a report from Councillor Alanna Mallon and Councillor Sumbul Siddiqui, Co -Chairs of the Human Services and Veterans Committee, for a public hearing held on February 26, 2019 to discuss what measures are being enacted to instill a greater level of confidence in local Cambridge Health Alliance centers to prevent another occurrence of this nature

Attachment A. Crane, Paula From: Mallon, Alanna Sent: Tuesday, February 26, 2019 1:49 PM To: Crane, Paula Cc: Ascolese, Liana Subject: Human Services Paula, Here are my comments from todays meeting: "I want to welcome everyone and thank you all for being here. I am especially grateful to Peter DeMarco, Laura Levis' husband for being here and sharing his time and thoughts with us this morning. We all know the facts in this terrible tragedy. Early on the morning of September 16th 2016, Laura Levis went to the Somerville Hospital seeking emergency care for an asthma attack. What happened then was a series of missed critical opportunities to save her life. From the inadequate lighting & signage, a locked emergency room door, a 911 call that was placed to a regional call center, to critical details from 911 staff not being relayed to emergency responders, a nurse that didn't leave the hospital door far enough to see Laura on a bench yards away and many others. Every minute that she wasn't found outside the ER was critical. All of the emergency I spent some time listening to the 911 calls, the dispatch between police and fire post the event, and reading every word of this story, and I am struck by the tragedy of this preventable death of a 34 year old woman who had her life in front of her, and by the grief of the loving husband she left behind. This hearing today is not to re-litigate those failings, as there have been productive conversations between Mr. DeMarco and CHA officials and staff, and I was pleased to see that these were honest and open conversations, but rather this hearing is an opportunity for the City Council to hear what steps the Cambridge Health Alliance is putting in place in the wake of this tragedy to ensure Laura's life wasn't in vain, and how the CHA is working to make sure no one ever loses their life outside the ER doors waiting desperately for help to come. I look forward to hearing an update from the CHA on where things stand to date, and when we expect this work to finish up. But first I want to invite Laura's husband Peter to speak."

Attachment B HUMAN SERVICES & VETERANS COMMITTEE COMMITTEE MEETING -AGENDA - Tuesday, February 26, 2019 10:00 AM Sullivan Chamber Call of the Meeting The Human Services and Veterans Committee will conduct a public hearing to discuss the lessons learned from the death of Laura Levis, and to discuss what measures are being enacted to instill a greater level of confidence in local Cambridge Health Alliance centers to prevent another occurrence of this nature. Opening Remarks Councillor Mallon and Introductions Remarks Peter DeMarco, husband of Laura Levis Cambridge Health Alliance Presentation Josh Posner, President - CHA Board of Directors Pat Wardell, CEO Discussion Public Comment Adjournment Page 1 City of Cambridge

: Attachment i FILED ON: 1/18/2019 HOUSE DOCKET, NO. 3197 • No. HOUSE. The Commontuealth of Massachusetts PRESENTED BY: Christine P. Barber To the Honorable Senate and House of Representatives of the Commonvealth of Massachusetts in General Court assembled: The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: An Act ensuring safe patient access to emergency care. - PETITION OF: NAME: DISTRICT/ADDRESS: Christine P. Barber 34th Middlesex Carmine Lawrence Gentile 13th Middlesex David Biele 4th Suffolk 26th Middlesex Mike Connolly 35th Middlesex Paul J. Donato Tricia Farley-Bouvier 3rd Berkshire 23rd Middlesex Sean Garballey James K. Hawkins 2nd Bristol Jonathan Hecht 29th Middlesex Kate Hogan Russell E. Holmes 6ih Suffolk Second Middlesex Patricia D. Jehlen Bradley H. Jones, Jr. 20th Middlesex 11th Middlesex Kay Khan Jay D. Livingstone 8th Suffolk Denise Provost 27th Middlesex Rebecca L. Rausch Norfolk, Bristol and Middlesex 24th Middlesex David M. Rogers 1 of 4

, 10th Norfolk Jeffrey N. Roy Daniel J. Ryan 2nd Suffolk José F. Tosado 9th Hampden Steven Ultrino 33rd Middlesex RoseLee Vincent | 16th Suffolk 2 of 4

FILED ON: 1/18/2019 HOUSE DOCKET, NO. 3197 .. .. :. No. HOUSE .. [Pin Slip] The Commonwealth of Massachusetts In the One Hundred and Ninety-First General Court (2019-2020) An Act ensuring safe patient access to emergency care. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: 1 SECTION 1. This act may be referred to as Laura's Law, after Laura Beth Levis. 2 SECTION 2. The departinent of public health shail promulgate regulations to require all 3 hospitals in the Commonwealth to meet criteria appropriate to ensure safe patient access at all times to a hospital emergency room or department, including but not limited to criteria related to 5 indoor and outdoor signage, indoor and outdoor lighting, best-practice way-finding, and security 6 and monitoring of all emergency department access points. Such criteria shall include minimum requirements for proper security monitoring of any prominent hospital doors or entrances that are locked at night through which a patient might try to egress, as well as the installation of panic buttons, emergency doorbells, or active video-intercom systems and any other safety features the 10 department finds necessary to ensure patient access to an emergency room or department. The criteria shall incorporate the most-current published industry standards, related to the above 12 criteria, including but not limited to the standards in the Facilities Guidelines Institute and The 3 of 4

International Association for Healthcare Security and Safety. The department shall promulgate 14 regulations not later than December 31, 2019. 15 SECTION 3. The commissioner of public health shall convene a working group to report and make recommendations on emergency department oversight. The report shall include, but 17 not be limited to, an evaluation of current emergency department oversight, regulation, and 18 enforcement, the adequacy of fees to cover inspection and oversight, the deterrent effect of penalties for violations of rules and regulations and cost recovery assessment for damages resulting from the failure to comply with rules and regulations, and any other matters the 21 working group finds that would enhance patient access and the safety of emergency departments. 22 The working group shall report its findings, including any proposed legislation to the joint 23 committee on public health no later than July 31, 2019. 4 of 4

Attachment D FILED ON: 1/18/2019 HOUSE DOCKET, NO. 3197 • • • HOUSE No. The Commonwealthy of lassachusetts PRESENTED BY: Christine P. Barber - To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General Court assembled: The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill: An Act ensuring safe patient access to emergency care. PETITION OF: NAME: | DISTRICT/ADDRESS: 34th Middlesex Christine P. Barber Carmine Lawrence Gentile 13th Middlesex David Biele tth Suffolk 26th Middlesex Mike Connolly Paul J. Donato 35th Middlesex Tricia Farley-Bouvier 3rd Berkshire 23rd Middlesex Sean Garballey James K. Hawkins 2nd Bristol Jonathan Hecht 29th Middlesex 3rd Middlesex Kate Hogan Russell E. Holmes 6ih Suffolk Second Middlesex Patricia D. Jehlen 20th Middlesex Bradley H. Jones, Jr. lIth Middlesex Kay Khan Jay D. Livingstone 8th Suffolk Denise Provost 27th Middlesex Rebecca L. Rausch Norfolk, Bristol and Middlesex 24th Middlesex David M. Rogers 1 0f4

i 10th Norfolk Jeffrey N. Roy Ind Suffolk Daniel J. Ryan 9th Hampden José F. Tosado Steven Ultrino 33rd Middlesex RoseLee Vincent l6th Suffolk 2 of4

FILED ON: 1/18/2019 HOUSE DOCKET, NO. 3197 HOUSE .... • No. [Pin Slip] The Commonwealth of Massachusetts In the One lundred and Ninety-First General Court (2019-2020) An Act ensuring safe patient access to emergency care. Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows: 1 SECTION 1. This act may be referred to as Laura's Law, after Laura Beth Levis. 2 SECTION 2. The department of public health shall promulgate regulations to require all 3 hospitals in the Commonwealth to meet criteria appropriate to ensure safe patient access at all 4 times to a hospital emergency room or department, including but not limited to criteria related to 5 indoor and outdoor signage, indoor and outdoor lighting, best-practice way-finding, and security and monitoring of all emergency department access points. Such criteria shall include minimum 7 requirements for proper security monitoring of any prominent hospital doors or entrances that are locked at night through which a patient might try to egress, as well as the installation of panic 9 buttons, emergency doorbelis, or active video-intercom systems and any other safety features the 10 department finds necessary to ensure patient access to an emergency room or department. The 11 criteria shall incorporate the most-current published industry standards, related to the above 12 criteria, including but not limited to the standards in the Facilities Guidelines Institute and The 3 of 4

13 International Association for Healthcare Security and Safety. The department shall promulgate 14 regulations not later than December 31, 2019. 15 SECTION 3. The commissioner of public health shall convene a working group to report and make recommendations on emergency department oversight. The report shall include, but not be limited to, an evaluation of current emergency department oversight, regulation, and enforcement, the adequacy of fees to cover inspection and oversight, the deterrent effect of 19 penalties for violations of rules and regulations and cost recovery assessment for damages resulting from the failure to comply with rules and regulations, and any other matters the working group finds that would enhance patient access and the safety of emergency departments. The working group shall report its findings, including any proposed legislation to the joint 23 committee on public health no later than July 31, 2019. 4 of 4

Attachment E CHA Executive Offices PHA Cambridg Health Allianc 1493 Cambridge Street • Cambridge, MA 02139 February 27, 2019 Honorable Chair Alanna Mallon Human Services and Veterans Committee Cambridge City Hall 795 Massachusetts Ave Cambridge, MA 02139 Dear Honorable Chair Mallon, Thank you again for the opportunity to share our learnings and changes related to the death of Laura Levis with the Human Services and Veterans Committee. I wanted to clarify a response that I provided to one of Mr. DeMarco's questions about Cambridge Health Alliance's support of recently filed legislation. Cambridge Health Alliance fully supports "Laura's Law" and will collaborate with Senator Jehlen, Representative Barber and Peter on how to improve ED access/safety across the industry. We are open to other initiatives, including working with the 9-1-1 system and local first responders and an asthma awareness campaign in our communities. 1 misheard Peter's question and unintentionally indicated support for the cap bill as well. Our Board and leadership team are still evaluating the legislation and have not made any decisions. We do have some concerns about potential unintended consequences of such a measure. I apologize for the confusion and shared this clarification with Peter as well. appreciate your leadership, thoughtfulness, and time during the meeting and hope that you will share my clarification with others on the committee. Sincerely, Patick & Wardell Patrick R. Wardell Chief Executive Officer Cambridge Health Alliance CC: Donna Lopez, City Clerk Louis DePasquale, City Manager Liana Ascolese, Aide AFFILIATED WITH: MasCeneral Hospital fir Chikiren HARVARD MEDICAL SCHOOL Beth Israc! Deacones dedical Cente DENTAL RECI DC HEALTH.

Attachment F Crane, Paula From: Marc Levy < [email removed]> Sent: Tuesday, February 26, 2019 12:33 PM To: Crane, Paula Subject: Comments from Feb. 26, 2019, meeting of the Human Services & Veterans Committee (with five attached emails as PDFs) Attachments: Photographer visit 1.pdf; Photographer visit 2.pdf; Photographer visit 3.pdf; Photographer visit 4.pdf; Photographer visit 5.pdf I have the privilege of editing the work of Sue Reinert when she writes about the Cambridge Health Alliance for Cambridge Day. I was struck by councillor Siddiqui's comments about transparency and accountability, and I think it shouldn't be lost that while Mr. DeMarco first wrote about this death in November 2018 - hopefully helping move CHA toward more transparency and accountability - it was not our first chance to learn about the death. Sue Reinert learned of it in late 2017 and asked CHA about it, but CHA chose at that time not to be transparent about it. While I understand many people here learned about this incident by reading the Globe in November 2018, but it was first reported publicly Jan. 2, 2018, in Sue Reinert's reporting on Cambridge Day. There's something symptomatic here about how institutions try to handle media these days, putting out press releases and doing social media: posting on Facebook, tweeting, even making videos for YouTube. But when a member of the media asks questions, those questions are often dismissed and sometimes treated with hostility, and the answers are put off and often incomplete. This is the approach taken by the City of Cambridge too, unfortunately. Sue Reinert is an excellent reporter, and a very fair one who has written regularly for years now about CHA advances, programs, research and finances - good news, bad news and everything in between. She is the only person doing regular coverage of CHA for the people of Cambridge. But her relations with CHA can be difficult; from my perspective, it doesn't feel like CHA is trying to be transparent and accountable. That can make it feel, obviously, like CHA is sometimes hiding something. Even when it's not. So it's heartening to hear Dr. Sayah to say that he doesn't think you can ever communicate enough. I hope that approach is truly embraced. I want to share a brief email exchange I had with the press office at CHA that resulted from Sue's regularly writing about CHA and the subsequent need for images to illustrate them. That is not practical approach for Cambridge Day, and raises the risk that access would be conditional - that CHA would let us in for a photo when it was good news, but not for bad. So I write back to ask... ... There was no reply. That was the end of the communication from CHA. That was a decision on the part of CHA, just like its decision not to answer Sue Reinert's questions about a death outside the Somerville ER in September 2016. But what we know now is that refusing to handle a situation doesn't always make that situation go away. It often makes the situation worse. 1

From: Marc Levy [email removed] Subject: Photographer visit Date: November 13, 2017 at 6:08 PM To: [email removed] Dear Mr. Cecere, I'm hoping we can arrange a visit to Cambridge Hospital by a photographer to get images Cambridge Day can use in the months and years to come for general coverage, such as when Sue Reinert writes about finance reports, Alliance accomplishments, elc. What can we do to make this happen? Marc Levy [phone removed]

From: Cecere, David [email removed] Subject: Re: Photographer visit Date: November 14, 2017 at 5:05 PM To: Marc Levy [email removed] Marc, Thanks for the note. As we do with other outlets, I'm happy to coordinate photography for each story as needed. Per our protocols, we don't coordinate shoots to generate a photo inventory for an individual media outlet. Should you want to take any exterior shots, I'm happy to accompany a photographer in accordance with privacy regulations -- we may also have some updated ones on file. David David Cecere Director of Corporate Communications Cambridge Health Alliance [email removed] Office: [phone removed] Cell: [phone removed] www.twitter.com/challiance On Mon, Nov 13, 2017 at 6:08 PM, Marc Levy <[email removed]> wrote: Dear Mr. Cecere, I'm hoping we can arrange a visit to Cambridge Hospital by a photographer to get images Cambridge Day can use in the months and years to come for general coverage, such as when Sue Reinert writes about finance reports, Alliance accomplishments, etc. What can we do to make this happen? Marc Levy [phone removed] The information transmitted in this electronic communication, including all contents enclosed and/or attached, is intended only for the person or entity

From: Marc Levy [email removed] Subject: Re: Photographer visit Date: November 14, 2017 at 5:07 PM To: Cecere, David [email removed] Bcc: Sue Reinert [email removed] And what is the reasoning behind those protocols? Marc • On Nov 14, 2017, at 5:04 PM, Cecere, David <[email removed]> wrote: Marc, Thanks for the note. As we do with other outlets, I'm happy to coordinate photography for each story as needed. Per our protocols, we don't coordinate shoots to generate a photo inventory for an individual media outlet. Should you want to take any exterior shots, I'm happy to accompany a photographer in accordance with privacy regulations -- we may also have some updated ones on file. David David Cecere Director of Corporate Communications Cambridge Health Alliance [email removed] Office: [phone removed] Cell: [phone removed] www.twitter.com/challiance On Mon, Nov 13, 2017 at 6:08 PM, Marc Levy <[email removed]> wrote: Dear Mr. Cecere, I'm hoping we can arrange a visit to Cambridge Hospital by a photographer to get images Cambridge Day can use in the months and years to come for general coverage, such as when Sue Reinert writes about finance reports, Alliance accomplishments, etc. What can we do to make this happen? Marc Levy [phone removed] The information transmitted in this electronic communication, including all contents enclosed and/or attached, is intended only for the person or entity to whom it is addressed and may contain material that is confidential, privileged or otherwise protected from disclosure. Any review, re- transmission, copy, disclosure, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this information in error, please contact the sender and properly destroy this communication and all copies thereof.

From: Cecere, David [email removed] Subject: Re: Photographer visit Date: November 15, 2017 at 10:43 AM To: Marc Levy [email removed] Marc, I've been doing this for more than a decade and have never fielded that type of request. We wouldn't do it if the Boston Globe or New York Times asked. We're certainly open to arranging shoots to support individual stories. Thanks. David On Tue, Nov 14, 2017 at 5:07 PM, Marc Levy <[email removed]> wrote: And what is the reasoning behind those protocols? Marc On Nov 14, 2017, at 5:04 PM, Cecere, David <[email removed]> wrote: Marc, Thanks for the note. As we do with other outlets, I'm happy to coordinate photography for each story as needed. Per our protocols, we don't coordinate shoots to generate a photo inventory for an individual media outlet. Should you want to take any exterior shots, I'm happy to accompany a photographer in accordance with privacy regulations -- we may also have some updated ones on David David Cecere Director of Corporate Communications Cambridge Health Alliance dcecere @challiance.org Office: [phone removed] Cell: [phone removed] www.twitter.com/challiance On Mon, Nov 13, 2017 at 6:08 PM, Marc Levy <[email removed]> wrote: Dear Mr. Cecere, I'm hoping we can arrange a visit to Cambridge Hospital by a photographer to get images Cambridge Day can use in the months and years to come for general coverage, such as when Sue Reinert writes about finance reports, Alliance accomplishments, etc. What can we do to make this happen? Marc Levy [phone removed] The information transmitted in this electronic communication, including all contents enclosed and/or attached, is intended only for the person or communication and all copies thereof.

David Cecere Director of Corporate Communications Cambridge Health Alliance [email removed] Office: [phone removed] Cell: [phone removed] www.twitter.com/challiance The information transmitted in this electronic communication, including all contents enclosed and/or attached, is intended only for the person or entity to whom it is addressed and may contain material that is confidential, privileged or otherwise protected from disclosure. Any review, re-transmission, copy, disclosure, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this information in error, please contact the sender and properly destroy this communication and all copies thereof.

From: Marc Levy [email removed] Subject: Re: Photographer visit Date: November 15, 2017 at 12:11 PM To: Cecere, David [email removed] Bcc: Sue Reinert [email removed] I don't think the Times or even the Globe would - or has - given the CHA such sustained and regular coverage, David. We take the Alliance very seriously and place an importance on it those institutions (and even the Chronicle) do not. So our needs are a little different than those of the Globe and Times, and I was wondering at the reasoning and concerns behind those protocols. Marc On Nov 15, 2017, at 10:43 AM, Cecere, David <[email removed]> wrote: Marc, I've been doing this for more than a decade and have never fielded that type of request. We wouldn't do it if the Boston Globe or New York Times asked. We're certainly open to arranging shoots to support individual stories. Thanks. David On Tue, Nov 14, 2017 at 5:07 PM, Marc Levy <[email removed]> wrote: And what is the reasoning behind those protocols? Marc • On Nov 14, 2017, at 5:04 PM, Cecere, David <dcecere@ challiance.org> wrote: Marc. Thanks for the note. As we do with other outlets, I'm happy to coordinate photography for each story as needed. Per our protocols, we don't coordinate shoots to generate a photo inventory for an individual media outlet. Should you want to take any exterior shots, I'm happy to accompany a photographer in accordance with privacy regulations -- we may also have some updated ones on David David Cecere Director of Corporate Communications Cambridge Health Alliance [email removed] Office: [phone removed] Cell: [phone removed] www.twitter.com/challiance On Mon, Nov 13, 2017 at 6:08 PM, Marc Levy <[email removed]> wrote: Dear Mr. Cecere, I'm hoping we can arrange a visit to Cambridge Hospital by a photographer to get images Cambridge Day can use in the months and years to come for general coverage, such as when Sue Reinert writes about finance reports, Alliance accomplishments, etc. What can we do to make this happen? Marc Levy [phone removed]

The information transmitted in this electronic communication, including all contents enclosed and/or attached, is intended only for the person or entity to whom it is addressed and may contain material that is confidential, privileged or otherwise protected from disclosure. Any review, re-transmission, copy, disclosure, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this information in error, please contact the sender and properly destroy this communication and all copies thereof. David Cecere Director of Corporate Communications Cambridge Health Alliance [email removed] Office: [phone removed] Cell: [phone removed] www.twitter.com/challiance The information transmitted in this electronic communication, including all contents enclosed and/or attached, is intended only for the person or entity to whom it is addressed and may contain material that is confidential, privileged or otherwise protected from disclosure. Any review, re- transmission, copy, disclosure, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this information in error, please contact the sender and properly destroy this communication and all copies thereof.