. Chair Comerford and chair Decker and also members2484 of the committee. Thank you so much for the opportunity to share my support for house bill 2253 also house bill 2307. And the other stroke legislation for the committee today On october 25th 2018. I nearly died at the age of 30 due to a massive stroke. As a social worker in crisis therapist. I was using my voice To support others who were not able to speak for themselves. Little did I know that just three weeks later after turning 30, I would completely lose ability to speak. Move, read2515 and write, assume became a person whose life depended upon others speaking and advocating for me on the day that I suffer my stroke. It was the fifth day in the road that I had a debilitating paddock with neck pain that forced me to leave my job to retire to my bedroom to seek relief.
I would be um It would this would be the night that my life changed forever. Later that2539 evening my husband and I were sitting on the couch and when all of a sudden I heard a lot of pop in the back of my head that's fizzled out like the sound of a firework. I was terrified. I tried to tell my husband but I found that it was physically not able to move or speak at all. After about 10 very long seconds I could finally gain control over my body again and I tended to speak. My words were not real words but they were incredibly jumbled up. I finally managed to say hospital at that time I was taken to the E. R. Where um I later found out was a level three hospital where a set waiting for a C. T. Scan. Almost 202577 minutes later I underweight A C. T. Scan. Where I was diagnosed with blood clots in my credit artery. Also my prefrontal cortex the doctors told my husband that I must be taken to a level one hospital. I would die from the damage due2591 to the brain loss and profusion.
An ambulance took me to the nearest level one hospital where I sent three. I sent three hours undergoing multiple. Come back to me that would take normally, take an hour but it was too late. The damage was too deep in my brain and not only can they not remove the cloth from my brain but I completely lost the ability to speak, move, read and write. I was completely trapped in some2619 of my own body, only able to move my eyes. My surgeon said that if I had been only one minute later, I would not be here today, losing everything After a month after turning 30 and living in the icu for over a month was absolutely devastating. The damage was severe, but I was not able to receive TP or get to the hospital or fast enough2643 luckily after spending a year in speech occupational and physical therapy, I work to regain a new life as a stroke survivor. I made it my mission through my platform stroke of luck to advocate for policies to improve stroke of care um for patients bringing me before your committee.
Today, as I mentioned, we have specialized treatment today that is not available at every hospital stroke patients have a low response rate to TP, which is a clot busting drug that was widely available at hospitals. Level one stroke hospitals can perform a minimally invasive catheter based procedure called a McKenna felt. Come back to me. Um supporting house Bill 22 53 today is what is most important to me because suffering the stroke um is2691 incredibly impactful and this life saving procedure can save lives and updating stroke procedure and protocols is now thankfully national trend that I believe massachusetts stroke patients deserve and their lives are worth it. So thank you for allowing me to testify and urged the committee to vote favourably on this legislation. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much for your powerful testimony and for using what happened to you after triumphing over it to help others. Thank you so much. Critical illustration falling for just
reminding yourselves if you're not speaking. Thank you. Um Thank you so much Miss Ward, I appreciate it. Um Next up um we have dr Jayaraman dr you were warmly welcome.
[MAHESH JAYARAMAN:] Thank you. I'd like to thank the committee for giving me this opportunity. I am an interventional neuro radiologist. So I'm one of the types of physicians who performs the throne back to me procedures that you've heard about. I'm also the current Vice President of the Society of neuro interventional Surgery and a resident of the commonwealth. Um We have an incredible opportunity for our stroke patients. We have a very very effective treatment that can reverse the2776 effects and the damage caused by the most serious types of stroke. We are fortunate that most of our citizens have multiple high level centers that can perform this procedure but we're crippled by a antiquated E. M. S. Triage protocols that prevent and delay patients getting to the right center in the right time. I'd like to encourage the committee to look favorably upon all of the bills. I know there was a previous comment that suggested that you know, we can work together. I think that's absolutely possible.
All of these bills have a common thread and that is the closest hospital may not be the most appropriate one. And getting patients to the right hospital can save2820 lives prevent disability. We also know that E. M. S. Professionals are trained to do this. They ready to do this. They want to be able to do this for their2830 patients locally in New England Rhode island, which is where I work was the first state to do this and we have been doing severity based triage in 2000 and 16. New Hampshire Vermont and maine have all also updated their protocols to severity based triage. So I think it's time for us in the commonwealth to get along and update our protocols And as a reminder every one minute that we can save can give a patient back a week of disability free life and every one minute that we can save, can save the health care system over $1,000. Happy to answer any questions I'd like to again thank the committee for the opportunity.
[COMERFORD:] Thank you so much doctor and thank you for referencing dr Young's2879 also his comment about E. M. S. Partners in this and their willingness and interest to be a partner in this work. Also thank you for referencing the conversation around some sort of combination of these best principles into a larger package. That's that's also quite important to hear your perspective on that questions for the committee from the committee.
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Okay seeing none. Thank you so much for your testimony and your expertise. I'm looking now for john brick it please
john are you with us? Oh yeah,
[JONATHAN2922 BRICKETT:] [HB2253] [HB2307] thank you very much. Chair Comerford and chair. Decker and the members of the committee uh for letting me take2931 this opportunity to testify this morning and I'm testifying in support of House bill 2 to 53 and to 307. Uh another stroke related legislation that may be before your committee. Um My name is Jonathan Brick it. I am 42 years in public service, public safety fire and E. M. S. And I am presently the director of one of the five regions region three which is the northeast corner of the state for emergency medical services under DPH and Williams Um The M. S. Is trained to recognize many2971 different issues that are faced with us every single day and being a street paramedic for a good many years.
Um thank our lucky stars that we had committees2980 like yours that supported different initiatives and legislation to allow us to recognize studies esti elevation in the my or a heart attack. The level three stroke facilities up to the LBO level one stroke facilities. All these things are very very important to E. M. S. Professionals day to day um severe strokes uh and an emergent large vessel inclusions, the highest rate of mortality and disability. And the fast E. D. Is a great tool to make sure that we are transporting people to the right facility in the shortest amount of time. And we've heard testimony from um real life people that have gone through this3033 and thank their lucky stars that they have made it through what they've made it through with at this point the current policy you've heard many times in the testimony already this morning is you take the stroke evolving patient that you recognize uh the M. S. Personnel to the closest facility that is stroke related.
That does have a cat scan. But that doesn't answer the question when you get into the large vessel inclusions. And this is what this these two bills will help generate some protocol and and treatment and issues that will help the ems professionals go to the right facility and bypass A Level three System. Um so I just need to to thank you if this is really a very good experience in the first time I testified in almost 42 years of being in this business. Uh and to see that the commitment from our senators and reps and and legislation groups out there and the doctors, real life patients have made a total great impact. So um I would be happy again to3111 answer any questions anybody might have and looking forward to seeing how these bills play out in the3117 committee.
[COMERFORD:] Mhm. Thank you so3121 much. It's actually your testimony was perfectly timed. Dr we referenced E. M. S. Personnel um and the central part of that equation. Um And3130 thank you for your celebration of these good proposals. They are indeed important proposals brought by our colleagues with expertise from advocates and folks most involved. So thank you so much. Um
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I'm going to move now to hear testimony on a single bill. Mr Sabadosa I see your hand up and I'm wondering if it was because there was maybe confusion there there were numbers of people who signed up to testify on three bill proposals and then others again it's all related today,
[COMERFORD:] Signed up to testify on H. 2386 and S. 1489. That's from rep Philips and Senator Moore and act relative to improving outcomes for sudden cardiac arrest.
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Um Your first on this list followed by and then I'll3180 read the names of the folks curt Anderson then a panel of Rebecca scott and abigail scott and I see you here, thank you. And then um Nadine Chandler I and then Theresa Falzarano. Um So back up to you joseph and thank you so much for being here.
Do you want me to speak chairman? I do. Yeah I do. You're warmly welcome to testify and remember just for everyone, um individuals are thank you so much. three minutes.
[JOSEPH SABATO:] Okay, thank you so much. The committee for this opportunity. I'm dr joseph Otto. I'm an emergency physician. I've got over 35 years of PMS. Medical directorship experience been five years, the last five years at University of massachusetts. And one of the things that discovered there as I offered to become the medical director for the 911 center is that our survival? Well for out of hospital cardiac arrest was three vs a national average of 10%. And so I've been working with Alison Perrin and I appreciate Senator Moore and representative Philips sponsoring legislation which together working together in passing this legislation in implementing this. We will save file 500 Massachusetts residents every year. That's where we stand because the national average is 10% and we just getting to the national average and we have opportunity to go even beyond that with things. But that's a place to start. And that starts with the tele communicators and making sure they are able to follow national standards. Which is what the this legislation will do.
The other thing is that our cardiac arrest related laws on defibrillators need some improvement from a standpoint that we need to have the state providing more guidance and leadership in that because the law is currently and not being followed and what has happened Thing is um public access defibrillators are not being registered with 911 and they're not being maintained? I've been contacted by defibrillator companies to tell me that several of the ones is that they have sold in the last few years are not being maintained, the batteries are dead, the pads are not active. And the third3338 thing that3339 will be very important for the few sure is to make sudden cardiac arrest a reportable disease statewide so that we will be able to collect consistent data track where we are, identify opportunities and also celebrate success. So passing this legislation will help us all save 500 lives moving into the future. And my hope is that we can even push it beyond that. And I'm happy to answer any questions. Thank you.
[COMERFORD:] Thank you much dr Subroto. Uh did you happen to send in your written remarks? Any information about the defibrillators that you mentioned?
[SABATO:] Yes. I I put that in my testimony that I submitted. Um They. Yes and I've witnessed this myself even in my own town when I3398 looked at the defibrillator in3400 uh there's3401 not signing engine the doorway. Um there's not adequate instruction on how to use it. These are all things that we can solve and we should be doing that. But because there's not unfortunately state leadership on how to do this and implement best practice. This is where we can step up and make a big difference with it.
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Very good, very good. Thank you so much for your critical leader uh and taking the time to make us smarter any questions from my colleagues.
Okay. Seeing none will be certain to look at your testimony dr um step uh, curt Anderson please.
[KURT ANDERSON:] [HB2386] [SB1489] Good morning madam. Chair. Can you hear me okay? Thank you. Uh my name is Carl Anderson and my family and I live in Beverly and I'm speaking today to ask you to consider supporting HB 2386 and Senate bill 1489. As members of this committee, you've heard a lot about the research and statistics related to survival rates of sudden cardiac arrest. So I thought I would use my time today to tell you a story about how did dispatcher assisted Cpr saved the life. On June 26 2019. Our youngest son Daniel went to a friend's house to play basketball. He was just 17 years old at3483 the time. During one of the pickup games, he collapsed in the court. Um, and his friends quickly recognize a serious medical emergency and dial 911. They also yelled for help and one of the friends, mothers ran outside and assess that Daniel was not breathing and had no pulse.
There are many factors that contributed to Daniel survival, but it all began with that 911 call by the time the mother ran out3509 and got by Daniel side. The dispatcher for atlantic ambulance, which is the ambulance company that services the city of peabody peabody was on the line and she was able to give precise instruction on how to effectively do cpr chest compressions along with being able to keep this amazing mother calm during an unbearably stressful situation. Another contributing factor to Daniel Survival was3532 as quick access to an 80 911. Records show that the PBD Fire department was able to arrive in under four minutes from the time of Daniel's collapse using their Brady aboard the engine, they were able to shock Daniel's heart back into rhythm.
Daniel required open heart surgery to repair a previously undetected congenital heart defect. But today he's a happy, healthy young, 19 year old man. So many memories have stuck with my family related to this incident. One of the things that has stuck out the most is that every single medical professional that has been part of Daniel's care team upon viewing his case has stated to us that cpr and defibrillation being able to being delivered in such a3574 quick manner is an absolute factor in saving his life. So today I hope you consider supporting these two pieces of legislation so that other people may have the same opportunity at a second chance as our son Daniel did. Thank you for your time. I appreciate it.
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Thank you so much for sharing Daniel's story and your family's story. Um, it is another uh incredibly moving example, um, regarding the necessity3601 of these Bills and stories matter to us. Thank you so much. I'm so glad for the outcome. I can only imagine what you feel. Thank you so much. Um, okay. Uh, we're going to move on now to a panel. Um, I see you Rebecca and Abigail scott.
You're warmly welcome.
[REBECCA SCOTT:] Thank you. I'm Rebecca and I'm happy and we just want to say good morning and thank you for having us speak as you've already heard More than 350,000 Americans every year, experience and out of hospital cardiac arrest in Massachusetts, fewer than 5% survive, which is well below the national average. Around 10%. Even fewer survived with intact cognitive functioning. I'm one of those survivors. Two years ago at age 45, my life changed forever. When my heart suddenly stopped. I recently had learned I was at risk for a regular heart because to family members have a gene mutation that causes arrhythmias and heart muscle defects. Although I had never knowingly suffered any symptoms. I was advised to complete a genetic screen to rule out having the same mutation. I was3682 surprised to learn that my genetic test was positive. I was advised to where a heart monitors to determine if my heart was beating irregularly. Before I even received the results of that heart monitor. My heart stopped. I was playing tennis with my then 13 year old daughter Abby 1 2nd. She was serving me a ball the next second I was collapsed on the court. It was that fast.
I never complained about feeling unwell. I just fell to the ground, luckily we were not alone. five Bystanders quickly sprang into action. Three took turns pushing hard and fast on the center of my chest. one deployed a nearby 80 Another3725 called 911 E. M. S. Fortunately arrived within minutes and continued with advanced life support and several more shocks. Six in total, after 15 minutes, they were able to restart my heart and transport me to the hospital. I spent the next four days in a medically induced coma to protect my brain and my organs. Nobody knew whether I would wake up and if I did, whether I would have normal brain functioning3753 when I came through. I had many broken ribs from CpR but luckily was otherwise stable. Although it has taken time for my brain and my body to heal, I am able to live a full life. The key point is that when cardiac arrest like mine is witnessed immediate and effective bystander cpr and early defibrillation can more than double the victims chance of survival.
In fact, it's the only way to restore a victim's heart rhythm so that they can survive Since the chance of survival decreases by 10% for every minute without CPR and defibrillation, waiting for emergency services to arrive is often fatal since my event. I've spent a lot of time digging into and learning about the rate of sudden cardiac arrest and survivorship. It's been disheartening to learn just how small the chances are to survive a cardiac arrest like mine. I was lucky when I experienced my cardiac arrest. Everything went just right. Most victims are not this lucky though, to improve the low survival rate in massachusetts, it's essential that we empower more bystanders to act like minded. My bystanders did not receive dispatcher assisted cpr instructions, but they've expressed how helpful it would have been to them. In the heat of the moment, Luckily there were five of them and they were able to reinforce with each other how to proceed. And they all had been recently trained. This is not always the case. Not all by Sanders are the skillful.
We are all victims is lucky. It can make all the difference to have a knowledgeable dispatch. Are urging an untrained bystander to attempt CpR or refreshing the steps for a bystander who is trained but still reluctant or flustered. Please support these bills to ensure that 911 dispatchers are trained and able to provide lifesaving intervention. Dispatcher assisted CPR can increase the chances by survival by 15% of a bystander stepping in and performing CPR. It can improve the quality of CPR provided by even trained by standards. You mean the coaching during this difficult and frantic time. It's a miracle that people can save a life with their own two hands. But sometimes people need to support on the other end of the line to remind them that they really can do it. And with that I'm going to introduce my daughter Abby who was present on the day of my arrest to speak about being a bystander.
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Thank you Rebecca and welcome abby.
[ABBY SCOTT:] Thank you. Good morning. Chair members. As you just heard my mother's heart stopped3913 suddenly without warning when she was playing tennis with me. I was only 13. It was incredibly scary and traumatizing. 1 2nd. My mother was standing on the other side of the net. We need to return my serve the next she was unconscious and on the ground. I didn't know what to do. I screamed, luckily I was not alone. There were several other people on the courts and they all do us. Five bystanders immediately helped. What happened next was a blur. But I know that my mother was unconscious for a long time before3949 the ambulance arrived and they were able to restart her art. It has been two years since that day, but it feels like yesterday. The fear and panic. I felt my mother collapsed is with me all the time to try and control my fears. I learned how to perform cpr This helps me feel more confident that I could help my mother in the future if she needs me and encourages me that I can save somebody else.
If I ever witnessed someone else's uh cardiac arrest. There are times though that I think back on that day and what what I would have done if we had been on the courts alone or at home with nobody else around. I know I would have called 911. But how would they have helped when I have been powerless? Just I'm just waiting to be at this story. It's okay. Take your time More than3997 911 operator. I've coached me on how to see my mother. If I had been alone with their mother, had survived and recovered as well as she did. If I had stood there just watching until emergency responders arrived, would have been too late. Mhm. Also, there are times when I think that would have been like if my mother had another cardiac arrest4017 in the future, if I am trained in CPR now, But would I be confident enough to do it alone? But I remember when I was trained to do one other thing, I think about my friends, but if one of their parents suffers a cardiac arrest, would they be prepared?
Most Children my age are not trained in CpR massachusetts is one of a handful of states that does not require CPR training as a high school graduation requirement. Last year, one of my classmates lost a parent cardiac arrest. He was not with his father when it happened, but what if he had been, what you have done what to do? If he had been the one to call 911? I'm so grateful that when my mom's heart stopped so many trained people were there to help. I know that most of the victims are not so lucky. I hope that in the future4066 everyone dispatchers can be trained to be, can be trained to provide cpr instructions to buy standards like me. So that by the end, Ayers can provide quick and effective cpr and defibrillation. I hope that if I ever need to call 911, can you give me a step by step instructions so I can be a lifesaver? We're waiting for an ambulance to arrive. Thank you SHOW NON-ESSENTIAL DIALOGUE
Abbi. How4089 amazingly brave of you To that testimony. Thank you so much. I have a 15 year old daughter. Um, so I I hear her in your testimony and Rebecca, thank you um for your own courage and for raising such a rock star um daughter. Um your4107 stories are both4108 exceedingly meaningful and very powerful for the committee to hear. Thank you. Appreciate you bro. Thank you. I don't see any questions but know that your testimony, like all the personal stories have hit4122 the committee where we should be hit, which is in our hearts and in our minds. Um, thank you very very much for taking the time.
All right. I'm going to ask for Nadine. Uh, it was next up on the list and I see you. SHOW NON-ESSENTIAL DIALOGUE
You're warmly welcome.
[CHANNAOUI:] [SB1489] Thank you so much and um I just, I've had lots of interactions with Rebecca and I just wanted to say, thank you so much for sharing your story, Rebecca um and abuse. So nice to see you as well. Um, so my, my testimony. Um okay. The walk I take across the hospital spans four different addresses and countless different silent experiences of individuals I pass. I am certain my posture exudes the responsibility and simultaneous heartbreak I am holding. I have my head up, my eyes ahead and a folder held tight to my chest. Inside the folder are documents for DNA banking and genetic testing. A 28 year old will soon pass from this life to another and his family waits in a hospital room for me to speak to them about possible strategies to uncover what might have led to the sudden cardiac arrest. This young man had no known heart disease, no apparent risk factors, no appearance of someone who could die of sudden cardiac event. He dropped down and blacked out in the presence of multiple people at a gathering to celebrate a presentation he had given earlier in the day.
By the time emergency personnel arrived on the scene, the damage from the cardiac arrest had rippled through his body and would shortly render brain recovery impossible in the medical documentation outlining the event. The words unclear if bystander CpR was performed, were replicated over and over again. This cardiac arrest event had multiple witnesses and had the responsiveness of emergency medical services and still the involvement of bystander CpR was unclear. I was left questioning what went wrong, How could the possibility exists that there was a lapse of time between this young man's claps and the arrival of emergency services. When no CpR was being performed as a cardiovascular genetic counselor, I regularly hold one time consultations with individuals who either survived a cardiac arrest event have been diagnosed with a seemingly hereditary heart muscle disease, predisposing them to cardiac arrest, or are the4277 family members to a cardiac arrest victim or survivor.
Together, we try to4282 piece together what tiny silent genetic factor might be coursing through their family lines. The genetic culprits, however, are invisible to the naked eye and delivering the news of a possible genetic risk to a person's heart Health often feels like writing a mystery novel with invisible ink. I might know the plot protagonists and the clues to look out for. But the reader often needs additional resources and tools to fully understand the information laid out for them. Even if there is pristine understanding of the information at hand, a cardiac arrest could still be looming with unbreakable force. We all harbor invisible mystery novels of our health trajectory. Most of us have no idea what kind of villains. Our hearts have to fight each day to keep us alive and well. The inevitable fact that we cannot see who is at risk of sudden cardiac arrest creates the need for policies that protect communities when a cardiac arrest presents.
There needs to be working accessible, automated external defibrillators that are accounted for registered and available for identification by 911 telecommunication Ayers There needs to be high quality CPR instruction delivered promptly to a 911 collar by a train, 911 tele communicator. There needs to be account of cardiac arrest as a reportable disease by the Department of Public Health so that research and data can accumulate and illuminate future actions to take for too long4367 massachusetts has fallen4368 short of proper cardiac arrest preparedness and persistent survival rates below the national average reflect this shortcoming For this. We ask you to please support h. and Senate Bill 1489 ensuring all dispatchers are trained and able to provide cpr hands on instruction. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much for your testimony. Um and noting the link with Rebecca and abby. That's very moving. Um thank you very very much. Questions from the committee.
Yeah. Okay, I see none Nguyen Thank you so much with this. I'm just going to interrupt the testimony on4406 this particular bill and warmly welcome Senator, lovely senator. I'm so glad you're able to be here.
[SEN LOVELY:] [SB1473] [HB2283] Thank you madam, Chair and to you and to chair Decker and the members of the committee. Thank you for taking me out of order. I will be brief. I offer my support of four Senate number 1473. An act governing the operation of ambulance services by not for profit hospital systems or services of4430 which I'm the lead Senate sponsor and House number 2283. An act governing not for profit hospital system or service service operating on ambulance service filed by Representative Finn Many municipalities rather than provide ambulance services directly contracts out there. 9-11 response to private ambulance providers, the cost to maintain ambulance equipment can be exorbitant, it can have a great financial impact on municipal budgets.
However, Municipalities still have the responsibility of paying 911 operators, even if they do not receive reimbursements for the ambulance services that are dispatched s 1473 and h 2283 would require not for profit hospital systems or services operating an ambulance service where awarded 9 11 contracts by a municipality to contribute contribute a minimum of 33% of the gross ambulance restates towards that municipalities fire based services. In addition, If the not for profit system is awarded a 9-11 contract by a municipality, the system will pay no less than 50% of the cost to operate the public safety answering point, also known as the dispatch call center. This would support the dispatching of 9-11 services in municipalities across the Commonwealth. Thank you for consideration and I ask for your positive consideration of these two bills. Happy to answer any questions. Thank you madam chair.
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Thank you so much. Senator for your expertise on this issue. I don't see any questions so mindful of your time and we'll certainly look at your testimony. Thank you so much for coming before the committee. Thank you again. Thank you. Thank you very very much.
Um Okay friends we're going to resume now on H. 2386 and S. 1489.
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Um And I'm looking for now Theresa Falzarano, please,
Theresa are you with us? Can you say hi thank you
[THERESA FALZARANO:] [HB2386] [SB1489] Thank you so much. I appreciate the opportunity here to share my story regarding these two very important bills. H. b. 2386 and Uh Senate Bill 1489. So it is my hope and sharing this story with you that it will help uh move these bills get passed and implemented. So as you can see um I have a picture here. So this is my brother. Uh So I don't know if you can see that but I wanted to show uh just a picture of him
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and he's your camera little. The committee would be able to see him. Sure. Mhm. No yup shifted shifted just a little4597 bit more if you want, yep. Okay.
Okay so so my brother, he had passed away about a year and a half ago um from sudden cardiac arrest. Um So I was working late one evening, got a call from my sister in law. She said your brother was on the treadmill, he was working out and he passed out and he's dead and that was at 9:30 p.m. She said there's nothing I could have done and she felt I could tell in her voice that she felt like she could have done more right. So she was she gave them she gave him cpr they also had to young two young sons4638 they're both five years old at the time and I think they in that moment of crisis they were they were trying to give him cpr Sue. Um And and um so I'll4651 never forget. So my she said you have to go to your mom's house and we lived in a few minutes away at that point you have to go down there and you have to be with her because there's going to be an officer that's going to be going to the house to let her know that um that that tom passed away.
So we went down and I'll never forget the screeching of her voice when she heard that her son had passed away and I put that in my testimony. She said no no no. She um it was really she couldn't believe it. She said no no no not my Tommy not my Tommy. How could this be. It just isn't right. And and as you can see he was a healthy man and there was no4702 sign that he was that he that he was unhealthy in. Anyway so my brother passed away in his home. Um, he was 47. Um, you know, and I just his wife, I spoke with her earlier today because I wanted to find out from her perspective, sort of how she felt that these bills could help. And in her words, and I'm sharing those with you. She said this these bills represent um an opportunity and a chance for bystanders.
And many of you have already mentioned this to do everything that they can do and give them the empowerment right to be able to jump in and jump to action, spring into action and be able to help in a time of crisis. And in4750 the end in the end, wonderful if they can save someone. But also, if not they have the peace of mind that they did everything they could, you know, in order to help somebody suffering from this tragic event. So anyway, I'm glad to share my story. Thank you so much. Thank you so much for sharing your story for sharing the picture and on behalf of4779 the committee. I'm so sorry for your loss. Thank you. Um, may your own activism help others as you say. Yeah, yeah. Thank you. Thank you so much.
[COMERFORD:] All right, friends, uh, we're going to close right now testimony on this bill. This is H 2386 and S 1489 that we've been hearing about and open testimony on S 1443 filed by Senator Hinds and act relative to volunteer ambulance service.
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And I'm looking now for David messier please. David, are you here?
I do not see David. Perhaps we'll catch him when he's available.
[COMERFORD:] So we're going to move now to another bill. This is H 2274 S 1523 filed by rep Dooley and Senator Pacheco an act relative to requiring trauma kits and public buildings.
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We heard4845 testimony at the beginning from rep Dooley I'm looking4848 for eric girl Nick and Daniel nad worthy please. SHOW NON-ESSENTIAL DIALOGUE
Eric are you here?
[ERIC GORALNICK:] [HB1523] [SB2274] Yes, chairman, would you like to go out? Thanks, you are warmly welcome. Thank you. Uh good morning chairs and thank you so much. My name is eric Orrall nick. I am an emergency medicine physician at Brigham and Women's Hospital, Mass. General Brigham. I am the chair of the section of disaster medicine for the American College of Emergency Physicians, which is the largest emergency medicine physician professional physician organization in the country. Um I also have been the previous chair of Mass Medical societies Committee on preparedness and served on several committees and the house of delegates. Uh In addition, I've also shared disaster committee at the Society of Academic Emergency Medicine, The leading cause of4905 death in the United States for those under 45 years of age is trauma and that trauma can be disabling uh, from the physical injury that results from car accidents, gun violence or falls In 2013.
The approximate cost of Trauma Care and Medical Bills and lost productivity was $670 billion dollars in the United States. Understanding that trauma care is a significant4933 burden on our society. There were approximately 247,790 us trauma deaths in 2014 And as many as 20% of those have been assessed as being preventable.4947 This aligns nicely with what we've learned the last 20 years in Iraq and Afghanistan. What we've learned is that through training and empowerment Of individuals that are not just medics, but every soldier, sailor, airman and marine that were deployed, uh, we're able to reduce death, reduce deaths on the battlefield by over 50%. And we've tried to bring these lessons learned to the civilian world and with that many of us began m pioneered a program called stop the bleed, which is focused on empowering the public to save lives by recognizing life threatening bleeding, applying pressure, packing a wound or putting material and wound and applying pressure or if it's an arm or leg applying a tourniquet it And we've seen and understand that these types of interventions4994 can reduce deaths by up to 67%.
So, uh,4998 this4998 legislation which have testified on previously on a number of occasions and our team has, um, we are highly supportive of empowering the public to save lives, by placing kids in public places, much akin to automated external external defibrillators as other other individuals have spoken about and you have other legislation and also similar to CPR. In fact, there5022 are several pieces of legislation today which are focused on empowering the public5026 to save lives, applying pressure by stopping the bleed, performing CPR activating and a D as many of the individuals have spoken today as a state where uh, we proud ourselves and pride ourselves in being the birthplace of democracy. All of these bills, not just the legislation that I'm speaking about now, uh, could particularly be powerful in democratizing healthcare and empowering the public by saving lives at the outset. Thank you so much for your time and happy to take any questions.
[COMERFORD:] Thank you so much dr girl nick appreciate so much you coming to make the committee smarter on this again, as you say, you've been weighing in um for some time on these issues, so very grateful to you. Um, and I appreciate the democratizing of health care. That's a concept I hadn't had in my head before, but it isn't, it's really very interesting training people In local communities to be smart about this. Training 911 operators um, to offer capacity support. So thank you so much. Um I'm looking now for Daniel network Daniel Nagorny please.
You can
[SHEILIA SILVER (MASS EMERGENCY NURSES ASSOCIATION):] [HB1523] [SB2274] Daniel is unable to be with us. This is Sheila Silvia from Maths emergency nurses association's speaking for Daniel.
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Sure. Sheila, are you able to testify for daniel? Yes, I am. Okay, very, very good. You're warmly welcome.
Thanks very much. The Mass Emergency Nurses Association wishes to be recorded in strong support for Senate Bill 1523 and House Bill 2274 as it is our opinion that this5139 legislation will have a positive impact on emergency and trauma care in the state. As a collaborating partner on the national stop the bleeding campaign. The Mass Vienna is focused as an interesting organization to promote the education and access to trauma kits and the training to use them when indicated trauma care is not the responsibility of a single group or specialty. Rather it is the collaboration from bystanders to tertiary care that leads to the best outcomes. The first step in the chain of survival is the steps taken in the moments after a traumatic event occurs in the same way that defibrillators have been placed in most public buildings and I listened to that powerful testimony earlier in the day.
The co location of trauma kits allows for the ready access to those trained and willing to take action to save lives. In the Hartford Consensus Report, which was published in 2015 by a collaborative group of surgeons, first responders and representatives from the military. It was noted that no one should die from control bleeding. So in order for that goal to be reached, we needed two things to happen. The stock to bleed program was the education developed by the American College of Surgeons and over 1.5 million individuals have been trade. The second thing we need is access to those resources and the emergency nurses association. Our goal is safe practice safe care and with that in mind and we strongly support the passage of this bill and we hope to see those trauma kits in public buildings around the state. Thank you very much for the opportunity to testify.
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Sheila thank you so much. I'm so glad you could come on and represent the nurses and thank you for your critical work. Um uh and all of your wisdom that you shared. Thank you so much and I should have turned my camera on but it's ok. It didn't work that well. So you don't think we heard you5253 loud and clear the picture is only a bonus. Um we heard your testimony. Thank you thank you so much. Um at this moment I'm going to go back up to the top of the hearing because Jessica Diaz I'm happy to say is here with us. Um Jessica you're warmly welcome to testify. Mhm Steps Hello, I think I'm5277 on mute. Uh
[JESSICA DIAZ:] [HB1523] [SB2274] thank you so so much. I'm sorry for being late. I was teaching this morning. Thank you to the committee for hearing my testimony on this bill. That is so so important to me. Um I live in Charlestown. I am a stroke survivor and a Mom Um I had a stroke nine years ago Um I'm a migraine sufferer. So initially I thought it was just a migraine until I stopped being able to move my left leg. I'm so fortunate that I lived so close to mass General Hospital, just a few miles and um got amazing treatment and diagnosis right away um when I was admitted it was thought possibly that I wouldn't be able to move my left leg. They hoped maybe in5324 five weeks I was given a blood thinner and thinner shot heparin and thankfully I woke up the next day and was able5334 to move my leg again. They considered my stroke a warning stroke. Um that could have been um possibly a sign that I5344 was going to have a massive stroke anytime in the future because5347 of the diagnosis I got, I was put on a blood thinner um and then a few months later I had a heart surgery to prevent any future strokes.
Um doing great today I had a full recovery nine years later um and I know it's because of the amazing care um5364 in quick diagnosis and treatment I received MGH and sadly having met so many stroke survivors um in the last nine years, I know that their5374 stories aren't always um have as happy ending his mind because they were misdiagnosed, they went to a hospital that was not able to diagnose and treat them quickly and um if you're not familiar, you know, timing is so critical with stroke, you only have a few hours to get certain drugs that can actually reverse the damage even if it's paralysis. Um Someone is experiencing during a stroke and that can mean the difference between a full recovery5402 and living a life with disability. Um So I just thank you for listening to my testimony and for considering just making sure that anyone presenting um with any symptoms of a stroke get to the right hospital to get the right treatment right away. Um So thank you so much and I'm just so happy that this bill is back up to hopefully help so many people um recover.
[COMERFORD:] Thank you so much for sharing your story you haven't heard. Um I say this because and I'm so happy you were able to get on. But this committee appreciates so much personal stories. I mean of course the folks coming with research and lived experience professionally are critical. Um What stories? Personal stories are really what helps us focus our attention because we feel them deeply with you. So thank you Jessica for taking the time. Thank you so much. I appreciate your time. Thank you very very much. Um Okay we're going to move down now and continue on with the hearing. Um Okay so we're opening now testimony on h. um which is an act governing not for profit hospital system or service operating in an ambulance service. Um This is combined. This testimony.
[COMERFORD:] This block of testimony is now combined also with H 2300 S 1434 enact relative to emergency medical services oversight. We heard chair Garlick on this earlier and s 1473 an act governing the operation of ambulance services and we heard senator lovely on this earlier.
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We have a panel, there are three folks um paul jacque craig hardy and Mark Sanders. Um just a reminder, we have six minutes panels. So you were warmly welcome to testify and please decide who goes first among you.
[PAUL JACQUES (PFFM):] [HB2300] [SB1434] [HB2283] [SB 1473] Good morning, Chair coming for chair. Decker Members of the committee and staff. Thank you for the record. My name is paul jakes, Legislative agent for the professional5537 firefighters in massachusetts joined by craig hardy, Legislative agent for the professional firefighters in massachusetts and Mark Sanders, boston firefighters local 718 legislative agent um in the interest of time we have submitted written testimony more detail than our verbal testimony today and I'll also be the only one testifying on these bills. Um5558 We would like to go on the record in support of House Bill 2300. Senate Bill 1434 House Bill 2283 Senate Bill 1473 as you heard earlier and mentioned that you've heard testimony from5572 Representative Garlick and senator lovely on these pieces of legislation but we would just like to add a little bit more information regarding House bill 2300 Senate bill 1434 enact relative to emergency medical services oversight,
This bill creates additional oversight to the Office of Emergency medical services under the Department of Public Health. It would streamline existing DPH Office of Emergency Medical Services governance to allow for needed forums and committee expertise to ensure timely consideration, advancement of PMS policies and procedures. Uh it would better support, would provide better support of an integration standard setting for all regional AMS councils to ensure all Ems personnel5614 regardless of location, are able to access the same level of responsiveness services and information. It would ensure needed due process and transparency at ohms with regards to licensure and investigation actions and would create a placeholder to begin critical5630 conversation of creating a permanent funding mechanism for the E. M. S. System as a whole in massachusetts.
Uh as far as House Bill 2283 and Senate Bill 1473, an act governing not for profit hospital system and service operating an ambulance service. This bill proposes requirements of non profit hospitals that operate and I have 911 ambulance services. Uh This bill requires nonprofit hospitals and health systems that are licensed under Chapter 1 11 of the general laws that has awarded a 9 11 911 contract by municipalities such as hospital or provider that would have to contribute 33% of the gross ambulance receipts toward the cost of such municipality, fire based service E. M. S for the purposes of enhancing such city and town public safety infrastructure and fire based services.
This bill also requires that if a nonprofit hospital or health system has the, that is licensed under chapter 11 of the mass. General laws is awarded a 911 contract by a municipality. Such hospital or provided shall pay no less than 50% of the gross ambulance receipts of the cost to operate the public safety answering point so called 191 in support of dispatching the 911 service for Miss Valley. You've heard similar testimony from the rapid senator. We have submitted more detailed written testimony and we ask that both of these pieces legislation be reported out favorably from your committee. Thank SHOW NON-ESSENTIAL DIALOGUE
you so much for your service and your testimony today and I'm very sorry I pronounce your last name incorrectly. It's deeply humbling. Um sometimes my pronunciation so I really appreciate you taking the time to make the committee smarter on these bills.5737 Um, and I appreciate my colleagues in the legislature's leadership on them. Um, and we look forward to your written testimony. Um questions from the committee.
Okay, I5751 see none at this time, but you can be sure we'll be back in touch. You need clarification. SHOW NON-ESSENTIAL DIALOGUE
Thank you very very much.
[COMERFORD:] Um Okay, friends at this moment. We're opening testimony now on the legislation we heard about earlier from Representative Higgins and Representative Lewis enact relative to environmentally friendly burial alternatives.
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We have five people signed up to speak. I'll read them in the order that I have them. Excuse me. Um, and and we'll take them one by one. There are no panels so I have Melanie, hamblin ken gag me, Caroline, maes ease, jasmine, Tanguay and Patricia muldoon Melanie. Are you available?
Okay. I don't see Melanie at this moment but we'll welcome Melanie if they have a chance to come on, Excuse me. I'm looking for, ken
I see, ken. Hi there, can you hear me? Yep perfectly thank you
[HB4036] And thank you for the opportunity to speak to this August body in support of age 4036 I was born and raised in lemon stir a city that5839 is inextricably linked with my family, My grandfather many years ago the land and in doing so he not only transformed the city's landscape, but he began a family business that eventually passed to my father the 2004 citizen of the year in Lemon Stir. He in turn passed the reins of the family business to my oldest brother. Each generation leaving an indelible mark on a town that we call home. My grandfather is buried in his5864 hometown with his wife and Children just says my father is buried in lemon stir someday to be joined by his wife and Children, a tradition that will continue for generations. Through my three older brothers and their families but unlike them, I have no partner. I have no Children and I have no church whose cemetery I wish to rest them. But what I do have is a love for lemon stir. That is no less than those who came before me. It is a town that I have given to throughout my life. From the public library to the volunteer run apple or richard to the hospital blood5895 bank.
Natural organic reduction is the last gift I wish to give of myself after my organs have been donated. I want what is left5903 to become a part of the town that my family has already poured it, sweat and tears into for over a century. I want to continue to help let mr grow to become more when I have nothing left to give. I want to not only go home, I want in a very real sense to be home. Natural organic reduction also ensures that I will die as I lived. I do what I can to minimize my impact on the environment from being a vegetarian to driving a hybrid. Similarly natural organic reduction saves one metric tonne of carbon dioxide from entering the atmosphere here compare to traditional burials or cremations. Just last week I met with my lawyer to finalize my will, since I have no descendants, I have directed my assets to be donated to charity. Natural organic production ensures that more of my estate will go to nonprofits and not to my own burial. I am proud to be represented by representative Natalie Higgins of lemon stir who has helped bring forward this bill and I thank you for considering this means for the citizens of our town and the citizens of our state to be at rest, be it with their families or with their hometowns. Thank you,
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thank you so much for your testimony and I share your esteem of rep Higgins for sure um, questions from the committee.
Okay, I see none. Thanks ken, appreciate you coming in. I'm now looking for Carolyn please.
I see you Carolyn. Hello? Yes, good morning, Perfect.
[HB4036] My name is Carolyn Mazes and I would first like to thank the entire committee for the opportunity to testify in support of House Bill 4036 which would allow for the natural disposition of human remains through natural organic reduction or noor or nor if you like. I first heard about natural organic reduction through a form for end of life or death bullets. And I was immediately enamored with the idea. I actually withdrew from a PhD program at Dartmouth College where I was studying health care interventions to improve the end of life6026 care and patient experience so that I could focus my energy on bringing this idea to scale. I'm a passionate soil health advocate, a lifelong environmentalist, an outdoors person and end of life Fiola and hospice volunteer and an entrepreneur and business person with over 15 years of strategic operations experience, most of which would fortune 100 companies and many of those years were sent in boston and Noor resonates deeply For me personally it's what I would want for myself. Environmentally. Anwar can help regenerate are damaged ecosystems and it can prevent further degradation. Spiritually, it has the potential to offer a unique sense of closure, of ecological connection and of meaning and speaking as an end of life Fiola these things matter both to the person who is dying and to their loved ones.
And finally commercially it will expand consumer choice and will offer a scalable option for those who live in an urban environment and are looking for a more sustainable or green death care option. Massachusetts has a great opportunity to be a leader in bringing Noor to the northeast. I delved into the environmental impact of traditional burial and cremation as well as the potential positive economic impact of legalizing Noor in the commonwealth in my written testimony. So I won't take time to rehash those details here. Instead, I'd like to quickly emphasis that there is widespread national interest in natural organic reduction and in updating the way that we think about an approach death in this country baby boomers changed the way that we approached birth and now they're changing the way that we approach death. They are asking for more and rightly so it is time that we bring innovation and transparency and competition to the death care or funeral industry massachusetts has the fifth highest average funeral costs in the nation and options for green or sustainable death care are limited to a select few individuals. The only way to make natural organic reduction6139 truly impactful is to offer it at scale.
An individual funeral establishment might have one or two vessels that require three plus months per process. My team and I have invested in the Morris amount of resources and have worked with compost experts over an extended period of time to develop technology that can optimise the natural conditions for an efficient, repeatable scalable and most importantly, safe process by opening up the options and opening up the playing field of competition, massachusetts can lower prices and improve the experience of residents in one of the most important and meaningful parts of our lives. Noor6173 won't be for everyone and that's okay. However,6176 I believe that we should all have the ability to choose a death care option that is aligned with our values and priorities. So I thank you for your consideration and I very much hope that you will choose to add natural organic reduction to the options that are available to6189 massachusetts Residents SHOW NON-ESSENTIAL DIALOGUE
thank you so6193 much Carolyn, appreciate you coming in and your passion for this questions from the committee.
Okay, seeing none. Thank you and we'll move on to jasmine who I saw popped on. Welcome Jasmine.
[JASMINE TANGUAY(FUNERAL CONSUMERS ALLIANCE OF EASTERN MASS):] [HB4036] Hi, good morning. Thank you so much for making time for my comments. Um, I did submit a letter to the committee6219 yesterday evening, but I really appreciate the chance to share these with you in person. So, um, I'm here to support bill 4036. Um I'm a lifelong massachusetts resident and I've become increasingly aware of the difficulty of finding affordable, environmentally sound and values aligned options for final disposition of our physical cells after we or our loved ones die. Um I'm also a board member of the nonprofit funeral consumers alliance of Eastern Mass. Um, and I've watched, we watched with admiration as states across the country have really thoughtfully added these additional options to um, you know, offer their residents access to these safe and tested methods to care for our debt. So alkaline hydrologists appeals to me and a lot of folks I know who would prefer dissolution to incineration of our remains. So this method uses less energy. Um, it produces no stack emissions unlike flame cremation, which creates a lot of toxic mercury pollution and so forth.
Um, and I I believe that even if you want can produce sort of a fertilizer that some people like to use to re apply to the earth to return our nutrients in a form that's usable um for other living things. But families bring home a product that's almost identical to cremated cremated remains um, a little bit brighter white because it hasn't been charged by the flames of the cremation chamber. Um and the natural organic production is something that I've been following very closely since it actually was just the idea of Katrina Katrina stable. She was a master's student uh in architecture at U. Mass Amherst. And um I've just watched this idea grow and be tested and refined and I think that the current technology is very, um, it's something that appeals to many, many people who I come across and it's just, you know, it's a beautiful affirmation of our place in the biological world and it's been proven to reduce carbon emissions by I think about a ton per person.
And I just know personally as a parent and you know, just a member of this planet, I feel like I want my final act to be a positive legacy for my Children and grandchildren and I don't want to contribute to another problem that's going to be born by future generations. Uh so I think that there is real interest among residents of massachusetts to use this really gentle natural method to complete the cycle of life in a manner that is consistent with their environmental and or spiritual values. And personally, my faith tradition implores me to respect the interdependent web of all existence which were part of6385 and returning our bodies back to the planet without creating pollution of our air and water and land. It's an ancient practice. It's as old as life itself and giving giving folks an opportunity to return to that I think is as a real gift. And I mean just practically municipalities are running out of space.
Green burial has tremendous benefits but it's hard in massachusetts a fine land for green burial cemeteries. Um, you know the resources, all of the hardwoods and metal and concrete that we used for burials and fossil fuels for cremations. Those aren't renewable and they're not going to last forever. So um, noor and alkaline hydraulics is that are respectful in their um, good use of resources and I think that in the future we're just going to see these as common sense options that are chosen by many, many people and it's a huge boost to the economy. Um, like Caroline said, you know, it's, it's allowing innovation to take place. It's allowing the creation of a new a new marketplace and good jobs for people and good choices for consumers. So thank you for letting me um, contribute these comments and I hope you reported favorably out of committee.
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Thank you so much Jasmine, really appreciate you coming in. Um, appreciate your expertise in your testimony.
Questions from the committee. Okay, seeing none. We'll look at your written testimony and certainly be in touch if we have questions um, person welcome last person on this bill is Patricia muldoon please. Okay, Patricia, I see you.
[PATRICIA MULDOON (FUNERAL CONSUMERS ALLIANCE OF EASTERN MASS):] [HB4026] Thank you so much. Chair Comerford and the committee. Um, I am also here to testify in strong support of Bill H. 40 36. Um, and I am the president of the funeral consumers alliance of eastern massachusetts which also covers the central part of the state. We are working in affiliation with the Fc. A. Of Western massachusetts on6515 this bill and we are consumer advocates as you've heard from jasmine were resources for learning about and creating meaningful, dignified and affordable post end of life care. We as a nonprofit support expanding and honoring people's options for after death care. As we say, losing a loved one is hard planning for what comes next shouldn't be. And as a result of that, particularly in our own state, we are concerned about the difficulty of finding those affordable environmentally sound value line options aligned options for the final disposition of ourselves and our loved ones.
I6556 will say that we had our annual meeting6560 yesterday and folks were very excited about the opportunity to support both alkaline, hydraulic Asus and nor out of these concerns. There is very strong support for expanding options that are6578 environmentally friendly for body disposition. When we give presentations to community groups and professional organizations, we consistently hear appeal for more options and the frustration for6593 for the lack of options in our state? Right now, as as was mentioned cemeteries are filling up. We have no green burial cemetery in the whole state. Why do folks who want nor 2? Why do they have to drive all the way to Maine to get some of these options. Let's bring our own state up to speed And house 4036 would add these both options um and as mentioned less energy no stack emissions, nutrient rich soil amendments and families can bring home the remains um on the case of nor that are uncharged.
No apple in hydraulics is sorry mix those two up um they are both respectful and reasonably priced and ecologically sound solutions that our state needs which is why we are supporting this particular bill. I do want to recommend to modifications to the bill That I hope can be considered. The first calls for a waiting period of 30 days in the case of unclaimed bodies6677 for the local boards of health And reducing this time to 10 days would reduce the cost of storage and address the needs of many indigent folks. The second issue um states that the medical examiner may waive its feet please change that should as we have learned that that option is rarely used. Thank you so so much and we hope you will reported favorably out.
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Thank you so much for your testimony. Um and sorry if I missed this did you say that you wrote those suggestions suggested amendments in written testimony. Yes you will be getting those shortly. Very good. And the committee and of course the representatives I'm sure we'll consider them. Thanks so much for your testimony.
[COMERFORD:] Um Okay friends uh we're going to close testimony on this bill and open6732 testimony on H 4220 representative Livingstone and act authorizing6737 local control of waste collection hours of operation.
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I have one speaker on this Kathleen Barrett and Kathleen I see you
Kathleen Barrett Um we're not hearing you
just going to hang tight for a second6779 um to see if we Kathleen a muted
Kathleen, the mute button is down at the bottom of your screen. It's a little microphone
mm shamus um I'm not signed into teams so I don't have a muting privileges. Can you try to a mute Kathleen Barrett for me.
Okay that's fine, that's fine. Um Just hang on hang tight just for a second folks
anyone from my team on with commuting privileges. Yeah
senator do we know that she's actually waiting to speak or that she's just signed in? You know madam chair. I very good question Miss Barrett may have you know as folks do understandably tuned into the hearing and then been otherwise occupied. Um
I think not seeing this Barrett respond um and not a mute her from this position that I have right now we will just say together that we will warmly welcome Miss Barrett's testimony um uh whenever she wants to send it to us in6881 written form
with that. I will just check to see if there's anyone else who6889 is on this hearing currently who6891 believes they should be heard today on any of the bills before the committee. SHOW NON-ESSENTIAL DIALOGUE
Okay I don't see anyone or6904 hear anyone madam chair without objection. I would bring this to a close after hearing from you if you'd like to make any closing comments. Uh no, just thank you for your great facilitation today. This was really both heartbreaking and inspiring um to hear people tell their stories that help inform policies that we're looking at and I just want to say congratulations to you, to members of our joint committee, to our staff, to Marissa, Kathleen Tain and Kate on my staff. Um this concludes at the moment, our last I believe public Health hearing of the many hundreds of bills that6946 have been before us. So um not a small feat and the amount of effort and work that the committee analyst and my staff have put into providing summaries for all the members and us has been enormous. So I'm just filled with gratitude for all the work that actually really is behind the scenes um that allows you and I to do our jobs. So um thank you for all of this uh for this partnership and to um and now the hard work continues as we look at sort of how to move um bills forward where we can thank you. Well, said Madam Chair, I join you in thanking your wonderful team and will raise up our legislative director, bryan Rossman also we have an unbelievable public health fellow and Julia Wynette who has been with us, helped make me smarter to prepare for these hearings and then today we have7001 Rachel, Khanna on as well. And Rachel's been part of these hearings in the logistics. You know, the as you know, the exceedingly important logistics back in so that we can run smoothly as a keen um, so very grateful to you all grateful to L. I. S. You have had no small lift. Um, these many, many, many hearings of the public Health Committee and grateful to our really stellar7025 members of the joint committee, which I know you echo all the time that chair. Um, okay, friends without objection, seeing no further testimony, I will bring this formal final public health hearing to a close again. I made it clear and the chair makes it clear that if we are called into service again for late filed bills, of course we will hear them. But for this moment this is the final meeting of the joint Committee on Public Health in this session. Um, and we thank you so much for your committed testimony. Um, and your participation. Thank you. The meeting is adjourned. Oh, SHOW NON-ESSENTIAL DIALOGUE
oh sorry, I missed. Um, I don't know if it's too late to testify. No, no. And is in a meeting and I just came back Kathleen. I'm so glad. I'm glad we had closing remarks. Uh, we were worried about missing you. Um, so I'm glad you were away from your computer but back now, so we will hear you. Um, and then great adjourn. Thank you so much. Please thank you.
[KATHLEEN BARRETT:] [HB4220] Um so good morning everyone. My name is Kathleen Barrett and I'm a current resident of boston massachusetts. Um, I'm7096 here in support of the house bill for 2 to 0, which is an act authorizing local control of waste collection hours of operation. Um, currently massachusetts does not regulate commercial waste collection pickup hours. However, the city of boston official waste collection trucks are regulated. Uh, these7113 trucks cannot come any earlier than six a.m. To pick up trash and my current apartment faces a public alleyway because this alley is public. Commercial trash trucks can come at any time to pick up trash. Um There's one trash and recycling company in particular. That comes every single morning when7129 my partner and I first moved into this apartment. We were not aware of the commercial trash trucks coming at all hours of the night every single night. This trash truck comes between the hours of one a.m. And four a.m. And stays for about 30 minutes right outside our window. Um Just this past week, a trash truck came on monday at 3:30 a.m. Tuesday at 12:38 a.m. Wednesday at 4:30 a.m. Thursday at 2:30 a.m. And friday at 4 17 AM. Even last night a trash truck came at 4:20 a.m. And stayed until about 4:40 a.m. And I'm currently exhausted. Uh it extremely, it's extremely7164 loud and wakes us up. It makes it really difficult to fall back asleep.
Um, it7169 often feels as though our apartment is shaking, it's so loud. We currently use a sound machine allowed fan earplugs and even soundproof curtains. Um, we're still woken up every morning by the sound of the commercial waste collection outside our window. My partner and I both work 85 jobs and we're currently exhausted due to lack of sleep according to the Sleep Foundation, lack of sleep can lead to lack of energy, mood changes, slow thinking and working memory. And I currently feel all those symptoms. We7196 have not gotten a full night's sleep since moving into this apartment and we find it really difficult to function in our day to day. Um, and because of this, I've developed sleep anxiety. It's really hard to fall asleep at night just knowing I'm going to be woken up by these trucks. We even tried reaching these um, commercial waste collection companies many many times. Um however, there's nothing forcing them to change their pickup times. But if this is passed with the passage of this bill, that will change and my neighbors and I will finally have peace of mind and be able to function in our day to day lives.
SHOW NON-ESSENTIAL DIALOGUE
Um, so thank you, thank you so much for coming to share your personal story.7233 Um, and probably the only person to have come to for this bill. So it's your testimony is that much more important. Thank you very7243 much. Um Okay, friends. I'm so glad we caught Kathleen Barrett Seeing no other people here to testify. This meeting will officially come to a close, and we are adjourned. Take good care.
All right, Did you?
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