Vermont Legislature SmartTranscripts:

[Rep. Alyssa Black (Chair)]: Welcome back. It's still March 11. We're pivoting to H816, and we have legislative council with us. So, markup and possibly asking questions. We're also going to hear a little additional testimony. You Hello. Hello. Hi, Katie.

[Katie McLean (Office of Legislative Counsel)]: Good afternoon. Katie McLean, Office of Legislative Counsel. I'm so glad

[Rep. Alyssa Black (Chair)]: to see you.

[Rep. Daisy Berbeco (Ranking Member)]: Good. Well, I'm glad I'm able to be

[Rep. Alyssa Black (Chair)]: here too. Which bill would you like to start with? Let's start with eightsixteen. And just to be clear, we only have you until 02:30, right? You have to be somewhere?

[Katie McLean (Office of Legislative Counsel)]: I think I could go over a little. Let me check my calendar.

[Rep. Alyssa Black (Chair)]: Trying to really be respectful of yours and Jen's time. Thank you.

[Katie McLean (Office of Legislative Counsel)]: Okay. So I've just pulled up the latest draft of h eight sixteen, which is the AI bill. And I have some changes highlighted in yellow that were requested. I also received an email from an other committee in the building that was interested in aligning definitions of AI. So we could look at those also if that would be of use.

[Rep. Alyssa Black (Chair)]: That's flagged for many.

[Rep. Daisy Berbeco (Ranking Member)]: Yeah, like three minutes ago. I had a conversation with them. Yeah. I

[Rep. Alyssa Black (Chair)]: think we had talked about that because we know that there's lots of AI builds and there was one committee that was sort of taking the lead on let's define so that we didn't have 47 different Within

[Katie McLean (Office of Legislative Counsel)]: our office, we sort of had a conversation before the session started about, is there a prevailing definition we should use? And we thought we'd let the process play out, and it seems like that is what is happening.

[Rep. Daisy Berbeco (Ranking Member)]: Can you share where Chittenden is working? Yes. I had a conversation. I met with Monique. Commerce. Okay.

[Rep. Alyssa Black (Chair)]: And I'm also Let's talk about it when we get there. Okay? Okay. Do

[Katie McLean (Office of Legislative Counsel)]: you want a review of what is in the bill generally? Or do you want me just to bring you to the changes? What works best?

[Rep. Alyssa Black (Chair)]: I would love a review.

[Katie McLean (Office of Legislative Counsel)]: A refresher. Okay. So the first part of this bill is a purpose section. Purpose to safeguard individuals seeking mental health services in Vermont by ensuring that therapeutic judgment, clinical decision making and therapeutic communication remain the responsibility of qualified mental health professionals and are not delegated to AI systems. Respecting individual choice and selecting mental health services, including community care and faith based options, and allowing the responsible use of AI for administrative operational documentation and quality improvement functions that support access, efficiency, innovation in mental health services. So those are our purpose sections. In section two, this is a section that governs unprofessional conduct for many professions. And there's a list of what constitutes unprofessional conduct. What is being added to this list is that for mental health professionals, the use of AI pursuant to the section that's being created in seventy one zero one. Then in title 18, we have a section that's being created about prohibited uses of AI. You have a definition of AI, which I might just skip over for now and have that conversation later. Same thing with generative AI. I'll just skip over that. Back to it. You have a definition of mental health services. That's in our jurisdiction. Means support counseling therapy or psychotherapy services provided by a mental health professional to diagnose or treat an individual's mental or behavioral health or provide ongoing recovery support, excluding religious counseling. The definition of therapeutic communication, meaning written or spoken interaction intended to diagnose or treat any type of mental or behavioral health concern. Provide ongoing support, provide advice related to a diagnosis, treatment, recovery. And then in subsection B, we have language that prohibits a person, preparation or other entity from offering, providing or advertising mental health services in the state that represent AI as providing therapeutic judgment, diagnosis, treatment or therapeutic communication. Nothing in this subsection B is to provide excuse me, prohibit the use or disclosure of the use of AI for administrative documentation, operational or quality improvement purposes when a mental health professional retains clinical responsibility as authorized in the section we're going to look at next. And then a violation of this section is enforced under the Consumer Protection Act by the attorney general's office. And this is language that is fairly standard throughout statute with regard to the Consumer Protection Act. Section four. This is now in title 26. So we were in '18. We were adding this language to the part of title 18 specific to mental health services. Now we're in title 26. This is specific to a professional regulation. So adding a new chapter or creating a new chapter about artificial intelligence and regulated professions, the idea being that there may be other professions at some point that have statutory language added specific to AI. So we have a general subchapter that's being added. And in this case, we're only adding definitions of AI and generative AI. And I'll skip over those for the time being. And then in subchapter two of this new chapter that's being created, it's specific to mental health professionals. So we have definitions, including a definition of administrative support, means a task performed to assist a mental health professional and the professional's delivery of mental health services, such as scheduling, billing, and general logistics, but excluding therapeutic communication. Definition of clinical responsibility means the duty of a mental health professional to review, approve and remain legally accountable for any use of AI or provision of mental health services. Consent means explicit affirmative act by an individual that communicates in writing voluntary, informed and revocable agreement. Consent does not include acceptance of broad terms, use agreements, passive agreements or deceptive practices. We have a list of who is a mental health professional under this chapter, and it's very broad. Licensed, certified and rostered individuals that provide mental health services as a physician, as an APRN specializing in psychiatric mental health, psychologist, peer support provider, peer recovery support specialist, social worker, alcohol and drug abuse counselor, clinical mental health counselor, marriage and family therapist, a psychoanalyst, an applied behavior analyst, and a non licensed or non certified psychotherapist, a non certified psychoanalyst in any other profession that provides mental health services.

[Rep. Alyssa Black (Chair)]: Can I have a question? Sorry. Go ahead. I was curious about on line two and three events as physician. Does that

[Rep. Daisy Berbeco (Ranking Member)]: mean psychiatrist or not necessarily?

[Katie McLean (Office of Legislative Counsel)]: Don't provide mental health services as a physician. Yes, it would include a difference, but I

[Rep. Alyssa Black (Chair)]: think it's broader than that. I was interested because all these other ones are very specific to the training of mental health, and I didn't know how that

[Katie McLean (Office of Legislative Counsel)]: would pushed out. It would certainly include psychiatrists, but I think it could be broader than Mental health services means support counseling therapy or psychotherapy services provided by a mental health professional to diagnose or treat an individual's mental or behavioral health or provide ongoing recovery support. Again, excluding religious counseling or peer support. And then we specify that peer support here means support services provided by an individual with a lived experience of mental health or substance use disorder who is not one of the certified individuals addressed in the definition of mental health professionals. We have a definition of religious counseling, counseling by purgeapastoral counselors, or other religious leaders acting within the scope of the individual's duties if explicitly faith based and not represented as clinical services. Supplementary support means a task performed to assist a mental health professional the professional's delivery of mental health services, excluding therapeutic communication and administrative support. Therapeutic communication is the same that we've already gone over in the previous section. And then there's a change here to add a definition of therapeutic decision. So that would mean the final clinical determination regarding diagnosis or selection modification or termination of treatment or care. Therapeutic decision does not include algorithmic risk scoring, data analytics, or other clinical decision support tools when used under the supervision and authority of a licensed mental health professional. And then in B, permitted uses. This allows the mental health professional to use AI for administrative support, supplementary support and operational or quality improvement functions, provided the professional retains sole responsibility for therapeutic decisions. Permitted uses include scheduling, billing, coding and claims processing, transcription and documentation support with patient or client consent, preparation and maintenance of clinical records, the identified data analysis for quality improvement and workforce capacity planning where the mental health professional reviews, modifies where it's necessary, and approves the final product. Under confidentiality in subsection administrative support and supplementary support tasks conducted using AI like transcription and recording are subject to privacy protection provisions and statute. And in subdivision two, consent by a patient or client is required when AI is used to record identifiable therapeutic communications. Under subsection D, prohibited uses, mental health professional shall not use AI in a manner that allows the artificial intelligence I don't know if I should say system or just artificial intelligence. Allows the artificial intelligence to independently make therapeutic decisions, independently diagnose, independently determine treatment, or independently generate treatment plans. Nothing in this subsection prohibits the professional from disclosing or describing how they use AI for administrative support or supplementary support to prospective current or former patients and clients. We've already hit on these exceptions a couple of times, but this doesn't apply to religious counseling, peer support by somebody who is not a certified peer support provider, or generalized educational and self help resources that do not report to offer mental health services. And this takes effect on passage.

[Rep. Alyssa Black (Chair)]: Thank you. You. Questions? I see that

[Rep. Daisy Berbeco (Ranking Member)]: I have a couple. One is on page nine, line three, peer support is accepted. But on page six, line five, mental health professional induced peer support provider. Is that going to cause any problem?

[Katie McLean (Office of Legislative Counsel)]: There's four wait, six, twenty five. So if the person is certified under Chapter 60 of title 20 picks. So if they're a certified peer support provider, then they are. This does apply to them. They are somebody who is not certified, this does not apply to them. Got it. Okay.

[Rep. Daisy Berbeco (Ranking Member)]: Do we need to work in a place for the new emergency response tier specialists? Is that an official title Right. For the service

[Katie McLean (Office of Legislative Counsel)]: mean, potentially somebody could be, but not necessarily. That feels so niche

[Rep. Daisy Berbeco (Ranking Member)]: that I attempted to exclude them. Wouldn't they

[Rep. Alyssa Black (Chair)]: fall into one or the others yet at the emergency? Would they either be a certified, in which case they're covered, or not?

[Rep. Daisy Berbeco (Ranking Member)]: So they wouldn't be certified pursuant to Chapter 60 or article.

[Katie McLean (Office of Legislative Counsel)]: They could be. Somebody could be, but not necessarily. We don't know who exactly is providing those services. That's why we came up with this special term that was unique to them. But potentially, somebody could be certified in working in that field, or they might not be. So I guess that is probably a correct assessment that either they are certified and then this covers them or they're not certified and then this doesn't cover them. But if you specifically Some of them are not mental health. Sorry, I'm kind of thinking

[Rep. Daisy Berbeco (Ranking Member)]: this out loud. Some

[Katie McLean (Office of Legislative Counsel)]: of the people in that bill don't have any special clinical training in So mental maybe it's not appropriate to lump them in with people who do have these clinical training.

[Rep. Daisy Berbeco (Ranking Member)]: And they explicitly do not provide mental health care to each other. They just connect each other to resources. And if you don't think it's going to be

[Rep. Alyssa Black (Chair)]: a problem, that's fine. Would point it out.

[Katie McLean (Office of Legislative Counsel)]: Doesn't feel like it will be a problem. I think if you were concerned and the decision is to carve them out because they're not mental health professionals necessarily, you could add them in section on page nine. But that bill hasn't passed yet, so that term actually doesn't exist yet.

[Rep. Daisy Berbeco (Ranking Member)]: Okay, yeah. If you don't think it's

[Rep. Alyssa Black (Chair)]: a problem, I'm not

[Rep. Daisy Berbeco (Ranking Member)]: gonna And nobody else does.

[Katie McLean (Office of Legislative Counsel)]: On

[Rep. Daisy Berbeco (Ranking Member)]: On line 11, you refer to qualified mental health professionals. Are we using that as QMHP? Is it an official

[Katie McLean (Office of Legislative Counsel)]: title? Yeah, that's a good question. Let me just go there. Ensuring therapy doesn't contribute. Therapy communication remain responsive. You know, that is a good point because that means something very specific. Doesn't mean, this is appearing in session law and it wouldn't necessarily track with that language in title 18. But I think maybe striking qualified and just saying mental health professionals makes more sense and is less confusing and tracks language in the bill.

[Rep. Alyssa Black (Chair)]: The Go ahead and

[Katie McLean (Office of Legislative Counsel)]: Well, I'll just mark it up here.

[Rep. Daisy Berbeco (Ranking Member)]: And then the The chair made a comment to me before leaving questioning the use of the word behavioral health, which, for the record, I have no problem with. I think it's correctly used. Where is that used? It's used on page I think it's line 17 on page six. I think it might be somewhere else too, but I know that's

[Katie McLean (Office of Legislative Counsel)]: one. A mental or behavioral health concern.

[Rep. Daisy Berbeco (Ranking Member)]: With the way that we've defined it in statute. Have to go back to that definition.

[Katie McLean (Office of Legislative Counsel)]: Yeah, I guess it's not trying to be a replacement for mental health. It's recognizing that there are maybe different things that could be falling into those buckets. Let me just pull up the statute.

[Rep. Daisy Berbeco (Ranking Member)]: Oh, it's also on page seven, line nine.

[Rep. Alyssa Black (Chair)]: Is this that word? I'm not worried about it. Not you. I'm worried about someone else being worried about it.

[Katie McLean (Office of Legislative Counsel)]: No, the chair noted that the term was used and asked whether we needed that. Okay. Let's just think about taking it out. So we have a definition of behavioral health. It means any behavioral condition bearing on health, including stress linked physical symptoms, patient activation and health behaviors that can be addressed through support counseling, change techniques, coaching and other interventions. As used in the VSA, the term does not include mental health conditions or substance use disorders. And it goes on, but it seems like it's creating a distinction here between behavioral health and mental health. So by using both in your bill, you are capturing anything that would fall into either bucket.

[Rep. Daisy Berbeco (Ranking Member)]: I think generative AI on page three, line one, is the only other thing. And as we mentioned, there in the Commerce Committee is a bill that we should align with if they've passed it already. I I think there was an additional testimony that we received recommending that we align with the It was on 08/14 recommending that if we use terminology that we align with nationally recognized terminology by some entity. I don't remember.

[Rep. Brian Cina (Member)]: I'm trying to remember it too, but it's a national entity that comes up with labels for technological standards. Like NIST, NEST, I'll look it up, but I know what you're talking about.

[Rep. Daisy Berbeco (Ranking Member)]: Yeah, but for now I think we need to align with whatever Congress has passed.

[Katie McLean (Office of Legislative Counsel)]: So this email that I received said that California's definitions are generally being copied across states as the national standard. I'll just read you what the AI definition is and the generative AI. AI means an engineered or machine based system that varies in its level of autonomy and that can, for explicit or implicit objectives, infer from the input it receives how to generate outputs that can influence physical or virtual environments. Then generative AI system means an artificial intelligence that can generate derived synthetic content, including text, images, videos, audio that emulates the structure and characteristics of the system's training and data. So I guess my question after reading this email is, is the suggestion that we copy California? Is that what is being suggested to use Californias or do they have a variation? Has Commerce said

[Rep. Alyssa Black (Chair)]: they're using California, or are they still coming up with their own?

[Rep. Brian Cina (Member)]: I'm asking AIO.

[Katie McLean (Office of Legislative Counsel)]: Well, this this email doesn't feel totally clear to me because it says definitions for comparison. Oh, wait, it looks like they are using the California in that one.

[Rep. Daisy Berbeco (Ranking Member)]: I have it written down. It's the bill that we were asked to use the definition for Jenna Raya from H eight 211.

[Katie McLean (Office of Legislative Counsel)]: Okay, so that tracks what I just read, the California one. But the AI one, does that track also?

[Rep. Brian Cina (Member)]: Do you know what California bill the definition comes from? This

[Katie McLean (Office of Legislative Counsel)]: says it's in the business and professions code. Email Oh, I do have the section number if you wanted to look it up.

[Rep. Alyssa Black (Chair)]: California law. This email is very unclear on what they want us to use. I'm thinking it's California, but

[Katie McLean (Office of Legislative Counsel)]: I feel like we maybe need a confirmation on that.

[Rep. Brian Cina (Member)]: According to AI, California increasingly uses NIST, which was the definition I was talking about, and that's why I was going to actually check myself. But maybe we could just look at NIST definition in California's, and if it's the same, then that's what they're talking.

[Rep. Daisy Berbeco (Ranking Member)]: Who is this email that you all

[Rep. Alyssa Black (Chair)]: keep referring to? It was from the Commerce Committee.

[Rep. Daisy Berbeco (Ranking Member)]: Well, I met with one of them and they told me to use the definition as they used it to Yes, which it's a very long email.

[Rep. Alyssa Black (Chair)]: They give multiple different reasonings. I'm trying to come up within the email what their conclusion is. They do have definitions for comparison where H816 and H211, but they don't give an H2 11 definition of generative AI or artificial intelligence.

[Katie McLean (Office of Legislative Counsel)]: Do you mind if I I

[Rep. Alyssa Black (Chair)]: think that we need clarification. Do we have a problem with the definitions that they're using?

[Rep. Daisy Berbeco (Ranking Member)]: No, that's why I said we should just look at the bill that they said we should reference and figure it out. And I don't think we have to resolve it right now. Think I can get with Katie and make sure that we're aligned with what Commerce did. Okay. That means that we

[Rep. Alyssa Black (Chair)]: will not be able to vote

[Katie McLean (Office of Legislative Counsel)]: out this bill. I can email back right now and just ask confirming that this means you'd like us to use the California definitions. Is that

[Rep. Alyssa Black (Chair)]: That would be great.

[Rep. Brian Cina (Member)]: I bet by the time we will ask our questions, we'll have an answer, and then

[Rep. Alyssa Black (Chair)]: we can vote on them. Hopefully. While we get a confirmation on what definitions they would like us to use, Does anyone else have questions? Go ahead.

[Rep. Brian Cina (Member)]: I wanna let Katie finish typing, and then I'll ask because I I know what it's like to be bombarded with things, so I'll try to do something.

[Rep. Alyssa Black (Chair)]: I'll give

[Rep. Brian Cina (Member)]: you a second, but I'll be ready to ask the senior if you're ready.

[Katie McLean (Office of Legislative Counsel)]: I'm at it. Let's see.

[Rep. Alyssa Black (Chair)]: So,

[Rep. Brian Cina (Member)]: there's two main things that feel unresolved to me. One is in the confidentiality and consent section, it says administrative support or supplementary support tasks conducted using AI, including transcription and recording shall be subject to disclosure prohibitions in 18 BSA, and then it has sections. And I could look those up, but I probably still would need to check with you. So I figured I would just ask you. Does that protect Do providers have to tell patients how the data is being shared by the vendors that they work with? And do the patients have to consent specifically to that sharing, or are we creating a situation where people are going to be unwittingly having their information shared through between companies and stuff without I and so I don't know what those disclosure prohibitions are. And even if I look them up, I probably need you to interpret it. I'll give you a second. That's my first, and I have a second separate question.

[Rep. Alyssa Black (Chair)]: I do have one.

[Katie McLean (Office of Legislative Counsel)]: Okay, I have the sections. I have to review them again.

[Rep. Francis "Topper" McFaun (Vice Chair)]: But

[Katie McLean (Office of Legislative Counsel)]: also, is that Oh, I have one of the tips. In Subdivision C2, you see that there is You asked sort of about patient consent, and there is patient consent required for recording. It's required

[Rep. Brian Cina (Member)]: to record, but what is clear is providers have to disclose to the patient how data is shared, because that's with the state inventory of use of AI, there's this, and I brought this up before with the hospital, and they were going to look at it, there's an inventory where you see exactly how the data is shared, you learn how these machines are learning, all this info is available to the consumer, and this way you know, okay, when the provider also understands how what they're using is mining the data of patients, even if it's not publicly sharing it.

[Rep. Daisy Berbeco (Ranking Member)]: So this bill doesn't address that? It doesn't? No. Those sections? Okay. No, because that would be addressing the

[Rep. Brian Cina (Member)]: data that It does, it's about data protection in the healthcare system.

[Rep. Daisy Berbeco (Ranking Member)]: W-eight 14 would be a better

[Rep. Brian Cina (Member)]: Yeah, or it may be covered by HIPAA. This is the thing. I just But

[Rep. Alyssa Black (Chair)]: I do

[Rep. Brian Cina (Member)]: think patients should be informed if their data is being shared. The healthcare system will, this just reminds me of opt in, opt out, where people weren't opting in, so we made it that you'd have to opt out. And then I learned that providers don't even give people that choice. Don't tell them. So now everyone's getting opted in to be high, not be high, what is it called? Vital. And so I'm concerned here that it's not going to obstruct, I'm not going to make me oppose it, but it's a thing that stood out, it's unclear how people's data will be shared, and we may not resolve that right this minute.

[Katie McLean (Office of Legislative Counsel)]: Yeah, I think you're asking a bigger question than I can answer just sitting here.

[Rep. Brian Cina (Member)]: So we'll let it go for now. And then the other thing is why are we only doing this for mental health? Because, yeah, so I'm not posing for mental health, but then I read it, I'm like, shouldn't all healthcare follow the same standards here? And that could be a simple thing. We just say healthcare. Because it also doesn't say substance use, but then there's providers in the listing who are substance use disorder treatment providers. And so it's like, well, maybe that's covered by mental health and behavioral health. But I I think the bigger issue is parity. Wouldn't it just be that in the healthcare system, we have consistent standards of how to protect people from AI and also allow it safely? I'm not saying we have to do it today. It could be a simple change we make, or it could be something that we do later, but it stood out to me.

[Rep. Daisy Berbeco (Ranking Member)]: Can I answer that or respond

[Rep. Alyssa Black (Chair)]: to Yeah, of course?

[Rep. Daisy Berbeco (Ranking Member)]: So the intent of this was to focus on mental health for a reason, and it's that with this topic, you appreciate more than a lot of us, being a complex and rapidly evolving one, I think we need to look at this practice specifically also because of the urgency with incidents of suicide. I wanted to focus a bill specifically on mental health so that we could do this right. And if there's an opportunity to look on it and extend it across other services, then I think that's fantastic. But I want to get it right for mental health, and I want to get it as soon as possible.

[Rep. Brian Cina (Member)]: I hear that because the chatbot thing is real. It's real. There are people dying because of that. So I get that. The two things that stood out in this final reading was data protection and parity. And so that's, those are some of my questions.

[Rep. Alyssa Black (Chair)]: I think it's a great question and it would open up lots of other things. I think that right now we're just down to time, unfortunately. I think it's a great question though.

[Rep. Brian Cina (Member)]: And speaking of time, I'm gonna take this opportunity to

[Rep. Alyssa Black (Chair)]: let you know I have to

[Rep. Brian Cina (Member)]: go to appropriations in ten minutes for 08:14, so when I leave, I'm not gonna say anything that I'm thankful. I need somebody to sneak out and come back.

[Rep. Alyssa Black (Chair)]: I'll Yeah, be sitting in your correct spot. Page eight, at the bottom, section two, it says nothing in this subsection shall prevent a mental health professional from disclosing or describing an administrative task or one thing, but the subsection three, the kinds of tasks seem maybe more substantive, and I just was wondering why it was like, nothing prohibited. Is that an important disclosure piece or not in this context?

[Katie McLean (Office of Legislative Counsel)]: Sure I completely understand the question. You'd rather have it say you have to disclose, rather than there's nothing prohibiting you from

[Rep. Alyssa Black (Chair)]: disclosing? Well, are in this disclosure section, and if if we're choosing not to, I'm just wondering why. Well, what is,

[Katie McLean (Office of Legislative Counsel)]: I read the definition, It

[Rep. Alyssa Black (Chair)]: seems like it could be a little more substantive, it

[Katie McLean (Office of Legislative Counsel)]: seems to be using AI in a sort way that something might be disphoning. Supplementary means a task performed to assist a mental health professional in the professional's delivery of mental health services, excluding therapeutic communication and administrative support. I'm sorry, I'm not fully understanding your question. So you want to know whether there should be a requirement to disclose that? I think that's a policy question. It's not a very helpful answer.

[Rep. Alyssa Black (Chair)]: I'm just wondering about the policy. Am I reading this correctly in that we're just basically saying that if a mental health professional wants to disclose to prospective current or former patient or client that they're using it for administrative purposes. There's nothing in this that this bill says that they cannot do that. Right. Yes.

[Rep. Brian Cina (Member)]: They don't have to do it.

[Rep. Alyssa Black (Chair)]: They don't have to do it. And

[Katie McLean (Office of Legislative Counsel)]: I think some of it, well, let me, before I say that.

[Rep. Alyssa Black (Chair)]: And that's great if I'm not wrong, okay. But the other part, just I don't know enough.

[Rep. Brian Cina (Member)]: Without knowing how the data is shared, know, like So

[Katie McLean (Office of Legislative Counsel)]: if you look at page three B, it says the person, corporation or other entities shall not provide, offer, advertise mental health services to state the represent AI as providing therapeutic judgment, diagnosis, etcetera. I sort of wonder if that language that you're talking about is meant to be sort of the counterpiece to that, to say, like, a person who wants to say I'm using AI isn't running afoul of advertising. Their comments about their use of AI shouldn't be seen as a violation of the.

[Rep. Alyssa Black (Chair)]: Maybe that's a little bit

[Katie McLean (Office of Legislative Counsel)]: of a stretch. Are you referring to

[Rep. Alyssa Black (Chair)]: the end block? To the. 12 blind spots.

[Katie McLean (Office of Legislative Counsel)]: Yes, Katie. I remember when

[Rep. Daisy Berbeco (Ranking Member)]: we were originally drafting it, I was like, I want to be really, really clear what's permitted or what's prohibited and what's not prohibited, because clinicians need to be clear. And we need to be clear what is AI and what is allowable as therapy and not. And I think you're right. I think that was too I mean, it makes sense to me that it tracks with just making it crystal clear. Is that what you're getting at, Karen?

[Rep. Alyssa Black (Chair)]: It's that, I don't know. I don't know the field as well as you. So I was just wondering about it. Language, the B here, doesn't include that supplemental. Supplementary support. Supplementary support

[Rep. Daisy Berbeco (Ranking Member)]: assists the mental health professional in the delivery of mental health services. So I don't really know. Read- So supplementary support is like something that's assisting you with note taking? That's what? Something assisting you with note taking.

[Rep. Alyssa Black (Chair)]: Oh note taking, no. Or billing. Administrative bills.

[Katie McLean (Office of Legislative Counsel)]: Administrative

[Rep. Alyssa Black (Chair)]: support. Okay, just asking. That was it. Alright, so any other questions? We are going to go to Lynn Courier. Hi Lynn, how are you?

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: I'm doing well. How are you all doing? Great. And

[Rep. Alyssa Black (Chair)]: Katie, have you gotten a response yet?

[Rep. Daisy Berbeco (Ranking Member)]: Yeah. Okay. So maybe Katie can. Yeah.

[Rep. Alyssa Black (Chair)]: Thank you. Thank you, Katie. Thanks for joining us today.

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: Thank you for having me.

[Rep. Alyssa Black (Chair)]: You ready

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: for me to jump in? No, just jump right in. Okay. Well, my thanks to the committee for hearing For my the record, my name is Lynn Courier. I am the executive director of the National Association of Social Workers Vermont Chapter. I am also the executive director for the New Hampshire Chapter. I'd like to begin by thanking you for taking up this extremely important issue, and ASW Vermont supports the passage of H116. The primary concern of NASW Vermont is AI platforms, including generative AI, providing therapy or mental health services independent of trained licensed mental health professionals. This is an issue that's being addressed in many states as we speak with legislation that has passed in Illinois and Nevada. If you ask AI if AI should be providing independent therapy,

[Katie McLean (Office of Legislative Counsel)]: AI will tell

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: you no, we've asked. And if you ask AI if you have a certain diagnosis and lay out some symptoms, the response will be that it can't make a diagnosis or treatment plan, but then it will. At best AI therapy platforms are the unlicensed practice of mental health care. At worst, the interactions are harmful and misguided and in some cases have ended in self harm or suicide. We have a growing number of examples and lawsuits of AI platforms expressly or by default providing therapy with tragic results. The one that truly breaks my heart is Adam Raines, who is a 16 year old boy who died last year by suicide. ChatGPT provided help and resources on how to tie a noose that would hold a human body. And of course, it could help with a heartfelt suicide note. AI is designed to be helpful. It is designed to provide resources. It is designed to share information in a friendly, nonjudgmental way. But it lacks the critical thinking and analysis of human professionals. AI pulls information from recorded therapy sessions. This is what it uses to create predictive responses. In other words, if the AI system has learned, and I put that in quotes, that people in response to feelings of depression cut themselves, this becomes the norm and the recommendation. AI is pattern matching. It is not deep understanding. Mental health professionals undergo education, ongoing training to achieve their licensure and maintain it. Artificial intelligence should not be allowed to provide services that require this licensure. We understand that the need for mental health care in this country outpaces our ability to adequately meet the need. However, AI therapy is not the silver bullet that we're looking for. The risks towards consumers are too high, and the safeguards are not yet in place to provide confidence. The data on the effectiveness of these tools remains hopeful, but really falls short of truly being called an evidence based practice, which is what we require of our mental health practitioners. So thank you for hearing my testimony. I'm very happy to answer any questions that you might have.

[Rep. Alyssa Black (Chair)]: Thank you so much, Lynn. We really appreciate your testimony on this reframing and getting us back to what we're trying to do here. Any questions for Lynn going She sent in her. Oh, would you send in your written testimony? I certainly can. Yes. That would be. Yeah, we'd love to refer back. I'd be happy to. Other questions?

[Rep. Allen "Penny" Demar (Member)]: I guess Allen.

[Rep. Alyssa Black (Chair)]: Yep, Allen.

[Rep. Allen "Penny" Demar (Member)]: Yes, I'm trying to keep track of what you're saying. So overall, you're not supportive of this bill or are you supportive of some of it?

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: No, we absolutely, we support the bill. Our primary concern is about these AI platforms that are putting themselves up as an equivalence. So, I mean, you can go on to these sites and they say, oh, you can do like $17 a month. If you had a psychologist, it would cost you this much. If you had a social worker, it would cost you this much. They're putting themselves up as an equivalency and it's happening not connected to anybody who's licensed or actually has training in providing therapy or differential diagnosis or treatment plan creation. That is the top note. What we are most concerned about is these platforms that are selling themselves as therapists or by default acting as therapists. So short version, we're in favor.

[Rep. Alyssa Black (Chair)]: Okay. Go ahead, Beth. This is silly and small.

[Rep. Daisy Berbeco (Ranking Member)]: I don't know if you referred to the bill, just so you don't have to correct it when you do send it

[Rep. Alyssa Black (Chair)]: to us. I don't know if you said 116. I just want to make sure your testimony said 816. I think when you started, you said h one sixteen, and it's 816. I just assumed that

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: my got ahead of my brain. I will make sure that that is correct in my written testimony.

[Rep. Alyssa Black (Chair)]: Great.

[Rep. Daisy Berbeco (Ranking Member)]: Daisy? Lynn, thank you so much for joining us and sharing your expertise as a social worker and someone who really will be instrumental in implementing the policies that this bill would introduce. I think I would just note that when approaching Legis Council for how to mitigate this issue that Lynn articulated so well, He contemplated how basically blunt of a tool to really regulate the AI risk to the general public. And I think that Council did a really eloquent job with it in terms of clarifying specific things like clinical responsibility and noting where that is required and that it includes review and approval by a clinician. And so we're not only protecting individuals from the harms of things like chatbots, but also we're protecting the quality of care that folks like yourself provide in Vermont. Also, would just note that we had testimony from someone who highlighted that this can be there's a lot more nuance to the risk that those chatbot type situations you talked about posed to us. And I've talked with the chair of Senate Health and Welfare downstairs, and they can take more testimony and detail on this as the bill moves forward, because we recognize that it's a much bigger issue than we have time to really comprehensively address in this session here.

[Rep. Alyssa Black (Chair)]: Or in this House, at this moment. Yeah. Yeah. But we are having good discussions with counterparts in the Senate Health and Welfare when it moves to that. Thank you. Thank you so much for your testimony. Katie, do you want to come back up? You've got a new version? And I have a new question up to the Great. May I ask, and I know that this question was asked and answered, I just wanted to clarify and I came in late. I apologize, I forgot I had to be in gum ops on that amendment. So

[Katie McLean (Office of Legislative Counsel)]: I had to go to gum ops real quick.

[Rep. Alyssa Black (Chair)]: The behavioral health, is it absolutely necessary? So we looked

[Katie McLean (Office of Legislative Counsel)]: at the definition of behavioral health in statute and it distinguishes behavioral health from mental health services. So to the extent you want to cover both, you would name both. Yes. We haven't made any changes, but I put them in.

[Rep. Alyssa Black (Chair)]: Let me pull it up. So

[Katie McLean (Office of Legislative Counsel)]: this is the draft 2.1. And the change you're making is this definition of AI. So I pulled we got a confirmation to use California's statue. The question that I'm wondering, is this term generative artificial intelligence isn't used in its own right in the bill. It's used it's only defined because the original version had this sentence, artificial intelligence includes generative AI. So my question was, is that accurate? Because it's not part of the California statute. So I'm sort of waiting to hear. And then depending on they say, you might have to make a decision whether to cut generative AI or every time you use AI to put both. I'm not quite sure how you'd want

[Rep. Daisy Berbeco (Ranking Member)]: to handle that. But that's what I'm wrestling with.

[Rep. Alyssa Black (Chair)]: So are you waiting for an answer from somewhere else?

[Katie McLean (Office of Legislative Counsel)]: Yeah, I just emailed.

[Rep. Alyssa Black (Chair)]: Well, how about unless anyone has any other questions around this particular bill, how about we switch fills while we're waiting for an answer on that? We have these we have both age 16 and age 17 warned or votes only because Katie has been very, very busy with cleaning services and it's been difficult to get her in. But you don't have to get these out today. We can try to find shortcuts of time before Friday to book these out.

[Rep. Daisy Berbeco (Ranking Member)]: Of learned that there's a class, a high school class, that is going to be submitting written testimony on this bill. They're focusing on it. And so on Thursday, we're gonna get some testimony, written testimony from some high schoolers on this.

[Rep. Alyssa Black (Chair)]: I just wanna let folks know. Yeah. 08:17. 08:17

[Rep. Daisy Berbeco (Ranking Member)]: or 08:16? 08:17.

[Rep. Alyssa Black (Chair)]: 87 okay. Let's move to eight seventeen.

[Katie McLean (Office of Legislative Counsel)]: Okay. So this, here's your amendment. We did try to get

[Rep. Alyssa Black (Chair)]: them in, apparently they were all on school break.

[Katie McLean (Office of Legislative Counsel)]: There's no highlighting in this draft because it's a rewrite. So I think you should maybe just come to this with fresh expectations. This is in title 18, which is our health title. It's adding a new section, mental health literacy and peer support initiatives. First, we have a purpose section. This section aims to strengthen protective factors among Vermont's youth, increase mental health literacy within school communities, and expand access to developmentally appropriate peer to peer initiatives that promote early identification of mental health challenges. And then we have a section on mental health literacy training. To the extent funds are available, including through federal block grants, a public school may apply to DMH or DMH's designee for a grant to provide mental health literacy training for educators and other school personnel. Mental health literacy training shall include topics related to working with youth in an educational setting, such as information about mental health conditions and symptoms, understanding common youth mental health and substance use challenges, reducing stigma and ignoring supportive school environments, strengthening protective factors and help seeking behaviors, recognizing risk factors and warning signs, responding to students with empathy and appropriate boundaries, information about mental health treatments and accessing mental health resources or services throughout the state. This section shall not be construed to require the adoption of a specific curriculum or instructional content. So if you remember the lead in here is such as, so these elements could be part of a training, but don't have to be. Peer to peer mental health support. Changing gears instead of literacy. This allows a school to establish a peer to peer mental health program that provides structured opportunities for student peer connection in a supervised school setting. A program that is overseen by a designated educator or school personnel member who is not required to be a licensed, certified or rostered mental health professional under Title 26. It emphasizes school and community based resources and how to access professional services when additional support is needed. At the top of page three, DMH is to provide oversight and guidance to any schools seeking to establish or maintain a peer to peer mental health program. In subdivision three, a peer to peer program established pursuant to this subsection shall be supportive and nonclinical. It is not to replace mental health services provided by a professional. Licensed under title 26, certified or rostered. Okay. And then subsection D, developmentally appropriate guidance. For any mental health literacy, so that was subsection B, or peer to peer support program, subsection C, established in this section, DMH is to develop age appropriate guidance that, in an elementary school setting emphasizes social and emotional development, peer connection and strengthening protective factors, and in a middle and high school setting emphasizes protective factors, reducing stigma and supporting students in recognizing and appropriately responding to risk factors and warning signs associated with mental health and substance use challenges, including co occurring challenges. In subsection E, there is a reporting requirement annually By January 15, DMH is to submit a written report to the policy committees evaluating the effectiveness of programming established in this section, including aggregated information on the number of schools requesting and receiving the department support, the number of students, educators and school personnel participating in programming, and findings recommendations regarding mental health literacy and peer to peer training, peer to peer programming. Takes effect this July, and it has a new name, and actually into mental health literacy and peer to peer supports in schools. That's it. Go ahead, Daisy.

[Rep. Daisy Berbeco (Ranking Member)]: I think on page one, line 15, we should strike including through federal block grants. I don't think it's necessary to change folders.

[Rep. Alyssa Black (Chair)]: So it's to include, right?

[Rep. Daisy Berbeco (Ranking Member)]: No. It says including through federal block grants and DMH. DMH noted that block grants at this time are not

[Katie McLean (Office of Legislative Counsel)]: eligible for this.

[Rep. Alyssa Black (Chair)]: Essentially, if we got rid of including so we're we're saying the same thing, which is if there are funds available in any way. Correct? Through grants or Yeah.

[Rep. Daisy Berbeco (Ranking Member)]: If you don't want to take it out, you don't have to

[Rep. Alyssa Black (Chair)]: take it out. No. No. It seems extraneous to me or unnecessary. Well, they asked to have it removed. Yeah.

[Rep. Daisy Berbeco (Ranking Member)]: And then the other thing to consider is page two, line 17. Under B, just saying it is overseen by an adult who is not required to be a licensed, certified, or rostered mental health professional. Because right now, we're requiring it to be a school professional, And that would require a certain agreement with the school staff and the Department of Mental Health that I think might impede implementation of one of these projects. So who

[Rep. Alyssa Black (Chair)]: would be that person if they weren't in the school?

[Rep. Daisy Berbeco (Ranking Member)]: It could be different at any school, right? And I think that's the flexibility that I'm suggesting we open up. Because what I heard early on in early versions of this was there's a lot of difficulty when trying to

[Lynn Courier (Executive Director, NASW Vermont & New Hampshire Chapters)]: merge or

[Rep. Daisy Berbeco (Ranking Member)]: tell schools what to do, especially with their staff. And I don't want to look like we're trying to do that.

[Rep. Alyssa Black (Chair)]: You want to substitute adults?

[Rep. Daisy Berbeco (Ranking Member)]: Yeah, I want to say in line 17, B is overseen by an adult who is not required to be a licensed, certified, or rostered mental health professional.

[Rep. Alyssa Black (Chair)]: Wouldn't we be opening it up to any adults? Well appointed adults? I mean, you're an educator or school personality member, I'm assuming you've gone through background checks and If we just put adult, it could be it's mean. You don't want that.

[Rep. Daisy Berbeco (Ranking Member)]: Sorry. No. But remember, this is not saying they shall do it, it's saying they establish that a school may do it.

[Rep. Alyssa Black (Chair)]: Yeah, but this is saying that if they establish a mental health program that they have to have an adult overseeing it. And that adult doesn't need to be licensed, certified or rostered mental health professional. But it also needs to be said at least that adult has to be a school, an educator or a school personnel member. So what if Vermont After School wants to do this? Wouldn't they be a designated educator?

[Rep. Daisy Berbeco (Ranking Member)]: Think so. No. Or a municipality wants to do it through 21c funding in an after school program. It's still going to go through the school's oversight or through the Department of Mental Health's oversight and guidance, and they have to stand up and define really the program and parameters.

[Rep. Alyssa Black (Chair)]: So, DMH has to essentially approve anyways? Oh, they provide oversight and guidance. Okay, I feel bad about that. I just didn't know if it was a random guy off the street or something like that. Can I qualify for those in that?

[Rep. Daisy Berbeco (Ranking Member)]: Because these would be grants, so DMH would have to write a NOFO or RFP or whatever for a grant. So there would have to be more definition on all of these things by DNA.

[Rep. Alyssa Black (Chair)]: Good, thanks. Thank you for talking with a lot.

[Rep. Francis "Topper" McFaun (Vice Chair)]: So what did you come up with the answer for line 17? Overseen by a designated educator, school fits now, member who is not required to be licensed, certified, rosters. I've seen some people in the school system that I wouldn't want, designated for that job.

[Rep. Daisy Berbeco (Ranking Member)]: Yeah, me too.

[Rep. Francis "Topper" McFaun (Vice Chair)]: So I think you've got to have something to protect. I don't know what I'm asking for, but I think we could be opening up a can of worms if we don't put some stipend, not a stipend, but clarification on food.

[Rep. Alyssa Black (Chair)]: I think what Daisy was saying is that later on, next page, it talks about how DMH is going to come up with guidance and the rules around who can establish and how it's established. So that it's not necessary because DMH will already be doing that. They will have to write a grant and define it themselves and they'll be liable for it. So have you ever met a coach that would be fantastic for

[Rep. Daisy Berbeco (Ranking Member)]: sitting in the room and getting kids together?

[Rep. Francis "Topper" McFaun (Vice Chair)]: I've seen others that I wouldn't want in that room.

[Rep. Daisy Berbeco (Ranking Member)]: That's right. So I think we need to give the experts the flexibility to define what sort of certifications or background checks or whatever adults need to have. I think they need to be adults.

[Rep. Francis "Topper" McFaun (Vice Chair)]: Do we need line 17 then?

[Rep. Alyssa Black (Chair)]: Daisy's suggesting It's we removed. Aren't you

[Rep. Daisy Berbeco (Ranking Member)]: No, not. Remove it? I said V is overseen by an adult member who is not required to be a licensed, certified, or rostered mental health professional. The reason that's important to have is because we do not want this to be construed as mental health counseling, support, any service. And so by articulating that, we're doing two things. One, we're articulating that it's not going to be another youth. And we're articulating that it's going to be overseen by someone. And also that they do not have to be a clinician. So it's kind of doing three things. Could we refer it to the Department

[Rep. Alyssa Black (Chair)]: of Mental Health? It is. Oh, it is? Yeah. So, it's overseen by an adult who is not required to be a licensed certified master mental health professional under Title 26. That's what you're suggesting. Then when we get down to two

[Rep. Daisy Berbeco (Ranking Member)]: Top of page three, the Department of Mental Health shall provide oversight and guidance to any school seeking to establish or maintain peer to peer mental health program pursuant to the subsection. And because they're grants, Department of Mental Health, I don't know if you've ever seen their

[Rep. Alyssa Black (Chair)]: RFAs, but they have to meet what? They're very specific. Yes. I've got Topper and then Karen.

[Rep. Francis "Topper" McFaun (Vice Chair)]: When you use the term Adele, Daisy, how do we define that?

[Rep. Daisy Berbeco (Ranking Member)]: I'm looking at Katie. Sorry, I'm working

[Rep. Alyssa Black (Chair)]: on your

[Katie McLean (Office of Legislative Counsel)]: AI issue. Who is an adult, somebody who has reached the age of majority, so somebody who is 18 years

[Rep. Daisy Berbeco (Ranking Member)]: of age. You would qualify to

[Rep. Alyssa Black (Chair)]: have the position. I know, that's what I thought.

[Rep. Francis "Topper" McFaun (Vice Chair)]: When I was listening to you, you said an adult number. Was it member or what?

[Rep. Alyssa Black (Chair)]: No, shouting out member.

[Rep. Daisy Berbeco (Ranking Member)]: Yeah, no, just an adult who's not required to be a licensed certified. Sorry, member was written there and they probably read it, but no.

[Rep. Alyssa Black (Chair)]: Okay, so this can be anybody that's ADD is over the world, correct? The Department of Mental Health is going to define that more closely. We are requiring is going to define what the adult what it means?

[Rep. Daisy Berbeco (Ranking Member)]: No. We are saying they have to The Department of Mental Health is going to have a grant program. They're going to oversee it. They're going to report to us every year on who participates in the outcomes. And they are going to do it through the program as funding is available. This bill has no money in it. It's just creating a pathway. So if the Department of Mental Health gets a federal grant, earmark from Bernie, please, anything like that, there will be this pathway and the Department of Mental Health will have a mechanism to develop a grant program, define who these adults are, and we would have to be making that appropriation anyway. So we will see it again.

[Rep. Francis "Topper" McFaun (Vice Chair)]: So you're saying that everything is going to be described in the grant?

[Rep. Alyssa Black (Chair)]: Yes. But

[Rep. Daisy Berbeco (Ranking Member)]: I don't want to be too tight. I want to let the experts define who they think is qualified to work with this.

[Rep. Alyssa Black (Chair)]: I agree with you. Sometimes we can get too prescriptive, and we have to let the people who are responsible for that develop the appropriate stuff, it's not really or the policy, the no gardens and statute. Karen? Yeah, so Daisy, when you get to section two, top of page three, it talks about mental health, sorry, health, providing oversight and guidance to any school seeking, because I think you've provided a really great application for after school programs and including that broader concept. Does that, just thinking about that, does that any school encompass after school programs necessarily or just bring it back? Yeah,

[Rep. Daisy Berbeco (Ranking Member)]: we would have to expand that language. We talked about that last time. We did. Yeah.

[Rep. Alyssa Black (Chair)]: Do we want to discuss that? Yep. He's focused on something else. That's okay. He's jumping to peer to peer. Yeah. Because the person who came from

[Rep. Daisy Berbeco (Ranking Member)]: the after school, we were

[Rep. Alyssa Black (Chair)]: saying, may apply for a grant and that was, we didn't solve it. Thank you. Thank you, Karen. Because we were going to

[Rep. Daisy Berbeco (Ranking Member)]: talk about that. You're in C1A, supervised school setting. Is that where you are?

[Rep. Alyssa Black (Chair)]: Why is it Community Line to page three, Line to any school? It could be beyond school, if

[Katie McLean (Office of Legislative Counsel)]: that was the conversation you had before. I think it would have to be changed in both places. Yes. Is

[Rep. Daisy Berbeco (Ranking Member)]: that something that people are

[Rep. Alyssa Black (Chair)]: generally in agreement with? We did hear testimony about the after school. Came up because it would consider schools only been one hundred and eighty days a year, and what about some of the time?

[Rep. Daisy Berbeco (Ranking Member)]: Can there be programs supported by DMH? And they're

[Rep. Alyssa Black (Chair)]: all supporting you. Programs like this. All That's the conversations. So general agreement that people would like to include that in this bill? Yeah. Okay, so we would have to make two changes in two different places. And Katie, I don't know page four, line one, the number of schools, which is number of schools at the end of that point. Page four, one. Member of schools and after school programs? So essentially everywhere where there's said schools? Yeah. Page three, eleven, 15. For August, what about all those age related ones? Maybe the a different

[Katie McLean (Office of Legislative Counsel)]: that could apply for both. Hold on, I have to go back. So page two, lines fifteen and sixteen, provide structured opportunities for student peer connection in a supervised school setting. Would it be broader than that if it's an after school program?

[Rep. Alyssa Black (Chair)]: Yes. 50 MHs okay. You haven't had a chance.

[Katie McLean (Office of Legislative Counsel)]: Supervised school setting or after school program? Supervised school or after school setting. Get a little close. Here.

[Rep. Daisy Berbeco (Ranking Member)]: Hi there.

[Rep. Alyssa Black (Chair)]: Stephanie, said. Oh, did you want to comment? Did you want to comment Stephanie? Or I'll take it back to that. Okay,

[Rep. Daisy Berbeco (Ranking Member)]: all right.

[Rep. Alyssa Black (Chair)]: This issue is not just after school, but not when school's not in session or, you

[Katie McLean (Office of Legislative Counsel)]: know, summer program. After school encompasses that. That's how you interpret it after school, that it could be like school vacation or summer.

[Rep. Alyssa Black (Chair)]: Down the hall. Val? This

[Rep. Daisy Berbeco (Ranking Member)]: seems to be more of a

[Rep. Alyssa Black (Chair)]: decision between a school and a department, but someone approached me and asked about parentheses and sent within program being instituted in schools. Is that something that

[Rep. Daisy Berbeco (Ranking Member)]: It was in an earlier version, so maybe that's why they're thinking about it. And it was in the earlier version because in that one, it was proposing that each school union or supervisory union select a curriculum for mental health literacy and that parents had to be notified the curriculum had to be made available to them. But this version explicitly says you cannot force any school to adopt this. The school has to apply for it. And the parental consent yeah, I don't know. Are you thinking that

[Rep. Alyssa Black (Chair)]: I think they would just want to know that it was I mean, an example, there's a class being administered in one of our schools, and another didn't agree with the illustrations in one of the books. But she did her homework inside. It's just more of like, will they know that it's going on once the school adopts it? That's a kind of semantic booking. Yeah, I don't know if it's a

[Rep. Daisy Berbeco (Ranking Member)]: know certainly for after school things, parents have to sign up for participation. I don't know that we can mandate a school to notify? Because this isn't a health thing. There's no health stuff done. And I know we received a letter citing a Supreme Court case that basically tracked to a youth that was having gender dysphoria. I just want to clarify that gender identity is not a mental illness. So although this is a mental health bill, that does not apply. Gender dysphoria is the stress that someone might have if they're experiencing being in a body that is not what they were assigned at birth, but that is not technically classified as a mental illness. So this bill does not deal with that.

[Rep. Alyssa Black (Chair)]: Thank you. Great. Let's see. So, we have a couple of changes that Katie has to make to this bill. Any other questions on this bill? How's eight sixteen going, Katie? Not well. Not well. What do we say about tabling both these bills for overnight and then trying to find fifteen minutes of Katie's time tomorrow. And then we vote on these two tomorrow. Give everyone some time to sit with them a little bit. Give Katie time so she's not flip flopping back and forth. Is there can we wait until and we wanna hear testimony from the the written testimony from kids.

[Rep. Daisy Berbeco (Ranking Member)]: Can we vote on 08:17 on Friday instead?

[Rep. Alyssa Black (Chair)]: Let's try to find we'll find time for Katie on Friday.

[Katie McLean (Office of Legislative Counsel)]: We have some time Friday morning. Yeah. Perfect. And I do have a draft, like, a 2.1 of h 17, if you wanted to just look at the changes you just asked for. Sure.

[Rep. Alyssa Black (Chair)]: Okay. Okay.

[Katie McLean (Office of Legislative Counsel)]: So the first change here. Yeah. Was to get rid of the language about the block grant. So that is gone. Gone. So there's nothing there. And then in subsection C, a school or after school program may establish a peer to peer mental health program that provides structured opportunities for peer support connection in a supervised school setting or after school program. Maybe how about a supervised school or after school setting?

[Rep. Alyssa Black (Chair)]: Okay.

[Katie McLean (Office of Legislative Counsel)]: Is overseen by an adult who is not required to

[Rep. Alyssa Black (Chair)]: be a licensed, certified, rostered mental health professional. Like an appointed adult or something. It just seems so underqualified at this point with just adults. I just want to let know DMH is going to make the qualifications, not us. Did we say as per section two or whatever? That's kind of what section two is as. But since people are going

[Rep. Daisy Berbeco (Ranking Member)]: to struggle over that word,

[Rep. Alyssa Black (Chair)]: we're not going to need that, it's not adequately supervised, we're saying that them the clarity or gives the rest of

[Katie McLean (Office of Legislative Counsel)]: the world the clarity. If you want to use that concept, I don't know if I'd put it there, but in two, you could say, shall provide oversight and guidance to any school, after school program seeking to establish and maintain a fair fair mental health program pursuant to this subsection, including qualifications for Yes? Yeah. Great dating. I just don't know how to say that. Insitting qualifications. Of

[Rep. Alyssa Black (Chair)]: the Designated adult. Of the adult. Designated. You took out a designated. Of the How about an adult? A pursuant to? Of the adult. And methods? Of the adults.

[Rep. Daisy Berbeco (Ranking Member)]: I'll figure it out. I don't want to waste your time.

[Rep. Alyssa Black (Chair)]: How about the overseer, since we say is overseeing?

[Rep. Daisy Berbeco (Ranking Member)]: Or the individual overseeing? Including requirements.

[Katie McLean (Office of Legislative Counsel)]: Backgrounds. No, we're not.

[Rep. Daisy Berbeco (Ranking Member)]: No.

[Katie McLean (Office of Legislative Counsel)]: We'll figure it out. And then I've changed this from school. So this is the developmentally appropriate guidance. So she'll develop age appropriate guidance. I'm gonna get rid of that. For elementary age children,

[Rep. Daisy Berbeco (Ranking Member)]: this is where the back goes.

[Katie McLean (Office of Legislative Counsel)]: Then the same thing for middle and high school age children that emphasizes.

[Rep. Alyssa Black (Chair)]: Did you

[Katie McLean (Office of Legislative Counsel)]: say students instead of children?

[Rep. Alyssa Black (Chair)]: I don't know, once you get to secondary. Youth? It's youth. Okay, youth. Or elementary? Youth or just middle high school? I don't know, what's a youth? What's a youth? Not movie. YouTube, my favorite movie. Oh, it's the best movie ever. My cousin Vinny. See my cousin Vinny.

[Rep. Daisy Berbeco (Ranking Member)]: Okay, okay. Sorry I did that. You know what? If we have this wrong, guess what? It's going to

[Katie McLean (Office of Legislative Counsel)]: be downstairs. And then there are reporting requirements, including a number of schools and after school programs requesting and receiving services.

[Rep. Alyssa Black (Chair)]: So remind me, maybe, the idea that organizations other than schools can apply for the grants, that we're waiting to hear back. Is that where that landed? We're going ensure that DMH comes back to us to make sure that they're A Okay with after school program. Applying for grants. Yes.

[Katie McLean (Office of Legislative Counsel)]: Okay, that's it.

[Rep. Daisy Berbeco (Ranking Member)]: Any

[Rep. Alyssa Black (Chair)]: other questions on this? Because I do want to take a break before we go into 02:30, and we're whittling down our time. Go ahead, Karen. So quickly, on age 16, there's two places where generative artificial intelligence is found. Oh, like that. Okay.

[Katie McLean (Office of Legislative Counsel)]: Different bill. I switched bills.

[Rep. Daisy Berbeco (Ranking Member)]: Oh, okay. I don't think that

[Katie McLean (Office of Legislative Counsel)]: one is mine. It? No.

[Rep. Alyssa Black (Chair)]: It's the 817. 816.

[Katie McLean (Office of Legislative Counsel)]: Oh, 816. Yes. Are two places. Yeah. I think there's a lot of work that maybe has to go on behind the scenes.

[Rep. Alyssa Black (Chair)]: Okay. So let's take a break. We will get Katie scheduled for whenever she's able to get in here, hopefully Friday on this one. And then let's take a break until 02:30. Yeah, maybe one. 02:30 and we'll be back here at 02:30 to go back to one eighty