good morning.
My name is ed flynn.
Boston city council I am the
vice chair of the boston city
council committee and veterans
military families military
affairs.
Today is AUGUST 28th, 2026.
The exact time is 10:00.
This hearing is being recorded
.
It is also being live streamed
at boston.Gov/city council tv
and broadcast on xfinity
channel eight rcn channel 82
fios channel 964.
Written comments MAY be sent to
the committee email at seek dot
that's at boston.Gov and will
be made part of the record and
available to all city
councilors.
Public testimony will be taken
at the end of this hearing or
if anyone would like to testify
virtually.
We'll try to get you in during
during the hearing.
If you have any scheduling
related issues and you need to
testify immediately, please let
me know and I'll try to get you
in to testify as we speak.
Individuals will be called on
in the order in which they sign
up, and they'll have two
minutes to testify.
I will not cut anyone off if
you need to speak for more than
two minutes.
Please take the time that you
need.
If you are interested in
testifying in person, please
add your name to the sign up
sheet near the entrance of the
city council chamber.
If you are looking to testify
virtually, please email our
city council central staff
liaison shane pac and shane s h
a n a.Pack@boston.Gov.
For the link in your name will
be added to the list.
Today's hearing is on actually
two dockets docket 0273.
It's an order for a hearing to
discuss lung cancer rates among
black veterans.
And the second docket is docket
0274, which is an order for a
hearing to discuss services for
women veterans.
Docket 0273 was sponsored by um
by myself.
Councilor councilor murphy and
councilor santana and it was
referred to the committee on
FEBRUARY 4th 2026.
I am joined by my
council colleagues in order
of arrival of arrival
council murphy.
Um I do want to acknowledge
well, I do want to acknowledge
as the vice chair I will be
chairing this um this hearing
today and councilor um henry
santana does, um, express his
respect for the veterans that
are here in the veterans
throughout the city of boston.
He's just unable to be here.
But he wanted me to know that
he is paying close attention to
this and want to acknowledge
his chief of staff ana calderon
,who really helped set up this
meeting as well.
So I want to say thank you to
ana for her support and
commitment to veterans military
families across the city
of boston as well.
Um, I do have a letter
of absence that I do want to
read into the record and then
I'm going to give an
opportunity for my
council colleague
councilor murphy to give an
opening statement and then I
and then um, I want to ask each
panelist, um, to give an
opening statement as well.
But before we do that, could I
just ask the panel maybe to um
go go starting from
commissioner santiago, could
you just, um, state your name
for the record and what
organization um, you you were
with?
So let me start with that,
commissioner santiago, please.
Uh, good morning,
councilor flynn.
Councilor murphy, uh, thank you
very much for.
Having me.
I am commissioner robert
santiago, city of boston
veterans services.
Thank you commissioner.
Good morning, councilor flynn.
Councilor murphy, my name is
craig diehl, a resident of the
city of boston.
And I am the state commander
of the veterans of foreign
wars.
Good morning, councilor flynn.
Councilor murphy.
My name is mark kennedy.
I'm with the boston.
Public health commission.
Good morning.
My name is malika whitley.
I'm with the american legion
post 78 and I also work with va
benefits.
And good.
Is this on?
Yes.
>> okay.
Good morning.
Uh, councilor flynn and
councilor murphy.
My name is brenda wiener.
i am a pulmonary physician and
researcher at the va boston
health care system and the, uh
,center for health
optimization and implementation
research there.
Thank you to this distinguished
panel for being here.
Um, thank you for testifying.
More importantly, thank you for
your commitment to veterans and
military families across the
city really across the country
as well.
I'm going to read a letter into
the record that I'm going to go
to straight to council.
Murphy dear chair santana, this
is from city councilor city
council PRESIDENT Bratton I
regret that I am unable to
attend to tomorrow's hearing on
docket 0273027 for hearing to
discuss lung cancer rates among
black veterans services for
women veterans.
While I am unable to attend the
hearing, members of my team
will be listening in to this
critically important discussion
and I plan to review the
recording.
I kindly ask that you read this
letter into the record.
Thank you.
Elizabeth and city
council PRESIDENT.
Uh we are also joined by city
councilor at large large rosie
louijeune.
Let me go to councilor murphy
for an opening statement.
Thank you.
Councilor flynn and.
Thank you to the panelists.
Thank you.
Commissioner santiago for all
you do here at the city and
obviously across the state and
country always showing up for
veterans as a veteran yourself.
Um, I mean I don't want to take
all my time just thanking
people for being here but craig
also and coming from like the
va and the different posts
across the city, we know that
many veterans when they come to
those places it's not just for
socialization even though
that's a wonderful thing.
It's also to connect and help
connect to the benefits that we
know the veterans.
Earned and in many times aren't
always aware of what's out
there for them.
And when we have subgroups like
this I think it's very
important.
>> that.
We're talking about and thank
you for uplifting these
concerns about the lung
cancer rates among our black
veterans and making sure our
women veterans are getting
everything they need while
they're enlisted but also when
they come home making sure that
they're supported.
So as a veteran mom, I know
it's important that we always
support our veterans.
But as a councilor I think it's
also important that we're
making sure and there's no
groups around the city who are
feeling as though they're not
getting what they need.
So just happy to be here and
also public health commission
in the va.
My pop up papa jack, my step
dad 92 now and he's getting a
lot of support from the va and
the senior home health care and
it's just wonderful to see full
circle, you know, spending your
life giving and then when
you're near the end people
showing up for you and it's
just great.
So thank you for all you do.
And thank you councilor murphy
.
I do want to give
council louijeune an
opportunity for an opening
statement louijeune.
Good morning everyone and thank
you for being here.
I want to thank you,
councilor flynn for your
leadership and for your service
to our country.
I also want to thank all of our
panelists for your leadership
and your service to our
country.
And uh, I want to thank you,
starting with the commissioner
for all the incredible work
that you do in the office
of veterans services to make
sure that our veterans in the
city have the resources that
they need, uh, once they come
home, um, to thrive and to
really, uh, be thanked for the
work that you've done.
I know you're celebrating, uh,
a lifetime of service this year
and it is a well-deserved one.
And uh, to everyone who is
here, uh, doctor wiener to um
uh and all of the panelists I'm
really, really appreciative
of the work that you do at the
post.
Um, uh, george is that I'm
sorry.
Craig.
Craig I'm sorry craig and uh
and mark craig and mark, thank
you for being with us today.
Um, we there are a lot of race
based health gaps in this
country.
um, and that is also true for
our veterans when it comes to
lung cancer and other types
of cancer.
So just know that in me and in
the city council you have
allies and people who are
committed to making sure that
we're doing everything we can
to close those gaps.
So thank you and we look
forward to continuing working
with you and partnering with
you.
Thank you.
Thank you, councilor louijeune
.
I'll give an opening statement
then I'll go right to our
panel.
Um, hopefully I only take two
minutes.
Woman veterans are one of the
fastest growing populations
within the united states
military and the department
of veterans affairs.
Yet many continue to face
barriers after leaving the
service.
Women veterans make up nearly
20% of those serving military
personnel and about 10% of the
veteran population.
But many struggle to access
gender specific health care,
mental health services,
childcare, housing employment.
Approximately 25% of women
experience military sexual
trauma, which can increase the
risk of ptsd, depression,
substance use suicide.
Some women also avoid va
services because returning to a
military environment can cause
anxiety.
The va has taken steps to
improve care through efforts
such as the deborah sampson
act, which expands primary care
in counseling services for
women veterans.
Other legislation including um
,the coding the brave act and
other pieces of legislation
focus on maternity and mental
health needs.
Massachusetts also supports
women veterans through the
women veterans network which
provide information resources
support.
However, more gender specific
health care counseling
childcare career transition
programs are needed.
The va should also work to fill
counseling positions and
increase the number of women
providing care.
Veterans also face serious
health risk including lung
cancer.
Military exposure such as a
dose can increase veterans risk
of developing the disease.
African american veterans face
additional disparities in lung
cancer diagnosis, treatment and
survival, improving access to
early screening and quality
treatment is especially
important for those communities
.
In boston, organizations such
as the va health care system
and the veterans outreach
center at harvard street
neighborhood health center
provide veterans with health
care in other resources.
Expanding these services can
help address the racial gap,
gender disparities ensure
veterans receive the support
they need after their military
service.
We must continue to work
together to provide all
veterans with access to the
critical care and services they
earned.
Before I go to council,
fitzgerald uh for an opening
statement I do want to
acknowledge the incredible work
uh, commissioner santiago
of your team um of you of your
dedication and support of women
veterans, of support
of veterans of color and also
working closely to ensure lgbtq
plus veterans are treated with
the dignity and respect that
they have earned.
Um, so having said that, I
wanted to give
councilor fitzgerald an
opportunity for an opening
statement.
Uh thank you chair.
Uh, I appreciate it and thank
you all for being here today.
Uh, in regards to this matter,
um, really here to learn more
about uh what sort of some
of the, uh, deficiencies MAY be
where we can be better how we
can help, uh, strengthen those
uh, going further, um, and
really look to you guys have
the answers.
So, uh, I just here for you to
educate us on how we can be
more, uh, supportive of you
all.
Um, and as always, thank you
for everything that you guys do
not just for our city but for
our country as well.
So thank you, councilor flynn,
I appreciate it.
Thank you, councilor fitzgerald
.
Um, at this time I do want to
ask the panel if they would
like to provide an opening
statement on women veterans on
how we're able to support, uh,
veterans of color.
Um, I know there's two specific
dockets, but we can combine
them into one if that's okay
with everybody.
And, um, I don't necessarily
have any time um, that I'm
putting the panelists on.
So take the time that you need
to make sure your message gets
out to the public.
I'd like to do.
These hearings because the
public does watch these and I'd
like to educate the public
about what we're doing here in
city hall and to ensure that if
veterans are watching they know
who to contact if they are in
need of services.
So let me start with
commissioner santiago and we'll
go right down the right down
the line and take the time you
need to discuss whatever is
important to you.
Uh thank you.
Chair flynn.
Good morning.
>> chair flynn.
Councilor murphy,
councilor louijeune
councilor fitzgerald, thank you
for, um for having us here.
Um, I do just want to touch on
something.
I wanted.
>> to thank.
The city council.
I know, um.
You know, it's it says a lot
about, um, your actions.
And, um, in your passion for
our veterans here in the city
of boston by showing up not
just on memorial day or
veterans day but also year
round for our veterans.
And that is definitely
something that, uh, that I see
on a daily basis and as a
veteran and as a commissioner
um, I do thank you.
Um, I also just want to thank
my fellow panelists who are
here today.
Uh, my fellow veterans who are
watching advocates and
neighbors.
Um, this is an important
hearing.
Um, and one thing that I love
about having this hearing is
that it's more of just a
hearing is also a conversation
about what we could do best for
our veterans when it comes to
the topics that we are talking
about today and sometimes it
rears into other topics as well
which is also welcomed.
Uh but today we're talking
about lung cancer uh rates
amongst african-american
veterans and uh our support
of our women veterans.
Uh, lung cancer is not simply a
medical issue and going to hear
a whole lot more about that a
little bit later on from uh,
doctor wiener who is here from
the va.
Uh, it's an issue that as far
as I'm concerned and many of us
are concerned um, is a racial
equity issue of access trust
early detection and whether
veterans receive the care that
they earned through their
service.
Many veterans face elevated
risks because of smoking
secondhand smoking uh, asbestos
especially those like myself
who have served on older navy
ships.
Uh, those who served in burn
pits around burn pits.
Uh airborne hazardous chemicals
and other toxic exposures that
are encountered through
military service.
Yet exposure alone does not
determine an outcome.
Timely screening.
Early diagnosis.
Access to specialists, reliable
transportation and trust in the
health care system can
determine whether cancer is
found when it is treatable or
after it has also progressed.
Va research indicates that
fewer than 10% of the
approximately 1.
>> million eligible.
Veterans studied have received
lung cancer screening, with
screening rates even lower
amongst black veterans.
The research.
Also indicates and identifies
barriers including limited
awareness, mistrust, stigma,
unequal relationships with
their providers and adverse
social determinants of health.
These are not failures of our
veterans.
These are warnings that our
systems must do a better job
of reaching the people that
they were created to serve.
There is also encouraging
evidence studies that found
that when black veterans
receive care within an
integrated va system, their
lung cancer treatment and
outcomes can be comparable and
sometimes better than those
of their white veteran
counterparts.
That tells us something that's
very important.
Disparities are not.
Inevitable when care is
accessible and it's coordinated
,culturally responsive and
equitable.
We can save lives and our women
veterans.
As the councilor has mentioned,
our fastest growing segment
of the veterans population with
more than 2.1 million women
veterans in the united states
today.
Approximately 20% of veterans
women veterans are black and
42% of women using va health
care system belong to race, a
racial or.
Ethnic minority group.
Yet women veterans are still
too often overlooked, mistaken
for military spouses or made to
feel that veteran programs and
facilities were designed
primarily for their male
veteran counterparts.
Women veterans.
Need comprehensive and
respectful care that includes
primary care, cancer screening,
reproductive and maternal
health care.
Mental health.
Treatment support following
military sexual.
Trauma.
>> menopause care toxics
exposure evaluations as well.
Homelessness prevention and
assistance navigating
disability claims and benefits.
They also need providers who
understand how systems, risk
factors and treatment
experiences are different for
them as women.
I want to recognize the
outstanding work of the women
veterans care center within the
va boston health care system
and its program manager carolyn
mason holly, whom I spoke with
yesterday.
This program here in boston
provides women veterans with
comprehensive coordinated care
in an environment where their
service, their experiences and
individual health care needs
are understood and also
respected.
Its specially trained providers
offer primary care gynecology,
maternal and postmortem
support, mammograms and other
preventive screenings,
menopause care mental health
counseling, support for
survivors of military sexual
trauma and also.
Family planning services.
Just as importantly, the
programs help women veterans
navigate the va health care
system and it connects them
with the specialists and
resources that they have earned
because of their service.
The center reflects an
important promise that women
veterans should never feel
invisible or like an
afterthought within the system
that they serve to defend.
They deserve timely,
compassionate, gender specific
care and a place where they are
recognized first and foremost
as veterans.
Also available to our women
veterans is the veterans call
center, which provides women
veterans with information about
va services and resources,
benefits and eligibility.
It's a toll free hotline which
is available monday through
friday from 8 A.M. To 10 P.M.
Eastern standard time and on
saturdays from 8 A.M. To 6:30
P.M. Eastern standard time.
The phone number is 855 va
women or (855) 829-6636 and
I'll repeat it again.
(855) 829-6636 and if you
wanted to contact the boston
office you can call
(617) 981-9277.
Also here in the commonwealth
of massachusetts the primary
program for women veterans as
was mentioned by
councilor flynn within the
massachusetts executive office
of veterans services or any
of us is a massachusetts
women's veterans network which
acts as a central resource peer
group an advocacy body
dedicated to empowering women
who have served in the military
since nine.
Since 2019, the mayor's office
of veterans services here in
the city of boston has hosted
an annual women veterans
retreat roundtable which has
provided women veterans with a
welcoming and trusted space to
share their experiences, learn
about available benefits and
healthcare resources and speak
directly with the leaders and
organizations that serve them.
Most importantly, the
roundtable ensures that women
veterans help shape the
programs and policies intended
to meet their needs.
It reinforces a simple but
essential message that women
veterans are not invisible.
They served, they sacrificed
and the voices must be heard.
Also here in the city of boston
we host an annual black
veterans appreciation brunch
recognizing the extraordinary
service, sacrifice and
continuing contributions of our
black veterans throughout
boston's history.
It is also an opportunity to
connect veterans and their
families with benefits, health
care and community resources
while creating honest
conversations about the
disparities that they have and
MAY encounter by celebrating
their achievements and
listening to their experiences.
We affirm that honoring black
veterans requires more than
recognition.
It requires sustained advocacy,
equitable access and meaningful
action.
Here in boston, we are
fortunate to have the va health
care system which is one of the
best in the country and the
world which includes campuses
in west roxbury and in jamaica
plain.
We also have world class
hospitals and cancer centers.
We have the boston public
health commission which we're
going to hear from here very
shortly.
We have community health
centers, the massachusetts
executive office of veterans
services with secretary eric
grinnell and deputy secretary
andrea gail bennett at the
helm.
We also have the massachusetts
women's veterans network led by
director jessica frost.
Veterans organizations like the
vfw, like the american legion
and the dav and trusted
neighborhood leaders.
And of course our partnerships
with our fellow city
departments like the boston
public health commission, h
strong, the office of food
justice, the mayor's office
of housing and neighborhood
services just to name a few.
We all work together to help
connect veterans and their
families with.
Health care.
And wellness resources,
nutritious food, food access
programs, housing assistance,
transportation benefits
advocacy, mental health support
and services for our older
veterans.
By working across agencies, we
can and continue to address the
social and.
Practical barriers that too
often prevent veterans
especially women veterans,
black veterans and all the
veterans and those facing
financial hardships from
receiving the care and support
that they have earned.
My hope is that this hearing
here today will lead to greater
awareness, measurable and
measurable action where more
veterans are screened.
More cancers are detected early
.
More women veterans receiving
the care designed around their
needs and life saved.
Lastly.
>> as part of our continuing
commitment to honor service and
sacrifice and as our nation not
only marks the 250th
anniversary of our country but
also here in a couple of weeks
the 25th anniversary
of SEPTEMBER 11th 2001
terrorist.
Attacks we must never forget
the nearly 3000 innocent lives
taken that day.
The first responders who ran
toward danger and all those who
continue to live with this
lasting effects.
SEPTEMBER 11th forever changed
our country and redefined
service for an entire
generation.
And in the days and years that
followed, americans step
forward to serve.
In our.
>> armed.
Forces.
>> in our fire and police
departments, in our emergency
service and in our communities
united by shared commitment to
defend our nation well more
importantly to care for one
another.
We especially honor the post
9/11 veterans who answered that
call, including those who never
returned home and those who
still carry the visible and
invisible wounds of war.
25 years later, our
responsibility remains clear.
Remember every life lost.
Honor every person who served
our country and ensured that
their sacrifices are never
forgotten.
The city of boston will never
forget.
This year we're also going to
host our annual recognition
ceremony on SEPTEMBER 18th in
city hall plaza.
We will gather with veterans,
families, community members and
the state leaderships of the
vfw, dav and the american
legion to reaffirm that our
prisoners of war and our
missing personnel will never be
forgotten.
We also invite everyone to join
us for boston's veterans day
parade on NOVEMBER 9th, where
we will recognize veterans
of every generation including
the post 911 veterans who
answered our nation's call
during these past 25 years.
together, these observances
remind our veterans that boston
remembers their service, boston
honors their sacrifices and
boston remains committed to
supporting them and their
families.
Thank you to the council for
bringing attention to these
critical issues and for your
continued commitment to our
boston veterans and their
families.
And I'm looking forward to the
conversation here today.
Commissioner santiago, thank
you very much for the um for
your testimony for your
leadership.
I do want to make one one
change to what I mentioned
earlier.
I know we were going to go
straight down the line.
Uh, commander meredith tuitt is
a member of the american legion
in the court of post and I know
she's going to the american
legion post convention now.
Um, I do want to take her out
of order.
Give her the opportunity to
speak.
Uh, provide an opening
statement.
Um, because I have great
respect for her as a as a
veteran as a as a as a woman
veteran, a veteran of color but
also um, a member of the court
opposed.
So I have to take care of my
commander as well.
All right.
Um, so could we ask, uh,
commander to it to um if we
could bring up sir?
Oh good morning, commander.
It's good to be with you.
Good morning.
morning, CHAIRMAN.
And morning everyone.
Um, I do appreciate you, um,
chair and the committee pulling
me out of turn.
As you know, I am out running
errands getting ready to head
to louisville, kentucky for the
national american legion
convention.
So I appreciate.
You pulling me out of turn.
Um, also I want to, um, thank
commissioner santiago for all
the work that he does.
>> for.
The veterans here in the city
of boston and all the other
panelists that are going to be
speaking.
Um thank you.
That will be we all have to
continue.
Our service.
For veterans veterans of color.
Um, and also for female
veterans.
I am district.
Seven suffolk county
council commander for the
american legion.
So I have about 20 posts under
me and then also commander
of the carter post in mattapan
.
So I'm always speaking with my
veterans veterans of color
female veterans.
I'm part of the vn, um and and
many other organizations.
Um first I want to say I, I
applaud and I appreciate the
doctors and the um the
advocates from the va who have
been working around the
screening of lung
cancer especially for african
american veterans and how
indigenous um veterans here in
the city of boston they have
been doing um screening and
going to different locations,
different posts over the past
uh, say two years or more.
Um, to be able to screen as
many of our comrades as they
possibly can to um, you know,
get them assistance and get
them help for those that um are
detected or and also to make
sure that those that don't have
a no they don't have but the
problem that I want to touch on
this base is here is that even
though they're visiting our
communities and coming into our
post and hello, we still lose
and we're still missing some
of our comrades who might have
lung cancer.
Our older generation who
sometimes can't get out to be
screened or at these locations
.
So how do we improve upon that
?
And I'm going to throw that on
your desk, commissioner
santiago.
I'm going to throw it on the
desk of our va um, doctor
because we need to be able to
work with our, um our system
and how we are doing the
screenings to be able to
accommodate our elders who
don't come out when they.
When there's a screening
because one they don't.
Follow social media to they
might not see a flier.
Um and ah we we've done
barbershops.
We've done all sorts
of different locations when we
were doing it at the um carter
post but we still MISS It.
So I just wanted to put that
out there was still missing a
lot of our comrades that should
.
Be able.
>> to get screened.
Right.
But I do applaud them for what
they have been doing.
Um, let's talk about service
for, um, female veterans.
A lot of times I have veterans
that say we shouldn't say
female veterans.
A veteran is a veteran.
Yes, but female veterans health
care is different.
We we, um you know, we give
birth.
We we carry children so we need
that um, again we need that
that that ob doctor to to deal
with and it took a while for
when the ob doctor left jamaica
plain it took them.
>> almost two years.
Before they found another one
and I I applaud carolyn for all
of the hard work she does to
make sure that we do have
doctors within.
The the.
Women's clinic and the new
clinic that they opened up
focused on.
Um menopause I think it's in um
in the bedford location but men
don't think about those things
women do.
So we have perimenopause, we
have menopause.
We have we have um carrying
children, we have our fibroids.
We have all these things that
men don't have that are crucial
to our livelihood and and our
health and our our mental
health is also something else
that is a different you know,
we we struggle with depression
in a different way because not
only depression about.
Our service.
especially women who have msi
and our military sexual trauma
and those that have the post
trauma, you know, um, and so
on.
But at many times we are all
focused on our children and and
taking care of our household
and and keeping our jobs and
you know, and being looked as
if we you know, as we are being
too aggressive and to this and
to that.
So the the the mental health
for female veterans is
different.
So that's something that we we
could do better.
You know um I have a lot of my
sister uh sister veterans who
say to me sometimes when they
go to a therapist that they
don't think the therapist is
really listening to them
because some therapists say, oh
,you know, you could you can
handle it.
You got.
Your strong you know, sometimes
we don't want to hear that, you
know and um those are things
that we need to be able to have
that cultural competency that
that um mental competency, that
environment that we're in.
So those are the things that we
we need to focus in that I
don't know if it's more
training or or how do we do it,
but those are the that I hear a
lot about from my sister um
comrades and I want to say um
for myself I went through um a
traumatic loss of like my
second mother uh, about a year
and a half ago.
And I want to tell people I
went to therapy because that
loss put me in a depression
that I didn't even realize i
could experience it.
And I'm always out here telling
my sisters go get help, go
going talk going this.
And I finally had to say to
myself go and get help.
Go and talk to someone because
it.
>> was very.
Hard and when I walked out my
door I still had to put on that
face that strong face because I
was working with veterans,
working with women and trying
to get things done.
But internally.
I was screaming.
But I was able to talk to a
therapist that was able to get
me through that.
So a lot of times we have to
think.
About women's depression.
Women's mental health is
impacted in different ways, you
know, um, also again I want to
thank commissioner santiago for
bringing it up.
A lot of times female veterans
are looked at as just the
spouse of a veteran and I've
been you know, talking about
you know, ways that we can
acknowledge that women served
you know, if it's a license
plate or whatever, I'm going to
have to go back and rally this
year to see if we can get some
legislation around that because
my veteran's plate on my car
people think it's my husband's
plate.
I don't have a husband yet, you
know, but those are things we
we um we work we talk.
About um.
Within the the female veterans
community it being acknowledged
not we used to be invisible.
We are now we're still in a
little bit in the saddle but
we're coming coming out you
know and um but it's not it's
not done.
We have more.
Work to do.
Right.
>> and a lot of times too.
Now what I'm having a lot of my
sister um.
Veterans talk about.
Is how they get looked at say
they go.
>> through a.
Divorce and there's child
custody issues and.
So on.
A lot of times because they're
female veterans, they're being
treated a certain way in the
court system because of the
they have female veteran or
they might have messed they
might have ptsd, it might have
this and.
>> the judges are.
Using that that because the
spouse that the.
The uh um battling.
With is using that against
them.
So those are things that I want
to put out there so we can
figure out how are we going to.
Work with our.
Systems to.
>> help our sisters that help
my sisters help my.
Sister comrades and I never you
know I'm not going to leave um,
my my veterans of color.
I serve as a.
Commander at, uh, long stand at
107 year old um post that was
strongly, um.
Veterans of color.
Um.
We we are treated differently.
And that's another thing when
you think about how different
ways.
That veterans are treated, you
know, and then you have to.
Think about.
When you are a veteran of color
and an indigenous.
Veteran and or also on how.
>> people look at you if it's
not your medical claim, if it's
not.
Your housing, if it's.
Not your mental health and and
so on.
People think that oh we're
making this up but no we are
treated.
Differently in all of these
avenues.
Because of the pigmentation.
Of our skin.
You know.
And is that fear?
No, because we all served when
we're on the.
Field together we don't see
skin color anymore like they
used to do back in the days
because when I went in they
still saw it.
But here we are now.
We're still going through.
Things because we are veterans.
And military attached of color
.
And so I want to say that
commissioner santiago's.
Office does as much as they can
um, comrade flynn, as a fellow
sailor we know that.
There are.
Still struggles.
Out there.
And we and that's what I
appreciate when you have these
hearings so we can.
Talk about.
What has.
Been done.
Good and what still needs.
>> to be worked on.
and um, I know I'll get beaten
up by by haywood fanelli and
some of my other comrades if I
don't talk.
About the veterans that are
still.
>> on the streets.
Still homeless, still looking
for a single room somewhere or
our.
Veterans that.
>> are on the street because
they don't take their meds and
they're off their meds.
I have one of my comrades right
now who we can't even find him
on the streets.
He.
Um stopped his meds.
He lost his apartment.
We know he's on the streets.
We know he's checking into pine
street but we haven't seen him
in months.
And we're still trying to.
Find him.
You know?
So these are things we need to
do.
Maybe we need to put together.
A group where we can go out and
.
Look for those that we know.
Are on the streets.
And their families are worried
about them and so on.
So those are things that I'd
like to get on.
>> to the the um onto.
The table onto a piece
of paper.
Somewhere so we can do more
work.
And maybe pull some.
Types of.
>> meetings together to talk
about how do we do this, how do
we walk the corridor and find
our missing homeless.
Veterans that are out there?
and I want to thank you for
the.
Time that you.
>> gave me counselor.
Um.
>> I want to thank the.
Committee for.
Allowing me to, um, join you
today and speak and also again
thank you to everyone.
Else who is going to be
speaking.
Behind me on the.
Panels and thank you,
commissioner santiago for the
work that you do.
And um.
I'm going to enjoy louisville,
kentucky for you guys.
Thank you so much.
Well thank.
>> you.
Thank you commended to it and I
know I speak on behalf of my
council colleagues in for the
panel, but we have a tremendous
amount of respect for you for
the work you do.
So safe travel and um enjoy the
conference and we'll talk when
you get back.
Thank you.
Committed to it.
Um, let us let us continue.
Uh, commander.
Good morning, councilor flynn.
Councilor murphy
council fitzgerald.
Um.
There's not many people that I
would let, uh, hop the line in
front of of myself, but, uh, my
comrade commander and good
friend uh, the commander to it
uh, she's definitely one that I
would yield waved for so yeah.
Yeah.
Enjoy.
Louisville commander.
Uh, again my name is craig
dealed.
I am, uh, resident of the city
of boston and live in south
boston.
Uh, I'm a member of the boston
police post vfw 1018 uh, and I
currently serve the vfw as the
state commander uh, in that
role um overall responsible for
146 posts across the
commonwealth, uh, between our
combat veterans and our
auxiliary members, brothers and
sisters, uh, there's over
20,000 of us across the
commonwealth and just here
within the city of boston we
have four vibrant posts that
are out advocating for our
veterans, advocating for our
neighborhoods every single day.
Um, so there is always a
presence of our veterans and
I'm not here only on behalf
of the state organization of of
the vfw but also again as a
resident of the city of boston
and uh, to speak on uh on
behalf of our four vibrant post
here in the city.
Um overall the the lung
cancer rates with our our black
veterans is alarming and a lot
of it goes back to uh, a darker
time within the defense
department, department of war,
whatever you want to call it,
uh, where there was significant
,uh, segregation of different
types of people in different
types of units and doing
different work.
Uh, as commissioner santiago
mentioned before there there's
folks that would be, you know,
serving in the navy that would
always be below decks.
They'd never see the light
of day and they're in
environments where there's
going to be a substance in that
environment and breathing in
fumes from the engine rooms
they're around hazardous
materials is just you know, the
part and parcel of uh, being on
the navy a navy ship, uh, you
know, the land forces they're
they're always going to be
again, uh, toxic exposures the
,uh between the burn pits
again being in hazardous uh,
locations of uh even being in a
in a tank in an armored vehicle
and infantry fighting vehicle
you're around those uh, you
know.
Those fumes you're around the
the fluids and those
environments are inherently
hazardous.
Uh, I mean, we all understand
when we raised our right hand,
uh, enjoyed the service, uh, as
a volunteer that we were going
to be putting ourselves into
these situations and for the
benefit of our communities
of of our country and in for
the world in general.
Uh, overall.
Know we don't go into the
service um broken.
Yeah.
But a lot of times will come
out of the service in that
state uh, again you know, it
might not be due to a
combat injury.
It could be just regular
occupational hazards within uh,
our our nature of our service.
But the the cancer rates within
our african-american, uh, black
comrades.
Uh.
>> is something that needs to
be continue to look at looked
at by by not only the va but as
as part of the overall health
care system that we're you
know, we're involved with it.
Uh, you know, I've had the you
know, the honor and pleasure
of working at uh both brigham
and women's and dana-farber uh
,for cip for many years and I
know firsthand and used to see
the the outstanding effects
that our health care system has
for not only our black veterans
but, you know, every anybody
within the city of boston in
the world at large.
Boston is a medical mecca
of the world.
You know there's no better
place to get sick or be hurt
now than that within the city
of boston between uh, the
pre-hospital care that boston
ems provides right through uh
through the va hospitals and
our uh our great, uh, you know,
health care system here in the
city.
Uh, what we're looking at
though is making sure that all
veterans and especially our
black veterans within uh, this
subset, uh, do have that access
of care.
Uh, we need to make sure that
we have between our
partnerships with, you know,
through the vfw, the
commissioner's office and the
through the va that we need.
To make sure that when I have a
veteran come to me saying hey,
I've got this stuff going on,
where can I go?
Uh, you.
Know, the vfw is there to be
able to.
Help.
>> uh, steer the veterans in
the right direction to get that
care be it uh, city service
going back through that through
the va.
Uh, we have a an incredible
network of veterans service
officers who assist uh, any
veteran not just vfw members,
any veteran with filing their
va, uh, disability claims and
we'll take them right through
the initial intake and if they.
Need if they get denied
initially we'll help them
through the appeals process
even though going as far as to
a hearing in front of an
administrative judge and we'll
take them through that whole
process free of charge to that
veteran.
Uh, we don't look for anything
in return.
We don't put any membership
requirements on anything.
We'll if you will help any
veteran uh, so that that's
important that's an important
distinction that, uh, we want
and need to make sure.
That through that process the
the vfw uh, in their power
of power of attorneys through
the veterans that receive va
benefits, uh, since the start
of the federal fiscal year this
past OCTOBER 1st have brought
$87 million back directly back
into the economy of the
commonwealth of massachusetts.
That doesn't get filtered to
any other attorneys that goes
directly into the pockets
of our veterans, um, that are
within our our commonwealth.
You know, the numbers are a
little skewed because some
of the south coast does get
pulled into the providence
numbers.
Uh, but that's you know, that's
fine as long as where those
veterans are being taken care
of.
Uh, if we extrapolate the
numbers, we're looking at $105
million directly into the
pockets of veterans, uh, with
across the commonwealth.
Uh, I wish I was able to then
break out what the what comes
back directly into the city
of boston?
Uh, I'm sure it's a very
impressive number.
Uh, but again through the vfw
and our service officers, um,
that economic impact that we're
making is huge and that does go
towards the access of care.
You know, if they're secure and
financially they're going to be
a little bit more secure in
themselves, you know, seeking
the medical help.
They feel like they're going to
be able to to go and seek that
help.
Uh so we get to get better to
get that at home so they get
that care through.
Uh and from start to finish.
Um uh transitioning to uh
women's veterans.
Uh, I had the.
I entered the service and uh I
got commissioned in 1991 uh,
over the years the the nature
of our military has has changed
quite drastically.
We have women serving in uh in
the air force in combat, uh,
equipped jets and strike
fighters.
Uh, we have uh, women sailors
serving on um armed combat and
ships and uh, the submarines
uh, we have women in the army
in the marine corps serving in
infantry billets.
Uh, there's they're doing the
same thing that the men are
doing.
uh.
We we.
Need to look at you know, again
embracing overall our women
veterans and we try to do that
by through the vfw.
We're encouraging our women
veterans that are members to
take on leadership positions
within our post, you know, to
so we can uplift their voices
to get another different point
of view than just the old boy
network of, you know, the smoky
uh, cave of a vfw or american
legion post of the days
of yore.
And those who thankfully don't
exist anymore uh, as uh,
commander tuitt had mentioned
uh uh, how you know, she's had
experiences where as somebody
has come up to to her and you
know, didn't recognize her as
the as the veteran.
Um.
>> you know, we make I try to
make my own personal point if I
have a couple come in front
of me.
Uh, I'll start with the with
the woman in front of me and
ask her where did you serve?
And oh, great, I served here I
served there or oh, I'm not the
veteran my my husband is well
still she's part of the veteran
family and that's important as
well that we embrace you know
not just the veteran the
service member but the entire
veteran and service members
family because they're serving
as well.
They're going through hardships
just as much as the service
member does is what, you know
when they go deploy and do
their jobs.
Uh, so it's very important that
again, we're uplifting our our
feet and women veterans making
sure their voices are heard uh
for uh expanding their the
leadership.
Uh of of our service
organizations to reflect the
true nature and the
demographics of our military
service.
Uh, you know, finally at the uh
at the police post we have our
we currently have our first
female or woman uh, command
post commander and lisa venus,
she's retired or soon to be
retired uh, boston police
sergeant, uh, army veteran and
uh she is our post's first
female commander and uh and
we're excited she's she's been
a hard charger coming up
through the ranks and uh, we're
looking forward to some great
opportunities with her uh,
through this year and going
forward.
Uh, so there is a changing
of the of the scenery, you
know, throughout the veteran
service organization.
So you know, I applaud you know
commander to it and there are
commanders here that know again
they're taking that leadership
role and their voices matter.
You know.
>> without their voices nothing
will change across our our
service organizations to
reflect the true nature of our
environment right now.
Um.
Uh, last I'd like to mentioned
as uh commander tuitt mentioned
the uh uh our homeless
veterans.
Yeah.
They count they're out there.
You know, it doesn't matter
that you know there are part
of any of our organizations
they served there.
They deserve our respect,
deserve our support.
Uh, the vfw will do everything
that we can to make sure that
across the board and through
our partnerships with, uh, the
with commissioner santiago and
his department that we do look
out and look after these
veterans.
Uh.
>> and the veterans of foreign
wars has a a national home.
Oh, meeting rapids michigan
that, uh, has been around for
over 100 years and they help
support uh servicemen service
members, their families that
are looking for a little, you
know, not a handout but a hand
up.
You know, they can go they move
their family there.
They stay rent free utilities
free for a number of years to
get back on their feet so
they're able to move on back to
you know, their communities
that you know that they're
looking to join or rejoin and
uh that might be something that
we can look at to uh within the
city there's a lot
of opportunities out there.
There's a lot of great
organizations that are doing
incredible things in their own
little of uh, their own lands.
But again, you look across the
table and across the room here
uh, it does take a village to
uh to support the veterans
community and all of our
communities.
Yeah.
This is not an individual
sport.
uh, we can't do it by
ourselves.
It does take a team and then
we've got a great team here
and, uh, we I do applaud the
the the city councilor.
Councilor flynn.
Councilor murphy.
Uh, councilor fitzgerald, I do
appreciate you taking the time
on.
>> a.
On a friday morning at the end
of AUGUST, uh, as the waning
days of summer are closing in
on us.
Uh, I do appreciate that you
guys.
You're all taking the time to
listen to us.
Uh, I would implore that you
take the time, um, in your busy
days to go visit our posts not
just when they're having a, uh,
a chicken bake or any type of,
um, you know, a fundraiser or
anything like that, you know,
reach out to the post, go to.
One of.
>> their meetings.
Um, that's when you're going to
have the one on one
conversations with our veterans
and you're going to find out
really what's on their mind.
So you got to take that with a
grain of salt that you might
not want to hear everything
that's on their mind.
But the you know, the veteran
is going to be able to give
you, uh, a true perspective on
the ground what they're dealing
with and it's going to be that
one on one interaction that is
going to really bring it home
to you.
Uh, when you're making your
deliberations, you're having
your your discussions, uh, in
matters not only dealing with
veterans but across the city
that.
You know.
Veterans are a small subset
of our society.
But you know, it's a very
diverse and distinctive group
that has already dedicated
their lives to public service.
Uh, they've raised their right
hand.
They've served uh they've given
their blood, sweat, tears, uh,
body parts and some of them um,
part of their minds to the
defense of our country and the
betterment of our society.
So again, thank you for your
support and I look forward to
any questions that you might
have.
Thank you.
Thank you commander.
Um, we have uh, mr kennedy from
the boston public health
commission, sir.
Thank you for being with us.
And I want to give you an
opportunity to, um, give an
opening statement again.
Uh, want to make sure we you
take the the amount of time
that you need to make sure that
your message gets out because I
do know a lot of veterans watch
this program on television and
want to give you an opportunity
for your opening statement.
Mr kennedy, uh, thank you for
being here.
Excuse me.
Uh.
Thank you, councilor flynn.
.
>> and of course, uh,
councilor murphy.
>> and fitzgerald as well.
Uh.
>> if I MAY.
for just.
>> one second.
Um, it was a real pleasure to
hear from, uh, matter to it.
I worked with her quite a bit
in the past while she was.
With state rep gloria fox.
Okay.
Yeah.
I was just a real pleasure to
hear from her.
Um.
>> again, my.
>> name is mark kennedy.
Thank you so much for having
me.
It's my pleasure and honor to.
>> be here.
I'm a senior program manager in
the chronic disease prevention
and control division at the
boston public health commission
.
And I'm leading the creation
and implementation.
Of the commission's first
chronic.
Disease and cancer.
Early detection initiative.
The mission of the boston
public health commission is to
work in partnership with
communities to protect and
promote the health and
well-being of all boston
residents, especially those
that have been impacted by
racism or systemic inequities.
To put my comments.
About lung cancer among
african-american veterans in
that.
Context.
>> let me start by highlighting
the city of boston and the
boston public health
commission's first population
health equity agenda, which we
refer to as live long and well
to live longer well agenda is
about.
Convening partners across
sectors to address the three
leading causes of premature
mortality in boston unintended
drug overdoses, cardiometabolic
disease and yes preventable
cancers.
Major cancers including lung
cancer are referred to as
preventable because there's a
screening.
Guideline associated with them
that can help to.
Detect these cancers early when
they can be treated with the
with the best chance
of survival.
Nationally.
,statewide and in boston, lung
cancer is the top cause
of cancer related mortality in
boston, lung cancer is the
deadliest and most frequently
diagnosed fatal cancer for both
men and women.
For black men.
Low I'm sorry lung
cancer causes more death than,
colorectal and prostate cancers
combined.
Overall.
>> when we look at trend data
mortality from lung cancer has
trended.
Downward but of course not for
everyone.
Massachusetts is near the top
nationally for early diagnosis
,surgical treatment.
And overall survivorship but
total incidence which includes
new cases is higher than the
national average.
This could be due to increased
screening.
But new cases are.
Not necessarily.
>> cases where the cancer was
diagnosed early.
we'll continue to.
Track local.
Data on age and stage of.
Diagnosis to quantify that.
Finding more.
>> new cases early leads to.
Less mortality.
Meanwhile, boston's black
population has a lower
incidence of lung cancer than
the.
National average.
Nationally, black individuals
with lung cancer.
>> were 13%.
Less likely.
To be diagnosed early.
They were 19%.
Less likely to receive surgical
treatment, 11% more likely to
not receive.
Any treatment and 13% less
likely to survive.
Five years.
When you compare to white
individuals.
All that said, lung cancer is
the leading cause of cancer
related death among U.S.
Veterans.
Veterans have a higher.
Rate of.
>> lung cancer and a lower rate
of survival than the general
population.
African american veterans face
higher risk to military related
exposures like asbestos,
according to the us department
of veterans affairs, veterans
have a 25 to 76% higher risk
of lung cancer and asbestos
exposure remains a significant
contributor to salivated risk,
which exacerbates risk for.
Black men.
African american veterans
experience disparities in
diagnosis.
Treatment and.
survival rates compared to
other groups.
The U.S. Department of veterans
affairs diagnosis it treats
approximately.
8000 veterans for lung cancer.
Each year.
>> veterans have a higher risk
for lung cancer due to.
Older age.
Smoking and.
Environmental exposures during
and after military service.
Smoking is the primary cause
of lung cancer, with many
veterans reporting that.
They started using tobacco
after.
Entering military service.
Exposure to radon gas is the
second leading cause.
I want you to note here.
If you would, that in addition
to these risk factors that
contribute to incidents, not
getting screened is also a
significant risk factor and
that contributes to mortality
because for lung cancer.
And any other cancer catching
and treated it.
Early exponentially increases
survivorship.
Systemically black veterans
have lower odds of completing
lung cancer screening than
white veterans, particularly
due to loss between referral
and the connection with
screening programs.
Let me conclude.
By saying this for lung
cancer veterans and the
general.
Population would benefit
tremendously from changes.
To the.
>> screening guidelines that
would further.
Expand access to screening in
2021, the U.S. Preventive
services task force expanded
access to lung cancer screening
to catch lung cancer earlier in
high risk groups, particularly
women as well as black adults
who adults who often develop
lung cancer with lower smoking
exposure.
The task force the task force
and talk expanded access by
lowering the starting gate from
55 to 50 and from reducing the
pack history requirement from
30 pack using a to 20 pack.
Use it here a year I'm
sorry you do still have to be a
current smoker or have quit
within the past 15 years to be
eligible.
In 2023, the american
cancer society went further and
eliminated 15 years since quit
criteria.
But lung cancer screening is
still tied strictly to tobacco
use for veterans who are
exposed to radon and or
asbestos.
For individuals who work in
occupations such as firefighter
construction, hair salons, etc.
For general public city
dwellers they were exposed to
elevated levels of automobile
exhaust and other environmental
carcinogens on a daily basis.
Lung cancer screening
eligibility needs to be
expanded beyond just tobacco
use.
Also, systemic changes need to
be made so that veterans who
are referred to or referred to
screening don't fall through
the cracks.
I'll conclude there and again
thank you for allowing me an
opportunity to speak and I look
forward to any questions that
you might have.
Thank you, mr kennedy.
Uh, we have with us now um,
doctor whitley who is also a
veteran and a member of the
american legion post.
Okay.
>> thank you.
Thank you.
Councilor flynn murphy
fitzgerald.
I didn't write anything.
Um, because, um.
One of the things that you know
happened to me yesterday was I
attended a debate and my
question was.
What laws or what funding.
Would you implement for high
denial cases denied among black
men?
And that question wasn't quite
answered.
So then I thought about.
When then I thought about.
When councilor murphy was um.
She she was campaigning for
her, um, you know, to compete
become a city councilor at
large.
And I stopped her and she was
in hyde park and I was having
this trouble with my claims and
I said to her, well, what do.
>> I do?
>> I need a 5 to 6 0995 and she
was like, give me your number
and then I have someone call
me um a via cell to walk
me through those um claims.
But I started to think about
when I wrote my dissertation
and why I became a doctor
of education.
So one of the things that I
noticed and I started to study
black women so that made it,
you know, kind of limited too
to black women veterans.
I one of the.
things I thought about years
ago because I just I just um
retired JUNE 1st.
I spent many years in the
military.
I had trouble navigating the
system and so I am happy.
With the statistics.
The lung cancer, the nasty.
But when I will press the
participants for my my study.
At all the 70 black women that
in that ten participant the
data exaggerated.
And one.
>> of the things they said to
me and you know we talked about
the va and how great the
healthcare was and um, women
the women trauma center they
said.
How how.
>> do I get there?
How do I navigate?
So with the.
Programs and all the great
things that we have, how do we
get our women black women vets
to go for screening.
If it's a high number of denial
for claims maybe not the fault
of.
>> them.
Themselves, maybe they just
don't know how to write the
claims or maybe they.
>> need.
Help with the claims that maybe
they MISS A part after they
hear the claim closes.
So I think about.
In the community.
We need to implement of if.
We're at the post.
That someone.
Can walk in and say you know
how do I do you know, how do I
complete a um claim if I'm able
to walk into the municipal
building in hyde park?
how do I.
Complete a claim as a vet?
So one of the things that I
want to say is that if I was.
If I was.
Watching this and I was just
out of the military and um or
msd, a trauma happened to
me because I served 30 years
ago.
How would I do it?
How would I navigate through
this?
So I oftentime just think about
that were to navigate.
Through the system and that.
Was that was.
>> my dissertation um black
women veteran navigating the
mental health system after
trauma.
So you know, I think I thank
you guys all for um the
statistics.
But I think that.
We need to focus on how do we
get them into the va.
What do we do on a city level?
What do we do.
On a community level?
To bring them in?
What if we.
>> want to talk?
You know what if we want to.
Say hey I want to do a claim.
Where do they go.
If they've never been to the va
or maybe denied for the va?
So.
>> thank thank you doctor.
Um important recommendations I
know we'll we'll be discussing
them in a couple of minutes.
So thank you for bringing
bringing that information
forward.
Thank you for your service.
Um, doctor wiener um, from the
va the center for health
optimization implementation
research.
Um, doctor europe.
Thank you so much.
Um good morning everyone and
thank you to the council for
the opportunity to participate
today and such an important
hearing.
And I want to also thank the
veterans who are present for,
uh, your service to the country
.
Um, my name is brenda wiener
and as I've already mentioned,
I'm a pulmonary physician and a
researcher at the va boston
health care system and it's
been my great honor and
privilege to take care
of veterans with lung
conditions for more than 20
years, including lung cancer,
and to engage in research to
try to address some of the
issues that we're talking about
today.
How do we improve veteran
health?
How do we improve access to
care and uh, and improve
equity?
Um, in addition to my roles as
a physician and researcher, I
also am the deputy chief
consultant for the national
center for lung
cancer screening for the
veterans health administration.
And I'm a professor of medicine
at the boston university
chobani and and avid dc school
of medicine.
I have also been a physician at
boston medical center.
So um I'm speaking from those
various perspectives but I do
need to also disclose that, um,
the perspectives I'll share in
this hearing are my own views
and don't necessarily represent
the positions or policy of the
department of veterans affairs
or U.S. Government.
So I'm here today because.
Veterans in our city,
especially black veterans are
dying from lung cancer and many
of these are needless deaths.
We are so fortunate that the
greater boston area is home to
some of the most active lung
cancer screening programs in
the country, including at the
boston va.
And if we were reaching more
veterans for screening we could
be saving more lives.
You've heard that lung
cancer is a critical issue
facing veterans.
Uh, and that 8000 veterans are
diagnosed with lung
cancer every year.
And just take a moment to think
about that and how many
families are affected by this
disease.
You've also heard that, uh,
veterans have higher rates
of lung cancer than others and
the us population due to um
military exposures among other
issues.
But perhaps more dire still is
this.
So I.
Testified before this
council about a year and a half
ago and during that time
approximately 7500 veterans in
this country have died from
lung cancer.
It's an average of 15 veterans
every single day.
In fact, lung cancer is far and
away the leading cause
of cancer deaths among veterans
.
But again, many of those deaths
could have been prevented.
catching cancer early when it's
still treatable is critical to
improving lung cancer outcomes
.
Early detection through lung
cancer screening followed by
timely treatment represents our
best hope to improve outcomes
for veterans and others at risk
of lung cancer.
Lung cancer screening means
getting a simple cat scan
of the chest takes just a few
minutes.
It's painless and having a
screening cat scan every year
can reduce lung cancer deaths
by 20%.
One of the hard truths we've
already begun to hear about is
that black veterans and black
men nationwide die of lung
cancer more often than any
other group in the us
population.
Um many develop lung cancer at
a younger age and with a lower
smoking history than white
americans.
And why is that?
It's because they don't often
know that screening is an
option or how to access it.
As you alluded to um and.
Then they experience.
Delays and gaps in every step
of the pathway from diagnosis
through treatment and are less
likely to get the best, most
effective treatments for lung
cancer.
The good news is that the va
system breaks this pattern when
black veterans.
Get care through the va.
>> their lung cancer survival
is the same as white veterans.
Va lung cancer screening rates
early cancer detection rates
and survival rates are equal or
better across the board than
those outside of the va system
.
And the difference here isn't
biology.
>> it's access to timely,
equitable health care.
And we're fortunate that within
the va system, va bostons lung
cancer screening program is one
of the leaders in the nation.
But many.
People who are eligible for
lung cancer screening veterans
and.
Other bostonians have never
heard of screening and they
don't realize that they qualify
for this lifesaving test.
In fact, fewer than 25%.
>> of eligible americans have
been screened for lung
cancer and black people are
even less likely to have been
screened than others in the
population.
So let me just take a.
Minute to raise awareness on
some key facts.
Guidelines recommend.
Lung cancer screening for
people ages.
50 to 80 years.
Old with a significant smoking
history.
And regardless of whether you
get it through the va or.
Outside of the va.
Screening is covered by
insurance.
>> and completely free with no
co-pays for people who qualify.
But sharing information.
>> at meetings like this isn't
enough.
Our teams at va boston.
>> and at our research center
choir.
Are actively working to improve
lung cancer screening.
awareness and expand access to
screening.
And we're doing this work.
Right now here in boston.
So first uh, the vet peer
connect study.
Um, last.
>> year we partnered with black
veterans and community.
Groups like nab vets, the
national association for black
veterans and the triad veterans
league led by boston's own
heywood for now.
To co-design a community.
Outreach program by black
veterans for black veterans.
We partnered.
Actually with with many people
um, here today.
We partnered with.
The um office of veterans
services from the city and the
commonwealth.
And veteran organizations
including the vfw and american
legion um, including
specifically uh vfw post uh
1018 and the carter post.
So thank you again for your
support and partnership.
Um.
So uh we partnered with those
groups to hold.
Community events around greater
boston trying to reach
veterans.
Where they.
>> are and help get them
connected to lung
cancer screening.
So we're now building on what
we.
Learned and vet.
>> peer connects to create a
sustainable program.
>> with greater reach.
We launched a new website and
social media campaign developed
together with.
veterans to share their stories
.
About screening.
And we're creating a toolkit.
>> for veteran organizations.
,uh, to use with.
Their own members.
We're also leading a precision
screening trial across 28 va
medical centers, including va
boston that's designed to
engage veterans who have the
highest benefit.
From screening but haven't yet
been reached.
And many of these are black
veterans.
And finally, we're kicking off
a project to connect veterans
who have a history of toxic
military exposures.
,um, to uh, the whole health
well-being.
Services at the va and also
connecting them to clinical
trials that will help better.
Understand the relationship
between.
Military exposures.
And lung cancer and what the
role of screening might be for
those veterans.
And these things are working
one veteran at a time.
People are talking to their
doctors getting screened.
Regaining trust in the va and
accessing the health care that
they.
Earned and deserve.
I want to acknowledge and thank
the.
Many veterans, community
partners.
And va staff who have helped.
Make this series of studies a
success as well as the support
of.
>> the city and the
commonwealth.
most importantly, I want to.
Thank the men and women
veterans who inspire our team
every day.
But there is still more work.
>> to do.
And we.
>> need the council and all
of your uh, help in these
efforts.
First, we hope you'll help us
to continue to build.
>> on this momentum.
The approaches that we've
developed are resonating with.
Boston veterans.
And let's continue to sustain
these partnerships and the.
Trust that we've built with.
Veterans and community
organizations.
And second, please help us to
continue to get the word out.
Partner with us to amplify
screening awareness through the
city's many channels.
>> and resources.
And then also as individuals
tell other veterans.
About lung cancer screening.
These one on one interactions
are.
Incredibly powerful and could
help save a veteran's life.
I can't think of a more
important goal than getting
veterans the screening and.
>> the health care that they
earned and deserve.
Especially black.
>> veterans and women veterans.
Who have.
>> been left behind.
That's not just my mission as a
doctor.
I really.
Believe that for all of us,
improving equity is a value we
all share.
And I'm honored to fight for
that and hope you'll continue
to work with us to achieve that
goal.
Thank you doctor.
Thank you for being here.
Thank you for the important
work you were doing.
Before I go to my colleagues to
ask questions um I do want to
go to public testimony and if
there is anyone here I know my
friend, um, donald mitchell is
here.
I believe he's an air force
veteran.
Uh, want to give him the the
opportunity to to speak and to
,testify?
Usually, donald, you got 2 or 3
minutes, but, uh, I don't cut
off any veteran.
A veteran thought a veteran
could speak as long as they
want you.
You've earned it.
I also want to acknowledge our
our friend that is not here.
I know he's been mentioned
heywood finnell a wonderful
advocate in the city um for for
veterans, military families,
veterans of color.
But donald um, would love to
hear your testimony.
Uh, my name is thomas you I'm
the PRESIDENT And ceo of don
foundation, which is a
nonprofit organization that
helps veterans to, uh, with the
resources that they need to get
housing, uh, a rent housing,
uh, furniture.
So, uh, certifications to help
them get jobs in the industry.
Uh, key to uh, key.
Problem with veterans or people
who are homeless is the fact
that they, uh, when come out
of incarceration or out there
they feel they you don't have
the the housing and employment
which is key to for their
salvation.
We help them out.
I organization will help them
out to uh find these resources
to to pay for some of these
things that they need.
Um um uh friends with my
brother here.
Uh, robert here we go back and
forth here.
Uh, cousin friend we just had a
roundtable veterans roundtable
,uh, obviously delivered.
Um, getting ready to prepare
for a stand down, uh, SEPTEMBER
11th so we could do free, uh,
resources, um, uh, and research
on what the veterans needs are
what their complaints are and
and and their concerns.
Um, we just sent, uh, through
just the, uh, roundtable we
just sent, uh, gentleman named
uh, brian mullen, uh, to one
of the partners that we met at
the uh, uh, roundtable and he's
been um, assisting because he's
had multiple uh, situations
that he's he's had problems.
So, our goal is to help our
veterans out.
Uh, I've been a, uh, veteran.
Uh, it was the um also on the
um uh uh retired uh local four
uh uh local four uh operator
and also uh within a half was
uh some uh civil engineering
construction.
So the construction part of it
is is part the other part of um
a company is called damage and
the soldiers uh llc, which
helps to find employment for
those, uh, people who who work
who needs, uh, plumbing.
So we'll be working there to
try to find.
The resources with these uh, uh
,veterans, uh, who want to uh,
I'm aware of uh.
Um.
Cosmo flynn and san diego um,
just coming to get involved and
I think I know mr kennedy.
We met uh, come to us.
>> so I going to be contacting
you in the future to try to
figure out how we could further
help our veterans on out.
Thank you.
Donald.
Thank you for being here.
Thank you for your testimony
and thank you for your
commitment to, um, supporting
veterans across our across our
commonwealth.
Um, I'm going to go to my
colleagues.
I'm going to start with
councilor murphy then go to
council fitzgerald.
I'm going to give each
councilor uh, maybe ten
minutes, um, to ask questions.
I know there's a lot of people
on the panel that might want to
weigh in to so um, if the
council goes over ten minutes,
that's that's fine.
We'll, um we'll just continue
the conversation.
Councilor murphy europe.
Thank you.
>> thank you for your.
Testimony, everyone.
One of the things I kept
hearing from all of you is the
screening.
>> and the.
Statistics are trending in.
>> a good way.
We are.
Fortunate to live here where we
have such great health care.
But at the same time, even
though nationally.
Our numbers MAY.
look good when we zone in on
you know, boston the state you
know specifically.
That we're still seeing that
more black women and men are
just not getting the care they
need.
So how do we make sure that you
know, because without the
screening they're not going to
get the support the health
support they need.
So what.
What should we do?
What can.
>> we do not just as a
council just.
>> as a city like to make sure
and as a medical doctor like.
Do you.
Do enough do you think to make
sure that you don't have to.
>> ask.
For it right that if a.
Doctor knows while you were in.
The navy we know you were on
the ship, you were in the
military, you probably were
exposed because many times
people you know aren't aware to
even ask for.
>> the.
Help and obviously you've said
it yourself and others saying
that too.
So what can we do from you
know, the medical side but also
all of you who are advocating
and working alongside our
veterans every day.
I'll say from.
The uh the medical standpoint
at the va we have implemented
um.
Systems to.
Help doctors on the front line
identify when um, the veterans
that they're seeing or.
Eligible for a lung cancer.
Screening and flag them to
remind them to make sure that
they offer it.
And I know that's the case and
um, in many health care
settings outside of the va as
well.
Um, that said, uh especially
primary care um, clinicians who
are handling so many issues um,
in a brief visit sometimes they
don't get to it.
So um I think it is also
important um, to raise
awareness uh, among the.
Public.
>> um, about lung
cancer screening and and
empower uh, folks to ask their
doctors about it.
Most insurance not cover it if
you don't qualify because when
you say qualify would the
doctor have to kind of say you
you smoke or there's reasons to
believe it it wouldn't
automatically be covered if a
doctor referred it.
So uh, insurance companies do
cover.
>> for people who meet uspstf
eligibility.
Criteria and there's no charge
for that and that's inside
outside the va system.
Um, but as mr kennedy alluded
to, uh, those criteria don't
catch everybody, um, who could
benefit from screening.
That's one of the things that
we are studying in that trial
that.
I mentioned.
We are doing precision uh, um,
approaches to predict who would
benefit from.
Screening.
.
Including people who fall
outside of the us preventive
services task force criteria
and offering screening to those
veterans.
Um, that's a clinical trial.
So it's not, you know, for
everybody but uh, hopefully we
will be able to reach uh
veterans in uh va boston as
well as the 27 other va sites
that are participating in that
trial.
Thank you.
Um.
I don't have any other really
specific questions other than.
You know, it was said people
just don't always know that
there are services out there
and how do we connect them.
And it's never at a loss of.
Hard work and.
Advocacy from your commission.
It happens I think.
For every department across the
city we often hear like well
how do I get that fixed?
Who should I have called or so.
Do you.
>> um is.
>> there some sort of like ad.
>> or.
Campaign or support?
Uh, you know, thinking of the
city level how to support our
veterans and advocate that way?
Um, I think one of the.
Uh, quickest way that we could.
Uh, collectively as a as a city
do it is to continue
partnership with the boston
health uh commission with
strong uh with the office
of neighborhood services.
So basically pretty much um the
village here in the city
of boston municipality to to
get together when we do go out
into the community and talk to
not just our veterans but our
veterans families, our
community members, our
community leaders it's just the
biggest thing that sometimes I
see is that, um, they see one
of our events that is just for
veterans but it's open to
everybody.
Is open to the whole community
.
>> is open to even to somebody
who.
Who MAY not even live in
boston, who.
>> could just be in.
>> the.
Area to come by and go to to to
the fair and expo that we had
according park this past
weekend and see what's
available to our veterans, see
what's available to the
community as well and that's
information that they could
pass on to someone who they MAY
know who's a veteran or someone
who they MAY know is uh is a
son of a veteran or a daughter
of veteran.
So um, all these events all
these uh, communications that
we MAY have or leaflets they
while.
From my.
>> office they MAY be geared to
veterans but actually they're
for everybody because everyone
should know a veteran or knows
somebody who knows a veteran
who has a person in their
family who was a veteran that
they could pass that
information onto.
So you know what I implore
people who MAY be listening who
who MAY be watching uh, to
understand is that read these
informations, come to our
events, be a part of our event
because it is for the benefit
of the whole community.
Um and part of that community
is our veterans because
veterans do cover all
demographics here in the city
of boston and we all in our
community.
So I think that um
communicating this to to to
everyone in the city and beyond
is very important.
I take the one of the uh,
things that um, we must do is
is to safeguard the resources
that that uh that comes in the
veterans uh, um, budget.
Um, we're being cut because
of ways and and we also we
really help them uh, funding to
do their research uh, the
policies funding to do what
they have to do boston helps
us, which is to do what the
city would be if if if you see.
Uh.
>> including the federal
government giving all these
cuts and everything are they we
need to safeguard our funding
that goes into our veterans,
uh, pool and make sure these
individuals get the resources
that they need to do the work
that they need to do.
Thank you.
>> um, I was going to mention
that too when we were going
through the budget cycle, the
fire department who many of the
members are veterans.
Did not.
>> receive that $1.2 million
grant and many much of that
grant was directly related to
screening and health care
support.
So it is important and if we
see that we're losing federal
state grants like how do we on
the council shift?
I know that we work closely
with your department to make
sure we're not losing any money
and if any way we can add more
to your department.
But thank thank you just.
>> all.
For being here and advocating
and just know I'm a support and
resource any way I can help
more than I am.
I'd love to thank you.
Thank you councilor murphy.
At this time I'm going to go to
council fitzgerald
councilor fitzgerald, you have
ten minutes.
Thank you CHAIRMAN.
I appreciate it.
Um.
>> so thank you all.
Uh, for the testimony as I was.
Sort of listening to everybody
I was writing down, uh, you
know.
The data is the.
Data, right?
And when so we.
Know that what we're.
Focusing on here today is an
issue.
>> and that's not being told
that that is being told to us
by.
Boots on the ground but also
through the data that we're
collecting.
And so I was trying to.
Think of.
>> uh, you know, what is the.
The number one.
Source of why this discrepancy
exists?
I'll refer to lung cancer at
the moment among.
Among black veterans.
And you know, I started writing
down a list of what.
>> I think could act right just
and I'm no doctor.
So you guys this is why you
guys are here, right?
but I was like there's either
genetics, there's education and
awareness about it.
There is the insurance, there
is your personal lifestyle that
can affect it.
There's the work lifestyle such
as where you might be where you
might have served.
Um and I added navigating the
system and because from uh what
I heard from this panel too is
that just navigating the system
um.
Like of all the things what do
we think of that sort of list
might be like if we were to
hone in on what would have the.
Biggest impact and there MAY be
others that I could add to
this.
List, but what would be the.
The area that we would say is
is it you know, hey.
>> if we collected insurance a
lot more.
People would be covered and we
could identify more early or is
it hey is it the education
awareness and getting.
And I know it's a mixture
of all.
Right but what what I'm asking
is if we were to prioritize it
right um you can't do much
about genetics uh, you know,
the.
Work lifestyle that's already
occurred right in black
veterans.
And so how do we know where we
can place people in the future?
Sure.
>> it might.
>> help future generations but
um.
Uh, that just knowing.
Where they are and making sure
that certain benefits are
available to them um, and then
and then helping navigate the
system I think that's in in any
sort of large, um, you know,
heavy paperwork type of setting
I mean car insurance, health
insurance, whatever it MAY be.
Right?
I think we all have trouble
nabbing people walk into this
building and the first thing
they usually say is I'm here to
help me.
Navigate city hall.
Where do I go?
Right.
Who do I talk to for this
issue?
So um I think that's important
one but.
Just trying to hone in because
I feel like if you extrapolated
out.
Outside of veterans to that the
data probably correlates right
.
Uh, that that uh, lung
cancer among black individuals
is also probably higher than
white counterparts.
And so that's what got me.
Thinking to the other things
of like well if we help one we
can.
Help the veterans.
If we.
Help the larger.
Continuum then we can help the
veterans.
But at the same time, what can
we learn from helping the
veterans that can educate us
that we can bring it out to the
larger continuum?
Right.
Um.
>> that you know, a lot of you
guys spoke on this but I guess
what I sort of.
Uh, is wondering is if.
We were to hone in, right?
because government gets pulled
in a lot of different ways and
we'd love to hone in on every
single one of these and but
that would be all day every day
and there's a lot of other
people asking for our help.
.
>> if we could hone in, what
would you think.
Would be the the best parameter
to sort of say let's solve this
one.
Let's solve education awareness
and put the money towards that
and put our effort towards
that.
Let's let's.
Tackle insurance and make sure
I think insurance is a sham
anyway I don't know how you got
you guys are the doctors but
just from a guy on the outside
the layman's person I think
that's the biggest thing we got
to tackle next.
But um, you know.
>> is it making sure.
>> the system is more
streamlined or at least more um
,you know that you.
>> can.
Work with it easier to
understand um I don't know.
>> so I put I put that all to
you guys and say if.
>> you had to prioritize.
What would you.
Think would be the the most.
Impactful one to attack?
And we could all have different
answers.
I'm sort of just wondering from
personal.
>> point of.
>> view it's it's.
>> there.
Is no right answer.
I'll guess I'll start counselor
.
thank you.
Uh for for for your question
and bringing that up and it's
it's it's everything you
mentioned, right.
It's it's a little bit
of everything but I think part
of it has to do also um which
we alluded to and incidentally
myself and uh and craig here
before we even came to the
council hearing we actually
were having a cup of coffee and
talked about it talked about
you know, what is the
underlying reason why uh, the
cancer rates are so much higher
in the black veterans community
and also in the minority
community as a whole.
And we could speak on that uh,
from our experience of the
veterans, it a lot of it has to
do with whatever their job
duties or collateral duties
were given to the black
veterans um in service um I
could speak.
>> on.
On on.
>> my experiences as a navy
veteran where you know, um a
lot of uh, minority veterans
of on average sailors like
myself we were told to go
sandblast a void on a ship, you
know, or we were working in an
engine room pretty much what
craig had mentioned earlier in
his testimony.
So, uh, you know, so a lot
of the.
And I'm not saying that that's.
>> the.
Reason why the rates are so
high.
I'm just you know, speaking
again on my experiences and
from what I've seen and talking
to other veterans as well, um,
that that could also be.
An underlying reason why.
Those numbers MAY be high is
because of of also the the
duties that we were given while
we were uh in service.
Now um, add that to the fact
that when you know, we're no
longer um in service and now
we're veterans navigating the
system, knowing the system,
knowing what um is out there
for us and like, uh, doctor
wagner had mentioned.
>> in.
Her testimony at the va, um,
they're doing a great job in
trying to get the word out
there but when it's not enough
to um it there's always work to
be done and that and so I guess
the the educational piece and
again trying.
To let everybody know that
these um that you know the lung
cancer screenings are there for
for veterans for for pretty
much anybody the city of boston
also has a policy for lung
cancer screening.
Um, you know amongst us uh
municipal workers, you know,
you know, go to contact your
cpa and see what those are,
what those MAY be.
But I think as far as veterans
are concerned, um, um the
education piece is huge.
Um, getting to those veterans
and and and malika had
mentioned that doctor wheatley
I mentioned uh in her testimony
when these service members
become veterans, you know, what
is the department of defense
doing when service members are
transitioning into becoming
veteran that coming back into
our communities?
Are we reaching them um, in a
timely fashion?
Um.
Once they.
>> come out I know uh, that the
state does what they can to
notify us municipalities us uh,
veteran services.
Offices throughout the state to
let us know who in our
community is returning from
service and reaching then and
letting them know and also
being able to be, uh, an asset
to them when they transition
and integrate back into the
system, um back into their
communities as well.
So it's it's it's it's really
not something that um that that
uh it's going to be um taken
care of immediately but it's
something that we're going to
be able that we have to
continue the conversation on
amongst.
>> our.
Groups and uh, advocacy groups
amongst the vfw that the dvs,
the american legion's um you
know, don and his and his
organization uh haywood and his
organization um and pretty much
all the veteran organizations
in the community as well.
And it also takes uh, the
council as well that, you know,
if and when you also go out
into the community, you bring
it up.
You know what,
councilor fitzgerald?
You know, if you're running
your community to be like you
know, I was at a hearing about
veterans and we talked about
lung cancer here.
You know, you know, lung
cancer amongst veterans this is
what's available.
So you know, just spreading the
word out there whenever we go
on to the community just bring
it up.
Even if the subject matter MAY
not be about veterans I always
bring up veterans.
Why?
Because I am a.
Veteran you know why not?
But uh but you know but you
know, make it part of the
conversation make it part
of the community conversation
about veterans, you know, about
lung cancer screening, about
women veterans.
You know, right now there's
close to I believe is 940,000
women that are there are
enrolled in the va.
But there's a there's 2.1
million women veterans that we
know.
So you know those numbers need
to go up as well so women
veterans could also get the
care that they need in the va
system um because it's there
for them.
Um, how many of them actually
went to the va to get that care
or is it the trust thing as
well?
Are we talking about trust?
They just don't trust the
system to help them out.
Just the same thing with black
veterans, the same thing with
minority veterans.
You know that there's been that
stigma for many, many years
that the va is not there to
help them.
You know, it could be the
trusting that we need a
breakthrough as well.
So there's a lot.
>> of there's.
It's it's it's it's it's a it's
a big web that we're weaving
here that we need to go through
and break through.
But I think the uh what it all
comes down to is the word
communication and you know,
talking to the veterans,
getting them out there, letting
them know that the va has gone,
you know, has come a long way.
And you know, I'm proud to say
that the boston va is
definitely the best va we have
in this country and it's
because of the partnerships
that we have with the state,
the partnerships that we have
with all these medical
facilities.
We have one of the best
nonprofits like home base is
located here through the mdh as
well.
So uh, you know all those
partnerships uh getting
together and communicating that
hey, we're here for you and
we're going to make sure that
you get what you deserve.
That's excellent.
Thank you very much.
Appreciate it.
But so.
Education from our point
of view of what a council could
do.
Education awareness is where we
should.
Yes tackle.
I just want to make sure I had
I don't know if anyone else you
don't have to but if anyone
else would like to chime in I
have other questions as well.
Uh I don't.
Okay.
>> but um um
councilor fitzgerald, thank you
for the question.
Um, I'm going to say from my
particular lane because
everybody here is bringing
whether it's an experiential or
a professional perspective into
this.
Again, as I said in my
introduction, my focus is on
early detection of in this
particular case of course like
it I've never had lung cancer.
I'm not a veteran.
I've never smoked.
I listen to your your list
of the things that could be
causing this genetics was the
first thing you said.
I don't know if it was any
particular order no particular.
But I would say that family
history or other genetics or
issues of a lot of cancers.
I think the biggest issue for
lung cancer is exposure to both
factors because we all have
said in various ways and shapes
and forms people didn't start
smoking until they entered
military service or some other
type of position that put them
in an exposure situation to
something other than tobacco.
A lot of that is what's driving
lung cancer rates up in a
particular for for black
veterans.
To answer your question, my
single word again from my lab
basically goes right back to
the guidelines and let me just
put some context around it.
What we do at the boston public
health commission at least in
terms of my job because I don't
provide any direct service so I
don't actually do the scope.
What I basically do in my role
is to communicate about school
okay.
But I always tell myself I am
doing a disservice to the
public if I don't go into that
job acknowledging that there is
a balance.
There's two dimensional chess
being played here because I
have to communicate something
that provides a call to action
to the public.
But when they get into the
medical system the doctor has
to do what I want them to do
when the patient shows up.
Right.
If the doctor's not going to do
that, why should I tell people
to go have it done if they
can't actually get it done?
The guideline piece I'm trying
to talk about here goes to the
fact that lung cancer screening
is basically tied to tobacco
use and a lot of the lung
cancer that veterans suffer are
from things other than tobacco
.
Okay.
Gotcha.
You also talk about veterans
that weren't smoking before
they came into military service
and they began to smoke as a
result.
So if you think about this this
this particular group and again
the other context of that is
I'm with the boston public
health commission.
But what we're talking about
here is population health.
It's a segment of our
population I.E. Veterans are
experiencing lung
cancer differently than the
general public.
What can we hone in on and
focus on with that?
You talk about we've heard the
tremendous work that the va
hospital is doing here which is
different, unique and better
than what's happening across
the country.
Yeah.
>> my hope is that there's an
opportunity with local
legislation engaging local
payers and a strong medical and
clinical institution like the
V.A. Hospital to say let's
let's set the tone for the rest
of the country for how to get
this right because we now can
basically create a local closed
loop that says what we do is we
screen people not just for
tobacco use but for exposure to
the things that we ask them to
do in the context of the
military service get payers on
board.
Open up lung cancer screening
to people that actually need
it, not just smokers.
Look at the financial benefits
of that over a period of time.
Look at the outcomes benefits
which is reduce mortality over
a period of time.
Present this to the country and
say look we are getting it
right in massachusetts you
could be doing more in wherever
you are.
That's not massachusetts
because we've got as you said,
we've got a community of local
resources clinically that are
probably the best in the
country if not the world and if
we get it right here for
veterans, not only will it
inform the way we treat
veterans across the country,
but that navigation system and
everything else that's involved
literally opens up cancer early
detection for other cancers in
other areas in a way that
informs the whole system.
Okay, I think we've got a
unique opportunity here and i
think the city council uh,
local clinicians, uh advocates
like myself communicators like
myself can really get on board
and put a plan together.
But it's what boston does lead
the way.
So I believe that we can do
that uh on that I know some
other folks wanted uh, to
potentially chime in.
So not.
>> just quickly.
>> as one might go.
Yes.
>> yeah, we can have a.
Big mouth.
>> um.
One of.
>> the things about veterans as
we.
Look for community.
Organizations because
of brotherhood sisterhood, um,
and we also lean on our faith
based churches.
So if.
We're talking about education
and you know, how would we
employ that education, how will
we get veterans in the door?
And you.
>> know, the va is a great
system and we have great
screening, but at.
A point we need to get um our
back.
To the door into.
Those screenings and then how
do we do.
>> that.
Any time that we are opening up
something in boston, I think
that any.
Community organization that
vets are attached to whether
it's the ymca.
Or whether they go to their.
Local communities um system.
Uh local community.
like um.
Hall or the polls all of that.
>> needs to be filtered down.
So if I'm walking into.
Any community um place that I
love to visit, I should be able
to know.
That this is free screening
because.
>> we can.
Offer it.
But the education.
Part of it.
How do.
>> we get them.
>> to the door and I keep how.
Do you how do you get us to the
door because you couldn't get
me through the door.
Ten years ago.
Um so.
So how do we do that?
So we really need to.
Start thinking about.
Where is our underserved.
Communities for that?
Where do they often.
Visit maybe the local
coffee shop.
Maybe um, the va in west was
always having a screening.
>> why do we need to hit the
local coffee shop.
Down the street.
At the ymca?
Because I know if I can.
See it and I say hey, this is a
screening.
You know, I MAY go and say oh
maybe call this.
Number for some information.
So I really think about the
educational piece and how we
build and bring them into the
door to.
Get the screenings.
Got to.
Doctor and uh I.
Completely agree with
everything people have said so
far.
I'll add one other thing.
Um I think I.
>> do think that.
It's uh access to health care
and then the costs as well.
I mentioned that the initial
screening if you meet the
criteria.
Is free of cost no matter where
you get it.
But what is often a barrier is
like if you need something more
than just.
That screening test if there's
a screening detected finding
that needs further workup.
There is cost associated with
getting the subsequent tests
and that's a real barrier for a
lot of people.
Um, so that's something uh, you
know, within the va those costs
are often lower outside the va
.
Yeah.
.
That can add up.
Um so I think that's something
that that could be addressed.
That goes a imagine that goes
to the insurance right.
That's yeah that's right.
Uh I know I'm well over my time
but just a two more if you
don't mind chair.
Thank you.
Um what I thought about is the
military doing anything.
>> now when we talk about the
workplace that has caused.
It.
>> uh.
>> is the military.
Doing anything now to identify
those positions that say, okay,
what are we.
Doing to prevent if.
>> I'm working.
Below deck.
>> in the engine room, you
know, 24 seven uh, are there
steps being take I don't.
>> need to know.
>> the.
Specific steps now but other
steps being taken to say.
How are we.
>> making that area a healthier
workplace for our military?
Uh, so that when they come out
they do not have these issues
uh post service.
Thanks for that question,
counselor.
Uh, across the military.
You know.
We we did.
Mention a lot of different.
Environments where you know,
you are in hazardous
conditions.
Uh.
You know.
Part of being commander is
looking after your troops.
So it behooves every commander
no matter what level from your
lowest level up through, um,
you know, the PRESIDENT Or any
of your service secretaries
that you want to have your
group.
I guess.
At the.
>> end of the day your your
employees you know, in the most
uh, healthiest, safest
environments.
Yep.
Um, a lot of times it's not
possible due to the conditions
where, uh where they send us to
do our work.
Uh, we're not always sent to
the most, uh, lush garden spots
across the world.
Um, but a lot of times you want
to take those necessary steps
to make sure that your soldiers
,your sailors, your marines,
your airmen, uh, are in the
safest environments if that
includes, you know, additional,
uh, personal protective
equipment.
Uh, a lot a lot of times the
you know, the guidelines within
the military don't always
follow osha.
Uh, but they you know, they're
very, very similar and
sometimes they're even more
more stringent, uh, to make
sure that, you know, again, if
you're if you're uh, service
members getting sick and unable
to perform their duties, then
you're no longer going to be
mission capable as a unit as a
as a vessel, as a piece
of equipment.
Uh, so at the end of the day
you're your biggest your
greatest asset is your
individual service member.
So you want to make them we
want to make sure that whatever
means are are appropriate and
uh uh for every situation you
are going to take care of that
service member uh, so that is,
you know, top of mind for for a
commander at any level is to
make sure uh, your your service
members are getting taken care
of as best as I can.
Okay.
>> but as long as.
We talk the military continues
.
To constantly review where.
They're sending, uh, their most
important assets and making.
>> sure.
That the the healthiest they
hope that, um, that.
>> would be.
More of the.
>> preventative work right is
all in making sure.
Absolutely and coming.
Home um, you know, back in 1998
99 I served a tour over in
bosnia at that point in time,
uh, the air quality was not the
greatest uh a lot of uh the
local you know, the bosnians
were burning their trash.
Their trash would go into the
rivers.
It was a uh an environmental
nightmare.
Uh, one of the things that as
we were redeploying, you know,
back home after our tour was
over was that we had chest x
rays, you know, to to get a
baseline of, uh, where our
respiratory system was at.
Um.
>> you know, it was a just a
few years ago but then
redeploying to places like the
middle east again, you're
you're not in the the most
healthiest environments and
again as a soldier again a lot
of times you're out outside
you're doing things but again
you can be in confined spaces
such as an armored vehicle or
any types of vehicles or or you
can be on a ship you could be
on an aircraft that again
you're not always in that most
healthiest environments.
And again it comes down to the
commanders uh to make sure that
they're taking care of their
service members.
So we're not ending up having
to visit the va afterwards
after we're done.
And to say thank you.
Um thank you.
I know well at the time.
>> thank you very much for the
added time to.
Thank you.
>> thank you.
Councilor fitzgerald.
Um.
Just one quick thing that I.
>> wanted to add also and I
know mark.
Has mentioned a lot about um,
uh, tobacco use of being
prevalent in the military and.
Part of the.
>> main reasons why that is is
because of the stressors that
military folks go through, uh,
in the job um, and to to
piggyback off what uh, the
commander here, you know, said
is uh, you know, the military
they do do what they can to try
to mitigate um, any dangers
from their assets, which is the
main asset which is which is a
service member.
Um, and I know that they do
have uh, you know, one of the
highest uh, uh, funded
cancer researchers in, you
know, in the world um, but uh,
they they do what they can but
of course there's there's
always more that could.
>> be done.
Could I make one other comment?
Um, I.
>> just want to.
Make sure that, uh, people who
have served veterans are aware
that, um, if they have had
military toxic exposures at
something the va is now
routinely screening everyone
enrolled for and uh, adding
them to registries to
understand what the health
effects are and that uh,
veterans who develop lung
cancer a number of other
cancers, other respiratory
conditions as a result of um,
uh well, they don't need to
approve it's considered a
presumptive condition.
Um, that entitles them to
benefits uh, from the va, um,
health care and benefits.
So yeah, that's all part of the
pact act that was signed by
PRESIDENT Biden.
Great.
>> excellent.
>> um thank you.
Thank you, councilor fitzgerald
.
Also give myself ten minutes.
But before I do that, um.
I have another absence that I
just want to read it into the
record.
Uh, dear chair santana, I
regret to inform you that I MAY
be unable to attend today's
meeting.
Uh, committee on veterans
military families, um, to
discuss lung cancer rates among
black veterans services for
women veterans.
I will follow up with
additional questions upon
reviewing my staff's notes in
watching the recording.
Please do not hesitate to
contact my staff with any
questions.
Sincerely and vk pep and
counselor boston city
council district five um I'm
going.
>> to give.
>> myself five minutes all I
made ten minutes so.
Um okay so I want to say thank
you to the panel for the
important testimony you
provided in the exceptional
answers and thoughts you you
responded to from from my
colleagues.
Um and I do want to ask um.
Two maybe.
>> two specific questions if i
may and I want to ask um both
both.
Doctors a question if that's
okay.
Um so and I listen closely to
to your testimony um maybe I'll
start with doctor whitley if
that's okay.
Um so so doctor whitley, as as
it relates.
To women veterans or black
veterans or both and I, I
listened about claims.
Related issues.
And and some of you points
about that which which I
certainly agree with.
So a woman veteran for example
that has a claim maybe it's for
military sexual trauma, maybe
it's for other military women
related health issues.
Um how challenging is.
>> it.
To to speak to someone at a vso
.
Or the va.
That when they're submitting
their claim that they can talk
to a woman that can understand
some of the challenges that
they are going to but also when
they go to the c and p exam um
,before the va that.
They're able to speak.
To a woman health care provider
because I think having a woman
health care provider or a woman
at the vso or at the va can
better understand some.
>> of the issues.
A a woman veteran is going
through and that MAY.
Because of because of that you.
>> might see the.
Percentage is lower than male
veterans.
Which which is totally totally
unfair.
Um in terms of success of a
claim but just wanted to get
what you get your thoughts
might be on that doctor.
So um, thank.
>> you for that question
because actually that question
um came up.
One of the things um.
,with the vso.
Um.
>> we don't have.
>> as many vs.
O's as you know, 1st MAY think
and.
Obviously it's about hard.
Around the clock.
You know.
So when if a woman walks in.
And a lot of times mst.
Is is an old.
Claim that you know.
They never.
Got any counseling maybe
they're ready to file that
claim and um they're sitting in
front of uh.
>> you know.
A male vso sometimes it's hard
to get out exactly.
>> what happened and it goes.
Back to shame.
Like I'm I'm ashamed it's
happened to me and I was.
>> supposed.
To be.
>> a.
You know, strong soldier.
So a lot of times when, you
know, I talk to women.
That's that's the first thing
that they say is that when.
>> I did my.
Comp and pin.
Um, a male.
Showed up.
>> yeah.
And I wasn't.
Given you know, I wasn't given
an.
Opportunity to talk to.
talk to a female.
And a lot of times, you know, I
felt that you know, his face
was.
Looking at me like that.
I can't believe that.
>> that.
Happened to you or maybe it
didn't happen.
>> to you.
So it can be quite difficult to
get a.
Female vso.
It's not.
Impossible and maybe the wait
might be a little longer.
Or maybe the, um wait might.
Be longer.
For, you know, comp.
And pin you know, with the
male.
So how do we reduce that?
I think.
That females that should have
an.
Opportunity and.
Not a long wait to talk to a
vso.
Who's a female.
But again I go I go back to um.
Commissioner santiago if you
call his office he could put.
You in.
>> touch with um someone who on
how to work a claim and.
>> a female.
>> to know how to.
>> work a claim.
But sometimes.
Often when you call for a vso.
You MAY have a male vso.
I had a male vso.
When it was time to work.
My client.
I didn't get a choice and for a
comp and.
Pin I had a female, you know.
Physician but that.
>> could.
Be difficult and that's one
of the reasons.
Why.
>> um, someone MAY.
Give up and they MAY get a
denial because they MAY not
give enough information.
On, you know, the.
Claim or exactly what happened
to.
So I think that.
Sometimes that's a 5050 what do
you think?
Um um.
So um so um and thank you and
thank you council for bringing
up that question which does
come up uh, quite a bit and I
had known some cases where a
woman veteran when.
>> she.
Was going through her camp that
ended up with a male physician
and she felt uncomfortable and
in some cases, um it was at a
private practice in his own
home, uh, which is totally
unacceptable.
Um, but your point um, while it
.
MAY be difficult, it's.
It's not impossible to get a
woman vso um, in our office
here in the city of boston we
have a diverse group
of veterans benefit specialist
to include, uh, women veterans
benefit specialists to help out
uh, through these claims.
But also we also have a network
of vsos throughout the state
through the massachusetts
veterans services officers
association.
There are a lot of vsos out
there in the commonwealth that
um that that are women and that
do specialize in women.
Uh the veteran claims as well.
We also have uh, you know,
organizations like the american
legion that the av the the vfw
um who also has vsos uh within
their organizations that are
both uh um uh uh women and men
as well to help on those
claims.
So if there is a woman veteran.
Who feels uncomfortable.
Working their claim with with
with with a male vso, uh, we
could definitely ensure that we
get her to that comfort level
that that she needs to get her
claim through uh, with with
with a woman vso.
So so rob just on just as a
follow up if if if a woman
veteran is watching this now
and a woman veteran does want
to file a claim and I would
hope they would go to a vso
because they they do
exceptional work.
Dave and I went through the dmv
um I know the vfw there's other
other ways to do it other vsos
american legion but how would
you how would you help that
woman veteran get in touch with
um, someone that could help her
with her claim?
That's that's a woman that
that's a woman.
I would recommend first, uh,
going through your local.
Veteran services office.
So if you're in boston,
obviously that's through the
the mayor's office of veterans
services, which is my office.
Um, and then, uh, you know,
talk to uh, cudahy who's the
senior veterans benefit
specialist there myself.
Uh, we're not open.
So who's a veterans benefit
specialist there?
Um, and and get their
comfort level to see another
way is like I mentioned was to
the msoa the uh the message.
>> to the veterans services
officer.
Association another way is
through the executive office
of veterans services for the
state.
Um, contact them and they will
uh, connect you to the women's
veterans network who also um is
uh has uh women vsos that that
are part of that uh
organization and that in that
network as well.
So there are many different
avenues that a woman a veteran
could take to reach a vso that
they feel comfortable with.
Okay, excellent.
Um maybe oh yes doctor.
>> so it's two different.
Things that I you know, I just
noticed.
If if a woman veteran is.
Watching right now.
Some people.
>> start at the va.
They pick up the.
Phone and there's an intake
person that calls.
The in person.
So now they don't recognize the
poea.
Which could be.
>> the.
Dab a bsl.
So they're talking directly.
>> to an intake person and then
they signed up a competent and
then.
They MAY not have a choice
whether.
>> it's male or female.
So if a woman veteran is
watching.
Right now I.
Would say you know call
commissioner santiago, call
your local.
American legion.
call your vfw, call a vso.
Then once you get in touch with
one of these organizations, we
will help you navigate the the
system of putting your claim to
will.
So I think that's the best.
If I was a woman vet watching
right now that's what I want to
know because the first thing I
would say is claims.
Let me dog the va and get it
and get it started.
You know.
Yeah that's a very very good
point.
Thank you willing to for saying
that that's a very good point
because that's what we do run
into that people do go to the
va first instead of going to
the local vso and um they
should always contact their
local vso first and then
eventually get that po po done
and then uh help that uh that
that veteran navigate the
system through that way as
opposed to going directly to
the V.A. Because that's exactly
what happens.
Thank thank you.
Um, let me get the vfw there,
counselor.
>> I'm sorry.
Okay.
Uh, we do have a.
Female, uh, veteran, uh,
services consultant that is
based at the jfk federal
building right here in boston.
Okay.
That is a great resource.
And again, the vfw will walk
the veteran through the entire
process from intake through any
potential appeals.
Um, so we don't just take your
poea and, you know, send you
off to the to the va and you
know, good luck to you and
we'll be able to walk you
through the process to make
sure that you are taking care
of your looked after and you
get your appointments scheduled
in a timely manner.
So you know, again within the
city of for the city of boston
per se, um the vfw at our state
level.
Uh, we do have a benefits
consultant that's based
straight at the jfk building
and we're happy to be able to
assist any veteran especially a
woman uh, veterans that uh um
that need any help.
Another thing I would like to
add, counselor, if I MAY, sir,
is that no veteran, no veteran
and I repeat no veteran should
have to pay to get their claims
processed.
So do you have a lawyer out
there or someone who thinks
they know and say, well, if you
give me 10%, 20% of whatever
you get from the va, I'll make
sure you get your procedure.
You clean processed.
Um that's a red flag.
You not go to that person.
There are many, many qualified
uh vsos out there you've heard
of up here through all these
organizations through your
local, uh, municipal offices as
well here in boston.
It's through my office to get
those claims done and processed
accurately and and and and for
free.
No veteran.
And I repeat again no veterans
should have to pay or should
pay to get their claims
processed.
And one more thing that I know
if someone's watching who has
denials of um service
connections we still we still
take care of you do the denial
yes.
All pows we go back in and see
why the denial happens because
I know people are saying well I
got denied so I'm not going
back in for anything.
All denials will look at that
why the service connection was
denied and it MAY be something
you know, just you know, easy
enough for you to correct.
So I want to put that out.
Yeah that's a that's a good
point.
Um with those you know you got
us going now the green there.
I know rob you and I worked on
I think they called them at one
time claimed shot to claim
shots.
Um the other point of of that
rob bright is.
Not only do they get.
10% of.
What you earn, they get 10%
of what you receive for the
rest of your life in perpetuity
.
Yeah, perpetuity.
Um so as long as you get va
disability they'll continue to
get 10% 15% of what you get
every month.
That's that's outrageous.
That's outrageous.
Yeah.
Totally is outrageous.
Um well let me go and rob thank
you for bringing that up.
That's a.
Great that's a great point.
Let me go to doctor.
Doctor alina.
Um, I was with you.
I don't know, maybe a year ago
I think we were at the kroc
center and with a group
of people and, um, you you were
talking to black veterans and
talking to them about, um, lung
cancer related issues and you
know, there was a steady group
of veterans that did come in
that did engage you.
So my question is what what
steps should a black veteran
take if they want to talk to
you they want to talk to
someone from your team.
Um, to learn more more about
your services.
Just give us an idea of what
what the steps would be.
Um, well.
Anybody is welcome to reach out
to me directly.
Um, my email address I can
provide it's renda dot wiener
at va gov r e and d a w I e n e
r uh vega and I'm happy to help
direct anybody um who has
questions or needs help about
uh, you know lung
cancer screening or or any
other issues I can try to
direct them, you know, um, to
what they need.
Know when when a black when a
black veteran is at the va.
Um, are they screened are they
screened for um any type
of respiratory issues or lung
related.
Issues automatically or do they
do they have to request that.
?
Um well so the process for lung
cancer screening specifically
is when somebody goes to their
primary care uh, clinician at
the va there's a process where
there is um an automatic
recording of their smoking
history for people who fall in
the age range for screening and
if they meet criteria for lung
cancer screening.
again, this is using the uspstf
criteria which doesn't capture
everyone.
Um, but uh, that will flag
their primary care provider to
discuss screening.
So hopefully the veteran
doesn't have to bring it up
themselves.
But um, and then the as I
mentioned, the va also
routinely screens that through
primary care or other
appointments for uh military
toxic exposures and whether the
veteran has any concerns about
that.
And oftentimes those are
respiratory concerns that
people have related to exposure
to burn pits or other um, other
uh toxic exposures.
Um, and so that also flags uh
puts a flag in the record to
discuss those concerns and
address them with the veteran.
Yeah.
>> thank and thank you, doctor.
Just um just as a fyi for for
the public I I've been I've
been in I was in the military
24 years um most of the
reserves but some active when I
was stationed overseas I was in
bahrain a small country got
bahrain and we went up to the
iraqi oil platforms all the
time and then when I came back
I also noticed um respiratory
related issues and I was
recommended to join or to enter
into the um what am I calling
it now?
Uh, it's the it used to be the
oh the registry.
Yes.
The gulf registry.
Um that is still open um and
accepting you don't necessarily
make a claim there but you
document that you were in a
particular area of the country
in what health related issues.
But I do want to recommend to
veterans that if you're in a
particular area and you do have
some health related issues that
you should um, enter into this
registry.
Um, so my final my final point
before we kind of conclude I
gave every I give it all my
colleagues um well over ten
minutes and well let me ask um
is there any public testimony
from anyone else that's here?
Okay.
So there's no more public
testimony here.
If any person at the panel
would like to give a closing
statement that would be helpful
and maybe as part of the
closing statement if you can
highlight what our next steps
could could be as a committee
on where we go from here
because I would like to do a
hearing maybe in outside
of city hall but maybe in
roxbury maybe in dorchester and
I'll listen to veterans all
veterans but um, specifically
listen to veterans of color,
listen to women veterans,
listen to them and um, in their
challenges, their concerns.
But I do want to ask and give
everyone the opportunity.
If you would like to have a
closing statement for 2 or 3
minutes, uh, to take the
opportunity then then I'll give
my colleagues an opportunity
for a closing statement for 2
or 3 minutes as well.
So let me start with um
commissioner santiago.
Uh, first and foremost, uh,
thank you very much again for
for holding this thank you.
And also to councilor santana
for setting up this uh this
conversation here today.
Thank you, councilor fitzgerald
,for also, um, being here and
for your thoughtful questions.
I'm sorry I took more most
of your time, uh, earlier
today, but, um, it's it's uh
it's it's it really makes me,
uh, optimistic.
Uh, on our next steps, um, we
we've talked a lot about
navigating the system here.
Um, and how do we get vets, uh,
into the system and I think,
um, you know, mark some of his
comments when he was talking
earlier about, you know, making
boston uh, set the example
locally for the rest of the
country.
I think that's, you know, a
great idea and I think it's
something that is worth looking
forward to going into what
councilor flynn said about
going into the community,
talking to the veterans and
seeing where the need is and
how we could get these veterans
into the system.
You know, like I mentioned
earlier, there's uh less than a
million women veterans that are
in the system.
But yeah, we have 2.1 million
women veterans um, in the
country, you know, and this is
also a way that we could also
work on getting them, uh, into
the system and having these
conversation now the continued
partnerships uh, both locally
statewide, federally and also
with the with with with with
other partner organizations is
going to be key to ensuring uh
the success of what we do to.
>> ensure.
That our veterans, um, have
access um, you know, uh, for
for all the benefits and
services that that they have
earned.
So I'm looking forward to the
future steps.
Okay.
Hey, craig.
Uh, thanks again,
councilor flynn, uh, for, uh,
convening this today.
Councilor fitzgerald, your
great questions and, uh, we
appreciate your, uh, the
attention that these issues are
being given.
Uh, first off, uh,
councilor flynn, I'd like to
offer up the boston police post
as some place to to host that,
uh, offsite, uh, meeting
hearing, you know, veterans
town hall, whatever you want to
call it.
We would be more than happy to,
uh, to host that and I work
with you on that.
Um, the overarching question is
how do we take care of this
problem?
Uh, it you know, I'll ask the
question of how do you eat an
elephant one bite at a time and
that's the way that we're going
to be able to to make the
conditions for not just the
black veterans that are dealing
with with lung cancer the women
veterans in their their
particular uh, health issues as
as women.
Uh but.
>> all veterans uh, across the
board, you know, no matter what
their other demographics are uh
it does take a village to to
solve this problem and right
up, you know, at this table
right here where a bunch
of folks that you know, we got
a.
Guy yeah.
We might not have the answer to
the question but yeah, I know
somebody else that does uh and
what we will do is make sure
that we do share that
information uh, with each other
that.
Okay, uh, you know, the.
Commissioner might have a
question if he asks me, I might
not know the answer but I can
reach out to my network
of other of my fellow state
commanders across the country
and say, hey guys, how are you
handling this issue?
And I'll have somebody from
idaho or from arizona or from
texas say, hey, this is what
we're doing here.
Like wow, that sounds like a
great idea.
Maybe we can replicate that in
boston.
Um.
>> it's those types of networks
and those types of ideas uh,
that will make this issue these
issues, uh, attainable where
we'll be able to help solve
some of these problems.
Um.
>> again, uh, part of what we
want what we do with the vfw as
well as the other service
organizations like the legion
and the dav.
Um.
>> when we're out in our
communities all the time that
we are community based
organizations.
That.
>> uh, we will be able to get
uh, uh, our folks together and
we come together monthly or a
daily basis depending on the
types of posts that we have.
Uh.
>> come out visit uh, we want
to be able to uh, be productive
members of the process here.
Um.
>> again like the last time I
was here and uh, provide a
testimony.
Uh uh, one word of caution
that.
The the rest of the
commonwealth pays attention to
what goes on in the city
of boston as far as as veterans
are concerned, they see that
oh.
If we just cut $750,000 from
the veterans budget, thank
goodness we had a group like
brighton one step up to help
fill that gap.
But that doesn't mean that next
year or even tomorrow they
their priorities change from
what the city of boston's uh,
veterans priorities are.
Um and then.
We'll never see that $750,000
again into the budget.
That's $750,000.
Goes back into.
The commissioner's ability to
provide that outreach, to
provide that education to the
veterans community of the city.
Uh.
>> so I just want to be able
to, you know, to implore upon,
you.
Know.
>> what happens here in boston
just doesn't necessarily happen
here in boston.
Uh.
>> the rest of the commonwealth
pays attention.
Uh, and.
I, I really.
yeah yes, I do demand.
That, you know.
Our council shows the
leadership across the
council across the.
Commonwealth that.
You know, boston is going to
take the best care of veterans
that we can and we are going to
stand up and provide that
leadership to make that happen.
So again, thank you for all
your efforts.
Thank you for your attention
and we look forward to being uh
again part of that village that
comes together to take care
of veterans again across the
city and across the
commonwealth.
Thank you commander mr kennedy.
Yes.
>> uh, again we just start by
expressing my sincere,
heartfelt thank you for the
opportunity to be here.
And let me rephrase to
privilege and honor to be here
uh, amongst um, city
council and esteemed members
of this panel, I'm really
thrilled to have been able to
continue to participate in this
discussion.
I made a lot of comments about
um the guidelines piece.
So again I stand by that and
um, what you said and what you
said and also sort of what my
comment it was basically a
build and it's this I don't I
think everybody in this on this
panel at some point mentioned
the word navigation.
We know the word navigation is
great.
I have a very high level
of resident residents.
I'm sorry to that because I
started my career in public
health as a patient navigator
at the at uh the dana-farber
cancer institute.
Um, I believe in that
application.
I believe in the power
of navigation to support
patients and get them to the
best outcomes that they could
have.
The point I want to make as we
talk about piece of the
application and the implication
is that there's a patient with
a diagnosis that is going now
through the system to make sure
that they get the treatment
that they need.
And our cancer plan for the
city I'm looking to move
navigation for the upstream.
I talk about the concept of a
screening navigator.
So pre patient how do you take
that that that that that
mentality that that um that
focus on on supporting a
patient while they go into
treatment and move it up so
that before the person becomes
a patient they get help with
navigating administratively and
otherwise how you move through
a system, how you get screened
for a particular location.
What are the follow up
procedures that allow you to
adhere to make sure that if uh
,as you mentioned earlier, you
might get a screening mammogram
but if there's something that's
wrong with that which causes
you to then have to come back
and get a diagnostic mammogram
,do you show up?
People understand the
difference between the two and
do you understand what it means
to to do that from a cost
perspective?
because massachusetts passed
legislation I think in 2024 we
call it the um the
cancer diagnostic bill.
The official name of the bill
is a little different, but it
took that diagnostic mammogram
cost sharing burden off
of women so that they could
continue to adhere to what that
screening member williams said.
Right.
My point was this navigation
sounds like all of us agree is
a critical part of this.
We know that cms put in
physician billing codes in 2024
that allow clinical practice to
reimburse for navigation.
Let's take advantage of that
and make sure that navigation
is a standard part, a standard
sustainable part of the way
people that waterfowl claims or
whatever behaviors are
introduced to and supported as
they move through the clinical
system in the va and again let
the massachusetts va be the
model for the rest of the
country not only when we're
talking about access to
screening for lung
cancer beyond just tobacco use
,but navigation for veterans
through the system so that
nobody falls through the
cracks.
Everybody has answers to
questions that they want and
they get through the system
with the best outcomes.
Navigation and guidelines I
think are two main points
of this.
I think the va uh veterans have
an opportunity to set the tone
for the rest of the country.
I hope you do.
Thank you, mr kennedy.
um, doctor.
Thank you.
>> council time.
Thank you.
Councilor fitzgerald.
One of the things that I, you
know, thought about is um, as
veterans we connect by
storytelling like we that's our
connection.
We we tell a story about, you
know, how we served and and
what we did and that's how we
connect.
But I think is, um, if we
continue to advocate for
equitable, equitable access to
resources and ways and
awareness about trauma, mental
health needs and health needs,
um, I think we can create a
program that culturally
identifies um, you know, black
on black female soldiers.
So why I said that is normally
when we think about um when we
are introduced to all these
these programs and we're
hearing these different things
on tv or in the media we don't
actually see see a person who,
you know, actually work in that
department or like you know,
the boston public health
scanner and the va.
So as long as we continue these
town halls and continue to have
this discussion, we'll bring
more veterans.
And if I'm looking right now at
this if I was I was if I was
home and I'm watching this and
I say hey you know I you know I
had trouble following the claim
right here on we have someone
from the vfw.
We have someone from the post
now I know who was on the list
so I just feel the same issue
as long as we continue that
navigating and making a system
as easy as possible for someone
to navigate through the system
for health care needs um for
mental health um needs and for
education that's that's all
golden ticket to get to you
know on that's in the city
of boston massachusetts.
We have a direct.
Excellent um thank you doctor
and and doctor juana.
Um, thank you so much for the
opportunity to be here today
for this important hearing, for
the thoughtful questions for
all of.
>> the, uh, wisdom that's been
shared.
By the other members of.
>> the panel and ah, also from
the public.
Um, I, uh, want to touch on one
other point that we haven't
talked about so much today.
Um, and that's that lung
cancer is, uh, highly uh,
stigmatized condition.
Because of the.
Uh the strong link with um,
smoking even though we know
that there are other factors
that contribute to.
Lung cancer risk.
But I want to say that nobody
no veteran no person.
Deserves lung cancer and we.
>> are here to help.
We are here to uh the va and
other health care systems.
And this amazing city uh, are
here with screening to try to,
um, identify cancers early and
get people into treatment.
I love the ideas about
navigation including veteran
peer to peer genetic navigation
um, which we have in the va and
uh and using the power of the
uh community.
based organizations.
That that veterans have access
to uh, to spread the word about
uh, screening and help people
get connected to um.
To services.
Um.
>> I also just want to say
because this is a stigmatized
condition.
Sometimes doing the community
events like we.
Did or like you know, like
you're talking about doing um
sometimes it doesn't reach.
>> the people who most.
Need to be reached, um, because
they MAY be reluctant to go to
something that's about lung
cancer or whatever because
of the stigma and and the shame
and blame that people feel.
So uh, one thing we learned
from our work and that peer
connects was that.
One of the.
Most powerful things was
actually reaching people who
maybe weren't eligible for a
lung cancer screening.
But then they went and talked
to other members of their
community, um, who.
Didn't come to the events but
like spreading the word that
way and helping convince.
People to come in and get the.
The health care that.
>> they need and deserve.
Thank you doctor.
Um, before I go to counselor
fitzgerald, um, for a closing
statement, doctor, I just want
to make one quick point or ask
a brief quick question many
veterans and or to rob santiago
,both of you, uh, many
veterans don't even know the
veterans and they don't even
realize that they can
participate in um services for
veterans.
They might be older at this
time, but.
>> they're.
Still eligible for services and
programs at the va and it's not
too late to sign up.
Is that correct?
Correct.
>> that's correct.
Absolutely.
Rob what should someone do if
they if they're an older person
.
They for years they weren't
treated well coming back from
service.
They they are veterans.
They don't they haven't engaged
in the system yet.
What's their first step?
Contact us.
Okay contest to.
Contact us get ahold of us.
We could navigate and
communicate with you what's
available to you?
Um.
Give this give the system a
second chance.
It's not.
Um.
Now I know that speaking
of stigma that, you know,
there's been a lot of um a lot
of veterans have been stigma
stigmatized because of the
services they got in the va
back in the 70s and 80s where
um where they didn't have the
kind of services that are being
provided today.
Um and the fact that, you know,
covers a lot of that,
especially when it comes to the
presumptive uh, conditions that
we're talking about here today,
uh, that that include many
different cancers.
so um, contact us, ask us
of questions, give the system a
you know, a chance and let us,
uh let us help you navigate the
system so that you can get the
services and benefits that you
had deserved and continue to to
earn.
So, um, contact us, contact
your local vso, contact your
local uh, veteran organization
.
Um, and uh, let us do our job
for you.
.
>> rob, give us your contact
information once again I know
you provided it already, but
give it to us one more time,
please.
So for the for the boston
office of veterans services you
could contact us uh
boston.Gov/veterans or you
could give us a call at uh
617635 3030.
Thank you rob um
council fitzgerald.
Thank you chair.
Uh, you know, I just want to
say.
Thank you.
>> all.
>> uh, for the.
Important work that you do.
Uh, because not only are we we
have the subset of veterans
that we can, uh that we can
help.
Um, but it will have an impact
on everybody, uh, veterans and
not veterans when we when we
talk about health, uh, we're
all the same human individuals.
And so if we can figure out
what's wrong with one subset,
hopefully we can apply it to
another and so on and so on.
And so just.
>> thank.
you all for uh, your leadership
and and the important work that
you do and please always feel
free to reach out to uh to to
add to myself uh, when when you
have to teach us what we need
to do for you.
Right?
You guys have you guys are the
ones going through it and
experiencing it and so uh and
that goes I know we didn't uh
we touched on it a lot but even
for the women veterans services
,uh, not a veteran and not a
woman.
And so I do tread lightly and I
take my cues from you all.
Uh, and so please educate
me and tell us what we need to
do.
Uh, but thank you again.
Well, thank you, thank you
john, thank you for being here.
Um.
It was an important discussion
on support services for women
veterans for how we support
veterans of color, um, on
medical care and coding, um,
and lung cancer screening and I
think my colleague
council fitzgerald uh,
highlighted an important point
that I kind of wanted to close
with.
Is the importance of of
listening, um, you know,
listening to women veterans
listening to veterans of color
listening to lgbtq veterans.
I don't have that experience
but I want to and continue to
be a strong supporter of all
veterans especially including
women veterans, veterans
of color, lgbtq veterans.
But it is about listening.
It's about learning.
And that's why I called this
hearing today so we can give an
opportunity for you to speak
about your experiences.
But more importantly, there
might be someone sitting home
that this information might
connect with them and maybe
they'll pick up the phone um or
send an email next week to rob
santiago or to or to the other
veteran leaders here as well.
Um, but we have to acknowledge
the incredible service
sacrifice of women veterans
of veterans and veterans
of color.
We're not giving them any
services.
We're not giving them any
programs that are in these
programs.
Right.
>> and as a nation historically
we haven't been welcome
welcoming to many women
veterans or veterans of color.
In fact, I'm going to provost's
I'm going to send a to the city
council a resolution to support
a piece of federal legislation
to support it.
And it's basically to ensure
that when black veterans
returned from world war two
they really didn't participate
or receive the veterans the
services that they earned
specifically on housing va, va
housing programs because
of that they didn't generate
generational wealth like like
other veterans have.
Um, but this piece of federal
legislation would provide.
Grandchildren or children maybe
I have to do a little bit more
research, um, giving them an
opportunity to get a little bit
of services such as um real
estate such as first time home
by by a programs through the va
because they were denied that
benefit due to racism they were
denied that specific program
due to the color of their skin
due to discrimination.
Um but that's a piece
of legislation I'm going to
look at.
I know you and I talked about
that rub for a while and want
to also acknowledge, um,
commissioner santiago we worked
on especially under PRESIDENT
Biden when gay and lesbians
were discharged from the
service.
They were discharged.
With a discharge that wasn't
honorable.
So when you have that discharge
that is not honorable.
Um, it it limits what benefits
and services you can get as a
veteran.
But through the work
of commissioner santiago, we we
did a lot of work at the
federal level.
Um, and I say gay gay and
lesbians now it's lgbtq plus
but we have to ensure that they
are also treated with respect.
And dignity that they've earned
in if they were discharged for
reasons um due to their sexual
orientation, I believe that
that discharge should be
upgraded and maybe maybe that's
an issue we're going to have to
continue to work on as we go
forward because I know I'm
committed to it and we're
committed to to that as well.
But having said that, this is
about justice.
This is about respect for all
veterans especially
historically especially
veterans that historically have
been denied access to the va
and to um services and programs
that they've earned this
hearing on docket number.
Zero seven um excuse me 0273027
for a hearing to discuss lung
cancer rates among black
veterans and services for women
veterans is adjourned.
Thank you.