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 3 of 3)
SHOW NON-ESSENTIAL DIALOGUE
Yeah.
Yeah. Yeah. Yeah.
Mhm.
Mhm mm hmm. Thank you.
Mhm. Can I get one more Mr. Chairman? Certainly. Representative thank you
REP KERANS - To Dr. Tolliver. Um I'm sorry I must be I guess I'm really out of it. Can you explain a bit about emergency room I mean kids go from school to the ER referred by the school and their parents is called once they're there.
DESTINY TOLLIVER - BOSTON CHILDREN'S HOSPITAL - Yes often uh there will be a child who has some kind of behavioral crisis. Um and in the case of my study we were looking at 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 saying 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 the73 parent is able to come to the school and get the child beforehand. Um, I'm speaking from the experience of the person at the ER in the emergency room receiving the child. And so, um, 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. Thank98 you. You have any other questions from committee members,
senators here? Okay. So without further ado we are going to the final panel. I believe on this bill, age 2080 for this panel consists of Michelle Hymowitz, Dr Matthews Birmingham and Dr Jane Singer take it away.
JAYNE SINGER - MASSAIMH - HB 2084 - We're going to go a little bit out of order and I beg the forgiveness of the committee. Thank you so much. Chair Cyr and Chair Madaro and very congratulations on what will be your first Father's Day this coming Sunday and thank you to members of the committee. My name is Jayne Singer. I'm a clinical psychologist and a neurodevelopmental 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 an assistant professor of psychiatry and pediatrics at Harvard Medical School.
And 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. And 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 emotional stability. Support for children's early emotional and behavioral health is a known investment that will reap not only the benefits in childhood outcomes later down the road but also represents a cost savings to societal programs when we can work in a manner that promotes wellbeing 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 to systematically put into place the additional training and244 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. And 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 on uh these, more on these standards. And we'll be hearing more about why complying with these standards are essential291 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 um 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 present or sometimes even knowing. Um And um those outcomes of324 child removal and expulsion often starts a very unhealthy path for the child and the family's 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. And 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?
MICHELLE HAIMOWITZ - MASSACHUSETTS HEAD START ASSOCIATION - HB 2084 - Uh Thank you. Chair Madaro Chairs Cyr and members of committee for the opportunity to testify. My name is Michelle Haimowitz and 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, the Thrives Act requires the Department of Early Education and Care as you heard, Dr. Singer say to promulgate performance standards to limit expulsion and suspension of Children from all EEC licensed, 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 performance402 specifications aimed at setting goals for404 substantially restricting the use of suspension expulsion, ensuring that the use of exclusionary policies when necessary is free of bias and discrimination, and encourage early education programs to access assistance to approved 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 grounded in comprehensive supports for the child and families. Programs use tiered approaches that include curriculum and interventions, family supports 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 develop 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 this 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 - HB 2084 - Thank you guys for including me. Thank you Representative um Madaro and Senator Cyr and I see other friends521 on the panel as well. Um, I'm here because of the quotation of Nelson Mandela. There's no keener way of judging a society than the way it treats Children. And the way we're treating Children is not effective to their need. And I'm going to speak specifically about the542 role, the ineffective role of suspension and exclusion and how it affects kids of color and what it does to them, to society and better approaches that are available. The first thing about using suspension and expulsion for schools, especially preschool students is that it558 does harm.
As a physician, I'm a child adolescent psychiatrist who works that Children services at Roxbury. I'm also the president of the board of NAMI and I'm involved with both Massachusetts Association of Infant's Mental Health and, and I can tell you that all these organizations exist and strive consistently to help us better hear people and the folks affected by these concerns. I found that the quotation I used all the time um by Jimi Hendrix knowledge speaks but wisdom listens. And I find the more I can listen, the less problems I have in general as well as with kids, specifically. The problem of using expulsions as a solution to a behavioral issue is that it confuses behavior for an attempt to communicate 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 you625 respond in a way that they feel frustrated so they often raise their voice. As martin Luther King said, people expressing their voice through riot is often the voice of634 those trying to be heard. And with kids, I can tell you that when they're not heard, they just try to speak more and often is through misbehavior. The problem with expulsion as a solution to children being not heard, is that it causes harm to the child and is disproportionately applied to children of color. We know that children of color are between 12-80% of kids in publicly funded preschool, but they're almost half of the kids expelled in preschool. We know that kids of color, both LatinX and African Americans are 2 to 4 times more likely to670 be expelled in preschool.
And the problem is when you expel the child in preschool, there are many more times, some says as high as four times more likely to end up being expelled by the time they get to high school. And once the child is expelled from high school, they're 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.700 And 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 lose their job because717 they have to go to the emergency room to be with their child.
I had a personal expense of a young man that I was asked to evaluate 3-4 years old in the program I work with in Roxbury and he was destroying the room. And I won't have time to go into details but when I732 spent some time listening to him, he calmed down and he helped me clean up the room that737 he had just destroyed. And so we are using cough drops for pneumonia when we're expelling kids who have behavioral issues. And so 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. And we know that including the community that cares for the child is very helpful. So SHOW NON-ESSENTIAL DIALOGUE
thanks 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 - HCFA - 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. Um, HCFA is a leadership823 team member of824 the Children's Mental Health campaign and as such, we endorsed the testimony you've already heard about this 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 MassHealth coverage to Children and adults who meet all eligibility requirements except immigration status. This section has also been filed as a stand alone bill along with the related bill to expand MassHealth 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 net programs. And874 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.
And 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, or Children's Medical Security Plan, which is one of the safety net programs. Uh, the seven year old was diagnosed with an adjustment disorder, which causes significant behavior issues at school and the940 emergency services teams recommended intensive therapy including in home therapy with the family, but it's not covered either.
Um And 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 visit956 per year cap. And this type of therapy alone is not going960 to provide the level of support he needs. Behind962 this story there are many more families965 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. Um so with that we ask you for this um section and for many others in this comprehensive bill to report House Bill 2084 favorably from your committee. We will also be995 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. Probably. Yeah, I apologize if I butchered that last name but please. The floor is yours,
Zakaria. You here? Yeah.
Well I do see that senator keenan is back on senator. Would you like to testify on this bill?
You're muted?
I apologize that they just had to switch computers again. So I appreciate your patients with that.
SEN KEENAN - SB 1297 - HB 2115 - Um, I welcome the opportunity to speak on the, on the bill. What this bill basically would do would be to create an on ombudsperson position with child advocate would require the advocate to establish his 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, you're going to regret that you ran into me, hold on please. And so I waited for her to go through the checkout line. And uh, even before she finished that, she ran out and she said, I have to talk to you about what's going on in child behavioral health. And I know the woman, she said, you know that I'm at1156 child pediatric behavioral health nurse. She said, I have never seen the system so difficult to navigate poor adolescents and 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 and 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 and, 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 ombudsperson 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's 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 behavioral health delivery system, particularly as it relates to young people. So I thank you for your time and ask for favorable consideration of this bill. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you Senator Burkina, do1259 we have any questions from committee members
quickly?
KERANS - Thank you just quickly. Thank 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.1283 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 more not necessarily complaints but more pleas from parents about their Children in emergency departments pre pandemic than I was during the pandemic. And 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 um they would just kind of handle it in that way. Prior to the pandemic um I I think there was just a sense of the complaints I got was that it was happening quite frequently.
And again I know it was during during the pandemic but there was happening frequently. And in one case we had at a local hospital a child who was boarded in the emergency department not for hours, not for days, but for weeks. It was a complex case but the child within 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 the, 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 will move on to Dr C Mallory.
Hello, can you hear me? Yes. Okay.
C MALLARY1404 - CONCERNED CITIZEN - SB 1297 - HB 21151405 - So um 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, 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 was a reason for this. So, MGL Chapter 18C Section 3 specifies that the Child Advocate should be chosen from a list of nominees recommended by nominating committee.1448 The nominating committee must include a representative of an organization that advocates on behalf of children at risk of a, who shall be designated by the Children's League of Massachusetts.
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 sheet of rules on the floor, once for lying down to sleep when they told me to sit up. Um, State partners of the Children's League include the Office of the Child Advocate, which is supposed to rain on abusive facilities such as those run by YOU Inc. But if the Child Advocate must be recommended by lobbying agency, which is financially supported by abusive facilities, how are we to believe that the child advocate can independently regulate such facilities or really tell people how to1496 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? And this is not a baseless concern. In 2013, I spoke to Aaron Bradley, a registered lobbyist for 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 to her clients facilities. Our exact words war, 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 imprison and abuse physically ill Children in lieu of medical treatment? And so therefore please do not expand the power of the Office of the Child Advocate until the serious conflict of interest is removed from MGL Chapter 18C Section 3. And that's my testimony of opportunity. Um, I would like you to clear up this, uh, this, 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.
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 and Dr melissa Pero.
I think there might have been in1624 Aaron the order. We have already testified, but there is another set of folks from the Children's mental health campaign. Who are your and ready to go. We will then transition to the other panel. Sorry for the confusion. Uh, no, no worries. It could have been on Iran, but thank you for flagging that the next panel will be marisol,1642 Garcia amara as a bookie. I apologize if1645 I mispronounced that and lisa Lambert,
LISA LAMBERT - PPAL - HB 2115 - SB 1297 - So I'm going to start. 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 in California. Don't ask me how they did that. For1663 PPAL our constituency are families and teens who have mental health needs and as are our staff. So this is something we all live and breathe and PPAL is also part of the Children's Mental Health Campaign. So Children who have MassHealth and receive CBHI services, the services that were created as a result of the Rosie D. Lawsuit, they already have an ombudsperson. She's the federal court monitor. In many ways, she's the prototype for the kind of work that an ombudsman person would do in this bill.
Um, but the Rosie D cases winding down, it may not have oversight after July and for Children who don't have MassHealth, they've never benefited from that kind of a service, which makes this bill very, very timely. Let1704 me give you an example of how this helps looks. I'll tell you a very fast story. A couple of years ago, the court monitor stepped in to help fix a snarled up situation. An elementary girl child who had outburst and 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 child1731 now used a girl's name, wore the clothes 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 went. By the time the court monitor got involved, there was a lot to fix1759 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 ombudsperson can make that same difference, the weed through and get that done.
I'd like to add1776 two more quick things about the bill. One as mentioned earlier, Uh the ombudsperson will 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's spread over 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 industry has got YELP and Trip Advisor. The tech industry has got a lot of review sites. I often say that parents are the Amazon reviewers, the mystery diners and the consumer reporters of, um and they would be able to provide input through an ombudsperson and through those interactions. There's never been an ombudsperson 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.
AMARA AZUBUIKE - BOSTON CHILDREN'S HOSPITAL - HB 2115 - SB 1297 - I'll go next 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 and 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 behavioral health pandemic1852 long before the COVID-19 pandemic which has only underscored the need. In the four years leading up1857 to the pandemic, Boston Children saw a 61% increase in psychiatric boarding. Currently. However, anywhere between 45 and 60 Children are boarding in our ED or on our medical floors awaiting psychiatric treatment.
Needless to say that behavioral health crisis is causing significant strain on children, their families, and the health care workforce. The current crisis makes this legislation all the more critical to enabling access to care. In my role at 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 are also countless examples of Children who are boarding for no other reason than 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.
And this common, in these common instances bed 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 in inappropriate, not therapeutic and restrictive settings. Families who are in behavioral health crisis and unable to access the care that they need would benefit greatly from an ombudsperson in the Office of the Child Advocate, who can assist them in navigating the complex behavioral health care1945 system. Admittedly as a former assistant attorney general in the health care division of the Massachusetts, Attorney General's Office and a current behavioral health policy specialist at Boston, Children's I myself find the behavioral 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 and1970 begin to address structural racism and health inequities that exist in the 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 gender. This legislation would provide every patient who is boarding with multiple agencies involved the same access to an ombudsperson who 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.
MARISOL GARCIA - HLA - HB 2115 - SB 1297 - Um, Good afternoon Chairman Cyr Chairman Madaro and members of the Joint Committee on Mental Health, Substance2008 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 and2027 I'm the senior director at Health Law 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 health services.
I'm here to testify for this legislation to protect Children's mental health services because access to mental health services save lives. Today I want to talk about Jonas, a 15 year old kid who has, Life on December 12 is 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 medicated with marijuana.
Francesca applied for services from DMH and Jonas was found eligible in September of 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 Holy Oak2109 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 home2123 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 found2136 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. He was discharged home over Francesca's objections. And then the Department of Children Families placed 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 Mass 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 recommended by other team members.
The DMH supervisor indicated in an email that it 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 for kids who have been accused of crimes in the2196 commonwealth. In August of last year, we represented Jonas in an IP Meeting with his school and the school district agreed to share the cost of a residential placement. But both the2205 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, DMH2215 and the family. EOHHS found DMH responsible and instructed DMH to cost share with the school district for his resident school.
Meanwhile, Jonas had acquired some delinquency charges based on events that happened at his DCF Star2226 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 accepted2236 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, Jonas was accepted at a residential school. And on December 12th 2020 the next day Jonas was killed by gun violence. I'm so sorry,2258 I'm really sorry.
After he was shot and killed Jonas' Community held a vigil for him in the middle of a snowstorm and the Daily Hampshire guys that printed a picture of his mother. The caption reads Francesca addresses the crowd at a peace march, memorializing her son and making a plea for greater access to mental health services for young people in the Holyoke community. Francesca is quoted as saying, I worked with a lot of people to try to save my son and my son was taken from me.
Boston University School of 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 saves2317 lives. And I testify today to urge his 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 this is a wonderful idea and I want to share very briefly a case I'm actually working2383 on now that it's opened my eyes to what's happening across the state. Chairwoman Decker had to help me when I had a constituent whose son spent eight days at the emergency room with no treatment waiting for a bed. On the ninth day he was supposed to be transported. They forgot to bring him which pushed 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 I'm just 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 in the meeting is disputing their recommendations. Will this bill help This 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 - So 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. And 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 agents which state agency is responsible and then would be able to authorize funds 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. Um So that's something that I think is 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.
So
I'm going to assume that we're back in action and if I don't hear otherwise from L. I. 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, Miss Perry earlier and we will now transition to attorney walter Gangel. Thank you. Uh, can you all hear me very well? Yes, Okay,
WALTER GANGL - KNIGHTS OF COLUMBUS - SB 1309 - Thank you folks. Um yeah, this said pre, Going back in time before2547 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. And that led to the 2012 adoption of the Overdose Good Samaritan Law in Massachusetts. And I think Massachusetts is about the 12th state to do that. Virtually all states have now2572 adopted similar laws. But in Massachusetts, there were no plans for promotion of that information. So police and local communities did the best to get the information out.2583 But it hasn't really been that effective and overdose abandonment where people run away and leave a person to die still still happens.
And this is especially information about this law is especially important now because uh, the experts are seeing 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, it's a synergistic effect and it's really more important now. So we our community our Knights of Columbus and Duxbury Facts2629 we've 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 and, and uh, it, uh, you know, but it really wasn't getting to the rest of the state. So it's a bigger megaphone is needed. And we identified two major subsets of the youth that need to have this information. First is the high school cohort and then the post high school core cohort. The high school cohort is relatively easy to get if you simply put in the education that schools are already required to give a requirement that they also educate the youth about the Overdose Good Samaritan Law. If you do that, you've got that cohort covered. And as the years go by, the that information will get out.
Um, We've been thinking about and we had plans. We actually were talking to CVS back before COVID happened about getting information to the pharmacies, to the2701 rest of the state and and 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, the, uh, legislature and the governor put in place this very simple law that says the education has got to include information about the Overdose Good Samaritan Law because it's2725 so important. So, so closely tied with the Narcan and the effect that the Narcan is having.
2731 And2731 in my written submissions, I, uh, spelled out how, how impactful the overdose problem has been on the country and in the state. In fact, I think it's 18,000 people have died of2747 overdose. It's been over the years it's accumulated and going up and up. And last year it saw a 5% increase in Massachusetts of overdose gas. It was 27% increase across2758 the country. So it's a serious problem. And as COVID goes away, overdose deaths still continue. And, uh, there's frankly, as of April, when tallying up the2771 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 I apologize, but we are out of time. And please, we encourage you to submit further comments for your written testimony from committee members.
Okay? Uh, 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?
Complete
Michael Bradley.
Okay, How about Tim Cruz Plymouth County District Attorney. Hi, can you hear2863 me? Uh, I apologize. He is pulled away in a meeting. Um, 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. 1 to 71 an act to protect minors from abusive contracts. First up to testify, john baker Simon
me. All right. So, I'm just testifying saying that abusive contracts have happened on the survivor of the contracts.
You me?
Yeah, we can hear john.
JOHN SIMON - CONCERNED CITIZEN - SB 1271 - All right, good. So with the contracts I would say that people can send out by school districts to easily. Like the minors they're sent out of program is way too easily these days. There needs to be more programs set in the public school system and there needs to be compensation for those who have been hurt by the contract. Um What else I have to say? Um There's also some programs where they break and hurt clients in restrains as part of trying to teach them lessons. This is what happened to me at some places. And 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 on there? And and I lived in those programs and some of the programs there's some clients that's said that they would rather die than actually live through that stuff there. It's pretty bad. I am done. SHOW NON-ESSENTIAL DIALOGUE
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.
MALLARY - SB 1271 - Hi uh you see me. Get me. Okay, so um the specific contracts 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. Um I realized that may seem strange to you, uh that these things exist and that I want to prevent them from doing that. Um 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 numerous3084 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 coercing me to sign was nothing more than a mind game. Guess what? The mind game 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 20s learning to forgive my parents for crimes against me, which it turned out they didn't even know about. Uh, 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.
Restrain consents give a veneer of legitimacy to vicious abuse and that is why they exist. They silence 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's not be naïve 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 are3157 labeled as having behavioral health problems. Disagreeing with the pompous nanny is not a behavioral health problem, but being brutalized by that same nanny legitimately will certainly create long term mental health problems. Myself3166 I 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 in writing. However, there's 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 coerced pre made statement which the student has signed and claim that is the student's comment on the restraint.
Furthermore, it is naive to believe that a student can write honestly about a restraint when any complaint of abuse may be construed as resistance 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't3234 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 require3243 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 incidentally3253 was modeled after the uh the banning in conversion therapy last year destroying identity, same sort of issue. So that's why you should support S 1271 and ban residential facilities from forcing minors to consent to abuse .Mind games like this belong in Chinese re education camps, not in America and that's it. SHOW NON-ESSENTIAL DIALOGUE
Thank you. Dr Mallory. Do3273 we have any questions from committee members? Mr Chair? 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 Chair Maduro's an awesome ally. Um that's not necessary.3299 So so well problem with if people wanted to and I just you know, I just this is an identity issue to me that that really kind of destroyed me and I do feel like in it3315 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 it's either a glitch with the I. T. P. S. Or something like that. So I'm glad you raised it will fix3329 it or fix that and thank you for your testimony.
REP MADARO - Thank you Dr. Mallary. 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 had received a Report from a girl in 2015 that said that she was forced, she said that she had sign 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. I don't think these things are out. SHOW NON-ESSENTIAL DIALOGUE
I was at one
MALLARY - Yeah that's um it's this uh it's a problematic facility and EEC Has um they they've really neglected to investigate it properly. They allow them to uh investigate themselves3373 when restraints, when complaints are received and exonerate themselves. Which really isn't the way that uh an 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 for 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 12 86 age 21 08 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 apologize. My video is is not working today, so I hope you can hear me all right through audio. I'm speaking today regarding H 2108 an act relative to a PACT pilot3446 program for children. Uh and I'm3448 proud to introduce this along side my Senate co presenter Senator Friedman. Uh and that's uh Senate number 1286. And 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 many 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 and frankly it's one that I wouldn't wish on anyone.
Uh and it's an unfortunate and tragic reality that my experience, this is one that is shared with tens of thousands of caregivers across the commonwealth. And uh they too have been forced to to watch loved ones suffer in agony ERs without treatment and wait until a bed opens up. And 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's. And on day 35 his daughter was finally placed in a psychiatric facility only after the condition continued to worsen. And uh, just a truly excruciating experience to go through on both sides as both a caregiver and now as a legislator. Uh, and I realize 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 short and potentially a long term3558 remedy to the boarding crisis for young adults under the age of 22 in particular. And 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.
3580 And3580 this act would provide intensive, comprehensive and non residential treatment3583 individualized for the person served while reducing the number of individuals who were boarding in3589 ERs both in regions and across the commonwealth. And I know we have some, uh, some expert folks who will speak to the mechanics and the logistics of3601 how this bill could directly impact, uh, 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't3626 see the next Panelist on, I know we're running a little bit ahead of schedule, but I 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.
MICHAEL BRADY - MCOPA - SB 1309 - Hi, Good afternoon. Thank you, sir. Sorry, I'm uh, couldn't here earlier duty calls unfortunately. Um, 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 curriculum3671 it will have a3672 positive effect in reducing overdose deaths. Um, 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 death3686 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 scene3696 so we can provide appropriate intervention and hopefully save lives. So that's that's really all I'm sure that echoes some of my colleagues that have spoke earlier. SHOW NON-ESSENTIAL DIALOGUE
Mm Thank you. Chief. Do we have any questions from committee members?
Okay, thank you so much. We will now circle back to s 12 86 H 2108 and act3717 relative to a packed pilot program for Children. The first panel to speak is consists of Karen jeffers and lydia condoms. Wait,
LYDIA CONLEY - ABH - HB 2108 - SB 781 - Great, thank you. Uh I believe Karen will be joining us shortly. So uh excuse me. Chair Cyr Chair Madaro, 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 you3754 know, and Senator Friedman would create a pilot program for a treatment model that3758 delivers intensive individualized non residential treatment for children and adolescents with mental health disorders. We are additionally quite strongly supportive of similar language that was included as a grant program in the FY 22 Senate budget. That's line at M 40053.
It's funded through the behavioral health outreach access and support trust fund. And we really hope to see this important program retained in the final FY 22 conference budget. As you may know, the Association for Behavioral Healthcare is a statewide association representing 80 community based mental health and addiction treatment provider organizations. Our members are the primary providers of publicly funded behavioral healthcare 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 constraints3806 and mounting needs for pediatric behavioral health services as you heard today in 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 wellbeing and recovery of young people with mental health disorders it's traumatic and it's unacceptable. There's3845 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 is one part of the solution.
ACT is an evidence based way of delivering a full range of services to people who have been diagnosed with a mental illness. Individuals who3863 participate in ACT are hospitalized less often and are shown to maintain more stable housing. In Massachusetts, the service is known as PACT Program of Assertive Community Treatment and it's only available to adults with severe and persistent mental health disorders. Our3879 members that deliver PACT report that it's a uniquely successful model because it focuses on 24/7 individualized and wrap around care. Services are delivered using a multidisciplinary team. They're often in the individual's home and they include an assessment3892 an 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. And we attribute this to the team based structure. The fact that the service isn't fee for service uh and the rates and the3928 model that3929 support an intensive service delivery That's evidence based. Other states, such as Missouri, have developed and steadily expanded ACT services to include youth uh for a variety of conditions. So, first episode psychosis, dual mental health and substance use disorders, and3944 autism spectrum disorders.
Just more evidence of the models, broad efficacy and potential. Missouri's ACT for Youth Program, participants successfully find jobs or continue with school and move out of the system of care. Expanding the PACT's team based high intensity integrated model to youth and3962 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. This3975 service would also rapidly increase access to timely and appropriate mental health services for a population that often faces long3983 waits, ED boarding and difficulties, navigating a complex system. And so on behalf of ABH and our remember organizations, we sincerely request that H 2108 and Senate 781 be favorable 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 jeopardy here?
I don't see her yet. Okay, uh we can always circle back up. 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, you can call on me anytime much appreciated. Uh Mr Darboe, are you here on behalf of the Public County Sheriff Department? SHOW NON-ESSENTIAL DIALOGUE
Mhm. This is actually Sheriff Mcdonald and I am using uh community um laptop here which we use for such things and Mr. Dubose our I. T. Guy. So Hello Sheriff. Uh would welcome your testimony on us 1309 if you'd like. Oh that would be wonderful. Thank you.
JOSEPH MCDONALD - PLYMOUTH COUNTY SHERIFF'S OFFICE - SB 1309 - I appreciate you taking the story as I was gathering4108 my thoughts as to what it is I4110 wanted to say uh to the group about this bill. Um What came to me was the story of some very dear friends of mine who lost, a good friend of mine lost his daughter to an abandoned overdose. She unfortunately got into some substance use issues. Uh and she found herself in an overdose situation which in all likelihood could have4137 been reversed and she would have survived. This is probably uh five or six years ago now that this took place. And she was abandoned and uh and she passed away from that overdose leaving seven children. And You know she was 41 years old at the time of her overdose.
She wasn't a high school aged kid by any means but I do think uh that the more efforts that we are4164 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 some4187 people very close to me. I'm happy to report that the children have have done pretty well. And 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 uh in uh, in that role in happier times. So I think everyone understands that, you know, this bill does not cost us anything uh, and simply adds another tool to the toolbox for us to combat uh, the deaths that are taking place4221 from, from this opioid uh, epidemic that we're living through. So that really is all that I had to say. I'm a big, very strong supporter of this. All the sheriffs are foursquare behind this as well. And uh, you know, 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. Um, and I also should have asked committee members had any questions for MS. Conley on on the last bill.
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. Uh Belich Friedman
is Miss Friedman here.
Well that that is all of the scheduled testimony for today. If anyone signed up to testify who I did not call on, please raise your hand. Now uh if I do not see anyone, we will be adjourning the hearing.
Mr chair. 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 I thank thank you to you really I think in modeling, particularly the4332 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's4341 really important that we're taking those brakes. So, so real kudos to you, um, for uh, for suggesting that. Uh, and um, we had talked earlier and I was supposed to jump in uh, when you have to change the type or, 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 leaving leaving 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 my fellow committee members. Thank you for your involvement and attention today to all those who testified. Thank you4383 so much for taking4384 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 before4406 coming out of this pandemic. So we greatly appreciate all your attention, a judgment. You want them help the course of the session.
So without further ado I think we'll adjourn.
Thank you Mr Jasper. Take care of us. Uh Here. Uh One moment we we do have a last minute testifier on right now.
4429 Oh4429 I4429 see. We've been joined by Liz Friedman. Hello Miss Friedman, would you like to testify on an act establishing a pilot 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.
LIZ FRIEDMAN - MOTHERWOMAN - HB 2080 - SB 1313 - Well, thank you, Chairman Madaro and Cyr for the opportunity to speak in support of S 1313 H 2080. Um Covid 19 has exposed the fragility of our mental health support systems and it 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 important 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 found out she had started vomiting. My daughter, who has never suffered with depression or anxiety. An easy going kid is suffering with both anorexia and bulimia. I have been in a tailspin trying to find the help she4512 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 before4534 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.4555 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 consider4569 additional measures to mitigate the health effects of the pandemic on the needs of family with children. End quote. I have served on the Massachusetts PPG Commission and the Massachusetts Commission on the Status of Women as the chair of the legislative committee.
When my daughter told me she had stopped eating, everything changed. When my daughter told me, by the end of that week, I had left my public roles and now4595 I provide full time care for my child. There isn't a program she can get into4601 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 mental health catastrophe to get our children4614 back to their healthy and happy selves, we must support parents. Parents need to be on the most stable ground we can4620 be especially when our children are in crisis.
This bill would create a pilot program already and tested 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. Um 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. And I thank you for your time.
MADARO - Thank you so much Mr. Friedman, glad you were able to join and and we were able to hear your testimony. I did have a question is this program intended for parents of only school age Children?4666 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?4673 Or is this uh pilot directed towards parents of younger students?
FRIEDMAN - Um This program, as the bill is written, is directed towards school age children. Um but I think that's an excellent, an excellent question. In 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 we'll be continuing to implement into the fall. So I believe that, you know, while we're thinking about a pilot program for school aged children, we don't have 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 um issues. And we were able to bring that program across the state as well, um to about 11, 15 different communities where we could see really great impact. One of the4742 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 healthcare right into um 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. And 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, so I think it's a place to begin.
MADARO - Thank you. Thank you. Thank you. And what criteria, if any will DMH be required to use to evaluate community organizations that apply to this RFP process?
FRIEDMAN - Um 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 make4801 similar sense to work with funded programs that DMH already has an established relationship with. That will of course allow us to expedite implementation. You know, we can I mean, really like next week I could run a training and we could have 200 people trained in order to provide structure for them 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 healthcare exponentially, practically overnight. Um, so yeah. SHOW NON-ESSENTIAL DIALOGUE
thank you, Mr Freeman. Do we have any other questions from committee members?
Okay, Hearing 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 it's seeing nothing. I think we will adjourn the meeting at the hearing for real this time.
Thank you all so much for your time. Take care. We'll we'll see each other soon. Thank you. Bye now.
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