Thank you for referring. Please continue to keep HB52 moving forward. Clean options for disposition of remains is essential.

Comments Document

To Whom It May Concern: The attachment contains written testimony in support of HB 52 - Alkaline hydrolysis. Thank you, Lily Buerkle

Please support HB 52. Alkaline Hydrolysis is much better for the air we all breathe than fire cremation, and it still leaves remains for loved ones to claim and preserve as they wish.

HB52: Excellent, we're finally getting it. HB255: I would limit this to those people at higher risk for this. There maybe a cost for testing. Not everyone can afford that. The bills finally addressing sickle cell are long overdue. I wish that there was a registry of some sort that medical professionals can access, so that pain medications would not be so stigmatized in this disease.

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Hi I am writing to you on behalf of The Well Connection UK, a media and publishing company. We could easily get virginia.gov featured in various publications such as magazines, online blogs and news sites. This would undoubtedly help virginia.gov with publicity, reputation, domain authority and organic search engine rankings. We have a wide range of options including completely free collaborations, sponsored posts, guest posts and banner ads. If this sounds of interest, please reach out to the senior business development manager, Anita at info@thewellconnection.co.uk and whatsapp +447395206515 (GMT) Kind regards Clifton Junior Outreach Assistant

Please vote in favor of this legislation. So many folks, just in this county alone have been diagnosed positive for Alpha Gal. Listing it as a reportable disease is a next step toward greater understanding and acceptance of the syndrome, therefore one step closer to consideration for greater research for prevention and treatment.

As a Virginia resident who has suffered from Alpha-gal syndrome (AGS) for over 24 years, I would like to register my strong support for HB 93 and urge its passage in the General Assembly. AGS is a tick-borne disease that causes a serious allergy to a sugar in mammal meat and mammal products (including many medicines). AGS is spread through the bite of a lone star tick. Shortly after moving to VA, where I immediately fell in love with hiking in the Shenandoah Mountains, I began to suffer unexplained bouts of severe hives. Allergists had no answers. Next came episodes of severe gastrointestinal distress and mysterious drops of blood pressure that send me to the ER. Eventually, the reactions got worse and I ended up taking my first ambulance ride to the ER in the middle of the night, in and out of consciousness from anaphylaxis. Eight years after my first reaction, I finally had a tentative diagnosis. Testing would eventually show that I was severely allergic to mammal meat. Several years later, after another very scary and cold January ride in an ambulance to the ER, I discovered I could also not tolerate dairy due to AGS. Navigating menus and ingredient lists is a constant battle, but my worst fear is being in an accident, ending up in the ER unconscious, and being administered one of many drugs that are made with mammal ingredients. A single dose of heparin, a very common blood thinner, could put me into severe anaphylaxis or even kill me. Thankfully, I am not as sensitive to minor amounts of mammal as some in the AGS patient community who suffer reactions even to the fumes of cooking mammal. I tell you all of this to emphasize that AGS is a life-altering, and even life-threatening, condition. As not just an allergy, but also a tick-borne disease, targeted public health education in hot spot areas can help prevent the disease from spreading. The Centers for Disease Control, which is encouraging states to report, has stated that “the prevalence of this condition is largely unknown.” They describe “a critical need” for “improved surveillance to aid public health decision-making.” This is especially important in Virginia. If surveillance is not improved, it will be hard to justify additional federal resources, even though VA is an AGS hot spot. Currently, most federal tick-borne disease funding is dedicated to preventing Lyme disease. However, 95% of tick encounters in VA involve lone star ticks – ticks not thought by the CDC to carry Lyme. Therefore, determining the true prevalence of AGS in VA could be key to increasing the allocation of resources, not just for healthcare provider education on AGS, but also for public health outreach related to tick bite prevention in general. Out of the 6 ER visits I have had with AGS reactions, only once did the doctor have a working understanding of AGS. Increased healthcare provider education might mean that my medic alert bracelet would be enough to save me (and many other Virginians with AGS) if I were admitted to the hospital in an emergency. A better understanding of the prevalence of the disease could also ensure Virginians are diagnosed sooner, something that might help save their lives. Finally, it would be an enormous public benefit if we could prevent more people from getting AGS in the first place by targeting resources to public education on tick bite avoidance. HB93 is an important public health measure for Virginia, and I urge you to vote yes.

As Cofounders of Two Alpha Gals, we have been helping others navigate the complexities of living with alpha-gal syndrome (AGS) since 2019, and we strongly support HB93. In addition to living with AGS ourselves, we have unique insight into the direct impact of the condition on the community through our mentorship program. A primary cause of concern for patients living with AGS is lack of knowledge among healthcare providers. In July 2023, the CDC reported that in a nationwide survey of healthcare providers, 42% were unaware of AGS, and another 35% were not confident in their ability to diagnose or manage patients with AGS. The passing of HB93 would provide a vehicle for cohesive and comprehensive education among healthcare providers in Virginia and is a foundational step toward directly improving the wellbeing of Virginians impacted by AGS. Because the number of cases continues to increase, it is critical to pass HB93 in order to determine the immediate effect of AGS on Virginians. Sincerely, Debbie Nichols and Candice Matthis, Two Alpha Gals LLC, www.TwoAlphaGals.com

As a board-certified practicing allergist and immunologist for over 20 years who regularly evaluates alpha-gal allergy patients, I completely disagree with the potential requirement to report alpha-gal allergy to the CDC or state registry. The reporting of medical conditions was started to prevent and control the spread of infectious diseases including poliomyelitis or later determining the source of foodborne illness outbreaks. This reporting was also extended to potential toxic or occupational sources of illnesses. Alpha-gal allergy is delayed reactivity to mammalian meat triggered in some people by tick bites. It is an allergy, not a communicable or infectious disease such as is Lyme disease. I agree that there is low awareness of alpha-gal allergy and more research is needed, but making it reportable is not the best approach. By the logic of the bill’s proponents, we should report every noninfectious disease where there is low awareness. We could also require bee sting or tree nut anaphylaxis to be reported. This would flood the CDC with additional disease reports and dilute the focus on infectious diseases. Reporting alpha-gal syndrome is unnecessary, unhelpful and a waste of public resources. Please do not pass this bill and allow the reporting system to focus on communicable and infectious diseases.

Comments Document

As a Director of the Alpha-gal Syndrome Awareness Campaign--a volunteer effort involving hundreds of people affected by alpha-gal syndrome, including Virginians--and creator of the Alpha-gal Information website--the most comprehensive resource on alpha-gal syndrome (AGS)-- I would like to register my strong support for HB 93. Passage of HB 93 would meet an urgent need for surveillance of alpha-gal syndrome (AGS), an emerging, tick-borne condition characterized by potentially life-threatening allergic reactions to a sugar found in mammals and products derived from mammals. The CDC reports that AGS is a growing clinical and public health concern, and state-level surveillance is a “critical need” to determine its true prevalence and trends in its expansion. This information is vital for public health decision-making. Importantly, passage of HB 93 would also serve as a mechanism to educate the scores of healthcare providers who remain unaware of AGS. Virginia is an AGS hotspot. Over 20% of residents in some areas of the state have the allergic antibodies (IgE) to alpha-gal associated with AGS, and up to 9% of these individuals may have full-blown AGS. A recent study found that more than 2% of a cohort from central Virginia had AGS. Other estimates suggest that up to 3% of people in the hardest hit areas may be affected. The CDC encourages states to report cases of AGS and has laid the groundwork for states to make AGS reporting mandatory. In September 2023 Arkansas became the first state to make AGS a mandatory, reportable health condition. Other states in high prevalence regions are expected to follow suit. By passing HB 93, you can make a lasting impact on the health and well-being of thousands of Virginians. This legislation presents a pathway to document the true prevalence of AGS and monitor its expansion, which is needed to facilitate and fund public health measures addressing this issue. Sincerely, Sharon Forsyth Alpha-gal Syndrome Awareness Campaign https://alphagalinformation.org/

I have Alpha-gal Syndrome. It's an allergy to mammal meats, products, and by-products. It can be life threatening, as reactions can present as anaphylaxis. Please pass HB 93 and make this tick-borne disease reportable to the CDC, so tracking of cases and it's spread can be evidenced. There is very little knowledge of this in the medical community, and resources and research are limited. By putting a quantitative spotlight on Alpha-gal Syndrome we have a better chance, as a state, to build valuable resources, advance medical knowledge, and unite agencies that should be working on this together to mitigate the spread and help those afflicted. Thank you

The Va Academy of Nutrition and Dietetics (VAND) strongly encourages reconvening this committee that has provided powerful Insights in the past to the disparities in Maternal Health and Mortality and highlighted Va’s higher levels in some population. Please support this important work for the Commonwealth as we work to improve access to care and improved outcomes for women and children in the state. Please reach out if we can provide more information on the role of nutrition in preventing poor outcomes in pregnancy And after the pregnancy. Thank you, Lesley McPhatter, MS, RDN, CSR

I support this bill. This bill provides measures for collecting and evaluating maternal health data to help guide life-saving and quality of life policies in the Commonwealth to improve maternal care, quality, and outcomes for all birthing people.

Comments Document

Regarding HB 169: This bill is urgently needed in our state. While Virginia's Department of Health Review team has worked hard on the issue of reducing maternal mortality, the Journal of the American Medical Association, the March of Dimes and other organizations have found that some states have had more success in recent years in bringing down the disparity between Black mortality and other racial and ethnic groups than Virginia has had to date. In July 2023, JAMA published an article called, "Trends in State Level Maternal Mortality by Racial and Ethnic Groups in the United States", and they found that these deaths were preventable and that Virginia was one of the states with some of the highest disparities in maternal outcomes. Illinois, on the other hand, stands out as an example rapid-paced progress that I hope Virginia will seek to duplicate or otherwise match. I have included a pdf attachment. It is a short document produced by Illinois discussing their approach. I hope the committee will consider language in the bill that will spur efforts to bring down the rate of these entirely preventable deaths a truly urgent matter that a wealthy and resourceful state such as ours should be able to accomplish.

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Hi I am writing to you on behalf of The Well Connection UK, a media and publishing company. We could easily get virginia.gov featured in various publications such as magazines, online blogs and news sites. This would undoubtedly help virginia.gov with publicity, reputation, domain authority and organic search engine rankings. We have a wide range of options including completely free collaborations, sponsored posts, guest posts and banner ads. If this sounds of interest, please reach out to the senior business development manager, Anita at info@thewellconnection.co.uk and whatsapp +447395206515 (GMT) Kind regards Clifton Junior Outreach Assistant

I am a sickle cell caregiver to my son. I fully support all bills that brings awareness and support to this painful disease. I support HB252 where there needs to be a statewide registry. No sickle cell patient should feel judged or labeled as drug seeking which is the reason I support HB257. My son has been admitted two times in 6 months. Each time has been stressful but a plan was put in pace both times and the care was great for him. As an adult, I fear his care may not be a great due to the labels that come with disease by some medical professionals. I feel these bills are a great start leading us in the right direction. We need sickle cell patients to know that they matter and will get the care they deserve. I support HB820, as well as HB255.

To the honorable members of the Health and Human Services Committee I am Robin Whitley the co-Convener for Hampton Roads of the Black Women’s Roundtable VA. We support issues that surround Black Women and Black Girls. Sickle Cell Anemia is prevalent among members in my paternal familial lineage. I was raised to believe I carried a Sickle cell trait but fortunately I do not. So many babies are born to women with this debilitating disease , when in fact with education, tracking, resources and research we can significantly reduce the number. I support HB 252 to develop a statewide registry to help build a database of individuals with SCD and match them with resources, screenings, generate data for funding and implement useful tools and programs. I also support HB255 There has to be a way to screen people to determine if they carry a sickle cell trait and annual physical exams are a good way to start with consent and an option to opt out. Likewise, I strongly support HB 820 to keep up with medical advancements and cutting edge technology and treatments for Sickle Cell Anemia to give assurance to all those diagnosed who should be on a state registry. HB257 is needed for adults who are going through crisis and may not have medical insurance or come to an ER for treatment as are often labeled as drug seeking. Finally, Sickle Cell Anemia is a painful disease but we can work together to make a huge impact. Please support these bills and thank you for considering my written statement.

I am a sickle cell caregiver to my son. I fully support all bills that brings awareness and support to this painful disease. I support HB252 where there needs to be a statewide registry. No sickle cell patient should feel judged or labeled as drug seeking which is the reason I support HB257. My son has been admitted two times in 6 months. Each time has been stressful but a plan was put in pace both times and the care was great for him. As an adult, I fear his care may not be a great due to the labels that come with disease by some medical professionals. I feel these bills are a great start leading us in the right direction. We need sickle cell patients to know that they matter and will get the care they deserve. I support HB820, as well as HB255.

I hope this message finds you well. I am writing to express my wholehearted support for the proposed bill that mandates adult wellness screening for sickle cell disease or the sickle cell trait during annual physical examinations in the Commonwealth. As the mother of two incredible daughters, Olivia (17) and Morgan Tarrer (13), both diagnosed with sickle cell disease at birth, I am acutely aware of the challenges faced by individuals and families affected by this condition. The introduction of mandatory screening tests is a significant step toward early detection and intervention, aligning perfectly with our collective vision of enhancing the quality of life for those living with sickle cell disease. Our family has recognized gaps in care, prompting us to establish the Virginia Sickle Cell Network—a sustainable network of resource partners dedicated to providing comprehensive support to individuals and families affected by sickle cell. We focus on advocacy, awareness, education, and support to meet the physical, psychosocial, and economic needs of our clients. The proposed bill creates an invaluable opportunity for collaboration. When adults undergo screening for sickle cell disease or trait, we can seamlessly integrate them into our network. The Virginia Sickle Cell Network welcomes individuals, caregivers, healthcare providers, educators, employers, and human services agencies to join our community. Together, we strive to achieve the following objectives: 1. Promote sustainable whole-person health for individuals and families affected by sickle cell disease. 2. Facilitate access to quality care for those who are underinsured, non-"established," or displaced individuals. 3. Connect patients and caregivers to community resources that address known social determinants of health, such as education, finance, food, health, housing, and transportation. 4. Cultivate future healthcare providers, educators, and employers dedicated to the compassionate management of those affected by sickle cell disease, aiming for optimal health outcomes. By supporting mandatory adult wellness screening, you contribute not only to public health but also to the empowerment and well-being of individuals and families affected by sickle cell disease. I encourage you to champion this bill, recognizing its potential to make a positive impact on the lives of countless individuals across the Commonwealth. Thank you for your consideration and commitment to the health and welfare of our community. Sincerely, Khristina Reid kreid@vasicklecellnetwork.org Virginia Sickle Cell Network Kreid@vasicklecellnetwork.org

HB52: Excellent, we're finally getting it. HB255: I would limit this to those people at higher risk for this. There maybe a cost for testing. Not everyone can afford that. The bills finally addressing sickle cell are long overdue. I wish that there was a registry of some sort that medical professionals can access, so that pain medications would not be so stigmatized in this disease.

To the honorable members of the Health and Human Services Committee I am Robin Whitley the co-Convener for Hampton Roads of the Black Women’s Roundtable VA. We support issues that surround Black Women and Black Girls. Sickle Cell Anemia is prevalent among members in my paternal familial lineage. I was raised to believe I carried a Sickle cell trait but fortunately I do not. So many babies are born to women with this debilitating disease , when in fact with education, tracking, resources and research we can significantly reduce the number. I support HB 252 to develop a statewide registry to help build a database of individuals with SCD and match them with resources, screenings, generate data for funding and implement useful tools and programs. I also support HB255 There has to be a way to screen people to determine if they carry a sickle cell trait and annual physical exams are a good way to start with consent and an option to opt out. Likewise, I strongly support HB 820 to keep up with medical advancements and cutting edge technology and treatments for Sickle Cell Anemia to give assurance to all those diagnosed who should be on a state registry. HB257 is needed for adults who are going through crisis and may not have medical insurance or come to an ER for treatment as are often labeled as drug seeking. Finally, Sickle Cell Anemia is a painful disease but we can work together to make a huge impact. Please support these bills and thank you for considering my written statement.

I am a sickle cell caregiver to my son. I fully support all bills that brings awareness and support to this painful disease. I support HB252 where there needs to be a statewide registry. No sickle cell patient should feel judged or labeled as drug seeking which is the reason I support HB257. My son has been admitted two times in 6 months. Each time has been stressful but a plan was put in pace both times and the care was great for him. As an adult, I fear his care may not be a great due to the labels that come with disease by some medical professionals. I feel these bills are a great start leading us in the right direction. We need sickle cell patients to know that they matter and will get the care they deserve. I support HB820, as well as HB255.

To the honorable members of the Health and Human Services Committee I am Robin Whitley the co-Convener for Hampton Roads of the Black Women’s Roundtable VA. We support issues that surround Black Women and Black Girls. Sickle Cell Anemia is prevalent among members in my paternal familial lineage. I was raised to believe I carried a Sickle cell trait but fortunately I do not. So many babies are born to women with this debilitating disease , when in fact with education, tracking, resources and research we can significantly reduce the number. I support HB 252 to develop a statewide registry to help build a database of individuals with SCD and match them with resources, screenings, generate data for funding and implement useful tools and programs. I also support HB255 There has to be a way to screen people to determine if they carry a sickle cell trait and annual physical exams are a good way to start with consent and an option to opt out. Likewise, I strongly support HB 820 to keep up with medical advancements and cutting edge technology and treatments for Sickle Cell Anemia to give assurance to all those diagnosed who should be on a state registry. HB257 is needed for adults who are going through crisis and may not have medical insurance or come to an ER for treatment as are often labeled as drug seeking. Finally, Sickle Cell Anemia is a painful disease but we can work together to make a huge impact. Please support these bills and thank you for considering my written statement.

On behalf of SAARA of Virginia we endorse Del. Hope's bill on Naloxone or other opioid antagonists onto its next stages. Thank you.

Michael Sizemore, Advocacy Manager of SAARA

Comments Document

Attached please find a letter from the National Safety Council (NSC) urging your support of HB 342, which would require state buildings to have opioid overdose reversal medications on site and train state employees on its use. This legislation is lifesaving and will help keep Virginians safe in the workplace.

The Va Academy of Nutrition and Dietetics (VAND) strongly encourages reconvening this committee that has provided powerful Insights in the past to the disparities in Maternal Health and Mortality and highlighted Va’s higher levels in some population. Please support this important work for the Commonwealth as we work to improve access to care and improved outcomes for women and children in the state. Please reach out if we can provide more information on the role of nutrition in preventing poor outcomes in pregnancy And after the pregnancy. Thank you, Lesley McPhatter, MS, RDN, CSR

I am a sickle cell caregiver to my son. I fully support all bills that brings awareness and support to this painful disease. I support HB252 where there needs to be a statewide registry. No sickle cell patient should feel judged or labeled as drug seeking which is the reason I support HB257. My son has been admitted two times in 6 months. Each time has been stressful but a plan was put in pace both times and the care was great for him. As an adult, I fear his care may not be a great due to the labels that come with disease by some medical professionals. I feel these bills are a great start leading us in the right direction. We need sickle cell patients to know that they matter and will get the care they deserve. I support HB820, as well as HB255.

I hope this message finds you well. I am writing to express my wholehearted support for the proposed bill that mandates adult wellness screening for sickle cell disease or the sickle cell trait during annual physical examinations in the Commonwealth. As the mother of two incredible daughters, Olivia (17) and Morgan Tarrer (13), both diagnosed with sickle cell disease at birth, I am acutely aware of the challenges faced by individuals and families affected by this condition. The introduction of mandatory screening tests is a significant step toward early detection and intervention, aligning perfectly with our collective vision of enhancing the quality of life for those living with sickle cell disease. Our family has recognized gaps in care, prompting us to establish the Virginia Sickle Cell Network—a sustainable network of resource partners dedicated to providing comprehensive support to individuals and families affected by sickle cell. We focus on advocacy, awareness, education, and support to meet the physical, psychosocial, and economic needs of our clients. The proposed bill creates an invaluable opportunity for collaboration. When adults undergo screening for sickle cell disease or trait, we can seamlessly integrate them into our network. The Virginia Sickle Cell Network welcomes individuals, caregivers, healthcare providers, educators, employers, and human services agencies to join our community. Together, we strive to achieve the following objectives: 1. Promote sustainable whole-person health for individuals and families affected by sickle cell disease. 2. Facilitate access to quality care for those who are underinsured, non-"established," or displaced individuals. 3. Connect patients and caregivers to community resources that address known social determinants of health, such as education, finance, food, health, housing, and transportation. 4. Cultivate future healthcare providers, educators, and employers dedicated to the compassionate management of those affected by sickle cell disease, aiming for optimal health outcomes. By supporting mandatory adult wellness screening, you contribute not only to public health but also to the empowerment and well-being of individuals and families affected by sickle cell disease. I encourage you to champion this bill, recognizing its potential to make a positive impact on the lives of countless individuals across the Commonwealth. Thank you for your consideration and commitment to the health and welfare of our community. Sincerely, Khristina Reid kreid@vasicklecellnetwork.org Virginia Sickle Cell Network Kreid@vasicklecellnetwork.org

To the honorable members of the Health and Human Services Committee I am Robin Whitley the co-Convener for Hampton Roads of the Black Women’s Roundtable VA. We support issues that surround Black Women and Black Girls. Sickle Cell Anemia is prevalent among members in my paternal familial lineage. I was raised to believe I carried a Sickle cell trait but fortunately I do not. So many babies are born to women with this debilitating disease , when in fact with education, tracking, resources and research we can significantly reduce the number. I support HB 252 to develop a statewide registry to help build a database of individuals with SCD and match them with resources, screenings, generate data for funding and implement useful tools and programs. I also support HB255 There has to be a way to screen people to determine if they carry a sickle cell trait and annual physical exams are a good way to start with consent and an option to opt out. Likewise, I strongly support HB 820 to keep up with medical advancements and cutting edge technology and treatments for Sickle Cell Anemia to give assurance to all those diagnosed who should be on a state registry. HB257 is needed for adults who are going through crisis and may not have medical insurance or come to an ER for treatment as are often labeled as drug seeking. Finally, Sickle Cell Anemia is a painful disease but we can work together to make a huge impact. Please support these bills and thank you for considering my written statement.