Volume 18, No. 1, Winter 2010
By Senator Rob O’Leary
In 2006, the Centers for Disease Control and Prevention (CDC) issued recommendations for healthcare providers to make HIV testing routine. In the 1970s when people knew little about HIV/AIDS, laws were written around the country to protect people from being tested for the disease without their knowledge or from having test results released without their consent.
Most laws required anyone getting tested for HIV/AIDS to sign a written consent stating that they understood what they were being tested for, and another form stating they had approved the release of their results to a certain party. What started as a protective measure has now become a roadblock for getting people tested.
According to the CDC, 21 percent of those infected with HIV do not know they have it. About one third of people who are diagnosed with HIV each year have already progressed to an AIDS diagnosis despite showing repeated trips to the doctors or emergency medical settings. In Massachusetts it is estimated that about 25,000 people have HIV/AIDS and, based on that number, around 5,000 people do not know their status. Up to 70 percent of new infections stem from “unknown carriers’’ unaware that they are HIV positive.
This makes frequent, efficient testing of the Massachusetts population an issue of paramount concern. Preventing the spread of the disease from people who do not know they have it is the first step in combating the spread of this disease. Lifting unnecessary restrictions will encourage more people to be tested for HIV as early as possible in more medical settings.
Based on recommendations from the CDC, the American Medical Association, the Massachusetts Medical Society and initiatives in other states, I have filed a bill to remove the “written consent” requirement. Massachusetts is one of only eight states still following the standard of “written informed consent” for HIV testing. This can be burdensome and intimidating since HIV is the only disease requiring this heightened standard.
This bill would change the requirement of “written informed consent” to “verbal consent.” That would still require healthcare providers to tell patients they are being tested for HIV/AIDS, along with high cholesterol, cancer and other “general consent” testing. Patients would retain the option of whether to have the HIV/AIDS test…or not. Next, the bill would change the requirement of “written informed consent” prior to disclosure of HIV testing results to third parties, and identification of the subject of the tests, to “written consent.” This change attempts to strike a balance of normalizing HIV test results, while retaining strict patient confidentiality.
Additionally, this legislation requires the Department of Public Health to commission a study on current best practices used to reach populations of the Commonwealth who are at an increased risk of contracting the HIV virus and currently are not accessing available testing procedures. The recommendations for improving access for at-risk populations will then presented to the appropriate joint legislative committees after six months.
What I am working towards is ensuring that more people get this potentially life-saving test and if they test positive that they get immediate access to quality care. HIV/AIDS affects every population, in every demographic, in every community. Getting tested should be a universal routine procedure.
We have come a long way in dealing with HIV/AIDS and a positive result is not the death sentence it was 30 years ago. If removing unnecessary barriers to testing could help save lives, then it is something I believe the Legislature must act on.
(Senator O’Leary, D-Cummaquid, represents the Mid and Lower Cape and Islands and is a member of the Legislature’s Joint Public Health Committee.
By Senate President Therese Murray
Carbon monoxide poses a danger year-round, but, in the winter, when we seal up our houses and turn on our heat, we put ourselves and our families at a greater risk.
Unlike smoke or fire, you can’t see, smell, or feel carbon monoxide and you may not realize you are being affected before it is too late. In fact, people very commonly mistake the first stages of carbon monoxide poisoning as the beginning of a cold or flu with headache, nausea or dizziness.
In 2005, Massachusetts passed a law that requires every residence, whether it is a house, condo, or apartment, to have working carbon monoxide alarms on each habitable floor of the dwelling.
This law stemmed from the 2005 death of Nicole Garafalo of Manomet. Nicole lost her life to carbon monoxide poisoning when the vent to the family’s furnace was blocked by snow.
After learning of this tragedy, my colleagues representing Plymouth and I authored the legislation in the hope that no family will every have to go through that kind of tragedy again.
Carbon monoxide is produced by common household appliances such as furnaces, water heaters or room heaters and, according to the Massachusetts’ Fire Marshal’s office, nearly 97 percent of all carbon monoxide incidents happen within a residence.
Since Nicole’s Law has gone into effect, the Fire Marshal’s office has reported that from 2005-2008 carbon monoxide calls by local fire departments jumped over 200 percent. For example, in 2008, fire departments responded to 15,245 incidents, in nearly 5,400 of which a carbon monoxide hazard was confirmed. The number of calls has increased simply from an increased awareness of the dangers of carbon monoxide.
Each year I work with the fire departments in my district and with State Fire Marshal Stephen D. Coan to raise that awareness level and help people get working carbon monoxide alarms installed by providing a limited supply of free carbon monoxide alarms. In total, since the passage of Nicole’s Law we have given away 1,200 of them to the Upper Cape communities in my district.
However, even with this increased awareness, many people do not have working carbon monoxide alarms installed. Just as with working smoke alarms, having a carbon monoxide alarm could save your life.
So, if you haven’t installed an alarm, please do it today. If you have already installed your carbon monoxide alarm, make sure to check the batteries in both your carbon monoxide and smoke alarms.
For more information on the dangers of carbon monoxide and Nicole’s Law, visit the state Fire Marshal’s website at www.mass.gov and click on State Fire Marshal, or call your local fire department.
(Senator Murray, D-Plymouth/Upper Cape, is the first female President of the Senate in Massachusetts history.)
By Representative Cleon H. Turner
As we’ve seen from the recent blizzard of 2009, unburying yourself from mounds of snow and getting back to life as usual can take a while. If you’re a senior or disabled, this can be doubly difficult. Therefore, this issue’s column is dedicated to helping you track down resources in the event of another snow storm or other calamity that might trap you in your home.
Many towns do not plow private roads and some towns that might have plowed in the past have stopped doing so due to the economy. Those towns that do plow private roads usually give them a low priority. When you hear the storm warnings, don’t wait. Verify that your street will be plowed…and when.
Big storms may cause your local Department of Public Works (DPW) or private contractor to take longer than usual to get to your road. But if it’s been more than 24 hours, call and make sure they know you’ve been overlooked. If you live on a private road that the town does not plow, make sure you and your neighbors have made arrangements for someone to do the job. An unplowed street can make it difficult or impossible for emergency vehicles to get to you if you need help.
Town DPW and most fire departments across the Cape have a cooperative policy in emergencies. If you called 911, the DPW will make every effort to ensure that the road is plowed when emergency vehicles arrive. If anyone in your household has a serious medical condition, call the local fire department make certain that your name and location are on their “at risk” list, if indeed one exists.
Should you lose power or need to evacuate, the Cape Cod and Islands Chapter of the American Red Cross will have shelters and can provide assistance. To reach the American Red Cross Cape Cod and Islands Chapter at any time in case of fire or other emergencies, call 508-775-1540.
Elder Services of Cape Cod and the Islands is another resource. They provide seniors with an answering service and hotline number in case of emergencies, 508-394-4630.
Notify neighbors or friends of your circumstances in advance so they can check on you. This can be critical if phone lines are out. Have plenty of food and candles. If you rely on the Visiting Nurses Association or Meals on Wheels, talk to them beforehand; Meals on Wheels has emergency meals they provide ahead of time.
Check your supply of medications. If you are on life-sustaining medications, make sure that you have enough to last several days.
Keep an eye on your neighbors. If they’re elderly or disabled, make sure they are aware of a pending storm and that they have taken the same precautions you have.
Remember, preparation is your best tool.
(Representative Turner, D-Brewster/Dennis/Yarmouth, is a member of the Legislature’s Joint Public Health Committee.)