Thursday June 16, 2016
Dear Physician Advocate,
We’d like to personally welcome you to the Eleventh Annual Residents and Fellows Day at the State House (RFDASH). Advocacy is an exciting and crucial part of the Pediatrician’s role in improving the health of children, and we wholeheartedly thank you for your involvement in this event. The landscape of healthcare policy is ever changing, and the ongoing cultural and legislative debates in our politically charged climate will have significant impacts on the lives of our young ones. Therefore, as ever, it’s an important time to advocate for kids.
We have a full agenda today so please take a few minutes to read through the information in this packet. It includes our schedule and other important legislative, advocacy, and lobbying information that will be useful today, and may be helpful to you in future trips to advocate for your patients on the Hill!
RFDASH was founded eleven years ago by residents in the Massachusetts General Hospital for ChildrenPediatrics residency program, and is now organized through a collaboration of all the Massachusetts pediatrics residencies. It was established as a time for the pediatric trainees of our state to come together as advocates for the children of our shared community. Since then, we have advocated for many bills which have been passed and are current Massachusetts law. This year, we will be focusing our efforts on 3 legislative topics that directly impact the health and safety of youth in Massachusetts: 1) Tobacco control, and the right to a childhood free from addiction, 2) The rights of our transgender youth, and 3) The resources needed for our child welfare apparatus, especially the Department of Children and Families (DCF).
We would like to especially thank the Massachusetts Chapter of the American Academy of Pediatrics (MCAAP) for their support in this endeavor. We are very proud of where RFDASH is today, and we are ever grateful for the help and mentorship of MCAAP leaders. We’d like to thank our speakers, as well as all of the other prominent advocates in our community. We would also like to again thank you personally for attending this event and bringing your expertise and passion. You, as a physician leader, have the vision, the knowledge, and the experience to truly make a difference in the lives of our children and families.
If this is your first exposure to physician advocacy, we welcome you and hope to guide and support you through this exciting day.We also urge you to stay engaged in pediatric advocacy even after you leave the State House this afternoon. As physician leaders, we canand will work together to continue to improve the lives of our children.
With deep respect and gratitude,
Mike Epstein, MD
Aisha James, MD
Molly Wolf, MD
Helen Myers, MD
Katherine Schiavoni, MD
RFDASH Co-Leaders
8:30am
REGISTRATION AND BREAKFAST
9:00am
WELCOME AND INTRODUCTIONS
9:15am
KEYNOTE SPEAKER
Marylou Sudders, ACSW, MSW
Secretary of the Executive Office of Health and Human Services of the State of Massachusetts
Former Massachusetts Commissioner of Mental Health
Former head of the Massachusetts Society for the Prevention of Cruelty to Children
Past associate professor Chair of Health & Mental Health at Boston College
FOCUS ON THE ISSUES
9:45am
Freedom from Nicotine Addiction
Jonathan Winickoff, MD, MPH
Pediatrician, Professor of Pediatrics at Harvard Medical School
Former Chair of the American Academy of Pediatrics Tobacco Consortium
Director of Translational Tobacco Control Research for the AAP
10:05am
Support for Child Welfare
Heather C. Forkey, MD
Assistant Director of Foster Children Evaluation Services (FaCES) Attending pediatrician with the Child Protection Program at UMass Memorial Children’s Medical Center
Assistant Professor at the University of Massachusetts Medical School
10:30am
Transgender Rights
Ladawn Sheffield, LMHC
Therapist, Trans Health team at Fenway Health
Past Educator in Contemporary Issues in Transgender Studies at Tufts Experimental College
11:00am
Ed Brennan, JD
Legal Counsel & Lobbyist, Massachusetts Chapter of the AAP
11:20am
SKILLS & TRAINING: How to be an effective lobbyist, legislation & lobbying Q&A
Alex Calcagno
Federal Relations, Massachusetts Medical Society
12:00pm LUNCH
1:00pm
LEGISLATIVE MEETINGS
Marylou Sudders, ACSW, MSW
Secretary, Executive Office of Health and Human Services
Appointed as Secretary of the Executive Office of Health and Human Services by Governor Charlie Baker in January 2015, Marylou Sudders leads the largest executive agency in state government, a $21 billion state budget with 22,000 public servants, and oversees critical services that touch almost one in four residents of the Commonwealth. Professionally trained as a social worker, Secretary Sudders has dedicated her life to public service and to some of our most vulnerable citizens. She has been a particular advocate for children, notably as the champion for the first children’s mental health commission when she was the Commissioner of Mental Health, and as the head of the Massachusetts Society for the Prevention of Cruelty to Children for almost ten years. She has been a public official, provider executive, advocate and college professor. Secretary Sudders has been honored and recognized by many groups for her contributions and commitment to public service.
Jonathan Winickoff, MD, MPH
Pediatrician and Advocate against Tobacco
Dr. Winickoff is a practicing pediatrician at Massachusetts General Hospital and Professor of Pediatrics at Harvard Medical School. He has training and experience in health services research, medical ethics, neurobiology, statistics, and behavioral theory. In addition to over 100 peer-reviewed publications, he has drafted key tobacco control policy and served as a scientific advisor for the CDC Communities Putting Prevention to Work, the Massachusetts Tobacco Control Program, Head Start, WIC, the Food and Drug Administration, Department of Housing and Urban Development, the Institute of Medicine, and the U.S. Surgeon General through the Interagency Committee on Smoking and Health.
His research has led to the creation of the Clinical and Community Effort Against Secondhand Smoke Exposure (CEASE) program, now available in all 50 states for free. He also helped describe the phenomenon of thirdhand smoke, once named the health idea of the year by the New York Times. His research has been used to support the creation of smokefree public housing in the city of Boston, the state of Maine, and HUD’s efforts nationally. His 2010 special report in the New England Journal of Medicine outlined the social justice, legal, and ethical imperative of implementing completely smokefree public housing in the United States.
Recently, in four research papers, he has studied raising the tobacco sales age to 21 and has also volunteered his time helping communities raise the age. As of June 2016, 121 communities in MA as well as NYC, Kansas City, Cleveland, and the states of Hawaii and California have raised their age of sale to 21. With colleagues at the AAP Richmond Center, Harvard School of Public Health, and Massachusetts General Hospital, he pursues public education, legal ethical, social justice, and biochemical analyses to promote child health.
Heather forkey, MD
Pediatrician Assistant Director of FaCES Foster Children Evaluation services
Dr. Heather Forkey is the Chief of the Child Protection Program and Director for the Foster Children Evaluation Service at the UMass Memorial Children’s Medical Center and Associate Professor at the University of Massachusetts School of Medicine. In addition to her clinical work with children exposed to abuse and neglect, foster care and trauma, Dr. Forkey has been the recipient of local and federal grants to address issues of children in foster care and to translate promising practices to address physical and mental health needs of children who have been traumatized. Dr. Forkey currently participates in a number of local, regional and national initiatives to translate the science of trauma into clinical care improvements. Dr. Forkey has published and presents nationally on the topic, and her work has been highlighted in the popular press, including Forbes, The Boston Globe and The Atlantic.
Ladawn sheffield, LMHC
Thearpist
Fenway Health
Ladawn Sheffield has been a therapist and member of the Trans Health team at Fenway Health since 2014. She received her Master of Arts degree in Counseling Psychology from Lewis & Clark College and her Bachelor of Specialized Studies degree in Comparative Religion from Cornell College. Ms. Sheffield taught Contemporary Issues in Transgender Studies at Tufts Experimental College. She has previously worked at SMYRC (Sexual and Gender Minority Youth Resource Center) and Camp Odyssey, a social justice and diversity camp for youth, both in Portland, OR.
Alex Calcagno
Director of Federal and Community Relations
Massachusetts medical society
Alex. Calcagno is Director of Federal and Community Relations for the Massachusetts Medical Society. She is responsible for advocating the Medical Society's position before the United States Congress, White House and Executive Agencies. Prior to coming to the Medical Society, Alex. was Assistant Director of the American Academy of Pediatrics Office of Government Liaison in Washington, D.C. for ten years where she lobbied for children’s health care.
Edward J. Brennan, Jr, Esquire
Chief Counsel
Massachusetts Chapter of the AAP
Counselor Brennan is a health care attorney who represents physicians, medical professional associations and health service entities in the areas of general health care law, administrative needs, risk management, regulatory matters and government relations. Counselor Brennan currently serves as General and Legislative Counsel to several medical specialty associations, including the Massachusetts Chapter, American Academy of Pediatrics, the Massachusetts Radiological Society and the Massachusetts Society of Anesthesiologists. As a registered lobbyist for 20years, he has represented the three medical specialty associations, in addition to other clients, on Beacon Hill and before various regulatory agencies of the Commonwealth.
PROTECTING YOUTH FROM TOBACCO AND NICOTINE ADDICTION
RE: H.4361, An Act to Protect Youth from the Health Risks of Tobacco and Nicotine Addiction
Massachusetts has a strong record in enacting laws to curtail tobacco use among children, however there is more work to be done, especially with young people who are particularly susceptible to nicotine addiction.
The Massachusetts Chapter, American Academy of Pediatrics strongly supports H.4361 and urges the Legislature to pass this comprehensive legislation that will reduce tobacco use and nicotine addiction among youth, improve health, save lives and reduce health care costs.
88% of smokers begin before age 18. Youth are particularly susceptible to nicotine addiction. Nicotine has harmful health impacts on the developing brain, and 95% of tobacco users become addicted to nicotine before age 21. H.4361 will go a long way in reducing this harmful addiction by:
· Raise the age of sale of tobacco products across the Commonwealth from 18 to 21. The Institute of Medicine report released last year found raising the tobacco age to 21 will result in a 12% decrease in tobacco addiction and prevent 250,000 deaths.
· Regulate E-cigarettes and treat these products as tobacco products, which they are. Use of the products on school premises would be banned, and the statute governing smoke free work place would apply to these products. E-cigarettes are being sold in fruit and candy flavors that are appealing to children, including bubble gum, cotton candy, Atomic Fireball, berry, peach, grape and vanilla. Clearly, such marketing can and does entice youngsters to use a product that encourages tobacco use and is dangerous in and of itself.
· Ban the sale of nicotine liquids and gels without child resistant packaging. In 2014 alone, the American Association of Poison Control Centers reported nearly 4000 adverse incidents related to liquid nicotine and e-cigarette exposures. This includes the death of a toddler and represents a more than 250% increase from 2013! The hazards are obvious: a standard eye dropper-sized bottle of liquid nicotine, with product in the standard concentration of 36 mg. per milliliter, contains sufficient drug to kill four toddlers.
· Ban the sale of all tobacco and nicotine delivery products in pharmacies and health care institutions.
To protect their communities, many of our cities and towns have enacted policies to reduce tobacco use and nicotine addiction that go beyond state and federal regulations. This has created a complex patchwork of laws that confuse retailers, distributors, consumers, public health officials across the Commonwealth. H.4361 will bring uniformity to our laws, protect our youth, and reduce youth smoking.
Tobacco and Nicotine use remains the leading cause of preventable illness and premature death in Massachusetts.
The MCAAP strongly urges the House to join with the Senate, which passed similar legislation (S.2269), to protect youth from tobacco and nicotine addiction by passing H.4361
H.1432, An Act to Establish an Interagency Child Abuse and Neglect Prevention Task Force
Child abuse and neglect is a difficult problem with incalculable consequences. As pediatricians, we see firsthand the effects of child abuse and neglect.
BACKGROUND
The MCAAP has followed with concern the recent events affecting children under the care of the Department of Children and Families (DCF). We welcomed the state-requested review and recommendations of the Child Welfare League of America. The MCAAP urges acceptance of those recommendations and adequate DCF funding to implement them.
There are approximately 120,000 Massachusetts children referred to DCF each year for concerns of abuse and neglect. A significant percentage of these cases involve injury or risk that requires medical investigation and interpretation. Massachusetts is one of a minority of states that has not developed and funded formal systems for conducting medical evaluations of children suspected of being abused or neglected. The MCAAP strongly believes that this situation should be remedied and that the Commonwealth must both create and fund a formal system for medical evaluations.