State Rep. Liz Malia, D-Jamaica Plain, sat down with Jamaica Plain News and tackled questions about what she's working on, Gov. Charlie Baker, substance abuse and more. This is Part II of the interview, click here for Part I.
Q: What is the most common thing you hear about from constituents?
A: We do a fair amount of intake around city services. There’s a rep I knew from the south coast and she used to tease us about doing city council work, too. But it comes with the territory -- basic access to services, to state services, housing, housing advocacy. Public safety is something I’ve always spent as much time on as I can. I haven’t been able to do as much on it lately. Since Boston implemented community policing there was a realization to help that in JP and the police have done a good job.
Q: You are the Chair for the Joint Committee on Mental Health and Substance Abuse -- what legislation in that committee would you really like to become law?
A: This is the best job I’ve ever had, chairing the Mental Health and Substance Abuse Committee. I’m staying in contact with the issues that we are addressing from a public policy in the state. I see the lack of addressing behavioral health needs, kids in schools and people’s lack of access to healthcare in general. More so now it’s behavioral health. It’s a major need and major concern we are starting to have more progress in.
We’ve done pretty well over the last couple of years. A law that we passed required insurers to pay for the first two weeks of detox treatment with people with substance abuse issues. That just went into affect on October 1, 2015. We have the opiate crisis and the mortality rate for overdoses is pretty horrifying. I think one of the basic things is funding programming.
A lot of my focus is with the budget and not specific parts of legislation. We need to finish the legislation that we started work on. We just passed a bill on a conference bill -- how do you control the amount of opiate prescriptions out there? The industry drove it -- a lot of people made a lot of money selling opiates in the pharmaceutical industry. We prescribe a lot of dangerous drugs, more than we need. It’s gotten out of control. Through legislation we are trying to improve prescription monitoring and provide the IT technology to do it. We’re trying to cut back prescription opiates. People get addicted to all types of drugs and when they can’t get it anymore they turn to heroin, and there’s a huge underground economy for heroin…The healthcare world hasn’t done a good job of training doctors. There are some substantial proposals in the legislature to get through conference committee. But one of biggest pieces is addressing fiscal needs. We need more beds… Faulkner Hospital shut down its detox program a couple of years ago. There was plenty of demand, but the economy kind of drove that. For the general healthcare model they got more money for an oncology bed than a detox bed. We have to bring behavioral health to where services are paid for -- we need beds, treatment, doctors who are going to specialize in addiction medicine and staff who will work with people with behavioral issues.
Q: You’ve been in the State House with several governors. How does the State House change with different governors? How is it now with Gov. Charlie Baker?
A: I think one of the things that is impressive with Governor Baker is that he has hired some really good people out of the human services…There are good and bad days and staff through the years -- the Romney years were kind of a black hole, not a lot of interaction.
Q: We’ve heard Gov. Baker is hands-on.
A: Absolutely. He gets it. His first piece about the substance abuse crisis was to say 'we have to do this.' One thing he proposed was for anyone coming into the ER who was brought back with Narcon is held for three days. Being immediately detoxed is nasty and people want to get high right away so they are much more at risk to overdose and die. We understood where the governor was coming from. Reality is we didn’t have the capacity to do it. We can’t leave them in ERs, and hospitals are maxed out with handling general problems -- car accidents, heart attacks. We’ve had good conversations with his people and senate in how do we ramp up to a system to provide services we need and a lot of is trying to address triage and the worst of the problems and taking care of people immediately. It isn’t something you can do in a month or three months. You need to put programs and facilities in place to give people a chance. Addiction is a brain disease. We need a much more long-term treatment system to help those people manage on their own.
Q: Oftentimes at the end of a legislative session there are marathon sessions at the State House to discuss dozens of bills. That doesn’t seem like a good management style. How can the Legislature avoid those marathon sessions to provide those bills the introspective attention they deserve?
A: It’s not an ideal system and every year is different and whether you’ve been here for a while, every year is different. Some of it is just human nature. Some of the things that are most difficult and have least accessible solutions we put off and I don’t think it’s an ideal way to do it, but I haven’t seen a way to get everyone to the table in the beginning of the year and parse out how much time we are going to spend on these issues. We get focused on one issue and then something else happens. Last year there was a lot of questions about managing the T, we had snowstorms week after week after week. And we got some focus on it, but how do we pay for system that works in the long term? We have cars that are 30-years-old on the Red and Orange Lines. You’ve got to plan for that -- I always come back to that we are unwilling to pay for what we need upfront. We’re down to 5.1% from 6.25% (on the income tax) -- that’s two billion a year from income tax. Push comes to serve and we finish up the budget. There are a lot of jobs that don’t get finished.
I’m hoping this year we can finish the transgender bill, the accommodations bill. You can work at a restaurant, but they’re not obligated to serve you. Issues that conservatives call bathroom bills. There are a lot more people that are aware that transgender issues are out there. But there is an artificial divide that gets set up by calling it a bathroom bill. I’ve been out for a long time. I think I was the second out legislator and I’ve been here since 1998.
Q: If you could change one thing about the Massachusetts government, what would it be and why?
A: (Laughs) I’m not much of a blue sky person… I’d like to see real integration and understanding to address behavioral health -- to keep it funded. We’ve had great people working on it. Our awareness has gone up. But we need to get to a point to pay for it. We’re working on it. That’s one of the reasons I do what I do. If you have a behavioral health issues, we have good access to insurance. That’s an issue that was born in Massachusetts -- health care access. If we had real access you could get the services you need -- like children who are homeless. Think about the cost to society for all the problems that are out there.
Another piece we’re making progress on is changing our criminal justice system from some sort of punishment mode to address real issues there. In some ways prison is the mental health hospital of the last resort and it’s one of the things I’ve learned -- that the huge amount of people who are incarcerated are not organically criminals, but they have mental health issues, are substance abuse users and they aren’t getting help and they end up in jail and we warehouse them. Something like $45,000 a year goes just to house someone in jail. For every dollar we spend on recovery intervention and outreach we would save $7 or $8 dollars on corrections, courts, ancillary services, public safety.
Q: What else would you like to talk about, or let Jamaica Plain residents know about?
A: I’ve been doing this work for mental health and substance abuse. I’d like to see awareness in the community that these are basic human needs we have to meet and to watch out for each other. If people need help to not get mad at them. I know that sounds a little Pollyannaish, but to continue to support programs for our kids; after school programs, continue to support the schools. One of the big things that bother me the most is about the supposed education shortfalls. Every time we have a major economic crisis money comes out from the education system and in the long term we pay for that.