From NJ PBS Studios, this is NJ Spotlight News with Briana Vannozzi.

>> Hello, and thanks for joining us.

I'm Joanna Gagis.

Briana Vannozzi is off.

Coming up, a pediatrician and former CDC leader responds to federal changes on childhood vaccines with advice for parents as kids get ready to go back to school.

Plus, exploring the ocean.

Two Rutgers oceanographers join us from their ship to talk about their research, looking at how warming waters are impacting marine life.

But first, we talk with Senate Education Chair, Vin Gopal, about a range of topics from funding the state's EMS task force to prescription drug costs and school funding reform.

That's next.

Funding for NJ Spotlight News provided by RWJBarnabas Health.

Learn more at RWJBH.org.

In Trenton, there are few places for bipartisanship these days, but Democratic Senator Vin Gopal seems to have found a few of them that he's made a priority this legislative session.

He's looking to fund the New Jersey EMS Task Force, which responds to mass emergencies in the state, and he's also taking on PBMs, pharmacy benefit managers.

Senator Gopal joins us now to talk about this and school funding as part of our Under the Dome series.

Senator, thank you so much for being with us.

I want to start by looking at the New Jersey EMS task force.

I'm gonna assume that the average New Jerseyan probably doesn't even understand what they do, but they respond to major emergencies from events like World Cup to flood response to, and I'm telling you what you already know, I'm helping to plan the COVID-19 vaccine logistics, but they were dealt a pretty major blow in this last budget.

Can I just ask you, why did the legislature not include $500,000 of funding in this last budget?

- Yeah, good to be with you.

I think it's been last several years, and unfortunately, like many things with COVID federal funding, we've had different things rely on ARP dollars and federal dollars and this was one of the areas.

The president, Mike Baskin, does a great job.

The organization does a great job.

Back in 2017, it became a little bit more of a quasi-government.

They're technically a third party, but they're providing an extraordinary government resource.

They just did during the World Cup.

And we have to figure out how we're not doing this every year on how to add them into the budget.

And I sponsored the resolution.

I was disappointed that it didn't make it in.

But what we have to do is really build support to make sure there's some permanent funding so we don't have to do this every year.

Yeah.

And for more context, last year they responded to 225 large-scale emergencies.

As you said, it has been a couple of years.

They've lost about 4 million over the last four years.

This is made up of about 250 volunteers, but what we've heard from their leadership is that it's their fleet and their buses and their response vehicles that need to remain current.

Can you tell us about the bill and how you would perhaps allocate a phone charge that already should be allocated for emergency response to fund this group?

Yeah, sure.

So the state essentially raids that fee, the 911 fee that's on your, you know, your Verizon or T-Mobile bill, on your cell phone bill.

And that is a fee that's supposed to be going to update, upgrade and maintain our, our EMS and our overall security or police radios, etc.

So I'd like to see that instead of the state just rating it, which it's been doing since its inception for years and years, dedicate that funding towards the EMS Task Force and other agencies.

That way we're not going to this annual issue where they got to chase the state for money, you got to get in the budget.

And then we also have to build support with the rest of the legislature.

It's not the EMS Task Force responsibility.

We need to make sure everybody knows what they do, what their purpose is, because many folks think, "Well, I got my local fire department, my local first aid squad."

I don't think they fully understand that there is this larger entity that is providing backup and providing a lot of support to your local squad.

And it seems like there is Republican support for funding this.

I've seen Senator Declan O'Scanlan vocal about wanting to support them.

I want to switch gears because there's another issue where there might be some bipartisan support.

You and Senator Doug Steinhardt put out a letter, an op-ed about PBMs, pharmacy benefit managers.

Can you talk to us about what you envision the state needing to do to ensure that PBMs are actually serving customers in healthcare rather than what we know are these vertically integrated corporations?

Yeah, absolutely.

And this is a bipartisan issue.

President Trump has actually led on this.

Democratic governors have led on this.

PBMs manage nearly 95% of prescriptions in the United States, and they're increasingly tied to major insurers or pharmacies.

There are clear conflicts of interest.

The largest, obvious one is CVS Care Mart, which also operates CVS pharmacies.

We see it with Optimum.

There are inherent conflicts of interest.

It's the same reason why we don't allow a mom and pop or a doctor's office to also be selling medication and also be having a blood lab and doing nine other services, because there's an inherent conflict of interest.

That conflict exists here.

Independent pharmacies are going out of business at a rapid growth, and we are seeing these PBMs without any transparency on what the pricing is.

They say it's proprietary information.

And at the same time, we see medication prices going, or skyrocketing right now.

So we're building a lot of support in the legislation.

So what's the solution?

I'm sorry, go ahead.

Yeah, that's what I want to ask.

What can you do?

Sure.

So there's a lot of things we can do.

One is obviously eliminating the spread pricing so we can see the profits.

I think it should be transparent.

To be clear, PBMs do not create any medications.

Pharmaceutical companies do that.

They're the middleman.

So what is the profit that they're making?

And they continue to say that that's proprietary information.

We also should be able to restore patient choice and make sure that we prevent a vertically integrated self-preferencing system.

So this is a good -- all of these are important.

If we know what we're paying for medications and we can see what the clear profits are in every other industry, you have to do that.

PPMs don't do that.

They hide it and by that time it's been marked up and passed along so many times that we don't know.

And just the fact that it's a huge conflict of interest in states like Governor Huckabee down in Arkansas has actually banned PBMs from owning and operating pharmacies, which seems like pretty common sense.

They should not, there's an inherent financial interest there.

Okay, switching gears, the state health benefits commission is deadlocked right now on whether or not to approve an increase in health care rates for state health benefits plan.

Those covered under the state health benefits plan.

First, I want to ask, do you have any thoughts about their decision?

As of right now, they don't have any agreement.

Do you have any thoughts on what they should do here?

Yeah, this is a big mess.

I think we have to start moving away from the state health benefits plan.

I think we have to make sure there are more competition.

We've seen very successful HIFS health insurance funds throughout the state who have really controlled their costs.

We also need to be looking at some of these specialty drugs that we're paying 100% out of pocket.

I know some of my friends on the public employee side are not looking to lower what they're receiving and I don't think it should be just on them, but everybody needs to come to the table here, including the corporations that are making record profits right now.

So we have a lot of different entities here in healthcare making a lot of money, whereas those receiving the health care are really getting screwed.

So I think a combination of these things have to happen, as well as really making sure we have managed health care plans, which the state health benefits plan has not done.

Do you see any legislation coming forward in this session to address that?

Yes, Senator Vitale and I are working together.

We're looking at school employees.

I also know that Governor Sherrill and her Chief Operating Officer Kelly Doucette and their team are also looking at this issue.

So I'm hopeful over the next 30 to 60 days we can have some recommendations that I think everybody will dislike a little bit, but hopefully it's not gonna hurt too much.

But we can't go on the path we're going because especially if you're if you're in the state health benefits plan, this is a ticking time bomb.

We have to we have to start figuring out this exit ramp and figuring it out now.

I just there's so many things we could talk about with education.

We don't have the time, but I just want to ask your special education funding review task force was a bill that moved forward but never made it to the governor's desk.

Are you planning to revamp that?

Do you still envision that task force coming in to review special education funding in the state?

Yes, Governor Sherrill and Commissioner Law have announced upgrading and redoing the school funding formula.

They're going through that public process now.

It's over the next several months.

There's going to be public hearings and a big piece of that is special education.

I hope and will be pushing for will be mandatory school district consolidation and shared services to try to lower costs, but to have a statewide special ed formula is what will serve parents, their children and taxpayers more than anything.

So I'm hopeful it's going to be part of this this fall.

All right, Senator Vingo pal.

We've got to leave it there.

Thank you so much for coming on.

Appreciate it.

Thanks a lot.

Under the Dome is made possible in part by the Corporation for Public Broadcasting, a private corporation funded by the American people.

President Trump is calling for major changes to the federal childhood vaccine schedule, a move that's drawing sharp criticism from public health experts.

The president signed an executive order calling for fewer vaccines to be routinely recommended for all children, spacing shots across more visits, and eventually breaking up the MMR vaccine into separate measles, mumps, and rubella shots.

But here in New Jersey, state officials say the rules for children remain unchanged.

So, what exactly is in the new order?

Joining me now is Dr.

Richard Besser, a pediatrician and the former acting director for the Centers for Disease Control and Prevention and the current president and CEO of the Robert Wood Johnson Foundation.

Dr.

Besser, thanks so much for coming on to talk to us.

I want to get a sense from you, your reaction to the president signing this executive order that changes really the scheduling, the recommendation for how and when, in particular, the MMR vaccine is given to children.

First, can you just tell us why these vaccines are grouped together?

Well, you know, Joanna, I don't think that the president's executive order will hold any legal ground, but it does confuse the situation for so many parents, people around the country.

You know, I practiced pediatrics for more than 30 years, and during that entire time, we've always given the measles, the mumps, rubella shots together in something called the MMR.

The reason for that was, you know, we try and reduce the number of shots that children need to get whenever possible, making sure that they still remain safe and effective.

I've never met a child who likes to get a shot.

There's one brave child there.

I've never met a parent who wants you to give their children more shots.

So when you can combine them, and that was done successfully in the 70s for the measles, mumps, rubella, you go that route.

In fact, there's no licensed products in the U.S., even if you wanted to give separate measles, mumps, rubella shots.

You'd have to go through that process.

They're available in some other countries, but because this vaccine is safe and effective, it's not available as separate shots.

- We've heard a lot of pushback, a lot of concern raised by the medical community, large numbers of folks from the medical community to the president's executive order.

Do you share those concerns?

What is your reaction?

- Yeah, I'm very concerned and I'm concerned for a number of reasons.

You know, over the course of the past decade, we've seen more and more politics put into something that should be a really personal decision and conversation between patients and their doctors, between parents and their doctors about their children.

I worked at the CDC for 13 years in Republican and Democratic administrations, and you never saw this kind of political divide around things like vaccines or other aspects of public health.

And so when you see the president injecting himself into something where he has absolutely no expertise, wanting to split up the MMR because he has a feeling that that's a better way to go, that's really dangerous.

And it's dangerous because some people will look at this and say, "Wow, maybe my doctor isn't doing the right thing.

Maybe I should not give my child these vaccines."

This is being done at a time where we're in the midst of a large measles outbreak across the country.

Over the past 18 months, we've seen more cases of measles than in the past 25 years combined.

And what you'd like to see is the president saying, if your child's not vaccinated against the measles, they should be right away.

If you're an adult and you haven't checked on your measles status, you should as well.

Together, we can get this under control.

But instead, he's following the lead of our Secretary of Health, RFK Jr., who's one of the nation's leading anti-vaccine advocates.

Yeah, that's exactly what I was just going to say.

We have a top official in the president's administration, Robert F. Kennedy, who we know has, as you said, been an anti-vaccine activist.

And we've seen kind of this growing movement of concern from parents, suspicion around vaccines, suspicion around big pharma and medicine.

How have you seen the public's attitude shift in terms of the numbers, in terms of who's actually getting vaccinated?

Yeah.

I mean, the first thing I think it is important to recognize that the vast majority of people in America believe strongly in vaccines, believe strongly in vaccine requirements.

They want to know that if they're sending their child to school, that they're not going to be around a bunch of children who aren't vaccinated, who could put their children at risk.

You know, I worry about that child who's at school who may have an immune problem where the vaccine didn't work for them or they couldn't get vaccinated.

If they're in a classroom with children whose parents decided that they didn't want to vaccinate their children, it puts those other children at risk.

And so from a public health perspective, it's so important that we do require children to be vaccinated when they go to school.

The numbers for kindergarten are still above 90% for coverage, but 90% isn't enough to stop measles in its tracks.

You need to be above 95% so that slight reduction in measles coverage around the country.

We will see that be one of the factors that's allowing measles to continue to spread.

The president is calling for more testing of vaccines.

Let me ask what kind of testing has been done and do you agree that more testing needs to be done?

It's critically important that whenever a new vaccine is being developed or coming onto the market, it goes through extensive safety testing as well as testing to make sure it works.

And we have or we had one of the best systems in the world around that.

And then once a vaccine is licensed, it's really important you look to see, well, are there any rare side effects that we need to worry about once you start giving a vaccine that was tested in tens of thousands of people to millions of people?

Those systems are really important and you want to always look to see how can you strengthen these systems.

But it's also very important that we don't give a sense that vaccines aren't tested for safety.

They are.

And as a pediatrician and as a parent, I felt very comfortable with my own children being vaccinated fully and on time.

And I felt very comfortable in talking with parents so that they could make the right decision for their children.

All right, we have to leave it there.

But great information for us.

Dr.

Richard Besser, President and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC.

Thank you so much for taking some time to talk to us today.

Thanks so much.

Really nice to be here.

Right now, a thousand miles east of Barbados, a pair of Rutgers University oceanographers are leading a 25-day expedition in the tropical North Atlantic.

What they're chasing is a process called salt finger mixing and whether it can keep nutrients flowing to ocean life as the planet and ocean water warms.

What they find could matter for the whole food chain.

So let's get into it with Jo Bredon and Cordae Seldin, who join us now from their research ship.

What are you studying right now?

Yeah, so we're out here studying how life in this environment grows.

The ocean covers about 70% of Earth's surface, and it plays a really important role in regulating global climate.

One of the ways that it plays an important role in climate is through what we call the biological carbon pump through the action of small organisms that live in the ocean.

So phytoplankton, small photosynthetic microbes make up the base of the food chain out here.

They play an important role in climate change, or excuse me, in climate by taking up carbon from the atmosphere.

That carbon can then either move up the food web or be exported into the deep sea where it can grow.

So our expedition today is looking, we're looking at how phytoplankton grow and how the physical mixing processes in this particular environment, which are also being impacted by climate change, affect that growth.

Okay.

So in that mixing process, right, it's something called salt finger mixing.

Joe, can you help us understand what that is and how you're exploring that, how you're studying that on this 25-day expedition?

Sure, yeah, so we have a really awesome interdisciplinary team out here.

My team leads the kind of physics side of things, so we study the ocean mixing and salt finger mixing is this, you know, really weird term, but it's a kind of simple idea.

I use two analogies to describe this.

You put milk in your coffee and you stir that around.

That's called turbulent mixing.

But if you put a teabag in hot water, that tea slowly diffuses out.

And so that's called diffusive mixing.

And so salt finger mixing is way more on the side of that lower energy diffusive mixing.

That's actually really, really hard to measure.

But when it, you know, you add it all up in the oceans across the world, it can have a really big impact on a variety of things.

- Okay, help us understand why that mixing process happens to begin with and why it matters.

- Sure, yeah, so I use that analogy of the tea bag, but in the ocean where we are right now, it's a really unique location.

So we have really warm, salty waters that are on top of colder and fresher waters.

And so if you can imagine a little blob, a little finger of really warm and salty water goes down into that colder, fresher water, it will actually diffuse the heat out way, way, way faster than it diffuses salt out.

And so it's getting colder, but it's still salty.

And so that means it's heavy and it sinks.

And the same thing happens with the colder, fresher water going up.

So that's why they call it salt finger mixing.

It's kind of these interleaving layers in the ocean that really, really enhance the mixing that happens in like the interior of the ocean, we call it, at depth that you wouldn't normally find without these kind of unique conditions.

- So Cordae, you mentioned warming of the ocean.

We know that small changes in the ocean can have massive changes for our planet overall.

Why does this matter and how do the changing ocean patterns impact salt finger mixing?

It's one of the ways in which nutrients can be moved from the deep sea where they build up into the sunlit upper ocean.

So phytoplankton, the plants of the ocean, just like plants in your garden, they need different things to grow.

They need water, they need light, and they need nutrients, right?

Like nitrogen and phosphorus that you might add to your garden to enhance growth.

So in the ocean, there's plenty of light, there's plenty of water, but there's not much nutrients.

Now, nutrients can build up in the deep water.

So when salt finger mixing occurs, they can, nutrients can be transported into the upper ocean, right?

Where there's light and where phytoplankton can grow and consequently be consumed by larger organisms.

- And I imagine this has a trickle up effect, I imagine, on marine life, yes?

- Yes, absolutely, right?

So if the base of the food web is doing well, then there's more food for everybody else to eat going on up.

- How are you studying this?

Because I've read that you have some machinery that's as delicate as a potato chip.

How are you studying it?

- Yeah, so we're using a lot of different instrumentation.

The potato chip reference that you just made, I'll start with that one because it's a really important part of our research effort here.

It's, we have two different instruments that do this, but they have these really, really sensitive probes that are on the front of this sort of torpedo looking tube.

And they measure kind of the energy in the ocean, the mixing.

And we drop them in the water, they fall down, sometimes as deep as, here's one that you're probably seeing right now, they fall down to sometimes as deep as 1000 meters, so you know, 3000 feet, and they'll measure the energy that's in the ocean, the mixing.

And then because we're on this huge ship, that we can put all different types of instrumentation into collect water samples.

And so that's where Corday's team takes over.

And the physics side, you know, we wait until we get those measurements back, and then the rest of the team goes and starts on their work.

Yeah, and you two are on a ship right now.

We should tell our audience, just lost a little bit of audio there, but we're going to keep going.

Corday, just a minute left.

What are you hoping comes out of this study?

- We're hoping to understand how important salt finger mixing is in delivering nutrients into the upper ocean.

So as the climate warms, we tend to think that there will be a greater, the warming of the surface layer will create a greater barrier preventing more nutrients from coming up through turbulent diffusion, right?

that Joe mentioned in his analogy.

We're curious to find out whether or not this diffusive mixing mechanism could offset that.

All right, good stuff.

Joe Grudone, Cordae Seldin Oceanographers with Rookers University.

Keep it up.

Thank you so much.

Thank you.

Thank you.

Finally tonight, the boys from Bayonne battled to a win last night in their first ever trip to the Little League World Series.

Bayonne, representing the Metro Region, beat the New England champion Bridgewater, Massachusetts, two to one with a walk-off home run from Mason Rincone, who also struck out eight on the mound.

They're the first team from Hudson County to reach Williamsport in 60 years, and the city's rallied around them with parents and fans wearing shirts that say "Bayonne vs.

Up next, Bayonne faces Westchester, Pennsylvania, Friday night at 7 as they continue their push toward the championship.

That's going to do it for us.

For everyone here at NJ Spotlight News, I'm Joanna Gagis.

Thanks for being with us.

We'll see you right back here tomorrow.

[music] NJM Insurance Group, serving the insurance needs of residents and businesses for more than 100 years.

NJM Insurance Group has been serving New Jersey businesses for over a century.

As part of the Garden State, we help companies keep their vehicles on the road, employees on the job, and projects on track.

Working to protect employees from illness and injury, to keep goods and services moving across the state.

We're proud to be part of New Jersey.

We've got New Jersey covered.

[music playing]