Training medical providers to ask patients about firearm ownership and storage will save lives and promote better safety practices, the city of Boston's health and human services chief told lawmakers Tuesday.
The proposal, which drew criticism from gun rights activists, would instruct state public health officials to develop regulations that add screening questions about guns into regular medical care and would allow medical providers to recommend safety counseling.
Supporters say the conversations will be "non-judgmental," similar to those medical professionals already have with patients about substance use and mental health, and will continue efforts to treat gun violence as a public health concern.
"Our priority is to encourage further conversations about gun safety, identify red flags for suicide and domestic violence and child access to guns," Boston Health and Human Services Chief Marty Martinez told the Joint Committee on Public Health. "We know that gun safety is a public health issue. As such, doctors are uniquely positioned to help prevent gun-related injury and death."
The legislation ( H 2005), filed by medical doctor and Boston Rep. Jon Santiago, does not outline specifics for how the new screening program would work. It simply directs the state public health commissioner to create a program for firearm screening and counseling, leaving how and how often patients would be asked to be determined after consultation with a range of stakeholders.
The bill also calls for creation of "guidelines for safety counseling for individuals that screen positive for the presence of firearms in the home" without defining how those would look or how the counseling would be offered.
"Armed with that guidance, doctors can then feel confident having these important conversations with their patients," said Dr. Jennifer Lo, medical director of the Boston Public Health Commission.
Lo said the bill is particularly important given the disparate effects of gun violence. While Massachusetts as a state has lower rates of gun-related violent crime than other states, women and people of color face higher risks.
The homicide rate from firearms in Boston declined between 2006 and 2015, but black residents were hospitalized for firearm injuries 36 times more frequently than white residents over that same span, Lo said.
Attorney General Maura Healey and the Massachusetts Medical Society (MMS) partnered in 2017 to offer new informational brochures and trainings to interested physicians on a voluntary basis, offering similar arguments about the value of screening for gun ownership to improve public health.
Some community health centers in Massachusetts have already begun asking patients about guns in the home, but the screening is not widespread and there are no clear state guidelines on how it should be deployed, supporters of the legislation said.
"Many doctors have already adopted the kind of intervention we're discussing today as best practice," Lo said. "This bill would simply make that practice universal amongst all medical professionals."
No other states have similar policies in place to implement a gun-question screening program, Martinez said, but the topic has been controversial across the country. In 2011, Florida leaders approved a law generally forbidding doctors from asking patients about firearms, but the measure was struck down in court six years later.
The Gun Owners Action League, a Massachusetts group, launched criticism of Santiago's bill last week when it was set on the committee's hearing schedule, writing that the bill "would empower doctors to treat gun ownership like a disease."
"Simply put, not only the bill, but the terminology used shows the disdain for simply exercising our civil rights in the Commonwealth," GOAL wrote in a post on its website.
Lawmakers on the committee asked several questions about how data would be handled under a formal firearm screening program, raising concerns about privacy and whether gun ownership would be protected by health confidentiality requirements.
Martinez said the MMS and attorney general recommended tracking on medical records when patients were asked about gun ownership and how they answered, but said that "would be treated like any other confidential information" and not available publicly.
