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[Speaker 0]: If you look on your webpage, there is a link to the Vermont statute around consent. And Katie is just looking for a high level summary of that for us. So whenever you're ready, Katie.
[Speaker 1]: Thank you, Rob. McBride, Office of Lenten, City Council. I'm sorry I couldn't find it quickly.
[Speaker 0]: Oh, that's great. It's like trying to write statute when everybody's watching you.
[Speaker 1]: I was also looking to see if there's something specific in the immunization chapter. So here it is. And I don't hold up, do I? Oh, I'm not logged in. Do you have it on your Yeah, we have it on
[Speaker 0]: our iPads, you don't need to do it. It's on our website.
[Speaker 2]: Thank you.
[Speaker 1]: Okay, so we have language that just defines what lack of informed consent means. So
[Speaker 0]: I
[Speaker 1]: think it's nice to look at the specific language there. It's the failure of the person providing the professional treatment or diagnosis to disclose to the patient such alternatives thereto and the reasonably foreseeable risks, that's the language that Lauren was really emphasizing, and benefits involved as a reasonable medical practitioner under similar circumstances have disclosed in a manner permitting the patient to make a knowledgeable evaluation. So this is talking about, one, what the practitioner themselves would anticipate, but also disclosure in a manner that the patient receiving the information can take in. And then we have an or, the failure to disclose the information required by D. D says that the patient shall be entitled to a reasonable answer to a specific question about foreseeable risks and benefits. The medical practitioner shall not withhold that information. And then the language goes on to say that a person, there could be an action brought to recover from medical malpractice based on the lack of informed consent. But this wouldn't apply in the case of an emergency medical So I think that's sort of the high level there.
[Speaker 0]: And that this applies not just to immunizations, but this applies across medical practice. Across medical practice, yeah. So there's existing law with regard to what the patient's rights are when it comes to health care professional's
[Speaker 1]: practice, I guess, is what you say,
[Speaker 0]: I guess what the word is. Okay, so I just wanted to make sure that committee members know what existing law is. And do you have any, I'm going say quick? Good work, Katie. Okay, great. Thank you so much, Katie. Appreciate it. Thank you for being so flexible today. Appreciate you today. Thanks a lot. I'm happy have it here.
[Speaker 1]: Speaking flexibility,
[Speaker 0]: thank you to our witnesses from Community Action for being flexible. We are going to now move to page five ninety four. We're changing topics. We will have additional witnesses on the amendment before us on 05:45 right at 01:00. We'll be hearing from the pediatrician who spoke to us previously. So we want to get the physician perspective about the proposed amendment. So we've heard from the department. Now we want to hear from people who are practicing, and we've also heard from the amendment sponsor. So have to get all rounds on this. Thank you, Representative Eastes, for being very flexible as we move along Okay, on so welcome. We're going to do a quick round of introductions just because I think Jenna's been here on Zoom already, but I don't think Paula's been here yet this year. So Theresa Wood from Waterbury, also representing Bolton, BULScore, and Huntington. Hi, Ray Garofano, Essex and Essex Junction. Nice to see you both. McGill, and I represent Bridgeport Middlebury, Virginia and Cambridge.
[Speaker 1]: Hello, Esme Cole of Hartford.
[Speaker 2]: Good morning, morning, Sonia. Sonia. Heidi I'm Guilford, and I also serve. Dan Noyes, Wolcott, Hyde Park, Johnson, and Belvedere. Thank you. We'll start with the press right up here. You for holding NBC five News. Ethan Carpenter, Zatz Rent Group Consultant. Chad Simmons, housing and home in the Midlands, Vermont.
[Speaker 1]: Hey, Schallberger.
[Speaker 0]: Not on the floor?
[Speaker 1]: Yeah, no, my computer's. Oh, you're coming here?
[Speaker 0]: Oh, okay, that's all good.
[Speaker 1]: Just keep going like that. Milgatham, the Long Grove Child Care Advocacy Alliance.
[Speaker 0]: Larry Murphy's committee assistant.
[Speaker 1]: And Representative Donahue. And Donahue from Northfield And Berlin, how would you square out the way?
[Speaker 0]: So thank you, thank you for being here. Thank you. As you know, we've been working on this issue for a long time. We're hoping to make some progress this year. And we appreciate both of you being here today to give us your reactions, your thoughts and processes about different elements of the spill, things that you might think could be helpful and things that you think might not be helpful. And I appreciate you both being here. I'm going to say particularly because we are in some very cold time right now and heading into a weekend where I know that you are going to be incredibly busy. So I'm just gonna pause just for a moment. I'm not gonna ask you to get out of your seat. I am gonna ask our witness if he's able to come back at 01:00. Yes. Thank you. So I was not going to plan D, I promise. So welcome to both of you.
[Speaker 1]: And we started at the beginning, and it's a community that has a purpose. So today, you're here to give you a response to purpose statements as stated in page five ninety four. Highlights for the court. And I'll read, and I guess I would periodically look to these people on staff or
[Speaker 0]: Why don't you go through your testimony, and if you see a place where you think that people might have questions, I'll keep my eye out, but I think I don't want to interrupt you.
[Speaker 1]: Okay, feel free. That's helpful. Today we'd like to highlight some of the core features of H91. Like walk through the purpose statements and provide comments. We're happy to work with others and provide specific suggestions for Purpose Learners next week. The first, number one, is to ensure that the narrowly tailored temporary emergency housing assistance is available to only the most vulnerable responders in crisis through fiscal year twenty twenty eight in a manner that encourages efficient and accountable use of taxpayer funds. We respectfully disagree with this approach. We believe that all people deserve shelter. A narrowly defined eligibility framework is neither inclusive nor equitable and fails to reflect the realities of homelessness. When access to shelter is restricted to tightly defined categories of the most vulnerable, many people in genuine crisis are excluded, many of those with the fewest resources to navigate the complex systems. This approach reinforces inequity rather than addressing them. Limiting access to shelter does not inherently promote efficiency or accountability of public funds. In practice, this often shifts costs elsewhere to emergency rooms, law enforcement, child welfare, and crisis systems, all the while prolong homelessness and increasing long term public expenses and the impact on our communities. True fiscal responsibility is achieved by providing timely, low barrier access to shelters that stabilizes people quickly and reduces the need for more costly interventions. Emergency housing assistance should be guided by creating a human centred, equity driven framework that recognizes homelessness as a crisis that needs emergency response. Accountability is best received through peer outcomes, coordination with community providers, and transparent use of funds, integrating the service system, and not narrowing access in ways that these vulnerable providers without life saving support. Second statement, Establish clear eligibility criteria, accountability measures, and case management. The new statement: Establish clear eligibility criteria, accountability and case management required as it is presented. Eligibility for emergency housing assistance is already cleared. Individuals and families are literally homeless. Adding additional eligibility criteria beyond livable homelessness to this excluding people in crisis, and creates unnecessary barriers to life saving childbirth. Please note that our staff and the staff at other providers are already very skilled at engaging people in case management, housing plans, benefit navigation, and accessing additional services. The call for greater accountability is also unclear, accountability to prove and allow purpose. The Housing Opportunity Program providers already operate with significant oversight, including monitoring the financial and service provisions, as well as habitability, visits, and checks on all of our counselors. Providers collect and submit detailed data, develop and manage approved budgets, and regularly report outcomes to the State. These accountability structures are already in place and are challenging. No new deficits have been identified to justify additional requirements. Finally, proposal introduces case management requirements without defining what case management entails or how it would be implemented. Case management should be an available support, not a condition of accessing a shelter. Requiring participation undermines trauma informed person centered approach and may discourage people from seeking help at all. Emergency housing must remain low barrier, voluntary, and responsive to individual needs, recognizing that stability and trust are often prerequisites to engagement and not the results of mandates. We already use proven techniques for client engagement, including meeting people where they are, motivational interviewing, community building, housing and financial education, and intensive service support. The third statement: transition from reliance on hotels and motels towards sustainability, permanent housing solutions, including recovery housing, transitional housing, and the Vermont Housing Investment Programme. We agree with the goal of transitioning away from reliance on hotels and motels towards sustainable permanent housing solutions, including recovery housing, transitional housing and the Vermont Housing Investment Program. However, this transition must be accompanied by one to one replacement of hotel and motel capacity with community based shelter beds. Any shift in strategy should be grounded in a data driven assessment of current need, regional capacity and system impact to ensure that people experiencing homelessness are not displaced or left without access to stay shelter. Without sufficient replacement capacity, reducing hotel and motel use, risk on shelter, increasing unsheltered homelessness and undermining varied outcomes these long term health investments seek to achieve. A responsible transition prioritizes continuity of care, geographic equity, and adequate shelter capacity while permanent housing solutions are developed and brought online. Four, establish a tiered continuum of care. Disagree with the idea of establishing a tiered continuum of care if it implies a linear or prescriptive system. Tiered support often attempts to fit people in predefined levels of service rather than meeting people where they are. This approach can unessentially force people into interventions that do not align with their needs, preferences or readiness. A best practice case management system builds trusting relationships grounded in dignity and recognises that people experiencing homelessness are the experts in their own lives. They share a meaningful voice.