[0:05] Good morning.

[0:08] My name is Ed Fland, Boston City Council. I am the Vice Chair of the Boston City Council committee and veterans, military families, military fears. Today's August 28, 2026, the exact time is 10 o'clock.

[0:25] This hearing is being recorded. It is also being live-streamed at Boston.gov slash city council

[0:33] dash TV in broadcast on Exfinity, Channel 8, RCN, Channel 82, Fios, Channel 964.

[0:44] Written comments may be sent to the committee, email at ccc.gov, that's at Boston.gov,

[0:52] in will be made part of the record in available to all city councilors.

[0:58] Public testimony will be taken at the end of this hearing,

[1:03] or if anyone wouldn't like to testify virtually,

[1:08] we'll try to get you in during the hearing.

[1:11] If you have any scheduling related issues,

[1:15] and you need to testify immediately,

[1:18] please let me know when I'll try to get you in to testify.

[1:22] as we speak. Individuals will be called on in the order in which they sign up and they'll

[1:29] have two minutes to testify. I will not cut anyone off if you need to speak for more

[1:34] than two minutes. Please take the time that you need.

[1:41] If you are interested in testifying

[1:42] in person, please add your name to the sign up sheet near the entrance of the City Council

[1:46] Chamber. If you are looking to testify virtually, please email our City Council central

[1:54] staff liaison, Shane Pack, and Shane, a Sage A&E. Pack at Boston.gov for the link. In your

[2:04] name, we'll be out at the list. Today's hearing is on actually two dockets, dockets 0, 2, 7, 3.

[2:11] It's in order for a hearing to discuss lung cancer rates among black veterans. In the second

[2:18] And I would like to thank Dr. Markett, his Dr. Zero 274, which is an order for a hearing

[2:22] to discuss services for women veterans.

[2:28] Dr. Zero 273 was sponsored by, by myself, counselor, counselor Murphy, and counselor

[2:38] Santana, in it was referred to the committee on February 4th, 2026.

[2:44] I am joined by my Council colleagues in order of a rival, of a rival, Council Murphy.

[2:54] I do want to acknowledge, well, I do want to acknowledge as the Vice Chair, I will be

[2:59] cheering this hearing today in Councillor Henry Santana does express his respect for the

[3:10] veterans that are here in the veterans throughout the city of Boston.

[3:12] He's just unable to be here, but he wanted me to know that he is paying a close attention to this.

[3:20] And one of the acknowledges his chief of staff, Anna Calderon, who really helps set up this meeting as well.

[3:28] So I want to say thank you to Anna for her support and commitment to veterans, military families across the city of Boston as well.

[3:41] I do have a letter of absence that I do want to read into the record and then I'm going

[3:47] to give an opportunity for my council call, council Murphy, to give an opening statement.

[3:54] Then I want to ask each panelist to give an opening statement as well.

[4:01] But before we do that, could I just ask the panel maybe to go starting from Commission

[4:09] to Santiago?

[4:10] Could you just state your name for the record in what organization you owe with?

[4:17] So let me start with that Commission to Santiago, please.

[4:21] Good morning, Councilor Flynn, Councilor Murphy, thank you very much for having me.

[4:24] I am Commissioner Robertson, Santiago, City of Austin, Veteran Services.

[4:28] Thank you, Commissioner.

[4:31] Good morning, Councilor Flynn, Councilor Murphy.

[4:33] My name is Craig De old, a resident of the city of Boston, and I am the state commander

[4:37] of the Veterans of Farm Wars.

[4:45] Good morning council to fully encounter the Murphy.

[4:48] My name is Mark Kennedy, I'm at the Boston Public Health Commission.

[4:53] Good morning, I am a name is Malika Whitley, I'm with the American Legion full 78 and I also

[4:58] work with VA Benefit.

[5:02] And good, is this on? Yes, it is. Good morning, Councillor Flynn and Councillor Murphy. My name is Rendo Weiner. I am a pulmonary physician and researcher at the VA Boston health care system and the Center for Health Optimization and Implementation Research there.

[5:20] Thank you to this distinguished panel for being here. Thank you for testifying more importantly, thank you for your commitment to veterans in military families.

[5:32] across the city really across the country as well. I'm going to read a letter into the record

[5:37] that I'm going to go to a straight to Council Murphy, Dear Chair of Santa Ana. This is from

[5:42] City Council President Braden. I regret that I am unable to attend tomorrow's hearing

[5:49] on Dawkins 0273-0274 hearing to discuss long cancer rates among black veterans services

[5:57] for women veterans. Well, I am unable to attend the hearing. Members of my team will be

[6:03] listening in to this critically important discussion and I plan to review the recording.

[6:08] I kindly ask that you read this letter into the record. Thank you. Elizabeth Brayden City Council

[6:14] President. We are also joined by City Councilor at Lodge, Lucy Louis-Gent. Let me go to

[6:27] Thank you to the panelists, thank you Commissioner San Diego for all you do here at the city and obviously across the state and country always showing up for veterans as a veteran yourself.

[6:39] I mean, I don't want to take all my time just thanking people for being here, but Craig also in coming from like the VA and the different posts across the city.

[6:48] we know that many veterans when they come to those places is not just for socialization, even

[6:53] though that's a wonderful thing. It's also to connect and help connect to the benefits

[6:58] that we know the veterans earned and in many times aren't always aware of what's out there

[7:04] for them. And when we have subgroups like this I think it's very important that we're talking

[7:09] about and thank you for uplifting these concerns about the lung cancer rates among our

[7:14] lack veterans and making sure our women veterans are getting everything they need while

[7:19] they're enlisted but also when they come home making sure that they're supported.

[7:24] So as a veteran mom, I know it's important that we always support our veterans but as a

[7:30] counselor I think it's also important that we're making sure there's no groups around the

[7:34] city who are failing as though they're not getting what they need.

[7:36] So just happy to be here and also public health commission in the VA.

[7:40] My public, public jack, my stepdad, 92 now, and is getting a lot of support from the VA and the

[7:47] Senior Home Healthcare, and it's just wonderful to see full circle, you know, spending your

[7:51] life giving, and then when you're at near the end, people showing up for you and it's just great.

[7:57] So thank you for all you do.

[7:59] Thank you, Councillor Murphy.

[8:00] I do want to give Council a whole weekend, an opportunity for an opening statement.

[8:04] Thank you.

[8:05] Good morning, everyone, and thank you for being here.

[8:07] I want to thank you, Councillor Flynn, for your leadership and service to our country.

[8:11] I also want to thank all of our panelists for your leadership and your service to our

[8:15] country.

[8:16] I want to thank you starting with the commissioner for all the incredible work that you do

[8:20] in the Office of Veterans Services to make sure that our veterans in the city have the

[8:24] resources that they need once they come home to thrive and to really be thanked for the

[8:31] work that you've done.

[8:32] I know Malika, you're celebrating a lifetime of service this year, and it is a well deserved one.

[8:39] And to everyone who is here, Dr. Weiner, to all of the panelists, I'm really appreciative of the work that you do at the post.

[8:51] George, I'm sorry. Craig, Craig, Craig, I'm sorry, Craig, and Mark, Craig and Mark, thank you for being with us today.

[8:59] There are a lot of race-based health gaps in this country, and that is also true for our veterans when it comes to lung cancer and other types of cancer.

[9:08] 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.

[9:15] So thank you and we look forward to continuing working with you in part with you.

[9:20] Thank you.

[9:22] I'll give an opening statement then I'll go right to our panel.

[9:26] Hopefully I only take two minutes.

[9:27] Women veterans are one of the fastest growing populations within the United States military

[9:33] in the Department of Veterans Affairs. Yet many continue to face barriers after leaving the service.

[9:40] Women veterans make up nearly 20% of those serving military personnel in about 10%

[9:48] of the veteran population, but many struggle to access gender-specific health care,

[9:54] Mental Health Services, Child Care Housing, Employment, Approximately 25.

[10:00] 1% of women experience military sexual trauma, which can increase the risk of PTSD, depression, substance use, suicide.

[10:10] Some women also avoid VA services because returning to a military environment can cause anxiety.

[10:16] The VA has taken steps to improve care through efforts such as the Deborah Samson Act, which expands primary care in counseling services for women veterans.

[10:25] other legislation,

[10:30] including the brave act in other pieces of legislation focused on

[10:34] maternity and mental health needs.

[10:39] Massachusetts also supports women veterans' full, the Women Veterans Network, which provide

[10:43] information resources support.

[10:46] However, more gender-specific healthcare, counseling, childcare, career transition programs

[10:52] I need. The VA should also work to fill counseling positions and increase the number of women

[10:59] providing care. Veterans also face serious health risk, including lung cancer, military

[11:06] exposure, such as espestos can increase veterans risk of developing the disease. African American

[11:13] Veterans, face additional disparities in lung cancer, diagnosis, treatment, and survival.

[11:21] Improving access to early screening and quality treatment is, especially, important for

[11:27] those communities.

[11:29] In Boston, organizations such as the VA healthcare system and the Veterans Outreach Center

[11:34] at Harvard Street, neighborhood health center provide veterans with healthcare in other

[11:43] help address the racial gap, gender disparities, ensure veterans receive the support they need

[11:50] after the military service. We must continue to work together to provide all veterans

[11:57] with access to the critical care in services they earned. Before I go to Council Fitzgeralds

[12:05] for an opening statement, I do want to acknowledge the incredible work commission of Santiago

[12:11] of your team, of you, of your dedication and support of women veterans, of support of veterans

[12:20] of color, and also working closely to ensure LGBTQ plus veterans are treated with the

[12:28] dignity and respect that they have earned.

[12:32] So having said that I wanted to give Council Fitzgerald an opportunity for an opening

[12:36] state.

[12:37] Thank you, Chair. I appreciate it and thank you all for being here today and regards to this matter.

[12:44] Really here to learn more about what sort of some of the deficiencies may be, where we can be better,

[12:50] how we can help strengthen those, going further, and really look to you guys have the answers.

[12:57] So I just here for you to educate us on how we can be more supportive of you all.

[13:02] And as always, thank you for everything that you guys do, not just for our city, but for our country as well.

[13:07] So, thank you, Councilor Flynn. I appreciate it.

[13:09] Thank you, Councilor Fitzgerald. 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 veterans of cover.

[13:23] I know there's two specific dockets, but we can combine them into one if that's okay with everybody.

[13:29] And I don't necessarily have any time that I'm putting the panelists on.

[13:35] So take the time that you need to make sure your message gets out to the public.

[13:41] I'd like to do these hearings because the public does watch these.

[13:46] And I'd like to educate the public about what we're doing here in City Hall and to ensure

[13:51] that if veterans are watching, they know who to contact if they are in need of services.

[13:56] So, let me start with Commissioner San Diego and we'll go right down the right down the line and take the time you need to discuss whatever is important to you.

[14:06] Thank you, Chair Fulano. Good morning, Chair Fulano.

[14:08] Councilor Murphy, Councilor Lusion, Councilor Fitzgerald. Thank you for having us here.

[14:13] I do just want to touch on something. I wanted to thank the City Council.

[14:17] I know, you know, it says a lot about your actions and your passion for our veterans here in the city of Boston by always showing up, not just on Memorial Day or Veterans Day, but also year-round for our veterans and that is definitely something that I see on a daily basis and as a veteran and as a commissioner, I do thank you.

[14:40] I also just want to thank my fellow panelists who are here today, my fellow veterans who are watching advocates and neighbors.

[14:47] This is an important hearing.

[14:50] 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.

[14:57] When it comes to the topics that we are talking about attitude.

[15:00] Day, and sometimes it reers into other topics as well, which is also welcomed. But today, we're

[15:05] talking about lung cancer rates amongst African American veterans and our support of our women

[15:11] veterans. lung cancer is not simply a medical issue. We're going to hear a whole lot more about

[15:16] that a little bit later on from Dr. Weiner, who's here from the VA. It's an issue that, as far

[15:22] as I'm concerned, in many of us are concerned, is a racial equity. An issue of access, trust,

[15:28] early detection and whether veterans receive the care that they earned through their service.

[15:34] Many veterans face elevated risks because of smoking, second-hand smoking, asbestos, especially

[15:40] those like myself who have served on older Navy ships. Those who have served in burn pits,

[15:46] around burn pits, airborne hazards, chemicals and other toxic exposures that are encountered

[15:51] through military service. Yet exposure alone does not determine an outcome.

[15:55] time screening, early diagnosis, access to specialists, reliable transportation, and trust in a health

[16:03] care system can determine whether cancer is found when it is treatable, or after it has

[16:08] also progressed. VA research in the case that fewer than 10% of the approximately 1 million

[16:13] eligible veterans studied have received lung cancer screening, screening rates even lower

[16:19] amongst black veterans. The research also indicates and identifies barriers

[16:25] including limited awareness, mistrust, stigma, unequal relationships with their providers and

[16:32] adverse social determinants of health.

[16:35] These are not failures of our veterans.

[16:37] These are warnings that our systems must do a better job of reaching the people that they

[16:44] were created to serve.

[16:46] There is also encouraging evidence.

[16:48] Studies that found that when black veterans receive care within an integrated VA system,

[16:52] their lung cancer treatment and outcomes can be comparable and sometimes better than those of their white veteran counterparts.

[17:00] That tells us something that's very important.

[17:03] Disparities are not inevitable.

[17:06] When care is accessible and it's coordinated culturally responsive and equitable, we can save lives.

[17:14] And our women veterans, as the Council has mentioned, are our fastest growing segment

[17:19] of the veterans population with more than 2.1 million women veterans in the United States

[17:24] today.

[17:25] Approximately 20% of veterans, women veterans are black, and 43% of women using VA health

[17:31] care system belong to a racial or ethnic minority group.

[17:37] Yet women veterans are still too often overlooked, mistaken for military spouses or made

[17:43] field that veteran programs and facilities were designed primarily for their male veteran

[17:47] counterparts. Women veterans need comprehensive and respectful care that includes primary

[17:53] care, cancer screening, reproductive and maternal health care, mental health treatment,

[18:00] support following military sexual trauma, menopause care, toxic exposure evaluations

[18:05] as well, homelessness prevention and assistance navigating disability claims and benefits.

[18:10] They also need providers who understand how systems, risk factors and treatment experiences

[18:16] are different for them as women.

[18:20] I want to recognize the outstanding work of the Women Veterans Care Center within the VA

[18:24] Boston Health Care System and its program manager, Carolyn Mason Holy, whom I spoke with

[18:29] yesterday.

[18:31] This program here in Boston provides women veterans with comprehensive coordinated care in

[18:36] environment where their service, their experiences, and individual health care needs are

[18:41] understood and also respected.

[18:44] It's especially trained providers, offer primary care, gynecology, maternal and post-mortem

[18:49] support, mammograms and other preventive screenings, menopause care, mental health counseling,

[18:55] support for survivors of military sexual trauma, and also family planning services.

[19:00] Just as importantly, the program's help women veterans navigate the VA healthcare system and it connects them with the specialists and resources that they have earned because of their service.

[19:13] The Senate reflects an important promise that women veterans should never feel invisible or like and at the thought within the system that they serve to defend.

[19:23] They deserve timely compassionate gender-specific care and a place where they are recognized

[19:29] first and foremost as veterans.

[19:33] Also, available to our women veterans is the Veterans Call Center, which provides women

[19:38] veterans with information about VA services and resources, benefits, and eligibility.

[19:43] It's a toll-free hotline which is available Monday through Friday from 8am to 10pm Eastern

[19:48] standard time, and on Saturdays from 8 am to 6.30 pm,

[19:52] he's their standard time.

[19:53] The phone number is 855 VA women or 855-829.

[20:00] Six, six, three, six, and I'll repeat it again. Eight, five, five, eight, two, nine, six, six, three, six. And if you wanted to contact the Boston office, you can call six, one, seven, nine, eight, one, nine, two, seven, seven.

[20:15] Also, here in the commonwealth of Massachusetts, the primary program for women veterans, as was mentioned by Council of Flynn, within the Massachusetts Executive Office of Veteran Services or EOS, is a Massachusetts Women's Veterans Network,

[20:28] which acts as a essential resource peer group and advocacy body dedicated to empowering women who have served in the military.

[20:37] Since 2019, the mayor's Office of Veterans Services here in the city of Austin has hosted an annual women's Veterans Roundtable,

[20:45] which has provided women veterans with a welcoming and trusted space to share their experiences,

[20:50] learn about available benefits and healthcare resources, and speak directly with the leaders and organizations that serve them.

[20:57] But most importantly, the wrong table ensures that women veterans help shape the programs

[21:02] and policies intended to meet their needs.

[21:06] It reinforces a simple, but essential message that women veterans are not invisible.

[21:11] They serve the sacrifice and the voices must be heard.

[21:15] Also here in the city of Austin, we host an annual black veterans appreciation of recognizing

[21:21] the extraordinary service, sacrifice, and continuing contributions of our black veterans

[21:26] throughout Boston's history. It is also an opportunity to connect veterans and their families

[21:31] with benefits, health care, and community resources while creating honest conversations

[21:36] about the disparities that they have and may encounter. By celebrating their achievements

[21:41] and listening to their experiences, we affirm that honoring black veterans requires more

[21:47] than recognition. It requires sustained advocacy, equitable access, and meaningful action.

[21:54] Here in Boston, we are fortunate to have the VA healthcare system which is one of the best

[21:59] in the country and the world, which includes campuses in West Rocksbury and in Jamaica

[22:04] Plain.

[22:05] We also have world-class hospitals and cancer centers.

[22:08] We have the Boston Public Health Commission, which we've been here from here very shortly.

[22:12] We have community health centers.

[22:13] The Massachusetts Executive Office of Veteran Services with Secretary Eric Bernoulli and

[22:18] Deputy Secretary Andrea Gail Bennett at the helm.

[22:21] 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.

[22:33] And of course, our partnership with our fellow city departments like the Boston Public Health Commission, H. Drong, the Office of Food Justice, the Mayor's Office of Housing and Neighborhood Services, just to name a few.

[22:43] We all work together to help connect veterans in their families with health care and wellness

[22:48] resources, nutritious food, food access programs, housing assistance, transportation,

[22:54] benefits advocacy, mental health support and services for our older veterans.

[22:58] By working across agencies, we can and continue to address the social and practical barriers

[23:03] that two often prevent veterans, especially women veterans, black veterans and older veterans,

[23:09] and those facing financial hardships from receiving the care and support that they have earned.

[23:15] My hope is that this hearing here today will lead to greater awareness, measurable,

[23:20] and measurable action, where more veterans are screened, more cancers are detected early,

[23:27] more women veterans receiving the care design around their needs and life state.

[23:33] Lastly, as part of our continuing commitment to honor services sacrifice,

[23:38] And as our nation not only marks the 250th anniversary of our country, but also here in a couple

[23:45] of weeks, the 25th anniversary of September 11, 2001 terrorist attacks.

[23:51] We must never forget the nearly 3,000 innocent lives taken that day.

[23:56] The first responders who ran toward danger and all those who continue to live with this

[24:01] lasting effects.

[24:02] September 11th, forever changed our country and redefined service point and entire generation.

[24:09] And in the days and years that followed Americans stepped forward to serve in our armed forces,

[24:14] in our fire and police departments, in our emergency service and in our communities, united

[24:20] by a shared commitment to defend our nation, one more importantly to care for one another.

[24:25] We especially honor the post-911 veterans who answered that call, including those who never

[24:30] return home and those who still carry the visible and invisible wounds of war.

[24:35] Twenty-five years later, our responsibility remains clear.

[24:39] Remember, every life lost.

[24:42] Honor, every person who served our country, and ensure that their sacrifices are never forgotten.

[24:49] The city of Boston will never forget.

[24:51] This year, we are also going to host our annual POWMIA Recognition Ceremony on September 18th

[24:56] in City Hall, Plaza.

[24:57] We will gather with veterans families, community.

[25:00] Members, and the state leaderships of the VFW, DAV, and the American Legion to reaffirm that our prisons of war,

[25:07] and our missing personnel will never be forgotten. We also invite everyone to join us for Boston's

[25:12] Veterans Day Parade on November 9th, where we will recognize veterans of every generation, including

[25:17] the post-911 veterans who answered our nation's call during these past 25 years. Together,

[25:23] of these services remind our veterans that Boston remembers their service, Boston honors

[25:29] their sacrifices, and Boston remains committed to supporting them in their families.

[25:36] Thank you to the Council for bringing the attention to these critical issues.

[25:39] And for your continued commitment to our Boston veterans and their families.

[25:43] And I'm looking forward to the conversation you today.

[25:46] Commissioner Santiago, thank you very much for the testimony of leadership.

[25:51] I do want to make one change to what I mentioned earlier.

[25:55] I know we are going to go straight down the line.

[25:59] Commander, Meredith, to it is a member of the American Legion in the Cata post.

[26:05] And I know she's going to the American Legion post convention now.

[26:09] I do want to take her out of water, give her the opportunity to speak, provide an opening

[26:15] statement, because I have great respect for her as a veteran, as a woman veteran, a veteran

[26:23] of color, but also I'm a member of the codapose, so I have to take care of my commander as

[26:29] well, right? So could we ask Commander to it to, if we could bring her to it?

[26:36] Yes, Commander. Good morning, Commander. It's good to be with you. Good morning,

[26:40] warm chairman and one and everyone. I do appreciate you cheer and the committee pulling

[26:48] me out of turn. As you know, I run in errands getting ready to head to Louisville, Kentucky

[26:55] for National American Legion Convention. So I appreciate you pulling me out of turn. Also,

[27:01] I want to thank Commissioner Santiago for all the work that he does for the veterans here

[27:05] City of Boston and all the other panelists that are going to be speaking.

[27:10] Thank you.

[27:11] We all have to continue.

[27:13] I will service for veterans veterans of color and also for female veterans.

[27:19] I am District 7, Suffolk County Council Commander for the American Legion.

[27:23] So I have about 20 posts under me.

[27:25] And then also Commander of the Carter Post in Manapan.

[27:28] So I'm always speaking with my veterans veterans of color, female veterans.

[27:32] some part of the WVN and many other organizations.

[27:39] First, I want to say I applaud and I appreciate the doctors and the advocates from the VA

[27:48] who have been working around the screen in a lung cancer, especially for African-American veterans

[27:54] and our indigenous veterans here in the city of Boston.

[27:58] And they have been doing screening and going to different locations different posts over the

[28:04] past two years or more to be able to screen as many of our comrades as they possibly

[28:12] can to get them assistance and get them help for those that are detected or also to make

[28:21] sure that those that don't have a no they don't have.

[28:24] But the problem that I want to touch on this face is here is that even though they're

[28:30] visiting our communities and coming into our post in our room, we're still losing

[28:35] with some missing some of our comrades who might have lung cancer.

[28:41] I will all the generation who sometimes can't get out to be screened or at these locations.

[28:48] So how do we improve upon that?

[28:50] And I'm going to throw that on your desk, Commissioner Santiago, I'm going to throw it on

[28:53] desk of our VA, doctor, because we need to be able to work with our system and how we are

[29:01] doing the screenings to be able to accommodate our elders who don't come out when they're

[29:09] screening because one day don't follow social media, two day might not see a flyer, and

[29:16] we've done bobbishops, we've done all sorts of different locations when we were doing it at the

[29:23] So I just wanted to put that out.

[29:25] It was still missing a lot of our comrades.

[29:27] That should be in the get screened, right?

[29:30] But I do apply them for what they had been doing.

[29:34] Let's talk about service for female veterans.

[29:38] A lot of times I have veterans that say,

[29:41] we shouldn't say female veterans.

[29:42] A veteran is a veteran.

[29:44] Yes, but female veterans health care is different.

[29:50] We, we, um, you know, we convert, we, we carry children so we need that, um, GYN, we need that.

[30:00] That OB doctor to deal with, and it took a while for when the OB doctor left to make a plan. It took them almost two years before they found another one, and I applied Carolyn for all of the hard work she does to make sure that we do have doctors within the women's clinic, and the new clinic that they opened up focused on menopause, I think it's in the veteran location.

[30:24] But men don't think about those things. Women do. So we have very menopause. We have menopause.

[30:34] We have carrying children. We have our fibroids. We have all these things that men don't have.

[30:41] That are crucial to our livelihood and our health.

[30:47] And our mental health is also something else that is different.

[30:52] We struggle with depression in a different way, because not only depression about our service, especially women who have the NST and military sexual trauma and those that have the post trauma and so on, but at many times we are all focused on our children and taking care of our household and keeping our jobs and being looked as if we are being too aggressive.

[31:22] to this and to that. So the mental health for female veterans is different. So that's something

[31:31] that we could do better. You know, I have a lot of my sister veterans who say to me sometimes

[31:39] when they go to a therapist, that they don't think the therapist is really listening to them,

[31:43] because some therapists say, oh, you know, you can you can handle it. You've got your strong.

[31:49] You know, sometimes we don't want to hear that, you know, and those are things that we need to be able to have that cultural competency, that mental competency, that environment that we're in, so those are things that we need to focus in, I don't know if it's more training or how do we do it, but those are things that I hear a lot about from my sister on comrades.

[32:14] And I want to say, for myself, I went through a traumatic loss of, like, my second mother about a year and a half ago.

[32:27] 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.

[32:38] And I'm always out here telling my sisters go and get out, go and talk, go in this.

[32:43] And I finally had to say to myself, go and get out, go and talk to someone because it

[32:49] was very hard.

[32:50] And when I walked out my go, I still had to put on that face that strong face, because I

[32:55] was working with veterans, working with women, and trying to get things done.

[32:59] But internally, I was screaming.

[33:01] But I was able to talk to a therapist that was able to get me through that.

[33:06] So a lot of times we have to think about women's depression, women's mental health, is impacted in different ways.

[33:14] You know, also, again, I want to thank Commissioner Santiago for bringing it up a lot of times.

[33:20] Female veterans are looked at as just a spouse of a veteran.

[33:26] And I've been, you know, talking about, you know, ways that we can acknowledge that.

[33:31] 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.

[33:40] Because my veterans plate on my car, people think it's my husband's plate. I don't have a husband yet.

[33:49] But those are things we work, we talk about within the female veterans community, at being acknowledged, we used to be invisible.

[34:01] We are now in still a little bit in the shadow, but we're coming out, you know, and but it's not it's not done.

[34:10] We have more work to do, right?

[34:14] And a lot of times, too, now, what I'm having a lot of my

[34:17] sister veterans talk about is how they get looked at,

[34:22] say they go through a divorce and there's child custody issues

[34:25] and so on. A lot of times, because their female veterans,

[34:29] they're being treated a certain way in the court system

[34:33] because of the female veteran, or they might have MST,

[34:38] They might have PTSD, they might have this,

[34:40] and the judges are using that

[34:42] because the spouse that they are badman with is using that against them.

[34:48] So those are things that I want to put out there.

[34:51] So we can figure out how are we going to work with our systems

[34:55] to help our sisters, to help my sisters, help my sister comrades.

[35:00] Never, you know, I'm not going to leave my veterans of color. I serve as a commander at a long

[35:08] stand at a hundred and seven-year-old post that it was strongly veterans of color.

[35:18] We, we are treated

[35:20] differently. And that's another thing when you think about how different ways that veterans

[35:26] treated, you know, and then you have to think about when you're a veteran of color and

[35:30] that indigenous veteran, or so on how people look at you if it's not your medical claim,

[35:37] if it's not your housing, if it's not your mental health, and so on. People think that

[35:43] all we're making this up, but no, we are treated differently in all of these avenues, because

[35:49] of the pigmentation of our skin, you know, and is that fear? No, because we all serve.

[35:57] When we're on the field together, we don't see skin color anymore like things used to

[36:03] do back in the days, because when I went in, they still saw it. But here we are now, we're

[36:09] still going through things because we are veterans and military attached of color. And so

[36:16] I want to say that Commissioner Santiago's office does as much as they can.

[36:24] Comrade Flynn as a fellow sailor, we know that there are still struggles out there.

[36:31] And that's why I appreciate when you have these here and so we can talk about what has been done.

[36:39] Good and what still needs to be worked on.

[36:42] And I know I'll get beaten up by he with Fonella and some of my other comrades if I don't talk about the veterans that are still on the streets.

[36:53] Still homeless, still looking for a single room somewhere.

[36:58] Or I will veterans that are on the street because they don't take their meds and they're off their meds.

[37:04] I have one of my comrades right now, who we haven't found him on the streets.

[37:08] He stopped his men, he lost his apartment, we know he's on the streets, we know he's checking

[37:15] into pine street, but we haven't seen him in months, and we're still trying to find him.

[37:21] So these are things we need to do.

[37:22] Maybe we need to put together a group where we can go out and look for those that we know on

[37:30] the streets and their families are worried about them and so on.

[37:33] those are things that I'd like to get onto the table, onto the paper somewhere so we can

[37:41] do more work and maybe pull some types of meetings together to talk about how do we do this?

[37:46] How do we walk the corridor and find out what Mr. and homeless veterans that are out there?

[37:52] And I want to thank you for the time that you gave me Councillor. I want to thank the committee

[37:56] for allowing me to join you today and speak and also again thank you everyone else who is going

[38:02] Please speak in behind me on the panels and thank you, Commissioner Santiago, for the work

[38:08] that you do.

[38:09] And I'm going to enjoy Louisville Kentucky for you guys.

[38:13] Thank you so much.

[38:15] Well, thank you, thank you, committed to it.

[38:17] And I know I speak on behalf of my Council colleagues and for the panel.

[38:22] But we have a tremendous amount of respect for you for the work you do.

[38:26] So, safe travel and enjoy the conference and we'll talk when you get back.

[38:31] Thank you, committed to it.

[38:36] Let us continue, commando.

[38:39] Good morning, Councillor Flynn.

[38:41] Councilor Murphy.

[38:41] Councilor Fitzgerald.

[38:45] There's not many people that I would let

[38:46] hop the line in front of them myself.

[38:49] But my comrade commander and good friend,

[38:52] commander to it.

[38:53] She's definitely won that I would yield way for.

[38:57] Enjoy the weeville commander.

[39:00] I had my name is Craig De Old, I am a resident of the city of Boston, with in South

[39:05] Boston.

[39:07] I am a member of the Boston Police Post VFW-1018, and I currently serve the VFW as the

[39:15] State Commander.

[39:16] In that role, I'm overall responsible for 146 posts across the Commonwealth between our combat

[39:24] veterans and our auxiliary members, brothers and sisters.

[39:28] 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.

[39:41] So there is always a presence of our veterans and I'm not here only on behalf of the state organization of the VFW but also again as a resident of the city of Boston and to speak on on behalf of our four

[39:58] of Iron Post here in the city.

[40:01] Overall, the lung cancer rates with our black veterans is alarming.

[40:08] And a lot of it goes back to a darker time within the Defense Department of War, whatever you want to call it,

[40:16] where there was significant segregation of different types of people and different types of units and doing different work.

[40:24] Commissioner Santiago mentioned before, there's folks that would be serving in the Navy that would always be below decks that never see the light a day.

[40:35] And they're in environments where there's going to be a specialist in that environment.

[40:42] They're breathing in fumes from the engine rooms.

[40:44] They're around hazardous materials.

[40:47] It's just the part and parcel of being on a Navy ship.

[40:53] The land forces, they're always going to be, again, toxic exposures between burn pits, again,

[41:02] being in hazardous locations of even being in a tank, an enormous vehicle, an infantry

[41:10] fighting vehicle.

[41:11] You're around those fumes, you're around the fluids, and those environments are inherently

[41:18] hazardous.

[41:20] We all understand what we raised our right hand

[41:23] in joining the service as a volunteer

[41:26] that we're going to be putting ourselves into situations

[41:29] for the benefit of our communities, of our country,

[41:33] and for the world in general, overall.

[41:38] We don't go into the service broken.

[41:42] But a lot of times we'll come out of the service in that state.

[41:46] Again, it might not be due to a combat injury, it could be just regular occupational hazards

[41:53] within our nature of our service.

[41:57] But the cancer rates within our African-American black could comrades is something that needs

[42:05] to be continued to look at, looked at by not only the VA, but as part of the overall health

[42:13] system that were involved. I've had the, you know, the honor and pleasure of working at both

[42:20] brave and women's and Dana Farber for six from many years. And I know first hand, and you

[42:27] should see, you know, the outstanding effects that our healthcare system has for not only our

[42:34] black veterans, but, you know, everybody within the city of Boston and the world at large,

[42:39] But Boston is a medical mecca of the world.

[42:42] There's no better place to get sick or be hurt.

[42:45] Then within the city of Boston, between the pre-hospital care

[42:49] that Boston EMS provides right through the VA hospitals

[42:54] and our great health care system here in the city.

[43:00] What we're looking at, though, is making sure

[43:02] that all veterans, and especially our black veterans

[43:05] within this subset, do have that access of care.

[43:11] We need to make sure that we, between our partnerships with, you know, through the VFW, you know,

[43:17] the Commissioner's Office, and through the VA, that we need to make sure that when, you know,

[43:23] I have a veteran come to me saying, hey, you know, I've got this stuff going on.

[43:27] Where can I go?

[43:28] You know, the VFW is there to be able to help steer the veterans in the right direction

[43:35] to get that care, be it a city service, going back through through the VA.

[43:41] We have an incredible network of veteran service officers who assist any veteran, not just

[43:49] VFW members, any veterans with filing their VA disability claims, and we'll take them right

[43:57] through the initial intake and if they need, if they get denied initially, will help them

[44:03] through the appeals process even though going as far as to a hearing in front of an administrative

[44:08] judge.

[44:09] We will take them through that whole process, free of charge to that veteran.

[44:14] We don't look for anything in return, we don't put any membership requirements on anything,

[44:19] we will help any veteran.

[44:22] So that's an important distinction that we want to need to make sure through that

[44:27] process, the VFW and their power of attorneys through the veterans that receive VA benefits.

[44:38] Since the start of the federal fiscal year, this past October 1st, I've brought $87 million

[44:45] back directly back into the economy of the Commonwealth of Massachusetts that doesn't

[44:57] that are within Earth.

[45:01] The numbers are a little skewed because some of the south coast does get pulled into the Providence Numbers.

[45:08] But that's fine as long as those veterans are being taken care of.

[45:13] If we extrapolate the numbers, we're looking at 105 million dollars directly into the pockets of veterans.

[45:20] Across the Commonwealth. I wish I was able to break out what comes back directly into the city of Boston.

[45:27] I'm sure it's a very impressive number, but, again, through the VFW and our service officers,

[45:36] that economic impact that we're making is huge, and that does go towards the access of care.

[45:44] If they're secure and financially, they're going to be a little bit more secure, and then

[45:48] seeking the medical help, they feel like they're going to be able to go and seek that help

[45:54] So we get to get better to get that care through, you know, from start to finish.

[46:03] Transitioning to our women's veterans, I've had the, I can't enter the service and I got

[46:10] commissioned in 1991.

[46:13] Over the years, the nature of our military has changed quite drastically.

[46:18] We have women serving in the Air Force and combat equipped with jets and strike fighters.

[46:26] We have women's sailors serving on armed combatantships in the submarines.

[46:35] We have women in the army and the Marine Corps serving in infantry bullets.

[46:40] They're doing the same thing that men are doing.

[46:44] We need to look at, again, embracing overall our women veterans.

[46:50] And we try to do that by, through the VFW, we're encouraging our women veterans that are

[46:56] members to take on leadership positions within our post.

[47:01] So we can uplift their voices to get another different point of view that just the old

[47:10] We have W or American Legion Post of the days of York.

[47:14] And those are thankfully don't exist anymore.

[47:19] As Commander II had mentioned,

[47:21] how she's had experiences where

[47:25] some of these come up to her and didn't recognize her as the veteran.

[47:32] You know, we're trying to make my own personal point

[47:36] if I have a couple come in front of me.

[47:38] I'll start with the woman in front of me and ask her, where did you serve?

[47:45] Oh, great. I serve here. I serve there. Oh, I'm not the veteran. My husband, as well.

[47:52] Still, she's part of the veteran family. And that's important as well.

[47:57] That we embrace, not just the veteran, the service member, but the entire veteran and service members family.

[48:04] because they're serving as well.

[48:05] They're going through hardship just as much as the service

[48:08] a member does as well when they go deployed and do their jobs.

[48:13] So it's very important that, again, we're uplifting our women veterans,

[48:18] making sure their voices are heard, we're expanding the leadership

[48:25] of our service organizations to reflect the true nature

[48:29] and the demographics of our military service.

[48:33] Finally, at the police post, we currently have our first female or woman command post commander

[48:41] at Lisa Viennis.

[48:42] She's a retired or soon to be retired.

[48:45] Boston police sergeant, Army veteran, and she's our post first female commander, and we're

[48:52] excited.

[48:53] She's been a hard charter coming up through the ranks, and we're looking forward to some

[48:57] great opportunities with her through this year and going forward.

[49:02] So there is a changing of the scenery throughout the veteran service organizations.

[49:09] I applaud, I'm commander to it, and our commanders here, that, again, they're taking

[49:16] that leadership role and their voices matter, without their voices, nothing will change

[49:21] when across our service organizations to reflect the true nature of our environment right now.

[49:29] Lastly, I'd like to mention, as a commander to mention,

[49:36] our homeless veterans, they count.

[49:39] They're out there.

[49:41] It doesn't matter that there are part of any of our organizations.

[49:46] They served.

[49:47] They deserve our respect.

[49:48] They deserve our support.

[49:50] The VFW will do everything that we can to make sure that across the board and through

[49:55] partnerships with the Commissioners Sanciago.

[50:00] And his department, that we do look out and look after these veterans. The veterans of farm wars has a national home.

[50:11] I'll meet and wrap its mission here in that. There's been around for over a hundred years, and they help support service members, their families, that are looking for a little, not a handout, but a handout.

[50:24] They can go, they move their family there, they stay rent free, utilities free for a number

[50:30] of years to get back on their feet.

[50:32] So they're able to move on back to their communities that they're looking to join or rejoin.

[50:41] And that might be something that we can look at within the city.

[50:46] There's a lot of opportunities out there.

[50:48] There's a lot of great organizations that are doing incredible things in their own little

[50:54] little their own lands, but again, you look across the table and across the room here, it does

[51:02] take a village to support the veterans community and all of our communities. This is not

[51:09] an individual sport. We can't do it by ourselves. It does take a team and we've got a great

[51:15] team here and I do a pod, the city councilor, I get a council of Flint, council of Murphy,

[51:22] Councillor Fitzgerald, I do appreciate you taking the time on a Friday morning at the end of August

[51:28] as the waning days of summer are closing in on us.

[51:32] I do appreciate that you're all taking the time to listen to us.

[51:36] I would implore that you take the time in your busy days to go visit our posts.

[51:43] Not just when they're having a chicken bag or any type of fundraiser or anything like that.

[51:52] Now, reach out to the posts, go to one of their meetings.

[51:56] That's when you're going to have the one-on-one conversations with our veterans, and you're

[52:01] going to find out really what's on their mind.

[52:04] So, you've got to take that with a grant of thought, you might not want to hear everything

[52:07] that's on their mind, but the veteran is going to be able to give you a true perspective

[52:14] on the ground, what they're dealing with, and it's going to be that one-on-one interaction

[52:20] that is going to really bring it home to you when you're making your deliberations, you're

[52:26] having your discussions and that is not only dealing with veterans but across the city

[52:31] that veterans are a small subset of our society but it's a very diverse and distinctive

[52:41] group that has already dedicated their lives to public service.

[52:45] They raise their right hand, they've served, they've given their blood sweat tears, body parts,

[52:53] and some of them, part of their minds to the defense of our country and the betterment

[52:58] of our society.

[53:00] So, again, thank you for your support, and I look forward to any questions that you might

[53:04] have.

[53:04] Thank you.

[53:05] Thank you, Commander.

[53:07] We have Mr. Kennedy from the Boston Public Health Commission, sir, thank you for being

[53:12] with us and want to give you an opportunity to give an opening statement, again, want to make

[53:19] sure we take the amount of time that you need to make sure that your message gets out because

[53:26] I do know that a lot of veterans watch this program on television and want to give you an

[53:31] opportunity for your opening statement.

[53:32] Mr. Kennedy, thank you for being here.

[53:35] And, excuse me, thank you, Council of Flynn, and, of course, our Council of Murphy and

[53:41] Fitzgerald as well.

[53:42] If I may for just one second, it was a real pleasure to hear from a matter of to it.

[53:48] I worked with her quite a bit in the past while she was at the State Preploria Fox.

[53:52] Okay, yep.

[53:53] So it was just a real pleasure to hear from her.

[53:56] Again, my name is Mark Kennedy.

[53:57] Thank you so much for having me.

[53:59] It's my pleasure and honor to be here.

[54:01] I'm a Senior Program Manager in the Product Disease Prevention and Control Division.

[54:05] at the Boston Public Health Commission.

[54:08] And I'm leading the creation and implementation of the Commission's first

[54:12] current disease and cancer-related detected initiative.

[54:15] The mission of the Boston Public Health Commission is to work in partnership with communities

[54:19] to protect and promote the health and well-being of all Boston residents, especially those

[54:24] that have been impacted by racism or systemic inequities.

[54:28] To put my comments about lung cancer among African-American veterans in that context, let me

[54:33] start by highlighting the city of Boston and the Boston Public Health Commission's first

[54:38] population health equity agenda, which we refer to as lived long and well.

[54:44] The live long and well agenda is about convening partners across sectors to address

[54:48] the three leading costs of premature mortality in Boston, and intended drug overdoses,

[54:54] cardiometabolic disease, and yes preventable cancers, major cancers including

[54:59] Thank you.

[55:00] Long cancer are referred to as preventable because of the screening guidelines associated with them that can help to detect these cancers early when they can be treated with the best chance of survival.

[55:12] Nationally, statewide and in Boston, long cancer is the top cause of cancer related mortality. In Boston, long cancer is the deadliest and most frequently diagnosed fatal cancer for both men and women.

[55:26] For black men, I'm sorry, lung cancer causes more death than breast, colorectal and prostate cancers combined.

[55:37] Overall, when you look at trend data, mortality from lung cancer has trended downward, but of course not for everyone.

[55:44] Massachusetts is near the top nationally for early diagnosis, surgical treatment, and overall survivorship.

[55:51] But total incidents, which includes new cases, is higher than a natural average.

[55:57] There's could be due to increased cleaning, but new cases are not necessarily cases

[56:01] where the cancer was diagnosed with.

[56:05] Wilkinson to track local data on agent-stated diagnosis to quantify that finally more new cases early

[56:12] leads to less mortality.

[56:15] Meanwhile, Boston's Black population has a low incidence of lung cancer than a natural average,

[56:21] nationally, black individuals with lung cancer with 13% less likely to be diagnosed early.

[56:28] There were 19% less likely to receive surgical treatment, 11% more likely to not receive any treatment,

[56:35] and 13% less likely to survive 5 years when you compare up to white individuals.

[56:42] All that said, lung cancer is the leading cause of cancer-related death among U.S. veterans.

[56:48] Veterans have a higher rate of lung cancer in a lower rate of survival than the general population.

[56:54] African American veterans face higher risk to the military related exposures like

[56:59] his best dose. According to the U.S. Department of Veterans Affairs, veterans have a 25-76% higher risk

[57:07] of lung cancer, and his best dose of exposure remains a significant tribute to this elevated risk,

[57:13] which exacerbates risk for black men.

[57:18] African American veterans experience disparities in diagnosis, treatment, and survivor race

[57:23] compared to other groups.

[57:26] The U.S. Department of Veterans Affairs,

[57:28] diagnosis, and treats approximately 8,000 veterans for lung cancer each year.

[57:34] Veterans have a higher risk for lung cancer due to the overage,

[57:37] smoking, and environmental exposures during an African military service.

[57:41] smoking is the primary cause of lung cancer, with many veterans supporting that they started using tobacco after entering military service.

[57:50] Explosive to rate on gas is the second leading cause.

[57:54] I want you to note here, if you would, that in addition to these risk factors that contribute to incidents,

[58:00] not getting scream is also a significant risk factor, and that contributes to mortality,

[58:05] because for lung cancer, in any other cancer, catching and treated it early, exponentially

[58:12] increase the survivorship.

[58:15] Systemically, black veterans have lower odds of completing a lung cancer screen than white

[58:19] veterans, particularly due to loss between referral and the connection with screening programs.

[58:25] Let me conclude by saying this.

[58:27] For lung cancer, veterans and the general population would benefit tremendously from changes

[58:33] to the screening guidelines that would further expand access to screening.

[58:37] In 2021, the U.S. Development Service does task force,

[58:41] expanded access to lung cancer screening to catch lung cancer earlier in higher risk groups,

[58:47] particularly women, as well as black adults who often develop lung cancer with lower smoking

[58:52] exposure. The task force, the task force I'm sorry, expanded access by lowering the starting

[59:02] The history requirement from 30 pack use the year to 20 pack use a year, I'm sorry.

[59:08] You do still have to be a current smoker or have quit within the past 15 years to be eligible.

[59:13] In 2023, the American Cancer Society went further and eliminated 15 years since quit criteria.

[59:21] But long cancer screening is still tied strictly to tobacco use.

[59:26] For veterans who are exposed to rate on and or asbestos, for individuals who work in

[59:31] like a patient, such as firefighter, construction, hair salons, et cetera, for general public

[59:39] city dwellers that are exposed to elevated levels of automobile exhaust and other environmental

[59:43] carcinogens on a daily basis, long cancer screening, eligibility needs to be expanded beyond

[59:49] just tobacco use.

[59:52] Also, systemic changes need be made so the veterans who are preferred to, or for the screening

[59:57] don't fall through the cracks.

[59:59] And that could be...

[1:00:00] And again, thank you for allowing me an opportunity to speak, and I look forward to any questions that you might have.

[1:00:06] Thank you, Mr. Kennedy. We have what the smell Dr. Whitley, who's also a veteran in a member of the American Legion Post.

[1:00:15] Thank you, thank you, Councillor Flynn, Murphy, and it's general.

[1:00:19] I didn't write anything because one of the things that happened to me yesterday was I attended a debate.

[1:00:32] And my question was, what laws or what funding would you implement behind the Nile cases, the Nile amongst black women?

[1:00:46] And that question wasn't quite answered.

[1:00:50] So then I thought about when, then I thought about when Councilor Murphy was, she was campaigned

[1:01:00] for her, you know, to come be, to come a city council at large, and I stopped her, she was in

[1:01:07] high park, and I was having this trouble with my claims, and I said to her, what would

[1:01:13] I need a five to six, oh, nine, nine, five, and it's just like, give me your number, and

[1:01:18] then I have someone call me a VSO to walk me through those claims.

[1:01:24] But I started to think about when I wrote my dissertation, and why I became a doctor of education.

[1:01:33] So one of the things that I noticed and I started to study black women, so that made

[1:01:37] it, you know, kind of limited to black women veterans.

[1:01:40] I wanted things I thought about years ago because I just retired June 1st, I spent many years

[1:01:51] of the military.

[1:01:53] I had trouble navigating the system and so I am happy with the statistics, the long

[1:02:04] cancer, the NST, but when I

[1:02:09] would press the participants for my study at over 70

[1:02:16] black women that, and at 10 participants, the data was saturated.

[1:02:23] And one of the things they said to me, and, you know, we talked about the B.A.

[1:02:28] And how great the health care was, and women, the women trauma center, they said,

[1:02:33] How do I get there?

[1:02:38] How do I navigate?

[1:02:42] So, with the programs and all the great things that we have,

[1:02:47] how do we get our women black women back to go for screening?

[1:02:52] If it's a high number of denial for claims.

[1:02:57] Maybe not the fault of themselves.

[1:03:00] Maybe they just don't know how to write the claims

[1:03:02] So maybe help with the claims that maybe they missed a part

[1:03:05] after a year the claim closes.

[1:03:09] So I think about, in the community,

[1:03:14] we need to implement

[1:03:17] of if we're at the post that someone can walk in and say,

[1:03:21] how do I do, how do I complete a claim?

[1:03:24] If I'm able to walk into the minutes of building

[1:03:27] in high park, how do I complete a claim as a vet?

[1:03:30] So one of the things that I want to say is that if I was watching it, and I was just started a military,

[1:03:39] or MST a trauma happened to me because I served 30 years ago.

[1:03:45] How would I navigate through this?

[1:03:48] So I oftentimes think about that word to navigate through the system.

[1:03:53] And that was my dissertation on black women veteran navigating the mental health system after trauma.

[1:04:03] So, you know, I think, I think you guys are all for the statistics.

[1:04:08] But I think that we need to focus on how do we get them into the VA?

[1:04:15] What do we do on a city level?

[1:04:18] What do we do on a community level?

[1:04:21] to bring them in. What if we want to talk, you know, what if we want to say, hey, I want

[1:04:27] to do a claim, would it go? If they'd never been to the VA, or maybe deny for the VA?

[1:04:36] Thank you, Dr. important recommendations. I know we'll be discussing them in a couple of

[1:04:43] minutes. Thank you for bringing that information forward. Thank you for your service.

[1:04:53] Dr.

[1:04:53] VA, a Center for Health, Optimization, and Implementation Research.

[1:05:00] Dr. Yarrup. Thank you so much. Good morning, everyone, and thank you to the council for the opportunity to participate today and such an important hearing.

[1:05:11] I want to also thank the veterans who are present for your service to the country.

[1:05:18] My name is Renda Weiner, and as I've already mentioned, I'm a pulmonary physician and a researcher at the VA Boston Health Care System.

[1:05:25] And it's been my great honor and privilege to take care of veterans with long conditions for more than 20 years, including lung cancer.

[1:05:34] And to engage in research, to try to address some of the issues that we're talking about today.

[1:05:39] How do we improve veteran health? How do we improve access to care and improve equity?

[1:05:48] In addition to my roles as a physician and researcher, I also am the Deputy Chief Consultant

[1:05:54] for the National Center for lung cancer screening for the Veteran's Health Administration.

[1:05:59] And I'm a professor of medicine at the Boston University, Chobanean, and at Appadizian School

[1:06:04] of Medicine have also been a physician at Boston Medical Center.

[1:06:09] So I'm speaking from those various perspectives, but I do need to also disclose that the

[1:06:16] perspectives I'll share in this hearing are my own views and don't necessarily represent

[1:06:21] the positions or policy of the Department of Veterans Affairs or US government.

[1:06:26] So I'm here today because Veterans in our city, especially Black Veterans, are dying from

[1:06:32] lung cancer and many of these are needless deaths.

[1:06:35] We are so fortunate that the Greater Boston area is home to some of the most active lung

[1:06:41] cancer screening programs in the country, including at the Boston VA, and if we were

[1:06:46] reaching more veterans for screening, we could be saving more lives.

[1:06:51] We've heard that lung cancer is a critical issue facing veterans, and that 8,000 veterans

[1:06:57] are diagnosed with lung cancer every year, and just take a moment to think about that and

[1:07:03] how many families are affected by this disease.

[1:07:07] You've also heard that veterans have higher rates of lung cancer than others in the U.S.

[1:07:12] population due to military exposures among other issues.

[1:07:18] But perhaps more dire still is this, so I testified before this Council about a year and a half ago.

[1:07:25] And during that time, approximately 7,500 veterans in this country have died from lung cancer.

[1:07:31] It's an average of 15 veterans every single day.

[1:07:36] In fact, lung cancer is far in a way,

[1:07:39] the leading cause of cancer deaths among veterans.

[1:07:42] But again, many of those deaths could have been prevented.

[1:07:46] Catching cancer early, when it's still treatable,

[1:07:49] is critical to improving lung cancer outcomes.

[1:07:53] Early detection through lung cancer screening,

[1:07:55] followed by timely treatment,

[1:07:57] represents our best hope to improve outcomes

[1:08:00] for veterans and others at risk of lung cancer.

[1:08:04] Lung cancer screening means getting a simple cat scan of the chest takes just a few minutes,

[1:08:08] it's painless, and having a screening cat scan every year can reduce lung cancer deaths

[1:08:13] by 20%.

[1:08:17] One of the hard truths we've already begun to hear about is that black veterans and black

[1:08:21] men, nationwide, die of lung cancer more often than any other group in the U.S. population.

[1:08:28] Many developed lung cancer at a younger age and with a lower smoking history than white Americans.

[1:08:34] And why is that?

[1:08:36] It's because they don't often know that screening is an option or how to access it, as you alluded to.

[1:08:43] And then they experience delays and gaps in every step of the pathway from diagnosis through treatment,

[1:08:49] and are less likely to get the best, most effective treatments for lung cancer.

[1:08:55] The good news is that the VA system breaks this pattern.

[1:08:59] When black veterans get care through the VA, their lung cancer survival is the same as

[1:09:04] white veterans.

[1:09:06] VA lung cancer screening rates early cancer detection rates and survival rates are equal

[1:09:11] or better across the board than those outside of the VA system.

[1:09:15] And the difference here isn't biology, it's access to timely equitable health care.

[1:09:20] And we're fortunate that within the VI system, the I Boston's lung cancer screening program is one of the leaders in the nation.

[1:09:29] 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 life-saving test.

[1:09:40] In tax, 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.

[1:09:49] So let me just take a minute to raise awareness on some key facts.

[1:09:53] Guidelines recommend lung cancer screening for people ages 50 to 80 years old with a

[1:09:58] significant smoking history.

[1:10:00] 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 copays for people who qualify.

[1:10:10] But sharing information at meetings like this isn't enough.

[1:10:14] 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.

[1:10:24] And we're doing this work right now here in Boston.

[1:10:28] So first, the vet peer connects study.

[1:10:31] Last year we partnered with Black Veterans

[1:10:33] and community groups like NavVeds,

[1:10:35] the National Association for Black Veterans,

[1:10:37] and the Triad Veterans League,

[1:10:39] led by Boston's own Haywood Finale,

[1:10:41] to co-design a community outreach program

[1:10:43] by Black Veterans for Black Veterans.

[1:10:46] We partnered, actually, with many people here today,

[1:10:51] We partnered with the office of veteran services from the city and the Commonwealth and veteran organizations, including the VFW and American Legion, including specifically the VFW Post 1018 and the Carter Post.

[1:11:10] So thank you again for your support and partnership.

[1:11:15] So we partnered with those groups to hold community events around Greater Boston trying to reach veterans

[1:11:21] where they are and help get them connected to lung cancer screening.

[1:11:28] So we're now building on what we learned and vet here connects to create a sustainable program with Greater Reach.

[1:11:34] We launched a new website and social media campaign developed together with veterans to share their stories about screening.

[1:11:40] And we're creating a toolkit for veteran organizations to use with their own members.

[1:11:47] We're also leading a precision screening trial across 28 VA medical centers, including VA Boston.

[1:11:55] That's designed to engage veterans who have the highest benefit from screening that haven't yet been reached,

[1:12:00] and many of these are Black veterans.

[1:12:04] And finally, we're kicking off a project to connect veterans who have a history of toxic military exposures

[1:12:11] to the whole health wellbeing services at the VA and also connecting them to clinical trials

[1:12:18] that will help better understand the relationship between military exposures and lung cancer

[1:12:24] and what the role of screening might be for those veterans.

[1:12:29] And these things are working.

[1:12:31] One veteran at a time, people are talking to their doctors, getting screened,

[1:12:35] Regaining trust in the VA and accessing the healthcare that they earned and deserve, I want

[1:12:42] to acknowledge and thank the many veterans community partners and VA staff who've helped

[1:12:46] make this series of studies a success, as well as the support of the city and the Commonwealth.

[1:12:52] Most importantly, I want to thank the men and women veterans who inspire our team every day,

[1:12:57] but there is still more work to do, and we need the council and all of your help in these efforts.

[1:13:04] First, we hope you'll help us to continue to build on this momentum.

[1:13:09] The approaches that we've developed are resonating with Boston veterans, and let's continue

[1:13:13] to sustain these partnerships and the trust that we've built with veterans and community

[1:13:17] organizations.

[1:13:19] Second, please help us to continue to get the word out, partner with us to amplify screening

[1:13:24] awareness through the city's mini-channels and resources, and then also as individuals

[1:13:29] tell other veterans about lung cancer screening.

[1:13:33] These one-on-one interactions are incredibly powerful

[1:13:36] and could help save a veteran's life.

[1:13:39] I can't think of a more important goal

[1:13:41] than getting veterans the screening

[1:13:43] and the healthcare that they earned and deserve,

[1:13:46] especially black veterans and women veterans,

[1:13:49] who have been left behind.

[1:13:51] That's not just my mission as a doctor.

[1:13:53] I really believe that for all of us,

[1:13:55] improving equity is a value we all share.

[1:13:57] And I'm honored to fight for that and hope you'll continue to work with us to achieve that goal.

[1:14:04] Thank you, Dr. Thank you for being here. Thank you for the important work you were doing.

[1:14:09] Before I go to my colleagues to ask questions, I do want to go to public testimony.

[1:14:17] And if there is anyone here, I know my friend Donald Mitchell is here.

[1:14:24] I believe he's in here for his veteran.

[1:14:26] I want to give him the opportunity to speak and to testify.

[1:14:32] Usually, Donald, you've got two or three minutes,

[1:14:36] but I don't cut off any veteran of that.

[1:14:38] I don't care.

[1:14:39] The veteran can speak as long as they want you've earned it.

[1:14:42] I also want to acknowledge our friend that is not here.

[1:14:46] I know he then mentioned Hayward Finale,

[1:14:49] a wonderful advocate in the city for veterans,

[1:14:53] military family's veterans of cover, but Donald's will love to hear your testimony.

[1:14:58] My name is Donald Mitchell, I'm the lead.

[1:15:00] Presidency or Dawn Foundation, which is a non-profit, and it helps veterans to, with the resources

[1:15:09] that they need to get housing,

[1:15:15] furniture,

[1:15:17] servications that help them get jobs in the industry.

[1:15:21] Key problem with veterans of people who are homeless is the fact that when they come out of

[1:15:28] or the outside of the field, they don't have the housing in the public, which is key for this operation.

[1:15:39] We help them, our organization will help them out find these resources to pay for some of these things that they need.

[1:15:49] I'm friends with my brother here, Robert here.

[1:15:55] We go back and forth here.

[1:15:57] Custom friend, we just had a round table,

[1:16:00] a written round table, an office of 11.

[1:16:03] Getting ready for a stand-down settlement 11.

[1:16:07] So we could do food, more resource and research on what

[1:16:12] the breakfast needs, and what they can place in their

[1:16:16] decisions, we just sent to the narrative, we just sent a gentleman named Brian Mullen to one

[1:16:26] of the partners that we met at the round table, and he's been assisted because he's had

[1:16:34] multiple situations and he's had problems.

[1:16:37] So, our goal is to help our veterans out.

[1:16:43] I've been a veteran of Air Force here, also I'm not retired,

[1:16:52] a local for operator, and also worked in Air Force

[1:16:58] to civil engineering construction.

[1:17:02] So, the construction part of me is the other part

[1:17:06] of our companies called Donald Mitch and the soldiers LLC,

[1:17:11] which helps define employment for those people

[1:17:14] who work in a who needs employment.

[1:17:17] So we'll be working, dealing with trying to find

[1:17:20] these resources that are things for our veterans who are near.

[1:17:25] I'm aware of the government's land in San Diego.

[1:17:34] I'm just going to get involved.

[1:17:35] I think I know Mr. Kennedy was a little bit

[1:17:40] contact you and a future to try to figure out how we can further help our victims on out.

[1:17:48] Thank you, Donald. Thank you for being here. Thank you for your testimony and thank you for your

[1:17:54] commitment to supporting veterans across across all of Commonwealth. I'm going to go to my colleagues

[1:18:03] I'm going to start with Council Murphy, then go to Council of Australia. I'm going to give each

[1:18:08] Councilor, maybe 10 minutes to ask questions.

[1:18:12] I know there's a lot of people on the panel that might want to weigh in too.

[1:18:17] So if the Council goes over 10 minutes, that's fine.

[1:18:21] We'll just continue the conversation.

[1:18:23] Council Murphy, you're up.

[1:18:25] Thank you.

[1:18:26] Thank you for your testimony, everyone.

[1:18:30] One of the things I kept hearing from all of you is the screening.

[1:18:35] And the statistics are trending in a good way.

[1:18:39] We are fortunate to live here where we have such great health care,

[1:18:43] but at the same time, even though nationally, our numbers may look good

[1:18:46] when we zone in on Boston, the state, specifically that we're still seeing

[1:18:54] that more black women and men are just not getting the care they need.

[1:18:59] So how do we make sure that, because without the screening,

[1:19:03] they're not going to get the support, the health support they need.

[1:19:08] So what should we do, what can we do, not just as a council, just as a city to make sure

[1:19:15] and as a medical doctor, like do you do enough?

[1:19:22] Do you think to make sure that you don't have to ask for it, right?

[1:19:26] If a doctor knows, well, you were in the Navy, we know you were on the ship.

[1:19:30] you were in the military, you probably were exposed,

[1:19:33] because many times people aren't aware

[1:19:36] to even ask for the help.

[1:19:38] And obviously you've said it yourself

[1:19:39] and others saying that too.

[1:19:41] So what can we do from the medical side,

[1:19:44] but also all of you who are advocating

[1:19:47] and working alongside our veterans every day?

[1:19:55] I'll say from the medical standpoint,

[1:19:58] at the VA, we have

[1:20:00] Of implemented systems to help doctors on the front line identify when the veterans that they're seeing are eligible for long cancer screening and flag them to remind them to make sure that they offer it.

[1:20:15] And I know that's the case in many healthcare settings outside of the VA as well.

[1:20:21] That said, especially primary care clinicians who are handling so many issues in a brief

[1:20:32] visit, sometimes they don't get to it.

[1:20:35] So I think it is also important to raise awareness among the public about lung cancer

[1:20:44] screening and empower folks to ask their doctors about it.

[1:20:50] most insurance not covered if you don't qualify because when you say

[1:20:55] qualified with the doctor have to kind of say you you smoke or there's reasons to

[1:20:59] believe it it wouldn't automatically be covered if a doctor refer to.

[1:21:05] So insurance companies do cover for people who meet USPS TF eligibility criteria

[1:21:12] and there's no charge for that that's inside outside the VA system. But as

[1:21:18] Mr. Kennedy alluded to those criteria don't catch everybody who could benefit from screening.

[1:21:26] That's one of the things that we are studying and that trial that I mentioned.

[1:21:30] We are doing precision approaches to predict who would benefit from screening, including

[1:21:37] people who fall outside of the U.S. preventive services task force criteria and offering

[1:21:42] screening to those veterans. That's a clinical trial, so it's not, you know, for everybody

[1:21:49] but hopefully we will be able to reach veterans in VA Boston as well as the 27 other VA sites

[1:21:57] that are participating in that trial.

[1:22:04] I don't have any other really specific questions other than, you know, what was said,

[1:22:10] people just don't always know that there are services out there and how do we connect them.

[1:22:14] And it's never at a loss of hard work and advocacy from York Commission.

[1:22:20] It happens, I think, for every department across the city, we often hear like,

[1:22:24] well, how do I get that fit?

[1:22:25] Who should I have called or?

[1:22:28] So, is there some sort of like ad or campaign or support thinking of the city level?

[1:22:37] How to support our veterans and advocate that way?

[1:22:44] I think one of the greatest way that we could collectively, as a city, do it, is through

[1:22:50] a continued partnership with the Boston Health Commission with H. Drong, with the Office

[1:22:56] of Neighborhood Services.

[1:22:57] So basically, pretty much the village here in the city of Boston municipality to get together

[1:23:03] when we do go out into a community and talk to not just our veterans, but our veterans,

[1:23:07] families, our community members, our community leaders, is just the biggest thing that sometimes

[1:23:12] I see is that they see one of our events that is just for veterans, but it's open to everybody.

[1:23:19] It's open to the whole community.

[1:23:21] It's open to even to somebody who may not even live in Boston, who could just be in the

[1:23:25] area to come by and go to the fair and explore that we had at court in part this past weekend

[1:23:30] and see what's available to our veterans.

[1:23:32] See what's available to the community as well and that's information that they could pass

[1:23:36] on to someone who they may know, who's a veteran or someone who they may know is a son

[1:23:41] of a veteran or a daughter of a veteran, so all these events, all these communications that

[1:23:48] we may have or leaflets, they, while from my office, they may be geared to a veterans,

[1:23:53] but actually, therefore everybody, because everyone should know a veteran or know somebody

[1:23:58] who knows a veteran as a person in the family who is a veteran, they could pass that information

[1:24:02] onto you.

[1:24:03] So, you know, what I implore people who may be listening or who may be watching to understand

[1:24:08] is that reading these informations come to our events via part of our event because it is

[1:24:16] for the benefit of the whole community. And part of that community is our veterans because

[1:24:22] veterans do cover all demographics here in the city of Boston and we are all in all communities.

[1:24:26] So I think that communicating this to everyone in the city and beyond is very important.

[1:24:33] I think the one of the things that we must do is the sake God, the misclasses that comes

[1:24:43] into the veterans' budget will be cut all sorts of ways and way of all sorts of ways.

[1:24:53] We need to help them find them to do their research.

[1:24:57] The posties wanted to do what they had to do.

[1:25:00] Mental Health System, which we need from the front and the dual decision for the big, if different agencies.

[1:25:06] It's included in our federal government doing all these cuts and everything all the way, we need to say God, our funding that goes into our metrics.

[1:25:13] to make sure these issues get the resources that they need to do with the work that they need to do.

[1:25:19] Thank you.

[1:25:20] I was going to mention that too when we were going through the budget cycle, the fight

[1:25:24] department, who many of the members are veterans, did not receive that $1.2 million grant

[1:25:31] and many much of that grant was directly related to screening and healthcare support.

[1:25:37] So it is important.

[1:25:38] And if we see that we're losing federal state grants, like how do we on the council shift?

[1:25:43] I know that we were closely with your department

[1:25:45] to make sure we're not losing any money.

[1:25:47] And if anyway, we can add more to your department,

[1:25:50] but thank you just all for being here and advocating

[1:25:54] and just know I'm the support and resource anyway.

[1:25:58] I can help more than I am.

[1:26:00] I love to do thank you.

[1:26:01] Thank you council Murphy.

[1:26:04] At this time, I'm gonna go to council of Fitzgerald.

[1:26:08] Council of Fitzgerald, you have 10 minutes.

[1:26:11] Thank you, Jeff. I appreciate it.

[1:26:15] So, thank you all for the testimony.

[1:26:18] I was sort of listening to everybody.

[1:26:19] I was writing down, you know, the data is the data, right?

[1:26:23] And so, we know that what we're focusing on here today is an issue

[1:26:27] and that's not being told that that is being told by boots on the ground

[1:26:30] but also through the data that we're collecting.

[1:26:32] And so, I was trying to think of, you know,

[1:26:34] what is the number one source of why this discrepancy exists?

[1:26:40] I'll refer to lung cancer at the moment among black veterans.

[1:26:44] And, you know, I said it right now, a list of what I think could have, right?

[1:26:47] And I'm no doctor, so you guys, please, this is why you guys are here, right?

[1:26:50] But I was like, there's either genetics.

[1:26:53] There's education and awareness about it.

[1:26:56] There is the insurance.

[1:26:58] There is your personal lifestyle that can affect it.

[1:27:00] There's the work life style, such as where you might have served.

[1:27:04] And I added navigating the system in, because from what I heard from this panel,

[1:27:08] to is that just navigating the system.

[1:27:12] Like, of all the things, what do we think of that sort of list might be, like, if we were to

[1:27:17] hone in on what would have the biggest impact, and there may be others that I could add to this

[1:27:22] list.

[1:27:23] But what would be the area that we would say is it, you know, hey, if we corrected insurance,

[1:27:30] a lot more people would be covered and we could identify more early, or is it, hey, is

[1:27:35] it the education awareness and getting, and I know it's a mixture of all, right?

[1:27:38] But what I'm asking is if we would have prioritized it, right, you can't do much about genetics.

[1:27:45] You know, the work lives that's already occurred right in black veterans.

[1:27:49] And so how do we know where we can place people in the future, sure it might help future generations.

[1:27:55] But that just knowing where they are and making sure certain benefits are available to them.

[1:28:01] And then helping navigate the system, I think that's in any sort of large,

[1:28:07] You know, heavy paperwork, type of setting, I mean,

[1:28:11] e-caronshare and health insurance, whatever it may be, right?

[1:28:13] I think we all have trouble nodding,

[1:28:15] people walk into this building and the first thing

[1:28:17] they usually say is, I'm, you know,

[1:28:20] to help me navigate City Hall, where do I go?

[1:28:22] Right, who do I talk to for this issue?

[1:28:24] So, I think that's important one.

[1:28:27] But just trying to hold it because I feel like

[1:28:29] if you extrapolated outside of veterans

[1:28:31] to that the data probably correlates, right?

[1:28:34] that lung cancer among black individuals is also probably higher than white counterparts.

[1:28:40] And so that's what got me thinking to the other things of like, well, if we help one, we can help the veterans.

[1:28:46] If we help the larger continuum, then we can help the veterans.

[1:28:49] But at the same time, what can we learn from helping the veterans that can educate us,

[1:28:53] that we can bring it out to the larger continuum, right?

[1:28:57] A lot of you guys spoke on this, but I guess what I'm sort of is wondering,

[1:29:02] is if we were to hone in, right, because government gets pulled in a lot of different ways

[1:29:06] and we'd love to hone in on every single one of these, but that would be all day every

[1:29:11] day and there's a lot of other people asking for our help. If we could hone in, what would

[1:29:15] you think would be the best parameter to sort of say, let's solve this one. Let's solve education

[1:29:23] awareness and put the money towards that and put our effort towards that. Let's tackle insurance

[1:29:28] and make sure, I think, in turn, it's as a sham anyway, I don't know how you get, you

[1:29:31] guys are the doctors, but just from a guy on the outside, the ladies person, I think that's

[1:29:36] the biggest thing we got to tackle next. But, you know, is it making sure the system is more

[1:29:40] streamlined or at least more, you know, that you can work with it easier to understand? I don't know.

[1:29:48] So, I put that all to you guys and say, if you had to prioritize, what would you think would be

[1:29:53] the most impactful one to attack.

[1:29:59] And we can all this.

[1:30:00] I'm sort of just wondering from personal point of view. There is no right answer.

[1:30:05] I'll guess I'll start concert. Thank you for your question and bringing that up. It's everything you mentioned.

[1:30:13] It's a little bit of everything, but I think part of it has to do also, which we alluded to and incidentally myself.

[1:30:20] And Craig here before we even came to the council hearing, we're having a cup of coffee and talked about it.

[1:30:25] talk about, you know, what is the underlying reason why the cancer rates are so much higher

[1:30:31] in the Black Veterans community and also in the minority community as a whole.

[1:30:37] And we can speak on that from our experience as a veterans, a lot of it has to do with whatever

[1:30:42] their job duties or collateral duties were given to the Black Veterans in service.

[1:30:48] I could speak on on my experiences as a Navy veteran where, you know, a lot of minority veterans of

[1:30:57] America sailors like myself, we were told to go sandblast a void on a ship, you know,

[1:31:03] or we were working in an engine room pretty much what Craig had mentioned earlier in his testimony.

[1:31:10] So, you know, so a lot of the, and I'm not saying that that's the reason why the racers are so high,

[1:31:15] I'm just speaking again on my experiences and from what I've seen and talking to other veterans as well.

[1:31:21] That could also be an underlying reason why those numbers may be high is because of also the duties that we were given while we were in service.

[1:31:30] Now, add that to the fact that we're no longer in service and now we're veterans navigating the system, knowing the system, knowing what is not to for us.

[1:31:40] And, like, Dr. Wyner had mentioned in her testimony, the VA, they're doing a great job in trying

[1:31:46] to get the word out there, but one is not enough to, there's always work to be done.

[1:31:53] And so, I guess the educational piece, and again, trying to let everybody know that the lung cancer

[1:32:00] screenings are there for veterans, for pretty much anybody.

[1:32:04] The city of Boston also has a policy for lung cancer screening amongst municipal workers,

[1:32:09] you know, go to contact your CBA and see what those may be.

[1:32:14] But I think, as far as veterans are concerned,

[1:32:17] the education piece is huge, getting to those veterans

[1:32:23] and Malika had mentioned that Dr. William mentioned

[1:32:26] in her testimony when these service members become veterans.

[1:32:31] You know, what is the Department of Defense doing

[1:32:35] when service members are transitioning

[1:32:36] into becoming veterans that come back into our communities

[1:32:39] are re-reaching them in a timely fashion.

[1:32:43] Once they come out, I know that the state does what they can to notify us,

[1:32:48] municipalities, us, veteran services offices, throughout the state to let us know

[1:32:52] who in our community is returning from service and in reaching them and letting them know

[1:32:58] and also being able to be and ask that to them when they transition and

[1:33:02] integrate back into the system, back into their communities as well.

[1:33:06] So it's really not something that it's going to be taken care of immediately, but it's something

[1:33:15] that we're going to be able, that we have to continue the conversation on amongst our

[1:33:19] groups, amongst advocacy groups, amongst the VFWs, the DAVs, the American legions,

[1:33:25] you know, Dan and his organization, Haywood and his organization, and pretty much all the

[1:33:31] organization and the communities as well. And it also takes the council as well that, you know,

[1:33:37] if and when you also go out into the community, bring it up, you know, what councilor Fitzgerald,

[1:33:41] you know, if you're running your community like, you know, I was at a hearing about veterans,

[1:33:45] and we talked about lung cancer here, you know, lung cancer amongst veterans. This is lots of

[1:33:50] available. So, you know, just spreading the word out there, whenever we go on to the community, just

[1:33:54] bring it up, even if the subject matter may not be about veterans, I always bring a veteran. Why

[1:33:58] because I am a veteran, you know, why not, but you know, but you know, make it part of the conversation,

[1:34:05] make it part of the community conversation about veterans, you know, about lung cancer screening,

[1:34:10] about women veterans, you know, right now there's close to, I believe, 940,000 women that are

[1:34:17] enrolled in the VA, but there's 2.1 million women veterans that we know, so, you know, those numbers

[1:34:23] need to go up as well, so women veterans could also get the care that they need in the VA system.

[1:34:28] because it's there for them.

[1:34:31] How many of them actually went to the VA to get that care?

[1:34:33] Or is it the trust thing as well?

[1:34:35] Are we talking about trust?

[1:34:36] They just don't trust the system to help them out.

[1:34:38] Just the same thing with black veterans,

[1:34:40] just same thing with minority veterans.

[1:34:42] There's been that stigma for many, many years

[1:34:44] that the VA is not there to help them.

[1:34:46] It could be the trust thing that we need to break through as well.

[1:34:48] There's a lot of, it's a big web that we're weaving here

[1:34:55] that we need to go through and break through.

[1:34:57] But I think that what it all comes down to.

[1:35:00] The word communication, 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 damn VA we have in this country.

[1:35:13] 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 non-profits like home base that's located here through the MGH as well.

[1:35:23] So, you know, all those partnerships getting together and communicating that, hey, we're here for you and we're going to make sure that you get what you deserve.

[1:35:32] That's excellent.

[1:35:33] Thank you very much.

[1:35:34] I appreciate it.

[1:35:34] But it's right.

[1:35:35] Education from our point of view of what accounts of the new educational awareness is where we should tackle.

[1:35:42] I don't know if anyone else, don't have to.

[1:35:44] If anyone else would like to chime in, I have other questions as well.

[1:35:54] Thank you for the question.

[1:35:59] I'm going to say, from my particular lane,

[1:36:02] because everybody here is bringing

[1:36:04] whether it's an experiential or a professional perspective

[1:36:07] into this.

[1:36:08] Again, as I said in my introduction,

[1:36:11] my focus is on early detection

[1:36:14] of, in this particular case, of course, lucky.

[1:36:18] I've never had long cancer, I'm not a veteran, I've never smoked, I listened to your list of the things that could be causing this.

[1:36:29] Genetics was the first thing you said I don't know if it was any particular order.

[1:36:32] No, particularly.

[1:36:33] I would say that family history or other Genetics or issues in a lot of cancers, I think the biggest issue for long cancer is exposure.

[1:36:42] particularly with backgrounds, because we all have said in various ways in shapes and forms.

[1:36:47] People didn't draw a smoking until they entered military service, or some other type of

[1:36:51] position that put them in an exposure situation to something other than tobacco.

[1:36:56] A lot of that is towards driving one cancer rates up in a particular photo for a black veterans.

[1:37:02] To answer your question, my single word again from my laying basically goes right back to the guidance.

[1:37:09] And let me just put some context around that.

[1:37:10] What we do at the Boston Public Health Commission, at least in terms of my job, because I don't provide any direct service.

[1:37:18] I don't actually do the swimming.

[1:37:20] What I basically do in my role is to communicate about the swimming.

[1:37:25] But I always tell myself, I am doing a disservice to the public.

[1:37:31] If I don't go into that job, acknowledging that there is a balance.

[1:37:36] there's two-dimensional chest being plucked here because I have to communicate something that

[1:37:42] provides a call to action to the public, but when they get into the medical system, the doctor

[1:37:48] has to do what I want them to do when the patient shows up, right? If the doctor is not going to

[1:37:55] do that, why should I tell people to go have it done if they can't actually get it done? The guideline

[1:38:02] I'm trying to talk about here, it 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.

[1:38:31] Okay?

[1:38:32] particularly group. Again, the other context I'll add is, I'm with the Boston Public Health Commission.

[1:38:38] But what we're talking about here is population health. It's a segment of our population,

[1:38:44] I.E. veterans, that are experiencing lung cancer differently than a general public.

[1:38:49] What can we hone in on and focus on with that?

[1:38:53] You talk about, we've heard the tremendous work that the VA hospital is doing here,

[1:38:58] which is different, unique and better than what's happening across the country.

[1:39:01] Yeah.

[1:39:02] My hope is that there's an opportunity with local legislation engaging local payers and

[1:39:09] a strong medical and clinical institution like the VA hospital to say, let's set the

[1:39:15] tone for the rest of the country for how to get this right.

[1:39:19] Because we now can basically create a local closed loop that says what we do is we screen

[1:39:27] people not just for tobacco use, but for exposure to the things that we asked them to do

[1:39:33] in the context of the military service.

[1:39:36] Get payers on board, open up lung cancer screening to people that actually need it, not

[1:39:43] just smokers.

[1:39:45] Look at the financial benefits of that over a period of time, look at the outcomes benefits

[1:39:51] which is reduced mortality, over a period of time, presents the circumference they look.

[1:39:56] We are getting it right in Massachusetts, you could be doing

[1:40:00] More in every war 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.

[1:40:11] 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-related detection for other canters and other areas in a way that it informs,

[1:40:29] the whole system. I think we've got a unique opportunity here and I think the city council, local clinicians, advocates like myself, communicators like myself, can really get on board and put a plan together.

[1:40:42] Well, this one Boston does lead the way, so I hope we can do that on that.

[1:40:46] I know some other folks wanted to potentially chime in.

[1:40:49] So, no, just quickly, it's not my fault.

[1:40:52] Yes.

[1:40:54] One of the things about veterans that's

[1:40:56] we look for community organizations because of

[1:40:59] brother and sisterhood.

[1:41:01] And we also lean on our faith-based churches.

[1:41:05] So, if we're talking about education,

[1:41:09] and, you know, how would we employ that education?

[1:41:10] How will we get veterans and the door?

[1:41:13] And, you know, the VA is a great system.

[1:41:15] And we have great screening.

[1:41:16] But at a point, we need to get that student door into those screenings.

[1:41:22] And then how do we do that?

[1:41:24] Any time that we are opening up something in Boston, I think that any community organization

[1:41:30] that that are attached to whether it's the YMCA over the regular day local communities system,

[1:41:37] local community like Hall or the Post, all of that needs to be filtered down.

[1:41:43] So, if I'm walking into any community place that I'd love to visit, I should be able to know that this is free screening.

[1:41:54] Because we can offer it.

[1:41:56] But the education part of it, how do we get them to do it?

[1:41:59] How do you get us to the door?

[1:42:01] Because you couldn't get me through the door 10 years ago.

[1:42:06] So, how do we do that?

[1:42:07] So we really need to start thinking about where is our underserved.

[1:42:12] serve communities for that.

[1:42:16] Where do they often visit?

[1:42:18] Maybe the local coffee shop.

[1:42:21] Maybe the VA and Westwater is having a screener.

[1:42:23] What do we need to hit the local coffee shop down the street

[1:42:26] at the YMCA?

[1:42:27] Because I know if I can see it.

[1:42:29] And I say, hey, this is a screener.

[1:42:32] I may go and say, oh, maybe call this number

[1:42:34] for some information.

[1:42:36] So I really think about the educational piece

[1:42:38] and how we will bring them into the door to get the screeners.

[1:42:44] And I completely agree with everything people have said so far.

[1:42:49] I'll add one other thing.

[1:42:51] I do think that it's access to healthcare and then the costs as well.

[1:42:57] I mentioned that the initial screening, if you meet the criteria, is free of cost no matter where you get it.

[1:43:04] But what is often a barrier is like, if you need something more than just that screening test,

[1:43:10] If there's a screening detected finding that needs further work up, there is cost associated

[1:43:16] with getting the subsequent tests, and that's a real barrier for a lot of people.

[1:43:23] So that's something within the VA, those costs are often lower outside the VA, that

[1:43:29] can add up.

[1:43:31] So I think that's something that could be addressed.

[1:43:34] that goes to the insurance, right, that's right, I know I'm well over my time but just a two more

[1:43:42] crook I should, you know, mind you, thank you. One, I thought about is the military doing anything

[1:43:48] now when we talk about the workplace that is caused it, is the military doing anything now

[1:43:53] to identify those positions that say, okay, what are we doing to prevent, if I'm working below

[1:43:58] deck in the engine room, you know, 24-7. Are there steps being take, I don't need to know

[1:44:04] these specific steps now, but are there steps being taken to say, how are we making that

[1:44:09] area a healthier workplace for our military so that when they come out, they do not have

[1:44:14] these issues post-service?

[1:44:19] Thanks for that question, Councillor. Across the military, we did mention a lot of different

[1:44:28] conditions, a part of being a commander is looking after your troops.

[1:44:35] So if he whoves every commander no matter what level from your lowest level up through, you

[1:44:41] know, the president or any of your service secretaries, that you want to have your, you're,

[1:44:47] I guess, at the end of the day, your employees in the most healthiest, safest environment.

[1:44:56] That's good.

[1:44:58] A lot of times it's not pop.

[1:45:00] We'll also do do the conditions where they send us to do our work. We're not always sent to the most lush garden spots across the world.

[1:45:12] But a lot of times, you want to take those necessary steps to make sure that your soul, who's your sale, who's your Marines, your airmen, are in the safest environment.

[1:45:23] If that includes additional personal protective equipment, a lot of times the guidelines within

[1:45:30] the military don't always follow OSHA, but they're very, very similar and sometimes

[1:45:36] they're even more stringent to make sure that, again, if your service member is getting

[1:45:43] sick and unable to perform their duties, then you're no longer going to be mission-capable

[1:45:49] as a unit, as a vessel, as a piece of equipment.

[1:45:53] So at the end of the day, your biggest, your greatest asset

[1:45:57] is your individual service member.

[1:46:00] So you want to make sure that whatever means

[1:46:04] are appropriate for every situation, you

[1:46:09] are going to take care of that service member.

[1:46:12] So that is a top of mind for a commander at any level,

[1:46:16] to make sure your service members are getting taken care of as best as they can.

[1:46:22] As long as we, I told the military continues to constantly review where they're sending

[1:46:27] the most important assets and making sure that the healthiest I hope that that would

[1:46:33] more the preventative work, right, is all I'm making sure.

[1:46:36] Absolutely.

[1:46:37] And coming home, back in 1998, 1999, I served the tour over in Bosnia at that point in time.

[1:46:45] The air quality was not the greatest, a lot of the local, you know, the Bosniians were burning their trash.

[1:46:54] Their trash would go into the rivers.

[1:46:55] It was an environmental nightmare.

[1:46:59] One of those things that, as we were redeploying back home after our tour was over,

[1:47:03] was, you know, we had chest X-rays.

[1:47:06] To get a baseline of where our respiratory system was at.

[1:47:12] There's just a few years ago, but then redeploying to places like the Middle East.

[1:47:18] Again, you're not in the most healthiest environments.

[1:47:22] Again, as a soldier, a lot of times you're outside, you're doing things.

[1:47:27] But again, you can be in confined spaces such as an armament vehicle or any types of vehicles.

[1:47:34] Or you can be on the ship, you can be on an aircraft.

[1:47:36] that, again, you're not always in that most healthiest environments, and again, it comes down

[1:47:41] with the commanders to make sure that they're taking care of their service members, so we're

[1:47:46] not ending up having to visit the VA afterward after all that.

[1:47:50] That's it.

[1:47:51] Thank you.

[1:47:53] Thank you.

[1:47:53] I know well of the time.

[1:47:54] Thank you very much for the added time, Jim.

[1:47:56] Thank you.

[1:47:57] Thank you.

[1:47:58] Council, Fitzgerald.

[1:48:01] Just real quick, I wanted to add also, and I know Mark has mentioned a lot about tobacco use

[1:48:07] of being prevalent in the military and part of the main reason why that is is because of

[1:48:12] the stressors that military folks go through in the job and to piggyback off what the

[1:48:18] commander here said is the military they do do what they can to try to mitigate any dangers

[1:48:25] from their assets which is the main asset which is a service member and I know that they do

[1:48:30] have, you know, one of the highest funded cancer researchers in, you know, in the world.

[1:48:37] But they do what they can, but of course, there's, there's always more that could be done.

[1:48:43] Could I make one other comment?

[1:48:45] I just want to make sure that people who have served veterans are aware that if they have had military toxic exposures,

[1:48:53] something the VA is now routinely screening everyone enrolled for and adding them to registries

[1:49:01] to understand what the health effects are and that veterans who developed lung cancer, a number

[1:49:06] of other cancers, other respiratory conditions as a result of, well, they don't need to

[1:49:13] approve. It's considered a presumptive condition that it titles them to benefits from the VA health care

[1:49:24] That's all part of the packed act that was signed by President Biden.

[1:49:30] Thank you.

[1:49:31] Thank you.

[1:49:32] Fitzgerald.

[1:49:33] Also give myself 10 minutes.

[1:49:35] But before I do that, I

[1:49:41] have another absence that I just want to read it into the

[1:49:43] record.

[1:49:45] Dear Chair Santana, I hope that you inform me that I may unable to attend today's meeting

[1:49:52] committee and veterans military families to discuss lung cancer rates among live

[1:49:58] veterans services.

[1:50:00] The woman 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 VKPAP and Councilor.

[1:50:12] Watch and City Council of District 5. I'm going to give myself five minutes. I mean, ten minutes also.

[1:50:25] So, I want to say thank you to the panel for the important testimony you've provided

[1:50:31] in the exceptional answers and thoughts you responded to from my colleagues.

[1:50:40] And do you want to ask maybe two specific questions if I may, and want to ask both

[1:50:51] both doctors a question if that's okay.

[1:50:58] So, and I listen closely to the test morning.

[1:51:01] Maybe I'll start with Dr. Woodley if that's okay.

[1:51:05] So, Dr. Woodley, as it relates to women veterans or black veterans or both,

[1:51:12] and I've listened about claims related issues in some of your points about that,

[1:51:20] of which I certainly agree with.

[1:51:23] So a woman veteran, for example, that has a claim, maybe it's the military sexual trauma,

[1:51:32] maybe it's for other woman-regated health issues.

[1:51:38] How challenging is it to speak to someone at a VSO or the VA that when they're submitting the

[1:51:47] claim that they can talk to a woman that can understand some of the challenges that they

[1:51:54] are going to, but also when they go to the CNP exam,

[1:52:01] before the VA, that they're able

[1:52:03] to speak to a woman health care provider. Because I think having a woman health care provider

[1:52:09] or a woman at the VSO or at the VA can better understand some of the issues a woman veteran

[1:52:17] is going through. And that may, because of that, you might see the percentages lower than

[1:52:26] nail veterans, which is totally unfair in terms of success of a claim. But just wanted

[1:52:35] to get what you thought might be on that doctor.

[1:52:39] So thank you for that question because actually that question came up. One of the things with

[1:52:46] the VSO.

[1:52:49] We don't have as many VSOs as one may think, and IVSOs work hard around the clock.

[1:52:58] So with a woman that walks in, and a lot of times MST is an old claim that they've never

[1:53:07] got any counseling, maybe they're ready to file that claim. And they're sitting in front

[1:53:13] of a male VSL.

[1:53:17] Sometimes it's hard to get out exactly what happened

[1:53:19] and it goes back to shame.

[1:53:21] Like, I'm ashamed this happens to me.

[1:53:23] It's supposed to be a strong soldier.

[1:53:27] So a lot of times when I talk to women,

[1:53:31] that's the first thing that it says that,

[1:53:33] when I did my content, a male showed up.

[1:53:38] And I was in a given opportunity to talk to a female.

[1:53:42] And a lot of times, you know, I felt that, you know, his face was looking at me like if that I can't believe that that happened to you or maybe it didn't happen to you.

[1:53:54] So it could be quite difficult to get a female VSO.

[1:53:57] It's not impossible.

[1:53:59] And maybe the weight might be a little longer or maybe the weight might be longer for, you know, competent, you know, with the male.

[1:54:07] So how do we reduce that?

[1:54:08] I think that female vet should have an opportunity and not a long way to talk to a VSL who's a female.

[1:54:17] But again, I go back to Commissioner Santiago.

[1:54:21] If you call his office, he could put you in touch with someone who doesn't know how to work the claim.

[1:54:27] And a female, not a worker claim.

[1:54:29] But sometimes often when you call for a VSL, you may have a male VSL.

[1:54:33] I had a male VSL when it was time to work my claim.

[1:54:36] I didn't get a choice. If a competent pen, I had a female, you know, a physician.

[1:54:42] But that could be difficult. And that's one of the reasons why someone may give up.

[1:54:48] And they may get a denial because they may not give enough information on, you know, the claim

[1:54:53] or exactly what happened. So I think that sometimes that's a 50-50, what do you think?

[1:55:03] So thank you again and thank you for bringing up that question which does come up quite a bit and I have known some cases where a woman veteran, when she was going through her CMP, did end up with a male physician and she felt uncomfortable.

[1:55:18] And in some cases, it was at a private practice in his own home, which is totally unacceptable.

[1:55:24] But to Malika's point, well, it may be difficult, it's not impossible to get a woman VSO.

[1:55:33] In our office, the University of Boston, we have a diverse group of veterans,

[1:55:37] benefits specialists to include women, veterans, benefits specialists to help out through these

[1:55:43] claims. But also, we also have a network of VSOs throughout the state through the

[1:55:47] to the Veterans Service as Office of Association.

[1:55:50] There are a lot of VSOs out there in the Commonwealth that are a woman and that do specialize

[1:55:58] in women veteran claims as well.

[1:56:01] We also have organizations like the American Legion, the DAV, the VFW, who also has VSOs within

[1:56:09] their organizations that are both women and men as well to help out in those claims.

[1:56:15] So there is a woman veteran who feels uncomfortable working their

[1:56:19] claim with a male VSO.

[1:56:22] We could definitely ensure that we get her to that comfort level that she needs to get her

[1:56:29] claim through with a woman VSO.

[1:56:32] So Rob, just as a follow-up, if a woman veteran is watching this now in a woman veteran

[1:56:40] does want to file a claim, and I would hope they would go through a VSL because they do

[1:56:47] exceptional work, DAV, I went through the DAV, I know the VFW.

[1:56:53] There's other ways to do it other VSLs, but how would you help that woman veteran get in touch

[1:57:04] with someone that could help her with her claim, that's a woman.

[1:57:11] I would recommend first going through your local veteran services office.

[1:57:16] So if you're in Boston, obviously, that's through the mayor's office of

[1:57:18] Veteran Services, which is my office.

[1:57:21] And then, you know, talk to McCutty, who's the Senior Veterans

[1:57:25] Beneficit Specialist there, myself.

[1:57:27] We're not a painter who's a Veteran's Beneficit Specialist there.

[1:57:31] and get their comfort level to see.

[1:57:34] Another way is, like I mentioned,

[1:57:35] was through the MBSOA, the Master of the Veterans Services

[1:57:38] Office Association.

[1:57:39] Another way is through the Executive Office

[1:57:41] of Veteran Services for the State,

[1:57:43] contact them, and they will connect you

[1:57:46] to the Women's Veterans Network,

[1:57:48] who also has women and VSOs

[1:57:52] that are part of that organization

[1:57:54] and that in that network as well.

[1:57:56] So there are many different avenues that a woman

[1:57:57] veteran could take to reach ABSO that they feel comfortable with.

[1:58:02] OK, excellent.

[1:58:05] Maybe, oh, you're stuck.

[1:58:06] So there's two different things that I just noticed.

[1:58:09] If a woman veteran is watching right now,

[1:58:13] some people start at the VA, they pick up the phone,

[1:58:15] and there's an intake person that call, the intake take person.

[1:58:19] So now, they don't recognize the POA, which

[1:58:21] could be the DAV of ABSO.

[1:58:24] So they're talking directly to an intake person,

[1:58:26] and in a sign of a competent, and they may not have a choice

[1:58:31] whether it's male or female.

[1:58:33] So if a woman veteran is watching right now,

[1:58:36] I would say, you know, call commissioner Santiago,

[1:58:39] call your local American Legion, call your BFW, call a BSO.

[1:58:44] Then once you get in touch with one of these organizations,

[1:58:49] we will help you navigate the system

[1:58:51] of putting your claim to it.

[1:58:53] So I think that's the best, if I was a woman

[1:58:55] that watch and write now, that's what I want to know.

[1:58:58] Because the first thing I will say is claims, let me dial the VA and get it started.

[1:59:04] Yeah, that's a very, very good point.

[1:59:06] Thank you, Monica, for saying that that's a very good point.

[1:59:09] Because that's what we do run into the people.

[1:59:11] Do go to the VA first, instead of going to the local VSO, and they should always contact

[1:59:16] their local VSO first, and then eventually get that POA done, and then help that veteran navigate

[1:59:23] the system through that way.

[1:59:24] as opposed to going directly to the VA because that's exactly what happens.

[1:59:28] Thank you.

[1:59:29] What we have to do with the VFW counselor, I'm sorry to cut.

[1:59:32] Okay.

[1:59:32] We do have a female veteran services consultant that is based at the JFT federal building right here in Austin.

[1:59:42] It is a great resource and again, the VFW will walk the veteran through the entire process from intake through any potential appeals.

[1:59:53] So we don't just take your PLA and send you off to the VA and good luck to you.

[1:59:59] We'll be able to walk you.

[2:00:00] Through the process to make sure that you are taking care of your looked after and you're appointment scheduled in the timely manner.

[2:00:08] So, again, within the city of Boston per se, the VFW, at our state level, we do have a benefits consultant that's based right at the JFK building and we're happy to be able to assist any veteran, especially women veterans that need any help.

[2:00:28] Another thing I would like to add concerted, if I may sir, is that no veteran, no veteran,

[2:00:36] and I repeat, no veteran should have to pay to get their claims processed.

[2:00:43] So, if you have a lawyer out there or someone who thinks they know and say, well, if you

[2:00:47] give me 10%, 20% of whatever you get from the VA, I'll make sure you get your claim processed.

[2:00:57] That's a red flag, I'm not good at that person.

[2:01:00] There are many, many qualified VSOs out there.

[2:01:04] You've heard about peer through all these organizations,

[2:01:07] through your local municipal offices as well,

[2:01:09] here in Boston, into my office, to get those claims done

[2:01:12] in process accurately and for free.

[2:01:18] No veteran, and I repeat again, no veterans should have to pay

[2:01:22] or should pay to get their claims processed.

[2:01:24] And it's one more thing that I know if someone's watching who has denials of on service connections.

[2:01:32] We still take care of you through the denials.

[2:01:35] All POAs, we go back in and see why the denial happens because I know people saying,

[2:01:40] Well, I got denials, so I'm not going back in for anything.

[2:01:44] All denials will look at that why the service connection was denied.

[2:01:47] And it may be something, you know, just easy enough for you to correct.

[2:01:52] So I want to put that out.

[2:01:53] Yeah, that's a good point.

[2:01:56] With those, now you got us going now.

[2:01:59] I know Rob, you and I worked on.

[2:02:02] I think they called them at one time claim sharks.

[2:02:07] The other point of that, Rob, right, is,

[2:02:11] not only do they get 10% of what you earn,

[2:02:15] they get 10% of what you receive for the rest of the life of the person.

[2:02:22] So as long as you get VA disability, they'll continue to get 10% 15% of what you get every month.

[2:02:30] That's outrageous.

[2:02:31] That's outrageous.

[2:02:33] The total is outrageous.

[2:02:34] Well, let me go and we're up.

[2:02:36] Thank you for bringing that up.

[2:02:37] That's a great point.

[2:02:39] Let me go to Dr. Weiner.

[2:02:43] I was with you.

[2:02:45] I don't know.

[2:02:45] Maybe a year ago, I think we're at the Crox Center with a group of people.

[2:02:49] And you were talking to black veterans and talking to them about lung cancer-related issues.

[2:03:01] And there was a steady group of veterans that did come in that did engage you.

[2:03:08] So my question is, what steps should a black veteran take if they want to talk to you?

[2:03:19] want to talk to someone from your team to learn more about your services. Just give us an idea

[2:03:26] what the steps would be. Well, anybody is welcome to reach out to me directly. My email address

[2:03:35] I can provide. It's Renda.wainer at VA.gov. R-E-N-D-A-I-E-N-E-R at VA.gov and I'm happy to

[2:03:45] to help direct anybody who has questions or needs help about, you know, lung cancer screening

[2:03:53] or any other issues that can try to direct them, you know, to what they need.

[2:03:59] Now when a black veteran is out the VA,

[2:04:06] are they screened, are they screened for any type

[2:04:11] of respiratory issues or long-regulated issues automatically, or do they have to request that?

[2:04:21] Well, so the process for lung cancer screening specifically is when somebody goes to their primary care

[2:04:30] clinician at the VA. There's a process where there is an automatic recording of their smoking

[2:04:37] history for people who fall in the age range for screening. And if they meet criteria for lung cancer screening.

[2:04:44] Again, this is using the USPSTF criteria, which doesn't capture everyone. But that will flag their primary care provider to discuss screening.

[2:04:53] So hopefully the veteran doesn't have to bring it up themselves.

[2:04:56] But, um, and

[2:05:00] And then, as I mentioned, the VA also routinely screens it through primary care or other appointments for military toxic exposures.

[2:05:08] And whether the veteran has any concerns about that, and oftentimes those are respiratory concerns that people have related to exposure to burn heads or other other toxic exposures.

[2:05:22] And so that also flies, puts a flag in the record to discuss those concerns and address them with the veteran.

[2:05:30] Yeah, thank you, Dr. Just as an FYI for the public, I've been in the I was in the military 24 years.

[2:05:40] Most of the reserves, but somehow, when I was stationed overseas, I was in Bahrain, a small country girl Bahrain.

[2:05:49] And we went up to the Iraqi oil platforms all the time.

[2:05:54] And then when I came back, I also noticed that respiratory related issues and I was recommended

[2:06:02] to join or to enter into the, what am I calling it now?

[2:06:10] It's the, it used to be the, oh, the registry, the golf registry that is still open in

[2:06:18] accepting.

[2:06:20] You don't necessarily make a claim, but you document that you were in a particular area

[2:06:25] of the country and what helped it with any issues.

[2:06:29] But I do want to recommend to veterans that, if you're in a particular area and you do have

[2:06:36] some health-related issues that you should enter into this registry.

[2:06:45] So, my final point, before we kind of conclude, I gave it all my colleagues, well over ten minutes.

[2:06:58] And, well, let me ask, is there any public testimony from anyone else that's here?

[2:07:02] Okay, so there's no more public testimony here.

[2:07:06] If any person at the panel would like to give a closing statement, that would be helpful.

[2:07:15] And maybe as part of the closing statement, if you can highlight what our next steps could

[2:07:23] be as a committee on where we go from here, because I would like to do a hearing maybe

[2:07:31] in outside of City Hall, but maybe in Rocksbury, maybe in Dodgeista.

[2:07:38] In listen to veterans, all veterans, but specifically listen to veterans of

[2:07:45] color, listen to women veterans, listen to them in their challenge, their

[2:07:51] concerns, but I do want to ask and give everyone the opportunity if you would

[2:07:56] like to have a closing statement for two or three minutes to take the

[2:08:00] opportunity, then I'll give my colleagues an opportunity for a closing statement for two

[2:08:06] with three minutes as well.

[2:08:08] So let me start with Commissioner San Diego.

[2:08:11] First and foremost, Chairwoman, thank you very much again for holding this thank you and

[2:08:16] also to Councillor Santana for setting up this conversation here today.

[2:08:21] Thank you, Councillor Fitzgerald, for also being here and for your thoughtful question.

[2:08:25] I'm sorry, it took more, most of your time, are early today, but it's, it's, it's really

[2:08:30] It makes me optimistic on our next steps.

[2:08:35] We talked a lot about navigating the system here, and how do we get into the system?

[2:08:40] And I think Mark, some of his comments when he's just talking earlier about making Boston

[2:08:47] step the example locally for the rest of the country.

[2:08:50] I think that's a great idea.

[2:08:52] And I think it's something that we're looking forward to going into what Constitut Flynn said

[2:08:56] about going into the community, talking to the veterans, and seeing where the need is.

[2:09:00] and how we could get these veterans into the system.

[2:09:03] You know, like I mentioned earlier, there's less than a million

[2:09:06] women veterans around the system, but yeah, we have 2.1 million

[2:09:09] women veterans in the country, you know, and this is also a way

[2:09:12] that we could also work on getting them into the system

[2:09:15] and having these conversations.

[2:09:17] Now, the continued partnerships both locally, statewide, federally,

[2:09:21] and also with all the partner organizations,

[2:09:24] is going to be key to ensuring the success of what we do,

[2:09:28] to ensure that our veterans have access, you know, for all the benefits and services that

[2:09:34] they have earned.

[2:09:35] So I'm looking forward to the future steps.

[2:09:39] Okay.

[2:09:40] Thanks again, Councillor Flynn, for convening us today, Councillor Fitzgerald, your great

[2:09:46] questions, and we appreciate the attention that these issues are being given.

[2:09:52] First off, Councillor Flynn, I'd like to offer up the Boston Police Post as someplace to

[2:09:56] host that our site meeting.

[2:10:01] Veterans town hall, whatever you want to call it, we would be more than happy to host that, and I work with you on that.

[2:10:08] The overarching question is, have we take care of this problem? I'll ask the question of, how do you eat an elephant?

[2:10:18] One bite at a time. That's the way that we're going to be able to make the conditions for not just the black veterans that are dealing with lung cancer,

[2:10:27] the women veterans and their particular health issues as women, but all veterans across

[2:10:37] the board, no matter what their other demographics are, it does take a village to solve

[2:10:45] this problem and right up at this table right here, we're a bunch of folks that we got a guy.

[2:10:52] We might not have the answer to the question, but I know somebody else that does.

[2:11:00] And what we will do is make sure that we do share that information with each other, that, okay.

[2:11:08] The commissioner might have a question and he asked me, I might not know the answer, but I can reach out to my network of other

[2:11:15] of my fellow state commanders across the country and say, hey, guys, how are you handling this issue?

[2:11:20] And I'll have somebody from Idaho or from Arizona or from Texas, say, hey, this is what we're doing here.

[2:11:27] Wow, that sounds like a great idea. Maybe we can replicate that in Boston.

[2:11:31] It's those types of networks and those types of ideas that will make this issue, these issues attainable.

[2:11:39] We'll be able to help solve some of these problems.

[2:11:45] Again, part of what we do with the VFW, as well as the other service organizations, like

[2:11:51] the Legion and the DAV, we're out in our communities all the time, that we are community-based

[2:11:57] organizations that we will be able to get our folks together and we come together monthly

[2:12:06] or our daily basis, depending on the types of folks that we have.

[2:12:10] come out and visit. We want to be able to be productive members in the process here.

[2:12:18] Again, like the last time I was here and provided testimony, a one word of caution that

[2:12:26] the rest of the Commonwealth pays attention to what goes on in the city of Boston as far as

[2:12:32] as veterans are concerned. They see that, oh, if we just cut $750,000 from the veterans budget.

[2:12:39] Thank goodness we had a group like Brighton one step up to help fill that gap.

[2:12:45] But that doesn't mean that next year or even tomorrow they're priorities changed from

[2:12:50] what the city of Boston's veterans priorities are.

[2:12:54] And then we'll never see that $750,000 again into the budget.

[2:13:00] That $750,000 goes back into the commissioners' ability to provide that outreach,

[2:13:07] to provide that education to the veterans community of the city.

[2:13:12] So I just want to be able to implore upon you what happens here in Boston just doesn't

[2:13:19] necessarily happen here in Boston.

[2:13:22] The rest of the Commonwealth pays attention.

[2:13:26] I really do demand that our council shows the leadership across the council across the

[2:13:35] commonwealth, that Boston is going to take the best care of veterans that he can and we

[2:13:42] are going to stand up and provide that leadership to make that happen.

[2:13:46] So again, thank you for all your efforts, thank you for your attention and we look forward

[2:13:50] to being, again, part of that village that comes together to take care of veterans, again,

[2:13:56] across the city and across the Commonwealth.

[2:13:58] Thank you, Commander.

[2:13:59] Mr. Kennedy?

[2:14:01] And again, we just start by expressing my sincere heartfelt thank you for the opportunity

[2:14:07] to be here.

[2:14:09] And when we refer to privilege and honor to be here, a MOOC's City Council and the

[2:14:15] State members of this panel, I really thrilled to participate in this discussion.

[2:14:21] I made a lot of comments about the guidelines, people, so again, I stand by that.

[2:14:26] what you said and what you said and what you said and also what my

[2:14:31] commoner is basically a bill and it's this. I don't I think everybody

[2:14:36] in this on this panel at some point mentioned with Navigation. We know the

[2:14:41] word Navigation School. I have a very high level of resident residents

[2:14:45] I'm sorry to that because I started my career in public health as a patient

[2:14:51] navigator at the board at the Dane of Fort Gierser Institute. I believe in

[2:14:55] and I believe in the power of navigation to support patients in the future.

[2:15:00] We have them to the best outcomes that they could have. The point I want to make is we talk about peace and navigation 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.

[2:15:17] And our cancer plan for the city, I'm looking to move navigation for the upstream.

[2:15:22] I talk about the concept of a screening that we get.

[2:15:27] So, pre-patient, how do you take that mentality

[2:15:34] that focus on supporting a patient while they're going through treatment?

[2:15:39] And movement of so that before the person becomes a patient,

[2:15:43] they can't help but navigating administratively and otherwise,

[2:15:46] how do you move to a sister?

[2:15:48] How do you get screened for a particular location?

[2:15:50] What about the follow-up procedures that allow you to adhere to make sure that if as you mentioned earlier you might give a screening

[2:15:59] mammogram.

[2:16:00] But if there's something that's wrong with that, which causes you to then have to come back and get a diagnostic mammogram.

[2:16:06] Do you show up if you understand the difference between the two and do you understand what it means to do that from a cost perspective?

[2:16:15] because Massachusetts passed legislation, I think, in 2012 or more, we call it the

[2:16:22] breast cancer diagnostic bill, the official name of the bill is a little different.

[2:16:26] But it took that diagnostic memory of a cost-sharing burden off of women, so that they

[2:16:32] could continue to adhere to what that's meaning, remember, where I've said.

[2:16:37] My point is this, navigation sounds like all of us agree as a pretty part of this.

[2:16:44] We know that CMS put in position building codes in 2024 that allow clinical practice to reimburse for the application.

[2:16:54] Let's take advantage of that and make sure that the application is a standard part.

[2:17:00] A standard, a sustainable part of the way people that want to file claims that whatever it has is

[2:17:06] are introduced to and supported as they move through the clinical system in the VA.

[2:17:12] And again, let the Massachusetts VA be the model for the rest of the country, not only

[2:17:18] when we're talking about access to screening for lung cancer beyond just tobacco news,

[2:17:24] but navigation for a veteran through the system, so that nobody falls into cracks.

[2:17:29] Everybody has answers to questions that they want, and they get through the system with

[2:17:33] the vast outcomes.

[2:17:34] Navigation and guidelines, I think, are two main points of this.

[2:17:38] I think the VA veterans have an opportunity to set the toll for the rest of the country.

[2:17:42] I hope you do.

[2:17:44] Thank you, Mr. Kennedy.

[2:17:46] Doctor?

[2:17:47] Thank you, Councilor.

[2:17:48] Thank you.

[2:17:49] I want to do things that I, you know, thought about is as veterans we connect by story telling.

[2:17:57] Like we, that's our connection.

[2:17:59] We tell a story about, you know, how we served and what we did and that's how we connect.

[2:18:04] But I think if we continue to advocate for equitable access to resources and ways of awareness

[2:18:13] about trauma, mental health needs and health needs, I think we can create a program that

[2:18:21] culturally identifies black female soldiers.

[2:18:27] So why I was said that is normally when we think about when we're introduced to all these programs and we're hearing these different things on a TV or in a media,

[2:18:39] we don't actually see a person who, you know, actually work in that department or like, you know, the Boston public health scheme and the VA.

[2:18:50] So as long as we continue these town halls and continue to have this discussion,

[2:18:55] We'll bring more veterans, and if I'm looking right now at this, if I was home and I'm

[2:19:03] watching this and I say, hey, you know, you know, I had trouble following the claim, right

[2:19:08] here we have someone from the BFW, we have someone from the polls.

[2:19:12] Now I know who else I'm dealing with, so I just feel the same as you, as long as we continue

[2:19:17] that navigate and make it a system as easy as possible for someone to navigate, do the

[2:19:24] for health kidneys, for mental health needs, and for education.

[2:19:32] That's all going to take it to get to, you know, that's in the city of Austin, Massachusetts, we have it there at.

[2:19:40] Excellent. Thank you, Dr. Weiner.

[2:19:45] Thank you so much for the opportunity to be here today for this important hearing for the thoughtful questions for all of the

[2:19:54] that's been shared by the other members of the panel and are also from the public.

[2:20:02] I went to touch on one other point that we haven't talked about so much today, and that's that lung cancer is a highly stigmatized condition, because of the strong link with smoking, even though we know that there are other factors that contribute to lung cancer risk.

[2:20:22] But I want to say that nobody, no veteran, no person deserves lung cancer and we are here to help.

[2:20:32] We are here to the VA and other healthcare systems in this amazing city are here with screening to try to identify cancers early and get people into treatment.

[2:20:44] I love the ideas about navigation, including veteran peer-to-peer navigation, which we have in the VA and using the power of the community-based organizations that veterans have access to spread the word about screening and help people get connected to services.

[2:21:12] I also just want to say, because this is a stigmatized condition, sometimes doing the community

[2:21:17] events like we did or like, you know, like you're talking about doing, sometimes it doesn't

[2:21:23] reach the people who most need to be reached, because they maybe reluctant to go to something

[2:21:31] that's about lung cancer or whatever, because of the stigma and the shame and blame that people

[2:21:36] feel. So one thing we learned from our work and got peer connects was that one of the most powerful

[2:21:43] things was actually reaching people who maybe weren't eligible for a long cancer screening,

[2:21:47] but then they went and talked to other members of their community who didn't come to the events,

[2:21:55] but like spreading the word that way and helping convince people to come in and get the healthcare

[2:22:00] that they need and deserve.

[2:22:03] Thank you, Dr.

[2:22:05] Before I go to Council Fitzgerald for closing statement, Dr. I just want to make one quick point

[2:22:12] or ask a brief quick question. Many veterans, or whatever I've sent you, I go both of you.

[2:22:19] Many veterans don't even know the veterans, and they don't even realize that they can participate in services

[2:22:30] full of veterans, they might be older at this time, but they're still eligible for services

[2:22:37] and programs at the VA, and it's not too late to sign up.

[2:22:41] Is that correct?

[2:22:43] Correct.

[2:22:43] That's correct.

[2:22:45] Rob, what should someone do if they, if they're all the person, they, for years, they weren't

[2:23:00] they haven't engaged in the system yet.

[2:23:03] What's there for a stop?

[2:23:05] Contact us.

[2:23:06] Contact us.

[2:23:07] Contact us.

[2:23:08] Get a hold of us.

[2:23:09] We could navigate and communicate with you.

[2:23:12] What's available to you.

[2:23:14] Give the system a second chance.

[2:23:17] It's not.

[2:23:18] Now, I know that speaking of stigma that there's

[2:23:21] been a lot of veterans have been stigmatized

[2:23:24] because of the services they got in the VA back in the 70s,

[2:23:27] and eighties where they didn't have the kind of services that are being provided today.

[2:23:35] And the pack that covers a lot of that, especially when it comes to the presumptive conditions

[2:23:40] that we're talking about here today, that include many different cancers.

[2:23:44] So contact us, ask us a few questions, give the system a chance, and let us help you navigate

[2:23:51] the system so that you can get the services and benefits that you have deserve and

[2:23:56] continue to to earn. So contact us, contact your local VSO, contact your local

[2:24:02] veteran organization, and let us do our job for you.

[2:24:08] Give us your contract information once again. I know you provided it already, but

[2:24:12] give it to us one more time please.

[2:24:14] For the Boston Office of Education Services, you could contact us

[2:24:18] Boston.gov slash veterans, or you could give us a call at 617-635-3030.

[2:24:25] Thank you, Rob.

[2:24:27] Council Fitzgerald.

[2:24:30] Thank you, Chief.

[2:24:31] I just want to say thank you all for the important work that you do, because not only

[2:24:36] we have the subset of veterans that we can help, but it will have it impact on everybody.

[2:24:43] Veterans are not veterans.

[2:24:45] When we talk about health, we're all the same human individuals.

[2:24:48] 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.

[2:24:53] And so, just thank you all for your leadership and the important work that you do, and please

[2:24:59] always feel...

[2:25:00] So I'll feed, reach out to to add to myself when you have to teach us what we need to do for you.

[2:25:07] You guys are the ones going through it and experiencing it and so.

[2:25:11] And that goes on, we touched on it a lot but even for the women veteran services, not a veteran

[2:25:17] and not a woman and so I do tread lightly and say I take my cues from you all.

[2:25:23] And so please educate me and tell us what we need to do but thank you again.

[2:25:27] Well, thank you. Thank you, John. Thank you for being here.

[2:25:33] It was an important discussion

[2:25:36] on support services for women veterans, for how we support veterans of color, on medical

[2:25:43] care, including lung cancer screening. I think my colleague, Council Fitzgerald, highlighted

[2:25:51] an important point that I kind of wanted to close with is the importance of listening,

[2:26:01] you know,

[2:26:01] listening to women veterans, listening to veterans of color, listening to LGBTQ veterans.

[2:26:09] I don't have that experience, but I want to continue to be a strong supporter of all veterans,

[2:26:18] especially in encoding women veterans veterans of color, LGBTQ veterans, but it is about

[2:26:26] listening, it's about learning and that's why I called this hearing today so we can give

[2:26:34] an opportunity for you to speak about your experiences but more importantly there might be someone

[2:26:41] sitting home that this information might connect with them, and maybe they'll pick up the

[2:26:47] phone or send an email next week to Rob Santiago or to the other veteran leaders here

[2:26:55] as well.

[2:26:57] But we have to acknowledge the incredible service sacrifice of women veterans and veterans

[2:27:06] of color, we're not giving them any services, we're not giving them any programs, they're

[2:27:13] in these programs.

[2:27:15] And as a nation historically we haven't been welcoming to many women veterans with veterans

[2:27:22] of color.

[2:27:24] In fact, I'm going to send to the City Council a resolution to support a piece of federal legislation

[2:27:36] and to support it, and it's basically to ensure that when black veterans return from World

[2:27:45] World War II, they really didn't participate or receive the services that they earn, specifically

[2:27:52] on housing, VA housing programs. Because of that, they didn't generate generational wealth, like

[2:28:04] other veterans have. But this piece of federal legislation would provide grandchildren,

[2:28:14] what children maybe. I have to do a little bit more research. Giving them an opportunity

[2:28:20] to get a little bit of services such as real estate, such as first-time home by a program

[2:28:29] through the VA because they were denied that benefit due to racism. They were denied that specific

[2:28:38] program due to the color of the skin due to discrimination. But that's a piece of legislation

[2:28:45] I'm going to look at. I know you and I talked about that rub for a while and want to also acknowledge

[2:28:53] Commission of Santiago, we worked on, especially under President Biden, when gay and lesbians

[2:29:02] were discharged from the service, they were discharged with a discharge that wasn't honorable.

[2:29:13] So when you have that discharge that is not honorable,

[2:29:19] it limits what benefits and services

[2:29:21] you can get as a veteran. But through the work of Commissioner San Diego, we did a lot of work

[2:29:27] at the federal level. And I say gay and lesbian, now it's LGBTQ plus. But we have to ensure

[2:29:38] that they are also treated with respect and dignity that they've earned. In if they were discharged

[2:29:44] for reasons due to their sexual orientation.

[2:29:50] I believe that that discharge should be upgraded,

[2:29:54] and maybe that's an issue we're going to have to continue to work on as we go forward.

[2:30:00] I know I'm committed to it, and Rob, you are committed to that as well. But having said that,

[2:30:05] this is about justice, this is about respect for all veterans, especially veterans that

[2:30:13] historically have been denied access to the VA into services and programs that they've

[2:30:22] This hearing on docket number

[2:30:29] 0, 7, excuse me, 0, 2, 7, 3, 0, 2, 7, 4, a hearing to discuss

[2:30:36] long cancer rates among black veterans and services for women veterans is adjourned.

City Council on 2026-08-28 10:00 AM

Agenda

Transcript