1 February 8, 2021
Ma/ta PUBLIC HEALTH COMMITTEE 9:00 a.m. PUBLIC HEARING
CHAIRPERSON: Representative Jonathan Steinberg
CO-CHAIRPERSON: Senator Abrams Daugherty Abrams
SENATORS: Abrams, Anwar, Lesser, Somers
REPRESENTATIVES: Arnone, Berger, Betts, Carpino, Cook, Dauphinais, Demicco, Elliott, Foster, Genga, Gilchrest, Green, Kavros, Kennedy, Klarides, Linehan, McCarty, Parker, Petit, Ryan, Scanlon, Steinberg, Tercyak, Young, Zupkus
REP. STEINBERG (136TH): Okay, very good. I don't see Senator Somers on the call yet, unless I'm mistaken, but we can always come back to her later. If there are no other comments, we will begin with the Public Hearing, and as I mentioned, we will start with the basic rules, the protocols for how this meeting will be conducted.
Obviously, this being our first Public Hearing, this is a new process for many of us. Yes, we've all participated in informational forums and some Public Hearings during the special session, but we also recognize that, given the difference of Zoom calls, there could be some technical problems during the Hearing. In fact, I'm willing to guarantee it will happen sooner or later, and we are asking everyone, please be patient, be tolerant, as we work through 2 February 8, 2021
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these challenges. We will try to make this as glitch-free as we can.
Please be reminded that Public Hearings are live- streamed and recorded in accordance with CGA requirements, and indeed, some hearings will actually be covered on CTN, as well. The first hour of the Hearing is reserved for public officials. If there are public officials remaining after the first hour, we will move to members of the public and then alternate between both groups. Today, we have only roughly about a half dozen public officials, so that should go pretty quickly.
Registrants can be removed from the hearing platform upon the completion of your testimony, in fact, they will be removed. So you have your time, you can be asked questions by Members of the Committee, and then you'll be removed from the hearing platform, and then you can continue to watch the hearing via YouTube Live or on CTN, if we're covered by CTN.
Committee Members, please, you must go to the participant icon or the reaction icon at the bottom of your screen and click on, "Raise hand" when you wish to speak. Please wait to be recognized by the Chair.
Microphones should remain on mute prior to entering the Hearing and when not speaking in order to enhance the meeting etiquette and avoid unnecessary and random interruptions. Background noise can get difficult to concentrate. Committee staff will help keep members on mute. Use of chat, either public or private is not allowed. All chat records are saved by default and therefore could be subject to FOIA request.
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If your connection drops, or you close out of the Public Hearing by accident, please rejoin using the link provided by the Committee.
Committee Members, if you encounter difficulties entering the Public Hearing, please contact the Chairs, Ranking Members or public health Committee staff for assistance.
And lastly, we are very proud of the way in which this Committee operates with a measure of civility and respect for all participants, we would ask that all of our people testifying behave in the same fashion. The vast majority of folks are really good, but if you violate basic norms of civility, if you attack Members of the Committee or the Legislature or virtually anybody, we do reserve the right to cut you off, and we'd hate to have to do that. So, we remind you to stay on topic, and to not make this personal. It's very important to us that we give everybody a chance to be heard without any concern about intimidation. And if we all model the right behavior, I'm sure this hearing will go well.
That's pretty much it for the rules, unless anybody else would like to comment on that. I see Representative Petit, your hand is up?
REP. PETIT (22ND): Yes Mr. Chairman. I assume we're going to use the raised hand function to queue up, number one. And number two. Representative Betts has had difficulty entering into the meeting. Thank you.
REP. STEINBERG (136TH): So, let's make sure we get Representative Betts into the meeting. Any other comments or questions? If not, we look at our agenda today, and the first up to speak is Commissioner Schiff, of the Department of Developmental Services. I believe he'll be joined by a couple of his people, 4 February 8, 2021
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though they may speak intervally. Commissioner Scheff, the floor is yours. Good morning.
COMMR. JORDAN SCHEFF: Good morning and thank you. I'm going to break my tradition of trying to speak to you extemporaneously, and for the sake of time, and our newfound way of interacting together, read a much-abbreviated version of my written testimony. So please indulge me.
Senators Abrams, Summers and Hwang, Representative Steinberg and Petit and members of the Public Health Committee, I am Jordan Scheff, Commissioner of the Department of Developmental Services. Thank you for the opportunity to testify in support of Senate Bill No. 416. This Bill implements numerous recommendations of the Department that improve and advance the important work of our agency. As this Bill contains five separate department proposals, I would like to take this opportunity to summarize and explain each of the sections of the Bill.
A written testimony provides additional detailed background and explanation on each section of the bill. Section 1, current State law outlines with which State agencies and other entities, DDS may share its abuse and neglect registry information. Specifically, the statute currently details that the department may make registry information available to DCF, DHMS and DSS for the purpose of determining whether an applicant from employment appears on our registry. As Governor Lamont's Executive Order Number 2 called for the centralization of human resources under DIS. DIS is now the single State agency overseeing the hiring for all of those aforementioned agencies. For this reason, Section 1 of the Bill proposes to allow DDS registry information to be made available to DIS, for the purposes of determining whether an applicant for 5 February 8, 2021
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employment with the- four human service agencies referenced above appears on the registry.
For background, the DDS Abuse and Neglect Registry is a confidential, centralized database that contains the names of former employees of DDS and agencies and programs funded by DDS who have been terminated or separated from employment as a result of substantiated abuse or neglect. This administrative process is separate and distinct from any legal process in which a person could be charged or convicted of such abuse or neglect through the Criminal Justice System.
After reviewing the drafted language of this section, DDS would like to respectfully request a technical amendment for the Committee's consideration for joint substitute language. An outline of our proposed technical amendment can be found in our written testimony submitted to the Committee.
In Section 2, this section would allow the DDS Commissioner or DDS Regional or Training School Director to provide consent for necessary medical treatment of an emergency nature when the individual's legal representative is unavailable or unable to give such consent. Currently, DDS has the statutory authority to authorize necessary surgery for such person where, in the opinion of the person's attending physician, the surgery is of an emergency nature, and there is insufficient time to obtain the required written consent.
There are circumstances, however, when an individual under the Department's care requires emergency treatment, other than emergency surgery, and there is insufficient time to obtain the required consent. In these situations, the Department is currently unable to grant consent for such emergency 6 February 8, 2021
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treatments. With advances in medical treatment that require less invasive treatments and surgery, DDS believes that allowing the Commissioner or his designees to consent to emergency medical treatment for an individual either when, a legal representative is not available to give consent, or the individual has no legal representative and the individual themselves is unable to give consent. This would allow that the individual with intellectual disability to have access to appropriate medical care while remaining independent and in the community.
Section 3, Statute currently prohibits DDS from notifying and sharing any documents regarding a report of abuse or neglect that warrants an investigation when an individual's legal representative is the alleged perpetrator of such abuse or neglect, or the legal representative is residing with the alleged perpetrator. To ensure that the ongoing protection of individuals with intellectual disability and those individuals that are reporting suspected cases of abuse or neglect, this Section expands the Statute to prohibit DDS from sharing the original report of abuse or neglect and the evaluation report, also known as the Final Report, with a legal representative who has been found to be the substantiated perpetrator of abuse or neglect, or who is residing with a substantiated perpetrator.
This provision would not restrict a court from allowing the substantiated perpetrator to have access to the report for purposes of illegal action.
Section 4, this Section updates appointments to the Camp Harkness Advisory Committee to reflect changes to the names of the entities appointed and replaces certain appointed entities that have ceased to exist with criteria to appoint new members. The Committee 7 February 8, 2021
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advises the Department with respect to the health and safety of the persons who attend and utilize the state-run camp. The proposed appointments in this Bill were unanimously approved and supported by the Camp Harkness Advisory Committee.
In Sections 5 and 6, the last two sections of the Bill would allow DDS to submit a person's DDS Denial of Eligibility letter in lieu of a reassessment, also known as a triennial assessment, for appointment of a guardian through probate court. Statute currently allows for DDS to submit a person's DDS Denial of Eligibility letter as part of the original appointment of a guardian through probate court, but this process was not extended to the reassessment process. This section simply extends this option to the reassessment for appointment of guardian through the probate court. This change in the Statutes would not limit the ability of an individual or his or her family to appeal a request after determination of eligibility from the DDS Eligibility Determination Unit.
Thank you again for the opportunity to testify in support of Senate Bill No. 416. I'm happy to try and answer any questions you may have. REP. STEINBERG (136TH): Thank you, Commissioner for your testimony. One quick question, with reference to the circumstances in which the person responsible is considered possibly an abuser, how do you protect the rights of the individual in that case, in that that person will no longer be sort of in the mix? Is there someone who serves in lieu of that person to represent the interest of that person? What happens in those circumstances? COMMR. JORDAN SCHEFF: Thank you, Representative Steinberg. Depending on the nature of the circumstances, the nature of the abuse or neglect, there are several provisions. One under emergency situations, though we rarely utilize this tool, the 8 February 8, 2021
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powers vested in me, I can take emergency custody of an individual and assume that representative status for a period of time, usually very brief, to outplace the person or to put in protective measures in what we call an Emergency Protective Services Order. And so that we do have a way to do that very quickly if we needed to.
Other times, it's a more systemic issue or an underlying issue, and it can be done voluntarily with the parents through conversation, parents, guardians, representatives. So the variety needs to be there. The court also has the ability to temporarily appoint a guardian ad litem or temporary conservator or guardianship where we need probates help to try and resolve that without my taking emergency custody.
REP. STEINBERG (136TH): So I take it that the examples that you've experienced in the past suggests that this system works smoothly, and that the individual’s rights are always represented by someone looking out for their interests?
CMMR. JORDAN SCHEFF: That is our intent. And that is most typically the outcome in the practice. REP. STEINBERG (136TH): Thank you, Commissioner. Other questions for Commissioner Scheff? Senator Hwang.
SENATOR HWANG (28TH): Thank you, Mr. Chair. Thank you very much, Commissioner, for joining us today. And I appreciate the proposal and clarifying aspects of this language. I do have a question relating to the testimony submitted by the Probate Court Administrator, in regards to Section 5, in which they kind of cited that it was kind of parallel to their statute. I just wanted to double check with you, do you agree with that assessment from a 9 February 8, 2021
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parallel path and trying to reach the same goal, through you, Mr. Chair? CMMR. JORDAN SCHEFF: Thank you, Senator Hwang. Rod O'Connor is joining me on the call today. I believe that our efforts in drafting that language were in conjunction with our colleagues at Probate, I just wanna-- I don't want to make that assumption, and Rod, I don't know if you can clarify that or not?DIR. ROD O’CONNOR: Yes, what they said in their testimony was that, we had two sections that we were fixing in Sections 5 and 6 of the Bill. And they said we only really needed the one section, which was Section 5, which was the Statute that dealt with triennial assessments, and we agree with them. So, if you were to move this Bill forward, we would accept, you know, their suggestion.
CMMR. JORDAN SCHEFF: And Rod, I'm gonna save Representative Steinberg the prompt, can you just state your name for the record, 'cause I think they're gonna want you to do that. DIRECTOR ROD O’CONNOR: Rod O'Connor, Department of Developmental Services. CMMR. JORDAN SCHEFF: Thank you. Senator Hwang, I hope that answers your question, we're happy to try and clarify further. SENATOR HWANG (28TH): It does. And I'm appreciative of the initiative by your Department to speak with affected parties within state government, and in this case, the Probate Court Administrator. So I wanna extend my appreciation and thanks and acknowledge that this is how government collaborates and works together on benefit of constituents. So, thank you very much for the answer. Thank you, Mr. Chair. REP. STEINBERG (136TH): Thank you, Senator. Representative Dauphinais. REP. DAUPHINAIS (44TH): Good morning, and thank you, Commissioner. Quick question, I'm trying to understand this DCF list that you were speaking 10 February 8, 2021
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about accessing. Are the individuals on this list -- I know they've been accused of something, but have they been actually tried and convicted?
CMMR. JORDAN SCHEFF: And I believe this appears in the full testimony, it is separate from any court proceeding. So there are statutes on the books that both, for two separate entities but now both embedded in DDS for what the statutory authority to reach a determination of substantiated abuse or neglect means. That includes a due process. We have due process elements in place for affected individuals, including a hearing and an appeal process. And so, it does not require a substantiation in a courtroom though, the threshold for substantiating abuse and neglect is separate from any criminal proceedings.
In addition to the name being on that registry, and there being a process prior to that referral to the registry, there's also a provision that the person can appeal or apply to have their name removed after a period of time, based on evidence of what's happened since the substantiation in their current- day situation. And we do give strong consideration to reinstating people based on the circumstances at the time that they apply.
REP. DAUPHINAIS (44TH): So, thank you. So, just to confirm, these people have not had due process and have not gone through a trial and then convicted in the courts?
CMMR. JORDAN SCHEFF: They have not had a criminal justice due process. They are given a notification, they can bring representation. There is a third party that we hire to administer the hearing process. So, there is a process. Not everyone who gets substantiated, based on that process ends up referred to the registry list, and there are several 11 February 8, 2021
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stops along the way. But correct, it is not a specific criminal proceeding.
REP. DAUPHINAIS (44TH): Not in a court of law, correct. Okay, thank you. REP. STEINBERG (136TH): Thank you, Representative. Any other questions for the commissioner? Now Commissioner, I see we've already had Mr. O'Connor speak. You have another one of your staff, are they intending to speak as well, as part of this hearing? CMMR. JORDAN SCHEFF: No, it is just the two of us. So I think we -- It's just Rod and I today. REP. STEINBERG (136TH): Well, thank you for your testimony. We will look over the Bill carefully, we appreciate your coming to testify before us today. Moving along, the next speaker on the list would be State Representative Bobby Gibson, followed by State Senator Dennis Bradley. Representative Gibson.
REP. GIBSON (15TH): Good morning, Mr. Chair. Thank you, Mr. Chair, for acknowledging me and thank you for allowing me to speak to Senator Abrams, yourself, Mr. Chair and Members of the Public Health Committee. I'm here to submit testimony on Senate Bill 326AA prohibiting the sale of flavored cigarettes, tobacco products, electronic nicotine delivery systems and vapor products. Again, thank you for hearing my testimony.
I thank you for this opportunity to share with you my wholehearted support of a ban on the sale of all flavored tobacco products in our State. As an educator and as a coach of hundreds of youth in Bloomfield, Windsor and in Hartford, I know how easily kids can be pressured into bad choices. Especially, if we allow the tobacco industry to work its marketing magic on them through enticing flavors, social media and TikTok, and down at the 12 February 8, 2021
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neighborhood store, or in many instances we call them, bodegas.
Let me be clear, parents, educators and community leaders must continue to give our children the lessons they need to grow up into resilient and disciplined young adults who strive to succeed with dignity, integrity and delight, despite adversity. Let's get flavored tobacco out of their way right now. These items, menthol cigarettes, mango and cherry-flavored vapes are everywhere. We know that the tobacco industry came up with these products because they knew kids would wanna try them. And once they do, they're hooked and they're customers for life.
Not much more than 20 years ago, a former tobacco industry executive said, and I quote, "Cherrysco is for someone who likes the taste of candy, and if you know what I'm saying." He said that in The Wall Street Journal. Now industry may be smart enough to not say that anymore, but they are still doing it and getting craftier every day in the ways that they do it. Right now, our kids are paying the price, but once they're hooked, we all pay the price.
And then there's the way the tobacco industry has systematically worked to target and enslave communities of color, and to addiction with menthol cigarettes. And I've seen this personally all the time. They gave free products away to kids in ionic neighborhoods of color. They stole our cultural heritage, and then plastered our communities with ads that tried, and in some ways succeeded, to make us feel relevant. They saturate our communities with way more tobacco stores than in wealthier, whiter neighborhoods. And they make these products, these menthol cigarettes, that are easy to get hooked on and harder to quit, than regular cigarettes. They made these products cheaper in communities of color. 13 February 8, 2021
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And I also note that people, some honest with good intentions, and some who are, maybe, just concerned about money, are worried about the adults who already are addicted to these products and have been for most of their lives. To them I say two things, one, we can't keep hooking kids on these products just because you got hooked in or addicted on these things 40, 50 years ago, when you were a teenager. We can't sacrifice our future to feed the addictions of our past, we just can't.
And number two, this law will not make it illegal for you to buy, use or possess this product. So if you can't switch to unflavored, or if you can't quit and you need to get your menthols from someplace outside of Connecticut, you won't be breaking the law, period. But you won't be able to get them at your corner market, and neither will the kids, which is actually most important. And that's the whole point. And that's why I support this Bill.
We need to step up and pass this legislation now. And this was the right thing to do for the kids in Massachusetts and California and over 100 towns across the nation so far, that is the right thing to do here in Connecticut. Part of that is that we need to keep moving forward, aligning with our neighboring States the policies like these two. This fits right into what I hope that the Governor Lamont sees this, as well.
By enacting Senate Bill 326 into law in Connecticut this year, we'll be preventing tens of thousands of kids from getting hooked on nicotine through flavored products. As a result, we'll begin to eliminate billions of dollars in future health care costs that would otherwise weigh on our children's generation as it moves into the future of full possibility. 14 February 8, 2021
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In conclusion, as an educator and as someone committed to being a humble steward of our collective future, I'm convinced that we must not follow flavored tobacco products or allow flavored tobacco products that can be severely damaged into our children's lungs during now, and especially during the COVID-19 pandemic to continue to be sold. Let's make 2021 the year that we say "no". No to big tobacco in Connecticut. Bettering our health means also bettering the health of our communities now and for years to come.
Thank you, Committee and on thank you Senator Abrams, Representative Steinberg, and Ranking Members of the Committee for hearing my testimony on Senate Bill 326. Thank you.
REP. STEINBERG (136TH): Thank you, Representative. I found that to be an excellent summary of the reason why the proponents of this Bill have this bill and Public Hearing today. I think you've covered all the notes. And particularly, I appreciate your perspective as an educator and understanding the implications of flavors on addiction of young people. There are questions starting with Senator Abrams, followed by Representative Betts. Senator Abrams. SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Chairman. Representative Gibson, I just wanted to say thank you so much for your service to our children as an educator, but also I agree with my colleagues that your testimony was incredibly accurate as to why we feel that this Bill is so important. So thank you so much for taking time out to come and speak with us and give us your perspective. REP. GIBSON (15TH): Thank you, Madam Chair, I appreciate it. 15 February 8, 2021
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REP. STEINBERG (136TH): Thank you, Senator. Representative Betts.SENATOR BETTS (78TH): Thank you, Mr. Chairman, and thank you, Representative Gibson, that was a very good testimony. I have two questions to ask. One is, with these flavored products that kids are using, I would consider that to be smoking, and if you consider that to be smoking. If I'm right about that, can you tell me the difference? Or is there a difference between marijuana, which has been looked at to be legalized and these products? Should they both be banned, or what's the distinction between the two in your mind is an educator? REP. GIBSON (15TH): Representative Betts, that's actually a very good question. I cannot protest to be a healthcare professional, however, I would venture to say -- without knowing or being an expert on cannabis, I would say that the vaping of the flavored products are more harmful. Not coming from, again, a healthcare professional's point of view, but from the view of access. Studies have shown that these products are harmful, and especially to our youngsters. And if our youngsters have greater access, I think there lies the problem with these vaping products. SENATOR BETTS (78TH): Okay, thank you very much. Thank you, Mr. Chairman.REP. STEINBERG (136TH): Thank you, Representative. I thought you had two questions, but I'm okay with one. Senator Anwar.SENATOR ANWAR (3RD): Thank you, Mr. Chair. Thank you, Representative, for your very effective and useful testimony. Would you be able to just speak again about the fact that there are people, possibly later today, who are going to come and say that this ban is going to disproportionately, negatively impact minority communities. How do we relate to them about the fact that they're attacked directly was to the minorities and that's the reason the minorities are using it more, but could you share that as an educator, and then also as a leader 16 February 8, 2021
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in the community?REP. GIBSON (15TH): Thank you, Senator Anwar, that is an excellent question. So, Senator Anwar, I have -- actually have lived in the community and actually have taught -- been a science teacher. I was a science teacher for approximately 25 years. And in those years, I would -- part of my units would be the human body, lungs, taking care of yourself, as well as the effect of smoking on your body and how the nicotine and the chemicals within these products get you hooked, and can destroy your lungs. And so, it's one thing to teach that to our students, right, as an educator. To let them know, but then to actually go to a bodega, a corner store, and you go in there, and you have someone walk in and they wanna buy a Loosie, or they wanna buy some type of vaping product, and we have these stores all over the place. And, you know, the corner store people will have these cartons of cigarettes, and they'll break them up into individual cigarettes and sell them one a piece, called Loosies. And they will make a product -- or a profit rather, far greater than if they even sold a box, or a carton of cigarettes to that customer.
And so, it's a situation where people are getting hooked, and they're paying more than they would if they were just to buy the cigarettes the traditional route. That's an attack on communities of color, because communities of color, they're buying these Loosies because they don't have the money to buy the bigger cartons. But if they weren't hooked, they would buy the bigger cartons and save money. So it's an attack on their health, it's attack on them financially.
If you drive through these neighborhoods, you'll see billboards with -- Well, I guess, you don't see those as much anymore, but you'll still see advertisements of these products in the stores or in the windows. And if you go to other communities, you 17 February 8, 2021
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really don't see that. I mean, without saying the communities, but there're some communities where you don't have bodegas, you don't have corner stores. The closest thing to a bodega would be a CVS. So, you won't go into a CVS and ask for a Loosie. So I hope I'm answering your question, 'cause I've seen it and it's real.SENATOR ANWAR (3RD): This does. Thank you so much. And just, if you would allow one little comment as well. People are gonna say that, "Look, if you ban it, you're going to increase the black market, so let's not ban it, because we want to protect the people from the black market." I mean, that's a very slippery argument, that means that we should not ban anything. But how would you respond to that concern people will bring up? REP. GIBSON (15TH): If you just think about that question, if you ban it, you're going to increase it on the black market. So let's protect the black market? So, let's continue to damage the lungs of our most vulnerable, the health of our most vulnerable because of that? You know what, in Connecticut you can't buy certain liquors, because they're too strong, or they're not allowed. You know what, we should lift all those laws. So, let's just have any liquids come in because those other liquors are gonna be on the black market. Alright? Let's not have any type of law enforcement because it'll increase the black market. This is a situation of not trying to get out doing work or enforce our laws, this is a situation which we need to protect the health of our constituents, especially our young people. That's what's most important. SENATOR ANWAR (3RD): Thank you so much. Thank you, Mr. Chair. REP. STEINBERG (136TH): Thank you, Senator. Thank you, Representative. Representative Dauphinais, followed by Representative Zupkus.
REP. DAUPHINAIS (44TH): Thank you, Mr. Chair. And thank you, Representative for your testimony. I just wanted to clarify, so this Bill would ban the sale 18 February 8, 2021
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of these products in the whole entire State of Connecticut, including to adults, correct?
REP. GIBSON (15TH): Yes.
REP. DAUPHINAIS (44TH): Thank you.
REP. STEINBERG (136TH): Okay. Representatives Zupkus.
REP. ZUPKUS (89TH): Thank you, Mr. Chair. Good morning, thank you for coming Representative. Do you know how much tax revenue this brings to our State? REP. GIBSON (15TH): No, I do not have that information. REP. ZUPKUS (89TH): Okay. I'm sorry, go ahead.
REP. GIBSON (15TH): No, I'm listening.
REP. ZUPKUS (89TH): I've been told by a few people that it's anywhere between 80 to 100 million, and I'm curious, number one, what's gonna happen and how are we gonna fix that? However, I hear your concerns in your testimony. I do -- I had the same questions as Representative Betts did about cannabis, because -- Listen, I don't smoke. I smoked when I was cool, you know, years ago. But I haven't smoked in a long time. But I struggle with telling adults that they can't have flavors, there's flavors in everything. So, is cannabis only gonna come out in one flavor? Are we going to look at the alcohol industry, the liquor industry, the beer industry? I mean, everything has flavor. So, is this the start to banning those things? What do we do about alcohol and young kids getting it? What are we doing to educate versus banning? Because I do believe adults are adults, when you're 21. And so, I'm just curious as your thoughts on some of that stuff.
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REP. GIBSON (15TH): Thank you, Representative, for that thoughtful question. And so, you know, let's start here, so you asked me how-- REP. STEINBERG (136TH): Thank you. Are there any other questions? REP. GIBSON (15TH): I was gonna respond, Mr. Chair.
REP. STEINBERG (136TH): Now thank you, Representative Gibson for your testimony today. Next up is Senator Bradley.
REP. ZUPKUS (89TH): Excuse me, Representative Steinberg -- Don't go, I wanna hear your answer.
SENATOR DAUGHERTY ABRAMS (13TH): Go ahead, Representative Gibson, go ahead. REP. ZUPKUS (89TH): Thank you.
REP. GIBSON (15TH): Rep. Zupkus, that's a good question, actually, 'cause this dialogueis very informative, and kind of thank you for that question. Yes, I'll start with your first one, no, I do not know how much tax revenue. You mentioned a number, I believe, of 80 million. But I would encourage my colleagues, let's all do a little bit more research. How about the future health care costs of our citizens who come down with health- related illnesses because of indulging in these products? You know, if we're making a certain amount of money on one end, are we actually paying in trying to provide health care costs for our people on the other end, right?
And I think your other part was about, you know, telling adults what to do. I am not wanting to tell adults what to do. I don't want anyone trying to boss me around, or tell me what to do. However, Representative, let's look at it this way. We are all legislators here, right? We're lawmakers. In a way, we tell people what to do all the time. And I'm 20 February 8, 2021
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saying that, kind of roughly, to drive my point. We don't necessarily boss people or tell them what to do, but we pass laws that affect the lives of people. And we pass these laws for the betterment of whatever, if it's their health, if it's for financial reasons, we do it all the time. And so, I will just say this, I'm gonna make it short, until you have -- Actually, I just keep thinking of this, 'cause it happens every day. You walk into a bodega, and you see someone buying a Loosie, or, you know what?
Or you go into a bodega and you see someone buying something that, you know, is not good for them, and it’s like, "Why are you doing it?" It's because they're hooked, and they don't have a way out. And I'm sure if they had their choice, they probably would not be smoking, but they're hooked. And so, sometimes, you know, adults need help. REP. ZUPKUS (89TH): So, thank you and I hear what you're saying. I think education is extremely important, because you're right, we make laws all the time. And I'm not one to believe that we should be doing that. We do tell people what to do, we enforce what they do, and I'm one for less of that, especially as adults. I think adults need to be educated and I think that the education for cigarettes and vaping is out there. I don't think it's good for you, and I educate my kids and people I know. I think that's what we all need to do versus just banning and getting rid of. Because again, I go back to the adults. I don't believe legislators should be telling adults, even though it happens often, I don't necessarily agree that we should be telling people what to do. But I appreciate your comments and thank you for coming. REP. GIBSON (15TH): Thank you, Rep. SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much. I don't see any other questions, so thank you so much, Representative Gibson. It was really very 21 February 8, 2021
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informative having you here, so thank you for taking the time. REP. GIBSON (15TH): Thank you, Senator, and thank you, everyone. And to all my colleagues, let's have a great day and be safe. SENATOR DAUGHERTY ABRAMS (13TH): Great. Next is Senator Bradley. Senator Bradley, are you with us? Okay, I don't see Senator Bradley on. Okay, then let's move to our next speaker, which is Beverly Streit-Kefalas. I'm terrible at names, I'm sorry, Beverly. Are you there? Can you please unmute?
ADMIN. BEVERLY STREIT-KEFALAS: Good morning. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, I apologize. Can you state your name, please?
ADMIN. BEVERLY STREIT-KEFALAS: I will, no worries. I'm Judge Beverly Streit Kefalas, I am the Probate Court Administrator. And thank you, Senator Daugherty Abrams, Representative Steinberg, Senator Hwang and Representative Petit, Members of the Public Health Committee for the opportunity to testify this morning on Senate Bill 416. This is the Bill that Commissioner Scheff just presented to you, and I'm here this morning to speak only on Sections 5 and 6 of the Bill.
In particular, in 2018, the Legislature amended Connecticut General Statute 45A-674 to allow the department to submit at the initial appointment of a guardian for an adult with intellectual disability, its letter of denial of eligibility for services instead of conducting a full evaluation. What Section 5 of this Bill proposes is that same parallel language for the Probate Court's Triennial review of these guardianships. And we support that parallel language. It's consistent with what was accomplished in 2018 and extends it to the three- 22 February 8, 2021
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year review conducted in those guardianships, and we're certainly pleased to have worked with the Commissioner and his team ahead of time, so that we had-- we were mutually supportive of the revision.
I did indicate in my written testimony that we really take no position on Section 6, because in my view, it already provides for that, no further assessment, and in essence the additional language is not necessary. And I noted that Mr. O'Connor indicated he would support revising or revision to Section 6.
So, in summary, I thank you for the opportunity, these are brief issues. I know you have a very full calendar this morning, and I appreciate the opportunity to answer any questions you might have.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much, Judge, appreciate you taking the time to be here and to offer your input. And especially working with the agency to make sure that we all get this right, because you are the one that, ultimately, is implementing, and so it's important to know your perspective on it. So, I thank you for that. Are there any questions? I don't see any, so thank you very much for your testimony, and have a great day.
ADMIN. BEVERLY STREIT-KEFALAS: Just, if I may, a quick shoutout to the staff. I know this Zoom is new to all of us, but I can tell you that from my perspective, it's been a very smooth process. I even appreciate the reminder link to participate today and I hope that the rest of the public also has such ease in participating, so thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Well, thank you for that. Okay, next we have Boise Kimber. If you could join us, please.
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BOISE KIMBER: Good morning.
SENATOR DAUGHERTY ABRAMS (13TH): Good morning.
PASTOR BOISE KIMBER: Thank you, Senator Abrams. Let me speak to Chair -- Co-Chair of the Public Health Committee. I want to oppose Bill No. 326 and the proposed ban of flavored tobacco products, including menthol cigarettes, and how it will likely affect the community in which I serve, and also the conference, and which I am President of and represents
It's my moral duty to examine prospective laws and ensure they will serve the greater good for our clergy members and church communities they are enforced upon. I fully support Connecticut efforts to stop the use of tobacco, however, I am concerned that the proposed ban is currently written too broadly and will have unintentional consequences that will disproportionately criminalize Blacks and adults.
The inclusion of menthol cigarettes and the proposed ban disproportionately affect Blacks and other communities of color. The inclusion of menthol in the proposed ban will criminalize Black smokers, including adult smokers. The majority of the current US cigarette market comprise non-mentholated cigarettes, which account for roughly two thirds of the market. Menthol cigarettes only make up one third of the current market, and yet 80% of Black Americans in the US who smoked cigarettes, choose menthol cigarettes, and thus the proposed ban of menthol cigarettes disproportionate punish, stigmatize Black smokers. A menthol ban includes unintentional consequences on adults, because many menthol users are Black adults. If the proposed ban were to include menthol cigarettes, it would also 24 February 8, 2021
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create increased interaction between law enforcement and Black members of my community.
As you understand, this is quite concerning in our community, as we continue to fight for police accountability when working with Black and Brown people with high-profile cases, such as Eric Garner, who died at the hands of an officer for selling a loose cigarette. It is imperative that we do not support laws that criminalize addiction. Education, not criminalization, is the effective way to detour smokers, as demonstrated by --
LINDSAY VAN BUREN: I hate to interrupt, but you've hit your three-minute mark, so if you could conclude your remarks.
PASTOR BOISE KIMBER: I am. Thank you so very much, I am concluding. The demonstration by the failure war on drugs and criminalization of victims who are battling an addiction is not cool, it does not work. Numerous reports show that criminalization of addiction sets a dangerous obstacle to good treatment. The more effective way to decrease smoking among youth and adult is to fund prevention and treatment program.
Again, we in no way to support the use of tobacco, we do however, ask you to carefully review the proposed ban in moderate, and so that it does not criminalize the stigmatization in the community in which I serve. Thank you so very much.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Pastor, for your testimony. I do want to point out one thing, that the way this Bill is written, the emphasis is really on the seller, not on a user. And so, some of your points about criminalizing people who are using these products, which certainly is not our intention in doing this Bill. 25 February 8, 2021
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PASTOR BOISE KIMBER: Well, may I answer that?
SENATOR DAUGHERTY ABRAMS (13TH): Of course, yeah.
PASTOR BOISE KIMBER: You're talking about the seller, so if we banned it in this State, that means that they may go to another State and purchase cigarettes in big quantity, and if they come back to the State, then it is illegal. And then these same individuals can be arrested and charged. I believe we cannot have it both ways. On one end, we want to criminalize -- we want to say that cannabis is going to be legal, that's on your table. On the next end, we're saying that tobacco products, all flavors, we want to dismiss. So we can't have it both ways in this State. We gotta have it one way or another.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Pastor, appreciate that. Are there any other questions? I don't see any, so thank you very much for your -- Oh, I apologize, Representative Steinberg.
REP. STEINBERG (136TH): Thank you, Madam Chair. I just wanna reiterate what the chair mentioned, for all those who are following this hearing, this bill does not criminalize behavior of individuals, whether they purchase the product in the State of Connecticut or elsewhere. It is targeting the sale of the product. I wanna be very clear on this. That's not the Bill, it's not criminalizing individuals. I understand the good Pastor's comments, but I wanna make sure that's totally clear to everybody watching and reading the Bill. That is not what the Bill says. Thank you, Madam Chair.
PASTOR BOISE KIMBER: Mr. Chair, you may put it in one way that is not criminalizing, but listen, if you banned it, and I go to another state and I buy it, and I come back here, I can be charged. 26 February 8, 2021
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REP. STEINBERG (136TH): No.
PASTOR BOISE KIMBER: Well explain that then.
REP. STEINBERG (136TH): Again, I invite everyone to read the text of the Bill itself. It criminalizes the sale of the product, not the possession or the use the product, some might want that, but all it does is criminalize the sale. We don't encourage people to go out-of-state and buy products and then bring them back in, but they would not be a criminal for having done so. That's a very important distinction. We use 'criminalize' in the legal sense, they will not be liable for some sort of criminal action.
PASTOR BOISE KIMBER: Mr. Chairman, you are taking the rights away from people who want to go to a store and buy cigarettes, you're taking that right away, and then you're say, "Oh, you will not be criminalized. You will not be arrested if you buy from a local store."
REP. STEINBERG (136TH): Well, you shouldn't be able to buy it at the local store, and that's the point we're making, that would not be allowed.
PASTOR BOISE KIMBER: Why not? We're going to be able -- if the cannabis bill is passed, we're gonna be able to buy that legally.
REP. STEINBERG (136TH): We're not here today talking about recreational marijuana, Pastor.
PASTOR BOISE KIMBER: No, no, but we're here talking about what you are trying to ban. That's what we're talking about. And you're saying that you're taking my right away from me if I want to smoke menthol cigarettes, you're taking my right away, that I 27 February 8, 2021
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can't go to the local store and purchase it. And if I go to the local store and purchase it, and some officer is watching me come out of the store, then I can be arrested for purchasing those cigarettes and the owner.
SENATOR DAUGHERTY ABRAMS (13TH): No, you would not.
REP. STEINBERG (136TH): That's not true.
PASTOR BOISE KIMBER: Well, the owner then. The owner who's selling it, will pay a consequence.
SENATOR DAUGHERTY ABRAMS (13TH): Yes, that is correct, but not the user, not for -- no one for possessing it or using it, just for selling it.
PASTOR BOISE KIMBER: Well, you're taking --
SENATOR DAUGHERTY ABRAMS (13TH): So it's just going to be -- it's all about what this says. I hear your point, and you're absolutely right. It would deny people the ability to go to their local store and buy these products, that's undeniable. But the consequence would not be on the person using or in possession of it, it would only be on the seller.
PASTOR BOISE KIMBER: But that's what you are saying now That means that the seller who is trying to make a living in these communities will be penalized by the fact of flavored tobacco cigarettes-- and you're trying to take that right away. And you're taking the right away from me going into a local store to purchase it. Look at this Bill. Look at it from a human standpoint.
REP. STEINBERG (136TH): Thank you. Representative Betts.
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SENATOR BETTS (78TH): Yes, thank you, Mr. Chairman, and thank you, Pastor. I have an open-ended question. And I'm not sure if the Chairs can answer it, or if anybody knows the answer. If somebody does purchase it, and it's illegal for the storeowner to sell it, what happens -- or does anything happen to the person who's just purchased menthol cigarettes, for example?
REP. STEINBERG (136TH): Nothing happens. If you were to recall, the Vaping Bill we passed years ago, again, that was focused on the seller, we have not criminalized the behavior of the person using the product. That was intentional. And to date, it looks as if that law's working pretty well. Once again, we are criminalizing the sale, not the possession or the use. We are hopeful that that will have a positive impact on tobacco addiction. Does that answer your question, Representative?
SENATOR BETTS (78TH): Yes, it does. And I wanna thank the Pastor, because I think he makes a very important point about the rights of people who are businesses and are trying to do something to help their business, and this just seems-- as well as the person who wants to buy. I'm not a smoker myself, who wants to buy menthol cigarettes. Is that the role of government to pick and choose what it is we can and cannot do? And again, even though we're not having marijuana today, we'll have it later on. That'll be the same question. Who is the judge in terms of what's acceptable and not acceptable? And does the government decide that or do people have the right to decide it for themselves? I thank you.
REP. STEINBERG (136TH): Thank you, Representative. Any other questions? If not, thank you, Pastor, for your testimony today. Next up is Amanda Martel, followed by Khuram Ghumman. Ms. Martel. We're trying to make sure everybody has a chance to speak, but I 29 February 8, 2021
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do not see Ms. Martel in the queue as at right now. Alright, unfortunately, we'll have to move on without her. Khuram Ghumman, if you would like to testify, please continue.
KHURAM GHUMMAN: Thank you, Senator Abrams, Representative Steinberg, and Members of the Public Health Committee. Thank you for the privilege to share my thoughts on this important public health issue. My name is Khuram Ghumman, and I am the Immediate Past President for Hartford County Medical Association, and I'm also a family physician who practice in East Granby, Connecticut. And I am talking about the Senate Bill 285.
The importance of passing this Senate Bill 285 is vital for providing quality care for Connecticut residents, as pressures continue to mount due to the pandemic and the ever-changing landscape in the delivery of medical care. Unfortunately, the number of primary care physicians is declining in Connecticut, and the trend is expected to continue. The best remedy for addressing the dilemma is to create broader disciplinary teams of caregivers, with a focus on disease prevention. This includes, allowing certified medical assistants to work at the top of their trained abilities by permitting them to administer vaccines. This is both efficient, safe and acts as a catalyst for improved care and access to treatment, as it frees up physicians, physician assistants, advanced nurse-practitioners and registered nurses so they could engage patients in other different clinical responsibilities.
The medical assisting profession started in about 1956, and according to the US Bureau of Labor Statistics, the employment of medical assistant is projected to grow 29% from 2016 to 2026, much faster than the average of other occupations. Medical assistants are allied health professionals, educated 30 February 8, 2021
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and trained to perform both clinical and administrative tasks in outpatient settings under the direct on-site supervision of a physician. Licensing of the medical assistant does not exist in most jurisdictions, however, almost all states permit physicians to delegate the administration of vaccines to their medical assistants, working under direct on-site supervision of the physicians. Connecticut is only one of the very few states that forbids physicians from delegating this task to their medical assistants.
Enacting a legislation that would permit physicians and other appropriate licensed health care providers to delegate to their medical assistants, the administration of vaccines under their direct supervision would result in greater access to care for our communities and our patients. This would allow physicians to delegate certain tasks, including vaccines administration to their trained and credentialed medical assistants, and the physicians would be enabled to treat different, greater number of patients.
Several other states have success utilizing the no licensure model for delegation of this task to their medical assistants. In 1985, the New Jersey Board of medicine issued rules that permitted physicians to delegate to medical assistants who meet education and credentialing requirements for the administration of injections.
LINDSAY VAN BUREN: I hate to interrupt you but you've hit your three-minute mark, if you wanna conclude your remarks.
KHURAM GHUMMAN: So my concluding remarks will be, due to ongoing pandemic and due to ongoing several challenges that the primary care physicians, in general, are facing in their offices in delivery of 31 February 8, 2021
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quality care, I will encourage this Committee to vote for this House Bill -- Senate Bill 285 to allow medical assistants to administer vaccines in an outpatient setting. And I'm happy to take any questions that I can help answer.
REP. STEINBERG (136TH): Thank you for your testimony. I have a question for you. It's my understanding that virtually every other state in the Union allows medical assistants to do these kind of vaccinations, yet the number of nurses in the State of Connecticut are adamantly opposed to allowing medical assistants to administer vaccines. I believe their issue is one that they don't feel that medical assistants are qualified and there may be some risk involved. Could you comment on that?
KHURAM GHUMMAN: So, sure, yes, thank you for bringing this to the Committee's attention, that most jurisdictions, most states in the country do allow medical assistants to administer vaccines, and the nurse's comment is well-taken, there will be additional, you know, X number of hours of training if they're required to -- the medical assistants, if they know more about the landmarks, the anatomy of where the administration will take place. So I think that is safe, and the skill needed to perform the actual administration of vaccine is there. Maybe a little more about the background about the safety of the anatomy and the physiology of how they are doing, I think additional few hours of training would help alleviate that concern.
REP. STEINBERG (136TH): Thank you. Is it your impression, and I'm gonna just ask you anecdotally then move on to Representative Petit, that in many collaborative settings, medical assistants under the supervision of a physician are performing these duties and have done so safely?
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KHURAM GHUMMAN: Yes. And as a matter of fact, my practice is in East Granby, which is like close to the Massachusetts border, so I have certain medical assistants who, you know, are licensed, who work on the weekends in the State of Massachusetts. So, the same person on a different day could do that in a different place, which is like, you know, right next door. But on a different day, the same person is unable to do the same task because of the restricting laws or the restrictions put on their skill set in a different location.
So I think you're absolutely right. This is already being done at a lot of other places, including our neighboring states, in, you know, Connecticut Rhode Island and Massachusetts.
REP. STEINBERG (136TH): Thank you for your testimony. Representative Petit.
REP. PETIT (22ND): Thank you, Mr. Chairman. Thank you, Dr. Ghumman, for your testimony. I would reiterate what the Chairman said, we've been told by OLR and CNA associations from across the country that 49 states allow this. Secondly, one of the counter-arguments has been that this procedure should be done often by registered nurses. But what we hear from primary care practices, especially pediatric practices, is that they really don't have an ability to hire registered nurses for these positions, since they're in such demand in other areas at a much higher price. Can you comment on the availability of nurses at a higher level being available to primary care offices to do this kind of procedure on a day-to-day basis?
KHURAM GHUMMAN: Thank you so much for bringing this other comment. So yes, absolutely, we run this challenge every single day. I mean, we've been looking to hire more nurses for the -- you know, 33 February 8, 2021
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we're always looking for additional help, but it is challenging to hire nurses. Especially in an outpatient setting to do certain tasks, including tasks like vaccinations.
And another comment on the same lines I would like to mention, medical assistants, as of today, even in Connecticut are allowed to do blood draws, which is, in a way, a higher risk procedure than administering a vaccine. So, the medical assistants are able to do venous blood draws in the State of Connecticut, which could lead to potentially -- you know, theoretically more complications than administering an intramuscular injection.
So, I would encourage our Public Health Committee to consider knowing the challenges are not as high as some of the other tasks that they are currently being completed by the medical assistants. So I think adding the vaccine administration would actually be helpful in adding to their skill set.
REP. PETIT (22ND): Thank you, doctor. Thank you, Mr. Chair.
REP. STEINBERG (136TH): Thank you, Representative. Representative Dauphinais.
REP. DAUPHINAIS (44TH): Hi, thank you, Mr. Chairman, and thank you, doctor for your testimony. I am a nurse and I have a few questions regarding this Bill. The medical assistants in it and this state, is their training different than in New York?
KHURAM GHUMMAN: I honestly could not comment, because I don't know what their curriculum entails in the State of New York or the State of Connecticut. So I would be making a informed comment on that. So I am not familiar with their specific curriculum in both states. 34 February 8, 2021
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REP. DAUPHINAIS (44TH): Do they currently-- do you know if in Connecticut they have a pharmacological course that they're taught, a pharmacy course? And are they trained to do injections?
KHURAM GHUMMAN: So, again, that's a very valid comment. So, what we are requesting for is not the medical assistant making the judgment of which vaccine to administer, they will simply be following the directions, with a checklist in place, that this vaccine drawn up in this injection could be administered to this arm in a step-wise checklist fashion way. So they are not making the decision on the pharmacological choices for the patient, they are simply following the directions from the licensed providers.
REP. DAUPHINAIS (44TH): So, this medical assistant that worked in New York and for you in your office, how was that individual trained to give -- to administer drugs or injections?
KHURAM GHUMMAN: I am not sure about New York. I commented about Massachusetts, but the medical assistants, you know, like I said, I am not familiar with the precise curriculum that they are taught in their medical assistant training in other states. However, like I said, there can be an additional X number of hours of additional training to the medical assistants, so they are familiar with the anatomy and the physiology of the injection site. However, they will not be making the decision on the pharmacologic components of which specific medication or the vaccine that they're going to administer. That will be determined and directed by the on-site physician.
REP. DAUPHINAIS (44TH): I know in my own training, we had a rigorous course of pharmacology and how to 35 February 8, 2021
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give an injection, and we were responsible for what we were giving an individual. We had to look at it, the dosage, the person, many, many things we had to look for when giving an injection. So I'm just curious, without that training and background and not part of the course, how you would -- you know, think it were safe? And additionally, I would probably argue differently with you that, withdrawing blood and injecting a drug into somebody is, I would say, equally, if not more -- you know, it needs expertise, in terms of how you would do that.
KHURAM GHUMMAN: So, you know, Representative, I completely, you know, see your comment and point of the safety in the coursework that is required. RN is absolutely more knowledgeable and more trained, in terms of the didactic component and the on-site, you know, clinical training, no question about it. What we are asking for is then, the medical assistants are not making the decisions on the nature of the pharmacological agent that they are going to give, they are going to follow the directions, with a predetermined, like a checklist model approach to delivering the injection, intramuscular injections for the patients. The vaccine, the vial, the dosage, the instructions will be given to them by the supervising physicians, and they are going to simply follow the directions and administer the vaccine.
REP. DAUPHINAIS (44TH): Understood. Thank you.
KHURAM GHUMMAN: Thank you.
REP. STEINBERG (136TH): Thank you, Representative. I think the key word is, 'supervised'. So that's an important point. Thank you for your testimony. I don't see any other hands.
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Before I move on to Jim Williams, I want to address the point of some frustration, I imagine, among the attendees from the public. A number of you continue to raise your hands. Unfortunately, we do not allow attendees testifiers to ask questions. Your only opportunity is to testify in your three-minute window and be asked questions by the Legislators. We do not entertain questions from the public in that fashion. So I apologize if there's been any confusion about the process here, but those are the rules. Jim Williams, followed by Nidal Dammad. Mr. Williams.
JIM WILLIAMS: Thank you. I'm Jim Williams, the Connecticut Government Relations Director for the American Heart Association. I would like to thank the leadership and Members of the Public Health Committee for providing me with the opportunity to provide comment on Senate Bill 326, which would prohibit the sale of all flavors and all tobacco products in all Connecticut locations.
We are in strong support of this Bill, but would very much like to see a friendly amendment added to the language that we feel is necessary and strengthens the Bill. The amendment that we request will address the concerns voiced by the Department of Consumer Protection and would explicitly and simply designate the Connecticut Department of Mental Health and Addiction Aervices as having the authority to conduct unannounced compliance checks of licensed premises to ensure compliance with this Act.
Heart Disease is the number one cause of death in Connecticut, and smoking is a leading risk factor for heart disease. 480,000 state residents of the adult population use some form of tobacco on one or more of the past 30 days, and an estimated 4,900 37 February 8, 2021
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adults die in Connecticut each year as a result of their own smoking.
In Connecticut, 900 kids under the age of 18 become new daily smokers each year. 56,000 kids who are now under the age of 18 in Connecticut will eventually die prematurely from their own smoking.
Smoking not only kills Connecticut residents, but it's also associated with some staggering monetary costs. $2.03 billion dollars in annual health care costs in Connecticut are directly caused by smoking, $520 million of which is covered by the State Medicaid program. The Federal State tax burden for residents from smoking-caused government expenditures is $799 per household.
By now we have all heard about the undeniable e- cigarette epidemic among our youth. This Bill, however, would ban all flavors and all products, to include menthol cigarettes, for which I will comment on further. Menthol cigarettes, the only remaining flavored cigarette, maintain a significant market share. While overall cigarette sales have been declining, the proportion of smokers using menthol cigarettes has been increasing. Menthol cigarettes comprise approximately 36% of the market, the highest proportion on record since the FTC began collecting this data in 1963. As the only flavored cigarette left on the market, it is no surprise that menthol cigarettes are popular among youth. Menthol cools and numbs the throat, reducing the harshness of cigarette smoke, thereby making menthol cigarettes more appealing to youth, who are initiating tobacco use. According to the FDA's tobacco product Scientific Advisory Committee, menthol cigarettes increase the number of children who experiment with cigarettes, and the number of children who become regular smokers, increasing overall of youth smoking. Young people who initiate 38 February 8, 2021
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using menthol cigarettes are more likely to become addicted and become long-term--
LINDSAY VAN BUREN: Sorry, you've hit your three minutes, if you want to conclude your remarks. Thank you.
JIM WILLIAMS: I'll just conclude by offering my willingness to answer any questions that you have now or at any time moving forward.
REP. STEINBERG (136TH): Thank you for your testimony. And I appreciate, particularly, your explanation of the health care impacts and costs of these addictions. I hope you'll be able to share with the Committee the data that you alluded to that suggests the cost to the State of having to deal with the ramifications of addiction. Because we are very concerned, obviously, that this will have some impact on state revenues by way of taxes, and it's important for us to recognize that the costs to the State may actually be higher than the revenues that we're losing in order to put this into effect. So thank you for that. Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Mr. Chairman. I just wanted to thank you for your testimony, Mr. Williams. Again, I wanted to touch on the same topic that the Chair alluded to as well. One of the arguments some of my colleagues and also the people in the community say about the loss of revenue to the State. If we look at that angle, and see from a very myopic perspective, I believe that we may lose a little bit, but we actually lose a lot more in the health and wellbeing and an unhealthy workforce. Could you just explain a little bit more about the loss of revenue to the State from the unhealthy workforce, but also, the Medicaid costs, directly?
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JIM WILLIAMS: Sure. As I mentioned, that there obviously are some pretty staggering financial costs to the State as a result of our citizens who are currently smoking. What it boils down to for each household is about $800 a year in health care costs. And I would also mention that there are some other concerns that have been voiced about cross border sales. And I would point out that Massachusetts currently has a full tobacco flavor ban on all products, New York, New Jersey, Rhode Island have banned all flavored e-cigarettes and I believe are all working again this session to include menthol cigarettes. And Maine is working on similar bills this session as well, as we speak.
SENATOR ANWAR (3RD): Thank you. Thank you so much for your testimony, again. Thank you, Mr. Chair.
REP. STEINBERG (136TH): Thank you, Senator. Representative Zupkus.
REP. ZUPKUS (89TH): Thank you, Mr. Chair. Good morning, Mr. Williams, nice to see you. Thank you for your testimony. In talking about, you know, this -- as you were just talking about the surrounding States, what has it done to the black market?
JIM WILLIAMS: You know, I would have to admit that I don't think I'm qualified to discuss what's happening on the black market. I kind of look at that as more of an issue for law enforcement. But what I will tell you is that when we did Tobacco 21, we weren't the first New England State to do so, and these same exact concerns came up, obviously. But, what happened was eventually it was passed on a national level. And I think, to a very large degree, those concerns have dissipated. I believe the same will happen by prohibiting the sale of flavored tobacco products. Now, as I mentioned, we're surrounded by states that have already done so, and 40 February 8, 2021
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Connecticut would just be the next state to do the same thing.
REP. ZUPKUS (89TH): Do you know what has [audible gap 1:13:21] Sorry, I don't know how that happened. Do you know how much, in these surrounding states, by raising the age -- they did, but us as well, that it has diminished the people under 21 in accessing these products? Because we just raised the age, what? Two years ago, last year, two years ago, I don't even remember, recently, fairly recently. So what's diminished in that under 21 population?
JIM WILLIAMS: Well, as I testified a couple of years ago on that Bill, I mentioned that, in my opinion, that was not gonna solve the youth tobacco epidemic. But what I did say was that it was one action that would certainly help the situation. I don't have the data in front of me, Representative Zupkus, I'd be more than happy to get it to you. But I do know that it has certainly made it much more difficult for kids to get access to those products. That being said, the reason why, you know, us and a large group of others want to ban the tobacco flavors, is that those products are available to kids. Kids under 21 are still getting tobacco products, although I would guess that it has been dramatically cut. And I believe the same will happen once flavors are banned.
REP. ZUPKUS (89TH): Could you just tell me how kids, if they're under 21, how are they accessing them? Why are we not looking at that part of it?
JIM WILLIAMS: I have two boys, they're 13 and 12 years old, and I'm guessing at some point, they're probably gonna access beer the same way we did when we were kids, from their friends. They cannot legally purchase it, but as was also pointed out in this conversation, if they have possession of 41 February 8, 2021
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flavored tobacco products, they will not be penalized in any way, shape, or form. But my guess is that, if they want an e-cigarette, or if they want a cigarette, they could probably get it from an older friend, but this will make it much more difficult for them to do so.
REP. ZUPKUS (89TH): My last question is, and I have to ask you this, are you in your organization gonna come out against legalizing recreational marijuana?
JIM WILLIAMS: Well, to be honest with you, as far as that issue goes, me personally, I don't think you should really be putting anything into your lungs except for clean oxygen. We don't have a position on the marijuana bill.
REP. ZUPKUS (89TH): Okay, thank you. Nice to see you. Thank you so much.
REP. STEINBERG (136TH): Thank you, Representative. Representative Betts, followed by Senator Hwang.
SENATOR BETTS (78TH): Thank you very much, Mr. Chairman, and thank you, Jim. I have a couple of questions. One is, given the strong belief conveyed by your organization and others today about prohibiting flavored cigarettes being sold, is anything being done on the federal level? If this is such a huge health issue, would it not be very clear on the federal level that this is not something we would wanna pursue as a policy, nationwide?
JIM WILLIAMS: I think everything kind of starts locally. You know, if you remember with Tobacco 21, I believe it started with Bridgeport in Hartford, and then the State passed it. And I think that's probably how, you know, other states have passed it. And largely, that's how I think it's gonna to be acted on the federal level. I know the federal 42 February 8, 2021
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government has weighed in on the sale of electronic cigarettes, but as far as completely banning all tobacco flavors, I'm not sure where they are at the moment with the new administration.
SENATOR BETTS (78TH): Thank you for that. Can you tell me-- you said they weighed in on the flavored cigarettes, can you give me or elaborate on that a little bit more as to whether they're passing something or something is under consideration?
JIM WILLIAMS: Well, regarding e-cigarettes, I can tell you that a couple of federal organizations have recognized the fact that e-cigarette use is an epidemic among our kids. You know, there are some products out there, for example, Juul, that have a much higher nicotine content than like a pack of cigarettes. What they're doing -- excuse me -- what they're doing right now, again, I'm not sure with regards to the new administration. I would like to hope that they end up banning all tobacco flavors and all products, but time will tell.
SENATOR BETTS (78TH): Thank you, Jim. Thank you, Mr. Chairman.
REP. STEINBERG (136TH): Thank you, Representative. Senator Hwang, followed by Representative Foster.
SENATOR HWANG (28TH): Thank you, Mr. Chair. Mr. Williams, I wanna extend my heartfelt appreciation for you and your organization's tireless effort in raising awareness. And I am a student of history, when I think about how this campaign began to look at smoke cessation and heart health and all the various things you all do, so you need to be complimented on that. I just wanted to follow-up with Representative Zupkus' question in regards to marijuana. You know, one of the major forms is the intake through smoking, and is your organization 43 February 8, 2021
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differentiating and not taking a position between nicotine versus narcotics?
JIM WILLIAMS: My organization does not have a position on marijuana. I believe it has to do with the fact that long-term usage has not been looked at enough. We may have a position on it moving forward, but currently we don't, Senator.
SENATOR HWANG (28TH): Long-term usage, meaning that health and potential developmental rationale. I am not sure, because I think there's quite significant evidence in regards to the impact, and in fact, it is currently a banned narcotic. So, I just wanted to be clear on the distinction you're making is, you're saying there's not enough study, so you won't take a position on it? Is that clear?
JIM WILLIAMS: I suggested that might be the reason, but what I can tell you is that long-term studies have shown that continued tobacco use leads to addiction and related disease, and ultimately, in many cases, death.
SENATOR HWANG (28TH): And you're saying it's inconclusive, according to you and your organization, that marijuana does not?
JIM WILLIAMS: I did not say that on behalf of my organization, I said that that was my thought. Because usually, the Heart Association --
REP. STEINBERG (136TH): Excuse me, if you wouldn't mind, Mr. Williams, I think you're being put in an unfortunate position. The discussion of recreational marijuana is not on this Bill, and in my view is not germane. I'm very hopeful that if there's a recreational Bill, that comes before the legislature this session, it will come before the Public Health Committee, and we'll have an opportunity to 44 February 8, 2021
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interrogate people who have information and a clear point of view, but I think we're getting a little bit far afield, you'll excuse me, Senator?
SENATOR HWANG (28TH): Not at all. But I do take offense the word when you accuse me of interrogating. So, let that be noted. Mr. Chair. I'm simply asking a question, if the question is not germane, I'm happy to refrain from it. But I'm simply trying to get a consistency in regard to our application, so let me be clear. If it's interpreted as interrogation, I never intended to and I am a little taken aback by the Chair's commentary on that.
With that said, Mr. William, let me reiterate what I said earlier, I'm greatly appreciative of the leadership effort of your organization. And I do believe that if your organization were to take a leadership role in many other positions that you've taken, I think it would help dramatically, for the greater public health and the long-term public health of our children and of our adults. So, I would encourage the organization to consider and deliberate, and offer a leadership role on that, to give us a guidance as you've so ably done on this issue. So thank you, Mr. Chair. And thank you, Mr. Williams, for your good work.
JIM WILLIAMS: Thank you, Senator.
REP. STEINBERG (136TH): Thank you, Senator. I apologize for any misinterpretation. I believe if you do look up the definition of interrogate, it does not have a pejorative connotation and would be appropriate in this case, but if you're offended by its use, I apologize. Representative Foster.
REP. FOSTER (57TH): Thank you so much for the opportunity to speak, Representative Steinberg. Mr. 45 February 8, 2021
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Williams, I really appreciate your organization coming and speaking in front of us today. I know that a lot of the work that you do, or all of it, is based on peer-reviewed scientific evidence that's published based on nationally representative data sets. So I'd just like to confirm, because I think there have been a couple of questions you've been asked to speak to. Do you endorse and support Representatives or Senators who are interested in getting more tobacco usage data, understanding the negative impacts on health and its cumulative impact over time, to use the state data set put forth by the CDC? And also the BRFSS data set, also nationally representative peer-reviewed data?
JIM WILLIAMS: Data is always critical and important. I don't think he could ever have enough.
REP. FOSTER (57TH): Okay. And are those peer- reviewed scientific data sets, those are the things that are used to inform the materials that you put forward, correct?
JIM WILLIAMS: Correct.
REP. FOSTER (57TH): Okay. And I just have one more question. It is your understanding, correct, that cumulative tobacco use over time has been unequivocally understood to impact cardiovascular disease health, and so anything that makes it more likely that any population, particularly children starting young, and using cigarettes or tobacco products, the cumulative impact of something that's an addictive or habit-forming substance that's used on a regular basis, would have a stronger, almost dose response, negative impact on someone's health, cardiovascular, lung, and et cetera?
JIM WILLIAMS: That's correct. In fact, I'll use a very personal example. My father started smoking 46 February 8, 2021
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Salem cigarettes when he was 15 years old, he smoked for 30 years, he quit for about 15 years. He eventually died from lung cancer, which went to his brain. My two young sons never had the chance to meet him, so that's why I take this issue very personally. I don't want my kids, or anyone else's kids, to hopefully ever get their hands on these products, which, if used by the manufacturer's recommendations, are likely to eventually kill you.
REP. FOSTER (57TH): Okay. I'm so sorry about your loss, and my family has also been impacted by the negative impacts of smoking. And so, I know that anything that leads to addiction, if we can prevent those habits from starting young, the younger they start, the harder they are to break, and so I really appreciate you testifying and sharing your data driven empirical expertise. So, thank you very much.
JIM WILLIAMS: Could I respond to Representative Foster quickly.
REP. STEINBERG (136TH): Please, quickly.
JIM WILLIAMS: Representative, I would also point out that it's important to have funding. And, as you may have heard, the State takes in approximately $450 million annually from the tobacco taxes and as a result of the Master Settlement, very little to none of which go to tobacco control efforts. So I think it would be very important for the State to strongly consider sending at least a strong portion of that money towards tobacco control.
REP. FOSTER (57TH): I appreciate your feedback. Thank you.
REP. STEINBERG (136TH): Thank you, Mr. Williams. I do not see any further questions for you today. Again, thank you for your testimony. Next up, we 47 February 8, 2021
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have number, I believe, 11, on the list, Nidal Dammad. I'm probably butchering the pronunciation, followed by-- even gonna be worse, Laith Shehaiber. Mr. Dammad, please.
NIDAL DAMMAD: Yes, how are you? Actually, I'm a retailer. I've been in the retail business for over 30 years. I understand your position on banning, say, flavored tobacco. The only problem is flavored tobacco is maybe about 40% of sales for small businesses, and that can be a big impact on the life of the business. In the meantime, why don't you -- I mean, instead of being selective, why don't you just ban all cigarettes, all tobacco products and just -- I mean, this is not really making sense. We try to be responsible as far as selling cigarettes to people of age over 21. Other than that, I mean, just like in Massachusetts, they banned flavored tobacco, but they made marijuana legal. It's not making sense, it's just not making sense. Thank you.
REP. STEINBERG (136TH): Thank you, sir. At this juncture, recreational marijuana is not legal in the State of Connecticut, and surrounding extents.
NIDAL DAMMAD: In Massachusetts, I was saying.
REP. STEINBERG (136TH): There we go. Thank you for that. Are there questions? If not, thank you for your testimony and your patience today. Next up is number 12, Laith Shehaiber followed by number 13, Barbara Rudini.
LAITH SHEHAIBER: Yes, sir, my name is Laith Shehaiber. Actually, I'm a retailer as well, but before I'm being retailer, I'm a professional. I work in a children hospital, for almost 10 years. I'm a IT specialist there, as a network engineer, before I being a retailer. I do wanna like start, like talking about how this is going to be affected 48 February 8, 2021
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our retail business. We already talked about it, everybody talked about how it's gonna affected the State, the tax.
I'm just gonna share like a small story about my family, and about-- I have two teenagers, two brothers, one of them now is 24, and the other one is 22. And they both start smoking at 18 years old. So they were like heavy smokers, they were smoking regular tobacco, and when these flavored stuff start coming out, they start doing that. They start smoking electronic cigarettes, trying to quit smoking because, it's all about education. You know, my brothers also are professional, they work in the children -- they work in San Francis Hospital, one of them, and the other one is working in Hartford Hospital. So they already aware every time I see him, I educating them, telling them about the cigarettes, how bad is it, how it's affecting -- their health is going to be affected, like their lungs in the long-term. Maybe they're gonna end up having cancer. So, they already aware of it, and they working hard trying to quit smoking, in general.
So they start with those flavor electronic cigarettes and that helps, to be honest with you. I can see my brother, they are lesser smoking right now, and they trying now to quit electronic smoking by their self. We don't have to push them. I came from a close culture, I'm from Jordan, actually. So, I used to be a teenager, so everything I'm trying to do, I'm seeing my friends have and I wanna try it. "Oh, you cannot do it, it's not here," you know? It's all about -- what I'm trying to say it's all about education. You need to talk to your-- you need to be a best buddy for your brothers, your son, talk to him, educate him, tell him how it is gonna be bad on their health. It's not about like, "Close," like, put them in one room and close all the doors, tell 49 February 8, 2021
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them, "You cannot get out. You cannot do this, you cannot do this, you cannot do that."
It's all about how you educate them. Let them make their decision. They are adults, like 22, 23, 24, 21. They know what's the bad thing for themself, and they know what's the really good thing for their self. So, let them make the decision by themself. This is what I'm trying to say, it's not about-- I don't care about the business, but we really need to care about the business now in this pandemic, right? We need to care about the State. The State cannot afford this, they really cannot afford this cut of tax. I mean, we really need to support each other.
It's all about education. If we need to ban the electronic cigarette, we have to ban other things that will hurt them, not tobacco, like alcohol, other stuff, marijuana--
LINDSAY VAN BUREN: Excuse me, you've hit your three minutes. If you'd like to try to conclude your remarks.
LAITH SHEHAIBER: Thank you very much. I just made my point. I think I'm clear on my point. I don't have anything to add. It just the only thing, just guys, it's all about the education. It's all about how we talk to our kids, it's all about how we have to let them make their own decision. They are 22, 23, 24, 21, they are adults. They know what's the best for their self, what's that wrong for their self. Thank you very much guys.
REP. STEINBERG (136TH): Thank you, sir. And I do take your point, I think we all agree that education is a critical component to addressing addictions and temptations to young people. Thank you for your testimony. Do I see any questions? I do not, again, thank you for your testimony. We'll move on to 50 February 8, 2021
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number 13, Barbara Rudini, followed by number 14, Nurul Alam. Ms. Rudini.
BARBARA RUDINI: Good morning Public Health Committee Members. I'm briefly going to provide a testimony today. My name is Barbara Rudini, again from Trumbull. I oppose SB 285, the ACT ALLOWING MEDICAL ASSISTANTS TO ADMINISTER VACCINES. According to the Connecticut website, medical assistants are currently prohibited from administering a medication by any route. There should be no exceptions. Currently, doctors and nurses who are certified to administer a vaccine are exempt from liability. It would be irresponsible to add medical assistants to this list. It's concerning that the language of this bill states that a medical assistant would be able to administer to anyone, in any location. This language is too vague and should be clarified.
Vaccines are a product that provides special training to administer. Medical error and patient safety needs to be considered, especially when there is no liability. There are always possible side effects with vaccines, and a medical assistant is not qualified and is prohibited from diagnosing patients, and therefore treating, if there was an emergency that needed to be addressed. There is no need for this law.
I also oppose any prohibiting of the vaping products and all that. I 100% agree there's a problem but prohibiting it does not provide a solution. There's arguably so many products that, you know, that harm people's health, even things in food, GMOs, things like that. I have teenage children, and I wanted to agree this is a problem. It is so commonplace using these vaping products and is horrible and they don't think anything of it. Somehow, we really honestly just need an aggressive campaign to, you know, have field trips to hospitals, or nurses come to schools, 51 February 8, 2021
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or in their schools to just help these kids understand. Even have first-hand accounts, like, you know, the "Mothers Against Drunk Driving" have all sorts of campaigns to really kinda make it real for kids, the ramifications.
And also, I believe there's so many kids with this problem who wanna stop, and I don't know if there's any opportunities that these kids are aware of that they can go to and say, "Hey, I need help with stopping the addiction of these products." But, you know, again, I 100% agree there's a problem, but prohibiting it is not gonna provide a solution.
I do agree that they should not be, like, anywhere near where kids can see these products, to even, like, be curious about it, they should be behind counters and really that really needs to be regulated. So that is my brief testimony for today. Thank you.
REP. STEINBERG (136TH): Thank you. You've raised the point with regard to tobacco products, both in terms of education and adequate support and rehabilitation. I think we would all agree that we'd like to see more funds go against that so that everybody has an alternative to find a way to deal with their addiction.
A couple questions for you with regard to the medical assistants bill. My understanding is 49 States allow medical assistants to administer vaccines. Why should Connecticut be special and different? Why should we be standing alone when every other state allows it, and has been doing so without the safety concerns that some people raise? I don't understand why we should be uniquely special in that regard.
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BARBARA RUDINI: Well, all the states have inconsistencies on other topics of vaccines. Also, Connecticut is one of five states that requires the flu vaccine for children in order to enter daycare and preschool. So why are we one of the five-- I think, it's five states out of 50 that require the flu shot for children when they're not infective? So there's a lot of inconsistencies, in terms of vaccines for states.
But particularly for medical assistants, I just believe because there's no liability specifically on this product, we really need to look at that piece of it, also. You know, medical assistants in this state cannot administer oxygen, or do other things. So, I don't have an understanding of what specifically all the other states have, but I think we just kind of need to look at what -- look at it maybe in a different way. What works in those states, and what doesn't work in those states, and learn from that, and apply that to our state, and maybe it will try to go into the right direction. But because there is no liability on this product, it adds another layer of complexity.
REP. STEINBERG (136TH): Thank you for that. One further question with regard to this. You made mention about your concerns about the site in which it could be administered and the like, and suggested some reforms. If we were to take you up on that and amend this Bill to make some of those changes, would you then be in support of it?
BARBARA RUDINI: Which bill?
REP. STEINBERG (136TH): We're talking about the medical assistants of vaccines. You mentioned that so if some things were to be changed in the language, if we were to make those changes, would you be in support? 53 February 8, 2021
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BARBARA RUDINI: It depends. One thing that I don't- - I'm very, very for having things done in a medical setting, under a controlled medical atmosphere. So, I'm not a fan of, for instance, like drive-through flu clinics, things like that. I'm very for about not -- for having vaccines in pharmacies, because it is a medical product. And I truly believe that should be administered in a medical setting, under proper supervision.
So, the language in the Bill says, "To any person, at any time, in any location." I don't agree with that at all. It just kind of gives a blanket, you know, ability for the medical assistants to do that.
Again, and I'm for having it in a medical setting, where it's truly supervised, where if there is a reaction, there is someone there to diagnose it, to treat it right away. So those are -- You know, this should be for any medical treatment product, anything. But especially for vaccines, because anybody who administers them has no liability, so that adds another layer of complexity to the issue.
REP. STEINBERG (136TH): So if we were to limit it to medical settings, and to deal with a liability issue, you'd support the bill?
BARBARA RUDINI: I'd have to hear more, because I don't know, I'm not expert on the qualifications of medical assistants. Because I believe that why should that be exception, and just in vaccines? If they can't administer any other medical product in Connecticut, why would there be an exception? I believe in consistency.
REP. STEINBERG (136TH): Thank you. Representative Betts.
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SENATOR BETTS (78TH): Thank you, Mr. Chairman. And thank you Barbara. Your testimony really got me thinking about 326 and the prohibition of flavored cigarettes and tobacco. And the more I thought about and listened to what you were saying the more I agree with the idea that prohibiting it is not going to be the solution to the problem. And that, in fact, our focus, we really wanna get people to make up their own minds not to smoke, is to educate people. And I think that's far more effective. And I agree with that approach because I think the prohibition, even though it sounds good, feels good, is not really a solution. It's more of a strategy to try and minimize it. But if we really think it's as bad as we all believe, then there should be comprehensive, very focused effort on educating people to the dangers and harm that's gonna come from smoking. So, I thank you, and again, I think it's a very constructive approach to addressing this serious problem. Thank you.
BARBARA RUDINI: And it's an epidemic because, I know-- I mean, this is such an epidemic, it occurs in inner cities, suburbs. It is so common among teenagers, among athletes, among everybody, and it's -- They really don't have a grasp on how harmful it is. And, you know, they really kind of need, I think, just more-- a really hands-on, people coming to the schools and saying how this negatively affected them. Because otherwise kids don't listen.
And I feel that a lot of kids do-- I know for a few kids who do want to stop, but they feel stigmatized, and they feel like they don't wanna be embarrassed by their friends. I don't know if it's just being able to go to the nurse, knowing that there's opportunity somewhere to get off of it. I don't know, it's a horrible, horrible, horrible problem. Kids, teenagers don't think anything of it, and it's 55 February 8, 2021
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horrible. And they're gonna get it, believe me, these guys are sneaky. These teenagers are sneaky.
SENATOR BETTS (78TH): Thank you very much. Thank you, Mr. Chairman.
REP. STEINBERG (136TH): Representative Foster.
REP. FOSTER (57TH): Hi, thank you so much for speaking. Just a quick question, you mentioned that you feel like students are going to get-- children are going to get it anyway, and you felt that education was really effective. But do you think you could speak to the difference in data between policies that prohibit substances that are deemed dangerous, versus the impact of education. Is one or the other more effective based on data?
BARBARA RUDINI: Honestly, kids nowadays-- I have teenagers, there's the DMV rules, for instance, where you can't drive a friend --
REP. FOSTER (57TH): I'm sorry, would you mind speaking to the data of the efficacy as opposed to your personal experience? Just because I think when we're making decisions on children of the State as a whole, we should be thinking things with bigger picture versus personal experience, with all due respect.
BARBARA RUDINI: Like for instance, when kids see first-hand that, actually, they talked to someone where something happened and then there was a consequence, they relate to it more. Because otherwise, it just goes in one ear out the other. And I know recently, one of my children, they were in a car with someone who didn't have their license for a year, and they realized the whole consequences, until it happens firsthand.
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So I believe that, you know, going to the schools and physically talking to these kids, and presenting it in a way that's very relatable and very real, that it can happen to them, that's the only way you reach out to these kids to know the consequences. And, you know, just stories of how people got burned, and how it affected their life. That's the only way to get -- you know, we're trying to target the kids, adults, you know, they have the information, there should be campaigns also for adults, too, because people don't realize, but you have to -- And I'm not a campaign person, but I know teenager brains, and I know what they retain and what they comprehend, and what they really consider. And then, until there's people they know, with people they see that have consequences, and they can relate to it, they're not gonna do anything about it.
REP. FOSTER (57TH): Okay. Well, ma'am, thank you so much for your opinion. I just do wanna clarify, though, for the record, though, that there is a tremendous amount of data that supports that policies that prohibit use of tobacco-based substances have broad-based impact on lowering the rates of children's access to these substances, and to that. I'm in no way, shape, or form, saying that education campaigns should not be happening. However, the impact on the number of children who will have decreased access and decreased duration of smoking over the course of their lifetime, which contributes to higher risk later in life is significantly more impactful with policy, sort of the public health upstream approach, versus the one- on-one education impact, which is super important.
I'm not in any way, shape, or form demeaning that impact of that look at education, but of course, the best, most robust impact from a public health standpoint that reaches the most people is the 57 February 8, 2021
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policy-based incentive. So thank you so much for your opinion. I really appreciate it.
BARBARA RUDINI: You're welcome.
REP. STEINBERG (136TH): Thank you. I don't see any other questions, thank you for your testimony today. We're moving on to number 14, Nurul Alam, followed by number 15, Diane Lewis. Nurul Alam, I see you in the participants list. If you could unmute yourself.
NURUL ALAM: Good morning, Mr. Chairman. Thank you for giving me the opportunity of this conversation. I'm with the small retailers, working in Connecticut and having stores. It's really, after listening all this conversation, I do really understand that it's totally jeopardizing the small business owners. Small owners whose living, surviving selling all the tobaccos. But menthol cigarettes. I saw lot of conversation came in the adult, younger youth are smoking menthol cigarettes, specifically. But I think from my own experience 95% people are smoking the-- adults-- Black people smoking these cigarettes.
So, if you're giving the adult people's right of their access, stopping their choosing what they want to smoke, what they want to drink, about their health. So, I don't think this is right idea to imposing this kind of bills. People should have a right to choose what they like to do it. And there is a lot of other stuff that's hurting the people's health, not only the smoking cigarettes, menthol cigarettes. Adults should have their access. And also, by banning the menthol cigarettes is not only going to jeopardize ourselves, is also revenue for the states, which is I saw the difference for the State -- Someone was explaining how they are breaking down.
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If I don't sell the menthol cigarettes in my stores, the adult people will have still access to buying the menthol cigarettes. I'm speaking to other state retailers, friend of ours, a lot of people, we are losing this cigarette sales, also other sales because that individual not coming to our store, buying the menthol and they are also buying the other stuff. When they don't have access to buy the menthol cigarette, we are also losing the other cigarettes. And by saying that, there is adult drug. Although I have a business in Hartford and others town -- states, the people don't have-- If they don't have access to come into this store and get the drug people who selling the drug outside, they'll be choosing menthol cigarettes outside of the store, outside the people then instead of selling the drug, they will be selling the cigarettes. Because cigarettes, menthol cigarette, new port cigarette is the mostly people, Black people are targeted and they smoke, even though we don't sell it, we cannot stop them getting the smokers getting the access for it. So they will be driving by other States, getting those cigarettes and selling it and we cannot stop them, we cannot change their habits. But we will be losing volume, our sales.
And on the top of it, we are losing all the volume, State have any option how to reset, how to offset our income by losing our sales. And we've been trying to -- for a state-level and government level try to raise our State minimum like other states, Massachusetts and other states.
LINDSAY VAN BUREN: Sorry, you've hit your three minutes. If you could try to conclude your remarks.
NURUL ALAM: Okay. So, we had been talked to a lot of Senators to raise our state minimum up to 22% profit, and we still working in the 8% of profit 59 February 8, 2021
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levels. And I haven't seen any effort from state or government level to increase our profit level of tobacco in state minimum cigarettes. Thank you for listening, I hope they will consider our -- all the points. Thank you again.
REP. STEINBERG (136TH): Thank you for your testimony. Are there any questions? If not, again, thank you. We will now move on to number 15, Diane Lewis, followed by number 16, Tim Andrews. Ms. Lewis.
DIANE LEWIS: Good morning. Members of the Public Health Committee of Connecticut General Assembly, thank you for the opportunity to speak with you this morning. My name is Diane Lewis and I am the Communications Director for the Voices of Women of Color, a for-profit policy firm dedicated to liberating oppressed people in areas such as housing, public health and education. I am here to express my support in favor of Bill SB No. 326, AN ACT PROHIBITING THE SALE OF FLAVORED CIGARETTES, TOBACCO PRODUCTS, ELECTRONIC NICOTINE DELIVERY SYSTEMS AND VAPOR PRODUCTS.
During the COVID-19 pandemic, it is important that our legislators are aware of the tobacco-related issues associated with COVID-19 and unhealthy lungs. Emerging studies suggest that COVID-19 patients who smoke have a higher chance of experiencing severe symptoms or death than non-smokers because smoking often leads to severe respiratory afflictions and is detrimental to the immune system. COVID-19 makes clear that our lung health is so tied to our public health and how we as a community must hold tobacco industries accountable for the harmful impact their products have on brown and black youth.
Stand with us for policies that will, during and after COVID-19, make our community stronger and 60 February 8, 2021
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healthier. As Communications Director, I have listened to the concerns of the Greater Hartford community and can attest that we need to prohibit the sale of all flavored tobacco products now. At a time when COVID-19 has disproportionately devastated the lungs and lives of communities of color, we have a responsibility to protect children's public health. Thank you very much for your time.
REP. STEINBERG (136TH): Thank you, I think you make a very valid point. I think we're all much more sensitized to the risks of respiratory issues these days, and anything that actually makes those problems worse is something we need to keep an eye on. Representative Betts.
SENATOR BETTS (78TH): Thank you, Mr. Chairman. And thank you so much for the testimony. And I fully understand where you're coming from. The question that came across my mind was, let's assume we passed and it becomes law, how much of a difference do you think that's gonna be, in terms of discouraging or preventing people from smoking? They may not be able to go to their local store, will they still be inclined to go elsewhere to do it? And would they be stopping smoking because of the law or because of some kind of educational program that shows it's harmful to your health?
DIANE LEWIS: I think we should do both. We should have a campaign that gets the word out, but we also need legislation to prohibit the sales. But I think, yeah, people are probably going to do, you know, what they wanna do, but we still have to at least have some type of legislation that prohibits it so that there will be consequences. Consequences usually stop people from doing things that they shouldn't be doing. So hopefully, if we can get it passed, that will be one of the consequences to smoking. 61 February 8, 2021
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SENATOR BETTS (78TH): Okay, thank you so much. Thank you, Mr. Chair.
REP. STEINBERG (136TH): Thank you. Are there any other questions? If not, thank you, Ms. Lewis, for your testimony, we very much appreciate it.
DIANE LEWIS: Thank you.
REP. STEINBERG (136TH): Next up is number 16, Tim Andrews, followed by number 17, William Skidd. Mr. Andrews.
TIM ANDREWS: Thank you very much. And thank you to the Committee Members for your service during these difficult times, and for hearing our testimony. I'm representing Americans for Tax Reform to make the argument that for our highly emotional issues such as this, it's important we look at the evidence and the science, and not base decisions and policy on anecdotes. And the data overwhelmingly shows that electronic-reduced risk tobacco alternatives, such as e-cigarettes, have a vital role to play in reducing smoking rates and smoking deaths.
Analysis by every mate, hundreds of studies have now demonstrated this. And a meta-analysis of all of these, the most comprehensive conducted by groups like Public Health England, have shown that e- cigarettes are 95% safer than combustible cigarettes, because without burning the tar, you don't inhale the hundreds of toxic chemicals found in cigarettes.
So it's a public -- In fact, Georgetown University Medical Center found if the majority of smokers in the US moved from conventional tobacco to e- cigarettes, 6.6 million lives in the US would be saved over the next 10 years. Over 30 of the world's 62 February 8, 2021
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leading medical bodies have endorsed e-cigarette as critical to harm reduction and saving lives. The FDA has said that it has a role to play in saving lives. And restricting access to adults who want to quit smoking is counterproductive.
And it's also critical to note that flavors matter for adults according to every survey, but they don't matter to youths. Youth smoking rates when flavor bans have been tried, so youth vaping rates, haven't had an impact. San Francisco, for instance, tried this, there was no impact in vaping but combustible tobacco amongst youths went up. But every study has also shown that it's vital for adults who want to quit smoking to experience a more pleasurable experience through flavors. So what we'll see in this Bill is it will have no impact on your youth e- cigarette uptake, but it will have a big impact in preventing adults from taking an action that is proven overwhelmingly, under hundreds of science studies, to save their lives.
Similarly, just briefly on flavored menthol bans for conventional tobacco, again, the data shows they don't work. Massachusetts tried this recently, and in six months, there was no impact at all in smoking rates. All it did was it drove cross-border sales. In fact, in Rhode Island in New Hampshire, more cigarette sales -- cigarette sales went up by more packs than went down in Massachusetts. All that it led to was a $70 million budget black hole in the six months alone. And it's similarly, up to almost $100 million Connecticut is set to lose to neighboring states and the black market if the menthol ban is passed. gain, no impact on smoking rates, and previous speakers have already said, how it'll disproportionately impact minority populations.
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So just to conclude, please look at the science and at the data, on both a menthol ban and also on e- cigarette flavor ban, because the data demonstrates that an e-cigarette-- menthol and e-cigarette flavor ban will hurt rather than help public health.
REP. STEINBERG (136TH): Thank you, I encourage you to share any data that you have with the Committee, we'd appreciate that. Representative Petit, followed by Representative Foster.
REP. PETIT (22ND): Thank you, Mr. Chair. Thank you, Mr. Andrews. That is consistent with data that I saw, showing that this law, if enacted would cost Connecticut about $100 million in tax revenues on a conservative estimate. I'm wondering if your analysis of the data nationwide, if you're in a position to -- what you would recommend would be the best approach in terms of attempting to diminish access to the negative aspects of combustibles and vaping, and go forward in a common-sense fashion based on the data, what suggestions would you have?
TIM ANDREWS: Absolutely. So, the data has shown that e-cigarettes are twice to three times as effective as any other nicotine quitting aids, such as patches and gums. The New England Medical Journal had a good analysis of this last year. And the reason for that is because they mimic the psychological effects of smoking, so they have been shown to be more effective.
The best thing that public health experts can do is what governments like the United Kingdom have done, which is encourage people to quit smoking to a better alternative. Now, yes, abstinence only is an ideal standard. Everyone can agree the goals is there would be abstinence only, but like in other areas, abstinence only doesn't work. This is why 64 February 8, 2021
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harm reduction is the approach that most leading bodies have shown is the best way for adults.
In terms of youth, everyone agrees that, you know, underage people should not buy vapes or combustible cigarettes, which are even worse, but the way you combat that is to address youth rates and not penalize adults. So, further enforcement procedures, further mechanisms and those sorts of things, as well as education programs, are what's gonna be critical here. Paradoxically, bans, by placing things on the black market can increase youth rates because, if you go to a store where you're required to show ID, have your ID scanned, that's gonna be a lot harder for you, than if you've got a black market. Because criminals, by definition, don't care about following the law.
Things also, such as Tobacco 21, which has increased the age to 21 means you're not gonna have a situation where some high school students can purchase things legally, and then distribute them at schools. We're yet to see long-term effects of what the Tobacco 21 movement has done, but I predict that we will see further reductions, quite significantly in both smoking and e-cigarette use amongst young Americans. And indeed, we've already seen significant drops in the last year already.
REP. PETIT (22ND): You know, a quick follow-up in terms of education, Connecticut's been abysmal in using tobacco trust settlement funds. We've diverted or used the money for other things and not for education. Are you aware of states that have had very successful education programs using their tobacco trust settlement funds to decrease the risk of smoking across any and all ages?
TIM ANDREWS: That's not data that I have at the moment, but I am able to look into that, and pass 65 February 8, 2021
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the information on to you and other Members of the Committee. But I think a lot of States, unfortunately, have taken money from the tobacco settlement fund and instead of using it for what it was intended, to reduce smoking rates, have gone and invested, they can just put it in general fund. And we're seeing that issue come up quite a lot in a number of states, unfortunately, such as Connecticut.
REP. PETIT (22ND): Thank you, Mr. Andrews. Thank you, Mr. Chair.
REP. STEINBERG (136TH): Thank you, Representative. Representative Foster.
REP. FOSTER (57TH): Thank you so much, Mr. Chairman. I am interested a little bit -- you've shared a lot of interesting data with us today, and as a research scientist, I have my doctorate, so I just -- if you forgive me for being a little nerdy and data-driven with my questions here, I'd like to ask for a couple of points of clarification. When you look at the data that looks at e-cigarettes as a pathway to smoking cessation, those studies, to my understanding, are a pathway from combustible cigarettes to e-cigarettes, but have not shown conclusive data that e-cigarette use declined after, correct? So it's not a pathway to nothing, it's a pathway from combustible to e, correct?
TIM ANDREWS: That is incorrect. The study in the New England Medical Journal that I referenced, which showed that they were twice as effective as a complete quit smoking tool. They were not completely effective, no tool is 100% effective, but they were twice as effective as gums, patches or any other tool. There is, at the moment, the data seems to show that most people go from simply using combustible, to dual using, then simply using e- 66 February 8, 2021
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cigarettes exclusively. And of those, some people end up quitting completely.
Now, I would argue that the evidence shows that even if they don't quit completely, the fact that on every single biomarker, exclusively using e- cigarettes as opposed to combustible cigarettes, shows rapid improvements in heart health, in lung health, in reducing risk to throat cancers within months, like the differences already in terms of the biomarkers, the chemical things in the body show marked improvements within months.
So I would say that, one, a large percentage do end up quitting all products entirely. But two, even if they don't, it's still a marked improvement over using combustible cigarettes exclusively. And I'm happy to share with you and your office again, various studies referencing this, I did put some hyperlinks in our written testimony which you can follow, but there are obviously considerably more studies that we could show. I think I don't want to bother all Committee Members with hundreds of pages of different studies, but if you have a particular interest with your background, I'm more than happy to send multiple academic peer-reviewed papers to you.
REP. FOSTER (57TH): So, I would appreciate that. There are two follow-up questions that I have, one, I'm a little concerned when I pull up the disclosures for the article that you referenced, funding disclosures, 'cause I think that's an important thing for us to consider when we look at the merits of well conducted research. And so, the second concern that I have is, a lot of times in the way that you've summarized the data, you often use the word, "Proven" and in the scientific method, we never venture to prove, we venture to accept or reject a hypothesis. And so, I just-- I'm a little 67 February 8, 2021
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wary of the way that the data was presented that you share today, and I do think it's really important upfront for us to look into, not just the funding of who is doing advocacy on behalf of bills, but also the funding on behalf of who is funding the research that we are looking into.
And so, I thank you very much for your testimony, I will have to read a little bit more of these data, including pulling up these funding notifications of the article you referenced as we are here, and if any other Members of the Committee have difficulty accessing these peer-reviewed publications, because they're all behind access walls, I'd be happy to share PDFs with folks who need them to be able to make an informed science-based decision here in this process. Thank you.
REP. STEINBERG (136TH): Thank you Representative, I think we would all benefit from having as much quality information as possible, so I encourage both the testifier and any Member of the Committee to share with other Committee members information that would help us with this decision.
Any other questions for Mr. Andrews? If not, thank you for your testimony today. Next up is, William Skidd, number 17, followed by number 18, Susan Myers. Mr. Skidd. I don't see Mr. Skidd speaking up, and I don't see him in the room. Oh, yes, he is in the room. Please unmute yourself, Mr. Skidd. We can't force you to do so though. Unfortunately, it may be a matter of timing, but Mr. Skidd is missing his opportunity. I am going to move on to our next person, number 18, Susan Myers, Miss Myers.
SUSAN MYERS: Yes. Good morning, everyone. I thank you very much for the opportunity to share my testimony. My name is Susan Myers, I am a resident of West Hartford, Connecticut. And the title of this 68 February 8, 2021
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Bill to me is broad and all-encompassing because it needs to be. We can't allow any loophole for the tobacco industry to circumvent, 'cause they're really effective at doing that. The reality is that all tobacco is bad for our health.
Given what we've learned about the significant health issues resulting from the use of tobacco in any form, it is unbelievable to me that we continue to fight the tobacco industry as they continue to find ways to expand their market share. In the course of doing so, the tobacco industry assures that more people become addicted to nicotine. While impacting lung health, which is far too often resulting in the diagnosis of lung cancer. The tobacco industry does not care about the cost of treatment for lung cancer, nor the loss of life from lung cancer. Our children are the ultimate targets for the tobacco industry. I find that to be unconscionable corporate behavior. And the fact that we have to legislate to correct that bad behavior is sad, but necessary.
The tobacco industry counts on engaging kids, and the basics of peer pressure. It's a marketing approach the tobacco industry has employed successfully for years. I've heard the statements as a mom and as an aunt, "I lit up a cigarette 'cause it's cool to be like the older kids." Or the menthol cigarettes, "They cool my throat and they don't burn like the regular cigarettes.", "I get into vapes 'cause I don't smell like cigarettes and my mom wouldn't know, but I still get a buzz." And then, "This tastes like mango, it can't be bad for me 'cause it tastes good." These are all the lies that you shared with our children.
As a mother and an aunt, I have first-hand experience with high school aged family becoming addicted to cigarettes, to nicotine, because older 69 February 8, 2021
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siblings or friends made it available. I have first- hand experience with other high school-aged family members who started vaping as it was, "Cool. Others were doing it." And they still don't understand the ramifications. And these are smart kids. Each of these young adults have heard from me about the dangers of tobacco, but peer pressure is a far greater force than the mother or an aunt's reason or an educator's reason. We do need to intercede.
From a healthcare perspective, taking action and passing this legislation puts the lives of our children ahead of the profits of the tobacco industry. As for the sale of tobacco products in stores, it's an opportunity for stores to find healthier options. Taking tobacco, in any form, out of our lives provides the promise of greater health, with health not compromised by tobacco. And I thank you and welcome any questions and clarifications.
REP. STEINBERG (136TH): Thank you, Miss Myers, for your testimony. Very cogent and I appreciate it. I do not see any questions for you.
SUSAN MYERS: Okay.
REP. STEINBERG (136TH): Any questions? No. If no, thank you for your testimony. Next up is number 19, Steven Schrag, followed by, Greer Levy.
STEVEN SCHRAG: Good morning. Thank you for the opportunity to testify this morning. I'm gonna testify on Senate Bill 288, AN ACT CONCERNING INDOOR AIR QUALITY IN SCHOOLS. My name is Steve Schrag, I am the regulatory and legislative program analyst for the Connecticut Council on Occupational Safety and Health, ConnectiCOSH. I have a quote to offer the Committee, quote, "The transmission of airborne infectious diseases is increased when there is poor indoor air quality. Evidence is increasing that 70 February 8, 2021
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inadequate, inappropriately designed ventilation systems in healthcare, or other crowded conditions with high-risk population can increase the risk of exposure. Fresh air ventilation is an important factor in contagion control."
Who said this and when? This is from a publication titled, "Indoor air pollution and introduction for health professionals," issued in 1993 by the American Lung Association, Environmental Protection Agency, Consumer Product Safety Commission, and the American Medical Association. How long must we wait for action to protect workers?
ConnectiCOSH is a coalition of workers, their unions, and safety and health professionals that came together in 1981 to ensure that every worker returns home to their families safe and healthy. We do this by conducting research and education programs to help workers organize and take action to work reduce workplace hazards. With regards to SB 288, we have a few comments. Section 5 mandates school air temperature and humidity range, Connecticut has a mostly unenforced cold statute and no heat stressed standard right now. The cold statute should be assigned to Conn-OSHA who actually has inspectors to deal with workplace hazards. On January 19th, 1973, the newly-created OSHA appointed a 15-member standards advisory Committee to deal with heat stress, no standard was created. How long must be wait for this? Conn-OSHA should be mandated to create a heat stress standard as soon as possible. Section 9, bond funding for public health emergency prevention. I'm sorry.
REP. STEINBERG (136TH): Please continue.
STEVEN SCHRAG: Okay. Public school systems are always strapped for resources. Walls are painted, rugs are installed before the invisible ventilation 71 February 8, 2021
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system is properly maintained. Money should be targeted for those schools that follow adequate industry standards. Section 3, monitoring in schools, the highest-ranking school officials, such as the Superintendent, should personally sign off on all local monitoring plans. This sends the right signal to all employees that this is a serious problem. Section 4, procedures for complaints. my experience is that the two biggest obstacles to ensuring safer and healthier workplaces are the two fear factors. The employers are not afraid of OSHA, and workers are afraid to raise their voice.
In addition to complying with whistle-blower laws and regulations, all employers should be required to create a workplace Whistle-blower Protection Policy that ensures day-to-day protections for health and safety complaints. All workplace safety committees should receive training on how to do what's called, root-cause analysis techniques to adequately follow up on all complaints that are filed. Section 2 --
LINDSAY VAN BAUREN: Excuse me, sorry, you hit your three minutes, if want to try to conclude your remarks.
STEVEN SCHRAG: Yeah, there's other sections that I wanna address, but I'll send it to you in my written testimony. We are happy to work with the committee regarding these suggestions to the legislation. We are excited to see some movement forward and protecting workers from airborne pathogens through improved ventilation systems. Thank you for your time and consideration.
REP. STEINBERG (136TH): Thank you, sir, for your testimony. It sounds as if you think we could go even further than we are in this Bill.
STEVEN SCHRAG: Yes, sir. 72 February 8, 2021
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REP. STEINBERG (136TH): And I would encourage you to make sure you submit any recommendations, but also if there's language that you'd like to see in this Bill, we'd be open to that. I guess the one question I have for you is, you make mention of Connecticut OSHA. Do they, to your knowledge, have the resources to do the kind of enforcement that you described?
STEVEN SCHRAG: No, no, no OSHA does, not at the Federal level, not at the state level. They need more resources to do enforcement. They do not have enough inspectors to cover the hundreds and hundreds of state and municipal workplaces in the State, in Connecticut.
REP. STEINBERG (136TH): It doesn't surprise me, but it disappoints me.
STEVEN SCHRAG: Well, as few resources as they have, they have more than Department of Public Health, which is why I made that suggestion. They actually have compliance officers who can go out into the workplace. Public Health does not.
REP. STEINBERG (136TH): That's a very good point, and we will certainly take that under advisement. Thank you for your testimony. Are there any questions? Senator Anwar, if you wanna raise your hand, you know the way to do it.
SENATOR DAUGHERTY ABRAMS (13TH): It is raised, so I don't know why--
REP. STEINBERG (136TH): Oh, it is. I can't see it, my fault. I apologize.
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SENATOR DAUGHERTY ABRAMS (13TH): Senator Anwar's hand is raised, as well as Representative Ryan.
REP. STEINBERG (136TH): Somehow my screen got messed up. So, Senator Anwar, followed Representative Ryan.
SENATOR DAUGHERTY ABRAMS (13TH): Well, I had the virtual and the physical both ways to cover my risk. Thank you so much for your testimony, thank you, Mr. Chair for allowing me to speak. Mr. Schrag, your testimony is very important to me, because as a pulmonary physician, and the number of teachers that we see and health-related challenges that they have from their indoor environment is pretty significant. I would say something which people will not be happy to hear, but I will say I see Department of Correction people and the teachers at the same level, from the indoor environment. That's how bad indoor environment is in both places.
And I also want to mention about the children. Our children are in the same spaces, where they're spending significant part of their day, and the indoor environment exposure is quite significant. I think we will probably, hopefully hear agreement on this across the board, that there is a problem. I want to clarify and understand this better. You made a suggestion about monitoring and enforcement. Could you repeat what you suggested? And what do you think would be the best way to have this monitored and enforced with limited resources that we have in some agencies?
STEVEN SCHRAG: Well, I think I made two suggestions, one was that, the plan -- the Bill requires that there be a plan put together around indoor air quality. My experience is, that lots of plans are really well-intentioned, they sit in a 74 February 8, 2021
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binder on the shelf. And the reality is, somebody who has the highest-ranking authority, whether it's the Superintendent of the school system, or whoever should sign off on that plan, and make sure that they send a signal to everybody that we're serious about this.
The second thing is -- that's at the workplace level, the second thing is it should be enforced by ConOSHA, who has the legal authority to make sure that all workers are protected from recognized hazards. SARS is a recognized hazard. Indoor air quality is, though there's no standard on it, there are recognized standards for that. That's who should be enforcing this, people who have some resources. And Senator Steinberg, you're correct. They don't have enough resources, but at least they have some to actually enforce the standard.
SENATOR ANWAR (3RD): This is very helpful. Thank you again for your testimony and look forward to more information from your written one. Thank you, Mr. Chair.
STEVEN SCHRAG: My pleasure, and I will provide that to you. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. Representative Ryan.
REP. RYAN (139TH): Senator, I too have a question. You did talk quite a bit about what your suggestion, especially for schools and the fact that there is a lack of resources. I think from what you were saying in your testimony that none of this is in statute. Do you think it would go a long way to have this in statute? And what you're sending into is your recommendations? Are they gonna include things that should be in statute to accomplish this?
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STEVEN SCHRAG: Yeah, my experience is, recommendations are all well and nice, but it's like having recommendations for speed limit on the highway. Unless there's a little blue light with a police car there, no one is paying attention to it. So there needs to be statutory enforcement of this. Standards that unions and their workers can turn to when they talk to their employer and say, "This is not just a 'May,' this is a, 'Shall'." And then, in fact, yes, we will make recommendations about what should be in statute.
I mean, I know that there's been discussions about a program that's been in place in the past, called, "Tools for Schools," which is a wonderful program administered by the Department of Health. But it is a "May" and it's not a "Shall". And in fact, when it's implemented, it's terrific, but it's not implemented uniformly. And there needs to be teeth behind that to get someone to pay attention.
REP. RYAN (139TH): And you say that we have access to that program, Tools for Schools, that we can use?
STEVEN SCHRAG: This was a program that was run under the Department of Public Health, and actually I worked with the former director of that to implement it in Waterbury, where I live. It is a terrific training program, but it doesn't have teeth.
REP. RYAN (139TH): Thank you, sir.
STEVEN SCHRAG: You're welcome.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much, Representative. I don't see any more questions, so thank you very much for your testimony, we appreciate your input. And again, please send us that language that you are 76 February 8, 2021
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suggesting, and obviously it will be considered as we move forward.
STEVEN SCHRAG: Thank you for your time.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, have a great day.
STEVEN SCHRAG: You, too.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have number 20, Greer Levy.
GREER LEVY: Hi.
SENATOR DAUGHERTY ABRAMS (13TH): Hi. Thank you for being here.
GREER LEVY: Yeah. My name is Greer Levy, and I'm a resident of Greenwich, Connecticut. I'm also part of the Greenwich Together Youth Coalition and a member of the Greenwich High School Outreach Club. I would like to thank the leadership and members of the Public Health Committee for providing me with the opportunity to express my support for SB 326, which would prohibit the sale of all flavors, and all tobacco products in all Connecticut locations.
My father has been a cigarette smoker since before he met my mother, almost every road trip grocery store run or gas station run, he would have to stop to pick up a couple of packs of Marlboro Lights, so I see tobacco usage daily. I'm aware of the absolute debilitating affect it has on people, and I've seen it even with my father. He has once even tried to use a device, called a blue, to quit smoking, but he said the tobacco flavor that was supposed to replace the cigarettes, tasted like a cigar, and he started using the device on top of the cigarettes.
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Additionally, I attend Greenwich High School, where vaping or juuling has run rampant. According to the CDC in 2020, nearly seven of every 100 middle school students, and about 23 of every 100 high school students reported current use of a tobacco product. Not a single one of my friends have said they haven't at least tried to vape once before, whether they were peer pressured into it or not, who knows? But what I do know is, when the nicotine product is flavored, my friends are more prone to give in and give it a try. They pick the vapes with the best flavors because that is what makes ripping it a fun hobby. Licking a lollipop or even chewing a piece of gum has now turned into ripping or inhaling vapor from a juul.
A typical scene with youth in Greenwich goes as follows: First, a person takes the device out of a bag, then out of curiosity, the surrounding youth asked what flavor the vape is. Then they're offered the vape. The scene is a little too familiar to me. I was once the person asking what flavor it is. And yes, I did accept the offer, just once. Because a coughing storm erupted and I never wanted my body to feel like that again. It was scary, not only scary because I was having that startling reaction, but also because I realized that this is a device people around me use each day and fill their youthful lungs with. It has become so common. No longer are they used occasionally or at weekend parties, but they have now made their way into every nook and cranny of our daily lives.
It hurts me to know that all of my friends may be addicted their entire lives because they wanted to try what the flavor pineapple lemonade tasted like. I don't want them to wind up being part of the more than 16 million Americans who are living with a disease caused by smoking. I don't want them to end up with a crippling addiction like my father. Thank 78 February 8, 2021
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you for this opportunity to share my voice in support of this Bill. I believe in it and you should too.
SENATOR DAUGHERTY ABRAMS (13TH): Well, thank you so much, Ms. Levy. Have you ever testified before?
GREER LEVY: No.
SENATOR DAUGHERTY ABRAMS (13TH): Well, you did an incredible job. And I hope that you go back and show your friends this and show your parents, they should be very proud of you. And it's so important to hear the perspective from a young person, because that's really what we're trying to accomplish here, is to break that cycle of addiction that you've seen played out in your own family.
So, it's just so important that you were here today, and that we heard from you. And I want you to know that you should encourage your friends to do the same if they see bills that are of interest to them. So, we do have some questions for you. We'll start with Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Madam Chair. Thank you, Mr. Levy, for your very important testimony. A little while ago, there were individuals who were -- one person was quoting studies that were funded by Juul, saying that it is actually helpful to stop cigarette smoking. And another person was sharing about his anecdote about somebody that he knew stopped smoking because of vapes. But what you're describing, if I understand you correctly, is vapes are the path for nicotine addiction and subsequent increase to combustible form of cigarettes, is that what you're seeing in schools?
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GREER LEVY: Yeah, that's correct. More people use e-cigarettes than regular cigarettes, especially 'cause they're flavored.
SENATOR ANWAR (3RD): Yeah. And that that's a path into nicotine addiction?
GREER LEVY: Yes.
SENATOR ANWAR (3RD): Okay. Thank you so much, thank you, thank you,
GREER LEVY: Of course.
SENATOR ABRAMS (13TH): Representative, Kavros DeGraw.
REP. KAVROS (17TH): Thank you so much, Madam Chair. And Greer, I just want to say, thank you so much for being here today, because your testimony is absolutely critical, and it is important that we're hearing from the youth, that this so deeply affects. Two years ago, I had the opportunity to work on this in my own community, and some of the things which I would ask you are, have you seen-- you know, people are worried about this black market, but we've heard of cases, in our district where, you know, youth are taking an Uber to the gas station that they know sells to youth. Or they have the Uber driver actually go in and purchase for them, so at the point of sale, there's not as much -- you know, in theory, it's great that T-21, but in practice, it's not always the reality. Where we've also heard of kids selling to other kids on the bus, so is that something that you experience in your community, as well?
GREER LEVY: So, for youth in Greenwich, it's mostly, they don't usually take an Uber anywhere, or have the Uber driver get it for them. But for youth 80 February 8, 2021
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in Greenwich it's more, they go in where they know that the store owner won't card them, and who benefit from making profit off of young kids 'cause they know they will buy it. And so, it's more, they do it themselves in stores where they sell to young people.
REP. KAVROS (17TH): Thank you. And again, thank you so much for being here today. And I'm sorry that you are having to go through this, but I appreciate that you're here to enlighten us on what it really looks like on the ground. Thank you.
GREER LEVY: Of course.
SENATOR DAUGHERTY ABRAMS (13TH): Well, thank you very much, Ms. Levy, it was a pleasure having you. And again, I commend you for taking the time to let us know your perspective, it's really meaningful, and I hope you do it again on any bill that interests you, and I hope that you encourage other students your age to do the same. Thank you. Next, we have number 21, Kyle Feldman
KYLE FELDMAN: Yes. Good morning, everybody.
SENATOR DAUGHERTY ABRAMS (13TH): Good morning, thank you for being here.
KYLE FELDMAN: Thank you for having me. To the Connecticut Public Health Committee, my name is Kyle Feldman, and I'm a Vice-President in National Convenience Distributors, NCD. NCD is a full-line convenience store distributor in the Northeast selling, grocery, frozen, refrigerated food, beverages, school supplies, health, beauty products, and general merchandise, as well as cigarettes and e-cigarettes.
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We have always recognized the value of our services, it's not surprising that during pandemics and crises, we are deemed an essential business, providing the very essential services and products to our customers who supply communities for their needs. We also find ourselves navigating the recent events that have led to a nationwide civil unrest across America, which also has put pressure on our business in obliging curfew orders for safety precautions.
NCD is one of the largest privately held companies in the northeast, over the last 100 plus years we have grown to over 25,000 customers, which includes thousands of customers in Connecticut. We have over 1,600 employees, many of whom are union members and live and vote within Connecticut. In addition to all of this, we're also a very large tax collector in the State of Connecticut, proudly remitting upwards of tens of millions of dollars a year in support of the State that enables us to employ so many individuals and touch many lives in a positive way.
This background is necessary for you to understand, so that you realize I'm not just some fly-by-night individual wanting my voice heard, or we, as an organization, are not only worried about revenue. Banning the sale of menthol cigarettes from Connecticut will lead to thousands of employees losing their jobs, many of which are union employees with health benefits and pensions. Hundreds of millions of dollars in lost tax revenue to the State of Connecticut, tax collectors are going into bankruptcy, the State won't have anyone to stamp cigarettes. Connecticut will encounter hundreds, if not thousands of people selling menthol cigarettes from lower tax jurisdictions. Crime will be out of control.
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The wholesale distribution industry understands the concern of banning the sale of flavored tobacco and vape products to the younger generations, but Connecticut already has a 21-year-old restriction for these products. Our organization is only requesting a dismissal on the potential ban of menthol flavors to the adult market. Bear in mind, these menthol-flavored purchases account for an average of 35% of total sales at your local Connecticut convenience stores, and represent roughly $150 million in tax collections to the State. These wholesale distributors are also very important tax collectors for the State. Should this ban move forward, many will be forced into bankruptcy, especially in the midst of COVID-19 Pandemic. A postponement would be a lifeline to many of these essential small businesses that can ill- afford to lose at least 30, 35% of their sales at this critical time, not to mention what the State has to lose in excise taxes in those lost sales.
In a perfect world, this would solely be a public health issue. However, we all know that we do not live in a perfect world, and therefore it is also now business and societal issue.
LINDSAY VAN BAUREN: You've hit your three-minute mark, if you could conclude your remarks.
KYLE FELDMAN: Yeah. A serious issue, nonetheless, that needs to be handled with care, thought, responsible action. Respectfully, we think you need to call a timeout so you could hear from the effective retailers, wholesalers, and the community as a whole and investigate whether a sales ban would actually keep the product away from kids, and take the time to better understand all the regulatory and market forces at play here. We're dealing with a pandemic and civil unrest, please don't make it 83 February 8, 2021
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worse. I thank you all for your time and consideration.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, Mr. Feldman.
KYLE FELDMAN: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Are there any questions? Seeing none, thank you so much for your testimony, appreciate you being here today. Next, I'm going to go back to number 17, Williams Skidd, I believe. Oh, I apologize, Senator, I just saw that after I dismissed the speaker.
SENATOR HWANG (28TH): That is okay, madam. It is part and parcel of the learning experience that we have. I should have spoken up sooner, so --
SENATOR DAUGHERTY ABRAMS (13TH): No, and I will give it more time, so that people can.
SENATOR HWANG (28TH): Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): I know people are jumping, so I apologize if went too quickly.
SENATOR HWANG (28TH): You bet.
SENATOR DAUGHERTY ABRAMS (13TH): So, Mr. Skidd, are you available to testify now? No? Okay, then we're gonna move on to number 22, Donna Kosiorowski. And I know I probably did not pronounce your name correctly. Number 22.
DONNA KOSIOROWSKI: Can you hear me?
SENATOR DAUGHERTY ABRAMS (13TH): I can, thank you so much. And would you say your name for us please? I apologize. 84 February 8, 2021
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DONNA KOSIOROWSKI: My maiden name was East, but my married name is Kosiorowski. Thank you, Senator Abrams, and Representative Steinberg, for allowing me to testify on Senate Bill 285, Medical Assistants. I'm actually testifying in opposition to that Bill. I've submitted testimony and I had some prepared remarks, but I've been listening in this morning, and I would like to share the following.
One of the topics that's come up is, why Connecticut is one of very few states that don't allow medical assistants to address vaccines. I've done some research on the other States and since Dr. Ghumman represented Massachusetts, I would like to comment on the information that I got regarding Massachusetts, and my research on Connecticut's Department of Public Health. Connecticut does not mention any type of standardized training for medical assistants. They recommend their preparation for medical assistants. They only have recommendations and no requirements. Dr. Ghumman referred to Massachusetts. The difference between Connecticut and Massachusetts is very clearly spelled out. They have a post-secondary program, accredited by a section of the Massachusetts DPH bureau of Health Professions licensure.
I'm in agreement with Representative Dauphinais, and I hope I pronounced her name correctly, that there are many questions about the preparation for medical assistants. And I do not believe, as a nurse with 50 years of experience, that you can't delegate in every circumstance to every person. There are variables that you can't predict, in advance.
One of my personal concerns, also, is that medical assistants should identify themselves, as should any healthcare professional so people know exactly who is providing their care. It's difficult to support 85 February 8, 2021
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this Bill as written, because it's very unclear what the regulations are, what the preparation is going to be, what the accountability will be, for people who don't follow. We have no standards here in Connecticut, and that's definitely a concern. I'm gonna say this with great respect, my dad used to say to me, "Just because all the kids in the neighborhood are jumping off the bridge, does that mean you're gonna jump too?" And just because all the other states, but Connecticut, and I believe it's New York, have not allowed their medical assistants, it doesn't mean that it's right for Connecticut, I think there's much more research to be done. I think appropriate stakeholders should be involved in developing an appropriate program if the decision is to go forward with this.
I neglected to mention that I'm a retired school nurse, I'm also retired member of AFT, and I'm the government relations Chair for the Association of School nurses, so I would like to, if I may, shout out to the school nurses in Connecticut, who in my opinion, have not been recognized for the work that they're doing in the schools. I do hope that you will take my comments to heart, and hopefully we can come up with some kind of DPH-recognized program for medical assistants in general. Regardless of whether they're allowed to give vaccines or not.
I have been researching the COVID vaccine, and I think for people that referred to the difficulty with that, from my--
LINDSAY VAN BAUREN: You've hit your three minutes.I If you could conclude your remarks.
DONNA KOSIOROWSKI: Okay. From my research, it's more -- there's not enough vaccine to go around, versus not having enough people to administer it. So, I thank you for the opportunity to speak to all 86 February 8, 2021
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of you today, and if you have any questions, I'd be happy to answer them.
SENATOR ABRAMS (13TH): Thank you so much for your testimony. There is question from Representative Tercyak. Representative.
REP. TERCYAK (26TH): I'm working hard at it. There we go.
SENATOR DAUGHERTY ABRAMS (13TH): There you go, you're all set.
REP. TERCYAK (26TH): Okay. Thank you very much. Thank you, ma'am, for coming and testifying with us.
I personally hate this Bill. I'm a nurse, and I'm asking you this because you mentioned being a member of a union, so there's -- although it's not your area of expertise maybe, you know. Every time this comes up, I wonder why do people hate LPNs? I'm not aware of any shortage of LPNs who are able to be doing this, and hardly cost anything more than a medical assistant does. Do you have any information on the shortage of LPNs or something like that that could possibly justify this?
DONNA KOSIOROWSKI: Well, I would definitely say that I don't, and most of my nursing colleagues don't hate LPNs. In fact, my best friend is an LPN. I think that people need to work within their scope of practice.
REP. TERCYAK (26TH): Wait, wait, wait, madam, let me interrupt. I don't think you hate LPNs, I think the people who want to take this work away from nurses and give it to untrained, unlicensed people, who are called medical assistants, I wonder if they hate LPNs. This is a job that is easily done by an 87 February 8, 2021
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LPN as part of their routine duties in an office setting. It's a way to help justify having another licensed medical provider as part of the practice, instead of somebody called the medical assistant.
I could see, if I was hearing that convalescent homes and doctors' offices aren't able to hire LPNs because there are none out there, that maybe we might want to do something to solve the problem of a shortage of people able to give vaccines or other injections. But I haven't heard that. Are you aware of anything?
DONNA KOSIOROWSKI: I'm giving you my personal opinion, 'cause I haven't researched this, but I do think it's all about the bottom line. It's all about what you have to pay people. If you're hiring a registered nurse or an LPN, you're certainly gonna have to pay them more than you would a medical assistant. It concerns me, as a nurse with experience in emergency room and intensive care, pediatrics and schools that we're continuously watering down the level of preparation. Again, I'm speaking as my personal opinion. We're watering down the preparation in the level of people that provide health care to our citizens, and that's definitely a concern.
I understand where the health care providers might be coming from, in terms of not being able to get nurses to work in their offices, but again, it's because the pay isn't there, and I think that everybody works for, you know, a salary. But I think LPNs have a place, they're trained, better trained, and there's more accountability for LPN in Connecticut than there are for medical assistants. I'm kind of concerned that DPH really doesn't, at least in my research monitor, the role and the 88 February 8, 2021
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function and the preparation for medical assistants, there's a lot of variables there.
REP. TERCYAK (26TH): Thank you very much. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. Next, we have Representative Dauphinais. Representative Dauphinais, if you're speaking, you're on mute, so.
REP. DAUPHINAIS (44TH): Sorry about that. Than you. Thank you, Donna, for your testimony. I wanted to just thank you. You hit on a lot of the things that I was trying to point out. I don't know if you heard Barbara Rudini earlier, but she also talked about liability, and she also really highlighted some important facts. So I just wanted to thank you for your testimony, and I agree with you 100%.
DONNA KOSIOROWSKI: Thank you, and I'm sorry I pronounced your name wrong.
REP. DAUPHINAIS (44TH): Okay.
DONNA KOSIOROWSKI: I was very impressed with Ms. Rudini's testimony.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much, Representative Dauphinais. And thank you so much for your testimony, as a retired educator myself, I love that you give a shoutout to school nurses, they're amazing people in my experience.
DONNA KOSIOROWSKI: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you for being here, we appreciate your testimony. Have a great day.
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DONNA KOSIOROWSKI: Thank you, you, too.
SENATOR DAUGHERTY ABRAMS (13TH): Oh, I'm sorry, wait a minute, there's another question, Representative McCarty.
REP. McCARTY (38TH): I apologize, Madam Chairman. If I may just ask a very quick question. So, the legislation does point out that there would be eight hours, I believe, I have to go back to -- actual administration of the vaccines, and I'm wondering if you could just comment on that. Would you be more inclined to support medical assistants administering the vaccines if there was more training involved? Is that what I'm hearing?
DONNA KOSIOROWSKI: I would have to see what that training looks like, because as I said in my testimony, my written testimony, vaccine administration is not just a task. If it was as simple as, you know, locating the muscle and putting the needle in there, that might be -- that's simplifying it a little bit. When you administer a vaccine, it's more than that. It's assessment, it's considering the individual client or patient, whatever you want to refer to them as, so I would definitely have to see what the language is and what the eight hours of training would be. I mean, I think it's kind of difficult at this point, to say you can train somebody in eight hours to do something that, you know, nurses take a lot more time to learn. It would depend.
And the other thing, and if I could respectfully say this, there has to be some accountability for assuring that there's standardized training, that everyone is capable, you know, just because you train somebody doesn't mean they're necessarily capable of doing whatever it is they're trained to do. So I hope that answers your question. 90 February 8, 2021
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REP. McCARTY (38TH): Yes, it does. And the training as specifies that it would be in a clinical setting, but I appreciate very much your testimony, thank you.
DONNA KOSIOROWSKI: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. Next is Representative Klarides-Ditria.
REP. KLARIDES-DITRIA (105TH): Thank you, Madam Chairman. Just a couple of questions on my end. Under this Bill, isn't the medical assistants, don't they have to be under direct supervision of an MD or an APRN, like in the same building, within, you know, eyeshot or earshot of their supervisor?
DONNA KOSIOROWSKI: According to what I saw in the Bill, yes, but--go ahead.
REP. KLARIDES-DITRIA (105TH): No, go ahead, finish. Sorry.
DONNA KOSIOROWSKI: So, you know, direct -- 'cause I did work in an office, I worked in a pediatric office. Direct supervision means they have to be in the building, it doesn't necessarily mean that they might be able to respond immediately if there's a problem, or if there's a question. But yes, there is some direct supervision, which is certainly helpful. But I don't think it solves the whole question of the training and the preparation.
REP. KLARIDES-DITRIA (105TH): And then, someone also mentioned, I don't know if it was you, about, there's different steps, obviously, that go into you have to make an assessment of the patient and whatnot, but all those assessments will still be performed by the healthcare professional by the MD, 91 February 8, 2021
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or the APRN, or the PA. So the medical assistant wouldn't be making any assessments, they would just be administering the shot, per the orders of the MD, APR and PA, correct?
DONNA KOSIOROWSKI: From what I understand that might be the intent of the Bill, yes.
REP. KLARIDES-DITRIA (105TH): Yes. And you had mentioned that--I think it was you, I apologize if it wasn't, that you compared it to Massachusetts? Did you compare any other states considering we're one of only two states in the country that don't allow medical assistants to administer?
DONNA KOSIOROWSKI: Yeah. Most of the time when I deal with legislators, they want us to look at States that are, you know, common with Connecticut, so I looked at New England, New York and New Jersey. New York does not allow it. The other states, though, were very clear in most of the research, that there were some standards, there was some preparation, you know, that was consistent across the states. And that there was some accountability through their Department of Public Health or whatever appropriate agency they have, and I don't see that here in Connecticut, I couldn't find anything.
REP. KLARIDES-DITRIA (105TH): Okay. So, is it safe to say that if we mirror -- find a state and mirror what they're doing, that that would make some of your questions answered, and we could make this Bill better?
DONNA KOSIOROWSKI: Yeah, I think it could be better, yes. Because I think there's too many unknowns with the Bill. Particularly with the preparation and the accountability, because also, once you administer a vaccine, if there's some 92 February 8, 2021
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untoward effect, or an allergic reaction immediately following, or shortly following that vaccine, you have to be prepared to manage that, to handle that. So, it's not just the task of the vaccine, it's the observation afterward to make sure that everything is --
REP. KLARIDES-DITRIA (105TH): And you observe, and that's why the MDA, PRN, PA are around, and that's why we have EpiPens that people are allowed to use on a daily basis.
DONNA KOSIOROWSKI: Correct.
REP. KLARIDES-DITRIA (105TH): And that simultaneous training with that as well. I understand your concerns, but what I'm trying to say is, if we could make some changes that mirror different states that people are happy with, then maybe that will be able to move this Bill forward and make all the parties happy. Thank you for your testimony.
DONNA KOSIOROWSKI: Yeah. That's a possibility, thank you for bringing that up.
REP. KLARIDES-DITRIA (105TH): Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. Next is Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Madam Chair. Thank you so much for your testimony. I wanted to just make a statement and see how you would reflect thisstatement. Right now, there is a strong push to have pharmacists be the ones providing the vaccines, and then there is conversations that pharmacy techs would be considered for that. Now, if I was to look at the hands-on patient care capacity, not the part on medications, but more so on the 93 February 8, 2021
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hands-on patient care, direct impact, medical assistants go through more training than the pharmacists and the pharmacy tech on the patient hands-on, touching management, IV access, and so all those things that have been done. How would you compare these two policies with each other?
DONNA KOSIOROWSKI: Well, I can't -- you know, I tried to get information on training for medical assistants, and it's not that easy to do, there's a variety of programs. So I don't know what they get trained to do. Obviously, pharmacists have a much higher level of education, in terms of pharmacology and understanding the effects. So, I really can't address, you know, your question at this point, because there's no standard program in Connecticut where I could say, "This is what they're taught and this is how they're taught to do it."
SENATOR ANWAR (3RD): Okay. And again, there are -- pharmacy education is more focused on learning about the medications and the impact and also making sure the concentrations are appropriate. But they are not necessarily learning of the anatomy and the hands-on dissection and work, or working to the body as much, so there are two different components. So, yes, their intellectual training component and educational training component is on a different scale altogether, I'm not questioning that. But if they are going to be giving the shots, injections going forward, and then we -- there is a movement or a conversation that pharmacy techs will be doing it, who have not even the pharmacist that need training, but the medical assistants training is at a different level from the direct patient interactions perspective.
So I just want to, maybe-- have you looked at that angle, too? And I understand where you're coming from, I respect that, but I know that there is a 94 February 8, 2021
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parallel policy that is going to be implemented, and that we need to look at the two from that prism, too.
DONNA KOSIOROWSKI: Well, and you're enlightening me on pharmacists, because I wasn't aware of the subject that you're bringing up, regarding pharmacists. And I don't know how the law changed to allow pharmacists to administer vaccines, so I can't comment on that. But what I'm saying is, that I think the Bill the way it's written, I'm concerned about it because I think it's too vague. I think there has to be some standard, there has to be some oversight and there has to be some accountability, and that may make it more palatable for people.
SENATOR ANWAR (3RD): Thank you.
DONNA KOSIOROWSKI: Does that answer your question? Okay.
SENATOR DAUGHERTY ABRAMS (13TH): Well, thank you very much for your testimony, and for your time today, it was really important for us to hear from you. I don't see any more questions, so thank you very much.
DONNA KOSIOROWSKI: Okay, thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have John Brady.
JOHN BRADY: Good morning, Senator, thank you for this opportunity. Good morning to the Committee. My name is John Brady, I'm a registered nurse and I'm the Vice-President of AFT Connecticut, a labor union of educators, State employees and approximately 7,500 registered nurses and other health care professionals, including medical assistants. We oppose SB 285, the medical assistance of vaccination 95 February 8, 2021
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bill, you've just heard from Donna and you'll hear from several other of our members over the course of the day.
First, let me say that, certified medical assistants are a valuable part of the healthcare team, however, the administration of medication requires more than the technical skill of inserting a needle. It requires the ability to assess the patient, before, during and after the administration of that medication. Currently, Connecticut medical professionals are licensed by the State, or they're certified by the State. These licenses and certifications can be revoked or limited by the State should these medical professionals fail in their duties. Medical assistants' certifications are not issued by this State and cannot be revoked, or limited by the State, as far as I am aware. Certifications in medical assistants come from one of four associations, each with different criteria and training requirements, and I've spelled some of those out in my written testimony.
The training for medical assistant can vary from a high school diploma, with experience in the doctor's office, to an Associate's degree, and there is a vast difference in the training of those different tracks to becoming a certified medical assistant. This Bill would allow a medical assistant, who attended as short as a ten-week certification program, the ability to administer vaccinations, and it wouldn't limit it to ages, so they can be administered to infants and children, which if I remember right, even pharmacists were limited in the first year of the change of that legislation, and then only in the second or third year, were they allowed to administer to children.
So we see this as a problem of lack of oversight by the State, lack of control by the State, and a lack 96 February 8, 2021
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of consistency in the training of medical assistants. We don't believe it provides the protections that Connecticut residents deserve, as far as that guaranteed training and oversight of healthcare professionals who administer medications.
And I'd be happy to try to answer any questions you might have them.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much for your testimony, we'll give everyone a minute here if they have any questions. I don't see any Mr. Brady, so thank you very much for your time today, appreciate you being here.
JOHN BRADY: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have Phoebe Lampos.
PHOEBE LAMPOS: Good morning. My name is Phoebe Lampos and I am a sophomore at Lyman Hall High School. I will be testifying in support of Senate Bill No. 326, AN ACT PROHIBITING THE SALE OF FLAVORED CIGARETTES, TOBACCO PRODUCTS, ELECTRONIC NICOTINE DELIVERY SYSTEMS AND VAPOR PRODUCTS. As a student, I've witnessed how many teens and adolescents are lured into vaping by the appeal of flavored tobacco products. Flavored vapes are directed mostly toward younger students, beginning as early as sixth or seventh grade. The Lymesac Youth Service bureau conducts a survey every two years regarding the popularity of vaping and other substances in our school. The survey in December 2019 indicated that 16.8% of all students in 7th through 12th grade reported that they thought using e-cigarettes/Juuls is not wrong at all.
Among younger students, flavors are much more popular because they make vaping seem safer. The 97 February 8, 2021
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survey also showed that 45.5% of 12th grade students reported having using electronic cigarettes in their lifetime. Most of these students are enthusiastic about the various sweet flavors of the vapors and do not generally understand them to be tobacco products. Many students feel that vaping is not as harmful as cigarettes, which is in direct contravention of the fact that one vape is equivalent to 20 cigarettes. Removing flavored vape from the marketplace, which clearly send the message that e-cigarettes/Juuls are tobacco products, which are just as harmful as cigarettes, if not more so.
Furthermore, there's a culture based around flavors among teens, where different flavors are traded or sold almost as if they were trading cards or collectibles. Eliminating these sweet flavor options would prevent younger kids from beginning to vape. Despite the fact that the law expressly prohibits people under 21 from purchasing vape products, 19.5 of all students in the 7th through 12th grades, reported that it is very easy to obtain e- cigarettes/Juuls. These products are finding their way into our middle school and high schools at an alarming rate. A large part of the reason for this spread is due to the lure of the sweet flavors that appeal to kids.
I strongly urge the Committee to pass this bill banning flavored tobacco products. We'll make our schools and communities safer, and kids less likely to engage in harmful practice of vaping. Thank you for this opportunity to share the situation of our youth on this pressing issue.
SENATOR DAUGHERTY ABRAMS (13TH): Ms. Lampos, thank you so, so much for your testimony. Have you ever testified before?
PHOEBE LAMPOS: I have not. 98 February 8, 2021
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SENATOR DAUGHERTY ABRAMS (13TH): You have not. Well, I hope it was a good experience, 'cause you did a wonderful job. And I hope that you consider doing it again, and tell your friends to do it if they see bills that interest them. But this particular Bill, it's so important that we hear from young people, because you are the ones that are seeing the effects of this. And really who we're trying to prevent from a life of addiction by doing these bills. So, I really, really appreciate you giving us your perspective, it's so helpful. And go back and watch this, you did a great job. Have your parents watch, they'll be so proud of you. Okay. Representative Zupkus
REP. ZUPKUS (89TH): Thank you. And thank you for coming and testifying, it's really wonderful to see young people coming. I have one quick question for you. Have you seen or heard of any advertisement, promotions, educational, anything on vaping being bad for kids?
PHOEBE LAMPOS: I know that our Youth Service Bureau creates presentations, and we present information to kids that vaping is harmful, but I see in middle schools that flavors are presented as more safe, and so they start in middle school and by the time they're in high school, they really need flavors, because they're already addicted. And they know that it's doing bad things to them, but it's -- they're already addicted by that point.
REP. ZUPKUS (89TH): And who is promoting that? I'm just curious.
PHOEBE LAMPOS: Who is what?
REP. ZUPKUS (89TH): In middle school.
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PHOEBE LAMPOS: In middle school? It's usually one group of kids, that's all it takes. And the flavors are so intriguing that it seems fine to start vaping. And they don't really see any effects until later on, and it's usually too late by then. So, I think it's really important that if we eliminate flavors, then it could eliminate the allure of vapes in sixth or seventh grade.
REP. ZUPKUS (89TH): Right, right. 'Cause I'm just curious about the education piece, because there's a lot of things, like we educate on drugs or, you know, and you see that, you hear that in the schools or wherever. And I was just curious if the schools are -- people in the schools where the kids go together, is it being promoted? 'Cause I don't hear it, radio, nowhere. So I was just curious. But thank you, thank you so much.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. We have another question from Representative Kavros DeGraw.
REP. KAVROS DEGRAW (17TH): Thank you so much, Madam Chair. And thank you, Phoebe, for being here today, because you're our second young person to testify today and it's so critically important, as Senator Daugherty Abrams said before. I would say, you know, I know your entire generation is often consumed by social media. I would ask, you know, is there advertising on social media? Or do you see videos on social media, whether it be TikTok or [audible gap 2:54:09], or SnapChat, you know, are there people doing it, or people may be in your social circle? You know, what kind of sort of promotions have you seen on social media?
PHOEBE LAMPOS: There is definitely a promotion, not as an ad from the company, but kids are posting videos of themselves vaping, or saying like, what flavors they've got. And around school, we see the 100 February 8, 2021
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peer pressure, and there's all kinds of flavors going around, being traded. And like I said, it's a culture that more generally kids try out.
REP. KAVROS DEGRAW (17TH): Yeah, that makes sense. And then, I would say, you know, you've had, I'm sure education as Representative Zupkus was saying around drugs or, you know, other issues that certainly we would want, you know, kids to not get involved with. And I think that education is important, but do you-- have you seen where even when you're educated on issues such as that, you know, kids do turn to substances that they probably shouldn't be using?
PHOEBE LAMPOS: Yes, I do feel that, although we educate kids about this issue, kids are still doing -- or it doesn't make them stop vaping if they already have started. Which is why I feel that flavors are the problem, because it gets kids so young that they just become addicted at such a young age, and it becomes really hard to stop by the time you're in high school.
REP. KAVROS DEGRAW (17TH): And I didn't get a chance to ask one of your peers earlier, but have you seen where kids are sharing vapes, in other words, like they take one and then they pass it to someone else? I have concern over that normally, obviously, but certainly in COVID times, that's really concerning that we would be putting our mouths and sharing devices in such a way.
PHOEBE LAMPOS: Right, I definitely see that. People will ask if their friend has a vape, and they'll just pass it to each other and go to the bathroom or something like that. It's a definite thing that happens if people pass vapes around.
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REP. ZUPKUS (89TH): Okay. Thank you so much, again, this was really great to have you here. Take care.
SENATOR DAUGHERTY ABRAMS (13TH): Representative Foster
REP. FOSTER (57TH): Hi Phoebe, I've been so impressed by you today. thank you so much for coming and testifying, I think it's so important for us to hear from you. Something that I've been thinking about as some of my colleagues have been suggesting that education is maybe a pathway, in lieu of policy, to ban access to these products. Is that there are many schools who have introduced vaping detection systems to try and stop the amount of vaping that may occur at a school. And I know that with those systems in place, there have been reports of kids using those substances that they're not supposed to have access to by their age anyways, less at school. Do you think that that means that those children are not doing them outside of the school setting? Because the way that we collect data in our state and nationally, it doesn't allow us to differentiate by town. So there is no way for me to look up data. Like if we've instituted this policy at the school, our kids in that town are vaping less? Do you have any experience of vaping detecting systems in the schools that you or your friends are in? And are kids still vaping outside of school or has that suppressed vaping for young people?
PHOEBE LAMPOS: We personally do not have vaping detection systems. However, I've seen at events like parties or outside of school, that many kids who don't normally vape or drink or anything like that do at the parties, because, you know, they think that it's fine. But sometimes that can, actually a lot of times that can lead to an addiction later on, if they're hanging out with the same kids who tell 102 February 8, 2021
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them that they've already done it or that it's fine.
REP. FOSTER (57TH): So you feel like school is not the only place of risk that we need, sort of, maybe a broader approach to make sure that kids don't have access to --
PHOEBE LAMPOS: Definitely, just one of the places, yeah.
REP. FOSTER (57TH): Okay. I appreciate your feedback, thanks so much, Phoebe.
PHOEBE LAMPOS: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Okay. I don't see any other questions. Thank you so much for being here. I don't know if you're at school today, but you can also tell your teachers and your leaders of the Youth Service Bureau that you did a great job. So, thank you so much, we really appreciate it. Next, we have number 25, Beverley Brakeman. Beverley, are you with us?
BEVERLEY BRAKEMAN: Yes. Hi, good afternoon, Senator Abrams Daugherty [sic], Representative Steinberg and members of the Committee. My name is Beverley Brakeman, I am the Director of UAW region 9A. I'm here on behalf of our union and our members who are dealers at Foxwoods Resort and Casino. We're here today to do something a little unusual, which is to ask that you consider amending Senate Bill 326, to add a smoking ban for the casinos. And I'm not gonna read my whole testimony, I'm gonna give you the highlights.
Some of you may remember, between 2008 and 2011, we brought this before the Legislature, and actually passed it in the State Senate one year. I know I 103 February 8, 2021
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don't need to expound on the dangers of secondhand smoke to Members of this Committee, but I do want to talk about some of the concerns I know will come up as you consider our request.
Currently, the tribes have banned smoking in their establishments, and I can say I went back when they opened up in June and what they have done to protect the workers and make it more safe, has been very impressive, and I just want to acknowledge that also. But the banning of the smoking has been like a godsend for our workers, and I just want to talk about that a little bit.
There are three arguments that have been lodged against this legislation, and I'm just gonna put them right out there for you and tell you what our position is. The first one is sovereignty, the UAW respects sovereignty, we've actually bargained our contracts with the Foxwoods. Under tribal law, we negotiated changes to tribal law and in respect, so that we could respect and bargain under their law.
Additionally, in a 2008 opinion by former Attorney General Richard Blumenthal-- We have an exhibit we sent to all of you with all this information, he was asked about the legality of proposed legislation to extend the smoking ban to the Casinos and concluded, "The extension of the ban to the Casinos would be a health and safety law that may be legally applied to the Casinos under Section 14A of the compacts." Should the smoking ban be amended to include casinos, we believe it would be enforceable under Section 13C of the gaming procedures, or under the State's liquor laws. Quite simply, the Casinos have their own liquor Law, Section 30-37K, which can be added to our current smoking ban legislation, and that's the basis for that opinion.
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Additionally, there are questions around reduced gambling and revenue loss to the State. One thing that's different than when we first came before this Committee and passed this Bill was that, gaming enthusiasts would be able to go to other states if we banned it in Connecticut. Well, now the surrounding states don't have smoking in their casinos in Mass, Maine, Vermont and New York. The COVID-19 smoking bans have been, like I said, very, very helpful to the workers, and we believe this type -- staying non-smoking after COVID could really be a hook for new business. There is some evidence which I've provided to you to show that actually going smoke-free can increase foot traffic in the Casinos and appeal to a whole new market. And there are informal studies that indicate lots of gamers really want a smoke-free environment now.
And the last issue is that non-smoking areas will fix the problem, and in fact, in 2009, we did our own study, we went in with air quality with Roswell Cancer Research Centre --
LINDSAY VAN BAUREN: You've hit your three-minute mark. If you could summarize, thanks.
BEVERLEY BRAKEMAN: Yep. And basically, it has been shown by experts that there's no way to reduce secondhand smoke exposure, except to just eliminate smoking entirely. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for that testimony, I appreciate it and understand that it's an expansion of another Bill, but looking at where smoking is taking place. I did have a question for you, but I will let my colleagues go first. Senator Somers.
SENATOR SOMERS (18TH): Yes. Good morning. I have a few questions, because the Casinos are -- part of 105 February 8, 2021
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them are in my district, and I have reached out to them and talked to them about this potential Bill that we saw coming through Public Health. And in speaking with the Mohegans, one of their issues is - - as should be probably for the Mashantuckets also, is they currently have an agreement with the State of Connecticut that they signed in 2008, which lays out what they are responsible for doing concerning smoking. They have adhered to that, they do their air quality testing on a quarterly basis. They have reiterated to me that they do not believe that anybody from your organization has reviewed any of their air quality testing and that they have been significantly impacted by COVID. They have put in new air-handling systems, and that the air inside of their casino is actually cleaner than it is on the outside.
So they are vehemently opposed to this. They are once again saying, why does the State of Connecticut enter into agreements with our tribal nation, and continue to go back on their word? So I wanted to see if you could speak to that, at all, as far as if you have seen their air quality testing, and to speak to the fact that they do have an honored agreement that they have been honoring since 2008. And especially at Mohegan, their employees have a choice where they work. If they're uncomfortable working within the area that is considered the smoking portion, they can be immediately moved to the non-smoking portion.
BEVERLEY BRAKEMAN: Sure. Thank you, Senator Somers for that. I also have spoken to Rodney Butler, and left a message for Chuck Banyan to let them know that we were gonna be bringing this forward. I think then the next speaker, who is actually part of the Health and Safety Committee can probably address the review of the data much better than I can, so I 106 February 8, 2021
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would have you, you know, pose that question to them.
I do know that we've collectively bargained for air quality studies, and for non-smoking pits. And our experience is that there really is almost no difference between the smoking and the non-smoking areas, and it continues to be an enormous work hazard for these workers.
And thirdly, in terms of the State's agreement with the tribes, we're really coming at this from the union that represents the workers, and what we've been able to collectively bargain, and in fact enforce. And we haven't seen much difference over the years, and we wouldn't be standing here before you if we had.
SENATOR SOMERS (18TH): Okay, if I can just follow up with that. I know that there have been some additional non-smoking areas that have been instituted since COVID, and perhaps, you know, that may be something that Mashantucket might be interested in continuing going forward. But I know Mystic Air Quality is the one who does the quarterly air quality tests at Mohegan. They say that the information that the non-smoking areas are just as bad as the smoking areas is absolutely false. So I think that this -- I do not support putting this amendment in on this Bill in any way, shape, or form, because I think that we have to respect the agreements that we have with our tribal nation. They are a sovereign nation, and I do think that once again, this is going too far. We have an agreement with the casinos, they have options for employees, at least at Mohegan, I have not had an opportunity to speak directly with Rodney from Mashantucket. We spoke briefly but not about the details, and this is something they have to report it to DCP. So, I just 107 February 8, 2021
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wanted to let you know, I will be adamantly opposed to doing this to our casinos.
BEVERLEY BRAKEMAN: Yes. And I understand that Senator Somers, and I appreciate your candor about that. I would say that agreement was made under Governor Jodi Rell, almost, what? 12 years ago now, and a lot has changed. But what has not changed is the workers experience, and I would argue, with all due respect, that agreements can change and should change, especially when people are dying as a result of those agreements. And it is not our experience that there's any difference at all between smoking and non-smoking areas.
SENATOR SOMERS (18TH): Okay. Well, they say the data shows differently, and --
BEVERLEY BRAKEMAN: Okay.
SENATOR SOMERS (18TH): So are you saying that people that have worked at Mohegan under the conditions are dying because of the conditions of the Casino? That's what you just said.
BEVERLEY BRAKEMAN: I can't actually speak to the workers in Mohegan because we don't represent them, but I can tell you at Foxwoods, yes, we have had people sick, and we have people died from lung conditions. Maybe even if they were conditions they had prior working in that environment has not helped them. So, yes, I am saying that.
SENATOR SOMERS (18TH): Okay. Well, thank you for that clarification on Mohegan versus Mashantucket, that's important. I don't want to have people that are watching this give them the false information that that is the case at Mohegan, so thank you.
BEVERLEY BRAKEMAN: Thanks. 108 February 8, 2021
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SENATOR DAUGHERTY ABRAMS (13TH): Thank you. Beverley, I was going to ask the question, but I think you may have answered it already, that as circumstances change, would you -- do believe that agreements have to be reexamined? I mean, I think that what we found out, especially through COVID, and the vulnerability of people who have lung issues, or might be in circumstances that compromise their lungs might be more vulnerable. So as circumstances change, is that how usually you would approach re-looking at something you've previously negotiated?
BEVERLEY BRAKEMAN: Yeah, I mean, I think we've been at this for a very long time, and because of these arguments I set forward, they're strong arguments and there's a lot of opposition to doing this. And I do respect sovereignty, and I do respect agreements. But I'm telling you, as somebody who represents these workers, this is some of the most dangerous places to work that you can go. Imagine if you had to send your son or daughter, or your mother or father into a casino to work and be smoked at all day long.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you,
BEVERLEY BRAKEMAN: No other workers in Connecticut have to do that, by the way.
SENATOR DAUGHERTY ABRAMS (13TH): We have Senator Kushner next.
SENATOR KUSHNER (24TH): Thank you, Representative-- Thank you, Senator, Daugherty Abrams, my good colleague. And thank you, Beverley, for being here. Obviously, this is an issue that I'm very familiar with, having been the Director of the UAW at the time that we attempted to ban smoking at the 109 February 8, 2021
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Casinos. And I appreciate your comments about the respect the union has for sovereignty and the ability that the union has worked very hard to respect that sovereignty and reach agreements were possible through tribal law. Nonetheless, I do wanna ask you about the study that you started to talk about, where you had people going through the casino with air monitors, do you wanna elaborate on that?
BEVERLEY BRAKEMAN: Sure. I was one of those people, and we did it in partnership with the Roswell Cancer Research Institute, and I included in your exhibits the results of that, which showed -- what we did was we walked from room to room, smoking and non- smoking, and they tabulated the results and showed very little difference in terms of the air particulate matter that was in the air, and that workers were breathing.
It also should be noted that the American Association of heating and air conditioning people have basically admitted that there's no ventilation system that will actually completely protect anyone from the dangers of secondhand smoke, except just to stop the smoking in that facility.
SENATOR KUSHNER (24TH): And another question, I heard you asked about, or a comment was made about the indoor air quality being better than the outdoor air quality, one of the things I recall, and I wonder if you are familiar with this is that, the agents that cause cancer are ultra-fine particulates, and it's their very specific particulates that are cancer causing. And so, is it perhaps true that air quality could be better on the inside than the outside, but not with regard to the ultra-fine particulates that cause cancer? In other words, you can make a general statement that the air quality is better inside than outside because of a lot of filtration that goes on through the HVAC 110 February 8, 2021
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system, but that doesn't necessarily mean that you are screening out the ultra-fine particulates that cause cancer. Is that what you --?
BEVERLEY BRAKEMAN: Yeah, I think that's a fair statement. Look, I'm not a scientist, but I mean, the statement that you could ever have indoor air quality that would be the same as going outside and breathing is something I'm not sure I could even wrap my head around, but certainly, the cotinine, is what it's called, which is the -- what's in the air, the particulate matter that's exhaled when you're smoking cigarettes. And you know, now that people are vaping, speaking of the Bill that we're asking you to amend, you know, the secondhand smoke from that is probably equally as dangerous and may have other chemicals that people are breathing in.
SENATOR KUSHNER (24TH): And, with regard to the State of Connecticut going back on its word, I would ask that you're not suggesting that State of Connecticut go back on its word, you're simply asking that we legislate as we can to protect the workers at these casinos, is that correct?
BEVERLEY BRAKEMAN: Yes. We're asking this Committee to amend the Bill so that we can legislate this. And yeah, that's what I'm here for today. The agreement is something that came about, that we would argue, doesn't have a whole lot of legs to it.
SENATOR KUSHNER (24TH): And that agreement was negotiated between the Governor and the tribes, as I understand in 2008 when a bill was pending to ban smoking but did not make it through the Legislature?
BEVERLEY BRAKEMAN: Correct.
SENATOR KUSHNER (24TH): Okay, thank you. Well, thank you for being here, and thank you for 111 February 8, 2021
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advocating for these workers, you know, I've known a number of them who did die. I knew them personally, I knew them well, they died of cancer. I did have an opportunity to speak with these workers over many, many years, and one of the things that they said was, they loved their jobs, they loved working for the Casino, they loved being there, they loved the work they did, but they hated the smoke, and they knew that it was -- it would potentially cause them great harm and death, potentially. So, I really appreciate you being here and advocating for them.
BEVERLEY BRAKEMAN: Yes and thank you for your history on this and helping us with this.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator. Representative McCarty.
REP. McCARTY (38TH): Yes. Thank you, Madam Chairman. And thank you, Beverley, for your testimony today. I would just like to point out, if I may, the great work that the tribes and the casinos have done for the State of Connecticut during this COVID period, they really took a tremendous interest in protecting the health of our citizens, so I wanted to point that out. And I respect the contract that tribes have with the State of Connecticut over -- and all that they do with jobs and helping us in the region.
I would like to ask you, you point out in your testimony, some studies, informal studies that were taken. If you could, perhaps, provide us with some of the names of those studies? Did you do surveys? Where is that information coming from with reference to the gamers that attend the casinos? If I could just ask, you don't have to do it right now if you're not able, but thank you.
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BEVERLEY BRAKEMAN: Yeah, we actually provided a whole package of exhibits that should be available to the entire Committee. No, I can't name them all off the top of my head, but you do have them. If for some reason you haven't gotten them, I'm happy to send them to you directly, if you'd like.
REP. McCARTY (38TH): Right. Well, I appreciate that, and thank you for your testimony.
BEVERLEY BRAKEMAN: You're welcome.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. I don't see any further questions, so thank you so much for being here and for your testimony today.
BEVERLEY BRAKEMAN: And thank you all for your time, and being willing to hear us out on this, we appreciate it very much.
SENATOR DAUGHERTY ABRAMS (13TH): Of course. Next is number 26, D. Stanley Lord, you're with us?
REV. LORD: Good afternoon.
SENATOR ABRAMS (13TH): Hello, welcome. Thank you for being here.
REV. D. STANLEY LORD: Thank you for allowing me to testify. I'm Reverend D. Stanley Lord, I serve as President of the Greater Bridgeport NAACP, National Association for the Advancement of Colored People since 1909. We stand in agreement, strongly support Bill SB 326. For far over 60 years, Big Tobacco has strategically and has successfully target the Black and Brown community with menthol cigarettes, which has shown to be more addictive, and harder to quit than regular cigarettes.
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Through longstanding predatory practices of tobacco industry, they have profited enormously off of the backs and the lives of Black Lives and our health, and we die disproportionately than others in the community. Over 45,000 Black and Brown Americans die at the hands of Big Tobacco every single year. And now they're targeting our youth.
All due respect to our previous store owners, they place these items in front of the store right next to candy. When you go to the stores, and go to the bodegas, we see these items in full display and make it enticing for our youth. We need to start to plan for the future of our youth. If these things continue to be allowed to be sold in the stores, enticing our youth, what future will our youth have? Please, we urge you and support this Bill, that we can end the tobacco industry's exploitation of Black Lives from their profit system by eliminating flavored tobacco products. Please, let's support our youth and get them off of these products. Thank you for your time.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, really appreciate your testimony. I think that some of the concern on this Bill is that it's unfairly targeting certain communities, and I would agree with you that I think that the message from tobacco companies, to try to negatively affect the health of certain communities, to target them to a life of addiction, that's where we have to focus our energies. And so -- and break that cycle, so I thank you very much. Representative Zupkus, you have your hand up.
REP. ZUPKUS (89TH): Yes, thank you. Thank you, Reverend, for coming, and I just have to say, I love your name, Reverend Lord. So, I think that's awesome. I have two questions for you, my first question is, with this problem that you're seeing, 114 February 8, 2021
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what education has been done, to the community, to the kids?
REV. D. STANLEY LORD: There isn't any. There isn't any campaign to say, don't do it. It may be something that we'll have to take up as an association, to educate our youth on the negative effects of vaping. And even the adults who talk about it say, "No, it's not good for the kids," In reality, it's not good for anybody.
REP. ZUPKUS (89TH): I do know that and have been told that the industry, the tobacco industry, every year gives 118 million,120 million, and I am curious, you know, where has that money gone to educate? Because I believe we need to educate on this issue, for sure. So, I think I have to find an answer to that question, which you might not know, I may ask our Chairs for that answer. So that's a concern, that all this money is being put in a settlement that happened, and there's no education coming out of it.
My second question is, how does your organization feel? Because vaping, recreational pot, it's almost the same. So, how does your organization feel about legalizing recreational marijuana?
REV. D. STANLEY LORD: Well, that's not really the topic for the day, so I'm not even gonna go discuss that at this present time. I didn't come to talk about recreational marijuana.
REP. ZUPKUS (89TH): Thank you. 'Cause, I mean, to me there's lots of things that are dangerous, and yes, we're talking about vaping, but to me, it goes hand in hand, so I would encourage you, and I hope that -- I don't know that we'll be seeing it in this Committee, but I do hope that you all come and talk 115 February 8, 2021
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on that as well, because I think that's dangerous for our kids.
REV. D. STANLEY LORD: But the reality is, recreational marijuana isn't -- technically we're gonna say that is not for sale for youth once it becomes-- if it becomes legalized. It's gonna be the same regulations as cigarettes, there'll be an age limit, so we'll have the same discussion, and the same regulations. But the fact that it's -- and it's sold, it won't be out front, they would particularly regulated. And it'd be certain stores you'd be able to get it, you won't be able -- I don't think I'll be able to get it at my local grocery store.
REP. ZUPKUS (89TH): No, but I would think that there're gonna be stores, like in Massachusetts, I have a 13-year-old, and you walk down the street, and they are there for sale. So, I'm just concerned about that as well. So hopefully, you'll come and testify, but thank you so much.
REV. D. STANLEY LORD: I will definitely do that.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. Senator Hwang.
SENATOR HWANG (28TH): Thank you, Madam Chair. Reverend Lord, great to see you.
REV. D. STANLEY LORD: Great to see you.
SENATOR HWANG (28TH): And more importantly, glad that you are feeling better, and none the worse by being impacted by COVID. So God bless you.
REV. D. STANLEY LORD: Thank you, God bless. Good to see you.
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SENATOR HWANG (28TH): And having sat through some - - been invited to a number of your general meetings, I appreciate the energy that you brought forward to the organization and congratulations on the 100th anniversary of your esteemed organization. I do want to ask you, from the standpoint of this important issue, you're one of the first community organizations to come out and speak on behalf of the community, and I want to applaud you. And could you articulate any other community groups that are aligned with you, from our urban communities that are speaking out against this potential health risk to our citizens and youth in our cities?
REV. D. STANLEY LORD: Well, I'm in the process of speaking with other community organizations here in this -- in our jurisdiction, in Fairfield, Stratford, Trumbull and Bridgeport to help them join -- get them to join with us in speaking out against, especially all of our next gen group, speaking with the community organizations like LifeBridge. I had a conversation with their Executive Director, where they do a lot with youth and he's on board going forward. So, we are actively pushing more organizations, especially organizations that support, or have programs for youth, so that they are pushing bills like this, to help protect the youth.
SENATOR HWANG (28TH): Well, I appreciate that you mentioned LifeBridge, which is the former ESW organization, and that has a history in the Bridgeport area of nearly over 130 years. So, we've got fantastic institutions that have served the interest and the good -- the well-being of citizens of the area, and they deserve tremendous recognition like yours. I just wanna follow-up what Representative Zupkus, and I hope, and I would encourage that as you interact with other organizations, that you will take a strong 117 February 8, 2021
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consideration and offer a voice in regards to legalized marijuana. I know you mentioned the fact that, in regards to the vaping and the flavoring that marijuana with the increased restrictions, young people wouldn't get access to it.
It's important to note that in the current Legislation that we passed, vaping and tobacco use is not for youth either, they still get access to it. So, I think as you and your advocates, which are a tremendous voice, and need to be heard, as we explore other issues related to community health and supporting that community, that you will speak out and offer a voice of conscience as well as wellbeing for those communities.
In the meanwhile on this issue, I am so grateful for your participation and coming to visit with us. And please do come more, and again, best to your general membership and continued best health to you, sir. Thank you, Madam, Chair.
REV. D. STANLEY LORD: Thank you again, but we will be definitely speaking on that issue when it comes up. We hope that when it is written, that it will not only-- if it does legalize it, it also decriminalize. So that our population who has been disproportionately mistreated in that area and has spent more time in jail than the other population for the sale will also deal with that as well.
SENATOR HWANG (28TH): And I would absolutely support that. And I know in our Judiciary Committee, we have undertaken the decriminalization process, but I think also equally important is a commitment that we have as a state to support reentry, and people who have paid their debt to incarceration that they get opportunities to be able to pursue a second chance. So, I thank you for speaking to that effect, and I do agree that we have to take a look 118 February 8, 2021
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at that from many perspectives, and not just simply from a revenue side, but also a societal and health- conscious perspective as well. Again, thank you very much for your perspective, madam. And thank you, Madam Speaker -- Madam Chair
SENATOR DAUGHERTY ABRAMS (13TH): Yes, Senator. Glad I got to you this time. And I just wanna add to your comment, Reverend Lord, that I'd also like to see-- although I don't know why we keep talking about legalizing marijuana, but if we are on that subject, I would also like to see any revenue benefits be put into communities that have been most impacted, as well.
REV. D. STANLEY LORD: Yes.
SENATOR DAUGHERTY ABRAMS (13TH): And I will offer two other things. Number one, smoking marijuana is not the only way to partake, so it doesn't have an equal impact with what we're talking about today in terms of tobacco and ingesting or smoking, as we're discussing today. And also, you know, I did a lot of work in my district, as I'm sure many of my colleagues have, and heard a lot of about the education that was going on through local health departments, and through our schools to educate our students on the problems with vaping. So I think that education piece is out there, and we need to do more.
A lot of what I heard was the community saying, "Okay, parents are doing their part, schools are doing their part, it's time for legislators to step up and do their part." So, thank you so much Reverend Lord. Oh, we have another question from Representative Foster.
REP. FOSTER (57TH): I'm sorry to have to have a [inaudible 3:29:07], too but I've been very 119 February 8, 2021
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interested and appreciative of your perspective, Reverend, on everything you shared with us today. I know a lot of things that we talk about with smoking, we focused a lot on children, and there's been some discussion on how banning flavors is a health equity issue. So I appreciate you coming and talking from the perspective of the NAACP, because I feel like when we see that there are disproportionate morbidity and mortality rates for cardiovascular disease, heart disease, and high blood pressure in communities of color, we need to talk about the fact that smoking is a predominant contributor to heart disease. And anything that we can do to make it easier for folks to struggle -- who are struggling with addiction to also manage other diseases, that we know are a disproportionate cause of death, contribute to an earlier mortality for folks is really important. And I view that as one of my primary roles as a legislator, to make evidence-based and informed decisions on promoting the health of everyone that I serve. Which means that we do need to pay particular attention -- I think you would agree, or -- and you could correct me if I'm wrong, should we be paying particular attention to communities that are disproportionately impacted by addiction, especially when they're being targeted, for early access? Can you speak a little bit to the health equity perspective that exists here?
REV. D. STANLEY LORD: If one thing that 2020 showed us was the disproportionate health inequities that we experience in the Black and Brown community, and due to the inaccessibility or affordability to health care, it has put our community in a very bad disproportionate stance to the regular population. So therefore, any type of bill that will help us reduce the population being to receive these types of products, especially when our community is has to deal with this since back in the 60's, when Joe 120 February 8, 2021
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Camel was cool. See, back in the 60's, the Black community, we didn't see ourselves in ads, we didn't see ourselves in commercials. But all of a sudden tobacco saw that and said, 'Hey, we can put Blacks in commercials and make it cool to smoke." They make candy cigarettes. So, when you go back to the history of how Big Tobacco has affected our community, yes, we need to find more bills like this that will help keep our community healthy, so that we won't have to deal with some of the ills that we've had, and Coronavirus really showed what types of ills they are, and how disproportionately we die from Coronavirus, and are still dying.
SENATOR DAUGHERTY ABRAMS (13TH): Well, Reverend, I am so glad that you recovered or are recovering, and I really appreciate you being here today and taking your time to share your perspective with us.
REV. D. STANLEY LORD: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much.
REV. D. STANLEY LORD: Thank you for your time. God bless.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. Next is number 28, Abigail Friedman.
ABIGAIL FRIEDMAN: Yes. Thank you. Co-Chairs Daugherty Abrams and Steinberg and Esteemed Members of the Public Health Committee, my name is Abigail Friedman, I'm an assistant professor of health policy at the Yale School of Public Health. My research focuses on how government policies affect tobacco product use, so I've come to testify before you regarding SB number 326 in my personal capacity as a Connecticut resident, but also as someone with scientific expertise on this subject. My statement 121 February 8, 2021
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should in no way be construed as reflecting a position of Yale as an institution.
To give away the punchline, the scientific evidence strongly supports banning flavors and combustible tobacco products as a public health measure, but the same cannot be said for banning flavors and electronic nicotine delivery systems like e- cigarettes. As I'm sure you know, federal limits on flavorings and conventional cigarettes do not apply to cigars, little cigars and cigarillos. These products are now at least as popular as conventional cigarettes among high school students, and they're over three times as popular among non-Hispanic Black high school students, a demographic that's long been targeted for marketing and promotion of flavored combustible tobacco products.
Combustible tobacco use is responsible for about one in five adult deaths every year in the US, so banning flavors in these products is imperative for public health and for health equity. The situation with electronic nicotine delivery systems is more complicated. Current evidence indicates that vaping nicotine is far less harmful than smoking, though not harmless. And randomized control trials find that nicotine e-cigarettes are as, or more effective than FDA-approved nicotine replacement therapies for smoking cessation. Particularly of concern here, multiple studies have found that adult smokers, who take up flavored e-cigarettes are more likely to subsequently quit conventional cigarette use, that is combustible cigarette use, then those who take up tobacco-flavored e-cigarettes. And there's a real concern that banning flavored e-cigarettes could increase adult smoking.
Indeed, if you look at San Francisco, who banned flavored tobacco products sales and menthol sales, that ban was associated with reductions in flavored 122 February 8, 2021
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e-cigarette use, among 18 to 24-year-olds, but increases in smoking and conventional cigarette use in that age group, which given what we know about the health effects would be on net, a bad from the perspective of public health. This doesn't mean we should ignore legitimate concerns about flavors and youth vaping. Indeed, I'd encourage you to be skeptical of arguments that characterize electronic nicotine delivery systems as either 100% good or 100% bad. That framing just does not match the evidence, and it does a disservice to us from a policy-making perspective.
We don't need to act like our only option with flavored e-cigarettes is a ban or no regulation at all. If the goal is to restrict youth access to flavored e-cigarettes without precluding adult use as a means of harm reduction, there are other options. For example, restricting flavored tobacco products sales to retailers that prohibit underage entry, in order to reduce youth access and incidental exposure, which I'm sure many small businesses would be happy about, as well. With time, the ongoing FDA review process at the Federal level of pre-market tobacco products applications should restrict flavored products available on the market to those whose firms can actually demonstrate, with quantitative evidence, that neither their product nor its marketing is inducing youth use, and that both the product and the marketing are appropriate for the protection of public health.
Thus, I strongly encourage the Committee to proceed in banning non-tobacco flavors, including menthol, in all combustible tobacco products, but not in non- combustible products where the evidence indicates a substantively reduced health risk relative to smoking, and where non-tobacco flavors may assist smokers in dropping the more lethal habit. Thank you for your consideration. 123 February 8, 2021
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SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for your testimony. Are there any questions or comments? Seeing none, thank you so much for being here today, I appreciate it.
ABIGAIL FRIEDMAN: Gladly.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have number 31, Saquib Zamir.
SAQUIB ZAMIR: Yes, hi, I'm Saquib Zamir, we are owners of five tobacco shops in Fairfield County. I would like to bring up solutions, rather than just the problems in this testimony.
Our stores all together have produced -- given sales tax revenue to the Connecticut State of approximately $383,000 last year, $113,000 in e- cigarette taxes. We have employees of approximately 12 to 13 employees, a payroll of $361,000 a year. I would like to focus on the fact that we are talking just about the problems from one side of economics or just the health issues, and I think the solution we have to look at is it should be more balanced, rather than writing off one side or the other. And I think the solution for sales to minors is the biggest issue in all this conversation. And I would like you to look at the fact that, how do people -- many are younger folks who have come on to testimony pointed out, how the kids get hands on the products, even though the stores are of age 21 requirement now.
I would like to look at the-- ask the Committee to look at the sales of online sales, which is a major loophole. Many parents give their kids their credit card, they go online and purchase items where online is only required to -- by the sellers to just say I'm of age, there should be more restrictive 124 February 8, 2021
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requirements for that. They should not be able to simply write-off their liability without checking IDs. We have states, actually at a federal level also, where they have asked USPS most recently, where if this product is like tobacco or electronic cigarettes sold, that they would be required for age 21-plus person to sign and have given their ID. I think the State should look at that as an option.
I would also suggest that at local stores, there should be more enforcement, or perhaps even like previous witness suggested from Yale, look at the option to make it only age 21-plus stores if you're selling flavor product of any kind, including gas stations. Previous bills from federal government actually had suggested that where you could continue the sales, but they would have to be in a closed environment, if you're allowed to. I say, 21-plus age only, stores should be allowed to sell that, as a solution, rather than just writing off one side or the other.
You also have to look at the fact that the loss of revenues, obviously, we all know, will be large, I think, substantially. Not to mention that we are in a pandemic time and let's face it, thousands of jobs would be lost, and in the time of pandemic where will we go look for a business or job, it's not gonna be easy, obviously. The other problem we have in Connecticut, at least as a retailer, I see on a daily basis is youth coming in with fake IDs, even though it's a felony to have fake IDs but that's very common. And in any of our five stores, we get at least five to six customers a day who tried to attempt purchase with a fake ID.
LINDSAY VAN BAUREN: Sir, you've hit your three minutes. If you can conclude your remarks.
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SAQUIB ZAMIR: Sure. I would just suggest that we look at this problem. We already have rules and regulations for 21 years of age, and we need to have stronger law enforcement, as well as look at the online sales and loopholes. That's, I think, how most of the kids from my experience were obtaining online, and that's how they get their hands on illegal, illicit products. And I think the key is law enforcement. Having a law does not make any sense unless we enforce the laws properly, and to the full extent, including looking at keeping--
SENATOR DAUGHERTY ABRAMS (13TH): I'm gonna have to stop you there. Thank you. Are there any questions from the Committee? Seeing none, thank you so much for your testimony, and for your time today, appreciate it.
SAQUIB ZAMIR: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next is number 33, Anthony Miranda. Anthony Miranda, you're on mute. Mr. Miranda, you-- Okay, there you go.
ANTHONY MIRANDA: Okay. Again, thank you so much for the Committee and the Representatives to give me the opportunity. My name is Anthony Miranda. I happen to be the Executive Chairman from the National Latino Officers Association. I'm retired Chief from police from ACS and the retired Sargent from the New York City Police Department. And what I'm testifying today, No. giving you support -- testifying against Bill No. 326, the unintentional consequences of such a bill, when you put a ban in place. And what I'm talking about is encounters and is particularly in most communities, especially communities of color, as you have many speakers talk about.
I was gonna say certain things, but I'm going to adjust it based on the testimony that you had, 126 February 8, 2021
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right? Because I want to explain to you when you said you're focused on sellers and not users, and in that equation, the reality is this. In order to violate the law, you have to constitute the sale in the eyes of the law, right? And constituting a sale means that you have to have an encounter with a person who is a buyer. And in that encounter, you have to have a process of identifying the person who's buying, which means you have a contact with people, mostly adults, that are in our communities. And what you are not talking about, it says, it doesn't result in arrest. It doesn't result in arrest for cigarettes. It results in arrest with disorderly conduct, resisting arrest and obstructing governmental administration when a person feels like, "Why are you stopping me or asking me questions when I'm not violating any laws?" Alright, so that's the confrontation that we're talking about. Self-initiated contacts between police and communities of color, and then contacts initiated by complaints-- quality of life complaints.
Eric Garner's case, if you remember New York, was about the quality of life case. Tt wasn't that they went after the cigarettes, is that the store owners were complaining about the illegal sales of people staying in their shops or around their shop selling it, which caused the police to respond. That resulted in that confrontation about ID and then resisting arrest and then it escalated to the point to his death, right? So when we're talking about, the unintentional consequences of what you propose, or additional confrontation in our community, not only with our youth, but with our adult population as well.
We all agree that the youth should not be smoking. And historically, education and the information out there has reduced smoking through all these years. And we see where we are today, where we were 20 127 February 8, 2021
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years ago, and 30 years ago, and 40 years ago, all the usage of cigarette smoke has gone down traditionally. But now what we're talking about is the impact of law enforcement confrontations in communities of color. And I say those are the unintentional consequences, which we are not considering right now. Adults have a choice to make. Our children need to be protected, and the only way you regulate them, and you regulate the industry is where it's controlled. When it's sold in the street, in the black market, what you are now having is a situation like illegal drugs being sold on the street corners, quality of life situations, now you're gonna have older people making transactions in the middle of a street to buy a pack of cigarettes, that doesn't make any sense. Then it's unregulated, and that means that anybody is selling it on the street can alter it, tamper with it, and there's no control mechanism for controlling it as well.
So, considering those things, again, only my assessment. I'm the only law enforcer so far that's spoken to you. But I know you might have a lot of questions for me, and I hope that you do, because I'm specifically talking about the unintentional consequences of enforcement, and the potential confrontations that we're now gonna have in communities, not only with our youth, but with our adult population as well. I think that sets a dangerous precedent for us to allow.
And again, speaking from law enforcement, I understand how those enforcement and policy decisions, how they actually take place in the street. Everybody who's spoken is talking about some type of regulation and controlling the sale, right? And the distribution of it. And when you talked about stores and the distribution and -- that's the 128 February 8, 2021
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control mechanism. When you put it in the street, you no longer have--
LINDSAY VAN BAUREN: Sorry, excuse me, you've hit your three minutes.
ANTHONY MIRANDA: Okay. When you create an illegal market for the sale of drugs, you no longer control the process. And that makes it more dangerous and becomes and makes our community more vulnerable to confrontations, if not, make them victims to robberies and assaults in the street.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much. Are there any questions from the Committee Members? Representatives Zupkus.
REP. ZUPKUS (89TH): Thank you, Madam Chair. Thank you, Mr. Miranda, for coming in today because you've brought up a point I've been thinking about, and the unintended consequences. I've spoken a lot about education, and I don't think there is a lot of education. I think the money that is supposed to go to, partly, education on this gets put somewhere in Connecticut, but I'm not sure. So, I just heard you mention, I believe, talking about the black market. So can you just give me a little idea of -- 'Cause I know we've seen with pot or whatever, you know, people get it. If they want it, they're gonna get it. So, can you just talk just a little bit about the black market and how you see this affecting that?
ANTHONY MIRANDA: So it becomes a product that's more easily transacted in the street, right? So, for the black market, or sellers selling drugs, they make a tremendous amount of profit. And when you ban something, it becomes an illegal item in the street. So, I think there's -- I can provide information, factual information, about the amount of money 129 February 8, 2021
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that's transacted illegally based on the sale of -- illegal sale of cigarettes, and the banning of products. So, what you're gonna turn this into, as it has done in different communities, is where there's street sales of these cigarettes, at the back of trunks of cars, or people setting up in banks, now sitting in establishments, restaurants, fast food spaces, and stores or corners, right? Which, to a police officer will look like a drug transaction, right? And something that we should be enforcing.
And then, if we start attacking people based on the fact that we believe a drug transaction is taking place, because that's what we're creating in the street now, then, what we gonna have is a confrontational situation. Again, people don't normally get arrested for, like you said, I'm not gonna get arrested for cigarettes. But they will get arrested when they resist arrest, obstructing governmental administration, these are the charges that are used in law enforcement, especially, again, when the initial contact is not reason enough for the arrest, it's the reaction of the individual based on the encounter with the law enforcement officer that escalates itself. Police officers don't wanna be in that business. There's enough crime in the streets that we need to handle those crimes, not what you creating, quality-of-life arrest situation, which is not necessarily where you wanna be putting law enforcement into that situation.
So again, you're taking something that is currently regulated inside of stores, which then there's a mechanism for enforcement, there's also a mechanism for a quality control, no tampering with the product. There's an age regulation, you control that atmosphere, right? And store owners have the ability to call for assistance. When you put it in the street, you lose those controls. And in fact, I'll 130 February 8, 2021
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take it one step further. If the kids believe -- it's two rationales to just say -- sometimes it's an attractive issue for kids to say, "Well, I'm breaking the law, look at me," right? And it makes it more attractive for them to go and do it.
The second thing is that, if the kids become addicted by it, and they believe that it's something that is illegal, right, 'cause it's banned, they may not be as willing to reach out to get the support that they need, right? So there is a dual conflict. We definitely don't want our children smoking at all, but we need to protect them properly.
REP. ZUPKUS (89TH): Okay. Thank you for doing -- saying that for me, appreciate it.
ANTHONY MIRANDA: Thank you.
REP. STEINBERG (136TH): Thank you. Are there any other questions? If not, thank you for your testimony. We move on to number 34, Zaheer Sharaf, followed by, Violette Haldane.
ZAHEER SHARAF: Thank you, this is Zaheer Sharaf. As a retailer in the State of Connecticut, I'm here today in opposition of this Bill to ban flavored and menthol cigarettes. I've always upheld all legal responsibilities that came with being a business owner in this State. Myself and my employees have always followed proper protocol with all tobacco sales to ensure that we do not sell to anyone underage. This Bill ultimately will encourage and create an environment where these customers that were once legally purchasing will now turn to other outlets, including illegal drug trade on the streets, or the black market. This will eventually cause a larger scale public health crisis that could have been prevented under your power.
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As retailers, we take a lot of caution to ensure safety of our youth and general customers. It's unfortunate that we are being seen as part of the problem. It is important to note that this ban has already been implemented in Massachusetts, and a consequent effect has been that residents of Massachusetts are now traveling to neighboring states to purchase these products. If Connecticut also chooses to ban menthol and vape products, we'll see the same effect, where there will be an influx of these products being purchased through other means, than somehow legally brought from other States to Connecticut. Connecticut residents will also travel to buy these things. This will directly cause a major revenue loss which could have been legally prevented.
It seems that the main reason why menthol-flavored products are being banned due to their upper-end addictiveness. I would like to pose a question to the members of this Committee, at what point do we draw the line of advising the public versus controlling? There is a reason why our society has the concept of legal age. because young adults are considered capable of making their own decisions.
To the physicians on this board, do you uphold a patient's rights according to HIPAA once they are at the legal age? Which by the way, is younger than the age to purchase tobacco. You do because they are considered adults capable of making their own decisions. As retailers, when we sell to those of legal age, we are selling with the understanding that the purchaser is fully aware of all possible risks of their purchase.
In 2020, COVID-19 was announced a global pandemic where people all around the world had their lives forever change. It is important to note that during this entire trying time, we the retailers were on 132 February 8, 2021
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the frontlines as we made our best efforts to provide and support our communities. We risk and continue to risk our lives every single day, as we keep our stores open to provide the essential items that the average American needs. This pandemic has shown how pivotal the role of retailers, is not only on a small scale where we provide--
LINDSAY VAN BAUREN: Excuse me sir, you've hit three minutes.
ZAHEER SHARAF: Yeah, I am about to conclude, yeah. For our communities, but also on a larger scale for our country's economy. The menthol cigarettes contribute to 40% of our sales. I strongly urge the Public Health Committee to understand the real consequences that will occur due to this Bill and truly ask if they are willing to take responsibility for what will cause an increase in illegal activity. It is also important to note that we are all proud residents of this beautiful state, who are making our livelihood the hard working way as American citizens are expected to, and we would like to see our state on our side as this will affect us greatly. Thank you.
REP. STEINBERG (136TH): Thank you, Mr. Sharaf. Are there any questions for him? Seeing none, thank you for your testimony today. Next up is, Violette Haldane violet, number 35, followed by Leslie Miller.
VIOLETTE HALDANE: Thank you. My name is Violette Haldane and I'm a resident of Hartford. I am speaking in favor of SB No. 326. My sister-in-law died of lung cancer. She smoked most of her life, starting as a teenager. She smoked menthol cigarettes. Smoking causes cancer, heart disease, stroke, lung disease, diabetes, and CPD, and the top 10 causes of death for Blacks, five of those 133 February 8, 2021
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mentioned are included, heart disease, cancer, stroke, diabetes, and chronic lower respiratory diseases. Nine out of ten Blacks who smoke, smoke a menthol product, but it should not be surprising as African-Americans were strategically talking targeted by the tobacco industry as the market for menthol products. TV and print ads featured Black using menthol products. White Americans had the Marlboro Man, while we had the glamorous images of the Kool and Newport ads. Black organizations got a lot of sponsorship and monies for their events and causes. The products that were specifically targeted to us from the 50's are now a part of our culture, with rappers, singers and artists, including the brands in their art. Our parents and grandparents were the initial targets, but they pass down their habits and likes to their children and grandchildren.
Connecticut has declared racism a public health issue. The targeting of Black people for menthol vapor products has led to a health crisis in the Black community. The cost of smoking is poor health, sometimes death, the health costs is high. When flavored tobacco nicotine products come up for debate, even though -- even if legislation is passed, somehow menthol always gets removed from that legislation. It shows the power of money and the disregard of Black life.
So I say if we're going to have this debate, ban all flavors, including menthol. We all know that flavors are in place to make the taste of the product more attractive to users. We understand cherry, mint, grape as flavors, but until recently, even I did not understand that menthol was a flavor. I'd say the original old gangster flavor. My aunt who died of lung cancer left behind children, nieces and nephews. Her son smokes cigarettes, menthol, of course. But at the time he watched his mom die of 134 February 8, 2021
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lung cancer, he was addicted. He's now switched to e-cigarettes, but he still smokes.
Illnesses caused by tobacco and nicotine products are preventable. The Connecticut Department of Public Health says $2.03 billion annual health care costs in Connecticut is directly caused by smoking. Let's tackle this health issue by making it a little bit harder to get started by banning flavored tobacco and nicotine products. Let's try to lower the cost of healthcare in Connecticut from smoking- related illnesses. Let's save lives. Let's begin to tackle some of the issues that cause health disparities. I say, "Lives over money." I work with an organization called Advocacy to Legacy, which educates individuals, families --
LINDSAY VAN BAUREN: Excuse me, you hit your three- minute mark, thanks.
VIOLETTE HALDANE: My last sentence. -- in communities how to advocate for themselves in order to change lives. Three of my students have taken the initiative to write and submit testimony for this act, one is scheduled to speak later, please support them, and please support this act.
REP. STEINBERG (136TH): Thank you for your testimony.
VIOLETTE HALDANE: Thank you.
REP. STEINBERG (136TH): We really do appreciate it. And thank you for the heads up on future testimony of your students. Are there any questions? I don't see anything. Again, thank you for your testimony today.
VIOLETTE HALDANE: Thank you.
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REP. STEINBERG (136TH): Next up is Leslie Miller, followed by number 39, Kevin Watson. There you are. Dr. Miller. I didn't recognize you for a moment. Please.
DR. LESLIE MILLER: Senator Abrams, Representative Steinberg, Senators Lesser and Anwar, Committee Members. My name is Dr. Les Miller, I'm the immediate Past President of Fairfield County Medical Association, a member of the Office of Healthcare Strategy involved in the Allocation Committee, and a Family Practitioner. Thank you for allowing me to present my fourth testimony supporting a medical assistant’s right to immunize. Given the pandemic, however, I wish that it would happen sooner than the date specified in Bill 285.
When I entered Connecticut as a young physician MAs were quietly, uneventfully, vaccinating in several offices. Medical assistants have continued to vaccinate in 48 of 50 other United States for many years. Connecticut remains the only New England State that does not allow medical assistants to vaccinate. Medical assistants in California have had the right for 19 years. Connecticut fails to move this legislation forward, not based on evidence, rather due to its own particular politics. While legislators would likely approve this Bill, it has never been allowed to come up for a vote in 4-5 years. Simple votes like this have downstream consequences. Physicians who train in Connecticut leave the State for more doctor-friendly environments. Connecticut as again ranked third most undesirable place for doctors to practice medicine practice.
Practices and health care organizations find it difficult to hire and keep doctors, even those who train here. Traditional, private practices have disintegrated to the burdensome overhead, cheating 136 February 8, 2021
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our public out of the choice of where to get its healthcare. The medical assistant is trained to be the third and fourth hand of a physician. Their function in most states include simple procedures to allow doctors to take on more complex tasks. Venipuncture performed by MA's is far more complicated than the simple poke of a vaccination. If difficult issue should arise with phlebotomy or immunization, the directing physician simply takes steps to help resolve the situation. It is incredulous that these medical office professionals, who have been trained to vaccinate as part of their curriculum and are daily involved in the prep for immunizations have been passed over, while pharmacy techs, who have less clinical exposure are approved in a split second to vaccinate for the upcoming pandemic.
The pandemic is entering an accelerated phase, with the British variant predominating. Community practice, which often use medical assistants, may at some point need to be dispensing vaccine. Therefore, allowing medical assistants to vaccinate now will greatly speed the process to herd immunity. Medical assistants have developed relationships with our patients and are knowledgeable about their comorbidities.
DR. LESLIE MILLER: They often come from communities that have significant vaccine hesitancy, and thus will be a force to increased trust and compliance imperative to controlling this pandemic. It is time to allow medical assistants to practice at the top of their license, just like all other professionals are required to do so. It is time to join the rest of the country and allow these people to vaccinate. Thank you so much.
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REP. STEINBERG (136TH): Thank you, Dr. Miller. I don't know if you were listening in on the testimony from earlier today from APRN, she made a number of points. One is that, maybe this work should be done by LPNs as opposed to MAs. And secondly, they represent that there may be some risk involved here because the MAs are inadequately educated. Would you comment on that?
DR. LESLIE MILLER: Yeah, I mean, I don't have the exact data. I mean, I do have a syllabus here, which shows that they learn -- they learn pharmacology, they learn anatomy, they have -- they practice their immunizations, on things kind of like -- kind of like the nurses do on chicken breasts, and probably I did as a medical doctor. They -- My experience with my medical assistants is they are my second hand and they are absolutely attached to me, and they are -- they do what I say, and they -- and I think they're totally competent at giving vaccines.
And as you know, they do phlebotomy all the time, which is absolutely much more difficult than giving a vaccine. They have to go under the skin. They sometimes don't see the vein. They have to feel their way through the skin. They have to find the angle of the vein under the skin, just by palpation. And then they have to go in and draw blood. This is something they can do. They also learned pharmacology, by the way.
REP. STEINBERG (136TH): Just to be clear, you make mention of the fact that they are under your instructions, they are under your supervision, but does that provide them with the perspective necessary to be sensitized to reactions and other untoward outcomes?
DR. LESLIE MILLER: So, you know, when they -- they can have an outtoward -- an untoward outcome when 138 February 8, 2021
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they're taking blood. A lot of people faint when they -- when there's blood drawn, and these people have to learn how to handle that, and they do.
REP. STEINBERG (136TH): Thank you. Representative Petit, followed by Representative Dauphinais.
REP. PETIT (22ND): Thank you, Mr. Chairman. Thank you, Dr. Miller, for your testimony. I had many of the same questions that Chairman Steinberg has gone over with you. But again, the big issue that a number of people have put forth the notion that practice -- private practice officers should just go out and hire LPNs or RNs. What I have heard over the past four or five years since I've been in Hartford is that offices had a great difficulty finding RNs and LPNs allowed to work in their offices. And to be able to compete with the other opportunities that are available to them. Can you comment on the availability of RNs and LPNs, in terms of working in offices?
DR. LESLIE MILLER: Well, I'm a Primary Care. An myself and Pediatrics operate on an excruciatingly high overhead. And as you know, most doctors who practiced in this State have now collapsed their practices, have moved on, and sold their practices. Many have left the State. People I knew and used to work with, have left the State due to the economics of working in Connecticut. I think that, for me, it's not an option. I will -- I will not be able to afford an RN or an LPN. And to be honest with you, if I have a choice between the two, the MAs are specifically trained to work for me and do the things I need them to do. And in fact, the nurses have been fighting to stop them from doing things that they do in many other states, that are not being done here in Connecticut, so they could be so much more helpful than they are to me. But I find -- 139 February 8, 2021
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I feel very comfortable with my MAs, and I find that they are literally my third and fourth hand.
REP. PETIT (22ND): Thank you, Dr. Miller. Thank you, Mr. Chair.
REP. STEINBERG (136TH): I would hope virtually rather than literally. Representative Dauphinais.
REP. DAUPHINAIS (44TH): Hi, I thank you, Mr. Chair. And thank you, Dr. Leslie Miller. You've expressed your -- you know, your support for MAs giving vaccines and being able to handle any event that would happen or occur at the time under a doctor's direction. Would you also support them giving any other medications under a doctor's direction?
DR. LESLIE MILLER: Well, we're not here for that, so I wouldn't comment on it.
REP. DAUPHINAIS (44TH): Okay. Because I mean -- I guess I'm asking because they all could have adverse events and things that could happen. And there's certainly an array of medication --
DR. LESLIE MILLER: You know, I'm the directing physician, and I'm responsible for whatever happens.
REP. DAUPHINAIS (44TH): Okay.
DR. LESLIE MILLER: As I am now, when they draw blood, every day, patient after patient, I'm the person.
REP. DAUPHINAIS (44TH): Thank you.
REP. STEINBERG (136TH): Thank you, Representative. Any other questions? If not, thank you. Next up is number 39, Kevin Watson, followed by Jennifer Jacobson. 140 February 8, 2021
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DR. KEVIN WATSON: I echo a lot of Dr. Miller's sentiment, but just from my perspective. I wanted to introduce myself. My name is Kevin Watson. I'm a board-certified pulmonary -- critical care and sleep physician, strongly supporting SB 285, authorizing medical assistants vaccination privileges under the guise of physician supervision. For perspective, I work on average 12-to-14-hour days between inpatient and outpatient settings, and this is not unique to the physician workforce.
I am also in a practice that is responsible for approximately 30,000 influenza vaccinations this season to the community and is urgently -- anxiously awaiting the COVID vaccine delivery to our practice. This Bill, as proposed, will ease the burden on the physicians in Connecticut. Senate Bill 285 will also positively impact both medical assistants and the population in Connecticut. Currently able to perform suture removal, phlebotomy, and other activities under the physician guidance, immunization capability of medical assistants is a needed support, and within their scope of practice outside of Connecticut.
Not only will this improve efficiencies for the delivery of needed preventative care; it will also enhance the individual medical assistant's marketability, and career growth. Although this Bill has been long overdue, the recent authorization of pharmacy technicians essentially establishes precedence for such which -- with much less training. Comparatively, the training requirements for medical assistants, as much as 10 months classroom and two months clinical, far surpasses that of pharmacy technicians with an average of two months' training. The -- Connecticut Department of Public Health through CMS has afforded pharmacy interns and technicians, vaccine authorizations, 141 February 8, 2021
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with an additional two-hour training on vaccinations. The current bill requires no less than 32 hours for the medical assistant.
Moreover Connecticut remains one of the few states limiting the capacity for medical assistants, specific to vaccinations. In short, this is a logical and beneficial Bill supporting the delivery of medical care in the State of Connecticut. I know time is short s. o in closing, from the perspective of a practicing physician in Connecticut for more than 15 years, I support vaccine authorization for medical assistants. Collaborating with physicians and medicals -- the medical assistants potential to enhance medical care is a welcomed opportunity for the population of Connecticut. And I thank you for your time.
REP. STEINBERG (136TH): Thank you, Sir. You've may have heard earlier testimony where somebody likened the fact that Connecticut is one of two states is -- who wouldn't follow 48 lemmings off a cliff, or something along those lines. I don't know how much knowledge you have of what goes on in other states, but given the California has been doing this for 19 years, are you aware of a real problem? Any pattern of bad outcomes related to allowing MAs to administer vaccines?
DR. KEVIN WATSON: Yeah, I'm always a little apprehensive about blanket policies. I would imagine that if there have been -- there's always gonna be issues in any delivery of vaccines per se, but it should certainly be anecdotal. And with the experience they've had in California, anything -- you know, we have the advantage of looking at California for any problems that may have arised to make this more efficient and safer in Connecticut. But certainly under the guise of physician 142 February 8, 2021
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oversight, I strongly support allowing the MAs to provide these vaccines.
REP. STEINBERG (136TH): Just to be clear, I was asking whether you were aware of data that suggests that there is significant risk based on other states?
DR. KEVIN WATSON: No, but I will plead ignorance to that, too. I haven't looked specifically for that data.
REP. STEINBERG (136TH): Thank you. Representative Petit, followed by Senator Anwar.
REP. PETIT (22ND): Thank you, Mr. Chairman. Just a quick comment. Thank you, Dr. Watson, for taking the time, you're selling yourself short. Mr. Chairman, I've known Dr. Watson and Dr. Miller for a long time. They both put in 100-hour work weeks on a routine basis. So, thank you for really making the effort to come out and testify on these bills. I know it's difficult for you to do that. So thank you very much. Thanks, Mr. Chairman.
DR. KEVIN WATSON: Thanks.
REP. STEINBERG (136TH): Thank you. Senator Anwar, followed by Representative Dauphinais.
SENATOR ANWAR (3RD): Thank you so much, Mr. Chair. Thank you, Dr. Watson. I was gonna say what Dr. Petit said was, at first, it's good to see you here and thank you for your good work during the pandemic. I truly appreciate the work that you've been doing. And again, your testimony is very important and valuable, and I hear what your concerns are. Thank you.
DR. KEVIN WATSON: Thanks. 143 February 8, 2021
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REP. STEINBERG (136TH): Thank you. Representative Dauphinais, followed by Representative Klarides- Ditria.
REP. DAUPHINAIS (44TH): Thank you, Mr. Chair, and thank you, Dr. Watson. I have a question. Do medical assistants currently give and deliver other medications, or other kinds of injections?
DR. KEVIN WATSON: From -- Certainly, in my practice, they do not. And I am not aware of that responsibility for medical assistants. I don't believe so.
REP. DAUPHINAIS (44TH): Would you be --
DR. KEVIN WATSON: But I would advocate that if, you know, one should go hand in hand with the other, and I may be getting into the weeds a little bit, but it would make sense that, as pharmacy techs should hopefully have the training on -- certainly application of that depends, God forbid, there is a reaction, you know, that might be something that could be an opportunity. Again, under the direction of the physician, God forbid for anaphylactic reaction, like we're seeing an adult leave with some of the with COVID rollouts.
REP. DAUPHINAIS (44TH): Just an EpiPen? Or would you be supportive of other medications, like insulin, or blood pressure medications or the like?
DR. KEVIN WATSON: I think, I would be only in support of our emergent medications, so such that are given for life-threatening circumstances. An insulin itself is not something that would be utilized in that fashion.
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REP. DAUPHINAIS (44TH): Okay. So you wouldn't be supportive of them delivering other medications outside of an EpiPen, perhaps?
DR. KEVIN WATSON: I would be -- You know, I would certainly like to see what proposals people have had, but right now, I would not. You know, I think the -- You always wanna have an antidote if you have a -- if you give something. And I think the potential for an EpiPen or something in that matter, if there's a -- if there's a true anaphylactic reaction to something, that could be life-saving, I think that would be sensible. But nothing beyond that at this point. No.
REP. DAUPHINAIS (44TH): Okay. Thank you.
REP. STEINBERG (136TH): Thank you, Representative. Representative Klarides-Ditria, followed by Representative McCarty.
REP. KLARIDES-DITRIA (105TH): Thank you, Mr. Chair. Thank you. Dr. Watson, for your testimony today. My question: Do you -- this bill as written, do you feel there's enough training for medicals -- medical assistants as is? Do you think we need to add anything different to it?
DR. KEVIN WATSON: No, I -- you know, as I said, the -- the -- you know, when you compare two hours of training for a pharmacy tech versus eight additional hours of training for the medical assistants, you know, I think that's certainly, you know, sufficient.
REP. KLARIDES-DITRIA (105TH): Okay, thank you.
DR. KEVIN WATSON: And I would argue that, you know, we should be -- if we're -- if we're comfortable with two hours of training for a pharmacy tech, how 145 February 8, 2021
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comfortable are we with more training for a medical assistant?
REP. KLARIDES-DITRIA (105TH): I agree with you 100 percent. Thank you. Have a great day.
DR. KEVIN WATSON: Thanks.
REP. KLARIDES-DITRIA (105TH): Thank you, Mr. Chairman.
REP. STEINBERG (136TH): Representative McCarty.
REP. MCCARTY (38TH): Yes. Thank you, Mr. Chairman. Thank you, Dr. Watson, for your testimony. Would you be able to comment in your experience with medical assistants -- and appreciate what you've commented on the training. But have you noticed, in your practice and experience, are medical assistants leaving the State of Connecticut, so going to other states where they might be able to practice their full scope of practice? I'm just curious as to whether you've seen any sort of exodus of medical assistants from our state.
DR. KEVIN WATSON: I -- I can't say I've seen in -- in -- I haven't really tracked it. I know I have had medical assistants that have moved, but I'm not sure specifically for a -- you know, a better job opportunity. But they've moved out-of-state for opportunities, whether it was specific to, you know, different improvement, different environments, you know, different employment or such, I can't speak to that. But I don't know any data that suggests that they're leaving because of one or the other.
REP. MCCARTY (38TH): Alright. And -- And I appreciate that comment, and I probably should have posed the question to Dr. Miller. So, I appreciate that honest response. Thank you. 146 February 8, 2021
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REP. STEINBERG (136TH): Thank you, Representative. Are there any other further questions? If not, thank you for your testimony today. Next up is Jennifer Jacobsen, followed by number 41, Melanie Kolek.
JENNIFER JACOBSEN: Hi, good afternoon. I'm Jennifer Jacobsen. Thank you so much to the Committee Members for affording me the opportunity to speak to SB 288, AN ACT CONCERNING AIR QUALITY IN SCHOOLS. First, just thank you very much for bringing this Bill forward again, and on this much-needed matter, at this time and has been for quite a while. I also am a member of the Board of Ed locally so I just wanted to share some thoughts. I did put in comprehensive testimony for everyone, that is far more detailed than what I'll just highlight for you here today. But just quickly speaking, most of my testimony focused on Section 1.
I presented for you some of the logistical and legal matters I feel districts would face in a two-hour rolling basis school closure, just from transportation to meal service to sped services. I also wanted to mention that when you're talking about closing schools, we normally also were talking about outside facilities because therefore school is closed. Therefore, now we're getting into before and after-school care, other activities, parks and recs. And so I thought that it would be possibly consideration to put in a exclusion there for outdoor facilities in terms of that area. But basically, advocating against school closure on these two rolling -- two-hour rolling basis for a lot of reasons.
The effective date of July 1st, I think we all know that three weeks is not gonna be enough time for potentially hundreds, if not thousands of schools, to get through even an RFP process, to do a needs 147 February 8, 2021
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assessment, never mind, secure funding, get through the town bodies, hire a contractor, and get this work done. So there needs to be a little bit more of a thoughtful approach to our timeline here that deals in phases and takes into consideration different districts sizes and needs. So clearly, a district that might have one building to do is going to require a timeline that is different than, say, district that might have 6, 10, 15, 20 plus buildings to do.
Also, taking into consideration what your knowledge may be on our contractor capacity in order to do all of that work within a timeline. Standard 62 itself, you know, I think that that's fine if that's gonna be the standard. But again, I'm gonna go back to the basic point, that school districts at this point, don't necessarily even know if they all have that standard in place, and buildings could be partially done, not done at all, or not need anything.
So again, we have to have a thoughtful approach to what work will need to be done in order to accomplish your goals, and all of our goals, which is obviously good air for our students and our staff. But at a deeper understanding possibly of all of the different types, sizes, and scopes of our buildings might be helpful here.
Lastly, the gym piece, on the temperature, I appreciate the intent there. I really do. But again, I'll reiterate that our kids and our teachers aren't spending a majority of their day in the gym. There are also curricular implications on closing gyms at this point. And then also back to our before care, our childcare issues, our afterschool programs, in addition to the curriculars that I've already mentioned. And I guess I will say, there seems to be a missing section of this Bill, and that's your funding mechanism. You know, Boards of Eds don't 148 February 8, 2021
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determine budgets, towns do, or the State does. So without that, I don't see how any of this is going to get accomplished. Districts are already required to have facility plans, long-term facility plans. So my question on that is how -- are we -- [crosstalk].
LINDSAY VAN BUREN: Sorry. Your three -- You've hit your three-minute mark, can you conclude your remarks though.
JENNIFER JACOBSEN: Okay. So my concluding remark is really that we do need to move an air quality bill forward in this state finally that addresses all of these issues, not only for students and staff, but for the health of the buildings themselves actually at this point. But does so in a way that doesn't cause chaos, deficits and, you know, problems legally, federally or state at the same time, and denying kids their access to their education. So hopefully, that can all come together in this Bill. Thank you so much. That's it.
REP. STEINBERG (136TH): Thank you for your testimony. I particularly appreciate your very practical considerations. And yes, we are not always aware of the process necessary to bring entities into compliance. So I'll ask you this. If we were not to make it effective immediately, recognizing many of the points that you make, what would be a fair period of time to bring schools into compliance, or perhaps it would be more than one- tier approach, initially having a plan and then maybe requiring full compliance at a later date? Do you have any suggestions along those lines?
JENNIFER JACOBSEN: I do. I really do. I think that we're gonna have to work with DAS, and we're gonna have to work with, you know, school grant construction, too, to basically get a needs assessment done first. So we're gonna have to assess 149 February 8, 2021
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in terms of -- Every district is gonna be different. I honestly feel like every district is gonna need their own IAP. You know, that's similar to an IEP, where we do the evaluation process, we identify what needs to be done, and we lay out our goals in how we're gonna get there.
I mean, again, you're gonna have districts that are different sizes, that these phases are going to have to be individualized based on the scope of the issue. Again, if you've got one building, that's one timeline. If you've got 20, that's gonna be another. So we're gonna have to work with the Department of Administrative Services and figure out a plan that can be customizable to each district's needs. Is -- It -- I mean, I can't give you a more definitive answer because we don't even have an idea of scope right now.
REP. STEINBERG (136TH): Well, clearly, you've given this a lot of thought. And I'd like to encourage you to continue to share your suggestions with this Committee. It's conceivable that we'll shape the final legislation if we move forward. And we do want to do the right thing by the schools, and not create an overly onerous burden. We wanna protect students, teachers, and visitors. And to your point, maintain and improve the quality of the buildings themselves in this regard. So you brought up some points we'll really have to think about to make the Bill stronger. Thank you for your testimony. Representative Zupkus.
REP. ZUPKUS (89TH): Thank you, Mr. Chair. And thank you, Jennifer, for testifying and bringing up all of these points. I share the same concerns with a lot of those. And -- But my one question is -- And I don't know if you can answer this, and I understand it's different, the scope is different. If you could average it out, what would it cost per school? I 150 February 8, 2021
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mean, because, you know, here is this thing, you have to do it, right? And it's an unfunded mandate. So I guess I'm -- I have no idea, but I'm just curious, and maybe just take a school where you are. What do you have -- Do you have any idea of the cost?
JENNIFER JACOBSEN: Well, I mean, I think that goes back to my original point, Representative. You may have raised an excellent point. We're gonna need to have a phase here while we're doing an assessment, and just -- just doing an assessment is gonna cost money because you're gonna, have to get somebody to come out and go to every single building and tell you what you need to get up to the standard, and then you go through the process of actually doing the work. So I can just tell you right now, due to COVID, you know, just one high school doing a retro- commissioning just of existing systems, just to see, get all that up to snuff is 1.7, and that's not necessarily going through the whole building to get to this standard if it doesn't meet that. So that's just a retro-commissioning on one high school.
So you're talking a very heavy lift. And to your point, I'm kind of gonna sit here, and I'm gonna say, "I hope it's not an unfunded mandate." You know, I mean, we're gonna need help here. This is a -- This is not just a health issue, okay? This is a security issue, too. And it's not just COVID. this has been a long time with mold and air issues. But also since Sandy Hook, too. You can't open doors anymore, you can't open windows anymore. It's not just health. So we all need to do this big lift together. And I know it's gonna take time, and it's going to be expensive, but that just can't be a barrier at this point. Because the longer-term costs when you get mold, and when you get -- that becomes a cost, too.
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So that just gives you a rough idea, But I can't even begin to tell you across the State, depending on the size of the building, how much of the building needs to be done; that's just gonna vary by building. So I think that we should get an idea about that so that we have an idea how to do it. And again, I was gonna finish with our long-term plans question before the time ran out, but are we supplanting this mandate for everything else, our brooms, our boilers, or undertake oil tanks, like, are those being pushed out to put this in front? We gotta be mindful of other things as well, that need to be happening on a parallel track, in my opinion.
REP. ZUPKUS (89TH): Right. And I would think that, you know, your Board of Ed and your superintendent, I would think people are looking at all of these. And know, you know, COVID is here, and this is what people are talking about, and all of these things. And that most schools have some kind of plan already, and are working on it. I mean, like you said, there's so much to do. And, you know, the states have prioritized this and prioritize that. Well, you need funding, and you need to be able to prioritize it with time. So I really appreciate your testimony, and coming today, and I don't know where the State would get all the money. I mean, 1.7 just to do -- I mean, this is an exorbitant amount of money for the State, or for a town, or a Board of Ed. So thank you.
JENNIFER JACOBSEN: And I would just say that the State's seeing it any way, because when districts put in a building project, or remediate mold, or to tear down a building, you're gonna see those costs on the other end anyway. So let's try to reconcile those upfront from a preventative, rather than a react. Let's spend our dollars wisely, right? So let's get prevention going in there rather than a -- after the fact, you know, crisis. 152 February 8, 2021
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REP. STEINBERG (136TH): Just to be clear, as a point of clarification, when you mentioned 1.7, you're not talking about a buck 70; you are talking about 1.7 million --?
JENNIFER JACOBSEN: I'm talking $1.7 million, just to do a retro-commissioning assessment of current existing HVAC systems in one high school. Yeah. So that's obviously a very large high school. But to give you the sense, that's not necessarily in every single part of that building, getting it up to Standard 62. You know, we don't even know that yet. We're gonna need to all go through this assessment process together as the first phase of this, I would imagine.
REP. STEINBERG (136TH): So again, to be clear, that 1.7 million represents the cost of the assessment, not for the remediation itself?
JENNIFER JACOBSEN: No, no, that is. That -- That includes -- That includes like getting the work done on a retro-commissioning. Yes, that is.
REP. STEINBERG (136TH): So that's the full nine yards identifying the problem and also addressing it?
JENNIFER JACOBSEN: Yes. And I hope I made my Director of Operations proud there. [laughs] If it's not, I'll let you know. But I think so, yes.
REP. STEINBERG (136TH): Well, that is an important clarification because [crosstalk].
JENNIFER JACOBSEN: Yeah, I'm pretty sure that is. Yes.
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REP. STEINBERG (136TH): It's both the assessment and the remediation? And the remediation could vary widely depending upon the nature of the problem identified.
JENNIFER JACOBSEN: Yes, exactly. So, I mean, if you're talking about districts with a lot of different buildings that are of a lot of different sizes, especially if they're old. You know, you can -- because how we're forced to do projects now in piecemeal, you know, a little bit here, a little bit there, a little bit this, there could be parts of your buildings that meet this, but then other parts that don't. So just, you know, I appreciate the heavy lift. I really do, but it's -- we just need to do it in a really thoughtful. And I don't -- You know, look, I don't think everyone should be given a decade, you know, to get this done, but three weeks, it certainly isn't gonna -- isn't gonna happen.
REP. STEINBERG (136TH): I think we take your point. Thank you. Are there any other questions? If not, again, thank you for your testimony today. We have a number 41, Melanie Kolek, followed by number 42, Jonathan Shaer.
MELANIE KOLEK: Good afternoon. I'd -- I'd like to commend Mrs. Jacobson for her comments. Certainly well pointed out. My name is Melanie Kolek, and I'm legal counsel for the Connecticut Education Association, and I proudly represent public school teachers across our state. And I have the privilege and honor of representing our CEA teachers and their workers' compensation matters. And over the course of, at least the last four years, we've seen a drastic spike in the number of cases involving exposure to mold, and other environmental toxins in their schools and classrooms. And as you may recall, I testified before you last year that the 2019-20 school year was by far the worst in terms of the 154 February 8, 2021
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number of teachers falling seriously ill due to just showing up for work. In relevant part, we counted at least 60 teachers in the Stamford School district who were suffering, and some who continue to suffer today from the known mold and exposures to toxins within their schools.
As you know, we have maximum temperatures for dog kennels and pet shops, but we have no minimum and maximum temperatures for our school classrooms. This inequity must be addressed. I think we can all agree on that. And not just in our school gymnasiums, since most of our students are in fact spending time in their core subject classrooms, and students simply cannot learn in environments that are too hot or too cold, there are many studies that's -- that show this. And our school staff and students shouldn't have to fear getting sick just by walking in the halls, and the classrooms of their school.
The Bill before you, again, is an accountability bill. It provides clarification as to where reports of classroom issues should be reported, which is absolutely critical. You heard Mr. Schrag talk earlier about the fact that our staff and our teachers, and even our students are reporting issues to administration. And those reports are not being carried forth to a director of facilities, for example, to get the job done, or at least advise the taxpayers in town, that there are things that need to be rectified within the school.
So this Bill definitely brings Connecticut much closer in line with national safety standards that are being used across the United States. And it's a fundamental issue that we need certainly to work on and move forward.
Representative Zupkus asked earlier about, you know, our Boards of Education, "Do they have these plans 155 February 8, 2021
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in place? Are they working on it?" I wish I could say that that was the case. We are simply not seeing that happen. Stamford again, perfect example, in 2008, they commissioned a district-wide survey of all of the things that needed to be done in the district, and then didn't follow through on, because of funding because of drop in the economy, et cetera. So those are the things that we need to have put in place. And I think if we can work together on making sure that these particular projects aren't kicked out because they need an -- something new -- other -- something new in the school, that those parallel projects are sort of put to the side and that we really make this a priority for our -- the safety of our students and our staff working in these schools. Thank you.
REP. STEINBERG (136TH): Thank you. I think you impress upon us that there is a measure of urgency, which creates a natural tension with having a fair period of time to implement the -- a law that would put obligations on school districts. But it doesn't sound like we have the luxury, as you say, of waiting for a Board of Education's -- or in combination with Boards of Finance, to determine they have the money to go forward with these things.
You know, we talk a lot in the legislature about using bonding money to help with school construction. It seems to me this ought to be part and parcel of some of our considerations if we're going to impose this on school districts. Representative Arnone.
REP. ARNONE (58TH): Thank you, Mr. Chair. So -- And this is a year -- two years ago when this came up. The first time it was a big wake-up call to many, many municipalities. We were going through air quality issues at that very time. Old single units in schools -- in elementary schools that were both, 156 February 8, 2021
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you know, in the window fixes -- air conditioners in the window fixes because the Board of Education, frankly, hadn't addressed this stuff for years and years and years.
So in your opinion, for all these municipalities out there that have to deal with the leaky roofs, 'cause this is not just an air quality issue, 'cause mold happens through moisture, through humidity -- dehumidification of the buildings, and staff getting sick. So when you see the smaller districts, you know, need that push from the State to stand up and say, "Hey, we're gonna start getting these bonds in." And also some of the federal stimulus money that just came through to the local municipalities is usable for air quality. So how far have we gone in a year and a half? Has it -- Has this -- the threat of this Bill helped at all?
MELANIEKOLEK: Well, if it has, I haven't seen it. I can tell you that there are -- there are schools that I've walked into just representing teachers that are significantly dilapidated. I -- I witnessed in a middle school and in the central part of Connecticut, where the -- the wall was actually coming away from the actual structure of the school, and water was seeping in, it happened to be a rainy day. And everybody knew about it. Everyone knew that there was this issue, and yet no one was taking the initiative to call someone to say, "We need this patched up. We need something done." And you're absolutely correct. I'm -- Some would say it's a bit of a misnomer to call it air quality. This is building condition quality. This is what we're facing.
So I do believe that there's a push that needs to happen. I do believe that the money is there. However, we, in the State, decide to collectively determine how that money is distributed and where we 157 February 8, 2021
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get it from. It's there. It's just a matter of making this a priority. Has to be, for our kids. Has to be.
REP. ARNONE (58TH): I agree. And our town just started addressing many of these problems. Another problem is the piecemeal. I just heard a previous speaker talk about -- these are getting fixed piecemeal because they can't go to referendum because -- You can talk to a lot of people in my district to say, "What do kids need air-conditioning for?" We built a high school; we had to argue to get air-conditioning in with our Building Committee. They think it's an unnecessary expenditure. So it's not only happens on your end, but we need to keep continually letting people know that these air quality issues exist. And they're not just luxuries in new schools, so. So thank you very much.
MELANIE KOLEK: You're welcome.
REP. STEINBERG (136TH): Thank you, Representative. And at the risk of adding more requirements, I would encourage you to, if you wanna share any other thoughts about how we might make this bill more about school, environmental quality. I think many of us would be here to see it. Representatives Zupkus.
REP. ZUPKUS (89TH): Thank you, Melanie. I just wanted to make myself clear. I am certainly not saying that kids should be in harms away. So that is not my point. My point is, it is an unfunded mandate at this point. But my effective questions -- my question to you actually is, when you talk about Stamford, I don't know what happened in Stamford, but just listening to you now about walking into a school, and the wall is separating and water coming in. For me, if that is not being taken care of by the school, by the Board of Ed, why would no one go to the Health Department or to the Department of 158 February 8, 2021
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Education? I mean, that's purely a safety issue. So didn't you -- when you saw that, what did you do?
MELANIE KOLEK: So, a few things, one is to make sure that the -- appropriate people within the district knew that there was a problem within that particular school. And that was just one example within that floor of that particular school that needed to be addressed. Second thing is that, for the teachers who were ill, certainly we would file a workers' compensation claim. Third thing is that we would advise the Department of Public Health.
You heard a bit about the Tools for Schools. My understanding is that, that school, in fact, had a Tools for School Committee. They developed a report. They submitted it to the -- whomever. I believe it was their district and possibly the Department of Public Health. I don't recall that specifically. But like we're hearing that had no teeth. It didn't have the teeth where there would be an enforcement mechanism. So to the extent that all of these people knew about the issue, there was nothing that would force someone to say, "This really needs to be rectified." I agree with you. It's certainly a health issue. It's an immediate health issue. But people were sort of turning a blind eye to it. And - - And that's not the only school that I'm seeing that in either.
REP. ZUPKUS (89TH): So you mean to tell me, that was happening in the school and the State Board of Education, the State Department of Education did nothing about it?
MELANIE KOLEK: I didn't -- I didn't say the State Board of Education. The appropriate vehicle, my understanding in doing these, and talking with the Department of Public Health is that it would need to come through the Department of Public Health if the 159 February 8, 2021
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town wasn't doing anything about it. My understanding is that that happened. I haven't been back at that school. I'm not sure -- I haven't heard of any issues in that school. I'm not sure if it's been renovated. But the State of -- the Board of -- the State Board of Education did not get involved in it, to my understanding.
REP. ZUPKUS (89TH): Well, I can assure you that if I was in that school [audible gap 04:36:38], and I would be pushing it all the way to the top, to the Governor. I mean, because that's -- those things are unacceptable that puts people -- I mean, the building could fall down, the way you're describing it. Like the building could -- that room could collapse. And so, anyway, that's a whole another issue. But I was just curious of -- as of how far anyone pushed, if you're not getting, you know, that immediately fixed. So thank you.
REP. STEINBERG (136TH): Thank you. I will say I come from a -- a wealthier school district. We've had problems with mold in two of our schools, and we have, at least two of our schools that we know now, are environmentally deficient. And that's a community that has plenty of resources. It's actually hard to keep up depending upon the age of a lot of your school buildings. So, it's a -- it is a serious problem. Any other questions? Seeing none. Thank you for your testimony today. Next up is Jonathan Shaer, followed by Kathleen Redmond.
JONATHAN SHAER: Good afternoon, Chairs, and Members of the Committee. I'm Jonathan Shaer, Executive Director of the New England Convenience store, and Energy Marketers Association. Today I'm testifying in opposition to Senate Bill 326. I have also submitted written testimony, which I hope you'll all take the time to digest.
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I have no doubt, you want to develop sound public health policy, but prohibiting the sale of flavored tobacco from legal sale in the State, products that have hundreds of millions of dollars in market demand, is not sound public health policy. It is an emotional reaction absent to the evidence of effectiveness. It is a public health and financial disaster in the making.
Like it or not, tobacco products have enormous market demand. And where there is demand, there is always a market. So the question is simple, do you want these products sold through your existing legal, licensed, regulated, enforced, and tax system where you have control of the products? Or do you want them sold online, over state lines, or sold in the shadows of a black market we have absolutely no control, nor draw any revenue? In fact, it's probably among the reasons you won't find prohibition among CDC's recommendations to reduce youth -- use or initiation.
Connecticut has the benefit of learning from the Massachusetts' mistake of full flavor ban that began on June 1st, 2020, and is on pace to cost the State almost $150 million dollars. In the first seven months of the ban, New Hampshire and Rhode Island have more than made up for the cigarette excise tax stamp sales reductions in Massachusetts. As for the claim, the lost revenue will be offset by the healthcare gains, the data suggests, more packs have come back into the State, either for personal consumption or illicit sales. Then we're lost. Same health problems without any of this -- any of the offsetting revenue or enforcement capability. It's a failure. And Connecticut has sovereign tribal casinos to contend with, something Massachusetts did not. You will not have the benefit of not making that same mistake.
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Over the past 12 to 18 months, the federal government has taken significant steps to restrict electronic nicotine delivery systems, and access, including raising the legal minimum age to purchase to 21, an expansion of the PACT Act, stringent, vape, flavor restrictions, and most significantly, the FDA's PMTA process, which has eliminated, and will continue to eliminate most vape products from the legal market.
Respectfully, if you don't fully understand these policies, what they mean and their impact, then you really should not vote for Senate Bill 326.
We all share the goal of protecting youth, including retailers who are the only people checking IDs. They work within the existing system, not against it. It's critical to recognize the user profile of ends versus the user profile of traditional tobacco products; they're not the same. To treat them the same with a simple blanket flavor ban is a major overreach impacting your adult constituents, our adult customers. Recognize the desire to do something meaningful to protect youth, but this is not the right approach. If you really wanna make an impact, there are practical steps, many of which I outlined in my written testimony. Thank you for your time and consideration. I'm happy to answer any questions you may have.
REP. STEINBERG (136TH): Thank you for your testimony. And I would encourage you to share data you have to acquiesce the effects in other states, and we'll all look very carefully at your written submission. Particularly, if you offer alternative approaches to dealing what we see as the problem, it would be much appreciated. Are there any questions? I don't see any. So again, thank you for your time, and we will look at your testimony carefully. Next 162 February 8, 2021
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up is Kathleen Redmond, followed by Janice Freschlin.
KATHLEEN REDMOND: My name is Kathleen Redmond, and I'm a volunteer with PAVE, Parents Against Vaping E- cigarettes, here in Connecticut. I support the ban on the sale of all flavored vaping products, and all flavored tobacco products, including menthol. This issue is deeply personal for me. My son was 13 when he was first offered e-cigarettes. Like so many teenagers, his desire to be accepted, set him up for addiction. He vaped only flavored products. He was told they were not harmful. They came in candy flavors. How could they be? His use of flavored e- cigarettes led to tension in our family. When I tried to take away his nicotine products, it was like I was depriving him of oxygen. He was 15 and I confiscated his Juul. He became so desperate that he held a large kitchen knife to his throat, threatening to harm himself, if I -- if I did not give it back. My husband called an ambulance.
A child who had never shown any propensity for self- harm, threatened to kill himself over nicotine. He was hooked by these flavored nicotine pods and threatened to take his life when he could not have them. Let that sink in. My son, now 19 is still hooked on flavored vapes, and faces a lifelong battle with addiction. Getting hooked at such a young age, derailed a promising future. He needed nicotine to function. He could not get through a 40- minute high school class without it. He soon refused to go to school. Not allowed to vape in the house, he holed up in his room. He became isolated, anxious. What he had thought was an avenue to social acceptance became a solitary activity. Every day, he was focused only on where he was getting his next nicotine hit. If it were not for school going remote last spring, he would not have been able to complete high school. 163 February 8, 2021
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Given his low grades and lack of engagement, college is a deferred hope. He has difficulty getting through a part-time job because he needs smoke breaks. And what little money he makes is mostly spent on nicotine products, and they are always menthol. He has admitted that he hates the unflavored pods and that he would not have been as attracted to vaping as he was, had the pods not been flavored.
Nicotine is the most addictive substance on the planet. And yet, as a society, we had finally driven the smoking rates down only to be blindsided by this new method of hooking another generation. These flavored pods have put our children at risk for cancer, vaping-related illnesses, severe COVID, and even mental health issues. It's too late to save my son from this turmoil, but it is not too late for other young people.
Please do what you can to ensure that they are not robbed of a better life. Please do not let large corporations, yet again, pick the pockets of our vulnerable youth, stealing their health and their happiness. Please consider passing SB 326. Thank you.
REP. STEINBERG (136TH): Thank you. And I wanna say how much we appreciate the very difficult story you have to tell us today. I think it underscores there are real ramifications in many cases and that -- With any addictive substance, there are real differences between individuals in terms of their susceptibility and its impact, and this is not trivial. Senator Anwar, followed by Representative Kavros DeGraw.
SENATOR ANWAR (3RD): Thank you, Mr. Chair. Thank you so much, Ms. Redmond, for your testimony. And -- 164 February 8, 2021
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And I know it's very difficult for you to come forward and share your story, to help other children, other families and -- and protect them. So I truly appreciate what you have done today by sharing your pain, and saving -- hopefully saving others. And I think our efforts hopefully are going to try to do the same. And I want the people who are listening, especially people who are in the industry, whether it's in the small business and also in the larger industries, listen to what this product is doing. And basically, your financial benefits are result in harms to individuals and entire families forever. And I think that's the reason why this becomes necessary. Because if we continue on the same path, we are putting a dollar value to the lives of our children, and then for small businesses. So, I cannot thank you enough for your taking the time to speak.
KATHLEEN REDMOND: You're welcome, Senator Anwar. And may I just add that it is very personal. It was hard to come forward here today, and I was worried about it. But I feel so strongly about it because no amount of education, whether the State provides it or the schools or whomever, parents, no amount of education is going to help if a child of age 13, who really doesn't know any better, is putting nicotine into their body, the most addictive substance on the planet, according to doctors and scientists. I mean, how are we gonna prevent them from becoming addicted? They don't know any better. No matter how many times we tell them in school or D.A.R.E. programs or whatever, it's just not something that they can appreciate. They're too young to realize the harm it can cause.
SENATOR ANWAR (3RD): Thank you.
MS. REDMOND: You're welcome.
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SENATOR ANWAR (3RD): Thank you, Mr. Chair.
REP. STEINBERG (136TH): Senator -- Representative Kavros DeGraw.
REP. KAVROS DEGRAW (17TH): Thank you. And I just wanted to thank you also for coming forward. You know, over the last two years, since vaping was put on my radar by parents in my District, I have heard countless stories like yours, of children both changed in physical and mental health. Children that -- And -- And we are talking about children here, that's one of the things that I think we absolutely have to remember.
And so, I know we've heard a significant amount about financial costs to our state and to small business today. But if you can share - while you perhaps have good health insurance - the costs that this has been on your family, whether it be financial, emotional, physical. You mentioned a little bit about your son's health. I'm sure there have been costs associated with both his mental and physical health. And we know it causes popcorn lung, you know, perhaps that's something that you're also concerned about.
KATHLEEN REDMOND: Yes, thank you for bringing that up. It has cost our family and our insurance company thousands of dollars, I mean, hundreds of thousands of dollars, really, because we have sent him to so many different programs to try to get him off nicotine. We've been so proactive that -- You know, I mean, it's cost ridiculous amounts of money. You know, literally even putting him in the wilderness, right, away from stores, from thousands of miles so that he couldn't get his hands on nicotine. He was - - Remember, he was 13 when he was offered this, right? And it's a chemical problem. It's something he can't control. We literally had to take him out 166 February 8, 2021
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of the environment because he was getting it in our town. He was getting it in the next town, right? Even at a young age, they look old, sometimes at 13, so I don't blame the store owners, it's difficult on them too.
But you're right. The costs are astronomical, both monetarily and emotionally. And it's really torn our family apart, on a lot of levels, I have to say. And our parent-child relationship is so strained as a result of these nicotine products, even still.
REP. KAVROS DEGRAW (17TH): Yeah. And I -- I have heard of the Wilderness Program. And in fact, know constituents who have tried the same or similar programs in order to get their children to not be addicted and to have that -- that space, you know, basically from this thing than actually the drug -- in many people's bodies. So --
KATHLEEN REDMOND: Well, keep in mind that the nicotine that these vapes are delivering are much higher than the nicotine that, you know, maybe some of our peers were smoking when I was a teenager. The -- It's such a high level of nicotine that it's so disregulating for them, that they just can't even make a decision. I mean, they're really -- you know, they're not their -- themselves. They're not -- They're so affected by these high loads. It's 6% nicotine. I think the doctors online could tell you it's extremely high.
REP. KAVROS DEGRAW (17TH): Thank you so much again for your testimony today. I really appreciate it.
KATHLEEN REDMOND: You're welcome. You're welcome.
REP. STEINBERG (136TH): Thank you. Representative Berger-Girvalo.
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REP. BERGER-GIRVALO (111TH): Thank you. Thank you so much for sharing such a personal story. Really, I just have a comment. I want to highlight something that you said that I've heard it referenced a number of times throughout the day, and that is the education, the opportunity to educate kids on the dangers of all of these things that are before them. Whatever -- whatever it is that we choose to throw an assembly in their direction on, whether it's on vaping or on sexual education or whatever it is, I think it's important to remember that when we were that age, when we were 13, when we were 14, we were not able to differentiate between what we were seeing on stage from an expert or a presenter, and then be able to come back to our friends and not roll our eyes about it. Even if we felt it, even if we believed in it.
So while I do believe that education is critical, I do not believe that that's gonna be the answer. And I really appreciate that you highlighted that.
KATHLEEN REDMOND: Thank you.
REP. STEINBERG (136TH): Thank you, Representative. Any other questions? Seeing none. Again, thank you for -- for being so courageous as to come speak to us today. We know it -- how difficult it is. But we really appreciate it.
KATHLEEN REDMOND: Thank you.
REP. STEINBERG (136TH): Alright. Next up is Janice Freschlin, followed by Nickey Kollie.
JANICE FRESCHLIN: Good afternoon, Chairman Abrams and Steinberg, Ranking Members Somers, Whang, Petit, and Members of the Public Health Committee. My name is Janice Freschlin. I am a licensed funeral director and embalmer, a general manager of 168 February 8, 2021
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DellaVecchia Funeral Home in Southington and Wolcott. And I am here to voice my strong support for SB 320, a bill that unanimously passed out of this Committee last year before COVID struck. SB 327 allows catered food and non-alcoholic beverages to be served in funeral homes.
We found, with the gradual change in the funeral industry, services have made a major shift from being traditional to something much more personalized that often occurs all at the funeral home. By offering a variety of levels of catered food and non-alcoholic beverages in the funeral home setting will allow families to thank those in attendance, without having the burden of traveling to different locations during their time of grief. Services like these are currently being enjoyed across the United States, including our neighboring states in -- of Massachusetts, New York, and Rhode Island. So this is not something that's unfamiliar to our area. And quite honestly, it's more frequently requested by the families we serve because they have been attending these types of funeral services in other states where it is allowed.
The -- We also experienced that the act of gathering after funeral services in a relaxed and familiar environment provides additional emotional support to the grieving families. And sometimes it just does not occur due to venue availability or even an accessibility. So this just gives families another option. The funeral home can provide a clean, safe, and controlled environment for people to gather, without compromising the strict guidelines caterers currently already abide by in the preparation of food.
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do will not compromise Health Department guidelines and recommendations by local and State Health Officials. Just a reminder that the intention of SB 327 is to allow the serving of only catered non- alcoholic beverages, and food in areas removed from any viewing or preparing of bodies. This practice has been proven, safe and successful in all 49 other states. And Connecticut consumers deserve to enjoy such comforts during their time of grief.
Another point that I think needs to be brought up is -- that is permissive. Funeral homes are not required to offer these types of services; it's just something that gives families another option. So DellaVecchia Funeral Home support SB 327, as it will benefit grieving Connecticut families and allow funeral homes to serve them much better. I'm more than welcome to answer any questions, if anyone has anything they'd like to discuss.
REP. STEINBERG (136TH): Thank you. My guess is, you will get some questions on this because we've heard really two sides of the story. I will hand it off to -- I'm sorry, Representative Arnone, followed by representative Petit.
REP. ARNONE (58TH): Thank you. So at present, what is allowed for a grieving family, that you are allowed to give them now in -- for beverages, for instance?
JANICE FRESCHLIN: What's allowed now is just when we are making arrangements, we can only offer packaged -- individually packaged food items, such as a granola bar.
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children there all day also. It's very stressful for the families too to be -- not be able to get some nutrition in -- at certain times. So also, a lot of people get confused at where this food will be served. So, could you speak a little about where exactly it could be served?
JANICE FRESCHLIN: Certainly, by an area that is not within the same -- within the same room as services are being held. So perhaps, it could be in a lobby area, and it doesn't have to be a full meal; it could just be something very simple as a tray of cookies or coffee or some sort of beverage for people to enjoy. And just maybe something to give the family, just a little break, if they need it to be.
REP. ARNONE (58TH): So both are funeral homes in my town here would like to see this Bill pass. They're both over 100-year-old family businesses, you know, in competition now with very large national businesses also. And they really feel that they need to provide this service for their clients, also. Then, like you said earlier, they don't wanna necessarily leave the funeral home and go to a restaurant where they could -- some funeral homes could actually build an area that would be a catered area. And I think it's a great idea too for caterers in the area, another place for them to actually have some business also. So I just wanted to say, I'm definitely fully in support of this. And thank you for your testimony today.
JANICE FRESCHLIN: You're welcome. Thank you for your support.
REP. STEINBERG (136TH): Representative Petit.
REP. PETIT (22ND): Thank you, Mr. Chairman. Thank you, Mrs. Freschlin, for your testimony. I was in 171 February 8, 2021
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fully in support of this Bill last year and am again this year. You've explained the simple nuts and bolts of it. I gonna take a different tack. When we had testimony last year, there was really very little testimony against your organizations. I really can't see a negative that is -- as it is permissive and follows the Public Health District's guidelines for catered food is just a sensibility that causes a small percentage of funeral homes to not be so sure about this type of legislation. What are your thoughts there?
JANICE FRESCHLIN: As far as their opposition, I think maybe the smaller funeral homes just feel that they don't have the space to offer something to the families. A lot of times, it's just learning to be creative as of where you can put these people. And again, it doesn't have to be offering a full meal. It could just be something very small and something very simple that does not require a lot of space, a lot of seating room.
REP. PETIT (22ND): Thank you. Thank you, Mr. Chair.
REP. STEINBERG (136TH): Thank you. Next up, is Senator Abrams, followed by Senator Anwar.
SENATOR DAUGHERTY ABRAMS (13TH): Hi, I just wanted to take a minute to acknowledge what your industry has experienced throughout this pandemic, and how, I'm sure, how difficult it's been dealing with families who are in grief and limited in how they can move forward in memorializing, their loved-ones. So, I just wanted to say that I very much appreciate the work that you do, and especially during this time, and I've always been supportive of this Bill. Thank you.
JANICE FRESCHLIN: Thank you.
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REP. STEINBERG (136TH): Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Mr. Chair. Again, thank you for your testimony. I just wanted to mention that we are the last state in the entire country that does not allow this. And this is actually not helping, but making it more difficult for the grieving families to be able to stay nourished. And it's not like there is a big celebration or party, it's just like survival at that time when people are traveling from different parts of the region or beyond to be at that very important time. I know that, except for one major testimony in the previous year, there was -- everybody else was very supportive of it. Do you have a number or percentages of your organizations? What percentages of funeral homes may be hesitant. as opposed to the ones who are supportive of the policy?
JANICE FRESCHLIN: Unfortunately, no, I do not have a percentage. I don't know if that's available, but certainly I can try to find out that information, get that back to you, if you like.
SENATOR ANWAR (3RD): Okay. Based on the testimonies actually overwhelming majority were positive, at least from the past. So that's supportive, and I -- it makes perfect sense. I hope that we will be the next and the final state to say "yes" to this proposal. Thank you.
JANICE FRESCHLIN: That would be good. Thank you.
REP. STEINBERG (136TH): Thank you, Senator. Any -- Any other questions? Seeing none. Thank you very much for your testimony today. Next up is number 45 Nickey Kollie, followed by number 49 C. Marcella Kurowski.
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NICKEY KOLLIE: Here I am. Good afternoon to the Chairs, Co-Chairs and Members of the Public Health Committee. I am Nickey Kollie, Member Services Coordinator at the Connecticut Energy Marketers Association. Over here, we represent over 600 family-owned heating oil and gasoline dealers across the State of Connecticut. And today, I am submitting testimony in opposition to Senate Bill 326. And also, thank you for allowing me to testify today.
We are opposing this Bill because customers of responsible retailers who are of legal age, retain the ability to buy and consume the products of their choice. In a time of heightened sensitivity, policing the choices of law, abiding in legally age- appropriate adults may very well come across some favorable. Being the freedom to choose tobacco products that have already been introduced to the market would inadvertently contribute to the legal sales of flavored tobacco, meanwhile making criminals of those individuals selling the product [inaudible 05:02:16] this data of the collection of almost $130 millions in tax revenue.
Connecticut, following the steps of many other states, are making progressive moves to legalize and decriminalize marijuana. It would seem contradictory to ban flavored tobacco or product that has never been on the DEA's drug scheduling system, and that is also not regulated under the Controlled Substances Act. According to the Store Tracking Analytical Reporting System STARS, the fiscal year 2020, flavored tobacco products were a choice of many adult consumers. STARS reports that, in Connecticut, 41.3% of cigarettes are menthol. Bans do not eliminate demand. Taking it will not break habits or prevent individuals from accessing these products elsewhere. Our Connecticut retailers take the proper precautions to make the sale of tobacco products to underage individuals -- to not make the 174 February 8, 2021
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sale of tobacco products to underage individuals. And for those who are not following those guidelines, laws, and restrictions, action should be taken.
I will say, I remember when I was in elementary school, there was a problem -- a program called DARE, The Drug Abuse Resistance Education. This program highlighted the probable consequences of smoking, drinking, and other habit-forming devices that could cause harm. From there, it was left upon us not to submit to peer pressure and to make smart decisions for ourselves. The best way to go about limiting habit-forming vices of adult products in the youth should be through education, not by government regulation. Our youth should be -- be given fact-based information and make the decisions based off the evidence presented. This is the way to prepare them to become a well-rounded individualistic-thinking adults. Please oppose Senate Bill 326. Thank you. Open for any questions.
REP. STEINBERG (136TH): Thank you. You covered a lot of testimony in record time. Picked all up on it. I really do appreciate it. Are there questions? I don't see any, but I'm sure we all registered the good points that you made. Thank you for your testimony today. Next up number 49 C. Marcella Kurowski, followed by number 50 Joanne Rodrigues.
C. MARCELLA KUROWSKI: Hi. Good afternoon, Members of the Public Health Committee. Thank you so much. I'm testifying today to oppose SB 326 because I fail to see how this will prevent individuals from smoking in the first place. Perhaps having an educational panel for parents and teens would be beneficial. September 26th, 2019 Representative Linehan held a forum titled Power to The Parents, The Opioid Epidemic, and Our Kids. This gave the public first-hand accounts of how pharmaceutical 175 February 8, 2021
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products affect families. Let us focus on addiction and mental health services. Thank you so much.
REP. STEINBERG (136TH): Thank you for your testimony, and for its brevity and directness. I certainly concur with you. We have a lot of opportunity to put it nicely, to invest much further in drug and mental health services. We underfund this in the State, and we need to really do focus on that. But I don't see the two problems as mutually exclusive. Are there any questions for this speaker? Apparently not. Thank you for your patience today. We very much appreciate your testimony. Next up is Joanne Rodrigues, followed by Mary Seidner.
JOANNE RODRIGUES: Hi. Good morning, Senator Abrams, Representative Steinberg, and Members of the Public Health Committee. My name is Joanne Rodrigues. And for the fifth time, I'm here before you asking your support in passage of the bill, which will allow medical assistants to administer vaccines. It has never been more important than it is now. As both an MA for Hartford healthcare and an instructor of 10 years, I can speak to both the training and the need for this Bill to pass. But let me preface this with -- to say that my support for this Bill would be for the medical assistants to be certified.
People have testified about the lack of standardization and training in the State. I would say, that's also true for nurses. An LPN program at technical schools, Stone Academy and Lincoln Tech are different. They're all governed by their accrediting agencies as to what the requirements of the programs are, so are we.
So, while the names of the classes vary, the content taught is dictated to us just like the LPNs. What I find bothersome, is that on January 23rd, Channel 3 News reported, and I quote, "The town of Vernon is 176 February 8, 2021
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ramping up their vaccination efforts. Town officials say they are training people to administer the vaccine so they can have more people at their sites." Unquote. So who exactly are they training, since the nurses are already trained? Are these non- medical personnel?
Now the Department of Public Health has set up a one-hour online training followed by a practical for certain allied health professions to be allowed to administer the COVID vaccine. EMTs, for example, they have no pharmacology training. I know this. I was an EMT. We are not asking to take or replace anyone's job. We're all very, very needed in the healthcare field. We're just asking to be allowed to do what we have been trained to do. It will benefit the providers and the nurses, but mostly the patients, reducing the time -- the wait times that they have to wait for a nurse to be freed up to go in and give a vaccine.
Also, it's gonna free up the nurses to do what they have received specialized training in. Assessment and triaging of patient, we're not trained to do that. So allow everyone to do their roles.
Have you been to a COVID-19 vaccine clinic? I've worked at them. Now, even with the age of the folks being eligible to receive the vaccine, being over 75, the wait to get the vaccine average is two to three weeks. And the lines at the clinics are very long. I also just got news this afternoon that they are now making appointments for people over the age of 65. The need's going to increase. I ask that you please allow us to do our part in this pandemic, and work and utilize our training.
And this last thought. If any provider, doctor, APRN, PA, anyone is not 100% confident in their MA skills and abilities, they do not have to delegate 177 February 8, 2021
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this task to them. This Bill does not say that only MAs could give vaccines; the Bill only provides options and opportunities. And ironically, many doctors have come out in support of this Bill, including the Connecticut State Medical Society. I thank you for your time today and for listening. And I ask if there are any questions.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much, Ms. Rodrigues. Appreciate your testimony. We do have a question from Representative Klarides- Ditria.
REP. KLARIDES-DITRIA (105TH): Thank you, Madam Chair. Thank you, Joanne, for your testimony. My question to you is, why, in your opinion, do you think there's opposition to MAs giving vaccine?
JOANNE RODRIGUES: My opinion only, is that I feel - - I feel personally that sometimes the nurses feel like we're trying to take over their jobs. Like the -- you know, the people in support of LPNs, well, they -- one of their major jobs is giving medications and vaccines. So now, if we do this, they're not needed. And that's so not true. But I really feel that's the opposition.
REP. KLARIDES-DITRIA (105TH): Right. And I feel that everybody, as you know, has their place, and they have things that they can and can't do. And to everybody that I've spoken to MDs, APRNs, this is a need that they're screaming from the rooftops, they need help with. An orthopedic surgeon that I work under for my other job is every year; we need to get this passed, we need the extra help. So please, do what you can to give us this extra support that we need. But thank you so much for your testimony.
JOANNE RODRIGUES: Thank you. And what I see working in the office, so many times -- And we have many 178 February 8, 2021
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nurses, I think we have like six or seven nurses and LPNs in our practice, as well as an RN. When the patient wants like flu shot, you know, they have to wait for that nurse to be freed up, and she may be on a call triaging, you know, the one that works with our doctor, she may be triaging a patient. I can't do that. I'm not trained for that. So, you know, we have to wait, which is tying up the exam room, which is making that patient wait. But it's also tying up the exam room to bring other patients in. So it would just, you know, speed up the whole process, which would benefit all of the patients.
REP. KLARIDES-DITRIA (105TH): Yes, it would make it much more efficient, I'm sure.
JOANNE RODRIGUES: Yes. Thank you.
REP. KLARIDES-DITRIA (105TH): Thank you. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. Representative Petit.
REP. PETIT (22ND): Thank you, Madam Chair. Thank you, Mrs. Rodrigues. Since you've been an instructor, and we've heard that the pharmacy techs get two hours, and DPH is giving up one hour of instruction. Can you give us a little bit more detail on nuts and bolts of what medical assistants go through to be able to do this?
JOANNE RODRIGUES: Absolutely. Well, I've taught at three different schools. The MA program, the average was a 90-hour pharmacology course, as well as a 30- hour clinical hands-on. So in the pharmacology course, you have a regular pharmacology textbook. They're taught about, you know, the sites, the rights, the wrongs, what to look for, the interactions, the reactions. They also have to know 179 February 8, 2021
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the top 50 drugs, and while, yes, that changes all the time. They're actually tested to that in their national certification exams. So they're familiar with the top 50 drugs. We make them do drug cards. You know, all the things that, you know, nurses do in training.
As for the clinical, they're taught to draw up the vaccines. They're taught dosage calculation, and we make them practice that, knowing the math of the calculations. They practice what we call the fake arms, that we purchase. They also have to make that wheel for the PPDs. We use the skin hotdogs and things for that. So, there is extensive training, and it's -- you know, it's really -- And they have to know all that material for their certification. They are tested on it.
So even though Connecticut and New York can't give the vaccines -- Again, the certifications are national. And I also sit on the -- I'm a chairperson of the TFTC, which is the Task Force for Test Construction for the AAMA. We write the test questions; there's a committee of us. And so, those pharmacology questions are in there. And they need to know that to pass that certification.
REP. PETIT (22ND): Thank you, Mrs. Rodrigues. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Madam Chair. Thank you, Ms. Rodrigues, for your testimony. I know that there's been a little bit of a concern, especially from some of the nurses and the nursing organizations around this. I'm just wanting to see what your thoughts were if there was a way to find some level of a middle ground recognizing that we 180 February 8, 2021
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are in the midst of a pandemic, we are going through challenging -- challenges with respect to getting enough individuals who can vaccinate our community. There is a waiting that is a pretty long, more than what would be acceptable. If there was this thing before three years duration, how would you feel if we limited to three years and see how things go with -- the way forward, with the medical assistants being able to give vaccines?
JOANNE RODRIGUES: I think that would be an excellent suggestion because I think it would give the opportunity for us to prove ourselves to the nurses and to show our true value to the providers. You know, being the doctors, the PAs, the APRNs, you know, showing our value to them and to show them that we're not there to take their jobs. You know, we're a medical team, and we need to work as a team, which supports one another and encourages one another. You know, there are so many things that nurses do that we cannot do. That we're not trained to do, and we're not trying to -- we're not trying to overstep our bounds of training.
SENATOR ANWAR (3RD): And again, right now my -- my concern is -- Again, I work with medical assistants, I work with nurses, and I also know pharmacists, and I work with the pharmacist, but I also know pharmacy techs. And right now -- Look, I'll tell you, the pharmacy techs do not get the level of hands-on training on human body that should allow them to be able to give the vaccine. So we have double standards where we are saying that it's okay for someone who is not trained at all to that level, and they can go through a "training online" and then be able to give the vaccines now to children in one of the other bills that we have. And where we have medical assistants who are far more doing hands-on work and restricting them because, "that may take away the responsibilities from the nurse." 181 February 8, 2021
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So I think we need to look at what is the immediate need right now, and who can provide that need in a safe manner. And right now -- Look, this is the financial game of the -- of the pharmacies taking on all the work from day one on the vaccine end because of the Big Pharma and their relationship with the insurance industry. That is resulting in us, not screaming about pharmacy techs being able to give the vaccines, and medical assistants are being questioned more so than some of the other things that are out there. So I just wanna put my concerns on the table for everybody to think about, I believe you have answered some of the questions about the training that some people raised, or did not know enough at this time. So- I think your testimony brings a lot of value. And I think, even if we do a time-limited because we are in the midst of a pandemic, that may be a way to get the comfort that not everybody has right now. Thank you again.
JOANNE RODRIGUES: Well, thank you. And, you know, just to reiterate about the training, the schools are -- you, know, are accredited. All schools and colleges are accredited. And it's that accrediting body that dictates the -- what has to be taught into the level that it's taught. So, they're a national agency, so the states that -- where MAs do give medications and, you know, and have been for years there's -- the standards are set for them as well as for us. And again, this Bill is not saying that we are the only ones that will be able to give a vaccine. It's just providing options and opportunities for the offices where, you know, it may benefit. And for these vaccine clinics where, you know, the lines are so, so long and, you know, the appointments are stretched out so far.
SENATOR ANWAR (3RD): Thank you. Thank you, Madam Chair. 182 February 8, 2021
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JOANNE RODRIGUES: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much. Senator Somers.
SENATOR SOMERS (18TH): Yes, I wanna thank you for your testimony. And I would just like to kind of put some -- a few things in perspective. We've had this bill now for years, and it has been stopped at the - - at the very last hour. 49 other states allow medical assistants to give vaccines. And I wanted to know -- And I have not been able to find any data that there has been adverse events based on a medical assistant giving an -- a vaccine. I also just would like to clarify on some of the speakers before, the Bill before us is not to allow pharmacy techs to give vaccines to children; it's for pharmacists to give vaccines to children. Pharmacy techs, T-E-C-H, have been allowed to provide vaccines under an executive order from the federal government through the pandemic. That's where that has come from.
Again, I don't understand fully what the pushback is because this is saying, "If you are a medical assistant working in a doctor's office, the doctor feels confident in your ability. Under their direction and supervision, you are now allowed to administer a vaccine." So, thank you for clearing up the difference in the educational standards. You know, we hear that -- we've heard that time and time again. And I just think it's important to put it into perspective.
Connecticut has a significant void of primary care physicians. The number one thing we're hearing from many of them, along with pediatricians, is to empower, like 49 other States have, to allow medical assistants to provide vaccines under their 183 February 8, 2021
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supervision. So I fully support this Bill. I'm hoping that it will pass this time, and it will help alleviate some of the issues that we have experienced here in the State of Connecticut. So thank you for your testimony today.
JOANNE RODRIGUES: Well, thank you. And again, you know, the thing is -- is that, any provider at all does not have to delegate their MA to do this, if they're not 100% comfortable.
SENATOR DAUGHERTY ABRAMS (13TH): Senator Somers, I'll assume you're done. Thank you so much, Ms. Rodrigues. Really appreciate your time and testimony. Thank you for being here.
JOANNE RODRIGUES: Thank you all very much. And thank you for your attention to this Bill.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have number 51, Mary Seidner, and next after that will be 52, Harsh Patel.
MARY SEIDNER: Thank you, Senator Abrams, Representative Steinberg, and Members of the Public Health Committee. My name is Mary Seidner, the Executive Director of the Lymes’ Youth Service Bureau, serving the youth and families of Lyme in Old Lyme. And I wholeheartedly support SB 326, the ban on flavors in tobacco products.
The story I'm about to share is about vaping in my community. However, this story is happening in every community in Connecticut. In Old Lyme, our prevention coalition recently conducted a survey for all students through Grades 6 through 12, to measure their attitudes and behaviors regarding alcohol and drugs. Our survey results showed a shocking increase in e-cigarette use among youth over the last two years. 20% of our youth report using electronic 184 February 8, 2021
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cigarettes in their lifetime. 20%. And by 12th Grade, 45.5% report using e-cigarettes in their lifetime. Let me repeat that. 45.5% of 12th graders in my community report vaping. That's nearly half of the entire senior class.
And the Lyme, Old Lyme community is not alone. Similar numbers are found in every high school in this state. In response to these shocking numbers, we rolled out several prevention strategies, including an educational intervention for students caught vaping at school. Our staff meets with each student individually to have a conversation about why and how often they vape, and we educate them on health risks and marketing tactics used by nicotine companies to target young people. During these sessions, most of the students admit they are full- on addicted to nicotine, and most have no intention to quit. They need a vape before getting out of bed in the morning. They can hardly get through the school day without vaping. Their developing teenage brains are now wired for addiction, possibly leading to other substances. And when we talk with these students about flavors, nearly all of them tell us that if the vapes tasted just like tobacco, they never would have started. The flavors make it fun and easy to start, and the flavors draw them in, and nicotine hooks them.
I ask you, do names like mango, vanilla cream, and bubblegum sound harmful? No, of course not. And that's why kids underestimate the risk and the harm of these tobacco products. And when was the last time you, adults, consumed anything flavored like cotton candy, bubblegum, cherry blast, blue raspberry? I don't know many adults who would enjoy these flavors. But these flavors are very popular in vapes, and they attract our young people, not adults, and lure them in to get hooked on tobacco 185 February 8, 2021
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products. And now our children have become tobacco customers for life.
We have a public health crisis in Connecticut and our nation; vaping is causing an epidemic of nicotine addiction in children. Tobacco is the leading cause of disease and death in our country, and it's entirely prevental --- preventable. Please protect our children. And please, ban the flavors. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much. And thank you for your testimony. But also, thank you for the wonderful student, Phoebe, that testified previously. I assume that you work with her.
MARY SEIDNER: Yes.
SENATOR DAUGHERTY ABRAMS (13TH): And have done a marvelous job, so thank you for that.
MARY SEIDNER: Thank you. Phoebe is a member of our Youth Prevention Coalition.
SENATOR DAUGHERTY ABRAMS (13TH): Well, she was fantastic. So thank you very much.
MARY SEIDNER: Okay.
SENATOR DAUGHERTY ABRAMS (13TH): Representative Arnone.
REP. ARNONE (58TH): Thank you, Madam Chair. Youth Prevention and prevention on a local note. We heard quite a few times today. Are we educating? Can you tell me how your coalition educates your community, and where the funding comes from?
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MARY SEIDNER: We received a local prevention grant, which is an LPC grant through DMS, through RBHAO, which most communities receive, but it's a very small grant. For me, Lyme in Old Lyme, it's just around $5,000. And that's for -- Most communities, that's what they have for prevention. Usually, it's a Youth Service Bureau or maybe a school or another organization that holds the LPC grant.
But in my community, the education -- we realized that vaping was new, and many people didn't really understand what it was. And so, we took a multi- pronged approach. First thing we did was activate our Youth Coalition, and you met Phoebe. But through our Youth Coalition, we had the youth educate the community. And so, not only their peers, but also parents, faculty at the schools, and the community in general. And we did that through a variety of strategies, some assemblies, Zoom meetings. We would go to every PTO meeting. We went to a faculty meeting, parent open houses. We've started a podcast. And through the -- during this pandemic, we've had several Zoom meetings and guest speakers talking about vaping. So those were some of the educational strategies that we've implemented.
REP. ARNONE (58TH): Thank you. We also have a coalition here in Enfield. I was a former Co-Chair of it myself, so I'm really familiar with all the great local work that comes out of the grant. Granted, the grant money is a small portion, but it's put in the right spot. So when the -- when the State or the federal government, you know, funds local groups to do what they do best, and that's target their community, I think that's a very important thing. And I just want to make sure everyone knows that there is a huge education push way ahead of this for probably over 10 years now. We've -- our committee has been going on for at least 15. 187 February 8, 2021
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MARY SEIDNER: Yes, and --
REP. ARNONE (58TH): So go ahead please.
MARY SEIDNER: We collaborate with -- We collaborate a lot with this because I don't see this as a school problem or a parent problem. It's a community problem. And so, I think that the community coalition really is -- And it's certainly the schools and the parents play a major role in it. But it's no one sector that is responsible. If these kids are vaping in school, they're vaping at home.
REP. ARNONE (58TH): Exactly. Thank you very much.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for your time and testimony. I would agree with you. I -- You know, locally, I've done a lot of work in my district with different groups. And I feel like our communities, our local health department, other organizations, our schools, are doing all they can to try to keep our youth away from this, and it's time for the government to step up and do our part, as well. So I feel that we started that with Tobacco 21, and we need to continue that work. It takes a village. But thank you very much for your time.
MARY SEIDNER: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have Harsh Patel, number 52, followed by number 53, Marvi Ayaz.
MR. PATEL: Good afternoon, Members of this community. My name is Harsh Patel, and I'm testifying against Senate Bill 326. As a representative of Lisbon Quick Mart and the overall convenience store industry. We, as a convenience store community, are here to provide products and 188 February 8, 2021
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services to customers that are in demand and legal for their use. By doing an overall flavor ban on tobacco products goes against the free-market principles that our State champions compared to our neighboring states. We are responsible gatekeepers that don't sell to underage customers and follow the rules and regulations of the State. Our efforts should not be a nuclear option that limits these products from adults and -- but a more surgical approach, which includes marketing. Marketing to youth that vaping and cigarettes is not good for them, and the addictive qualities that it has.
Also, in addition to vaping products, the FDA has gone on to limit the number of products that are -- will be available on the market with the PMTA process. We should allow this process to follow through before doing an overall ban on all flavored products.
In addition to this, by doing an overall ban, it does open up black markets. What we will see is a market shift from regulated stores that are selling to adults to black markets that will be readily available across parking lots, schools, just like other illicit products. In -- Other things that I've heard throughout this meeting today is people talking about loosies. Now, as convenience store industries, we comply with the rules and regulations to almost a 90% enforcement. Now, these stores that are selling products illegally should be fined per enforcement and not taken off overall community. I appreciate your consideration for my comments, and I thank you for your time.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Mr. Patel. Thank you for taking your time today to testify. Let me see if the Committee has any questions. Seeing none. Thank you so much, Mr. Patel. Next, we move on to number 53, Marvi Ayaz, 189 February 8, 2021
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followed by number 54, Kristen Record. Thank you for being here.
MARVI AYAZ: Hi, Respected Public Health Committee. My name is Marvi Ayaz, and I own a business in the city of Groton. It is a convenience store and a gas station. it is located on 399 Benham Road, Groton, Connecticut. And I am opposing this Bill 326. I am not here to talk about the loss of revenue for the State of Connecticut and the loss of revenue in the city of Groton, nor will I talk about the loss of revenue for my business, which will force me to lay off my employees to reduce my expenses because of this ban.
What I am here to talk to you about is the health of others, which is your concern as well. The main question that arises is, will this restriction have less smokers than what we have now, or will this increase the amount of smokers? These illicit sales will be occurring with a certain targeted people, which most likely will be our children in the corners of schools, rather than adults who can legally purchase these. I saw this happen with marijuana, and now I will see this with menthol cigarettes. To have this remain legal, with the system in place to control the customer base is going to curb illegal transaction. This can do the same thing, but more importantly, prevent flavored tobacco from being an illegal uncontrolled gateway drug for our children.
Some states have legalized marijuana. Are they users of marijuana increased or decreased or the same? Legalizing marijuana created more revenue for those states. This ban will result in cigarettes coming from other states that have lesser tax than Connecticut. Therefore, this will increase cigarette -- single cigarettes being sold, commonly known as loosie. As a result, kids will have more of an 190 February 8, 2021
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incentive to smoke because of the affordability. Not only is this ban affecting our children, but this ban will not be beneficial for the entire society. This will result in an increase in young smokers. Sellers will not be licensed dealers, nor will they be following any state regulations.
Therefore, this will be tax-free money, which will create more problems in society, leading to more issues in public health. Rather, we should collect money in the form of excise tax and sales tax. We can utilize this money to have public awareness programs to explain the consequences of smoking.
Also, just an FYI. I would like to add that according to Connecticut Tobacco Revenue, this State's spending on tobacco prevention is 0.0 million. I would like to conclude with my final point. I have my Master's in forensic science, and I came across an article from Med-Pay stating, researchers have discovered a genetic variant exclusively in individuals of African descent that they say significantly increases preferences for smoking menthol. African-Americans with the variant of the MRGPRX4 gene are five to eight times more likely to smoke menthol cigarettes, compared to those without it. This study was performed by Dr. Dennis Drayna, who has an MD and a PhD of National Institute of Deafness. As a result, African- Americans or anyone who wants flavored cigarettes will have to go to other states or buy illegally from a black marketeer. When there's a demand, one will always find a way to buy it. Respected Public Health Committee, I would like to thank you for your time.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for your testimony. Really appreciate it. I'm gonna wait for a minute, and see if there's any questions 191 February 8, 2021
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from the Committee. Seeing none. Thank you so much for taking your time to be here with us.
MARVI AYAZ: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have Kristen Record, number 54, followed by number 55, Dr. Robert Russo. Kristen, go right ahead.
KRISTEN RECORD: Hi, good afternoon. Thank you. Good afternoon, Distinguished Members of the Public Health Committee. My name is Kristen Record, and I'm testifying on SB 288. I'm a resident of Bridgeport, and I've taught Physics at Bunnell High School in Stratford for the past 21 years. I'm the Co-Vice president of the Stratford Education Association, and I'm the 2011 Connecticut State Teacher of the Year.
Last March, right before the pandemic began, I spoke before this Committee on a similar bill related to school indoor air quality. You might recall that I told you the story of my seasonal allergies, about the unfortunate experience of having my classroom flooded during a rainstorm. And then, how I realized that after the 20-year-old carpet was removed. It wasn't me that had been sick; it was my classroom. Sadly, most of the classrooms in my building had that same carpeting. And through conversations and surveys, I discovered that many other teachers in my building had allergies, asthma, and headaches, all attributed to indoor air quality in the building. It took filing two OSHA complaints, and over three years to finally have a full remediation plan put into action.
During 2019 and 2020, I co-led an effort with CEA to investigate extreme temperatures in our classrooms around the State. Teachers recorded temperature and humidity levels in their classrooms into an online 192 February 8, 2021
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database every morning and afternoon. The results were astounding. In May and June and August and September, we saw temperature levels regularly in the mid-eighties, and often in the nineties. Some of the districts close their schools for excessive heat. And I myself have taught a few physics classes in the hallway because it was cooler than being in my classroom.
And then there's the winter months, when teachers and students wear coats and gloves in cold classrooms, and the teachers bring in space heaters to keep our room temperatures above 65. When was the last time any of you needed to wear your coat all day because it was 60 degrees in your office? Or spend hours in a hearing room where the temperature was 80 or 90 degrees? I'd venture to guess, never. But those are the conditions we're asking our teachers and students to endure while trying to deliver and receive a high-quality education. And it's just not right.
And then comes the COVID pandemic. How are we supposed to believe that the same systems that are unable to regulate temperatures properly in our buildings are keeping us safe from COVID? The same systems that weren't properly maintained to mitigate dust and mold are still there, but teachers are being told that "school is the safest place to be". That was bad enough when I could keep the windows open, but now it's the winter, and that's not possible. It's really not safe. Why isn't there money available to districts to address these issues? Educators and students really need your help. We're getting sick at school due to poor indoor air quality and extreme temperatures, and the result is increased illness and loss of instructional time. This has only been exacerbated by the COVID pandemic. 193 February 8, 2021
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I urge you to not only support SB 288, but also amend it to include acceptable temperature ranges for schools, as well as include bond funding for the remediation of problems with HVAC systems. Thank you for your time and attention.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much. I do remember your previous testimony. And being a fellow, well now, I'm a retired educator, I think that this is an issue that's been long overdue. And as you said, it's only been exacerbated by the COVID pandemic. So I think now is the time that we really face this head-on. So I think there's a question from Representative Arnone.
KRISTEN RECORD: Thank you.
REP. ARNONE (58TH): Thank you, Madam Chair. What was your experience that it's almost three years from the first reporting through ConnOSHA to where you came three years later? What was that experience like? I know a lot of schoolteachers in my district, they didn't even know how to file an OSHA complaint, let alone, you know, fight for two or three years on it. So could you speak a little bit to that, please?
KRISTEN RECORD: Absolutely. As I said, I'm the vice-president of my local, so I might have a little bit of a leg-up in terms of a rank and file teacher to know the systems and the processes. But I surveyed our members. We took pictures in classrooms of air ducts and mold and classrooms and the carpets. We filed reports. We took it to our building principal, who said it was out of her hands; the District central office that it was out of their hands. And so we -- I went as the representative of the teachers in the building, and I electronically filed the OSHA report. The Representative from OSHA came, did several 194 February 8, 2021
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walkthroughs through our school building, tested many sites within the school building, and when the results came back, showed that there had just been complete negligence on the part of the town, in terms of the upkeep of the air ducts and the ventilation system. We identified the rugs as being trip hazards and has -- that had been stretched out show many times that even a good washing or cleaning wasn't possible and couldn't do anything because the rugs were just degrading.
And so then, we had to basically negotiate with the school district, and the school district had to negotiate with ConnOSHA because there were certain time limits that OSHA put on the school district that then the town and the school district didn't have the ability to meet because they had -- did not have the funds to do what was necessary to mitigate the problems in the building. So, things had to be done slowly over time and piecemeal. And to be truthful, the project's not even done because of the pandemic. Ideally the -- all the flooring would have been replaced in our school last summer, but that's actually -- it hasn't been able to happen yet.
So, the classrooms did have all the carpet removed, the dust and the filters were all fixed and cleaned. The district instituted a brand new protocol in all of the school buildings because, OSHA made the assertion in their report that if this is what was going on in one school building, then all of the other school buildings that had typical system -- representative systems, that the same thing must exist in the other buildings. So they required the district to mitigate those issues in the other school buildings, which was done.
But right now, in my school, most of the rooms where the carpet was removed, we just have concrete floor because the flooring project hasn't been able to be 195 February 8, 2021
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finished. But, you know, hopefully it will be. But my building is one of 14 in Stratford, and there are other buildings that have the same exact problems. And you know, the answer is continually from the town "We wanna do the right thing, but we don't have the funding to do it." And it's also time-consuming because you can only mitigate many of these issues with mold and carpeting and flooring, when students and adults are not in the building for a long period of time. And then, of course, COVID happened, and, you know, there's a lot more problems with that. But routinely, teachers are looking around and seeing that -- that housekeeping things are not, you know, being taking place and done properly on a day-to-day basis. And that was going on before COVID. And so now that we have the situation where supposedly deep cleaning is being done, but we still see some of these same exact issues that had existed for years before, it's really troubling to educators. And it makes teachers more trepidatious about spending time that they don't need to, in a school building.
REP. ARNONE (58TH): And did you find it shocking, the negotiation between OSHA and the District where you would think if this was a private -- a private world, they would get fixed, you would get fined, or else?
KRISTEN RECORD: Absolutely. You know, I understand the idea. But, you know, the District was fined, what I would consider to be a minimal amount of money, but they were given extra time to mitigate the situation. You know, the files that we had reported were all -- everything that had happened was in, you know, the fall and in the early winter. And it wasn't for months and months later, that the first action steps were taking place. So what would happen in a public school? You're absolutely correct, Representative, compared to the private 196 February 8, 2021
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sector. Yeah, I think the private sector would have snapped to it much faster or else, as you said.
REP. ARNONE (58TH): Yeah. Thank you very much for being an advocate, not only for the employees, but also for the children, because they're suffering from the same things, and they go home, and their parents don't know where they're -- where they're getting it. So, thank you very much.
KRISTEN RECORD: I completely agree with you. You're welcome. The environment where I teach is the same environment that my students learn. So it -- it's one in the same.
SENATOR DAUGHERTY ABRAMS (13TH): Good point. Well, thank you very much for being with us today, and for your testimony. And thank you for all your work. You know, educators have been incredible during this time, so it's my pleasure to take this opportunity to personally thank you.
KRISTEN RECORD: Thank you so much for saying that. It's really appreciated.
SENATOR DAUGHERTY ABRAMS (13TH): Next up, we have Dr. Robert Russo, followed by number 58, Michael Schoenfeld. Dr. Russo?
DR. ROBERT RUSSO: Yes. Thank you very much, Senator Abrams and Representative Steinberg, and the other Members of the Esteemed Committee. I'm Dr. Bob Russo. I'm sorry, I'm in a bad atmosphere in the building. I am the Executive Director of the Connecticut State Medical Society. We represent more than 4,000 physicians within the State of Connecticut. We are in support of the two bills, 326, and Bill 285. Written testimony submitted on both, but I'd like to talk to 285.
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I've listened to a great number of the people today, and I really think that if we could recenter this conversation about medical assistants, it would be helpful.
Remember the situation that these medical assistants are in, are within the shell of a physician's supervision inside an office. Therefore, the physician takes responsibility. Earlier today, you heard somebody match us up against Massachusetts, and say in their research, they didn't like the match-up. Well, that's not research; that's one story. There are 48 other stories throughout the union [inaudible 05:43:28] 19 years. When we went to the AMA and asked for if any of those states had ever repealed their work or their bills, the answer was, no. Went into LexisNexis and tried to find out if there were any injuries by a medical assistant in vaccinations, but you can't actually find it because the responsibility is the physicians. In these setups, remember, you can walk into a pharmacy and get a vaccine. You cannot walk into a doctor's office and demand a vaccine. The doctor is in charge and has to order the vaccines, so it is under order.
There were some earlier questions also about where in the hierarchy within an office, the medical assistant is an -- are they pressuring the LPNs or the nurses? And the reality of it is, if you go into these offices, you'll see that they're very efficiently run and that everybody has a role. The role of giving a vaccine is down the list of technical difficulty. If you can draw blood, you can easily give a vaccine.
The other thing that came up earlier too, I think that is a significant point, there really is not a lot of assessment by a medical assistant, and the supervision, it was once stated earlier today that, as long as the doctor's in the building. That's 198 February 8, 2021
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absolutely not true. The definition of direct supervision is that the doctor is readily available, meaning within vocal range of what's going on. It is not that he's in the cafeteria when somebody is doing something in his office. So I think this question about, why are we the last? I think it's a protective mechanism for a problem that doesn't really exist. If I'm an RN, and I'm qualified to do the things that an RN or an APRN or a PA or an LPN, there's plenty to do in these office situations. The fact that someone's giving a one-off vaccine, really doesn't make sense. And it doesn't make sense that we have to -- this is, I think, my fourth or fifth time testifying on why physician assistants, under the direct supervision of a physician, has to go through these sort of things.
If there are any questions, on either bill, by the way. I was the Chairman of a secondary -- private secondary school, one of the largest in Connecticut, for years, and we had a vaping problem there. Still have a vaping problem. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thanks, Dr. Russo. Appreciate your time and -- and your perspective. Representative Petit.
REP. PETIT (22ND): Thank you, Madam Chair. Thank you, Dr. Russo, for that testimony for -- as you have said about the fifth year in a row. And again, I've asked this to several other people. Some people seem to indicate that this can be easily fixed by hiring LPNs and APRNs, but when talk to primary care physicians and pediatricians, they told me that people in those areas are not readily available for the schedules that offices have, and they're competing in a difficult arena where there's huge demand for both of those. For the service of RNs and LPNs. Could you have any comments on that from the membership of the State Medical Society? 199 February 8, 2021
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DR. ROBERT RUSSO: And I think if you're more -- if you're as qualified as an RN or, for that matter, an LPN, this routine procedure that's done over and over and over again, it isn't a challenge. It really is a lower incident of work that doesn't challenge. It is, you know, give a shot, move on, give a shot, move on. If you're an RN with all that training, you don't wanna be doing that. And the doctor doesn't wanna be doing that. You don't want the -- If you have an office of medical team, and your team is designed to move patients through and get things done in an efficient way, and to make sure that things are done with the highest quality, the one thing you don't want is to use the time of an RN to do something that could simply be done by a pharmacist assistant.
I mean, there isn't -- We're not fighting back against pharmacist assistants. What we're saying is, be efficient. Let us run our offices as part of a medical team that knows what it's doing. Look, I take responsibility. If something happens in that office, the doctor is responsible. I think Dr. Miller brought it up earlier today. It's her office; it's what they do, it's what we do. We accept those responsibilities.
REP. PETIT (22ND): Thank you. Thank you, Dr. Russo. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative Petit. Representative Tercyak. [pause]
DR. ROBERT RUSSO: Hello. Am I not hearing?
SENATOR DAUGHERTY ABRAMS (13TH): Representative Tercyak? No, I'm --
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REP. TERCYAK (26TH): Here we go.
SENATOR DAUGHERTY ABRAMS (13TH): There you go.
DR. ROBERT RUSSO: There you go.
REP. TERCYAK (26TH): Wow. What a gift that I can start over and be more polite this time. But I feel like nurses are not being heard about this. The fact that other people can do it, and nurses -- and let's divide it fairly. Nobody's saying you should have RNs doing this instead of medical assistants. Although, my doctor comes back into the room and gives me my flu shot every fall, when I'm there for my physical. It's just a few extra seconds more together. But it's a very interesting and nice touch
I'm thinking about, as I've listened to you talk, that I hadn't really appreciated so much before. If we managed to split up the jobs of nurses and take - - whether LPNs or RNs or whoever, and take away whatever can be done by other people and delegate those tasks, someday, instead of nurses being the most trusted professionals in America, we can be as unpopular as doctors are. It's just a worldview doctor. Do you -- If you believe your only value to the patients comes about when you are doing the highest value, apparent value work, then you can give away jobs to people who aren't licensed. You can have feeding techs in the convalescent homes. That was a fad for quite a few years, too. You know, 'cause it's all the same. If you think that there's a relationship and value in that relationship, then what we're talking about, looks like all we're talking about is money.
Just a little feedback, you can like have some time disagree with me if you like, but I'm aware, I couldn't figure out how to put it in a question, now 201 February 8, 2021
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that I've ended. But thank you very much for coming and being with us today, Sir.
DR. ROBERT RUSSO: Well, let -- lemme answer that. Okay?
REP. TERCYAK (26TH): Yeah.
DR. ROBERT RUSSO: It isn't that there are defined jobs when there is a medical team leader, the physician, running their office. It's how they determine the office should be run. What position, what jobs are given out to the team expressly? It isn't a question of saying to a nurse, "you cannot do this," or "you can't do that," we all chip in. There's a lot of sharing of whatever the jobs are. The days of Marcus Welby are over. You can't run it like that, where somebody can run around, cover all the bases at all times. That's why APRNs were developed. That's why RNs were developed. That's why LPNs developed. It is part of the team approach. It is not this sort of -- nobody's getting squeezed out. Earlier in the conversations, people were asking, "Do we know that LPNs are migrating?", or things like that. There's no database on that. It's all hearsay. There's no research. We can't, even in the State of Connecticut, tell why some of the younger physicians are leaving. There's not a database for it. But to say that a physician and the team that he works with, it's gotta have strict rules about how the office is run. And that their training for a medical assistant isn't adequate. That's just not right. It's not fair either. It's not fair to the medical assistants and the efforts they put in. And it's not fair to the doctors that make a determination.
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think they're capable of doing it, he's not, or she's not gonna let them do it. I mean, I don't agree with your argument at all, I'll tell you the truth. Sorry about that.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much. Thank you, Doctor. I don't see any other questions, so I will thank you for your time and your testimony.
DR. ROBERT RUSSO: Thanks for hearing me. I appreciate it. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Appreciate you. Number 58, Michael Schoenfeld. Michael Schoenfeld, are you here with us? I see you there.
MICHAEL SCHOENFELD: Hello.
SENATOR DAUGHERTY ABRAMS (13TH): Yep. Hi, thank you for being here.
MICHAEL SCHOENFELD: Alright. Thank you. Thank you for all the Senators and Representatives for allowing me to speak today. I am speaking in opposition of SB 326. My name is Michael Schoenfeld, and I own Manchester Tobacco & Candy Company. A three-generation local family business operating in Manchester, Connecticut for over 73 years, with 46 full-time employees. We are a legal distributor that only sells reputable manufactured products to legitimate licensed Connecticut stores, gas stations, and more.
I understand the goal of this Bill is to reduce youth initiation of nicotine products. I have two daughters, 14 and 17. I want the best for their health and safety. The ideology is reasonable and laudable. But I'm very concerned; the Committee does not understand the true source of youth access to 203 February 8, 2021
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vape and tobacco, nor appreciate the reality of the current market, along with the unintended consequences a ban would have. Selling only to licensed retailers. My family business doesn't sell illegitimately sourced products. I don't do the internet. I don't do anything that should be illegal. You may not like vape cigarettes, smokeless, or cigars, but you have to acknowledge they are manufactured by heavily regulated companies and sold legally in the entire country and state through a heavily regulated system.
My primary use with this Bill is that it was this -- dismantle the system, decades in the making, and undermines your goals. If passed, you would take a legal product and transfer from an organized distribution system, to illegal unregulated and an unenforced black markets, neighboring states, and evenly to a possible Connecticut tribal casinos.
Do you know today, I don't consider other wholesalers, companies that do what I do is my biggest competition? Instead, its trunk slammers, loosie dealers, internet and organized gangs that sell products 50 cents on the dollar. This is real. This exists. This policy you're considering today will accelerate this problem beyond comprehension.
Let's playout what would happen if a flavored tobacco was banned. An adult customer is told they cannot buy menthol cigarettes in a convenience store, or from any other store that matters. What then? Does anyone really think the person will say, "Oh, well, I guess I'll no longer smoke menthols." Of course not. They go to Google on their phones or ask Alexa. They'll quickly learn that these products are available online or in other states like New Hampshire. So, it becomes a small inconvenience. That's all. For some spirited individuals, an 204 February 8, 2021
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illegal business opportunity awaits, where millions of dollars in demand are available.
Products in high demand to not be banned without consequences. And in this case, the consequences are dangerous and expensive. But this is not just about $150 million dollars the State stands to lose, nor it's about protecting the health of over 1,700 retail locations in Connecticut, which employ over 26,000 jobs during the pandemic. It's about handling and handing over the sales of flavored tobacco to shady market participants and not being able to enforce them. Isn't it ironic to anyone that the committee, that the State is keen on moving marijuana and sports betting into regulated tax markets but is pursuing a policy to do the exact opposite with flavored tobacco? I'm almost done. Sorry.
The Committee has a reasonable goal, but this approach will protect public health. So, I ask you, when is public safety not part of public health? When products are unregulated, people are in danger. In fact, this bill is not going to stop youth from vaping. It will just increase the chances of having more accessibility to it. Thank you very much for your time. I look forward to any questions. And thanks again.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, Sir. There's a question from Representative Cook.
REP. COOK (65TH): Thank you, Madam Chairman. Hi, Michael. Thanks for being here with us. I have a couple of questions. What did you say the name of your company was?
MICHAEL SCHOENFELD: My company is Manchester Tobacco & Candy Company, and we are a wholesaler.
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REP. COOK (65TH): Manchester Tobacco & Candy Company?
MICHAEL SCHOENFELD: Correct.
REP. COOK (65TH): And what products do you sell?
MICHAEL SCHOENFELD: So, I sell tobacco. I sell mostly cigarettes, tobacco, candy. I sell toilet paper, water. We are a direct distributor that sells directly to the consumers, such as packaged stores, gas stations, and convenience stores. So, we are licensed, and we can only sell to those licensed distribution. I can't sell on the internet. I don't sell, you know, unregulated products. I have controls in which I get audited by the State of Connecticut, and they, in turn, have the ability to look at my records. They were here last week or two weeks ago, and they had no problems. My controls are also by the manufacturers, which we have to do inventory, so we don't buy an illegal product elsewhere. And then we have to get forms, filled out by our customers, that are shown that they are responsible and set up with the State of Connecticut from a sales tax perspective and a legal license. They fill out the forms, and therefore I'm there full responsible to giving it to them. And then they're supposed to be the gatekeepers to sell to 21 or older participants.
REP. COOK (65TH): So, then my next question would be, earlier on -- So I'm not sure how long you've been with us, maybe since the beginning. Earlier on, there was a comment about the amount of tax revenue gained from the sales of vapes, or if you will, flavored tobaccos, fill in the blank whichever, choose. Do you have any idea of what you collect in sales tax gained from those items of what you sell in a given year?
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MICHAEL SCHOENFELD: Yes, I do. I usually don't allow it on a public forum of what --
REP. COOK (65TH): You don't have to give us a specific. If you would like to generalize it, that would be fine.
MICHAEL SCHOENFELD: So, there's three things here. We need to separate cigarettes, and tobacco, and vape. Okay? They're really three separate categories, and three separate things. In the cigarette revenue department, there's no way that the internet sales have accessed it. We have to stamp the product. And for that, I would say, in general, we're talking about $400, probably $360 million a year combined in the State of Connecticut from cigarette revenue. Okay?
REP. COOK (65TH): [crosstalk] specific, not the vaping. Okay.
MICHAEL SCHOENFELD: So -- So on a good percentage of that. And what we do is, we take a check, we write to the State of Connecticut, and then they give us these stamps that we have to put on to the actual cigarettes. And what happens is, you cannot sell in the State of Connecticut cigarettes, unless those stamps are proper. Now that doesn't mean there's illegality that people have found some ways to get around it. That exists today, which we've been screaming about for years, about more regulation. I'm encouraging it.
I would say, vape for me is very limited, okay? I sell maybe three different kinds from the main manufacturers. And it's kind of ironic, today when I walked in, I had someone email me, or mail me, a catalog of all the vape products, which I don't carry, which is allowed in New York, and it's highlighting for me to buy with flavors of cotton 207 February 8, 2021
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candy and flavors of -- I was appalled by this, okay? This is something that is so unacceptable, and it defeats the problem of what we're doing here. In other words, this is how I believe that youth is getting access to this. And I asked my 14- and 17- year-olds and I sat them down and I said, "What's the problems in schools?" And they told me, "Dad, you can get marijuana, like gummies, and they have one or two guys in school that can do it. You can get flavored alcohol, peppermint schnapps, or, you know, different types of beers, and they grab them out of the cabinets -- out of their liquor cabinets of their families. And they get vape, which is a huge problem." I agree, 100 percent about it. I said, "Where do you get it?" They go, "Online." And I've heard a lot of people saying that the retailers are the main focal point of having an elusive way of getting into the hands of 14 and 15-years-old.
Now we have, from what I was told, a 91% chance of carding of accuracy. That doesn't mean there are some individuals in this State that do that. That doesn't mean they're -- there's -- 99 doctors are good; one doctor may be bad. It doesn't mean that we just say, you know, everyone is bad, whether it's a chain, whether it's an independent store. But the cigarettes are probably the base of the actual revenue from the Connecticut. The vape, there is based on how much liquids you have. And you have to understand there's different types of things. There's closed systems and open systems. And these systems that are open, to me, I think that can be a potential problem. They're just throwing them in. The systems that we buy are closed, which means you can't take the pods out. I would say that's probably as far as the tax revenue very little. I think tobacco is another revenue. But what we've seen in tobacco, which is Skoal, Copenhagen, cigars, that is so highly illegal, as we speak. They go to Pennsylvania called trunk slammers, and they drive 208 February 8, 2021
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there. In Pennsylvania there's, let's say, a 1% tax, whereas the State of Connecticut has a 50% tax. They go in, and they sell on the streets, whether it's loosie dealers, whether it's anyone in the community at 50 cents to the dollar.
So, the tax revenue in that particular aspect, we do not give a lot because that is so heavily illegal, that you will not see it. So, cigarettes are probably the most regulated, with the most control, in which I think the most revenue is generated. And I think if you take menthol as part of that, you will lose between $130 and $150 million dollars a year of actual revenue of that. And again, I -- I'm not saying that that should be the focal point of what we're talking about today. [crosstalk].
REP. COOK (65TH): No, that is absolutely not.
MICHAEL SCHOENFELD: I think it has to come into the conversation that I'd rather take $150 million and put it to something that goes to youth initiation to -- of education or put it into something that could help other people to do it. If you're gonna just give up $150 million, might as well, give it a try to do this and -- and put the money where it really could go.
REP. COOK (65TH): Thank you for that. Yeah, I don't disagree with you that this is not about the money. For me, it was more along the lines of a clarification, and it sounded like you had a pretty good handle on this. So, I thank you for your expertise on that information. I do find it very interesting that you're talking about the difference between the closed system and the open systems. I do have a couple of -- Well, now they're young adults. And so, you know, 21 and 22 years old. And so, obviously, they have been in the thick of this system since they were in high school as well. It 209 February 8, 2021
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troubles me to see the amount of kids that just, you know -- anywhere and everywhere, it doesn't matter, that this is just the thing that happens. And I think that, you know, a lot of kids don't often understand the complications or the dangers that's in an open system, as opposed to the closed system. I do agree with you that that is vitally important for us to look at.
You said that you had some potential thoughts on how that this could be done a little bit of a better way. Are you interested in sharing any of that with us?
MICHAEL SCHOENFELD: Absolutely. So, the first thing is, I think enforcement is also very helpful. Okay? We have laws that we protected to be 21. Which in hindsight, it's a good thing because you're -- you're evening it out with alcohol, you're making the playing field there. Where's the controls consistently to stop the seven or eight percent retailers, where the youth say they can even get their product from? Okay? So again, most people say -- that are coming on here are saying, "They -- They're smoking at 13." Where did they get that product from? Okay?
This marketing, and I don't really wanna name the name of the company, is getting just marketed to me as -- If it's getting to me, it's getting to anywhere else. The amount of the internet sales of illegal product from China, from Korea. In other words, you have to separate that there's some main manufacturers such as Reynolds and Philip Morris and ITG that whether you like them or not, they have been working with the federal government, with the PMTA's, and trying to regulate the use of this. Okay? They don't come up with bubblegum flavors. I don't sell any of that. None of that. I mean, I 210 February 8, 2021
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think that is really an important issue to be had. It's coming from such a demand that people are making it, and the product is not safe, and it is not regulated.
So, I think if we start -- Why are we allowing UPS and FedEx, and all these people to allow to come into Connecticut and email and use that transportation system to come into this? I think that, you know -- There was another gentleman that gave a lot of other issues from a retail perspective of what they can do. I think in order to help this problem, okay, we really need to stop and think about what's causing it. Okay? And I know people don't really understand that you have a system set up. But I am someone that is legitimate. I am here to be audited. I am here that have records. I can show you where every piece of tobacco is sold to every individual customer. Okay? And they are also the ones that are being audited as well.
So, I think the internet sales is a big thing to really focus on. I think education is a big thing because if we're using the money to start off young, maybe the youth won't start smoking. Cigarettes have gone down. I don't recall seeing that menthol is a direct derivative of people smoking. Okay? Now, let's be honest with you. Nicotine is probably a problem. It's Marlboros, which is a non-flavored, or Newports, which is a flavored; both have nicotine in it. Okay? Does the menthol really make it more addictive? I don't think there's been factual proof based on that yet. And that's a concern of mine because, you know, you're taking from bubblegum flavors from vape, which needs to be addressed, and then you're taking an adult smoker who is saying that, "Well, this nicotine is done."
You know, I'll make one other little point that I know people have said, the price structure in the 211 February 8, 2021
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State of Connecticut is regulated. So, everyone in the State, that I sell to, has a formula that we have to sell. I cannot sell in a specific urban market lower in one price, or in a nice higher upper-class market that has more money, at a different price. Those prices are all regulated the same. In fact, my physical price of, let's say, a menthol cigarette like that's popular, that Newport, is higher than a Marlboro, based on the manufacturer they give to me, and then what we sell to by law. So, the State of Connecticut has a system set up in place for an equal playing field, so that it isn't targeted to specific areas. So, I thought that's something that people aren't really aware of and know.
Look, I've been doing this since I was a little kid. And I understand that what we sell is a product that is very questionable. I don't think it's any more questionable than alcohol or questionable than -- than guns or questionable than marijuana, or even having a lottery from the State of Connecticut, that advertises on that. I think we all are in agreement that there's vices in society that exist. The problem is, if we just focus on just one little aspect of one little vice and say, "This is how we can fix it." It didn't work for alcohol in the 1930s. Does it really gonna work if you abolish menthol and have people go to a different state.
Now, if the federal government went and said, "Okay, we're gonna get rid of all of menthol." Okay? Maybe you're gonna put all the states, all the businesses, all the kids on the playing field, you still will have some illegal aspects, but I think that, you know, it's different when you're taking a few states that are doing it. And someone asks me, "Well, where's your data? Where's your proof?" Massachusetts has not been successful. Forget about the monetary aspect of the hundreds of millions of 212 February 8, 2021
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dollars that they've lost. They have videos of surveillance of people selling on the streets illegal product, making $5,000 dollars a day because New Hampshire's laws are probably, maybe, I don't know, 50% difference in sales tax.
So, in other words, the State of Connecticut, it's $43 on average that we have in this state in a carton of cigarettes. You can buy in New Hampshire because there tax from Connecticut is different. So, they drive to New Hampshire, buy it cheaper, and come back, and they'll either use it for consumption and sell it. And the question comes down, are we helping, as a Public Health, those people? Are those people gonna leave Connecticut and go out and live in New Hampshire, so that that liability comes back on us? And look, I've heard some extremely heartwarming scenarios from people, and I agree with them. It's awful to have your child start smoking. It is awful to have people die from this particular product. But this particular law, the way it's written, it needs to be, in my estimation, amended. It needs to have some people that understand both sides to make it enforceable, and to make an impact, so the youth doesn't continue to smoke, and even start.
REP. COOK (65TH): Thank you. Thank you for your testimony. I appreciate your time, and your information. Thank you, [crosstalk].
MICHAEL SCHOENFELD: Thank you. I'm sorry. I was long-winded.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you.
REP. COOK (65TH): No, no, no, I appreciate it.
SENATOR ABRAMS (13TH): We're gonna -- We're gonna move on to the next person. Representative Petit. 213 February 8, 2021
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REP. PETIT (22ND): Thank you, Madam Chair. Thank you, Mr. Schoenfeld, for your testimony. You mentioned a little bit in the last questioning with Representative Cook, and you've been in this game a long time. I just wanted your perspectives on the Massachusetts experiments, which has been going on eight months; you commented on that a little bit. Anything else to add in terms of what you see in the impact of what Massachusetts has done just right now?
MICHAEL SCHOENFELD: Yeah, I think it's been a complete failer -- failure, and I think we can back that up for some data. And the reason is, you can measure the amount, first of all, that is done through the cigarette tax stamps. Okay? So, when I purchase from the State of Connecticut, we buy the physical stamps. I can, like, show you what it looks like in a second. Once that happens, you will see that in Massachusetts, that their tax stamps dropped significantly, but the bordering states, whether it was even in Connecticut, New Hampshire, and especially, you know, New Hampshire, it has gone beyond the expectation of what Massachusetts lost. So, I think what you're seeing is that it may rise of an easier way because you've allowed people to maybe be inconvenient, but to be able to have that access.
So, I think that has been -- they have video, like I saw. I even saw it on Channel 8, of people taking, you know, cigarettes and selling them in loosie distributors. They sell them -- Now, I don't know if everyone understands what those are, but you have -- Loosies are when people go out on the street, they open up a pack of cigarettes, and they sell them to individual people. Now, does that happen in convenience stores? I would say 91%, no. That doesn't mean every convenience store might do it. 214 February 8, 2021
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But that's where the regulation comes in. They shouldn't. But the majority of them do it because they're buying from me, and I can justify that through my revenue and through my sales.
So yeah, I see that Massachusetts has not worked. I think there are some other people that I could refer to, to give you specific data on that, to specific data in relation to the menthol ban, and to show that, you know -- What -- What's gonna make that person really say, "Well, I gave up menthol, so I'm not gonna smoke anything." If you take that choice away, are you assuming that person's just going to stop and quit? We've heard testimonies that people are addicted to this specific product, and you don't want them to start. Well, if they're -- if the laws are 21, they're not gonna start. And what you're seeing is a decrease in this, and you're seeing the main manufacturers have control and do things.
The problem is it's coming from Massachusetts, and it's starting to become an issue that they can get more illegality and more internet illegality.
REP. PETIT (22ND): Thank you, Michael. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. I don't see any other questions. So, thank you very much.
MICHAEL SCHOENFELD: Thank you very much [crosstalk].
SENATOR DAUGHERTY ABRAMS (13TH): -- for your -- for your time and your -- for your testimony, appreciate it.
MICHAEL SCHOENFELD: Thank you.
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SENATOR DAUGHERTY ABRAMS (13TH): Next up, we have Holly Mullins-Hart, number 61, followed by number 62, Rebecca Lautenslager. So, if Holly Mullins-Hart is here? I see you there, but you're on mute. Holly Mullins-Hart is on mute. I don't know if that's something that our Administrators have to take her off. But you're still on mute. Okay.
HOLLY MULLINS-HART: Good afternoon. Can you hear me?
SENATOR DAUGHERTY ABRAMS (13TH): I can. Thank you.
HOLLY MULLINS-HART: Good afternoon, Committee Members. And thank you for allowing me to speak this afternoon. My name is Holly Mullins-Hart of the Cyril F. Mullins Funeral Home in Trumbull, Connecticut. I have submitted written testimony also, so I will be brief with my additional comments here today. I think -- I'm speaking on behalf of the proposed Bill SB 327, allowing food and beverage in funeral homes.
I think it's important to note that this Bill is not being brought forward by our association, the Connecticut Funeral Directors Association, which does a great job representing the needs of Connecticut funeral homes and the families we serve, such as lobbying to increase the amount an individual can set aside to pre-pay for their funeral before going on Title 19, and helping to pass legislation, allowing unclaimed cremated remains of our veterans to be entered in the State Veterans Cemetery.
The reason this is not being brought forward by our association is that the silent majority of funeral homes are not in favor of this. Most of us only learned there was a hearing, last week, so had little to no time to prepare as we are all busy 216 February 8, 2021
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doing our jobs as funeral directors during this pandemic. This Bill was brought forward a few years ago, and the decision rendered at the time, was to offer pre-packaged foods to our families during the arrangement conference. Why this is being brought forward again, and during a pandemic of all times, is suspect. I believe it is because there are a select group of firms who want this to increase their profitability, while the restaurant business is hurting badly, and our local health departments are currently overwhelmed serving the needs of the community during this pandemic.
The public is not asking for this bill to be revisited. Therefore, I believe the decision rendered a few years ago should remain in effect. And I was also surprised to hear that there was testimony on this last year. I'm not sure if that was correct, but if there was, our association did not notify any of us. So, I'm sure there -- Again, there's a large majority of us who were completely unaware that there was testimony held on this last year.
I've been a lifetime member of the Connecticut Funeral Directors Association. My father was past president. And I know this meeting was scheduled today, starting at 9:00 AM, when many of us have funerals on Monday mornings. So, it is my belief that there were a number of people who would have liked to speak today, but either, were unable to during, you know, conflicts, or just weren't aware of this. So, I thank you for listening to me today. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for your testimony. Yes, we did hear this Bill last -- about a year ago, so -- so that is correct. I'm sorry, you didn't know about it then. We have a question from Representative Dauphinais. 217 February 8, 2021
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REP. DAUPHINAIS (44TH): Hi, good -- good afternoon. And thank you, Madam Chair. Just curious, as to what your opposition is to this Bill specifically?
HOLLY MULLINS-HART: Specifically, I think -- Again, this was many, many years ago. There was not food and beverage allowed in the funeral homes. There was no legislation on this. I'm going back many years. And the Connecticut funeral directors put that into effect because they found that it really was not the place to have food and beverage in a place of reverence. Many of us are small mom-and-pop funeral homes and are not geared up to be in the restaurant business. And again, just from health concerns. And especially now, during this pandemic, I think at a minimum, it should be revisited at a different time. We are overwhelmed as funeral directors during this pandemic, and so is our local health department. So again, I think that the timing is just very disturbing.
REP. DAUPHINAIS (44TH): I guess I'm -- I'm -- Just my -- my thought is, you don't have to do it. It's - - It would be available there for those that would want to do it. So, I'm just wondering why you would be opposed to allowing some that do want to do it, to do it.
HOLLY MULLINS-HART: Because I think it would put local restaurants out of business, many of them. If people had an opportunity to do everything at the funeral home, I guess it would be like Stop & Shop with the local bakeries from years ago. So sometimes, when we get too big, it's the little guys are at an unfair advantage, and I think that is, I'm sure, part of the reason in Connecticut. We have not been in the food industry. We did not come into this business to serve food. We came into serve our families. And again, I believe that this is being 218 February 8, 2021
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pushed from large corporations on a nationwide scale who are doing this for their own profitability under the guise of doing it as for what's best for our families. So, I'm questioning that. I haven't heard any of our families asking for this.
And again, the Connecticut Funeral Directors Association is not bringing this forward. I would think that that would be the appropriate association to be bringing this forward, representing the needs and interests of funeral homes and their families. So, I find it odd that it's not being brought forward from them if it's so good for the funeral directors in Connecticut at large.
REP. DAUPHINAIS (44TH): You know, my thought is that, it would help small businesses. I know in the world of COVID and the environment that we're in, so many people are doing take-out and catering and that sort of thing. And it would eliminate the need to go from one place to another and make a combination at another place that -- I guess, I'm still trying to understand why anybody would be opposed to them doing it. And I don't really think I've heard you really say. You sound like you're defending the restaurants. But I don't know why you would be against a funeral home that might want to do it. They're not forcing you to do it.
HOLLY MULLINS-HART: Well, again, I think at some level it puts you at an unfair advantage if families are able to do it at one firm. Most of us, obviously not during the pandemic, but we'll have multiple wakes going on at the same time. And so, to have food and beverage being served in an environment where there would be very loud conversation during a prayer service, you know, I think that that would not be advisable.
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And again, I think the next level would be -- We did have a hearing on this many years ago, and as I said, the outcome of that was to have pre-packaged food given to our families during the arrangement conference. We had a full hearing on that. I believe it was maybe 2014-15; I'm not exactly sure. But that was the decision rendered at the time, and everyone was in agreement with that. So, I'm wondering why it's being brought forward again. I don't hear the public asking for this.
REP. DAUPHINAIS (44TH): Okay. Thank you for your remarks.
HOLLY MULLINS-HART: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Is that it, Representative? What's that?
REP. DAUPHINAIS (44TH): Yes. I'm sorry. Yes, it is. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Okay. Okay. Thank you very much. I don't see any other questions. Senator Anwar, did you have a question now, or --?
SENATOR ANWAR (3RD): Yes. Thank -- Thank you, Madam Chair. Actually, for some reason, my ability to 'raise hand' doesn't work anymore, so we are gonna figure out what's going on. Yours too, Representative Arnone. Oh, maybe we're asking too many questions, so the principal took the privilege out.
SENATOR DAUGHERTY ABRAMS (13TH): No, no, no, no.
SENATOR ANWAR (3RD): There's a time limit of how many questions we should ask. Thank you so much for your testimony. I think -- I just wanted to understand, do you think that the fact that 49 other 220 February 8, 2021
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states have this -- I -- I think you're -- I don't see you anymore here.
HOLLY MULLINS-HART: Oh, I'm -- I'm sorry. I thought that my testimony was finished. I'm sorry.
SENATOR ANWAR (3RD): Do 49 other states have this rule or an -- or opportunity for the families to be able to get nourished while they are grieving. But the only state in the country that doesn't have it is Connecticut. And you feel that all 49 are on the wrong track, or we are different in our conditioning in state? I'm just trying to understand the -- extreme opposition that you come with, on a concept which is accepted by the entire country, except one state. So, are they wrong, or we are standing on the right?
HOLLY MULLINS-HART: I'm not speaking on behalf of other states. I think that's the beauty of our country, that each state can do what's best for the families they serve or the constituents. I guess I'm wondering why something like this would be passed when the majority of funeral homes are not in favor of this? Again, we took, you know, polling on this years ago, and it was over two-thirds of the funeral homes were not in favor of that. Those are those who did respond. There were other people, I'm sure, who either didn't respond for whatever reason, or had no opinion.
SENATOR ANWAR (3RD): [crosstalk] Do you mind if I ask you a question about your study? Which year was that study done?
HOLLY MULLINS-HART: Again, I apologize. I'd have to go back on when we had the hearing back in 2013 or 14, it's when a decision was rendered [crosstalk] pre-packaged food.
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SENATOR ANWAR (3RD): So, eight years ago you had the study done, and -- and then you -- your perspective is that, right now, the people don't want it. But I have had from my district, the Third Senate District, about four or five funeral homes that have reached out, and they have said, "Please do this. We need this." So just in my district alone, and then I asked some of my other colleagues, and their -- So I want to also understand, are each and every funeral home in the State of Connecticut is your member?
HOLLY MULLINS-HART: Members of the Association? No, that not every member is a member of the Connecticut Funeral Directors Association. But a large majority of us are Members of the Association. I believe some of my colleagues who will speak later can give you specific numbers on that. But again, I'm wondering just as we -- as the Connecticut Funeral Directors Association has brought up so many issues that are important to our state. I listed two of them briefly. I'm wondering, if this is something that is good for Connecticut, why the Connecticut Funeral Directors Association is not bringing this forward. But instead, it's being brought forward by, in my opinion, select few, who are corporate-owned?
SENATOR ANWAR (3RD): Okay. So, I'm -- I'm just gonna make a quick little statement. My -- I'll share my thoughts. This -- First of all, this is not bad for restaurants, it's actually going to be good for restaurants, if I understand this right. The other thing is, obviously I -- I has -- I'm hesitant to accept blanket statements. And when your study is about eight years old, and you don't even have all the -- the funeral homes as your members -- And literally, every single one that I have spoken to, they are supportive of this, so your membership study needs to be repeated maybe, and maybe we need to have a better understanding. But if you look at 222 February 8, 2021
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the testimonies in the last year, you would see there was only one testimony that was against it, and there were many funeral homes that spoke in favor. So, it's worthy to -- to look at some of that aspect just to -- to have a broader understanding. But I wanna thank you for your testimony today.
HOLLY MULLINS-HART: And -- And Senator, if I may add -- if I may comment on that? To that point, the testimony that was held last year. Again, I believe, if many of us were made aware of that, you would have had further testimony. Our association, the Connecticut Funeral Directors Association, who regularly informed their members of when hearings are going to be held, new legislation coming up, we did not receive any of that in any of our literature. So, I believe we were completely in the dark on this. And again, the timing of bringing this up in the middle of a pandemic, here in January and February, two of the worst months for funeral directors, when we're overwhelmed serving our families and the local health department, I think it's suspect. That's -- That's my opinion. I think the timing on this was in very poor taste.
SENATOR ANWAR (3RD): I'll -- I'll agree to disagree. Thank you so much.
SENATOR DAUGHERTY ABRAMS (13TH): Okay. Thank you very much for your testimony. Appreciate your time and perspective.
HOLLY MULLINS-HART: Thank you. Appreciate you listening to me. Thank you all.
SENATOR DAUGHERTY ABRAMS (13TH): Of course. We're at number 62, Rebecca Lautenslager. Rebecca, are you there?
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REBECCA LAUTENSLAGER: Good afternoon. My name is Rebecca Lautenslager. I'm speaking on behalf of the Shaughnessey Banks Funeral Home in Fairfield. And I am also testifying in direct opposition of Senate Bill 327, an act concerning the provision of food and beverage in funeral homes. I'm going to echo several of Holly's sentiments on the matter. You know, we as -- Well, we here at Shaughnessey feel that the topic of food and beverage in a funeral home is just not important at this time, while we're experienced in a global pandemic. We feel this Bill directly contradicts CDC recommendations of keeping indoor gatherings at a -- at a minimum, not to mention serving food in the vicinity of a deceased body, which could be viewed as unsanitary.
It's also my strong view that the Department of Health and the Public Health Committee should be focusing on getting the public vaccinated, and getting proper personal protective gear to medical workers and other health facilities, including funeral homes. The Department of Health seems to be very overwhelmed right now with the vaccination process. And the proposed bill is simply not a priority at this time, in my opinion.
So, I went to mortuary school to learn how to guide grieving families, as well as, how to prepare a deceased person for viewing, burial, and or cremation. Not how to properly handle food for large groups within my business. Restaurants have so many regulations as does the funeral business, but none of which I'm an expert on, nor do I want to be. And we're kind of wondering, who's gonna monitor and police issues that may arrive with food in the funeral home. The State inspector has been told recently that he only needs to visit each funeral home once every three years, versus every year as it always was in the past. This is due to state budget cuts. So, we're just kind of wondering who is going 224 February 8, 2021
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to monitor, you know, any regulations having to do with the actual food in our building. Is the local Department of Health going to be burdened with this task? Again, we feel that they're already overwhelmed.
Also, who is gonna be liable if someone chokes to death, or has a severe allergic reaction? Would that be the caterer, or would that be us? You know, we would have to increase our liability insurance causing a greater financial burden to our business.
And I do think that this bill hurts restaurants. A lot of restaurants really rely on the profits from funeral receptions. And these businesses are severely struggling during the pandemic. Not to mention, the State will also lose tax revenue from alcohol sales at these restaurants, that they sell during funeral receptions. I personally feel the majority of CT Funeral Homes only want to focus on their client's immediate needs when losing someone they love, such as celebrating their loved-one's life and laying them to rest in a respectful manner. And that is my testimony today. Thank you for having me.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much. I appreciate you taking the time to be here. Any committee members have any questions? If you are having trouble getting in, you can either -- or raising your hand, you're welcome to text me, or the Administrator. Make sure you get a chance to answer your -- to ask questions. Don't see any. So, thank you very much for your time today.
REBECCA LAUTENSLAGER: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Yeah. Next, we have Seth Lapuk.
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DR. SETH LAPUK: My name is Seth Lapuk. First, thank you, Senator Abrams and Representative Steinberg for allowing me to testify. Speaking in support of SB 326. Like I said, my name is Seth Lapuk. I'm a pediatric cardiologist at Connecticut Children's, an associate professor of pediatrics at University of Connecticut. I'm also the past president current board member of the Connecticut Chapter of the American Heart Association, and past board member of the Founders Affiliate or now Eastern States Board of the HA. But most importantly, I'm a concerned citizen of the State of Connecticut, and I urge your support in this Bill.
Tobacco use is not just a professional concern of mine; this is a personal issue as well. Both my parents began smoking in their early teens. At that time, we had no information as we do today regarding the devastating health effects, and costs of nicotine tobacco use addictions. Of course, now we have had this information for 50 years, at least. But due to the savvy tobacco advertising and tobacco companies and their greed, nicotine addiction still is an enormous health issue, and we all pay the cost.
I watched my father's quality of life deteriorate significantly over the last 30 years of his life, resulting for his -- from his long-time addiction to smoking. And he had tried numerous times for -- from about the age of 40 on, to quit this habit. He tried all sorts of cessation techniques, but he eventually ended up with debilitating chronic obstructive lung disease, COPD, and bladder cancer. Both these severely impacted his life, limiting his activity to brisk walks for the last 20 years of his life. Now I'm watching my mother suffer through extreme shortness of breath, secondary to tobacco-related COPD. She's -- was able to quit over 40 years ago, 226 February 8, 2021
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and still, she'll never regain any of her original lung function.
There's strong -- There's strong data that if a person does not begin smoking before 18 or now 21, they virtually will never start. This is because of the -- This might be because of the immature brain is more susceptible to the effects of nicotine, or immature decision-making capabilities, impulse control, or susceptibility to advertising and peer pressure. Of course, the tobacco companies take full advantage of these developmental immaturities. Given that upwards of 80% of youth smokers will continue smoking as adults, the obvious time to intervene is in adolescence and young adulthood.
The use of electronic cigarette products has skyrocketed amongst our youth. The last study I looked at went from 2001 to 2018, and the use of electronic cigarettes among high school students had -- had skyrocketed. As we've heard earlier, up to 50-plus percent of high school children, probably even higher, at this point. The use of designer flavors, make no mistake, you know, this isn't for the adults trying to quit smoking, as was indicated before the use of these designer flavors, and these proxies. Of course, slowly, to increase their sales and to addict our children to these -- to these high levels of nicotine that's ubiquitous in these products.
Despite the FDA's ban on flavored cigarettes, the overall market for full -- for flavored tobacco products is growing and growing and growing. Continuing a long tradition of designing products that appeal explicitly to new users, tobacco companies in recent years have significantly stepped-up introduction and marketing of flavors of other tobacco products. We've heard about all the ones that are out there. And particularly, in e- 227 February 8, 2021
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cigarettes, and cigarette -- cigars, and cigarettes, or whatever you call the little things, as well as smokeless tobacco and hookahs, these include menthol flavoring.
The rate of menthol cigarette use has been increasing tremendously and is truly marketed to the African-American Black community of our country. With their colorful packaging, sweet flavors, today's flavored tobacco products are often hard to distinguish from the candies they display. Which other people have brought up, and I'll reference the name of the company as our -- one of the earlier presenters just have? There's growing strong evidence that a significant --
LINDSAY VAN BUREN: Sorry to interrupt, you've hit your three minutes. Do you think you could conclude?
DR. SETH LAPUK: Yeah. Real quickly, that -- there's good data to suggest that vaping is a gateway to combustibles, gas combustibles are worse, we get that for the long-term health quality issues. But to use that as a -- as a bridge to just say we shouldn't use -- we shouldn't ban any of these things that addict our children, because some adults might use these products to quit smoking, I think is a -- is a straw man argument. If you wanna quit smoking and you're an adult, and people have been pressing this today, you should have the right to, you know, use these products to quit smoking. I don't think having it flavored is gonna make that big of a difference. And I think --
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. I'm gonna have to stop you there, because you're over your time. Thank you very much for your testimony. Let's wait a minute and see if any Committee Members have any questions for you. No, I don't see any. So, thank you very much for your time -- Oh, wait, I'm 228 February 8, 2021
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sorry. Senator Hwang. Senator Hwang, did you have a question?
SENATOR HWANG (28TH): Yes, I'm sorry. Thank you, Madam Chair. I wanna thank Dr. Lapuk for your work every single day, and on the front line. That being said, I think you share some of the personal experience, and as a medical physician, you have seen the challenge of it. So, in your testimony, you've articulated before you were stopped was the - - the real explanation as to some of the rationale for it. Despite the economic challenge that -- that may be confronting with revenue loss. Can you kind of elaborate a little bit from a medical basis your -- your explanation, and continue on, if I may?
DR. SETH LAPUK: Well, one is, just the tremendous addictive nature of nicotine and that -- that, some of these products are -- a lot of these products have tremendous amounts of nicotine. And the idea is, you wanna get these kids early. And we've heard eloquently how family members just can't get their kids to quit. As far as the economic point, if that's what you were bringing up, the healthcare costs -- And as a pediatric cardiologist, I don't see a lot of this. But the healthcare costs of smoking, and just look at the COVID, you know, you can get a vaccination early for COVID, if you're a smoker, 'cause they get sick. People that smoke are in poor health; we all pay that.
Earlier on, someone mentioned that the smoking costs of Medicaid from smoking-related -- smoking-related illness in Connecticut alone is $2 billion dollars a year. And I'd also question the lack -- the -- the drop-in -- in tax revenue. If we get rid of these flavors, the people that are smoking, the adults that are smoking, are -- are addicted. They're gonna continue to smoke and buy those cigarettes and give you -- and contribute to the tax rolls of -- of 229 February 8, 2021
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Connecticut. And even if they didn't, even if everybody quit smoking, that would be terrific. I mean, if we lose some tax revenue for that, but then save it on the other end, a few years down the road, because we're not paying -- Walk through any ICU or walk down the street and watch smokers. They're costing all of us, enormous amounts of money. And yes, they have the right to do that, but, you know, I'd rather that money go somewhere else.
And finally, there are the education component, the Heart Association, school districts, towns are -- are doing their very best to educate kids. But when you're going up against these enormous companies that have marketing departments, that will far outspend any of what -- what towns and -- and -- and organizations like -- like the American Heart Association, it's -- it's -- Somebody else was talking about level playing fields. That's the on- level playing field.
SENATOR HWANG (28TH): No, I thank you very much. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator. Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Madam Chair. So, Dr. Lapuk, thank you so much for your testimony. Earlier, there was somebody who was very articulate, spoke about how a ban is going to actually not necessarily impact the behavior of the current smokers who are using menthol-based tobacco products. And I know there's no published data to say that, but this was anecdotal based on some videos and so on from Massachusetts. I just wanna make sure that because you're cheating -- dealing with children, the real issue of this Bill is not about the current smokers. We actually have to have different mechanisms for addressing it. The -- The 230 February 8, 2021
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current Bill is about the future smoker, the next generation of smokers. Can you allude to that, and then make sure that all of the legislators and the community hears that argument and understand it?
DR. SETH LAPUK: The addiction rate and -- So on some of our boards of -- we have superintendents in schools and teachers, and we've heard from other people already today. The -- the severe addictive nature of this, and how early it gets in the schools, and how the flavors market toward these children is immense. I mean, you can be wearing a hoodie with a little -- on the string, there's a little vaping heater, thumb drives, that -- you know, if you're in the middle of the school. But even if it -- Even if you were able to -- they were able to leave school to smoke, the addictive nature, they -- they -- This isn't a -- a way you can educate or punish kids out of. They are addicted. And we're addicting in a whole new generation, just like the cigarette companies did to the World War II Veteran -- World War II folks, when they gave them free cigarettes. They didn't want to be nice to these soldiers; they wanted to get them addicted.
The school systems, and talking to my friends that are schoolteachers, this is a ubiquitous problem that is going to just, you know, pay dividends well into the future, pay costs well into the future. Not to mention, what the net -- which we haven't studied very much of, what this addictive nicotine is doing to the developing brains. Now that's not my field of expertise, but I've heard people discuss it, and we have no idea, you know, what these high levels of nicotine do to -- to pre-adolescent, adolescent, and even young adult brains. So, I hope that answered your question, Senator.
SENATOR ANWAR (3RD): Thank you so much. Thank you so much. 231 February 8, 2021
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REP STEINBERG (136TH): Thank you, Senator. Representative Kavros DeGraw.
REP. KAVROS DEGRAW (17TH): Yes. Thank you, Doctor, for being here today. And to that last point, I guess my question would be, you know, we don't know the effects yet on the -- the nicotine on the brain. My other question would be, and perhaps you're not seeing it yet, but have your colleagues, or perhaps any other doctors you know. Sometimes, you know, I have heard anecdotally about, you know, a child having a collapsed lung. I know that when people are coming in with COVID, they're asking if you're a smoker or if you vape. So, I guess I would just like to hear if -- are there any specific medical issues that concern you, or that you've already heard about in reference to the vaping?
DR. SETH LAPUK: I've read a few articles. I don't know if I would consider it, you know, solid facts, we don't know. But that it does appear, there are some European studies that the people were getting sicker -- there was a subgroup of people that were getting sicker when they vaped, if they were vaping, from COVID infections. That was at the beginning of -- I think it was back in March or April. I have not seen anything since, but I haven't been looking either. That's not my field of --
REP. KAVROS DEGRAW (17TH): Okay. And just in terms of general health, you know, as a pediatric cardiologist, what are your concerns about these young people who are vaping as young as 12 or 13? Like long-term.
DR. SETH LAPUK: Long-term, there was some data. Again, we haven't had enormous -- a long-term -- we haven't looked out far enough. But there does seem to be a direct effect on the endothelium or the 232 February 8, 2021
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lining of the vessels from nicotine and their reactivity. I haven't studied -- I'm not an expert of that. I did read some things about that. We do think it will likely cause increases in -- in overall heart disease. Nowhere near as much as others have pointed out as to combustibles, but it is a -- it's been shown earlier on about five years ago, three years ago, as a -- as it definitely increases the rate of combustible smoking later on. So, that and of itself translates to -- We're starting to see a leading cause of preventable heart disease in America is -- is tobacco. Period. Combustibles.
I think if -- people were making the argument that, well, if people should have the use of that too, or maybe even flavored cigarettes to, flavored vaping to use it as a cessation aid. Well, you know, perhaps that could be done through prescriptions or cessation centers where you get, you know you can get these products as a medication. There is a whole kind of literature on that or thought on that. So, there's other ways of supporting the bill, and then still allowing the adults, the cessationability qualities of the -- of these products.
REP. KAVROS DEGRAW (17TH): Thank you very much. Appreciate it.
REP STEINBERG (136TH): Thank you, Representative. Senator Hwang.
SENATOR HWANG (28TH): Thank you, Mr. Chair, for the second time. And I'll just be quick. I want to extend to you and to the American Heart Association my appreciation for the tremendous work that you have done and will continue to do. And please extend to Mr. Williams that our prior exchange was by no means, a challenge to him. It was an encouragement that the incredible role that you have and raising 233 February 8, 2021
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awareness and public health wellness was one where I would encourage you to explore the other issues that we may explore in the General Assembly and provide leadership role in that.
But I want it to be clear that the American Heart Association and the great work that you do, and the history that you have in raising the awareness when other people did not, needs to be applauded and complimented. So, I wanna thank you and repeat and reiterate my support of the American Heart Association, the great work that you do. Thank you, Mr. Chairman.
DR. SETH LAPUK: Thank you.
REP STEINBERG (136TH): Thank you, Senator. I see no further questions. You've gotten your full money's worth. And thank you for your testimony today. By the way, I was joking. There is no cost to -- to be clear. Next up is number 65, Tj Clarke, followed by Darnell Goldson. I see Tj is here. You can just unmute. [pause] Okay, we're gonna give you another 20 seconds. There we go, Tj.
T.J. CLARKE: I'm sorry about that. Technology -- Camera issues. Thank you, Representative Steinberg to you and Senator Abrams and the Members of the Public Health Committee of the Connecticut General Assembly. My name is Tj Clarke, City Councilman, here in the City of Hartford. I'm a resident of the City of Hartford, and also, I serve as the majority leader for the council. I'm here to express my support in favor of Bill -- Senate Bill No. 326 (RAISED), AN ACT PROHIBITING THE SALE OF FLAVORED CIGARETTES, TOBACCO PRODUCTS, ELECTRONIC NICOTINE DELIVERY SYSTEMS, AND VAPOR PRODUCTS.
I would like to make you aware of the tobacco- related issues associated with COVID-19, and 234 February 8, 2021
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unhealthy lungs that are affecting many communities in our state while we continue to live in this pandemic. Emerging studies suggest that COVID-19 patients that smoke have a higher chance of experiencing severe symptoms or death than non- smokers, because smoking often leads to severe respiratory afflictions, and is detrimental to the immune system.
COVID-19 makes clear that our lung health is so tied to our public health and how we're going to get back to our feet in this country to build back better for our collective future. Stand with me with -- for policies that will, during and after COVID-19, make our community stronger and healthier. Believe in the promise of the next generation. In recent years, 4,900 adults in our state have died each year with our own smoking in Connecticut. When the medical data all comes out from COVID-19, how many of -- how many more of -- how many more than 7,000 deaths in Connecticut will show some association with smoking? We need to prohibit the sale of all flavored tobacco products now at a time when COVID-19 has disproportionately, excuse me, devastated the lungs and lives of communities of color. Thank you for your time.
REP STEINBERG (136TH): Thank you, Mr. Clarke, for your testimony. We're very glad we were able to make it all work. You make some very good points. I don't see any questions. So, thank you for your testimony. Next up is Darnell Goldson, followed by Andrew Salner.
DARNELL GOLDSON: Thank you, Mr. Chairman and the Committee, for allowing me to, well, speak to you today. I am Darnell Goldson. I'm from the City in New Haven, former alderman in New Haven, currently an elected member of the Board of Education, and formerly the president of that board. I'm speaking 235 February 8, 2021
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to you today on -- in opposition to Senate Bill 326. Specifically, opposed to the -- the cigarette ban. Let me -- I'll tell you, I've -- I had some points just like everyone else about the -- about all the different issues around revenue loss and so on.
But I wanna tell you a personal story. When I was about 11 or 12 years old, my -- myself, and few of my friends ended up with several large boxes of cigarettes. I won't tell you how we got them, but we got them. And during that time, I started experimenting with smoking. That we had these cigarettes, and we're sitting there in a garage and just smoking away. And when my father sent me to the store to get him cigarettes, I always took his money and gave him the cigarettes we had in the garage and made a little bit of money off of it. So, he wasn't aware of it, of course.
So, I was smoking. I wasn't really enjoying it, but everybody else was doing it, so I figured I'll do it also. So, one day we had someone from the -- I believe the Health Department probably, I was in sixth grade at that time, come to our school, Lincoln-Bassett School in New Haven, and give us a lecture. You know, we're sixth graders sitting around, you know, hearing somebody talk to us. But then he took out a display which included the lung of a smoker and the lung or non-smoker, and I never touched a cigarette again after that. Why? My father was a smoker. Why did I stop smoking -- Why did I stop smoking cigarettes and never touched a cigarette again? It's because of the education. Because I was educated by a professional on why I should not be smoking.
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that logic. What I do understand is education. What's been frustrating for me is to see all of this money come into the State from this tobacco settlement, and a very small portion of it going actually to education. And that's where, you know, my concern lies. And I think, if this legislature was very serious about stopping youth from smoking, and I don't think anybody who testified today thought that that was not a worthy cause. Why won't we put more money into education as opposed to criminalizing it? I mean, would it have been easier for someone to slap some handcuffs on me when I was in the 12th grade? I mean, in the sixth grade? Maybe it would have scared me straight, but what scared me more was that lung that I saw, and understanding that I could be going in that direction. And maybe - -
KASS FRUIN: Mr. Goldson?
DARNELL GOLDSON: Yeah.
KASS FRUIN: Sorry, just, your time is up. Just if you can give a closing statement. Thank you.
DARNELL GOLDSON: Alright. Alright. So criminalizing, you know, there's -- there's a saying that I'm going to twist around a little. It says, "The road to jail is paid with good intentions." And when you criminalize this, you're going to be hurting people in my community, people that I know, who are going to -- who smoke, and going -- who are going to continue to smoke, no matter how they have to get it. So, I hope that, at the very least, you strip the cigarette ban out of this. I don't have any issues around with the vaping stuff. I hear it's really terrible. But I would hope that you would strip the cigarette ban out of this. Thank you, Mr. Chair.
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REP STEINBERG (136TH): Thank you, Sir. And I agree with you that it's unconscionable that we divert funds from the tobacco settlement fund, and aren't doing enough on education. I think that's something we should all take seriously. I don't see any questions. Thank you, Sir, for your testimony today. Next up is Andrew Salner, followed by Andrew Haripaul. Mr. Salner, or Dr. Salner perhaps.
DR. ANDREW SALNER: Yes. Thanks, Representative Steinberg, and Distinguished Members of the Public Health Committee. I'm pleased to offer testimony to support Senate Bill 226. I'm the Medical Director of the Hartford Healthcare Cancer Institute at Hartford Hospital, where I direct the Helen & Harry Gray Cancer Center. I'm a practicing oncologist, and I'm proud to be a long-term volunteer for the American Cancer Society.
Flavored tobacco products are luring kids into a lifetime of addiction, which they otherwise may very well have avoided. We must do everything in our power to stop that. That means ending the sale of flavored tobacco products. Tobacco 21 is one part of a comprehensive strategy that helps reduce youth access to tobacco products and we truly appreciate the leadership and action of Connecticut leaders to pass that legislation in 2019. It was an important step in the right direction. Flavors are what makes these products so appealing to youth and are driving the e-cigarette epidemic. Given how popular flavored e-cigarettes are amongst youth; if retailers are still allowed to continue selling them, kids will find a way to obtain them. Entirely removing these products from the market is the only way to curb their use by kids and create tobacco-free generation.
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products will still be available for those adults who are attempting to quit cigarette smoking. On balance, the banning of flavored products will do more to enhance the public health approach and eliminate -- limiting product accessibility to kids and a lifetime of addiction. Mint and menthol -- menthol-flavored products are a major contributor to the epidemic of use of these products by teens. There is no public health justification to exempt them from any policy proposal. A majority, 57%, of youth e-cigarette users use mint or menthol-flavored e-cigarettes. And these flavors are only second in popularity to fruit-flavored e-cigarettes. Amongst 10th and 12th grade Juul users, mint is the most popular flavor. And by the way, one Juul e-cigarette has the same amount of nicotine as an entire pack of cigarettes.
Here's a little bit of recent Connecticut data. 3.7% of high school students smoke cigarettes. 5.7% of high school males smoke cigars. 27% of high school students regularly use e-cigarettes. 12.1% of adults smoke cigarettes. 4,900 adults die each year in Connecticut related to tobacco-related disease. Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined, and thousands more die from other tobacco- related causes.
This is really a public health issue of major proportion. Massachusetts became the first state to ban all flavors. We ask you to join our neighbors to the North in setting the pace nationally to keep our kids and our communities safe. Thank you very much.
REP STEINBERG (136TH): Thank you, Doctor. Senator Anwar.
SENATOR ANWAR (3RD): Thank you so much, Mr. Chair. Thank you, Dr. Salner, for your testimony. Thank you 239 February 8, 2021
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first for being here. I know how busy you are, because when I try to get you -- to see patients, it's a long wait. So, I truly appreciate you taking care of the patients. I think there was an argument that was made on the financial cost to the State. And somebody has said that we will lose about $100 to $150 million, if we do the right thing to reduce the exposure to the next generation of children. The way I see this, you either lose money now or you lose it later. Could you tell about the cost of cancer treatments per patient, and then how many that is impacting the Medicaid and the taxpayers, between Medicaid and Medicare?
DR. ANDREW SALNER: Well, our available data would suggest $2 billion a year in state Medicaid dollars. The Medicare amount would be much higher than that. And that's related to all healthcare costs related to tobacco, not just cancer, but treating treatment of heart disease and lung disease and all of the other issues related to tobacco use. We won't lose all of the tobacco-related income because those smokers who are gonna continue, are gonna smoke unflavored cigarettes. So they'll be able to get them, and we won't lose all of that revenue. But I do believe that the trade-off will pay us at least four -- between 4 and 10-to-1 in dividends by us taking this preemptive action.
SENATOR ANWAR (3RD): Thank you. This is very powerful. So, for every dollar that we lose on this end, we are going to make a lot more, four to -- How many times you said? Four to --?
DR. ANDREW SALNER: Four. Between 4 and 10 to 1. Yes.
SENATOR ANWAR (3RD): This I -- I'm hopeful everybody hears this part because this is relevant because we are selling our community short by giving 240 February 8, 2021
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a dollar value to the children, by saying that, "Oh, we wanna save that $100 million. So, let's poison our children, so we get the tax money." And we are not only not making money, we are losing far more, and losing our children in the process as well. So, thank you so much for your very valid and important testimony. Thank you so much.
DR. ANDREW SALNER: My pleasure.
REP STEINBERG (136TH): Thank you, Senator. Any other questions? I don't see any. Thank you, doctor, for your testimony today.
DR. ANDREW SALNER: Thanks very much.
REP STEINBERG (136TH): And for waiting for your opportunity. Much appreciated. Andrew Haripaul, followed by number 71, Daniel Cowan.
ANDREW HARIPAUL: Okay. Can you hear me?
REP STEINBERG (136TH): Go right ahead, Andrew.
ANDREW HARIPAUL: Okay. Thank you for the opportunity to speak here today. I'm asking to oppose Senator Bill 326. I am first a parent and second a retailer in the State, in the Hartford Town and New London County, representing both retail gas convenience, as well as liquor stores. I agree with the good intent of protecting the youth from nicotine initiation, but as a licensed retailer, it is our duty to make sure that my staff is trained to ID and identify anyone who appears to be under the age of 30. We have an ID checker, and our registers also ask for the age to be inputted. And also, we train our guys. When in doubt, we deny the sale, as our livelihood isn't worth the penalties of selling to a minor.
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And just so you know, this is what the ID checker looks like. And we're able to scan any State ID, and it will tell us then if it's a fake ID, if it's real ID, and if they're of age, and if their ID has expired. It is against the law for anyone under 21 to buy, or someone else to buy and give to a minor; that's where enforcement should step in and target that.
I believe that education both at home and at school should be pushed to maintain our youth to making their own decision. In regards to vape and ban on vapes against -- flavors rather. Again, it falls on our end to make sure that we don't sell to minors. Flavor or not, there shouldn't be a judgment. You know, just a little side note, you know, many of you guys drink, and it would be -- You know, the question is, would it be right to ban chardonnay versus merlot, or tequila versus scotch? Or is the point that all alcohol is bad for you and should be banned? We all choose our poison in this life. We live, whether it's smoking, gambling, drinking, eating unhealthily, deciding to drink sugar versus non-sugar items, and many other things we choose. If you consider banning one type of flavor versus the other, then maybe the Bill should focus on stop selling in total, and not one or the other, specifically menthol versus menthol or flavor versus non-flavor vape.
And people generally with an addiction, will generally leave one addiction and pick up another. So maybe in the case of a flavored versus non- flavored, they will sacrifice the taste and move across. Our retail industry is very beat up and torn pre-COVID, and now more so than before. Gas margins are down, cigarette margins are limited, store sales are down, wages are up, as well as many other expenses. Our business creates jobs, stimulate our economy, and provides a living to many others, and 242 February 8, 2021
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many other entrepreneurs included. I think this Bill needs to be studied more in detail and not focus on one aspect to be fair.
Just a side note, we don't sell candy beside cigarettes to compel any minor, to make a decision to buy cigarettes, or any flavor cigarettes at that. Nor do we say to every customer, "Would you like cigarettes today?" Whereas you go to some food services, let's say, "Would you like fries you’re your purchase?" Product availability in nearby states and online purchases will not disappear. If somebody wants it, they'll figure out how to get it. And with the Massachusetts ban on flavors and such, all of our sales have spiked. And whether it's flavors and Newports and the menthol's, Newport being one in particular, so they've all gone up. Meaning people are now leaving Massachusetts and coming into Connecticut to make those purchases to take back home in their travels. I believe --
KASS FRUIN: Your three minutes has been up, if you wanna go ahead and give your final remarks. Thanks so much.
ANDREW HARIPAUL: Sure. This kind of leads me to believe -- I don't know if this is necessarily a racist situation or not, but you know, if you're saying that one race is more prone to going to one flavor versus the other, and maybe not the other race, then maybe it might be raising a race situation rather than the overall situation of an addiction, whether it's a flavor or not.
Thank you for your time. And once again, I hope you take my thoughts into consideration.
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testimony. Next up is Daniel Cowan, followed by number 73, Josephine Colacci.
DANIEL COWAN: Good afternoon. I'm running in response to Senate Bill 288, AN ACT CONCERNING INDOOR AIR QUALITY IN SCHOOLS. As a professional engineer in the State of Connecticut and a Board of Education Member in Woodbridge, I find the effects of this Bill to be concerning. I submitted written testimony with links and some attachments for your use but I'd specifically like to emphasize a few points.
I specifically desire that this Bill be removed from legislation, this session. My conclusion -- My concluding statement holds the most compelling reason why. At this -- At the -- This Bill at its heart, desires to solve a real problem in schools. Ventilation devices, HVAC systems, break and are not repaired. And I agree, this does not provide the environment that we want for our students or staff. However, the strategies outlined in this Bill are overreaching unrealistic and represent a desire to make a go-no-go lever to close the educational buildings in the State to in-person learning without good cause.
In reading much of the testimony from the teachers and the staff that occupy these buildings, that is attached to this hearing, the issues they raised have nothing to do with meeting or not meeting ASHRAE 62.1. Most of the things described come from faulty DDC sequences of control, failure to repair existing mechanical systems. Focusing on just meeting ASHRAE 62.1 will not address these root causes of these issues and will only exacerbate the very real problems these teachers and staff face. There is no body of evidence to support that not meeting ASHRAE 62.1 makes a building instantly unsafe. In fact, there is a body of evidence that 244 February 8, 2021
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demonstrates natural ventilation can work and does work in many environments and has been allowed in building code for many years.
As we all know, buildings are better if you try to ventilate them more often, and as much as they can be. But ASHRAE 62.1 was designed for engineers to use at the time of building. A very simple bill could be drafted wherein the staff of a school could certify that the ventilation equipment provided to the school as part of the original construction process certified by a professional engineer is running. Not -- So if the goal of the school is better IAQ, or Indoor Air Quality, let's target that and fund that, not just throw ASHRAE standard 62.1 and hope it makes the problem better.
Many schools have invested in better filtration, which is a great first step in solving IAQ problems. There are many emerging technologies that treat viruses, mold, and other indoor air contaminants. We have -- already have Tools for Schools, which was mentioned earlier on today, that reduces VOCs is in the school. And it's a wonderful website; I'm actually on it right now; it has tons of resources for everyone to be used. So, let's incentivize and better fund these programs, and allow third-party engineers to deeply dig into retro-commissioning of these buildings.
With specific regard to the text of the Bill, Section 1.A.4 speaks to 62.1 -- speaks to 62, it does not reference 62.1 or 62.2, which indicates to me that the person that wrote this Bill does not have the experience to be citing this standard. Additionally, the lack of knowledge of 62.1 by the bill author is in 1.A.5, where it says Routine Indoor Air Quality Monitoring Program, which refers to the IQP procedure in 62.2 and doesn't -- and is not the only way to comply with the standard. 245 February 8, 2021
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Finally, the credentialing portion of this is very concerning. Given that it obviously -- Given by the obvious support letters by specific groups, I think it's important that the State -- It's important to state that we need -- we do not need a new Voluntary Credentialing Program because the State requires all people who work on these systems to be licensed already. Human comfort is not merely a dry bulb temperature issue, humans sweat for a reason and human comfort is a function of temperature and humidity. So ASHRAE Standard 55, 2017, thermal comfort of humans is a much better guide than just an upper and lower threshold. Finally --
KASS FRUIN: Mr. Cowan, if you wanna go ahead and wrap up. Your three minutes is over. Thank you so much.
DANIEL COWAN: Okay. Finally, the most compelling reason not to move this forward -- this Bill forward is there is already Public Act 0320 -- 220, that has the same flaws of this cited above, and does have some better parts than this Bill. It is already part of our law and is listed on Tools for Schools, and so we need to do a better enforcement of the existing laws and not just write new laws that will be ignored. Thank you.
REP STEINBERG (136TH): Thank you, Sir. You made a lot of points in a short period of time, for which we're appreciative of. It sounds like you're well- informed on many of these issues, and we would very much appreciate your input. And we will look at your written testimony carefully and the links that are attached because it sounds like we could improve upon this Bill. And that is indeed our intent. I will say though that one of your initial statements about this being some sort of effort under COVID to keep schools closed, couldn't be further from the 246 February 8, 2021
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truth. This Bill was first broached before we knew that COVID existed. And that bill is roughly the same as what we talked about last year. So, I can assure you that COVID has absolutely nothing to do with this Bill, other than perhaps to have given us some greater insight as to issues with HVAC systems in schools.
REP STEINBERG (136TH): Any questions? I don't see any. Thank you for your testimony. I hope you stay engaged. You obviously offered a lot of fairly expert input. We appreciate that. Next up is Josephine Colacci, followed by Gregory Conley.
JOSEPHINE COLACCI: Thank you, Mr. Chair. My name is Josephine Colacci, and I am Director of Government Affairs for the Association of Surgical Technologist. We're here today to express our support for Senate Bill 285, which allows medical assistants to administer vaccines. And we actually would encourage the Committee to expand it to include surgical technologists. AST has over 40,000 surgical technologists as members of our association. We are -- There are approximately 1,090 surgical technologists in the State of Connecticut, according to the Bureau of Labor Statistics.
Surgical techs are under the direct supervision of a surgeon during an operating room procedure. They serve as the surgeon's co-pilot, and among many other functions, provide instruments and supplies to the surgeon during surgery. They operate complex surgical equipment, such as robotics. They handle specimens such as kidney stones and biopsy tissues. And more importantly, they perform precise actions known as sterile technique in order to provide and keep the immediate surgical area sterile.
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techs to administer vaccines, is very similar to a profession that's already in state statute in Connecticut. It was put in state statute in 2015 for central service technicians. And also, Massachusetts has very similar language for surgical technologists. The proposal that we're offering allows a grandfather clause, so anyone currently working as a surgical technologist would be grandfathered in, and would not have to obtain the certification, and it also exempts out nurses and other healthcare professions.
We understand if the committee doesn't feel that this is the right venue for us to amend our language in, and we're open to having discussions with the Committee on what a possible avenue would be for us to put our language in legislation that is moving. And with that, I'm happy to take any questions. Thank you so much for your time.
REP STEINBERG (136TH): Thank you. I'm curious, what is the urgency of having surgical technicians be entitled to vaccinate? Are they in a setting where that is likely to come up? It -- Frankly, as far as I'm concerned, it came a little bit out of the left field.
JOSEPHINE COLACCI: We just felt that it would be another healthcare profession that would be able to administer vaccines for the State. I'm sorry, I cannot hear.
REP STEINBERG (136TH): I have to work on the mute button, as soon as I hit it and I don't hit it the right way. So, thank you for letting me know. Any comments or questions from any other Members of the Committee? If not, I also wanna commend you on having perhaps the most serene background of anybody that we've had on so far.
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JOSEPHINECOLACCI: [laughs] Thank you.
REP STEINBERG (136TH): Of course, now, the competition goes for the rest of the day. Thank you for your testimony. Moving along, we have Gregory Conley, followed by number 77, Craig Olin.
GREGORY CONLEY: Good afternoon. I apologize for the lack of serenity in my background. My name is Gregory Conley, and I run a nonprofit based in the State of Connecticut called the American Vaping Association. And we advocate for pro-vaping policies with the end goal of reduce -- reducing cigarette smoking among adults, and youth in America and improving public health. We're today to strongly encourage the Committee to reject Senate Bill 326, because its enactment would actually end up harming public health by discouraging adult smokers from quitting. All while, as we've seen in Massachusetts, simply send Connecticut citizens across state lines, or through other means, to acquire their tobacco and nicotine products.
Earlier today, you heard excellent testimony from a Yale professor by the name of Dr. Abigail Friedman. Dr. Friedman has had -- never had any connection to the tobacco or nicotine industry. She is an academic and a respected one. And she gave testimony, highlighting her own research, finding that adults in the real world who use flavored vaping products are more likely to succeed in quitting long-term versus those using only tobacco flavors. Dr. Friedman should be the resource to this Committee. Her Yale professorship brings her a great deal of respect, and her research, which has been funded by the FDA, really should be read by Members of this Committee because she is a serious academic that has looked at this issue not in -- not as an emotional tool. She recognizes, "Yes, we should ban." They -- She believes, in her personal capacity, that menthol 249 February 8, 2021
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cigarettes should be banned for public health reasons. But with vaping products would still many people in Connecticut continuing to smoke cigarettes, we need alternatives.
And lastly, I'll note, the FDA's PMTA process is underway. The FDA, in the near future, every vaping product will either be approved and authorized by the FDA under an appropriate for the protection of public health standard, the entire public health, including children, or they will be denied, and it will be a felony to continue to sell the products. So great changes are coming. This industry that you've heard from today wants to work with legislators. I'm glad to answer any questions on the federal side. There's also internet sales regulations that have just gone into effect at the congressional level. Thank you very much. And thank you for your service.
REP STEINBERG (136TH): Thank you, Sir. Thank you for your testimony. Yes. To your point, we've heard testimony from a number of individuals who suggest that vaping remains an important tool perhaps for smoking cessation. Would you be supportive of the bill if we were to carve out vaping to be used under a doctor's prescription as a cessation product?
GREGORY CONLEY: No, because the standard -- there are completely different standards. What the FDA is reviewing now is this PMTA, a Premarket Tobacco Authorization from the FDA Center for Tobacco Products. And that has a standard of -- if we have released this product with specific marketing conditions, will it benefit population-level public health? That is what companies in Connecticut and across America have spent on each individual product. Some of them, hundreds of thousands of dollars or millions. They haven't tried to put the products through the pathway at the FDA Center for 250 February 8, 2021
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Drugs because that's a prohibitive path. Pharma -- Big Pharma itself, with its record profits, they aren't really putting new nicotine replacement therapy products through the approvals route because it's just not a realistic option without changes.
REP STEINBERG (136TH): That's unfortunate. If we really wanna encourage smoking cessation, we should make that path more reasonable.
GREGORY CONLEY: And what -- what -- Sorry.
REP STEINBERG (136TH): I'm sorry, go ahead.
GREGORY CONLEY: I'll just add, what Dr. Friedman is advocating for, is this concept of Tobacco Harm Reduction. The idea that not every smoker, even though we want them to quit, not everyone is willing or able to quit. So, if we can get those adult smokers onto harm-reduction products, which is what the FDA is looking at. Then, if we want to encourage them to quit that, let's wait to encourage them until they've moved down to the product that isn't killing 400,000 people each year. And so, as Dr. Friedman said, it's not 100% good, 100% bad, there has to be middle ground.
REP STEINBERG (136TH): That's what I was seeking, was there's some middle ground. Representative Foster.
REP. FOSTER (57TH): I just -- I do wanna let you know that I've taken a lot of the academic research advice from Dr. Friedman to heart, and what we're talking about. But I do believe that there is -- there is a likely pathway that will significantly decrease the access of these products at the easy access point that they exist, where children are very frequently getting their hands on them and forming new addictions. And there is like this 251 February 8, 2021
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behind -- you know, like perhaps an over-the-counter -- behind-the-counter option, that might be a pathway.
And so, I'm hopeful -- I'm asking if you are interested in hearing or having conversations about what potential options and modifications to this Bill would make it possible to reduce the harm of starting new addictions of products that are being pretty intentionally marketed and taken up by young people? And then also allowing it to be an -- in essence, an advent, right? Like it's something that is -- it's supporting reduction. From what I've seen in the study so far, it is almost always in conjunction. And I -- I'm -- I plan to learn a little bit more about this. But it looks like all the studies today that I had seen, I've looked at it in conjunction with a smoking cessation evidence- based program. So, if it's always used in conjunction with the program, why wouldn't it work for it to be behind-the-counter?
GREGORY CONLEY: So first, in the real world, not clinical trials where they're letting people also use the gum and patch and comparing it against people that don't use the gum or patch. In the real world, virtually all usage, is either people who use it in addition to smoking cigarettes to reduce smoking, or they make the switch fully. And they're not using nicotine replacement therapy alongside it. Keeping the products behind the counter, if that's not already the law in Connecticut, it absolutely should be. There's no purpose to have any tobacco or nicotine product around candy.
Restricting products to adult-only stores. There are some negatives to that because you can go to any 7- Eleven, stay the purchase a pack of cigarettes, so you're making it harder for adults to access the products. But you could have until the FDA actually 252 February 8, 2021
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issues its PMTAs and says, "These particular products are appropriate for the protection of public health after exhaustive study." Until that comes, the vaping products have to be only sold at adult-only environments. That would better protect public health and still allow adults to access these products and protect youth, than just a ban altogether. So, there's definitely room for movement on this.
REP. FOSTER (57TH): And to be clear, I meant, behind the pharmaceutical counter, not behind a counter. Because I think, like a cash register, behind the counter is very different from behind a pharmaceutical counter.
GREGORY CONLEY: If you -- If we lived in a theoretical world where the manufacturers today could supply their products to pharmacies, and only people who came into the pharmacy with a doctor's note could pick up that product, that's something that would be a nice world to be in. That would restrict access to youth. But that's not the world we live in. No pharmaceutical -- No pharmacist is going to dispense a non-approved, non-FDA through the medical approval process that would take five- plus years if we started today. That's not going to happen in the United States, just with the way the system, pharmacists do not dispense non-FDA through the medical route products.
REP. FOSTER (57TH): Understood. Thank you for working through that with me. I appreciate your expertise.
GREGORY CONLEY: Thank you.
REP STEINBERG (136TH): Senator Anwar.
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SENATOR ANWAR (3RD): Thank you, Mr. Chair. Mr. Conley, just wanted to clarify. So, you're saying Dr. Friedman's studies have compared the existing pharmacological treatments for smoking cessation, and compared them directly with the vaping process, and she found that they were equally good or better? Is that what you suggested or --?
GREGORY CONLEY: Senator Anwar, No. What Dr. Friedman did, her -- one of her studies which is cited in my written testimony that you likely have, is, she compared in the real world, smokers who try to quit with flavored vaping products and smokers who tried to quit with tobacco-flavored vaping products. And I believe she also just looked at smokers who didn't try to quit with anything, just followed them in the real world. The conclusion of her study was that -- and other studies, is that flavored vaping products, adults who use those products are more likely to become smoke-free. When we're talking about comparisons with the nicotine gum and patch, that's in published clinical trials. So, for example, about 18 months ago, the New England Journal of Medicine published a groundbreaking clinical trial comparing the nicotine patch to vaping products, and vaping products were about twice -- adults who were using vaping products in the study were about twice as likely to be smoke- free six months --
SENATOR ANWAR (3RD): But who -- who funded that study, though? Do you remember that?
GREGORY CONLEY: That was New England Journal of Medicine. It wasn't funded by the New England Journal of Medicine. But it was not a tobacco or nicotine industry-funded study, it was government- funded. I would stake my reputation on that not 254 February 8, 2021
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being a tobacco or nicotine industry study, nor anything involving Dr. Friedman.
SENATOR ANWAR (3RD): Okay. Okay. Alright. We'll talk more about that. Okay. So -- But hear me out. So -- So --
GREGORY CONLEY: Yes, Sir.
SENATOR ANWAR (3RD): Your argument -- So your argument from your industry, obviously representing the vaping industry here. So, your argument is that we should continue the vaping industry to flourish with the flavored products because of the theoretical benefit of smoking cessation in a subgroup who were never compared with the standard of care that has been FDA approved at this time. But at the same time, the same product is being used to incite the next generation of children to take on nicotine-based products with the next, going over to the combustible products, and so on.
So, if I look at the pros and cons of the two options with the limited data that you have, I look at the potential of suggestive benefit to the long- term damage. And I say from a public health point of view, it does not make sense to me. Again, this is just me. I just practice medicine, but -- and see people with diseases and also have been trained in public health and deal with public health issues. But --
GREGORY CONLEY: Completely understand, great question. First, we are a 501c4, so we do not represent the industry. Sometimes our beliefs on what is best for public health conflict with what the industry is seeking in legislation.
Second, the evidence on vaping products in the real world and clinical trials being better than the 255 February 8, 2021
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nicotine patch and gum is supported by the Cochrane Group, which you're likely familiar with as a doctor. Their published report, while they say there's more evidence needed, they are very bullish on vaping products, the evidence showing them being better than the NRT in the real world and in clinical trials.
And yes, when you're looking at the Food and Drug Administration, accepting and reviewing applications for all these products from manufacturers across America on in a basis where each product needs to show to the FDA that marketing it would be appropriate for the protection of public health, taking into account adults and children users, and non-users. The FDA is going through an intensive multi-multimillion dollar process right now with these products, where in a year, 18-months' time, it will be a federal felony for products to be sold that contain nicotine that are not approved through that FDA PMTA process. So, what we are arguing is, when the FDA who got us through COVID and approved vaccines in a fast and efficient and safe manner, when they are going to be going through all these products and regulating on a very strict basis, why are we rushing to just enact prohibition that would ignore any future findings of the FDA?
SENATOR ANWAR (3RD): Well, we'll talk more because what FDA has done in the last four years is very interesting, and read best [crosstalk]
GREGORY CONLEY: We're looking at some differences.
REP STEINBERG (136TH): Your [inaudible 07:27:37] the use of the word 'interesting', Senator.
SENATOR ANWAR (3RD): Thank you.
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REP STEINBERG (136TH): And are there any other questions? If not, thank you for your testimony today; we really appreciate it. It was very helpful. We'll take a close look at your written testimony as well. Next up is number 77, Craig Olin, followed by David Hancox.
DR. CRAIG OLIN: Good afternoon, Representative Steinberg, Senator Daugherty Abrams, and other Members of the Public Health Committee. My name is Dr. Craig Olin, and I am before you today, as the current President of the Fairfield County Medical Association. I've had the privilege to practice internal medicine in Fairfield County for the past 25 years. And greatly appreciate the opportunity to testify before you today.
On behalf of my 1,300 physician colleagues, I'm here to join the chorus of other physician voices you have heard today, from around our state, to express our strong support for this Bill, Senate Bill 285, which would finally allow certified medical assistants to administer vaccines under the order, and importantly has been emphasized all-day, that direct supervision of a physician or advanced practice registered nurse in the outpatient setting. My predecessors, as they've reviewed with you today, have been coming here for years trying to get a similar bill passed. I have not had the opportunity to listen all day as most of you have. But from what I have heard, much of the Q&A and testimony seems to all come back to an underlying issue of what is really the appropriate scope of practice for a medical assistant.
As we've heard testimony, they are trained and certified with many hours of education on vaccination, and they're just simply not allowed to practice at this level in our state. I think, and our member physicians feel the time is long passed 257 February 8, 2021
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to put our past behind us and do what 48 other states do and increase patients' access to vaccines while easing the burden on our medical practices of administering these vaccines.
Our protracted emergency we find ourselves in now, has caused many patients to postpone care and vaccinations, and it makes this all the more furthermore urgent. Everyone is stressed to their limits, catching up on physicals and vaccines, and we need as many people as possible to safely do this in our offices. I'm not gonna review a medical assistant training, you've heard that many times today. But we physicians feel that's more than adequate under these specific guidelines in this Bill to assure that there's no safety issue to our patients.
The State and we physicians are really, I think, looking at this as a way to get vaccinations to as many patients in our state as possible. If we're gonna close the gap we have on healthcare disparities, we need lower-cost methods to get vaccinations into patient's arms. There's a growing shortage of physicians coming. Nurses are absolutely critical to our roles, but this is not a function that only they should be able to perform. Time that medical assistants will spend giving vaccines, as you've heard, many offices cannot afford an LPN or an RN, so the physicians do it themselves for thousands of patients, those couple of minutes add up to a lot of time.
So, any time we can free up for physicians to do other things, while their medical assistants, under their direct supervision, giving vaccines will allow them to do other things. For these reasons, we really implore you to pass this Bill and ask it can become effective as soon as possible to greatly expand the number of people able to vaccinate our 258 February 8, 2021
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residents. Thank you. And I'd be happy to answer any questions.
REP STEINBERG (136TH): Thank you Dr. Olin. I'm not gonna address the issue raised with regard to the current emergency we've covered, because what we're talking about is a statutory change that would have permanent impact.
You know, you touched on something we've heard from the nurses, which is -- this is a matter of finances, profitability. You know, the average person out there figures all doctors are wealthy, so what's the problem? You know, why can't you afford to use an APRN or an LPN to do the job? Why is it that you are comfortable and intending to focus on MAs to provide this function, as opposed to nurses?
DR. CRAIG OLIN: One of the settings I have the privilege of working in is AmeriCares, which is a free clinic. I have many colleagues that are providing services in similar environments, Community Health Centers. These are not-for-profits. And all of these places in our state cannot -- you know, they have to pay a nurse -- It's essentially double the rate of a medical assistant to perform this. So, it's not a matter of a doctor trying to make an extra $25,000 a year by having an MA or instead of a nurse. There are many settings where there are RN nurses. As Dr. Miller and others testified, medical assistants, are already here. They're already in our offices throughout the State. There are -- I don't have the numbers, but I can imagine there is an LPN or an RN that could staff every private physician and clinical office in the State. No way, no how. We have the MAs, they're trained to do this; we need to let them do it.
REP STEINBERG (136TH): Thank you, Doctor. And I also agree, AmeriCares is a wonderful program. My 259 February 8, 2021
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father participated after he retired from private practice and take care of a lot of people that way. So, what gives you confidence that MAs working with you, under your supervision, are ready to provide vaccines? Would you just automatically confer that ability on all of your MAs?
DR. CRAIG OLIN: No, I -- I don't think so. I think this Bill does a very good job of listing out the requirements for their training. You know, there are people who call themselves medical assistants. There is a certification process, there are national certifications and you outline those in this Bill. And I think we -- you know, we would be happy to see some form of extra training as many of the MAs in our state may have trained 20 years ago, and never been able to give them vaccine. I think, whatever, you know, I think each position may feel comfortable with some in their office, but I think it -- it would behoove public health in our state to have the standard of certification, and perhaps extra education or -- and/or an exam. But I think new graduates get this in their education, and they're taught to do it. So, I think it would really be more of an issue for people that are long out of school.
REP STEINBERG (136TH): Thank you for your testimony, Doctor. And congratulations on taking over the field for County Medical Society. I know they're a fun group. Any other questions? If not, again, thank you for your testimony, and for your patience today. We move on to number --
DR. CRAIG OLIN: Thank you.
REP STEINBERG (136TH): -- 78, David Hancox, followed by number 80, Don Williams.
MR. DAVID HANCOX: Thank you, Mr. Chairman. And I'd like to thank the Committee for allowing me to 260 February 8, 2021
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speak. I'm David Hancox, and I was the Director of state audits in the New York State Comptroller's Office. I've written and taught on issues focused on assessing government programs and policies such as Senate Bill 326, banning flavored tobacco products before you now.
First, before I start, I'd like to point out that RJ Reynolds has compensated me for my time preparing these comments, but the opinions expressed are my own. I have also submitted written testimony to your website.
While banning all flavored tobacco products may appear to be an expeditious and politically safe step towards achieving public health policy goals, the evidence from other jurisdictions reveals that our prohibition will not reduce smoking. The case- in-point has already been made but in the first three months of Massachusetts statewide flavored tobacco ban in 2020, menthol cigarette sales in Massachusetts neighboring states consumed roughly 70% of the banned market. The remaining 30% converted to in-state non-flavored cigarette sales. There is no evidence that smoking rates declined.
Furthermore, a ban on all flavored products will be detrimental, not only to your state budget, but as it has been already pointed out, also to retailers and small businesses. These products account for 44% of tobacco product sales in Connecticut generating more than $168 million in sales and excise taxes in 2020. Menthol cigarettes alone generate nearly $150 million dollars in taxes. Tobacco retail sales in Connecticut, which occur primarily in convenience stores are over $800 million annually, slashing that market by nearly half, will cost retailers in your state more than $360 million, not including the loss of sales of products commonly made along with 261 February 8, 2021
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tobacco purchases. The result will be, lost jobs, decreased wages, and perhaps a shuttering of small businesses. And legal sales lost to these retailers will fuel the State's already significant black market for cigarettes.
Finally, a flavored tobacco ban will undermine public health policy conceived by the FDA, and already supported in your state's tobacco taxation schedule. When the tobacco taxes were last raised in Connecticut, legislators slashed by 50% the tax on products approved by the FDA for marketing as modified-risk tobacco products. Nearly half the currently approved MRTP products are flavored. Along with the MRTP designation, the FDA also is currently assessing thousands of pre-market tobacco applications for new tobacco products, including e- cigarettes and other vapor products, many of which are flavored.
Denying your state's adult tobacco product users, the benefit of the FDA's consideration of tobacco harm-reduction simply is not in their best interest, and subverts Connecticut's existing policy on this issue. Thank you for your time. And I welcome your questions.
REP STEINBERG (136TH): Thank you. Any questions? Seeing none. Thank you for your time.
MR. DAVID HANCOX: Thank you.
REP STEINBERG (136TH): Moving along. We're gonna move on to number 80, Don Williams, followed by LeeAnn Ducat. Welcome Former State Senator and Former President Pro [Ten 07:39:18], Don Williams. Please continue, Sir.
DONALD WILLIAMS: Thank you very much, Representative Steinberg. And, hello, and thank you 262 February 8, 2021
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for this hearing to the Members of the Public Health Committee. My name is Don Williams. I'm the Executive Director of the Connecticut Education Association. Used to be with you in the legislature, was also [First Selectman Tom Thomson [07:39:34] before that. And it's very nice to see you, even if it's by Zoom.
Thank you for raising Senate Bill 288, AN ACT CONCERNING INDOOR AIR QUALITY. You've seen this legislation before, it was raised last year, had broad bipartisan support, and that was before the pandemic brought everything to a halt.
Few things are as important to the health of students, teachers, and staff, as the quality of the air that they breathe. I'm sure you're aware of news reports regarding the challenges of schools. Some have been forced to close because of high temperatures, humidity, mold, and poor air quality. The importance of the issue is obvious today, especially to help stop the spread of disease such as COVID-19, but also childhood asthma and respiratory problems. The Bill provides standards for improving and maintaining HVAC systems, heating, ventilation, air conditioning systems that helps prevent the transmission of viruses, mold, and other toxins. The Bill would require Boards of Education to implement an air quality monitoring program by June 30th, 2023. Regional councils of government could be used to help regionalize and oversee program in an efficient way.
The Bill really should contain clear standards for temperature and humidity, specifically starting on July 1st, 2024, give some lead time there. It would call for temperatures to be maintained at 65 to 78 degrees in schools. For perspective, that's the same standard that's required by our Department of Agriculture for pet stores. And to underscore that 263 February 8, 2021
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point, we should provide clearer temperature standards and protections for children in our schools, at least the same that we do for pets in pet stores.
And my final and most important point is that in order to address this problem, towns need resources. This legislation would allow towns to bring HVAC systems into the 21st century by accessing school bonding construction funds. It's a logical use for the funds. Connecticut needs schools that are safe and accessible to students and the community throughout the year. Improving schools to support and protect the health of students, teachers, and staff is a proper and sensible use for bonding funds. So, thank you very much for your time and consideration of this important legislation. Be happy to take any questions.
REP STEINBERG (136TH): Well, thank you for your testimony. I'm sure you can appreciate from your former role how challenging it is to have sufficient bonding funds for all the needed uses. But certainly, we've always prioritized school construction as a major use of bonding funding. And this is something I would agree is equally important is to maintain schools in a healthy environment. You may have heard testimony earlier with regard to the significant process hurdles that are involved in providing schools, the opportunity to do the appropriate assessments, to engage the appropriate professional consultants, and to obviously, implement it should the funds be available.
You made some mention of 2024. Do you have some thoughts about how we could logically and fairly rollout a program of this sort?
DONALD WILLIAMS: Well, you know, as a former municipal official and also someone who worked on 264 February 8, 2021
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the Council of Governments, I think doing it on a regional basis through the COGs is a sensible way of doing it in an efficient way, where we can save some money and provide services to towns. We don't need to have 169 towns, or all the school districts that are out there kind of reinvent the wheel. I think it should be done on that kind of a basis.
REP. STEINBERG (136TH): Thank you for that. That might require some additional talent at the COG level if they're gonna carry this on. Obviously, we also have the educational centers as well, that might be of some help. Any other questions? Representative McCarty.
REP. MCCARTY (38TH): Thank you very much, Mr. Chairman. And welcome, Mr. Williams. I just would like to go on the record by saying, we all certainly recognize the importance of maintaining safe and healthy schools for our students and our teachers. But as we learned today, this is a little more complex, and I just -- and we're committed to finding the appropriate solutions. And I certainly really appreciate Representative Chairman Steinberg's comments, that we are looking at the best ways to approach this issue, right now. So, I'm just wondering if CEA has any position on the SR-2 funds coming out that do certainly allow some of the funding to be used. If we have schools that are in need -- immediate need, would you -- would CEA be amenable to using -- I know we have lots of other needs for those funds as well, but I just wouldn't wanna see a district go unattended to currently, if it was an immediate need. If you would, maybe just respond? I hate to put you on the spot.
DONALD WILLIAMS: So that -- that's a great question. You know, I would wanna make sure that any funds that are earmarked for educational purposes, specifically for the education of students in the 265 February 8, 2021
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classroom, that those funds remain for those purposes. If there's other funding that's really for infrastructure, and it can help with our schools and public buildings, then that's certainly appropriate. But, you know, coming out of this pandemic, we're gonna need to do a lot to rebuild connections and mostly the human connection when all students are back in schools, and we have some sense of normalcy again.
So anyway that's -- that's a long answer to your question. But if those funds can be used for infrastructure, as opposed to being there for education in the classroom, then we're open to that. Otherwise, carving out some of those dollars that are already earmarked for school construction, this is foursquare right in the purpose for that kind of funding.
REP. MCCARTY (38TH): Thank -- Thank you, Mr. Chairman. And I agree with both of those comments, so thank you very much.
REP STEINBERG (136TH): Are there any other questions? If not, always good to see you. Thank you for your testimony today.
DONALD WILLIAMS: Thank you very much. Thank you.
REP STEINBERG (136TH): We have LeeAnn Ducat, followed by Mukhtar Ahmad.
LEEANN DUCAT: Good afternoon, and thank you for having me. I'm here today to speak about a few bills on the agenda, all but one. The first one I would like to oppose is SB285 medical assistants and vaccines. While I appreciate the State's interest in expanding access to vaccines for those who want it, and freeing up valuable time with doctors and nurses, the medical assistant simply is not versed 266 February 8, 2021
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enough in how to respond to adverse reactions properly. So, I would request that the Committee consider leaving that up to more trained professionals.
The next bill I would like to address is SB 288, the air quality in schools. While I think that the title and the concept of the Bill sounds great. It will only grow big government and take the responsibility off of the towns. I believe this is a town issue, and they need to decide where the money comes from. Any state mandate on the towns would force decisions, that could adversely affect the student population.
Next, I would like to oppose SB 326, the flavored vapes. If I choose to kill myself with whoppers, diet cokes, and flavored vapes, that's my decision. You are only going to encourage a black market to emerge, because this market is very big, and it is not going away.
And lastly, I'd like to support SB 327. Funeral homes offer a unique experience for those grieving their loved ones, and people take comfort in food. I say, "Let them eat cake."
I would just like to make a procedural objection, and wonder if in future hearings, the Committee would consider leaving the view on the Zoom call gallery view for the remainder of the hearings, so that we can see which legislators are engaged, and which ones are not. The public really appreciated that in the in-person testifying experience, and we would like to -- we would like you to consider the same experience on the Zoom call. Thank you for your time.
REP STEINBERG (136TH): Thank you. I'm looking at gallery view. I assumed everybody else was as well. 267 February 8, 2021
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So, I do believe we're within the limits of our technology.
Any other questions, comments? If not, thank you for your time. Next up is Mukhtar Ahmad, followed by Bill Garrity. [pause] Mukhtar, I believe you -- we see you walking to a vehicle, and maybe you are about to talk now that you're in the vehicle. It's all yours. [pause] If you'd like to begin your testimony? Mr. Ahmad, if you're gonna speak, we're gonna ask you to do it now, or else we'll have to move on. I guess we're gonna move on. Then next up is Bill Garrity, followed by number 84, Paul Angelucci. Welcome, Bill.
BILL GARRITY: Thank you. Representative Steinberg, and Members of the Public Health Committee. While I'm getting used to Zoom, it really stinks. And I miss being able to be in front of all of you guys to have these conversations in person. I'd like to take the opportunity to provide testimony against Senate Bill 285, AN ACT ALLOWING MEDICAL ASSISTANTS TO ADMINISTER VACCINES.
My name is Bill Garrity. I'm a registered nurse with more than 25 years' experience in bedside nursing. I was elected President of University Health Professionals, Local 3837, and I'm serving my third term in that capacity. I'm also an AFT Connecticut Vice-President, and Divisional Vice-President for Health Care. As a UHP president, I represent over 2,800 members in that membership. There are more than 600 nurses, 100 advanced practice registered nurses or APRNs, 30 physicians' assistants or PAs, and 200 medical assistants. So, I do feel I'm fairly qualified to speak about this Bill.
This Bill looks very much like HB 6025 of 2017, and HB 5214 of 2018. Read through much of the support, and I've listened to a lot of stuff today. And I 268 February 8, 2021
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don't even have to wonder what's different this year, COVID-19. Individuals have pushed multiple years trying to get this law passed in Connecticut, and now see an opportunistic path trying to play on the public fears.
DPH has already reported, there were 11,500 eligible professionals that have volunteered to be part of the teams to do wide-scale vaccinations this year. This is not a bill that's talking about just doing this, you know, short-term or for this year. This is something that they're trying to get done and have been trying to do for many years. No matter what, how you look at it, vaccinations or medications, and medication administration is a duty and skill that should be done by a licensed professional.
At UConn Health, our medical assistants are an integral part of our healthcare team. Many of them would like to do more for patients, but even applying oxygen is not allowed because it's considered a medication. Assessment is the second aspect of this Bill that concerns me. Nurses are trained extensively to look for these issues and problems that may be the arise. They're educated in anatomy and pharmacology. They're trained and taught to be assessing before, during, and after any medical patient -- any medical treatment for a patient. I believe that just looking at this as a medic -- medication administration as a simple task is a mistake. On a number of occasions, I've had conversations with Members of the Healthcare Committee, and one of the big questions I get asked is, "Why are 48 other states --" And I wanna make sure I get that right. "48 other states." Because on a number of occasions, I've heard people say, "We're the only state that doesn't do this." New York also does not have a law like this. 48 other states are allowing to do this. And it took me some time to think about that for a little bit. And 269 February 8, 2021
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unfortunately, it's a divide-and-conquer mentality among pretty much everybody we deal with. It's having to go ahead and look through, okay, this is the weakest area that we can start. Let's start here, and let's start chipping away, chipping away, chipping away. At what point in time were things going to change where nurses will no longer be giving other medications on top of it. At what point in time will nurses no longer be giving pills? At what point in time will nurses no longer be giving IV antibiotics? These are -- You know, every -- You know, anybody can do this. That's what -- That's what we're saying right here. And I do not believe that's the case. And I will say thank you for letting me testify today, and ask if I can answer any questions, I'd be happy to try.
REP STEINBERG (136TH): Thank you for your testimony. You know, I'm sure there are probably physicians in the audience who kind of asked the same question about how their career arc has changed somewhat. And whereas they spend a much more time dealing with insurance paperwork and many other things and less time in direct care. Certainly, I think nurses have every reason to expect they will continue to do many of the things they do. It's an interesting speculation.
Let me ask a question. If medical assistants were required to take additional educational and experiential training, would you then be supportive of having medical assistants provide vaccinations?
BILL GARRITY: Again, I'm a nurse, and I've always felt, and for 30 years, it's always been administering medications is the purview of a nurse. So, I might be a little bit of a tougher sell on that.
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REP STEINBERG (136TH): You know, at one point, doctors objected to nurses doing all sorts of things they're doing today.
BILL GARRITY: You're right.
REP STEINBERG (136TH): I find it very curious sometimes. Any other questions? Seeing none. Thank you for your testimony.
BILL GARRITY: Thank you.
REP STEINBERG (136TH): Moving along. We have Paul Angelucci, followed by Corey Pegues. Did I have that pronounced correctly?
PAUL ANGELUCCI: Yes. Paul Angelucci.
REP STEINBERG (136TH): Please continue, Sir.
PAUL ANGELUCCI: I'm here in support of Bill 288. I appreciate your time and your work on this. You have my testimony. I won't submit it -- I won't read it, but -- And I'm here wearing many hats too. I'm an educator and taught in the classroom for 11 years in the Technical High School System. And I'm also a plumbing and heating contractor. I teach in our Technical High School System. I do -- I taught plumbing and heating. Today, I'm the Vice-President, and I represent 1,150 teachers throughout the State, in all four corners. And I feel strongly in support of this Bill. But my fear is, it's gonna get pushed and it's too aggressive. Some of the temperature, highs, and lows, are aggressive to reach. And you know, with the pandemic in mind, I just can't see our state going another year where, you know, the temperature is regulated in a pet store and the kennels and it's not our schools.
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I've been in our schools -- our state schools when - - And they're all high schools up there, 17 comprehensive high school. And I'll be in a town where some of the schools are closed because of high humidity and heat, 98 degrees. You know, our students sitting there dripping. And the school right down the street is open. So, limits are needed. I am in support of construction funds being used for this, as well. I really see this as an investment in the most important infrastructure we have, which are today's students and staff. And I thank you for your time, and I would answer any questions you have.
REP STEINBERG (136TH): Thank you for your testimony. You know, you use the word 'infrastructure'. It seems to be a common refrain in the State of Connecticut, whether we're talking about transportation or energy or water infrastructure, housing infrastructure. And now, we've got school infrastructure based upon a lot of really old buildings with ancient HVAC systems. It's tough to have enough money to go around. But I take your point that this is -- certainly should be a priority, keeping our kids and teachers safe and healthy. Any other questions or comments? If not, thank you for your testimony today, and your patience, and waiting for that opportunity. We much appreciate it. Next up is Corey Pegues I believe, or Peg -- You can pronounce it if I've got it wrong. Followed by Sterling Osborn.
COREY PEGUES: Hello? Can you guys hear me?
REP STEINBERG (136TH): We can. Please continue.
COREY PEGUES: Yes. Hi, I'm Corey Pegues. I'm a retired executive from the New York City Police Department, with 21 years in policing. I also have two degrees, a Bachelor's and a Master's in criminal 272 February 8, 2021
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justice, and a postgraduate certificate from Columbia University from the Police Management Institute, and was a professor at two different colleges. And I'm calling to oppose the ban of Bill 326, the menthol ban. And so, I told you my layout, because I want you to know, you know, my expertise. And I can assure you that there would definitely be unintended consequences by banning these cigarettes. But we could just look at a few national cases that involve cigarettes. The most glaring was Eric Garner, who was selling loosie cigarettes, he ended up dying at the hands of the police. Sandra Bland, who was told to put a cigarette out by the police officer, she ended up dying in a cell.
You have a 14-year-old from Rancho Cordova, California, just within the last seven months, that was accosted by a police officer because he was smoking a Swisher, which is unregulated out in California. You also have the most -- the biggest case in America this past summer was George Floyd. He was supposedly going into a bodega to buy untaxed cigarettes. So, this is a major problem in a Black and Brown community.
When you speak of the ban -- you look at bans, all the bans that we've had in America, the war on drugs, it didn't work. Three strikes out, it didn't work. Bans usually don't work in America. 50% of cigarettes sold in New York State are illegal. And so, what's gonna happen is, you're gonna open up an underground market. You could just look at your next-door neighbor in Massachusetts, what's going on. The underground market is going to explode. So, the gangs, the Bloods, the Crips, and yet there's the MS-13. All of those gangs are going to switch from selling drugs to go into selling cigarettes because there's minimal fines, and very, very small jail time. 273 February 8, 2021
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When the -- America is talking about criminal justice reform for Black and Brown communities, basically, why would you impose a ban that's going to impact that one segment of community that America is actually now, including Connecticut, is trying to help bridge the gap between the Black and Brown community and police. Me being a police officer for such a long time, I do know in Black and Brown communities, police hunt, and in non-minority communities, they protect and serve.
COREY PEGUES: And this is gonna give the cops one more tool in their toolbelt to pull out when they want to use it and it might not be just for the cigarette. There's other things that cops can do. When you make a ban you're gonna open up that underground, but the only way for the police to find out who the big cigarette sellers are, is to get the little fish. You know, when you're trying to get the big fish you gotta get the guppies. And the guppies are gonna be the Black and Brown people that sell it, illegal cigarettes, smoking illegal cigarettes, and you have to interrogate them to find out where they're getting their product from. I really hope that you guys look at this really hard, especially with marijuana on the slate to be legalized soon, and you're --
LINDSAY VAN BUREN: Excuse me.
COREY PEGUES: Yes.
LINDSAY VAN BURENYou've hit your three minutes, if you could just conclude your remarks please.
COREY PEGUES: Okay, I wanna leave you off with this. With marijuana being legal in 13 states and you guys are probably gonna be talking about it soon, just look at this picture. In a few years if 274 February 8, 2021
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it's legalized in your state, your 22-year-old son to be able to smoke marijuana, but your grandma with her 65, been smoking menthol cigarettes for 45 years won't even be able to take that cigarette smoke. That's something for you to really think about.
Thanks again for having me. Again. My name is Corey Pegues, and I'm representing the Law Enforcement Action Partnership better known as LEAP.
REP. STEINBERG (136TH): Thank you for your testimony. I apologize for mispronouncing your name. I would like to believe that your suggestion that drugs -- gangs would stop selling drugs and might start selling cigarettes instead might be a boon to society. But I don't think that's really what you intended. Are there any other questions? No. Thank you for your testimony, sir. Next up, we have Sterling Osborne followed by number 87, Neil Patel.
STERLING OSBORN: Good evening. And thank you everyone very much. I know the day is late, so I will keep my remarks brief. I have already submitted my testimony written. So, I just wanted to kind of touch on a couple of points.
I wanted to first mention that one of the things that we talked about a lot today was that the greatest concern seems to be around youth vape. And I can absolutely understand why that is. But I'm concerned that the Bill is all-encompassing to all products that are flavored, and within my industry alone, that makes up about 50% of our sales. And for the majority of time, responsible manufacturers and retailers don't sell the products that are mentioned. But there is an underground market that does sell some of those vape-flavored vape products. Currently in my store, in my 22 stores, we are only allowed to sell menthol and tobacco flavored, we don't have any more of the other flavors, the mango 275 February 8, 2021
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and things like that. So, when this happened in Massachusetts, I talked to a few of my colleagues up there, their business declined 15 to 28% when the menthol ban went in alone. That's on top of the sales that they were already down from the pandemic. We have multiple controls in place that we use to ensure that we sell these products responsibly, including we scan all IDs at the point of purchase to ensure that we're they're not a fake ID, that they're a real ID. We card anyone under the age of 40 that appears to be that way. We participate in state's things and federal things which we pass.
We are also even in discussions with some of the manufacturers about adding software that would limit the number of a specific brand that can be purchased. So, for example, you could only purchase three juul pods, or things like that. Or three packs of menthol cigarettes.
So again, I know I'm beating a dead horse when I say this, but my concern is that what this Bill is going to do is hurt small businesses significantly. And what it's gonna do is drive the current market for these products underground, making it that much harder for us to regulate, and that much more difficult for these controls that we have in place to be controlled. I know that there are places in Massachusetts that are currently selling menthol cigarettes under the counter, you just have to know the guy to get the guy to be able to purchase the product. So that's kind of my two cents on the matter. And thank you all very much for taking the time to listen to me. I really appreciate it.
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appreciate it. Next up is Neil Patel, followed by, whose name? Hussnain Gondal.
NEIL PATEL: Hello, can you hear me?
REP STEINBERG (136TH): Yes, we can, sir, please continue.
NEIL PATEL: Good afternoon to all the Members. My name is Neil Patel. I live in Woodstock, Connecticut. I'm the owner at Thompson Wine and Spirit in Thompson, Connecticut. My store is pretty much located at a quarter mile to Massachusetts line. And I'm not a health expert to make any comments or statement as far as the flavor ban or the menthol ban and how that affects the health goes. But as my fellow retailers have said that this is 40% of our pretty much business. I grew from one employee to now having up to ten employees at my store. This would definitely disrupt our industry at a business level. I've been with -- I've been hearing all comments since morning and I've heard a couple of seniors that came along earlier and raised a concern about this product being available at the middle-school level. I think there should be restrictions as far as, you know how we sell the products to whoever that we sell it to. Maybe there should be a mandated ID checks regardless of the age. Maybe we should keep the, you know, I have a robot system, where I check the ID gets their address gets their information, and we know that this is, you, a certified person that buys it. Maybe we should make them responsible to the people that are giving it to the kids.
Second of all, we know that marijuana is still not legal in Connecticut, but not that we can't find it on the streets. I think this will just create this massive black market. A lot of stores in Massachusetts are doing it under the table. And I'm 277 February 8, 2021
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sure that will happen in Connecticut; we would lose a lot of revenue. I rest my case at that. Hopefully, this decision is taken at a broader view. Thank you.
REP. STEINBERG (136TH): Thank you, Mr. Patel, for your testimony. Yes, we do take your testimony very seriously and appreciate the potential impact on businesses across the State. Any questions or comments? If not, again, thank you for your testimony. Next up is Hussnain Gondal, sorry, I apologize. I know I got that wrong. Followed by Donald Balasa. Please unmute yourself, sir. There you go. For some reason we can't seem to hear you could you check your volume perhaps?
HUSSNAIN GONDAL: Hi. Can you hear me now?
REP. STEINBERG (136TH): That works. That's great.
HUSSNAIN GONDAL: Thank you, Mr. Chairman and Committee Members for allowing me to testify today in front of the Public Health Committee. I am conversing in opposition to SB 326. My name is Hussnain Gondal. I am an undergrad business student at the University of Connecticut and I'm with my family in the gas station and convenience store industry for quite a few years, as well. I believe prior speakers have highlighted the facts and figures together for us very well and therefore, I will not be discussing the loss of revenue to the State or any of that. However, I believe I see a side to this Bill that most of you haven't seen for several years. I was a high school student not more than a couple of years ago. Many of my peers from high school have ended up attending institutions and colleges in Massachusetts. When they moved to Massachusetts, they did not stop smoking flavored tobacco vapes or menthol cigarettes. However, they now just have instant messaging groups on Snapchat, iMessage and Instagram where one person who is 278 February 8, 2021
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visiting Pennsylvania, New Hampshire or any other state for that matter, will take orders for about 50 or 60 different students and ask for a profit on top of the purchase price. That is only one way these products are being purchased.
Another very, very common way of purchasing these products is on websites like Craigslist and eBay, where a mint vape device will be called a Mint Stake, and it will be hand-delivered or available for local pickup only. Please keep in mind that the sellers of these products are not licensed by the State. There is no reason to believe that they will check the age of the purchase -- person purchasing the product, and that these products will be purchased from a reputable distributor, and not just from wholesale websites from China, such as Alibaba.
We are also in business in Rhode Island where flavored vapes have been banned for about a year, give or take. Just last week, I had a young customer who walked in and asked and I'm going to quote him word for word: "Do you know where the guy who sells the disposables in the parking lot of the Motor Inn is today?" Because there is a Motor Inn and right across the street from us? And he asked, do you know where that guy is today? Because he knew they were not available to us -- from us, because we are licensed retailers. However, they also knew that they can buy the vapes and the devices from an unlicensed in un-responsible person across the street in a parking lot out of his car. My last thought is that in middle school and high school, we were counseled numerous times, numerous times, I mean, like once or twice a week about the side effects of drugs, alcohol and cigarettes, which is why the number of drinking and cigarettes-smoking students is very low compared to the [Eastern ratio 08:10:29]. And when I'm telling you not once, that means not once we were told about the side effects 279 February 8, 2021
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of vaping, which is why we can see that the ratio is about 27% of high school students are smoking e- cigarettes. My final remarks to the Committee today is to keep these factors in mind and think whether approving this Bill will actually keep our community and children safe, or put them at risk to not only purchase products but to purchase questionable products from unknown origins. Thank you very much.
REP. STEINBERG (136TH): Thank you for your testimony it seems you're right on time. You made some excellent points. I would hope at this point that schools are prepared to teach students about the dangers of vaping, given how the vaping epidemic has been very problematic for schools and their ability to carry on with their business. But you make some good points. Are there any comments or questions? Seeing none again, thank you for your time. Thank you for your patience today. We will move on to number 90, Donald Balasa followed by Kimberly Espice.
DONALD BALASA: Thank you, Mr. Chair. My name is Donald Balasa. I'm the Legal Counsel of the American Association of Medical Assistants in Chicago. I monitor legislation and also write legislation and proposed regulations. I'm going to bring some additional information on Senate Bill 285. I speak in favor of this.
First, I'd like to draw your attention to a report to the Connecticut General Assembly from the Connecticut Department of Public Health dated February 1st, 2013. On page 15, it reads "Literature and other information reviewed and evaluated by the Scope of Practice Review Committee demonstrated that certified medical assistants are educated and trained to engage in medication administration, under the direct supervision of a licensed 280 February 8, 2021
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physician. Accredited education and training programs that lead to certification as a medical assistant had been in place for many years in Connecticut and other States, and include coursework and clinical training and pharmacology and medication administration." So, the education of medical assistants has been mentioned, and now you have a statement that was made by the Department of Public Health.
Now, I realize that this legislation is not limited to the COVID-19 vaccination issue, but I think the following is germane. The Center for Disease Control and Prevention in their COVID-19 vaccination program interim playbook, listed medical assistants as vaccinators. But even more significantly, the National Council of State Boards of Nursing, which represents all Boards of Nursing in all American jurisdictions, released a statement December 15th 2020, which reads as follows: "Waivers by the Governor or Board of Nursing may be necessary to authorize an RN or LPN to delegate vaccine administration to certified medical assistants, medication aides and emergency medical technicians/paramedics." So here you have the organization that speaks for all Boards of Nursing, stating that medical assistants can be delegated the administration of the COVID-19 vaccinations by nurses. And again, I realize that we're not talking about COVID-19, per se, and yet, I do believe this is an important piece of information.
If you'd like to find these documents, you can go to our website, which is aama-ntl.org, and you'll see this on our homepage in the right column. Also, I have the scope of practice laws for medical assisting in all states. So, if you'd like to do a research, you can just click below State Scope of Practice Laws, which is near the left-bottom of our homepage. And you can see exactly what every state 281 February 8, 2021
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requires for medical assistance, the duties that they allow, and that they do not allow. I'd like to go to the legislation itself. First of all, I need to point --
LINDSAY VAN BUREN: Excuse, you've hit your three- minute mark, if you wanna try to conclude your remarks.
DONALD BALASA: Alright. In Section 1, it states that medical assistants must graduate from an accredited program in order to be considered eligible to be delegated. In these vaccinations, also, you can actually go to the website of these two accrediting bodies --
REP. STEINBERG (136TH): And I'm sorry, sir, you misunderstood the idea was to conclude your remarks not to start a new subject.
DONALD BALASA: Okay, very good.
REP. STEINBERG (136TH): You've provided us with -- with substantial testimony, which we greatly appreciate. I think to your point, this may not be related to the COVID emergency, but we will have more information as to the level of success of inoculating people once we come out of COVID, and we'll be able to actually find out if there have been any problems. So that's an excellent point.
Are there any questions or comments? Seeing none, thank you for your testimony. We go from Chicago it looks like maybe to San Francisco with Kimberly Estes, followed by Jason Prevalige.
KIMBERLY ESTES: Good evening. First and foremost, I would like to thank you for this opportunity to show my support of SB 326 and to share my family's reality as it relates to vaping. A reality that 282 February 8, 2021
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compelled me to volunteer with PAVe, Parents Against E-cigarettes in order to advocate for my son and for all the children of our State of Connecticut.
As a health care professional, I was open and honest about educating my children regarding the dangers of vaping as they entered middle school. We had discussions about both the risk and the lure of flavorings. Sadly, our efforts as parents did not prevent one of our children by being intrigued by the famous -- infamous -- the infamous bubblegum scented vaping cartridges.
While we did not know it at the time, his vaping journey had begun at the early age of 10 years old. His continued vaping since that time has been dictated by flavors, he will not vape any product unless he likes its flavor. I can quote all the research you want to make the case for why we need to end the sale of all flavored tobacco products to protect our kids.
According to the 2020 National Youth Tobacco survey, over 80% of teens who vape are using a flavored tobacco product. And in a 2020 research article, according to Wang TW et al titled, "E-cigarette Use among Middle and High School Students, United States 2020.", mong high school students who use any type of -- E -- any type of E -- flavored E-cigarette, 73% use fruit, 55.8% used mint, 37% used Menthol, and 36% candy flavored. But while the research is compelling, I would argue that common sense is just, and maybe even more compelling. When a highly- addictive substance, in this case, nicotine is altered by adding flavorings which mimic children's products such as cereal, candy or gum, it is inevitable that there will be a bad outcome. Young children will continue to be lured into tobacco use. It is therefore up to us as adults in our society to step-up and protect our children by banning 283 February 8, 2021
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flavorings in all E-cigarette and other tobacco products.
While my son -- while my son has been successful in breaking the vaping habit, I cannot get the vision of my 10-year-old child vaping out of my mind.
Thank you again for your time and consideration. Please approve SB 326.
REP. STEINBERG (136TH): Thank you for your testimony today. We very much appreciate it. Are there any questions or comments? If not, thank you for your testimony.
KIMBERLY ESTES: Thank you.
REP. STEINBERG (136TH): We move on, Jason Prevalige followed by number 93, Dr. Stacy Taylor.
JASON PREVALIGE: Esteemed members of the Committee, my name is Jason Prevalige, I live in Fairfield and I work at St. Mary's Hospital in Waterbury. Thank you for the opportunity to speak before you today. I represent the Connecticut Academy of PAs and I'm speaking to raise Bill 285, AN ACT ALLOWING MEDICAL ASSISTANTS TO ADMINISTER VACCINES.
In concept, we very much appreciate and support the intent of this raised Bill. However, as it’s currently written, we respectfully ask for physician assistants to be included in the ability to supervise the MAs alongside the already named physicians and Advanced Practice Registered Nurses. As you're likely aware, PAs work across all specialties and practice settings. Very often PAs working environments where they are working in conjunction with an MA only. And thus, the ability for us to be able to order a vaccination and have the MA administer it under the oversight of the PA 284 February 8, 2021
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is crucial. Such ability will ultimately increase access to care as PAs will be able to care for more patients in the time that otherwise would be spent performing the vaccinations themselves.
Medical Assistants are currently supervised by PAs in a multitude of settings, as delegated by the physicians with whom we work in collaboration with. At the direction and with the oversight of the PAs, MAs have for over five decades, acquired vital signs and lab specimens, applied dressings and splints and performed a myriad of office- based testing. It should be noted that the majority of APRNs in the State of Connecticut continue to work under collaboration agreements with physicians and not an independent situation. This Bill however, applies to all APRNs, even though majority of whom are still working under agreements similar to those that PAs work under. And as ConnAPA has previously discussed with this Committee, exclusion of PAs from such statutes allows for interpretation that PAs should not be performing such acts by various workplace administrators.
If SB 285 was passed without the inclusion of PAs will send a strong and erroneous message that PAs should not supervise MAs and all the care they can and should be able to provide. If PAs are excluded from this Bill, appropriate care will be reduced because of the new and unintentional barrier that will be imposed on the PA profession. And we've learned one thing from this past year during this pandemic, is how disparate and limited access to healthcare already is. And I ask this Committee, please not add further to those limitations and include PAs in this Bill. And with that, we thank you for your time on this matter and your dedication to the patients and citizens of Connecticut.
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REP. STEINBERG (136TH): Thank you for your testimony. I was wondering when we were gonna hear from the PAs. This is why we on the Committee so much love Scope of Practice, because everybody has a point of view. So, thank you for that. Representative Genga.
REP. GENGA (10TH): Yes, thank you for your testimony. Under this Bill would be required to get additional education and training?
JASON PREVALIGE: Not that we would envision and not as I see it written in the Bill, no.
REP. GENGA (10TH): So as your professional expertise, you'd be able to do this without any further training?
JASON PREVALIGE: Correct. These are things that we do on a daily basis as it is. I mean, I could very well order a vaccination and administer it myself. But instead, we are just asking that we have the ability to have the MAs administer that for us. It was not changing our Scope of Practice at all, or our ability to order anything different. We already have MAs providing other tasks to us, this is just one additional task. And it's something that we already, you know, could physically do ourselves, or would have an RN do in place.
REP. GENGA (10TH): Thank you.
REP. STEINBERG (136TH): Thank you, Rep. Any other questions or comments? And now we'll move on to Dr. Stacy Taylor.
DR. STACY TAYLOR: Good afternoon -- late afternoon, Senator Abrams and Representative Steinberg and distinguished members of the Public Health Committee. On behalf of the physicians and 286 February 8, 2021
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physicians in training of the Connecticut State Medical Society, thank you for the opportunity to provide this testimony in support of raised Bill 285.
Vaccines are key to the health and wellbeing of our communities when administered by properly-trained personnel with onsite direction and supervision. CSMS strongly supports the ability of physicians to delegate appropriate procedures to qualified medical assistants, certified Medical Assistants who are appropriately-trained and have been credentialed by a nationally accredited organization should be allowed to administer vaccines. All the medical assistants in our office are not only trained in performing vaccinations, but also have been trained in basic pharmacology and safe medication administration. However, they are unable to utilize that training.
The administration of vaccines would occur under the direct supervision of a physician, meaning that the patient has been evaluated by the physician. The physician ordered the vaccine after determining it is appropriate and safe to administer; is present at the site where the services are being performed; is able to provide guidance and assistance when needed; as well as emergency care in the event that an adverse reaction occurs and that physician knows the medical assistant is trained and capable to give the vaccine. The supervisor must ensure that the tenets of safe medication administration, the right patient, the right drug, the right dosage, the right time, via the right route, and the right observation afterwards are adhered to. It is when those tenets have been overlooked and mistakes have been made by people of all levels in healthcare.
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in healthcare. It bears noting that emergency federal regulations presently permit pharmacy assistants with far less training to perform this task. My medical assistant is my right-hand and has capably handled the variety of emergent issues from chest pain and fainting, to potentially suicidal and violent patients before I've even entered the room. However, a simple procedure such as giving a vaccine for which she is trained, she is unable to do. I would be the one taking the responsibility for ordering the vaccine and understanding the implications of that vaccination and being responsible for the outcome.
All I am asking is for the medical assistants and others like her to administer the vaccine while I can continue to do tasks that utilize the advanced training that I have received, including perhaps, convincing another patient to get a vaccine. Many physicians especially in primary care, and especially now, given additional economic hardships may have difficulty finding much less --
LINDSAY VAN BUREN: Excuse me. You've hit your three- minute mark, if you could conclude your remarks.
DR. STACY TAYLOR: Okay. They may not be able to afford an RN and even an LPN with a mean salary of 48,000. But they might be able to afford an MA with a mean salary of 32,000. Who is more readily available? Thank you very much.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for your testimony, Doctor. Really appreciate you taking the time to weigh in on this important bill. Let's see if any committee members have any questions for you. Seeing none, thank you very much for being here. Have a great evening.
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DR. STACY TAYLOR: Thank you very much for listening.
SENATOR ABRAMS (13TH): Of course. Next, we have number 96, Cynthia Rumba, followed by number 99. Joseph Quaranta.
CYNTHIA STREMBA: Hi, I'm Cynthia Stremba, I'm the Director of Volunteers for PAVe. I'm reading this on behalf of a PAVe mom from Avon, Connecticut. She writes, "My name is Laurie."
SENATOR DAUGHERTY ABRAMS (13TH): Excuse me, one minute. Can you tell us what PAVe stands for please?
CYNTHIA STREMBA: Oh, yeah, I was gonna get to that.
SENATOR DAUGHERTY ABRAMS (13TH): Okay.
CYNTHIA STREMBA: That's okay. Parents Against Vaping E-cigarettes.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you. Thank you.
CYNTHIA STREMBA: My name is Laurie. I'm a volunteer with Parents Against Vaping E-cigarettes here in Connecticut. I joined PAVe because vaping has changed the course of my life and that of my son and I wanted to speak out. Today, I respectfully urge you to support SB 326.
Our youngest son now 23 is addicted to nicotine. We had no idea he had been vaping throughout high school and college, and it wasn't until I found these small, colorful cartridges in his bedroom that I researched what they were and learned how harmful they actually are to his health. When I asked him why he started vaping he said, he was told that it would help him quit smoking, which at the time he 289 February 8, 2021
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thought was more harmful. He says he continues to vape because he believes it relieves his anxiety. As a Prevention Coordinator, I know that he and other youth continue to vape because they're addicted. They can't stop on their own.
Although I've tried logic to reason with him, the truth is that his vaping habits have been solidified. He now has tremors, breathing problems and high blood pressure. In my experience as a Prevention Coordinator in Rocky Hill, students try vaping to fit in, to relax, alleviate boredom. They perceive vaping as harmless; it's not.
The big tobacco companies don't think twice about how dangerous chemicals contained in their products will impact young hearts and lungs. It's all about the money. Our 23-year-old has been addicted to nicotine for years. We discuss quitting options with doctors and he's tried those options but they haven't worked. Now we're even more concerned since a recent Stamford-led study has shown that our son has greatly -- greatly increased chance of contracting COVID-19 and that the virus has been fatal for some with weakened lung capacity from smoking or vaping.
As an advocate for youth, I have educated hundreds of youth and their families for over 20 years. We have learned that punishing students for addictive behavior doesn't end usage. They're addicted, they need to be detoxed and rehabilitated. Unfortunately, those types of programs are cost-prohibitive or unavailable for many families. What we can do to end this addiction is to prohibit the sale of all flavored tobacco products. A 2020 Surgeon General report concluded that prohibiting flavors including menthol and tobacco products can benefit public health by reducing initiation among young people. Now remember that 90% of smokers begin smoking 290 February 8, 2021
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before the age of 18, 90%. Nicotine addiction is a youth issue. It becomes an adult issue only because youth get older.
So please support SB 326 so that we can keep an entire generation of young people from becoming nicotine addicts and big tobacco's next lifetime customers. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for that very personal and moving testimony, appreciate it. Are there any questions from the members of the Committee? Seeing none, thank you so much for your time and for being here with us today. Have a good evening.
CYNTHIA STREMBA: You, too.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have number 99, Joseph Quaranta followed by 100, Jennifer Banham.
DR. JOSEPH QUARANTA: Thank you, Senator Abrams, and other members of the Public Health Committee. I am here today to testify in support of Senate Bill 285. I am a primary care physician practicing in Branford, Connecticut, and I also am the President of the Community Medical Group, which is an organization of approximately 1,100 independent clinicians, physicians, Nurse Practitioners across New Haven and Fairfield counties. On behalf of all the members of my organization, I encourage all of you to support this very important Bill. Lots of issues have been discussed about this Bill today. I won't repeat them all, but I will highlight a few points from a physician perspective.
First of all, I do want to stress that the ability for the medical assistant to administer the vaccine in this Bill is delegated under the authority of the 291 February 8, 2021
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physician supervising them. And I think that's an important point and that the physician ultimately bears responsibility for the actions of the person working under them, is working on the direct supervision of that physician in the same geography and that physician and that physician will have the ability to determine whether the medical assistant has the capability to administer that vaccine going forward. I think it's a very, very important point to understand that you're not just entrusting the medical assistant with the responsibility, but their supervising physicians who ultimately bear responsibility for the work that they do.
The second point I wanna raise is an important point that's come up many times today is, we are reaching a point where it is becoming very challenging for primary care practices to be able to deliver vaccinations in a timely manner in their offices. This is due to the overwhelming strain being put on these practices, and the financial burdens that we're under. The ability to have the option, and this is just the option doesn't mean that we don't have to use RNs or LPNs to provide vaccines, but the option to use medical assistants will be an important tool and our ability to maintain services to our patients. And what we've learned lately is that vaccine, and not just COVID vaccine compliance, but vaccine compliance across the board is a challenging Public Health issue that we all have to face going forward. And I think the ability to get your vaccine in a trusted, safe and known place is going to be one of the key things to ensure vaccine compliance going forward. And the ability to continue to get vaccines in your primary care provider's office under the supervision of your physician is gonna be critical going forward.
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need going forward for more people to give vaccines and more people to support this activity. And this will really just allow us to continue to deliver vaccines safely. So many other topics were brought up today, in support of the Bill, I think they were all very good points. I just wanted to highlight those, and how important this is to both our patients and our independent providers. And I thank you all for your time today and would be welcome to entertain any questions that you might have.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much, Doctor, it's nice to see you again. And I would say I do appreciate you bringing up the point that this would make it optional. It doesn't mean that anyone in their practice if they didn't want to do this would not be required to do it, so thank you for that. Are there any questions from the Committee? Seeing none, thank you so much for your time. I know how busy you are. So, I appreciate it. Thank you.
DR. JOSEPH QUARANTA: Thank you so much.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have Jennifer Benham, followed by number 103. Ruth -- Ruth Canovi.
JENNIFER BENHAM: Hi, thank you. Please vote against SB 285. Vaccination carries inherent risks with the COVID-19 vaccines as of January 29, there were 453 deaths in the United States; 383 life-threatening reactions and 156 people who suffered permanent disability. Medical assistants do not have the training or prescribing authority to administer life-saving treatments on serious adverse reactions per.
The Bill also does not indicate what subjects will be covered in the proposed education. It would be 293 February 8, 2021
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encouraging if medical professionals advised patients on how to file a claim for vaccine injury, what side effects to watch for and how to locate the vaccine injury table. For example, rubella vaccines are responsible for chronic arthritis and patients can be compensated for this debilitating injury. My friend's 20-year-old son has to take powerful immune suppressants to control his rheumatoid arthritis. My own son developed full body eczema and numerous food intolerances the day after his four-month immunizations. I assumed the pediatrician would report the reaction as a matter of routine. Years later, I discovered it hadn't been reported and filed a VAERS report.
Another friend's husband contracted GBS after a flu shot when he was in his late 30s. He now suffers mental health issues, constant neuropathy and is on permanent disability. His reaction was never reported, and he certainly was not aware of the fact that he could have filed a claim for injuries.
A few years ago, there was a massive recall of Takata airbags. At the time, there were over 60 million of them in the US. Most of the time these airbags inflated properly and saved lives. Occasionally they exploded and killed the occupant instead. Was the government's response a mandate that all vehicles should be equipped with --
SENATOR DAUGHERTY ABRAMS (13TH): Excuse me -- excuse me Ms. Benham.
JENNIFER BENHAM: Yes.
SENATOR DAUGHERTY ABRAMS (13TH): We need you to keep your testimony to the subject that's at hand. So, whatever it is with respect to one of these bills that you want to testify to, we're happy to 294 February 8, 2021
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hear your testimony but we need you to stay on the topic. Thank you.
JENNIFER BENHAM: Okay, well, in that instance, the government agreed that something designed to protect people shouldn't be killing them instead. Do you know how many deaths it took to issue a recall? 17?
SENATOR DAUGHERTY ABRAMS (13TH): I'm not -- again, I'm not seeing the correlation. If you can make that clearer for me, perhaps?
JENNIFER BENHAM: Well over 9,000 deaths have been reported to VAERS from vaccination. So, what number do we have to reach before you will consider the possibility that we need to re-evaluate our vaccine program.
SENATOR DAUGHERTY ABRAMS (13TH): Well, we're not -- this isn't about our vaccine program. So that's what I'm--
JENNIFER BENHAM: Because I think you need to recognize that vaccines are not --
SENATOR DAUGHERTY ABRAMS (13TH): This is not -- this is -- none of our bills have to do with the vaccine program. So, if you'd like to testify on one of the bills we have before us, I'm happy to hear you. But otherwise, I'm gonna have to stop you there.
JENNIFER BENHAM: Even our physicians may lack the skills necessary to assess a patient's vulnerabilities adequately and medical assistants certainly will be lacking in that expertise. In one government study, one in 50 had a serious adverse reaction, and one in 35 developed a new onset chronic disease. And I linked that with my written testimony. I don't know when -- 295 February 8, 2021
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SENATOR DAUGHERTY ABRAMS (13TH): Thanks so much, I appreciate it. Okay. Are there any questions? I don't see any questions. So, thank you so much for your testimony.
JENNIFER BENHAM: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have next we have -- next we have -- Let's see, it seems that the -- that we might have some speakers we didn't think we had. So, let me go back here a minute. Number 102, John Murphy. Are you available Mr. Murphy?
JOHN MURPHY: Yes, I am.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for being here. Go right ahead.
JOHN MURPHY: Good evening, Senator Abrams, Representative Steinberg, Members of the Public Health Committee. My name is John Murphy, and I'm here today representing para-educators who work in Plymouth, Stratford and Stamford, who are members of United Auto Workers, Local 376. We are in favor of Senate Bill 288, AN ACT CONCERNING INDOOR AIR QUALITY AND SCHOOLS WITH AMENDMENTS.
Last March, you heard a similar bill, the same title and you heard about deplorable conditions our students and our educators have had to endure. And today, you've probably heard the same things and probably other things that have happened. We endure extreme heat and cold temperatures, respiratory problems due to mold, dust and other things. Our paras work one on one with special needs students, many who have underlying health issues and are even more susceptible unhealthy air. With 113 school-aged 296 February 8, 2021
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children having asthma, it's triggered by airborne particles and leads to lack of learning.
And the Bill was well-received until again, the State shutdown last year now we have COVID to deal with. So, I'd just like to urge you to pass indoor air quality standards for our schools. And keep in mind what's going on with COVID. We have standards for pet stores and kennels for a minimum-maximum temperature standards and ventilation. We think children and educators should have the same. And I know I'm lucky to have both of my legislators serve on this Committee, Senator Anwar and Representative Genga. And Senator Anwar can tell you about the long-term effects of airborne foreign agents and Representative Genga taught at East Hartford High School and can attest to how extremely hot and cold temperatures affect student learning.
So, we urge you to pass this Bill, we urge you to talk to your leadership about it and get the Governor to pass it. And I'd like you to talk to our Congressional Delegation and work with President Biden to secure funding to upgrade our air-handling systems. And if that's -- we don't get it all there, then we really need to think about funding it to the -- through school bonding. You know, not only will you provide a safer environment for educators and students, but you will employ hundreds if not thousands of tradespeople to retrofit our schools. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, Mr. Murphy. Appreciate it. I too am a retired educator so I know first-hand what those conditions are. So, this is a very important bill to me. And you are well represented on this Committee. So, let's see. Representative Genga.
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REP. GENGA (10TH): Thank you, Madam Chairman. Mr. Murphy, thank you for your testimony, but you mentioned amendments. Could you expound on what amendments you think should be made?
JOHN MURPHY: There's nothing about COVID in the Bill and I don't know, again, I know you're talking about Omnibus bills, or Aircraft carrier Bills that are going to deal with COVID, and maybe they get folded in, but it seems to me it should be specifically addressed here. You know, if we can help -- everyone wants our kids back into schools and our teachers back into schools and to feel safe about it. I know Don Williams, has told me and I am sure he testified today that when he was first selected, when he found select -- his time in Thompson, he found that some of the air filters in the schools had not been changed in decades. You know, we need to have a system that will require regular maintenance. And so, it's just -- we need to think about how COVID fits into all this. And again, I found that to be absent in the Bill. So that's my biggest issue.
REP. GENGA (10TH): Good point. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): All set, Representative? Thank you, Representative Genga.
REP. GENGA (10TH): Yes, thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Okay, and Senator Kushner. Senator Kushner, did you have a question? Your hand's raised.
SENATOR KUSHNER (24TH): I was muted on two forums. And I thought I was unmuted. I had to unmute in two places, I apologize. I was saying how much I appreciate John's testimony today on behalf of these workers, and I used to represent those workers when 298 February 8, 2021
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I was with the UAW. And I think it's so important to recognize the conditions that people work in, in our public schools. And, you know, I appreciate that you also raise the issue of the students, and particularly, the students that need special attention and how, you know, this is an area we really need to address. And I hope we address it sooner. It's gone on for far too long. I just wondered if -- I know there are many issues that affect the indoor air quality. And you've talked about a few of them. Are there any others that you want to bring to our attention as we discuss this in this session?
JOHN MURPHY: No, not really. I mean, we've had experts who know far more about this than I, like Steve Schrag that talked about it. But again, we -- we need to do a better job, especially again, with the para-educators like you said they work with special -- a lot of the special needs kids. They can't work six feet away. They have to be in close contact with our -- with our students that are in special needs, and sometimes they can't wear masks. So, until we get everybody vaccinated, we need to increase the quality of the air handling in the schools.
SENATOR KUSHNER (24TH): I agree with you on that point, as well, because my daughter-in-law is an educator in the Meriden schools and she works with the three and four-year-olds who have special needs. And she often -- they often don't -- aren't able to wear masks. And so, I think you're bringing this up to us today. It's really critically important and I appreciate all the work that you're doing on behalf of these workers and also the students that they are working with. Thank you,
SENATOR DAUGHERTY ABRAMS (13TH): All set, Senator? Senator Moore. 299 February 8, 2021
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SENATOR MOORE (22ND): Thank you. Thank you for that testimony, John Murphy, I appreciate that. You know, you -- I don't think any of us would disagree that we need to look at this. But you did bring up a good point that if it's not going to be bonding, that we need to speak to our federal legislature -- legislators if this passes, because I think it's going to be an even larger problem in the future when you consider how many teachers and children have gone through this COVID and may have lung problems. So, I also am on bonding, so if this makes it through, you've got a champion here for it. Okay?
JOHN MURPHY: Very good. Thank you.
SENATOR KUSHNER (20TH): Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator. Senator Anwar.
SENATOR ANWAR (3RD): Thank you, Madam Chair, just wanted to say 'Hello' to John and let him know that, obviously, we are going to be supporting this. This is much needed. As I mentioned earlier. I see people from the Department of Correction and the teachers at the same level, it’s almost like the indoor environment for both the places are pretty bad. But the teachers are almost at the same level telling us how bad some of the schools are with their indoor air. So, thank you again.
JOHN MURPHY: Thank you.
SENAOTR DAUGHERTY ABRAMS (13TH): Okay, yes, and I just want to remind everyone that this was a bill that was of great interest to this Committee of pre- COVID. So, it's only become more essential since. So, I think now's the time to really act on it. So, 300 February 8, 2021
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thank you so much, Mr. Murphy, for your testimony, and for being with us tonight.
JOHN MURPHY: Thanks for having me.
SENATOR DAUGHERTY ABRAMS (13TH): Sure. We're going to go to Robert Dudley now. Robert Dudley.
DR. ROBERT DUDLEY: Hi, thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you.
DR. ROBERT DUDLEY: Thank you. And so, Dear Senate and House Public Health Committee, Chairs, Ranking Members and Committee Members. I'm Dr. Rob Dudley, a primary care pediatrician from New Britain and the immediate past president of the Connecticut Chapter at the American Academy of Pediatrics. I'm testifying on behalf of our nearly 700 pediatric members in favor of SB No. 326. Thank you for the opportunity to testify today on this important issue.
E-cigarettes are the most commonly-used tobacco products amongst youth and it's rising at an alarming rate. As a school medical advisor, I hear about the explosion of vaping in middle and high schools across the State. Many schools now have to close or monitor their bathrooms due to E-cigarette use, and data through 2020 indicate a continued steep climb in teen vaping. Currently about one in four high school students in Connecticut use E- cigarettes.
E-cigarettes contain a liquid solution that's usually flavored, and the flavors can come in -- and include gummy bear, cotton candy, cherry crush, and many others that appeal to kids. These are often marketed in bright colors using popular imagery. Studies show that favorites play a major role in 301 February 8, 2021
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youth use of tobacco products such as E-cigarettes and cigars, and the government study has found that over 81% of kids who have ever used tobacco products started with a flavored product.
Tobacco companies have a long history of developing and marketing flavored products as starter products to attract kids. Flavors improve the taste and reduce the harshness of tobacco, making them more appealing and easier for beginners, often kids to try and ultimately become addicted. Since most tobacco users start before the age of 18, flavored tobacco products play a critical role in the industry's marketing playbook. Flavors can also create the impression that a product is less harmful than it really is.
The issue is one of -- also is one of health equity tobacco companies have historically targeted menthol flavored products to communities of color. As a result, 85% of adult African-Americans who smoke cigarettes are smoking menthol cigarettes, compared to 29% of white smokers. Menthol boosts nicotine effects in making cigarettes more addictive, and most African-American youths start smoking with a Menthol flavored product. Removing them from stores is an important step in reducing the disparities and tobacco-related mortalities suffered by this community.
As pediatricians, we take the long view on preventative health for our patients. Flavorings in tobacco products pose a danger of lifelong nicotine addiction with all the associated morbidity and mortality that we have fought so hard over the past couple of decades to eliminate. Please support this common-sense legislation to protect our youth. Thank you.
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SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much for that testimony. Really appreciate you taking the time. Are there any questions from the committee members? Seeing none. Thank you and have a great evening.
DR. ROBERT DUDLEY: Thank you so much, you as well.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have Ruth Canovi.
RUTH CANOVI: Good evening, distinguished members of the Public Health Committee. My name is Ruth Canovi. I'm the Director of Advocacy for the American Lung Association in Connecticut. Thank you for the opportunity to speak with you today. We've submitted written testimony on three bills, Senate Bill 115, about tobacco-free pharmacies, Senate Bill 288, around indoor air quality in schools and Senate Bill 326, removing flavored tobacco products from the marketplace.
The COVID-19 pandemic has placed increased attention on lung health, and I commend the Committee for your prioritization of the policy, it's so clearly linked to our health. We support all three of these bills and I'd like to spend the majority of my time on Senate Bill 326, which we strongly support. The need is clear, even in 2021 tobacco use is a very present and real issue in Connecticut impacting too many. 4,900 Connecticut residents die annually due to tobacco. Tobacco costs Connecticut more than $2 billion annually. And considering the presence of COVID-19 and the numerous tobacco-caused diseases, it is imperative to prevent youth from starting to use tobacco and to help everyone quit.
So why address flavors? Flavors are one of the main reasons kids use tobacco products. The National Youth Tobacco Survey in 2020 revealed that teens 303 February 8, 2021
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made several notable changes in how they used E- cigarettes. When very limited federal action removes a small number of pod-based flavored E-cigarettes from the market, youth followed the flavors and disposable E-cigarettes which can still be flavored, use -- their use skyrocketed -- sky-rocketed by 1,000% among high school E-cigarette users and 400% among middle School E-cigarette users. But it's not just about E-cigarettes and so we need a comprehensive approach and not pick winners and losers of Public Health protections based on the method of nicotine addiction. We must treat all tobacco products the same. The health disparities we see with tobacco use and tobacco-related disease are some of the reasons the Lung Association supports prohibiting the sale of all flavored tobacco products. Continued proof of the impact of flavors, a recent study showed that while overall cigarette use declined by 26% over the past decade 91% of that decline was due to non-menthol cigarettes, showing just how impactful flavors are because the only flavor that is allowed is menthol cigarettes still, and flavored cigars are a growing issue. Sales of flavored cigars have increased by nearly 50% since 2008.
I've heard a lot today about the need to educate. We learned a great deal from our policy successes with traditional combustible products. The Lung Association has long advocated for program funding for tobacco prevention and cessation programs, in addition to policies that limit access, like pricing, addressing social norms, like where you can and cannot use these products, raising the legal age of sale and removing flavors from the marketplace.
Connecticut is surrounded by States that have taken action on flavored tobacco products and we have the opportunity to do this right and protect all young lives from the toll of a lifelong addiction to 304 February 8, 2021
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tobacco. Thank you for your leadership on tobacco for a long time in this Committee and I'm happy to entertain any questions you may have. But I really thank you for your time and attention.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much. And thank you for the work you do on behalf of the people of Connecticut. Appreciate it. Are there any questions or comments from Members of the committee? Seeing none, thank you so much for being here and for your testimony.
RUTH CANOVI: Thank you Have a good evening.
SENATOR DAUGHERTY ABRAMS (13TH): You, too. Next, we have Michele Parente, number 104, followed by number 108, Linda Alderman Michele Parente are you with us? I see you there but you're on mute. Michele Parente. Okay, we'll move on to Linda Alderman. Linda, are you with us?
LINDA ALDERMAN: I am.
SENATOR DAUGHERTY ABRAMS (13TH): Great, thank you so much.
LINDA ALDERMAN: Esteemed Members of the Public Health Committee, my name is Linda Alderman. I live in West Hartford and I'm a volunteer with the American Cancer Society Cancer Action Network. I'm here to testify in support of Senate Bill 326. And I thank you for the opportunity.
Connecticut's children need your protection right now. The US Surgeon General has stated that 56,000 children alive today in Connecticut will die prematurely from the effects of smoking if changes are not made to modify current behavior. More than 80% of teens who have ever used tobacco, and more than 95% of teens who have ever used E-cigarettes 305 February 8, 2021
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started with a flavored product, and the use of flavored products make it much harder to quit. Flavors are a marketing weapon, which the tobacco and E-cigarette industries use to target young people for a lifetime of addiction. A significant percentage of youth who use E-cigarettes do not even know that these products contain nicotine. A typical Juul cartridge or pod, however, contains about as much nicotine as a pack of 20 regular cigarettes. Approximately 25% of high school students in Connecticut currently use E-cigarettes and over 70% of these students use flavors.
Further, almost half of adolescents who smoke use menthol-flavored cigarettes and the tobacco in E- cigarette industries don't only target our children. They target racial and ethnic minority populations, as well. And smoking in under-served communities has further exacerbated the health disparities that these marginalized groups already experience. Menthol tobacco products are more heavily-advertised to Black Americans, and low-income populations. And 85% of all Black Americans who smoke, use menthol cigarettes. My family was directly and detrimentally impacted by the targeted marketing of the tobacco industry. My father, who enlisted in the US Army Air Force in 1942, at the age of 17, to defend our country in World War II, quickly became addicted to cigarettes because the tobacco industry targeted the military to create a generation of cigarette smokers. Although he desperately tried, my father was never able to break his addiction to nicotine, and he eventually died of lung cancer after years of suffering. He often told me that his addiction at such a young age led to his inability to quit smoking. The tobacco industry is targeting our State's young citizens and vulnerable under-served communities by flavoring tobacco and E-cigarette products so that there will be yet another 306 February 8, 2021
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generation of nicotine addicts to buy their products. I'm here today testifying because my father cannot be and I'm asking you to protect Connecticut's youth and under-served communities from being the tobacco and E-cigarette industry's easy mark and from a lifetime of addiction, health problems, and from a potentially early and painful death. Please pass Senate Bill 326, and end the sale of all flavored cigarettes, tobacco products, electronic nicotine delivery systems and bigger -- vapor products. Thank you for your time.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Ms. Alderman, thank you very much for your testimony and for sharing your personal experience, as well.
LINDA ALDERMAN: My pleasure.
SENATOR DAUGHERTY ABRAMS (13TH): It was meaningful. Are there any questions or comments from the members of the Committee? Seeing none, I'm going to thank you and say have a nice evening.
LINDA ALDERMAN: Thank you. Good evening, everyone.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have a 110 Mary Yordon. Followed by 111, Maggie Cleary. Mary Yordon, are you here with us?
MARY YORDON: Yes, thank you very much. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Great, thank you.
MARY YORDON: Good afternoon, Senator Daugherty Abrams, Representative Steinberg and all the Members of this Public Health Committee. I'm a teacher certified in Social Studies and French, and the President of the Norwalk Federation of Teachers. I'm also Divisional Vice President of AFT Connecticut 307 February 8, 2021
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for pre-K-12. Our members include more than 15,000 teachers, paraprofessional’s school nurses, and other school personnel across the State. It is on behalf of certified educators in AFT Connecticut that I reach out to you today to support SB 288.
This legislation would establish reasonable standards for air quality and requires communication about complaints regarding air quality. COVID, of course, makes air quality issues even more important than ever, since effective ventilation reduces risks significantly. We would like to see the gymnasium temperature standard applied to the rest of the school as well in Middletown, Wethersfield and Norwalk, as it has been mentioned previously today. There have been temperatures on all ranges of the spectrum, including this winter, hovering at around 50 degrees that lasts for three or four or more hours or even full school days. It's not okay.
Problems are not confined to old buildings in Norwalk in a building that had a $75 million renovation in 2005, with good hard-working maintenance staff, we have employees getting sick for years due to mold, dust, humidity and air quality issues. There are incidents of rashes, headaches, burning feelings, swelling in skin, eyes, and lips and throat, chronic unexplained hair loss, serious respiratory infections related to building conditions. People had to leave early, call out sick, take leaves and even retire early due to poor health, all in ways that have been documented to be related to the building conditions. Since 2015, in this building, we've had floods of water and sewerage, mold, mold remediation, OSHA inspections, citations with recommendations and requirements. We had an UConn occupational health and environmental medicine study with recommendations. We're still waiting on some of the recommendations to be implemented, and one study follows another. The 308 February 8, 2021
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Union has had to file FOIA complaints to obtain air testing results and we really have never been able to get good records of air filter changes. That's something else that was mentioned earlier today.
Troubling conditions and health problems persist. Occasionally we have great cooperation from the District. The reporting and notification in this Bill is important and will really help very significantly in this issue. School employees all over the State work in environments of excessive dust, humidity, mold, heat, cold and poor ventilation. Better and more regular information with clearly established standards for air quality, and notification of building complaints will contribute to more informed decision-making locally, and can help build better relationships between the parties. This legislation promises a good improvement in our ability to understand, discuss and address air quality in buildings in an informed manner, while we safeguard the health of our students and staff.
We request that funds also be made available that has been discussed, we would definitely need to support this with funds to support the needed improvement. Thank you very much for your time and service to this issue, and to Connecticut's residents.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, and I just have to say, as I've been trying to say to all the educators who are here, that you have all gone above and beyond. And I'm just so proud to be a retired educator myself and can't imagine what you've all done during this pandemic. So, I thank you so much.
Are there any questions or comments from the Members of the Committee? I don't see any, I think you know, 309 February 8, 2021
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from listening, that there's a lot of support for this Bill. And so, I hope we can move it forward.
MARY YORDON: Thank you very much.
SENAOTR DAUGHERTY ABRAMS (13TH): Next, we have Maggie Cleary followed by Michele Parente.
MAGGIE CLEARY: I am here. How are you?
SENATOR DAUGHERTY ABRAMS (13TH): Good. Welcome.
MAGGIE CLEARY: Thank you. Good morning, Senator Daugherty Adams -- Abrams, sorry, Representative Steinberg and Distinguished Members of the Public Health Committee. My name is Margaret Cleary, and I've been a Registered Nurse at Danbury Hospital for three years, and I'm the Legislative Liaison for Danbury nurses AFT, Local Unit 47. I'm here to testify against Senate Bill 285 and ACT ALLOWING MEDICAL ASSISTANTS TO ADMINISTER VACCINES. Though administering a vaccine may seem like a simple task that anyone could do with minimum -- minimal training, it is more complicated. It involves knowledge of the pharmacology, anatomy and most important assessment skills to evaluate for reaction or contraindications to the vaccine. Assessment skills are not part of the medical assistant training and therefore they do not have this competency. There is a reason that Registered Nurses go through extensive training to enhance their ability to constantly assess their patients. It is a patient safety issue to allow medical assistants to administer vaccines. According to the Premier Safety Institute, improper use of syringes, needles and medication vials during routine healthcare procedures such as administering injections have resulted in more than 50 outbreaks and 150,000 patient notifications in US hospitals and non- hospitals, setting -- settings with transmission of 310 February 8, 2021
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blood-borne viruses including Hepatitis-B and Hepatitis-C virus to more than 600 patients. This proves that there are considerable risks involved in vaccine administration.
Additionally, it is inappropriate and inequitable to be placing higher levels of burden or responsibility on a less-educated and extremely lower-paid professional without increasing their pay and education along with the added responsibility. The average RN in Connecticut makes about $38 an hour and on the other hand, a medical assistant on average makes about $18 an hour. These wage disparities are based on the amount of education required for the position, as well as the significance of the responsibility. The wage disparity shows it would be unfair and unsafe to give a highly technical task carrying higher risk to a person with less training and less compensation for their expertise.
I understand that it will be argued that this Bill will aid in a swift administration for the COVID-19 vaccine. While we all agree that we want the vaccine distributed as quickly as possible, it must be done safely. It's a new vaccine with many known and possibly unknown side effects, which create even more need for a highly-skilled professional to administer the vaccine.
It is also not necessary to increase the amount of people eligible to administer the vaccine when there are over 11,000 licensed nurses and other healthcare professionals who have volunteered on the COVID-19 vaccine registry to help with the vaccine. While this is anecdotal, I will offer that I received an email asking if I would help administer the COVID-19 vaccine in Connecticut and responded to that I would I have heard nothing back regarding this.
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Additionally, Danbury hospital where I'm employed has not asked me or add to my knowledge any other staff nurses to assist with administering the vaccine. We need to be focused on mobilizing qualified professionals and allocating funds to pay them rather than allowing under-qualified and under- paid professionals to administer exceedingly important medical care. Senate Bill 285 will put patients at greater risk by allowing under-qualified and under-paid individuals to administer life- saving vaccinations, and it is not necessary in order to distribute the COVID-19 vaccine.
Thank you for the opportunity to testify, I would be happy to answer any questions.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much for your testimony. Are there any questions or comments from the Members of the Committee? Senator Kushner. You're on mute.
SENATOR KUSHNER (24TH): I just -- it takes me a minute to unmute, but I just appreciate your testimony here today, being the Senator from Danbury. I have a great appreciation for the nurses and all the medical employees at the hospital, you've done an amazing job to keep us safe, and to treat people who have had COVID. And I've had the opportunity to meet with you all before and tell you how much we appreciate your service. But I thought I would take this opportunity publicly as well.
You know, we have had a lot of testimony on both sides of this issue today. And I guess I'm interested in your experience as a nurse, and what the adverse reactions are that you've seen that you're able to identify what your training is, to be -- that puts you in a position to have that expertise and to be able to have that within your scope of practice. 312 February 8, 2021
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MAGGIE CLEARY: Absolutely. Thank you for your thanks. I would say that -- you know, first you have to assess the vaccination site, you need to find the correct muscle to put it in, make sure it's getting in the right space. I've heard with this, particularly the COVID-19 vaccine, anaphylactic reactions and things like that to react to. There can be muscle ache, there can be like site reactions. There can be immediate reactions to the vaccine. And then you will also have to, throughout the process, maintain like sterile technique and stuff to make sure that the blood-borne illnesses and such don't happen while administering the vaccine?
SENATOR KUSHNER (24TH): Thank you for that answer. And I know that this Bill, the way it's drafted is not just particularly COVID-19. And I know that, you know, from what we've been hearing, there haven't been a lot of reactions, particularly to the first vaccination that people received. But are there other vaccines that this Bill would allow medical assistants to administer that could have a higher rate of reaction, and so is that something we should be concerned about?
MAGGIE CLEARY: Oh, I'm not 100% sure on the reactions to other vaccines and such. I don't personally do tons of vaccinations. The only one I've really experienced is the flu shot, which is a less high acuity one, and I haven't done many other vaccinations as a hospital nurse, so I can't really speak to that.
SENATOR KUSNHER (24TH): Okay. Thank you for being here to testify, and thank you, Madam Chair. T
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator. I don't see any other questions. And Ms. 313 February 8, 2021
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Cleary, I just wanna say thank you so much for your work throughout this pandemic. We know what our healthcare workers have done, and it's greatly appreciated.
MAGGIE CLEARY: Thank you.
SENATOR A DAUGHERTY BRAMS (13TH): Have a good evening. Next, we have Michael Briscoe, number 112, followed by number 114. Christopher Algoo. Michael, are you with us?
MICHAEL BRISCOE: Yeah, I am.
SENATOR DAUGHERTY ABRAMS (13TH): Go right ahead.
MICHAEL BRISCOE: Alright. Can you hear me?
SENATOR DAUGHERTY ABRAMS (13TH): Yes, we can.
MICHAEL BRISCOE: Good. To the Honorable Co-Chairs and Members of the Public Health Committee, we the undersigned opposed, raised Senate Bill No. 326, which would ban the sale of flavored tobacco products. We oppose punitive laws that disproportionately affect African-Americans. Senate Bill 326 includes menthol cigarettes, which is the preferred choice of the over 80% of African- Americans who choose to smoke cigarettes. A ban on menthol cigarettes would give police another reason to interact negatively on the retail level, or the individual citizen for a low-level non-violent offense.
At a time in which we know that interactions between law enforcement and young men and women of color lead to all too often tragic results, we should be looking at a way to lessen any negative encounters in our community with law enforcement. All Connecticut residents under the age of 21 are 314 February 8, 2021
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already banned from purchasing any tobacco products. Prohibiting adults from being able to purchase menthol cigarettes in an effort to address the sale of tobacco products to minors will principally affect African-American smokers. We believe Senate Bill 326 creates another rationally -- another racially discriminatory public policy and will lead to increased crime, targeted enforcement, unfair treatment and illegal street sales. Emphasize, illegal street sales. It is for these reasons we oppose Senate Bill 326 an urge you to vote "no" on this measure. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much for that testimony. Appreciate it. Are there any questions or comments from the Members of the Committee? Seeing none, Mr. Briscoe, I'm gonna thank you and have a good evening.
MICHAEL BRISCOE: Yes, ma'am. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have Michele Parente. Michele, are you with us?
MICHELE PARENTE: Yes, I am. Can you hear me?
SENATOR DAUGHERTY ABRAMS (13TH): Yes, we can.
MICHELE PARENTE: Okay, thank you. So sorry about the technical difficulties earlier. I am Michele Parente from Parente-Lauro Funeral Home. We've been in business since 1940. I am third-generation funeral director and current operator and part owner was my father. And we are opposed to the ACT CONCERNING FOOD AND BEVERAGE IN FUNERAL HOMES. And permit me to kind of speak for the heart. I will not have so much as a percentages to give you but basically, as licensed funeral directors and embalmers, we wear many hats. We're therapists were lawyers, and sometimes we're even florists. But our 315 February 8, 2021
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facilities are really not built for catering. They - - I mean, our building itself is almost 100 years old. And serving food in an establishment that's not originally built to handle that is quite the task. I really also feel, knowing a lot of the owners of catering halls and restaurants, personally, I think this Bill would actually take away from their opportunity, you know, other small businesses to make money. And such, you know, hard times during a pandemic. You know, the food industry suffers enough. And quite honestly, funeral homes, we've also suffered we are very under-appreciated at the moment, I think. And it's really sad, but you know, we adhere to all these laws, and we do them gladly because it's our job. And, you know, I think we feel a little left behind and a little -- it's kind of like a slap in the face to have this Bill come up out of nowhere in the middle of a pandemic with -- on top of everything else that we do, and we do it gladly, do not get me wrong. But to have to serve food and beverages is just right now not a good idea, considering we can barely have anyone in our funeral homes to begin with.
So, and you know, everyone's required to wear masks, gladly and to serve food and beverage just makes no sense. We literally have to take your mask off to eat or drink. In fact, we don't even let anyone use our water fountain right now, because that requires taking your mask off. So, you know a funeral home is just that it's a place to conduct funerals alone. And facilities like ours are -- they're a place of worship, where you can go and you pay your respects to a loved-one you've lost and you pray for their soul. And traditionally, a repast is done after the funeral is over.
So, I think for most people that have to come back to the funeral home after they've just been there for two days, sometimes three, and to re -- you 316 February 8, 2021
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know, hash up those horrible feelings of being in the funeral home, it's not a pleasant place for most people. So, I think going to an actual restaurant or catering hall is a better option for them. And I also feel that this Bill is like devoid of public safety entirely. Just -- especially now, during a pandemic, it just makes no sense to me. So -- and I will leave it at that. And thank you very much for allowing me to speak and for your time, everyone.
SENATOR DAUGHERTY ABRAMS (13TH): No. Thank you for being here, Ms. Parente. We really appreciate you taking the time to give us your perspective. I do have some questions for you. Senator Moore.
MICHELE PARENTE: Yes, Senator Moore.
SENATOR DAUGHERTY ABRAMS (13TH): Senator Moore, we can't hear you, so just so you know. Senator Moore, are you there? You have your hand raised. But you're unmute.
SENATOR MOORE (22ND): Can you hear me?
SENATOR MICHELE PARENTE: ABRAMS (13TH): Yes, now I can hear you. There you go. SENATOR MOORE (22ND): I said to Ms. Parente --
MICHELE PARENTE: Yes, madam.
SENATOR MOORE (22ND): I know them very well. I grew up on Washington Avenue. I know the Lauro-Parente Funeral Home and you know, when I heard this Bill the first time, it just struck a chord like I couldn't understand. I've been to a lot of funeral homes.
MICHELE PARENTE: Yes.
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SENATOR MOORE (22ND): And I don't -- I mean, and you've got a really nice one there in Washington, I know you've improved the parking lot and you have a beautiful location.
MICHELE PARENT: Thank you.
SENATOR MOORE (22ND): I just don't understand why anybody would want to be at a place where you just had a funeral and then go eat there. And who has the capacity? It's got to be a very small number of people who have the capacity to host an event. MICHELE PARENTE: Yes, that's another thing, capacity. Yeah.
SENATOR MOORE (22ND): So, I didn't understand where this was coming from. I don't think it's a good idea. I do think about the health implications, also. But the aesthetics of having food in a place where you're having any type of funeral, you know, even if it's a short one.
MICHELE PARENTE: Yeah.
SENATOR MOORE (22ND): But I was wondering how many large funeral homes do you know of that could really handle a capacity of 100 people?
MICHELE PARENTE: Honestly, off the top of my head, probably just a handful. I mean, I know -- and that's just Fairfield County, that's all I know. But I mean, I'm sure in other counties, there's probably -- maybe there is bigger funeral homes. But yeah, I mean, the majority -- you know, we're still -- a lot of us are still family-owned and operated. So, we don't really have the capacity. And like you said, we do have the capacity, but we're still opposed.
SENATOR MOORE (22ND): And then I look at the other side of this, that there, there is a -- I think some 318 February 8, 2021
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of this is about etiquette and where you would go to eat. And I know that a repast people start to be coming to go to a place of celebration, not mourning.
MICHELE PARENTE: Yes.
SENATOR MOORE (22ND): And I just see this is a strange request to try and turn it into -- a funeral home into a caterer.
MICHELE PARENTE: A party. Yes, and it's --you know, funerals are very dull, even though we're -- during COVID and everything, we still do a lot of very much traditional funerals. And a lot of people do not appreciate a party in the funeral home. You know, it's a time of somber, unfortunately. But that's just what it is.
SENATOR MOORE (22ND): Well, thank you for your testimony.
MICHELE PARENTE: Thank you. Thank you.
SENATOR MOORE (22ND): Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator Moore. I don't see any other questions. So, thank you very much, Ms. Parente, for your testimony, and thank you for the work that you're doing. I know your industry has had a difficult time during this time. So --
MICHELE PARENTE: Thank you. We appreciate that. Thank you. Thank you all for everything you do to I've been watching this since nine o'clock this morning, and all the bills that are up and running and -- and it's been an eye opener, that's for sure.
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SENATOR DAUGHERTY ABRAMS (13TH): I'm gonna hold you one more minute because Representative Genga has his hand up. Representative Genga, did you have a question for Ms. Parente?
REP. GENGA (10TH): Yeah. To her point about this Bill coming up during the pandemic, this Bill was heard last year and actually went through Public Hearing.
MICHELE PARENTE: Okay.
REP. GENGA (10TH): And it's my -- it's my understanding that it's optional. It's not a requirement.
MICHELE PARENTE: So, there's a very fine line with optional, because in order to keep up with competition, per se, if the other guy or woman offers this, then you kind of have to offer it, too. But I see what you're saying.
REP. GENGA (10TH): Also, I'm not sure, but I remember from last year, there were many other states. Do you have any idea how many other states allow this?
MICHELE PARENTE: I think we are one of the two last states that don't allow it. And to that -- and to that, I would say, you know, if they all go jump off a bridge, do we go jump off a bridge with them?
REP. GENGA: I don't see the analogy, but --
MICHELE PARENTE: Well, I like to think that, you know, Connecticut, we're very -- you know, it's New England, it's Connecticut. So maybe we are a little more traditional than everybody else. And maybe we should stand strong on some points. And not just 320 February 8, 2021
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fall in line with all the other states. That's the beauty of our government. Each state is different.
SENATOR DAUGHERTY ABRAMS (13TH): You're on mute, Representative Genga, you’re on mute.
REP. GENGA (10TH): I don't know how that happened. Sorry about that. But it was my understanding that it could be as -- like a particular day like this, where people are offered cookies and coffee, not a particular catering. That could be allowed if -- But I don't really see people who would, as you said want to have a meal in a in a funeral home.
MICHELE PARENTE: No. Well, I think we're allowed during arrangements to give packaged foods. So yeah, maybe some coffee and some cookies. But I find it hard to believe that anybody wants to eat -- During arrangements, people come in, they're not thinking about food. They're thinking about their deceased loved-one and how they're gonna handle it on -- you know how they're gonna pay for it, the last thing they're thinking about is food.
REP. GENGA (10TH): So, this would be a choice -- this would be a choice.
MICHELE PARENTE: It would be another option. Sure, but I just, I don't think it's a good option. And like I said before, I think it -- I think it takes away from the catering halls. There's some really big catering halls, especially around us. And for them to not use their hall -- yeah, they can ship the food to us. But guess what, then they don't get the charge of charging for using their hall, and I mean, they're gonna -- they're gonna lose out, I think, restaurants, they've lost out quite a bit so far.
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REP. GENGA (10TH): Thank you for your testimony, it hasn't changed my mind. I appreciate it.
MICHELE PARENTE: Okay, thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Okay. Representative Genga?
REP. GENGA (10TH): Yes, I am. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative Cook.
REP. COOK (65TH): Thank you, Madam Chairman. Michele, I just -- I have a couple of questions. Are you -- are you believing that this bill is for full- blown catering, or just for the family members to have some food if they're standing there greeting visitors that are paying their respects to a loved- one that is passed on?
MICHELE PARENTE: I believe it will turn into full- blown catering. You're opening a door -- you're opening Pandora's Box to full-blown catering in a funeral home during COVID.
REP. COOK (65TH): Yes, no. But that's not -- that's not what this Bill does, as it reads right now, correct?
MICHELE PARENTE: I'm not sure. I just know that serving any kind of food or beverage in the funeral homes right now is just not a good idea.
REP. COOK (65TH): So, I think that as -- so I come from Missouri, and we have had -- for as long as -- I'm 51-years-old, so as many funerals that I've in, for my 51 years, there's always been the ability for a family to have some type of nourishment in the 322 February 8, 2021
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back room, not for the general public, to be able to keep up their stamina to greet the visitors that are paying their respects to the loved-one that is passed on. I'm not right now advocating one way or another for whether this Bill should or shouldn't pass, but it's for -- it's for conversation as to the Bill's merits. I do not believe in any way, shape, or form this legislation is about a full- blown catering option, or pitting restaurants against, if you will, a funeral home. The way that I -- the way that I interpret this is, this is about - - When my father passed away, there was 850 people that came through the receiving line at a funeral home. We were there for eight and a half hours. And if I went by -- and it was in Missouri, but if I went by that policy here, I would have to have missed some of those folks that were paying their respects or I would have had to have in my world, left the respect that I was doing for my father in my family, to leave the premises to go get something in my body and not go without something in my system for over eight hours, or even my children at that point. So, my point --
MICHELE PARENTE: That was a very long funeral, usually they're not that long.
SENTATOR COOK (65TH): Yes, but that's not uncommon for folks that have lengthy stays. I think we have to get past that COVID pandemic, because there will definitely be like past-COVID. And so, what I'm asking is, do you find it to be a problem for a family member or for families if they have food in the back room, not a catering event? Because if my understanding is right now, you're not even allowed to have coffee or tea. It's only supposed to be water. Do you have a problem with coffee, tea and small --?
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MICHELE PARENTE: So [crosstalk 09:25:33] but people are gonna do what they want, even in my facility. I cannot control everyone. And they bring in what they want when they want anyways. So, there's really not much I can do about that. Yeah, right now I have the right -- if try and bring his 15 platters of, you know, food that is going to make a complete disaster of my funeral home. Sure, I have the right to say "no". Chances are and I'm probably not just speaking for myself. I'm not the only funeral home that won't say "no". But guess what? I have that right. And this Bill takes away that right.
REP. COOK (65TH): I don't believe the Bill takes away the right. I think the Bill gives the option -- I think the Bill gives the option for family members for facilities that choose to offer a family, only a family in my world, I believe it's only a family. Not the general public. It's just the folks that are there in the receiving line.
MICHELE PARENTE: Well then, try controlling that. I mean, it just -- this just -- it just opens Pandora's box. I don't know how else to explain it. That's just my point of view.
REP. COOK (65TH): No, that's fine. I just was -- for clarification, you know, we're, we're one out of two, I believe states that do not offer these 48 other ones or 47 other States offer this. So, I'm just -- you know, and I've had Funeral Home Directors on both sides of this aisle reach out to me. So, I was just curious as to what your interpretation of the Bill was, because the actual Bill, I don't believe has anything to do -- in its current form. I think that's very important that we are honest about what the Bill states in its current form. And in its current form, it does not say anything about catering for the general public. To 324 February 8, 2021
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my knowledge, I believe it's only for the family members that are paying their respects.
MICHELE PARENTE: Yeah, and that will be extremely hard to control.
REP. COOK (65TH): Well, I mean, and then that's to each his own. I'm not going to debate that, but I just wanted for clarification. So, thank you so much. Thank you for indulging me.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. Representative Tercyak.
REP. TERCYAK (26TH): Thank you very much. I just wanted to associate myself with Representative Genga's comments. I think there's nothing wrong with having some water dunes and hot chocolate and diet soda for the family. Whether it's a long or it's a short visitation, whether there's anybody there or not. I, myself, was first introduced to this issue - - I asked the young widow if she would like anything. And she said, Yeah, I'm dying for a Diet Coke. I went to see if they had Diet coke instead of Diet Pepsi. And it turned out they had nothing, because we don't allow them to serve anything except for water. There's -- you don't have to go too far in America to get a Diet Coke. So, everything worked out. But I think that along with Representative Cook, there's space here to be nicer to the family. And as far as I'm concerned, to be nicer to everybody who comes in, really. A plate of cookies, some hot chocolate. Thank you very much, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. I don't see -- you've been so patient, Ms. Parente, thank you so much for your time and for your comments and answering all the 325 February 8, 2021
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committee's questions. So, thank you much, you have a good evening.
MICHELE PARENTE: Thank you, you, too. Take care.
SENATOR DAUGHERTY ABRAMS (13TH): Next we have No. 114. Christopher Algoo.
CHRISTOPHER ALGOO: How are you doing? I am a gas station owner and convenience store owner in both Massachusetts and Connecticut. I would like to speak to you about why the flavor menthol ban would be detrimental to our business and community.
Since I have gas stations and convenience stores in Massachusetts, as well as Connecticut, I'm in a unique position to discuss what the menthol-flavored ban did to our business and community. First off, it is important to understand that the tobacco category on an average convenience store makes up about 60% of our total inside store sales. And of that, 25 to 30% is menthol and flavors. Keeping all of this in mind, the average tobacco customer does not just buy tobacco, they buy gas, snacks, coffee, beverages, and lottery.
When Massachusetts banned menthol and flavors, we lost that customer. But we didn't only lose the sale of a pack of smokes. We lost the customer who bought all their basket items, sending our average store sales down 25%. What's worse is we also lost gas revenue. Due to this loss, I had to cut my employment in some of my stores over 50% simply because we did not have enough business anymore.
Currently, I'm considering closing at least one of my three locations because it is not profitable anymore. I believe that this is a federal issue, not a state issue. Banning the sale only pushes buyers to surrounding states having the unintended result 326 February 8, 2021
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of hurting our local business. In Massachusetts, most of the customers we had for menthol are flooding the New Hampshire border and buying cigarettes at half the price and reselling to our community. Things are so bad in Massachusetts that it is currently considering resending the menthol ban. They have a bill up for vote amended -- Amendment 224 of Senate Bill 4. Currently, it is illegal to sell cigarettes to anyone under the age of 21. Also, many have talked about selling loosies, this is also illegal. Please do not punish us for people in stores that break the law. We are trying to make a living and service our community lawfully. Our stores are essential as COVID-19 has shown. It boggles my mind that the State would consider legalizing weed but wants to ban menthol cigarettes. What's next? Are we going to ban flavored liquor or Hennessy because it's a minority drink? Where do we as a society draw the line?
This Bill is aimed at protecting youth. It is important to know that the cigarette and tobacco use by youth is at an all-time low. In fact, in the past decade, cigarette usage has gone from 15.8% to an all-time low of 4.6%. It looks like what we are doing is correct. We are carding, we are doing the right things.
In summary, how can something that costs jobs and destroys small business be beneficial to the community? How can lost customers, lost revenues to the State be helpful to our community? Small business is under tremendous strain, rising rents, minimum wage, property taxes, not to mention the devastation from COVID, has destroyed years of hard work from an average businessowner. In some cases, small business owners are taking in more and more debt to survive, are we? We need to --- we need you to hear us. We need you to understand passing this 327 February 8, 2021
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Bill will destroy us. Thank you. If you have any questions.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you Mr. Algoo. Thank you for being here tonight. Are there any questions or comments from the Members of the Committee? Seeing none, I'm going to thank you so much for your testimony -- Oh, I'm sorry. Just a minute. Representative Genga.
REP. GENGA (10TH): Hi. Thank you for your testimony. I see that you have businesses in both Massachusetts and Connecticut?
CHRISTOPHER ALGOO: Yes, I do.
REP. GENGA (10TH): Okay. What is the law regarding this in Massachusetts?
CHRISTOHER ALGOO: Massachusetts, they've banned all flavored tobacco, as well as menthol cigarettes.
REP. GENGA (10TH): All?
CHRISTOPHER ALGOO: All flavored tobacco and menthol cigarettes. So now we're losing customers New Hampshire, Rhode Island and Connecticut and New York, because people are just flooding the borders.
REP. GENGA (10TH): How has that affected your business overall?
CHRISTOPHER ALGOO: So, as I indicated in my testimony, we were down 25% in sales. And I've had to basically lay off 50% of my workforce in some of my stores that are high menthol or flavors. And I'm also considering closing one of my locations, because it's not no longer profitable.
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REP. GENGA (10TH): How many locations do you have, if I could ask?
CHRISTOPHER ALGO: I have three locations in Massachusetts?
REP. GENGA (10TH): Okay, thank you for your testimony. I appreciate it.
CHRISTOPHER ALGOO: Thank you very much.
SENATOR DAUGHERTY ABRAMS (13TH): Representative Genga, I guess you're all set. Seeing no other questions or comments. Thank you very much for your time this evening and for taking your time to let us know your perspective. Appreciate it.
CHRISTOHER ALGOO: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Next we're going to move to Chris Farugio. Chris Farugio are you there? Thank you, welcome.
CHRIS FARUGIO: Hi, good evening, everyone. [audible gap from 09:34:44 - 09:34:54] working in Greenwich, Stamford and Monroe communities. I know it's been a long day for many of you so I want to -- I've been here with you, a lot of testimonies I want to clarify a few things.
The CFDA has taken a neutral stance on food and beverage. There are many members that would like to see this Bill passed and there are many members that feel that it should not be passed.
Another thing to clarify, we are the last state to have this Bill passed. So, 49 States have passed this Bill, we are the last state. Everyone has spoken about having small funeral homes. So, my question to them, in 49 other states, and they're 329 February 8, 2021
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are not small funeral homes. This is an option. This is not something that every funeral home has to do. This is absolutely an option. This will give family members a chance to have, when they come in the morning, coffee, a bagel, a muffin. It will be in a separate room. Not with the decedent, not prepared by the funeral home, not in the kitchen at the funeral home. It will all be brought in and catered. That is the very important key to this Bill.
I always think about how, in all religions in all different parts of the world, people gather around food. And that's very important for a lot of people. And many people have spoken about -- that they would like to have food during their funerals. Just -- that's is so important for so many people to be able to have a bite to eat, to offer something to their guests. Again, we're not looking to take -- be a full-blown catering hall at any of the funeral homes. If a family wants a choice to have, and go to a preferred catering of their choice, they're going to go to that funeral home -- I mean, to that -- to that catering hall of their choice or restaurant. People have their favorite restaurants. This is just another option for funeral homes to be able to serve their community. And that's basically everything. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much. Appreciate your testimony. And as I said before, I know that this pandemic, I know it's been particularly hard on your industry. So, I thank you for your service.
CHRIS FARUGIO: Thank you very much.
SENATOR DAUGHERTY ABRAMS (13TH): Are there any questions or comments from the Members of the Committee? I think we've had a lot of testimonies to 330 February 8, 2021
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this and that yours is very much valued. But I think people have a clearer understanding I think, of what it is. Senator Hwang.
SENATOR HWANG (28TH): Thank you, Madam Chair, and it indeed has been a long day. But I do wanted ask Mr. Farugio, your company, it's a Leo Gallagher, right?
CHRIS FARUGIO: That is correct, yes.
SENATOR HWANG (28TH): And is it a -- we've heard many of the family-owned businesses like Shaughnessy, and the Parentes -- Is your organization, a family-owned local business or is it part of a larger entity?
CHRIS FARUGIO: We are part of a larger entity, that is correct.
SENATOR HWANG (28TH): Of how many organizations? Is it the regional or nationwide?
CHRIS FARUGIO: It's nationwide, it's over 2,000.
SENATOR HWANG (28TH): And from your other entities, maybe, as you mentioned, many of the other states is serving, providing food and catering an integral part of your current business model?
CHRIS FARUGIO: It helps families. I wouldn't say it's an integral part of the business model, but when we're able to offer families something additional, it is -- families do accept it. And they they like it. In most other states this is not something that is new. Representative Cook mentioned earlier in Missouri. This is a very common thing in most other states. And in a state like New York, they passed it just several years ago. They can't believe that they didn't pass it sooner. Because 331 February 8, 2021
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everything -- you know, even the small funeral homes have been so welcoming to this fact that they are able to offer someone something, and we can't offer anything right now. And that's -- that's really the key part of this.
SENATOR HWANG (28TH): Can you repeat that statement again? You said every funeral home where?
CHRIS FARUGIO: In New York State, almost every – every funeral home in New York State, they passed the Bill about three years ago -- three or four years ago now. And every funeral home in that state is extremely happy and satisfied with that they passed this Bill.
SENATOR HWANG (28TH): Now, I appreciate that, you have clarified it's New York State. Then what would you say to many of the family-owned, small business funeral homes that have spoken out today, and quite passionately and quite patiently since we started this at, I believe it was nine or ten o'clock, I've lost track. What would you say to many of them that have spoken very vocally and passionately about their opposition to this? It seems to be a difference of opinion.
CHRIS FARUGIO: I would say [audible gap 09:40:53]
SENATOR HWANG (28TH): Sorry, I can't hear you.
CHRIS FARUGIO: I'm sorry. It is an option. They do not have to offer it. But if they choose to offer it, I think that the families would be very appreciative of it. And it does not have to be -- one is looking to have a full-blown meal. People are just looking to be able to offer families something when they when they need it. And this is a time during grieving that people are -- they're not eating. They're hungry, they haven't eaten for days. 332 February 8, 2021
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And if we're able to help them, you know, to nourish them and to give them some energy to get through this, I think that that is very important. And no maybe not right now during the pandemic but things will -- we all know things will get better, we hope that they will get better. And we wanna be there for those families that want to continue on with their services.
SENATOR HWANG (28TH): No, I appreciate your thoughts. And we also heard from some of the homes in regards to older buildings, and in some cases, very significant historical landmarks in prominent areas in the community. And they have spacing questions. Do you have excess space that could very easily be used to adapt to some aspect to catering within your current entity?
CHRIS FARUGIO: Not necessarily. No. I mean, it's a matter of finding the space. And like I had said earlier, in 49 states, there are many small funeral homes that were old homes at one time converted to funeral homes. And if they're in 49 states, if they're able to find the space, Senator, I think that many funeral homes are able to find the space here. And there are many, many independent funeral homes that would like this Bill passed. There are, that is why it's -- the Connecticut Funeral Home Association has taken a neutral stance because there's arguments on both sides.
SENATOR HWANG (28TH): Well, that's another topic of interesting conversation, but I'll leave it at that the day is long. But I do appreciate your perspective. And I'll just simply close by offering a perspective that in these days of the COVID, the important role that you have, in all of your important organizations that do what you do, to give people a peace of mind and comfort during this important time. That that is very much appreciated. 333 February 8, 2021
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Number two, and also in the COVID, of social distancing, and space being a huge premium, I think you're right, I think you even said it, maybe not right now in this COVID environment, should we be considering it. And maybe I'm not putting words -- I don't want to put words in your mouth, that there is a particularly acute sensitivity, that social distancing, not having enough space, that if we statutorily make that change that puts the additional pressure that may take away from the first and foremost priority, to do everything you give -- you can to give comfort, support, and safety. You know, maybe it's not the right time right now, to consider the proposal of this Bill. So, I really do appreciate your thoughts and an opportunity for me to thank all of the funeral homes that that are participating today, that you do an important job in these very, very difficult times. And we applaud you and thank you. So, thank you, Madam Chair.
CHRIS FARUGIO: Thank you, Senator.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, Senator Wong, I always appreciate that you throw it back to me, because then I know when you're done, but thank you for doing that. Senator Moore.
SENATOR MOORE (22ND): So, thank you, sir, for your testimony. This is really quite interesting to me this -- this shift. So, I want to ask you, do you represent small or medium-sized -- I'm just thinking Connecticut, size of funeral homes?
CHRIS FARUGIO: Well, I represent for myself, I think I represent all funeral homes that are in favor of passing this Bill.
SENATOR MOORE (22ND): So, what is the size of them? Are they small business or are they large? 334 February 8, 2021
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CHRIS FARUGIO: Well, I guess -- so one of my funeral home -- my funeral home that's located in Greenwich is very small. It's an old -- you know, at one time an old residence. I don't think -- it has to two viewing rooms. And you know, that setup and allowance -- allowance setting, and people feel very comfortable in that setting. So, if this Bill were to be passed, the family would greet friends in one room, and there could be something to offer guests and the family in the other room.
You know, a lot of people are not having the traditional funerals as we've had over the years, and they're having more celebrations of life, they are choosing cremation as a form of disposition more often, maybe than burial. That's, you know, our, you know, state provision is at a 50% chosen rate for many families. And so many families choose to have cremation, and they have an urn present for the service. So, they don't have maybe a traditional calling hour, as many families do. And during this time, that would give people an opportunity to gather and be able to pay their respects to the family, maybe have something small to eat, and then leave or the family would be able to have something small to eat. So that's -- that's kind of where we see this -- if this Bill was passed, that's where we see this going.
SENATOR MOORE (22ND): So, I just think about the funeral homes that I've been in and they're mostly small businesses, with not the capacity to handle many people in doing virtual funerals. And I've seen a lot during COVID are virtual, and some people deciding just to go directly to the cemetery, right. Or even if it's at a church, it's been, you know, limited amount of people. I was thinking about what Senator Hwang said, you know, maybe at another time, I would think that this might be something to 335 February 8, 2021
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consider. I think about COVID, the last thing I want people do, is to stand around and eat. And I understand people, you know, who've lost a loved one wanting to have a little something to eat, right. But I also don't see funerals lasting a very long time now. I see them, you know, doing the formality of having it and people moving out. And maybe it's a -- maybe it's a discussion for later, but I don't think it's an -- it's from right now during COVID, I just don't think it's an appropriate time to have something like that.
And I try to be open and think about, not how we've done things before, but what, what the future looks like and considering people who are going through grieving, and I can't seem to wrap my arms around understanding why this would be important right now. Or even at a later time, how it could be important, unless you had a facility where people could step out someplace and go eat, and the places I think are very small. And I don't think anybody would want to be eating in front of other people as they're coming through a funeral. Or step -- they could step away, but I've been -- I listened to what Representative Cook, I went to a legislator's funeral where the block was around the corner, right. And I think it's -- and it could be that I'm old school, I just think it's to be respectful of those people. I don't see people having anything other than water, or coffee or tea or stepping out for a moment to get out of the line and letting another family stand there. So, I'm gonna to continue to listen, but thank you for your testimony.
CHRIS FARUGIO: Thank you. Well, Senator, as of right now, you cannot even offer coffee or tea.
SENATOR COOK (22ND): I just said water. I could see someone getting water, so that they didn't -- and it's overcome and you just want to give him a little 336 February 8, 2021
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sip of water or something like that. But I'll continue to listen. Alright. Thank you.
CHRIS FARUGIO: Okay, thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much. I believe that you have answered all the Committee's questions. Thank you for your patience and for your testimony this evening. Appreciate having you.
CHRIS FARUGIO: Thank you. Have a good evening.
SENATOR DAUGHERTY ABRAMS (13TH): You too. Next is 119, Giovanna Mozzo. I'm probably mispronouncing your last name. Giovanna Mozzo.
GIOVANNA MOZZO: Good evening.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, welcome.
GIOVANNA MOZZO: Thank you for having me. And yes, you said my name correct and my last name as well. Some people do mess that up. I don't know how but they do. Good evening, Members of the Public Health Committee. I know it's been a long day. It has been a long day for me as well. So, I'm gonna make this hopefully short and sweet and to the point. My name is Giovanna Mozzo, I'm the Director of the Hub. It's a division of RYASAP, Regional Youth Adult Social Action Partnership here in Bridgeport. We are the designated Regional Behavioral Health Action Organization RBHAJO, as we are called for Southwestern Connecticut and a member of Connecticut Prevention Network, CPM.
CPM is the coalition of the five RBHAJOs who are focused on substance misuse and mental health prevention efforts. I'm here to support today the Bill No 326, AN ACT PROHIBITING THE SALE OF FLAVORED 337 February 8, 2021
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CIGARETTES, TOBACCO PRODUCTS, AND ELECTRONIC NICOTINE, DELIVERY SYSTEMS AND VAPOR PRODUCTS. According to the FDA, menthol cigarettes lead to an increased smoking initiation among youth and young adults, greater addiction and decreased success in quitting smoking. Whether smoking traditional cigarettes to or smoking out of a battery-operated device it is a leading preventable cause of death and disease in the USA. Addiction is serious and can lead to lifelong health burdens and premature mortality. 95% of adult smokers began before reaching the age 21. Menthol cigarettes increase youth initiation and half of youth who have ever tried smoking, initiated with menthol-flavored cigarettes. Between 2010 and 2020, it was estimated that 2.3 million people would start smoking because of menthol cigarettes. In 2018 the US Surgeon General first called youth E-cigarette use as an epidemic. Flavored E-cigarettes continue the tobacco industry's long history of targeting kids with flavored products such as cotton candy, bubblegum, and even mango-flavored. Tobacco companies continue to talk -- target kids with other flavored products, including cigars in hundreds of flavors, including menthol cigarettes. Similar to national and state trends, vaping is increasing dramatically in southwestern Connecticut. In 2017, one of our youth surveys in a local suburb, determined that there was a 25% of freshmen and sophomore -- sophomores and 45% of juniors and seniors reported vaping during the last month.
In 2018, and 2019, youth surveys in the region found that teens perceived vape to be far less harmful than cigarettes. Approximately one in four high school students and Connecticut use E-cigarettes regularly. Research shows that flavors play a key role in youth use of tobacco products, including E- cigarettes. From 2019 to 202 the proportion of current E-cigarette use -- users using flavored E- 338 February 8, 2021
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cigarettes increased by 20%, from 68.8% to 82.9%. Nearly three million youth use flavored E-cigarettes including over one million who use menthol flavored E-cigarettes.
Recent national data suggests that the popularity of vaping is leading to an increase in cigarette smoking, reversing decades long of prevention work. Teens who use vapes are four times more likely to smoke cigarettes. In our role as members of the CPN, we provide indirect services relating to prevention of substance use issues. That includes collaborations with a wide variety of community coalitions and state-wide organizations for educational initiatives, prevention strategies and legislative advocacy. Community coalitions have recently been worth making efforts toward the prevention and cessation of vaping among youth in our region, which is an important focus of our work. I'm available to answer any questions and I am thankful and happy to be here tonight.
And thank you all for all the work that you're doing, especially during this this difficult time with COVID being on our hands.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much. We have a question for you from Senator Hwang. Senator Hwang.
SENATOR HWANG (28TH): Thank you, Madam Chair, Giovanna, how are you?
GIOVANNA MOZZO: I'm doing well. How are you?
SENATOR HWANG (28TH): I am wonderful. I just want to publicly do a shoutout for the effective and invaluable job that you and all of your counterparts. Just unsung heroes in support, and counseling and education in regards to addiction 339 February 8, 2021
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services and the many programs that we've done together on opiate addiction. And the proliferation of that from -- from substance abuse and the devastating impact on individuals' lives and their families' lives is really remarkable. And I thank you for your testimony. But I just wanted to do a big shoutout to you and all of your colleagues that do the remarkable job of supporting those that have been impacted and caught into the web of addiction and wanting to prevent that from happening in the future, but also those that have been caught up in it to get out with support and kindness. I can't say enough about the great work you all do. So, thank you very much. Thank you, Madam Chair.
GIOVANNA MOZZO: Thank you. It takes a village.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator Hwang. REP. McCarty.
REP. McCARTY (38TH): Yes. Thank you very much, Madam Chair. I too, would like to echo the comments of Senator Hwang. But I did have a question, I know the Regional Behavioral Health organizations are doing a great job. But I was surprised in one of the -- I believe it was one of the community surveys that went out that the parents themselves, and we heard testimony today from a number of parents, that they're really unaware in many cases of that -- this vaping in -- with our high school students and even middle school, that it's -- they're not aware that its existing. They say that they're opposed to it, but is there anything more that you think we can do to educate the parents?
GIOVANNA MOZZO: I think that -- So we try our best to reach out to many of the parents in our communities, our local Prevention Councils do a fantastic job. However, we don't reach everyone, right. I think that when we look at prevention 340 February 8, 2021
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dollars, and how we can have dollars go toward prevention and specifically the education piece. I think that's something that we should be working on, is putting those dollars to prevention. To have more people on the grassroots, going out to communities and really focusing their efforts that way. Prevention dollars just need to be increased, to be honest.
REP. McCARTY (38TH): Okay, again, thank you for your good work. Thank you.
GIOVANNA MOZZO: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative. I don't see any other questions or comments. So, thank you so much for being here and for your testimony this evening.
GIOVANNA MOZZO: Thank you so much. Have a good night.
SENATOR DAUGHERTY ABRAMS (13TH): You, too. Next, we have 121, Mary Blankson, followed by 122, Aidee Nieves. So, Mary Blankson, if you're --
MARY BLANKSON: Yes, I'm here.
SENATOR DAUGHERTY ABRAMS (13TH): Great. Thank you. Welcome.
MARY BLANKSON: Perfect. Thank you. Thank you so much, Senator Daugherty Abrams and Representative Steinberg and the Distinguished Members of the Public Health Committee. My name is Mary Blankson. I'm a Family Nurse Practitioner by training and the Chief Nursing Officer of Community Health Center Inc. I have worked at the Health Center for many years and have supported over 100 medical assistants, 50 registered nurses, and 12 licensed 341 February 8, 2021
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practical nurses for years and I have testified on various bills to support medical assistants' Scope of Practice, to include any amount of medication administration. So, I am here today to actually testify in favor of SB 285.
Again, I recognize many of your faces because I have been here every single year for every single bill. This year, though, in the midst of the global COVID- 19 pandemic, allowing medical assistants to administer vaccines takes on unprecedented urgency. With the support of the State, CHC has stood up three mass vaccination sites, including the State's largest at Pratt & Whitney runway in East Hartford, which I'm actually at this location right now. And we're in the process of putting more states -- more sites online. One of the largest constraints to adding more sites is staffing. So, allowing medical assistants to administer vaccines is critical to the State's ability to vaccinate the percentage of population necessary to achieve herd immunity. On December 7th, the Department of Public Health actually implemented new regulations that allowed EMTs, paramedics, dentists, dental hygienists, even veterinarians, and podiatrists to be able to engage in COVID-19 vaccination with some additional training. Many of whom I have trained myself, you know, making sure that they understand the landmarks, the vaccines, where to administer them. And of course, I think one thing that you have heard from many other folks testifying on this Bill, against to this Bill, really, unfortunately shows the lack of understanding of the actual vaccine process.
Again, this Bill does not in any way support medical assistants to assess or to make the decision to vaccinate. That decision is solely belongs to the licensed clinician. Even for dentists, dental hygienists, and all of the other team members that 342 February 8, 2021
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we've been allowed to train. T the decision still lies with that licensure one group, not with the second tier of individuals able to vaccinate.
Also, the surveillance or the monitoring post- vaccine is also not in the scope of practice or on the table for this particular Bill for vaccination. What is on the table is for medical assistants to be able to adhere to a procedure and a protocol to be able to implement this process, which is actually much like many of the procedures that they do every single day, delivering clinical wave tests, doing finger pricks, phlebotomy and other types of things that do involve using sharps on the human body.
I think -- you know, with primary care, although I know that this Bill is not just for COVID-19 vaccines, I want to point out that in primary care, we deliver this care in a team-based setting, which means we all work together. And we all make sure that each one of us practices to the top of our license certification or education. And so, to really exclude medical assistants in the original regulation that came out on December 7th, I actually see is very insulting to this wonderfully trained group of individuals that went to accredited programs that include, you know, specific curriculum focused on medication administration, and specifically on injections. I personally have hired many medical assistants that have come from many other states across the country --
LINDSAY VAN BUREN: Sorry, excuse me, you've hit your three minutes if you could conclude you remarks.
MARY BLANKSON: Okay. Yes, I will. I will just say that part of helping individuals to practice to the top of their license means making sure that every member of the care team has that honor and that 343 February 8, 2021
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privilege to do. We know medical assistants are trained to this if they attend accredited programs and are certified, and so I implore you this year to please bring this Bill to a vote, get it to where it needs to go so that we can access this group of individuals.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you so much, Representative Steinberg.
REP. STEINBERG (136TH): Thank you, Madam Chair. And thank you for your testimony today, I have only one question. Do all the other nurses know that you've gone rogue?
MARY BLANKSON: Yes, I often say that I'm probably one of the most-hated nurses in Connecticut, but also one of the most loved. I've worked seven days a week since this pandemic started pretty much. I myself will go on the frontlines and vaccinate when I'm short vaccinators. You know, I have looked high and low. I've interviewed so many individuals I am bringing on all kinds of team members. If you have granddaughters or nephews or nieces who, you know, want to work on vaccines, please let me know. But again, I have no plans to reduce my nursing workforce. I continue to build it up. But I really want my nurses doing what's even more value-added, which is that care management, right? The pandemic is one thing, but we still have diabetics that haven't come back into our office since COVID. We have hypertensives that still haven't achieved control. We have folks who are being treated for hepatitis C that need additional support to make sure that they maintain medication adherence, our HIV patients, I mean, so much more. You know, our nurses -- there's no risk of nurses losing jobs or losing workforce time. We simply are saying, you know, even if I could just get more help with COVID- 19 vaccines or flu vaccines, it would really free up 344 February 8, 2021
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a significant amount of highly-skilled, highly- expensive also, time of my registered nurses to make a huge impact to our chronically constituents.
REP. STEINBERG (136TH): Well, thank you. Your testimony is very refreshing. Real shot in the arm, so to speak. Thank you very much.
REP. PARKER (101ST): Senator Abrams, it's Representative Parker. I was trying to -- I don't see the Zoom raise hand. Do you mind if I --
SENATOR DAUGHERTY ABRAMS (13TH): Oh, sorry, Representative. Are you going into Participants? If you open that list, and then look at the bottom, you'll see Raised hand. Do you see that?
REP. PARKER (101ST): No, I don't I just see Invite or Mute me, which maybe I should just mute.
SENATOR DAUGHERTY ABRAMS (13TH): No, wait, don't do that. Okay. Well, well, Representative Petit was before you I think and then I'll and -- then I'll call on you. Thank you, Rep. Petit.
REP. PETIT (22ND): Thank you, Madam Chair. And thank you, Ms. Blankson, for your excellent testimony. I agree with Co-Chair Steinberg, you have brought the argument back to reality, people kept on bringing up spurious arguments that MAs weren't going to be able to assess who needed a vaccine, to assess them afterwards. And the issue is to allow them to administer the vaccine not to make the decision about who needs one, and what kind of therapy they need after. So, thank you for bringing us back to reality in terms of what's the intention of the Bill is. And thank you for all your service over these last 11 months. And hopefully, you will submit testimony because when we just looked online, we didn't see it. Thank you, Madam Chair. 345 February 8, 2021
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SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative Petit. Representative Parker.
REP. PARKER (101ST): Thank you, Senator Daugherty, Abrams. I just wanted to thank Ms. Blankson for sharing. She's a constituent here in 101st. I admire your work and thank you for bringing this point of view. And just to be clear, there are no suggestions that you would make to the language of the Bill as it stands to improve along the lines of what we've heard before, you think that what is presented is a strong option?
MARY BLANKSON: Absolutely, absolutely. I do think you know, for any organization that does allow medical assistants to then administer medications, I do think -- you know, we have to make a decision about our own employees and sort of when -- like, for example, if they graduated 10 years ago, I certainly -- of course, I'm going to train in competency, even if they graduated six months ago, I'm going to train in competency, you know, have the protocols in place. But I think the Bill as it stands is a strong Bill, and I know that medical assistants will be able to do this.
When you look at some of the other testimony again, opposed. Most of the articles that are presented are really around acute care. It's around IV medications or other types of things, which is not what this Bill is asking for. So again, you know, should the language be modified later on for only flu and COVID or only other things, I will take what I can get. But I really -- I would love this Committee to even just invite me to be a part of even piloting this. You know, if that were something that the State would be interested in to show you what a robust program of training and supporting of medical assistants doing this can really do in terms of 346 February 8, 2021
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tracking outcomes or other information. So -- and I certainly invite you all to come and visit Pratt & Whitney and see mass vax in action. It's pretty, pretty incredible.
REP. PARKER (101ST): Thanks, madam. Thanks, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you Representative. Is there anyone else who has a question, Representative?
RE. STEINBERG (136TH): Madam Chair, Representative Klarides-Ditria has not had a chance.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Representative Klarides-Ditria.
REP. KLARIDES-DITRIA (105TH): Thank you, Madam Chair, my hand -- raise hand feature is not working either.
SENATOR DAUGHERTY ABRAMS (13TH): Really? Well, thank you for texting and letting us know because we'd like to hear from you.
REP. KLARIDES-DITRIA (105TH): Otherwise, I'd be waving my hands. Mary, thank you for your testimony. I echo what a bunch of the other legislators said, you finally put it into perspective. Hopefully, other people been listening and are taking everything that you're saying to heart because I think it's an important thing to get our, our medical professionals on the same page and not have it be a turf war and just do what we need to do to get people the help that they need. And that's it. Excuse me, at the end of the day. So, thank you very much for your testimony. Thank you, Madam Chair.
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SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Rep., sorry that you had a problem. So just text us so we know because we can't see everybody all the time. So, I think that's it. If anybody else is having a problem, please text one of us and let us know so we can get you on, but I think that that might be the end. So, thank you very much for your testimony, really appreciate it.
MARY BLANKSON: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Have a good evening. Next is Aidee Nieves, followed by Thomas Bryan.
AIDEE NIEVES: Thank you. Greetings, Co- Chairs, Senator Mary Daugherty Abrams, Co- Chair, Jonathan Steinberg, Vice-Chair Saud Anwar, Vice- Chair Julie Kushner, Vice-Chair Julian Gilchrest, Senator Moore and Esteemed Members of the Connecticut General Assembly Public Health Committee. I am grateful to you for your public service on this Committee and to your constituents and our State, especially during COVID-19. I urge you to pass SB 326 to ban the sale of all flavored tobacco products state-wide.
As a mother and a new grandmother in Bridgeport where I serve as President of the city council. I believe that we must do everything we can to protect our kids' health. And that means all of our kids' health. Public Health is the people's health, it is the community's health. We must take real steps to reduce health disparities in a state where the census track you can grow -- with census track you grow up in can mean the difference of 19 years in your life expectancy. The pandemic has only magnified such a shocking reality and inequity.
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That is why I'm helping to lead the passage of a similar policy in Bridgeport to ban the sale of all flavored tobacco products here. We can't wait any longer, especially at the time -- especially at a time when COVID-19 continues to disproportionately devastate the lungs and the lives of my community. Getting these products out of our community will make a meaningful difference in reducing health disparities and making our communities health -- healthier and more productive for generations to come.
The tobacco industry's products are the leading cause of preventable death in our country to please its shareholders, Big Tobacco must find and hook replacement smokers. Flavored tobacco and E- cigarettes exist to do just that. When we talk about flavored tobacco products, let's not forget about the granddaddy of them all menthol cigarettes. For decades, Big Tobacco has targeted menthol cigarettes at predominantly black neighborhoods. So that now 85% of African- Americans who smoke cigarettes are smoking menthols.
At the same time, African-Americans are dying from heart disease, lung cancer, stroke, and other tobacco-related diseases at the rate far higher than non-African-Americans. Roughly 45,000 Black men and women are dying at the hands of Big Tobacco every single year. I hear from parents, educators and coaches despite Tobacco 21, the kids still have easy access to flavored tobacco products. When you have a product like flavored tobacco, whose whole purpose is to hook kids, you can't expect the limitation on accidents -- access to prevent them from getting their intended consumer. You have to eliminate their availability. That's what we're trying to do here in Bridgeport. And what I'm hoping you would do state- wide by-passing SB 326 to protect all kids in our state from these tempting and addictive products. 349 February 8, 2021
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We are going to do our part in Bridgeport, but I encourage you to take this effort and make it stronger. I don't want kids from my city to be able to get these products from friends or families or retailers in other cities 10 miles down the road. The sale of flavored tobacco or flavored E-cigarette products should be prohibited everywhere in our State, as they are in Massachusetts, California and more than 100 municipalities across the country -- across the nation. Doing so will have a powerful and massive impact.
LINDSAY VAN BUREN: Excuse me, you've hit your three-minute mark, if you could conclude your remarks.
AIDEE NIEVES: Okay, [audible gap 10:12:24 - 10:12:34] tobacco-related disparities. Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Councilor Nieves, thank you so much for your service and for your dedication to the young people of your city. I really appreciate that. Senator Moore. Senator, go ahead, Senator Moore.
SENATOR MOORE (22ND): Good evening, Aidee.
AIDEE NIEVES: Good evening, Senator, I didn't see you on there. I saw you earlier. I'm like she left. I didn't scroll --
SENATOR MOORE (22ND): Been hiding.
AIDEE NIEVES: Nice to see you again.
SENATOR MOORE (22ND): Thank you for your testimony. Now, Aidee, you know, earlier today, several people of color have come on, and spoken about how this is gonna harm Black and Brown children. That, you know, 350 February 8, 2021
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I think they're talking about the police accountability and police abuse, which I think is a whole separate issue. Can you speak to what this means really to our children who often suffer the highest disparity in health, and especially now and especially during COVID, when you see many of their parents, who are smokers, now having lung problems as a result of being diagnosed with COVID-19. Can you talk a little bit about what this means to our children?
AIDEE NIEVES: Well, in a city like Bridgeport we already have a high rate of youth with asthma, who already have predisposition, breathing problems and family members who have predisposition, even as adults. And part of that also goes to obesity. I mean, when we're talking about these flavored cigarettes, you can go to the corner store and pick it up. And it's something that they see in front of their parents. So, they realize that it's okay to smoke, right? It's a norm. And we want to start to begin to talk about healthy lifestyles, and the fact that health inequities, and we're seeing that health inequity in the combination of smoking, asthma, and the density within the community in which you live, have all an impact. And to begin to ban this for the children, we'll have healthier children who can run outside and play. We'll have healthier families who will be able to last another 10 -- extra 10 years because you can be from Bridgeport, but you can go down the road, at least 9, 10 -- 10 or 15 miles and that changes, longevity, and we're talking about mortality rates.
And the care, the care factor, that goes on after someone who has smoked -- who started smoking at the age of 15. At the time, they're 40. They look like they're 70 sometimes, and I've seen that in family members, and in parents at my school, I worked in the educational facility for a long time as a school 351 February 8, 2021
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secretary. So, I saw the impact of what it was like when a parent still smoked. And the child had asthma, and the -- them having a parent quit and they struggle with that and the impact of what that means for care, asthma, after-care for both family members when it becomes an issue. And it's really hard when you are -- my grandmother died of lung cancer about 15 years ago, and she was a smoker for a very long time. She was smoking from when she was a young girl. This is my father's mom. I didn't know that's what she had, that she was a smoker for so long, but it was already too late because she smoked all the way up until her 60s.
So, the impact of cigarettes is very near and dear, even more so because I'm a grandmother but because I work with youth, and I volunteer a lot. And we need to start changing our lifestyles, especially in urban centers where health and inequality is very -- is very rampant inaccessibility, especially now with COVID-19 in the long-term long impact that COVID-19 is gonna have on our children and their families.
RE. MOORE (22ND): So, thank you, you know, I smoked from the time I was 16 to 40. I know everybody thinks I'm 41 but the long-term effects of that. I always worry about what's gonna happen later because it doesn't have to be current. It could be 20 years later. But I smoked Kools and Salems Virginia Slims because I couldn't handle Pall Mall or Camel, they were just too strong. So, it was more attractive to have that Virginia Slim that long, pretty cigarette as you're smoking, right? Now understanding how bad it was for you. But also, I don't think at that point that the addictive drugs were in it. But when I think about people, what they've named, some of these additives, why would you not attract children? And it's done intensely to attract children. So, I think what is your ordinance gonna do in Bridgeport?
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AIDEE NIEVES: So, what the ordinance is gonna do -- and that was one of the concerns it's not about criminalizing, it is just like Tobacco 21. At the same time that they're doing the checking for tobacco. It's to make sure that there aren't any products there. Give them -- as they've done in Massachusetts, they gave about a six-month period for businesses to remove the product from the shelving to get it out. And we don't want to criminalize this to say like this is going to be enforceable by the police department, it's more of a health and social services enforcement through the DPA of our local municipality, just as they're doing in Tobacco 21. And then impose the same type of fines that that Tobacco 21 has.
REP. MOORE (22ND): And those fines would be to the seller, not to the child?
AIDEE NIEVES: They're not to the child.
REP. MOORE (22ND): Well, thank you.
AIDEE NIEVES: Thank you.
REP. MOORE (22ND): Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Senator Moore. Councilor Nieves, I don't see any other hands raised. So, I thank you so much for your time. And this Bill would be just what you're describing which the onus will be on the seller, and that it would not be a penalty for use or possession or selling of it. So, I wish you luck in your endeavors. And thank you so much for taking your time to be with us this evening.
AIDEE NIEVES: Thank you very much for having me, have a great evening.
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SENATOR DAUGHERTY ABRAMS (13TH): You, too. Next, we have Thomas Briant. Mr. Briant, are you there?
THOMAS BRIANT: Yes, I'm here, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Welcome, go right ahead.
THOMAS BRIANT: Co-Chair Abrams and Steinberg and Committee Members, thank you for allowing me to speak this evening. I'm speaking on Senate Bill 326. My name is Thomas Briant, and I am the Executive Director of the National Association of Tobacco Outlets, which has retail store members in Connecticut.
Connecticut has a regulatory structure for tobacco products to ensure that taxes are collected and are only sold to legal-age adults. This Bill would move those products from a regulated environment and into an existing illicit market that would grow exponentially. Why? Because adult prohibition failed in this country before. Adults will simply turn to an unregulated, illicit seller or buy products online or in a neighboring state. The end-result is that the health-related purposes of the Bill will be undermined because adults will continue to use these products.
According to the 2020 National Youth Tobacco Survey, current tobacco use by high school students is at historic lows and declining. Cigarette use is at 4.6%, smokeless tobacco at 3.1%. Pipe tobacco at point 7% and electronic cigarettes at 19.6%. Any debate about banning all flavored tobacco products needs to differentiate between the appeal of flavored electronic cigarettes versus traditional tobacco products. The data on youth tobacco use does not support the wholesale banning of all traditional tobacco products. This is not to suggest that 354 February 8, 2021
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electronic cigarettes should be banned, but only to emphasize the problem with treating all tobacco nicotine products the same.
If Senate Bill 326 was introduced because young people use electronic products, the FDA and Congress have taken significant actions to remove many flavored electronic products from the market and to curb youth accessibility. Last year, the FDA adopted a ban on flavored cartridge-based and pod-based electronic cigarettes, except tobacco menthol flavors, which are preferred by adults. Then, the FDA required manufacturers of all tobacco products that were introduced after February of 2007 to submit marketing applications to the agency by September of 2020. The health aspects of these applications are critical, because the FDA must determine for each application and each product that the product is quote "appropriate for the protection of the public health", closed quote, in order to authorize the manufacturer, continue -- to continue to marketing the product. If it's not approved, it has to come off the market.
Also, in December, a federal law was expanded to include electronic nicotine products and now requires online sellers to verify a buyer’s age, obtain a signature of an adult upon delivery to a home and click -- collect state taxes. As a further detriment to the public health, this Bill would remove two products from the market that have received a special FDA modified-risk tobacco product determination, which means they have a lower risk to the user. Since they're flavored, those products would also be removed. An option for the Committee to consider is a study to research the youth appeal issue, understand FDA and federal actions to curb electronic cigarette use and reconciled statewide regulatory policies.
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Thank you for your time. And I urge you to read my letter which has more detail. Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you, Mr. Briant for your testimony. Are there any questions or comments from the Members of the Committee? In a moment. Seeing none, I'm gonna thank you for your testimony. Thank you for being with us this evening.
THOMAS BRIANT: Thank you, Madam Chair.
SENATOR DAUGHERTY ABRAMS (13TH): Next, we have Rahn Bailey. Mr. Bailey.
RAHN BAILEY: Yes.
SENATOR DAUGHERTY ABRAMS (13TH): Welcome. Thank you for being here. Go right ahead.
RAHN BAILEY: Well, thanks for having me. My name is Rahn Kennedy Bailey. I'm an adult child and adolescent actually, psychiatrist doing clinical work and forensic work and research work here in Los Angeles now. I'm gonna react to speak today, my role of past President of the National [inaudible 10:22:53] Association, one of the largest groups of African-American physicians really focused on healthcare disparities in the Black community for African-American physicians and their patients. I've been serving since about eight years ago, and then I moved on to the Board of Trustees of our [inaudible 10:23:08] which is a Research Institute, where we do work looking at how to lessen racial ethnic health disparities. I've been paid for my time today.
I'm a forensic psychiatrist. I've been asked to share some of my thoughts about the company, RJ Reynolds. Really, the issues I think being raised are pretty straightforward, and others have kind of 356 February 8, 2021
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talked about it so I will keep my comments pretty brief today, really addressing the proposed ban on cigarettes probably all forms, and how in the past that has been shown have a disproportionately adverse impact on African- Americans, some comments you heard today. But as a doctor, I share that I spent 30 years of my career, in Texas in 1990, working with patients with all forms of behavioral challenges, trying approaches with addiction, stop drinking alcohol, and also smoking cigarettes, and other high-risk behaviors. And the reality is laws such as these, often in my experience, I've seen the unintended consequence of actually causing further danger and injury, although we actually started off with pretty good intentions.
I comment that --particularly is a case, I think, in the Black community, where very often the motivation of these ordinances are strong and are good, effective and part because they've been such adverse negative impact very often on a health perspective in these communities, but the struggle that we've regularly seen, and we've seen in other jurisdictions as well, is that very often how they're implemented by the reality of how very often law enforcement arrives at Black community, at least to young Black and Brown men, fortunately, I think, impacted by being in our jails and prisons.
So really, the issue, I think, is that the grave danger that lies in enforcement. How can we actually address that? So, I'm really here to speak for education. I think we've had education in the past, we've actually made the point to individuals that they shouldn't smoke because of the healthcare consequences that can actually impact youth. In my experience, there has been much more effective strategy, a pro-education model, many States were funded, I just heard the back of money earlier to do --I think we should relook at that. That's probably 357 February 8, 2021
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a better direction going. Because I think the other process, the legal process, just creates a framework, I think we're often at the lower level, they're often harassing individuals at the street level.
I'm aware that the ban is directed at retailers. But the fear I think, for doctors like myself in forensic medicine, you go to jail because of seeing individuals' struggles is, how enforcement very often is imposed differently by, I think, local law forces settings. They use it as a pretext just to harass and confront. I think one of your speakers today commented about how the things actually start off in one way, like the Eric Garner case, and then he ended up with some other kind of difficulty, We got somebody who spoke on law enforcement background, who spoke in regards -- only by simply saying that it's not remote, whether it's Eric Garner, or the case in California, the young man was kind of a beating by the policeman of a 14-year-old. These issues are real. I think we have to address issues regarding tobacco use and other forms of behavioral difficulty that affects communities. But I think that criminalizing it in this setting, even though unintentional, has the adverse impact. I think that hurts when you wanna help it. It should be focused on education. I think we can work together and do that in a fairly effective way going forward. Thank you very much.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much for your testimony. Greatly appreciate it. Are there any questions or comments from the Members of the Committee? Okay, seeing none, I'm going to thank you for being here this evening. And I appreciate your input. Have a good evening.
RAHN BAILEY: Thank you.
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SENATOR DAUGHERTY ABRAMS (13TH): Next, we have Syed Sami, 125. No. 125. Welcome.
SYED SAMI: Can you see me?
SENATOR DAUGHERTY ABRAMS (13TH): We can -- I cannot. Now I can. There you go.
SYED SAMI: Good evening, everyone. I'm speaking in opposition to SB 326. My name is Syed Sami. I'm the proud owner and operator of approximately 25 gasoline sub-stations throughout the State of Connecticut. More importantly, I'm a part of each and every single one of these communities where these businesses are located, as well are my employees.
With that said, my businesses not ones which were built overnight, and they are not businesses, which I hold to low standards and low accountability when it comes to the sale of age-restricted products. I would like to offer my experience as a reasonable, compliant community retailer of both non-flavored and flavored tobacco products. When retailers received a license to sell tobacco, we willingly agreed to state and federal standards and laws and to the penalties for non- compliance, including fines and penalties up to and including loss of licenses. The worst penalty and the greatest deterrent is damage to our reputation in our community. All of my stores have systems in place where any age-restricted product are scanned into a point-of-sale terminal, the transaction cannot proceed. And without the individual data of birth and the age being verified and ID scan in order to proceed and any new hires, as well as current employees extensive -- extensively trained, refreshed and reminded of this policy throughout each transaction of age-restricted product.
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I believe the ban of this product is derived from good intention, and I have no doubt about that. Unfortunately, the demand for this product will go - - go away -- will not go away and those who are seeking such products will find other ways to purchase them, whether it be online, where there is no way of checking the age of the individual, making the purchase -- product being purchased outside the State of Connecticut or something far worse, the black-market demand this will create, the demand for this product will not simply disappear. They will be they will be fulfilled by non-compliant unregulated sales and distribution. This would pose a greater risk to the health and safety of not only the consumer of those products, it will provide medical and health professionals and with less information on what chemicals and additives are being consumed by users. More strain on law enforcement, tasked to survey, enforce and prevent the sale of such black- market products which at the time do exist. And with the legal ban, we are equipping these illegal and unregulated products to expand the range of consumer without being able to pinpoint who is responsible for supplying in getting them into the hands of the community members.
I conclude with, if this Bill passes I and my business will survive. But it will force me to let go of many employees due to the loss of sales of not menthol and flavored cigarettes and vapes. But the adult customer who purchased other products at my store, in addition, such as groceries and other necessities. You have any questions, more than happy to answer.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much for your testimony. Mr. Sami. Are there any questions or comments from the members of the committee? Seeing none, I'm going to thank you for your time this evening. 360 February 8, 2021
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SYED SAMI: Thank you.
SENATOR DAUGHERTY ABRAMS (13TH): Thank you very much for being here. Next, we have Steven Cousin, 126, followed by 127 Matt Bailey. Mr. Cousin, are you here? Mr. Cousin here? Okay, I don't think so. Let's move on is 127, Matt Bailey here. Bailey. No.
MATT BAILEY: Hi there.
SENATOR DAUGHERTY ABRAMS (13TH): Hi, and you are Mr. Bailey. Welcome.
MATT BAILEY: I am. Thank you. I had to pull over I was driving so I am glad that it worked out. I'm glad to be able to speak with everyone today. And I've been working throughout the day. So, I haven't been able to watch all the testimonies, but I did get some feedback from some folks. I just wanna address real quick. Some people have -- it seems made some assertions that those of us who are in favor of food and beverages, being able to be served to the families that we serve, are part of a rogue group that are trying to undermine our State Association and that nothing could be further from the truth from that. I mean, if CFDA wasn't neutral on this matter, our friend Mike Duggan would be walk in the halls making sure all of you knew about it and they have voted to be neutral.
I served on the Executive Board of the CFDA when this first conversation began some time ago. And I'm proud of my role within funeral service here in the State of Connecticut as a family-owned funeral home. As a fourth-generation Funeral Director and part of one of our longest serving funeral home families in the State. And I'm proud of the work that we do. I'm proud that NFDA asked me to serve as one of the mentors last year for the mentors' program for 50 361 February 8, 2021
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newly-licensed and young Funeral Directors. I'm proud of the work and the trainings that I have done for all big three associations in our trade profession. I'm proud of all of these things, and I take some umbrage at the allegations that we are trying to undermine or do anything different. And I have to say a couple of words as well about some of my colleagues who work for companies that are run by publicly-traded companies.
I'm a small family-owned funeral home. But I do not think that my colleagues who work for a larger company care less about the people in their community that turn to them. People they go to Rotary with, people they go to church with, people they coach literally with their consummate professionals. And I don't think we should undermine them because of who it is that employs them. I don't think that's fair.
I understand that some of my colleagues do not want food and beverages in funeral homes. And I respect that, and I have empathy that they feel differently. The difference is that I am not trying to have the State of Connecticut implement through statutes, policies that force them to embrace the opposite approach. They are trying to get the State of Connecticut, to force through statutes, those of us who are in favor cannot be able to do so. I think it is far past time that Connecticut joins the 49 other states that prove every day that this is something that is effective, that is popular, that people want. We see it but the arguments that I've heard against food and beverages in funeral homes are being demonstrably proven wrong, every single day, in 49 states, where it is successful, where it is embraced, where it is safe, and what people are doing.
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The reality of the situation is we've had food and funerals every day in Connecticut for years, they're happening in churches. But as our society is changing, and culture is changing, the second largest faith community we see in the nation is what they call the religious nuns, people aren't able to have those opportunities and those options necessarily any longer. They're not part of one of those communities.
I was so appreciative last year, when this Committee listened attentively to the arguments that were made on both sides. I think the Chairman made an excellent point and observation last year when he observed that some of the language against it seems just to come from an anti-competitive nature of people who are trying to hold back their colleagues from doing things that they don't wanna do. And I hope that the unanimous support that it received last year is something that we'll see again this year as well. And I know it's a long day for all of you. So, I'll try to be brief with that.
SENATOR DAUGHERTY ABRAM (13TH): Thank you so much. Thank you for your testimony and I appreciate your comments. I have such respect for the entire industry and all you've been doing, particularly during COVID. And I understand that there might be some disagreement around this issue but it does not take away from the good work that you all do. So, thank you for making that comment. Are there any questions or comments for Mr. Bailey? Seeing none, thank you so much for your time.
MATT BAILEY: I'll get back on the road. Thank you.
SENATOR DAUGHERTY ABRAM (13TH): Next, we have number 131, Bakul Shah. Bakul Shah, I see you in the list. You're -- you're on mute. If you don't know 363 February 8, 2021
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that. You have to take yourself off mute I believe. Thank you.
BAKUL SHAH: Okay.
SENATOR DAUGHERTY ABRAM (13TH): Now we can hear you, welcome. Thank you.
BAKUL SHAH: Thank you for giving me an opportunity to talk tonight. First of all, actually, I own and operate a convenience store in Connecticut for over 20 years and I sell tobacco products for a long time. Let me just tell you one thing that even though I've been selling tobacco for 20 years, I'm not a smoker. I sell a lot of liquor, I don't drink. So, my point is that, you know, is the education, it's the values that lives a permanent impression for prevention. We sell basically legal tobacco products to the people of 21 years or older. The tobaccos are being stored in the back of the store where nobody have an access to it. We check an ID to everybody who comes in to buy the tobacco and we only sell it to the person who are 21 years or older. On and off, the FDA comes out and do an inspection. And these are a few of the reports that I'm showing you that inspection reports that we passed inspection successfully. So -- now there are several of them. So, we are doing a very important job here to prevent the tobacco being handed out to the young -- young kids.
So, what I have seen that Massachusetts recently passed is no flavor ban. And the effect of that is very devastating not only for the State for -- but also for the businesses that have been selling tobacco. So, since Massachusetts banned this flavored tobacco, which includes the menthol, their sales dropped 24%. New Hampshire, the neighboring state, their sales went up 65%; this data is based on the stamp that each State sends to their 364 February 8, 2021
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retailers, the quotas went up 17%. And the menthol sales alone in New Hampshire went to 91%. Rhode Island's menthol sales went up 40%.
So, what is -- also and I have read quite a few reports recently and found out that there is absolutely no effect on the smoker, people smoking the way they have been smoking. So, banning something is -- doesn't really help the health, you know, crisis that we are facing. It is more that they have to put in more efforts into educating kids, educating people. So, we provide an important shield, that once the tobacco gets into the wrong hands, and just removing the shield will have a devastating effect on the people's health because now nobody's there to check an ID, nobody is going to do follow-up and know who's selling what. You know, and definitely this menthol and other flavors being a very hot commodity, will push everything into a black market, where the product may come from anywhere around the world, people can have an access to internet, and I've seen a lot of people buying from across the border, and there is no way to prevent that from happening.
So, if somebody wants a tobacco product, they will get it eventually anyway. So -- and I mean, I see every day that in my store, you know, people talk to one another saying that, "Hey, you know, I'm going to New Hampshire. Do you want any carton of cigarettes? Do you want anything?" They talk to one another, and we see that every day. So, my point is that, you know, if you really -- this ban is not going to have the effect that that everybody sees and we are in -- we see customers on every day -- every day basis. So -- and we talk to them. And so, we provide a very valuable feedback that, you know, just -- For example, that if somebody is hurt, you know, you don't really cut their hand, you know, you just provide a treatment to that -- you know, for 365 February 8, 2021
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the problem that they have. So, in -- for me, I mean, I would say that, from my experience, that you know, this ban will not have an effect on the health in concern that a lot of people have.
KASS FRUIN: Excuse me, sorry. I just wanted to let you know that you've passed your three minutes. If you could just provide a closing statement. Thanks.
BAKUL SHAH: Yeah, so from my long-time experience, I would say that now it's gonna have an adverse effect on the small businesses, you know, that is going to get economy affected, but at the same time, the ban wouldn't have any positive results that the lawmakers want to see. Thank you. Thanks for your time.
REP. STEINBERG (136TH): Thank you, Mr. Shah. Any comments or questions? If not, thank you again, for your testimony and for hanging with us all evening. Really, really do appreciate it.
BAKUL SHAH: Thank you, sir. Thank you.
REP. STEINBERG (136TH): I understand that somehow, we missed Ingrid Gillespie. Ingrid, followed by Dorian Fuhrman.
INGRID GILLESPIE: Hi, Representative Steinberg and other Members of the Public Health Committee. Thanks for coming back, I appreciate it. I'm going to keep it very brief, end of a long day for everybody. I'm here representing Connecticut Prevention Network. And I'm Director of Prevention for Liberation programs, and speaking in support of Bill 326.
Basically, I've been listening for the last few hours to the testimony and I certainly want to reinforce about the fact that the flavors do, establish and entice use. They simply are a 366 February 8, 2021
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marketing tool designed to increase sales and use. And they're definitely working, as many people have said, 81% of youth who start vaping start with -- because of a flavor.
I've also had the opportunity this year, to go into the schools a lot and do vaping presentations and teaching with the kids. And I can tell you unequivocally to the quite a few hundred that I've taught now, that whenever we ask about why kids start, they will consistently say, "It's the flavors."
Throughout the testimony that I've heard today from many people, retailers, physicians, et cetera. It's -- there's a distinction between youth initiation use, which is what we're talking about with these flavors. And in terms of, you know, what's going on with that, versus youth smoking cessation, which I totally understand. And I've taught that a lot also. So, I get the distinct difference. But what we're talking about is how flavors are impacting a new generation of smokers, which tobacco companies, they do need a new customer base. If this was flavors was strictly about smoking cessation, which is a declining base, you know, we would be having a different conversation. So, I can also empathize with the retailers. And I think this Committee and other Committees as we move forward in this new era, we need to look at a new way of doing business. And we have some ideas, certainly around that to be able to address that.
But I think basically, what we're talking about is stopping youth initiation. That is the biggest target population for flavors by far. Certainly, menthol cigarettes, as many have talked about targeting adolescence and racial minorities, of which many tonight have identified other issues related to that. But I just wanted to certainly 367 February 8, 2021
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reinforce what the data says what we're talking about, youth initiation, stopping a new population of smokers. And to Representative Steinberg's earlier comment, yes, we do need more education. And yes, we do need to advocate for tobacco health trust fund dollars to be going towards that.
So, thank you very much for the opportunity just to be able to share those points. I've put a lot in our testimony. Oh, I did read, by the way, I pulled up that study from Yale while I was waiting, and there are some clear limitations to the study by Friedman. So, I highly recommend reading that study. Thank you very much.
REP. STEINBERG (136TH): Thank you, I want to congratulate you for coming back. And I think being near the end gives you a chance to summarize. Your last comment though with regard to Dr. Friedman's work, you said there were some issues with it, could you just give us context?
INGRID GILLESPIE: So, I just pulled up the report. And on the, you know, the study talks about limitations, it just says one of the sentence statements is that "The analysis does not establish a causal relationship between flavored E-cigarette use and smoking initiation or cessation", which was the point brought up earlier on, they have enough other limitations. With any study, I try to get a copy of the survey questions to see, couldn't get that with this one. So that might be a point, too, so people can look at that particular piece. But there are -- not to say that he didn't have concerns, but that study he kept referencing does have some limitations.
REP. STEINBERG (136TH): Well, thank you for pointing that out. Perhaps we can reach out to her 368 February 8, 2021
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and see if she can share with us the background material.
INGRID GILLESPIE: Right, yeah.
REP. STEINBERG (136TH): Thank you. Any other questions or comments? If not, thank you, once again, for resurrecting yourself in this context.
INGRID GILLESPIE: Yeah, thank you very much for letting me speak. Thank you.
REP. STEINBERG (136TH): Certainly. Next up is number 133, Dorian Fuhrman, followed by Mary Consoli.
DORIAN FUHRMAN: Hi, thank you so much for having me here this evening. I'm speaking in favor of SB 326. Because flavors hook kids. In 2018, I co-founded Parents Against Vaping E-cigarettes with two other moms. But what began as three moms sitting around the kitchen table has turned into a national grassroots movement of parents who won't stand by and let Big Tobacco target our kids. You've heard many Connecticut PAVe volunteers testify today and share their deeply personal stories of youth nicotine addiction. We are all volunteers we are not paid to be here. I would like to respectfully point out that the doctor who just spoke is paid by RJ Reynolds to oppose a ban that would save people, a page straight out of the Big Tobacco playbook. There has been a lot of information shared today and I will veer from the written testimony I submitted to address some of these issues.
Many of the store owners who are speaking out against banning flavors have seen their revenue and staffing increase one tenfold as a result of flavor bans in all of Connecticut's neighboring states, New 369 February 8, 2021
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York, New Jersey, Connecticut, Rhode Island. All these states have banned flavored E-cigarette products and Massachusetts has also banned all flavored tobacco products, including menthol cigarettes. Kids and adults are crossing state lines to purchase these products resulting in a boon for Connecticut store owners who are putting profits over the health of our kids.
There was mention of online sales. Why ban flavors when kids can just buy them online? Actually, Congress just passed a bill that would prevent the United States Postal Service from shipping any kind of vaping product. And UPS and FedEx have also committed to not shipping vaping products. Education has been mentioned and this must start at a very, very young age. You heard a PAVe volunteer talk about her son who started vaping at the age of 10. While not common, we have heard of young kids vaping more often than we would like, but there must be parent education as well and we do that, PAVe does that. Many vaping companies like Juul & Views, both of whom are owned by Big Tobacco Altria, which invested in Juuls, Philip Morris and Views, RJ Reynolds, targeted kids on social media and still sponsor concerts and racecars. The products are small and easy to hide and parents are often unaware. The youth vaping epidemic took many parents by surprise. But education cannot take the place of a full flavor ban it must work side-by-side.
Menthol alone is used by over 3,018 E-cigarette users. That number however, is likely much-much higher. The current teen favorite is mentholated iced flavors such as blueberry ice and lush ice. Kids who vape are four to seven times more likely to begin smoking traditional cigarettes. Since the teen E-cigarette favorite is menthol, it is logical to assume these kids will migrate to the only flavored cigarette left on the market, menthol. Tobacco 370 February 8, 2021
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companies have used menthol cigarettes to target African-Americans for decades. Menthol cigarettes are highly addictive and more dangerous than regular cigarettes. One in four high school students here in Connecticut are using E-cigarettes and the frequency of use has steadily increased. Among current e- cigarette users -- youth E-cigarette users rather, there has been a 1,000% increase in the use of flavored disposable vapes.
We will simply be playing an endless game of whack- a-mole in the absence of federal -- cohesive federal guidelines and until Connecticut like its neighboring states, bans all flavored E-cigarettes and other flavored tobacco products. And that must include menthol cigarettes. Thank you.
REP. STEINBERG (136TH): Thank you for that testimony. Just to be clear, you stated that menthol cigarettes are considered more addictive than non- menthol. Is that because of the flavor?
DARIAN FUHRMAN: Yes, it's absolutely, because of the flavor and the mentholated and we've noticed that among E-cigarette users more and more are using menthol because, you know, the flavors themselves are the most highly addictive part of the of the E- cigarette and it -- you know, it prove -- I'm sorry, it prevents teens from perceiving harm and they start using because of the flavors and then they become addicted because of the nicotine. So yes, and you know, the government banned all flavored cigarettes in 2009 except for menthol cigarettes. So those are the only flavored cigarettes left on the market.
REP. STEINBERG (136TH): Thank you for your testimony. I too hope the federal government will do the right thing. But I for one have gotten tired waiting for it. 371 February 8, 2021
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DARIAN FUHRMAN: But we can't wait, exactly.
REP. STEINBERG (136TH): Any other questions or comments? If not, thank you for your testimony today. Next up is Mary Consoli, followed by Anne Hulick. You're ready to go, Ms. Consoli, go ahead.
MARY CONSOLI: Hello, good evening. Senator Daugherty Abrams and you Representative Steinberg and the Members of the Public Health Committee. I too will be -- cut my testimony down because it is late. I'm Mary Consoli, I'm a Registered Nurse with 50 years of experience. I'm retired but hold an active license. And I'm volunteering to give vaccinations. I'm here to testify against Senate Bill 285. I feel this was granting the unlicensed person the ability to practice nursing without a license. I'm definitely opposed to this. I've listened to a lot of the testimony. You can -- mine is submitted and you can refer to that. I wanted to address the educational for medical assistants. There's not consistent training, there's no uniform certification, and the certification is not by the State. It's the AAMA certifies them. But that's not the State. That's like the schools of nursing, certifying and licensing the RN. It should be done by the State. They -- some of the MA programs is a two-year MA program. And then there's a 10-week MA program. And it's just inconsistent.
I also wanted to address the concern about no volunteers. There's 11,000 volunteers that have signed up, and I am Chair of my Parish Nurse program. It's now called Faith Community Nursing. And we had a meeting and two of the nurses that attended, volunteered for their towns, and they were told they were not needed. I have another friend that signed up for the paid program with the State 372 February 8, 2021
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and she has not heard back. So, I don't know where this person is not getting their volunteers from. The long lines when you go to the facilities, there's certain COVID setups that they have to follow. So maybe that's part of the reason why these long lines, plus a lot of people want the vaccinations, not so much the number of stations that set -- are set up. That's all done based on COVID standards.
In my testimony, I said there's two people that spoke, one from the Hartford Hospital healthcare system, and one from Yale. And their problem was the vaccine is not available. The gentleman, the doctor that's head of their program from Yale, New Haven said they could vaccinate 20,000 a day if they had the vaccine. So, I don't know where that is.
One of my big issues with this Bill is everybody -- people that have testified said "under the direct supervision". This Bill doesn't say that. It says "under supervision or control and responsibility", it doesn't say direct. And the other thing is "Other settings". What are the other settings, you know, that they refer to? This is what my concern is. You know, where -- where are they going to be giving, practicing. There's no doctor's office here. And that's what I'm very concerned with in this Bill. It says, "A Medical Assistant may administer a vaccine under the supervision, control and responsibility of a physician." What does that mean?
KASS FRUIN: Sorry, I want to make you aware that you've reached your three minutes. If you can go ahead and give a closing statement. Thank you so much.
MARY CONSOLI: Okay, alright then. I just wanted to -- and this is my last comment that they said the 373 February 8, 2021
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other 48 other States have this. And I said, well, as we can tell by the previous testimony of the subjects, there are many laws that other states have that are not in Connecticut. I can think of --like in capital punishment; you talk about recreational marijuana. But I just think that there's many issues, and I think that needs to be addressed. And having MAs, give injections is not the way we want to practice nursing in Connecticut. I'm happy to answer any questions.
REP. STEINBERG (136TH): Thank you, madam. Just to be clear, and I want to be very clear for the maybe three or four people who are still watching us on television. We need to be careful not to conflate what's going on with the COVID emergency and availability of volunteers with this Bill. The use of volunteers has been enabled by the Governor's Executive Order. We're talking about a permanent change to -- ability to administer vaccines. So, I just want to be clear on that. Senator Kushner, followed by Rep. Tercyak.
SENATOR KUSHNER (24TH): I just want to thank Mary for her testimony here today. Mary is a constituent in my district. And, you know, I've known you many years, Mary, and your service to the community, and particularly your medical, you know, being a nurse that so many people love and appreciate your whole life career in nursing and in helping our community. So, I wanted to recognize that and thank you for being here today to testify.
MARY CONSOLI: Thank you, Julie. And if I may, there was a comment otherwise, you were asked about the -- what's needed for the assessment skills with the vaccine, and actually, not just the vaccines for COVID but any vaccine. When you get in to have the reaction, you have to be able to assess if the patient's having any respiratory distress. That's 374 February 8, 2021
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probably the most early sign and the one that's most dangerous, because they do develop rashes. But it's the early signs of respiratory distress going into anaphylaxis, any swelling of the body, especially upper respiratory system. That's what you have to be able to be trained to watch. And I can appreciate this and the other person that testified saying the medical assistants would just give the injection and the nurses and trained personnel work after then I can appreciate that. But I wanted to address your concerns and your question. Thank you for, for asking that. And I just wanted to address what's needed.
SENATOR KUSHNER (24TH): Thank you very much for that. Thank you, Mr. Chairman.
REP. STEINBERG (136TH): Thank you. Representative Tercyak.
REP. TERCYAK (26TH): Thank you very much, Mr. Chairman. Generally, I have a policy against speaking to greet people. These meetings have to end somehow, and we have some responsibility. But I'm gonna break that tonight in that for constituent but for Mary. Thank you very much for all that you have done. A fine example of a career spent at the patient's side, making the same -- making the journey with the patient. And for those -- having known you a lot of years, I'm not surprised to hear how you're active and useful in accomplishing so much right now. Thank you very much. Thank you very much, Mr. Chair.
REP. STEINBERG (136TH): Thank you. Any other questions or comments? No. Thank you very much for your testimony, for your patience this evening. Anne Hulick, followed by 136, Gerylyne Laut.
ANNE HULICK: Hi, good evening. 375 February 8, 2021
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REP. STEINBERG (136TH): Good evening, Anne, please go forward. You're a lovely shade of purple today. I'm not quite sure --
ANNE HULICK: I know, it's the lighting here. I apologize. Good evening, Representative Steinberg, Senator Abrams, Vice-Chairs, Ranking Members and Esteemed Members of the Public Health Committee. I'm here tonight representing the Connecticut Nurses Association. You are -- like many of you, I wear a couple of hats. I am not only the Connecticut Director of an environmental nonprofit organization, but I also have been a decades-long member of the Connecticut Nurses Association and I serve as their government relations liaison. So, I am submitting -- I'm speaking on behalf of that association this evening.
It's no surprise too, that CNA does not support raised Bill 285 as written, but we'd like to offer some recommendations. We understand the complexities of a changing workforce. I've been here all day. We've listened all day to the very compelling testimony on all sides. We appreciate the issues that you all are grappling with. And I wanna thank Representative Steinberg for his comment a moment ago about -- this is not necessarily about COVID. This is about a longer-term policy and practice change. So, thank you for that Representative.
Connecticut Nurses Association understands the changing workforce needs the goal of maximizing access to care and the challenges faced by licensed providers in managing a busy practice. The Connecticut Nurses Association's primary concern is always ensuring the public's health and in providing safe high-quality care. We know you all share the same goal, as do the physicians, APRNs, and PAs in those practices. The primary concern of the 376 February 8, 2021
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Association with medical assistants administering vaccines really does center around the variability of the education of the programs in Connecticut. In reviewing these programs, we've learned that summer is short, it's 10 to 12 weeks for certification. Others can lead to an Associate degree. The curriculum varies, but generally includes focuses both on administrative functions, as well as clinical tasks ranging from scheduling, billing codes, filing, to taking blood pressures, EKGs and doing other procedures. All of that has been talked about at length today.
We also agree that all members of the healthcare team should practice to their full scope, so as to maximize quality, efficient and accessible health care. The medical assistant is an extremely valuable member of the team. However, we still believe that giving an intramuscular injection is not a simple task. It requires a level of assessment, understanding of anatomical landmarks, muscle size, needle length, et cetera. We understand that the licensed providers are ultimately accountable here in this Bill for the delegated work. But we still believe that consistent standards for education and practice, not only serve the medical assistants and the patients, but the licensed providers as well.
For the past three years, CNA has collaborated with faculty, medical assistants, licensed providers, nurses, and have submitted recommendations that we believe might assure the highest level of patient safety for all.
KASS FRUIN: Just to let you know, you hit your three-minute mark, go ahead and wrap things up. Thank you so much for speaking today.
ANNE HULICK: Thank you so much. I just wanna conclude by saying we really want to work with all 377 February 8, 2021
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the members of this Committee, with the MA programs with the physicians, and the Department of Public Health to assure consistent and the highest level of standards. We know the workforce is changing, we accept that. We'd like to be -- have a seat at the table in helping make sure that we get the best outcome for the patients, the providers and the medical assistants. Thank you so much.
REP. STEINBERG (136TH): Thank you, Anne, and I'll take you up on your invitation to participate and help us see if we can find a path to, as you say, recognize the changing landscape. But we do want to assure quality and safety. I have half a mind to ask you about water quality in schools, but anybody with half a mind should probably be asking questions. So, I have to save that for another day. Any other questions or comments? If not, thank you for your time, as always much appreciated, all you good work.
REP. BETTS (78TH): Representative Steinberg.
REP. STEINBERG (136TH): Oh sorry, I must have missed it.
REP. BETTS (78TH): You didn't -- you didn't miss it. But I haven't been able to find the ability to raise my hand, I guess it's off my phone. But if I may --
REP. STEINBERG (136TH): Alright then, go right ahead.
REP. BETTS (78TH): Thank you very much. And thank you for your testimony. I've listened to most of this virtually the whole day. And I put myself in the position -- everybody's talking about patient safety, having the highest quality, we all want that, we're all wishing the same thing. If I were a doctor, I'd be hard-pressed to believe I would allow 378 February 8, 2021
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somebody else to administer a shot if I did not have confidence in their ability to not only do it, but know what they're doing. So, can you explain to me the need to or the reason for not allowing the doctor to use their discretion to somebody who has been trained in doing that? Can you enlighten me as to why that would be an unsafe or bad idea?
ANNE HULICK: Yes, thank you for that question. It's really important and I think the Association's position that certainly we don't -- you know, we have the highest respect for physicians and licensed providers, APRNs, et cetera. And it's not about their ability to delegate appropriately or train appropriately. I think it's more a recognition and an understanding of the general business of these practices and wanting to assist frankly, it's not -- not trying to be oppositional. It's wanting to assist to make sure that the medical assistants are all on the same level in terms of education and practice standards so that when they're entering the workforce, all of the providers can be assured that everyone has the same level of competency, I guess. It's kind of like as when we graduate from nursing school and go through, you know, our licensure exams and competencies in the practical setting during our orientations where we are, you know, there's some level of baseline standards that are in place that we're required to meet as we get hired, and we are accountable to under our license for the -- from the Department of Public Health. So, I don't think it's in any way to your question, Representative, that, you know, we certainly understand and admire and respect the physicians' level of expertise and delegation, and they should have every right to do that. We just want to make sure that we have some consistency in terms of the standards of education for the people coming out of those programs.
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REP. BETTS (78TH): Okay, thank you very much. Thank you, Mr. Chairman.
ANNE HULICK: Thank you.
REP. STEINBERG (136TH): Thank you, Representative. Do we have any other questions? If not, Anne, thank you for your testimony today. We look forward to your future contributions. Next is Geralyn Laut, followed by Dale Cunningham. You're still muted, Geralyn. [pause]
GERALYN LAUT: Thank you for your patience. My name is Geralyn Laut. I'm President of Glastonbury and I'm on the Board of Directors for Amplify one of the five regional behavioral action organizations. I'm also a certified tobacco treatment specialist and prevention professional. Needless to say, I'm here in support of SB 326.
We as a country are shattered by the loss of the number of lives due to COVID. But tobacco or as I see it, the tobacco industry, has been killing that same number of people every year for many years. 480,000 people across our United States with 5,000 in Connecticut. Before me, I have a copy of the Surgeon General's Report issued in 2014, 50 years of progress. This is the supplement, another 1,500 pages combined. This report was issued 50 years after the first Surgeon General's Report in '65 that linked tobacco with latent death, disease and disability. I'm afraid that we're gonna have a similar report regarding vaping. But it may take years for that report to happen. And in the meantime, we're gonna have lots of lives lost, lots of innocent victims last.
Please don't wait to deter youth from adopting a lifelong addiction to nicotine that alters their brain chemistry, just to the degree that a homeless 380 February 8, 2021
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person chooses cigarette over food, or someone facing a terminal illness will still continue to smoke or pregnant young woman hearing the risks on the child, will continue to smoke cigarettes.
Nicotine has the power to addict people to the degree that they will do something that they know is harmful but they can't stop. I've heard numerous people recovering from heroin and alcohol addiction that quit smoking, many die trying. Nicotine alters the brain chemistry to make people more susceptible to other drugs. Please, let's do what we can to make that not happen to our future young people today. If you're concerned about health equity and racial disparities, menthol is definitely killing more people. Banning menthol is intended to protect minorities not harm them. Thank you for your time and for being here all day today.
REP. STEINBERG (136TH): Thank you for your testimony. I agree with you. There's so much we still don't know about vaping because we haven't completed the research. So, there are a lot of unknowns out there. Any other questions or comments? If not, thank you for your testimony. Thank you for hanging with us all day today. We really appreciate it. Next up is Dale Cunningham, followed by Kevin O'Flaherty.
DALE CUNNINGHAM: Hi. Good evening. My original testimony said "Good Morning", but I appreciate being here, listening all day, and an appreciation for all of you listen to multitask many bills at one time. My name is Dale Cunningham, I reside in Legends, Connecticut. I've worked at Lawrence Memorial Hospital for the last 30 years. I'm a neonatal nurse. I've been a nurse for 45 years. I've been a union leader at LNM for 20 years. I'm President of the Nurses Union at LNM under AFP, Connecticut. And I represent over 600 nurses. We 381 February 8, 2021
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have come several years in a row on a similar bill. I'm here to talk not in favor of SB 285, allowing medical assistants to administer vaccine. I'm not gonna read my testimony, I'm just gonna comment on all that I've heard today. Here it appears to me, it seems to be nurses versus physicians today, quality of care versus efficiency of care. Licensed personnel versus certified personnel. I have not -- very vague on what vaccines will be administered. There are many vaccines. As a neonatal nurse, I'm exposed to mostly pediatric medication. Vaccines change constantly. We have to -- even doing this for 40 years, I have to verify the new medication, the manufacturers change, many facets in the administration of a vaccine for a baby or a pediatric patient. I have not heard a lot of comments on that today. But that is a big concern of mine.
I did not hear how the verification process would be. When I give a medication now, I have to double- check it if I'm not familiar with the dose, I look it up in the resources we have available. I didn't hear any of that mentioned today about certainty of what medication is being administered. It seems like it's just thought of as a task to give a vaccine to someone. So, I don't look at it that way. I just want to point that out.
As a personal note, like say, when I was 19-years- old, I received injection, I've had permanent nerve damage from that injection. So, it does take a qualified individual to administer medication through syringe needle.
The other thing that wasn't mentioned a lot when we -- when we take an order from a physician, and then we go to administer that medication to a patient and these days, we have the neonatal nurse have parents. So, the doctor talks to the parents about the 382 February 8, 2021
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medication, then they leave the room and we have to give the medication. Well, the parent then starts asking questions about the medication. I recently was at my physician's office and I said to the MA, you get the vaccination, the COVID vaccination? And he proceeded to tell me that he was fearful of the vaccination and he didn't know enough about it to get it.
KASS FRUIN: Excuse me Miss Cunningham, you've reached your three minutes. I just wanna let you know you've hit your three minutes, if you wanna go ahead and give your closing statement. Thank you so much.
DALE CUNNIGHAM: Okay. I just basically have many concerns about the vagueness and the process of administration of vaccines, especially for children. And I just want to quickly mention that there's lots of nurses over 50 who appreciate the low stress environment of getting vaccines.
REP. STEINBERG (136TH): Thank you for your testimony. I think you did raise a number of points that we hadn't discussed earlier. I do hope though that the situation is not quite as oppositional as you describe it. I'd like to believe that parties can agree to disagree but also find common ground. And if there are ways in which we can make this piece of legislation less vague and more appropriate, we'll be glad to hear from you on that.
Are there any other questions or comments? If not, thank you for your testimony. We really appreciate it; you added some good points we really needed there. We have Kevin O'Flaherty, followed by number 140, Lindsey Stroud.
KEVIN O'FLAHERTY: Good evening, everyone. Thank you, Chairman -- Chairperson Abrams, and Chairperson 383 February 8, 2021
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Steinberg, for your leadership on this issue. And thanks to the rest of the Committee for being here and giving me the opportunity to speak this evening. My name is Kevin O'Flaherty, I represent the Campaign for Tobacco-Free Kids here in Connecticut, we rise in strong support of SB 326, which would ban the sale of all flavored tobacco products, as well as SB 115, which would prohibit the sale of all tobacco products and pharmacies and health care facilities. I've submitted written testimony, but I wanted to take my time this evening to address two arguments that the industry keeps bringing up. One is the so- called failed experiment in Massachusetts. To be clear, the only party who's -- who see this law as a failure, or the tobacco industry, and their retailers who opposed it all along. The legislature and its leadership were strong supporters of the law and they remain so. Governor Baker, who is a bit more conservative than the legislature there has publicly said that they should not delay the law and remains in full support of it. That's because the goal of the law wasn't to actually reduce smoking among adults. The goal was to reduce smoking and vaping initiation among youth by getting these products that are designed to addict kids out of the stores where the kids see them, out of their hands and, frankly, so far, there is zero evidence to suggest that the law has not been effective in that regard. The fact that many adults have bought tobacco in other states after the initial implementation of the law, does not mean that it hasn't worked. On the contrary, the percentage of tobacco products that are sold to or used by kids is actually very small. After all, there are far more adults at any one time in the country than there are teens. So that's expected.
It's also important to note that Massachusetts fully anticipated tax revenues declining as a result of 384 February 8, 2021
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this law. And that so far, the actual experiences that they've seen are in line with the projected revenue impacts that they expected. The legislators in Massachusetts made a choice to put the health of the Commonwealth and protecting their kids above the financial interests of retailers and their own state revenue. And we can do the same here.
I have to just say that to sacrifice generation after generation to tobacco addiction, in the name of making it easier for older generations to keep using the very products that hooked them in the first place when they were kids, or because we're afraid to lose revenue from those sales, is reprehensible. I think it's time to stop that from happening in Connecticut.
Secondly, this law will only be enforced through health departments or similar entities against retailers, not by the police, or any individual or against any individual persons. It doesn't criminalize the purchase use or possession of these products. To suggest that making these products less available to kids by taking them out of the stores, while not criminalizing their possession at all; to suggest that that is somehow going to increase interactions between law enforcement and persons of color, is both deceitful and insidious. And I say insidious, because to take a false argument, and use it to play into very legitimate fears that exist in the Black community, the persons of color have about law enforcement, and then exacerbate them in a way that actually does more harm to the very communities that they're claiming to protect.
That's why the NAACP, the Urban League, the National Medical Association, and many other organizations that see first-hand the impacts that the industry has inflicted on Black and Brown communities support this legislation, and most of the folks who are 385 February 8, 2021
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against it, or either people who profit from the tobacco products, or who have received money from the industry, please don't let them fool you. There is no evidence of increased police enforcement, gang violence, or anything along those lines that are attributable -- attributable to these policies in Massachusetts, or in any of the 100-plus other cities who have implemented a comprehensive ban on the sale of flavored tobacco.
Thank you very much for your time this evening and the opportunity to testify. And I'm happy to answer any questions you might have.
REP. STEINBERG (136TH): Thank you very much for your testimony. And again, coming late sometimes affords you an opportunity to have perspective on what's gone before and I also take your point, that I was disappointed to hear that the verdict was already in Massachusetts after such a short period of time. Typically, we like to give people at least a couple more weeks before we decide whether or not they've been a success. So, I think you make a good point. And I also appreciate the fact that you've kind of refocused really the goals of the legislation as opposed to some of the things we've heard today. Are there -- oh yes, we have a number of questions. Senator Anwar, hello, -- followed by Representative Zupkus.
SENATOR ANWAR (3RD): Thank you, Mr. Chair. Thank you, Kevin, for your testimony and your strong arguments. I think, if you can allude to the fact that the time it has been since this law was enacted in Massachusetts, because a lot of people have come in and tried to convince us that Massachusetts is a failure. And I think the two parts that I think is worthy to mention is that we're looking at the future, while we're looking at the current times, but there is a future. And then the other part is 386 February 8, 2021
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the -- the use pattern change that is there. And who's studying and how soon can you get real data rather than anecdotal industry-based videos and so on?
KEVIN O'FLAHERTY: Right. Well, that's a good point Senator Anwar, all we've really seen of the so called -- so-called exploding Black market in Massachusetts is some homemade selfie videos of some people, you know, perhaps buying cigarettes, that video, you know, could have been taken before, like -- you know, these transactions occur, they always have, they always will. And, and to your -- to the point I made earlier, there's no evidence that we're seeing increased gang violence, or any kind of criminal activity around this, that's actually damaging communities in Massachusetts.
But I think to the point that both Representative Steinberg and yourself are getting to, you know, we've never tracked youth tobacco use rates by sales. I mean, you can -- that gives you a sort of an aggregate look at how many people are buying products. But that's not what really tells you whether youth rates are going up or down. That's from, you know, nationally led by the CDC and other federal government agencies, as well as state agency surveys that are administered every one to two years. And that's where we'll really be able to tell whether the use rates are going down. But to the point of all these lost sales, again, you know, the vast majority of sales of tobacco sales are to adults. And so, the fact that a big chunk of adults might still be buying these products and might be getting these products in another state, doesn't mean that the fact that these products are no longer in stores. Kids don't see them, they don't see the advertising for them, and it becomes much harder for them to get, that doesn't mean that that the -- those youth rates aren't going down. And we fully 387 February 8, 2021
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expect them to the -- the evidence shows that flavors are a big part of why kids are ever getting hooked on these products. And if you make them unavailable and make them less available, we'll see those results. To that point as well, we think it's important that that we do start taking a regional approach and not wait for the FDA so that Massachusetts doesn't, and Connecticut doesn't and Rhode Island expands their ban, from just flavored E-cigarettes to all flavored tobacco products, etc. But the cross border, the ease of crossing the border to get those products will go down, and we'll see an even larger impact.
SENATOR ANWAR (3RD): And Kevin, another part is that somebody was trying to convince us that a small segment of the adults may get benefit in smoking cessation from the flavored products, and therefore the flavored vapes should continue to be used. But if we were to look at -- let's say, first of all, I question some of that data, but -- but let's say if it's accurate for a second. Even if it's accurate, the broader impact on the wellbeing of the next generation of our children, how does it play into the spectrum? And also, can you comment on the Attorney General's -- the State of Connecticut's Attorney General's position, how does that impact our situation in our state?
KEVIN O'FLAHERTY: I appreciate those questions Senator Anwar. So -- so first off, the strongest study, which came out of England that showed that that E-cigarettes could be as effective or slightly more effective than just using NRT. The product that they actually gave to the individuals to start using that to try to help them quit, was not a flavored product. It was just a tobacco flavored E-cigarette product. So that -- and they use that evidence but they then tried to say that that means we have to have flavors for adults to quit. And that's just not 388 February 8, 2021
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true. There's no evidence to show that they need flavors to quit. The people who really wanna quit, and that vaping might help them quit, would be able to use a non -- a non-flavored product or a tobacco product as well.
But I think the bigger point or the bigger answer to your question is if you looked at the data, you know, what the -- to paraphrase a well-known quote, you know, the plural of anecdote is not evidence. In short, there are some people who are using these products to quit, but you're making decisions not about individual health. That decision should be made between a doctor like yourself and their patient. You're making decisions to benefit the public health and when you look at what has happened in the country with the advent of E-cigarettes, what we've seen over the last six or seven years is this huge explosion in the sales of E-cigarettes, and -- and then if you plot a line of what the youth use rates were, during that time, it directly mirrors that increase.
I'm just gonna -- I'll show you a quick graph here. And I'll share this with the Committee. The Blue Mountain is actual sales of E-cigarettes, the red bars are youth use. And so, you see that that has gone up dramatically. But what you also see is that when you look at that same mountain of sales, you may have a hard time seeing this, those little red bars at the bottom are the adult use of E- cigarettes. And they stayed steady between 3.2 and 2.8%, going up and down. As the -- as those sales increased dramatically, adults were not part of driving that increase in sales. And the most damning of all, is that when you look at this, this is the adult smoking rate. And as you can see, again, with that mountain of sales, the rate went down, but only at the same rate it was going down before those sales increased. This is the background smoking 389 February 8, 2021
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declines that have passed because of the tobacco taxes that you've passed in the past because of smoke-free laws and other policies.
So, from a population data perspective, the evidence does not support that e-cigarettes are being used to help adults quit. Those sales are on the backs of kids. And that's what we're trying to stop here today.
SENATOR ANWAR (3RD): Thank you. Thank you, Mr. Chair.
REP. STEINBERG (136TH): Thank you, Senator. And I wanna congratulate you for being able to use visual aids in a challenging environment. And perhaps you'd be willing to share those with us so we can look at them at our leisure. Representative Zupkus.
REP. ZUPKUS (89TH): Thank you. Thank you, Mr. Chair. Hi, good evening, Mr. O'Flaherty. A couple of questions for you. You made a comment a minute ago about health dep -- police are not going to be monitoring this, this is going to be the health department so they could go into a store and find the store is it -- did I hear you correctly.
KEVIN O'FLAHERTY: Now the only -- the only target of these laws, if you want to call it a target, is licensed retailers. We're trying to get these products out of the stores. So, it might be the Health Department, it might be the Department of Taxation, whoever enforces tobacco retail licensing laws in the State. They go in to do their normal inspections. Or if they get a report that a retailer is selling products that are now prohibited to be sold, they would be cited for carrying products and attempting to sell them that that they're no longer allowed to. This law doesn't penalize people on the streets who happen to have a prohibited product 390 February 8, 2021
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regarding -- regardless of their age. It's only about getting these products off the shelves so that they're not so easy for kids to access.
REP. ZUPKUS (89TH): Okay, because I'm not for Health Department's doing -- giving fines, and maybe another group that tobacco, whoever. But so, do they -- is that how it's done in other states?
KEVIN O'FLAHERTY: Yes, that's right, in Massachusetts and the California law which hasn't gone into effect yet, but it's very similar to the Massachusetts law. The users of these products are not penalized, it is -- it is only saying what retailers can and can't sell in that state.
REP. ZUPKUS (89TH): Right. Okay. And then speaking of Massachusetts, someone, before you -- prior to you, could have been the last speaker or a speaker before, mentioned that in Massachusetts, there is a law right now, a proposed piece of legislation, to rescind their legislation. Are you -- is that -- are you familiar, is that true?
KEVIN O'FLAHERTY: I am -- that bill was introduced last year as well. In 2020, there were several bills, one would have delayed implementation for a year. The retailer said, Oh, this is a fine law. We just want you to delay for a year because of COVID.", which I think is probably disingenuous. I think their goal is to repeal the law. And then there was another bill that would have repealed the law in general. They also asked the Governor to use his Executive Authority to delay implementation of the law. Those bills did not move, they died in Committee. Those Bills have been reintroduced.
I know last year that that bill in Massachusetts, a constituent can basically ask a legislator to introduce a bill and legislators are sort of 391 February 8, 2021
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obligated to introduce it, but they don't necessarily request a hearing for it or anything like that, unless they agree with it and believe in it strongly. I believe that was the case with these bills last year in Massachusetts. I'm not sure if it's the case with the bills this year. The leadership is strongly supportive of this as is the Governor. There is no appetite in Massachusetts to repeal this law.
And as I mentioned earlier, the financial revenue impacts have been exactly what they expected. So, it's not like this is throwing the budget out of whack and I'm not -- I will not sit here tonight and tell you that the State will not lose revenue if you pass this law. You will. You know, and you're not gonna lose as much as the industry says you're going to lose. But some people, you know, will actually quit smoking as a result of this, which is good. Some adults, some will cross state lines, most of them probably just switch to non-flavored products.
REP. ZUPKUS (89TH): Yeah. So, I was just curious, because I had heard in a prior speaker that that -- and so it is back on the table. So, we'll just have to wait and see what happens. So maybe they will do something with it. Maybe they won't but it is back.
KEVIN O'FLAHERTY: People always trying to do that. Yes.
REP. ZUPKUS (89): With everything. Yes. And so, could you just briefly, I have not heard of your organization. So how long has it been in existence? And exactly, are you targeting just tobacco with kids?
KEVIN O'FLAHERTY: Yeah, we have been around I think now for 24, 25 years. We started -- we were not funded by money from the master settlement. But we 392 February 8, 2021
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started around that time, to try to really increase the ability of the Public Health Community and other advocates to be able to pass policies that would help reduce tobacco use. We are strictly a policy advocacy organization. We support programmatic working communities. But we -- that's not the work we do. We try to pass laws that would reduce tobacco use among adults and kids.
REP. ZUPKUS (89TH): So, you don't educate children or anything you strictly are policy-driven?
KEVIN O'FLAHERTY: That's right. We do support funding for tobacco prevention programs at the state level as well, but -- but we don't do that work ourselves or take any money for that.
REP. ZUPKUS (89TH): Okay, just my last quick question. So, it's just tobacco. Are you -- are you going to come out on recreational marijuana? Which - -
KEVIN O'FLAHERTY: We are NOT -- we are focused strictly on reducing the impacts of tobacco use on our nation in general, but especially on our kids.
REP. ZUPKUS (89TH): Okay. Thank you.
REP. STEINBERG (136TH): Thank you, Representative. Just to also comment on your -- one of your previous questions. If you recall, the Tobacco 21 Bill we passed two years ago, administration and enforcement is lauded over several agencies depending upon the specific task at hand. So, I would not worry about the Department of Public Health having responsibility for this. It will likely follow the same framework that we instituted two years ago. Representative Carpino.
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REP. CARPINO (32ND): Thank you, Mr. Chairman. Mr. O'Flaherty, you had some charts. So, I'm hoping you might be someone who can answer a question I've had since early this morning. How long can we as Connecticut policymakers -- or how long do we need to wait to find out the implications on either use, access, or sale? Because let's be honest, that happens, otherwise, we wouldn't be having these conversations, to our youth as a result of raising the age of tobacco to 21?
KEVIN O'FLAHERTY: Yeah, I'll be interesting to see what happens now that it's a national law, to see if they're able to sort of, and I'm not a researcher, but I sometimes can speak well to things that are discovered through research in this field. Because there's a lot of noise in the background now. With all these different policies that have happened, whether it's the states reducing or increasing the age at different points, tax increases, which, while they definitely reduce tobacco use among adults, they have an even stronger impact on kids, et cetera. But my guess would be that in the next year or two, we'll be able to see some clear results of what that impact was from NCI and other national organizations that will be looking at that.
REP. CARPINO (32ND): Thank you. So, you think it's another year or two to see what are -- the implications are of what we've already done?
KEVIN O'FLAHERTY: I think that's probably right. But, you know, again, I think you do see the implications overall, in terms of youth use going down in general. Again, the E-cigarette problem, if you want to just call it that, it also adds noise to this, because these are products that came on the market, especially with Juul in 2016-2017. And totally created this new incentive for kids to want to start using tobacco products that they didn't 394 February 8, 2021
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have two or three years earlier. And so, it's hard to, you know, separate all of that out. But my guess is that brighter people than I am looking at that. And hopefully, we will have some clear indications of it again in the next couple of years.
REP. CARPINO (32ND): No, and I appreciate that. Because regardless of where this bill goes, I'm just looking for facts. And it's very hard to determine how successful we are if we don't know what our starting point is. So, I thank you, and I thank you for giving us your time tonight. Thank you, Mr. Chairman.
KEVIN O'FLAHERTY: Thank you for your support.
REP. STEINBEBRG: Thank you, Representative. Are there any other questions or comments? Seeing none, again, thank you for your testimony today. Really much appreciated.
KEVIN O'FLAHERTY: Thank you, Representative.
REP. STEINBERG (136TH): Moving along, number 140. Lindsey Stroud, followed by Margaret Carrera.
LINDSEY STROUD: Hello, can you hear me?
REP. STEINBERG (136TH): Yes, we can.
LINDSEY STROUD: Okay. Alright. Members of the Public Health Committee, thank you for allowing me the opportunity to testify today regarding banning the sale of flavored tobacco and vapor products. My name is Lindsey Stroud. I'm a policy analyst with the Taxpayers’ Protection Alliance. And I did submit testimony but I would just like to kind of highlight a few things.
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One, youth in Connecticut are not overwhelmingly using E-cigarettes because of flavors according to the 2019 Youth Risk Behavior Survey, which the State does in conjunction with the CDC. When high school students were asked for the main reason on why they use E-cigarettes, only 5.2% of them responded because of risk flavors. Conversely, 12.9% cited friends and family members and 18.2% cited other. This is similar to data that you find in other states, including Rhode Island and Vermont. There have been adverse effects of flavor bans they've been still are new and states and localities that have done them there's still been increased and vaper use as well as combustible cigarette use.
For example, San Francisco banned flavored e cigarettes in 2018. And between 2017 and 2019, vapor product use among high school students increased by 125%. But worse, combustible cigarette use increased by 38.3%.
I would like to point out that the numbers of the previous speaker brought up as in regards to E- cigarette sales do not include vape shops or online stores so they don't really grab the big picture. I've been actually looking at data from the Behavioral Risk Factor Surveillance survey which actually looks at adult behaviors. And actually, E- cigarette actual -- use actually correlates with stronger reductions of smoking rates among younger adults. Between 1998 and 2008, ten years after suing tobacco companies smoking rates among current smokers and Connecticut aged 18 to 24 years old, decreased by 43.7%. Ten years after e cigarettes market -- market emergence between 2009 and 2019, young adult smoking rates decreased by 70.8%.
Further, E-cigarettes are associated with a larger decline in average annual percent decreases. Between 1998 and 2008 the percentage of current smokers aged 396 February 8, 2021
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18 to 24 years old decreased on average 2.42% each year. Between 2009 and 2019, annual percentage declines averaged at 7.52%. Perhaps, problems -- problem -- deeply problem some with this ban is that Connecticut spends very little funding on tobacco control. I20 years of time, Connecticut allocated only $36.4 million in tobacco control programs. During that same time period, the State received more than $6.2 billion in tobacco tax revenue, and 1.885 billion in tobacco settlement payments. Further between 2017 and 2020 during the so-called Youth Vaping Epidemic, Connecticut, dedicated $0 per year in tobacco control funding.
Rather than imposing bans lawmakers do utilize more existing tobacco dollars towards prevention programs and work with public health educators and tobacco and vapor retailers to address youth vapor and tobacco use. Thank you for your time, and I'm available for any questions.
REP. STEINBERG (13TH) Wow, that was really fast. Thank you for your testimony. Senator Haskell, again? Just kidding. I think it's the first time you've actually raised your hand, please go for it. Go ahead.
SENATOR HASKELL (26TH): It is the first time. Thank you, Representative -- Chairman Steinberg and Ms. Stroud, thanks for your patience today. I have a few questions. You were moving quickly and I didn't quite understand one point that you made. You said that evidence seems to show that young people aren't drawn to vaping because of flavors but for some other reason. I just -- it strikes me as implausible I worked at a convenience store all four years of my college experience and Juuls came into the store when I was a freshman, nobody bought them. Then there was a mint flavor sophomore year, they became more popular, but it was only when mango hit our 397 February 8, 2021
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shelves, that we started to sell out each and every single day. So, I guess my question for you is, what was the study you were referencing that young people are vaping because of family influences and not flavors? Can you slow that one down and walk me through it?
LINDSEY STROUD: Yeah, absolutely. It's actually multiple state studies with the Youth Risk Behavior Survey that is done every other year with the Centers for Disease Control. So not every state actually asked this question, but some of them do. And they asked what is the main reason why you use E-cigarette products? And they only -- some can say as many as they like, some of them don't actually let you can only choose one of them. But there's multiple options, including friends or family, other, because they're available in flavors, they're less harmful, they're easier to get. And overwhelmingly, you're seeing the first tab two answers always friends or family members, or other flavors usually consistently is like third in line as far as a reason to use it.
SENATOR HASKELL (26TH): Interesting, it doesn't sync with my experience at all being behind the counter or the young people I know who are vaping. But I will look dig into the study. I saw that you were testifying in earlier in the day and I saw that you work for the Taxpayers Protection Alliance. I did, I don't know, maybe 20 -- 20 minutes worth of googling and couldn't find how the Taxpayer Alliance -- Protection Alliance is funded. Could you provide any details on the funding for that organization?
LINDSEY STROUD (26TH): I'm brand new. So, I actually don't know. And I just started in January. But I don't think they actually disclose any of their funding. But I can get back to you on that one. I'll talk to the big bosses. 398 February 8, 2021
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SENATOR HASKELL (26TH): Correct that they don't disclose any of their funding, although we ordered it. And I'm wondering if you could confirm that the Taxpayers Protection Alliance is funded by the Koch Brothers.
LINDSEY STROUD: I cannot confirm that.
SENATOR HASKELL (26TH): Understood. Well, I was really moved by a -- I will wrap up with this question, Mr. Chairman, and I appreciate the indulgence. I was really moved by a story earlier today about a mother who actually saw her adolescent son become so addicted to nicotine, which we know and has been proven time and time again that nicotine has a chemically-addictive component and an otherwise healthy young person was driven to suicidal ideations. And it struck me as unusual. But granted, I serve on a bunch of different Committees, and don't spend all of my time invested in this particular topic.
So I was surprised when again, in doing some digging, trying to find out more about the Taxpayers Protection Alliance, I came across your Twitter and earlier today, during this hearing, you said "I've heard this story in several hearings. If your kid is threatening to kill themselves because of nicotine, this is beyond E-cigarette or Big Tobacco. This is a mental health issue or lack of control." Is it accurate to say and I understand you advocate on this issue in many States, you've heard that story in multiple hearings? Is this an issue that young people are actually driven to suicidal ideations in many different contexts all around the issue of nicotine addiction?
LINDSEY STROUD: I’ve heard that particular story, different iterations of it from the same woman and 399 February 8, 2021
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different testimonies. But you don't overwhelmingly see, you know, vaping nicotine addiction, especially, you know, in the throes of the opioid epidemic, especially right now.
SENATOR HASKELL (26TH): Well, that's a relief. Thank you for your testimony. And thank you, Mr. Chair for the indulgence.
REP. STEINBERG (136TH): Thank you, and don't be a stranger, Senator. Any other questions or comments? If not, thank you for your testimony today and for your patience in waiting so long.
LINDSEY STROUD: Thank you.
REP. STEINBERG (136TH): Next up is Margaret Guerrera, followed by Philip Gardner.
MARGARET GUERRERA: Good evening, Senator Daugherty Abrams, Representative Steinberg, Senator Summers, Senator Hwang, Representative Petit and Members of the Committee. The Connecticut Society for Respiratory Care appreciates this opportunity to provide testimony concerning SB -- Senate Bill 285, an act allowing medical assistants to administer vaccines. My name is Margaret Guerrera and I'm the current President of the Society.
After reviewing the published testimony related to this Bill this past week, we noted that a medical assistant suggested the addition of nebulizer therapy to this Bill. In listening to some testimony this evening, I also heard medication administration done by medical assistants. It's been our past experience to that similar bills that have been proposed considered adding nebulizer therapy. So I'm here today to testify on that -- in that regard.
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Let me tell you a little bit about the CTSRC. We're a professional organization that represents respiratory therapists practicing in the State of Connecticut. There are over 1,700 licensed respiratory therapists living and practicing here. Respiratory therapists are employed in various settings, including acute care hospitals, rehabilitation and extended care facilities, homecare and physician's offices. Our education and training are specific to the cardiopulmonary system and includes rapid and focused assessment of acutely-ill patients. Our profession is well- regarded by our colleagues. And our value during this pandemic has been equal to that of our nursing and physician colleagues.
While administration of medication by nebulizer is done in the home by many patients and their caregivers. This patient population is typically considered stable and in their normal state of health. When nebulizer therapy is administered in other healthcare settings, such as a physician's office or clinic. These patients are often acutely ill with breathing difficulties, and many times their next step is the emergency room. Therefore, it is critically important that the treatment is administered by a healthcare practitioner who's trained in cardiopulmonary assessment, and who can identify deteriorating conditions and medication side effects during the treatment.
In addition to this, the treatment is only as good as the person instructing the patient on the breathing technique necessary for optimal inhaled deposition of the drug. This too requires the skill of a well-trained practitioner.
We hope that this helps the Committee understand the level of training required to perform what may seem like a simple procedure on the surface, but when 401 February 8, 2021
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combined with an acutely-ill patient is not. It is our belief that medical assistants do not have the educational background to administer nebulizer therapy to acutely-ill patients, nor do they possess the skills necessary to identify and react to deteriorating patient conditions. The CTSRC is opposed to medical assistants administering nebulizer therapy in any healthcare setting, and therefore opposes the addition of the administration of nebulizer therapy to this Bill, should that be considered.
In addition, the CTSRC is also supportive of vaccine -- vaccination administration by licensed healthcare professionals such as respiratory therapists. The CTSRC supports adding appropriately trained respiratory therapists and list of health care providers who are currently allowed to administer vaccines. We feel that this is especially important during the current mass COVID-19 vaccination program. Thank you for your consideration of our position.
REP. STEINBERG (136TH): Thank you. Are there any questions or comments? If not, thank you for your time. Moving on. We have Philip Gardner followed by Andrew Albright.
DR. PHILLIP GARDNER: Good evening. I'm Dr. Philip Gardner. I'm the Co-Chair of the African- American Tobacco Control Leadership Council. We're a national organization that's been fighting for menthol -- get menthol off the market since it was left on by the FDA, by the Senate and the FDA in in 2009.
I've listened to most of the testimony today and I must admit, I wanna bring people up to date on what menthol actually is and what it actually does in the body so that this is not a theoretical question. Menthol is the chief constituent of peppermint oil. 402 February 8, 2021
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It masks the harsh taste of smoking, has cooling sensation, it activates taste buds, it actually activates the same taste buds that capsaicin does, which is the active ingredient in hot sauce. It increases throat grab, and basically -- not basically that's what it is by definition, menthol is an anesthetic. It allows for easier and deeper inhalation. The more nicotine you take in, the more addicted you become, the harder it is to quit.
Also be aware that mentholated cigarettes inhibits nicotine metabolism. When nicotine enters your liver, it becomes cotinine and if it has menthol limit, menthol slows down the metabolism, meaning it stays in your body longer. Menthol also -- what we say activates neurotransmitters in the brain. If you smoke a menthol cigarette, it will attract more nicotine receptors in your brain than if you don't smoke a menthol cigarette. We've known this for years. This is why the tobacco industry puts it in there. It increases what we call side -- it increases transbuccal drug absorption. What that means is if you're chewing tobacco that has menthol in it, it crosses the gum barrier much more effectively. And probably most problematic, menthol in cigarette smoke leads to greater cell permeability, meaning if there's menthol in the smoke that you inhale, it goes into the cell much more effectively than if it didn't have menthol in it.
There's been a lot of talk here this afternoon about menthol being harder to quit. Actually, there's a number of studies on this. What's most interesting to me is that menthol smokers try more often to quit, while at the same time, they're less effective at doing it. We have study after study after study and it's because of the number of things that go on. There's another thing you should know about about menthol and nicotine. The darker your skin means the 403 February 8, 2021
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more nicotine is stored in your body. This is melanin and nicotine. And if you are an African- American who are disproportionately smoking menthol cigarettes, then you're saving menthol in your body, which is problematic at best.
Let's be clear that the idea that -- I'm just going to read you this, be appraised that 85% of African American adults in 94% of Black youth who smoke are using menthol products. These striking statistics are because of predatory marketing in our community. By predatory marketing, we mean there are more lucrative advertising, there are more promotions and I guess what is the main thing that pisses me off, is that they're cheaper in the Black community? It's cheaper in poor communities to get flavored tobacco products. I think that the tobacco industry has something to do with that.
Let me just say that there's some groups going around that are funded by the tobacco industry saying that there are some groups going around that are funded by the tobacco industry saying that---
LINDSAY VAN BUREN: Excuse me. You hit your three minutes. if you could conclude your remarks.
DR. PHILLIP GARDNER: I'm gonna conclude right now, Thank you very much. They say these are our cigarettes. Nothing could be further from the truth. These were pushed down our throat by the tobacco industry and we would like to get the tobacco industry to get these death sticks out of our community. I'll answer any questions anybody has. Thank you very much.
REP. STEINBERG (136TH): Well, thank you, Doctor. I would have thought after 12 hours of testimony that we'd heard about all we needed to hear, but you've just shared a lot of information about the science 404 February 8, 2021
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in menthol that I was not aware of. And I'm hopeful that you will be willing to share the studies that you refer to. This is new insights for us. So we very much appreciate it. Clearly, you've done a lot of research on this subject over a period of years. Representative Petit.
REP. PETIT (22ND): Thank you, Mr. Chairman. Thank you, Dr. Gardner. So, in summary, we've heard a lot of testimony going both directions in terms of the Black community. To sum up what you said, you think the advantages of banning menthol and other flavors would actually be in total a benefit to the Black community as opposed to a negative?
DR. PHILLIP GARDNER: Precisely. The main killer of Black people in the United States, historically and today, have been tobacco products. Black folks died disproportionately from lung disease, heart disease and cerebrovascular stroke. There are folks that are out there that say, "What about the --" -- I heard one of the doctors earlier say, "What about the unintended consequences?" Think about it for a minute. What are the intended consequences of smoking? Half of the people that use cigarettes die from them. The tobacco industry has to replace these people every year. They don't care about Black people. They don't care about any of this stuff.
The other thing that came up and I appreciate the discussion that went on earlier, we should decriminalize -- and it seems like this Bill does, decriminalize commercial tobacco products. There should be no reason for people being arrested for possession use or purchase of these products, as I think was pointed out by Representative Steinberg. There's other ways to deal with this. We don't need people with guns and hoses and sticks beating up kids because they have a cigarette. I just have to say that, you know. 405 February 8, 2021
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And then lastly, still other groups in the Black community put out the thing, that this thing -- and this is where I wanted to end. That this is our cigarette and that we're being racist and discriminatory. Look, let me just be as frank with you as possible. It's very hard when a Black person says to a White Legislature that you're being racist because you're taking my cigarette and we go, "Oh, I don't wanna be racist." But the point is, this isn't our cigarette. For 50 years and, you know, much-- longer presentation. We could go through this, but for 50 years, you might look at it this way, in 1953, 5% of Black folks smoked menthol. By 1968. It had almost tripled to 14%, by 1976 it had tripled again to 42% by the minute--
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