2021-05-10 00:00:00 - Joint Committee on Public Health

2021-05-10 00:00:00 - Joint Committee on Public Health

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SEN DIZOGLIO - SB 1416 - Thank you so much. Uh Madam293 chairs and through you to the members of the Joint Committee on Public Health. I'm honored to join you today to request your consideration of my sponsored legislation Senate Bill 1416 an Act requiring the chief medical examiner to provide certain information in substance use related deaths. Madam Chairs this legislation requires that the Office of the Chief Medical Examiner disclose information regarding a deceased person suspected to have died from substance use related causes within a certain period of time. I was speaking, the purpose will be filing this legislation is uh belong to a local uh coalition, so to speak of families who are338 experiencing issues in their families with substance use disorder.

And many of those families have experienced death in their families due to the disease of addiction. And what we found in speaking with these families is that after losing a loved one under these tragic circumstances, some families, many of whom are unsure whether those substances played a role in367 the death of their family member, wait months and sometimes over a year for the results of autopsies and toxicology reports from the medical examiner's office. So this build mandates that autopsies379 be performed within three months of such a death. And382 not only would this provide closure to those families who want to know what the circumstances of their loved one's death were, but it would also ensure that the commonwealth maintains the most accurate possible count of these deaths related to overdoses.

I know that uh, you all certainly understand that in the Legislature, the information regarding these things is very valuable to us when we're making decisions on funding and policies that we work on to help these struggling families. Um, the data is not going to be accurate if we don't have those reports coming in424 in a timely fashion. Uh, so, you know, I know that this is also a funding issue as well and I know that we433 need to work on this through the state budget process as well. But this is just one additional vehicle that I believe that we can use to try to contribute to making sure that again, we have the most accurate and up to date information so that we can make appropriate policy decisions in the Legislature and also ensure that families who are struggling with these issues also have access457 to the information that they need to be able to move forward. So I thank you for your time, madam chairs and members of the committee. I uh encourage a favorable report of this legislation and I look forward to working with you on this so that hopefully we'll see that favorable report. Thank you so much.
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REP GARLICK - HB 2329 - So good morning to everyone. I am Denise Garlick. The representative from Needham Dover and Medfield, speaking to you on H 2329 an act relative to accelerating improvements to local and regional Public health systems to address disparities in the delivery of public health services. Um warm hello to the chairs and to all the members of the committee. This bill is frequently referred to as569 SAPHE 2.0 that's S-A-P-H-E. SAPHE is an acronym for State Action to Public Health Excellence.575 It builds on legislation that was passed unanimously in both Chambers and became law just weeks into the COVID-19 pandemic in 2020. But it is the product not of the pandemic but of more than a decade of discussions.

I myself as the chair of the Needham Board of Health in 2004, engaged in this discussion about local and regional public health and it is the work of the Special Commission on Local and Regional Public Health. It was signed into law and it granted a voluntary grant based approach to improving local public health systems. Phase one was filed as a first step to implement615 the findings of the Special Commission and the plan was to build momentum towards the broader changes needed in local and regional public health. The COVID-19 pandemic worldwide getting very hot in Massachusetts illuminated both the strengths and exacerbated the areas that needed to be strengthened in local and regional public health that had been documented in the commission report.

And the pandemic proved that it is imperative that we accelerate the timeline to include the specificity and the direction needed for emergency and longer term needs of the commonwealth system. Both SAPHE 1 and SAPHE 2 are targeted to meet the goals656 of the commission. SAPHE 1 passed unanimously in both chapters chambers and SAPHE 2.0, currently has many representatives and senators who are deeply connected to their districts and their local public health in a desire to strengthen regional public health. The members of the legislature pushed hard for the local public health voices, skills and connections to be better utilized during this time of the pandemic and the commonwealth being under a state of emergency.

And while the response to the pandemic has demonstrated the willingness resiliency, the creativity of some local health departments. Unfortunately, the variability of services provided across municipal health departments leads to disparate quality of care and services across the commonwealth. The areas to be strengthened by this bill include funding and train qualified staff access to public health, nursing, consistent use of the maven virtual epidemiological network, consistent enforcement of public health rules, complete and consistent data collection and reporting in addressing health inequities. At this time I share my time with Representative Kane and wish to commend to her um commend her as remember not only of this committee, but as a true leader, um having served faithfully on the Special Commission on Local and Regional Public Health And caring forth in her voice and her actions the true mission Representative Kane.

REP KANE - HB 2329 - Thank you Chair Garlick for that and uh thank you madam Chairs for having this bill on the hearing docket for us today uh swiftly moving us into this conversation as it is not only relevant to the time that we're in, but certainly as Chair Garlick said, a conversation that has been occurring for a very long time. Um as many of you know, the Commonwealth of Massachusetts is the only state in the nation that has a local board of health for every single community, all 351. And what that has produced over time has certainly been um strong local control, but a lack of efficiency and effectiveness in terms of how we deliver local public health services. The commission of which Chair Garlick was instrumental in getting legislation adopted for brought together a really diverse and broad group of stakeholders, including folks from the administration.

The commissioner of DPH chaired our commission, also had representation on it from administration and finance as813 well as DEP and agricultural resources.816 Um And it also brought together voices from across the commonwealth. So representing folks from small communities, rural communities, cities, diverse areas as well as stakeholders on the statewide level, who look at things from a more fiduciary perspective. So the Mass Tax Payers Foundation as well as the MMA. And what this diverse group of stakeholders found was uh that there is much work to do to ensure that we can effectively and efficiently deliver local public health services. As Chair Garlick said, we do not have a minimum standard across the commonwealth. So depending on where you live is depending on what services you have access to.

And we knew at the time that it was going to take a multi step868 approach to adopt all of the commission's recommendations, which was which were unanimously adopted by the commission itself. And the first step SAPHE 1.0 was a terrific first step and I'm very proud of what we did here in the commonwealth. Um but we also knew that there's much more work to do and while the members of the commission knew that during the entirety of our work, what has been eye opening, I think for people all across the commonwealth is just how important it is that we accelerate the work that we need to do. And so that is why we come to you today. I also just want to point out that um I did sort of both as a special commission member, uh and appointee of the Minority Leader a designee.

But I also am somebody who serves as a town meeting member and appointed finance committee member in my community. Um and for that reason, I want to make clear that the goal of the commission,923 and certainly the goal of this legislation is to not have an unfunded mandate on our communities or to take away local control. It is more so to recognize that funding local public health should not just be a local responsibility, it should be shared statewide. Um and that also we need to ensure that there is access to a minimum level of services across the commonwealth. That it should not depend on your zip code and your ability to fund that only locally as to whether or not you have access to them.

So you're going to hear from a great panel, um several great panels today of people who are really deep into this on a day in and day out basis. Um and I really want to again just thank you for bringing this issue to the forefront by having this hearing today. And certainly as I know um my co filers, Chair Garlick and Chair Comerford, we're all looking forward to working with stakeholders and with you madam, Chair Decker in order to ensure that we can find a way to bring this bill out of committee favorably and uh before our fellow legislators. So thank you.

SEN COMERFORD - Thank you so much Representative Kane, Chair Garlick. I'm deeply grateful for your long leadership on this. And as you both rightly said, this has been uh an issue that you have led, that the legislature has been unified and unanimous on uh long before COVID. But COVID hastened the work, hastened the intensity, hastened the urgency with which we grapple with how best to support sustain and deepen our commitment to these intrepid local boards of public health who have been on the front lines of keeping us well during this pandemic and doing so much else as they do that important work.
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REP DECKER - Um I just I want to thank my colleagues um both Chair Garlic and Representative Kane for their work. Early on you know, I reached out to you guys um looking at the work that you were doing prior to the session and really appreciating the leadership that you're bringing to this issue. And again with this bill, I think that I have a bunch of questions that I'm going to say for the panelists because we have a lot of panelists before us, but I really wanted to just say thank you so much the importance of this work and moving forward. We're not out of this pandemic yet. Although life feels a little different and a little better for1067 some people, we don't actually know what the next chapters of this pandemic and this virus look like.

And I think if anything what we've seen um and1075 you've laid out here is that the inequities um throughout our communities really are a matter of life and death. Um and so it really statewide leadership1083 requires local investment. Um And I just want to appreciate both of you for your ongoing work and my my co chair for bringing this forward this year, but it really comes down to life and death and lives were saved and lives were lost because we did not have a more robust local response to to all of this. So thank you.
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REP KHAN - Uh thank you madam Chair and1112 thank you to Senator Garlick and Representative Kane for your work uh in this area. And um as a nurse myself, I'm very appreciative of the opportunity to take a look at the the public health system that we have1135 here in Massachusetts.1136 So I did have a couple of questions and maybe, I don't know they can be answered or not. But the one thing that I've been aware of and I don't know why this has happened, but I wondered if you've taken a look at, for example, I'm very interested in the school nurses and really support our uh school nurses I have1156 worked long and hired on providing support for them.

So I was just wondering. I find that it's it's slightly different. Like in the city of Newton, for example, the school nurse has come under the1171 Department of Public Health, but in some communities they come under the school department. So I didn't know whether you've had a chance to look at that or not, and I have no idea how that works or why that's happened and maybe it doesn't make a difference. But I just was wondering if you had any thoughts about that. That was one question and then the other question was, and I know I've approached you about this in the past and maybe the panel will be able to answer this.

But I was always struck by the fact that, you know, with, as you mentioned, 351 cities and towns and each one has a public health department. And so I just wondered, I just wanted to hear a little bit more about the possibility of some regionalization because some1218 towns and cities or towns anyway are really tiny and maybe it would be more useful to have them have more of a regional approach in some of the cases. Particularly out west I think where you have very tiny little towns, so I didn't know what1235 the thinking was along along those lines. So thank you very much.

KANE - Certainly may I respond madam chair. So let me answer in reverse order and I'll certainly allow Chair Garlick I think to answer probably the nursing questions she probably may want to address. Um but on your second point, one of the things that uh SAPHE 1.0 does is continue in this further, is it to incentivize communities to share services. So again, as a member of the Shrewsbury community we're a member of the Central Mass Regional Public Health Alliance. You will hear from the Shrewsbury town Manager today. For essentially the same amount of money that we are investing just into our own community for health services. We when we joined the alliance, uh received access to all of the public health services at the city of Leicester had, which were tremendous.

And um, that is really the goal of this legislation is to continue to encourage Um, cities and towns to create these shared services districts. And we're seeing more and more of them. Um and that was the funding that was just released. The performance action grants by DPH last week, $8 million dollars was again to continue to see cities and towns working together so that their dollars are used more efficiently and that residents are getting more effective service access. So that is very much Representative Khan a goal of this legislation. And I'll allow Chair Garlick with who is much more who can speak to nursing, much more influential than I can.

GARLICK - So, so thank you, Rep Kane. So Rep Khan I think you and I have both had many discussions about the school nurse arena, how the nurses are trained, how many nurses are in the schools, how that's funded. Um, and then there is undoubtedly a great deal of work that still needs to be done there. I do want to make a comment though that for the school nurses in the commonwealth oftentimes in the communities where there were not services available in the small rural communities, um, and in smaller communities, it was the school nurses who took the lead. I represent three towns, none as big or as well resourced as Newton, but the town of Needham has a full health department, um, with qualified trained staff.

Next door to it is the town of Dover that has only a volunteer health department of individuals that are elected. And beside that is the town of Medfield, for which the1387 school nurse herself was the Public health nurse during the height of the pandemic and still is assuming so many of those roles. So I think that we have to acknowledge everything that the school nurses have done. And Rep Khan you and I have to continue to have our conversations about how to strengthen the work and the service and the funding of school nurses, just like we are talking about local and regional public health.
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KHAN - Um Yes, I mean, I think it's this is great. I mean, I've always been as Rep Garlick has, I think the school nurses provide so much uh to our school system and I'm a big supporter of them. I just I was just a little confused and maybe it's because of the size of the community. You know why, for example, in the city of Newton, we have the public, we have a strong public health department and the school nurses come under that. They don't, we have school nurses, but there they're overseen1450 by the Newton Public Health Department. And maybe that's easier to do in a city, uh, rather than in a town. So that's, I was just a little confused of, of how that got set up. And I don't know whether, um, that's part of it, if that's something, I mean, I would be interested in certainly talking1469 about that more to see if I can understand better, you know, how that works and why, why it works that way. So thank you. Thanks for your answers.

COMERFORD - Thank you so much. That's an important. I see, I see, chair garlic nodding the important piece of this puzzle, right? As as both the speakers have said 351 communities in the Commonwealth 351 ways of working through the complexities of local public health and and you know, this bill aims to streamline some of that work and and make it more consistent so that people anywhere you are in the commonwealth can expect something similar in terms of capacity and in terms of standards. Um I just also want to point out to Rep Kane's um discussion of the 8 million that was just apportioned for these regionalization grants as part of the last budget push through the legislature and just thank colleagues for their support of that funding. That's part of, you know, it's a piece of this puzzle is how do we responsibly fund local public health?
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SEN MORAN - Thank you, madam. Chair. Much appreciated. And you touched on my question1543 there at the end, um, regarding funding. And I, you know, I think this is really a moment in time that we need to catch the wave from what we have learned. I mean, I know many of my constituents um, really were focused on, um, perhaps the benefits that were untapped with the local municipal ready responses Um, when we had more of a larger regional vaccine program. And I have to commend my colleague Senators Cyr , um, who really with the Cape and Islands consortium, made use of county government.

And with our aging population, really with, you know, worked with community health centers as we all did to target um, vaccinations. And so my question is, and, you know, being, uh, sort of new at this point and catching up to where you're at with this legislation, which just seems brilliant and common sensical, um is there opportunity to use the information? Maybe seek more information from local public health officials1618 to really kind of hone the process, because it seems that there really is no better time than now to move this forward. Thank you.
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KANE - So I think, you know, your points are spot on, and certainly a lot of this has been driven all along the process by local public health folks. Uh They were on the commission uh and very effective voices for what needed to be changed. Um and also, you know, many times upset that they weren't able to do all that they wanted to do locally because they didn't have the funding, you know, from, their local town. Um It is again not something that we think about often whether on the state level or on the local level. Um and so uh you know, I think there is a very strong desire and we heard that. The Special commission had two um1683 times that we went out and held public hearings across the state to get feedback and input from all members of local public health, both the people who are in positions on the boards, but even more importantly, the people who are doing the work day in and day out. And so this product comes as a result of their strong input and desire to see changes at the state level.
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REP GARBALLEY - HB 2294 - SB 1440 - Uh well Chair Comerford Chair decker. Thank you so much for hosting this hearing today and I'm very appreciative that you have put this bill on the docket so early in the session. That really goes to how important this issue is for both of you and I'm grateful for your leadership and I'm grateful last session um that you reported the bill out favorably and the bill actually was engrossed by the House and hopefully now allowing more time we can get it over the finish1791 line. So I am here to testify on behalf of H 2294 and supportive of Senate Bill 1440 an act granting1800 equal access to original birth certificates to all persons born in Massachusetts. And I have filed this bill on the House side with Speaker pro tempore Kate Hogan and Senator Gobi who you will hear really quickly after Um I speak.

So ah for full transparency Um I'm adopted along with my identical twin brother James. And under Massachusetts general law, we do not have access to our original birth certificate. Under law currently if you were born between 1974 and 2008, You do not if you're adopted, you don't have access to your original birth certificate. But if you were born before 1974 or after 2008 you have access to your original birth certificate. To me, this is about vital records, it's about your identity. And right now in Massachusetts, we have three types of citizens right, citizens who are not adopted and they have their original birth certificate that identity that says who they are, those who are adopted and can get access to their original birth certificate and those who are adopted but can't get access1886 because they were born within that1889 33 year gap.

Now I may not seek to gain access to my original birth certificate. That's not why I filed this bill. I filed this bill because I believe it's a right that all citizens in Massachusetts gain access to their identity, their original birth certificate. So many states have passed this legislation. If there are unintended consequences that members of this August committee and the chairs might be concerned of I can tell you that in the, I believe 15 many maybe other states that have passed this legislation, I haven't heard of one concern about giving all adoptees their identity. And so I would ask that you support this legislation. I'm so appreciative as I stated earlier that you have put this important bill early in the session on your docket among very important other pieces of legislation and I would hope um that you would pass this bill um and thank you both chair Comerford, Chair, Decker and members of your great committee.
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SEN GOBI - SB 1440 - HB 2294 - Thank you Madam Chair and I also would like to extend my thanks for getting this on the docket so early in my good friend, uh the Chairman Sean Garballey for the work that he's done on this for a number of years. And you're going you are going to hear from some other folks, including my constituent and friend Jean Strouse who has done um, wonderful work on the issue nationwide. And she is a wealth of information and brought me kind of into the, into the fold on it. I also just want to thank this committee even you know, when, when I was listening to the previous testimony with, with Rep Kane and Chair Garlick. Um, you know, this committee focuses on equity.

You know, we saw that during the pandemic. It was extremely important to you to make sure that, that there was regional equity for people to get tested for vaccines for COVID and to actually get the vaccines. That was extremely important in our vulnerable populations. This is no different. This is an equity bill as you just heard from my good friend Sean as he spoke about this. You know, think about it. So if you were born July 16th, 1974 no problem. You get it. But 24 hours later that matter, uh, forget it. You're not getting your original birth certificate. So, you know, the equity issue of it is so important. You know, why are we creating, why did we create this other class of people? It makes absolutely no sense, especially in today's day and age.

So you're going to hear from folks that, that will tell you some more heartfelt stories. But you know, I'm just appealing to you from a real equity point of view to take a2068 look at this. And you know, you've done the right thing in the past and I have no doubt that will happen again. And I'm certainly hoping that this will be the year that we can make a major change in Massachusetts and bring equity to all. So again,2082 I I appreciate your help in listening And I thank you for your consideration.
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KRISTINA KIMANI - MPHA - HB 2329 - SB 1386 - Um hi everyone, my name is Kristina Kimani, I'm the assistant policy director for the Massachusetts Public Health Association. We are a statewide organization that is the champion for public health in the commonwealth. And I just wanted to start off by saying thank you to Chair Comerford and Chair Decker and the rest of the members of the committee for allowing testimony today. Um, I always have a tough act to follow after going after Rep Kane and Chair Garlick. So I'm going to try to cut down a little bit on my testimony because we have many other experts to hear from today and they've done just a great job of outlining um, the importance of this legislation.

So today you're going to hear testimony from a variety of advocates who are here for one main reason. And that is to ask you to accelerate improvements to our local public health system because all of our commonwealth's residents should have access to essential public health productions period. So although many of us have known this for a long time, the COVID-19 pandemic has clearly shown that the local public health system in Massachusetts is not adequately structured, staffed or financed to meet large scale public health challenges. And despite the dedication of our state's local health staff and volunteers, the commonwealth's decentralized approach to delivering public health services really leads to extreme variabilities across municipalities in this both puts the2255 entire state at risk and exacerbates current racial and health inequities.

So passing this legislation should be simple. And that's because the groundwork has already been laid in Massachusetts and Rep Kane and Chair Garlick did a great job outlining that long history. Um, and so I just want to thank them, the members of the Special Commission and Senators Lewis and Comerford for all of the work that they've done laying this groundwork and helping to get SAPHE 1.0 passed last spring. I want to point out that another report was actually just released this past Friday, a national report, um, which is from Trust for America's Health. And2292 this report is titled The Impact of chronic underfunding on America's public health system. Um and this report includes recommendations that emphasize what we already know here in Massachusetts, that we need sustainable public health investments.

We need to improve data systems and a focus on on adjusting health inequities that put communities of color at particular risk. So how will SAPHE 2.0, move us forward? Simply put this legislation does not accept the status quo. And as Chair Decker said earlier, public health is really a matter of life and death and this legislation will not allow public health protections to be optional anymore. It will ensure access to protections to all Massachusetts residents regardless of their zip code. So leaders across the state are in agreement and they're calling for this change. This legislation has garnered support from rural communities, suburban communities, Gateway cities mayors and town managers, health directors, board of health members, public health nurses. And the list goes on.

You're going to hear examples today from many of those leaders on why each and every aspect of this bill are just critically important to not just improving our commonwealth's public health system, but also to advancing health equity across the state. So advancing those goals through this bill means four simple things one establishing minimum public health standards for every community, two increasing cross jurisdictional sharing of public health services. Three creating a statewide uniform data collection and recording system and, of course dedicating2382 sustainable state funding to local boards of health and health departments.

It really shouldn't have taken a pandemic for us to be having this conversation, but2394 it did. So. Now let's build on the ground work that has been laid and take the necessary steps to move us rapidly to improve and invest in our local public health system so that our local parts of health and health department can meet the challenges of both today and tomorrow. So thank you all so much for your time. I'd like to turn it over next to my colleague Cheryl Sbarra from the Mass Association of Health Boards.

CHERYL SBARRA - MAHB - HB 2329 - SB 1386 - Thank you. Um First of all I want to thank Chairwoman Comerford2419 and um Chairwoman Decker and members of this committee for allowing public testimony on this very critical and timely piece of proposed legislation. I also want to thank Rep Kane and Chair Garlick for all the work they've done. They've been partners in this effort and we could not have had any better partners. I am Sheryl Sbarra, I am the executive director and senior staff attorney for the Massachusetts Association of Health boards. We are a membership association that represents the 351 local boards of health that we're talking about this morning. Much like police and fire and what a lot of people really don't understand is that boards of health2467 derive their legal authority from the power of the commonwealth to protect the health, safety and welfare of the residents of Massachusetts.

Yet, unlike police and fire is Rep Kane alluded to, funding for local public health comes solely from local tax dollars as allocated either by town meeting or city or town council. This means that municipalities with2489 the same number of residents can have health departments with vastly different resources depending on the budget the municipality decides to allocate to its board of health. But regardless of that budget size, all boards of health are responsible for enforcing federal, state and locally mandated laws. And the list of these laws is too cumbersome to really go through this morning. But I'm going to just mention a few. One is the state sanitary code, which includes housing regulations, food establishment regulations, medical and biological waste2527 regulations.

Then we have food protection laws which include laws surrounding milk and dairy products, seafood and shellfish,2533 slaughterhouses. We have regulations relative to public lodging places, disease prevention and control, including disease surveillance, isolation and quarantine. We have environmental protection laws, including hazardous and solid waste laws, septic and sewage laws. And then we have a litany of other laws, including nuisances, noise and trades, drinking water Fluoridation. And again, this is not an exhausted list. Yet every single health department in the commonwealth is charged with enforcing all of these laws in order to protect their resonance. Rarely will you find an adequately resourced health department in Massachusetts.

There are some, but but it is rare. Instead, you'll find a health department applying band aids to situations that require much more. This has been happening for decades and decades and decades in our state. And as is always the case, as a lot of people have already mentioned those who need public health services the most get hurt the hardest. Poor communities and communities of color has some of the most poorly funded health departments in Massachusetts. We can't continue applying band aids as a means of delivering crucial public health services. We need to do major surgery here and this piece of legislation is the surgery that we need. Massachusetts residents, all of them deserve a system that provides everyone with basic public health protections and that provides needed funding to support core public health services2638 in every city and town. Thank you very much and I will turn this over to my colleague.

ASSAAD SAYAH - CHA - SB 1386 - HB 2329 - Good morning. Thank you for the opportunity to testify in support of S 1386 H 2329 an act to accelerate equity2656 and effectiveness of our local and regional public health system. First, I want to recognize the leadership of sponsors, Chair Comerford and Representative Kane and Garlick as well as the support of Chair Decker. I'm Dr. Assad CEO of the Cambridge Health Alliance and Commission of Public Health for the City of Cambridge. I am an emergency physician by training with extensive experience in emergency preparedness and community health. Local public health officials have stepped up to respond to the COVID-19 pandemic amid significant challenges and constraints and truly deserve our utmost appreciation.

Yet the pandemic has dramatically brought to light the long overdue need to transform and invest in the local public health system. The current decentralized structure of 351 individual boards of health leads to variability of public health capacity and inequities in public health protection across municipalities. With no dedicated state fund to local health department some of the communities hardest hit by COVID-19 had the fewest public health resources to respond. Municipalities are collaborating in promising ways to extend the reach of collective public health efforts. As one example, the Cambridge Health Alliance is working with the Metro North Vaccine Partnership. A collaboration of nine cities, including four of the hardest head to advance tailored community initiatives to equitable COVID- 19 vaccinations.

Revere mayor Brian Arrigo, who's testifying today is at the forefront of this work with area colleagues. Now is the time to build on that momentum by passing and implementing this bill and funding the recommendations of the June 2019 Special Commission on Local and Regional Public Health. The Legislature's Health Equity Task Force, which I'm honored to co chair, support urgent policy action and new funding to make this a reality. COVID-19 showed us in stark terms the public health threats do not stop at municipal or global borders. Public health challenges of the future2793 demand or robust statewide health infrastructure that fosters cross jurisdictional shared services that leverage scale,2800 best practices and enable greater focus on the social factors that account for 80% of health status.

It also fosters every community's capacity to meet minimum public health standards through a credential public health workforce uniform data recollection and reporting to measure public health indicators, including for diverse and vulnerable populations and dedicated state funding for ongoing operations2828 planning and technical assistance. Passage of this priority legislation is imperative to the public's2834 health. Thank you for this opportunity and for your leadership to advance this public health.
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DECKER - First I just want to thank the panel for their work throughout the year and certainly during the pandemic. Um thank you both to Miss Kimani and to Miss Sbarra. I also just want to speak to Dr. Sayah's work. I think for me when Representative Garlick and Kane first approached me about this bill, it was just so clear um the necessity. Because when I think about the role that Doctor Sayah I was able to play in Cambridge, we have a well financed board of public health that is attached to a world class hospital. And the amount of work in the amount of um the agility to pivot so quickly from being involved very quickly to how do we house our unhoused2904 safely? How do we test our unhoused people in our community safely?

How do we quickly get to our nursing homes and work on testing2914 and contact tracing and vaccinations? How do we work with our public housing residents? All of this was being done through our board of Public Health, with the oversight and the leadership with Dr. Sayah. And this is in a community that is able to finance its board of public health. And to be clear, Cambridge is a tale of two cities. We have the we have the extraordinarily most wealthy people in the world who live here. We also have people who are really under resourced and low income as I grew up in2945 public housing in Cambridge. And so to see how taxing it was. And we also were working in partnership with our schools, as was mentioned earlier the relationship between the board of health and our school nurses um and just keeping our and those who were able to go to school.

So just to see how incredibly taxing it was and to know that absolutely this effort, because it was robust and it was funded was able to do so much so quickly and absolutely saved lives. And it's unacceptable that that kind of response doesn't exist throughout the state. Also, did I tell you, seven days a week of testing um has been available to Cambridge residents for most2983 of the pandemic when testing first became available. So it's not okay that this is not what, your your zip code should not determine this kind of access in this kind of protection. And so I just want to say thank you to Dr. Sayah for really modeling what a robust um public health response looks like in3002 the middle of a crisis. Um, and to thank you for3005 your leadership in charing the Health Equity Commission statewide and and to working with your panelists here I know we're going3012 to hear from more.

But what I really appreciate is the Cambridge Health Alliance doesn't just serve Cambridge, It serves our communities that have been also disproportionately the hardest hit communities, which are no in no coincidence, communities that are predominantly under resourced families, communities of color and immigrants. And so to3029 just say that this kind of response, um, it should be, it really, for me, falls into the category of good public health is an acknowledgment of human rights and access to being safe and cared for regardless of where you live. And so thank you for your leadership and showing us how that gets done. And for not resting on a local response but also wanting to lead statewide. Thank thank you.

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CRAIG ANDRADE - BU SCHOOL OF PUBLIC HEALTH - SB 1386 - HB 2329 - Thank you for this opportunity. My name is Craig Andrade, I am Associate Dean of Public Health Practice at BU School of Public Health and also a board member on Brockton's board of health. I fully support the SAPHE 2.0 initiative um and all its elements that are meant to strengthen local public health. I grew up in Brockton's Richmond street housing projects, the oldest of four boys raised by a strong caring single mom on public assistance. The conditions of poverty, hunger, safety, and challenged access to self care and all the other basic resources families need um were challenged then and are still challenged now in the city of Brockton.

Brockton is a majority minority city and one of the 20 communities hardest hit by COVID. One only needs to drive six miles from my present home into Eastern, a majority white community to understand the stock realities between communities who have and those who have not. Social determinants of health, those foundational elements that help create people's health status, housing, food and security, employment and on and on and on were exacerbated by COVID and were significantly problematic in Brockton, well before COVID ever arise3214 on the, on the, on the scene. In the board of health, we have we have struggled to maintain a professional staff.

The previous executive director of our health department, someone who came on without any experience in public health was in his position for decades and learned on the job. Over time, he learned how to navigate the challenges of the responsibility to maintain the public's health and all the different sectors and elements that are work that is done. Early in COVID, we unfortunately lost that executive director who over decades gained some level of experience and was able to move things forward. It took a significant amount of time that fill that position, largely because of the low salary that is only what we can tolerate3271 in the budget that we have.

Out of the goodness of hearts of retired nurses and dedicated dutiful school nurses took and sat in those positions in the early part of COVID as we tried to navigate the challenges of a lot of things that we didn't understand. And finding and tracking who was exposed, how they were affected, tracking and doing that on the fly without experience was a challenge. And we did the best we can. Only within the last several months did we finally find a position that would, fill that executive director position. And it was the first position in decades of someone who had a public health experience. Now, as we move through um vaccination and find ways to make sure that everybody that needs help gets help we still struggle.

Like other communities, there are significant amount of population 14%, um those that are of color in our community are less likely to get the access to care they need and to be hardest hit by COVID. And vaccination we know that um black LatinaX and other communities of color here in this city, as across the commonwealth are Uh, much less likely to get the vaccine. 14 times less likely than our white residents in this community. So this SAPHE 2.0, will be a significant boost on raising our capacity in all different ways and making sure that we have equity throughout our community regardless of where they live and what their background and social determinants are. Thank you.
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BRIAN ARRIGO - CITY OF REVERE - HB 2329 - SB 1386 - Good morning and thank you for your time today. I am Brian Arrigo, Mayor of the city Revere. As we've all felt throughout COVID-19, diseases do not respect municipal boundaries. My community was one of several that remained at a heightened risk of infection but maps breaking down infection rates within municipalities do not tell the story and do not tell the full story of COVID-19 in the Commonwealth. While each municipality is comprised of unique populations, unique neighborhoods, uh, unique traditions, the commonwealth's economy and culture necessitate travel and collaboration at a regional level. My community in the city Revere is home to a diverse working class population.

Our residents work throughout Boston and beyond every single day. Low income communities and communities of color have been disproportionately burdened by high rates of COVID-19. And in order to most effectively respond to our residents' needs, we needed to meet folks where they were. So for us, that meant boots on the ground outreach, making sure that we had a sharp focus on equity and accessibility. Uh, and I'm happy to say that my team has consistently stepped up to the plate. Also instrumental were countless collaborations and information sharing sessions that we had across municipalities and across multiple partner organizations. Our partnerships with folks like East Boston Neighborhood Health Center, Cambridge Health Alliance have delivered astonishing, astonishing high rates of vaccination for our LatinX population as well as convenient vaccinations for all.

Our combination of expertise and execution has yielded results and it does serve as an example of how much stronger we can be when we join forces. So while I'm grateful to have learned from our neighbor cities and towns and from our partner organizations, we should not have been developing these partnerships simultaneously with the spread of COVID. So this is why I'm here today to advocate for SAPHE 2.0. SAPHE 2.0 would inscribe the lessons of the pandemic into law uh and ensure that every resident of the commonwealth is served by the best possible public health leadership. Formalizing the networks that we've developed into strong regional hubs of public health information uh and more importantly, funding would not only offer a more efficient public health and public good for our residents, but it would also allow us to fully grasp the regional dynamics that shape healthy communities.

The social determinants of health, food access, family and home stability, environmental justice and countless others these all contour our communities. But our partnerships and3577 sharing our perspectives on a regional level have enabled our municipalities to rise to the occasion, and3586 that's the only way we're going to be able to rise to the occasion. In order for the3594 commonwealth to meet its full public health potential and to make full use of our unparalleled wealth of knowledge and data, we must pass SAPHE 2.0. Thank you again for your time and I really appreciate this opportunity.
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KEVIN MIZIKAR - TOWN MANAGER OF SHEWSBURY - HB 2329 - SB 1386 - Good morning chair Comerford Chair Decker. It's a pleasure to be before you. Uh, and for the rest of the members of the committee.3620 I'm happy to be here with you to share my support for SAPHE 2.0. I've had, I had the distinct pleasure of serving as the Massachusetts Municipal Association's representative on the Special Commission for Local and Regional Public Health. I am extremely proud that the blueprint for public health excellence that underpins the legislation3642 before the committee today and I remain extremely concerned about the challenges that public health in Massachusetts faces.

I realized that some may have questions regarding this legislation, like so many other bills of its kind, including what the costs are and how can they be paid for? And having served in executive leadership roles in three Massachusetts towns and being the person that has often had to make tough financial decisions and justify them. I will not sidestep or discount the validity of these questions. Rather, it's my intention to share a clear example of how to achieve high performance at the municipal level while managing public health costs. Fiscal year 21 is the ninth year that the town of Shrewsbury has been part of the Central Mass Regional Public Health Alliance. For the town of Shrewsbury the benefits of joining this cross jurisdictional partnership have been exponential.

On July 1 2012 with the inter municipal agreement in effect, the town of Shrewsbury immediately had a team of 26 public health professionals with refined sets of skills and expertise, including a medical director, epidemiologist, full divisions of experts in the areas of environmental health nursing, emergency preparedness and community health. We have substance abuse and mental health specialists who actually proactively work within the community, strategically improve the well being of the community. Prior to that, as many other cities and towns currently have, we only had 2.5 full time equivalents to manage the broad and diverse scope of work that public health is charged with that many3744 of my colleagues have already spoken about.

So even though Shrewsbury maybe geographically advantaged to leverage solid public health infrastructure next to New England's second largest city, this model is replicable. It is cost effective. Shrewsbury's Public health budget has increased on average by 3.2% annually from the year prior to joining the alliance through the current year. That is nearly one full percentage point lower than the average annual change for the overall municipal budget. Simply stated our cost benefit from a 26 person team by partnering with seven other cities and towns in the region is the same as3786 running a three person public health shop. It comes down to economies of scale of course. If the 351 model of public health administration does not work we can still retain the individual control of local boards of health.

Let me be clear there3801 is no change in the policy or other controls that are provided to local boards of health. Especially through this legislation, each individual board of health will retain the control that3813 it currently has. This has been a very successful model that we've used in the Central Mass Regional Public Health Alliance and individual boards can set the policy tempo and projection as they choose to move forward for their individual town while ensuring robust public health is provided to all residents. And finally circling back, yes, there are questions of cost however, this is a matter of leadership. If we do not recognize the need to take responsibility as leaders to improve public health comes during the world's worst global pandemic when will we? We must stamp the blueprint and set the standard through SAPHE 2.0. Thank you for the opportunity3855 to be before you today.
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SOLOE DENNIS - SPRINGFIELD HHS - HB 2329 - SB 1386 - Good morning madam chair and Good morning all the ranking members. My name is Soloe Dennis uh work in the city of Springfield. I'm the Deputy Public Health Commissioner. The city of Springfield is the third largest city in in Massachusetts. It's a minority majority uh city. The challenges we feel in the city of Springfield is very broad. As a Deputy Public Health Commissioner my responsibility encompasses a lot and SAPHE bill 2.0 will enhance our capacity to better develop policies, programs and system to assist the most vulnerable population in the city of Springfield.

The City of Springfield's Black and Latino population lags behind white counterparts when it comes to health outcomes such as perinatal uh mortality3987 mental and child health, chronic disease. People of color in Springfield were, behind a mirror to hospitals for cardiovascular disease, Latinos residents and black residents compared to the white counterparts in the city of Springfield. As you4006 can see, the challenges we face in the city is very broad and SAPHE bill 2.0 will definitely enhance our capacity to help the most vulnerable population. But most importantly, it will enhance our capacity to make our residents better prepared to be more resilient community when it comes to public health planning and programming. But also we'll be able to serve the most vulnerable population.

I urge you all to support this bill as a local public health practitioner on the forefront of this battle. It's a matter of life and death. A lot of our resident depend on4050 us for a whole lot of information as COVID has shown us whenever calls come into the health department we are at the forefront. We are at the forefront in terms of providing critical messages, critical information, but also critical resource to residents that these residents depend on us. And this bill will definitely help us to improve our work but also provide critical information to our residents. And once again thank you all for your support and for your leadership and thanks to the Massachusetts Public Health Association.
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JACKIE AGUILAR - LAWRENCE BOH - HB 2329 - SB 1386 - Hello Distinguished madam, Chair, Panelist, senators, representatives and legislators. My name is Jackie Aguilar. I have been working for the city of Lawrence for about three years as a public health nurse and before I joined the city of Lawrence, the city did not have a full time public health nurse for at least4111 seven years. So you can imagine when I got there then nothing was really done. Um I'm in favor of the SAPHE4118 2.0 act bill. It will be great to establish public health standards for every community in the commonwealth as the bill states. Not all cities or towns in the commonwealth have enough capacity or infrastructure to have a public health department. And this bill will accelerate4135 improvements to the system to several residents regardless of race income or Zip code.

I am the only public health workers in the city of Lawrence, a city which has a population of over 80,000 people plus. When the COVID pandemic head, I was not able to cover all of the contact tracing that I needed to do as well as to continue monitoring and investigating4157 all of the other communicable diseases, including doing my case management for tuberculosis cases. Doing surveillance was impossible. We're about to reach 10,000 cases of COVID-19 and you can imagine that many cases were not reached to isolate or quarantine within the 72 hours recommended by the Mass Department of Public Health. In Lawrence the contact tracing was and it is very challenging because there they were And there are multi generational families sharing one apartment.

We're also challenged in Lawrence because we have a large number of Lawrence residents4195 who are essential workers. And they provide services to other communities in the commonwealth and across state lines. Reaching them was almost impossible. They were somewhere else. Language and culture barriers, housing and food insecurities, unemployment, and lack of trust in government were some of the other challenges that we're facing. Thankfully, we got temporary help from public health students and the school nurses who were able to join the team. But even with the help from 27 school nurses, there were new challenges. As knowledge of the virus developed procedures4229 needed to be updated.4231 I am still the only resource public health nurse in the city of Lawrence for all staff, residents, businesses everyone.

As of today, we no longer have the school nurses as they returned to their school nursing jobs. We're getting by because of great partnerships, but it should not be the way we should have a system in place. A standard training for public health Department staff is needed so we can be consistent on the care we provide to the community. Between balancing contacting, contact tracing with vaccination clinics the public health nurse may not have time to get up to date with the Mass Department Public Health recommendations. And in an ideal situation, cross trained staff will be available to inform the nurse and the public concerning the many changes.

We require dedicated sustainable state funding for the local public health departments. In the city of Lawrence we need more professional public4286 health nurses and more resources to best support the needs of the community. The ongoing pandemic has exposed gaps in our public health system as you all mentioned. The state needs to support the local public health help by providing funding, infrastructure and training in order to create a standard public health system in all cities and towns of the commonwealth. Thank you for your attention and for this opportunity and for all your help passing this bill to the next level. Thank you again.
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DAMON CHAPLIN - NEW BEDFORD HEALTH DEPARTMENT - HB 2329 - SB 1386 - Good morning. Uh First I'd like to thank the Committee on Public Health for allowing my public testimony. My name is Damon Chaplin, and I am the health director for the city of New Bedford's Health Department, Public Health Department. City of New Bedford is located in the southern coast of4356 Massachusetts and is home to a population of approximately 105 residents, including undocumented population of approximately 10,000 individuals. New Bedford is a gateway city and the seventh largest city in the state, with one of the most active commercial fishing ports in the country. New Bedford Health Department has 22 staff and according to the nature of 2019 national profile of local health4379 departments, the New Effort Health4381 Department has approximately 65% fewer staff than health departments within cities of similar population size.

Like many other densely4388 populated cities, New Bedford4391 has been confronted with the devastation of the COVID-19 pandemic, the opiate, the opioid epidemic and homelessness and as a result, suffers from a disparate number of poor health outcomes for its black and Latino residents. The city of New Bedford currently has approximately 14,670 total positive COVID cases and a total of 360 total deaths. And although our Latin and black community only makes up approximately 30% of our population, they represent almost 40% of our total COVID positive cases. Like many other gateway cities, our community was one of the hardest4429 hit by the COVID-19 pandemic. The SAPHE bill 2.0 aims to improve the overall structure of public health across the state so that we can all be better4439 prepared to meet the public health challenges of the future and address the structural inequities that exist within the system.

One core component of the bill that will help to advance equity is the provision that establishes sustainable state funding directly to local health departments in order to ensure that every community can provide a minimum level of public health services to all residents and will do so by way of a formula that has equity at its core.4465 As far as we know, we are one of the only states that does not dedicate, that does not have dedicated funding to public health in this manner. We must move beyond the whack, a mole style of state funding for local public health services, where the majority of the communities are supported through a combination of exclusively local funds or competitive state grants that only go to some communities.

This process disadvantages lower income communities and reinforces inequities. It is hyper focused on the written word and supports a culture of inequity, which has historically undermined our most at risk communities and perpetuated health disparities among black and white residents because of those already unfunded and understaffed health departments are less likely and less able to compete in the competitive process. This bill directs the state Department of Public Health to determine an estimated and sustainable local public health budget so that as a state, we can move to a more dedicated form of investments where local public health departments of all4529 sizes, structures and capacity are able to plan and grow towards a healthier and more sustainable future with equity at its core. Again, I thank you this morning for my time.
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PHOEBE WALKER - FRCOG - HB 2329 - SB 1386 - Thank you so much. And good morning everyone. Good morning also Chair Decker and honorable members of the committee. Um I'm also served on the Special Commission, but on this panel, I'm here representing a small regional health district in Northwestern Massachusetts, which covers about 15 towns over 325 square miles with health agents4584 and a public health nursing team. Our smallest town has 120 residents, our biggest has 5000. So these are the towns Rep Kane was talking about earlier. I'm here today to point out how well cross jurisdictional sharing can work as a way to provide equity and public health protections in the commonwealth's 200 rural communities.

In addition to the vital role of public health nurses and the need to have one serving every community, I actually wanted to talk about an additional example of how regional public health can protect residents better than going it alone. And as we know, safe and affordable housing is one of the most important social determinants of health. Local public health has a vital role in ensuring that all residents, especially our neighbors with incomes near or below the poverty line, are doing so in housing that does not expose them to rodents mold lack of heat, lead paint or other hazards. But doing that takes a lot of work. And right now, the state does not require it to be done or fund it to be done.

Our region has the oldest housing in the state, and the districts two shared health agents work hard on complicated cases across the many small towns. In rural areas, housing code enforcement is particularly complicated by the fact that many people own the unsafe housing they live in. And often the problems with the housing include non functioning septic systems, which are complicated and expensive to fix. Being a compassionate professional housing inspector requires training, experience, connections to social services and housing4675 rehabilitation resources and more. And small towns on4679 their own cannot afford to invest in this kind of expertise. So being part of the regional health District gives them the resources to protect their residents.

Two recent examples of people we are working to keep safe are a family of five people and five dogs living in a decrepit two bedroom trailer and an elderly, disabled woman living with a serious hoarding disorder in a very unsafe apartment. Both of these current cases require lots of time, lots of connection to resources, skill and compassion. And the SAPHE 2.0 bill would make that kind of support available to everyone. Not just the lucky towns. Thank you for your time.
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REP SCHMID - Thank you, Madam Chair. Thank4743 you and also to Chair Decker for the work that you're doing on chairing this very important panel. I just wanted to give a brief uh tip of the hat to Damon Chaplain.4757 I represent just a few precincts in New Bedford, but I've had a chance to see uh personally uh the work that he's done, reaching out to get people vaccinated in New Bedford. It's been very difficult because New Bedford has populations that do not have internet access. Uh It's hard for many people to use transportation getting to the regional vaccination centers. Uh We have many people who can't necessarily get away from work during the vaccination hours. And of course we have large populations who are deeply skeptical of government and uh stay away from anything that they feel uh might uh concern them. So I've watched Damon reach out to these folks. He's done a great job and I just wanted to recognize that. Thank you Madam Chair.
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DECKER - So to, and this would be to any of you, first of all, to all of you who are serving at the local level. Um Thank you, thank you for everything you're doing. Um and I know that you've been asked to do more than is reasonably expected. The two questions I would have for you are what has it been like for either you or if you're lucky enough to have any staff working with you in terms of the morale, what has this experience been like? You know, this is this is unlike not, this is not about not getting to enough restaurants or not doing enough housing inspections right.

To be serving in this role in the middle of a pandemic knowing that the stress of really life and death is what's been at stake. Um what has this done4884 to the morale of any of you? And you know, what would this experience have looked like had you actually had the resources that was required of you and the mandates, quite frankly that were asked of you? The expectations of what we asked of our local boards, um, was, was a4902 lot and it did not match the resources and the training that many boards throughout the state have. So if any of you could speak to that.

CHAPLIN - Yeah, I can um, I can add a comment to to the question. Um, personally, for me, it's been, um, absolutely draining. Uh, and we will most likely within our public health system see a number of public health professionals leave the profession because of4930 the stress, um, that we've encountered. Um, personally, I've lost a few family members, uh, to this pandemic. Uh, but specifically about the 2.0, um, I think one of the things that it gives us is a life preserver. Um, we didn't have anyone to pull on at the local level. Um and so we oftentimes felt on an island by ourselves and not having enough staff to really support the needs from a data perspective from an enforcement perspective and from a communications perspective. And we just did not have the staff to kind of meet the demand.

And so I think for this, for us and for me, for this particular bill, uh it's enormous because dedicated state funding will allow us to build our departments to a level that can support the community. We don't have, you know, every year, as has already been mentioned uh we go through this process where our budgets are oftentimes at risk of being cut. Even in a pandemic, our budgets are at risk of being cut. And so with that in mind we're not able to build and put in place those positions, those key leadership and senior positions that allow us as a community to move forward. So um long answer. Um this is a long time overdue. I've been in this profession for a very long time and the disparities among local health departments are ginormous in Massachusetts. Uh and it's not fair to those folks who5019 live in those communities that don't have adequate health departments or don't have an accredited Health department. Thank you.
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WALKER - I think I would echo my, my colleague exhausted, absolutely exhausted trying to hold together all the pieces. Find the little tiny chunks of money here and there, find another nurse who could add more. The number of people I've hired, who I've said, it's just going to be like 10 hours a week for a couple months and then it's, you know, 30 hours a week for you know, 16 months. Um uh you know, the trying to keep people's morale up in the heartbreak of the contact tracing is intense It's very intense. And so having to struggle to do all of the the finding the resources, figuring out what to do when you just can't find them Um and having to do all of that staffing up even, we're so fortunate. We are a regional district. We had nurses on Maven already. You know, we had a skeleton to build out from and so we were able to keep all of our contact tracing local and that we were reaching people within hours of hearing of their diagnosis. You know, that was amazing. But that took an absolutely exhausting level of effort and a lot of, a lot of money that I'm not sure I actually all have uh in the end.

DECKER - Yeah, I just want to I mean, I just want to say thank you to all of you and um I have to, I asked the question because I have to believe that a lot of the work you're doing is pretty invisible at the local level and at the state level. Um and but the word, you're first responders, you're right there at the ground level and you're not able to look away from the grief and the pain and the stress of this job. And so I just want to say, as a legislator and as the chair of the Committee of Public Health, um I just want to acknowledge that and say thank you and I know that it's our job to do more than just thank you, but to do better. Um5147 and so um you know, thank you for your for all of your work. But thank you for bringing that5153 to this to this hearing as well. That's our job is to hear what it means to actually are we failing communities. Um and if we are how and then our job is to then think about what are the tools and the bills that allow us to respond to that5167 and respond to it and if we don't explain to you why we're not. So but to hold us accountable. So thank you.
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COMERFORD - Well, thank you. Um, so that you you missed then my heartfelt, Thanks for your service and for taking the time to bring5194 the stories of your work to the committee. We respond to those kind of uh, open mind, open heart5200 stories. That's our job as Chair Decker said to listen and to respond to the best of our ability and uh, in this public health committee, uh as public health officials, you are our main event. So thank you so much.
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5228 ANDREW5228 LOVER5228 -5228 UMASS5228 AMHERST5228 -5228 HB5228 23295228 -5228 SB5228 13865228 -5228 Good5228 morning everyone and thank you to5230 both of the chairs for this opportunity to address the committee. Um, I'm an infectious disease epidemiologist and an assistant professor of EPI at the School of Public Health and Health Sciences and I've been actively involved in the contact tracing program here at UMass Amherst from the start. And a lot of our experiences there really highlights some of the challenges with local public health um, throughout the commonwealth. Um, one of the great ironies of public health is that when it's going well, it's largely invisible. And so due to the really heroic efforts of thousands and thousands of local public health workers, things have run pretty smoothly for decades.

Um, but the pandemic has really highlighted the immense challenges and um, these gaps are critically important to address now while we have5285 the momentum and the um, the need to desperately do this. Um and I think it's important to realize that many public health staff have been working constantly for 18 months and um, there will be a huge turnover in staff. People are quitting, people are burned out and it will take decades to rebuild up even that health capacity. So it is critical to find the funding and to support systems of local public health. Aside from all The contact tracing work and the pandemic related I'm also a resident of Shrewsbury, which is a small town of 1200 people in uh, Senate Comerford's district. And we have a halftime nurse and that is our entire board of public health.

And to even expect, um, a very diligent and trained and motivated, motivated professional to deal with the barrage of needs um, for local public health is unrealistic. And so the5344 commonwealth is unique5345 in that we have no regional or county level boards of health. And that system exists for a very good reason in a lot of other states, actually, all the other states. So I would really say and then support this SAPHE 2.0 Bill. It's a critically important piece of legislation to fund and to protect the health of all residents of the commonwealth. Thank you.
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JAMES DOLAN - DOLAN FUNERAL HOME - HB 2217 - HB 2245 - Thank you for having me. Um I just wanted to speak on House Bill 2217 that Representative Arciero Uh sponsored as well as uh House bill 2245 um with Representative Chan which are very similar bills. The bill is to amend Chapter 46 Section 9 which is important um to help grieving families to help their loved one's funeral services Held in a timely manner. The bill also accommodates the doctors and the medical staff by giving them 24 hours to complete a death certificate. While usually that's done within 1-2 hours after death although the majority of the doctors and the nurses um nurse practitioners will sign the death certificate a short time after death.

Unfortunately there's still a number of doctors and nurse practitioners who do not. This bill would strike a balance between the family and the medical staff needs. Many faiths such as Jewish, Muslim and Hindu will require funeral services to be held as soon as possible. There are several steps that occur after a death certificate is signed in order to legally bury or cremate someone. It is essential to have the death certificate signed within 24 hours um after the death in a timely manner for that. After the doctor completes the death certificate, the funeral director has to complete the vitals such as the social security number, um Parents5572 names and where they5573 were born. Um Veterans information and the family has to verify the death certificate that the information that the funeral directors put in is5582 accurate.

Then the Board of Health where the death occurred in that community has to accept the death certificate before either the burial or cremation permit can be issued. If cremation is going to occur, the medical examiner has to view5597 the deceased as well as the completed death certificate signed by the doctor or the nurse practitioner. All of these steps take time. This bill would also make the death certificate fully electronic. Um the Commonwealth has invested um significant resources back in 2014 and 15 to bring the archaic5618 paper system into the 21st century.5622 As a transition to the electronic system, the state instituted a paper medical worksheet option to sign the death certificate. This option was essential six years ago to help the medical staff who did not have the technological knowledge or equipment to complete the death certificate online.

Medical community over the past six years has been given electronic training in the credentials to complete the death certificate online. By making the system fully electronic as the state intended it to be, will speed up the process to facilitate the family's religious services and the traditions excuse me to get the permit necessary to have either the barrel of the cremation done in a timely manner. I urge your bought in passing of the bills to amend Chapter 46, Section 9. Thank you.
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ROBERT STEELE - CONCERNED CITIZEN - HB 2412 - Yes. Uh Good morning Madam Chair Comerford and Madam Chair Decker and thank you for allowing me to speak um to ask you for a favorable report regarding an act to improve next of kin access to deceased medical records. Um The bill will allow next of kin who named on a death certificate that access5771 medical records without the expense of probate court and provide hopefully consistency with other, all the health institutions across the state of Massachusetts,5783 which currently the state law says there must be an appointment by the probate court for someone to be either an executor or an administrator of an estate.

Um Certainly some estates uh don't require an appointment if there is no estate so that's what led me to my situation. Uh My daughter Erin uh died in 2019. She was killed by a heroin fentanyl overdose. And unfortunately her life, she struggled with opioid addiction for approximately 18 years. I was led after her death to try and seek out what her addiction journey was like and I went first to Franklin Medical Center in Greenfield Mass, which is part of Bay State Health. And I started with them because in 2001, Erin was involved in an accident and her pelvis was fractured in five places And she was in the hospital for about six weeks. And I know this is where she first was introduced to opioids.

I was quite amazed when I went to Bay State asking for her uh medical records uh that they just requested I fill out a form, provide a death certificate with me being named as Erin's next of kin. And within a few weeks I had 1200 pages of medical records dating from 2001 to 2019. Um So I thought, well I knew she had been in other medical institutions in the state and I knew she spent5913 time at a hospital in Northampton Mass Cooley Dickinson hospital throughout her struggle. So I went down to the medical office at Cooley Dickinson thinking it would5922 be pretty much a similar routine of fill out a form provide the death certificate. And it was in that medical office, I was informed that I needed to have an appointment by the probate court, that it was a state law.

And uh I asked if they could cite the state law and the people in the medical office couldn't even cite the law. They just said I needed to go to the probate court. So at that point I was uh quite confused and wondered how can that be that two health institutions would have two different policies. Uh And when I finally found out what the Mass General Law was, um I sought I wanted more information uh from other healthcare institutions and I wanted to find out if they followed the state law or if they amended the law on their own. And I was led to seek medical records at Mercy Hospital in Springfield. And they provided me with the medical records without an appointment from the court.

And I was really surprised that national uh corporations, uh pharmacies like Walgreens and CVS, uh they did not require an appointment from probate court. They accepted also copies of the death certificate. And I did have to fill out a form with them that I got notarized, but it was it was pretty easy. And uh my reason for trying to avoid the probate court was I did apply for a voluntary administration appointment by the court. But I was advised by the service center at Franklin County Courthouse that because Erin's estate was insolvent that I should save my money and not even get it, I didn't need it. There was nothing to really no business of Erin's to be taken care of that needed an6063 appointment from the court.6065

And then it went further that the voluntary administration appointment would not allow me access to her medical records. So I would have to go to the next step in probate court, which would cost more as a personal representative to get access to medical records. So in the long run it just didn't make sense and that's why I'm hopeful that you would support this. This committee can support this bill to make it easier for families to access a deceased person's medical record. It shouldn't require any additional funding I don't think from the state. And I think it will be very helpful for families um, that they go through a sudden death a natural death, a tragic death. And again, on behalf of myself, I want to thank you very much for your time and listening to me. And because Erin is a big part of this request, I'd like to share a picture of Erin with the committee. This is her at 18 years old. And yeah, uh, she is a big impetus behind me trying6152 to make something good for out of her tragedy. Thank you.

COMERFORD - I just want to thank you, transforming your grief6165 into advocacy not only for your own family, but for other families. So I just want to go back just to to make sure that I'm really underscoring what you said. Um So in your case some hospitals tried to be helpful. Um They saw you as of course what you are a grieving parent when you asked for that information and then in some hospitals um they were not able to go out of their way to help. And so your your point here is that this bill would make the law uniform so that hospitals do not incur liability when parents such as yourself ask for medical records.

STEELE - Yes, I look at if Bay State Health has been able to do this for a number of years and one of their compliance officers has told me they've done it for years. They have it on their website. They cite the state law but at the end they've added a sentence that a death certificate with the name of the requester as next of kin is on the death certificate they will, they don't need appointment from the court and they will do it. But yes, other hospitals go strictly by the state law and don't allow this um amendment uh on the on their own.
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SARAH NEVILLE - CONCERNED CITIZEN - HB 2294 - SB 1440 - My name is Sarah Neville and I live at 40 Eleanor Street in Chelsea Massachusetts. Um I'm currently a PhD candidate in social work at Boston College and I'm also an adoption researcher. I myself am not adopted, but my parents have adopted two of my siblings. And when I was 19 years old, my mom revealed to me that before I was born she placed a child for adoption, her own biological child. So for my mom, she was faced with an unexpected pregnancy in the late 80s. And um my mom's parents encouraged her to hide her pregnancy by living in a maternity home run by a Catholic adoption agency.

My mom had decided that placing the baby for adoption was for the best Um But she had no choice in6379 the circumstances of the adoption. She really6382 wanted to have a relationship with the baby's parents, the baby's adoptive parents, but the nuns told her no. What she needs to do is put this all behind her and6392 forget it ever happened. And that would be best for her so she could move on and forget all about it. A few years after that she tried to um send the adoptive parents a letter,6403 but the social worker who handled her adoption refused to send it completely. She just said, nope, I won't send it. My mom has been searching for my half sister for some years now and she has had no success. Um I support this bill as an adoption researcher and a social worker researcher. And my mom supports it as a birth mother.

I'm telling her story to illustrate the fact that birth mothers were not promised anonymity. Um it was the higher ups and the adoption agencies who thought that secrecy and sealing birth certificates was the6440 best way to protect adoptive parents from the interference of anyone else such6449 as um such as birth mothers. This bill doesn't force anyone to contact anyone else or to have a relationship with anyone else. It just gives adopted people the right to their own personal information. And if those adoptees contact a birth family member then those individuals are perfectly free to turn them away and not respond to them.

So I urge you to report favorably on this bill, but more than that, I really implore you to please use your influence um this session to get this bill on the floor for a vote because this bill has you know, died in three consecutive sessions. Not because it really has any opponents, but just because it's been passed over by the Legislature. So I'm asking you to please please um do everything you can to grant adopted people their rights this session and um get this bill to pass. Thank you so much.
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JEAN STRAUSS - CONCERNED CITIZEN - HB 2294 - SB 1440 - Um first off, I want to thank Senator Comerford very much for your leadership on this issue, not just today, but in the last session. We really appreciate being able to speak with you all. Um so I'm from East Brookfield and I'm an adoptee. But more important, I'm a An6576 author and6577 a filmmaker. I've been documenting this issue for over 30 years across the country. The need for adoptees to have access to their original information. I'm not just past film the passage in the enactment of legislation, but also I followed adoptees and their families, sometimes for months or even years following their receipt of birth certificates.

6595 And6595 I think this long term study allows me to assure all legislators that these bills are vital to the emotional and physical well being of your constituents. So I've lived in Massachusetts much of my adult life, but actually I was born and adopted in California. And something happened this year that, um, underscored for me the need for records. Um, my birth mother died in July from COVID And it was an incident that sparked in me the desire to finally apply for my own6627 birth certificate. There is records, are sealed in California, but there is a process where you can just file an application. So, um, I decided to do that. My birth mother and I had known each other for 33 years and although she didn't replace the mom who raised me in any way, we had a profound friendship.

So I filled out the requisite form, um, and sent it along with 40 pages of supporting documents, including a notarized permission form my birth mother had signed. Um and of course I anticipated that it could get turned down. And I've been doing this for decades, anybody that's in this room right now, I could tell you we've watched people be turned down for their request for information. But when the clerk of the court from the county where I was born called me this past December to inform me that my application was not enough. And instead I would have to pay $425 to file a formal court case that I would need to hire a lawyer that I would need to fly to California to be in court in person simply for the chance, not the guarantee, but the chance that they might let me have my original birth certificate.

Um I couldn't help it. I wasn't expecting it, I burst into tears and I sobbed on the phone to this clerk. It reminded me even though I had witnessed it, it's so different when it happens to you personally. Um I was devastated and I, it was diminishing and dehumanizing and I am 66 years old. When will I be old enough to have access to a document6713 that any other citizen can file a form for and get. Um you know, when will I be considered a good enough citizen to be given that privilege? What do I have to do to be equal to them? Because equality is the question on the table today. Um and I'm so proud of Senator Gobi by the way for sponsoring this bill because I am one of her constituents. And she's the kind of legislator everybody wants to have as their senator or their state rep.

She listened and she took time to educate herself about the need for equal access to all and Representative Garballey who I got to know last session is just6757 amazing as is Representative Hogan. So I hope the committee moves this forward and as Sarah said, doesn't just help us get this through committee, but helps us get it onto the floor. And in doing that, I know for sure that these citizens in Massachusetts that are between the ages of 21 and 47 who are denied access, you will be providing them not only with the equality that they deserve, but the dignity, the humanity and the respect that they need to feel like they're full citizens of this commonwealth. I now know this again from personal experience and I feel it in my heart. I thank you very much.
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RENDA CUTTER - CONCERNED CITIZEN - HB 2294 - SB 1440 - My name is Brenda Cutter and I'm an adoptee. I was adopted in 1956. Um and I'm also an adoptive parent of two grown daughters. I'm also a lawyer that cares deeply about civil rights and equality. Um, and I think from I look at this issue from all of those perspectives. Um, and I thank you very much for giving me the opportunity to speak today on this. Um, so Gloria Jean Saint Peter is my original name. Um I know this because I was able to obtain my birth certificate back in the day. Um, but in Massachusetts, most adoptees, those born between 74 and 2008 cannot access their birth certificates. Um and I6911 and many others, some of whom you see here today have been working for years to try to eliminate this gap Um with repeated bills that have been filed and just haven't made it over the finish line for various reasons.

Um, in my advocacy to date I focused on education and I tried to persuade people to reflect on how they would feel if they were denied access to their own vital records, their own birth certificates. I've tried to make the case a call to empathy in a reasonable logical way6944 that adoptees all adoptees um should have the same civil rights and the same equality as every other Massachusetts citizen. Um and I've been careful to reassure those that may be nervous that, yes, I love my family and no one who wants to know their own history is6965 indicating that they're troubled or lacking in loyalty. Um it's simply a matter of wanting to know one's own identity um in its various forms.

Um recently I observed the reactions to a fantastic article that was written by journalist Steve Inskeep in the New York Times in March, and I urge anyone interested in this issue um to read. It was March 2021. Um and he talked about his own story. He has obviously been a journalist for decades, and he talked about advocacy for open records and what that meant to him. Um, Most people who responded to that article it was a long article were very supportive. But, you know a few weighed in, um and the main theme was sort of were concerned about the birth parents privacy. Um, but I mean, it's important to say that the only national birth parent organization in this country that's been around uh, for as long as I've been interested in this issue, decades, 100% supports open records.

Um, I really think that these privacy concerns that get stated are usually from maybe a very, very small group of adoptive parents who might be a little scared or a little threatened at their Children, Um it will some, it will affect their relationship with their parents. Um, but I, you know, I'm here to say there's no reason to be threatened. Um, I found my birth parents back when I was 20, which is a long time ago, and it didn't have any effect on the love that I have for my family. And really only helped to make me feel more secure in my identity. Um and amazingly, one of my daughters uh found her birth parents in China, which is astonishing. Um it's hard to do.

Um and in our family that experience and supporting her through that experience really only brought more love into our family. And you know, for both of us, for her, for sure, and for me, um its just having that information about your beginnings is it's so critically important. Um I almost can't explain probably only adoptees on the panel know how that feels. It's kind of just answering the questions that we have about where did they come from? How did they get on this planet? Um So this is a um very simple bill and see of complex problems that we have to solve in this world it's really something really so simple to solve. Um literally this gap group of adoptees is the only ones that don't have rights to a birth certificate. Everybody else does every other citizen. Um That's not equality.

Um And you know how basic is it a question of civil rights to7140 have your own vital7141 records? Um And as Jean said, there's something kind of humiliating and strange about not being able to access literally your own birth certificate. Um So Gloria Jean Saint Peter, that is my original name, I don't use it. Um But I lived in that name for six months. Um and that type of information should not be kept from me or from anyone else. And I guess I would say that you know adoption should not be like the witness protection program. It shouldn't really function that well. So I urge you to support House Bill 2294 Senate Bill 1440. Um Thank you very much for your time today. I really appreciate that. I appreciate hearing from other people.
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ADAM PERTMAN - NCAP - HB 2294 - SB 1440 - My name is Adam Pertman. I am a resident of Newton Massachusetts and I head the National Center on Adoption and Permanency, which is a national education organization. I should say education research because that's where I'm going to start. Um, we've heard for over a year how important it is. Follow the science follow the evidence. Follow, follow what we know to be true. I've been studying this issue in particular and many, many others relating to adoption for going on 20 years um, now in my role at NCAP and before that, the Donaldson Adoption Institute, which did seminal work in the field. Its objective, it's research based, it's not affiliated with anybody. We just we do research.

And the common thread across all of it, All of it is that providing adopted people with their own information across the spectrum of information um serves their needs, serves the needs of their families, contributes to their mental health on and on and on In addition to being an equity issue, which I certainly agree it is. If you're born a day to later a day too early, it should not affect what rights you have. Um But in terms of the evidence, the evidence is singular, singular that this doing what you are pondering doing benefits everybody concerned. I'm an adoptive parent. We know our kid's parents, birth parents, everything's all right. And by the way it's not about search.

Everybody can search now. You can use DNA. You can use the internet. People are meeting literally every day without a birth certificate. So why are we keeping them sealed? And so the only7355 other thing I want to say because I do want to keep this very short. As you consider whether to do this or not and as your colleagues in the Senate will consider whether to do this or not, please know that you're not conducting an experiment. For years people in the Bay State have been getting their birth certificates if they were born at the right times um and no harm done. Whatever, and this was this was mentioned earlier today. Whatever you think if you think there are negative consequences that this could have. Look at the evidence. New Hampshire to Alabama, to Oregon, to Illinois, to New York.7399

Across the geographical spectrum. Across ideologies, states have done this and you know what has happened in all those7409 states? Absolutely nothing bad, nothing. And millions of people have gotten a piece of their souls back. In the time in which we live whether you're talking about evidence or whether you're talking about rights, how we can continue to perpetuate this inequality is beyond me. It really is. And I hope with all my heart that you can pass this legislation, advocate for this legislation and just get it done.
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TITO JACKSON - CONCERNED CITIZEN - HB 2294 - SB 1440 - Um I want uh, I want to thank um uh, the co sponsors, uh, Sean Garballey, Kate Hogan as well as Anne Gobi. Um I am uh privileged and honored to be here today. Um I ironically was born on April 11 1975. Um I was born nine months um almost to the day um of um this kind of lock out. Um and I would submit to you uh for me personally, um I just recently found my mom. And my mom Is actually featured in a book that I read five times in college called Common Ground. I'm a history major and7565 a sociology minor and I will admit to this August board, I only read the chapters that my mom was actually in Uh so I can do my papers.

And so um literally I read about my own birth in that book multiple times7580 and I didn't make the connection. Um I would also to let you know that my mom was sexually assaulted. She was trafficked by her mother. Um And she had7593 no choice in the adoption. And in 2011 after losing her middle son um to uh act of violence um she uh told her other two sons who are my brothers who I have recently met um that she had she had another child. And Um she went in 2011 and fought the fall 2011 to Boston City Hall to go get the uh the birth certificate um for a baby boy Twyman. Um ironically she was turned away, she sat there for about two hours trying to get get this information. But even more ironic, I was upstairs in Boston City hall serving as a Boston city7647 councilor.

So my mom and I were literally in the same place at the same time, but we did not have this information to connect us. I paid my $500 to the Home for Little Wanderers. Um, and a a couple of months made7664 that connection. Not everyone has $500. Not not everyone can wait for that process. And when we think about COVID, my mom just got over COVID. I had COVID last year. We literally could have both missed one another based on in this life, based on this lack of information. And I will7686 note to you as an African American, one of the most amazing thing that's happened to me in my whole life is that when I find that I found out I was part of the Twyman7699 family in Common Ground, there was a chapter that goes back to slavery.

So someone who's been walking around trying to do this, work around diversity, equity and inclusion, all that good stuff. I literally instantly had a history a heritage and a connection that I never had before. And by the way, I had read it all multiple times. And so what I want to ask of you listen, I know this is hard for some folks. One we're not here doing what I normally do is asking you for something that costs a lot of money. That's normally why I come see you. Um, I'm asking this probably probably the first last and only time that I come and ask you for something.

Uh, when it comes down to it, this is about completing ourselves. It's about public health because how I came to this is, I had a physician who pushed me around.7756 Um, you know, the, you know, any of the disease stakes that I had. All of those things are so important and lastly it completed my puzzle. Um, This year I celebrated, um, ah, the, um, the first time and I had two mother's Mother's Day situation. A little bit more expensive than normal, but it's all good. Um, but uh, it was, um, one of the highlights of my whole life. And so I thank you for the consideration. This7788 one I really ask for you ladies as well as7792 gentlemen to punch this in and get it over the finish line.

It's been here multiple times, but I would7801 submit to you and I heard the public health, uh, issues that you were talking about earlier. This is connected. I thought about not being here and my mom literally two weeks ago just kicked7812 COVID. We could have passed on this side and not been able to see each other until the other side. I, I ask you, and I honestly, I beg of you, um, to actually move this legislation forward. It is life or death, its completion, not completion and it helps relationships, mental health, public health and the like. Thank you so much, Madam Chair.
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DECKER - Um that story was so powerful in the Globe. Um and you know, just to be clear, there's no begging necessary here. The House actually, we enacted this bill, we voted it out. It went over to the Senate and I have to believe, but for the, our ability to try to figure out how to respond quickly to a pandemic that this had, I would have hoped that this would have gone through the Senate. I don't know that, but I would have hoped. Um and um Representative Sean Garballey has been talking to me about this bill for years and it really hit me because it's very personal to him as well. And it's just there's7919 something really, the fact is that nobody knows why these like arbitrary dates were chosen is a whole other conversation that somebody might want to explore.

But to say that it's um it really is, it's outrageous to begin with. It makes no sense. And just, you know, to everyone who's been on here telling their stories, it takes a lot of courage um and heart and um and energy. So thank you for all of that. But I did not want this moment to go by in a world in which we don't get to see each other in person too often right now Just to say um really powerful reading that and so happy for you and for your mom. And and I expect that we will be trying to move this bill through the House as well and um and look forward to getting7965 it out in the Senate this time too.
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J.M SORREL - CONCERNED CITIZEN - HB 2294 - SB 1440 - Thank you. Uh thank you Madam Chair. And I almost live in your district. I did for most of my adult life I'm three houses over the line. So, um, but I have a lot of admiration for you. I also just want to point quickly and I am going to stick to a script and I'm Hold me to being under three minutes. But I used to serve as, as Grandes health agent 20 years ago. So um incredibly supportive of um everything that all of the people in public health we're speaking to earlier and my hope after this pandemic is that our medical and public health systems work together more8043 routinely going forward like they do in other countries rather than only in a crisis, so just had to put that plug in.

But this, um, these bills in the House and Senate are personal for me. Over three years ago when I was 57 years old, I was able to get my original birth certificate from Pennsylvania. I was adopted at nine months old from a foster home. And while it was normative for me to be in my adoptive family and I still maintain close, really close ties to my cousins, I was curious to know if I had birth siblings and to learn about my biological background. My adoptive parents have been deceased for 10 years, but they were always supportive um, of me wanting to learn more about my biological roots. Little did I know when I inquired that Pennsylvania law was a day away from changing for the first time unsealing the records so that I could get my original birth certificate. Talk about timing.

After paying $15 and sending in the form six weeks later, the birth certificate arrived in the mail. It was a hard opening experience to see my given name at birth and my parents8112 names and ages at the time of my birth. There's more to my story, but suffice it to say I'm engaged in a relationship with my birth mother who happens to live in Cambridge Mass. We've each lived in Massachusetts most of our adult lives. She also has lots of friends in Northampton. And she had a son at age 43 So8131 I have a kid brother and I like him and his wife very much. I also learned about my health history and this information has actually been crucial. I was able to contact my birth father who is in California and just last month I connected with a sister I did not know I had.

She's amazing. Like me she spent her adult life serving others in addressing societal and justices. My identity was intact in some ways before I decided to look into my roots. And yet genetic information has answered questions I didn't even know I had. It's no small thing. I believe it's a fundamental right for a person to know where she or he comes from for better or for worse. I've come to realize that it's important to know about my birth origins. And while it doesn't preclude complication and ups8182 and downs, it's been an essential piece of my puzzle. It's not about the outcome, it's about knowing who I am more fully. Both nature and nurture are factors in each of our lives. In Massachusetts it should not matter when you were born in order to obtain your original birth certificate. This issue has been considered for years in the legislature and now is the time to act. Thank you for making this a priority. It's a profound and important human right. Thank you.
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CLAUDIA D'ARCY - CONCERNED CITIZEN - HB 2294 - SB 1440 - So hi, I'm Claudia Corrigan D'Arcy. I'm actually not a resident of the commonwealth, but I am from New York. But I came to the Commonwealth the first time in 1987 as a pregnant woman to give birth at a Massachusetts agency. And I finished the last part of my pregnancy in Massachusetts And then did give birth there in 1987. So this bill is directly there and you are all supposed to be protecting me with this law that's there right now. The law that has been there to protect me from him. This is my son Max who I gave birth to in 1987 and gave up for adoption. And I really8301 did not need to be protected from him cooking kitchen, uh, cooking dinner last night or that we had wonderful Mother's Day yesterday.

Um, so as a birth mother and not just8317 as a single birth mother, but as someone who's spent the last 20 years doing this work, um, I was part of the team, in New York where we passed the bill. I don't even know what to say anymore about passing this because I feel like I've written this committee and every one of you many letters over the past couple of years about different reasons why, where we are. And so I was reflecting on this and I was thinking, Well the law changed in 2007. We met each other for the first time in 2007. Since 2007 we've managed to do a heck of a lot healing and yet that law is still there. We've managed to get New York to open, which that was no small feat in itself. And yet Massachusetts still has a law that you just have to take out 13 words.

You already know it works. I mean, Adam's lovely testimony, talking about how the science makes sense. I turned to8379 Max and I said8380 he's our Fauci. Um the science works but you know that the science works in your own state. There is no difference between someone who was born at the stroke of midnight in 74 and afterwards. It's just silly. And then I look at my four Children, the other three are treated completely differently and get their birth certificates and you cannot and it's ridiculous. And we did not need this protection. Um Because I do have one minute left.

I will say one more thing. Um When I was 19 and scared and vulnerable, I was trusted as a person to make a choice. No one looked out for me really. You had the laws but I made that choice as a birth mother to placed my child. Why am I now not at 53 much more knowledgeable and much more able seen as an adult who can hold up and not be protected. Like why did I not need to be protected when I was8441 19 but I need this protection now when I can say to you know I do not I do not need it, I do not want it. And if I did not want to talk to him anymore, I think we could figure it out on our own without a law. I talk too much.
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8471 MORAN8471 -8471 Thank8471 you madam chair and thanks um for all those who have testified to8475 really bring the life to this issue. And I just was curious because it seems like there is such a patriarchal undertone to this issue that was brought up I think by Claudia pretty vividly. I'm just wondering if some of the researchers, um, might have or anyone really, um, some knowledge about any national women's organizations or Massachusetts state women's organizations, if they, whether they have sort of read into um, to this legislation. Thank you madam8513 chair Both chairs Thank you.
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D'ARCY - I can't say for sure. Um, off the top of my head and maybe someone who's8536 close in state since I am in New York can't talk about in state organizations. I can say historically that there's actually kind of been a, a weird kind of a miss between women's organizations and then looking at what is8550 definitely, um, a patriarchal, you know, establishment and a lack of equity in adoption relinquishment specifically. Um, there's just definitely a conflict there where a lot of feminist organizations do look at adoption as a reproductive choice. And um, unfortunately as a birth parent advocate, I do feel that incredibly a lot of the8574 feminist organizations have closed their eyes to the exploitation basically of, of young women with lack of resources and support.

Um, and and to be completely honest, it's because often the women who are in power and privileged in the feminist organizations are often adoptive parents themselves. And I think there is some inherent bias of it. Um, we are getting a little bit more now. I think people with understanding trauma and the child separation8604 of the borders I think people are able to really jump over and kind of see adoption relinquishment as more of an equity issue, but we still have a very long way to go. That's kind of the general if that helps any.
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MARLEY GREINER - BASTARD NATION - HB 2294 - SB 1440 - Ah My name is Marley Greiner and I am the executive chair and co founder of Bastard Nation, the adoptee rights organization. We are the largest adoptee rights organization in the United States. We support only the full restoration of the right of all adopted people without restriction or condition to a copy of their original birth certificate and related documents and records. I'm also adopted. I have been involved in the movement for over 40 years and I've had my original birth certificate from Ohio Since8693 1981 with absolutely no social disruption. Uh we support passage of House bill 2294 Senate bill 1440 as written and urge the joint Committee on Public Health to vote the bill favorably and to move it onto the floor for a favorable vote.

Last year, an identical bill passed the House as you've mentioned, but it was not heard in the Senate. We believe that if it hadn't been for the pandemic, it would have been heard. Uh current Massachusetts law allows adoptees to8723 obtain their original birth certificates without condition at age 18 If they were born on or before July 17th 1974 or on or after January 1st 2008. The OBCs of people born between those days remain sealed, unavailable only by court, available only8741 by court order. Uh this bill simply levels the playing field and let's all of Massachusetts adoptees be treated the same way. 15 years ago, Bastard Nation was closely involved in the SB 959 campaign. That bill would have restored the right of all Massachusetts born adoptees to unrestricted uh to be able to uh to obtain their birth certificates unrestricted without conditions.

I came8765 to Boston, I walked the halls of Beacon Hill for a few days and8773 testified on behalf of the bill before the Joint Committee on Children and Families. Uh talking to legislators and their and their aides I was assured repeatedly that this bill was a no brainer. It would pass, you know, don't worry about it. But then nothing happened. I left8792 Boston confident that the bill8794 had a good chance of passage but sadly nothing happened. And after months of compromise, uh and some confusion and lack of communication uh, from legislators and sponsors the bill uh was passed and uh, that split Massachusetts adoptees into two classes, the haves and have nots. The have nots were between those two dates of the halves could not uh, could not obtain their birth certificates.

A Logically simple, accident of date of birth they have not found themselves and their publicly held birth certificates tossed into a black hole along with their right to equal treatment and due process. Under current law, the state, the state of Massachusetts clearly understands the principle that adopted people have a right to their own original birth certificates. The state now has the opportunity to right that grave wrong that was done 15 years ago. Ah it has a chance to level the playing field and make the rights of all the state's adopted citizens, not just some equal to the, not adopted and equal to those within their own adoptive class. Please do the right thing. Support uh support these bills, vote due pass get them onto the floor and um get them past, make Massachusetts adoptees equal. Uh and I do have a you had a question8880 earlier about feminist and women's organizations. Connecticut8883 now supports the records8884 bill there. Ms Magazine has written in favor of uh of records access and uh I am the former vice president of Columbus Ohio Now and we certainly support it. And I was told at one time that Now actually had a8903 resolution in support of of access.
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GREGORY LUCE - ADOPTEES UNITED - HB 2294 - SB 1440 - Thank you madam. Chair Comerford Chair Decker and members of the joint committee. I appreciate the opportunity to speak in favor of House file 2294 Senate file 1440. My name is Gregory Luce. I'm the president of Adoptees United, a national nonprofit organization dedicated to adoptee rights. I'm also an attorney and the founder of Adoptee Rights Law Center a Minnesota based law firm where I represent adult adopted people. I'm considered8957 a national expert on issues related to adult adopted people and their rights to identity, heritage and citizenship. I'm also an adoptee and I have deep roots to Massachusetts. I'm a graduate of Boston University and most of my birth family has resided in Massachusetts for generations.

My birth father resides in a Boston suburb and my birth mother and my maternal grandparents are buried on Martha's Vineyard where my aunt, a retired cobbler still resides with her Children and a grandchild. As we've already heard from Councilor Jackson, Senator Comerford and Representative Garballey and many others,8988 millions of people and hundreds of thousands of Massachusetts residents are impacted in some way by adoption. My written testimony gives context to Massachusetts current law and its division between the haves and have nots of a state issued birth record. You've heard today from9004 others who have talked about DNA about their right to identity, about the shame that was used to coerce birth mothers to relinquish Children in the past.

You've heard that no promises of9016 anonymity were made to birth parents including my own who was actually kicked out of Mount Holyoke after she became pregnant and was, to the dismay of school administrators not married. Today however, I'd like to provide additional humanizing context. Let's take two people born and adopted in Massachusetts, a brother and a sister. The girl is born in Lowell in August 1974 the boy in Somerville in late 1973. They are adopted into the same family and in Middlesex County probate and family court their adoption decrees issued on the same exact date in 1975. Fast forward to today, in which they are adults, one 48 years of age, the other 47. The brother applies for a copy of his original birth certificate.

He fills out form R109 pays $32 and within a few weeks he has a copy of his own birth record in the mail. There's a sister adopted on the same day and in the same court also fills out the same form, pays the same fee, but in a few weeks she gets nothing other than a letter rejecting her application because she was born in Massachusetts at the wrong time. She grew up in the same house, in the same place with the same neighbors and with the same parents. Yet she has denied the right to her own identity. I remind this committee that Article 7 of the United Nations Convention on the Rights of Children States Unequivocally that the child shall be registered immediately after birth and shall have the right from birth from birth to a name, the right to acquire nationality and as far as possible, the right to know and be cared for by his or her parents.

A right to know who your parents are enshrined by the United Nations Convention on the Rights of Children. That is what is at stake here. A Massachusetts law that compromises that universal right and disallows the release of a birth record solely related to the luck of where and when you were born. Had, for instance the adopted woman in my example, have been born 20 miles away in Nashua, New Hampshire rather than Lowell Massachusetts, she9132 would be able to apply for and receive her New Hampshire original birth record without question. This is the same result in Maine Rhode Island New York and other states. It's time now to make Massachusetts adopted people whole. It's time now the Massachusetts recognizes the inherent right of adult adopted people to possess their own records, their own histories, their own stories and to claim our full economy as humans. We too are human. And I urge this committee to vote due pass on H 2294 Senate 1440. Thank you.
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CATHERINE LA RUSSA - CONCERNED CITIZEN - HB 2294 - SB 1440 - Hi, my name is Catherine La Russa and I would like to present to you why access to my original birth certificate is so important to me. From a very young9187 age, I have known I was adopted. My origins have been a giant and distressing mystery throughout my life. Not having information on9199 myself has caused me great heartache. I was a teenager when I first looked up the laws to obtain my original birth certificate and was absolutely devastated to9208 find not all adoptees are granted access. I am one of those unfortunate adoptees to be born in the gap years. To know I was simply born at the wrong time to be given access to such a crucial part of me is demoralizing and cruel.

I investigated further to find that I would most likely never be given access to my original birth certificate. There needed to be a good reason and someone else would decide for me if my reason was good enough or not. I've had to live the next years of my life with this pain that I may never get to know such integral information about myself that non adoptees take9247 for granted every day. What have I done differently than adoptees born before 1974 and after 2008? Adoptees born between 1974 and 2008 are not criminals. So why are we treated as so? Why do some adoptees get access to their original birth certificate and others don't? It is discrimination and completely unfair. I've had to grow up with no medical history, racial identity or information on my origins.

Imagine growing up in a family and in a community that looks nothing like you where you always feel different and like an outsider. I have now had to pay $300 for DNA tests for some sort of information about myself. You are not adopted. You are very privileged to not know what all of these questions and heartaches feel like. My amended birth certificate erased me. And I9295 would finally like to know the full truth about myself what I have spent my whole life searching for. I implore you to please report favorably so access to original birth certificates for adoptees born in the gap years can soon be granted. We are no different than adoptees that were born outside of them.

And I wrote that in 2019 for the other hearing This year, I have some new information to share. This year. I have been diagnosed with a rare blood disorder and kidney disease at the age of 30. If I had access to my medical history, it is very possible these conditions could have been diagnosed earlier or even prevented. What other ailment do I have waiting for me that I don't know about. Denying me access to my birth certificate has caused me both mental and physical anguish. And I would like to thank you for your time and for this opportunity.
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ETTA DAVIS - ACCESS MASSACHUSETTS - HB 2294 - SB 1440 - Honorable chairs and members of the Joint Committee on Public Health. My name is Etta Lappen Davis. I'm the coordinator of Volunteer position of Access Massachusetts, a grassroots effort to restore the human right of access to their original birth certificates to all adopted persons born in the Commonwealth. Since our beginning in 2013, Access Massachusetts has heard from hundreds of adoptees waiting with bated breath for Massachusetts to give them access to their own vital records. Access Massachusetts filed legislation in 2015 and again in the subsequent two legislative sessions.

The bills were reported out favorably by committees assigned for third reading and passed by the House in the last session. There is intense support for these bills and as we try for the fourth time, it is long past time for their passage. Access Massachusetts members and supporters are grateful to the many legislators, including members of this joint committee, who have signed on to H 2294 S 1440. We are9454 especially grateful to Senator Anne Gobi and Representatives Kate Hogan and Sean Garballey for sponsoring. We submitted several additional documents our frequently asked questions, position statements in9466 support of access to birth certificates from prestigious national organizations and a letter of support from the Academy of Adoption and Assisted Reproduction attorneys written in support of our previous filing.

Access Massachusetts believes that current Massachusetts law is discriminatory because it denies adoptees born in the gap years access to their original birth certificates without a court order. These bills are about restoring the human right for all persons born in Massachusetts between those dates to obtain non certified copies of their original birth certificates from the registry of vital records. It is our fervent belief that all adopted person should have9514 the same right as all other citizens of Massachusetts. Access Massachusetts believes there can be no rational justification for granting access to an original birth certificate to someone born on one date while denying the same human right to someone born a day a month or a year later. These bills are purely and simply about ending discrimination against adopted persons who were born in Massachusetts during the gap years, and about treating people equally. We urge you to champion equality and report out favorably on H 2294 S 1440. Access Massachusetts stands ready to assist the committee as you consider these bills. Please contact us if additional information from us would be helpful. Thank you very much for your consideration.
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