Will raw milk be allowed or prohibited? This was the question considered at the Board of Health hearing I just attended in Framingham, Massachusetts, a town of 70,000 people approximately 25 miles west of Boston. (See my previous post on the subject for the full background.)
After two and a half hours of public comment, discussion, and deliberation, the three-member Board of Health voted that Doug Stephan would be allowed to sell raw milk from his farm in Framingham, subject to existing state regulations, and subject also to additional regulations imposed by the Town of Framingham; regulations one of which was determined last night (weekly testing in place of the state-mandated monthly testing), and some of which are still to be determined.
This result is a significant, because Stephan's farm will be the raw milk farm nearest to the city of Boston, and is likely to become a source of choice for raw milk.
It is also significant because it marks the first time that a town or city in Massachusetts has implemented its own regulations on top of the state regulations. A precedent has been set.
Raw Milk In Massachusetts
Massachusetts has state requirements concerning the sale of raw milk. The milk must come from a farm with a special state raw-milk license. The milk must be sold on the farm where it was produced. The milk must be tested once a month, and must meet certain requirements. The test results must be posted at the point of sale, along with specific warnings about the nature of raw milk. The bottles must be labeled in a particular way. With the exception of cheese aged for at least 60 days, no processed raw dairy products are allowed to be sold in the state (so no cream, no skim milk, no yogurt, no kefir). These state requirements have been in place for a while. More details are available on the NOFA Massachusetts website.
Massachusetts also grants authority to jurisdictions to further restrict whether, and how, raw milk can be sold. This level of granularity with respect to raw milk regulation is unusual, and is perhaps consistent with Massachusetts' "big government" reputation.
Up until now, towns and cities in Massachusetts have either allowed raw milk sales from all farms compliant with state regulations, or prohibited raw milk sales completely. Tonight was the first time that a local Board of Health has elected to create additional, jurisdiction-specific restrictions. My guess is that most jurisdictions are either too urbanized to have significant dairy farms, or too resource-limited to want to complicate things, instead letting the state licensing bureau take care of the whole matter. Framingham seems to fall in the crack.
I believe that the arrangement in Massachusetts is unnecessarily complicated. Raw milk drinkers in Massachusetts will get their milk one way or another—from sources within the state, or from sources in nearby states, almost all of which allow the sale of raw milk. The more sources there are, the more choice buyers will have, the higher standard they will hold the producers to, and the more likely they will be to report problems. Banning raw milk sales in Framingham, for instance, would have done very little to prevent people from drinking raw milk, but it might have restricted the availability enough to discourage people from reporting problems with their sources.
There is significant disagreement within the state government about the desirability of raw milk. Two state agencies sent letters to the Framingham BOH advising them on the licensing issue. The agency responisble for regulating unpasteurized milk in Massachussets, the Massachusetts Department of Agricultural Resources, whose mission is "to ensure the long-term viability of local agriculture in Massachusetts", wrote a letter strongly in support of granting the license, and categorically against municipal bans. The agency responsible for regulating pasteurized milk, the Massachusetts Department of Public Health, whose mission is not made quite so clear on their website, wrote a letter saying that they continue to have grave concerns over the sale of raw milk in Massachusetts. These letters were both read into the record.
The Framingham Board of Health consists of Michael Hugo, the Chair; Tammy Harris, the Secretary; and Nelson Goldin. Ethan Mascoop is the part-time, paid Director of the BOH. There was a stenographer, taking notes. And there were approximately 46 members of the public in attendance, including Doug Stephan, the farmer.
Mascoop, the Director, having surveyed raw milk laws in other states, expressed concern that the Mass regulations might not be strict enough, citing issues such as labeling, frequency of testing, inspection criteria, liability insurance, and herd size. He also questioned the tools available for enforcement of the regulations. Hugo noted that these concerns would have to be considered in light of the limited resources of the Framingham BOH, limitations which would argue against implementing Framingham-specific regs that would put a burden of monitoring and enforcement on the local BOH. He also expressed some concern over raw milk drinkers' potential unwillingness to report raw-milk-related illnesses, out of a feeling of loyalty to farmers.
There was discussion on the issue of organic milk, and antibiotics. Most of the raw milk dairies in Massachusetts are not organic, and do use antibiotics on their cows when they are sick. Milk from cows actively taking antibiotics cannot legally be sold. There was discussion about whether the current state regs around testing milk for antibiotics were sufficient. Note that this same issue affects milk for pasteurization as well.
Stephan, the farmer, appeared frustrated and impatient with the process. He remarked that if he had known how difficult it would have been to run the farm, citing the milk issue and an issue related to water rights, he would not have bought the farm, and would instead have allowed the property to be sold to developers, who would have replaced the historic farm with subdivisions. And if he had known how protracted the process with the Framingham BOH was going to be, he would have attempted to bypass them, dealing only with the state, an approach that he believes would have been within his rights.
Karen Clickner, who runs a large holistic health clinic in Brookline, spoke to the health benefits of raw milk in helping to remedy many conditions, including infertility. She answered various questions posed to her by the BOH, including questions about whether she recommends raw milk to infants (yes), severely immunocompromised individuals (no, because it can be difficult to digest), and pregnant women (generally not; the beneficial bacteria can be ingested by other means).
David Gumpert, author of Raw Milk Revolution, spoke at length about the epidemiology of raw milk, including the fact that estimates for the number of raw milk drinkers in the US vary between half a million and ten million, and the fact that statistics around food-related illnesses are notoriously incomplete and inaccurate. Speaking directly to the issue of raw milk in Massachusetts, Gumpert pointed out that in the state of Massachusetts, since 1999 there have been no reported raw-milk-related illnesses, whereas in the past 3 years pasteurized milk has been identified as the cause of 3 deaths and one spontaneous abortion. The BOH questioned Gumpert quite a bit, and Gumpert conceded that statistically speaking, raw milk seemed to represent a greater risk than pasteurized milk.
Richard Lerner, a local veterinarian, spoke against raw milk, making some arguments that we've all heard, and focusing specifically on the perceived laxness and inadequacy of regulation of raw milk by the state.
I had a few things I wanted to say, and I also had a statement from a friend I was prepared to read, but public comment was curtailed before I was able to get to the microphone.
The defining question of the evening, I think, was how to balance risk against freedom. Michael Hugo, the Chair, told us that he eats sushi with his 88-year old dad, and nearly lost a raw-oyster-eating contest to him. Mascoop, the Director, related that new FDA model regs will recommend prohibiting the sale of raw or undercooked foods to children in public eating establishments. Nelson Goldin asked whether we should protect people who don't want protecting. Cigarettes and alcohol were mentioned jokingly. I wish they had been considered more seriously. They certainly represent a greater public health threat than raw milk. It is possible to get a motorcycle permit in Massachusetts by presenting a valid car license and taking a written test; there is no requirement to demonstrate an ability to ride a motorcycle. How about hang-gliding?
The ultimate decision was that Stephan would be allowed to sell raw milk from his farm, subject to state regs, and subject to additional requirements, including weekly testing (in place of the monthly testing required by the state), and other requirements to be determined by the BOH, informed by an advisory committee consisting of Mascoop, Stephan, and Richard Lerner the veternarian. Hugo and Goldin voted in favor of this decision; Harris voted against it.
This is a partial victory. Is it better than a Framingham ban? Absolutely. Does it open the door for additional Massachusetts jurisdictions to enact their own local raw milk regulations? Perhaps, but I doubt too many jurisdictions with dairy farms would have the time or inclination to do this.
Do I think the decision is unfair to Stephan? Yes. Given that there have been no raw-milk-related illnesses reported in Massachusetts since 1999, it seems clear to me that the state regs are adequate in practice, and that Stephan is being unnecessarily impeded from doing business. He has demonstrated himself to be a responsible farmer, and he should be allowed to sell his products to people who want to buy them.
I look forward to driving to Framingham to buy his milk.
See also David Gumpert's post on the hearing.