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Friday, April 19 Legislative and Public Health Updates

Table of Contents


  • Legislative Updates

  • Public Health Updates

  • A Glimpse at the Past Week

  • Services and Resources


 

Legislative Updates


As I noted last week, the House’s budget process is now underway. The House Committee on Ways & Means released their Fiscal Year 2025 (FY25) budget last Wednesday, and Representatives had until Friday evening to file amendments. In total, 1,495 amendments were filed by Representatives. Here is a glimpse of some of the amendments I filed, both in my capacity as the Representative from Cambridge and in my capacity as the House Chair of the Public Health Committee for the state.


  • Cambridge Community Center (#782): Earmarks $250K for the Cambridge Community Center (CCC) for continued capital improvements and to continue funding their behavioral health resources. 

    • I have been fortunate to earmark funds for the CCC over the last number of years. This money allows the CCC to continue moving forward with important capital improvements and supports their work that provides enrichment services, after-school care, a food and supply pantry, and other programs for traditionally underserved communities and neighborhoods. The Community Center has been recognized as a Resilience Hub, a national designation for community-serving facilities augmented to support residents, coordinate communication, distribute resources, and reduce carbon pollution while enhancing quality of life. 

  • Cradles to Crayons (#783): Allocates $400,000 to the Cradles to Crayons’ Clothing insecurity relief and essentials distribution service. Several years ago, I suggested that Cradles to Crayons seek an earmark in the state budget. Although I knew it would take a couple of years to lay the groundwork, I am proud that I have been able to help them secure a $600,000 earmark for ARPA funding and, for the first time, secure a $200,000 earmark in the FY24 budget. 

    • Cradles to Crayons is the only Massachusetts organization that mitigates clothing insecurity and diaper needs on a large scale. In FY23, they distributed over 337,000 packages throughout the Commonwealth — including hygiene kits, diapers, winter jackets, and more — and were contracted by the state to support newly arrived families in the emergency shelter system.

  • School Markets Program (#784): Earmarks $110,000 for Food for Free's School Markets Program. 

    • Soon after I was elected as a State Representative, I worked to secure an earmark for Food For Free’s Weekend Backpack Program. At the time, the program did not serve every school community in Cambridge. I made a commitment to secure additional funds, ensuring every family, regardless of the school they were enrolled in, could access the program. Currently, 1,000 families benefit from what is now called the Weekend Eats Program in Cambridge and Somerville.

    • Over the last 8 years, I have been able to secure additional funds for this program, which has expanded and serves communities well beyond Cambridge, distributing over 8.4 million pounds of food yearly. 

  • YWCA Funding (#785): Earmarks $1,500,000 to YWCA organizations to be distributed equally between the Alliance of YWCAs member organizations. 

    • Prior to FY19, the YWCAs were not receiving state funding in line with the YMCAs and Boys & Girls Clubs. This exclusion was not intentional, but through my work with House Leadership, we are now intentionally earmarking funds that support the important work done by the YWs. YWs support young women and are one of the few programs also supporting queer, non-binary, and transgender youth. YWs also maintain a strong commitment to fighting racism through anti-racism programming.

  • School-Based Behavioral Health Technical Assistance Center (#786): Earmarks $2 million for TA Center’s operations and funds the launch of two regional hubs.

    • Five years ago, I worked to author landmark legislation after spending almost a year meeting with dozens of organizations and individuals to better understand the obstacles and needs for adolescent behavioral health. While working to pass this legislation, which we did last session, I was able to secure an earmark to fund UMASS Boston’s BIRCh Center to support the operations of the school-based behavioral health technical assistance center in the state budget. Now that we have passed the legislation, I continue to work to expand funding to allow for the launch of two regional hubs that will work to connect schools with resources at the TA Center. 

  • Cambridge District Court (#787): Requires the Court Administrator of the Executive Office of the Trial Court to relocate the Cambridge District Court, also known as Third District Court of Eastern Middlesex, from the city of Medford to the city of Cambridge by December 31, 2024.

    • The Cambridge District Court has been illegally located outside of Cambridge in Medford for more than ten years. It is the only court in the Commonwealth that is located outside of its jurisdiction, as outlined in state statute. This is an issue of access to justice. The difficulty of accessing the court — which, if you’ve ever tried to go, you know that it is not easily accessible by public transportation — can be seen by the drop in the number of restraining orders being filed.

    • I have filed this amendment for years, in addition to the bill I continue to file, to ensure the judicial system is held accountable for the urgency of what is at risk: equitable access to justice. I continue to have conversations about the need for the relocation with advocates from Transition House and the Boston Area Rape Crisis Center. I recently met with the Court Administrator and the Chief Justice of the Trial Court to try and work with them to expedite the relocation while ensuring they continue to innovate and hold satellite courts. 

  • Lift Kids Out of Deep Poverty (#788): Lifts EAEDC (Emergency Aid for the Elders, Disabled and Children) grants by 10% over FY23 levels (TAFDC 10% increase achieved in HWM). Also moves effective dates for both EAEDC & TAFDC increases to October 2024.

    • I am proud to have worked with Senator DiDomenico and House and Senate leadership to achieve TAFDC and EAEDC grant increases in the last three budgets. Despite these gains, TAFDC and EAEDC grant levels have lost more than 40% of their value since 1988. 

    • After the Governor’s 9C cuts — eliminating the 10% increase secured in the FY24 budget — the maximum TAFDC benefit for a family of three with no income is only $783 monthly, well below half the federal poverty level. The EAEDC grant for one person is only $401 a month. 

    • This amendment seeks to regain the FY24 increases — a 10% increase in TAFDC grants was included in the House Ways & Means budget, which is why I am only calling for an EAEDC increase in the amendment — and notably moves the effective date six months earlier (from April 2025 to October 2024) to avoid similar 9C threats in the future.

  • Improvements to Emergency Assistance for Children and Families (#789): Expands tracking and reporting language in the EA line item to include data on families placed on the waiting list; creates an ombudsperson unit within the Executive Office of Housing and Livable Communities (EOHLC) with language similar to that which was enacted within the FY22 budget; and officially removes the EA asset limit. 

    • I am proud that the House has taken the lead on setting the course for the state to navigate and respond to the housing crisis facing the Commonwealth. These proposed language changes would support ongoing efforts by improving tracking and creating an ombudsperson unit to help advocate for people in the shelter system and provide them with all available resources.

  • Improvements to the RAFT Homelessness Prevention Program (#790): Earmarks $10 million within the RAFT account to provide grants above the general $7,000/household/year cap to families and individuals when the administering agency determines that a higher grant is essential to resolve a housing crisis; prohibits the Executive Office of Housing and Livable Communities (EOHLC) from imposing a notice to quit requirements on households seeking assistance with back rent and move RAFT benefits upstream; requires direct-to-tenant payments in cases where the landlord is not cooperative with the RAFT application and documentation process; and directs EOHLC to provide forward rent payments for eligible households as long as the award would not exceed the 12-month benefit cap.

    • Much of the language changes proposed in this amendment align with my bill, An Act providing upstream homelessness prevention assistance to families, youth, and adults (H.1312). It is important to move RAFT benefits upstream; programs like RAFT are essential in keeping people housed, which is especially salient in the current housing crisis.

  • Extending EITC to ITIN Filers (#791): Outside section that expands EITC benefits to folks who file taxes with individualized tax identification numbers (ITINs). This language is based on An Act to increase family stabilization through the earned income tax credit (H.2762). 

    • The only thing between ITIN filers and their ability to access EITC is where they are in their journey of becoming citizens. This amendment would allow them to benefit and would expand EITC support to more working families in the state.

  • Maternal Mortality and Morbidity Review Committee (#1218): Outside section that ensures the Maternal Mortality and Morbidity Review Committee (MMMRC) receives all essential records needed for timely review and comprehensive recommendations by statutorily requiring entities, including licensed medical professionals and other state agencies, to provide the Committee with critical data needed to conduct a thorough case review. This amendment also adds a MassHealth representative to the list of MMMRC members to support the work of the Committee and address emerging threats. 

    • Since 1998, rates of pregnancy-associated mortality in Massachusetts have steadily risen. Data from the Department of Health indicate that Black non-Hispanic birthing people are 1.9x as likely to die during pregnancy or within one year postpartum compared to white non-Hispanic birthing people. Black birthing people also have a 70% greater risk of severe maternal morbidity, labor, and delivery complications. 

  • Adult Emergency Room Diversion Initiative (#1219): Earmarks $1 million for the Department of Mental Health's Adult Emergency Department (ED) Diversion Initiative 

    • These programs provide a therapeutic, community-based alternative to hospitalization for adults experiencing behavioral health crises who are in or at risk of entering an ED. They are able to have their needs met with these diversion programs rather than enter into an ED, where they may wait a long time to be seen and remain in crisis until then. 

  • Special Commission Relative to Children and Adolescents with Intensive Behavioral Health Needs (#1222): Outside section that establishes a special commission to study alternative models that serve the needs of children and adolescents who need to be adequately addressed through the current system capacity. 

    • As the behavioral crisis and pediatric capacity-related challenges continue to rise, providers report increased challenges in placing children who are state agency-involved, ready to be discharged, and require services outside of medical, behavioral, or ED settings. A 2022 survey found that there were a total of 69 state-agency-involved pediatric patients stuck across EDs, surgical, and psychiatric units. Of those children, 83% were DCF-involved. This amendment is crucial in helping state agencies find alternate locations for children who do not require inpatient-level care. 

  • New England Medical Association (#1223): Earmarks $100,000 to support training, recruiting, and retention of physicians of color across the Commonwealth.

    • Racial inequities in healthcare have persisted for decades and have been well-documented over the past 20 years. Health disparities persist despite the efforts Massachusetts has made to address the issues. We know having a diverse workforce that reflects the communities being served is critical to achieving better healthcare outcomes. 

  • Behavioral Health ED Crisis Evaluations (#1225): Outside section to expand access to mental health services by aligning coverage requirements of behavioral health crisis services with how these services are delivered under the reforms made by the Roadmap for Behavioral Health Reform. This amendment would also ensure commercial coverage of these services and extend required coverage of adult community crisis stabilization to also include coverage of youth community crisis stabilization services.

    • Commercial insurers refuse to cover the required behavioral health emergency department (ED) crisis evaluations that they cover in community-based settings. The Roadmap had not been implemented at the time Chapter 177 was passed, and ED-based behavioral health crisis evaluations were largely provided by Emergency Services Programs. This language ensures those services are still covered when provided by hospitals.

  • Coverage for Substance Use Disorder Services Rendered by Peer Support Specialists (#1227): Outside section that would require the Bureau of Substance Addiction Services (BSAS) within the Department of Public Health (DPH) to prepare a comprehensive plan that addresses barriers to certification and credentialing of recovery coaches. It would also establish a comprehensive peer support program that provides mentorship, technical assistance, and support resources for the well-being of peer support specialists. Based on An Act relative to reimbursement for recovery for peer specialists (H.991). 

    • Peer recovery specialists provide a unique and valuable role and perspective for those in recovery. Based on a shared lived experience, they are able to offer support and advice and reduce the likelihood of relapse. 

  • Community Health Workers (#1241): Outside section that would require insurers to reimburse for the covered services provided by community health workers, allowing hospitals to pay them more equitably. This would assist in efforts to diversify care teams to be more reflective of the populations they serve and professionalize a role with an ever-increasing importance in safety-net communities. Based on An Act relative to health equity and community health workers (H.1184). 

    • Despite the critical services they provide, community health worker positions are often funded by one-time grants rather than insurers. Community health workers are certified and licensed healthcare professionals who deliver care to patients outside of hospitals. They are often trusted members of their communities and provide essential culturally and linguistically competent health education.

  • State Agency Acceleration for Child and Adolescent Psych (#1242): Outside section that would require DCF to escalate cases of children involved with state agencies in need of behavioral health care, including convening an emergency team to coordinate care for the child and determine an appropriate setting. Additionally, it requires that congregate care programs be reimbursed to hold a bed while a child from said program receives treatment in another setting. 

    • I filed this amendment to address the behavioral health crisis and pediatric capacity challenges seen across healthcare facilities in the Commonwealth. Providers report increased challenges in accessing care for pediatric patients who are state agency involved, ready to be discharged, and require services outside of medical or inpatient level of care or the ED. These patients are often referred to as “stuck” pediatric patients because of the challenges associated with transferring them to appropriate dispositions for care.

  • Synthetic Nicotine Tax Loophole (#1259): Outside section to add nicotine pouches into the definition of "smokeless tobacco product" to subject it to a tobacco tax (currently not subject to a tobacco tax at all).

    • Nicotine pouches are the latest products used by the tobacco industry to continue their sale of addictive and life-threatening tobacco products. They currently are not subject to any tobacco tax, keeping their prices low and accessible to youth. Nicotine pouch sales are up 700% comparing the last five months of 2019 to the first three months of 2022, according to research by the American Cancer Society.

    • I am proud that my bill, An Act protecting youth from nicotine addiction, which called for an excise tax of 75% of wholesale on e-cigarettes, was adopted into Chapter 133 in the Acts of 2019 — the omnibus package passed to modernize tobacco control knowing that e-cigarette and vape use by youth were on the rise. I hope that this amendment will be adopted to continue the Legislature’s leadership in addressing youth tobacco usage.

  • Charles River Task Force on Equitable Access to the Charles River (#1261): This amendment calls on the Department of Conservation and Recreation (DCR) to form a task force to examine equity along the Charles River. The task force must center environmental justice principles and populations and will be composed of government officials, nonprofits, and residents.

    • This amendment is designed to ensure greater diversity and representation — specifically of residents of color and folks who live in subsidized housing and are low-income — in all conversations regarding the incredible resource of the Charles River. This amendment provides additional resources at the request of DCR, which has acknowledged it does not have a track record of leading conversations through an environmental justice lens. This does not preclude any current planning from moving forward; it does ensure that DCR will have a process that informs how to ensure it captures the diverse voices that are typically excluded. The exclusion is not intentional, but the absence of diverse voices of people who are experiencing poverty, low-wage workers, and people of color is not always intentional or organized in spaces that DCR typically relies on for community engagement. This commission will provide DCR and the larger Charles River community recommendations on how to ensure these voices are, in the future, intentionally included. 

  • Charles River Bicycling and Pedestrian Improvements (#1262): Language-only earmark to insert language into the DCR operating budget calling on them to use some of their budget to plan for and repair the Paul Dudley White path in Cambridge that is cracked and eroding — posing safety and usability concerns — in FY25. 

  • Strengthening Community Connections (#1263): Outside section to ease restrictions on visitation policies for incarcerated people and their families and require training for correctional staff to ensure visitors are treated with respect. Based on An Act to strengthen family and community connection with incarcerated people (H.2314).

    • I filed this amendment because visitation is critical to the well-being of both incarcerated people and their families and communities. It can help alleviate the isolation inherent to incarceration that leads to trauma, emotional and psychological harm, and disciplinary issues. Restrictions most negatively impact children and parents, particularly Black children, who are nine times more likely than their white peers to have an incarcerated parent. 

  • Cambridge Health Alliance Safety Net Hospitals (#1372): This amendment will encourage the Governor to include CHA in a program that allows the Federal Government to provide additional desperately needed federal dollars to ensure that the CHA, a safety net hospital, can continue providing services to at-risk populations in Cambridge and throughout the CHA system. This includes patients and programs in Revere, Malden, Everett, and Somerville. 


I have also co-filed two amendments alongside my colleagues:


  • Alternative Voucher Housing Program (AHVP) (#667): Filed alongside Representative Rob Consalvo, this amendment would increase the AHVP line item by $500,000 to $16,855,696. AHVP is a program run by the Executive Office of Housing and Livable Communities designed to help people with disabilities live independently in housing they choose through mobile (tenant-based) rental vouchers. This amendment is based on a bill we filed together, An Act to create affordable homes for persons with disabilities (H.1305).

  • Updating Vital Records and State Forms (#1380): Filed alongside Representative Mindy Domb, this amendment would add a gender-inclusive marker to birth certificates, driver's licenses, other forms of identification, and all state documents. Additionally, if someone changes the sex designated on their birth certificate (X, F, M), they can also change the name on the birth certificate through this bill. State agencies with youth in care would also be required to share information and develop processes for youth who wish to change their gender designation. This amendment is based on An Act relative to gender identity on Massachusetts identification (H.3017).


Debate on all the amendments before the House kicks off next Wednesday, April 24th. The House will vote on a finalized budget by the end of the week, and then the Senate will kick off their budget process in May.


Please don’t hesitate to reach out to me or my staff if there are any amendments I filed that you’d like more information about, if there are any amendments you’d like me to consider co-sponsoring, or if you have any questions about the budget process in general.


 

Public Health Updates


Massachusetts Public Health Council Clears MGH to Add 94 Beds 

On Wednesday, the Massachusetts Public Health Council unanimously approved a request from Mass General Hospital (MGH) to add 94 new licensed inpatient beds to its downtown construction project. The proposal is part of an effort to alleviate the capacity crisis that has resulted in long wait times, delayed care, and strained operations currently faced by emergency departments. Earlier this year, MGH announced it has been facing an ongoing capacity disaster and needs more beds to help combat a sharp uptick in demand. Between October 2022 and September 2023, there was a 32% increase in total hours spent in the MGH emergency department from the previous 12-month period. Additionally, the occupancy of the main campus’s inpatient beds increased from 85% in fiscal year 2019 to nearly 96% occupied by fiscal year 2023. The approved proposal will increase the total number of licensed beds in the hospital’s main campus medical and surgical rooms from 900 to 994. The new beds will become gradually available as Mass General Brigham’s new clinical building, the Phillip and Susan Ragon Building, begins its phased opening in 2027. 


Drug Shortages Reach Record High

Drug shortages have surged to a new high this year. According to the American Society of Health-System Pharmacists (ASHP) and the University of Utah Drug Information Service, 323 drugs are running low, exceeding the previous record of 320 drug shortages set in 2014. Shortages affect both basic and life-saving medications, including oxytocin, chemotherapy drugs, and medications to treat attention deficit hyperactivity disorder (ADHD). The popular diabetes and weight loss drug Semaglutide, also known as Wegovy and Ozempic, is among those facing shortages according to the Food and Drug Administration. The Federal Trade Commission and the Department of Health and Human Services (HHS) are investigating potential causes of shortages, including whether drug wholesalers and purchasing companies are contributing to the problem. Earlier this month, HHS released a white paper highlighting steps it has taken to address drug shortages, including making efforts to strengthen supply chain resilience for medical products and pharmaceuticals and promote market transparency. 


CDC Study Finds No Association Between COVID Vaccine and Sudden Cardiac Death

A recent study by the Centers for Disease Control and Prevention (CDC) found no link between the COVID-19 vaccine and sudden cardiac death in previously healthy young individuals. The study, conducted by the Oregon Health Authority, examined death certificate data of individuals aged 16-30 who received either the Pfizer or Moderna vaccine from June 2021 to December 2022. Although there were 40 deaths among vaccinated individuals, the CDC clarified that cases of myocarditis and pericarditis after vaccination are rare, primarily occurring in young males within a week of the second dose. The CDC continues to emphasize that the benefits of the COVID-19 vaccine outweigh any known risks. Despite misinformation on social media suggesting a link between the vaccine and death, over 81% of all adults in the US have received at least one dose of the COVID-19 vaccine.


 

A Glimpse at the Past Week




It was a great day at the annual Patriots Day observance listening to Charlie Sullivan, who helped us imagine Cambridge as a center of revolutionary activity and sentiment. On the way to Lexington and Concord on April 16, 1775, the British marched through Cambridge, overwhelming the small population of less than 1,500 people. As Charlie reminds us, Cambridge was scorched to the earth, burning every tree in sight. As the British retreated after the colonists’ victory, they were met by militias from surrounding towns, including Cambridge. 


A highlight of the event is the welcoming of General William Dawes, who, alongside other night riders, warned colonists of the British incursion. Though often overshadowed by Paul Revere, General Dawes’s actions ensured militias in Cambridge and beyond were prepared for battle the following morning. The ride is commemorated yearly on Patriots Day. 


While the ceremony fails to make any mention of the historical context of Indigenous people who were dispossessed of their land and often their lives, it is not lost on some of the young people I had conversations with regarding the annual reenactment. Here is a link to some limited additional historical context.


I appreciate Charlie, the Cambridge Historical Commission, and the Cambridge Department of Veterans Services for ensuring this is a fun and informative event each year. If you missed the event, you can watch it here.


 

City Offering Free At-Home COVID Tests in Partnership with the Cambridge Health Alliance

The tests can be picked up Monday through Friday from 8:30 AM to 5:30 PM in the CHA lobby at 119 Windsor Street. Cambridge businesses or organizations that would like free rapid tests to provide to customers can call the COVID-19 hotline at 617-933-0797 to request them. The at-home COVID test expiration date can be checked here.


Cambridge Public Health Helpline Supports Residents with COVID-19

To speak with someone, call the confidential COVID-19 Hotline at 617-933-0797. Learn more here.


Intimate Partner Abuse Prevention Helpline

This initiative is designed to prevent intimate partner violence by fostering accountability and change in people who harm or may harm their partner. You can find more information at 10to10helpline.org or by calling 877-898-3411.


Overdose Prevention Helpline

The Massachusetts Overdose Prevention Helpline is a virtual spotting/overdose detection service for people who use drugs. Learn more at massoverdosehelpline.org or access it by calling 800-972-0590. 


De Novo Center for Justice and Healing

De Novo is a Cambridge-based nonprofit that provides free civil legal assistance and affordable psychological counseling to people with low incomes. You can learn more about their services at denovo.org.

As always, please contact me with questions or concerns at Marjorie.Decker@mahouse.gov.

 

Sincerely,  

Marjorie


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