2021-05-03 00:00:00 - Joint Committee on Public Health
2021-05-03 00:00:00 - Joint Committee on Public Health
(Part 1 of 4)
SHOW NON-ESSENTIAL DIALOGUE
way
to wish everyone a good afternoon. Thank you for joining us. While this is not how we usually have gathered, It has become more usual over the last year. It is our first joint committee of Public Health and it is our first virtual hearing. So I hope that we're able to find a way to combine these um but that they won't be out of necessity um in the near future. So um I am joined here today by my senate co chair joe Comerford from the city of North Hampton, the great city of North Hampton. I love it. Um And I believe, I'm just gonna say, I believe my committee members that I am joined by our my vice chair brian Murray who is here in the virtual world somewhere. Mr. Vice chairman. Thank you. Um Committee members, paul Schmidt,58 committee member Jack Patrick, Louis60 committee member um Andy vargas committee member john santiago, committee member, brian ash, committee member, que con committee member Van IT howard. Welcome Vanna. I think this is your first hearing um As a new member and committee members, Hannah kean and Sean Dooley. So those are members from the house that I wish to welcome here today and before we jump straight into the hearings. Um I just want to ask my my co chair senator coma for to introduce her members. Thank you so much, madam chair. It's good to be with you um And back serving on this wonderful committee. I'd like to welcome Vice chair Susan Moran also starting her first session with us formal session, full session uh And senators, Chandler Roush Sear and O'Connor, who106 are the senate members of this committee? Yeah great thank you. It's great to have everyone here before we proceed. Just a few housekeeping details. Um Please do remember to put your mic on mute. So that's a new instruction here for a committee hearing.123 Um We might miss that one in the future but please do put your if you're not speaking please put your mic on you. Um If you have a question and your committee member please um use the appropriate committee chat. Um to convey that you would like to be recognized by the chair. Um In the case of testimonies by panels, I ask145 that members hold all of their questions until the entire panel has concluded its testimony. Um And committee members are also I guess you can use the raise your hand function to um also conveyed to us. So raise your hand, use the chat or try texting and we will make sure we recognize you. Um staff is watching out for you um For those who are here to testify before us today, we have a lot of people signed up. Please limit your testimony to no more than three minutes out of respect for everyone else that they can be heard. Um You will see time notifications in the chats. We will try to remind you that where your time is at 32 and one. If you're testifying on more than one bill Please provide your testimony on all bills during the three minutes allowed. Um We are asking190 you not to have repeated um appearances before us in the same hearing. Um If you would like to speak further, have additional written comments, please of course submit those to the committee staff as well, testimony submitted from an organization. So if you're submitting testimony today and you're representing an organization, an institution accompany corporation. Just know that upon request that testimony is always made available to the public. Um And we will um go ahead and hear testimony in the order that the bills were listed on the notice in the form that was sent out. And I'm seeing um Senator Friedman pulled the short straw and is the lucky one who can begin. So we're just gonna jump right into this because there's so many there. Welcome Senator Friedman,
SEN FRIEDMAN - SB 1439 - HB 2261 - Thank you Madam Chair um and to Madam co chair and to the members of the committee and thank you so much for allowing me to talk to you today. I am here to testify in support of S. 1439 and the companion bill filed by you madam Chair H 2261 Um And I also wanted to thank very uh deep thank you to Samir Severa who brought me this bill last session. Um I brought us both I believe last session. Um This bill is really quite simple and straightforward. It would require the chief medical examiner to review and approve any findings and report related to the case of the death of a child under the age of two years old.
The oversight requirement would also extend to any changes to an autopsy report for a child under the age of two and any change would have to be reviewed and approved by the chief medical examiner. Right now the associate medical examiner who may have very limited experience with pediatric cases can revise a death determination without any oversight from the chief examiner. And this bill is intended to310 recognize the fundamental differences between pediatric forensic pathology, an adult forensic pathology. And These cases they involve319 very, very young children. Their complex, they're sensitive, fortunately they're rare. They represent fewer than five of the cases handled by the medical examiner's office but in the mean.
But that means that the cases deserved to be reviewed by the most experienced medical examiner and that is the chief medical examiner. Um Last session this bill was referred received a favor favorable report from this committee. I know that COVID limited our ability to move many of the bills that we would have liked to forward including this one. So I'm respectfully asking and urging you to report this bill favorably at your earliest convenience so that we can ensure that this really important piece of legislation reaches the finish line and becomes law. I think this is um a small ask for a very important issue and I think it will um especially helped380 those who find themselves in this terrible situation um as parents. So thank you so much for hearing my testimony. SHOW NON-ESSENTIAL DIALOGUE
Thank you at this time whether any questions from members.
Okay Hearing man. Thank you Senator Friedman. Thank you. I just add399 my thanks to you, Senator Friedman for this important bill and to you, madam. Chair Yes. Um Thank you. I if somebody actually has their hand up, so409 I've got to figure this out here. It's not clear who
I'm gonna have my staff text me right now because I see a hand up, but I can't see who.
Mhm.
Okay. You know what um Senator Friedman, if a committee member has a question and they haven't been able to get to you're gonna have him call you. Okay? You know what I mean? All right, thank you. Senator Friedman. Thank you. Okay. This time I'd like to welcome together rep steve Owens and Representative Dave Rogers. Yeah,
REP ROGERS - HB 2393 - Thank you, madam Chair uh greatly this is Representative Rogers. Um I'm joining you from my iPhone in these technologically complicated times. And so I appreciate this opportunity. Um And if Representative Owens also wants to speak,464 uh honor your obviously your time constraints and I want to thank you Chair Decker and Chair Comerford and members of the committee for your time and attention on H 2393. That's an act relative to improving asthma in schools. I filed a bill I filed with Representative Owens and the bill is focused on protecting children by improving indoor air quality in schools. Uh it's known that indoor air environments are likely sources of triggers for individuals with allergies or asthma and the COVID-19 pandemic has forced us inside far more than ever before adding to the potential risk for those triggers.
The CDC states that patients with moderate to severe asthma could be at greater risk for more severe disease. And with students now returning to schools full time, there's no better moment to take action to ensure air quality in our schools is not yet another health concern their parents and students need to work. Worry about communities of color are disproportionately burdened by asthma when comparing cases to white Americans, black Americans specifically are 1.5 times more likely to be diagnosed, five times more likely to visit the emergency room with asthma and alarmingly up to three times more likely to die from asthma. While these differences are not new.548 When you add these to the systemic health inequalities and the disproportionate devastation that communities of coloured Have suffered during COVID-19.
We're facing a problem that must be addressed. Um While I filed this legislation for now for for eight years, it's clear to me that there's no time or no moment at which it's been more opportunity to act on indoor air quality and this can begin now. Um so, um um again, I respectfully ask for you attention to this, Roughly 12% of children in Massachusetts have asthma, but with some schools see rates as high as 30 to 40% and with schools that have a bad uh huh record596 on on asthma, bill calls for an indoor air quality plan for cleaning products that are safer and for a whole variety of other measures. So chair comfort, chair decker, thank you so much for your time and attention. I really do appreciate the opportunity. I know you're operating under extraordinary circumstances holding a hearing in this fashion. So, so I'm very appreciative. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Representative Rogers.619 Um at this time I would ask Representative Owens to come forward.
REP OWENS - HB 2393 - Hi sir, again, thank you627 so much for coming third chair decker. I apologize for being also on my633 iPhone. Um I just, just to add to what uh what sherry Rogers is that I just wanted to you know reflected how just how much this bill meets the moment that we're in. But it is also it's also important when COVID is behind us. Uh That's why I come to you not just as a colleague but as a as a child, parent of a child with asthma. Our youngest son has been hospitalized several times due to his asthma. Uh first time when he was only two before that I might have thought that asthma wasn't serious that it just meant that kids get out of breath and that they when they exercised. But but now I know firsthand what it's like what it's like to spend days and nights in the hospital waiting for your child's oxygen levels to return the normal.
I know what it's like to hear even the chinese cough or680 sniffle as if it were a car alarm and I'm not alone. DPH. Says one out of every 10 school age children has asthma. Uh So our sons as was under control now with medication. But every year we have to submit a copy of his action plan to his elementary school. And696 what this bill would697 do is require the schools to do the same. The schools with the highest incidence of asthma to put together their own plant, an indoor air quality management plan. Um Just to reduce the constant exposure to allergens the children experience every day while they are in school cleaning products also can trigger asthma if they contain the chemicals, perfumes, pesticides, etcetera. So this would require uh environmentally safe cleaning products as well. So I thank you for your time not to726 repeat what what they're Rogerson said, but thank you so much and I urge you to pass this bill or reported out so that the whole school community can breathe a little easier. Thanks. SHOW NON-ESSENTIAL DIALOGUE
Yeah thank you. Representative Owens, welcome to your first public health hearing um and thank you for this bill as a vivid memories of being in the er as a child myself with asthma and um living in public housing. So I certainly understand the correlation and appreciate you bringing the bill the bill forward. Um at this time are there any committee members who have questions? Um Just to remind committee members we have a a dozen plus legislators who are signed up ahead of time and then we're hoping to get straight to the public. So if you have a burning question for your colleague let me know otherwise. Save775 it.
SEN COMERFORD - I raised my hand. Yeah thank you so much to both representatives for this important testimony and this really important bill. I had a question um and I can follow up offline as well on the environmentally preferred cleaning products. Um Would you imagine d ph um factoring in the kind of products that would be banned and the kind of products that would be preferred? I can't imagine that DPH would do labels X company better than why company. What was your thinking here? SHOW NON-ESSENTIAL DIALOGUE
Representative points or Rogers either one.
ROGERS - Yes. Uh I think Senator Comerford uh you're right. That would be highly unlikely that DPH would do labeling. Um What I found doing research is mostly only the federal government has the kind of depth of reach with scientists um and to do that kind of detailed analysis and and labelling. But I think what the bill calls for it defines what environmentally preferable products are and then calls for their use as part of a larger indoor air quality plan. And um I'm happy to follow up with you and work with the committee um on you know, best practices for how if there is any specific drafting we need to on the bill uh in addition to what's already there.
COMERFORD - Thank you so much. I see the connection to DPH in the bill and understand that the state would certainly have to consult with the DPH for that level of granularity. Thank you so much.
ROGERS - Thank you. SHOW NON-ESSENTIAL DIALOGUE
Okay. Um at this time I would ask Senator Sear and I know Representative Lewis who is a member of the committee. You sent me a text but it was I was getting ready for this. All I saw was you with the name. See I don't know if you were asking to speak together. I'm going to guess that's what it is. If it is of course you both are Senator Segal and then Representative Lewis
Representative Lewis, I don't know. I can't see if Senator Sears on here. So if you want to start.
REP LEWIS - HB 2349 - SB 1404 - No worries at all. And thank you so much for your flexibility. I know that Senator Cyr and Chynah Tyler we're free a little later. So maybe they'll have a chance to share their testimony later in the hearing. Uh, but again, thank you so much for this opportunity. Just want to take a minute to talk about H 2349 an act relative to HIV prevention Access for young adults of bill. I filed with Representative Chynah Tyler and I'm working closely with Senator Julian Cyr on the companion bill in the Senate S 1404. Again, I want to thank the chairs for scheduling this bill for such an early hearing. It may be a surprise to many of us. It certainly was to me that youth between 13 and 20 for account for 15% of all new HIV cases here in Massachusetts.
And while our commonwealth has a lot to celebrate in our combating of this pandemic by fighting stigma and decreasing the number of new cases, there is currently a gap in our state laws that is preventing everyone from accessing HIV986 prevention medication. We have a long track record of leading the country in preventing new HIV cases. Our current laws allow young adults to access HIV testing and HIV treatment, even in situations where parental consent cannot be obtained, which has saved countless lives, and again, has been a model for the rest of the country. But because HIV prevention1011 medication did not exist when the current laws were written, the same1016 17 year old who currently has access to birth control, abortion services, HIV taste testing and HIV treatment.
Even if parental consent cannot be obtained, currently cannot access HIV prevention medication, even if her doctor recommends it and believes that not having access to this medication dramatically increases her chances of contracting HIV as many of you know, prior to being elected, I served as the founding executive director of Out Metro West, a regional nonprofit for LGBTQ, Middle and high school youth. And it was at the request of the young people themselves that we partnered with area public health organizations to ensure that none of our participants were denied the information and resources necessary to make informed decisions, especially around HIV.
It was in this context that I first encountered our current laws as it related to HIV prevention policies and1073 met young people without full access to this medication allowing young adults access to HIV prevention services is definitely within the spirit of our current laws, but we need the committee's help today to make this technical fix to ensure that no one is prevented from accessing HIV medication recommended by their medical professionals. Without this change. I worry that the inequities in access and prevention will only worsen, leading to greater personal suffering and collective public health declines. I'm happy to1104 answer any questions the committee may have now or at any time and again. I'm grateful for this opportunity to speak with you all. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Representative Lewis. Um
Are there any questions for Representative Lewis at this time?
Okay. Senator Common for Do you have your hand up? Okay. I think it's up there in the little chat box. Um Thank you. And I will ask again. I can't see his Representative Tyler joined with us this time. Where? Senator Seer
Okay. I don't see Senator sear. Right. We'll come back to them. Thank you. I'm sorry Senator Lewis. Yeah. Yeah. Okay. At this time I would like to welcome,
I can't say one of my favorites just that we've known each other since high school. Um Senator Saudi Domenico. Um Come forward. It's good to see you.
SEN DIDOMENICO - SB 1409 - HB 2383 - Great to see you, madam Chair. Thank you to you. Your doctor Comerford member of the committee. I would be very brief. This is an important bill that I have filed for several sessions. Uh Senate Bill 1409 And our companion bill, Representative O'Day, House 2383. And I'm speaking in support of an act regarding paediatric palliative care. Which would address the critical need for pediatric palliative care services from all eligible students and children about the commonwealth. As you know, the ST Peter Claver Care Network provides comprehensive care for children under the 19 living with life limiting illnesses and unfortunately end of life services.
And it's an important source of support for our families. They provide nursing and on call services counseling, sibling support, social services, volunteer support, complementary therapies,1215 respite care and unfortunately again, bereavement care if needed through the testimony of some people today, you'll hear how these services go above and beyond DPH services in an effort to normalize in his life during these trying times. So that's the program's inception. While the 4000 children and their families have been served by this critical program. Currently, about 505 children are receiving services today. However, year after year,1245 we have to keep fighting for additional dollars.
Because we have underfunded this program in the past and the waiting list keeps growing. It's1253 unable to serve all the children and families in need of the services. The waitlist, Comey stands at 135 children. That is1263 very misleading because providers don't refer children when there's a wait list. So the number is even higher than that. This bill would also allow children to receive services under the age of 22. Currently, children in high school can even age out of the services, which is not acceptable, especially when it's within our capabilities to change that number. That is why I filed 1409 in the Senate to guarantee adequate funding.
These children deserve quality care and support throughout the duration of their illnesses and at the end of their lives, their families deserve the support they need as they face one of the most traumatic times in their lives. And I also want to say, we have a strong coalition of members who have been working on this bill for several sessions. And I've heard the personal stories of these families, particularly under life services where kids don't have time to wait. This wait list is unacceptable uh, in1314 a commonwealth like ours. So we have the resources to buy this care for our students, ensuring that these children and families have the extra care. That's what they need. It's only should not be subject1324 to appropriation. And I respectfully request your support for this bill going forward. Thank you very much.1329 SHOW NON-ESSENTIAL DIALOGUE
Thank you, Senator.
There's any questions for Senator Di Domenico. I will move on to Representative Barber.
Thank you. Representative Barbara.
REP BARBER - HB 2331 - Thanks chair Decker, chair. Comerford really appreciate all these critical issues um that are coming before you were regarding children's health and strong support to the last actually, three bills, all the bills that we've heard so far. It's just really important issues before you today. Um I will be brief. I come before you today on H 2231 and Act Improving Eye Health. Um this is a bill, an issue that I've worked on for a number of years with children's health, um advocates working on improving children's I care. So in Massachusetts, only 59% of students who enter Kindergarten have had the required vision screening from their primary care provider And in school districts and low-income communities. The reported school screening screening rates are much lower, at around 31%. Um, So while Mass was a leader in requiring kids to get vision screening to start kindergarten,
We need to build upon this and do1398 much better than we're doing now. Um we now know that of course uncorrected vision impact school readiness literacy and can lead to behavioral issues and many other challenges for children. And recent reports star, really strong correlation between children's vision and early literacy success and these effects are really most acutely felt by low income children, children of color and kids with disabilities. We know that children don't know what the problems are with their eyes and that they need to have high quality screening and follow up care. So the COVID crisis has only exacerbated this issue, like with many things for over a year, children statewide haven't had any formal screening for the most part and1445 any fittings for eyewear. Um so Massachusetts is really failing children in this regard right now.
This bill is the next step that we're taking on these issues. So we had started to work on these issues a few years ago and found a number of challenges with data many different agencies working on different pieces of this. So in the FY 18 state budget we created a childhood vision and Eye health commission. Um I served on that commission along with a few experts who you'll hear from today, optometrist, ophthalmologist, school nurses, people who are experts on these issues as well as DPH EEC DESE And that commission we worked on consensus recommendations on these issues facing children's vision. So creating uh data system statewide for comprehensive screening, ensuring eye exams happened earlier much earlier than kindergarten to actually catch and treat these diseases. And then looking at provider shortages, particularly in Western Mass. There's almost no pediatric providers, but also in other parts of the state.
So we base the legislation before you off of the commission's um recommendations. And this bill would create a statewide data system for screening and follow up care for children in schools. Um And it would also create a children's vision advisory council to continue to make recommendations because this will be a long term fix. Um Unfortunately, given the pandemic, we do not yet have the final version of the commission's report. We've been working really closely with DPH and we understand the report should be completed um in the next month. Um So we know that this bill might change somewhat when we get the final final commission recommendations. So we appreciate the committee's patients. We may1553 have some small changes to make to the bill but we hope to keep working with the chairs and with the committee on this important issue. So thank1563 you. SHOW NON-ESSENTIAL DIALOGUE
Thank you Representative Barbara, We look forward to working with you and hearing more. Um as this moves along. Um If there are no questions for Representative Barber, I will welcome Senator Julian Seer.
SEN CYR - Thank you. Chair Decker and to share common for two members of the committee. Appreciate the opportunity to testify on a bill you've heard about and to others you'll help out shortly. Um want to testify in support of the bill I filed with represented Jack Lewis and represented Chynah Tyler, an act relating to HIV prevention Access for young adults um in my capacity as one of two openly LGBTQ members of the Senate uh and and and six members in the House. I'm very intentional about legislating to improve the lives of our community, which often still not have adequacy or representation. Um and I really think about this in the context of the HIV aids pandemic, the first pandemic of our era era which hit our community collectively hard in my community here on the Cape and Islands.
Particularly, you know on the Outer Cape. I grew up in in the Outer Cape in Provincetown in the eighties and nineties and I saw how many people we lost HIV right, These are my my parents, friends and and our neighbors and loved ones. Um and and so getting to zero HIV infections is really personal to me, as it is to so many of us. Um and while we've made really significant progress, um we have a unique vulnerability for LGBT people that remains according to the Department of Public Health MSM. Uh male to male sex remains the predominant exposure mode uh in Massachusetts from 2009 to 2018. And we know that LGBTQ youth are at high risk uh for HIV infection, particularly black and latino men and young men. Um so of new infections in Massachusetts, 35% of adolescents and young adults um.
Recently diagnosed are black or Latinx. And so prep pre exposure prophylaxis that you heard about from Represenatative Lewis is a game changing medication. Um, speaking as a queer man, virtually all of my friends and peers take prep, I take prep. This is just something that, that that is part of um, good public health, but we need to make sure that that minors in Massachusetts, um, particularly LGBTQ youth1697 who may not have a supportive parent or guardian get access to this life saving medication. Um, I really view this is very much akin to birth control. I view the bill that we filed is very technical in nature. I am proud of what this body did in support of the row act and I really think that this is just uh, in a way, a technical piece that we need to fix to make sure that we are um protecting all people in Massachusetts.
But particularly, um, young men who have sex with men, particularly black and Latinx, um, uh, queer queer youth. So I'm really hoping that the committee can take swift action here. This is something the committee has advanced uh, in prior sessions and I'm hoping for a favorable report. I want to briefly mention as well in support of an act relative to modernizing childhood lead poisoning prevention, which I filed with representatives largest. Uh, this is something another issue I've been working on since my days of being a mid level bureaucrat, The Department of Public Health Massachusetts needs to modernize our, our childhood lead prevention interventions. I'm particularly concerned in1760 the pandemic. We've had a young, a lot of young people right at home, um, with higher risk of exposure to land.
Uh and we've got a lot of work to do here. So1772 you're going to hear more about this from, from Vargas. Um but really when we look at, you know, again, looking at health equities more than not, it's the children of black and brown families who are disproportionately exposed to lead in homes. This has led that should be removed decades ago. The bill would modernize our childhood lead uh prevention laws1791 and it would provide a stable funding stream for us1795 to uh to be addressing the issue, and then finally want to testify in support of an act to update postural screening in schools. Um The law is currently governing postural screening Are well intentioned, but they were put in place in the 1980s. Um and so this bill, this law,1813 the bill we followed essentially amends an antiquated law that requires annual posture screenings and grades five through nine. It's just really not necessary.
I can speak. I remember doing these postural screenings as like an awkward fat middle schooler. They were terrible, like they were really awful. Um and I just think that like we got to find a better way to do this and you know, let's move beyond the world where we just, you know, make all the boys take off their shirts in the locker room, you know, as that kid, that was like a you know, that that was an experience. I I would have preferred not to have to do multiple times in every grade through the fifth through nine. So I'm hoping we can take action1855 there. Thank you both1856 for your leadership. I couldn't be prouder to have both of you, his colleagues in this most important work and thank you for your time and I'm grateful for the collaboration um with my colleagues in the House to take action on these bills. So thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you Senator here. It's always good to see you. Um and thank you for all of your work. Um if nobody has any questions for Senator Sear, I will move on to Representative Duffy, but if someone has a question madam chair, I actually didn't get to a mute.
COMERFORD - So thank you Senator Cyr for your leaders on all of these1888 things. I actually wanted to double back if I could to rev barber, I couldn't a mute quickly enough. I'm sorry. No, no, no, it's nothing. No, you're doing beautifully um in these crazy virtual times rick barber, we can hold this. But I was curious as I looked at the great bill and thank you for leading it and your abiding commitment to this issue, the connection to local, public health and maybe that can be sort of in the next iteration. We saw local public health sort of become the repository of all kinds of twists and changes. And, and we also during COVID and we also saw a really great connection between school nurses and local public health. Um, so I'd be really interested in seeing that. And then also the what you were talking about in terms of incentivizing or potentially incentivizing through your continued to work on this pediatric. I care especially for places like Western Mass, where there are sore desert. So I just wanted to put a, put a pin in both of those issues for future conversation.
BARBER - Thank you Chair. I really appreciate that. And you're right. Um, as we're looking at a comprehensive system for screening, we know so much of this falls in the school nurses right now and1955 figuring out how we can do that as a community, as a team model is really important. So, um, great points and we'll definitely as we continue to work on this, um keep that in mind. So thank you for that comment.
COMERFORD - Thank you so much. SHOW NON-ESSENTIAL DIALOGUE
Great, thank you. Thank you Senator sir. Thank you Representative Barber, um at this time I would welcome Representative Pat Patricia Duffy also welcome, you know, I just feel like all of these new reps who are coming on here for the first time in their first term. This is not new for Representative Duffy because she's a1990 part of that special club of those of us who are staff alumni and then legislators. But welcome Representative.
REP DUFFY - HB 2277 - Thank you so much. Thank you. Chair Decker. Thank you Chair Comerford. And yeah, I've been in the building, but this is very special to be sitting here and testifying on a piece of legislation that I found myself. So um, so happy to be here. And I'm speaking on H 2277 It's an act to promote local agriculture and school nutrition. Uh, currently section 223 of chapter 111 requires school districts to submit wellness policies around nutrition and physical activity. And in this legislation, the legislation very simply adds the phrase at the end of that and school gardens. Um, further the regulation could require coordinating support for school gardens with professional agricultural and horticultural associations. So you know, this idea of having public school children uh, creating their own gardens, learning about food, learning what good nutrition really is, learning about the difference of good local food.
Many people have been working on this uh, for many, many years and you know, I'm honored to step in and enjoin that parade. I won't surprise many of you that I um uh huh was inspired by this idea in the Massachusetts local2084 food action plan written by the Massachusetts Food System collaborative. I know that the food system collaborative has uh, submitted written testimony and they may in fact women, pink cough may actually be here to uh, they've got um, suggestions growing on this idea and I consider them very good suggestions. I would welcome working with the committee. Uh, and uh, of course with DESE on how to make uh, this idea as practical as possible. Um, and I just think it's a, it's a conversation that's happening on many levels of government and I think it's got incredible potential to not only help our students help our families, uh propagate the idea that food is medicine, support our local farmers. Uh, and I appreciate the opportunity to speak here with you all. SHOW NON-ESSENTIAL DIALOGUE
Thank you Representative.
If there are no questions, I will move on to Representative Tricia Farley behavior.
REP FARLEY-BOUVIER - HB 2280 - Thank you so much, Madam, Chair and Madam Chair,2158 members of the committee. Um You know, it's been really interesting listening to all these bills and the breath of policy before this committee is quite stunning and and and so very very important. Um I'm here today uh to testify on H 2280 which is a bill about concussions and specifically about youth concussions and specifically about youth sports concussions. So concussions truly are health crisis that we have. If we had the number of cases of measles or something like that that we have of concussions um in in our schools, we would be paying more attention. But concussions aren't invisible um injury. We can't, we don't always know what happens. we can't see it easily. Um But it has had, it has a great impact on the lives of individuals. I actually filed this concussion uh sorry, this concussion bill several years ago um and subsequent to that have suffered to brain injuries myself.
And um it really does make a huge impact on your life um and recovering from a concussion um takes a great deal of time. Um and medical intervention. Uh2248 this bill, you know, it's not any kind of magic bullet in any way. What it does is create a2258 commission to study um concussions and how to address them um in high school sports. And it's important that uh this be addressed in both public high schools and private high schools. And as we learned when it2276 comes to any public health issue, it's very important to collect the data. We need to have a comprehensive way across the state to collect the data on head injuries that happen as a result of athletic activities. Now, it doesn't um hasn't gone by me that the chairs of this committee are both mothers and their mothers, either of high school students or no, not too far from now going to be high school students. Um And youth sports are part of, you know, part of your lives.
Um And you know, I I think that people generally know that football is the sport that uh has the highest number of of concussions. What you what is a surprise perhaps is that it is girls2329 soccer, that is a very close second. Um in that not boys soccer, but girls soccer. Um2334 And uh you know, when we're looking at sports like lacrosse and hockey, um and and all the different sports that that our kids can be involved in and what is it that we hope this commission will address things like yes tracking it. Yes. Having a response, but included that in that commission, we'd like to see what can we do to prevent these head injuries. Right? So this is not a far reaching bill. It's a bill to take some important steps beginning steps so that we really can address these issues. So I thank the chairs for your time, your consideration um and the committee and I do hope that we can take some good steps forward this session on preventing uh youth concussions. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Representative. Um And I2384 would ask if anyone has any questions of you at this time. Okay. Uh
I see somebody as a question, but I'm not familiar with him as a member. So I'm going to move on. Um Representative Hawkins,
the museum different place than it is on zooms. Found it though.
REP HAWKINS - HB 2315 - Thank you. And I will be brief. I wanted to testify on the little lungs Bill H 2315 constituents have reached out to us to bring this bill back and we appreciate really appreciate your committee bringing it to a hearing so quickly. I also want to acknowledge Joanna Lulacs who is on the list to testify later on because she had one of these, You can't make this up stories the last2445 time the hearing in the last session was for this and2448 she still managed to testify in person. Um, She's got, her thesis was the, an analysis and act to protect little lungs and she'll be testifying later.
Uh, the dangers of secondhand smoke are well documented and the only effective way to protect non smokers and vulnerable children is to eliminate smoking in enclosed places including public spaces and cars. This bill would prohibit smoking in a motor vehicle with children who are required by law to be secured by a child passenger restraint. And it calls for $100 fine for offenders and I will also submit a more detailed testimony later. You don't have to listen to. Thank you. Thank you. I appreciate, appreciate chair Decker and chair. Comerford, thank you so much for your efforts on this. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you for your uh there's some feedback. I don't know if anyone else can hear that. Um Okay at this time I2499 would welcome Representative Miranda who has joined us.
REP MIRANDA - HB 2371 - Good afternoon everyone um to Chairwoman Comerford, chairwoman Decker and members of the committee. Today, I'm here in support of H 2371 and act relative to conducting fetal and infant mortality2515 review. In May of 2017, I was present at the live birth of my middle sister, Cristina's daughter, Mila, was born at just 21 weeks and after watching her take a few breaths, she passed on the day before. My sister had complained of severe pain to her providers and was told to stay home, take Tylenol and rest in the early hours of the next morning, my sister was rushed to the hospital with me by her side and went into early labor, Neela had a story. She2557 was loved and more than anything, my2560 sister wanted to be a mom her entire2563 life. This experience has stuck with me for the last four years and it's something I'll never forget. In 2019, in my first week as a freshman legislator.
I received a presentation from the march of dimes Massachusetts chapter for women legislators. It was in that room where I heard the alarming data at all. Six of my2586 zip codes in my district had some of the poorest maternal health outcomes and the entire state. I knew then as one of only three black women in the entire legislature, now four, um, and a lifelong resident of this district, that I had to make this a top priority for myself, for my community, for black women and for my sister. After this presentation, there2612 was a deep sense of defeat. I did not know how to name the emotion. I'm not a mother, but I thought2621 of them.I thought of my sister and my mom, my friends and all my family members to whom that I never knew how to describe what I2631 knew that they had been through, which now I know is maternal injustice after this moment and then became a leader in maternal health and injustice in the commonwealth.
Passing legislation to establish the Commission on racial inequities and maternal health, as well as filing three other bills this session to extend postpartum coverage from 60 days to 12 months. This conductive fetal and infant mortality review and across reviews across the state and to ensure duelist services are covered under NASA, this is a public health crisis even in our commonwealth, with the greatest health institutions in the world, black women here are still 2-3 times as likely to have an infant that passes away by their first birthday, although Massachusetts remains a leader in positive maternal health outcomes are successes not equitably distributed across this great state. Communities such as Roxbury and Dorchester, Mattapan and Hyde Park here in Boston, Springfield would stir in Brockton continue to have, despite disproportionate rates of fetal and infant mortality.
Understanding socio economic factors influence on health across a lifetime is significant to know that black mothers across income and education levels are still two or three times as likely to have an infant who dies by their first birthday, which means that education where you live and where you work, actually have no determining, um, no determining factor on whether your children survive an act relative to conducting fetal infant mortality review will empower local boards of health to establish these reviews in their towns in cities, it would establish a process for DPH for local boards of health to request information on fetal and infant mortality. In short data sharing from the Department of Public Health to local health entities and center the voices and experiences of the most impacted communities across our state. The femur bill as it's caused process.
It will be community based, outcome oriented and allow local communities to identify the root causes behind inequitable rates of fetal and infant. To provides a tool for our community to better understand health disparities and inequities which are different and identify systemic barriers and improve the performance of public health functions across the commonwealth. you in advance for your consideration and I ask that you please report this legislation out of committee with a flavor favorable report. See we're failing black women and we're not listening to black women and good is not good enough. Black moms,2797 birthing people and babies deserve to stay alive in our great comin up and we don't want them to remain nameless. And data is incredibly important to be able to share that data so that we can fix the root causes, impacting our families. Thank you all SHOW NON-ESSENTIAL DIALOGUE
represented Miranda, Thank you for your testimony for the generosity of sharing your own family story and just as importantly for in your first term, being an incredible leader um on this issue and I really am so grateful to have you on this commission that you ushered into law. And so we're gonna do a lot of really good work that's going to save lives and um who gets elected matters. So thank you. I'm really happy to have you here
madam Chair. I'm just going to jump in if referenda is still here. She might have gone, okay, I'll take my question to her directly. I share your appreciation for her. Stellar. She's here senator. Go ahead.
COMERFORD - Sorry, Rep Miranda, thank you so much for this important testimony for your leadership, which is really unparalleled um and for showing us the way um and what needs to be done. I had a very technical question on this very important bill. It was I wanted to understand your thinking about rounding the work in local public health, so the work of due diligence and what made you, what made you go there um to local public health and put that kind of work centered on local public health. I just would love to understand that better.
MIRANDA - It comes from two parts before my work, here was a community organizer and I understand the power of resident led leadership and really centering um Because we know our communities and I thought would be fitting that these cities and towns are 351 of them in Massachusetts, no two are the same and allowing the local boards of health to2923 learn from each other and to connect to the larger public health system, I think would be best Boston has different challenges than Springfield and Worcester and then small towns and rural communities and the Cape. Um, and so that's where, uh, the strategy was to make sure that we didn't leave local boards of health behind. Um, We need to make sure that we end these devastating statistics from Pittsfield to P town and so therefore we're going to center the people who know their communities best.
COMERFORD - Excellent. Thank2957 you. It actually provides one more imperative for strengthening local public health so that they would have the capacity. Yeah, absolutely. Very interesting. Thank you so much. Rep SHOW NON-ESSENTIAL DIALOGUE
Thank you Representative. Um at this time I would welcome Representative Tricia Haddad. He is with us.
She may have to come in a little bit later if she's not here right2981 now.
Okay. Representative Que con
REP KHAN - HB 2338 - SB 1471 - HB 2331 - SB 1525 - HB 2335 - SB 1401 - SB 1464 - HB 2333 - Thank you very much. Chair Decker Chair Comerford, distinguished members of the committee and I'm also honored to have an opportunity to have a seat on the health for this session as a legislator and the dance practice nurse. I'm thrilled to have the opportunity because I used to play on four distinct bills that are among my right Session and I sincerely appreciate your patients in advance as I will give my remarks and try to be as concise as possible. Uh but I feel I would like to discuss his house 2338 And Senate 1471. An Act relative to newborn screenings for congenital cytomegalovirus uh here from here on known as the CMV Uh this is for screenings for congenital CMV. as well as required prenatal education through clinical care and require hospital.
Uh I've been hopefully home birth at some point which aims to reinforce the prevalence of infected babies in Massachusetts. And I would also add that this also relates to maternal justice because we want all babies to be screened for this particular virus. CMV. Is how is a herpes virus that can be contracted anytime. Congenital CMV is acquired in utero and can result in a much more serious side effects. And I just wanted to mention, I believe Moderna is here to testify. So it's one of their top priorities. CMV Is the leading viral cause of birth defects and developmental disabilities including hearing loss, mental disabilities, physical disabilities, vision loss, seizures, cerebral palsy and the most serious can result in3097 death.
CMV can be severe children are other congenital condition, including people fetal alcohol syndrome, Zika, congenital rubella syndrome, spinabifida and HIV AIDS. About one in every 200 babies is born with a congenital CMV infection, which is huge of these babies. Around one in five will have long term health problems that it is highly preventable with education and easy prevention measures such as frequent handwashing, avoiding sharing food, avoiding contact with the child saliva, all during pregnancy. CMV goes largely undetected because the majority of affected babies are asymptomatic at birth. However, being symptomatic free at birth does not necessarily exempt asymptomatic CMV. The positive infants from the disease uh impacts later in life.
So it's so important to test these babies now and it can be done easily. I believe like we test other for other uh issues when babies are born in some hospitals infants. So there's actually no statewide policy about screening for CMV. And in some hospitals infants are only screen for CMV if they feel they're hearing screening or display other risk factors. Other hospitals have no policy at all. About 15% of infants with CMV will have no symptoms of birth but will later develop hearing loss. So targeted screening is really important because hearing loss due to CMV. Often worsens or develops later in childhood. A policy targeted screening of infants who failed the newborn. Hearing screening fails to detect a majority of CMV cases.
Furthermore, if the testing is not done within the firts 21 days of3207 birth is impossible, accurately determined if an infant was born with CMV. So I think this really does speak to the need to really do this. Um And CMV. Universal screening would require that all3219 infants regardless of symptoms with the screen for CMV. And again I think it's about social justice, racial justice um and maternal justice. So I would really greatly appreciate um taking a strong look at this bill. It's a brand new bill but I think it's extremely important and I really hope that the committee will give it3241 strong consideration. The other bill that I wanted to also mention is and I think I think I failed to mention, I think I believe Senator Lovely is3250 the co-sponsor of this particular piece of legislation, the CMV.
Um and then I'd like to just mention House 2331 and Senate 1525 Senator Mike Rush the co sponsor of that of this particular bill. It's an Act protecting children from harmful diet pills and muscle-building supplements Uh3269 So this is not a new bill that's been around for a couple of sessions and um And if it's if enacted, it would regulate the sale of dietary supplements that are marketed for weight loss and muscle building, banning the sale of these products to minors under the age of 18. Dietary weight loss building are often ineffective, adulterated and mislabeled and contain unlisted illegal pharmaceutical ingredients that pose serious health risks and they are not FDA approved. There a a number of problems when it comes to the3299 regulation of weight loss, muscle building supplements.
And to begin with such items are often linked with eating disorders as well as body dysmorphic disorder, a mental disorder characterized by the obsessive idea. One's own appearance is severely flawed and therefore warrants exceptional measures to hide or fixed ones. This more part of one's figure, and more than 11 of teens report using dye ever report to diet using dietary supplements for weight loss. A second significant issues that may that many diet pills and muscle building supplements are incredibly dangerous and have caused consumers to suffer injury and even death as a consequence. So such harm is largely due to the inclusion of substances that are legal but unsafe in the concentration using these products. Also, adulteration with prescription pharmaceutical compounds, excessive dozing by conservative. It's just really something that has to be looked at. And a third major problem is that the product, uh,
Uh, there's insufficient oversight by the food and drug administration. It's a 30, believe it or not, a $38 billion dollar a year. Industry rarely and barely regulated. It's allowing dangerous products to slip through the cracks. Only after reports of serious injury or death. Does the FDA take supplements off the shelves? In fact, back in 2015, Attorney General Maura Healey joined 13 other attorney attorneys general to sign on to a letter to Congress requesting for the federal investigation into the manufacturing, the dietary supplement and what3395 2019 the FDA announced a crackdown on dietary supplements, sending warning letters to companies whose products are being legally marketed and as unapprovedI can go on. But I'm just um I know that we have some experts to testify on this bill as well. So again, I hope you will give a strong consideration. It did get reported out of health care in the last session, went to healthcare Finance is another extremely important bill and mentioned other bills on on my list.
One is the uh it's house 2335 senate3432 1401 Also, I think Senator Cry spoke on this bill when he was broke. It's an Act to update postural screenings in schools. And I really think again, I think this should be strongly considered. And I think our was talking about um school vision screening. So here's another opportunity for school nurses to spend more time on other other issues besides postural screening. Most of these kids are all screened in with their pediatrician and again, taking off your clothes and having to go through this3462 as a team is really difficult. So this would reduce the antiquated state requirement of possible screening. The school nurses3472 really approve of this and would like to have more time to be able to doum the postural screening. And then I'll just mention quickly um an Act to protect youth from the3484 health risks of sugary drinks. Also sponsored by Senator Lewis uh in the Senate, it's House 2333 with Rep Santiago. SHOW NON-ESSENTIAL DIALOGUE
And uh okay, help Helen testimony. I'm gonna ask where they keep their, somebody needs to put their mikes on mute, continue Representative Con
KHAN - Okay, so this really establishes a number of public health initiatives to improve the health outcomes of youth to the commonwealth. And I really would like to make sure that we get the sugary drinks out of the schools in particular and try to find other drinks without sugar to add to the, I don't know if there is anything other than water um to the to put into the schools instead. Um we know that sugary drinks contribute to a higher rates of Type two, diabetes, obesity, cancer, etcetera. And this bill is highly supported by the American Heart Association and I hope that you'll also take along a strong look at this, this this bill as well. It's also been through the Health Care Committee in the past as well. So I just want to thank you very much uh for giving me the time to testify in four bills. I hope I didn't overstep my time, but Um, SHOW NON-ESSENTIAL DIALOGUE
thank you very much. Representative con. Um and to my colleagues who are being incredibly patient, we've just3565 done an hour's worth of testimony for legislators and we have almost 70 people from the public who are still trying to testify. Um so I thank everybody who submitted testimony. Um and I think at this time I have two more people to more legislators on our list to um speak and so I'm just gonna get straight to senator lovely and then senator uh dissolve leo so if we can just jump to senator, lovely,
okay if Senator lovely is not here will take her when she's able to to come on. Um And Senator Diana dazzled Leo,
Is she here? Mhm. Uh um Okay so at this time that is what I have for legislators wishing to testify. Thank you everybody for your patients. Um and uh for those of you3605 who colleagues with chime in to say that you'll just submit your testimony. I appreciate that as well.
Mm.
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