2021-04-05 00:00:00 - Special Joint Oversight Committee on the Soldiers’ Home in Holyoke COVID-19 Outbreak
2021-04-05 00:00:00 - Special Joint Oversight Committee on the Soldiers’ Home in Holyoke COVID-19 Outbreak
SHOW NON-ESSENTIAL DIALOGUE
Yeah.
Okay. I think I'm still muted. You're you're um I just Oh sorry yeah,
something like that. We should be good.
Okay,
good afternoon everyone. I am Representative Campbell, welcome to all of you on this easter monday and Passover weekend. Um thank you for being here today. Um We are going to start off with the pledge of allegiance as we do before these hearings. Please join us. I pledge to the flag of the United States of America and to the republic for which it stands. One nation under God indivisible with liberty and justice for all.
Yeah. Before we um launch right into um today's hearing, I just want to recognize the members of this special Holyoke Joint committee that are serving. Um Representative Arciero. Representative balls are representative birth E um Representative to cost Representative Dome, Representative Duffy, Representative Fin Representative Markey, Representative paris Ella and Representative Wagner. Um on the Senate side we have our colleagues uh Senator Rush, who is the co chair of this committee, um Senator Goby. Um Senator O'Connor, Senator Villas and also Senator Cronin again uh thank you so much for being here today.
REP CAMPBELL - Today we um we have um some folks that have stepped forward uh to offer us some testimony and discuss with us some questions about moving forward. Uh as we have been with this committee, we are we are looking at the immediate causes Um that led up to the tragedy at the Holyoke soldiers home and the death of 76 at least 76 veterans. But the committee has also heard testimony from many um about um circumstances and policies that were in place prior to the immediate crisis. And today uh we are looking at some of those issues as well. And we have with us here today some individuals who have been serving the veterans community for many, many years and were extraordinarily grateful uh for you being here with us today.
Um The first um the first individual that is with us today is um Tommy Lyons um he's currently the chairman of the Chelsea Soldier's home of the board there and but has done many, many um served in many, many other capacities um and tom if if you would um before I introduce my senate colleague and chair senator rush quite a number of the committee members are you have not been introduced to before, and if you could just take a moment um to uh speak to your background a little bit um in terms of your military service, but also the things that you have been doing within the veteran community in massachusetts since then, um which was so grateful for. But a lot of the committee members have never met you. So if you could just take a moment to do that, that would be um so very helpful.
THOMAS LYONS - CHELSEA SOLDIERS' HOME - I certainly will, Madam Chair and thank you. So, I am Tom Lyons, I served in the Marine Corps during and end of Vietnam from 1967-1970. Upon getting out of the marines, I went to work at the Boston Edison Company. As I tell folks, I actually had a real job at one time digging ditches and laying cable all over the city. I left Boston Edison after 16 years and278 went to work for Ray Flynn when he became the Mayor of Boston, I was hired to become the deputy commissioner for the city of Boston in 1985. I worked at the city for 10 years and had left the city and I went and became the executive director at the New England Shelter for homeless veterans, which is now the New England Center and Homes for Veterans where I worked there for about 7-8 years, left the center and then went to work at Mass Housing Finance Agency, where I stayed for 16 years and helped to create veterans housing all over the Commonwealth, and I have served in many capacities on board, both at Chelsea, and at Great Marine and past president twice at the Mass Veterans Service Officers Association, where I'm still very active. SHOW NON-ESSENTIAL DIALOGUE
Mhm. Thank you so very much for that, and thank you for your service, of course. Um and uh but thank you also for your service following your service,351 um to352 continue to work with veterans. Um I know personally that many veterans have been helped um and served because of your service um here in the commonwealth of Massachusetts. So I want to offer those thanks that at this time I'd like to introduce and uh turn the floor over to Senator Rush, um, and uh, allow him to to start off Senator you with us. Yes, I am here Linda, you're killing me. I have to go after tom Lyons. You do, you do, you totally killed389 me. And I just want to say thank you Tommy as well. Um you know, there's no secret if you work398 in veterans issues, um, uh, kind of the forefather401 of the veterans issues402 and all the good things we have405 here tom Lyons has led the way long before it was fashionable to do so and long before anybody was talking about these issues. Uh, so Tommy, thank you for all of that and all, you're doing your guidance and the tremendous work you do every day for vets, Thank you.
Thank you. Senator. Um, I appreciate um is uh is Chair Campbell um pointed out part of this committee in addition to finding out and getting to the bottom of the tragedies that took place. We are also charged with moving forward to make sure those things don't happen again. And what do we do best here in massachusetts is we use brain power to solve issues. And the455 collective group you have in front of you bring unbelievable amounts of wisdom and knowledge to the issues directly affected by this committee and the covid outbreak in long term care and housing of our vets and their families. So, uh as Representative Campbell pointed out today, uh we we not only want to be able to build upon our report as to what the problems were, but then to take the next step as legislators to make sure that we do everything possible, that they never happen again. So I'm I'm excited and optimistic to hear from an outstanding panel today who have been working to help veterans and housing issues as their careers. So, so thank you and welcome to all of you and I turned it back to you, Chair Campbell, Thank you Senator. Thank you very much. Um and that was intentional to uh to have Tommy go first and that applies to both of us as well, a tough position, a tough517 position to be Tom would you like to offer any opening remarks before we consider any questions?
Um
LYONS - Again, thank you for the opportunity to speak today. As I've been introduced, I am Tom Lyons and I'm Chairman, the board of trustees at the Chelsea Soldier's Home. I first want to commend Superintendent, now Secretary Cheryl Party and Deputy Superintendent Eric Sheehan and and all the staff at Chelsea Soldier's Home for their hard work commitment, dedication to our veterans. They have done an amazing job keeping our veterans healthy and safe. Communications between the Trustees Superintendent and staff was critical from the very beginning of the pandemic. All established policies, protocols were presented and discussed with me and shared with Trustees.
I spoke to the superintendent three to four times a week. It was on one of those leadership calls that I heard from Superintendent the need for iPads that we had veterans who unfortunately were not able to be with loved ones, but we're dying and when I presented this to the leadership and the board of trustees at the Bright Marine, where I also at the time sat as on the board, Bright Marine stepped forward and purchased 350 iPads where we could then share with Chelsea and the Holyoke soldiers who are helping to try to make a difference to those veterans who were dying during that difficult time. Planning by discussion by the leadership team at Chelsea started around the end of January in 2020.
The incident command team was formed early March and initiated operations plans that sometimes have them working 15 hours a day. After many months into the pandemic, leadership did an assessment, asking three questions; for us what caused and contributed to the COVID-19 outbreak at the soldiers home? And there are three possibilities. First, location, we cannot definitely know how the virus first entered the facility, one possibility is community spread. Chelsea has a very high rate of confirmed COVID-19 cases. Nearly a quarter of the soldiers' home employees are Chelsea residents and 44% of the employees who tested positive lived in Chelsea.
Second, the building lay out. The quickly long term care and skilled facility was built707 over 75 years ago. It features that have an open world setting and shared bathrooms. Third, availability of testing. There was a lack of testing materials and a slow return of test results in the early phases of the pandemic. Initially, testing was only conducted when someone had symptoms. Second question, did the Soldiers' Home leadership comply with all requirements to provide timely and accurate accounts of the number of infected patients and staff and the number of deaths associated with COVID 19? And the answer is yes. The Superintendent for the Soldiers' home, who had been leading your organization for several years, is a seasoned health care executive,759 retired colonel with years of incident command experience.
She assigned a deputy superintendent as incident commander. The deputy superintendent has approximately 10 years of experience in health care. She was the bureau director for the Bureau of Health, Health Care, safety and quality at the Massachusetts Department of Public Health. From the onset of Covid 19, the Soldiers' home has provided accurate and timely reports to the Executive Office of Health and Human Services, Department of veteran services, the Massachusetts Department of Public Health and the US Department of veteran's affairs. Additionally, all regulatory guidance was followed by the home and there were incidents when our medical leadership team look and took accidents prior to the recommendation from regulatory agencies.
The third question was, what if anything can be done in the future to prevent or reduce the likelihood of a similar outbreak? First, the community living center, which started before the outbreak, the construction of the new 154 bed community living center will provide the opportunity for our veterans to reside in private rooms. This configuration will better support infection control and the new facility is expected to open in the fall of 2022. Second, conversion to private space. The incident command team requested and received approval to move forward with decamp to configure more private space in the current building to minimize infection transmissions risk until the new facility is completed. Private spaces were completed last October.
Third, employment and training. We are hiring additional infection control staff for the round clock, education and monitoring and an occupational health nurse who has been hired to assist in developing, implementing and documenting all employee related health and safety programs. In closing, I'd like to leave you two recommendations; the first is, we must continue to strengthen communications with the veterans community. For far too long, the veterans community were getting information from the media whether it was tv or the print and I for one, try to share as much information about what I knew as I could.918 Then we must continue to strengthen the communications with all the state and federal agencies.
Lastly, I'll close with something that's going to be, I know very controversial and I would consider creating one board to oversee both homes. I think this in the long term would be the best option that we have moving forward to care for our veterans in the time that they have. I will close with that, Madam Chair and answer any questions. SHOW NON-ESSENTIAL DIALOGUE
Yeah, thank you very much Mr Lyons. Um you you bring I think some important information to the committee. The first piece of information that I think stands out is it964 appears that at Chelsea there were a number of key leaders that had credentials and um experience um to lead any um long term care facility. And you know,
CAMPBELL - From your perspective, do you think this experience with health care, the credentialing that was present in some of the positions there was really important as the crisis broke and and broke and and the numbers increased?
LYONS - Absolutely. As well as their military experience in organizing and presenting situational awareness, you know, I think their ability go to bring the staff together, look early on, as I said, we started talking about this Covid in the late January and started to put protocols in place and move forward. But I think Secretary Party at the time with her team put together at least a plan that could be in place and to put us in the best position to care for our veterans. SHOW NON-ESSENTIAL DIALOGUE
It um and correct me if I'm wrong, I don't wanna I don't wanna put any words in your mouth.
CAMPBELL - It sounds like at Chelsea, there was a consideration before all of the information started flowing from government entities per se, that Covid was a serious virus that needed to be reckoned with. That there was recognition before the crisis management emerged at the Chelsea Soldier's home that recognized the seriousness of this virus, that there were individuals that saw what was going on in the rest of the country and the world and felt that this was going to be something important. Was that your perspective?
LYONS - Absolutely. And to the point where Mass Port started to look at closing down somewhat towards the end of January beginning of March, that was a clear indicator to both the leadership in the board of trustees that we had to take this serious once we saw that there was some restrictions being put in place for travelers. That's when I think the leadership at1126 Chelsea really took it serious.
CAMPBELL - To my understanding, there where individuals at Chelsea that specifically had training and education, formal training and education in infection control, is that correct?
LYONS - Yes. Well, yes, to the point that I made that the Superintendent had a healthcare background, that the deputy Superintendent had a healthcare background as well, I think that was certainly helpful in terms of getting people to understand what we may be facing. SHOW NON-ESSENTIAL DIALOGUE
Thank you. I I know I'm not gonna take any more questions. I
CAMPBELL - I know that there are a number of questions um just regarding chain of command that the committee would like to hear from, I will let others turn to those. But you had mentioned, you know, a board. Can you give me from your perspective in terms of logistics, in terms of policy, what would be the advantages of doing that? Of having one board to perhaps standardize, there's many areas that I think all of us would have opinion on, but to that thought, how do you think that would be advantageous for the commonwealth?
LYONS - Well, I think, you know, having one board puts both homes under the same umbrella, and protocols and policies would be the same for both. Operationally, I think it just makes sense that both both homes would operate under the same guides and I think that better serves everyone throughout the whole commonwealth. SHOW NON-ESSENTIAL DIALOGUE
mm, thank you so very much. Um, Senator Rush. Um, do you want to, um, ah, ad at any questions?
SEN RUSH - I do just a comment and then a question, if that's okay. The comment is, you know, as we continue to have this discussion here to investigate this, there's an educational component that I see because again, people have been under the impression maybe, and still are that the homes belong solely to the communities they reside in and that's just simply not the case. There's an opportunity to be educating folks that these two homes belong to all taxpayers of the commonwealth and every veteran in Massachusetts. So, there's that educational component, which I think is so important to this discussion. Tom, I'm wondering, you've been in the field for years, housing and veterans housing, working to create opportunities, moving forward, if you could draft a blueprint, what would you tell this committee, one or two or the three taught things that must be done moving forward looking at the Soldiers' homes and best practices currently in use to have a greater reach out to veterans and their families? So, just anything you have as you would see as a blueprint moving forward would be greatly appreciated.
LYONS - Sure. You know, I think one of the things I would look at is particularly the housing and it's one of the ear is I saw when I was at the New England Center and we were looking at having successfully moved our veterans out of that facility into some permanent housing. When I got to Mass housing, I saw the importance of how do we create and build affordable housing across the commonwealth? I would say in this regard, Senator that I would want to look at or suggest we look at how do we build and look at creating may be assisted living facilities across the commonwealth and in particular, areas where we know we have a high concentration of veterans, and the facilities where quality of life issues can still be maintained, aging in place can still happen, but you don't have that density of people living under one roof. I would also say it would give the loved ones an opportunity to be closer to their government, so I would like to look at1426 the veterans housing, the way I looked at the affordable housing across the commonwealth and look at where we could potentially build those units of assisted living that I think veterans sure could use and need. SHOW NON-ESSENTIAL DIALOGUE
Okay, thank you. Thank you very much. That's that's all for for me for now, Chair Campbell. So thank you. Uh Thank you Senator.1455 Uh I believe Senator Gobi um1459 wish to have a follow on conversation. Senator, you're still with us,
Senator Goby. There you are. You're you're muted. Yeah. Okay. Thank you. Actually had asked um some of the same question I had, and thank you tom I appreciate the work that you've done, and I appreciate you being here today. And
SEN GOBI - I also had some questions about that one board makeup, and I'm just kind of curious because I assume that you thought about that somewhat, could you kind of give us what you would see as the makeup of that board or what would you expect it to look like if it was one board?
LYONS - I think the one board idea came about when I first became Chairman of the board in Chelsea, and saw that, you know, operationally and from a board perspective, things weren't aligned the same if you will, that they we're kind of different protocols in place. When I was asking questions about it and not having an ego, but someone who cares about veterans, I saw this, you know, one board as an entity that can really help them make a difference in putting in place a structure that both boards can operate under.
GOBI - So you are talking about like one oversight board, but1550 still have the two separate boards of both?
LYONS - One umbrella and it could be made up of veterans, nonveterans from across the commonwealth, that brings a certain level of expertise, if you will to help both homes, be able to move forward in the way that we keep our veterans safe and healthy. SHOW NON-ESSENTIAL DIALOGUE
Okay, thank thank you for that. I appreciate, Yeah, thank you. Senator. Um Senator Villas, Would you, would you like to speak? Yes, madam. Chair, Thank you very much. Can you hear me? We can. Good to hear your voice. Likewise. Likewise, I hope you're well, sure. Lions, how are you, sir? How you doing? Good to see you again. Yeah. Likewise, before I ask my question, I just want to say thank you. I was up at the royal soldiers on that day. You guys deliver those ipads. And that was just a really cool day. And the impact that that had is um, is still talked about, you know, whether it was communicating with family members, just so many good things. So from the bottom of my heart, thank you so much for that. That was that was really cool. Thank you
SEN VELIS - The question I had for you, you mentioned something in your opening remarks about kind of reporting accurate numbers and how initially at Chelsea, I think what you said, I want to make sure that I understand you correctly, you mentioned that it was absolutely critical to report good numbers up, something along those lines. Can you just speak to that because I've got a follow up question?
LYONS - Sure. I think, you know, one of the things early on when information was flowing and people were asking about veterans who were testing positive, what was the numbers in terms of veterans that maybe have died? It really became apparent to both Superintendent Party and leadership that whatever information was flowing from Chelsea, it was done as accurately as possible to do it, you know, to disseminate the information to all the parties that I spoke to of veterans who were tested positive to the veterans who have passed.
VELIS - Yes, and I guess my follow up is because in my opinion anyway, I think one of the most least discussed aspect of what happened in Holyoke in terms of the Pearlstein report, to the extent it's accurate and other things is kind of that disconnect between what was being1771 reported up and what was the requirement and what I mean by that was that if you look at the1779 reporting requirements section of the Pearlstein report, it talks pretty extensively about that it wasn't until March 30th when those reports needed to include not1790 just confirmed Covid deaths but also Covid deaths that were suspected and deaths that were Covid tests were pending.
I think that was really important for the following reasons because that if the Soldiers' home was reporting only up confirmed cases versus suspected and pending, chances are that number is going to be significantly well that might not be the right word, but it's going to be lower than if you're also reporting pending and suspected cases for the obvious reason that there's lab time between the time the test goes out, by the time you get that result. One of the things that I haven't been able to get over is that, you know, if you look at it, I mean for all intents and purposes, the home, I'm talking about Holyoke now, not Chelsea in some respects and I think the Pearlstein report on some levels credit them for what they were reporting up information based on the guidance that they had at the time.
Again, it wasn't, you know, even the time period from March 24th to March 29th, all that was required that you report up confirmed cases and it wasn't until the following day, the 30th that it was suspected cases. I guess here's where I'm going with that and I'm really trying to look at this from the perspective of the going forward as opposed to the past, I think it's a reasonable conclusion on some levels if that there wasn't that disconnect between what the EOHHS and DVS was asking for and what the Soldiers' home was giving them. I guess by way of example, if earlier they had been asking for not just confirmed cases but also suspected and pending,1888 that number would have been higher coming from the Holyoke Soldiers homes in terms of deaths. I think it's also reasonable to infer from that1899 at some point in time that may have caused leaders at the state level to say, we've got a serious problem here, more people are dying that initially meets the eye.
So that accurate reporting, we've said it a million times on these hearings, these chain1917 of command issues, this was a serious, serious breakdown in communication, that again, I think not to be redundant, but I think was one of the most compelling things discussed in the Pearlstein report. In fact, on the bottom of page 128 it says, you know, given the multiple day lag in getting results1939 of Covid-9 tests during this time period, it would have been well served to require notification about deaths of suspected COVID-19 patients far earlier than they did. Tons of ambiguity, so many things happening and easy to be a Monday morning quarterback but I think that's a really, really, really big deal that breakdown in communication. I'd be interested in your thoughts on that.
LYONS - Well, all all I can1962 say Senator is that from the time we went into that operational mode, Superintendent Party and his staff when asked for that information and, if my memory serves me right, you know, we're talking, I believe like an April timeframe when our information started to to flow up. We were trying to be as accurate and timely as possible because as you say early on, there was so much2034 going on and so many different numbers that were being thrown out in terms of cases and deaths.
I think one of the things that we as board in Chelsea was wanting to make sure that those numbers were accurate that were going up and no one from our board was giving out any information to anyone, all that information had to go through the Superintendent on2066 up to who she was reporting to. So it was a matter of having those numbers as accurately as we can, but as a board, we were there to support the staff and the Superintendent and it didn't get into any of the numbers that was being thrown around. When I say we were reporting in a timely and accurate way from the very beginning, you know, that's what Chelsea was doing.
VELIS - No, and I appreciate that. I guess my question would be, was Chelsea reporting just confirmed cases or confirmed as well as suspected cases? Because I think part of this dialogue right, we want to talk about making sure, so that guidance from the state from DVS and EOHHS, so what I'm trying to figure out the reporting just confirmed cases. Is that something that only applied to Holyoke or did that apply to Chelsea as well? Because I would have to imagine that was both homes because it was coming from above, right?
LYONS - It's my understanding that we were just providing the positive cases, correct.
VELIS - I guess I'm asking and agree, disagree, what have you but I think that's kind of a really big deal, that consistency in information, that's something you agree with?
LYONS - Well, I think it gets to my point of if we had one board reporting up, then one body would be reporting up, and in this case, you know, we have two boards and two facilities that were kind of operating on a parallel course and they may not have been operating under the same guidance, if you will.
VELIS - No, and then I think I'll just finish up with this, just more of an observation. I just think that's a really big deal, you know, if you're reporting up, we have two deaths versus we have eight deaths, I think if you're on the receiving end of that, that would have an impact. Again, this was at the beginning of2193 the pandemic, this time period. I mean, the Holyoke, you know, it was unfortunate, but Holyoke Soldiers homes would be really one of the first places if you will at least in the commonwealth to really get whacked by this but I think at that point in time, two deaths versus eight deaths would have caused a lot more urgency for people to act. SHOW NON-ESSENTIAL DIALOGUE
Again, I thank you, I thank you for your candor. And as always, great to see you looking forward to seeing you in person. Thank you. I'm don rep Dome, are you still with us? Would you like to ask a few questions? Yes, Thank you very much, madam, Chairwoman. And hello, Mr Lyons, I'm mindy dom I represent the third Hampshire we've2243 never met, but your reputation, procedure. Well, I'm Tommy Hi, I'm Indy. Uh, I really appreciate your comments and I appreciate the three questions that you laid out that you were asked to respond to, which are kind of similar to this committee's mission of looking back and looking forward. And I want to ask you a couple of questions that I hope are not redundant and2261 if they are, I apologize and you can say I've asked and answered that one. Um,
REP DOMB - You mentioned that there was an incident sort of task2269 force that was created at the Chelsea Soldier's home pretty early on and I think you said it was late January and I just wanted to clarify the timeframe in my own mind. Was that accurate?
LYONS - Yes. It was the third week in January when the incident command team first stood up and started to get the information about the virus and what may be coming our way.
DOMB - Do you remember, did they do that out of their own initiative or was that was something that was recommended to them by somebody in the state or somebody in the medical community? Somebody on their board?
LYONS - No, I believe that was the initiative of the Superintendent Party and the leadership at the home.
DOMB - When you think about it in retrospect, it's maybe the most critical decision of everything, right? Is to sort of say, it looks like we're going to have a crisis on our hands.
LYONS - Absolutely, and that's why I wanted2332 to make sure I gave them the shout out, if you will, commending them for what they did early on and what they continue to do.
DOMB - I agree. So as part of that incident team, that's when they develop these sort of what you call the protocols, which I'm assuming are sort of like the Covid protocols, at least version of it.
LYONS - Right, exactly.
DOMB - It came out pretty quickly after that team was formed or did that come out like in late February? Or I don't know if you remember exactly when?
LYONS - Well, you know, I remember at our February trustees meeting, we talked about the protocols and as I said in my remarks, what the board always appreciated was the Superintendent and her team presenting to the trustees what was going on, what they were looking at doing, what protocols they wanted to put in place as it relates to not only the people in our long term care, but more importantly, those veterans who are in our dorm facility who go off campus to work or go off campus just to do other things. So the protocols that we put in place early on, started to take the shape of how are we going to create the space that we are going to need should this virus hit the campus and what do we have to do?
DOMB - Thank you. So at one point in your comments, you said that I think it was something like that the Chelsea Soldiers' home took action based on what the regulatory agencies would then come back and tell you, and I was just confused about this. I didn't know if that was in response to the protocols that were being developed or like what prompted the regulatory agencies, which I'm assuming are like EOHHS etcetera2451 to come back and say, do this, do that. Was it in response to your initiative or was it in response to a protocol that was being developed or?
LYONS - It was in response to how the virus, how the pandemic started to become really critical and the protocols we had to put in place were visitation, you know, no more person to person visitation, no more for the dorm residents to go off campus, and even to the point of closing the cafeteria. So it was all looking at putting in place the necessary protocols to keep people safe and and certainly the one that reduced visitation was the toughest. SHOW NON-ESSENTIAL DIALOGUE
and still is. Right. Right. So I'm seeing that when
DOMB - What I'm understanding based on what you're saying is I just want to really clarify this for my own sense because I'm not sure, I don't think I quite understood this before, it's more like a dynamic, right? Superintendent Poppy would develop these protocols in response to I guess what she was seeing like on the ground, like in the facility and action would be taken based on those protocols but then you would also be hearing from the department about these other kinds of protocols that needed to be put into place and these other kinds of policies, so it's more like a give and take almost, is that it?
LYONS - I want to say it was a give and take. It was2610 in addition to you know, here's what you're doing, CDC has come down with some changes that they would like to have implemented and so2619 it would come down that2621 way. So it was in addition to what we were doing, here's some other measures that we can take to ensure the health and safety of the veterans.
DOMB - Thank you. One more question, and again, I apologize because I think you've just been asked a lot of questions on the submission of data, but I guess what I'm aware of is that I'm sensing that there's obviously been different practices between the two facilities, so I'm trying2646 to wrap my head around what specifically they are, and I understand that Chelsea submitted timely and accurate counts. I'm wondering if you remember what the earliest date of those submission was? And I'm assuming they were submitted to state government agencies like DPH, DVS, EOHHS?
LYONS - Yes I mentioned the departments that we reported to. I honestly can't remember when the first initial reporting started but I would say it had to be early on when we first started to see a loss effect in Chelsea happening during this pandemic. SHOW NON-ESSENTIAL DIALOGUE
because and I'm sorry to make you have to remember that. I I realize it's painful. I I really do and
DOMB - I feel badly asking the questions about it. Because I'm thinking that the incident team was created in like late January. I'm wondering if that was2710 probably around the time when maybe there would have been some count, even if it was a count of we're not seeing anything, but we're concerned about it, that might have been when or maybe a week or two after that, that counts might have started to come out of Chelsea, but I think I can kind of piece that together if you can't remember the exact time.
LYONS - Yes, no, honestly, I can't remember the exact time. SHOW NON-ESSENTIAL DIALOGUE
Um Mhm. Okay. Thank you and thank you so much, your service and your and your willingness to come to the committee to talk to us. Thank you. Thank you, madam Chair.
Okay, thank you so much rep dome Tommy. I have uh, I don't see any other hands raised from other committee members, but I have a a follow up question as well. If you'll indulge me. And that is, um, I'll make it very clear when we,
CAMPBELL - When we see some differences between2764 the end result of Chelsea and Holyoke, what comes across to many is the importance of healthcare experience, health care knowledge, healthcare expertise, that is able to recognize a serious health care challenge before it becomes a crisis. I'm just wondering if you2780 could comment on your perception of how important the backgrounds of some of the individuals who were at Chelsea and how important that was for them to recognize perhaps what might be a crisis moving forward before that seemed2812 overly obvious to many who perhaps we're not health care experts. Do you think that that had a an important role in how Chelsea was able to deal aggressively with this crisis?
LYONS - I certainly think it helped. I think the other piece of that too is as I stated, both the Deputy and the Superintendent had a military background where they had the ability to take situations and organize and to be able to put a plan together and execute that plan. I think that2852 certainly helped to create an environment in which staff could look and trustees could look at and say, okay, we have the leadership here that's going to put together the things we need to in terms of keeping our veterans safe. I think2877 that situational awareness that folks get when they climb the leadership rank in the military know what to do when situations happen.
I think the medical or the healthcare background certainly gave them the awareness of how serious this is going to be, but it was the combination of their awareness, but also their skills at organizing and in bringing people together. I would also say, go out and get information, don't sit and wait for information to come down. The Superintendent and Deputy, they were going out gathering information and bringing it back that I think really helped them put together a team, if you will, that really took this pandemic head on and did the best that they possibly could with great support. SHOW NON-ESSENTIAL DIALOGUE
Oh, well, thank you very very much for being with us today. Um Your perspectives are very, very helpful to us and thank you for your continued service. Um and we're looking forward to seeing you a lot as we we have this event coming to boston and we'll be in touch, I'm sure. And if there's anything else you'd like to share with us an afterthought when um you're not on a zoom call, um please feel free to um to send us um something in writing. Um uh feel free to do that at any time. And we we truly appreciate your presence here today. I don't see any other questions. And so hopefully we will see you soon in person. Well, thank you very much. And I would like to close with justice thought and one thank you for the hard work that this committee is doing uh and looking at um what happened over the last year, but just to be close with this thought, um It's okay to look back, but don't stare. And and and I think the message is, let's not get too caught up staring at what happened. They'd rather come up with the creative and and really motivating ideas of how how do we move forward?
Well, um we really appreciate that. Um We feel we can make a contribution in that respect. And3086 um so we're we're very thankful for that thought. It's it's um it's uh motivating us to to move forward um And to uh to the best of our ability established some some guidelines that are are in law that will prevent this from occurring again. So again, thank you. Um Be safe be well and hopefully we'll see each other soon. Okay? Thank you very much. Thank you.
So with that. Yes. I think that's a more,
we have a uh another expert with us today and his name is Andrew Mcauley Andy. Are you are you with us?
Yes ma'am, I'm here. Okay thank you, thank you so much for for being here today. Um Thank you for first for your service to your country. Um and thank you also for continuing that service for many, many years uh here in the commonwealth um with our with our veterans and um most of our committee uh has not been introduced to you and um if you would just take a moment to introduce yourself some of your military service background and also um the important work that you're doing today as we speak.
ANDREW MCCAWLEY - NEW ENGLAND CENTER AND HOME FOR VETERANS - Thank you, Madam. I do have an opening here. Madam Chair, Dean Campbell, Chair Rush and members of the special committee. My name is Andrew McCawley and I serve as the Chief Executive of the New England Center and Home for Veterans. It's been a distinct honor for me to be able to be part of the center for the last 10 years having taken this role back in June 2011. I am originally from the commonwealth of Massachusetts having been born in Dorchester and grown up on the South Shore but spent then a little more than three decades in the United States Navy and had the opportunity to serve and travel the world and work with great folks in3224 our nation's military. Thank you for inviting me here this afternoon to speak with your committee, I want to ensure that I am available to you and that I am able to address any questions that the committee and its members may have.
I know that some3238 members, especially, Madam Chairperson Campbell and Senator Rush are very, very intimately familiar with the center's mission and helped make it what it is today, but for folks who may be less familiar, the New England Center and Home for Veterans is the nation's premier and one of its largest private community based providers of human services to veterans who are experiencing challenges following their military service. Now, in its third decade of service, the new England Center is a private institution in downtown Boston, with the very public mission of helping to fulfill this nation's pledge to support those who have served and worn the cloth of our military. It offers a broad array of programs and services that enable success, reintegration, meaningful employment and independent living.
Since its founding here in Boston in 1989, the New England center has helped more than 28,000 veterans regain control of their lives, and although it is located here in Boston, it is more than a state or even a regional service provider, it serves veterans from across the country. It is open 24 hours a day, it serves as a one stop support facility3307 for veterans of all ages and all areas. It provides housing and I want to emphasize both transitional housing, with as many as 200 transitional veterans residing at the center and 100 permanent supportive housing units for veterans, clinical support, education and employment services in a very secure and support of veterans specific environment. It supports as many as 1300 individual veterans each year and on any given night may be home to as much as 300 veterans. The COVID-19 public health emergency has certainly affected and continues to impact the entire community of the world.
It has impacted every aspect of our3350 lives and this pandemic has presented a daunting challenge to New England Center in that the coronavirus poses a dire health threat to a very Covid susceptible population of veterans that we serve just by its nature. But the pandemic and the restrictions necessary cannot prevent the committed and professional staff of the center from providing the very hands on, high touch face to face, human service3376 models that they deliver to veterans. They are essential services that enable veterans success and help ensure their welfare and dignity. As in everyday operations and service delivery at the center, irrespective of the Covid 19 pandemic, the generous and important resources provided to New England Center by the Massachusetts Legislature have been very helpful in enabling the center to meet and to date, overcoming the challenges of Covid and to be successful in our mission of keeping veterans safe. Thank you, Madam, Chair Dean Campbell and Mr. Chair Rush, I'm available to answer any and all of your questions and the questions of your committee. SHOW NON-ESSENTIAL DIALOGUE
Uh, thank you very much for that. I think it puts in context. Um, some of the work that you have been doing and uh, your presence here today is is just so very helpful. So
My um
CAMPBELL - My question is a general one and that is, you know, in your current capacity, do you see any trends for long term care that3440 will be emerging as we move into certainly long term needed care for our Vietnam veterans, right? For sure and future generations. Are there any concepts either nationally or here in the commonwealth that are being looked at in terms of how we can take care of our veterans in long term care and provide them the best here that our country has to offer is certainly? Do you see any any needs coming down the road that we should be especially cognizant of and we should be thinking because our challenge is to try and look into the future and that is hard but do you see any trends um that we should be aware of, we should consider any concepts for supporting our veterans as we move forward?
MCCAWLEY - Yes, Madam Chair, I think that, you know, as you and I have discussed in the past, I think that understanding the needs of veterans overall is a very complex issue. Veterans overall in this country are very, very successful, they contribute to our society in proportions way out of their numbers, but it is a shrinking population and one that may risk losing some sponsorship and stewardship in the public discourse if we don't focus on it. The New England Centre started out as a shelter, it started out as actually a shelter, we don't like to use that S word for veterans who are experiencing that disabling and disruptive condition of homelessness, we've really tried to transition to be a human services provider, but we recognize that the veterans that we specifically serve is a small percentage of veterans, but nonetheless, it is a significant number of veterans, and what we see is similar to the broader veteran population, it is an aging population.
So, I think in the public discussion around veterans needs, it really has to be about aging with appropriate supports and safety and that generally as the previous testifier said, it's about supportive housing and having people to be able to live with appropriate supports in their own homes, with sufficient support and ability to age in place because veterans will age generally faster, especially the veterans we serve, so that their clinical age is many times older than3605 their chronological age and we have to have supportive aging specific housing assets and services in place. SHOW NON-ESSENTIAL DIALOGUE
Thank you. That that's very helpful. And I, um,
CAMPBELL - I concur with the challenge that we have before us. You know, it seems like we're increasingly focused on the use of special operational forces, in other words, we don't3628 see these large deployments of forces3630 where the entire country is able to absorb all of this and understand the continued service of service members around the world, I think that they would probably be mostly surprised to know where our service members are right now and in what capacity they're serving, and there's a significant number of them, but that's very much appreciated. Are there any3654 comments in terms of mental health care in general or memory support? Do you have any thoughts on that?
MCCAWLEY - Certainly, Madam Chair. Veterans that we serve, again, some of the most vulnerable and challenge veterans, absolutely do not see themselves as victims of their service. Many times, you know, people face significant challenges, hazards, trauma in the course of their service, whether it be for one term of enlistment or a career, but overall, I believe that veterans are proud of what they have done and they do face behavioral health challenge. In fact, I would submit that that is the focus of the center, homelessness as a condition is generally a symptom of behavioral health challenges and people, veterans experienced vehicle health challenges because there are people and people experience challenges, but they do very much respond and are more likely to connect and stay connected with services because there is a frankly, still remains a stigma around mental health, both in the veteran population, but in society at large, and if we can deliver appropriate behavioral health services and in a supportive fashion, and3745 we generally do that, using the idea that veterans are a group and they are much more likely to raise their hand and say I need help when they are with surrounded by fellow veterans, and I think that's really important. SHOW NON-ESSENTIAL DIALOGUE
I thank you for that. I was that was going to be my follow up question. Um,
CAMPBELL - We have some experience with home based here in the commonwealth of Massachusetts and that point has been3771 raised that, you know, when veterans are in a group, it can make that call for help a little bit easier for them and more likely to occur. So I appreciate that perspective. SHOW NON-ESSENTIAL DIALOGUE
Um, Senator Rush, do you have anything that you would like to ask or comment on? I do a good afternoon Andy, how are you? Well sir, great to see you as always. Um,
RUSH - I'm wondering, and again, if you heard at the beginning, this committee is charged with looking at the past, but more importantly, looking forward, Tommy Lyons just summed it up very, very well. I'm wondering and I've had the opportunity to visit many times and anyone on the call,3819 who hasn't, I would suggest you reach out to Andy McCawley, because it's really one of the most incredible things I've ever seen, the transformation of lives that take place at New England Center, the amazing work being done on a regular basis. My question is, could you talk a little bit about the center's focus on, I think you guys call it the Housing first model, if I'm not mistaken, so if you could just talk a little bit about that from the timeline of the day that somebody comes to the shelter in dire need and then where do they go from there? If you could just walk this committee through what you folks do in that respect? Thank you.
MCCAWLEY - Yes, Mr. Chair. You know, again, I've been with the center for just about a decade and all I know is anecdotally, you know, what were the previous service models uh you know, in our society before that, but I arrived here at the time as the center and I think overall, you know, the US Department of3880 Veterans Affairs, the Health and Human Services and overall the human services discipline was really coming to grips with the idea of this housing3905 first, the idea that housing is a tenant, that housing is a basic human right. When people are in crisis and they lose their housing, previously, it had been about sending or enrolling people in shelters or transitional programs and keeping them there for generally a protracted period of time. Like anything else, it tends to, you know, work tend to expand to fit the time allotted for it and the standard policy and the public policy would would look at two years.
3933 The3933 idea that someone who is experiencing homelessness and lost their housing situation would then spent two3938 years in a transitional program before they were ready to be accessed into permanent housing. The housing first Model, I think, turns out a little bit on its head, and recognizing that just the idea of having permanent housing is such a stabilizing influence, with the idea3952 that it's not get people in a3955 position where they can access to permanent housing and then let them go, the ideas place people in housing with appropriate supports that can then slowly be, you know, stepped back from so that then they can establish increasing independence and be more successful in their tendencies. So, when a veteran enrolls in our transitional program and this has continued through the pandemic with appropriate testing protocols and medical monitoring, we have continued to house people.
So that the idea is when someone enrolls in our transitional program because they have lost their housing and are experiencing homelessness, the goal is within six months or less, that we are able to find and help them transition into permanent housing with appropriate support so that they can have a successful tendency. The idea that then as they are in permanent housing, they can increase in their independence and their reliance on the supports that the center, its staff and other agencies provides them can decrease over time, but regardless their living with independence, they're living with dignity and they have a home. Of course, we've seen here among a pandemic and an infectious disease that's transmitted through aerosols is that having your own home within which to self isolate4025 but with appropriate supports is a lifesaver literally. SHOW NON-ESSENTIAL DIALOGUE
.
Thank you. That's that's that's fantastic. And
RUSH - Just as a follow up, can you talk briefly about what your day to day life became running the center during the pandemic at the beginning of the outbreak?
MCCAWLEY - Yes, sir. Again, like just about everybody, you know, 13 months ago in February, it was something that we just were starting to see emerge. Senator Rush, there's a saying we have in Navy, I'd rather be lucky than good,4068 especially in naval aviation. That doesn't mean that you aggregate the idea that your fate is not under your control but you also recognize in a very demanding and complex and hazardous environment. There are situations that arise that you may or may not be able to control, but you really have to react to those things. I think the center and the staff here, I'll put a plug for them, the staff here has spent its time since last February focusing in increasing magnitude on the impact, the threat and the risk of this terrible pandemic to what we knew was4120 a very Covid susceptible aging population, significant comorbidities, congregate setting, challenges with responses and things like that we knew and also resource constrained.
We knew it was going to be a risk and so4135 as we became more smarter or more aware of4139 actually what the most effective practices, we we're always instituting it. So it's been about Covid, Covid, Covid, but not to the exclusion of providing those vital human services because we've frankly seen the isolation, the lack of supports that a result of the very necessary shutdowns and restrictions in social mixing and human interface has been as impacting if not more so on the lives of the veterans we serve. SHOW NON-ESSENTIAL DIALOGUE
Okay. Thank you very much. I certainly appreciate you being here today and thank you for all your doing. And I'm going to turn it back to Chair Campbell and we certainly will be in touch. Thank you so much. Andy.4190
Mhm. Senator Villas is would you like to make a question just briefly madam, sir. Thank you so much sir. I appreciate you, appreciate you coming here. It's been it's been great listening to you.
VELIS - Just a couple of things4206 as you look at the population going forward, obviously, you know, women are making up a larger population4212 of our veteran population and then certainly some of the injuries we've seen in some of the more recent conflicts with, again, TBI, some of these real catastrophic injuries, multiple amputees, I'm curious what impact your take on what that means for veterans, homelessness in the future, how you deal with that and just kind of your thoughts. I mean, we're seeing changing demographics and are we keeping pace with that? Are we prepared for that?
MCCAWLEY - Yes, Senator, those are really good points. I think one of the drums that I certainly and our staff here have been sort of pounding for almost a decade is in fact to try to highlight just what you've explained here, that the population of veterans, many times, people see it in a sort of homogeneous way. It is a very diverse and a changing population. The only and the fastest growing segment of veteran population or female veterans and they have challenges as well that may be born from their experience in the services or exacerbated by that and they4270 need they need similar levels, if not more of support, but different types and in an appropriate environment.
As we see4277 folks age, someone might be egregiously, you know, disfigured or they might not even know it, but it might surface 10, 20 and 30 years after their service. So we can't just focus on the active duty transitioning folks, many times that will occur much later. So, absolutely, are we transitioning? I think we are positioning ourselves, but we certainly cannot take for granted that we have the most relevant and impactful services. It takes almost daily monitoring of what the needs are, what the trends are, and being in touch with that landscape of need to develop the most effective and impactful services.
VELIS - Yes, just a quick follow up, you know, one of the things that it's always been a pet peeve of mine, you know, when I've come back from overseas being a reservist, so you kind of out process, you go to your active duty installation, they take you through a series of questions, what did you see, what you're exposed to all that? And then it's kind of you're out the door. One of the more recent phenomenon is kind of going back to the woman veterans is, you know, sexual trauma in the military where a lot of this happens again overseas places in Iraq and Afghanistan and this is a real serious concern I have for folks who are in the reserve and Guards because I don't think a lot of people realize this, I think when in an active duty installation, you're much more able to pick up a lot of these things and offer those supports but if you're a reservist or a guard, you get mobilized, you come back, you do your basic questions, I shouldn't even say that, I can't speak directly to the guard side of it.
My experience has been on the reserve side of it, but you come back and then you're back in your civilian life and I'm concerned about the number of people that fall through the cracks that might4386 not even know they need those helps. So I've been kind of banging this drum for a long time now, you know, these wrap around services for our guard members and reserve members in particular who might fall through the cracks.
MCCAWLEY - Senator, I couldn't agree more, you know, having done 30 plus years in the navy, I really was not sensitive or aware of that particular aspect that4404 you talked about with guard and reserve. I've had an education and I think Massachusetts does it as good, if not better than any state and I think that speaks to the innovation that's here. The point is, we have to be in the community, you know, veterans aren't this monolithic block, they are individuals and they're becoming more and more diffuse as our population grows and the veteran4428 population contracts, they become diffuse in the community and you have to be in touch with them and sensitive and it might not be a year, five years or 10 years. When I left active duty, I had no idea what the issues were going4442 to be when you follow on and so I don't think that can only be a service role. It has to be supported, follow on support for their lives following military service. SHOW NON-ESSENTIAL DIALOGUE
appreciate that sir.
No more questions. Uh Thank you Senator Villas. Uh you know, I think that point is so well taken in that the number of forces that are reserve or guard moving forward is only going to increase. Um And uh I think that's a very critical point in terms of outreach, how we how we move forward. Um Thank you for bringing that up. Um at this time we're going to take a two second um uh say two minute recess. Uh I don't see any more questions uh India I want to thank you so very much for for sharing with us. And if you have some thoughts afterthoughts after today, please email them to us as we move forward again. We are really trying to take the perspective of moving forward and how we can legislate on this situation. So thank you so much and please feel free to contact us. Uh at this time4509 the committee will take a five minute recess. We have an additional individual who has stepped forward to testifying she recently um uh presented at a massachusetts Veterans need assessment here in the commonwealth um during the pandemic. So uh we will have the opportunity to speak with her um after a very brief recess. Thank you. Thank you, madam Chair. We're honored to partner with the commonwealth. Thank you. Thank you. Thanks Andy.
Yes, she she was 10 seconds ago. Yes, she is. Okay, so we're good. Okay.
We will reconvene
Natalie, thank you so much for being here with us today and for all that you're doing5041 in terms of research to support and help our veterans. And I think what you've recently been involved with in terms of a needs assessment, um as it relates to the pandemic and following is really appropriate for what we're doing here. Uh We are taking the tragedy that occurred to Holyoke and uh our goal is to put forth some very specific recommendations that can be ultimately put into law, uh to ensure that this tragedy would never happen again. So we're looking forward. Um and I5079 would like if you would just take a moment to introduce yourself um and the organization um that you have been working with and um this event that you recently attended in the purpose of it, and then ultimately maybe some of the um conclusions or important discussion that took place at at that event. Okay,
NATHALIE GROGAN - CNAS - Thank you so much to the Chairs and members of the committee for the opportunity. My name is Natalie Grogan. I am a researcher in the Military Veterans and Society program at the Center for a new American Security in Washington, DC.5120 We are a national security think tank and the program specifies in research relating to military personnel, veterans and civil military relations. In 2020 with the support of Brian Marine, I worked on a Massachusetts veteran needs assessment that was published in December of 2020. The report was not intended to cover a worldwide pandemic, but since we started our data collection in March of 2020, that became one5152 of the most important parts of the report. The report covered several areas of expertise in relation to Massachusetts veterans, the COVID-195161 pandemic specifically, housing healthcare, financial stability and social support and included in the report was some quantitative analysis related to the veteran population in Massachusetts. SHOW NON-ESSENTIAL DIALOGUE
Thank you5175 so very much. And is that um would you be able to um maybe summarize briefly some of the findings of that report? Yeah, sure.
GROGAN - Some of the findings of the report specifically to COVID-19 reached into across the commonwealth, veterans had a wide variety of experiences relating to the pandemic, which as previous panelists on this on this hearing made clear, veterans are not a monolithic group. There's lots of variety among their life experiences. Some veterans experienced challenges relating to childcare, specifically women veterans, more elderly veterans had a lot of things to say to our research team about the isolation and mental health issues they felt during the ongoing of the pandemic as well as of course, the medical problems with their relationship to the pandemic. Additionally, the effects of the COVID-19 pandemic were not uniform throughout Massachusetts, people in more urban areas had an extremely different year than people who were in more rural parts of the Commonwealth. I can go into a little further detail if you would like or I can of course send the, send the committee a copy of the report. SHOW NON-ESSENTIAL DIALOGUE
A copy of the report would be most most helpful. Um,
CAMPBELL - One question I would have or any thoughts and we realize these are your own as a researcher, do you have any thoughts or comments on5265 the future of long term care for veterans? Areas that receive would be important to them, absolutely necessary? Any thoughts on national best practices, national data that would indicate trends in care for veterans as we move forward, especially, of course, long term care.
GROGAN - Sure. So in the course of the research, I conducted some quantitative analysis examining population trends facing the Massachusetts veteran population with three specific takeaways and trends relevant to the future of long term care facilities and soldiers home specifically. First, the veteran population is shrinking while the general population is increasing, sometimes dramatically, a demographic change that is predicted to accelerate in the future. Second, due to these demographic changes, veterans will make up a significantly smaller percentage of the Massachusetts population, with some variation across counties. Put together the third takeaway, as veterans become a smaller segment of the population, there is significant risk of reduced resources being available to their needs, which can have tragic results. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. Um
CAMPBELL - Do you have any specific data on the type of care that might be needed for veterans as we move forward? For example, you know, Senator Velis with the last conversation we had about dementia care,5353 traumatic brain injury, illnesses and and injuries of those sorts. Do you have any comment on that?
GROGAN - I can't speak to specific medical instances among the veteran population, but as the veteran population becomes concentrated in the over 65 age category, medical needs specifically including dementia and those needing long term care will increase proportionally. So this leads to a situation where the veteran population drops off within the general population exactly at the moment, when their medical needs increase dramatically, especially medical needs that need long term care.
CAMPBELL - Do you have any data in front of you? Certainly, send it. But do you have a sense of basic proportionality of what type of decrease that we might be anticipating?
GROGAN - Publicly available data indicates a number of county level and statewide population trends. While the general population at both the state and county levels are growing, veteran population numbers are declining as a reflection of generational change. The rate of decline in the Massachusetts, veteran population is nearly three times greater5435 than that of the United States, at an annual rate of 3.5% as compared to the national rate of less than 2%. Compared to the national5446 rate of decline in the veteran population, only two Massachusetts counties, Franklin and Suffolk have declined slower than the national average.
The greatest per capita veteran population decline in Massachusetts has taken place in Hampshire County at a rate of 12.3%. Only two counties are an exception to the declining trend and veteran populations, Dukes and Nantucket counties, mostly due to retirement relocations. The overall decline of the veteran population, both nationwide and in Massachusetts can be explained by the aging of conscription era veterans and the broad context of generational change. The generations affected by5506 military policies include veterans of World War Two, Korea and Vietnam, who make up the vast majority of long term care residences for veterans, specifically in some instances, upwards of 90% of their residence.
Since conscription ended in 1973, individuals who were 18 years old at the time of the switch are now over 65, which makes at least for the next five years, categorizing this population quite simple related to census records of the over 65 population. In both Massachusetts and the United States, the population of individuals over 65 represents roughly 15% of the population. Massachusetts counties with smaller senior populations than 15% include Middlesex, Nantucket and Suffolk County's. Suffolk County is home to the lowest proportion of seniors in Massachusetts at 12%, while Barnstable County is home to the highest per capita senior population at 30.6%, demonstrating a wide variety in the proportions of veterans throughout the counties. SHOW NON-ESSENTIAL DIALOGUE
Thank you very much. And
CAMPBELL - That detailed information is that contained in your report?
GROGAN - Yes, it is, including some graphics if that is of assistance. SHOW NON-ESSENTIAL DIALOGUE
Thank you so very much. That's very helpful. Um, Senator Rush, would you uh, like to comment or5590 question? Yes, thank you very much and thank you for being with us here today. We really appreciate it. Um uh
RUSH - When we work on issues in Massachusetts, for many, many years now we ensure that data is driving decision making, so this is really really important. If you were advising our committee, moving forward, looking at the Soldiers' homes, looking at veterans, is there any advice from the data and reporting you have and a blueprint that we should put together to treat our older into aging veterans? I'd love to get your input on that.
GROGAN - Well, one specific problem that occurs in data for this veteran population is a veteran status hasn't been included in the US census since 2000. So there are a number of assumptions that are forced to be made, Massachusetts does keep very helpful records for their citizens but it is challenging to compare that to the rest of the population. So any type of question regarding veteran status, whether it's at the state or national level is very helpful and is almost irreplaceable when mapping out potential population trends. SHOW NON-ESSENTIAL DIALOGUE
Thank you very much. Great job on the5671 research. Thank you. Thank you. Um it's very timely and helpful for us um as we move forward. Um uh leader balls or I believe it is with us and has a question comment. Red balls are yes. Hi, thank you for your research and and thank you, madam Sheriff, recognizing me. Um
REP BALSER - I was struck today, maybe I should mention last session, I was the house Chair5701 of the Joint Committee on Elder Affairs and like you, our researcher today, when I took on that responsibility, I didn't5711 know that it was going to end up being about a global pandemic that was targeting older adults but that's in fact what5719 that job turned into just as yours and your research turned into. One of the things I was struck in both your comments today,5727 as well as the two prior folks who testified today was how similar the comments were in the context of services to be available for veterans that are similar to the conversation about older adults generally.
So we've heard a lot about how long term care facilities need to be improved, a shift to private rooms and making it more of a home for our aging adults, and the importance of expanding the continuum of care, you know, include assisted living and supportive independent housing. You spoke today in your research about the importance of services, you know, for aging veterans, that just struck me as so similar to the conversation we have about what's important for all older adults but you also talked about the decline in numbers relative while our aging population generally is actually growing and is becoming an increasing proportion of our whole population,5789 you note that the numbers for veterans are going down and you made an interesting and5794 powerful comment, you expressed worry that that could lead to tragic results, and I have a feeling you meant that there could be a reduction in services to veterans because of the decreasing numbers.
I wonder whether you could speak to the importance of services that are organized uniquely for veterans, so, you could imagine if there were fewer veterans, maybe someone would say, well they could live in any long term care facility, why does it have to be a Soldier's home or you know, there are assisted living for older adults, why would it have to be veterans? I wonder though, if you could, and in this committee, we've talked a lot about what proportion of the board should be veterans and should the leadership, the superintendent and the deputy superintendents, and should these people be veterans, so I was wondering if out of your research, you could comment on the importance to the veterans you talked with and interviewed and studied of having a special focus, a special expertise around veterans for these services. I hope made the question clear and I'd be interested in your thoughts about that.
GROGAN - Sure. Of course, there is a balance between allying the veteran population with the general elderly population and there are a lot of recommendations that would deal with both segments of the Massachusetts population. So I don't mean to imply that they're totally separate, but there is overlap within them. Some instances for veterans that are unique, veterans in general may encounter instances during their service that predispose them to negative health outcomes following service, that could be any types of environmental damage done from the types of conflicts they were engaged in.
However, veterans in general, regardless of type of service, are generally, as a whole, less healthy than comparatively aged population that has not served in the military. That is due to a huge number of factors, it could be the amounts of stress put on an individual's body or the different types of skills that were required in the military that are not as relevant to civilian employment, so there are innumerable list of reasons why veterans experience worse health outcomes than their non veteran peers. But because of that, veterans are often at higher risk for developing post service medical complications and are therefore, it's very important to have individuals who may not, I do not feel that they necessarily need to be veterans themselves, but to be well versed in the experiences prevalent among veterans.
Thank you. I find that really helpful and important. I think it will be important in whatever report. Um, this committee, you know, ends up is that we highlight some of those unique qualities because it was concerned, you know, your point about the decreasing numbers and the potential that services could be reduced because of that. It's important to underscore those points you just made. So I appreciate that. Thank you mm. SHOW NON-ESSENTIAL DIALOGUE
Okay Senator Villas I believe you would like6030 to comment or ask a question
man. I'm sure I did but I know I know that the rectum had her hand up before me. Okay well your true gentlemen thank you rep don't why? Thank you madam Chairwoman and Senator Villas thank you so much for letting me go first. Um And thank you mr Grogan for your really terrific research.
DOMB - I have a question, it's about this whole idea of the collection of data and how we can best understand it. In my previous position operating a basic need service organization and collecting a lot6069 of data on a variety of things, including food pantry recipients, I was encouraged by a good6076 friend of mine who worked in services for people6080 who had served in the military that when we collected data, because we weren't, as you noted, we weren't actually expected to collect data on veterans, but we wanted to, we wanted to sort of show what we were doing, we were6095 encouraged to use the term people who have had military service because the thought was that a lot of people who are veterans, but not necessarily veterans of combat don't view themselves as veterans. I'm wondering if you could just6107 reflect on that understanding that I had at that time and if it's accurate in sort of looking at whatever data comes up that uses the term veterans, particularly since I think a lot of people have had military service but not necessarily seen combat.
GROGAN - That's a very interesting question, thank you. I have found that the term veteran means different things to different people including individuals who have served in the military. A common question that has come up in my work has been to switch from veteran to have you served in the US Armed forces when collecting data. However government and a lot of non profit research uses the term veteran, so we are almost forced to use a term that we realize will not fully encompass the veteran population and some people may selectively opt out of using that term. It's not universal but there have been multiple studies that women veterans in particular have shied away from using the term veteran because of a cultural association of what a veteran is and what a veteran looks like and who a veteran is.
So once individuals are posed the question, have you ever served in the US Military, some6187 people will say yes, who said no to the veteran question. That is a challenge and that's something when conducting original research. It's very important to be mindful of that distinction. When we conducted focus groups and interviews for this needs assessment. The question of who is a veteran was quite interesting among the different types of populations that responded but in the general data analysis, the term veteran was used almost 100%.
DOMB - Thank you so much. I'm wondering if in populations or in areas or regions where there6217 may be increases in6219 younger people in terms6220 of the population range who have served in the military, if they would be less if age also plays a role and someone disqualifying themselves as a veteran from that cultural idea versus an older person?
GROGAN - That is certainly possible that the term veteran could have a picture of somebody who is older than somebody in their 20's or 30's or specifically an older man that may not have the same type of life experience as a younger woman veteran.
DOMB - So when you looked at the declination of population in Massachusetts and by County, you were just looking at people who identified a certain way with us and who also had a certain age, right?
GROGAN - I mean, the population decline, we had to use government population records to look at the change over time. We could not conduct our own research from 2016 after the fact, although I do think that the discrepancy between people who self identify as veterans and those who may be veterans but don't use the term is drastically smaller than the decline that we predicted just due to the demographic changes. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. And this has really been helpful to my own understanding of the population and research is terrific. Thank you. Thank you
Villas. Are you still with us? I am Madam. Chairman. Thank you so much. And I appreciate you talking. This is6330 this has been this has been great and very helpful.
VELIS - A couple questions. I guess the first question is how do you account for the, I know we're spending a good amount of time talking about the veterans population and what that looks like in the future and one thing that intrigues me about that is how do you predict the unknown? How do you account for the unknown? I guess what I6352 mean by that is this is just for my the morning headlines, if you will just reading them to you, Russia steps up aggression in eastern Europe, China tightens grip in the south China sea. Due stay beyond the May 1st withdrawal date in Afghanistan for the current peace agreement are ongoing activities in Iraq and some of the bombings that were doing.
I know you know this, I was just doing some homework, you guys are phenomenal organization studying national security. But right now we're in this kind of this transition, if you will, from the global war on terrorism to potentially and God forbid preparing for some type of a near pier adversary conflict with a China, Russia, North Korea, Iran. I think it's safe to assume, obviously stating the obvious, that would be all of our worst nightmare come true but if it did come true, I just think there is reason to believe that the veteran numbers, the current projections would increase exponentially if one of those conflicts were to come to fruition.
So I guess when you're doing these assessments, how do you account for and I think this helps us in any number of ways, how do you account for that hypothetical that unknown that we hope never happens but if it does in fact happen, shouldn't we be considering that when talking about the future of these homes, the futures about the population's etcetera.
GROGAN - Certainly. So it seems the question you're asking is whether or not in the future conflicts could reinstitute conscription?
VELIS - No, I hope not but I guess what I'm saying is that you know, I guess one of the lessons we learned from 9/11 is that the kind of the erasing of that distinction, if you will between the active component and6459 the National Guard and the Reserves, there's a lot of folks right now, right, we're drawn down in Afghanistan, we think we've drawn down in Iraq and all these other places where right after 9/11, a6470 lot of the folks who are currently in the Guard and the reserves may have attained that veteran status, but they might not now because the operational tempo has gone down significantly. But if we were to engage in one of those conflicts, you're going to see that go right back up. So I guess to answer your question, no, kind of what I just described but also, I mean, I don't if something like that were to happen, who knows what would happen at the national level in terms of re instituted conscription.
GROGAN - Right. So it is of course impossible to know everything that will happen in the future when making these types of models. The population forecasting model that CNS uses, the geometric growth model which does rely on the rates in the past to effectively predict the rates of population change in the future and that is an assumption built into the model, however, because of the6520 veteran population specifically, there are some assumptions that can be made related to death rates of previous generations over the years in the United States, an increase in medical knowledge, an increased lifespans throughout the United States makes the predictions a little more solid but however they will never be 100% just due to geo political factors beyond our capability and policymakers and policy researchers in the national security space do have some ideas of what future conflicts will look like but we don't know for sure.
We have predictions made by experts at the pentagon, but whether one happens instead of the other is unknowable but this is an important part of predicting models because these are known unknowns. These are elements of the population that may change in the future, and if they do, we will adjust our models but we are discussing veterans of World War Two, Korea and Vietnam decades after those conflicts ended. If we were involved in a conflict that required a great increase of the military population, then those numbers would be available almost immediately for changes in budgets for decades down the road.
VELIS - So I think, and I think you stated it so part and I think the the rhetorical question based on your answer, the numbers that you have right now, if in fact we were to enter one of those conflicts, the numbers you had would be6632 subject to change?
GROGAN - Yes. The numbers would be subject to change and there would be room to make that change with time to spare before those veterans need long term care in their later later years of their lives. SHOW NON-ESSENTIAL DIALOGUE
Excellent. And
VELIS - Wouldn't it be, I mean, I guess on some level and I'm speaking for myself and myself only but as we kind of have these discussions about kind6656 of projecting into the future as much as we don't want to consider that possibility, isn't it something that at least should be part of the conversation in terms of what if this did in fact happen? You know, providing some leeway if you will to account for that?
GROGAN - Yes, certainly. Questions of what if this happens are extremely important for making long term decisions, for making short term decisions, we do generally have to rely on more immediate known knowns instead of the known unknowns but they're extremely important for making long term plans, especially when it relates to demographic change that the United States has seen drastic demographic change in the past century,6695 some of which could never have been predicted 100 years ago, but now seems much more realistic. SHOW NON-ESSENTIAL DIALOGUE
Excellent. Thank you.
VELIS - I have a completely different topics, something from your report that I was hoping that you could just expand that a little bit if you're talking about Western Massachusetts veterans and you say the often isolated vets of Western Mass may lack transportation and don't have access to the quantity and quality of social support available and the more populated parts of the state. If you could just speak to that6725 a little bit.
GROGAN - Certainly. From our focus groups and interviews with local6730 veterans, we made an effort to speak to veterans from across Massachusetts realizing that life experiences are quite different. Something that came up6737 multiple times when speaking to veterans outside of boston was that many, but not, of course not all service providing organizations for veterans are headquartered in Boston and the options for veterans outside of Boston are either to travel to Boston or use the services of organizations that have spread their resources across the smaller cities of the commonwealth.
So that's something that came up multiple times that they did feel like the options for veterans in Massachusetts were enormous and they were full of options for veterans who lived in the urban environment or the Greater Boston region, but that hadn't fully spread6783 out to non Boston area veterans,. Especially because veterans who lived in Western Massachusetts were generally but not exclusively older veterans who lacked the technological ability to access virtual resources that were in Boston. This was also taking off during the Covid pandemic during the summer that a lot of service organizations pivoted to virtual6805 services to reach veterans outside of their immediate towns and localities but that did leave out many veterans who were not as familiar with virtual offerings.
VELIS - Just to be clear because you referenced Western Mass specifically and then you mentioned Boston, is it Western Mass kind of exclusively that you're seeing6827 this or is it the most pronounced in Western Massachusetts? Because obviously, as you know, as we all know, there's6834 more in the commonwealth and just Western mass and Boston. So I guess by way of example, there's the same phenomenon apply and say Southeastern Massachusetts or Cape Cod or is it you specifically identified Western Massachusetts as a problem spot if you will or I'm not a problem spot, a place where there's access to services a more pronounced issue.
GROGAN - We specifically noted that Western Massachusetts did lack more of the resources than other non Boston areas. However, due to the sample size of our veterans that we spoke to during the course of the report, we did not feel comfortable making specific pronouncements on non Western Massachusetts, non Boston areas because we didn't speak to enough veterans to make those pronouncements, but we did for Western Massachusetts. The comparisons that we also included in the report included pre existing data from other organizations, we were unable to reach veterans in every single city in Massachusetts to make the comparisons stick across the board. If that answers your question. SHOW NON-ESSENTIAL DIALOGUE
I can't thank you enough for your time. I appreciate it. Thank you. Mhm. Thank you very much. We have6916 another question or comment. Um Red Paracel, are you still with us? I am. Thank you, madam Chair. Thank you very much for your testimony today.
REP PARISELLA - I'm not sure if you addressed this, but I just had a question and Senator Velis has sort of brought it up earlier. You know, we don't have like these big military installations in Massachusetts, like other states might have, you know, we don't have a Fort Hood and fort Bragg or something like that, or big Naval station Norfolk, so it's a lot of the reserve serving in their communities. How does that impact the quality6951 of services that veterans can get in here in Massachusetts?
GROGAN - Sure. So in the report and in my work about veterans, we find that veterans upon leaving service do one of three things, return to where they were originally before they entered military service, set down roots where their last installation or go somewhere completely different. The go somewhere completely different is a little bit of a wild card in terms of data collection because if somebody is returning to where they had roots, we do find that they have a little bit of a leg up upon accessing services because they may be more familiar with the service providers, they may have family members who can assist on their behalf while they're still in the military and so Massachusetts being a place without installations that people stay in upon leaving service are split between the two populations of people who are already familiar with Massachusetts, either they grew up there or that was their last place of residence as an adult before entering service or they left, they came to Massachusetts on their own accord. Maybe because Massachusetts has a reputation of being very veteran friendly7023 in terms of employment and other types of benefits. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Sorry, my dog just said a barking fit, apologize for the
life of a zoom meeting. I appreciate that, appreciate that.
PARISELLA - So, but Massachusetts does have sort of that unique aspect of what, where every community is supposed to have a VSO veterans service officers. So how does that maybe help in a way whereas we might have those big installations, but we do have those services available.
GROGAN - Yes, the the VSO in every town concept was something that7057 came up in multiple interviews from local veterans. We did speak to veterans service officers in different cities as part of our7065 research and their commitment to the VSO in every town seemed to be very effective when reaching different veterans. However, veterans did in our local interviews with veterans who are not stakeholders themselves did find that there were some smaller towns who their resources were stretched between multiple service officers who had to cover multiple towns, so it was a draw that was mentioned as why people decided to return to Massachusetts, but that there was a little bit of stretching that had to do with the population of veterans may be in more rural Western Massachusetts, areas of the commonwealth were spread a little thin in terms of Veterans Service7110 officers, through no7111 fault of the individual service officers who were dealing with the population. SHOW NON-ESSENTIAL DIALOGUE
Great, I really appreciate it. Thank you very much. Thank you. Mr.
Thank you very much. Um Natalie, are there any other members of the committee who wish to comment or or add a question at this time?
Okay. Um Natalie, thank you very very much. Uh7132 have any afterthoughts based on any of the questions? Please feel free to comment um to the committee that would be most appreciated and we will circulate your um your report uh to the rest of the committee, some of whom were not able to join us today. Um, so we will get that out um broadly and and want to thank you for uh, for what you're doing really to help veterans. Um and it's most appreciated in your testimony and bearing with us with questions. Was most helpful. So thank you so much for having. May I ask one more question? This is Representative tom I'm sorry. No, apologies. Next. Sorry, go ahead. Thank you. I'm sorry. And thank you. I don't know if your report covered this and I don't think it did, but I
DOMB - I just realized that your expertise, though, may be able to answer a question for me7197 when you look at veterans facilities across different states, is there a ratio of veteran to full time staff that you think is sort of either the average or the optimal?
GROGAN - That's a very difficult question to ask and to answer because there is such a wide variety of types of service providers. Service providers that are in urban areas are dealing with just issues that are significantly different to service providers that deal primarily in rural areas, in suburban in between. So keeping that in mind it's it's almost impossible to say a specific ratio, however, the smaller the better for more more individualized services for veterans, because one size does not fit all and a targeted approaches is always beneficial for veterans.
DOMB - Do you know of research that has looked at it from the perspective from just a specific model of a 24 hour health care facility?
GROGAN - The only research that I can think of off the7256 top of my head really specifies elderly individuals in need of long term care and not veterans specific residences, which adds another dimension to the research. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you, madam, Chairwoman. I'm sorry to interrupt a pleasure. Um Are there any members of the committee who wish to comment or add a question at this time? Okay. I am seeing none. I don't see that well, but I'm hearing none from my colleagues here. Um, I need a motion to adjourn,
so moved. Okay, and I need a 2nd 2nd. Okay. Thank you very much. This hearing of the Special committee to investigate the tragedy at Holyoke is over and again. Thank you for all who are able to be here today. Right. Thank you so much. Thank you. Thank you. Thank you very much for being here today. Hmm.
Mhm.
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