Vermont Legislature SmartTranscripts:

[Alyssa Black (Chair)]: Good morning, everyone. It is Friday the thirteenth, which I'll don't care. I'll say it again. I left my phone at home this morning. If I if I had my phone, I would have known it was Friday the thirteenth. I didn't realize that until afterwards. Okay, so today, for the rest of this morning, or however it's keyed or long, we want to talk. After today, we have three weeks left till crossover. Crossover, I think, is February I mean, March 14 this year, tenth. And it's the last week after we get back from town meeting break. So we have two weeks, then we have town meeting break, and then we have one week. So anything that we're going to get out, anything that is a priority, anything we want to do unrelated to any of the Senate bills that may or may not be coming our way, we need to finish in the next three weeks. So it's time to talk about what we want to do. If there's anything pressing that anyone really, really wants to take up, now's the time to speak, and we'll see if we can fit it in. Popper, Daisy and I have been discussing kind of what we think, so present it to everybody. A lot of this is based upon a couple weeks ago when we did priorities, and I know that we've had some bills come in since that time that we haven't really talked about, but just sort of grounding us on the limited time that we have left and what we can accomplish, because we cannot accomplish everything. Just got to be okay with that. So, we have five eighty five, which is the bill from the Department of Financial Regulation. We've just been referring to it as Tucker's bill. There were lots of things in there. Tucker and I have been having conversations with the Department of DFR, trying to hone in on where we want to go with it. We're probably going to be working on some new language and getting that ready, and then we'll take that back up. Hopefully next week we'll have something in place. I think Thursday, Tasha, did we Oh, Thursday afternoon. Complicated even more, we actually don't have Thursday morning of next week. So, that limits our time a little bit additionally. So, we have five eighty five, and to move on that.

[Francis “Topper” McFaun (Vice Chair)]: Where is that right now?

[Alyssa Black (Chair)]: It's here. I got it right here.

[Francis “Topper” McFaun (Vice Chair)]: Well, I've got a copy of it too.

[Alyssa Black (Chair)]: We've got a fair amount of testimony already on that. Remember that was the one that we did like three separate days, Jen had to come in and do doc threes and

[Francis “Topper” McFaun (Vice Chair)]: all sorts But then we kind

[Alyssa Black (Chair)]: of stopped it. We didn't stop it. We've been in collaboration with DFR.

[Allen “Penny” Demar (Member)]: And the agency. And the agency Absolutely. And

[Alyssa Black (Chair)]: So, okay, so we've got that. I hear a positive emails.

[Lori Houghton (Member)]: What do you need? I didn't hear you, I'm sorry.

[Alyssa Black (Chair)]: Positive emails. Oh, good. Do you want me to forward that stuff? Is something that- Is it coming through just you or is it coming to House Healthcare? Usually when people send me things, they'll send to the whole committee. Yeah, because I don't think I need to speak out for it. Just realized today, Pasha is actually not on our House Healthcare email group. So typically when people They just added. They added to it. Okay. So usually when we get any kind of public comment or written testimony, goes to Tasha, and Tasha posts it on our website.

[Allen “Penny” Demar (Member)]: If you think it's important, And we all know about

[Alyssa Black (Chair)]: you can tell it just came to you, absolutely forward it. Okay? All right. So, we are taking today, we are taking testimony on, I cannot remember the serial number. 558. Which is? Which is having to do with school based services. And this is sort of a real priority for the administration.

[Brian Cina (Member)]: Oh, the Medicaid school based services.

[Alyssa Black (Chair)]: Yeah. Okay. And if you remember, we did hear something when they were giving budget testimony about how they're moving something from, I think, AOE to Diva, and we're going hear about that today. Can I ask a question about that? I don't know the answer properly.

[Lori Houghton (Member)]: You may or you may not. I'm just wondering about the Ed Committee response to this bill, or do we hear from them or I haven't seen We'll do the walk through, of course, haven't read it.

[Alyssa Black (Chair)]: It was referred to our committee, so we haven't even done a walk through yet. We'll talk about that then. We'll talk about that then.

[Allen “Penny” Demar (Member)]: Okay.

[Alyssa Black (Chair)]: All right, also, next Friday, I've asked Brian and Daisy, because we had three bills come in. There's actually four. Oh, okay, four.

[Brian Cina (Member)]: It's four AI bills.

[Alyssa Black (Chair)]: Are only three in our committees?

[Brian Cina (Member)]: No, they're all on there.

[Alyssa Black (Chair)]: They're all on there? Next Friday, Jen and Katie, because Jen's done some, Katie's done the others, they're going give us walk through all of them. What's those numbers? I'm not sure.

[Brian Cina (Member)]: The numbers are 644, 814, and 816. 644. 814, 816, and all three of those have chatbots, which is why we were going to do those as a cluster. There is one that is 776 that talks about the finance of healthcare system AI, we can look at that later, but we had chosen the three chat bot ones to go in the same day with the neuro writing.

[Alyssa Black (Chair)]: And I think next Friday we're just going to get an overview of what any of it even means. How

[Francis “Topper” McFaun (Vice Chair)]: would they We'll

[Alyssa Black (Chair)]: find out next Friday. Okay, so next Friday we'll take up testimony from three AI bills that we've got.

[Brian Cina (Member)]: And I just confirmed, Chen, that the fourth one fits into one of those, but we'll come back to that another time because we don't want to do too much in one day.

[Alyssa Black (Chair)]: And we're just getting an introduction to the topic next Friday. What a way to send you home on. That would be exciting at least. So the three of us have sort of prioritized Oh, when we did our original priorities, one of the bills that was highlighted by multiple people is the emergency examiner certification. And if you recall, when we had all the nurses in here that day, and they talked about that bill as being a priority of theirs that they really wanted to see. That had to do with who could perform an initial mental health exam on a patient. If they wanted it expanded to physician assistants because oftentimes that physician assistant is the only available in an emergency department setting. Because that was prioritized by multiple people in here, we thought we should start taking up some testimony on that.

[Lori Houghton (Member)]: We're talking about May?

[Alyssa Black (Chair)]: Yes. Yes. Okay. I don't know, maybe we're suckers for the nurses, but it seems like we, We're very well spoken. We did a bill last year around workplace violence, and that had come from them. We like to support. As Topper said on the floor, and he reminded me of this, tools consistently be the most well trusted occupation is nursing.

[Allen “Penny” Demar (Member)]: That's

[Alyssa Black (Chair)]: right. Yes, it is. We love some nurses.

[Brian Cina (Member)]: I do too, but I do want to just be fair that we just heard from the mad freedom person that we didn't really hear from patients on that violence bill. I can tell you that there's people who are going to the hospital now who are homeless, and when they don't want to leave because they're suicidal and cold and there's nowhere for them to go, and they get angry, they're labeled as aggressive, no trespass, and then they can't even go to the hospital anymore.

[Alyssa Black (Chair)]: All the more reason why we should take it up. And we obviously, anytime we take up a bill, we always try to hear from every single person.

[Brian Cina (Member)]: I think that was my point, that I want to make sure we hear from the patient perspective this time and be more careful about that.

[Alyssa Black (Chair)]: So we will ensure that the investigator may be testimony that we invite in and hear from

[Brian Cina (Member)]: all of Oh yeah, we definitely should hear that.

[Lori Houghton (Member)]: Absolutely. So I know that for APPs, advanced practice providers, nurse practitioners, PAs, nurse practitioners have a track that includes mental health psychiatric nurse practitioners. I don't know about PA education. So that would be something of if we could pay We're going to find out. Okay, so as long as I'm on your

[Alyssa Black (Chair)]: list for witness. Didn't say we're going to pass it. We may open it

[Lori Houghton (Member)]: up and say, no, this is

[Alyssa Black (Chair)]: a bad idea, but it is something we should at least Okay. We have, what else did we There's a couple of things that we had talked about that we're sort of talking about with DFR and maybe incorporating into five eighty five. I wanted to get everybody's thoughts. We heard last week the prosthetics, expanding coverage for multiple prosthetics, and I wanted to sort of get everybody's thoughts on whether we want to hear additional testimony and if that's something that we might decide to take up. We would obviously need to hear from our insurers, as it would affect benefit plans, we would need to hear from probably Department of Vermont Health Access, as it would affect Medicaid. And it seemed like the testimony that we took that there was enthusiasm amongst the committee for maybe looking into that. So I just wanted see if everyone still a week later felt like that was something that they wanted to do. Yes, I do.

[Lori Houghton (Member)]: I'm interested, I'm also interested in the testimony here was very focused on athletes, and I'd be interested in hearing about people who are not athletes, how this would have been done. Then is that a vote for we should hear further testimony? Yeah, well, I guess. I don't want to delay it for that. So unless people feel like we're all settled on it. That was it just seemed really focused on that population. And I was just thinking about expanding. Well,

[Alyssa Black (Chair)]: that's what we take testimony for is we try to get all the perspectives of that. Go ahead, Emily.

[Francis “Topper” McFaun (Vice Chair)]: I think we need all the testimony because I thought of it and that would be the toughest bill to say no that we've done here, But, to say that you are going to give them, and we heard a little bit of testimony, that they would have a lifestyle, I don't think we would be doing any justice to our Medicaid system, our insurance companies, if we provide a prosthesis for every activity a person wants to do. I don't think I'd be very responsible on our part.

[Alyssa Black (Chair)]: Sounds like we need to hear from those insurance companies.

[Francis “Topper” McFaun (Vice Chair)]: And it would be nice if we could.

[Alyssa Black (Chair)]: And those are great questions to ask. Write your questions down that you can have ready.

[Allen “Penny” Demar (Member)]: I got them.

[Alyssa Black (Chair)]: Okay. Remember, just because I say that we should take it up doesn't mean we're going to pass anything. We could hear all of the testimony and say, well, this is a terrible idea. And after that, This is really just what should we focus on and what should we take testimony on in our remaining three weeks. Monday Monday and Tuesday, nobody, I'm not here Monday. Tuesday and Wednesday of next week, we will be doing our budget memo, working on our budget memo. That's what we need to focus on those two days. It's my hope that by Wednesday we can have that budget now done. And then once that's out of

[Brian Cina (Member)]: the way, can focus on these policy Are

[Francis “Topper” McFaun (Vice Chair)]: we going to have a list of all our tasks?

[Alyssa Black (Chair)]: Yes. Yes. Daisy has been you know how people are giving us testimony and I keep going like this to Daisy? Because Daisy's got a big spreadsheet on her. She's been adding

[Francis “Topper” McFaun (Vice Chair)]: was hoping you didn't say big spreadsheet.

[Alyssa Black (Chair)]: It's a big spreadsheet. Huge. It's huge, huge spreadsheet. Everyone gets spreadsheet. Just like we have voted

[Francis “Topper” McFaun (Vice Chair)]: on We've

[Alyssa Black (Chair)]: done it before. Our Karen and Cal. Typically, go through all the asks. We usually categorize them by what's in the governor's recommend, what's in base funding, what's in one time. And then we start going through all the various advocates, stakeholders, their asks, and then we will go and we will rank them. Each individual person has to rank their top, I think three. I think maybe we've done five before, but I feel like this year it might be our top three priorities. And then we add up everybody's rankings and those are the recommendations that go to house corporations. Can I say something real quick? Yes, of course.

[Daisy Berbeco (Ranking Member)]: I was going to point out that's also how we got to the list of bills that Alyssa has been going through right now. And I sent this email to you all a few weeks, if I can resend it. But I just appreciate the very diplomatic process that we went through to decide which bills to address this year. Everyone voted on these, and then I plugged them into a little Excel calculator and ranked them, and just really appreciate that you have allowed this process to be so diplomatic that everybody's preferences and priorities are getting addressed. Was really nice.

[Alyssa Black (Chair)]: The other bill that we haven't really talked about, but I've had a lot of other members excuse me, other members that are not on our committee is representative Boswell's Bill, what is it? H? Tasha, do you remember? I've been here. 741? '30 736. Yeah. Which is a pill about medications like specialty medications that people take for rare diseases in an inpatient setting.

[Allen “Penny” Demar (Member)]: We're going to bring it up Friday.

[Alyssa Black (Chair)]: We're going to bring it up. I'm not even sure if it's a problem, but I would like to take testimony on it, particularly with the many, many other members in the House that have expressed a lot of interest in it because they have been personally affected by it, or members of their family.

[Allen “Penny” Demar (Member)]: What you got to tell? What you got?

[Alyssa Black (Chair)]: So last week I was snagged by Tina Keshava, optometrist from Melbourne. Yes.

[Allen “Penny” Demar (Member)]: Did she

[Alyssa Black (Chair)]: talk to you? I'm assuming you're talking about the optometrist bill. That bill is currently in the Senate and they are taking testimony on it. I suspect we will be getting that bill from the Senate. We have a companion bill, but the Senate is, I think, moving on that. So we can thankfully wait until after crossover to address that bill. Also, is the APRN bill in the Senate, is that in hospitals? Moving now now? Yes, they are moving to contact. They're taking maybe some final testimony next week, likely we'll take action on that. What number is that? Do not. It's +1 608. Yes, I think Representative Goldman has a companion bill for that subject in the House, so we will be getting that as well. I will tell you, we're also getting a big primary care bill. Is there a for

[Lori Houghton (Member)]: there a number for that? S-one97,

[Alyssa Black (Chair)]: it's still way better at the early stages.

[Lori Houghton (Member)]: Is it going to make it?

[Alyssa Black (Chair)]: It's early, late. Right now? What time was it? He just wants to make sure. Where am I going?

[Brian Cina (Member)]: Transportation is free. Sorry about that. I do have something to add, but I guess I'll

[Alyssa Black (Chair)]: Oh, you wanted to throw out the number when you talk about it?

[Brian Cina (Member)]: No, because this is only going to take five minutes. It's just a brief build instruction.

[Alyssa Black (Chair)]: We know, Jen, do know you if S142 is moving? It's the Oh, international health Yes, they just took testimony on that this morning and we'll be hearing more. Okay. All very favorable testimony this morning except waiting to hear from the board member practice, we did not testify today.

[Daisy Berbeco (Ranking Member)]: All 16 of them voted not to support it.

[Alyssa Black (Chair)]: Been able to report

[Daisy Berbeco (Ranking Member)]: back to Senator Harrison for the last couple of months. Yeah, when that comes over, I'll be prepared to get the data update if we want

[Alyssa Black (Chair)]: to move it. Great. Does that mean you're reporting it to? Do I already have a Yeah, sure. If we take it out. Sure. That's the testimony on sent home longer patient. Great. Alright. What about 583? 583. Sorry. No. I don't know if I want to add on me. I'm not sure what I'm doing with 583 yet. Okay. Not sure what I'm doing yet. There's been some substance on it, so I was just wondering about who's I've been trying to find a path forward for it, and I am running out of paths. It's in the woods. Yes. Okay. Was there Wait, before you Was there anything else that we had identified?

[Daisy Berbeco (Ranking Member)]: Mental health schools?

[Alyssa Black (Chair)]: There is a bill that's currently in house education. So, we would have to have, if we were going to take up testimony on it, would have to have that committed to our committee. Daisy and I will see if we can maybe get it committed to our committee.

[Daisy Berbeco (Ranking Member)]: I would really like to get it committed to our committee because it was, I know, one of the committee's priorities, as it has been of advocates that have testified this last week. There are problems with the bill, though. I think we would need to do some work on it because we don't want to offer any unfunded mandates to the schools, of course. So we would need to do some work on that, but also we need to address the youth mental health problems in So if we can find a

[Alyssa Black (Chair)]: way to do that, it would be good. But I'll try

[Daisy Berbeco (Ranking Member)]: to do as much work as I can ahead of time.

[Alyssa Black (Chair)]: That It's 5,000 eight-seventeen. Do you have a question about that? Ahead, Daisy. Haven't

[Lori Houghton (Member)]: read the bill. I haven't read five seventeen in recent, so it's not in my brain. But is there a connection with 558? That's the one we're looking at later?

[Alyssa Black (Chair)]: No. Was No. There anything else you had identified that were Facility

[Daisy Berbeco (Ranking Member)]: fees.

[Alyssa Black (Chair)]: We talked about. Well, we have, in May, have sort of site neutral payments. So, we're talking with BFR about that. I had a question. Yes. Go ahead. Because I was thinking of it as somewhat equivalent, but with site neutral, you don't have a solid metric, whereas with facility fees, maybe there's a more solid basis, but maybe they're a conversation you were to have at the same time. Is that how Okay. That would

[Daisy Berbeco (Ranking Member)]: Can I be Brian Cina for

[Alyssa Black (Chair)]: a minute? Sure. Is it going be about AI? No. What is the other thing about AI? Maybe the universal primary care. Remember, we're getting a big. I just wanted you to be able to have a moment to speak to that. Yes, we are. I'm holding all conversations around various primary care things in anticipation of what comes to us from the Senate. Okay, now we chime in on that. I hope y'all love talking about primary care because

[Lori Houghton (Member)]: for the last two months

[Alyssa Black (Chair)]: of the session, you're going to be talking about it a lot. I was lying in bed last night hoping I could get a printout still of that meeting of the funding we just got at healthcare. I mean, think you guys have the From

[Lori Houghton (Member)]: the Premed Care Board. Oh,

[Alyssa Black (Chair)]: that's another thing. Hopefully next week, did we say I'm going to work with Green Mountain Care Board and lining up testimony. You're talking about what we heard yesterday around the critical

[Francis “Topper” McFaun (Vice Chair)]: Last week, the eleventh. The three hour meeting they had.

[Alyssa Black (Chair)]: Oh, that's upstairs.

[Daisy Berbeco (Ranking Member)]: Oh, the spreadsheets. Okay.

[Francis “Topper” McFaun (Vice Chair)]: I guess I'd send it to all of us.

[Alyssa Black (Chair)]: Oh, oh. We're talking about the

[Lori Houghton (Member)]: racial

[Alyssa Black (Chair)]: transformation. Natasha, that should be posted on JFC's meeting from last week. Would you mind printing that out for who else wanted it? I'm sorry. Thanks, Chitt.

[Allen “Penny” Demar (Member)]: Yeah. I'll I'll I'll take it too.

[Alyssa Black (Chair)]: I couldn't see the screen at last week's meeting, so I went up and I'm like, can I get a paper copy? Yeah. Kept losing that. That's how I got one.

[Allen “Penny” Demar (Member)]: No, some of that probably care stuff that's going to be in there too.

[Alyssa Black (Chair)]: We're gonna be, like I said, often an awful lot about primary care. Might be sick a lot by then. Well, I'm nervous about the town meetings, because I don't really know what to expect. They had, I I don't know tell you about.

[Allen “Penny” Demar (Member)]: Are you nervous about?

[Alyssa Black (Chair)]: Town meeting. What do

[Allen “Penny” Demar (Member)]: mean, making a break or what?

[Alyssa Black (Chair)]: You're worried about what you're gonna out I your don't want to misinform, I don't want to say anything. I don't want to talk too much. You know what I mean? And I don't want to talk too little, I want

[Daisy Berbeco (Ranking Member)]: to give something, but I just What

[Allen “Penny” Demar (Member)]: you know most about, and that's self care.

[Francis “Topper” McFaun (Vice Chair)]: Might know

[Alyssa Black (Chair)]: more I'm about wondering what has sunk in.

[Allen “Penny” Demar (Member)]: The big ticket items that they're gonna talk about, the schools, mapping and that kind of stuff. And you say it's

[Alyssa Black (Chair)]: all a work in progress.

[Lori Houghton (Member)]: There's a map on the table.

[Allen “Penny” Demar (Member)]: Nothing's been set up. I'm out yet.

[Alyssa Black (Chair)]: I know school choice is one of the larger, we don't have to get into that. Okay. So

[Allen “Penny” Demar (Member)]: The caucus may have a summary too.

[Alyssa Black (Chair)]: I did sign up for that, they sent me.

[Allen “Penny” Demar (Member)]: You did? Okay.

[Alyssa Black (Chair)]: Okay, so that's sort of what we identified. I think with all of those things, it will pretty much consume our remaining three weeks. But what I really am interested in, because this is the last year of biennium, which means anything that doesn't make it this year, we start fresh, that bulletin board will be empty. It's dead, dead, dead. Everything's dead. Everything's dead. I gotta tell you, there are so many things on that that I would absolutely love as I'm going through them. I'm like, oh, I really wanted to do that. I wanted to do that. As the chair of government operations reminded me a half an hour ago, he's a former chef, When you're in the weeds, you just got to put out tickets. So we've got to put out our tickets as fast as we can, but we cannot do them all and we have to let some things go as much as we don't want to. There are so many things that are priorities for so many people. But we have limited time. We have limited capacity, so is there anything that anyone is feeling like I don't want to let that go?

[Francis “Topper” McFaun (Vice Chair)]: It would be nice if we could do it all. In a perfect world, money is no problem, I would say they are all important. But as a committee, we better pick and choose priorities. You hate to say it, but when you make a decision here, you've got to put a value, a money value. And we owe it to the Vermont people, the taxpayers. So we're trying to help, but it's not going be easy. Is

[Alyssa Black (Chair)]: there anything that you feel You think we're dropping the ball on?

[Francis “Topper” McFaun (Vice Chair)]: No, they're all important. I guess if I had to pick up priority right now, I think this mental illness has better be addressed. If I was to give in and spend money, that's got

[Allen “Penny” Demar (Member)]: to be where it is.

[Alyssa Black (Chair)]: I think that that is a challenge that we hear over and over in this committee on every single subject that you bring up, which is why we had those kids in here this week. Was it this week, last week? This week. If we're going to do anything, shouldn't we be helping our kids?

[Francis “Topper” McFaun (Vice Chair)]: Still think we're missing the boat a little bit. Trust me, healthcare is not top of my list, okay? You all know that.

[Alyssa Black (Chair)]: Am less

[Francis “Topper” McFaun (Vice Chair)]: acclimation. Can't

[Alyssa Black (Chair)]: afford college,

[Francis “Topper” McFaun (Vice Chair)]: girl. You know, we talked about healthcare here and there, prisons and homes. You know, I guess I'm different than most people. I think it starts right at our elementary school. I've got kids that are teachers, there are signs that go unnoticed. And when they're unnoticed at first, second, third grade, then it's going to be evident at middle school and higher, and then it's going be twice as bad. So, heard a lot of it the other day, but middle school and up, I think we are missing the bowl.

[Alyssa Black (Chair)]: I don't know what you

[Daisy Berbeco (Ranking Member)]: mean by you're different than other people. I mean, and I are exactly the same.

[Francis “Topper” McFaun (Vice Chair)]: I think everybody is, but we don't talk about that one much. I've coached many different levels of girls, boys, basketball, soccer, baseball, there are signs of illnesses. They go unnoticed, and then all of a sudden we wonder why they dropped out in high school or something. Think we're missing the boat by not starting earlier.

[Alyssa Black (Chair)]: Do you feel as though, 08/17? I've I've I've seen that I've I've got

[Francis “Topper” McFaun (Vice Chair)]: it, we just got it right here. You just described it.

[Alyssa Black (Chair)]: Okay. All right, here my man. Here my

[Francis “Topper” McFaun (Vice Chair)]: man. Be careful.

[Lori Houghton (Member)]: Leslie. Here's what I worry about. I totally get the schools because it's sort of this community and it's important and their resources. But when we think about social determinants of health and social drivers of health, I think about the kids who go home to these very dysfunctional places. And that's a place I worry about too. And I'm not sure what the solution is, but I worry about expecting the schools to solve it all. Schools are out a lot in the summer. Kids are back in those environments. And I would like the Department of Health to do more, as a driver of health. So that's a worry of mine. I get that that's true about our schools, but it's big responsibility to put on them.

[Francis “Topper” McFaun (Vice Chair)]: Worry about that. But when you do that, the home life comes into play.

[Lori Houghton (Member)]: I hope so.

[Francis “Topper” McFaun (Vice Chair)]: When you start talking to children, you'd be surprised what you learn about their home life.

[Lori Houghton (Member)]: Oh, I totally get it.

[Francis “Topper” McFaun (Vice Chair)]: It's all one. It's not like just do school stuff and that's it. It's all one.

[Daisy Berbeco (Ranking Member)]: We also had the Vermont afterschools have contacted me and asked to be part of that conversation, part of that bill conversation.

[Lori Houghton (Member)]: Going beyond just a school setting.

[Alyssa Black (Chair)]: I think you're wrong, but I'm getting a sense from the committee that this is a topic you'd like to talk about. Yes. Okay.

[Allen “Penny” Demar (Member)]: Now we're gonna move on page 17, getting it out of that committee and in here.

[Francis “Topper” McFaun (Vice Chair)]: Let me read it first. I just got it.

[Allen “Penny” Demar (Member)]: You can add to that.

[Francis “Topper” McFaun (Vice Chair)]: I'll just grab it. We

[Alyssa Black (Chair)]: will have a conversation about whether or not we can pass it.

[Lori Houghton (Member)]: But maybe if I may, and Jen, maybe you could help me. Is there a bill in the Senate that might take us beyond 08/17 or in case we don't get it

[Alyssa Black (Chair)]: all done in time to

[Daisy Berbeco (Ranking Member)]: help? Sorry,

[Alyssa Black (Chair)]: I don't know. Is it the author? The drafter? Drafter, okay.

[Allen “Penny” Demar (Member)]: I'm gonna tell you a story. It's a short story.

[Alyssa Black (Chair)]: A top story, so don't forget we're online.

[Francis “Topper” McFaun (Vice Chair)]: He's changing.

[Alyssa Black (Chair)]: He's modifying.

[Allen “Penny” Demar (Member)]: Rerouting. I think it'll be alright. We talk about young people and the mental health problems that they're having. Let's see, figure out how to read it. I go to a place and at that place, there are a lot of elderly people. And what they talk about is how they're feeling and the change that's come in their life and the anxiety that that's causing and the depression that that's causing. And it's for a variety of reasons. Have I got enough money to support myself through the rest of my life? It's really, I won't say it's unbelievable because it's happening, but the stuff that is brought up in those conversations says to me anyway, that the elderly are in crisis as well. All right. And we can't, like you said, we can't do everything for everybody, but whatever we do, let's do it well. Let's do it. Okay.

[Alyssa Black (Chair)]: So let's on with that. Is there anybody, anything? Brian, you're back just

[Brian Cina (Member)]: Well, there is something. I don't want to leave

[Alyssa Black (Chair)]: Well, a I don't what it is. I wanted to give her the opportunity to You had had your hand up before, but I think you covered it. It's primary care. We'll be discussing it a lot. Okay.

[Brian Cina (Member)]: Yeah, don't need to cut ahead of anyone either. It's just if this is the last call, I want to make sure I'm online.

[Alyssa Black (Chair)]: Go ahead.

[Brian Cina (Member)]: Okay, it's up, it's my turn. So the only thing that we haven't discussed that I have to throw a pitch in for is the clinical psychedelic bill that's in our committee. In the past, it went to human services, and I think it's because it was framed as a substance use disorder treatment related issue, and I'm wondering if it ended up here this time, because the understanding is that it's broader than that, and also the trend is going to be towards co occurring disorders being in this committee. It sounds like we may not choose that, but AHS told us they're treating them in a more unified way. So it's weird to me to be split, continue splitting it. However, the number is eight fifty nine.

[Alyssa Black (Chair)]: Eight fifty nine.

[Brian Cina (Member)]: Yeah, so eight fifty nine. What it does is it's called an act relating to psychedelic therapy in clinical drug development trials. The first part of the bill builds, so for those who are new, Vermont created a psychedelic therapy advisory working group, and that working group met for half a year and issued a report in November 2024, and they said that they weren't ready to recommend any action at that time. But if you look at their recommendations, which are referred to in this bill, in the findings, that further study was needed and that there was promise. They didn't say, We shouldn't do this. They just said, We're not ready to take action on anything yet, and we need to study it more. And then as usual, the legislature didn't do anything. So what this bill does is it picks up where they left off, and it says, let's continue studying it, but let's also take some action because there's been some breakthroughs since. So it would recreate the working group as a board, and it would empower that board, and I won't give a walkthrough now, but it empowers that board with certain action steps, which it would be nice to be able to do a walk through so people could consider this. It does add a new section, which is for Vermont to enter into a partnership with the Texas Consortium, which is 13 states led by Texas that are currently trying to get the FDA to allow clinical drug development trials for ibogaine, which is the medicine that I was able to take in December that really changed my life. And so my hope is that, whether it be in this committee or in human services, that this bill be considered, because the potential of these medicines, now we're at a point in history where we're seeing a peak of trauma, a peak of mental health issues, like a peak of substance use disorders. And some of these medications, when you look at the research and their effectiveness, one dose is enough to change the course of a person's life versus putting someone on a drug, and then they're on a drug for the rest of their life to not take another drug. So anyway, that's kind of my sales pitch for it, is that we take testimony on it, and perhaps we decide this needs to go to human, or leadership decides this should go back to human services because they are the ones who passed the original bill, not us, or maybe leadership decides it gets done here, but it may sound complicated, but it really is taking a step forward on something that the body already decided on. It's not like we never did this before. We did it, and then it kind of stalled. That's my sales pitch. Can I just ask? I realize that work has been done previously on it.

[Alyssa Black (Chair)]: Mhmm. But typically when we take something up, have to start the work all the way at the very beginning. You feel as though with the time constraints that we have in three weeks with the other things, do you really think we would have time to?

[Brian Cina (Member)]: I feel like we would be rushing it if we tried to do it, but on top of everything else we're doing. I think if we weren't trying to do so many other things, it would be okay. But to me, now if human services could fit this into their schedule and they didn't have to reinvent the wheel because they did it before, I would prefer that it go there if it meant action would happen. Because in the Senate, they're going to go to the same committee and I think that what happened, just to give people more background, what happened in the past is it came out of the Senate from health and welfare and then got sent to human services. So the same Senate committee is going to get it in the end. So I think the question, and if it doesn't make it this year, it won't be the end of the world, but that's another year that goes by that Vermont falls behind, because 13 other states have joined together in these clinical trials. Once again, it's not the end of the world, it's just sad because there's so many Vermonters who have benefited from this medicine. There's a man who is willing to testify who had brain cancer and his brain is regrowing. Like it really, for some people, not everyone, it can be miraculous. So yeah, it should be in the menu.

[Alyssa Black (Chair)]: When was the last time you said that it came out of human services previously? Well, how long ago?

[Brian Cina (Member)]: In 2024. Janet could always confirm this, but the report was in November 2024, which leads me to believe it passed in 2024 and the effective date was July 2024.

[Alyssa Black (Chair)]: Katie wrote this one.

[Brian Cina (Member)]: Yeah, sorry, Katie wrote this one, sorry.

[Daisy Berbeco (Ranking Member)]: Yeah, because this does treat, I mean, the clinical trials would be looking at treating mental health conditions, like severe depression.

[Brian Cina (Member)]: Depression, trauma, PTSD, suicidality, addiction, all of it. Co occurring disorders is really how we need to think about it now, because they're often co occurring.

[Alyssa Black (Chair)]: I definitely would support this though.

[Allen “Penny” Demar (Member)]: When did Texas start this?

[Brian Cina (Member)]: They just started the They passed their bill last year, and they are on the verge of signing a contract with a developer now. So like this consortium And what's interesting in Texas is it's a Republican state, and this was led by Republicans. So I have-

[Allen “Penny” Demar (Member)]: Is that interesting to you?

[Brian Cina (Member)]: It's interesting because you would think that some people question why Republicans would support psychedelic therapy, but when you look at the reason why, it's cause it's an effective cheap way to cure addiction. It's like a very easy, it's a cheap natural way to address it.

[Allen “Penny” Demar (Member)]: It helps people.

[Brian Cina (Member)]: It helps them fast and it's cheap and it's natural.

[Allen “Penny” Demar (Member)]: Why wouldn't anybody support that?

[Brian Cina (Member)]: Because they get campaign donations from pharmaceutical companies. Not to make it like that. Yeah, yeah,

[Alyssa Black (Chair)]: yeah, yeah.

[Allen “Penny” Demar (Member)]: That's what

[Alyssa Black (Chair)]: Well, they will look at THC as therapeutic, because the pharma is so powerful.

[Brian Cina (Member)]: Or people judge they think drugs are bad. They think if it makes you have a psychedelic experience, it's bad. I would say it's harmful if it's done the wrong way.

[Alyssa Black (Chair)]: That's why we need to

[Brian Cina (Member)]: regulate it. Well, at least in this case. Like in this case, yeah.

[Alyssa Black (Chair)]: Would you mind if I checked in with the human service committee to see what their capacity is?

[Brian Cina (Member)]: I would like it if you did that. Would like it if you did that, and then we could decide what and if we were going to take it up here, I could talk with witnesses to make sure it's as efficient as possible. We don't take lots of it wouldn't be lots of excessive stuff. We could really whittle it down to who do we really need to hear from, because it passed already. Yeah. You know, it's not like, and we could also, I always want to put this out there, that if the clinical trial piece is too controversial, we can always ask the board to study that and come back in a year with that. You know what I mean? So there's a way to take the controversial part and hold off on that and move forward with the study part. Anyway, there's more to I don't want to take up time now on it, but there's more to be heard about this because it's not just ivogaine. The VA is rolling out Do you need some medicine?

[Francis “Topper” McFaun (Vice Chair)]: No, just have to eat some seeds in my cold.

[Brian Cina (Member)]: Bless you. The VA is considering rolling out pilot projects in some of these medicines down in Vermont, has a VA, so there's potential there too. Anyway, guess, Chair, if you can talk to human services, that'd be great.

[Alyssa Black (Chair)]: I'll be happy to do that. I have a quick question. Yeah.

[Daisy Berbeco (Ranking Member)]: There's a $300,000

[Brian Cina (Member)]: Opioid settlement, yeah.

[Alyssa Black (Chair)]: Yeah. Would you be able to do this bill without that?

[Brian Cina (Member)]: I think that the compromise here would be to remove that part of the bill and roll it into, like ask them to work with the Opioid Special Fund Abatement Committee, the OSAC, to come back in a year with recommendations on investment. Would be actually, that, I think we'd have to, to be honest, I think I don't want to short circuit the process. I think the only way this is going to fly is if we do that at this point, because the OSAC is coming to the floor in a week or so. So for us to try to change that is going to be controversial. But if we say, hey, next year we want the OSAC to consult with psychedelic therapy board and come back with money, it delays our participation by a little, but it's not, but we're still moving forward with the planning because it would also give the Psychedelic Therapy Advisory Board time to work with local providers to figure out who's willing to do the clinical trials.

[Alyssa Black (Chair)]: Okay, anyway.

[Allen “Penny” Demar (Member)]: You for

[Alyssa Black (Chair)]: our human services. All right.

[Lori Houghton (Member)]: Leslie, on another topic, if that's okay. I was just going through the Senate health and welfare agenda for next week, it turns out that rare diseases day is February 19 and they're taking testimony. So I don't know if it be relevant to seven thirty seats.

[Alyssa Black (Chair)]: What are they taking up testimony? It just

[Lori Houghton (Member)]: says Rare Diseases Day, Carolyn Sheridan, National Organization for Rare Disorders. So it might be a way to

[Alyssa Black (Chair)]: get at the information we were wondering. Babe, when are we planning on doing that? Thirty six. 07:36 was Friday morning. Friday? And you're telling me that the

[Lori Houghton (Member)]: Thursday? It may not be

[Alyssa Black (Chair)]: in person, so it could be some, who knows. It's a national organization. Let me talk to the bill sponsor. Maybe we can move that to I mean, if they're in the building, it might be nice. We did jail at one on Thursday, I need to do 07:36. Okay. Alright, let's talk about that for Thursday. Alright, anything else?

[Brian Cina (Member)]: No, but thanks for letting me make the pitch on that one. You're welcome.

[Alyssa Black (Chair)]: Can I have that number?

[Brian Cina (Member)]: 859. Thank you. Oh, there is one more thing, no kidding.

[Alyssa Black (Chair)]: So this is just for an advisory board, correct? So you're not asking to make it legal to prescribe, what are you asking for? I'm trying to

[Brian Cina (Member)]: What the bill does is it doesn't legalize psychedelic medicines, it has the board explore ways to safely implement clinical trials in Vermont. So what I'm getting at is like, it's not like it legalizes it, like you can go to the store and buy them. I don't think that's what I want It for would be more like a doctor isn't going to lose their medical license for doing a formal clinical trial and studying how it affects, how it helps people and then writing papers and then people getting health in Vermont through those means. In the hope that someday that there will be a therapy option here, that when you're at end of life, you can get mushroom treatment or if you have trauma, can get or a psycho stimulant addiction, can get, can get eye ball game treatment.

[Alyssa Black (Chair)]: Are you

[Brian Cina (Member)]: laughing at the thought over there? Thanks

[Alyssa Black (Chair)]: for your question. A lot of that going on now. That's very true.

[Lori Houghton (Member)]: For some future conversation, Brian, and maybe we need to be offline, but I just wanted to think about what clinical trials in Vermont means. And that's a complicated question. Clinical trials in and of themselves have So a certain just wondering, that makes it harder, almost, a bigger hurdle.

[Allen “Penny” Demar (Member)]: But I think Brian's talking about going in with the consortium that Texas started.

[Lori Houghton (Member)]: Okay, because I was just looking at the beginning part of it. Clinical trials in Vermont is what it says.

[Brian Cina (Member)]: Yeah, the idea is that people

[Alyssa Black (Chair)]: in Vermont can get it here or not. Well, get it, but anyway. We could always We just buy it. Okay.

[Brian Cina (Member)]: Yes, that's what I mean. Get treatment here, not get it.

[Alyssa Black (Chair)]: Because you

[Brian Cina (Member)]: can get it here now, it's just it's unsafe if you don't have a person who knows what they're doing.

[Lori Houghton (Member)]: But that's different than a clinical trial. Okay, let's

[Alyssa Black (Chair)]: table that. Yes. We obviously have lots and lots of questions, which is why I'm thinking this is a lot of time. I'm not sure we, including house healthcare, have the time, but let's talk to our bank down the hall, see what their capacity is. Okay, we All right, thanks everyone.