CAPTION FILE
Joint Committee on Judiciary Hearing
December 21, 2022
OPEN CAPTIONING PROVIDED BY:
Tracy Ukura, RPR, CRR, CRC
Mona Leviton, RPR, CRR, CRC
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This is being provided in an unedited format.  Open Captioning is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.
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>> Chair Day: Alright, welcome, everyone, we'll resume oversight hearings with the Joint Committee on Judiciary. I'm co‑chair Michael Day and with me is co‑chair Senator Jamie Eldridge. To my right is Chief of Staff Patrick Prendergast, to his right Deputy Counsel Alex O'Connell, to her right Christopher Hendricks and to the far right Representative Alyson Sullivan, and over to the left is Seamus Corbett from MLS, making this hearing possible and to his right Research Director Mike Musto. 
>> Chair Eldridge: Thank you, Mr. Chair. I want to introduce Michael Carr, Chief of Staff and legal counsel David Emer. Thanks again to the sheriffs coming for us. 
>> Chair Day: Today is hearing three of the four subject areas we're conducting oversight hearings on. Today will focus on correctional officer wellness, and as we get started on that topic, I welcome the sheriffs representatives of the 14 sheriffs and five that have joined us here today. I do want to say a quick word beforehand that our goes to the sheriffs were weighty, this is part of an ongoing dialogue between the legislature and our sheriff's offices. I greatly appreciate the rapid turnaround. I know it took a lot of work to produce the responses to our questions. We are still obviously working through a lot of them. We appreciate them very much. We appreciate your ability to get here and have a discussion with us very much. The discussion will be ongoing. The administration may change, the legislature may change, but the relationship between the legislature and the sheriffs is an ongoing one and we look forward to this being a constant running dialogue as we move forward here. With that, let me introduce those who have joined us today. From are in folk, Sheriff McDermott. To his, from my perspective, right, Sheriff Cocchi, from Hampden County, Sheriff Koutoujian from Middlesex County and Sheriff Cahillane, and behind him Sheriff Ogden from Duke's County. We should have had a chair, I apologize. Sheriff Cocchi, I think is the chair you call of it the Association of the President. 
>> Coming in President of the MSA, right now Vice President, first and foremost, happy holidays to each and every one of you and thank you for having us here today. On behalf of the Massachusetts Sheriff's Association I want to start by saying thank you to Chairman Day, Chairman Eldridge and the members of the Joint Committee on Judiciary for your invitation to testify today. Thank you for your interest in the collective good work that the sheriffs in our compassionate, dedicated staff are doing on a daily basis. Before we go any further, Chairman Day, you mentioned the turnaround and I'd like to publicly thank each sheriff's office staff for the work that they did to collectively get these reporting mechanisms back out. They worked hard. They got it done, and we as sheriffs are very grateful for their dedication. The sheriffs were provided with just over a week to compile thousands of pages and pages of data, policy and procedures and explanations related to the Criminal Justice Reform Act of 2018. As discussed prior with Chairman Day and President Steve Tompkins, the timeline provided to the sheriffs did not allow for every sheriff's office to complete their response and to participate today. We are pleased to report that 11 of the 13 sheriff's offices that hold incarcerated individuals have provided their responses and documents thus far. We will continue to provide additional documentation and responses as they become available. 
We ask that in the future, the committee provide us with just a little more time to complete such tasks and allow us the opportunity for all to participate. As fellow elected officials, we stand committed with you to improving outcomes for all who live and work in our correctional facilities and are equally committed to implementing and executing the requirements of the Criminal Justice Reform Acts of 2018. As we navigate this hearing today, we respectfully request that any specific question for an individual sheriff that is not able to respond here today or participate today be given the opportunity to report out in written testimony at a later time. In closing, I want to note how proud I am of the Massachusetts sheriffs being national leaders in the field of corrections. As you know, the Massachusetts sheriffs have loaning prioritized the humane treatment of incarcerated individuals and the successful re‑entry into our communities. I hope this committee and the entire legislature is equally as proud of your sheriffs. We'd like to highlight several of the overall agenda items for today's testimony. 
Officer wellness, both officer and inmate wellness remain a priority for the sheriffs. We recognize this as a crisis and a challenge. Here are just a few examples of the work being done. The Massachusetts Sheriffs Association enlisted the National Institute of Corrections to assist the Massachusetts sheriffs in providing mental health first‑aid training for our correctional officers. It is a program designed to assist correctional officers experiencing a mental health or substance use‑related crisis. The correctional officers learn risk factor and warning signs for mental health and addiction concerns, strategies for how to help someone in both crisis and non‑crisis situations, and where to turn for help. We also provide and continue to provide crisis intervention training. It's called CIT, and that is for correctional officers. 
Among many examples we do, and will continue to offer include employee assistance programs, peer counseling, specialists to talk to with staff about their wellness, Summit on Officer Wellness hosted by Sheriff Koutoujian, both in‑service and academy training and specialized critical incident training, just to name a few. We are committed to exploring any and all options for staff and incarcerated individuals. Correctional officer training. Sheriffs have long been committed to national and promising practices, training standards, for example, behavioral health, inmate mental health awareness, implicit bias training, LGBTQI training, part of a PRIA training for certification, LGBTQI Commission for which Sheriff Cahillane is a member. Staffing analysis. As part of the collaboration with the 101 Commission, three sheriffs have been part of a National Institute of Corrections Staffing Analysis, virtual instructors led by elite training program, Bristol, Essex and Hampden. Phase one was completed and summarized in the 101 Commission Report. Phase two is currently in the process, where the three pilot also complete the remaining staff analysis of their agencies, and in 2023, the remaining ten sheriffs offices will begin. Phase three whereby they will participate in the National Institute of Corrections lead staffing analysis program, the Massachusetts sheriffs are leading the way nationally on this endeavor with the NIC. 
The Massachusetts Sheriffs Association participated in a discussion with Assistant Attorney General Amy Solomon to discuss the nation's staffing shortages and the crises in our nation's jails, identify challenges and proposed recommendations from the 14 Massachusetts sheriffs offices were included in this important dialogue. The sheriffs are committed in the development of a correctional academy with standardized curriculum developed and reviewed by national subject matter experts. 
Inmate welfare. The sheriffs are committed to the health and safety of all incarcerated individuals. Efforts include expanded access to medication‑assisted treatment by all 13 sheriffs offices, expanded access to mental and behavioral health to include the two evaluation stabilization units in Hampden and in Middlesex Counties. Overarching goal, to improve the continuity of care in medications among the 13 sheriffs offices for individuals experiencing mental illness, and those individuals returning from Bridgewater State Hospital to one of the evaluation and stabilization units in Middlesex or Hampden. We are proud of the collaborative work with the 101 Commission to highlight the wide array of services, programming, interventions, and reinvestments of each of the 14 sheriffs’ offices. Sheriffs collectively believe that re‑entry begins on day one of someone's incarceration. Each sheriff's office continues to enhance and expand their community re‑entry and post release services. Examples include employment services and job assistance, vocational training, educational training, housing, clothing, counseling, and community partners, just to name a few. Restrictive housing. Regardless of restrictive status, all incarcerated individuals have access to programming and services. The sheriffs are committed to the expedient return of all individuals to general housing where appropriate. 
Education, sheriffs continue to provide an incentivized educational and supportive programs for the women and the men in their care. Examples include: GED and HISET testing, college courses, partnerships with community high schools to offer diplomas, not a GED, a legitimate diploma with our partnerships. The sheriffs are committed to embracing IGNITE, a national program to which two hours of education to every incarcerated individual Monday through Friday and beyond, our emerging adult units in our facilities. IGNITE stands for inmate growth naturally and intentionally through education. Our goal: Eliminating generational incarceration through education by restoring values, hope and purpose to our inmate population. It has even grabbed the attention of Harvard University researchers. The Massachusetts Sheriffs Association is hoping for legislative support for a dead indicated line item for sheriffs who want to expand their current educational programs such as IGNITE. The offender management system, cross‑tracking. The sheriffs welcomed and committed wholesale staff time and resources towards the implementation of the Commonwealth's cross‑tracking initiative. It is a complex and staff‑intensive endeavor. We applaud the work and support of EOPPS as we work collaboratively with other criminal justice partners to create a cross‑tracking public dashboard. That is our brief summary of the important and responsive work that is being done by the sheriffs of the Commonwealth, as it relates to the implementation of the Criminal Justice Reform Act of 2018. We thank you again for the opportunity to speak with you today. With that, we welcome any questions, and I know Chairman, you mentioned officer wellness, but while you have us here, please feel free to ask us any question on any of the topics that you feel you could use a little more clarification or guidance on. Thank you very much. 
>> Chair Day: Sheriff Cocchi, thank you, I know it was a joint statement from the MSA. I welcome any comments any other attendants would like to make to the committee at this time as well. 
>> Chair Eldridge: Thank you to each sheriff for coming for the committee and Sheriff Cocchi, thank you for representing the sheriffs in your statement. You talked about the emerging adult units, I'm wondering if you could talk ‑‑ you or obviously any of the sheriffs talk about the emerging adult units and like to learn more about the mental health services offered within your House of Corrections for officers and other people. 
>> I'll speak briefly and hand it to others. The emerging adult program it's a MAGIC program, it's 18 to 24 years old, offenders are brought there. It's to really get some out of the element of doing time with folks that have been doing time for a long time; in other words, getting them accustomed to coming in and out of a correctional facility and making that almost status quo. We really want to engage, talk about the criminogenic factors are that brought them to incarceration and really work on building a level of support as they get ready to go back to the community. We do that through accountability. We have mentors that come in. We work with ROCA, comes in and they provide activities. We always use the saying the idle mind is the devil's workshops. We don't have idle minds in our correctional facilities, the importance of programming. 
I also want you to remember the philosophies in the sheriffs' offices when we have the ability to have somebody incarcerated with that us we don't take that time for granted. It's a time where we have an audience that we can infect and offer change. So it's asking individuals to wake up in the morning almost as we do, shower, shave and get ready for the day's events and that day's events is a multitude of different programming, educational services, work programs, and so on. And we ask them to look in the mirror, so if you come to us with a domestic assault and you're spending time at the sheriff's office, whether you're 18 to 24 or outside of the age group, I can assure you that you're going to be going into anger management classes. You're going to have some type of domestic violence appropriate class, and you're going to have to complete those classes, and in doing so, we're hoping to make a cultural shift on having you understand that sometimes, it's the substance use and the mental health component that leads you to the act of violently hurting somebody. So we don't just give a domestic violence class or an anger management class. You have to address the core root, and that's what the intake process is and the assessment processes, so when we look at mental health, you look at substance abuse, I would say 90‑plus percent of the people coming to our facilities come in with a touch of substance use. Of that 90 in Hampden County 49% mental health, put them together, that's cooccurring, 50% come with cooccurring disorders. You can't address the behavioral issue until you first stabilize the mental health component, from the mental health component stabilizing, you can stabilize and educate to substance use. When you address the mental health and substance abuse, at that point and that point only can you then make a shift to educational, vocational programming, because they're in a better frame of mind, a clearer state of mind to understand the programs being offered, but more importantly in a better place to make that shift from relying on and being dependent on substances to now being dependent on three square meals a day, nutritiously balanced, and now getting out and doing, accomplishing the goals of your incarcerated plan, which is to attend certain programs. So the emerging adult program has been fantastic on separating the younger offenders from what we would call the old school gentlemen who have made coming to jail a very easy thing. We don't want it to be easy. We want it to be important. We want it to be changing. It has to be a changing opportunity. 
>> The idea of the young adult came to me some years ago personally because I realized it was about the age of 26 when I sort of woke up from my fog of young adulthood and of course, all of the science shows this very fact, 18 through 26‑year‑olds develop at later rates than anyone suspected, despite the fact that we allow people to, you know, buy alcohol and go to war, they really don't fully mature neurologically until they are about 26 years old, and of course, when you think about it, the rental car companies figured this out a long time before society because they don't rent to people that are less than 26 years of age because they know the risk factors, the actuaries figured this out. 
So in seeing the tremendous amount of evidence that maturation happens at about age 26, there's a later frontal lobe development, there's a later maturation, there's a, as young adults, people engaging in riskier behaviors naturally, and naturally, they don't seem to understand the consequences of their actions, which is ripe for being the largest group of recidivists in our systems, right? They don't understand that their actions have the long‑term consequences. Many of us worry about our kids not understanding if they don't study hard, the "actions have consequences. These are much more extensive. We started a first adult young offender program in a jail, they did the Manhattan Project, smart, progressive group and the program had remarkable results. It's a different way of engaging the corrections officers with the individuals and both of you might have seen this, where the individuals in our care, officers are actually in many ways mentors, not just corrections officers. You'll see a whole different vibe in there. You'll see an individual speaking with an officer individually throughout the rest of fat silt, not many incarcerated individuals will speak with an officer individually, because others will suspect that they're speaking about things maybe they shouldn't be sharing with an officer. They wear their flip‑flops instead of sneakers laced up tight because they don't have to be ready to go at any turn. They have their back turned watching television to many of the other people, a whole different realm that you see, and it has had results. By the way, these are all young adult offenders, gang‑engaged, gang‑involved, you know, and when our studies have shown internally, I don't know if we have the data quite yet but when you compare this age group in our packed program versus this age group that did not decide to or cannot complete in the program the number of disciplines are significantly less than across the facility. I think we only had one fight over these many years and through the restorative justice circle it was cleared up right away. Most of these young adults, by the way, it's not substance use disorder. It's trauma, and so it's much more a mental health address in some ways and as Sheriff Cocchi mentioned it's teaching regular habits of productive life, making your bed, getting to places on time. Some young men didn't know how to shave before they came to our facility. A lot of these things are going on that are really important and we have found that our recidivism rates, a lot of the guys in the young adult offender unit are in for state potential crimes, pre‑trials, and they're in for potential long periods of time so the end of our people getting out and recidivating is much lower, 1% or 15%, lower than our population or the state average as well. These are really great programs. 
I wanted to mention one last thing, too. I know that this is a discussion about corrections in Massachusetts and on behalf of the sheriffs, Nick, I just thought of it as Nick was speaking, Massachusetts, when I speak, when we go nationally, we participate nationally, is always thought of as being one of the best corrections states in the country. They're always coming to us for a lot of stuff. I know when you're in the state, you may not realize this. I get that. We can always be better. I don't mean we're doing it when we don't need to improve. Nationally we are looked up upon and actually asked to have people sent to our facilities to speak to them. As a matter of fact, the large jail network, I didn't think of this until now has a large jail network, Nick will tell you and Pat has been there, too, 50 or 75 of the best correctional professionals across the country, they're undersheriffs and chiefs of the best facilities across the country and we are hosting them for their annual conference here in Massachusetts between Hampden and Middlesex. In fact, they're extending an extra day because of the great programming we have and the exposure they want to bring to sheriffs and jailers across the country. So thank you. 
>> Chair, and I'll send it over to you, Pat, quickly, you talked about the mental health. The mental health in Hampden and Middlesex we have regionalized units, but every office has a level of service provided. 
>> Chair Eldridge: Sheriff, excuse me, are those employees of your House of Corrections or private mental health counselors?

>> Great question. I believe in family, and I try to bring them in so we all work together towards the same goal, so they are employees of the Hampden County Sheriff's Office. We have certified masters level clinicians that are the ones that actually sit down, do the assessments and find out what level of risk factors are there and what is the protocol that's going to move forward, whether it requires a 15‑minute wellness checks, one on‑one wellness, referencing the medication to a psychiatrist. We also have several, we call them mental health counselors and they stay on this particular unit and they engage in everyday activity and conversation with the individuals to see where they're at, and how they're progressing along. We probably have, I have a population now just under a thousand total, and we probably have about 30 clinicians that are spread out through four facilities that go around and they go into the units and meet the offender where they're at, checking on them, if they're in general population. If you're living on the unit, the mental health unit, we have clinicians and counselors that are there to conduct the daily activity and the daily business of what's happening, so a very in‑depth, the key is, when we 18A them to Bridgewater, we try not to do that. We try to keep them local. If we feel we have to, we'll send them over to there were the key is that they come back to Middlesex or Hampden before they step out and go back to their originating county that they came from. 
>> Chair Day: Sheriff, a clarifying question. Your decision to have those providers as employees is not uniform across the 14 sheriffs departments, correct? 
>> No. 
>> Chair Day: Some sheriffs outsource? 
>> Some are on contracts with mental health contractual folks, but what we're finding right now, especially in health care in and mental health, it's getting very difficult to bring people in. So to have them as part of our workforce, we now handle and control the hiring process, which means we can forecast out somebody who is retiring, leaving, asked to leave, whatever it may be and question speed up the process of getting somebody in. It is critically important to have a caseload that is manageable. There's nothing worse than having people that are certified to do the work, but yet are overwhelmed and can't get to the next person. We don't do that. We have to have people seen. There's standards. There's timelines, how often they must be seen and what the timeframe is and we meet those standards. So the other thing I would just say about having them as part of the staff is, the vision comes from the top. My predecessor Mike Ashe brought them in. I, working there 30 years, understood the value. I'll be quite honest with the panel, no Correctional Institution should operate without a Mental Health Unit. None. Not today. It is prevalent. It is necessary. And then there's steps that you can then use, Hamden and Middlesex for the tougher cases, that are unmanageable with the staff. You can send them to us. We have the depth to handle the more difficult cases. If we can't handle them, which is very, very rarely, there's potential for 18A to Bridgewater. When they come back, they have to then go back through the process of re‑acclimating to Hamden or Middlesex, and then when they're medically compliant and they receive ‑‑ the originating County is prepared to receive them, they have the medication that's necessary, and so there's a continuity in medication, and a continuity of therapy, and then we send them back. What we're seeing is a much more stable but longer stabilized individual that is compliant for the mental health component. 
>> Thanks Nick. Mr. Chairman, I think when it comes down, specifically when it comes to the emerging adult population, uhm, you know, it comes down to a big factor, trust. And a lot of these young folks that are coming into our facilities come from broken families. Certainly they've come from a history of problems in high school and post‑high school years. What we make sure of on our officer level, the first people they're coming into contact with is intake, an intake officer. They're working with case officers, with mental health clinicians, to evaluate their particular needs, and we make it a point to make sure that we establish a trust factor with these individuals, that a lot of times they're rejecting some of the things that they may, in fact ‑‑ we know are beneficial to them. The first hurdle to overcome is to get their trust. They have to understand we're there to help them. We're here to offer opportunities for them. And it's amazing to see as a newer Sheriff, having gone through my two years being Sheriff, national audits from the American Corrections Association, the National Commission of Mental Health, the Department of Corrections, numerous audits over the course of time, and it's given me an opportunity to kind of highlight all of the homework that we've done to focus on, on mental health, Substance Use Disorder, as well as to me what was the foundation for emerging adults, is going to be education. And so we make sure our incarcerated individuals know exactly when they come into the facility, the programs that we have to offer. And once we've established that level of trust with the individual ‑‑ these are, they're legal adults, can make their own decisions. We can't force them into programming. We're fortunate in Norfolk with a trained staff that knows how to build trust. We're very successful in having most, the vast majority of our population participating in educational programs. And particularly, those individuals that don't have a high school education, the success rate going through our HiSet program, and having participated in some graduation ceremonies of these individuals, it breaks your heart to see some of the ‑‑ to hear some of the stories of why they didn't get to where they needed to go in the first place, and having come to our facility, giving them the first opportunity to ever feel like somebody cared for them, somebody was willing to invest in them, and they have for the first time ‑‑ and some of these folks, especially our pretrial detainees, who may be facing hardcore time, the first time they have a hope, opportunity they may, in fact, see the light at the end of the day perhaps when they get out of our facility or finish their sentence in a longer facility. 
We're facing now in Norfolk ‑‑ excuse me for my hoarseness ‑‑ a young man from the Quincy Public Schools. He's facing a serious charge. Murder. Life in prison. How do you establish trust in that individual. He comes from a broken family. He was involved in drug issues, who hasn't finished his high school education, who is on an I.E.P., which we were able to get from the Quincy Public Schools through that cooperative relationship and that trust factor between our agencies. That individual now is participating in an educational program that will at least get him on the path towards seeing where he can possibly go. But at the end of the day he's facing life in prison. That's a psychological issue that he's going to have to deal with. 
We're fortunate in the facility we have three certified clinicians, mental health clinicians, to work with the individuals, to coach them, talk to them, to get them through the issues they're going through. We make sure our clinicians also train our corrections staff. Our corrections staff, they're the ones ‑‑ they're the one‑on‑one leaders when it comes to working in the housing units. They need to be able to identify where the mental health issues may creep up, and they come up fairly regular. It can happen at any given time of the day. And especially with a young person, dealing with a loss of a loved one, as simple as somebody passing away, not being at a funeral, a wake, and these trigger mental health issues, and our officers are very well‑trained to identify that, and engage our mental health clinicians to make sure the proper programs are in place and the counseling's in place for these young individuals. Once again I circle back. It comes down to trust. 
I think we, as sheriffs, make sure we impart in our ‑‑ I mean, I'm graduating seven new officers tomorrow night, and I met with them yesterday. It's just a different training that we're giving the Corrections Officers these days. They need to be at a level of mental health counseling that they can be compassionate, that they can identify these issues, and correct them very quickly before it leads to what often times in the past has been tragic circumstances, whether suicide issues, further addiction issues. These are the things we have to deal with. So as a newer Sheriff, I'm really proud of the, of our operation at Norfolk, but certainly being able to be educated by my fellow sheriffs from across the Commonwealth, and to see what programs that we've done for the emerging adults on mental health, as well as all of our populations. And I'm really proud of the efforts that we've done. So, thank you, Mr. Chairman. 
>> Just a couple of points. One of the things that probably a lot of people don't recognize, is that Massachusetts has the lowest incarceration rate in the country. And that is because people are working hard every day. And the correctional officers ‑‑ and I know the term "Guard" was used during some of the earlier hearings, but we're developing correctional officers that are multifaceted. It's no longer the idea that you get a uniform and a set of keys and you lock people up. Because we understand that you can't do that anymore. And so the dynamic has changed. 
We establish Correctional Case Managers, who are trained correctional officers, but have a degree in maybe some other field, or a field in Criminal Justice, but can then be educated on handling mental health issues and/or LGBTQ issues. So, this is the evolving piece that's happening at the present time, but has been evolving for years. 
Remember, one of the other things that it's the elephant in the room for all of us, because we spent more time on Zoom over the last three years than I think any one of us would want to admit, but it was our survival to make sure that people were safe. During that period of time, during COVID, I think I came to realize a lot of individuals who are in our care, uhm, were ‑‑ had failed in the school systems, and so when they ended up with us, probably teaching them on Zoom was probably not the best, and so they needed the face‑to‑face. And so getting the educational staff back into those classrooms and doing educational programming, doing anger management, all of those things are, were priorities for us. Because I'm in a smaller county and smaller counties have to definitely do things a little differently, I have a hybrid mental health situation. I have contract services for two reasons. One is, that I can't afford to have a psychologist on staff full time at this point in time, but I'm looking in that direction at this point in time, because more and more the demand is there. But ‑‑ so by contracting out those services, I have psychologists and psychiatrists coming in to the facility, along with a part‑time psychologist who is educating new staff. Because one of the things that also happened during COVID was a lot of staff left. Whether they reached their retirement age and said, okay, you know, I've had enough, but there were others who said, you know, I really don't need this career, I don't need to be afraid every day. You know, that was everybody from correctional officers on through staff, that happened across the country, and it happened in every walk of life. We were no different. And trying to replenish those individuals. Now when we replenish, we replenish with people who have some connection to mental health and disorder management issues. 
Also, medication assisted treatment. You know what?  It has driven the correctional beliefs in Massachusetts. I believe it's the right thing to do. It's working well for those who are engaged in it and who are taking it seriously about their addiction situations, and they are ‑‑ those individuals are getting better and staying healthy. And remember on the, the County side, our population isn't with us that long. They move fast. And so having care in the community when they go back is a priority for us. Making sure that they have a connection to that community, and whether it be mental health or substance use disorder help, those have to be priorities. I think we all take that piece serious. 
We take it serious for the staff as well. The staff have been through a traumatic exercise for three years and are continuing. And now they're talking about possibly in January having another spike, you know?  Well, we're already kind of preparing for that piece, that, okay, how do we keep our staff safe through the holiday season, so that not only are they and their families safe, but on top of that, the inmate population stays safe. So those are just a couple of thoughts on those ideas. 
>> Chair:  Thank you very much. I wanted to offer comment ‑‑ and Sheriff Cocchi, I appreciate what the Hamden County Sheriff's Office has done, in terms of your employees are the mental health staff, because I ‑‑ a lot of our commentary today will be in response to testimony yesterday, and going into the state prisons, is that there's an incredible concern with the Department of Corrections with Wellpath, that they're providing inferior mental health care, healthcare, and including especially Bridgewater State Hospital, and if someone is an employee of, you know, a Sheriff's Office, is going to do a better job and be more responsive than, you know, something that's, you know, to a national contractor that often isn't focused on providing the best care, but is perhaps just looking at the bottom line, and so I appreciate that. 
I did want to ‑‑ the follow‑up I had, just on mental health care, is ‑‑ and part of this, I think it speaks a little to Sheriff Cahillane, what you said about the stress that correction officers are feeling, in part because you have fewer correction officers, fewer people generally working across industries, is what is the mental health care provided to correction officers; and have they been seeing more stress as a result of reduced workforce, you know, working overtime, or COVID impacts, etcetera?  
>> Very quickly on your comment on Sheriff's Office staff versus an example like Wellpath, I always look at it ‑‑ and this is not the time because, quite frankly, I think the legislature's been very good to the sheriffs, especially on our budgets coming through COVID, and we're very grateful for that. However, with that said, I will say it's like when you go to build a house. Everybody's got this grand scheme in their mind what they want, and they have a budget, and when that budget is given by the bank, you have to then fall within it. So the granite countertops goes to Corian, and hardwood floors going to some level of non‑scratching floors. The reason I give the example is because I think that's why some folks go to contracted services, because it's cheaper because you're getting what you pay for. That's not the way to deal with the mental health population or the substance abuse populations that are incarcerated. But there's no question, the 101 Commission I think was developed out of the rising budgets in the drop of population. Let's never mix the two together. To understand, that the population of men and women coming to jail, even though it's lower, and we're the least populated correctional system in the country, the amount of costs to take care of them is rising by the day, from healthcare, medication, mental health, medication‑assisted treatment, all the facets, that's just the severe stuff. And never mind all the ancillaries that are critically important to education, vocational education and training and things like that. So, while I just say I agree with you, Chairman, I think that sometimes people believe something's better than nothing; I don't proscribe to that. I would like for the funding be there where the Sheriff's Offices are regulate the level of care. And if the care isn't there, the level isn't being met, we release them and we go find somebody who can do it, and do it the right way. 
>> Chair Day:  If I can jump in before we turn to the question about mental health for the correctional officers. You highlighted the changing nature. Understanding the population, what services they need to be rehabilitated. That changes what you're all doing. It changes what we do and how we fund things. And I think it's going to change how you all operate. Hopefully it does. You just alluded to the fact you think everyone should have full‑time care inside the walls. I don't think anyone would disagree with it. When we look at reality, though, when you have smaller departments with smaller populations, where that may not make sense. Whereas, you have a larger Sheriff's Department, it makes sense. We need 24/7 care. We have a bigger population, more afflicted. Have you all thought of consolidating those services, when you have somebody who needs the care, rather than contracting in one department at a given time, bringing Middlesex, or whomever, they'll take those individuals, because they can offer better, more continuous services?  
>> When somebody reaches that level of care, we reach out for Western Mass. It would be to Sheriff Cocchi's office for the ESU. But for 50% of the population, they may have mental illness, but it's not an acuity that they need the level of services. But we do it on a regular basis, where when an individual has a level of acuity, they would go to the ESU. Sometimes the ESU will evaluate them, change their medication, get them situated, and bring them back to us, and/or they may get sent on to Bridgewater unfortunately, you know?  So that already happens within the system for those people, but it would not make sense to send everybody to the ESU. Because most of these individuals can live and work and go to the educational programming and the substance use programs that they need within their own facility, within their own community. But there is a percentage that does get moved to the ESU and then come back. 
>> I apologize. Just to follow up on that. Sheriff Koutoujian, you're welcome. Are these formalized policies, when we reach the level we'll reach out and the understandings are in place and there's not ad hoc basis of one Sheriff ‑‑ 
>> No. All of the mental health clinicians communicate with each other. These were established many years ago as a way to sort of stem the tide to Bridgewater. You know, now the tide does not move towards Bridgewater as much as, you know, we would like ‑‑ I mean, the three largest mental health facilities in the country are Rikers County and Cook Mental Health, are the largest in each of the counties. My population in 2019 was about 11% had mental, significant mental health issues, and now it's 49%. If you consider the chronic illnesses, it's 65%. When you consider the physical, mental health issues, as designated by the National Commission on Correctional Healthcare. We are accredited by that. We're all accredited by ACA. We all work together on that. The idea is, when someone is having trouble, they send them to us, Nick or I, we have more clinicians we use to address those issues. 
We work really hard, by the way, with family and friends of the mentally ill. It should be noted the family and friends of the mentally ill, which are the family members of those incarcerated with significant mental illness advocating on behalf of loved ones. We've worked with them to make sure we're establishing better procedures. Because some of their concerns were, you know, someone would go from Pat's department to Nick's department, and then ‑‑ then maybe if Nick had to send them to Bridgewater, they'd go back to Pat's department without the medication. We work very much with EOHHS and EOPSS to make sure it's consistent. They come back to Nick for continued stabilization, and if appropriate go back to there. Nick has larger ESU. Ours are constrained by space. But we have a number of clinicians. The idea about the hybrid?  I'm a personal fan of a hybrid. You can't afford to pay a psychiatrist to be on staff. It's $250,000 OR more a year to get someone in there. If you can hold them even. They can make more. My belief is you need to hybrid the higher level staff. The physicians, psychiatrists can be done through a vendor. But I believe a lot of our great work can be done through our own offices as well. 
>> Just one quick point on that, as this is ‑‑ this is decided by medical professionals, not the correctional people. Because we know that at the point that they're needing these services, that it has to be the medical professionals that make those decisions as to where they would go. 
>> The short answer, we all have ‑‑ have procedures, protocols. It's a still systemic issue we have with the, our ESUs. 
CHAIR:  Thank you. Are you seeing more of your employees are requesting mental health support?  Has there been more stress because of pandemic impacts, because of working overtime, etcetera?  
>> Yeah. So, let me just say a couple of national figures. International associations of chief of police survey found 78% of agency struggled with recruitment. These years we all see it. It's unbelievable how difficult it is now. Another survey from PERF, Police Executive Research Forum, resignation rates increased 43%. Compounding the retirement rates increasing by 24% during the period. We've done a hundred operational positions in my facility alone. That's concerning. You want to make sure you're providing appropriate care and custody and control. We have been desperately adding. More successful recently because we've changed the recruiting methods, in how we're doing it, to get more people online. So we are seeing ‑‑ like I've had an uptick. A class ago, I had four individuals in a class. We continued to do rolling classes. It's not just once or twice a year. We're getting temporary officers in place, who can be trained and become correction officers through the academy. This is the greatest concern, these forces are really wearing people down. We feel like we stabilized it a bit in Middlesex, but it's not as good as it should be either. It's a problem. 
>> If you look at it a little bit, it's called burnout. If you look at Rikers Island five years ago, the average workday for correctional officer was 16 hours a day. Forced every day. They lasted two to three years. But if you break it down, if you didn't have the extra shift you were being forced over every single day of the week, you probably can maximize and double the amount of time you spend in this type of profession. To Peter's point, there's no question we're very concerned but the mandatory holdovers because that's where the mental health is starting to stem. 
I will also say that I lost two correctional officers in the last year to overdose. Two. I won't say that's mental health, but we all know mental health is a piece of that. We did not have any suicides. The last suicide we had on a correctional officer was back probably 20 years ago by one of our retirees who ended up taking his life. I take it very personal when we lose somebody. Especially at the ages we lost these two correctional officers. One was 26 years old. The other one was 42, with a family. Overdoses. There is no question our line of work every day is impacting the welfare of the correctional staff that come in every day. 
What do we need to do?  We're reaching out to national advisers. People that have Best Practices. The Massachusetts sheriffs made the year 2023 the year of the correctional officer; meaning, what can we do more on mental health and wellness for our correctional officers. The answer isn't money. That I can tell you. It's not higher salary. The answer is quality of life issue improvements. What does that mean?  I was a correctional officer for 20 years. I understood what it meant for quality of life issues. So when I came into office, I brought change. But things are changing. And they're changing rapidly. 
You have to understand, in 2007 the counts were at the highest in the Commonwealth. We had 2400 people incarcerated in Hamden County in 2007. Today, we're less than a thousand. It is harder to manage the unit today than it was in 2007. Because when you have 2300 people incarcerated, you have people who literally do the right thing while incarcerated. They follow the programs. They follow the protocols. They abide by the rules. 
If you're in jail today, you've been in front of a judge numerous times. You've left many of issues and incidents in the community. So, you're not ‑‑ you're not comporting to the rules and regulations of a Correctional Institution. It's very difficult to manage these men and women that are incarcerated today. It's taking a lot of compassion, professionalism, and it's taking a lot of patience. And it's the same thing over and over again. So, our staff are getting frustrated, and they're getting, quite frankly, the word is "Burnt out."  And I don't have the answer to it. I will say that individuals come into us, some like the work, some don't. The ones that don't, we certainly don't want to keep there. We don't want them to do something that they may regret, so we let them leave, but that's another void that Sheriff Koutoujian was talking about and results into a holdover. So, our staff are doing a tremendous amount of work. They're working very hard. And ‑‑ 
>> Let me reiterate what Nick said. We had 1200 starting with sheriffs, and 800 now. The work is harder now than it was then. I think it's unusual to think about the social network effect lifting up in a jail, the behaviors, but I think ‑‑ and also the level of mental health and acuity of those in our places, those left behind is much more significant than ever before. While the numbers are down, the work is much harder and much tougher, and much more straining on our staff as well. 
>> Yesterday's hearings, a couple times ‑‑ because I was very intrigued and thought they went very well, but we heard the word "Guard."  Any man or woman who comes in, puts a uniform on in one of our correctional facilities, is unequivocally a correctional professional. They do not guard. Guards guard ‑‑ Pinkerton, they guard money. Our men and women effect positive change in people's life. Change the culture of an environment in which people live, that's conducive to positive change just by their pure attitude alone. Listen, we don't have all A ball players, but I'll tell you, we're A and B ball players. That rests on our shoulders. Every person who gets hired at Sheriff's Office comes into my office, has an interview. If they don't meet the grade, they don't get the job. There's testing. Academic testing. There's physical testing. The days of the good old boy networks and hiring through patriotism, it's gone. It's long gone. You have to make a benchmark. Meet the grade. Pass the exam. Pass the physical. Pass the drug screening exams. 
We have psychological exams. So, all of these components come into play when it comes to our staff's mental health, and still I'm so pleased that you are recognizing there's still an issue, not just in corrections, it's in law enforcement, it's in fire, it's in First Responders' work. What do you go and respond to?  You're sitting down having your lunch and a code blue goes off, the alarm sounds. You get up and you run, and you're running to somebody that potentially tried to hurt themselves, cut themselves, got into a vicious altercation where there's weapons involved and this is what you see as a first responder in that unit. Some people can cope and let it go. There's coping mechanisms. There's people to talk to, but some will never let that image go and that's where we find there's a lot of traumatic incidents that happen inside of the facilities. Thank you. 
>> Chair Eldridge: Thank you so much. I also wanted to learn more about, you know, talking about helping the incarcerated people in your custody, you know, become more productive citizens with the specific focus on vocational education programs, and I will say yesterday, we did hear a bit from some of the advocates about, you know, concerns about special education, and reaching those who are incarcerated who have special education needs or challenges of how sheriffs are reaching those individuals, so the education piece as well as vocational programs that your offices provide to your incarcerated men and women in your custody. 
>> I think you heard from Sheriff McDermott he had an IEP that he worked with the school district on. There's a lot of work ‑‑ let me just say this, and I say this, when you say "with all due respect," it's usually something not so nice that's going to follow. In listening to some of yesterday's testimony from some of the advocacy groups, I appreciate what they do. They fight and they fend and they protect and they stand up for people that need that support. But what do you think we do? That's what we do every day of our life. We go to work every day to take the people that are incarcerated in our custody and raise them up to be better men and women, better mothers, fathers, brothers, sisters, husbands and wives, to go back into the community to have productive citizens, to have another shot at getting it right. That's what we do, believe every single day and honestly, sometimes a simple thank you from some of the advocacy groups would go a very long way toward their local sheriff's office. We live there every day. I'm in those units. Every single day, 365, we're on call, we're at our facilities, year after year. If you really go and you talk to the people that are incarcerated in our care and custody, will you get a small percentage that don't feel they were treated right, feel we didn't accomplish or support them in their needs. That's a small percentage. That small percentage is what yesterday's hearings really put focus on and made to bring to big light, and I think that's an unfair characteristic of the work being done in each and every sheriff's office around the Commonwealth. It's a percentage. Look at the big pictures. How about the letters and notes and people and family members that call our office and thank you for giving their little Johnny back from years ago. Those are the things that I have to just say that I listened yesterday and I appreciate what the advocacy groups do and I respect it, but stop diminishing the incredible work that's being done, that is nationally recognized around this country by the men and women who have taken an oath to walk in every day, swipe a time clock and live hour by hour, shoulder to shoulder, elbow to elbow with the offender population, live with them and help them become better people. 
>> Very briefly, sir, education is one of the most important things we do with other programming. In Middlesex as with many, we have relationships with Merrimack College, Framingham State, Middlesex Community, Northeastern to name a few. Sometimes we get a better offer from a different university or college, we go with them because it's a better value and quite honestly, the motivations can be much greater, too. We included that on, with our policy 441 and procedures. I know that some of the issues yesterday were the waiting lists. As of today in our shop, and I'm sure probably with most, we have no waiting list for adult basic education and we do have 45 individuals on a waiting list for adult secondary education, but that's really a product of staffing limitations, that's really it. We would easily love to be able to do that but that's a staffing limitation. We have two individuals on an IEP in our facility as well, and we have that a number of people who have gotten their high school degree, not their GED, the HISET, so we're working with high schools when we can to have someone graduate from high school instead of getting their HISET as well. These are some of the things we can do and with regard to that adult secondary education, I go the to be honest with you, some of the best stuff that I see out of that and I've gone to a number of the classes and heard my own individual talking about existential threats which I still don't understand exactly what it means. I don't know exactly what it means but this is the level of work they're doing and quite honestly, what the leap is ‑‑ this is just an insight that I see ‑‑ the leap is not the fact that they're being educated at a college level. It's the fact they now know they can be educated at a college level. They never thought they could do something. That was for college kids. They weren't worthy of college education and here they are at a class with a professor, Perkins Grants and even me sometimes in the classes realizing I can carry on a conversation about any of these things and it's very empowering. The trick is when they get back out, can they continue to participate in these, and that's our greatest wish but sometimes those supports are not there for them, too. 
>> And Chairman, I'd also ask to give DESE a call. They come N evaluate our educational programming and they come in and audit us and we're pleased with the audit results we get from DESE and they give us our grant funding to continue to move forward with the programs. Sometimes what's on the surface, yeah, can we do better? Absolutely. There is waiting lists at certain times but some of the reasons for a waiting list is it's two rival gang members. One can go, one can't. Until this individual graduates or finishes the program, this person can't go. That would require a pause in his access into the program's building but what we'll do with this individual, he'll be in vocational. We'll do educational/vocational and swap them so they're at different parts of the facility at different times so there's no altercations. Those are some of the factors that go into a waiting list. I encourage a review as well with DESE on our educational program. 
>> Chair Eldridge: I thank you for coming before the committee, unlike DOC and EOPPS thank you for answering the questions. Also beyond the educational, too, the programs. 
>> I was going to highlight the fact in Norfolk, one of the things, all of the programming in place is always fantastic unless when you look at the Bureau of Labor Statistics and find out where the jobs are, we could be training all there is and figuring out what great programs these are but if there's no job available for the people based upon the training we provide it's all for naught. We look for where the job needs are, for instance a simple example getting a CDL license, there's a huge issue with trucking in the nation in terms of transportation so we have a course that focuses a ten‑week course that gets individuals focused on getting their CDL license. That's great, but we also think that it's important that you need to identify who the employers are going to be that these folks can engage with. One of the first hires I had when I became sheriff was the Director of Re‑entry Services and he hit the ground running in terms of identifying CORI‑friendly employers who were willing to give our guys a second chance. We have over 300 ‑‑ we don't have enough incarcerated individuals to find jobs ‑‑ we have over 300 that are ready and willing and able and I think that becomes the work of what the relationships that we build in our communities, and these are folks that are going back into the 28 towns that I represent and it's small, a painting contractor, for instance, who I met at a rotary club breakfast who said I'm more than happy to take one, two. I could take ten of your guys if they could learn how to paint. I hired a retired corrections officer who is a carpenter. We're renovating one of the houses on our Braintree campus and bringing some of the men to learn carpentry skills. First time ever one of the guys has used a skill saw, he learned how to build a set of stairs and all of a sudden, he said whoa, I can do something potentially with my life afterwards. There are some barriers sometimes, too, as well. I think some things that we have to look at in terms of teaching trades. I talked about my friends in the plumber’s union Local 12, all of our guys at the labor unions have been more than generous in saying whatever we can do to help. The problem is that, you know, a lot of these vocations require licensing, and I think there's some barriers there in terms of getting somebody who is formerly incarcerated with a conviction on their record to get a plumber's license or electrical license and that's a barrier we need to work together to figure out how best to deal with that, but I think those vocational programs are key at teaching these folks how to work on the outside. Because we have a program at Northeastern which is fantastic. People can get college credits, but college isn't for everybody either. I think vocational programming is absolutely necessary to teach individuals how to, you know, do an oil change, get a job as a mechanic. All of the building trades are a fantastic opportunity. We need to find out where the jobs are, and then build our programming around that. 
>> You mentioned, Chairman, vocational programming. We offer custodial maintenance service, they're taught how to do custodial maintenance, we offer a Serve Safe certificate in the food industry, we have a culinary food service program with the Holyoke Community College, MGM Culinary Center. We have a prison industries which does upholstering, sewing, we have a graphic arts division, we teach them how to do graphic arts, we have a wood shop area where they build sheds that are built to a house regulation so they can frame. We have a welding department, state‑of‑the‑art and the new welding on a capital skills grant. You can get your OSHA 10 card, and the other thing worth mentioning in the last two, we have an arborist program. We're teaching individuals how to cut down massive trees and when they're done, we send them off to Northern Tree making 45 bucks an hour. That's big‑time money but they have to go through a regimented safety course for the City of Springfield and lastly, a workforce initiative program a 501c3, allows us to take an individual released on Tuesday, come back to us for Wednesday and do an honest day's work and we're paying them and we'll do that until we bridge the gap to full‑time employment so they have food, they don't have to go steal, beg or borrow. They have enough food and money to Sean themselves until we can get them into that job interview that we've already scheduled but it's later next week. So they have the access to come to us, work and at the end of every day, we actually pay them on a debit card, they come back the next day and we pay them. And these are things that are very thinking outside the box, but it's all job‑related, and lastly, I'll say the biggest employer in western Massachusetts, Bay State Health has come to my office and they're starving for employment. They want people in maintenance, grounds maintenance, food services, and they're coming in and partnering with us. They need help, so when we're getting these skills, as Sheriff McDermott said, we're trying to identify the areas of skill vocations that there is a need in our communities, plussing them up and getting them to these folks so they can be interviewed and taken on for some job opportunities. The tough part is retention. So we do employ a job retention specialist that goes out and meets with these folks and while people are incarcerated and working, which we have a pre‑release center and they can come and go while they're still incarcerated, attendance is at 100%, the job supervisors absolutely love our men and women. When the incarceration severs and there's no post‑release supervision left, that's where we see a little bit of a dip in job retention. So I would encourage when we look at criminal justice reform in the future, I think one of the key components to successfully having people stay longer on the right path is substantial but manageable post‑release supervision, in having them continue to have to meet a certain level or meet a bar that keeps them sober, keeps them on track to showing up to work every day because the three key components in re‑entry is housing, employment and wraparound services. Those are the three legs of the stool. Without a job, you're going to lose your home. You lose your job and you lose your home, what internal commitment do you have to go to your mental health appointment, your substance abuse appointment or your health care appointment? You're not going to. You're going to self‑medicate to make the job loss and the loss of your home go away and that's self‑medicating through substance use. 
>> Chair Day: So thanks again for coming in and answering these questions. The House has some questions here so I'll get into some of the questions from colleagues as well as the general questions we have. And I'll try to do it in a subject‑by‑subject matter, circling back to what the original topic of this hearing is, and then we can move into different areas. With respect to correctional officer safety well‑being, the DOC regs mandate they have an annual review process of their own regulations that they promulgate for the Houses of Corrections. The regulations we've seen have not been updated since 2009. We asked the DOC about these annual review process, the response we got was that they perform compliance audits twice a year, compliance audits obviously aren't annual reviews as defined by their own regs. Do the annual reviews occur outside of a compliance audit? 
>> With the Department of Corrections DOC audits there's two per year. You're asking if there's an annual review of policy outside the audit per se? 
>> Chair Day: The regulation requires they make recommendation for changes that the sheriffs issue a written response for the Commission to review. Does that occur? 
>> I do know we were involved in a forum that we went through for CMR reviews, and this was just prior to COVID, and I thought we had some very good dialogue, Chairman. Quite frankly, with the PCDU, the Policy and Development Unit for the Department of Corrections and I thought they were very open to listening to the sheriffs. There's been several times on certain issues that would come up that the DOC may be moving in a different direction but understanding the Department of Corrections and sheriffs offices are totally different with the population they serve and with the community‑based engagement we have versus the DOC so I would say they've been very open in listening to any requests that we've wanted to have made, and amendment made. 
>> You mean do they come in and inspect us twice a year, give us some findings and then we respond to that? Is that what you're saying? 
>> Chair Day: The compliance audit, which we've seen. 
>> Yes. 
>> Chair Day: And those are public records, we read all those. That's almost a check the box, are they doing this, are they doing that. Then the portion of the regs that I believe requires them to say, we review what's going on here, we need to update what we're doing. Those haven't been touched in our reviews since 2009. That piece is one weigh wanted to get into it. Not for you all to opine on, have you requested regulatory changes? 
>>	>> It's fair to say for all the sheriff’s offices we don't go by the minimum standard, Chairman. What we do is elevated our level of standards by ACA standards, national institute of correctional health care, mental health accreditations. Sheriff Koutoujian brought in Lindsay Hayes when it comes to suicide prevention and increasing. When you look at the CMR, the CMR is the minimum standard. That's the minimum standard that you have to uphold to pass your audit. We don't prescribe to those minimum standards. We come in much higher than that. Just based on our philosophical beliefs in going with the best correctional practices nationally. 
>> If we're not understanding your question properly, we'd be glad to respond, too. 
>> When it comes to our individual policies, procedures, there's an internal review annually for us. That's not just like we decide once a year we get together and plow through because it's voluminous in terms of the amount of procedures and processes that we have and guidelines we have in place. There's an ongoing review that does come to my attention at least annually to sign off on the policies every year for our own internal office and those are reviewed, you know, when it's DOC comes in for their review of our stuff, certainly when ACA was in, that was pretty intensive in terms of the standards we needed to meet and having been through the process directly myself, because it was my first time in office, you know, it was quite comprehensive and we were proud of the involvement of our staff, our officers, our superintendent, our chiefs of staff and we were fortunate we received a perfect audit score from ACA and that's what we shoot for, in order to get accredited from ACA, you need stuff like a 98% on ‑‑ you need 100% on your mandatories but on your non‑mandatories you need about 96%, 97% and we were able to get a perfect score and I know that's something that all of the sheriff’s offices shoot for. It's not always attainable but those bars are set higher in the Commonwealth of Massachusetts. 
>> We can definitely get ‑‑ 
>> Chair Day: I'll follow up with the MSA. We've seen in 2018 we defined restrictive housing, prohibited for over 22 hours and still a reg on the book says hold them for more than 22 hours. I understand your position, sheriff, you go above and beyond the regs. 
>> That's not our policy. 
>> Chair Day: CMR that's still on the books with that respect. 
>> Correct. Our individual policies in our own offices supersede those, so again, the CMR maybe hasn't changed since the change but quite frankly, that's a discussion probably yourself and legislature and maybe the Department of Corrections. 
>> Chair Day: We'd hope to have that discussion. 
>> Our policies, just so you know, on restrictive housing, our policies have been changed to comport with the Criminal Justice Reform Act of 2018. 
>> Chair Day: We appreciate that. We received the various responses that indicate that. We appreciate that much. 
Sticking with the DOC's piece for a second here. The Commissioner to Prevent CO Suicide came out with recommendations. We asked about the adoption of any of those recommendations and didn't get much from the DOC of anything regarding the adoption of those. We did get some concerning responses from the sheriff’s offices, some of whom said we never received a copy of it. We didn't see it, so no, we haven't adopted any of them. That, candidly, is unacceptable. We have a legislative commission on which the MSA sits and they are saying to us, we never got a copy of it, so no harm, no foul. We're talking about, and I don't need to underscore to you all, the mental well‑being of our correctional officers, our front-line workers. So I would hope that the MSA would be able to address that with the particular offices that are telling us they never received a copy of this report and reviewed the recommendations and certainly haven't implemented the recommendations. 
>> You can rest assured that will be addressed and a written response. 
>> Chair Day: With respect to best practices, the DOC they are charged with basically setting a broad framework policy regulations for the House of Corrections and by their own recount, sharing best practices and we'd hope that would be done without us having to get involved legislatively. Certain things professionals should be doing. We would think the organization would be sharing best practices on mental health across the board. Is that occurring? 
>> Yes. 
>> Chair Day: From the DOC with the MSA? 
>> Through the Mass. Sheriffs Association we are always sharing best practices, during our monthly meetings and we also have meetings of different levels, superintendents, and others as well that we'll be sharing best practices. 
>> Chair Day: One of the questions as a panel, is there accountability on adopting best practices there? We understand there are 14 independent sheriff offices. We'd asked a question what incentives, one of the recommendations from that Commission was that you adopt mandatory physical and behavioral health assessments period I can to assist COs in their mental and physical health. We'll get into the DOC piece separate, that's nothing you have to deal with but from your own responses we received a wide array of different answers as to what's being done with respect to behavioral assessments on an ongoing basis. Some required up front at the hiring and stops and some incentivize with cash incentives and you have collective bargaining agreements on the mandatory piece so I'm not saying this can be done immediately, but there are varying levels of responsiveness that occurs from the different offices, some have greatly incentivized physical fitness and mental well‑being. Some seem to say we will check the box and move on. Can we address the disparity in process? 
>> Each elected official has the possibility to negotiate. So to blanket a request through contractual obligations is very difficult to do. You know, you bring up contractual obligations and I appreciate that, because one thing that's been really a major component of the mental health, I think issues that are happening with correctional officers as Sheriff Koutoujian and I talked about is the mandatory holdovers. One of the reasons the holdovers are taking place is because of the PF MLA. Now, I agree and support PF MLA especially for those who don't have those type of options in their individual workplaces, but when you're talking to correctional institutions that have contracted obligations, our correctional officers get four, five weeks’ vacation, five personal days. If they go six months without a sick day, they get another personal day or a day's pay. We have so many incentivized pieces to foster good attendance, and then the PF MLA came, and we have people taking three months off every year. We just calculated our hours, 4,500 hours, which translate into 18 posts for an entire year vacated. That was 18 people per day had to be held over because of PF MLA. I'm not against it. I'm saying when we institute and implement these type of things and you have contracts that have been decades of bargaining give and take back and forth, this is critically crippled our staffing pattern, which has been a contributor to the mental health overwhelming of our correctional officers, and I try ‑‑ I go around. I met with 27 correctional staff over the last two weeks on the 4:00 to 12:00 midnights and days. Number one issue is staffing. I hear you. I said but you guys understand something, when you book out of work, you take PF MLA, when you have a toothache and don't come to work, you're holding over one of your fellow brothers or sisters, so yes, I'll take some ownership, too, we can do better at getting the numbers plussed up, but you have to take ownership there as well. So when we talk about the contractual obligation, there's no question that you know, there's a hiring process, and there's a past practice in how we do things and any change in that ‑‑ hiring, we can make any change because we're not an employee. The unions don't come in and govern pre‑employment. It's once they're hired, once we offer them that job, and once they've made their statutory time as far as their probationary period, then they become part of the bargaining unit and at that point, we're really handcuffed in many ways in how we can continue to address, but with due and probable cause, we suspect somebody of substance use, we're going to mandate them for drug testing, and if not, the union will be put on notice that the person may not have an opportunity for employment. 

We can work out individual, I call them, letters of continued employment where we can keep people on the right path. But a lot of work's been done, Chairman, on mental health, but not enough. And you can't standardize it per se, but we can come up with a minimum standard. 
And then quite frankly, there are people at this table that are very progressive at the Sheriff's Office, and maybe there are some that aren't as connected. Some that maybe didn't put enough effort into understanding what their population of men and women who work for them are going through. But as an elected official, and as an executive body, I think that that renders itself in a six‑year term. 
>> Chair Day:  Sheriff, again, part of the rationale behind the oversight hearings is to figure out what's working, what's not. As the body that created your authority of sheriffs, we've got the ultimate responsibility for fixing something that may not be working. So if there are groups or offices that aren't rising to a level of minimum care, that's what we want to know about. And we need to act legislatively. If the individual, elected officials aren't doing that, that's why we're here today, to figure that out. Again, this is an ongoing conversation. Legislation, the need for it, will be debated among our colleagues as we get going, but if we're hearing some aren't doing as much as others and we need to step in, that's why we're here. 
With respect to the, I guess I personally take some concern with the fact that legal rights are, if you take that leave and then you're hurting your colleagues here, that also is a mental health issue ‑‑ 
>> Yes. Yes. 
>> Chair Day:  ‑‑ if COs are hearing that. It's a concern to hear that message. To be candid. 
The critical response teams, when you get an incident of trauma, Sheriff Koutoujian referenced a lot of individuals, inmates are there because of trauma, and how they grew up, what they experienced, and we know, and we've heard from COs, when they deal with trauma, they see trauma on the job, it doesn't end when they punch the clock or badge out at the end of a shift. Do you have on your ‑‑ on your CRTs, do you have debriefs set up for the traumatic incidents?  Could you give us a flavor how the sheriffs handle it?  
>> Each one of us have our own wellness programs. When I first became Sheriff I hosted a national ‑‑ honestly I didn't realize the temerity it took to host a national conference on wellness. Attended by 300 leaders across the country. We did another one, as the Sheriff Koutoujian mentioned. We work with the Department of Justice to design a program. The diagnostics center. The review of literature you see in your packet was because of our engagement with that, with that Department of Justice initiative, and that is there as well. 
Because of what we did here, we established what is by the Department of Justice I believe is considered a best practice. We have now an external EAP, for high‑level psychological needs and address not only that, but their family members are entitled as well. We make sure it doesn't stop at the employee. It goes on to the family members. They will also struggle, whether work related or not. 
We also established a peer support team, which is made up of officers within our facility. From every shift, every rank, diversity of experience and demographics. We have a full‑time position running that program as well. 
And so I would not say, and actually it's interesting because I speak with relatives that are firefighters about do you have a mandatory debriefing, and even they don't have mandatory debriefings. We don't have one. But if there's an incident, and quite honestly, if there's an inmate self‑harm issue, it is traumatizing. It's not just the fights, this and that, but it's also when someone hurts themselves, that is something that is traumatizing to our staff, and we take that all very seriously. The peer support team will immediately step right in and connect with every single person involved with that situation. Just to make sure they know they have these resources, they can talk about it at any time. Any time there's an incident, external or internal, we have a group of peer support specialists that are trained in this way to immediately step in and address those needs quickly. 
>> Chair Day:  And I'm not asking you all for your specifics, but is that fairly uniform, is that uniform across, that everyone has some sort of debrief and de‑escalation piece at the end of the traumatic incident?  
>> Most of those are required by ACA standards. So our NECC standards. That's what standardizes it across the board. One of the other things I experienced nine or ten years ago is with the death of an officer, that the critical response team from the Department of Corrections is topnotch, and they came in as outsiders to be friends to the rest of the staff. It was a welcoming experience. 
So there are people out there that are within the system that can also give credit to what happens, and it's not the person that you're working a post with every day. It's somebody from outside, who has the same level of experiences that you've had, but are, have some distance. And that team spent probably the next six months communicating back and forth with those people who were closest to that officer. So those are the types of things that we bring to the table. 
Our Mentor programs. When new officers come in, we assign them to a Mentor. So that that Mentor can give them guidance on where they've been and how they, how that Mentor themselves have lived through the program. 
I remember back in my younger days, I happened to be the shift supervisor when the first suicide happened at the facility of an inmate, and for about six months I questioned myself about that, and I didn't have those, I didn't have any resources to turn to, and actually it was my wife that became my resource. And she said, you know, you've analyzed this every way to Sunday, and you realize that there was nothing else you could have done. And you know, and I went back and I did that again. 
And so the resources have to be expanded across the board. And it's not just in corrections. It's in any, any of the First Responder communities. Because the trauma is getting worse, you know?  And the officers that are coming in and out of our facilities every day are dealing with more horrific situations. And there's a level of acuity that happens 
>> In closing on this line, I want to say, it is true, if there's a loss of a life of an officer or incarcerated individual the peer support specialists go right how. It's not just because an officer might feel like they had not performed professionally. It is honestly they know the people. For decades sometimes, they've been with us so many times. While you might socialize with them on the outside, there's a human connection, and loss for the officers as well. It's just on the human side. 
>> Chair Day:  It's also great to hear, Sheriff, the state is bringing resources to bear when the incidents occur as well. Credit to the DOC for bringing their professionals along. 
>> We'll also share as well, we've done that as well. Whenever there's the need, we'll share our own officers. Especially if there's going to be a large gathering, something like that, we'll also share our officers to man posts, or, you know, to attend posts for other shops that have large funerals or things like that too, and so we're always doing it for each other as well. 
>> Chair Day:  You both mentioned families, the importance of families to all of us, but obviously to our COs as well. Could you talk about the resources available for families who spot changes in their loved one's behavior when they come home?  Are there resources they can call up and say, hey, there's something going on, we need to intervene before something devolves?  
>> Yes, they receive documentation with the information. Quite honestly, it is something we reiterate every chance we get. At my own academy graduations when I have the families there, or our recruit family orientation night, I always speak to the families. Oftentimes they're the only one really watching out for the individual, their responsibility, the responsibility of the officers to stay in touch and listening to their families. What all of us do is a lot of family activities to engage in that level as well. We do hockey and baseball games. Free skating at local arenas. We've done family orientation nights. We do a lot of these types of activities to engage with the families so they can also understand who we are, and then they can understand there are resources. At every one of the engagements we speak about the resources available to their loved ones, but to them as well. 
>> Just to further add, that we're talking about a group of men and women who are all alpha, which makes it difficult for them to come to it alone. We rely on the mechanisms, the mechanisms, the acting‑out behavior, the signals taught in the national trainings to our staff. But even to their families we encourage ‑‑  I know I do when I meet with families prior to the graduation, we talk about the insurance card, and the importance of the insurance card. On the back is mental health and substance use numbers to call. 
They also know they can call us at any time. My phone rings more ‑‑ I deal more with staff issues than I do with offender issues. And that's just the way and the nature of the business. You know, somebody asked me sometime what's the toughest part of your job. It's knowing that I have hundreds of families that rely on their husband or their wife, their brother, sister, coming home safe and being in the right frame of mind. That's the toughest part of the job, making sure they have the resources and tools to themself, or with a team approach, navigate whatever type of mental health or substance use component, or just lack of understanding the work. So, we do a lot when it comes to the families. Again, it's very difficult to pry out of an alpha individual in a uniform, who thinks that he can't show weakness, and we have to break the stigma. Here it is 2023 coming in, the year of the correction officer, breaking the stigma. Whether mental health, substance abuse. 
Don't forget, many of the staff will use mental health and substance abuse when they get in trouble. Sometimes it's the behaviors that get them into a path of discipline that reveals that they are in crisis, and then we don't just abandon them, say, okay, that's it, you made too many mistakes, you're gone. The behaviors have shown that there is a mental health or a substance abuse issue. We go walk with them, side‑by‑side with them. We get them into treatment, bring them back. We put them on a very accountable work plan, so as long as they continue to meet the grade and do what they need to do, we get them back into the workforce, back doing the things they need to do. 
>> Mr. Chairman, yes, one of the first things, having a benefit from Boston College, Assistant Dean, who was studying to get her Ph.D. in this particular behavioral health area, and she introduced us to an independent Employee Assistance Program. As well as we have internal one in Norfolk, peer‑to‑peer support professionals. The state has their own version of an EAP program, I don't want to disparage it, but however, we believe having independent EAP program that had 24/7 response available to both the officers themselves, not just officers, but any employee of the Sheriff's Office going through any kind of traumatic issue, but also available to their families as well. It doesn't necessarily have to be just a critical incident. It could be a variety of things. It could be frustration in the family. It could be, you know, husband‑wife issues. It can be child‑related issues. It could be legal‑related issues. It could be credit issues. It could be financial programs. The EAP assistance we offer, I'm very confident, it is one of the best available. The tough part, I think as Sheriff Koutoujian talked about, the alpha employee using the services, and it is constantly reinforced the services are available to them at no cost to them individually. That is part of our budget, that we pay for that service for them. I think it's invaluable. 
>> Chair Day:  Thanks. Picking up on those two points, the stigma inherent in the population there, obviously we don't need the Northeastern study to tell us, based on your experiences, that this is a huge challenge, and so I'm somewhat encouraged by the varying levels of responses, in the different services and resources offered, the varying levels of involvement the Sheriff's Office from our requests on the end, and hope the NSA will help to push out Best Practices on that, in that respect, and the legislature is here to assist in what you're doing in that end. 
I had a question from a colleague on workers' comp for mental stress claims. Is that ‑‑ we know that these workers' comp claims are compensable under our statutes. Do you keep track of data on those particular claims?  And I guess as a side piece, we know the DOC's self‑insured. Are you all self‑insured for worker comps as well?  
>> So our worker comps claims, we do take care of those out of our annual budget. So we are responsible for that. I will tell you the workers' comp claims on PTSD and mental health have risen. I'm not saying they're all not legitimate. I think many of them are. Just based on what we're seeing in the communities today. 
I do think that you will see ‑‑ and we do correlate them. We do track them. You will see a correlation of people that go out on workman's comp with mental health is correlated with disciplinary track issues. When they feel they're getting to the end of the line with behaviors, attendance issues, suspensions, oftentimes, and we see this, that they all of a sudden will pull a "I have a mental health problem and I'm going out" ‑‑ stress, that's what they call it, going out on stress. It's a difficult thing to prove with the doctors that are out there. We have private investigators and go and check. Let's be honest, when it's mental health stress, you're encouraged to go hunting. You're encouraged to ride a bike. You're encouraged to go and play golf. It's mental health/wellness. So it's very difficult to get the men and women back off of mental health stress. And a lot of it, we see ‑‑ I'll say, my office sees it is correlated with disciplinary issues starting to build and they're in fear of losing their job 
>> I would say the industrial accident claims have increased and the mental health claims within that has increased as well. Sheriff Koutoujian mentioned PFMLA have been a significant issue. And especially with the nonregular ‑‑ sporadic?  What do we call it?  
>> Intermittent. 
>> The intermittent FMLAs. You can't plan it. My shift, I took a look at the listing, we're down nine staff people just to start the shift, because of FMLA, PFMLAs. And on a good day, with the days off, there's only five people scheduled to work, and you're down five. This is what we face every day. As Sheriff Koutoujian mentioned, we get having the industrial accident protection is good. It is the extension sometimes that is more concerning. We get after an incident, physical or otherwise, there can be a period of time. Just some of them go for a long period of time, as well. We're having to send the letter after one year, if you don't come back to work you will be terminated, and we get a lot of people coming back to work at that point too. 
>> Chair Day:  Let me shift gears to inmate welfare. There was testimony yesterday about the high number of suicides of our inmates in correctional institutes, and there were outliers among the House of Corrections. Specifically PLS mentioned Bristol and Barnstable. I understand they're not here and we can follow up with them specifically. If you all would like to offer a brief, general comment what you're doing regarding that particular problem. 
>> I know our Sheriff's Office already provided the information in 2021 as part of the annual reporting mandates for restrictive housing and some of our inmate welfare. I kind of take offense to that comment by PLS quite frankly. We get people to us that are extremely sick. Mental health and substance abuse‑wise. And there is nothing worse than a loss of life in our custody and care. Nothing. To the point where I've actually attended funerals of the individual who passed in my custody. Because he had no family. He had no money. So I called the Sisters of St. Joseph's, and we buried him right up there. And I attended the Mass. Where was PLS?  Where were they?  I had staff to mourn for weeks. Let's not turn suicides in Correctional Institutions into a political football. Thirty years I've walked those tiers. I can't tell you the lives we saved. Going out in an ambulance to not come back but came back. Because of the men and women who pound those tiers every day. Yes, we have suicides, and one is one too many. And in my briefcase I have a list, a name, a name of every one of them. They're not numbers. They're people. And I have every one of those names in my briefcase and I carry it with me everywhere I go. I take extreme offense, umbrage to PLS pointing fingers how we do our work. We've done thorough, extensive suicide preventive measures. Extensive. I don't think anybody does it better than we do it. 
>> I'm not sure how to follow that, Mr. Chairman. It's well‑said. It is worth remembering it is our responsibility to keep these people healthy and well. I have attended a service like Nick that no one was there except for me. I will say, reiterate the point I made before, when you consider the chronic conditions that our population has, and that can be the asthmas, the diabetes, the cancers, the heart, all these other things, and you add in the psychiatric chronic conditions, designated by the National Commission on Correctional Healthcare. Our population, 65% has chronic illness. Uhm, as Nick had said, we have brought in the Lindsay Hayes, not just to ‑‑ not just after a suicide or attempted suicide, but also following up every two years since then. Just to make sure that we're still sort of staying on top of it, if there's anything more we can do. We've found some great things we can do. 
Not only that, you might have read we've put in place a family support services coordinator, which is connecting with the families of the incarcerated individuals, right?  You know, we remember the incarcerated individuals, and focus on them. Sometimes we remember the victims of the crimes ‑‑ not as often as we should ‑‑ and we really forget completely the families that suffer while the person's incarcerated. It provides great opportunity to provide the connection with the office. So if there is an individual in crisis, that the family may know about but we may not, we can step in. 
Also, we did a few other things after the Hayes' report we thought up. The outgoing call from the institution, that there's a warning, a recording that says "If you're concerned about the well‑being of your loved one, please call this number."  We received dozens of calls there too. There's a lot we do. I think the level of mental health I think today in corrections is a whole different level of engagement with mental health. When I started, probably when Nick was a CO, it used to be you have the operation staff, security staff, and mental health staff, and the mental health staff is saying I think this guy, this person is having this stuff, and the operational stuff, and thanks, we got it. Now it is completely the opposite, that the mental health actually it's completely dovetailed, and they're meeting with restrictive housing three times a week, the operational staff and mental health staff. This goes on all week long, all monthlong, all yearlong. It is always where the operational staff is consulting with mental health and vice versa consistently. I think it has made us a better operation as well. I think it's happening across the board. Nick?  Pat?  
>> Most facilities are evaluating on day one, once the person comes in the door. And that's where it starts. From the security staff, the correctional officers, most of them are CIT trained. They go to a week of training, to evaluate how to engage the individual who may or may not have mental health issues. Those are priorities for us. But what used to be viewed as paramilitary organizations are no longer paramilitary organizations. Because each individual officer, each individual correctional supervisor, and each individual captain, major, whatever the rank is, also have to wear the hat of being a medical professional, being a mental health professional, to work with the rest of the staff to make sure that there's a safety valve. And the safety valve becomes exactly what Peter was describing. It's no longer the silos. Everybody has to work together. That's what we're seeing across the board in our correctional facilities on a County side, so that it works better, and so there's no longer, well, that's the case manager's problem, or that's the mental health problem, and that's not a security problem. Everything is everybody's problem, and that's how, that's how we've evolved over the last ten years. 
>> So to Peter and Pat's point on the correctional officers, I thought, Pat, you just made a really good point. We don't want to call them necessarily professionals, but they do, our staff, they have a fingertip of understanding of medical issues, how to respond. CPR, first aid. Tourniquets, apply pressure on a wound. Mental health. They have mental health training, to identify somebody who could be substance abuse active. They have training in that. 
What we're really talking about when we talk about our men and women, and we talk about correctional officers or correctional professionals, because there are so many other people who play a role in the stay of somebody, and it's not just the men and women in uniform, I think they're heroes. We're asking so much of them, to do so much in so many different arenas. 
I just want to come back to the last piece of how many people have left our facilities in an ambulance, and we were told to get the next of kin notification ready. And the EMTs, the paramedics, that came have said this over and over again:  If it wasn't for your correctional officer and your medical department's swift, quick response, this person wouldn't have made it, and they made it, and they recovered, and they came back, and they went home to their families. Let's not lose sight of those. And if we're going to talk about ‑‑ I want to dig deeper on suicide prevention. I want better answers and better solutions. But in my 30 years of being in this business, never once while working in a unit did somebody who successfully committed suicide ever walk up to anybody and tell them "in five minutes I'm going to do this."  It's the quiet man or woman. It's the person who truly is deeply troubled that found a way. And our job, when that tragic incident happens, is to convene a committee and to find a way to not let this happen again. 
We have to close the back of the bunks. We've welded ‑‑ they had beds, bunks made for corrections around the country, and they had holes in them. For people who urinated themselves, so the urine wouldn't pool. What'd they use the holes for?  They used them for ligatures. We had to weld every one of them in. 
We used to give stools in the units, so you could sit at a desk and write a letter. But the way they were crafted 32 years ago, they had ligature innuendos, where people would hang themselves. When I tell you the lengths that some people go through to self‑harm, it's tragic and it's sad to the commitment that they've had to make their life to harm themselves. 
It's very important we continue this dialogue, both Chairmans, and we get better answers, and we come up with better solutions, but I can assure you, and I say this not to you, but I'm saying this to a third‑party probably watching, let's not use a successful suicide, someone's passing, and their family as a political football to knock the work of the sheriffs. We need to look at that individual case, and we need to find out, investigate what happened. If there was wrongdoings, we deal with it. With a swift, firm hand we deal with it. If there were no wrongdoings, we then collectively get together and we start to figure out how to not let that same situation happen again. 
>> You know, because this is such an important issue, we've, in our office we have ‑‑ and we have three employees that are specifically that are, that includes two mental health clinicians and one Corrections Officer who are certified as mental health first aid trainers, and we have a third mental health clinician who is a certified suicide prevention trainer. Those mental health staff participate and teach suicide prevention classes to all of our academy recruits, as well as a three‑year certification course in mental health first aid. 
Our current employees, I have ongoing suicide prevention and mental health training as part of our annual in‑service curriculum. To say that this is an important issue is an understatement. It clearly is. We take it very seriously, as sheriffs, and particularly I can speak to Norfolk's commitment to it. This wasn't something that was always part of the direct curriculum. We believe it's important. We believe it needs to be part of the curriculum. I think my colleagues share in that, and I think their own Sheriff's Offices do the same. If not the same thing, but comparable things throughout the agencies, and so it is important to us all. 
>> Chair Day:  Thank you. Let me shift gears again a little bit here and focus on some of the oversight we're conducting, the status of LGBTQI populations. We've heard from some sheriffs that identify compliances with a litany of issues preventing appropriate transfer of certain inmates. Could you address that a little more fully for us. Particularly we heard testimony yesterday and over the course of time that transgender inmates aren't being transferred, and some of the responses is, are, that admin doesn't allow us to do so. Can you help us understand better from your perspective?   
>> One of the sheriff's offices has a women's regional facility. We have presently three transgenders at our women's facility. I was just there last Saturday and had the pleasure of sitting down and chatting with one of the young ladies. We have a committee, transgender committee that will review any individual that comes in and identifies a specific gender and whatever the request is, we'll sit down and make sure that it's an appropriate request. If it comes through on a minimus it's automatic, we send them to the women's facility. They don't stop at the male facility, but we've also transferred people that did not come to us with a minimus change, that came to us with a House of Correction male identified as a female. We put our committee together on it. We felt it was in the best interests to make that accommodation and move the individual to the women's facility. I will tell you, we have had zero issues, to my surprise. It has been very smooth. The individuals that are identifying on another gender in other facilities have comported themselves in a very respectful way, the programming, the fulfill their needs, whether it's a bra, a night coat, we do the same for, if somebody's identifying and wants to stay at the main institution, where the males are, we'll provide them those type of items. It actually has gone extremely well. No issues, no issues from other offenders giving people a hard time. I am very pleasantly surprised in how the cross‑gender, the identifying and the movement to different facilities has worked out in Hamden County, and we've had quite a few over the past two years, and I'm very pleased in how it's worked. 
>> We've had a few of these cases and as Nick said, quite honestly, I remember the first time we had to order a correctional grade bra. I was really stunned by this, and suddenly nervous about this person coming into our facility. She was homeless. She had struggled a lot. She came into our facility and there was no problems at all with our officers, with her. At some point, actually, we were holding, I think some of the concerns are where you place people. She had come off the street and we put her into our health services unit, and at some point, she was doing quite well there, and some point she wanted to go into general population and of course, we had our concerns but there was not a reason to hold her in health services. It was restrictive housing unit but we put her in general population and it worked out really well. I was impressed with our officers. We cover this in our basic training academy, we cover this in our annual service training every year. I wanted to mention, I know some of the concerns with regard to restrictive housing so I did run our numbers there. No one is placed in restrictive housing based upon their self‑identified gender, full stop. It's not just a reason. We have had 32 LGBTQI individuals over three years in the restrictive housing unit, 1.49% of all of those that attended that unit, and they had exactly the same length of stay, 5.3 days as the non‑ ‑‑ you know, the other, the more general population, so there was no difference in the way they were treated, and they were not overly represented down there as well. 
I know Sheriff Cahillane was on the commission and maybe can fill a little bit of what you might need as well. 
>> I won't ‑‑ excuse me ‑‑ I won't speak for the Commission, because the report should be out within the next month. We've had a lot of work that we've done. We've attended a lot of meetings. We have continued to do it, even though it's technically sunsetted, but we felt that it was an important mission that was dictated by the legislature. One of the pieces that I would have loved to have seen on the Commission was that there was legislative representation on there, because we were a Commission assigned from everywhere else but the, the legislature didn't have a member on the Commission, and we had to, let's face it, during COVID‑19, we had some things we had to work through, but one of the things that came out in our discussions, and I'm 100% supportive of, from our standpoint on the sheriff's side is that education is always important. Educating staff, educating supervisors, educating all the way up to the sheriff and the superintendents, that on understanding the cultural differences between the LGBTQI community and the rest of the community. That being said, our responsibility as sheriffs is that we are required by law to treat everybody safely and humanely, and I stand by that, because everybody should get the same level of care. Everybody should be treated the same and so I think a big part of that goes a long way when we start educating the staff as to what that means. Even though we do it on a level in‑service training and we to it at the academy trainings, there's always room for improvement and I think the issues surrounding the LGBTQI+ community is just that. I personally have spent some time now engaging a transgender organization in my community to work with educating our staff on what does it mean to be a transgender individual, not just a transgender individual in an incarcerated situation, because that's very different, but just so starting with the correctional officers again, because they're the first line of defense in anything that happens, correctional officers, treatment staff, nurses, that will be the core group. So there's work to be done on that piece, but it should not just be that piece that we focus on, because sometimes when we focus on one piece, we can put targets on people's back also, and that can be a dangerous thing. One of the things that we did discover or I discovered was that in a lot of facilities, because especially in the county side, individuals who are with us for such a short period of time, they don't want to be identified anything other than an inmate or an individual who is incarcerated for a short period of time. They don't want anybody to know what their personal business is, and that's their right. And so we have to ‑‑ we have this balance that we have to work with when we're trying to protect these individuals and at the same time get them the services that they need. 
>> Chair Day: Thank you, Sheriff. I don't want to speak for my co‑chair but that may have been the first time that there was a complaint that a legislative committee member was not attended. 
>> We had no request that a gender request was not fulfilled. With the women's facility we've had several, but they've all been obtained. 
>> Chair Day: I continue to beat this horse, but we view this as an ongoing discussion with you all where legislation and fund something needed and I guess on the funding piece, we heard yesterday that some county houses are not offering LGBTQI‑specific programming because they stated they were unable to handle the safety issues that that presented. So we look forward to ongoing dialogue about that, getting into that a little bit more, as to what the rationale is there, and whether it's a funding issue or whether it's a structural issue inside those houses moving forward. 
>> Um‑hum. 
>> Chair Day: Sheriff Cocchi, you mentioned the Correctional Funding Commission where we took a holistic look at the funding mechanisms of the Department of Corrections, your offices, including staffing, including training and MAT which you referenced earlier, that you're well on the way to getting uniformity in our approach on staffing, or at least how we're able to review those as the budgetary, ultimate budgetary authority. The legislature wants this apples to apples comparison to figure out who needs what. We're not ‑‑ you know, get everything on the same page. Staffing and you have three pilots rolling out, that's encouraging to hear so we can understand what the staffing picture really looks like. Same thing on training, when you get uniformity training. We heard earlier today whether it's correctional officer mental health, safety, training, the uniformity across, it doesn't have to be specifically uniform, but we have a baseline and that's encouraging and the MAT, the advances on MAT is encouraging. Could you talk briefly about anything, the MSA or you individually are doing now on your own, before you don't have to wait for legislative action on this stuff to get your financial reporting apples to apples? We've got ‑‑ one of the frustrations I think you hear from the legislature is we put in a report requirement, and we get 14 different reports and formats and well, we hit the minimum here and I'm going into more detail there. Have you all had discussions since the Commission wrapped its work because the recommendations were put out there, some of them legislatively, some take care of your own business type of recommendations. Could you talk about how that's been received and what you've been doing to get to this apples-to-apples request? 
>> Yes. So first of all, I thought the 101 Commission, and I'm sure it's going to be an ongoing look, I thought did a fantastic job overall, taking a dive into, as you say, apples and apples, understanding what we're comparing, and then taking a look at some of the underfunded agencies that may be out there, that are coming to the end of their budgetary allotment in, you know, May, versus some of the others. So what I'd like to see happen over the course of this next year, or next couple years, as I hopefully lead my brother's sheriffs at the MSA is to streamline and get our reporting consistent, and correct me if I'm wrong, I say this tongue‑and‑cheek but we send a lot of reports. Who reads them? 
>> Chair Day: We're hoping to streamline the ones that actually use them. 
>> Back at you. 
>> I'm going to ask that question again. No [ laughs ] ‑‑ but there is a lot of reporting and it's necessary. I get it. [ Laughs ] you're a good man. 
>> Need his phone number. 
>> You're a good man. But even today, 250 work hours to get here, 15 staff. I'm so proud of them. I hope ‑‑ and I will say publicly, I will be here with anybody who is going to review my particular submission, and I'll come down with a couple people and we'll go through it tooth and nail to explain whatever we have to. That's the real work. The testimony the last couple hours and we can go for as long as we want, that's the agency heads coming to you and saying this is what we're doing, but rest assured, the practitioners, the men and women that are back at our offices, the ones doing the work every day, they can best explain it, because it's daily activity for them, where we entrench ourselves in it. We don't make ourselves ‑‑ we're in our units. We go, we talk with the inmates. We're on the policy level. We're in the conferencing area of our facilities, but the documentation that we sent is going to very clearly show this committee who's doing what, who's making the grade as far as the Criminal Justice Reform Acts of 2018, and who's got work to do. We can testify, but I'm sure there's things I left out that we're doing that are fantastic that I just forgot about, but it will be in the report and it will be in all the documentation that came with it. So when we look forward and we talk about how can we get more consistent, I agree with you, Chairman, we need to do that. I'm going to work with Carrie Hill closely on that, get our reports to look alike, to report the same numbers that are being looked at and we're going to forward them and we will make it a point if our reporting mechanism is to some other agency, we will make it a point to also report if you'd like to this committee and we will send them to where they got to do and cc and send them over so you have them at your fingertips but I think that's what we're working towards in this legislative cycle to come. 
>> Chair Eldridge: So thank you so much, and I just had one more question. Been a great discussional round, incarcerated people, that have mental health challenges and I'm just wondering for those that have served their sentence and they're not going to state prison, what are the efforts to connect them to mental health services when they return to their communities? So I'm just wondering if you could talk about that. 
>> Sure. Many of our facilities and offices are in ‑‑ some have, I know Sheriff Koutoujian does and myself and Sheriff Cahillane and McDermott, we have all‑inclusive services, where you have your center, but it's a center where we release all of our individuals from and it's a one‑stop shopping. There's mental health services there. There's sex offender treatment provided there, there's college courses, education, substance abuse. We have what we call re‑entry specialists. We help them get their ID at the RMV so they can get some level of work. One thing I will tell this Committee if you can help us in any way, we have a tremendous amount of trouble in Puerto Rico, obviously with the devastating hurricanes and things that have happened, we are not having success getting identification and birth certificates from Puerto Rico. It's taking not weeks; it's taking months if at all. And Hamden County with the high population we need some support and help to the point where I almost thought about flying a staff member out there to meet somebody that we could just talk to, because that's a major hindrance in letting them go back into the community, but we have what we call on mental health just as we do at MAT, it's called bridging, bridging people to the community, and it's a process that takes place in preparation. I'm going to say the word again, preparation to somebody leaving. See, what happened during COVID and MAT is people were going in front of the courts and the courts are saying dismissed. There was no preparation. The person was going into the community without a script, without a continuation of medication services. We have worked on that. When it comes to mental health, we have DMH that comes in for the severely mental health ‑‑ the severe mental health cases, and that's a transition that happens in the community. They stay in contact. We also have individuals that we will take in our custody to their mental health or health care appointments, so they've walked through the threshold of the door for the first time, arm‑had‑arm with one of our re‑entry specialists so that anxiety level that happens to people when they first get out in the community, they get nervous, making the right decision becomes a little bit more difficult than when you have somebody on your side. They've already walked through the threshold of the door. They know who the doctor or the physician's assistant they're going to see. There's a comfort level there. They're more apt to show up again. It's called relational building, relational model, so by getting people to walk through the door, to get them set up with the re‑entry plan so their mental health services, substance abuse, their health care and their employment are all tied into another meeting and engagement after they leave incarceration. We try to establish that up front about, again, about building relationships. But again, it comes to that word, preparation. We have to have time to prepare for that person to step into the community to make sure that they're seeing. We in Hamden County have a national model on zip code. You see the doctor in the facility that you will see outside the facility based on your zip code in the City of Springfield. So you now have that relationship built. He or she already knows your health care concerns, your chart, so when you go back to the community, you pick up right where you left off. 
>> I'm sure a lot of you folks read the Pine Street Inn article yesterday with supportive housing, right? It's not really rocket science, not just housing but supportive housing is really needed for a lot of these folks, and we have some of these programs. One thing that a number of us have participated in is the Behavioral Health Justice Initiative funding through EOHHS, which is science mental health navigators. You know, we think about navigators in the health care system, we think about them for medication‑assisted treatment, but they can really be used for this purpose as well and I think that is something that we don't use them enough for or call on them enough to kind of raise that level as well. Sometimes coordinating with DMH or DDS is a challenge. It just is, you know. It's not ours. It's theirs, or it's no one's, and we have a hard time with that as well. I think one of the things we probably should think about, you know, I think we are, is whether or not you use more long‑acting injectables to support people as they're leaving, too. A lot of people with serious mental health issues just don't like the way they feel, they think they're fine, they don't need it anymore which is where the advent of long‑acting injectables with substance use, a form of suboxone or naltrexone is workable, they can do it every three months or six months, that's something we also should be trying to look at more to find out if that can stabilize people for longer, during which time we can work with them to continue that stabilization. 
>> One of the things that we've done is, we have a program called the Bridge to the Future and those individuals that are close to the end of their sentence can be involved in a work release program, finding housing and finding mentors in the community and finding sponsors, if they have a substance use disorder, and those are all requirements that are built around the whole re‑entry package, and it's worked really well going out into our local communities, but also, women who are sentenced to the western Mass. women's facility are coming out of Hamden County's facility, and if they are citizens of Hampshire County and coming back to Hampshire County, a lot of those women will be set up with our reentry specialists and then all of their programming will be set up in our community, where they're going back to, because, and we've heard it for years from the legislature that one of the expectations is that we take care of individuals in their own community, and I took that to heart years ago, when I heard it from different committees, that that should be an expectation of citizens. If you're coming back to the community, you should be managed in that community, and so those are one of the priorities that we have, in the re‑entry process for those individuals going back, but again, it's the legs of the stool. If you put the legs under them, they stand a shot at surviving, they stand a shot at becoming citizens again, and just going about their business and those are the people, I run into them from time to time at a gas station or I ran into an individual at, started out at the Bridge to the Future House five years ago, five years ago. He's now the supervisor in a manufacturing company, and he came up to me to just let me know that, had I not given him the trust to be in that program, he wouldn't be where he is today, and he travels every day from Springfield to East Hampden to this workplace that is a manufacturing company and doing very well and well by his family. That's why we do the work. That's the reality of it. 
>> I went out with my navigator area to the low bell encampments and the people from my office knew almost every one of the encampments and trying to fight for them and support them in many ways. Thank you for the monies that the legislature put forth to allow us to have access to long‑acting injectables, it was something you did last year as well so thank you for that. Sheriff McDermott? 
>> I think the biggest frustration I think that at least I've experienced and I think it's possibly consistent with my colleagues, for us, is when we talk about recidivism rates, we talk about folks that are in a revolving pattern. There's nothing more frustrating I think as sheriffs, not us, but our staff, when you see an individual come back through the doors of your facility. You're like, geez, Johnny, what happened? We had you in the HiSET program, Northeastern and job readiness program, built your resume, sent you out on your way and unfortunately you come back in. It's the post‑incarceration disconnect that I think is problematic for all of us. What we're trying to do and you know, I've had my prior years of service with the trial court in the Probate and Family Court, relationships I built with the Trial Court are strong. We're looking at a creative solution to figure out we can have some degree of, the word isn't control but some post‑relief intervention. After we are working with the trial court, working with probation, working with our district attorneys, working with our local police chiefs, to figure out ways in which we can monitor and partner with our post incarceration individuals to figure out ways to which we can monitor and help them. Once again, it goes back to my earlier testimony about building that trust, the relationship, but if that starts up front with working with the trial court and when those individuals are getting sentenced, we need to almost know what that individual's going to need when they're coming into our facility. We're the grand time‑out is what it comes down to in the sheriff's offices is what people get sentenced up to two and a half years in the House of Corrections. We have an opportunity to help these individuals, but a lot of times when they get sentenced to us, they're not there for two and a half years for the vast majority. We need to know when they're coming in, if they get a 30‑day sentence, a 60‑days, 180 days, what can we possibly to with that individual when they're in our care and custody but more importantly, how are we planning for their post‑incarceration world and unless there's some kind of conditions that I believe in decarceration, lowering sentences to make sure there's a commitment of the individual post‑incarceration and it's a little bit different than the probation model, because probation is oftentimes a reactionary model. You violate your probation, guess what you're going? Back to jail. That to me is more harsh than what I propose to do. Look, you get a probationary period, you get less of an incarcerated sentence, but you're also going to be sentenced post‑jail to work with our community corrections facilities, to work up to a year up to two years, whatever it may be the Trial Court deems appropriate. There's a little bit of teeth, not to re‑incarcerate, not to send them back but divert them into a program that's less incarceration but as Sheriff Cocchi talks about making sure the individuals go into their appointment, sometimes even driving them, making sure they show up on the job with that ongoing relationship with the employer. How is Mike doing? Is he making sure he's coming to work on time? How is he doing in his evaluations? That to me is the way they solve the situation. We're doing a great job as a state in Massachusetts, because of ongoing partnership we have as elected officials, as folks who focus on social justice issues. I think there's the one disconnect I've seen in my short staff as Sheriff, as we maintain custody and care ‑‑ 
>> As a comment, I think you're right, Sheriff McDermott. That would take legislative support. Pre‑COVID what you saw inside the institutions was, offenders wouldn't take parole. They denied it. They wanted to do what they call a clean wrap. They didn't want to go out with conditions over their head. They didn't want accountability when they went out into the community. This would be something from a legislative perspective how you could initiate some level of maybe certain types of crimes that left victims in the community, that there would be a mandatory post‑release supervision. It could be done in a bunch of different ways, but parole, pre‑COVID, was not being utilized to its fullest extent because the inmates were deferring and walking out of the Correctional Institutions on a wrap‑up, having nothing over their head. 
>> That's why the Navigator turned it on its head. It is a positive social network engagement out there trying to help you to be successful, and not making sure you're successful and they will violate you. In many of these lives it is the only positive social network they have in their entire social network. Everyone else is someone negative. The only one who cares about the well‑being is sometimes these professionals. 
>> Chair Day:  Sheriffs, we're going to say it many times today, and we'll say it many more times, we're looking forward to the dialogue where the legislature needs to be involved. Parole is a great example. I know there's another special Commission coming out of Criminal Justice reform and police reform instructing and instructive on that point. Those are the ones welcome when we work together to improve what we're doing on the corrections side. I want to thank you all for coming today. The black and white is helpful, and the work you did, the staff did to get this information to us in a short period of time. As I said, it's part of an ongoing dialogue we're having with you all, that will continue, but your presence, and your ability to put color to the black and white is what these hearings are about, and so we appreciate it very much. Because I think a lot of questions were answered that the paper doesn't do justice to, and a lot of further questions were raised that we will continue to talk with you all about, but I want to thank you all for taking the time to come here, to testify with us, and we look forward to the continuing engagement moving forward. Thank you so much. 
We are going to give the sheriffs a moment to collect their things, and then we'll resume. 
We're going to come back to order now ‑‑ well, we'll let the sheriffs continue to vacate for a moment. 
As we've noted throughout these hearings, the hearings themselves are intended to provide the legislature and the incoming administration with more color on the state of our correction system, compliance with the CGRA, and we thought it would be instructive, at least helpful, to point out the response from the administration to our questions, or to our document requests, and the reason we asked them to appear, to help answer questions that these documents raised, or answer questions that we posed in our document requests themselves. 
I would ask, as we did yesterday, Mike Musto, research director, to put up the slide show of some of the questions and responses we received to our document requests. That we received in December. 
So we had asked ‑‑ Mike, if you could move to the next slide. We had asked for policies on regulations and CMR relating to the House of Corrections. We asked for documents related to the annual DOC review of House of Corrections practices and policies as mandated by the Department of Corrections own regulations. As well as the changes required, or the changes recommended by the DOC in the wake of those reviews, and any responses from the sheriffs to those recommendations. Those are all required in the DOC regs themselves. 
The response we received ‑‑ if you can move to the next slide ‑‑ "operational audits are conducted twice a year by DOC representatives of each Sheriff's Office correctional facility. The results of the audits are posted in the DOC's annual reports."  
As we had heard earlier today in discussions with the sheriffs, those are compliance audits. Obviously they're not recommendations or policy reviews. I think it is fair to say counting and ticking off boxes doesn't equal recommended actions, or certainly don't represent the sheriffs' position. We'll make sure the DOC follows regulations here. I think there's a reason they're in place. Hopefully we can achieve compliance moving forward. 
The next slide ‑‑ if you would, Mike ‑‑ House of Corrections. We discussed earlier today with the sheriffs, mental health Best Practices. We asked the DOC for policies, plans, and information on their efforts to share mental health Best Practices for correctional officers at both the state and local level, to ensure consistent trainings, and to facilitate the sharing of ideas between their EASU and the House of Corrections. 
The response we ‑‑ if you move to the next slide. We did not receive any response addressing that request, and as we've heard today, the sharing of Best Practices for mental health for our correctional officers seems to be lacking, to put it charitably. We're going to work with the sheriffs and MSA to make sure they do more along the lines of sharing Best Practices, but certainly the DOC's voice in this is an essential one as well. 
Next slide if you would. 
We had asked about the EASU, Employee Assistance Service Unit. We asked about information about staffing levels, training and job descriptions for those EASU employees. Including information, as I said, about staffing, training, and job descriptions. 
We received ‑‑ the next slide, Mike ‑‑ the response:  This work is being done through the EASU. They referred us to the website that contained a significant amount of information responsive to our requests. 
We went to the website, which we had seen before, and while the EASU website contains very good information on resources available to correctional officers seeking help, as well as the services available to them in‑house, what it doesn't include is any of the information we requested on staffing levels, the training that these employees are receiving, job descriptions for them as well. So, disappointing in that respect. And again, I think a question that could have been easily addressed here today. 
If you can move to next slide, Mike. 
We went to physical exams, behavioral assessments. You heard testimony earlier today regarding the policies for physical exams and behavioral health assessments. One of the recommendations of the Commission on preventing correctional officers' suicides was that they have mandated physical exams and behavioral health exams. And we had asked for policies relating to correctional officer physical examinations, and behavioral health assessments, and information on whether those were mandatory, or whether they were incentivized, and if they were, how. We heard, and we've seen from the sheriffs' responses, that mandating this at this time may be difficult because of Collective Bargaining Agreements, and contractual obligations, but that some of the sheriffs have taken it upon themselves to incentivize behavioral health assessments among their correctional officers, as well as physical ‑‑ I just blanked ‑‑ physical fitness, continuing physical fitness. 
The EOPPS response ‑‑ moving to the next slide ‑‑ was these policies and procedures are easily found on DOC's website. The website to which they referred us to was the selection and training policy on hiring practices. So, again, this policy we already had in our possession relates to hiring. We know physical exams and behavioral health assessments are very important in screening and hiring individuals, but to, if we really care about our well‑being of correctional officers, it doesn't stop at hiring. That's really when our mental health and physical health assessments and ongoing check‑ins should ramp up, is after the hiring with these high‑stress jobs. So, again, we haven't seen anything to that effect yet. 
If you can move to the next slide. 
We had asked about stigma in workforce diversity. I had asked for policies, regulations, and orders that EOPPS created a change to the Northeast report, finding occupational stigma is rampant in the correctional officer workforce. We also asked for steps being taken to increase workforce diversity in the DOC. Documents evidencing the racial, age demographics in the workforce. We heard consistently from the sheriffs about the difficulties of breaking stigma in the workforce, mental health challenges. 
If we can move to the next slide. 
The response was to provide additional support to correctional officers. In December of 2022 DOC entered into a service agreement with Commonwealth Medicine to expand on the role of the ombudsman. Initially passed by the legislature to review COVID‑related safety issues. 
I want to sincerely applaud the administration taking this positive step to expand the role of the ombudsman in the wake of the November inquiry, but also would like to know what, if anything, the administration did in addition to this response in December in the wake of the report issued more than a year ago. Unfortunately, we didn't receive any information on that end either. 
The next set of slides deal with an issue we weren't able to discuss here today, have not been able to discuss because of the lack of the presence of the administration, and that ‑‑ if you can move to the next slide ‑‑ the Interstate Corrections Compact. We asked for documents related to the ICC and the New England Corrections Compact, including current number of individuals held in DOC facilities pursuant to these agreements, their classification levels, their sentences, and the DOC communications with their states of origin relating to the classification levels, as well as the number of inmates sentenced in the Commonwealth and transferred to other states. The EOPPS response directed us towards the policy, which we had, and wrote that interstate exchanges are common practices used by the majority of states to maintain facility safety for both management protection reasons. Exchanges do not simply trade one security risk for another. For example, an inmate, inmate presenting management issues, may be exchanged for an inmate with protection issues, or vice versa. 
For context here, in August of 2020 correctional officer Matthew Tidman was struck on the head with a piece of equipment causing severe injuries housed at MCI Shirley under an ICC contract. We haven't found anything in our research that sheds light how many ICC transfers we accept, or any details about these individuals that we are accepting into our system. Again, we have the regulation; we know the regulation to which the administration directed us. What we don't have is an answer to our questions with respect to the ICC. 
If you can move to the next slide. 
Again, relating to the ICC ‑‑ pardon me ‑‑ we asked for the contracts with other jurisdictions made pursuant to the ICC or NECC, including all compensation received or paid out under these contracts. In response:  No response. 
Again, here we asked for the financial impact these contracts have on the DOC. Whether a positive or a negative. We're trying to find out is this a cottage industry, or a helpful arrangement where we can send an inmate we cannot adequately protect to another jurisdiction, and vice versa. We've gotten zero response. So we will, again, seek these answers from the incoming administration and determine whether or not legislative action is necessary. 
Next slide, the final one, and again dealing with ICC reporting. We asked why EOPPS does not include any information on individuals held in their custody pursuant to the ICC or NECC in their annual reports, which they are mandated to report on all inmates held in their physical custody. The response ‑‑ if you can move to the next slide ‑‑ no addressing that whatsoever. Again, we received zero insight, unfortunately, on what apparently is for now a black hole in our corrections system. We have no idea whether there are three inmates or 300 inmates currently being held in Massachusetts under the ICC or NECC, and how many inmates have left Massachusetts to go to other jurisdictions. As a result, we have no idea what the financial impact is one way or the other on the Commonwealth for these arrangements, and again, an area we will follow up with in the next administration and hopefully get more information on that respect. 
With that, that will conclude the piece of these hearings relating to correctional officer safety, training, and programming, and I will turn it over to my co‑chair, Senator Eldridge. 
>> CHAIR ELDRIDGE:  Thank you to Chair Day. I'm just going to take a five‑minute break. I think Miss Pritchard is here. I want to give her a few minutes to settle in. We'll take a five‑minute break. Okay?
>> Chair Eldridge: Are we all set, guys? 
Alright, we're going to return to the Judiciary Committee's oversight hearing. So we have the next topic is Bridgewater State Hospital, and I just want to say, uhm, that as both the Senate Chair of the Judiciary Committee and Senate Chair of the Criminal Justice Reform Caucus, the caucus over the past year has had a greater focus on Bridgewater State Hospital including two visits. I think that the dynamic that has happened is that we appreciate the reforms by the Baker‑Polit Administration a few years ago to bring in health care providers, specifically Wellpath and not have correctional officers directly in contact with, whether patients or those who are incarcerated who have severe mental health needs. I think what has happened since then is there is a closer look at the services Wellpath has provided, concerns how some Wellpath treat patients at Bridgewater State Hospital, and I think a real call for the legislature now to take a closer look at Bridgewater State Hospital and its physical facilities, how patients are being treated there and whether it actually should be an entirely different facility, not a correctional facility but a DMH facility that treats those, whether those that are civilly committed or criminally committed. So I appreciate the outreach by the Disability Law Center, which is in charge of the legislature to overseeing Bridgewater State Hospital as well as family members of Bridgewater State Hospital, some members of whom are here today. 
We have to testify for the second day, I really appreciate her coming back, Tatum Pritchard, Director of Litigation for the Disability Law Center. Attorney Pritchard, if you want to come forward and thanks again for your testimony yesterday. Appreciate it. 
>> Good afternoon. Thanks very much for having me again, just to reintroduce myself I'm Tatum Pritchard from the disabled law center. DLC gives our sin veer appreciation to the committee for inviting to testify regarding our long‑term work at Bridgewater State Hospital. As I stated yesterday, we're the protection and advocacy agency for people with disabilities in Massachusetts. We have had an over eight‑year pretty intensive presence at Bridgewater State Hospital. This began with conducting investigations into the excessive use of seclusion and restraint and also an investigation into the death of a person served at Bridgewater; therefore, we acted as a monitor of two settlement agreements at Bridgewater regarding and addressing those excessive solution and restraint practices, and now as Chair Eldridge said, we are conducting regular monitoring pursuant to both our federal authority as the protection and advocacy agency and pursuant to a legislative line item. 
The line item is important because it expands DLC's access to monitor and investigate the physical environmental issues of the facility which I think we can all agree are extensive. These include mold throughout the facilities. We also have the ability, because of the line item, to monitor continuity of care for persons served, and as part of the line item, we issue those reports every six months. Our next report is due out in January, because our reporting period just ended on December 15th. 
During DLC's most recent six‑month monitoring period, which as I said just ended, DLC also opened three investigations into the violent treatment of persons served by Wellpath and DLC staff. The conditions and treatment available for persons served at Bridgewater should concern everyone in the Commonwealth. Massachusetts detains persons served for evaluation and treatment of serious mental and behavioral health issues at Bridgewater, an aging state prison, confirmed to have persistent, widespread issues with mold and other general continues issues. We are one of only two states that sees fit to have our correctional agency run a forensic hospital of this kind, rather than our Department of Mental Health, and unlike other hospitals run by our Department of Mental Health, Bridgewater is not accredited in any way as a hospital. 
As we have done in our most recent reports, DLC wishes to highlight for the committee several serious issues persons served currently face at Bridgewater State Hospital, and to some extent also in the Bridgewater State Hospital units at Old Colony Correctional Center. The primary issue we'd like to address is forced medication administered in violation of Massachusetts Law. As stated in our reports, Bridgewater's involuntary medication practices particularly its use of what it calls emergency treatment orders, ETOs for short, and failure to report those as chemical restraint plainly violate Massachusetts Law the fact that DOC and Wellpath continue to endorse ETOs as a component of treatment at Bridgewater State Hospital parents a reevaluation of agency oversight of Bridgewater. Since the 1980s the Supreme Judicial Court recognized few legitimate medical procedures are more intrusive than forcible medication of anti‑psychotic medication and recognizes that doctors who are attempting to treat as well as maintain order in the hospital have interest in conflict with those of patients who may wish to avoid medications. Given these tensions, the Supreme Judicial Court and our legislature has seen fit to sanction administration of involuntary anti‑psychotic medication in only three limited circumstances. One is commonly known as a Rogers Order where a judge makes a substituted judgment decision that the individual would accept the medication if they were competent to do so, and approves a treatment plan that can be administered. Those are not counted as restraints, due to the court's authorization. We are also permitted in Massachusetts to administer involuntary medication under the state's police power, those instances are what we call chemical restraint, to prevent an imminent threat of harm to one's self or others when there is no less intrusive alternative to that administration, and finally, there is a limited exception to administering the medication involuntarily in rare circumstances to prevent immediate substantial and irreversible deterioration of a serious mental illness. 
What we have at Bridgewater is a whole new fourth category that Wellpath and DOC try to exempt from this very clear statement of law in Massachusetts and call it "treatment." It's not restraint. It's treatment they continuously say. It's treatment to prevent potential harm to self or others or intolerable level of distress. They have made some changes to their policy over the course of this year; however, the issue remains the same. They created an unsanctioned way to force‑medicate persons served at Bridgewater, absent an emergency, absent necessary reporting under Massachusetts Law, and absent a court order, as well as those limited circumstances of irreversible deterioration. In addition, as our reports have discussed, in practice, ETOs are often administered well after any emergency circumstances or problematic behaviors that justified the order have passed. In our report, we discuss a couple of those incidents which involved people receiving medications after spending 45 minutes for an hour or two hours of calmly resting in their cells. They might be sitting, reading, sometimes even sleeping when a team of Wellpath staff suited in riot gear come, wake them or disturb them and then come in and forcibly administer medication via very long needles. Obviously, this is quite foreseeably traumatic for persons served who experience this, in addition to being illegal. This I think is an incredibly serious issue, and it's, frankly, shocking, given the clear state of the law, that it continues. The second issue that I'd like to continue, if I may continue, is the culture of Bridgewater. There is a punitive carceral environment at Bridgewater. While correctional officers were removed from Bridgewater and security of the facility was transferred to Wellpath years ago, and we did experience a calm period in which things seemed to be moving in the right way, we now find ourselves in a situation where Wellpath security staff are essentially emulating the behaviors we'd expect from correctional officers and doing so in the absence of the strict oversight and reporting requirements required by Department of Correction Regulations in other prisons. For obvious reasons this puts persons served at great risk and also leads to a real lack of training and appropriate oversight of Wellpath staff. 
The third issue I'd like to raise is the physical plant. Bridgewater State Hospital is a prison. Persons served who are there for evaluation and treatment must live in small, stark and often unclean prison cells. Moreover, the overall structure is deteriorating with a lot of physical plant issue, as I mentioned before, including widespread mold and modular buildings in use way past their expiration. To put it as plainly as possible, Bridgewater doesn't provide an appropriate hospital environment in any way and is also a drain on the Commonwealth's resources. Publicly available information indicates that the Commonwealth has spent well over $3 million on Bridgewater State Hospital remediation improvement projects, just since DLC's July 2022 report, and this is just a fraction of the costs that the Commonwealth has put into maintaining this dilapidated facility in recent years. 
Finally, I wanted to highlight, which was a new issue in our last report that persons served with limited English proficiency are denied equal access to the range of Bridgewater State Hospital services, including group programming. As I'm sure you're all aware, Title VI requires Bridge water to ensure meaningful access to programs for people with limited English proficiency through bilingual staff and/or qualified interpreter services for oral communication and translated written documentation. We simple a don't see this, for at least not consistently, leaving a lot of groups at Bridgewater State Hospital completely underserved and of course, this translates into difficult adjustments for those individuals, the inability to access treatment that can help them transition out of Bridgewater State Hospital, and can negatively impact them when going before the court with respect to their commitment hearings. I would also note that, you know, these one‑way in which this issue compounds with the issue of ETOs is that with the lack of communication, many people who have limited English proficiency also are at risk of suffering interventions like ETOs due to their lack of ability to communicate with staff. I'm happy to take any questions about that or other matters that have come up in our reports. 
>> Chair Eldridge: Great, thank you so much, Attorney Pritchard. Really appreciate you coming, again, to the second day of the oversight hearing and do have a few questions. One of them relates to a recent meeting I had with Bridgewater State Hospital Family's Group. There's families here in attendance, is that regarding the restraint of a patient at Bridgewater State Hospital and forcibly applying medication is one family member recounting that decision did not even require a psychiatrist or a psychiatrist to see that person, that patient who was in mental distress. Is that, if I may ask, is that common? Is that allowed at Wellpath? 
>> It's accurate that those kinds of orders are often issued without the doctors seeing the individual. It's usually done through a network of phone calls, a game of telephone about the observations of the individual, and then the doctor decides based on those representations over the phone whether or not to order that extreme intervention. 
>> Chair Eldridge: Um‑hum, so a person is in the cell, which I, having seen the cells, I fully acknowledge, extremely outdated, very small, and someone has a mental health crisis, and a psychiatrist doesn't even have to see that person physically in order to be forcibly restrained? 
>> That's right. 
>> Chair Eldridge: Thank you. In your July 2022 report, which you had talked about, there's a mention of video evidence of force against patients, where DOC staff initiated the force, and I'm just wondering if you could, whenever possible talk about what was the evidence involving this situation and what was the DOC's response. 
>> It's something that happens all the time. While we call things seclusion and restraint, what it amounts to is putting your hands in some way on a person's serve, that's the same for chemical restraint although much more extreme because you're forcing them to either ingest or take a shot of a medication that they don't want. We have seen a large number of videos of interventions, those included the use of chemical restraint, as well as with respect to those three investigations we opened in this reporting period. Simple uses of force, without apparent justification by Wellpath staff, and with respect to another even use of force by correctional officers that led to significant injuries of an individual in the Old Colony Units the Bridgewater Old Colony Units. So what we have seen as led to the uses of force, like I said, it varies. You know, we haven't yet reported on the circumstances of those three investigations that must wait, but with respect to the ones that we have discussed specifically in our report, you know, incidents can be altercations with other persons served in the unit or with one of the staff, and that could simply be words or gestures or it could be making contact, and in some cases, it could just be being really noisy and using a common correctional term, which Wellpath is prone to do, creating a "climate" issue. For those reasons, people can be taken to their room by force, escorted by staff who put their hands on them, put them into their cells and as I said, later a team of ‑‑ if an ETO is ordered, a team of Wellpath staff, known as TSTs, will come suited in riot gear and with riot shields, enter their cell and often forcefully take them down to their bed, where they ‑‑ where a nurse comes to administer the medication. 
>> Chair Eldridge: So that staff, as you said is sometimes in riot gear to apply that medication. 
>> Almost invariably the staff are in riot gear to apply ETOs. 
>> Chair Eldridge: Wellpath staff or DOC? 
>> Wellpath staff only. 
>> Chair Eldridge: Okay. 
>> It's a much less controlled version of a DOC use of force. Wellpath staff do not have the same level of training as correctional officers and as I said previously, they don't have anywhere near the same level of reporting requirements or oversight by Administrators. 
>> Chair Eldridge: And in reading the response from the DOC, is it correct DOC actually acknowledged that they weren't aware of that, and they would look into it further, in other words, it was a real red flag? 
>> DOC acknowledged an increased need for oversight. The response didn't include that the requirements of the DOC regulations use of force regulations would be applied. What they did say was that there would be some additional review of videos. To my knowledge, unlike in DOC, this isn't happening for every one of those incidents. If there's a use of force in the DOC, the officers must create reports. Those become a part of a package with the video and then that is reviewed by various levels of DOC Administrators. That they did not permit to do that to protect Bridgewater persons served. They offered what appears to be a periodic review of video footage by DOC health services, and I note my understanding is, they have reviewed the videos that DLC, we have identified. They have not sought to identify other instances, to my knowledge. That of course is cause for concern, because we can only know what we know as an outside organization. We know a lot, but we're not there every day, and we're certainly not there 24 hours a day. So it's cause for concern, and it indicates a lack of ownership of the problem by relying on what we identify. 
>> Chair Eldridge: Thank you. More generally, for all of the patients at Bridgewater State Hospital, you know, I think there's an assumption by the general public perhaps, you know, most legislators that everyone, because people, the patients there have mental health challenges, mental health crises that they're receiving therapy, what percentage of the patients at Bridgewater though receive individual therapy? 
>> I apologize if this isn't in one of our reports, but I don't remember that percentage off the top of my head. If you have it in front of you, I'd be happy for you to share. 
>> Chair Eldridge: Sorry for the leading question. According to the June 2022 report, only 20% of the patients were receiving individual therapy.
I'm just wondering if that's your observation as well from other, from all DLC's investigative work? 
>> Yes, we don't observe a lot of time spent with persons served providing individual therapy. That seems accurate. Overall programming is ‑‑ while there is a schedule of programming, actual participation in programming as you walk around seems pretty limited. 
>> Chair Eldridge: Are you able to describe what the programming is at Bridgewater State Hospital? 
>> Uhm, I know that there are groups available normally. At present, I understand that Recovery Place which is where a lot of the programming happens, is closed due to rodent issues, so a lot ‑‑ my understanding currently, much of the programming would be on unit that from my observation and you know, I could consult with my colleague, who is here, because he goes there every week, but my observation is on unit programming mostly consists of small groups in the day room, like music therapy, art therapy, and things like that. Nothing that you would think you would find in what's meant to be a psychiatric hospital that offers intensive treatment. I'm not seeing on the units, you know, CBT or DBT happening. 
>> Chair Eldridge: Um‑hum, alright, thank you. I know one of the continued disagreements between DLC and DOC and Wellpath is around the clinical distinction between a medication restraint and involuntary administration of medicine. Could you go into more detail about what that disagreement is? 
>> I mean, the disagreement I suppose amounts to DLC believes Bridgewater should comply with Massachusetts Law and Bridgewater disagrees. Bridgewater believes they should be able to provide treatment in whatever form they deem appropriate, but Massachusetts Law doesn't permit that, if the treatment you have deemed appropriate is forced medication, and you don't have a court order, it's not an emergency that you're recording as a chemical restraint, and the individual is not at risk of irreversible deterioration. 
>> Chair Eldridge: Thank you. What is DOC's interaction with Wellpath in terms of treatment at Bridgewater State Hospital?  
>> We do have meetings with administrators, though I wouldn't call them frequent. We have been in discussions with Wellpath to have more frequent meetings, but those meeting are really, my understanding is, that they are meant to address more sort of regular issues, more day‑to‑day issues, of problems that persons served are experiencing. 
You know, for instance, in the last reporting period there was very disturbing graffiti on some of the cells. Like swastikas, things like that. That had been there for a long time, and were obviously concerning to persons served. We contacted Wellpath. After a period of time they painted those cells that had that disturbing graffiti. 
But with respect to the issue you raised, uhm, you know, just now about medication, we are ‑‑ I suppose we're at a point where it's an agree to disagree. There's no dialogue about that issue. You know, we can provide input, but we don't always find it to be very fruitful when we have those sorts of interactions about the larger, more systemic problems. 
>> Chair Eldridge:  And when anyone goes into Bridgewater State Hospital, of course now within the units you see Wellpath staff and not many Department of Corrections staff or correction officers. What is the training level for those Wellpath staff that are sort of on the units?  
>> To my knowledge, uhm ‑‑ well, the training is ‑‑ they do get trained. They have a lengthy orientation. I believe it may last a week. And they go through what's known as the MAT training. Our staff has had the training to go to the MAT training and watch the initial training and retraining, and we have concerns about that, which we'll be able to share in our upcoming report. 
But overall I would say that the staff are ill‑prepared for the environment and for what's being asked of them. While normally, and because we're the PNA, we're looking at the use of ETOs from the lens of how difficult it is and concerning it is for persons served, but it is also, as you've just discussed in your last panel, it takes a toll on the individuals who have to do it, and I don't believe that ‑‑ or I suspect, I will say, that Wellpath staff are not well‑prepared for all that is asked of them, and don't receive sufficient training. My understanding is, their training falls far below what a correctional officer would receive. 
>> Chair Eldridge:  Thank you very much. Those are all the questions I have. I don't know if Chair Day has some questions. 
>> Chair Day:  Thanks, Chair. Just a few. 
June to November of '21 Bridgewater or Wellpath reported zero medication restraints, and 370 administrations of ETOs. After the report came out, have they reported any medication restraints, or reclassified any previously classified ETOs?  
>> They're holding fast to the position those are not chemical restraints. I would have to ‑‑ I'll have to wait with respect to commenting on the information that we received during this reporting period, but, no, there's a standard position that Bridgewater doesn't do chemical restraint. Part of that is the fact that Bridgewater policy defines chemical restraint as involuntary medication administered for, to address emergency behaviors that are not related to mental illness. Obviously I think it would be hard to find such instances at Bridgewater State Hospital. 
>> Chair Day:  Is it fair to say, you think the ETOs are defining their way away from what would be a medication restraint, or something that would otherwise require a Rogers Order?  
>> Yes. 
>> Chair Day:  With the absence of the Rogers Order, is medical adherence to prescribed course of medication "I'm refusing to take my medication right now" in the normal world, or at least the statutory world, if I, as a provider, want to provide you to take it, I would go to court and get a Rogers Order to do so, and that's done fairly regular in this setting, correct?  
>> That's right. That's right. If the individual refuses to take a medication on their Rogers treatment plan and the staff or doctor require it through a forceable medication, that does not count as a restraint, right. 
>> Chair Day:  With respect to what we would envision as a chemical restraint, that needs to be reported and very highly documented, and very minutely reported; is it fair to say?  
>> Yes. 
>> Chair Day:  We had asked for the videos you referenced in there, we asked for videos of all ETOs, and were ignored in that request. We'll follow up again on that end. 
I guess the question that we have, which you may not have an answer, or may not feel comfortable answering, is whether or not the ETOs are being used in the absence of Rogers Order, so they don't have to go to court, or chemical restraints, or a combination of the two?  It strikes me as fantastical we can have 370 ETOs in an abbreviated period of time and zero medication restraints. 
>> It is a surprising set of figures. Yes, I think with respect to usage, I think ETOs can be what is used while someone is, has pending Rogers petitions, when clinicians don't see fit or see appropriate to wait for a court order. 
We have seen situations in which ETOs are used on people where there is no Rogers petition, and there will never become a Rogers petition. 
We have also seen ETOs used, oddly, in some of those limited circumstances, where I suppose you could say that there was an irreversible deterioration risk, but instead they're categorized as ETOs. 
Finally, we have seen some instances where ETOs are administered for people who have not complied with their, the Rogers medication administration, uhm, and ETOs are being administered for medications that do not appear on their Rogers treatment plans. So, they're going outside of the treatment plan and imposing a whole other medication as an ETO. 
>> Chair Day:  I guess the final question I have is, in your opinion does this require further legislative action, or is this a, something that can be addressed internally with a change of leadership or a change of approach?  I mean, it strikes me that we're almost nailing a wall here. When we try to follow a court doctrine or jurisprudence, we enact certain statutes, and there's a way around it by redefining a practice. What's your advice on how to address this best, if anything, beyond a change of leadership and a change of approach, or whatever?  
>> In all honesty, I truly believe that the law is pretty clear. The SJC made it clear. Massachusetts General Law 123, section 21 makes it pretty clear. And so, you know, if there's something the legislature could do, that would be great, but I can't identify it because in my mind the law is pretty clear that this is not allowed. And it's really just a matter of demanding compliance with the law. 
>> Chair Day:  Great. Thank you very much for your testimony. And your work. 
>> Chair Eldridge:  Thanks again for appearing before the committee. I really appreciate you and the great work the Disability Law Center does. 
>> Thank you very much. 
>> Chair Eldridge:  I mentioned earlier the Bridgewater State Hospital Families Group. Donna Winant, would you like to come up to the mic and testify. Thank you for coming. 
>> It hit home... (Indiscernible) 
Honorable legislators, ladies and gentlemen. Do you have an hour?  Just kidding. I have a lot to say. And normally I have this ‑‑ I've testified before ‑‑ this clean testimony all printed out. Today I have this. So it may be a little choppy. 
I'm Donna Winant, founder and director of Family and Friends of Individuals With Mental Illness. We advocate for those who are justice involved. We want to obtain a continuum of comprehensive and humane healthcare. 
I'm also a grandmother of a grandson with schizophrenia at Bridgewater State Hospital for almost nine years. 
So, today I'm hoping to shock you (laughing). Maybe shake things up. Shock you and shake you up. 
Shock 1:  The disability ‑‑ at least to us, the family members, the Disability Law Center of January 2022, a report our esteemed legislator ‑‑ thank you ‑‑ Representative Michael Day declared deeply disturbing. 
We have read prior Disability Law Center reports, but that was kind of a wake‑up call by Representative Day. So, thank you. Because it is deeply disturbing. 
The issues including the building, the conditions, the DLC reports that it's not safe for anyone. It's not safe for anyone. 
Shock 2:  ‑‑ shock No. 2:  Chemical restraints, what are they. We've heard a little bit from Miss Pritchard. You know, we heard about the riot gear. Can you imagine being seriously distressed, seriously mentally ill, and having these people come at you, come at you ill‑trained, lesser trained than the correction officers. And the correction officers have not always been well‑trained. 
If you remember, the 23‑year‑old Josh Messier. He was literally suit cased and restrained. This is another kind of restraint, this chemical restraint. What they do is they take these people ‑‑ as Miss Pritchard points out, they're calm. Some have calmed down. Rather than descend, they take their ‑‑ they take their pants down. Long needles, four of them. Two in each buttock. And they force these people with chemical restraints. It's inhumane. It's inhumane. And you know how frightening it is. And Josh Messier died from pulmonary ‑‑ a heart attack. This can happen. The fear. The adrenaline. The force. This could happen to them!  
In addition, uhm, this is what the following July '22 DLC, the emergency treatment orders. BSA chooses power ‑‑ quote, power to control an individual's behavior or resolve arguments and can lead to escalation. They're claiming they're going to de‑escalate violence, but this can lead to escalation of conflict. And can ultimately result in serious injury and even death. That's Page 12. 
Placing BSA under the Department of Mental Health will best ensure Best Practices and care. Being placed under the Department of Mental Health, who have the expertise, they have the expertise, and they also have the mandate to care for those with mental illness. These are their people. These are not criminals. These are their people. They have mental illness. They should be with the Department of Mental Health. And this is ‑‑ this could preserve lives. This could preserve lives. 
And you know we hear a lot through the grapevine from the inside. We're not supposed to, the family members, but I've heard several suicides in the past few months. And I also knew a young man. I do have the privilege of giving our classes to the families and patients at Bridgewater State Hospital. One good thing that is being done at Bridgewater, and one of my former patients ‑‑ two of them, but one died of suicide. It's heartbreaking. It breaks our hearts. And, you know, we family members don't just suffer. We all suffer. Every one of us suffer. Our loved ones suffer; we suffer. We suffer the heartache for them day after day, minute after minute. It's hard to live our lives in joy. And did you know that DMH has better regulations, better regulations in training their staff, and better de‑escalation practices. 
My grandson just yesterday told me he's upset at the number of fights among the patients. It's not the first time he's told me that. It's upsetting to him. Why isn't the staff helping to control this. Why aren't they creating conditions to make it, you know, an easier life. Yes, they have mental illness, and yes, they're going to have behavioral issues, but there are ways to help mitigate those issues so that there's not so much fighting among the patients themselves, who must be frustrated and angry and hurt. 
Shock 3:  After the damning January 2022 DLC report there was a barrage of bad press. Not just bad press, but a barrage of bad press. Which we family members were applauding. Our voices got loud. We went from asking diplomatically, to insisting. Our voices became loud. We demanded changes. 
We had legislative involvement from Senator Cindy Friedman, who came to the family meeting with us, asked for a report, and was told she would get one, and never did. You're not the only ones not getting any responses. 
Representative Day, Representative Balser, Senator Eldridge, others ‑‑ and even Senator Brownsberger met with us, and he kind of didn't have a real understanding, but he cared enough to meet with us at our request, and hopefully he learns about these issues so all of you can help us. I think Lesley Salbosa. So, you legislators are reaching out. But we need all of you. We need all of you. We have you, our heroes, but we need all of the legislators to hear our cries. 
We also had the Criminal Justice Reform caucus. We have bad press, loud family voices, legislators, and the Criminal Justice Reform caucus. And guess what?  After the ‑‑ after our ‑‑ after January 2022, the July 2022 report comes out, there was little to no improvement. What is it going to take?  
So here we were, the family members. We hoped for better. We thought for sure this was going to push them into making positive changes. We were not only shocked, but we were disheartened, saddened, and frustrated. These are the comments by my fellow family members. 
Shock No. 4:  The BSA hearings. So, I went ‑‑ you know, I started listening to hearings, because my grandson had a hearing, and I was shocked!  Here are these doctors, these psychologists, who are supposed to be treating our patients. I don't call them persons served very seldom, because I don't think they're served very well. So they're supposed to be treating our patients. Here they are at the hearings saying, well, they don't groom; well, they don't go to programs. Guess what?  That's their symptoms. They have mental illness. They might be depressed. Sure, they don't groom. That's common. Why are you using that against them for them to move forward to the Department of Mental Health?  They were more like prosecutors, and my husband used the word "Arrogant."  I believe their civil rights ‑‑ and we've been told actually by Christopher Blake, public defender, by his office, that their civil rights are being violated. That's something to take note. 
Finally, shock 5:  I'm going to get personal. My own grandson's deteriorating condition. He entered Bridgewater State Hospital as a physically healthy 21‑year‑old. Mentally he was unravelled, but a physically healthy young man, well‑cared for by his family, grandparents. He was well‑cared for. This was almost nine years ago. As a result of poor nutrition, lack of fresh water ‑‑ the staff gets coolers, but the patients have those rusty pipes. They can't use the coolers. They're not allowed. They're second‑class citizens I guess. Little push to medical care and grooming, etcetera. He is now covered on torso, neck and face with large red welts. Getting worse. I have to witness this. His mother had to request a treatment for this severe skin condition. He has a cyst under each arm. Probably because he doesn't groom well. But they will not push him. They will not coax him. We would if he was in our care. I've done it. His teeth is rotting. He had perfect teeth when he went in. During the past two days ‑‑ I've been there. I've been there yesterday and the day before. He has an abscessed tooth, and his face is swollen. Yesterday is worse. Pushing up his eye. The left side of his face is swollen. They're giving him antibiotics. They're going to have to pull his tooth. He said the first night, for eight hours he was in such pain he wanted to die. Not commit suicide, but wanted to die. And so the night after that his mother and I compared notes. Neither one of us could sleep. We both woke up crying. It's just horrible. It's horrible. This is my loved one. This could be anyone's loved one. Mental illness does not discriminate. 
My grandson's charges have been dropped, yet he languishes there because of the shame and blame game. There are over one thousand lawsuits to Wellpath, the healthcare provider, for substandard care. My grandson's a victim of that substandard care, as many others are. 
Also, on June 7th, 2021 a traumatic event happened. My grandson ‑‑ and I don't blame any other persons there that do have violent behavior. He just happens to be one of them that doesn't. And he was grabbed by a big staff member named Isaac ‑‑ I was never given the last name ‑‑ picked him up, threw him, crashed him onto the cement floor, breaking his finger, causing injury. When he had the surgery the next day, they never would call to let us know how he was. Again, we had sleepless nights. What kind of hospital does that?  If he were in the Department of Mental Health, we would have known he was okay. He made it through the surgery. 
So, in finishing up ‑‑ oh, I just want to say. Many people with serious mental illness live, have a life expectancy of at least ten years less, but this kind of treatment that my grandson's going through that many others ‑‑ he has us to speak for him. So many have nobody. How much of their life is being drained away, their life expectancy, without a quality of life?  
And so I just want to finish by saying systemic issues are deep‑seated. They're decades old. Both the DLC and NAMI say it is incumbent upon the Commonwealth to build a new facility and place this population under the DMH, Department of Mental Health, where it belongs. If the DMH doesn't want them, too bad. They can learn to cope with them. You know, it's not a security issue. They can get the security they need. This is their people. We've met with them. They were ‑‑ they dissed us basically. It's not diplomatic, but it's the way it was. Please hear our voices. Please help our marginalized populations. These are our loved ones. They're my grandsons, other's grandsons, their sons, their fathers. They're loved. So, they deserve better. And I want to finish with saying barbed wire and mental illness do not mix. Thank you. 
>> Chair Eldridge:  Thank you for your testimony. If you want to stay for some questions?  Would you be comfortable with that?  
>> I did do some printouts in case it's helpful for you. 
>> Chair Eldridge:  Thank you so much for your courage to come forward. Your husband's here. And we had some other family members who were to come, but it's ‑‑ it's obviously a personal issue. I do hope, despite the fact there's a lot more room to make progress, uhm, that the support groups are really having an impact on elected officials to advocate, you know, more strongly. 
>> I think slowly but surely they are. 
>> Chair Eldridge:  Uh‑huh. 
>> Oh, thank you. Thank you. Thank you very much. 
>> Chair Eldridge:  So, we'll review that written testimony. I'm ‑‑ 
>> It's not necessarily this one, but it's other ‑‑ you know, from other testimonies, and it's relevant I think. 
>> Chair Eldridge:  Sure. Absolutely. 
>> I have a list of reasons why the DLC ‑‑ I mean, the DMH should be in charge of Bridgewater. I made a bullet point list. 
>> Chair Eldridge:  Sure. So, it sounds like you visit your grandson frequently. How frequently do you visit your grandson?  
>> Twice a week normally. It takes us an hour and a half each way. We get there. We have to go to a different building to get tested. We have to account ‑‑ we now have, because of COVID, we now have to account ‑‑ we have to make an appointment, and so we have to leave early in case of traffic. It's a good five to seven hours, you know, a day to do the one‑hour visit they allow. 
Sometimes they bring our loved ones in late, and we only have an hour to eat our meal, and my grandson would like an hour and a half. You know, and so 'cause we play gin rummy, he taught me how, and he generally beats me. And we don't have time to eat and do that. So, he'd like a longer visit. So I have requested it from the administration, but their answer is "We'll get back to that."  So you give them ‑‑ the families have the same issues. So we give them an issue. "We'll get back to that."  We give them another. "We'll get back to it."  Another, and another. Then the issues are this big (Indicating). And guess what?  They're unresolved. 
>> Chair Eldridge:  And when you cite those issues or complaints, that's with the Wellpath staff person?  
>> With Bridgewater State Hospital/Wellpath, yes. 
>> Chair Eldridge:  Is there a point person for family members?  Is there a specific person?  
>> They have a Family Engagement Specialist, Donna Libbo, who is a social worker. She's very well‑meaning, that's a kind person, but, uhm, she tends to paint the pretty picture. You know, we're doing this, we're doing this. And we see behind the scenes. You know, there's not always the pretty picture. And ‑‑ yeah. 
>> Chair Eldridge:  In terms of behind the scenes, as someone who visits there frequently, and the Disability Law Center, you know, part of the report Attorney Pritchard highlighted the physical conditions of Bridgewater State Hospital, as well as Old Colony. Could you describe your ‑‑ what you think of the physical conditions of Bridgewater State Hospital?  
>> They won't allow us in. We've been allowed in, my organization, FEMI, has been allowed in in Middlesex, Hamden, Worcester County jail. All three. We applaud their efforts. We think they're doing a good job overall, you know. Everybody might have a few problems and everything can be fixed, but I think overall they're doing pretty well. But we're not allowed into Bridgewater. They say it's privacy issues. Then why were we allowed in the other three institutions?  What are they hiding?  
>> Chair Eldridge:  You talked about, were very descriptive about the traumatic experience of someone who has a medical restraint, and so being the founder of a support group, obviously working with other family members of loved ones who are at Bridgewater State Hospital, are there any other experiences you want to talk about, about what that is like when a Wellpath staffer restrains and forcibly medicates a person?  
>> I think it might ‑‑ I've heard from some of the patients, it evokes a sense of fear. They don't want to ask for help. And they see what's going on with these, you know, forced chemical restraints. It just traumatizes them even further. And it traumatizes the family. Because, you know, when we know they're suffering, we suffer along with them. 
>> Chair Eldridge:  Absolutely. Are there any updates to the support groups from Bridgewater State Hospital, or from Wellpath, when these issues are raised?  Is there any sort of scheduled updates you get from Bridgewater State Hospital or Wellpath?  
>> Would you repeat that, Senator Eldridge?  
>> Chair Eldridge:  Yes. In terms of the support groups, is there any regular update from Bridgewater State Hospital or Wellpath when all these issues are raised?  Is there any regular interaction?  
>> I think now they're responding to a few of the issues. Only because of, you know, because of the added heat. And also, your work. But it's slow. And the administrator rarely comes on to the meetings. He rarely shows up. 
>> Chair Eldridge:  The administrator for Wellpath?  
>> For Wellpath, yes. He's lacking in response to the families. 
>> Chair Eldridge:  Have you or any other family members who have loved ones at Bridgewater State Hospital, has there been any interaction with the psychiatrist, psychologist, the senior staff at Wellpath?  
>> We have talked with one of the psychiatrists ‑‑ well, several. I actually like Dr. Shaun Ryan, so I'll name him. But there was another leading psychiatrist who was ‑‑ who assured us after that January 2022 report, and I thought, oh, he has insight, we're going to get improvements about the ETOs, and it didn't happen. It didn't happen. 
>> Chair Eldridge:  And when was that?  When was that conversation?  
>> That was ‑‑ well, it was after the January report. I'd say maybe a month or two later. 
>> Chair Eldridge:  Okay, and so early this year?  
>> Yeah. We thought maybe we'd get some change, but we didn't. I mean, what is it going to take, you know, Senator Eldridge?  I really don't know. I really don't know. 
>> Chair Eldridge:  That's why we're so grateful for you to come before, before the committee, and for the Disability Law Center's work. 
>> Thank you. 
>> Chair Eldridge:  I know we'll interact more into the next session. I don't have any other questions. I don't know, Chair Day, if you have questions. 
>> Chair Day:  I don't. I echo the senator's words of thanks for appearing today, telling your story and sharing it with us on your grandson's and on your own plight, your family member's plight as well. 
>> Thank you, Representative Day. Thank you for the work you did with the patients at Bridgewater State Hospital. Thank you. 
>> Chair Eldridge:  Thanks again. So we don't have any other individuals coming before the committee to testify regarding Bridgewater State Hospital. We do have a couple slides. You know, I would say it really emphasizes or highlights and reflect the testimony of the Disability Law Center and family members. So if Michael Musto, if you could put up this last slide deck?  
And so these are questions that the Judiciary Committee asked Wellpath and the Department of Corrections. 
The first ‑‑ next slide ‑‑ question we asked for the contract and contract extension between Wellpath and the DOC or Bridgewater State Hospital relating to Wellpath's work at Bridgewater State Hospital. EOPPS response ‑‑ next slide ‑‑ no response. Next slide, question, we asked for the contract and contract extension between Wellpath and the DOC or Bridgewater State Hospital relating to Wellpath's work at Bridgewater State Hospital. EOPPS response, next slide. No response. Next slide. Question we asked was regarding Wellpath's involuntary medication policy. We asked for Wellpath's and Department of Correction's recent use of involuntary sigh crow tropic medication policy. EOPPS response did not provide the policy. Next slide. Regarding emergency treatment order ETO video recordings, we asked for video recordings of ETOs administered, including the incident reports filed for those ETOs as Chair Day asked earlier. EOPPS did not provide the videos or information requested. Next slide regarding medical grievance policy, we asked for the number of medical grievances filed since 2019 and how the Bridgewater State Hospital process differs from those at other DOC facilities. Next slide, and the EOPPS response was no response. So speaks very loudly in the lack of response. I thank the experts and family members who came before Bridgewater State Hospital section, which was the last portion of this two‑day hearing and I want to hand it back to Chair Day and I think it's been a productive two days and I thank you and your staff for all the preparation, for having, despite the DOC and EOPPS not responding, not being here before us, we got a lot of helpful information and documentation about the progress that's left to work to be done. So thank you. 
>> Chair Day: Thank you to Chair Eldridge as well as your staff for the work that's been done here and to the committee members working remotely on these issues as well. I want to thank the judiciary staff who have been putting long hours during this holiday season and during the entire session and again, Patrick Prendergast, Staff Director Diane Williams, general, Alex O'Connell, Michael must co, Talia Quinn, legislative aide and how long this is going at it, former director Jack manning and former legislative aide Dan Hudson. This has not been a three‑day endeavor. It's been a year‑long task of chasing down or tech attempting to chase down answers and guidance on implementation. Thank you to the House staff, court officers, house events coordinator, Iona Clark, the great Seamus Corbett who helped us try to put a hearing on technologically, a thank you to Carl Richardson, ADA Coordinator and Mona Leviton and Tracy Ukura, the CART team. CART is computer‑aided realtime translation services, this is instantaneous translation. It is for access for Deaf or hard of hearing individuals and through this CART team's hard work our hearings and actions in the legislature are more accessible to more of our residents than ever before, so a huge thanks to that team for driving us forward. I'll close with this. We and our hearings noting that none of our laws are static, as we progress as a society, our laws have to change to keep pace. Over the past few sessions, this legislature has tackled issues ranging from gaps and challenges in our substance use disorder, mental and behavioral health services and access to technology, including regulating gaming and cannabis and ride sharing, things our president cessors likely never fathomed. Our area, one area of everyday life that our predecessors did fathom and one in which we have as a people been working on improving is our criminal justice system. Through fits and starts throughout our history we progressed a more just system, one more accessible to all, one that is not reactionary but hopefully and rather proactive in removing outdated concepts, approaches and laws in our criminal justice system. So the two goals again of these hearings have been to examine how successful we've been in realizing these goals and the legislative intent of reform that we've passed and to set the table not only for the incoming Healey administration but the next session of the legislature offering a deep dive perspective on the implementation of the Criminal Justice Reform Act of 2018, where it's worked, where it hasn't and why. These hearings have illuminated for me that many areas we need to address in our corrections system as well as many areas we should celebrate as progress. Access across the subject areas we examined in these hearings I think is reason for optimism and demonstrable need for the legislative, executive and judicial branches to work together to continue to move us towards a truly modern corrections system that makes us all safer. The decision by this Administration to refuse to engage in this discussion was plainly not good government. Too often this committee's review of the implementation of the Criminal Justice Reform Act we've been led to the inescapable conclusion that many of the goals of these laws that we've enacted have been frustrated by this Administration's inaction or inability to execute. I say those conclusions are inescapable because we were prohibited from engaging in discussions yesterday and today that would have afforded the Baker Administration the opportunity to answer questions, to highlight successes, and to address the criticisms we've heard over the course of these hearings. That's part of responsible governing. We learned through a press release from the United States Department of Justice last night that this administration reached a settlement that will now require the Department of Corrections to provide meaningful services to individuals in mental health crises while in custody, and will install an independent federal monitor to ensure compliance, a press release from the federal government. Accountability should not be anathema. As a legislature, we're optimistic the incoming administration appreciates the fact that government works better with open, honest and frequent communication between the three branches. We look forward to working collaboratively with all who share the goals of making our criminal justice system better for all of us. With that, thank you. Any closing words? We'll close the hearing and get back to work soon. 
(Meeting adjourned at 2:15 p.m.)