2021-06-16 00:00:00 - Joint Committee on Mental Health, Substance Use and Recovery
2021-06-16 00:00:00 - Joint Committee on Mental Health, Substance Use and Recovery
(Part 1 of 3)
SHOW NON-ESSENTIAL DIALOGUE
Yeah,
Yeah. Yeah.
Mhm. Mhm.
Yeah. Good afternoon everyone and welcome to the Joint Committee on Mental Health substitution Recovery. Thank you so much for participating in today's hearing. My name is Adrian Madre, proud to serve as the House chair of this committee. Joined today by my good friend and Senate co chair. Senator Julian Sear, very grateful to have the opportunity to work with someone who I consider a friend and someone who has done tremendous work in this space. Uh Senator C are great to have you here today. I'm also joined by members of the committee from the house. Just want to recognize them briefly. We have the House vice chair of the committee, Michelle Dubois, Representative Natalie Higgins is here Representative dan carry representative Michael, kush Merrick, Representative sally, Karen's and Representative Hannah kean and rep paul tucker as well. If I missed anyone on the committee, let me know because I cannot see gallery view right now. So, uh you know, teams were all still learning. Um and uh with that I'll turn it over to chair here,75 who would like if you'd like to say a few words and to introduce members from the Senate? Thank you80 Cherry Maduro. And likewise delighted to be at the helm of this joint committee with you. We've got a lot of important work uh to do uh and just delighted delighted to get get going. Um This afternoon. I know we have Senator Patrick O. Connor who is on the call or call on them, whatever this is on the team so that with teams with us right now and I believe that is the only member of the Senate currently on. Um Of course I'm I'm toggle between looking about who are participants are and
no I think that's it for the moment. So looking forward to the hearing. Thank you all for your patience and working with us and thank you too. L. I. S. And and the staff of the committee and my staff as well. We're making today happen.
Thank you senator. We've also been joined by representative trauma win of the committee as well. And I do see some other colleagues here, former chair of this committee, Marjorie Denker Rep Lewis is here, you will be hearing from them shortly. So folks, today we'll be hearing testimony on bills144 regarding Children and youth, mental health and behavioral health care, The mental health care, mental health and well being of our Children is of course a critical issue that has only been exacerbated over the past year with the effects of the COVID-19 pandemic and after a very difficult year resulting in the loss of loved161 ones, forces of comfort and stability. Currently, Children are exhibiting higher instances of need for acute care and elevated symptoms of anxiety and depression as a whole. Last month, Senator Sierra and I co sponsored a resolution on behalf of the committee recognizing the first week of May as Children's mental health week in massachusetts to raise awareness of the mental and behavioral health needs that youth in the184 commonwealth face on185 a regular basis. So we're very excited and we look forward to hearing from speakers today about potential solutions to address the symptoms and root causes of Children's mental health and behavioral health challenges long term. And again, I thank you all for being here today. Now, before we get into the meat of the hearing, just want to go over a quick review of the process. So today the committee will be hearing oral testimony on bills before us related to the subject matter. Please be aware that this hearing is being recorded and streamed live. An archived copy will be made available on the Legislature's website after the hearing220 to the remote nature of this hearing. Those wishing to provide oral testimony were required to sign up in advance if you were not able to sign up in229 advance to provide oral testimony or you do not wish to do so today. You233 may submit written testimony to the committee and we encourage you to do so. You can do that at any time, testimony can be emailed to committee staff listed in the hearing description or243 to chair Sierra and myself. Those testifying today are also welcome to submit their testimony in writing due to their schedules. It is our policy to take legislator testimony out of turn. All other speakers will be called to testify in the order of the bills bills being heard and in order to accommodate the large number of individuals testifying today, speakers are asked to please limit your testimony to no more than three minutes. Staff will be keeping time in the meeting chat. I want to emphasize again that oral testimony should be kept to three minutes max so please be succinct as we have a lot of material to get through today. If you have longer thoughts to share, we encourage you to submit written testimony to the committee After each testimony, committee members will be given the chance to ask questions. We ask that all individuals not currently speaking to please keep your microphones muted and just as a heads up, my wife and I recently recently welcomed our first child. He is one month old tomorrow and since I'm working from home today, there303 may be times when I need to step away from the camera momentarily to take care of him. So I apologize in advance if I disappear quickly and finally I want to thank L. I. S. For facilitating this virtual meeting and to my staff for their diligent work and putting today's hearing together. And of course thank you to all those testifying today for your time and perspective on these important pieces of legislation. So you will also get a 12th warning by the way. Uh you know of that three minutes when you're when you're providing oral testimony.333 So with that I do want to just start with some of my elected colleagues who are joined who have joined us this morning or this afternoon I should say. And I know Representative Decker who again is the past chair of346 this committee uh is scheduled to provide initial testimony on H. 2084 known as the thrive act and she is joined with the panel. So Representative Decker, please take it away. Um
REP DECKER - HB 2084 - Thank you. I want to thank you, Mr. Chairman and Chairman Cyr for this hearing today. Thank you for all of your incredible366 work that you've also been doing behind the scenes leading up to this hearing. Your staff have been incredible and congratulations to both of you, this is really exciting. I'm just going to jump into this and I am joined by one of my north stars from the city of Cambridge who has experienced working throughout the commonwealth on Children's mental health, Alys Cohen who is here today, who works in the Cambridge public schools391 and provides support district wide for behavioral health for teachers and students. So I will let Alice start, have her three minutes and then I will wrap up with my my take on this bill because I know Alice is actually still in school right now. So Alice, you're welcome to jump off whenever you need to but I'll let you start. Thank you for joining us today.
ALICE COHEN - CAMBRIDGE PUBLIC SCHOOLS - Thank you for having me, it's really an honor to be here. I appreciate the opening comments very much. You know, the issue of our inadequate response to kids, mental health is not a new issue. Young people have been telling us with their behavior that we're not meeting their needs for a long, long431 time. It has seemed to me that we are not listening to them. 15 months of living in pandemic fear has altered all of our brains and exacerbated issues for young people. As we heard in the442 beginning of this hearing, we are seeing an alarming increase in young people reporting anxiety, depression and self harm. We have a lot of healing to do and we have to treat the impact of all this isolation.
The need that we have at the moment exceeds our capacity and our services favor the privilege. So what that means is that young people are forced to repeatedly472 fail in order to be seen. We exclude these children with punitive and restrictive measures just at the moments when they need us the most. This failure is so unnecessary and it has such long term effects in terms of confidence and identity formation for young people. Without additional resources, we will continue to repeat this cycle of failure and that's done us. Without additional intervention, we're complicit in this failure, let's not be. Thank you.
DECKER - Thank you, Alice. So to both of my the chairs of the committee and to members of the committee, thank you for taking this bill up so early in the session and I really appreciate, it's an acknowledgement by both of you of the crisis that we're facing around children's mental health. Chairman Cyr, you know that I started working on this bill at the very beginning of our first session together Chairing this committee and then the pandemic hit and it was time to step back, take a look at the executive orders that were being passed and really try to both address the pandemic and then keep our eyes open to sort of how this was going to continue to unfold.
What we know is that as Alice has mentioned, we were not meeting the needs of our children and adolescents in terms of where they were at and where they needed the support for mental health. I'm going to provide you with few statistics just to give you some579 context of where we're at and then you will be hearing from other people about where we're at, prior to the pandemic and where we are today. But I will just say that this is a crisis, we are experiencing a mental health crisis and it is a growing crisis in our children. In one Boston hospital593 between the months of last July and October, we saw a 49% increase in the number of children who went in for suicide ideation and suicide attempt.
Prior to the pandemic, we did not have enough services in our schools nor in our hospitals to address the growing crisis of children's mental health needs. The challenge has been for us is that because we have not adequately provided families, students and schools with618 the tools to meet the needs of our adolescents and youth, mental health, it grows into a crisis. One of the things that I love about Alice and I've known her630 since my kids were little, I've632 known her as a professional and I saw her up for support as a mom trying to navigate this for for children. It's clear that we often like to think about children as having resiliency, it's also clear that resiliency is only as strong as the tools644 that we provide our young people to match the trauma and the stress of what they're enduring.
We're not just born resilient, we either survive and have a traumatic survival that we navigate for the rest of our lives or we provide young people with additional tools to understand the stress and their trauma and to then live healthier lives but it's a choice. When I think about where we are today and I know both of you are very aware of the on growing crisis that continues to exist in our emergency. We refer to it as the ED Boarding crisis for people who aren't thinking about it with this jargon, it's684 about Children who were taken to the emergency room and who are sitting there for over 12 hours. I know that both of you as chairs of this committee and I continue to get these calls even over the weekend from colleagues who are having constituents whose children are in crisis and have been sitting in emergency rooms for two days, five days seven days, 14 days and while they're sitting there in an emergency room, they are not being serviced with what they need.
The longer children sit in an emergency room, the less qualified and eligible they become for programs that they would have been able to enter had those programs been available on day one, but we're not actually meeting the needs of our young people with the services that are available. So I'm going to just say very quickly, this bill was born out of a labor of love of knowing that as policymakers, we really can make choices about how to change the narrative and the experiences and meet the needs of people in our community. I can tell you that I met personally with at least 75 stakeholders to talk about what this bill would look like, how to address the needs and whether or not it actually would move the needle from the Department of Education to Department of Mental Health, to parents, to advocates, providers, clinicians, hospitals and so it was not done as a vacuum and you'll hear from a lot of those folks today.
It establishes for the first time, a comprehensive school board, behavioral health advisory board. We work in silos around a lot of the issues that we approach, this is especially true for768 how we approach the issue of behavioral health. It's true how we approach it in our schools, it's true how we approach it in our health care provider systems. This would actually be, and it's as you will see in the legislation, it really brings together a broad group of people who are all doing important work,786 but do not have a mandatory formal place to come and talk about best practices and training. It will provide through the technical center that's created and that we've already started to fund through the last two budgets for an amendment process, it will provide hands on training for school officials who desperately needed this prior to the pandemic, they certainly need it when many of our young people have not had the light and the soft touches of up streaming of services, of teachers, of social workers, of the cafeteria person who's been able to see them and understand that they're struggling and be able to help do that.
So I really worry about the crisis that continues to unravel because it's not one that's waiting for us, look at the data, it's already there but what it looks like moving into the fall and not having this kind of support in our schools moving forward. It also addresses the issue of what's happening to kids when they're836 in the emergency room and they're boarding and they are waiting, it takes on the issue of integrated care. The idea that we we can no longer silo our medical body needs of care from our mental health needs. So if you provide acute care as a place of service, you have to also have a plan to provide behavioral health care. It addresses the issue of pay parity, we cannot just provide some specialized hospitals the rate while many of our hospitals are also doing this care without the same rates of pay.
This is an ambitious bill, but I868 want to be clear,870 it's a really important bill, and if we're going to change the needle, now is the time to be bold and to really do this for880 our schools in addition to providing the kind of hands on training, as well as real time access for every school to log into a website and see what programs are available that does not exist right now. It also acknowledges that for often, many of our young people are in situations where we know we've done incredible work in the house around reducing poverty, direct correlation, right that when people are experiencing poverty, they are experiencing more behavioral health crises, reduce poverty, reduce behavioral health crisis.
So while we've been in this incredible track in the legislature of trying to reduce poverty for those who are living in deepest poverty, it's also important to remember, we're at a time that's919 really trying to look at the issue of disparity, both in economic disparity and a time of reckoning of racial disparity. Children are often treated in schools, particularly children of color, are approached with behavioral health care needs, misdiagnosed and mistreated in very different way than their counterparts who are white. This is about saying that this place of time is a perfect opportunity to take the heightened awareness, commitment and concerted effort to really say, how do we change the narrative for all children knowing that children of color particularly have always been on the underserved and have been impacted by systemic racism but also knowing that this is a time more than ever to lean in increased resources and take the data.
You know guys, you know, make like I've just like taken my969 stretch and like spoken from sort of what I know here from looking at this issue for 2.5 years, the data is there, you're going to hear it, you have it and I am available to be of any service as you know. I appreciate, you986 have a lot on your plate. I also know that you both care deeply about this issue and that whatever we do it will be because your hands have absolutely been on guiding this and happy to take any questions. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you, madam. Chair, appreciate your uh significant leadership in this space during the past session and as it continues during this session, are there any questions for the chair or should we move on? I'm not sure rep decker, do you have your other panels? You should move on. You have a lot of people, anyone has a question. I'm happy to talk to a great senator. Do you have any questions? Just delighted, um that that representative decors filed this legislation? This legislation we have discussed many times, uh and I think really eager to to see um you know, some real focus and work from particularly in this open space. So, um thank her for her ongoing collaboration and talking leadership and I think having her as a sponsor of this legislation like likely bodes good things for us getting something done here. I think it's urgent of course, you know, the Senate we've been really committed to um of course taking up1075 mental health and I think having this partnership in the House is gonna hopefully that that bodes well for we can get on the session. So thank you Representative Chair decorations say for for making this happen and convening this awesome group of people are going to hear from about this bill. Yeah, thank you both of you. Thank you. So if there's no1096 one else from your panel rep decker, I think we will move to Representative Jack Lewis and take him out1102 of turn and then we'll return back to this bill to hear the next panel. Uh Senator excuse me, Representative Lewis will be testifying on H. 211111 and X. Supporting uh an act relative to student mental health. Uh Lewis, Please take it away,
You're muted.
Yeah,
we can't get here to Jack. Let's try this again. Perfect.
Oh, it wouldn't be a zoom or a teams call without some some tech issues. Happy to normalize them for everyone else on the call this afternoon.
REP LEWIS - HB 2111 - SB 1266 - Thank you so much for this opportunity to speak on these bills and for taking me out of order. I want to continue the conversation around youth mental health, specifically suicide prevention as we've heard some from Chair Decker and Alice on her panel just moments ago. I want to speak to bills H 2111 and S 1266, an act relative to student mental health. These are bills that1190 in the House, Natalie Higgins is the co lead sponsor with me and there's also the companion bill in the Senate with Senator Joe Comerford. These are bills based on legislation recently passed in California, Wisconsin, Arizona and Michigan and soon to be in several other states as well. While the bill is very simple, it has been helping to save countless lives in these other states.
What it states is that the suicide prevention lifeline and the crisis text line to life saving numbers that we all wish young people had available to them at all times. The law would require that these numbers be printed on the backs of student IDs, all future student ID needs to be printed. The reason for this grows out of the reality that at a time1246 of crisis for ourselves or for other for our friends, for other young people, we don't want students going online and trying to google, in the case of a health emergency, your friend might be having a stroke or a heart attack, you don't go online and google, everyone knows to pick up the phone and dial 911.
With mental health, especially suicide prevention, these numbers exist, they're becoming more well known, but they're hard to remember. So what these other states have done is they've asked themselves, what do students have with them at all times and how can we utilize that to make sure that young people have access to the services they desire? And the answer is their student IDs. Something that most students need to get on the school bus or to buy lunch. So based on successful policies in1296 these states, in local high schools like Ashland High School and St. Johns High School in Shrewsbury, I worked with mental health organizations and the Massachusetts Superintendents Association to put forward this legislation to make sure that moving forward, all future student IDs include these lifesaving numbers.
As many of1317 you know, prior to getting elected, I had the great honor of serving as the executive director of a regional organization for LGBTQ young folk. While we did so much programming around a variety of subjects, there was always the reality that we knew based on Metro1337 West Risk assessment surveys that when I walked into a room and I had 60 youth looking back at me that based on the surveys that those same youth took in their high schools, that one out of three, 20 out of the 60 had attempted suicide over the last year. As an organization, we worked with schools, we worked with parents, we work to make sure that everyone, those youth and all of their classmates had access to these life saving services but as we've heard from previous speakers already, this pandemic has reminded us how difficult it can be when we're isolated from the support we often have.
For young people, even as we come out of this pandemic, there isn't always the guidance counselor down the hall or the supportive parent in the other room. There are those late nights, there are those weekends where people don't know where to turn and sometimes they turn1393 to a friend but even that friend doesn't know where to turn but if we're able to join these states and codify this law again with the support of the Massachusetts Superintendents Association, I am confident that countless young people in all of our communities when they need that additional support and they don't know where to turn, will grab their student ID, turn it over and make that life saving phone call. I'm happy to answer any questions any of you may have, I know Rep Higgins, my colleague sponsor is on the committee as well, we're both here to be supportive in any way we can to move this forward. SHOW NON-ESSENTIAL DIALOGUE
Yeah. Thank you. Representative appreciate your important work on this issue. Right. Higgins, did you, did you want to offer some remarks?
REP HIGGINS - Thank you, Chair Montero, Chair Cyr for taking up youth behavioral help so early in the session. It's no surprise that I have a number of bills related to this topic and I'm really thankful for Rep Lewis and Senator Comerford for inviting me to join them in this advocacy for this really simple but meaningful piece of legislation that can save young lives and really work to normalize and end the stigma around mental health services. I think that it's really important that we're working with our youngest residents to make sure that they know where to call for help, how to call for help when themselves or their loved ones are having a crisis. So thank you for taking up this bill so early. SHOW NON-ESSENTIAL DIALOGUE
Thank you Representative rep
REP NGUYEN - Thank you so much and thank you to you both for your work on this. I wanted to see if, alongside this, is there an educational component to it as well to educate the students on how to use it and when to use and all of that? I think it's a great idea to have the numbers available, but would love to hear more about that education piece. SHOW NON-ESSENTIAL DIALOGUE
Mhm.
Okay. You're muted now. Okay. Now you're admitted and my new didn't. There we go.
Yeah. Still with us, it's still with us
LEWIS - As we talked to superintendents and principals, there is definitely a great interest in assuming1538 we're able to pass this legislation and next year when student IDs are printed, that we could take part in a coordinated effort to make sure that folks know that these resources are available. I think there's a great amount of energy around that next step and while I'm supporting that energy, I'm also trying to make sure1558 that we don't get too ahead of ourselves until this law becomes commonplace across the commonwealth. So, yes, but before we can do that, we need your committee to both vote favorably and hopefully, the House and the Senate joined forces1575 in getting this to the Governor's desk as quickly as possible. SHOW NON-ESSENTIAL DIALOGUE
Thank you Matt Lewis Representative Karen's
REP KERANS - Thank you, Mr. Chairman, thank you for the presentation, sounds like such a simple thing that we can do, which makes it very appealing. Could you share those phone numbers may be in the chat that would it be okay for, you know, I would love to share these numbers on my admittedly anemic social media sites, but I would very much like to share these numbers and to make this widely available as you said, to reduce stigma, just make it as normal as call 911 if you're having a heart attack and I didn't even jot down, I didn't get both numbers, perhaps you could share them.
LEWIS - I'll put them in the1633 chat and very grateful to colleagues to share them. That conversation around stigma when I worked with all of these young people, we tried to put these numbers on a little piece of paper that they could put in their pockets, their purses, their wallets but it was hard because a little piece of paper often gets lost but there was a secondary piece of what does it mean if someone sees that you're carrying around a special little piece of paper that no one else has in their pocket and the stigma around mental health and seeking supports and so I think there's also a piece of this where by putting it on every student ID, everyone has access and no one is singled out as needing additional special support.
In conversations with the Superintendents Association, I'll admit, I assumed our first meeting was going to be met1682 with some concerns about local oversight and unfunded mandates, instead, as soon as I stopped talking and wrongly anticipating their concerns, they reminded me that this is an issue that every single school, every single school district has faced, and that they wanted to do everything in their power as quickly as possible and as comprehensively as possible to make sure1707 that not a single other youth in their school districts were lost. So I'm just grateful to all of the partners in this work, including my colleagues but I'll go grab those numbers now and drop them in the chat. Thank you. And I hope we move this quickly. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you very much. Do we have any other questions from committee members?
Senators here? Uh thank you for the best one. I just want to recognize Senator Nick Collins who has joined us.
Thank you very much. All right. Without further ado we are going to uh hear testimony from Senator Patrick O. Connor who is here with the constituent. They will be testifying on S 1309 and act to increase substance use prevention and awareness and reduce overdose abandonment. Senator take it away,
SEN O'CONNOR - SB 1309 - Thank you Chair Madaro, congratulations to you and your wife and Chair Cyr, I appreciate as many people have said taking up these important matters that deal with our children and their mental health so quickly in the session, I think this is something that the state really needs1780 to focus on and I'm so proud to be part of this committee and all the work that so many people are doing up here in the Legislature to address this because I do think it's one of the the biggest issues that we have to face. Today, I'm here to testify on behalf of Senate Bill 1309 and I'm proud to be testifying alongside my constituent Temeka Perry who has taken a personal tragedy and transformed it into an opportunity to increase the chances of survival for those suffering from substance use disorder.
I also want to thank Walt Gangle, who you hear from later today, Walt has worked to spread awareness about overdose abandonment and started the friends don't let friends die campaign and we are fortunate to have him and his leadership and trying to pass this bill. This legislation would expand on the commonwealth's good Samaritan laws through education and awareness. All public schools would be required to update their substance use prevention policy, which is statute by law that they need to create to include plans to educate students about the dangers of opioid addictions and the commonwealth good Samaritan laws. The bill guide schools to employ successful methods to raise awareness by learning from what other public schools are doing right now and what currently works.
It also encourages sharing a collaboration between schools, DESI and the DPH to hone in on best practices as we continue to evolve in this practice and making sure that students know the good Samaritan law is. Awareness of this law save lives plain and simple. Those witnessing an overdose must never be held back from calling 911 for any fear of legal consequences when life was on the long line, and unfortunately we1872 still see this happening today. I'm proud that this bill has the support of educators, administrators, school community members, of the Massachusetts Fire Chiefs Association, the District Attorneys Association, the Mass Police Chiefs Association, as well as South Shore hospital and their board of directors. Now at this time, I'd like to turn it over to my constituent Tameka who approached me1891 five years ago when a personal tragedy, unfortunately happened to her son Kai, and wanted something to be done about this and we took that tragedy and turned it into this piece of legislation. So without further ado, Tameka the floor is yours. SHOW NON-ESSENTIAL DIALOGUE
Thank you Senator O'Connor. Um, I'm having some difficulty with my video. Can you guys hear me okay? Thank you. Okay. Thank you. Um,
TAMEKA PERRY - CONCERNED CITIZEN - My name is Tameka Perry and I'm here today once again in support of the proposed bill that will increase substance use prevention awareness and reduce over deuce abandonment. On May 4th, while standing at the courthouse, I received a text that changed my life forever, the text read Kai is dead. Kai is my son who lost his life at the young age of 20 years old while in the company of people he trusted. While I'll never know exactly what happened in that apartment that night, I do know that emergency services were not called, the people in the apartment did not call and make any attempt to save Kai's life whether it had been for fear or self preservation.
In essence, there's a possibility that my son would still be here today if that call was made sooner. Kai had his entire life ahead of him and while he was responsible for his choices, I do believe the lack of education on substance use led to his death. It was determined that Kai died from combined drug intoxication, he was not aware of the effects of multiple drugs in his system, drug half life or how an overdose can occur. I have always spoke to my children about the dangers of using any form of drugs. I also believed that I was well versed on the topic as I was exposed to addiction in my family.
However, since my son's passing, I've come to understand that that what was taught and what is actually going on are not one and the same. I am not alone, I am just one of2011 thousands of parents that are grieving the loss of their children that they were left to die while in company of others. We must educate our children and all aspects of substance abuse, not just the basics. The basics have been taught for many years yet thousands are forming new addictions and dying. In addition to proper education, they should also be encouraged to call 911 if they find themselves in the presence of someone experienced a medical emergency, including an overdose. These types of conversations have been under the table far too long, let's get them on the table and out in the open.
This is not math or science, it's life. Unfortunately, reality is that everyone at some point2050 will know someone struggling with2052 addiction. After Kai's passing, I became aware that many of his high school and college friends are actively struggling with addiction as well despite whatever community they are coming from. Addiction knows no race or socioeconomic status, it does not discriminate. The age of a child starts using or experimenting with substances is becoming younger and younger and the only way to battle this epidemic is to educate them from the beginning. In closing, I ask that you consider the gravity of this proposed bill as2082 a mother of a child that2084 was abandoned during a medical emergency.
I would like to believe that if even one person in that apartment had the information, this still would affect would have for their predecessors. I just might not be talking with you here today, asking for your assistance, all the lives lost but we can save so many lives by acknowledging this horrific disease and keeping the conversation going as our children didn't have to don't didn't have to die in vain. I apologize for my shakiness. You know, circling back to this. My brother was found dead a couple days ago, he suffered from substance abuse as well as a teenager. Of course, 25 years ago, we didn't have any support or resources, so it's still a big issue and he was left alone as well. So thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Okay, Miss Perry. We are so sorry for your losses and uh just you know, I'm impressed with the2164 courage that you have2165 to share your personal story. It's a fight for changes in this space. And I thank you and Senator O'Connor for joining us today and testifying. Are there any questions from committee members?
Okay. I don't see any.
REP MADARO - I did have one question, Senator; how are schools currently crafting their substance use prevention policies? Does DESI or another state agency provide a model policy oversight or2191 any guidance?
O'CONNOR - That's a great question. I don't have the specific answer for you from the knowledge that we have in talking with school administrators when it comes to this. It's a lot of just having the school committee put together a proposal and that the, you know, trying to get resident experts to provide the best assistance they have. I don't know if there's a top end threshold where DESI2216 puts down specific guidance, but what we're trying to do really is just make sure that while that guidance is being prepared, however, it's being prepared that they include the good Samaritan law as a requirement from the state. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Senator, thank you very much for being being able to be taken in order to Thank you. Are there any other questions? Senator sir, do you have anything? I just want to recognize that? Senator Villas has joined us in Centerville says the vice chair of the Senate vice chair of the committee. Thank you.
Thank you again. Miss Perry. Senator O'Connor, thank you so much for joining us today. We will now turn back to um House Bill 2084 Act to create a thriving public health response for adolescents. Also known as the Thrive Act, which chair decker testified on earlier. Uh, do we have Courtney Cello, Melissa hero or Donna Marsh available to testify?
You have all three of us. Okay. Take it away please. Great,
COURTNEY CHELO - MSPCC - HB 2084 - Thank you so much. Good afternoon, Chairs Cyr, Madaro and through you to members of the committee and thank you for the opportunity to testify in support of House 2084 and act to create a public health response for adolescents. We've been affectionately referring to this bill as the thrives act from the children's mental health campaign. My name2303 is Courtney Chelo, and I'm the assistant director for government relations at the MSPCC. In that role, I manage the children's Mental Health Campaign, which is a statewide coalition working to ensure that children and families have access to the behavioral health services and supports they need at home, in schools and in their communities.
As you heard from Chair Decker earlier, there is a2322 broad range of pieces in this bill, I am going to focus my comments today on the school based behavioral health portions and that's because schools often serve not only as a place for students to learn, but also as a place where a child's behavioral health needs are identified and treated. Children and2339 youth in need of behavioral health services are three times more likely2343 to access those services2344 if they are provided in school compared to clinical settings. However, many schools do not have the resources and capacity to address the behavioral health needs of all students and are often under equipped to support the needs of black and brown students whose behaviors are subject to punitive measures like suspension and expulsion at 2.2 times the rate of their white peers.
These issues have been compounded by the COVID-19 pandemic and the strains that is put on2369 both schools and the children's behavioral health system. Inequitable distribution of resources leads to an equitable outcomes. It is vital that we develop a statewide infrastructure to support student behavioral health. We can't keep going community by community, we really2384 need to make sure that we are taking an approach to ensure that every district has the capacity and the tools that they need to provide at least a core set of behavioral health supports for their students. So the thrives act includes five key provisions that address school behavioral health. I'll outline them in brief, but I'll let the experts on this and our subsequent panels share further details.
So first, the bill establishes a school based behavioral health advisory council that will work in support of DMH and DESI and local educational authorities to advise and support their efforts to develop and implement school behavioral health infrastructure, including advising around universal implementation of multi tiered services and supports with an explicit focus on commitment to eliminating systemic inequities and disparities and access to school based behavioral health. To that end, the council will also convene a permanent data subcommittee to focus on the scope and nature of behavioral health needs of students, to understand the outcomes of behavioral health promotion, prevention and intervention services and supports and to understand the gaps and disparities and access to services and emerging patterns and trends in student behavioral health.
Second, the bill establishes a school based behavioral health technical assistance2457 center that will provide web based in person and remote supports to administrators, teachers and school behavioral health staff. Third, it requires districts to create behavioral health crisis plans, including protocols for facilitating access to mobile crisis services in addition to the current requirement to2475 have a plan for medical emergencies. This really creates parody with physical health crises, making sure that we're prioritizing a healthcare response over a disciplinary or police response when there is a behavioral health crisis. Fourth, you'll hear more in a moment about mental health education, requiring schools to incorporate mental health education into the curriculum.
Finally, the Thrives Act will support preschool aged children who face rates of expulsion letter three times higher than students in grades K through 12 and we have an entire panel that will speak to you more about that. I know2510 I am at time, so to say it is more crucial than ever to support students and to meet2515 the increase in behavioral health needs in schools. The COVID-19 pandemic has highlighted the importance of ensuring school-based behavioral health resources are available and accessible to all students who need them. Timely action is needed2526 now so that the commonwealth is prepared to meet the needs of the whole child as they walk through the2532 doors of their schools this fall. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you Courtney. I do just want to remind folks that we are asking people to limit their testimony to no more than three minutes. So please do your best to be succinct and if you have longer thoughts to share, feel free to submit them via written testimony to the committee, I'm not sure who's next on your panel, Courtney, but please take it away.
I will turn it over to you Melissa.2560 Thank you. Uh
MELISSA PEARROW - SCHOOL OF PSCHOLOGY UMASS BOSTON - HB 2085 - Thank you, Chair Cyr and Chairman Madaro for taking this testimony. My name is Melissa Pearrow. I am a professor of school psychology at UMass Boston and I'm speaking on behalf of the birch2575 project. This project is happening in coordination with one of my colleagues at UMass Amherst, Dr Sarah Whitcomb and it's funded by children's Hospital with the goal2585 of providing professional development and resources. I won't reiterate the data that shows how much our students need help, but I will want to reinforce how of those students who do get help, 75% of those kids get help in schools.
That is one of the reasons why we're helping advocate around this thrive act, because we see2605 the need for a statewide technical assistance center. One of the first tasks that we completed with our project was to look at how staffing ratios are compiled across2616 the state And we noticed that there are 26 districts where there is the highest level of student economic need, in other words, are most poor districts and communities and they have the worst staffing ratios. These 26 districts are throughout the Commonwealth and more than half, are representing our gateway cities, which means that2638 they also have a larger proportion of students who speak a language other than English and are Hispanic.
We also learned to understand of these districts, are they accessing the resources that are state currently provides? There are numerous grants through the Department of Education that target behavioral health, however, what we learned is that only a third of these districts did not access any of these grants and supports, which means that our most needy2666 districts were not getting the support that could be helpful from them from the Department of Education. We also learned that more than a quarter of them do not belong to Educational Collaborative, which are regional strategies to help build the capacity of the districts.
The other thing that we noted is that there are no collaborative in Western Mass, which means we've got a2686 whole section of district2687 administrators and superintendents trying to best meet the behavioral health needs of their students without any organized resources or support from the state. So as we broach this idea of what it meant to have a technical assistance center, we've spent the last2705 six months, looking at how would2706 this even be helpful, our school something schools would be interested in.2711 We've surveyed more than 500 school behavior health providers, conducted seven focus groups, talked to 20 state agency staff and other states would provide technical assistance and learned more about how these services are helpful and what we have learned is that some areas have a greater need than others. Western Mass and the Cape, you're asking for this at higher rates. They're asking for help with profession development structures, they're asking for help with technical assistance and elevating parent voice and all these are all the reasons why we are seeking support from you for HB 2085. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you Melissa Donna Mash please. Yes,
DANNA MAUCH - MASS ASSOCIATION FOR MENTAL HEALTH - SB 1286 - HB 2084 - HB 2108 - Thank you very much. I'd like to thank Chair Cyr, Chair2762 Madaro and the honorable members of the committee for having us. Today, I'm speaking on behalf of the Massachusetts Association for Mental Health where I'm the President CEO and the Children's Mental Health Campaign where I'm a member of the executive committee and we are going to submit longer written testimony today in support of both House 2084, Rep Decker's thrives act and also House 2108 and Senate 1286 on the Pack Pilot Program for Children. So I'm just going to speak about section nine in the thrive, picking up on Melissa's testimony about mental health education for students. The pandemic has further our response to kids, Children and youth.
We have an opportunity to learn from this and to act now to educate our Children and youth on their own mental health and well being and support the their agency and equipped them to not only understand the gift of their mental health and how to protect and preserve it, but how to get help when there's a challenge to it. Parents reported that a third of their Children were experiencing harm to their emotional health. Yesterday we saw our own Department of2834 Public health reporting on a group of youth identifying as non binary in more than 15 the last 30 days there they've experienced poor mental health.
This is the time that we educate our kids appropriate to their developmental stage about their2854 mental health and wellbeing about their brains in the same way we teach them about the circulatory system, how muscles work and other physical health knowledge. We acknowledge that DESI is working on a revised framework for health education in schools. We recognize there's going to be a need, as Melissa has outlined to support training, provide technical assistance to educators and we're here to2875 support that. Our kids health and well being depends on it, their health and productive future, depend on it. So thank you for your consideration.
Very briefly, I want to note that the act relative to a pack pilot program for Children is an opportunity and an evidence based program from the program for assertive community treatment for Children that can prevent or mitigate mental health crises, it can serve as a solution to emergency department boarding. This is a multidisciplinary home based, working with schools, working with families, it's evidence based, it's scalable and it has great outcomes. In fact, the sentinel study on this, which documents all studies across settings in numerous locales across the country and in Europe was written by the Boston Medical Center department of2930 psychiatry and we will provide that as part of our testimony for your review. So again, it's an important opportunity to manage a crisis in our state, by providing the top service that fits well into our current continuum of care and is reimbursable by both Medicaid and private insurers. Thank you very much. SHOW NON-ESSENTIAL DIALOGUE
Thank you very much. Don appreciate your testimony on this. We have any questions from committee members,
mr chair, I just like to recognize that Senator john keenan has joined uh hearing as well. Uh huh. Thank you. Senator
Alright, without further ado we will move on to. Oh actually I see that Senator lovely has joined us and uh we will take her out of turn. I know she has a commitment this afternoon. Uh Senator lovely is here to testify on Senate bill 13 03 and act relative to establishing a model school policy on suicide prevention please? Senator, thank you for being here.
SEN LOVELY - SB 1303 - Thank you, Chair Madaro, Chair Cyr and members of the committee. I would like to offer my support for Senate number 1303, an act relative to establishing a model school policy on suicide prevention. According to the latest data from the CDC, suicide is the second leading cause of death for3014 young people ages 10-24. On average, a young person dies by suicide every one hour and 25 minutes in the United States. These statistics point to a very serious yet preventable public health crisis. As children3026 and teens spend a significant amount of their lives in school, the personnel that interact with them on a daily basis are in a prime position to recognize the signs of suicide risk and make appropriate referrals. S 1303 would require public and charter schools serving grades 7 to 12 to adopt a student suicide policy prevention intervention and post mention policy.
Elements of the policy shall include, but not be limited to increasing awareness of the relationship between suicide and suicide risk factors, identifying training opportunities in recognizing suicide risk and referral procedures for school employees, training and how to respond in a crisis situation when a student is in imminent3067 danger, as well as developing relationships with community organizations and agencies, referring students to health, mental health, substance use and social support services. In addition, that policy must specifically address the needs of high risk students. It is my hope that by having a school wide system of developed, thoughtful and comprehensive policies, we can reduce the number of young people who commit suicide. I, therefore, reiterate my support and respectfully request the committee's positive consideration. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Senator. Do you have any questions from committee members?
Senator tear.
Just think thank you is in our lovely for this legislation and testimony and your product commitment um, on youth3116 suicide, mental health. Thank you for joining us and thank you for taking me out of order. Much appreciated. Thank you very much. So. I should say we were on a zoom earlier today where I did get to meet one of your chickens.3128 So I I, uh, and any time you'd like to bring one of your, one of your animals or pets? Family members, I should say, uh, to the mental health substance recovery committee. They are most welcome. Thank you. Thank you. Mr. Chairman. And thank you again, everyone. Much appreciated for your time, Senator, lovely. I'm actually disappointed that I didn't get to see the chickens. Well, I'm back in the house, but when I'm in the Henhouse, I'll make sure I went up to say hello, next. Thank you for being with us today, senator. Thank you. We are now going to go back to the thrive act. H 2084. We have another panel led by shell. Ordinary Doctor Destiny tolliver, Angela Wallace and john Crocker. Take it away, folks. Hi,
SHELLA DENNERY - BOSTON'S CHILDREN'S HOSPITAL - HB 2084 - Good afternoon, Chair Cyr, Chair Madaro and members of the committee. Thank you for providing the opportunity to testify in support of the thrives act. I'm Dr Shella Dennery and I'm a social worker. I've spent my career in the last 20 years working in school mental health, in partnership with the Boston public schools. I'm the director of the Boston Children's Hospital neighborhood partnership program, which is a comprehensive school basement behavioral health3203 program that does clinical work but also training and support in schools. I also worked with the children's mental health campaign and helped develop an advisory board for behavioral health over the last year for schools. I'm also a parent to a 1st and 3rd grader, which I think keeps me humble and it's an honor to be here today.
So the impact of the pandemic, along with ongoing incidents of significant3224 racial injustice and racism, continue to have profound impact on our school communities. The disparities in support services have always been there in schools, but this past year have been highlighted and exacerbated as we have heard. We all know that Massachusetts has been called out often as a leader in education and we know that is not often the case for all students in Massachusetts is often dependent on zip code and where you live and we know that all students deserve more than that. This is also true in terms of behavioral health supports and services. It has been made clear to all of us this past year how important schools are and how important the social, emotional and behavioral health is of all of those inside, including the students, the educators, the school staff and the school leaders.
Behavioral health, as we've heard today, it's a public health issue and it is a crisis for all3274 of us in Massachusetts right now, we know that if any of us needed to find behavioral services for our children today, that it would be difficult, if3282 not impossible. We know that schools need a comprehensive, structured and coordinated approach to better support the whole child and some schools in Massachusetts are already doing this work. It's the equity issues that are concerning to many of us who are in the field. In preparation for today, I pulled my testimony from 2013 and the bad news is, I'm saying exactly the same thing I said then today, not much has changed and the needs have only increased.
This is an incredible opportunity to make changes in this space and to do something different, especially that we know that this is where kids are, they are in school and we know that that's where they're accessing services. There seems to be only one approach or solution when this conversation is brought up about, it's the idea of individual counseling and therapy as being the option and those of us who work in schools know that it's a range of services that are provided, it's an innovative approaches around small group work is around classroom intervention, it's around education, it's around having care, coordination, drop and serve his services, open door policies for you.
We really need to rethink this medical model of behavioral health service delivery for schools and offer child's schools are available to offer child centered and holistic support. But this is only true if we have the staffing needed and the support. So to be clear, this is not just about kids with diagnosable behavioral health disorders, this is about all kids, but all youth do need support3358 and it's different levels and intensity from day to day, hour to hour and week to week and there's a fluctuation and3364 we know that supports having them and having them be available is3367 a game changer for schools. So we hope to provide services and support for kids when they need them and it's way beyond having a crisis plan, we need to3375 be proactive and not reactive and how we support youth and their families.
So I want to close out by saying there's promising programs all over the state and supports across the state and many schools are already doing this work on their own and the field of school mental health, which I've been a part of my3391 whole career. We have done this work, we have best practices ready, we have models that exist, we know what to do, we are just lacking the resources, the funding staffing and the infrastructure to support this work and to put it into implementation. We do need well resourced technical assistance centers, we need a plan for integrated professional learning and development, we need to increase positions as well and we also need to partner with community organizations.
So I would like to see our state be one of the first to actually have a proactive and impactful system that can make a difference in sort of providing tiered supports for youth. I also want us to make sure we're including school voice and school leaders and school teachers and families and youths in these conversations. So thank you. SHOW NON-ESSENTIAL DIALOGUE
Sorry, we are over time. We have so3442 much to get through. I hate to, I hate to say that was we have time to hear from your fellow panelists. Thank you so much for your testimony.
Dr tolliver Angela Wallace john Crocker, any one of you Please feel free to take it away. Yes. Hi. Can you all hear me? Yes. Okay. High
DESTINY TOLLIVER - BOSTON CHILDREN'S HOSPITAL - HB 2084 - Chair Cyr, Chairs Madaro and members of the committee, thank you so much for the opportunity to speak today. My3473 name is Dr Destiny Tolliver and I'm a pediatrician and researcher trained at Boston Children's Hospital and Boston Medical center and I'm currently at the national Clinicians scholars program. As I testified today I'm thinking of a seven year old girl, I took care of in the ER she was brought in by an ambulance for out of control behavior at school but when I went into the room she greeted me with a smile. She was sitting calmly watching Tv and not quite sure why she was there by herself.
Her mother arrived from work soon after and we checked to make sure that there were no acute physical or mental health needs. After missing about half a school day, we sent her home with recommendations for outpatient mental health providers. Thinking of children like her, my team examined the ER visits at Boston children's for behavioral outbursts, comparing children who were referred to the ER from school with those referred from home and other locations. In this work which were preparing for journal submission, we found that the children sent to the ER from school for behavioral outbursts were more likely to be black or Latin X or were more likely to have special educational needs such as individualized educational plans, 504 plans or learning disabilities.
Interestingly, three quarters of Children who came to the ER from school for behavioral outbursts reported having mental health providers and two thirds have special educational needs. In other words, most of the children that we saw were already connected to mental health providers or have been identified as having being legally entitled to additional supports. But despite this, many are still coming to the ER for behavioral crises indicating that they need more support. Overall, nearly a third of all ER visits her behavioral outburst came from school but being sent from school was itself associated with a higher likelihood of being discharged home rather than requiring impatient or other higher level of care.
This means that these were visits that disproportionately impacted black and Latino X children as well3578 as those with special educational needs which could potentially be addressed without an ambulance ride, hours in the ER lost work and wages for parents and the social stigma and lost learning time for children. All things that accompany being sent to the ER from school. With our help, there's an opportunity here for3594 schools to bolster support for these kids. In our study, over a third of the money paid to our hospital for visits from school was paid by Mass health and 1/5 of the money paid for children with behavioral outbursts was paid for children who were then discharged home from the ER meaning these are kids who didn't require further psychiatric care so these could be considered preventable visits and unnecessary costs.
Rather than spending public funds on preventable ER visits, I ask you to join me in supporting this bill which provides an opportunity to invest in schools, prevent ER visits, support children's3625 ability to remain in school and give them3628 the tools to thrive while doing so. So that's again why I'm asking for your support for HB 2084 with favorable passage out of committee and I thank you for the opportunity to testify on this important issue and I'd be happy to take any questions. SHOW NON-ESSENTIAL DIALOGUE
Thank you dr tolliver and well done just within the three minutes, appreciate you being so succinct. We will get through the rest of your panel and then turn to questions. Next up is Angela Wallace.
All right. Hello. Um,
ANGELA WALLACE - MAMH - HB 2084 - Chair Madaro, Chair Cyr and members of the committee, I want to thank you for taking the time to listen to my testimony today. My name is Angela Wallace, I'm a rising senior about in college and I'm affiliated with MAMH. Today, I come before you to ask that you support H 2084,3672 an act to create a thriving public health response for adolescents. I ask you to pay close attention to section nine of the bill, which promotes physical and mental health education in all grades for all students in public schools. For 11 years, second to 12th grade, I've had the privilege of3689 being a student in the sharing public school system.
While, I'm honored to have had the opportunity to receive an education in Massachusetts, it saddens me to know that mental health education was not a primary facet in my schooling. I graduated from a school district that fosters a high achieving environment and as a result, my peers and I discovered that there is an unspoken pressure for us to succeed in3710 vigorous academic spaces. As a black woman who was educated in a predominantly white school, I felt isolated and pressured to prove my worth and intelligence in a society that doubts my ability to succeed. I found myself engaging in activities that lead to persistent sadness and suicidal thoughts as a means of proving myself to others.
Society tells me to assume the role of the strong black woman, a damaging image that requires me to suppress my feelings, thereby sacrificing my mental and physical well being in order to please others. Based on negative portrayals of mental health conditions in the media, my refusal to ask for help stem from the fear of being deemed weak, dangerous in a problem. Fortunately, my mother encouraged me to seek therapy outside of school and I thank her for not only helping me understand that I am not a problem because of my mental health struggles, but for teaching me the strength in opening up about my feelings. Numerous friends of mine have3765 expressed to me their mental health struggles which lead to suicidal thoughts. They refuse to seek help and discuss their mental state in high school and fear of being perceived negatively.
While sex education has been at the forefront of my health education for many years, there is also a dire need to incorporate a mental health curriculum that will serve to promote well being and enhance student understanding of mental health topics. This will work towards addressing the feelings of hopelessness, my peers and I frequently face. Supporting Act H 2084 will help diminish the tablet nature of mental health for the topic should be discussed openly with the omission of any negative stigma. The future leaders of America need to be educated on the issue, realize they are not alone if they are struggling with mental health and recognize that it is acceptable to ask for help. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Angela, thank you so much for sharing your personal story. It is really important that we hear personal narratives from people like you and thank you for being willing to do so. Today. Last on the panel is john Crocker,
Hi everyone wonderful to see you today. Uh
JOHN CROCKER - MASS SCHOOL MENTAL HEALTH CONSORTIUM - HB 2084 - Chair Cyr, Chair Madaro and members of the committee. I3835 appreciate you hearing my testimony. I am the director of school mental health and behavioral services for public schools and the founder and director of the Massachusetts School Mental Health Consortium, which is an organization with a membership of over 150 districts across the state, committed to providing opportunities for collaboration resources, technical assistance and professional development and advancement of school mental health. I am testifying today on behalf of thrives act, I believe that establishing a school based behavioral health technical assistance center is incredibly important.
I've seen the growth of students, I have seen the expansion of services and the improvement in the quality of services and the sustainability of those services when professional development technical assistance resources are shared with districts who otherwise do not know necessarily where to go to receive that help in establishing a comprehensive school mental health system. We need to elevate school based behavioral health to an imperative and that means providing universal supports to all districts and not putting barriers in the way for districts to be able to access, that's important. I think that promoting consistent models and language promoting evidence based practices, ensuring that there are meaningful and expert opportunities for professional development, technical assistance coaching are provided to districts in order to advance school mental health universally.
Our students desperately need to support. There has been a lot of data share today, I don't know that I need to share much more than this piece of data, which is that we're seeing a 2-3 times increase in the prevalence rates of anxiety, depression, and post traumatic stress. We have to position ourselves to universally provide care to students across all tiers of support. That does mean evidence based therapeutic support, but it also means quality social emotional learning. Schools are positioned to provide preventative and proactive treatment to students. We are the prevention arm of the mental health system, writ large and we have to take that charge seriously.
Otherwise, we're never going to be able to address the prevalence rates that are rising. It has to be the case that we are getting ahead of problems and not reacting to crisis and diagnosis. Community based mental health is wonderful, but they cannot do it alone, you need to partner well with them. So I want to just close with a thought around the school based behavioral health advisory council, I think that that's a wonderful opportunity to not only in collaboration with the TA Center, we're going to be able to increase readiness and with an advisory council to be able to support policy, to be able to support best practice and inform DESI and DMH in partnership with them. I think that's a wonderful model that hits on both the policy and practice side. So4007 I'll close there. Thank you so much. I appreciate you hearing my testimony. SHOW NON-ESSENTIAL DIALOGUE
Thank you john appreciate your your fellow panelists for joining us today. Have any questions from committee members.
All right. Uh Mhm. Representative Karen's please
KERANS - Thank you. Incredible panels. First to, Mr. Crocker, apologies if you had a different title. I'm asking you because you're I believe a superintendent in Methuen, did I get that correctly?
CROCKER - I'm the director of school mental health and behavioral services.
KERANS - Okay good. Wondering4052 if you can comment on discussions awareness, steps being taken to address the problem of disproportionate expulsions and maybe a leap to judgment about children's maybe acting out. It's been a while, my kids are older now, but I know of whence they speak when when folks are telling us too quick to just to expel, too quick for a suspension. Is your group talking about how to address that internally?
CROCKER - Yes, absolutely. I think one of the steps it needs to be undertaken is to reflect on the fact that we need to understand the function of behavior, we have to understand what is at the root cause of behavior so that we can address the needs of students comprehensively. Behavior is a form of communication that we need to be able to have an incredible sensitivity to what that behavior is saying so that we can not address a behavioral problem that has as its root cause mental health needs with the behavioral intervention. So I think that some of the work that we need to do4129 is to expand the use of good data systems, screening, universal screening to be able to identify students early, find emerging concerns.
I think also initial assessment practices, so using data to be able to understand what is behind specific behaviors and how students can be more comprehensively supported,4145 we don't want to ultimately use exclusionary discipline practices to address what is ultimately an emotionally based problem. So I think that there's work to be done in the realm of data and assessment, but there's also work to be done to unpack disproportionality across subgroups. So we've undertaken some work to unpack some data that helps us to understand which groups of students are perhaps being over identified or under identified based on specific criteria. So are we excluding?
Are we suspending students who are in a specific group more than others? Are we providing mental health services to4191 specific students more than others? Are we identifying students for mental health concerns more than others? That disproportionality did I think is really instrumental in shaping policy. SHOW NON-ESSENTIAL DIALOGUE
Thank you.
Mhm. Can I Get one More? Mr. Chairman? Certainly. Representative thank you
KERANS - To Dr Tolliver. I'm sorry I must speak I guess I'm really out of it. Can4224 you explain a bit about emergency room? I mean kids go from4231 school to the ER referred by the school and their parents is called once they're there?
TOLLIVER - Yes. Often there will be a child who has some kind of behavioral crisis and in the case of my study we were looking at4246 agitation and aggression and the school will evaluate and determine what to do and sometimes that involves sending them to the emergency room. They generally call the parent at the time that they're doing it, so the school will call, the parents say that this child is going to the emergency room. The child will be sent via ambulance and the parent may arrive sometime after, or sometimes the parent is able to come to the school and get the child beforehand. I'm speaking from the experience of the person at the ER in the emergency room, receiving the child and so, these are the stories that are given to us, but I know that the schools processes vary from school to school, city to city and so on. SHOW NON-ESSENTIAL DIALOGUE
Great. Thank you. Want to look into that a little bit more. Thank you. Yes, thank you. Thank you. You have any other questions from committee members,
senators here. Okay. So without further ado we are going to the final panel,4303 I believe on this bill, H 2084 this panel consists of Michelle Hymowitz, dr Matthews Birmingham and dr jane Singer Take it away.
We're going to go a little bit out of order and I beg the forgiveness of the committee.
JAYNE SINGER - MASS ASSOCIATION FOR INFANT MENTAL HEALTH - HB 2084 - Thank you so much, Chair Cyr and Chair Madaro and very congratulations on what will be your first father's day this coming Sunday. Thank you to members of the committee. My name is Jayne Singer, I'm a clinical psychologist and a4341 neuro developmental specialist and I am the president of the Massachusetts Association for infant mental health birth to six and I'm also the director of developmental in relational health at the Brazelton Touchpoints Center at Boston Children's Hospital and Assistant professor of psychiatry and pediatrics at Harvard Medical School. I represent a workforce that supports the emotional well being and mental health of very young children, their families and the practitioners who provide care for them and who consult to direct caregivers, whether those caregivers are families or educators. This support is essential to the success of young children in the classroom, not only in preschool in the early years, but for years afterwards by setting down key foundations in learning readiness that really requires emotional4395 stability.
Support for children's early emotional and behavioral health is a known investment that will reap not only the benefits and childhood outcomes4409 later down the road, but also represents a cost savings to societal programs when4420 we can work in a manner that promotes well being and prevents more serious and costly difficulties later on. So our early childhood mental health workforce supports the thrives Act because it would require the department of EEC systematically put into place the additional training and support for early educators that they need in order to comply with the performance standards that are called upon from the thrives act, the performance standards that would limit expulsion and suspension of Children from all EEC licensed early education and care preschool programs.
This would include more training on understanding trauma, supporting whole families and their communities for the good of all, and we'll be hearing shortly from Michelle and Matthew more on these standards and we'll be hearing more about why complying with these standards are essential to a child's emotional health and sense of security. The thrives act itself, the standards that it will uphold will also promote more engagement with families in order to collaboratively find solutions to managing disruptive behaviors in a sincere hope that no child ends up getting transitioned on their own in an ambulance directly from school to an emergency room without a parent present4516 or sometimes even knowing.
Those outcomes of child removal and expulsion often starts a very unhealthy path for the child and the families disengagement from the system. So I strongly urge you the committee to consider the thrives act as an important investment in the health of the future culture and society across Massachusetts. I thank you so much for your time. SHOW NON-ESSENTIAL DIALOGUE
Mhm. Thank you Dr Singer. Uh Miss Hymowitz Doctor Birmingham. The floor is yours going to go next. Uh
MICHELLE HAIMOWITZ - MASS HEAD START ASSOCIATION - Thank you, Chair Madaro, Chair Cyr and member of the committee for the opportunity to testify. My name is Michelle Haimowitz, I'm the executive director of the Massachusetts Head Start Association. We Represent the 29 head start and early head start programs in the Commonwealth serving our state's most vulnerable young children and families. So the thrives Act requires the Department of Early4575 Education and Care, as you heard Dr. Singer say to promulgate performance standards to limit expulsion and suspension the children from all EEC license. Head Start program Performance standards currently include a prohibition on expulsion and require programs to prohibit or severely limit suspensions for all Head Start programs.
The bill would require EEC to issue performance specifications aimed at setting goals for substantially restricting the use of suspension expulsion, ensuring that the use of4603 exclusionary policies when necessary is free of bias and discrimination, encourage early education programs to access assistance to approve teacher skills and to support individual children and their families to address behavioral health concerns without the use of exclusionary disciplinary practices. Head Start programs that currently abide by these standards require substantial support and resources to implement this policy that are grounded4626 in comprehensive support for the child and families.
Programs use tiered approaches that include curriculum and interventions, family supports4633 and trainings, mental health consultations, individual interventions and other supports. Family engagement is crucial, and programs not only communicate effectively with families regarding behavioral and mental health, the families are engaged as critical partners in the work of high quality social emotional learning. Programs developed4651 strong preventative guidance and disciplinary practices that work hand in hand with education, mental health and family engagement team members. Trainings and professional development for staff are grounded in trauma informed approaches and mental health supports for children and families.
These supports, though, are financially and administratively challenging. With its severely limited resources, EEC has provided some access to tools and support for programs to reduce suspension and expulsion, however, this work must be supported by a wider availability of resources, including teacher and administrative training, wider availability of mental health consultations, which is critical and technical assistance. The work also requires the establishment of clear set of standards akin to Head Start program performance standards and the suspension and expulsion policy within for all early education programs in the commonwealth. So thank you for the opportunity to provide this4705 testimony, I'd be happy to respond to any questions at the conclusion of this panel. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. Doctor Birmingham.
MATHIEU BERMINGHAM - NAMI - Thank you guys for including me. Thank you, Representative Madaro and Senator Cyr and members on the panel as well. I'm here because of the quotation of Nelson Mandela, there's no keen way of judging the society and the way it treats children and the way we're treating children is not4736 effective to their need. I'm going to speak specifically about the ineffective role of suspension and exclusion and how it affects kids of color and what it does to them to society4746 and better approaches that are available. The first thing about using suspension and expulsion for schools, especially preschool students is that it does harm. As a physician, I'm a child adolescent psychiatrist who works with the children services, the Roxbury. I'm also the president of the board of NAMI.
I can tell you that all these organizations exist and strive consistently to help us better here people and the folks affected by these concerns. I found that the quotation I used all the time by Jimi Hendrix knowledge speaks for wisdom listens and I find the more I can listen, the less problems I have in general as well as the kids, specifically. The problem of using the expulsions as a solution to a behavioral issue is that it confuses behavior for an attempt to communicate as as Mr. Crocker mentioned. The behaviors of children are the language of children. So imagine someone trying to speak to you and you don't hear what they're saying and you respond in a way that they feel frustrated, so they often raise their voice.
As Martin Luther King said people expressing their voice through right is often the voice of those trying to be heard. With kids, I can tell you that4830 when they're not heard, they just try to speak more and4835 often is through misbehavior. The problem with expulsion as a solution to children being hurt not heard is that it causes harm to the child and is disproportionately applied to children of color. We know that children of color between 12-80%4847 of kids in publicly funded preschool, but they're almost half of the kids expelled in preschool. We know that kids of color, both Latino4857 X and African Americans are 2 to 4 times more likely to be expelled in preschool and the problem is when you expel the child in preschool, there are many more times, some says has four times more likely to end up being expelled4875 by the time they get to high school and once the child is expelled from high school, the eight times more likely to end up in the criminal justice system.
So we have a pre school to prison pipeline all because we don't understand how to listen. Finally, there are more effective ways of responding to children trying to be heard. Often it's an attempt to describe an unmet need. We heard today about what happens when kids go to the emergency room, often in the emergency room, parents are asked to leave their job and I've had many parents who lose their job because4909 they have to go to the emergency room to be with their child. I4913 had a personal experience of a young man that I was asked to evaluate 3-4 years old in the program I worked with in Roxbury and he was destroying the room and I won't have time to go into details but when I spent some time listening to him, he calmed down and he helped me clean up the room that he had just destroyed.
So we are using cough drops for pneumonia when we're expelling kids who have behavioral issues. The solution is to learn to listen and use interventions that do work. We know that facilitating supportive adult child relationship is helpful, we know that helping children develop a sense of self efficacy and perceived control is important for helping them regulate their behaviors, we know that including the community that cares for the child is very helpful. SHOW NON-ESSENTIAL DIALOGUE
So thank you so much for your testimony. I apologize, but we are running short on time. If you have other thoughts to share, please. We encourage you to submit written testimony to the committee and I want to thank your fellow panelists for joining today as well. Do we have any questions from committee members?
Seeing none? We will turn to the last scheduled testimony for age 2080 for Suzanne curry from health care for all.
SUZANNE CURRY - HEALTH CARE FOR ALL - HB 2084 - Thank you very much, Chair Madaro. Chair Cyr and members of the committee. My name Suzanne Curry, I'm the behavioral health policy Director at Health Care for All and I'm testifying today in support of House Bill 2084, an act to create a thriving public health response for adolescents. HCFA is a leadership team member of the children's mental health campaign and as such, we endorse the testimony you've already heard about this5024 bill and the many reforms that will increase access to children's behavioral health services when and where they need them, whether it's in the community at school or at home. I'm going to take this in a bit of a different direction and want to highlight one section of the bill that's also important to advancing the health equity goals that we all hold and speak about today.
Section 12 of the bill would expand comprehensive mass health coverage to children5048 and adults who meet all eligibility requirements except immigration status. This section has also been filed as stand alone bill along with the related bill to expand Mass health to immigrant children with disabilities, both of which we strongly support. So certain immigrant children in our communities can only access very limited services through safety net5069 programs and this includes many of the behavioral health programs and services that we know that they need. We're grateful that these programs exist but the bottom line is that none of the programs cover the range of health care, behavioral health and other services young people need, let alone children and youth with higher health, including behavioral health needs.
We do know that immigrant families also have been disproportionately impacted by the COVID-19 pandemic and have faced significant barriers to accessing linguistically and culturally competent care even before the onset of the pandemic. We hear from many families on our consumer help line and from partner organizations and providers about how this lack of coverage impacts the families they work with. So I'm going to give you one story to give you a sense of what I'm talking about. Two brothers ages nine and seven, the nine year old is paraplegic due to spina bifida and needs a new wheelchair. It's not covered by CMSP, the Children's Medical security plan, which is one of the safety net programs.
The seven year old was diagnosed with an adjustment disorder, which causes significant behavior issues at school and the emergency services teams recommended intensive therapy including in home therapy with the family, but it's not covered either. Despite transportation and other barriers, this had started pre covid, the seven year old was able to start outpatient therapy but CMSP has a 27 visit per year cap and5152 this type of therapy alone is not going to provide the level of support he needs. Behind this story, there are many more families who are struggling to find care for their children.
California, Washington state Oregon, new York, Illinois and Washington DC have already expanded comprehensive Medicaid coverage to all income eligible children regardless of immigration status and we hope that Massachusetts will follow suit and put this coverage expansion into law. With that, we ask you for this section and for many others in this comprehensive bill to report House Bill 2084 favorably from your committee, we will also be submitting written testimony and happy to take any questions. Thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. Do we have any questions from committee members?
Seeing none that concludes our scheduled testimony on age 2084. The DR act, we will now be shifting gears to s 12 97 age 21 15 and act to protect Children's mental health services. First up is a member of this community and sponsor of the Senate version of the bill. Senator john keenan.
Senator keene. Are you with us?
Perhaps you're on mute?
He looks a muted and he was just on, I just accident if we want to go to another member and come back to him. Certainly we will circle back to the senator. Next we'll hear from Zachary roman Crowley. I apologize if I5263 butchered that last name but please5265 the floor is yours
exactly where you here? Yeah,
Well I do see that Senator keenan is back on senator. Would you like to testify on this bill
community?
I apologize that they just had to switch computers again so I appreciate5296 your patients with that.
SEN KEENAN - SB 1297 - I welcome the opportunity to speak on the bill. What this bill basically would do would be to create and on budget position with child advocate would require the advocate to establish this position. Just by way of a quick story, the night before last, I was at the checkout line of stop and shop and a woman in the next line said, you're going to regret that you ran into me, hold on please and so I waited for her to go to the checkout line. And even before she finished that she ran out and she said, I have to talk to you about what's going on in5345 child behavioral health. I know the woman, she said, you know that I'm a child pediatric5349 behavior health nurse. She said, I have never seen the system so difficult to navigate who are adolescents in their families.
So what this bill does in essence is that it helps set the framework for the coordination of efforts by family and adolescents and their family members to work their way through the system. We hear time and5370 time again, that it is incredibly difficult. We heard testimony all day today about students going from schools to the emergency department and then being released with their parents with the idea that they will go to the outpatient system and then they go to that outpatient system and they really have a problem navigating it. So this legislation would create an ombudsman person position to help them navigate their way through the system.
It would also charge the ombudsman person through the Office of Child Advocate with collecting data, collecting information on complaints, advocating on behalf of adolescence and doing a whole host of other things for the benefit of these young people. This bill is supported by many groups, we're going to hear testimony shortly from a group and I also want to acknowledge and thank my colleague in the house, Representative Malia who has filed a companion bill. So again, I think it's5427 critically important that we have somebody in place to help young children and their families make their way through what we all have to acknowledge is a very complex and complicated behavior, health delivery system, particularly as it relates to young people. So I thank you for your time and ask for people consideration5447 of this bill. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Senator. Do we have any questions from committee members
quickly?
Thank you. Just quickly
5471 KERANS5471 -5471 Thank5471 you, Senator. I'm assuming that the situation that your constituent referred to has to do with the pandemic or no?
KEENAN - She expressed concern that it was pre pandemic worsened by the pandemic and she has been in contact with my office previously and that's been our experience as well. We heard about young people going to the emergency department and I was receiving in my office not necessarily complaints but more pleas from parents about their children in emergency departments of pre pandemic than I was during the pandemic. I don't know why that is because I know that it's been occurring but I think um you know there may have been some degree of resignation during the pandemic that the child went to emergency department if they got home, they would just kind of handle it in that way.
Prior to the pandemic, just a sense of the complaints that I got was that it was happening quite frequently and again I know it was during during the pandemic but5532 there was happening frequently. In one case, we had at a local hospital a child who was bordered in the emergency department not for hours, not for days but for weeks. It was a complex case but the child was in that emergency department for weeks being boarded and that tied up resources within the emergency department, it did not most importantly help the mental health status of that young person, it certainly created a lot of anguish and anxiety for that patient's family. So we have so much work to do and the ombudsman position would help people navigate their way through this web of services and programs. SHOW NON-ESSENTIAL DIALOGUE
Thank you. You think you have any other questions from committee members?
Okay. I just want to double check. I do not see him on the participant list but is mr Kralik here to testify?
Okay. In that case we will5591 move on to Dr C. Mallory.
Can you hear me? Yes?
C MALLARY - CONCERNED CITIZEN - Okay, so this is a bit of a testimony of opportunity for me. I urgently came on another bill and I saw this one. I'd like to say that I don't disagree with the stated mission of the Office of the Child Advocate, nor do I disagree with the idea that these kind of systems should be easy to navigate. However, I do want to impose increasing the power of this office because I have serious doubts about the ability of the office to fulfill its primary function without conflict of interest, and there is a reason for this. So, MGL Chapter 18 C section 3 specifies that the Child Advocate should be chosen from a list of nominees, recommended by nominating committee.
This nominating committee must include5644 a representative of an organization that advocates on behalf of children at risk of abuse, who shall be designated by the children's League of Massachusetts inc. This I have a problem with because the children's league of Massachusetts is a provider lobbying agency, their members are listed on their website, organizational members include you inc, a company which twice subjected me to 20 minutes, I can't breathe restraints at the age of 13, once for dropping a sheet5668 of rules on the floor, once for lying down to sleep when they told me to sit up. State partners of the Children's League include the office of the child Advocate, which was supposed to rain an abusive facilities such as those run by you ink but if the child Advocate must be recommended by lobbying agency which is financially supported by abusive facilities, how5685 are we to believe that the child Advocate can independently raging late such facilities or really tell people how to navigate the system in a way that won't profit these facilities at kids expense?
How is it a good idea to expand the power of the child advocate when such a serious conflict of interest exists? This is not a baseless concern. In 2013, I spoke to Aaron Bradley, a registered lobbyist with the children's league. I had seen that she was behind the chins reform of 2012, which I read in its entirety and although reform was certainly necessary, I had seen that there was an enormous safeguard missing to protect kids, namely there was and is no obligation whatsoever for the courts to consider that a minor may have a legitimate reason for missing school, such as untreated physical illness. I hope that this lack of safeguard was an accidental oversight.
I contacted Aaron Bradley of the children's League in hopes that we could work together to correct this oversight so that innocent kids were not needlessly institutionalized. She told me that there was no oversight and flat out refused to support anything that would reduce the flow of kids who are clients facilities. Her exact words were, we work for them. We represent them. Is this really the sort of organization that should be nominating a child advocate? Can we trust a child advocate who is nominated by facilities that are perfectly happy to prison and abuse physically ill Children in lieu of medical treatment? So therefore police do not expand the power of the Office of the Child Advocate until the serious conflict of interest is removed from MGL chapter 18 C, Section 3. That's my testimony of opportunity. I would like you to clear up this conflict of interest, it might be off topic for the main subject of this bill, but you really can't be giving this much power to lobbying agencies.5786 SHOW NON-ESSENTIAL DIALOGUE
Thank you. Dr Mallory. Do we have any questions from committee members?
Okay. Uh, seeing none. We will now shift to the first panel testifying on this bill, which consists of Courtney, cello, donna mosh and5810 dr melissa. Pero.
I think there might have been an error in the order. We have already testified, but there is another set of folks from the Children's mental health campaign. Um who are your and ready to go? We will then transition to the other panel. Sorry for the confusion. No, don't worry. It could have been on Iran, but thank you for flagging that. The next panel will be marisol, Garcia Amara5839 as a bookie. I apologize if I mispronounced that and lisa Lambert, so I'm gonna start
LISA LAMBERT - PPAL - My name is Lisa Lambert and I'm the executive director of ppal, the parent professional advocacy league. Even though I think today Microsoft Teams thinks that I am my son Paul, who's in graduate school in5856 California, don't ask me how they did that. For PPAL, our constituency, our families and teens who have mental health needs and as our staff, so this is something we all live and breathe and Paul is also part of the children's mental health campaign. So children who have Mass health and receive CBHI services, the services that were created as a result of the Rose ED lawsuit, they already have it on this person. She's the Federal court monitor. In many ways, she's5883 the prototype for the kind of work that Ombudsman person would do in this bill. But the Rose ED cases winding down, it may not have oversight after July and for Children who don't have Mass health, they've never benefited from that kind of a service, which makes this bill very, very timely.
Let me give you an example of how this helps looks, I'll tell you a very fast story. A couple of years ago, the5907 court monitor stepped in to help fix a snarled up situation. An elementary girl child who had outbursts and5913 depression needed and was receiving intensive community based treatment. Two years earlier, the child announced she was born a girl in a boy's body and her mother and the pediatrician worked really hard together to make changes for her. The girl of the child now used a girl's name, wear the close of a little girl and it was good, the school and her therapist had been accepting and they were much more worried about her mental health issues than anything else.
They had the new coordinator and the mom told the new coordinator, she herself had bipolar and had mental health issues and the coordinator went outside of her agency's protocol and filed charges of neglect with DCF because she was worried about everything and so that's where she might. By the time the court monitor got involved there was a lot to fix and she could do it because she had the ability to do it. She called the agency CEO, she called DCF and of course, talk to the mom, she had the skills and the authority to get answers and to solve problems and an ombudsman person can make that same difference, the weed through and get that done. I would like to add two more quick things about the bill, one is mentioned earlier.
The ombudsman person will5978 also collect data which can be a game changer. There's no single entity collecting data around children's mental health in the commonwealth and it's5985 spread over5986 multiple state agencies. Secondly, parents are not often asked for their feedback on children's mental health services and it's important feedback. The hospitality industries got yelled in trip Advisor. The tech industry's got a lot of review sites. I often say that parents are the amazon reviewers, the mystery diners and the consumer reporters of... and they would be able to provide input through an ombudsman person and through those interactions. There's never been an ombudsman person to help children, youth and families trying to access behavioral health services before the court monitor has shown us what's possible and what a difference it can make. Thank you for the chance to testify today. SHOW NON-ESSENTIAL DIALOGUE
6024
6024 Also,6024 next
AMARA AZUBUIKE - BOSTON CHILDREN'S HOSPITAL - Good afternoon, Chairs Madaro, Cyr and esteemed members of the committee. Thank you for the opportunity to provide testimony in support of an act relative to protecting children's mental health services. My name is Amara Azubuike, I'm the director of behavioral policy and advocacy at Boston Children's Hospital. I also serve on the leadership team of the children's mental health campaign. As many of you know, children have been a behavior health pandemic long before the covid 19 pandemic, which has only underscored the need. The four years leading up to the pandemic, Boston children saw 61% increase in psychiatric boarding. Currently, however, anywhere between 45-60 children are boarding in our ED or on our medical floors awaiting psychiatric treatment.
Needless to say that behavior health crisis is causing significant strain on children, their families in the health care workforce. The current crisis makes this legislation all the more critical to enabling access to care. In my role at6083 Boston Children's, I advocate on behalf of our patients and their families on a daily basis, striving to break down administrative barriers to access to acute psychiatric treatment. While there remains a shortage of acute care beds to meet the escalating needs, there are6097 also countless examples of children who are boarding for no other reason than6101 administrative complexity and barriers. It is heartbreaking to know that a child has to wait for much needed treatment simply because their insurer disagrees with their local school district on who is responsible to pay for the treatment or to manage the treatment moving forward.
In these common instances, that availability is not the barrier, the silos that persists among government agencies like DMH, DDS, DCF, local school districts and the health care system is causing the most vulnerable children in our state to board for longer periods of time an inappropriate, not therapeutic and restrictive settings. Families who are in behavior health crisis and unable to access the care that they need would benefit greatly from an ombudsman person in the office of the Child advocate, who can assist them in navigating the complex behavior health care system. Admittedly as a former assistant Attorney General in the health care division of the Massachusetts Attorney General's office6150 and a current behavior health policy specialist at Boston Children's, I myself on the behavior health care system, extremely difficult to navigate.
This legislation, however, would support families by reducing some of the administrative barriers to care during one of the most trying times in their lives. To close, I wanted to share briefly how this bill would also even the playing field and begin to address structural racism and health inequities that exist IN behavioral health care system. Oftentimes, I see firsthand how families with privilege and the right connections are better equipped to navigate the system and can more readily access the care that they need. However, every child should have the same access to timely care, irrespective of their zip code, their race or their thunder.
This legislation would provide every patient who is boarding with multiple agencies involved the same access to an ombudsman person they can have in their corner as they seek the care that they deserve and need. Thank you for the opportunity to provide testimony today. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much.
Um,
MARISOL GARCIA - HEALTH ADVOCATES - Good afternoon, Chairman Cyr, Chairman Madaro and members of the Joint Committee on Mental Health, substance use and Recovery. I'm so grateful to see so many folks who care about the same issues that we do here and I appreciate your patience with me as I tell this story. My name is Marisol Garcia and I'm the senior director at health advocates, I lead the work of HLA's largest initiative, the mental health advocacy program for kids. As many of you know, this is a statewide evidence based legal services program that provides free legal services to families to ensure that young people with mental health needs have access to mental services.
I'm here to testify for this legislation to protect children's mental health services because access to mental health services saves lives. Today, I want to talk about Jonas, a 15 year old kid who has failed wires Life on December 12, I am here telling his story because his mother could not be. In March of last year, Jonas's mom Francesca called our intake line because Jonas needed more support. He had been diagnosed with ADHD, disruptive mood regulation disorder and anxiety disorder. His school had been repeatedly calling his mom to pick him up when he would punch walls and yell and eventually Jonas became too anxious to attend school because they would send him home when he struggled. Jonas was really having a hard time at home as well.
He did not want to take his prescription medication and self medicate with marijuana. Francesca applied for services from DMH and Jonas was found eligible in September 2019. DMH provided community based continuum services. But Jonas was still not stable. Francesco was desperate to find help for Jonas, so she filed a child requiring assistance petition in the Holyoke juvenile court in January of 2020. As a result, Jonas was placed in the custody of the department of children and Families. If you're keeping score, this is the second state agency. Jonas mental health needs only worsened when his home was destroyed by a microburst in May of 2020. During the darkest time of the COVID-19 pandemic, Jonas and his family were moved to a hotel by the Red cross.
In July, Jonas was screened by the mobile crisis team and he was found to meet medical necessity for a short term community based treatment bed but when no bed could be found,, he boarded at the emergency department, something we've heard a lot about today for two weeks and he received no mental health services during that time. He6346 was discharged home over Francesca's objections and then the department of children families place Jonas in another short term placement, a star bed to receive assistance with accessing appropriate medication for his mental health needs. To try to figure out a plan for Jonas, his treatment team which included a map for kids, staff attorney, staff from DCF, DMH, the juvenile court and others met last July and in the meeting, DMH refused to provide services that was recommended by other team members.
The DMH supervisor indicated in an email that it6375 would be tough to identify a placement for Jonas and asked whether the latest incidents would bring up any support from the Department of Youth Services. The Department of Youth Services is our facility that we use for detention for6399 kids who have been accused of crimes in the commonwealth. In August of last6403 year, we represented Jonas an IP meeting with his school and the school district agreed to share the cost of a residential placement but both the department of Children families and DMH refused to take on any of the cost. We then filed a request for a Unified Planet team through EOHHS.
EOHHS convened the team with DCF and DMH and the family. EOHHS found DMH responsible and instructed DMH to cost share with the school district for his residential school. Meanwhile, Jonas had acquired some delinquency charges based on events that happened at his DCF star placement and he was held by DYS on bail. This is our 3rd state agency. While being restrained by DYS staff member, Jonas's arm was broken. Last September, Jonas was conditionally accepted by a residential school but they would not allow him to enroll until his broken arm healed so he could be medically cleared for restraint, if necessary. Many other placements then also refused to accept Jonas.
Finally, on December 11 2020, Jonas was accepted at a residential school and on December 12 2020, the next day, Jonas was killed by gun violence. After he was shot and killed, Jonas community held a vigil for him in the middle of a snowstorm and the daily Hampshire printed a picture of his mother. The caption reads Francesca addresses6486 the crowed at a peace march, memorializing his son and making a plea for greater access to mental health services for young people and the Holyoke community. Francesca is quoted as saying, I worked6500 with a lot of people to try to save my son and my son was taken from me. Boston University School Public Health tells us that 98% of the hundreds of families served by my program report experiencing at least one barrier to mental health care and 63% of our clients report experiencing bureaucratic delay.
Access to mental health services saves lives and I testify today to urge this committee to support this legislation creating an ombudsman in the office of the Child advocate to ensure that other mothers do not lose their sons due to bureaucratic delay. Thank you for your consideration of this testimony and I'm happy to answer any questions you might have. SHOW NON-ESSENTIAL DIALOGUE
I'm sorry for my emotion. No, no worries. Attorney Garcia, I know these are difficult issues to talk about it. Thank you so much for your testimony today. Do we have any questions? Committee members? Mr Chairman if I may please. Representative tucker.
REP TUCKER - Thank you, Mr. Chairman and to everybody that has testified, thank you. I think is a wonderful idea and I want to share very briefly, a case I'm actually working on now that has opened my eyes to what's happening across the state. Chairwoman Decker had to help me when6574 I had a constituent whose son spent eight days at the emergency room with no treatment waiting for a bed. On the 9th day he was supposed to be transported, they forgot to bring him which pushed6584 it out another three days. No exaggeration during this hearing right now, within the last 20 minutes I've just heard from son is back in the hospital, he's 14 and the text just came in.
The medical provider and psychiatrist for my son said that he needs a long term residential program. The DMH Representative in6605 the meeting is disputing their recommendations. Will this bill help hits family? I'm going to meet with them tomorrow morning at 10:00. I've been trying to work with them. Is this something that would fall within the purview of what it is that we're discussing here?
GARCIA - Rep Tucker, you've been such an incredibly long time supporter of our work and I'm so grateful that you're on this committee. Our hope is that it would help because the idea is that the Office of the Child Advocate would have the authority to authorize funds would determine which state agency is responsible and then would be able to authorize funds to to free up those dollars that state agencies are saying are unavailable though some of them return funds each year. You guys may know this, so that's something that I think is a solution to the type of problem you're talking about. SHOW NON-ESSENTIAL DIALOGUE
Thank you. I appreciate all of your testimony today is is very timely and it's very powerful and I appreciate it. Mr Chairman. Thank you. Thank you. Do we have any other questions from committee members?
Okay. We are now going to take a short break. We will resume the hearing at 3 10. So 10 past three we will come back and we will resume testimony. Thank you all for being here and I'll see you at 10 past three.
Okay?
Going to assume that we're back in action and if I don't hear otherwise from L. A. S, but we will now transition to S 1309 An act to increase substances prevention and awareness and reduce overdose abandonment. We heard from Senator O'Connor and its constituent mr Perry earlier and we will now transition to attorney walter Gangel. Thank you. Uh, can you all hear me very well? Yes. Okay, thank you folks. Uh, this study pre
WALTER GANGL - CONCERNED CITIZEN - SB 1309 - Going back in time before 2012 when the overdose good Samaritan Law was enacted in Massachusetts, overdose deaths were exploding everywhere and EMS were reporting overdose deaths where people were running away and abandoning a victim. That led to the 2012 adoption of the overdose good Samaritan law in Massachusetts. I think Massachusetts is about the 12th state to do that. Virtually all states have now adopted similar laws, but in Massachusetts, there were no plans for6768 promotion of that information. So police and local communities did the best to get the information out but it hasn't really been that effective. An overdose abandonment where people run away and leave a person to die still happens.
Information about this law is especially important now because the experts are saying that the combination of overdose, good Samaritan law and Narcan has an exponential effect and if you don't have the good Samaritan law, people aren't going to stick around to give the Narcan and if they're not aware of that, if they are aware of it, they're more likely to do that. So it's a synergistic effect and it's6814 really more important now. Our community, our knights of Columbus and dictionary facts. We produced thousands of wallet cards about overdose and the good Samaritan law and as the police received them and we got more requests to translate into three other languages, we did that and we were giving the information out, but mostly in southeastern Massachusetts but it really wasn't getting to the rest of the state.
So it's a bigger megaphone is needed. We identified two major subsets of the youth that need to have this information. First to the high school cohort and then the post high school cohort. The high school cohort is relatively easy to get it if you simply put in the education that schools are already required to give, the requirement that they also educate the youth about the overdose good Samaritan law. If you do that, you've got that cohort covered. As the years go by, that information will get out. We've been thinking about and we had plans, we actually were talking to CVS back before Covid happened about6883 getting information through the pharmacies to the rest of the state and6887 get it to everyone but that's fallen flat on its face and we need to get it restarted and we'll do that. But we really like to see the legislature and the Governor put in place this very simple law that says the education has got include information about the overdose good Samaritan law because it's so important, so closely tied with the Narcan and the effect that the Narcan was having.
In my written submissions, I spelled out how, how impactful the overdose problem has been on the country and in the state. In fact, I think6923 it's 18,000 people have died of overdose. It's been, you know, over the years, it's accumulated and going up and up. Last year, we saw a 5% increase in Massachusetts of overdose gases. It was 27% increase across the country, so it's a serious problem. As Covid goes away, overdose deaths still continue and there's frankly, as of April when telling up the numbers, more people have died from overdose deaths than from Covid in Massachusetts. So that's going to keep going forward and unless we get on top of this problem. SHOW NON-ESSENTIAL DIALOGUE
So the angle I apologize, but we are out of time. And please, we encourage you to submit further comments. Be a written testimony from committee members.
Okay, seeing none. We will shift to the next person to testify. Who is Clinton Police Chief Matthew, Clancy
Chief Plants here. You're here.
All right. Moving right along. We now we'll hear from uh, Plymouth County Sheriff, Joseph Macdonald It.
Sheriff McDonald you with us.
Okay. Is Michael Bradley here from the Massachusetts Chief of Police association?
Can we create
Michael Bradley?
Okay. How about tim Cruz Plymouth County District Attorney. Hi, can you hear me? Yes, I apologize. He is pulled away in a meeting. Uh, so, I just wanted to let you know. Um, he was waiting, but something came up here. So, if you don't mind, we will submit his written testimony. Sounds good. Thank you so much. Thank you. Take care
that concludes the testimony on S 1309 We will now shift to S. 1271 an act to protect minors from abusive contracts. First up to testify, john baker Simon
me.
All right.
JOHN BAKER SIMON - CONCERNED CITIZEN - SB 1271 - So, I'm just testifying saying that abusive contracts have happened on the survivor of the contracts. So with the contract, I would say that people can send out by school districts to easily like the minors they sent out to the program way too easily these days. There needs to be more programs set in the public school system and they need to be compensation with those who have7129 been hurt by contract. There's also some programs where they break and hurt clients with restraints that's part of trying to teach them lessons, which happened to me at some places. It's just abusive. It's like why would they do that? Because the staff are lazy, they don't get enough pay to put up with the bullshit. Sorry? Most after they get up there. It's just very emotional angry. What happens with stuff that's going there. I lived in those programs and that's in the programs. There's some clients that they'd rather die than and actually live through that self there. It's pretty bad. SHOW NON-ESSENTIAL DIALOGUE
Mhm. I am dan
mr Simon, thank you for sharing your testimony. It is really important that we hear from personal experiences like like yourself. Thank you. Do you have any questions from community members?
Okay, moving along. Next up is Doctor See Mallory.
Hi. Uh You see me, hear me? Okay,
MALLARY - So, the specific contracts that that I wrote this bill for are the contracts whereby the program actually tries to make the minor sign a supposed consent form to be restrained. I realized that may seem strange to you that these things exist and that I want to prevent them from doing that. So you may think such contracts of giving the supposedly giving the kids constrained to be restrained are legally irrelevant because a sensible court would not uphold them. You may say that abusive restraints are already against the CMR and that's dangerously missing the point. So let me tell you why I care about this, I was a DCF kid then DSS and I was forced to sign numerous consents to restrain me.
I was told that failure to do so would lead to me being put in a DYS facility indefinitely. Even at 13, I knew that my consent was legally meaningless and that of course in me to sign was nothing more than a mind game. Guess what? The mind games still worked. It worked because being forced to consent to your own abuse is so alienating, so dehumanizing, so shameful that it took me 17 years to realize that most of our society does not actually approve of six grown men sitting on a junior high kid to punish them for disrespect. So I kept my silence and I spent my 20's learning to forgive my parents for crimes against me, which it turned out they didn't even know about.
I kept my silence rather than speak of the abuse because it was too painful to be reminded that my family and my society approved of what was done to me. Restraint consents give a veneer of legitimacy to vicious abuse and that is why they exist. They silenced victims and protect abusers no well intentioned CMR regulation can do a thing to stop abuse when the victims are too ashamed and alienated to speak. And let's7327 not be naïve, great restraints will be abused as long as kids have no right to remove themselves from abusive situations. In the eyes of your laws, minors are not fully human. They have no right to defend themselves or retreat from danger and when they disagree with adults who refuse to listen, they are labeled as having behavioral health problems.
Disagreeing with the pompous sanity is not a behavioral health problem, but being brutalized by that same ninny7366 legitimately will certainly7368 create long term mental health problems Myself, I7371 am an Ivy League scholar who will turn 40 this year, but I will never forget what it was like to believe that I would die at the hands of my government and that no one would care. I was required to choose a pronoun to testify today, so I chose the pronounce it because my humanity was stolen from me by these cruel mind games and I don't want my government pretending that it was ever given back. As for the current legal status of restraint consent signed by minors. I don't know if these consents were required under a previous version of the CMR.
I do know that the current CMR may incentivize them. Specifically in 603 CMR 4606, a student who has been restrained must be given an opportunity to comment on the restraint writing. However, there's7408 no way to ensure that the student was not forced to write to an agreement to the restraint ahead of time. A residential facility may be able to assert a quick worst pre made statement, which the student has signed and claim that as the students comment on the restraint. Furthermore, it is naïve to believe that a student can write honestly about restraint when any complaint of7424 abuse may be construed as resistance to treatment and punished by extended imprisonment at the same facility that performed the restraint. Captive human beings cannot truly give consent to being brutalized or approve of a brutality that has already occurred.
So don't ask captive human beings for consent or approval, it's not like what they want for themselves matters in the eyes of the law. Don't require captive kids to agree that restraints may be necessary or to process why beat down that scarred them for life is their own fault. Let them keep what little dignity and identity they have left. This bill incidentally was modeled after the ban in K conversion therapy last year, destroying identity, same sort of issue. So that's why you should support 1271 and band residential facilities from forcing minors to consent to abuse. Finally, games like this belonging Chinese re education camps, not in America and that's it. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Dr Mallory. Do we have any questions from committee members? Mr Try. I would just say um you and I are corresponding offline just on the pronoun piece. We're looking to that. There's no reason why pronouns need to be required and signing up for this. So I don't know if it's a problem with L. A. S. It did make me a little bit uncomfortable. I'm glad you raised that. A not attuned to us. Uh Chair Maduro's an awesome ally. Um that's not necessary. So, so,7509 well, problem with the people wanted to and I just, you know, I just this is an identity issue to7515 me that that really kind of destroyed me and I do feel like in it, but this kind of stuff is still going on that's not acceptable. So our apologies for that and we'll follow up on that, I think yes, it's either a glitch with the I. T. P. S. Or something like that. So I'm glad you raised it will fix it or7533 fix that. And thank you for your testimony. Thank you dr Mallory.
MADARO - I did have one question is the reason this bill was filed because minors are still being asked to sign contracts in Massachusetts despite lacking the capacity to do so?
MALLARY - In so far as I know, they are. You know I received a report from a girl in 2015 that said that she was forced, she said that she had signed her rights away at Chamberlain School in Middleborough so I think it was that sort of thing but we didn't get into details about it. SHOW NON-ESSENTIAL DIALOGUE
don't think these things are out.
I was at one point.
Yeah that's um it's this uh
MALLARY - It's a problematic facility and EEC have really neglected to investigate it properly. They allow them to investigate themselves when complaints are received and exonerate themselves which really isn't the way that investigation ought to go but I don't want to get too far off topic here and I thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you dr Mallory. And again thank you for7602 flagging the issue about the pronouns. The senator and I will circle back with L. A. S. And look into that. That was news to us and that that should not be a required piece of information to input to testify. So thank you for bringing that to our attention.
Okay I guess I'm done. Thanks thank you very very much. We are now going to move to S 1286 H 2108 and act relative to a packed pilot program for Children. First up is committee member and house sponsor, Representative Michael Kushner eric,
REP KUSHMEREK - HB 2108 - SB 1286 - Good afternoon, Mr. Chairman and Chairman Madaro and Chairman Cyr. I'm speaking today regarding H 2108, an Act relative to a pact pilot program for children. I'm proud to introduce this along side my Senate co presenter, Senator Friedman and that's Senate number 1286. Like so many, I have had the terrible misfortune of being a caregiver to a loved one, forced to board in the ER and we've heard so many7670 horrific stories and also touching stories here today of folks boarding in the ER awaiting psychiatric placement. It's a gut wrenching experience that I've seen firsthand too many times.
Frankly, it's one that I wouldn't wish on anyone, and it's an unfortunate and tragic reality that my experience is one that is shared with tens of thousands of caregivers across the commonwealth and they too have been forced to, to watch loved one suffer in agony and ERs without treatment and wait until a bed opens up. Just last week, I heard from a father, a constituent of mine, regarding his 14 year old daughter, who had been waiting placement for 30 days at Boston Children. On day 35, his daughter was finally placed in a psychiatric facility only after the condition continued to worsen. Just a truly excruciating experience to go through on both sides as both a caregiver and now as a legislator.
I realized there's no single action we can take today or even this session that will fully prevent this scenario from taking place over and over again. The reality is, this is going to require a series of complex actions across public, private and non profit sectors to adequately address this situation. But I do believe that H 2108 is one such step that we can take that will provide a short7758 and potentially a long term remedy to the boarding crisis for young adults under the age of 22 in particular. In Massachusetts, we have a service known as the Program for assertive community treatment a pact. However, that's only available to adults with severe and persistent mental health disorders and this bill would create a three-year pilot program for youth under 22.
This act would provide intensive, comprehensive and nonresidential treatments, individualized for the person served while reducing the number of individuals who were boarding in ER's both in regions and across the commonwealth. I know we have some expert, folks who7795 will speak to the mechanics and the logistics of how this bill could directly impact both our region and mental health across the commonwealth. So I respectfully ask that this committee report this bill favorably out of the committee and I appreciate both of your time this evening as well as the distinguished members of this committee. Thank you, Chairman. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Representative, appreciate your work on this. Do we have any questions from committee members?
Okay. I don't see the next Panelist on. I know we're running a little bit ahead of schedule, but I7829 do see that Michael brady from the massachusetts Chiefs of Police Association creation is back on. I want to just circle back to you chief and see if you'd like to still share some comments with us.
7845
7845 MICHAEL7845 BRADY7845 -7845 MASS7845 CHIEFS7845 OF7845 POLICE7845 ASSOCIATION7845 -7845 Good7845 afternoon. Thank you sir. I'm providing testimony on behalf of the Mass Chiefs of Police Association in support of the education of the overdose, abandoned good Samaritan law. As police chiefs in the commonwealth, we feel that including effective education about OGSL in the schools, substance abuse curriculum will have a positive effect in reducing overdose deaths. Students will understand that if they find themselves in a situation where they are present during an overdose incident, they will not hesitate to call 911 to prevent death out of fear of the repercussions of being present during that overdose situation.
So this bill is about saving lives and getting our first responders to the scene so we can provide appropriate intervention and7892 hopefully save lives. So that's really all, I'm sure that echoes some of my colleagues that have spoke earlier. SHOW NON-ESSENTIAL DIALOGUE
Mhm. Yeah. Thank you. Chief Do we have any questions from committee members?
Okay, thank you so much. We will now circle back to S 1286 H. 2108 and act relative to a pact pilot program for Children. The first panel to speak is consists of Karen, jeffers and lydia Congress. Okay,
great. Thank you. Uh I believe Karen will be joining us shortly. So uh excuse me,
LYDIA CONLEY - ASSOCIATION FOR BEHAVIOURAL HEALTHCARE - HB 2108 - SB 781 - Chair Cyr, Chair Madaro and distinguished members of the committee. Thank you for the opportunity to testify in strong support of House 2108 and Senate 781, an act relative to a pact pilot program for children. This legislation sponsored by Representative Kushmerek, as you know, and Senator Friedman would create a pilot program for treatment model that delivers intensive individualized non residential treatment for children and adolescents with mental health disorders. We are additionally quite strongly7958 supportive of similar language that was included as a grant program in the Fy 22 Senate budget. That's line at M 4000 0053, it's funded through the behavioral health outreach7969 access in support trust fund.
We really hope to see this important program retained in the final Fy 22 conference budget. As you may know, the Association for Behavioral Health Care is a statewide association representing 80 community based mental health and addiction treatment provider organizations. Our members are the primary providers have publicly funded behavioral health care in the commonwealth. We serve 81,000 Massachusetts residents every day, more than a million annually and employ about 50,000 people. Our member organizations have continuously reported capacity constraints and mounting needs for pediatric behavioral health services as you heard today and other settings. 32% of our members report prescriber wait times of 1 to 3 months for a child, 79% of our out patient provider organizations reported wait lists for services with 50% reporting wait lists for independently licensed clinicians for children.
The inadequate availability of community based care for young people leads to the boarding of ED of young people in the emergency department, it's a phenomenon that is detrimental to the well being and recovery of young people with mental health disorders. It's traumatic and it's unacceptable. There's8055 a recent health Policy Commission data showing that 39% of pediatric behavioral health emergency room visits in Massachusetts result in boarding. Assertive community treatment or ACT as one part of the solution. ACT is an evidence based way of delivering a full range of services to people have been diagnosed with a mental illness. Individuals who participate in ACT are hospitalist less often and are shown to maintain more stable housing.
In Massachusetts, the services known8083 as ACT program of assertive community treatment and it's only available to adults with severe and persistent mental health disorders. Our members that deliver ACT report that is a uniquely successful model because it focuses on 24/7 individualized and wrap around care. Services are delivered using a multidisciplinary team there often in the individual's home and they include an assessment and outreach, medication, treatment, care, coordination, symptom management, harm reduction, family services and housing support. The goal of pact is to focus on the aspects of an individual's life that are important to recovery, including community integration and using a structured intensive treatment model.
Our members who deliver pact again, currently available only to adults, report significantly reduced turnover rates among pact team members of staff versus other services. We attribute this to the team based structure, the fact that the service isn't fee for service and the rates and the model that support an intensive service delivery that's evidence based. Other states such as Missouri have developed and steadily expanded ACT services to include youth for a variety of conditions, so first episode psychosis, dual mental health and substance use disorders and autism spectrum disorders, just more evidence of the models broad efficacy and potential. Missouri's ACT for Youth Program8163 participants successfully find jobs or continue with school and move out of the system of care.
Expanding the impacts team based high intensity integrated model to youth and young adults will fill a critical gap in the behavioral health continuum for youth whose needs are not met with currently existing services or have they have not worked out for them. This service would also rapidly increase access to timely and appropriate mental health services for a population that often faces long waits, ED boarding and difficulties navigating a complex system. So on behalf of ABH and our member organizations, we sincerely request that H 2108 and Senate 781 be favorably reported out by the committee. So thank you for your consideration of these comments. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. Miss Conley. Is Karen jeffers here?
I don't see her yet. Okay. Uh We can always circle back if she joins a little later. Uh We will now transition to the second panel who was testifying on this bill consisting of dr melissa Pero, Donna mosh and Courtney Cello.
This is Donna mosh. Our panel testified at the beginning of the hearing Representative. I think it must be an error in a repeat. Okay apologies thank you for coming. Apologies needed up and if you need anybody to talk more about this, you can call on me anytime. Much appreciated. I see. Mr Darboe, are you here on behalf of the public County8272 Sheriff Department?
This is actually Sheriff Mcdonald and I am using uh community uh laptop here which we use for such things and Mr. Dubose our I. T. Guy. So hello sheriff uh would welcome your testimony on this 1309 if you'd like. Oh that would be wonderful.
SHERIFF MCDONALD - MASS CHIEFS OF POLICE ASSOCIATION - SB 1309 - Thank you. I appreciate you taking the story as I was gathering my thoughts as to what it is I wanted to say to the group about this bill. What came to me was the story of a good friend of mine lost his daughter to an abandoned overdose. She unfortunately8309 got into some substance use issues and she found herself in an overdose situation which in all likelihood could have been reversed and she would have survived. This is probably five or six years ago now that this took place and she was abandoned and and she passed away from that overdose leaving seven children. You know, she was8339 41 years old at the time of her overdose, she wasn't a high school aged kid by any means but I do think that the more efforts that we are able to undertake to notify people of the good Samaritan law, I can understand people engaged in illicit activities when things do go south, when things go very badly, I imagine that their first instinct would be to flee.
It's unfortunate, but I think that takes into account human nature. I think about this anecdote that took place to some people very close to me. I'm happy to report that the children have have done pretty well. What brought it to my mind is my daughter is going to be starting as a freshman at American University in the fall and one of this woman's daughters will be starting there with her, so I will be able to see them in that role in happier times. So I think everyone understands that, you know, this bill does not cost us anything, it simply adds another tool to the toolbox for us to combat the deaths that are taking place from this opioid epidemic that we're living through. So that really is all that I had to say. I'm a very strong supporter of this, all the sheriffs, our forces8418 were behind this as well. If there's any questions, I'm happy to take those. SHOW NON-ESSENTIAL DIALOGUE
Thank you Sheriff Mcdonald, do we have any questions from members of the committee?
Okay. Thank you Sheriff. Thank you indeed. Thank you all. I just want to double check that Karen Jeffries is not, I don't see her on the participant list. Uh and I also should have asked committee members had any questions for Miss Connelly on on the last built.
Okay. That moves us to the final bill of today's hearing as 13 13 H 2080 and act establishing a pilot program to provide a support structure for parents during the covid 19. Global pandemic is Senator Roche here.
Senator Mr Church senator rashes unable to join. I think the the hearing may be over by the time she's able to join so we should proceed without her understood. Uh8474 Belich Friedman
is Miss Friedman here.
Well that that is all of the scheduled testimony for today. Uh if anyone signed up to testify who I did not call on, please raise your hand. Now if I do not see anyone, we will be adjourning the hearing
mr chad. I just like to chime in and first of all, thank everyone for their testimony and bearing with us on this beautiful afternoon. I'm also thank thank you to you really, I think in modeling particularly the break that we had. I think it's really important these um, you know, we are in the business of mental health and I think it's really important that we're taking those brakes. So, so real kudos to you. Um, for for suggesting that uh, and um, we had talked earlier and I was8536 supposed to jump in uh when you have to change the type or8539 or take a bottle or something. But I guess you folks in the moderate housework holders to efficient because I was not naked but really grateful for for your leadership uh, and and and and leading leading this hearing while juggling so much else. And of course congratulations to you and your family.
Thank you so much senator. It's a pleasure to chair this committee with you and to my8563 fellow committee members. Thank you for your involvement and attention today to all those who testified. Thank you so much for taking time out of your busy schedules to join us. Uh It is so important that we hear testimony on, on these types of issues and uh, you know, we did make a deliberate decision to uh, make this one of the first topics that we took up this session. It's obviously the issues impacting Children and youth when it comes to mental and behavioral health have always been important, but there's certainly more pronounced than ever before coming out of this pandemic. So we greatly appreciate all your attention engagement you want them of8598 the course of the session.
So without further ado I think we'll adjourn.
Thank you Mr Chair to take care of uh here. Uh We we do have a last minute testifier on right now.
Oh I see. We've been joined by Liz Friedman. Hello Miss Friedman. Would you like to testify on an act establishing a8621 pilot8621 program to provide a support structure for parents during the COVID-19 pandemic? Yes, I would and I can't see you, but I assume you can see me. We can see and hear you. Okay? Good, thank you. Well,
LIZ FRIEDMAN - MASS POSTPARTUM DEPRESSION COMMISSION - SB 1313 - HB 2080 - Thank you, Chairman Madaro and Cyr for the opportunity to speak in support of8641 S 1313, H 2080. Covid 19 has exposed the fragility of our mental health support systems and has created an even larger mental health crisis now impacting children as a result of the stress and isolation of the past 15 months. As a commissioner on the Massachusetts Postpartum Depression Commission, it was clear to me that the most important8662 way to care for infants mental health is to care for parents mental health. When parents are in good mental health, their children are more likely to thrive, when parents struggle with depression and anxiety, their children suffer. This is true, whether we are parenting infants, children or teenagers.
Four months ago, my 13 year old daughter told us that she had stopped eating, then we found8683 out she had started vomiting. My daughter, who has never suffered with depression or anxiety and easy going kid is suffering with both anorexia and bulimia. I have been in a tailspin trying to find the help she needs and she has been put on very long waiting lists and my family is not alone. The number of young people suffering mental health crises has skyrocketed during covid. This pilot project would ensure that parents receive critical mental health support so that they are able to provide stability, advocacy and support for their children as they recover from mental health crises.
Again, these issues existed before Covid but have been exacerbated and laid bare by the pandemic. Hospitalization of young people suffering from eating disorders has increased by 30%. Youth mental health admissions have spiked 300%. 9% of children who come to an ER with a mental health issue end up boarding because there are no psychiatric beds available. 27% of parents reported worsening mental health for ourselves. An AAP study concluded that quote, the coronavirus disease pandemic has had a substantial tandem impact on parents and children in the US and urges policymakers to consider additional measures to mitigate the health effects of the pandemic on the needs of family with children.
I have served on the Massachusetts PPD commission and the Massachusetts commission on the status of women as the chair8784 of the legislative committee. When my daughter told me she had stopped eating, everything changed. By the end of that week, I had left my public roles and now I provide full time care for my child. There8797 isn't a program she can get into until the end of July. We've been waiting for six months and are still waiting. Children are in crisis, parents are in crisis and in order to move past this mental8810 health catastrophe, to get our children back to their healthy and happy selves, we must support parents. Parents need to be on the most stable ground they can be, especially when our children are in crisis.
This bill would create a pilot program already tested and implemented in the Bureau of Substance and Addiction Services since 2019 through the use of trauma informed evidence based peer support groups for parents to receive the support we need to address the mental health challenges of both ourselves and our children. I want to conclude by saying, thank you, thank you for holding this hearing so early in this session, we will be submitting additional written testimony as we were unable to coordinate with medical and mental health experts to appear in person today. I thank you for your time. SHOW NON-ESSENTIAL DIALOGUE
Thank you so much. Mr even glad you were able to join. And uh, and we were able to hear your testimony.
MADARO - I did have a question Is this program intended for parents of only school age Children? Do parents become ineligible to participate if their Children have graduated from a K 12 school in the past year, if they graduate during the program? Or is this pilot directed towards parents of younger students?
FRIEDMAN - This program, as the bill is written, is directed towards school age children but I think that's an excellent an excellent question. The Bureau of Substance and Addiction Services where we've been running a parallel program since 2019, what the Department of Public Health has found is that they started implementing this program in their inpatient and outpatient treatment facilities and they keep expanding and seeing greater impact. So we've already done three or four trainings, trained hundreds of their providers, both professionals and pure recovery specialists and will be continuing to implement into the fall. So I believe that, you know, while we're thinking about a pilot program for school age children, we don't have8922 to stop there, that's just a place to start.
We've also done this program with MCPAP for moms when MCPAP was expanding to doing their work with mothers and perinatal mental health issues and we were able to bring that program across the state as well to about 11, 15 different communities where we could see really great impact. One of the things that's very important about a program like this is that we're able to put support groups into the pathway of mental health care, right into primary healthcare pathway so that we can triage people much earlier. We can get people off of wait lists and we can get them into support groups where we can provide the beginnings of a stabilization for them. Often, that's all people need when they're in a mental health crisis, they need that support group that lets them know you're not alone, you're not the only one, and actually you can get through this, we'll get through this together. So, I think it's a place to begin. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Thank you. Thank you. And
MADARO - What criteria, if any, will DMH be required to use to evaluate community organizations that apply to this RFP process?
FRIEDMAN - Well, that's another excellent question. I think that we probably would want to work with mental health organizations. We primarily, you know, through BSAS we are working with all of their funded programs, I think through DMH it would make similar sense to work9002 with funded programs that DMH already has an established relationship with. That will of course allow us to expedite implementation. You know, we can really like next week I could run a training and we could have 200 people trained in order to provide the framework so that they could provide these evidence-based support groups, and then we could expand our capacity to provide primary mental health care exponentially practically overnight. SHOW NON-ESSENTIAL DIALOGUE
Um So yeah, thank you. Mr Freeman. Do we have any other questions from committee members?
Okay, Hearing SHOW NON-ESSENTIAL DIALOGUE
none. Thank you so much for joining us. I'm glad we were able to squeeze you in, and uh I don't see anyone else that was signed up to testify that we may have missed earlier. Uh If that is the case, please give us a show to raise your hand now. Uh and otherwise seeing nothing. I think we will adjourn the meeting of the hearing for real this time.
Thank you all so much for your time. Take care. We'll see each other soon. Thank you. Bye now.
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