From WXXI news.

This is connections.

I'm Evan Dawson.

This is the fifth in our series of conversations with your elected leaders.

Following the passage of the recent New York state budget, the budget of more than $270 billion that passed just before the end of May.

And we've been talking to your elected leaders about not only the process.

It was a very late budget this year.

It led to a very short legislative session, but also some of the issues not only related to the budget, but some other New York State business issues going on here.

We're talking about data centers and debates from the Trump administration about Ice and their behavior, and a lot more here.

Senator Samra Brouk is my guess from district number.

I have 55.

Is that correct?

Is it still 55?

50?

55?

It's nice to see you back.

It's great to see you too.

Thank you for being here.

And and we're also going to talk later this hour about black maternal health.

And certainly that is something that Senator Brouk has been focused on.

We'll be talking about that with the Senator as well.

Listeners, you can ask questions as well if you want to email the program connections at WXXI, Dawg Connections at Georgia.

You can join the chat on YouTube if you're watching live in the six news YouTube channel.

What was it?

Was there one big headline from the budget this year to you?

Oh well, first of all, I think this budget was one for the bucks.

Honestly, I think in my tenure this is the latest budget we had.

So, you know, process wise, I think my headline is you never really know.

You know, there were so many people saying, oh, I think we've got it.

I think we're doing it.

And just it just kept going and going and going.

But I think, you know, one thing I will say is it's an arduous process, but I think compromises were come to on several, items.

Now, was I elated about all of them?

No.

But I am at least pleased that we were able to move in some direction.

And then, you know, honestly, especially locally and through my chair position, a major headline is that, we got the second year of funding for the Daniels for pilots.

And, the reason why that's so important is that last budget season, the governor really put mental health at the top of her list.

Right?

And we were talking about that, it was a major part of her executive budget.

And so we were kind of in the arena.

Right.

Like that was the table that everyone was negotiating and and we were able to to that negotiation, get this $8 million for the Daniels law, first phase.

So this year it was really up in the air.

You know, mental health was not a major cornerstone of the governor's budget.

And when that happens, it becomes that much harder.

And so knowing that we were able to get a second year of that $8 million really shows that.

I do think we're on the right track to finally passing it.

Remind the audience for Daniels lawyers.

Yes, I guess I just figure everyone at this point knows Daniels law.

So, you know, Daniels law is certainly, the my kind of marquee legislation that I hold with some member Bronson introduced in February 2021.

It is named for Daniel Prude, who, as we all know, lost his life, while he was in a mental health and substance use crisis because we didn't have the right people to show up.

And so what Daniels law does is it creates a statewide, a statewide, response system for, mental health responders to show up to those, mental health crises.

And so, you know, we see other states doing this.

And truthfully, we have municipalities across the state who do it right.

We have the pick team here locally.

We've got different things in different counties.

But what we're trying to do is create a statewide standard so that no matter where you find yourself in any corner of New York State, you know that if you are in a crisis, you the right trained people, peers, mental health counselors, social workers will show up.

Who opposes it?

You know, we had opposition in the past.

I think now there's usually individuals who are opposing it.

It's because of a lack of understanding and a lack of ability to kind of see how it will play out.

And that is, exactly why we did the Daniels Law Task force.

Right.

And so we have a report that we can really look at that brought in perspectives from all over the country and even up to Toronto.

So it was technically an international report.

And so that really showed us how we can implement this in New York State.

But that's also why we're doing this phased approach that came from the report from the task force saying this should really be a phased in approach.

Let's see how it works in the urban, suburban and rural areas and let's, you know, kind of scaffold the funding that way.

So when you say, you know who's against it, I don't know of any major groups who are against making this move.

I think it's really in the weeds of how do we move it forward, how you know, how quickly do we go, how much do we fund it at those kinds of things, which is a great place to be.

I wonder if, the way you characterized Daniel Prude's death, is that he was in the midst of a crisis, mental health and substance abuse, and he we didn't have the right people to show up at this point.

Years later, do you think the RPD agrees with that characterization?

I would never, you know, speak for someone else or speak for an entire police force who, you know, I'm sure throughout the force, different police.

Right.

But what about the leadership?

Do you think the leadership agrees with it?

I don't know.

You know, I don't know how they would characterize it.

What we do know, though, is from the aftermath of the Daniel Daniel Prude's death, what we did learn is that I think largely law enforcement that was involved was following the protocol that they knew.

And so as a policymaker, the thing you want to look at is if that's the protocol, we've got to change the protocol.

And so we took it a step further, where instead of just changing our protocol of a police force, let's change the entire emergency response protocol.

And so I do think that there's large agreement about that.

But of course, you know, I would never put words in someone's mouth.

But I will say the police Chief Association is in support.

It is in support of Daniel's law.

You know, I wrote, an op ed a couple of years ago with the former police chief, but now current police chief in Albany.

So I do think there's an understanding that we need to start differentiating, right, the different types of emergencies and have the correct people answer so that police aren't overburdened with everything.

And you got the chiefs on board.

The police chief's Association has given us, not just support, but also explained in their own terms, right, that they understand that their presence escalate the situation inherently.

So it's been it's been a good back and forth of discussing this.

And so what needs to happen in the future to get it fully where you want it to go?

Well, where I wanted to go is full state wide implementation, be the first state that has a state wide, law like this on the books.

The next steps, I think, are, there is a report due, from that pilot funding.

So, you know, pick got the $2 million, other areas.

Got it.

I think one down in Long Island, and one in a more rural area.

And so we want to look at that report, and then we want to make an informed, fiscal ask of, of the money that we believe this truly needs to do it.

Right.

Throughout New York State.

And then it becomes a budget ask I'm trying to get this into a future budget.

All right, talking to Senator Sommer Brook here, let's, and we're going to divide this hour into two parts here, and we're going to move fast with the senator because there's a lot to cover.

I was driving through a rural part of New York State this weekend, and I was moved by how many signs I saw with it.

Just a data center with a slash through it.

And, in the rural part, I mean, I'm not saying the any other parts of the state would agree or disagree.

I'm just I noted a bunch in a rural area that was probably a more conservative area politically.

That tends to be how this works.

The eastern part of your district is more rural than the western part of your district.

What have you heard from constituents on the data centers, the data center moratorium?

And where do you stand on that?

Yeah.

It's always interesting to travel around and see how different the areas are.

And it's one of the amazing things about the 55th district, because we do have a little bit of everything, which I think keeps me honest and keeps me really informed as to what a diverse, you know, constituency, believes.

I have to tell you, I think, emails and calls about, voting on a moratorium for data centers was one of the highest volumes we've ever seen on really any topic.

And so this year it was a very hot topic, for individuals calling in and asking me to support, a moratorium in legislation around that.

I did support the legislation that passed through the Senate.

And I support, you know, the governor expediting some of that, through her executive order.

Conceptually.

And so, you know, where I stand is shouldn't be a surprise to anyone.

It's generally how I approach most of our issues here, which is first and foremost, it's is this community driven.

Does the community fully understand, are they educated on this change that may be coming to them?

And we have to remember that this is a time when we are seeing from all over the country, right, in Georgia, in some of these other state horror stories that we're seeing in the news around how this has changed people's lives, their ability to have drinkable water.

Right.

Their ability to have peace in their communities.

And we're seeing that in so many instances where they don't have, better relationship with, you know, constituencies as we do in New York.

There's neighbors who were not informed and not involved in the decision making.

So I think that we absolutely need to better understand what this means for the communities where they're going to be built.

I think we have to have a full grasp on what it means, for, the environment.

But of course, environment is not, you know, this, nebulous idea.

It is literally the air we breathe.

It is the water we drink, it is the food we eat.

Right.

And so I think there needs to be a good sense of that, especially for communities which are often rural communities that don't feel like they have a strong voice.

And I know in New York that is the case as well.

So I'm really interested in seeing more information on exactly what this means.

And the last thing I'll say is I'm not anti-tax.

I'm not, you know, I worked in the tech industry for a long time.

What I know, though, is private sector technology often outpaces our ability to create policy to safeguard.

And so I'd like to see those things happen at the same time.

All right.

Two more quick ones on this.

I don't know.

I, I suppose there may be some Republicans who support the moratorium.

I don't know, it's been very sort of politically divided on this program.

And your Republican colleagues in the legislature have told me that they think the concerns that you're talking about are overblown, and that if New York State ups out of data centers, other states will opt in and we're going to lose out on jobs, construction, all kinds of economic development.

Well, you know, I've actually met with the like, for example, the local building trades.

And they were disappointed.

Right.

Those were real jobs.

And I'm not saying that they aren't.

I'm saying they may be delayed for sure.

And I think absolutely the building trades, along with committee members, everyone should be at this table making a very, impactful decision for a community, whether it's negative or positive.

Right.

So I don't disagree that this could bring jobs.

It it will hopefully.

Right.

And we should work with those individuals who it will employ.

And at the end of the day, you don't have a workforce if you don't have water.

That is drinkable, you don't have a workforce.

If you don't have clean air, guess what?

When they're done working their tails off at work, they want to go home and they want it to be peaceful.

They don't want actually most people at data center right in their backyard.

There have to be certain conditions.

And, you know, unfortunately, I think it's kind of I think on the other side, a scare tactic, right, to, say, well, everyone's going to leave, no one's going to do it.

And it's like, well, we have to worry about the health of the human beings who do that work.

And then a tech question is, you know, you've got to experience in tech and, data centers, not all about AI.

And this is not even a data center question.

This is an AI question.

The heads of the AI companies tell us that they think there's anywhere between a 5% and a 25% chance, or sometimes even higher, of human extinction from AI.

Like within our lifetimes, you know?

So probably not, but also maybe.

So what would it take for you to actually oppose AI?

I mean, like support actual pausing or stopping of any sort of AI progress does that, I guess I'm I want to are you unnerved by what the tech leaders are saying about what could happen with AI?

I think a logical person listening to something like that should be a little unnerved.

Yeah, right.

Nobody like, opposes like or is like standing up to say, hey, wait, we should actually stop it.

Well, I don't know if that's true, to be honest.

Like, you know, I know that, so I used to be on our information technology committee in the Senate.

Senator Gonzalez is the chair of that.

And we've talked at length and she has brought to our conference, on multiple occasions around things we need to do to, better understand AI and ensure that it is not causing harm.

Whether it's to children, whether it's to those with mental illness.

And so in New York State, we've actually looked at a number of pieces of legislation around kind of curbing those effects.

Now, the truth is, once technology is out there, it's nearly impossible to just, you know, the cat's out of the bag, right?

You can't stop innovation in that way.

But we do need to be thoughtful.

I think, around how it's advancing.

Is it being done?

You know, consciously.

Is it being done, you know, with racial justice, social justice in mind and, and really thinking through the negative and positive impacts that it brings.

So I think that's probably more the measured approach, which maybe is why everyone's not, you know, there's no one saying, stop it, just stop all of it.

Right.

Other than maybe like, you know, my, my grandmother who's maybe, you know, doesn't really want it, although she uses it now too.

So, but but I'll tell you, it's a great example of why we're trying to curb some of that, because actually, I heard a story of someone, you know, asking AI about, like, a diagnosis or something to do medically.

And I was like, no, they are not doctors.

You need to talk to your, you know, your physician.

You're human beings in charge.

Yes, yes.

We need human beings in charge.

Okay.

Some other issues that Charlie emails to ask Evan at this.

At the risk of sounding like a broken record, can you ask Senator Brouk the current status of fixing tier six for teachers and state workers?

I just spent two months teaching back in the city after retiring in 2024, and the overwhelming discussion topic was whether tier six could be fixed to a more reasonable level.

Several millennial teachers had quit where I subbed, and the others are doubting whether they teach until retirement and survive financially.

Yes, I know some changes have been made, however, I believe more should be done.

This is an existential issue.

Every year I get a letter asking if I'd like to go back full time.

That's how desperate districts are getting.

Yeah, Charlie, I'm with you.

As are some of my neighbors who just walking my dog around the neighborhood.

People are bringing this up to me, and we're bringing it up to me.

Actually, on behalf of their adult children, who taught locally.

So, I mean, Charlie said it there, and I wasn't sure if he was aware, but yes, we did make changes.

Some substantive changes for the first time in a very long time.

This year.

Now, is it enough?

Probably not.

Obviously, there's still massive shortages.

Obviously, this is an issue we need to continue working on, but here's why I have hope.

And I actually shared this with a lot of the teachers who we we talked about, you know, where we landed in the final budget.

The reason I have hope is because just a few years ago, when tier six came up, at least, you know, in the Senate conference in Albany, it was this idea of, sure, you know, that's great that you support that, but like, that's never going to go anywhere.

That's not going to happen.

You know, it's not an organized play.

You know, unions really need to organize against this and all of this fast forward three, four years later, and I shared this with a lot of the individuals, you know, who are working on this, mostly in the labor movement, that it is unbelievable what the labor movement has done to organize itself from public, you know, all from all kinds of different entities, right?

Teachers, nurses, all of this and really make their voices heard in Albany.

And I think we have begun to put a face to what this means, not just for the individuals who are stuck right into your six, but for, you know, the kids who need that education.

And for all of these things, there is a ripple effect.

So I think we are on the right track now that we've been able to do something.

The governor obviously understands this will continue to be a priority.

And I think now it's, continued collaboration, right?

Every time I meet with any group, I say, if you think you're loud, be louder, right.

Because we have to make sure that people understand that there are faces to these issues.

And many times these are those frontline workers who we depended on for education, for medical care.

Right.

Who aren't going to receive, what they need to support their own families and maybe could move to a private sector.

Oh, they could they could move out of state.

They can move anywhere.

Yeah.

You Republican colleagues say we can't afford this.

Yeah, well, I think that's a common thing that we hear.

Right.

I think again, a budget is about your priorities.

And if we believe that these workers are a priority, if we believe that people deserve to put in work, to put in their time and to actually, you know, get the funds back to support their own families and live comfortably and stay in those careers that they love.

Then it's a worthy investment.

When your colleague, Sarah Clarke from the Assembly was on this program, she talked a little bit about this.

And I want you to talk about the headline said Senator Samra Brouk and Assembly Member Sarah Clarke passed child care capacity expansion legislation.

So she talked a bit about it.

Can you describe, why this was a priority and what this means?

Yeah, I love caring child care bills Assembly member Sarah Clarke, she, schooled me on this, you know, before I started.

And now, you know, I love working on it.

She's so, so passionate.

So, you know, this, expansion bill is really about creating parity, you know?

So I think and, you know, again, I've learned this from some member, Clarke around how we actually attack this issue of the childcare shortage, right?

There not being enough seats of people not making enough money.

And one of those things is around the fact that there are simply different rules for the number of children based on age, whether you're in a center or if you're in a home.

Other than that, the care is pretty much the same.

So this is really it's a it's funny, it's a very small change, but it would actually open up more seats.

And, I think it was last year or the year before we joined with a number of, you know, in-home care providers and got to visit and see, these are beautiful, homes that they've created and centers they've created, and they have the ability the same as a center based, daycare has the ability.

And so, you know, again, I am the mother of a toddler and an infant.

I, I, you know, I hope it's understood that I would do the due diligence to make sure that there was never an issue with safety for children.

And this, I believe, is not something that will diminish safety but will increase capacity.

Yeah.

That was one of the things that, we talked about with your colleague.

And my guess is that if anything got hung up here, it was this idea of, well, don't you need more people, you know, the ratio of provider or caregiver with kids?

Are you worried about safety?

What you're saying is there's a red line on safety for you.

This bill does not cross any red lines on safety.

Yeah.

Fair as written.

Absolutely.

I mean, you know, obviously we've seen horror stories that always make the headlines and they absolutely need to be investigated and taken care of.

And it's horrifying for a parent.

But as written, this legislation really doesn't, kind of cross that line of making anything dangerous and proven by the fact that we're working with O'Keefe's on, you know, some of these changes so that they're also comfortable with it.

So in our second half hour, we'll talk more about some of these issues.

But I want you to talk a little bit, if you could, about the community doula directory and what happened in this year's budget and what that is.

Yeah.

So help people understand that.

Yeah, absolutely.

So the community doula directory, really came to be once we finally passed, Medicaid coverage for doula care.

And so doula care, again, doulas are non-medical professionals that give informational, emotional, physical support, before, during and after childbirth, to both the birthing person and the partner, if there is one.

And so the major change was that we fought to get Medicaid coverage for doula care.

That represents about 1 in 2 births in New York State, because that many folks are unmedicated, during childbirth.

And so with that comes the idea of, okay, now we need to get doulas to accept Medicaid, which is sometimes an honors process.

And we need people to understand who the community dollars in their areas are.

And so, we passed my legislation for Deo to create this doula directory.

I think the headline actually, now that we have that directory is one we've gotten it up to over $400 are now in this directory.

I mean, that number has continued to go up and up and up.

But on top of that, we've also kept in very tight communication with the dual community in New York State.

We joined meetings, weekly, with them to understand the needs and how it's rolling out, but also the Deo.

And so most recently, we were able to kind of liaise some information that came to us through the doula community with Deo to actually make changes to the directory to ensure that the information was actually getting to the individuals who needed it, little things like making sure, you know, translations are more accessible for individuals who are seeking information, not in English or easier.

Representation.

So you can see more easily where these doulas serve, right, in which county.

And so, so that, you know, continues to grow.

But I think, you know, the headlines are gone of like, Medicaid for doula care, right?

We did that a couple of years ago.

Now, it's kind of the hard work that a lot of people won't see, which is how do we actually get this care in the hands of people who need it?

Has there been any opposition in Albany as you've worked on this?

Do you like funding this?

Yeah.

Well, on the funding, you know, we also get a dual expansion grant, which I fought for a quarter million dollars.

In the first year, we've been able to get that every year.

So, you know, it's always a fight to get that money.

But other than that, I'm very proud to say I can disagree on everything else having to do with maternal and reproductive care with my Republican colleagues.

But we agree on doulas.

You do.

We do.

A lot of them have daughters who have had doulas.

And so it's a very nice conversation, in general, on the issues of, mental health, postpartum care and anything else you want us to understand about anything that you're working on in Albany on those issues?

Yeah.

Well, I think, you know, in especially in this budget as well, we tried to increase some of the investments in maternal mental health care that continues to be one of the most common, the most common complication that people are facing.

It's 1 in 5 women.

It does not look the way you think it's going to look.

It's not just postpartum depression.

It's anxiety, it's OCD.

And so, we did have increased, funding for postpartum support.

But every day I hear from people who don't know about those resources.

So we've got to do more, to get that information out.

And on the mental health side, a really exciting one is that there is now, teen mental health first aid for every 10th grader in New York state.

This is something that my office did just as a community program every year on the back to school time.

And now it's going to be statewide for all 10th graders to get that training, which I think is absolutely paramount to, address the mental health crisis of our young people, because that peer support is proven to be the most effective.

All right.

So those are some issues we're going to talk about in our second half hour.

Can I squeeze in two more I know I'm respecting your time here.

Squeeze okay.

Okay.

Briefly here I want to get back to law enforcement.

New York State, is doing its part to try to bar ice from wearing masks when they are doing their duty.

So we've seen across the country, Ice agents, especially this winter, spring, summer, wearing masks when they are engaged in all kinds of activity.

And New York State essentially saying, you cannot do that.

The Trump administration has tried to intervene in various ways legally.

The Trump administration says New York state is out of line here.

First of all, where were you on this issue?

Oh, I mean, I think it's a major step forward for us to implement something like this.

And I think it goes down to the fact that and this was a lot of conversation that was had as well in Albany.

The fact is, when you put on a uniform the same as any, elected official government official, there is a higher bar for your conduct for, how you treat others in that position.

And we are all deserving of understanding and knowing who is coming, you know, to enforce whatever law on us.

And so it's it's a safety measure as well.

Right.

And so we've seen what happens when we don't have some of these, safety measures, and we see a terrorizing of communities across this entire country.

We've seen terrorizing of communities right here.

It wasn't too long ago I was there on, Westminster Road, West Westminster.

It right in the park area.

And so, you know, listen, if you're going to wear that uniform, if you are going to represent this country or this state, then there is also an obligation that you come your face is shown, your name is shown, and you're doing that work in the confines of that role.

Some of your Republican colleagues have told us they're concerned about doxing about people being harassed at home or worse.

And, you know, as a public figure yourself, I, I've never met a public figure who didn't have to endure some sort of heat.

But what do you make of the concern that some of your colleagues have about doxing?

Well, as someone who's experienced this.

Right.

And a lot of elected electeds have, unfortunately, it's a different time right now to be an elected official.

We are very, I think vulnerable in many ways.

And things are just shifted in the political winds.

And we've got a, you know, a president that's condoned violence.

So, so that is true.

And I'm not going to say that's not a scary thing, because it is.

I also believe that the answer is not that you get to hide your identity while terrorizing the individuals in the community.

Lastly, environmental goals.

The New York Times says that this budget makes New York State no longer a national climate leader.

Do you agree with that characterization?

I still believe we're a leader, to be honest.

I still believe New York is a leader.

We've done a lot of things.

First and you know, the like you know, to the highest order than a lot of other, state.

Was I disappointed that it was a conversation to kind of slow down some of that trajectory?

Absolutely.

I think that is the existential biggest threat to future generations and ourselves.

We are already living it.

Right.

So this budget goes too far.

You think, on pulling back, I think it's a compromise.

I think it's a compromise.

We had to get to the end of budget season, right?

Like we had to get dollars out the door to programs that needed at our schools, needed a finalized budget.

You know, they were going deep into me without it.

And that is the reality of state government, right?

We're not we're rarely going to solve a major issue in one session.

A lot of things have to build on each other.

And so nothing is the final word.

And my hope is that environmental advocates and environmental justice advocates, you know, work with us as we continue into future sessions to ensure that we don't fall behind.

Is that your biggest disappointment in this budget season, or is there that'll be the last question is, do you have to squeeze in so much more?

I really, do you have a bigger disappointment?

I mean, I'm always a little disappointed because if I were writing the budget, it would be the way I think, you know, everything should go.

And I think we do need to be bold when it comes to environmental protections and investing.

I also understand the absolute pragmatic and realities of where we are and what is actually feasible.

And so, to have this job is to constantly be a little disappointed in where things land, but not the most disappointed.

Right?

And to still find some things to be proud of, like the Daniels law funding, like the dollar funding, like, you know, the foundation aid increases.

So there's always something good that comes out of it.

Come back.

Well, let's come back and talk more extensively about Daniels law in the future.

I mean, I mean, I know there's a lot that's going to happen.

Thank you for your time, as always.

Absolutely.

Thank you.

State Senator Samra Brouk from district number 55.

Short break.

And on some of the themes we've been talking about, we'll continue the conversation on the other side.

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This week.

Economist Eric Morris is helping us sort through a number of issues related to the economy, especially related to the affordability crisis.

What is driving prices up?

What would allow prices to come down?

Why are food prices so sticky and so high?

What about housing?

Other things?

We'll talk about it next hour.

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This is connections.

I'm Evan Dawson a few months ago, we had a chance to sit down with Phyllis Sharp and talk to Phyllis, who is a certified doula and owner of Royalty Birth Services, about some of the work that Phyllis does that her colleagues do, but also some of the things that might make it more accessible for more people.

And that's some of what Senator Brouk was talking about.

We're going to continue that conversation.

Phyllis is back with us.

Grab that microphone.

Get real close to you, both of you ladies, if you could.

Nice to see you back here, Phyllis and I. It's nice to see you as well, too.

And did I hear did you say you helped deliver you around for twins coming into the world today?

Twins this morning and twins this morning.

How are they doing?

They doing fantastic.

Well, mom, it is nice to see you.

And nice to see Tracy Renee Webber, who is director of the midwifery division at the University of Rochester Medical Center.

Yes.

Thank you for being here.

Thank you for having me.

Tell us what the midwifery division is, because sometimes you, as you know, people say midwives.

Oh, and then you have this idea of what a midwife is versus what a midwifery division is going to do.

So what do you do?

Okay.

So a midwifery division is made up of midwives right.

So certified nurse midwives at the University of Rochester, we are registered nurses who have advanced practice training in complete ObGyn care.

So we take care of patients not only throughout pregnancy, low to moderate risk pregnancy, but also during care, infection testing, contraceptive management, breast health, pelvic health, other things and how would you say the public understanding of what midwifery is has sort of progressed.

Do a lot of patients do a lot of expected mothers have an understanding of what it is that you do?

Yeah.

The one thing that confuses our patients on occasion is they say, okay, I have my baby.

So I'm going to go back and find a guy in and I'm like, no, we do that too.

Like, I think they think that we deliver babies and that's it.

But we provide full scope.

What we doing here?

Okay.

And so some of what Senator Brouk talked about is related to well, I'm going to start with the community tool, a directory here.

So Phyllis Sharp here.

The the senator says we need more access to dollars for more people around the state.

We need a directory that helps people located.

Do we need supports that allow people on Medicaid to be able to access those services?

How would you say that is going?

I think it's a it's going pretty good.

I think that, there is a lot of always a lot of work to do.

Number one and getting, doulas, you know, trained and ready to go.

And then also, making sure, signing up for, Medicaid is a simple process for them because we are as doulas, we're not really billers.

But we, you know, we out.

We're out doing the work with our hands and being as, when Medicaid, we have to do our own billing.

And so that makes it a little bit difficult for some people, and it keeps them from taking that next step.

And that's the one thing we have to really begin to overcome.

How often are you interacting with Medicaid daily.

Daily.

Okay.

And does that go well?

Typically yes it does.

I think for me the process is is fairly simple.

I think just getting past the signing up process and, you know, you sign up for Medicaid and then you have to sign up for each individual insurance, like Blue Choice action MVP, Molina, like all the different ones.

So it's not just signing up for Medicaid once.

You once you sign up for Medicaid, you get your Medicaid number that you're approved to bill for Medicaid.

Then you have to sign up for each individual insurance.

And that's when people start getting a little discouraged at times.

You and I have talked in the past, but how?

At times there is a perception of, oh, well, a doula is for a certain income bracket.

A doula is for only, you know, really well-off people.

Have you had people say, look, I can't afford a doula, I'm on Medicaid.

Does that come up?

Yes it does.

You know, they're on Medicaid.

They are on an essential plan because the central plan pays for, doulas as well.

And that's the word we really need to get out.

We still people still do not know that their insurance pays for do lots.

And so really getting that word out, really being able to, attack that as far as, like the ads go, like, do that for everybody.

Those things are really important to really get into the communities face right now, to let them know that Medicaid will pay for your doula services.

Tracy does it for everybody, does it for everybody.

And you guys in the midwifery division, you're good with your doula colleagues over there.

Love this one right here.

Yes.

Yeah.

We work really well together with our, doula community.

Right.

So, you know, coming from New York City, I had a different experience with doulas.

I didn't see doulas in a hospital, in as much.

And, since moving here about eight, going on eight years now, which is crazy.

I'm about eight years ago.

I see that we have a really thriving doula community and also a thriving midwifery community between, the two hospital systems and doulas have been very welcome.

Okay.

And so, for, I guess for the community that is still confused about what it is that you do fill it.

So you're helping out with, the, the arrival of twins this morning.

What's your work entail?

Yeah.

So it's different for every single birth.

But like this morning, twins.

We had a plan C-section.

So I was there for the plan C-section with them to support them.

We had originally planned to have a vaginal birth for the twins.

Which was definitely possible, but there were some little issues that made mom going to a different direction.

But, we're still there to support you.

So even for a planned C-section, we're there to educate you, to make sure you understand what you're saying.

Yes to a no to so you can say, make informed decisions.

We are also there to hold your hand and your partner's hand, too.

You know, when things are, a little, little, you know, out of sorts, you know, to make them feel as comfortable as possible and really help them with birth planning where, you know, we're non-medical so we don't do any medical things, but we are there to really support them.

And emotionally we're there to give them education.

We're just there just for them, just for that family.

And we really want to support them in any way that we possibly can.

Tracy, from your perspective, do you feel like patients, expectant mothers, families have the information they need and the access to what they would need to be able to have the choice whether if they want to do if they don't, is that going well?

So it's going well in my division because we provide them with doula information.

Even at their first prenatal visit, we have that conversation with them and then follow up with them throughout the pregnancy.

If they feel like they can't afford a doula, like, for example, our patients who are Medicaid, then we tell them, oh no, yes, you absolutely can.

And then, you know, walk them through that process.

But even for our patients who so I think the equity piece is getting a lot better because to your point, there were people, who could afford doulas.

And then before the legislation was put into place for Medicaid to cover doulas, there was a little bit of inequity there.

But now the balance is getting a lot better.

And I will say, like as a midwife, whenever my patients have a doula hired and a dual is present in a room, it is such an amazing experience because the doula and the patient have an established relationship.

I don't always walk into a room of a patient that I know.

We are a large midwifery group.

So sometimes I walk in and I'm meeting them for the first time, but they have this symbiotic relationship going on with their doula and their birth partner, and they're all working together.

I just disappear into the wall like I'm a fly on the wall.

I'm here.

If you need me.

I'm going to intervene.

If you need me to.

If you don't want me in here at all, I'm out of here.

So I let the doula and the patient dictate what they need me to do.

Yeah, Phyllis and I discussed last time we talked about this.

There was an old stereotype, and I say an old stereotype, probably a decade old.

Now that, you know, doulas and doctors, especially obis, are at odds all the time or that that it can be uncomfortable.

And I've been told that mostly that's not too much of a thing anymore.

What do you see?

I saw that in New York City.

You did, I really did, but since moving here, I haven't seen it.

As a matter of fact, during the pandemic, it was our department chair, doctor, even Pressman who made the deal as part of the the medical team so that doors were not restricted from the rooms.

Because you remember, at the height of the pandemic, you can only have your birth partner and yourself in that room.

And that was it.

There were hospitals in New York City where you couldn't even have your birth partner.

People were giving birth by themselves.

And we have patients who had doulas hired and they were on like zoom or, you know, whatever on video chat, trying to, you know, be coached through their labors and Doctor Pressman was able to make doulas, you know, part of the medical team.

So they were not considered a visitor, and they were able to be there to support their patients so that, like that spoke volumes for me.

Do you think some of that tension is still happening in places like New York City, or is that you think that's outdated?

I, I'm not there anymore.

Enough to know.

Okay.

But I did come from a hospital back.

I didn't need it.

But I did come from a hospital where the prior chair, banned Dallas.

Oh, from the hospital.

And I don't think old paraboloid.

Yeah.

I mean, this is going to be a very good question, but can you do that?

I guess you, I guess you can do.

They're not employees of the hospital so.

Yeah.

Okay.

What do you make of that story Phyllis.

That's wild.

Yeah.

That's crazy.

Yeah.

You know, people deserve to have whatever support that they would like, and no one should restrict that from them.

So, I'm just glad I'm in Rochester, New York.

Yeah.

Because we do, we have been able to build a fantastic relationship with the Obis here, in the city, you know, even, like I had an event in, March, it was called the Dula and Doc event, and I had doctors on a panel, that came from the different hospitals and, and the do laws.

Also, we had about 80 people there, and they really talked about the relationships between docs and doulas and how we can make it better and make it better for our patients and our clients as well.

So, before we kind of broaden out in terms of maternal health on this particular subject, if you're sitting down with Senator Brouk or any state leaders and they say, yeah, what do you specifically need or what what what can we do on the policy side?

Is there anything that comes to mind?

Tracy.

Aside from supporting doula support midwives, there are definitely some pay equity issues throughout the state and not so much in New York City.

But I will say here in the middle part of New York State and Western New York, there's definitely a lack of diversity.

So I think if we can figure out a way, I know, the University Buffalo is going to be starting a midwifery education program, which is really promising.

But if there's a way that we can get more people of color, to apply to midwifery education programs, I think that would be phenomenal because, you know, I've gone into rooms of patients and like, I start to visit and I walk out to get in there, you know, someone to assist me with the visit.

They're like, oh, is the midwife coming in now?

And they didn't even realize that I was their midwife, even though I thought I introduced myself.

But, you know, sometimes that has happened.

Or they're looking at me like, wow, like you're a midwife.

Like it just never dawn on them.

That a person of color could be an advanced practitioner.

What is going to create, a pipeline of people of color moving into this?

I mean, recruitment, what is it?

Yeah, I think if we started recruiting into these programs, some HBCU nursing programs, like schools of nursing, that would be really important.

When I was in school, we had a bridge program between our school, which was the Yale School of Nursing and Howard University, and it was phenomenal.

So what they would do is they would bring students up from their junior year and they would work on a scholarly project with, one of our faculty members.

They would complete their last year at Howard, and they were guaranteed membership into whatever program that they wanted to go into at the School of Nursing.

So and that was really important in that program was developed based on our dean at the time, Catherine Gillis, finding a letter that was written to a student who told her that she had to leave the program because she was black and she wasn't allowed to see patients in the hospital.

And she found a copy of that letter, and she was like, you know what?

Nope.

I'm going to reverse this.

So and we didn't have a necessarily diversity issue at that point, but I think it became really important to her to kind of break any barriers that might be present, even back in 2003.

So, and when you say the state could do more to support midwifery, there's a pay equity issue.

Yeah.

Like like for example, in for a while, like if a doctor got paid, let's say 100% for a delivery midwife would get paid 80% for the same care, like things like that, or just making sure that our salaries, match where we're working, like in New York City.

I started off making $70,000, paying, you know, exorbitant New York City rent, you know, as a midwife.

They were nurses were making more than I was.

And I had a lot of responsibility and liability and all the things and tend to student loan debt to pay off.

So I think if we provided a little bit more pay equity and made the profession of midwifery more attractive to people, that that would be important.

Our midwives still paid less per delivery than an OB.

Now, I think that that balance has been leveled up a little bit, as of about two years ago.

So I haven't really heard anything recently.

But in the past year, I think we might be $0.95 on the dollar.

But I'm not 100% sure.

I know that that was corrected at some point.

Okay.

And only because I have to play the devil's advocate here.

So if I were to say, you know, if I were a state policymaker and I said, Tracy, I hear you, but there's, a body of work that a midwife can do.

There's a body of work that nobody can do, but there's also a body of work that an OB can do, smaller, but other things that a midwife cannot do.

Right.

And so therefore we have to have some inequity.

So the, the ObGyn should bill for what they do specific and the correct individual.

So if there's something I can't do, like for example, if my patient is, you know, bleeding and they need a hysterectomy, of course, you know I'm not going to go in and do that surgery.

I'm not trained to do that.

It doesn't even make sense.

The doctor should do that and Bill for it.

But I'm going to Bill for delivering that baby, and I'm going to deliver that baby like I'm not doing anything different than the physician should do.

So why should I be paid less for the same work?

And being paid less for the same work was a signal to possible future midwives that maybe you shouldn't do this.

Or maybe I think so, because I think maybe midwives felt like, okay, we're we're we're the reimbursement is less.

We're not being paid as much.

We're not respected.

Like I think it just became a matter of respect.

And then also, you know, if the hospital is not being reimbursed is mostly maybe we're not going to get paid as much.

And then, you know, it's true.

Like, I knew nurses that were making far more than I was, you know, as a, as a midwife.

So it's like, why am I going to go to school, get all these loans and then come out making less than I'm making now as a registered nurse?

Okay.

So before I turn to Phyllis, then make the make the case that I'm a, I want you to make the case to a young black student who is thinking about a lot of possible careers, and you want the student to know that you want to see more midwives who look like the black mothers who would love to have that opportunity.

But the students got a lot of possible career paths.

What's the case?

So if you are a student and you a nursing student in particular, and you are really interested in black maternal health equity and working with immigrant populations and working with indigenous people, and especially if you are a person of color, then it is really important to you that you are at the table.

And it may not be midwifery, it might be a pediatric nurse practitioner, a neonatal nurse practitioner.

Like when it comes to maternal job health, people of color are very much needed.

So if you are willing to roll up your sleeves and dig in, then we are here to support you.

All right, Phyllis, so when you sit down with state policymakers now, you tell them, what do we need most?

What is what is what is most doable or achievable that we haven't done yet?

For me, I'm going to piggyback on Tracy a little bit, but, there are different types of midwives as well too.

And I think that, what if you don't want to be a nurse, right?

Do you?

You want to be a midwife, but you don't want to do the nursing degree part of it.

What can we do and how can it how can it be legal here in New York State?

Right.

Because we really want more home birth midwives.

We really want, different types of midwives to be able to work in the hospitals and get equitable pay as well, too.

And that's another, pathway for, having, do lots of different nationalities, I mean, midwives of different nationalities to be able to, work with, with that's our popularity with our population.

Yeah.

And so for me, I just would love to see those paths open up in New York State and make them legal.

Yeah.

Like there are certified midwives.

There's certified nurse midwives, which is what I am.

And that's what we are at the University of Rochester.

But you're speaking about certified professional midwives, and they're not recognized here in New York State.

Are they recognized in other states?

They are, yes.

And so they're they're they are home birth midwives.

But that is an opportunity for people who may not want to incur a whole lot of debt and go to school for 10,000 years, like I, like I did, to enter in midwifery and it creates another path of like another mode of delivery for our patients as well, is there are people who are totally fine having a hospital, a hospital, birth, but then you can have a home birth too and be safe.

And that's okay.

So that's a I feel like it's probably a whole other conversation.

Home birth, subject of home birth and home birth birth centers.

Yeah, I, I am not probably qualified to even.

I it makes me very nervous and it makes a lot of people nervous.

And I don't mean to denigrate the choice that people would make, but you're saying, Tracy, that it's doable.

And in my mind, I'm going like, I want all of the best resources, you know, all the bells and whistles.

And yeah, so it is doable for patients who are very low risk, though.

Okay.

So in home birth, midwives are really smart because they understand, oh this patient is risking out.

So she had a couple of high blood pressures or now she has gestational diabetes or the baby's really big or even over the course of the labor, if they know this, she's taking too long to get from three centimeters of force in meters or whatever the case may be.

I've delivered home birth midwife patients and it's gone really well.

So we have a relationship with the home birth midwife community so that they know, like I think something is going on in, this person needs to be delivered in the hospital.

They'll give us a call and we'll just take over their care.

You want to add to that?

Okay.

And that is a whole other conversation.

Yeah.

We don't want to get there in general.

Can I ask both of you let's close with this.

Do you think, the relationship that your profession has with the policy makers?

Is it a good one?

I mean, do you think the people in charge are listening, at least well enough?

And that there are there's good communication.

We have a committee, here in New York, State of midwives throughout the state that I'm on.

And we meet regularly with some of the policy makers or people representing the policymakers in Albany.

And that has been going well, like looking at, a particular policy related to midwifery practice throughout the state.

We don't meet as often as I would like us to, you know, because there's multiple people on the committee and conflicting schedules or whatever, but at least the state and they they reach out to us.

So at least the, there is a, momentum going in that department.

And then we have the New York State Association of Licensed Midwives or New York Midwives, and they have a really powerful advocacy, wing and legislative wing that works with the with the state as well.

So they know who they are.

So it's pretty positive.

I think it's okay.

Yeah.

It's it's getting a lot better.

And I think like legislators like, you know, salmon Brook and you know, getting, you know, support for Douglas.

I think that's our end.

Right.

So if you're supporting doulas, you're supporting midwives as well.

So, you know, continuing to have these conversations and partnering with our doula community is really important for us.

Feel.

So you think it's pretty healthy right now?

Yeah, I think it's going pretty well.

We also have like committees.

That work with the legislation in New York State that talks about like the different things that we would need, the support that we would need.

And they're really trying to make things happen for us all.

I'm really appreciative and really, looking forward to what the future holds for doulas, and midwives as well too.

And so as we wrap up here, are you working as much as you want?

Could you be working every day?

Do you have to limit so you're like, not work every day?

Well, I mean, like, are you like in there in a delivery room every day I, I'm there enough.

Yeah a couple times a week.

Okay.

Yeah.

So I could be busy every day, but I don't have that kind of energy.

So the reason I ask is like, I want to give a picture as we close to what the need is because, you know, you could literally could be doing it every day.

If you if you said yes, I could be.

Yeah.

So there's a lot of need.

There's still so much need for do laws, so much need for midwives.

Really I really want to see people move into this profession and absolutely love it as well to say, well, Phil Sharp is with royalty birth Services and it is always lovely to talk to you.

Thank you for being here.

Thank you.

Thanks for sharing your expertise.

And the same to Tracy Renee Webber, who is, director of the midwifery division at the University of Rochester Medical Center.

Thank you for being here as well.

Our thanks to Senator Samra Brouk, who joined us earlier at this hour.

We have more connections coming up.

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