Vermont Legislature SmartTranscripts:

[Rep. Robert Hooper (Member)]: Good

[Rep. Lisa Hango (Vice Chair)]: afternoon. It's Tuesday, May 5, 02:00. We are going to start taking testimony today on S-two 78, which is an act relating to cannabis. And our first witness is Cheala Livingston. Hi. Hi.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: How are you guys? Thanks for I'm having Cheala Livingston. I am the interim deputy commissioner for the health department, normally just the chief of staff. And I did bring a coat, but I can't put it on because I'm still too warm for walking up the hill.

[Rep. Lisa Hango (Vice Chair)]: Very hot. Sorry. No. We are always roasting. You're welcome to the bed.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: And then online is Tony Fallon. He's on our clinical team in the Division of Substance Use. And so he's our subject matter expert for the questions that I can't answer, which I'm sure may come up. So I didn't know what exactly you all wanted. I prepared a couple of things that I can just walk through in terms of the differences between the House and the Senate bills. But I really am happy to take direction from you. Sure.

[Rep. Lisa Hango (Vice Chair)]: Yeah, you might as well start with what you've got.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: All right. So from a public health perspective, just broadly, not about the bill specifically, but broadly, the most important things for us when talking about the different things that have been discussed in these bills this year, maintaining the existing THC potency caps, concentration limits, and single serving package limits to reduce the potential for overuse, dependence, and emergency care are really important. And again, I'll get into what's in which bill. But those are important to us at the health department. Maintaining existing purchase and possession limits to discourage heavier consumption diversion to underage peers is also important to us. And then maintaining advertising rules to decrease the chance that young people see and are influenced by this product marketing is very important to us. We have a lot of research around marketing and targeting and what how important it is to keep products out of sight from youth in terms of the marketing. So I'm going to dive a little bit into the details of the bills. The current version of the bill, as passed by the Senate bear with me here does not raise the TC Ponce caps or the concentration limits, and it does not modify the advertising rules. So we are very happy with that. However, the current version of the Senate bill does increase the single serving package size and purchase and possession limits, which we would love to leave alone. Those are my main points. I don't want to keep talking. I could talk about cannabis, and Tony and I could discuss lots of data and information. But those are my important points. So I don't know if you guys have questions about that or

[Rep. Lisa Hango (Vice Chair)]: Yeah, I have a question for you. So, you're saying that if we increase the amount that's in each package, that it's more of a risk for younger people. Are you finding that younger people are getting these products from legal places where they buy them legally?

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: So the only way I can answer that directly is with poisoning data. So we know poisoning data, like our calls to the New England Poison Center, which we fund as part of a New England group, those have gone up for cannabis use. And so this is I want to be really clear. Often, it's very unintentional. Somebody has a product in their house, then a kid gets their hands on it. It happens a lot to pets, too. We're a little less worried about the pets. The health department, more worried about the kids. So if a kid consumes that, the bigger the amount, the worse the outcome for that kiddo. They're the kids that end up in the EDs or urgent care settings. And we have seen an increase in the calls to the poisoning center for that type of problem since the regulated market came online.

[Rep. Lisa Hango (Vice Chair)]: And do you keep track of visits to emergency departments that are based in Vermont or all around?

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Vermont. So ED visit data we have and we can show you as well. And Tony, I don't know if you have those numbers off the top of your head. I can look at my computer. Grab my computer and look that up for you. But we can send you the data on emergency department visits, poisoning calls, and then just When we see, basically, the dose is the poison, that's for anything in public health. And so when you see higher concentration limits or higher quantities, that can be more serious in terms of the outcomes for how frequently they end up wanting to use, their risk for dependence, all of the pieces that end up in problem cannabis use that we don't want to see down the line. Tony, did I mess any of that up?

[Rep. Robert Hooper (Member)]: Without having to chart, what do the numbers look like? When you say they've been approved, what does that mean?

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Let me let me just pick up my computer. That's that's okay.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: I am trying to pull those up as we speak, folks. We have it all online. So I'm trying to pull that up so I can give you give you numbers. But broad swath, no, Cheala. You you hit it exactly.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah, Tony is going to be faster than me there, but we

[Rep. Kate Nugent (Member)]: will get that. Hold that question. I'll stand by.

[Rep. Sandra “Sandy” Pinsonault (Member)]: What is the size that we're talking about? I'm trying to find it in the bill.

[Rep. Lisa Hango (Vice Chair)]: So, believe we are not the package size. No, no, the package size.

[Rep. Robert Hooper (Member)]: Section four.

[Rep. Lisa Hango (Vice Chair)]: It's 10. It's 10 items of five milligrams each is currently allowed. And I believe they this the bill increases it to 20.

[VL Coffin IV (Member)]: No, it's five currently, and they wanna increase to ten grams per hash and one ounce, two ounce. Is that what we're talking about? The for those limits?

[Unidentified Legislative Counsel/Member]: Well, the bill does two things. Increase the as prospect summit it looks to increase the packaging limit from one hundred milligrams to two hundred milligrams. And then also how much a person can possess from one ounce to two ounces. So, section one and section three? Four. No, four. Three and four. So, it would be from one ounce to two ounce of cannabis and then from five to ten grams of

[Rep. Sandra “Sandy” Pinsonault (Member)]: Shall not contain more than two hundred mg of THC.

[Rep. Lisa Hango (Vice Chair)]: Right, so there we already have a limit of five mg.

[Rep. Robert Hooper (Member)]: Okay.

[Rep. Lisa Hango (Vice Chair)]: Like for an edible say, and you're allowed to have up to 10 in a package and this would say you could have 20.

[Rep. Sandra “Sandy” Pinsonault (Member)]: Oh, right here. Two ounce, one ounce to two ounce, and five grams to two.

[Rep. Lisa Hango (Vice Chair)]: Yeah, Cheaven has an answer for it.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: No, no, not an answer. Just the packaging is important. So the canvas control board and the folks are doing a good job with the packaging. And that's part of the deal here, is trying to maintain when you have if a kid gets into one pack of something, they can only get one smaller serving. And that packaging is harder to get into. And so the more they can get into and breaking into one, the worse off we are. I will say I'm focusing on kids. It's also an issue for adults. If I served you guys birthday brownies, not cannabis brownies, just regular old birthday brownies, and I give you a brownie this size, you might just eat it, even though you really only want it onetwo the size. And so that is just a human nature thing. That's like, oh, here's your serving of whatever. Right? I don't know if it's an old movie, but if you saw, like, Super Size Me, right, like, this is a problem that is not specific to cannabis. It is simply a issue.

[Rep. Lisa Hango (Vice Chair)]: I have this data, I certainly don't think we need it right this time. It's fine, it's fine. Don't worry. I know that you have it. And I actually have another data question for you that maybe if you can email us or share it later. I'm wondering about comparisons between states that do have either a higher potency, like milligrams per package limit and their corresponding like, visits, calls to poison control, visits to the ED, and, like, their helpline, you know, the addiction helpline things. Just, I like to compare things. That would be interesting to see, I think.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: That's a really good question. So I will say that we are a little unique, which I think is really positive. So I'm not making that thing. And that we do have the potency. We do have some different caps in other states. It might be a little tricky. What I can tell you is there is a lot of comparisons between states with regulated markets and states that don't have regulated markets and use rates. The states that do have regulated markets have seen increases at different rates of use. However, I think it might be I will look for that. I think it might be a little hard to answer that. But it's a great I love that question. I just don't know that the environment exists to make that comparison.

[Rep. Lisa Hango (Vice Chair)]: Yeah. That's the hard thing about all this. Yeah, but I can look at this stuff. And then my other I just had another question for you.

[Unidentified Committee Member (override for diarization error)]: And it's gone, but I'll

[Rep. Lisa Hango (Vice Chair)]: think of it. Does someone else have any questions? I'm going to have to think of mine. Oh, I know what it was. Does the Department of Health have education efforts and outreach for adults who are legally purchasing cannabis about how to store it, what

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah. Yeah, we do. So we have safe storage campaigns. We have how to Talk to Your Kids campaign. So we have a lot of different public health campaigns about how to store it, going slowly, overuse, what that looks like, kids and how to talk with kids not little kids, like how to talk to teenagers. We do a lot of prevention work in communities through our coalitions and our prevention consultants and in schools. And a lot of that is funded by, actually, the cannabis, the tax that goes into the Substance Misuse Prevention Fund. So yes, absolutely. We have a number of campaigns that I could pull those together, too, and send them to you to work on that with Vermonters.

[Rep. Lisa Hango (Vice Chair)]: And do you just do you say this isn't always my wheelhouse cannabis stuff, but now I have a lot of questions. Do you work with or are you the ones who put out that? What is it called? The risk assessment Yeah, yeah, yeah. That comes from you? That comes from the health Okay, good. And that must inform the update you get about cannabis and that Yep.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: So one thing that I think is really important from that survey, so for those who are less familiar with it, it's a national survey run by the CDC but administered by states. And in Vermont, it's very cool. We actually go to all schools. You only have to do a sample of schools. In Vermont, we do every school and survey every student. And so that way, we can give schools their own data and supervisory units their own data. And we have the state level and county level reports in that. We ask a lot of different questions about cannabis use and many different substances and behaviors. And one of the things that we've seen is among the youth who use over the last few years, they're using it more frequently. And so that is not a good trend. So our increase in youth use, there has been an increase. It has been not huge, but still there, still not ideal. But even more concerning than the increase of the percent of kids who use within thirty days is the amount that they're using is increasing, so the frequency with which they are using cannabis is increasing.

[Rep. Lisa Hango (Vice Chair)]: And that's directly tied, probably, to just easier access to it, probably.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Maybe, we don't know. I can't tell you the class from that survey.

[Rep. Lisa Hango (Vice Chair)]: It's just a survey about the use. Thank you. Did anyone else have more questions?

[Rep. Robert Hooper (Member)]: Intensify with what you've just told us?

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah, yeah, how do they target different issues? So absolutely, so there is actually just a needs assessment that was done for the state or substance use prevention, so not just cannabis, all substances. And it's a requirement of a federal grant, but it's great that we have to do it because it's not just for that federal money. It's for all of our work. And right now, the way that we organize prevention work in the state through the health department is through regional call them prevention lead organizations. They're just regional organizations that have a region. And they narrow in on what's the problem in their community, where are the gaps in their community, what are the trends and the issues that they're seeing among their youth or their adults? And then they target evidence based or evidence informed interventions using that prevention dollar fund that we have here in Vermont to try to address those specific gaps, needs, trends, changes. Because even in Vermont, even in a small state, it is something that's different community to community. So it's actually very exciting because we haven't had that type of systemic, long term investment in prevention, where we know the dollars are going to keep coming so that we can do this over the long term with communities and really support the work. Because, unfortunately, prevention work does not bear fruit overnight. It takes a long time to have it down on the ground and have it take effect. And so it depends. It's the answer. It depends on the community. It depends on the gaps. But there are some really, really cool and exciting work happening in our Vermont communities right now. And I think it's really great that we're able to do some more regionalized community led work.

[Rep. Robert Hooper (Member)]: Family support is there in the family spectrum. I'm thinking really about young people, not that 18 ago, where a child is struggling or is using this stuff, parent doesn't have strength enough or doesn't want to be embarrassed by the fact that maybe they don't like this whole idea of their being, their substance in the community, but more importantly, their family, and seeing this child go through this. Is there support for families around this? I'll start And education program.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah. I mean, so I'll start with the Let's Talk Cannabis campaign, which we run, which is about it's targeted at parents and adults and how to talk to kids about use. That's pretty big, right? That's broad. That's a population wide intervention. There's school based intervention. So we have student support specialists in schools that we fund who can do more direct service type work with students. Of course, they have to either self identify at school or be identified at school for that to work. And then I'm gonna turn to Tony for any other community based treatment, Tony, that you know of or that I've missed.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: From a treatment standpoint, a lot of what we're doing is really around kind of changing cognitive patterns, teaching people to be able to do, manage kind usually stress related pieces when it comes to, know, without cannabis. So just to piggyback off what we were talking about before, the negative impacts that we're looking at. So to the folks asking about the data systems, we've seen not only the calls to poison control go up, so pre regulated market, there would be a call or two a year to poison control. Now we're talking in the mid-20s to mid-30s calls to poison control since the start of the regulated market of accidental ingestion for children. We've seen an increase for adults in those folks at emergency rooms. So somewhere around, you know, again, we do things that the health department went on, you know, based on, you know, 100,000 visits. We're increasing up to 11 of those are cannabis related, either primarily around cannabis or not, or secondarily related to cannabis. So we start looking at both the negative health impacts, so educating folks on the health impacts, and looking at the other pieces. Where I think the worry for kids, for me, beyond kind of the potential for addiction is, is that when we start drilling down on some of these data numbers, we look at kids who have like depression. So kids reporting depression in schools. Of those children who are reporting having depression, it is almost a fifty percent of them are using cannabis. As where for kids reporting depression who don't use, the numbers are much smaller. Kids who don't use cannabis are much smaller. For kids who are experiencing suicidal ideation, their use of cannabis is higher than it is for the kids who don't. So the dovetail between how these illnesses all impact each other and the sense of despondence that kids are experiencing and the management of their symptoms by using cannabis is really concerning for me. And how do we avoid giving more cannabis, putting kids in a position where there's more cannabis accessibility for them.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: All right, I'm going to very quickly attempt to share my screen, let's see if works. All right. So You asked about emergency department visits. So here's the emergency department visit data. So this is only to 2022. So we don't have the last three years, and that will get updated soon. But as you can see, the ED visits for cannabis and this is not for an

[Rep. Kate Nugent (Member)]: age group, right? This is just all visits. All.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: It's going up. Inpatient visits, I want to be really clear, it's very low. But we're not seeing a big increase in that. This is I'm not going to know how to say this right, Tony. But for hyperemesis syndrome specifically, I'm also seeing an increase and only again to 2022. So need to update those data, but this is the type of data that we monitor and report out on. That's just the emergency department data. Tony was telling you about, again, going back to that youth risk behavior survey data. I'm going to send an email to your committee assistant and chair that has links to a bunch of different cannabis use data briefs and data resources that you can scroll through. And let us know if you have follow-up questions from them. But we do have volumes of

[Rep. Lisa Hango (Vice Chair)]: this kind

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: of information. I don't want to overwhelm you with it, just because I could. Could go on and off.

[Rep. Lisa Hango (Vice Chair)]: Rut Coffee?

[VL Coffin IV (Member)]: Yeah. I'm just looking at your site.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah.

[VL Coffin IV (Member)]: Which one you got? Marijuana use in Vermont, but it only shows to 2021. So there's In this one, I'm trying to find the newer version. The newer version,

[Rep. Kate Nugent (Member)]: yeah.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: We will

[Rep. Robert Hooper (Member)]: It just

[VL Coffin IV (Member)]: puts data to 2019 and 2021, but it doesn't

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: I think I sent an email of this nature to another committee, And so I will find that and it will give you the most updated stuff. Some of it we don't update every year, like that ED one we haven't updated in a few years. Some of it we update every time it comes out. So the Youth Risk Behavior Survey comes out every two years. That we update every two years consistently. Or Behavioral Risk Factor Surveillance System data is the adult version of that. That's a phone survey of all Vermonter. It's survey of Vermonter, of every Vermonter. And that, we also update those data every year in report that I can get.

[VL Coffin IV (Member)]: Yeah, because I'm trying to I'd like to compare from this report to a newer one. Mhmm. Because right now, it says we're among the high you know, when this was came out in 2021, that quoting from it, marijuana use among Vermonters is consistently among the highest in the country and is the highest for twelve to seventeen year olds and eighteen to twenty five year olds.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: So that has been true for a long

[VL Coffin IV (Member)]: Right. And I wanna know if there's

[Rep. Matthew Birong (Chair)]: any like, like, making this.

[VL Coffin IV (Member)]: Now is it you

[Rep. Kate Nugent (Member)]: know? Did it change?

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Tony, do you know that off the top of your head? That's that's, like, since I started working at health department fifteen years ago, that has been the case. Been a leader leader in a bad way

[Rep. Robert Hooper (Member)]: in that.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: We have been a leader in a bad way and continue to be a leader in the bad way.

[Rep. Lisa Hango (Vice Chair)]: Pinsonault?

[Rep. Sandra “Sandy” Pinsonault (Member)]: Has the age changed? Like, is it getting younger and younger? I mean, it's scary to think that 12 year olds are habitual cannabis users. Is it like, like

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: is the use going, is it going to, so we do a middle school survey. I don't know that data off the top of my head. I will look that up for you if that has increased.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: I don't think the ages are decreasing as much as discrepancy of those folks who are smoking are smoking more and more frequently. So we go from, you know, twenty percent of youth now who do smoke reporting they smoke 20 times or more a month. Versus, you know, I smoke once, you know, I've smoked once, the chronicity of their use is becoming more earlier.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah. Here's the poison data really quickly. So like Tony said, going up, here is the data that Tony mentioned before that I think is really important. It's who is using. Again, I want to be really clear. This is not causal data. This is association, right? But you can see that the cannabis use versus no cannabis use is very different when we're looking at some of these other risk factors. And then, these are the really highest users of cannabis. So they're using twenty plus days a month. They're six times more likely to have attempted suicide in the past year than those who don't use. So there are associations with some pretty serious outcomes that we see. This is why we get

[Rep. Lisa Hango (Vice Chair)]: I just want to make it clear that as we're talking about this, it could be that. People who are who are experiencing depression are using this as they are using a variety of substances to try to handle the situation. So it's not necessarily that using the cannabis is

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: this is not possible. Yeah, I just

[Rep. Lisa Hango (Vice Chair)]: wanted to make it clear as we were talking to the rest of the committee that it's not that it's it's not like using cannabis causes young people to feel to have suicidal thoughts. They're just kind of. And

[VL Coffin IV (Member)]: understood the cause.

[Rep. Lisa Hango (Vice Chair)]: Okay, I know I was just kind of talking about that. It's hard to know in these situations because like, when I see the data about the calls to the poison control, I think that seems pretty serious. But then I think, oh, also, people are probably more likely to call knowing that now that it's legal, they are going to get in trouble as a parent or an adult for having this in their home if a child takes it. Like, you know what I mean? I just it's it's hard to to take this data on a straight level, which are probably other factors. I

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: definitely want to underscore the youth risk behavior stuff because that's not causal. I do want to give you a quick causal study, which is a different national study in just a second. I would say I disagree with you on the poison control one. So kids so not that people didn't use to make brownies and candy on their own, but not at this level. And so kids are way less likely to chew on a bud of weed that's sitting around a house than they are to pick up a gummy bear, pick up a brownie,

[Rep. Lisa Hango (Vice Chair)]: pick up a cookie, pick

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: up a gummy looking thing. Looks just like the vitamins, whatever. And so I think that it, will hopefully people feel comfortable calling poison control. People call poison control. It's anonymous, which is by design because it's pretty you know, people get into trouble in all sorts of different ways. So, think it is really reflective of the fact that there is product that is attractive to children in much higher quantities now. But I hear you, and I do think it is important that people feel comfortable

[Rep. Robert Hooper (Member)]: to call my children.

[Rep. Lisa Hango (Vice Chair)]: They should.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: I have done it. I've felt places to call

[Rep. Lisa Hango (Vice Chair)]: for my children. You're not parenting if your kid has something to do. I was wondering, Toni, did you have testimony, Veron? I know Chair of Iran said you both had a start at 02:30 and it is 02:30 right now. Did you have testimony or anything you wanted to say on your own or you two working together?

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: No, ma'am. I was just here to support Cheala.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Okay. I didn't want to tell you. So there's many different studies on campus use and mental health outcomes. And again, I really appreciate you underscoring the causality versus association. There's a very recent study that just came out last month about 400,000 or so adolescents out of California. And it was a longitudinal study. So youth risk behavior survey, we're asking you all the questions at once. So that's why when I say we can't figure out what came first, we're not looking at the causation. We're just looking at was it associated. With longitudinal studies, we can see that means over a long period of time, and we keep asking the same questions. And so then we can see what came first. And in that, they did see much higher risks of developing depressive disorders and anxiety disorders and other mental health disorders when those kids were users of cannabis and users of marijuana. So again, I want to be really clear, Vermont data is just association based. But when we look at the science that's coming out of other states that look at longitudinal causality, we are seeing pretty good evidence that, unfortunately, there is a causal link between use of cannabis and fairly serious mental health problems that we are seeing a higher prevalence of in Vermont and in the nation among our youth, such as depression and anxiety. It's not a Again, my message is the Vermont data are the Vermont data. It's what we do as a surveillance tool here in the state. But the science and the evidence that is developing out of the nation when we do it academically or when we do these bigger longitudinal studies is really solidifying to say, This is not good for kids. We do not want kids using it. It is not healthy. It has real consequences. The more they use, the more frequency with which they use, the worse it is. We don't want it. And so that's why we're asking for the Again, the Senna version, for the most part, is really good from our perspective, but why we're asking for the change in the serving size and to keep

[Rep. Lisa Hango (Vice Chair)]: it the same. Thank you. I think we all agree we do not want the children to have this. I know.

[Rep. Kate Nugent (Member)]: I know,

[Rep. Lisa Hango (Vice Chair)]: and it's too bad. Hard to hear that data from the California study. It's difficult.

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: Yeah, that's not great.

[Rep. Robert Hooper (Member)]: Are we going to do some of that? Are we going to do some of that work here?

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: So that has to be a big I mean, those have to be funded and run out of academia and national level institutions. We at the Health Department do not have the resources or capacity to run them. They are awesome. They're needed. We often rely on the federal government for funding and supporting a lot of that work. I agree. UVM, there have been really cool studies that have come out of Vermont and UVM. But we also don't have that many people, so that could be a surprise occasionally.

[Rep. Robert Hooper (Member)]: We don't have many children. And I've seen a lot of I'm not inexperienced. Look at Tony, and I know Tony knows the street as well as I do. And I have a lot of trouble. A lot of trouble with legalization, I have a lot of trouble with the societal change. I think parents should be held accountable for the care of their children, and we talk a soft line of talk on this subject. We need to be a little more forceful in my personal opinion. Tony, I don't know whether you remember me or not.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: I absolutely remember you, sir.

[Rep. Robert Hooper (Member)]: I appreciate that. I appreciate you too. That's a great presentation. Thank you. I'll send you a follow-up

[Rep. Kate Nugent (Member)]: Wednesday. Thank

[Rep. Lisa Hango (Vice Chair)]: you so much. Appreciate it. All right.

[Tony Fallon, Division of Substance Use (Clinical Team), Vermont Department of Health]: Thanks for having us.

[Rep. Lisa Hango (Vice Chair)]: Thank you. Next is Amy Turncliffe, who's the Founder and President of Rockford Scientific Consulting. I'm Sam. Hi,

[Dr. Amy Turncliffe, President, Rockford Scientific Consulting]: Hi, thanks for having me. Can you all hear me okay?

[Rep. Lisa Hango (Vice Chair)]: Yeah. Could you identify yourself for the record, please? And then you can go right ahead. Yep.

[Dr. Amy Turncliffe, President, Rockford Scientific Consulting]: I am Amy Turncliffe. I wanted to give you just a little background about who how I'm qualified to speak to you all today. I have a PhD in neurobiology and I did postdoctoral training with Bertha Madras at Harvard Medical School. And then over the past twenty years, I've been a consultant in mental health and substance use disorders. Over the past ten years, I've used my expertise really focused on prioritizing public health and cannabis policy. So I live in Massachusetts. I've spoken on the topic in New Hampshire, other states, and federally. So I really appreciate the opportunity to talk to you all. I finally, I always mention this, I am mom to three kids and they are 19, 17, and 14, and I'm auntie to two nephews who are growing up in Vermont, which is an absolutely gorgeous state. They are 16 and 14, so we have a lot of teens in our family right now. All right, I wasn't sure about the format of today. I usually speak in very formal hearing proceedings. I just want to congratulate all of you for the collaboration with your Department of health. And I mean, honestly, it's refreshing to see, so I really do appreciate that. I wanted to just, because I'm a neuroscientist, I usually ground everything in science and just do just a quick kind of level set on cannabis. And I'm sure you're all well versed, I'll try to skip through what I was going to cover. And then I was asked to speak about just cannabis events and kind of the public health concerns. And if you decide to move forward with cannabis public events or private events, and what might be some outcome measures that you might want to take a look at to ensure you're tracking, what might be happening or not. So this is kind of piggybacks on the conversation you were just having around a single serving size and whether or not that should be increased. In Massachusetts, we have a serving size of five milligrams. I know some other states have ten milligrams as their serving size, but I think it is important that in May 2021, the National Institute on Drug Abuse defined a single dose unit as five milligrams of THC. So that's kind of the federal kind of for research purposes dose unit, and then that's essentially about equivalent to one serving of alcohol. So five milligrams THC, one serving of alcohol that defined as a beer, that's 5% alcohol or a one ounce serving of an 80 proof liquor. I mean, that's the standard alcohol. And then I think, I believe have a THC flour cap of 30% THC back in 1990. I think I graduated high school in '91, so we'll just call it 1991. I'm dating myself. Standard THC flower was about 3% THC. So now a joint or a pre roll today is generally about 10 times more THC than a joint of the same size would have been in 1990. So a vape cart, I grabbed one off of a dispensary website from Vermont that contains 86.5% THC. It's a one gram vape cartridge. It contains eight sixty five milligrams of THC. So that's about equivalent to almost ninety, nineteen ninety joints. And it's about equivalent to one seventy hundred three servings of alcohol or one hundred and seventy three point five milligram, Nida defined THC dose units, and that's a little bit more than a keg if you're equating it to alcohol. So I think that's a single bite cart. So just so you know, and then one ounce of cannabis flower, that's 30% THC is about eight thousand four hundred milligrams of THC. That's about eight forty joints from 1990. And it's about sixteen eighty five milligram NIDA defined THC dose units. It's approximately equal to 10 kegs of beer or 13 gallons of 80 proof hard alcohol. So just to give you an idea of, I rarely see it broken down in this way, so if you're thinking about increasing from one ounce to two ounces, you can double all of those numbers. I just think it's, I think as a nation and society, we have to start kind of breaking it down so that you can understand what that actually looks like in terms of dosing. Yeah, it's interesting that you're comparing it

[Rep. Lisa Hango (Vice Chair)]: to alcohol because you can buy a keg.

[Dr. Amy Turncliffe, President, Rockford Scientific Consulting]: Yeah, you can.

[Rep. Lisa Hango (Vice Chair)]: You know what I mean? Yeah, you can,

[Dr. Amy Turncliffe, President, Rockford Scientific Consulting]: but if people were to be walking out, I I don't know how often people are buying like 20 kegs, right? So it's just something to think about, right, in that way. And which brings me to my next point, which is I don't usually equate it to alcohol. This is actually the first time I've ever equated it to alcohol in my presentation, actually. And the reason for that is what I'm going to talk about next, which is when someone consumes a cannabis product, right, the THC, if you consume it through an edible, it's absorbed fairly slowly into the bloodstream, but if you inhale it, it's pretty rapid. So the THC enters the bloodstream, THC is lipophilic, and I don't know, maybe you know this already, I'm sorry if I'm repeating something you already know, but it's lipophilic, which means that it sticks to fats and lipids in the body. So once it is absorbed into the bloodstream, it rapidly redistributes from the blood into fatty tissues. And the brain happens to be one of the most fatty tissues in the body, but also into fat cells around the body. And then THC can be released slowly from fatty tissues, including the brain, for days, weeks, or months. This is why someone can fail a drug test long after they've already consumed. The impairment from, generally, the impairment from a five milligram dose that someone who doesn't use regularly takes lasts about two to more than eight hours. It's highly variable because the THC is lipophilic and it stays in the body for a very long time and can be released over time. That's very different from alcohol, and alcohol is hydrophilic, meaning it dissolves in water, and alcohol distributes throughout the brain and body in a relatively predictable way. So that's, we typically say it's metabolized and cleared relatively quickly and typically within hours. And we usually say, write a drink an hour. If you do a drink an hour, you're probably okay to drive. And that's very different from THC because THC accumulates in the body. And if somebody uses regularly and you're about the teens that are using more frequently or even young adults that are of age, we know that unfortunately our highest percentage of them are using, then the THC accumulates. And it can actually take months and months after someone who uses regularly to stops using for that THC to clear the body. Okay, so just to summarize a high THC content increases the potential for health and safety harm. THC is processed by the body very differently than alcohol, so that's why I don't usually use the comparison. THC is fat soluble and alcohol is water soluble, meaning that THC can accumulate in fatty tissues, especially the brain, and can be released over time, which increases the potential for delayed impairment and for prolonged impairment. And then cannabis in particular, THC can cause short and long term impacts on physical, cognitive and mental health, including cannabis sinusoid psychosis, which is actually my area of expertise, but I'm not talking about that today. And then these impacts are especially relevant for adolescents, And I do want to point out that's now being recognized as up until age 32. There was just a recent study, a really impressive elegant study that showed that adolescents extends to 32. And so that's because of the important role of the endocannabinoid system in brain development, and that's our natural endocannabinoid system that the THC interacts with. So I now just wanted to hopefully quickly move through the public health concerns with cannabis events. And the first is social normalization. And I think that your previous guests talked a little bit about this, which is that young people are influenced by what they see and hear in their family and in social circles and in their communities. So social cannabis events, especially public events in communities are likely to reduce the perception of harm associated with cannabis. And then research has shown that more cannabis outlets in that community is associated with more youth use and more intention to use. And when I say more youth use could be more young people using and or more the people who are using use more frequently. And even if entry is restricted to adults 21 plus social use venues can normalize cannabis use as something that's something to do for fun. And it's especially when it's located near areas where there might be adolescents hanging out. And then, so essentially the concern is not only direct underage entry, which also is a concern, but also increased visibility, adult to youth diversion, and then just exposure to higher THC products and reduced perception of risk. The second public health concern is over consumption. And this is obviously a concern regardless of whether you're talking about social consumption or not, but typically when people are consuming in a social environment, there's some amount of kind of, would call it peer pressure, but a little bit. And people who aren't experienced consumers are consuming with people who are, they might feel like the need to consume more. So I mentioned that a Nyna defined dose unit is five milligrams, regardless of consumption methods. I mentioned that THC is fat soluble compared to alcohol, which is water soluble, which can make it highly variable and the clearance of THC can be much slower. And then we have high THC content in today's products with like a half a gram joint, that's 30% THC can deliver one hundred and fifty milligrams of THC. The signs and symptoms of overconsumption can be cardiovascular like palpitations and tachycardia, gastrointestinal, we mentioned cannabinoid hyperemesis syndrome, which should be abdominal pain, nausea and vomiting, and then central nervous system, dizziness, sleepiness, lack of coordination, confusion, amnesia, anxiety and nervousness, paranoid reaction, delusions, hallucinations, depersonalization, dissociation. And I had a little thing about cannabis induced psychosis and schizophrenia, but I won't, that's not for today. And then public health concern number three, I think is usually the largest that people think about, which is impaired driving. Not only does that impact the person who's driving, but also pedestrians, other drivers, police, EMS, and kind of the general local liability exposure. THC has many of the same impairment effects as alcohol, including slowed reaction time, foggy memory, impaired coordination, impaired attention and judgment. And then studies have actually found that even if a person feels like they're okay to drive after consuming THC, they still show impairments in key driving functions. So THC impairment can be delayed, it can be hard to self detect, and then less predictable than alcohol. And in fact, Colorado I'm always blown away when I recite this, but the Colorado Department of Public Health and Environment says publicly, it's on their website, to wait at least six hours after smoking marijuana containing less than thirty five milligrams before driving, biking, or performing other safety sensitive activities. And if you've smoked more than thirty five milligrams, you need to wait longer. And I was just saying that a pre roll that's a half a gram can be one hundred and fifty milligrams of THC. And then wait at least eight hours after eating or drinking marijuana containing less than eighteen milligrams THC before driving, biking, performing other safety sensitive activities, and if you've consumed more than eighteen milligrams, wait longer. So even a standard five milligram dose unit, the Colorado Department of Public Health and Environment would say wait at least eight hours before driving. Public health concern number four is secondhand smoke exposure. So if smoking or vaping is allowed, workers, patrons, nearby residents, people walking by the venue may be exposed to secondhand cannabis, either aerosol or smoke, and this is generally considered counterproductive to smoke free workplace advancements. The CDC notes that secondhand cannabis smoke contains not only THC, but many of the same toxic and cancer causing chemicals that are found in tobacco smoke, and in some cases at even higher amounts. And a study was just published that found high levels of toxic metals in vapor from THC vapes. So this raises concerns for employees, pregnant people, people with asthma or other respiratory diseases, and then neighboring businesses and housing. And then the fifth and final for today, public health concern is a lack of compliance with public health protections. So I do certainly want to commend Vermont because you all have honestly, in my opinion, been leading the way for public health protections or one of the states along with Connecticut leading the way for public health protections. So Vermont has enacted proactive policy measures to reduce cannabis related public health and safety harm, but as we've heard, even with the best of intentions, local officials may face practical enforcement issues in areas like preventing co use with alcohol or other drugs, monitoring intoxication and impaired driving, preventing diversion to underage people, managing odor complaints, ensuring worker protections, and avoiding accumulation of impacts in communities that are already burdened. And then some of the public health related outcome measures that you may want to track or continue to track because it sounds or track more closely. It sounds like some of these are being measured already in Vermont, which is great because you'll have a history and you can look forward. It would be collection of quantitative and qualitative data from your host municipalities and would include the impact on utilization of local services, like first responder utilization, law enforcement, and to services, tracking OUI cannabis, underage use, emergency response for both physical and mental health crises, and then local and state emergency medical services utilization include medical emergencies that have a cannabis code. And I know that coding can be tricky. Would just encourage you to make sure that your physicians are using cannabis coding. And then if event attendees are allowed to leave the premises with product, as they will be in Massachusetts, which I don't think is a great move, consider assessing child poisoning data moving forward and comparing it with where you're at, which may again fall under emergency medical service utilization or may just be poison control calls. And then compliance checks are a great way to see how things are going. So especially for public events, where you can look at underage access compliance with provision on alcohol co service, and then any compliance with sales limits and permitted product types and things like that. And then the second bucket I had in terms of category was assessing your local and state adolescent health survey especially in and around communities that are hosting cannabis events. So this may help to show if changes in cannabis or THC product availability are happening, changes in perception of harm, changes in perceptions disapproval that may be associated with seeing events publicly. And then you can also include or ask to be included questions about whether teens or underage persons report seeing or attending a state licensed cannabis event. So that's all I had, unless anybody has any questions. Thank you so much.

[Rep. Lisa Hango (Vice Chair)]: Did anyone have any questions?

[Rep. Kate Nugent (Member)]: Nugent? As far as collecting that local data, have you seen municipalities do it? Or how would you go about it, do you think?

[Dr. Amy Turncliffe, President, Rockford Scientific Consulting]: Yeah, so I haven't seen a great it depends on what you're talking about. In terms of local and I think it sounds like you have this, too local adolescent health survey data. In Massachusetts, that's done in a hodge podge way. It sounds like if you have a much more coordinated process for that, so hopefully that will be easier. In terms of collecting quantitative and qualitative data, I think that would be something you need to be asking communities for at the outset, because I don't see that community, local municipalities are doing a great job of collecting data. I don't even see that they're doing a great job with compliance checking just generally of their retail establishments. And maybe that's, I want to put it very kindly, maybe that's Massachusetts specific because Massachusetts has had a lot of issues with our regulatory bodies and enforcement and communication maybe with local kind of municipal leaders. So I would just recommend that you do that from the start and have a very clear kind of a list of what you'd be asking of them.

[Rep. Lisa Hango (Vice Chair)]: Thank you. We really appreciate it. Okay. Thank you all. Thank you. Alright. Next, have sheriff Mark Anderson on Zoom.

[Unidentified Legislative Counsel/Member]: Hello.

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: Good afternoon, Madam Chair.

[Rep. Lisa Hango (Vice Chair)]: How's it going?

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: It's going well. For the record, Mark Anderson, Wyndham County Sheriff. I am here on behalf of the Vermont Sheriff's Association. I'm the past president of the association and I was the person that we can make available on short notice. So that's why I'm here today. Do you want me to just fire away? I don't have much testimony.

[Rep. Kate Nugent (Member)]: Sure.

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: Great. We have no awareness of this bill. The other body did not invite us in, so it was a bit of a surprise when I saw this. I do appreciate the House Community on Government Operations and Military Affairs inviting us in for it, but we have no position because we didn't even know it was a topic. I understand that I'm being asked to speak to Section five. So the primary factor here is whether or not it makes sense for law enforcement presence to be there. I'm gonna make analogs to alcohol and hearing the prior witness speak to why she doesn't make it. I totally understand all those things, but we do have systems, infrastructure, and logistics in place with alcohol, specifically through the Department of Liquor Control or Liquor and Lottery now, they have an enforcement branch. And so there are analogs, at least in structural systems. It's not uncommon for organized license events to have some form of a security plan, law enforcement presence. To have this specified by cannabis control board makes sense and is consistent as far as I understand it with what liquor, the liquor control board does. The primary concerns from law enforcement are generally around impaired driving. While I don't believe this bill is to deal with impaired driving specifically, I have to use as an opportunity to make my honorable plug. One of the issues and areas that Vermont law enforcement has struggled is identifying funding for what we call a green lab. A green lab is a training tool that we use to train law enforcement officers on what a person, who is impaired by, cannabis, what they look like. We have what we call wet labs, which is where we have people who are dosed with alcohol in controlled settings. And then we can, in a training environment, show law enforcement officers how to recognize signs and symptoms of impairment with alcohol. Green labs are difficult because most of the funding related to alcohol enforcement is federal funding and federal funding currently prohibits any purchase of marijuana, cannabis related products. So we struggle anytime it comes to how do we actually fund that program. Last legislative session, we were trying to see if we could secure an amount of money from the opioid settlement funds to see if we could use that. It's not a significant amount of money in the grand scheme of the state budget, but it's not a small amount. I wanna say it was in tens of thousands of dollars to procure all the things that go to operating a green lab. If the committee has any interest in hearing testimony on a green lab, John Flanagan, who is the state coordinator for the drug, field sobriety testing and all the things with impaired driving. John Flanagan, who's at the Vermont Police Academy is a great person to ask for. That said, that's my honorable plug. As a sheriff, the only concern that I have in Section 5 is if I were asked to provide services for an event and I don't have people, then what? It seems that private security is an alternate option. So broadly speaking, with little prep time for this bill, I don't have any brilliant thoughts to share with you other than what I've said so far.

[Rep. Lisa Hango (Vice Chair)]: Right. Thank you, Sheriff. If you are interested in coming back after you've had some time to review it and discuss it with your colleagues, just let us know. That would be great. We can check back in with you too about that. And if Rob Coffin has a question.

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: Yes,

[VL Coffin IV (Member)]: you. Just for future, if you could please come back.

[Rep. Robert Hooper (Member)]: What

[VL Coffin IV (Member)]: happens when you pull someone over and you suspect them of being impaired, but they're obviously, you know, you don't smell alcohol on them or anything, but say you smell cannabis in the view, what are the procedures there or can you even test on the road?

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: So a few things. We in Vermont, most law enforcement officers who perform patrol work will take the National Highway Traffic Safety Administration's standardized field sobriety testing course. So that is how we teach Vermont law enforcement how to recognize and detect an impaired driver. Notice I did not mention alcohol. It's not an alcohol specific training, but it came out of the origins of alcohol. So there's a secondary course which the legislature back, I want to say about fifteen years ago, as part of the legalization efforts, said all Vermont law enforcement needs to have what's known as ARIDE. That stands for the Advanced Roadside Impairment Detection Enforcement Training. We love our acronyms. That is an advanced level of training that we provide law enforcement officers after they have some experience recognizing impaired drivers to recognize at a greater degree and be able to direct how we collect further evidence on an impaired driver. There's a third level, which is known as a drug recognition expert. That was a program developed through both clinical and field tests and studies with the International Association of Chiefs of Police and National Highway Traffic Safety Administration, Johns Hopkins University and many others that trains law enforcement officers on how to recognize what type of drug, what category of drug a person is impaired by. If they're impaired by one category such as a cannabis product versus alcohol, we can actually differentiate where those impairment levels come from. And that is a result of some advanced training that roughly I want to say we're at about 50 DRE trained officers in the state of Vermont. So the A ride feeds into the DRE program. DREs are funded through federal funds to help assist and offset the burden of the state budget in recognizing and reducing motor vehicle crashes related to impaired driving. I will also throw out one fun fact, which is generally speaking in Vermont, motor vehicle crashes are driven by three primary categories. One is speed, one is distracted driving, the third is impaired driving. So this is a significant concern when we talk about reducing motor vehicle crashes. AAA for years advertised the total impact of motor vehicle crashes on economies. We're talking over a billion dollars lost related to motor vehicle crashes. Now, I'm not saying that's impaired driving related. I don't want to suggest that. But when one third of the crashes in Vermont are impaired driving related and we consider all of the impacts, whether it's the loss of a vehicle, loss of work time, loss of medical medical expenses, all the things that tie to what happens for motor vehicle crashes. It's certainly one of the reasons why law enforcement cares so much about impaired driving. But I also will say when people can be responsible and can do things in a well regulated environment, like that's a good thing. And that's why we have systems and institutions in place. So to that end, I think that there's ways that we can develop structures based on the policies the legislature comes up with. And I probably answered that question in about 500 sentences more than you needed.

[Rep. Kate Nugent (Member)]: I was just wondering if the tracking place of last drink if that has become, or if you know if it's become more uniform across the state when people are found to have, you know, be intoxicated or?

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: Thank you, Rep. Nugent. So place of last drink is collected when we submit a person who's been arrested for driving under the influence or suspicion of driving under the influence. When they are processed, we collect it in what's called the DMT, it's our evidentiary collection tool that's located at most law enforcement agencies. So that's where we generally capture the place of last drink, Department of Liquor and Lottery, and I suggest Brandon King, if you need to hear more about that. Department of Liquor and Lottery does a lot of work based on that. We also capture it in the statewide Valcor records management system. This is a tool that all or almost all law enforcement in Vermont uses. There's some agencies who opted to go a different path. So generally speaking, it is 95 to 98% available. If it's collected, the DMTs are a place where it is collected because it's prompted by the investigating officer. That will not impact cannabis as it stands right now. Software updates would need to be done. I believe it's the Department of Health who manages the DMT program.

[Rep. Kate Nugent (Member)]: Yeah, guess that was, yeah, so is that happening for cannabis? I guess my question, yeah.

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: It would have to be a voluntary identification in the Valco records management system. The DMT is the wrong tool to collect the evidence. When we talk about collecting evidence for drug impairment, we're usually looking at a blood draw. So, Place the Last Drink, John Flanagan will actually be another person to talk about how it reflects on impaired driving other than alcohol. He collects a lot of data points and charts and graphs and pictures to point out what drug impairment in Vermont looks like on our highways.

[Rep. Lisa Hango (Vice Chair)]: All right, thank you so much. Thank you for coming in at the last minute.

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: My pleasure. Great to see you committee and thank you

[Rep. Robert Hooper (Member)]: for your time.

[Unidentified Legislative Counsel/Member]: All right, yeah, let us know if

[Rep. Lisa Hango (Vice Chair)]: you want to

[Rep. Kate Nugent (Member)]: come back.

[Sheriff Mark Anderson, Windham County Sheriff (on behalf of the Vermont Sheriffs’ Association)]: Yes, ma'am.

[Rep. Lisa Hango (Vice Chair)]: All right, and then finally we have Gene Hamilton, who's the Director of Program Development from the Land Access and Opportunity Board. Hi, nice to see you again.

[Jean Hamilton, Co-Director, Land Access and Opportunity Board]: Hi there, thank you all. Yes, thank you. We just got notice of this invitation, it sounds like many others, just an hour or so ago. So I'm sorry that I am not there in person, but appreciative of the invitation. I'll start with an introduction. My name is Jean Hamilton. And as you just said, I am one of the co directors of the Land Access and Opportunity Board. And yeah, just appreciate you inviting us in to testify on the bill. I will also say since we just got notice, I am actually not sure what the current version you I don't know that I'm up to date with your most current version of the policy language. And so I'm gonna do my best here. And and hopefully, if if there is an opportunity this year or in the summer to keep working with you all on aligning the along the CCB's priorities of supporting initiatives

[Cheala Livingston, Interim Deputy Commissioner, Vermont Department of Health]: like the LAOB.

[Rep. Lisa Hango (Vice Chair)]: Yeah, we're working on the version that was passed out of the Senate.

[Jean Hamilton, Co-Director, Land Access and Opportunity Board]: Great. Okay. Thank you. So I'm sorry. What was that?

[Rep. Matthew Birong (Chair)]: No. I'm sorry. That was a little banter between reps one and seven. Yes.

[Rep. Lisa Hango (Vice Chair)]: Yeah, go ahead. Thank you. Yeah, it's the same version. So we're just starting to take testimony on it now.

[Jean Hamilton, Co-Director, Land Access and Opportunity Board]: Oh, got it. Okay, you're just starting now. Okay, got it. Thank you. Okay, so the Land Access and Opportunity Board was created to improve access to woodlands, farmland, and land and home ownership for Vermonters from historically marginalized or disadvantaged communities who continue to face barriers to land and home ownership. This is challenging and complex work. And as we enter into our testimony today with you, I want to start as we so often do by sharing our touchstones and inviting you to hold these touchstones during our time together today. So LAOB's touchstones are to listen generously, to speak your truth from your heart and mind, to make the way we work together an example of what is possible, and to trust that we all hold a piece of the puzzle and that we need each other's pieces to understand the whole picture. I know we've been in with your committee before, so I will not say too much about the LAOB, but I do want to say this. The LAOB was created to help the state of Vermont understand and remove the barriers that disadvantaged communities face in achieving land and home ownership. Our communities face barriers that are the compounding result of generations of unjust and discriminatory laws and practices. And the reason we're here today is because one of those sets of laws and practices is the war on drugs and the discriminatory nature of how cannabis has previously been criminalized and the impacts, the long lasting intergenerational impacts of that criminalization on our Vermont communities today. So discriminatory policing of cannabis has undermined our community's economic stability, and economic instability causes housing instability with damaging impacts for all of us. The Vermont Department of Health found in its 2024 state health assessment that quote, lack of affordable, safe and accessible housing leads to housing insecurity, mental health deterioration and financial strain. Key housing issues include substandard housing environments due to neglected maintenance, the high cost of housing, a limited number of contractors available to make repairs, landlords raising rents while not maintaining properties, and economic support policies and initiatives for affordable housing that are not addressing acute needs. Housing discrimination further limits access for many marginalized communities. You know, it's interesting that we have this relationship between housing and the Department of Health and this conversation that we've heard today from the prevention team about the corollaries and a question of coralizing and causation between substance use, cannabis use, and deteriorated mental health functions. Something that I really want the committee to think about as we're thinking about is this causal, is it correlative, is to incorporate into the vision, how does housing instability, how does homelessness or losing homes, being evicted, not having economic opportunities that are obvious to you in your community, how do those factors cause and correlate with declined mental health and potential substance use disorders? Housing is an incredibly important factor when we think about what are the most important ways that we prevent substance use disorder. Since its creation, the Cannabis Control Board has recognized the disproportionate impact of the historically government led policies that fueled the economic oppression of Black and Brown people for generations and continues to disadvantage these individuals, as well as indigenous people, people of color, and other historically marginalized groups. The board, in this case, the board is the CCB, aspires to build an equitable and accessible program in order to mitigate the past harm inflicted by the prohibition of cannabis. The CCB in its 2024 Act 166 report also found that quote, given the inherent barriers to accessing the industry and the ongoing challenges to achieving sustainable success, the CCB and the Cannabis Advisory Committee concluded that the social equity program alone is inadequate to mitigate the harm caused by historic drug policies and has called for the creation of a community reinvestment fund in many prior legislative reports. And in that report, it recommended dedicating 25% of the cannabis excise tax to the land access and opportunity board for community reinvestment. So when s two seventy eight passed out of Senate Economic Development Committee, it contained an appropriation for the LEOB. And we support the CCB Act 56 report finding that led to this led to this inclusion in their version. And that finding is quote, from a public health and prevention lens, directing cannabis excise tax revenues to provide grants and technical assistance for affordable housing, land access, and community led development would help address upstream determinants of health, stabilizing families, reducing stress and insecurity, and creating safer, more resilient neighborhoods. We

[Rep. Lisa Hango (Vice Chair)]: at

[Jean Hamilton, Co-Director, Land Access and Opportunity Board]: the LEOB have done the groundwork and are able to deploy funds into programs and projects that have been vetted and developed by our communities in collaboration with state agencies and service providers to heal the very real harms of housing and economic insecurity experienced by our communities who have been negatively and disproportionately impacted by discriminatory cannabis criminalization. We at the LEOB are interested and ready to work actively with you all with this committee, more broadly with the whole legislature, with the CCB, with the Department of Health and any other parties that are willing and ready to work with us to ensure that the cannabis market we have here and that we continue to build addresses our community's core needs for stable housing, land access and opportunity. Again, I'm gonna say it again and again, housing, access to land, access to economic opportunity are core structural drivers of both public health and thriving community economies. And in the bill that passed out of the Senate that you all are working on, some specific recommendations that we see as opportunities are really interesting to see what's coming out of the federal government right now. And so in Section 27, as we are facing the potential of interstate commerce around cannabis, it is more important than ever work that to protect Vermont's interests related to our marketplace. We are supportive of the provision included in that section 27 that agreement shall include included appropriate provisions reflecting board programs and efforts to promote the inclusion and support of individuals and communities in the cannabis industry who are linked to populations and neighborhoods that were negatively or disproportionately impacted by cannabis criminalization. We also support the expansion of that beyond the cannabis marketplace, because as we've heard and learned from the CCB before, many more community members have been negatively impacted by the prior criminalization of cannabis than are able to or want to participate in the cannabis marketplace. So these equity investments really can and should extend out beyond just the cannabis marketplace. And this is an opportunity to take an excise tax from cannabis and invest in the stabilization and security of all of our Vermont communities housing needs. We also at this point when we're looking at interstate commerce and a growing cannabis market really need to think about expungement and are we doing enough? How can we improve our expungement program so that we are serving folks who no longer live in Vermont, but were impacted by Vermont's criminalization of cannabis. Another aspect I think your committee probably has eyes on, and I hope you will have eyes on is that as we face the very real possibility that our cannabis marketplace will shift into an interstate marketplace, that Vermont will be entering into the challenging circumstances that we face in so many of our marketplaces, like food and agriculture and manufacturing, That Vermont does not have the same kind of access to economies of scales that other states have. And our cannabis marketplace, because it is so highly regulated, is really at risk. There's a lot of challenge for small scale producers. And we are very much at risk by being kind of consolidated into the businesses that have a high level of capitalization and are large businesses that do have those economies of scale. What Vermont has proven again and again, is that we compete when we compete on our excellent brand values. We compete well when we create marketplaces that are based on craft production, local businesses that have direct relationships with their consumers. And unless we do this to support our cannabis market, we will see a cannabis marketplace that spins out in a direction that does not support these core kind of selling points. What brings extra value to Vermont and Vermont businesses when we cannot compete on those economies of scale. And so especially as we face the potential for planning for interstate commerce, it's really exciting to see that there are still direct sales provisions in here. And in this bill we encourage that that continues because of the value that direct sales channels create for small scale producers and small businesses. And moving forward, know this it has been really interesting for me and also for LEOB to work on cannabis policy over the last couple of years. We see some exciting opportunities with this bill and again we are grateful that your committee is taking it up and giving us an opportunity to speak on it. Moving forward, we would like to continue working with you and we really encourage you to address these issues. This bill really deserves to have some appropriations tied to it and specifically to make investments into the Cannabis Business Development Fund. This is a marketplace that businesses need a lot of help to navigate. This is a complicated capital intensive business that does not have any of the typical support structures of the Small Business Association or Farm to Plate or any of those other places where we typically support our small businesses. The Cannabis Business Development Fund is really important. If we are expanding the fund availability to more producers, but not putting more money into the fund, that is going to create a problem. So expanding appropriations there, really thinking strategically about how do cannabis excise taxes, how can we use these taxes to address the critical needs our communities have around housing and developing civic capacity at the community level so that communities can lead on the problems that they are facing. Working together again, to really strengthen and deepen opportunities for craft producers and developing and strengthening Vermont's identity as a craft cannabis marketplace. And then one of our biggest disappointments this year with this cannabis legislation is that there, once again, we have a year that there is no meaningful cannabis legislation addressing the needs of medical marijuana patients and providers. And so really encouraging this committee and all of you as legislators and lawmakers to connect with the medical community and hear about the needs from patients and make sure that we are not continuing to fall behind on addressing those needs. So thank you for inviting us in and I hope this was okay how this landed. I didn't know exactly what you were hoping to hear testimony on, but I'm very open to hearing any questions, feedback, or redirection if you were hoping I was going to speak on something else today.

[Rep. Lisa Hango (Vice Chair)]: That was really helpful. Thank you. And thank you for being amenable to coming in at the last minute to talk about it. Did anyone have any questions? All right.

[Rep. Matthew Birong (Chair)]: Just a little bit more commentary. I came in late from being up in house ag on the hemp So, apologies for, like, loose communication with you. We were late taking this bill up for any witness testimony. So this was really what you gave us is what we were looking for. We're just looking for a table set of where your head was at with your organization for the bill as passed by Senate. And now that we've cleared our deck of a couple of other big things that we had to get out of the way, we're really peddled out on this one. Would like to have you come back once we start getting a little bit deeper into the sections, but we really just wanted to get your perspective on the words that's sent over by Lisa.

[Jean Hamilton, Co-Director, Land Access and Opportunity Board]: Okay, great. Thank you so much. I have to admit that my mind has started to shift into the like, what can we do after session? Because is anything else still happening? It's exciting to hear you're working on this, Bill. And I will shift my brain back into what could we work on together this year and follow-up with you, Cheair Bhairong, if that's okay.

[Rep. Matthew Birong (Chair)]: No, that's wonderful. And yeah, no, so we are really just starting to take our first leg of testimony hearing from stakeholders about what was sent over from the Senate so we can decide how and what we're gonna do with the words in front of us now. Great. Cool. And it's good to see you.

[Jean Hamilton, Co-Director, Land Access and Opportunity Board]: Nice to see you all. Thank you.

[Rep. Matthew Birong (Chair)]: All right. Any other questions for our guest committee?

[Rep. Robert Hooper (Member)]: No. All

[Rep. Matthew Birong (Chair)]: right, cool. And with that, I guess that is our final order of business for the day, correct?

[Rep. Lisa Hango (Vice Chair)]: Yeah, I would say.

[Rep. Matthew Birong (Chair)]: Do you want to take us off?