Hearst Connecticut Media. September 15, 2023.
Editorial: Editorial: CT’s ‘kids cabinet’ has potential to help address mental health crisis
Connecticut’s lawmakers are in a race with children, and they have a lot of catching up to do.
Children have that stubborn way of continuing to grow every day. Nothing can stop that. And with growth come obstacles they and their families need to address.
Two years after the pandemic arrived in March 2020, lawmakers were well aware that a mental health crisis was growing among Connecticut’s children as well. In a 2021 survey, more than one-third of the state’s children expressed feelings of sadness or hopelessness. One in seven teens acknowledged seriously considering suicide.
Children didn’t need to be infected with COVID to feel the invisible scars it left as a result of the likes of social distancing and a rise in online bullying.
The General Assembly passed, in bipartisan fashion, legislation to address the crisis. In more simple speak, our state leaders made a promise to children.
The children, and the problem, continued to grow. Emergency departments felt the pressure, as did services that were already stretched. Struggling families faced further setbacks, sometimes facing bankruptcy as a result of extreme costs associated with treatments and services.
Lawmakers face a lot of obstacles in trying to fulfill their promise. Federal COVID funding won’t last forever. But we’re starting to see movement in the right direction. Mobile mental health crisis teams are now available around the clock. And four urgent crisis centers were recently opened. Not only can the centers help families navigate a labyrinth of possible services, but they free up space at hospitals’ emergency departments. These issues are not in the wheelhouse of emergency rooms.
These children are wounded. A bleeding child reliably gets immediate attention. These children are bleeding emotionally, and in need of just as much urgent help.
To Gov. Ned Lamont’s credit, he launched the latest initiative by admitting “we will have a lot of catching up to do.” He was announcing the establishment of a “kids cabinet” that could advise him on children’s issues.
It’s a wise step. Collaboration has never been one of Connecticut’s strengths, but this concept calls for 10 agencies to work together. Department of Children and Families Commissioner Vannessa Dorantes will lead the cabinet. It’s another smart step. The last thing we need in a crisis in a power struggle, and DCF belongs at the top of this food chain.
We encourage the agencies to seize opportunities to collaborate. Many already do, of a fashion. These agencies are largely made up of experts who have tough jobs, and share a mutual interest. Comparing notes on their experiences and ideas can only be for the betterment of Connecticut’s children, and the state as a whole. They could also benefit by engaging private agencies that also provide services, as well as some of the many clients they all serve.
When it comes to mental health services for children, Connecticut was behind long before COVID, which is why so many families in need are on waiting lists that last for years. We may never catch up, but at least we’re picking up the pace.
Boston Globe. September 17, 2023.
Editorial: Massachusetts’ 351 health departments means inefficiency — and unfairness
Standards, money, and regionalization will all help.
Over the last few years, Massachusetts’ uniquely fragmented public health system has made progress in becoming slightly less fragmented. State grants and federal funding in the wake of the COVID-19 pandemic have helped communities hire staff, share services, and become better trained. But there is more work to be done to modernize a system that is often incapable of meeting basic responsibilities, like inspecting restaurants and septic systems.
A bill pending in the Legislature would create minimum standards for local public health departments while providing the money departments need to meet those standards. Transforming a haphazard, locally driven public health system into one that is regionalized and modern will be a monumental task. But it is necessary to ensure every resident has access to a comparable level of public health services — things like safe food and safe water — regardless of where they live.
Today, some communities host vaccine clinics and have a nurse available to visit elderly residents. Others have none of that. “It truly does depend on where you live as to what services you are able to avail yourself of,” said Cheryl Sbarra, executive director of the Massachusetts Association of Health Boards.
While most states operate public health services at the county or district level, Massachusetts, with its strong tradition of local control, has left public health up to individual cities and towns, resulting in redundancies, underfunding, and an uneven patchwork of services. Without even standard credentials for public health workers, a 2019 report by a Special Commission on Local and Regional Public Health stated, “Where you live determines not only the depth and breadth of public health protections that are available, but also the qualifications of the individuals providing the services.”
The COVID-19 pandemic drew attention to the system’s inadequacy when the state paid millions of dollars for contact tracing and vaccine clinics, which could potentially have been done by municipal public health officials, had those departments been better resourced and available statewide.
The special commission’s 116-page report lays out a blueprint for reform. Its recommendations include establishing statewide standards for what services public health departments should provide; sharing services across jurisdictions; improving data reporting; establishing standards for public health worker credentials; and distributing funding to help departments meet the new standards.
The Legislature began this work in 2020 by creating a grant program that funds public health staffing and training, including efforts to share services. The Department of Public Health has incentivized communities to work together by offering technical assistance.
Public Health Commissioner Robert Goldstein said from fiscal 2021 to 2023, the state provided $27 million in grants, and over 310 municipalities entered shared service agreements.
Shin-Yi Lao, director of Newton’s public health services, said Newton, Brookline, Belmont, and Arlington are sharing an epidemiologist who analyzes public health data and environmental health specialists who conduct inspections. They are considering collaborating on regional vaccine clinics and reciprocal permitting, so a camp or food truck inspected in one community can operate elsewhere.
The needs for regionalization are often greater in rural communities, which often do not have a strong property tax base to fund public health. At one point, the Franklin Regional Council of Governments was employing one full-time and one part-time staffer to cover the public health needs of 15 Franklin County towns. Grant money has since allowed it to hire more staff. “There was no possibility we could give vaccines, investigate every restaurant, every housing complaint, review every septic plan,” said Phoebe Walker, director of community health for the Franklin Regional Council of Governments.
In December 2021, the Legislature allocated $200 million in American Rescue Plan Act funds to public health infrastructure. Goldstein said the state is spending that money on training, capacity building, and developing performance standards.
The next step is for lawmakers to pass what advocates call the State Action for Public Health Excellence Act, or SAPHE 2.0. The Legislature passed the bill unanimously in July 2022, but then-governor Charlie Baker returned it with an amendment and the bill died. It was reintroduced this session.
The bill would set up a process to implement the 2019 blueprint. This includes developing statewide standards for services provided and workforce credentialing, requiring data reporting, and providing technical support and money through grants and formula-based funding. Money would be contingent on communities moving toward meeting the standards. The bill would support efforts to share services, recognizing that smaller communities would be unlikely to meet the standards by themselves.
Setting minimum standards for workforce credentialing makes sense. The state sets minimum qualifications for building commissioners and library directors. There is a need to ensure that someone inspecting pools, housing, or restaurants is qualified. Goldstein said in some places today, “We’re using a 20th-century public health workforce to operate in the 21st century.”
Data reporting is also vital. As the 2019 report notes, data are a fundamental part of public health, yet Massachusetts cannot answer basic questions like how many foodborne illnesses were traced to restaurants and were those restaurants appropriately inspected?
The Healey administration supports the bill. Goldstein said DPH can write performance standards but only the Legislature can mandate that communities follow them and appropriate money. He called the bill “an important next step for local public health.”
A preliminary cost estimate based on the 2019 blueprint, cited in testimony by the Massachusetts Municipal Association, pegs the cost at $140 million. But that number is outdated and does not consider the COVID relief spending.
The policy would unquestionably require an influx of state money. Lawmakers will have to carefully craft it to avoid placing unfunded mandates on communities and to ensure that more money gets spent on public health, rather than simply having state money supplant local money. But many states, unlike Massachusetts, do pay for public health services. And in the long term, a move toward sharing services will be more efficient than having 351 health departments.
Bangor Daily News. September 19, 2023.
Editorial: With delay, PFAS disclosure law can be made better
Now that the state has delayed requirements that companies disclose PFAS in their products sold in Maine, regulators can revamp the reporting to ensure it is more meaningful to Maine consumers.
Because PFAS, a group of man-made chemicals, are in so many products, collecting this data – and making it useful – is a massive undertaking. Because of this, and the fact that the Maine Department of Environmental Protection didn’t have the staff needed to create and maintain the listings, lawmakers this spring extended a deadline for manufacturers to report on products sold in Maine that contain PFAS. Under a law passed in 2021, the requirement was set to go into effect on Jan. 1, 2023. That was extended to January 2025.
Only a few companies had reported the information by Jan. 1 of this year and the information was not uniform.
Maine was the first state in the country to require such a PFAS registry. However, without consistent information being readily available to consumers, the registry that was envisioned was only of limited benefit in practice.
With the delay, lawmakers, the DEP and companies that will be required to report can make the data more user friendly and useful. The delay, however, should not become a tactic to weaken or further stall getting this information to Maine consumers.
A ban on added PFAS – also enacted as part of the 2021 law and set to take effect seven years from now – still stands. By 2030, any product containing intentionally added PFAS may not be sold in Maine unless the state determines that the use of the chemicals is unavoidable.
While the 2021 law has already been in effect, it has not lived up to its potential for several reasons, Bangor Daily News politics editor Michael Shepherd reported in April. One reason is that the Mills administration had granted more than 2,000 extensions to the reporting requirements that came online in January.
By late April, only 60 companies had complied with the reporting requirements.
Trade groups, led by the Maine State Chamber of Commerce, called the rules unworkable due to lack of laboratory capacity and say businesses need more time to comply.
Because versions of PFAS are used in so many products, from waterproof clothes to grease-proof food wrappers to non-stick cookware, they have been found in water supplies, farms and elsewhere. Because they are slow to break down, they are often called “forever chemicals.”
A recent study, published in the scientific journal Exposure and Health, linked more than $60 billion in annual health care costs to PFAS exposure. The research suggests that long-term PFAS exposure could contribute to or exacerbate ailments such as low birth weights, endometriosis, adult-onset type 2 diabetes and infertility in both men and women.
Early estimates, which are likely to be dwarfed as more PFAS contamination is found, are that it will cost $400 billion to remove the chemical from the nation’s drinking water. Those costs should be borne by the chemical makers.
In the meantime, the best way to stop PFAS contamination is to reduce the use of these chemicals, where practicable, and to stop releasing them into the environment. Maine’s law was an attempt to start doing that. While the reporting requirements have been pushed back, the urgency to phase out these chemicals remains.
Portland Press Herald. September 17, 2023.
Editorial: Attacks on public meetings, elected officials should be met with unified front
Maine municipal officials taking steps to strengthen rules regarding harassment and other disruption must do it without sacrificing public participation.
Many of the bigots disrupting local government meetings throughout Maine lately come from the same dark corner of our politics as the neo-Nazis who have been increasingly public here in recent months. In some cases, they may be the same people.
Their goal, in all that they do, is to disrupt the hard work of building more fair, open and prosperous communities, and to intimidate those who are doing it. The meetings are an obvious target for white supremacists – local government requires different people to come together to peacefully solve problems, and that couldn’t be more antithetical to what they stand for.
By dedicating ourselves to the cooperative process of government – and by generally working together, despite our differences, to make our communities better – we can show the world just how wrong and pathetic those bigots are.
First and foremost, that means keeping our public meetings public. When the COVID-19 pandemic shut down public gatherings in 2020, Zoom provided a way to continue public participation remotely. It helped people take part in meetings who could not have when that required physically attending.
Remote meetings also opened the way for anonymous disruptions. Almost immediately, people began logging on under fake names and addresses so that they could post offensive statements or images. Those disruptions continue to this day. Council meetings in both Portland and Hallowell this month were disrupted by people making antisemitic, homophobic and racist comments.
In both cases, the callers specifically targeted community leaders known for promoting diverse, inclusive communities. “Callers have also become more sophisticated over time, now using actual Portland addresses and sometimes the real names of local business owners to seem more legitimate,” the Press Herald reported last week.
Similar incidents have occurred in Bangor, South Portland, Biddeford and elsewhere.
These incidents are not pranks; they are meant to shock, disrupt and intimidate. The perpetrators want to stop officials from conducting the business necessary to run a community, and they want to scare minorities, making them think twice before they get involved.
But that doesn’t mean Zoom meetings should be shut down, as some have suggested, in order to keep the bigots from disrupting municipal business. Allowing the public to attend meetings from home eliminates barriers such as finding parking and child care. We should continue to promote public participation, and we cannot let the worst people among us dictate how we run our local government.
“Access to public meetings and that face-to-face, whether virtual or in-person, opportunity for the citizenry to talk to their elected officials is foundational to our democracy,” cautioned Carol Rose, executive director of the ACLU of Massachusetts, in an interview with The Washington Post earlier this year.
It’s a balancing act; elected officials do have an obligation to place limits on aggressive attempts to keep others from having their voices heard. The Portland City Council already has some measures in place and is developing others, as is Hallowell. Cities and towns should work together to see what rules and measures are most effective in keeping meetings civil, open and engaging for all.
And it is up to everyone with power and standing in our communities to speak out whenever bigots get too comfortable or too brazen. Councilors, selectmen and women, mayors and school board members – regardless of where they stand politically, local elected officials must present a united front against people who have views incompatible with a free and just society.
Portland City Councilor April Fournier, one of the targets of anonymous calls, shared on social media last week a letter she wrote to keep herself focused on the important work she and others do, despite the attacks. It contains a lot of wisdom for those faced with the same challenge.
“I will continue to do this work. I will continue to show up for my community. Whether we agree or disagree,” the letter reads. “I will continue to hold this space and create more space for the next generation that will come after me.”
We may not be able to change the minds of those who are lost in bigotry and can’t see how a diverse and inclusive society benefits all of us.
But good people can crowd them out – and prove them wrong.