Vermont Legislature SmartTranscripts:

[Theresa Wood (Chair)]: Good morning, we are back, Health and Human Services Center today's Wednesday, February 11. We are now taking up H660 and doing march ups, so Jubilee can you join us. Morning. Good morning. Katie McLean, that's the

[Katie McLean (Legislative Counsel)]: legislative council. I'm not logged in

[Theresa Wood (Chair)]: to Zoom yet. So do we have a new draft or we do? Yes, it should be 2.1.

[Katie McLean (Legislative Counsel)]: Section one of that draft has no changes, but the Department of Health provided, there's my link,

[Theresa Wood (Chair)]: some reversion language, and that is what the additional sections are. And folks, I think you all got an email yesterday, Theresa forwarded the language from Sheila based on some of their analyzing the Rural Health Transformation grant and what's possible within that money. They requested some changes to the opioid settlement funding and the new version incorporates those changes, correct? Katie? Sorry, yes. Yes, okay. So what we're going to be reviewing and I'd like us to kind of make decisions on funding amounts, if possible, today, because we do have the two recommendations from OSAC and the health department that are slightly different. So as we're going through, first maybe we'll review the changes from the health department and then we'll go through Katie, maybe then we can do each section and then we can have a quick discussion about we're, whose dollar amount we're in agreement with and look at the discrepancies. Okay.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: I I have it pulled up.

[Katie McLean (Legislative Counsel)]: As I said, I'll just start walking through it. Section one, as I said, is the same as the earlier draft you saw, 1.1. So in subdivision one, you have an appropriation, dollars 455,000, to the health department to fund 26 outreach or case management staff positions within the preferred provider network for the provision of services that increase the motivation of an engagement with individuals with substance use disorder and settings such as police barracks, shelters, social service organizations and elsewhere in the community. And then as part of that subdivision one is language that it is the intent of the General Assembly that these positions shall be funded annually by the Opioid Abatement Special Fund unless and until the Special Fund does not have sufficient monies to fund this expenditure. That was matching language from last year's appropriation, not necessarily the appropriation amount, the dollar amount, the language. Next, you have an appropriation and you have two different amounts. So the amount in yellow, the 1.4, is the health departments. 1.75 is the advisory council. This is an appropriation to the Department of Health for Recovery Residences certified by the Vermont Alliance for Recovery Residences. And again, you have this language. It is the intent of the General Assembly that recovery residences be funded annually at not less than fiscal year 27 levels, unless and until the special fund doesn't have enough funds in it. Next is, again, two different number amounts, 1.1 from the Advisory Council, 1.25 from the Department to the Department of Corrections to provide Peer Recovery Center coaches in Vermont, correctional facilities, and probation and parole offices to provide group and individual coaching and reentry support. Next is 250,000 to DCF's OEO to support long term programs at shelters for individuals experiencing homelessness, including harm reduction supports, transportation to recovery meetings and appointments and clinical nursing programs. Subdivision five, 200,000 to the Department of Health for distribution to the Vermont Alliance for Recovery Residences to provide initial entry fees and rent for individuals newly entering recovery housing.

[Theresa Wood (Chair)]: Subdivisions. Can I stop you for one second? Yes. What is a five one of the ones that the health department asked to eliminate?

[Doug Bishop (Member)]: Yes.

[Theresa Wood (Chair)]: Yeah, I was trying

[Anne B. Donahue (Ranking Member)]: to sort out that cross. I

[Nolan Langweil (Joint Fiscal Office analyst)]: can refer folks to my sheet, it's all there. And you can see what each did. If the health department doesn't have recommended, they're not recommended.

[Doug Bishop (Member)]: I do believe your email may have referenced that, but I guess that's sort of our decision to make whether So it would still appear here until we make that decision to either agree or disagree with Department of Health recommendation, I guess, is how I would

[Katie McLean (Legislative Counsel)]: Keep going. Okay. Subdivision six, the request is $900,000 from the advisory councilor, 1.2 from the department to the department for the creation of new recovery resident beds that are NAR level three or higher. Subdivision seven, 2 hundred and 48,000 to the Department of Health for the pre hospital Vermont EMS Buprenorphine Treatment Program to expand training for emergency service providers on carrying and administering buprenorphine after administering naloxone. Subdivision 8200 and 87,000 to DPS to expand the Public Safety Enhancements Team's Harm Reduction and Strategic Community Intervention efforts in more Vermont communities. Subdivision nine, 35,000 to the Department of Subsidized Room and Board for Individuals in Rutland Mental Health Services Transitional Housing Program. Subdivision ten, two hundred and 88935 to the Department for Distribution to Elevate Youth Services to support the creation of a low barrier drop in teen center and Berry to provide food activities, positive adult role models, peer counselors, prevention and recovery program and direct connection to treatments. Subdivision 11128999 to the Department of Health for distribution to the Greater Falls Connection to enhance youth engagement and education and to expand prevention focused staffing and youth programming states in response to facing community need. Subdivision 12, dollars 200,000 to the Department of Health for Distribution to Interaction Friends for Change to increase access to community based therapy, housing, crisis, medical recovery and employment supports for youth in Windham County. Subdivision 13237646 to the Department for Distribution to Springfield Project Action for public safety enhancement team coordinator positions in Bennington, Springfield, Brattleboro, St. Jay and Central Vermont for the purpose of providing administrative support, meeting facilitation, data tracking, outreach, event coordination and sustainability planning. Subdivision 14, dollars 300,000 to the Department of Health for distribution to VTAR and Recovery Partners of Vermont to establish new recovery residences in Brattleboro, Middlebury, Addison, Randolph, Chester and St. Albans regions. Lastly, Subdivision 1526697 to the Department of Health for Distribution to a Newski Partnership for Prevention to provide funding for staff time and stipends for partners to deliver medicine safety education to elementary aged youth during school with family engagement. So those are the appropriations. I know you have some work to do on that section. The next three sections came from the health department. They're amending previous appropriations. So in 2023, you had an appropriation that was amended in 2024, and now it's being further amended. So that amount had been 1.5 divided equally between four opioid treatment programs. And the proposal is 1,056,000, getting rid of the language about equally between four opioid treatment programs to cover costs associated with partnering with other healthcare providers, to expand satellite locations for the dosing of medications, including costs associated with the satellite locations, physical facilities, staff time at the satellite locations and staff time at opioid treatment programs to prepare medications and coordinate with satellite locations. In Subdivision B, satellite locations established pursuant to the subdivision one shall be located in Addison in Eastern Or Southern Vermont and striking through the language and in a facility operated by DOC. In Subdivision 2500000 to establish a satellite location in Northwestern Vermont and removing language, a second children in clinic addiction treatment center. So that is the first one. Second one, this is amending an appropriation from 2023 appropriated $100,000 and now the new amount is $91,712.66 to implement a wound care telehealth consultation pilot program for the purpose of utilizing wound care experts to provide telehealth drop in appointments to address syringe use by individuals with opioid use disorder. The last of these is an amendment to a 25 appropriation, fiscal year twenty five appropriation. And that would remove this 1,000,000 appropriation of settlement of special fund monies for grants to providers to establish community based stabilization beds for individuals transitioning between substance use disorder, residential treatment and their recovery systems. Then we have the bill taking effect 07/01/1926.

[Theresa Wood (Chair)]: Steady. Doctor.

[Nolan Langweil (Joint Fiscal Office analyst)]: Shakti.

[Doug Bishop (Member)]: Thank you. These letter sections, where did these requests come from? And Nolan, am I missing anything? Are they reflected on your sheet?

[Nolan Langweil (Joint Fiscal Office analyst)]: They're not for record Nolan, I will talk physicians. They're not reflected on my sheet because I was only focusing on the current recommendations and then showing if they had been done previously. The sheet does not show previous appropriations that are not being recommended. That makes sense. So if you had an old sheet from last year, you'd see there's a bunch of things that were on that sheet are not being recommended this year, then it was no fun with the sheet. But what I'm going to do is, I'm going update the sheet that will show the House Human Services recommendations and I'll also add a reversion line. But I'm not gonna put everything that's ever passed because the sheet goes 10 pages.

[Doug Bishop (Member)]: Yeah. And so these are reversions. These are reversions. And they are coming to us from the Department of And then just an observation, I think one of these maybe line eight, I'm sorry, section eight, page three, line three, the 287,000. I think that is a The Department of Health. To request, so that would be yellow. Page three, line three. Oh. That would be no one on your sheet. It's number eight, public safety enhancement team, 287000. Yep. It's just for consistency document, it would be highlighted in-

[Katie McLean (Legislative Counsel)]: Are they different? It's only highlighted in yellow when there

[Theresa Wood (Chair)]: were two different competing amounts.

[Doug Bishop (Member)]: Oh, not informing us that, okay.

[Theresa Wood (Chair)]: Yeah, if the amount is not highlighted, that means the OSAC and the department of Health recommendations were the same.

[Katie McLean (Legislative Counsel)]: Or they It was not no. One

[Theresa Wood (Chair)]: had

[Katie McLean (Legislative Counsel)]: it, the recommendation. One had it and the other one didn't. Yeah, it's only when there's a conflict on a monetary piece where

[Eric Maguire (Member)]: This is really helpful. Thank you.

[Nolan Langweil (Joint Fiscal Office analyst)]: What PageRankin does, it has every recommended appropriation from both sides in there. Yeah. So it doesn't say there's a BDH or OSAC. The only time you would know if there's difference is there's two competing appropriations. Right. Otherwise, there's a good place to know the difference between it's a B. H. Or an outside recommendation of

[Eric Maguire (Member)]: the machine. Yeah, the stretch.

[Theresa Wood (Chair)]: That's right, yeah, which I can see much bigger.

[Nolan Langweil (Joint Fiscal Office analyst)]: So

[Theresa Wood (Chair)]: I guess one question I have and Eric you might know the answer to this is does the OSAC have any opinion on the reversions that were offered by the health department?

[Eric Maguire (Member)]: We didn't hear anything in a long time, so there was no opinion that could be provided.

[Nolan Langweil (Joint Fiscal Office analyst)]: I have one more comment. Yeah. The other thing to keep in mind is because it has both appropriations from both of them, the number that's in the bill is not reflected in the sheet yet. It's much higher than both. So you're going to have probably 6 plus million dollars of recommendations to be mindful about that and the future balance. Again, what I would do is I could put the other sheet that has everything in it. As you can see, line is a little more backwards than that.

[Eric Maguire (Member)]: Talking about these reversions, I'm still not quite clear probably, but are those largely bookkeeping corrections or are they actually changes in programming that happened

[Nolan Langweil (Joint Fiscal Office analyst)]: after the fact?

[Theresa Wood (Chair)]: I actually don't know that.

[Nolan Langweil (Joint Fiscal Office analyst)]: For the record, no, I'm Great question, and I would say ask the health department to testify. Reversions when we're trying to take money items with previous appropriated, but it does not say why they want

[Eric Maguire (Member)]: to do Yeah.

[Nolan Langweil (Joint Fiscal Office analyst)]: So was trying to be here to write that question down. I We just did you get Okay.

[Theresa Wood (Chair)]: That's ready. Go ahead.

[Anne B. Donahue (Ranking Member)]: Brenda?

[Nolan Langweil (Joint Fiscal Office analyst)]: Muted.

[Theresa Wood (Chair)]: You're muted. We can't hear you.

[Brenda Steady (Member)]: Can you hear me now?

[Theresa Wood (Chair)]: We can.

[Brenda Steady (Member)]: I just want to make sure, is there anything in there for that safe injection site for Burlington?

[Theresa Wood (Chair)]: There isn't currently, but we need to talk about it. So

[Brenda Steady (Member)]: I'm I'm against not it. I just want everybody to And I would like it maybe as an amendment or something so that I could vote on this section because last year I had to vote on the entire bill because nobody would put it would accept my amendment, which they could have still voted for it.

[Theresa Wood (Chair)]: Well, currently, there's nothing in the bill right now. So when, when we have the discussion, we can

[Brenda Steady (Member)]: It just puts me in a difficult situation because that's the only one thing I wouldn't vote on. And so it makes me look like I don't wanna help. You know what I'm saying?

[Theresa Wood (Chair)]: Thank Thank you. Okay, so we need to get the health department, Jessica, go ahead.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Yes,

[Theresa Wood (Chair)]: Jessica. I'm the health policy director of the Department of Health.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: And for the conversion that is being requested for the MDU for

[Theresa Wood (Chair)]: Department that of

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: was no longer needed. Because they were able to establish the medication using existing systems with up to delivery instead of having a separate unit. So that's that 444,000 being diverted back into the fund with the DOC medication dosing unit. And then the Department of Health project stabilization beds and reengagement beds. In fiscal year 'twenty six, the department received base general fund appropriations for those, so we no longer need the million dollars from the Fort Given and Payment Special Fund for that work. So those three engagement beds are funded in base now.

[Eric Maguire (Member)]: Can I ask just I'm not entirely clear where you're just going go through it again so I can be very clear? The section on page six, section four is the point you were just speaking about, I believe. Are we on the same?

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Yes. Page six, section four is the reversion for the stabilization. That

[Nolan Langweil (Joint Fiscal Office analyst)]: And is

[Eric Maguire (Member)]: then now the one before that, you mentioned something about $440,000 I don't see that

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: That one that starts on the bottom of page four, section 14, which is where we're talking about the niacinogen dose of the meds. And so the change in that amount from 1.5 million to one point zero five six is that $4.40

[Eric Maguire (Member)]: I see, okay, got it. And

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: then just to be clear, there's another change in language in that section. Or yeah. British. Was 500,000 that was appropriated to establish another medication dosing unit satellite location in Chittenden County at Howard Center and Howard Center has declined So to start we are just requesting not a change in funding there, but just a change in language to allow the department to work with another partner to establish that MTU in Northwestern Vermont.

[Eric Maguire (Member)]: Okay, so may I ask another question, So do I understand that the 500,000 that you're talking about, Pattenden, is that part of the $1,000,000.05 6?

[Theresa Wood (Chair)]: Yes. Okay. Yeah. Alright.

[Doug Bishop (Member)]: Just quickly, my apologies because they did explain that when they did do a presentation in regards to So me saying, no, didn't hear anything about We

[Eric Maguire (Member)]: are aware of it, yes.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Okay. And just to put a finer point on that piece, in the letter from the committee, you will see those two versions that I just spoke about recommended. Oh, I

[Eric Maguire (Member)]: see. They're also recommended. Yeah. Okay. Then, sorry, do you have anything to say about section three on page five? It's actually section three, section 14.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: That one is the limb here, the diagram inversion, and that one is a matter of foot sweeping, the project was concluded and there was 8,000 and change, or 9,000 and change, or clapped over, so that is just kind of sweeping it back in.

[Nolan Langweil (Joint Fiscal Office analyst)]: Thank you. Pardon me, TikTok for that. Okay,

[Theresa Wood (Chair)]: so that explains the revisions, and so am I did I hear that two of them OSAC was fine and one of them was a bookkeeping issue?

[Eric Maguire (Member)]: Yes.

[Theresa Wood (Chair)]: Jessica, page five, line eight, that $500,000 is now, instead of going to Howard Center, is that the one that you said Howard Center declined? So then that's going somewhere else. And then that's safe, okay, so that takes care of the revisions.

[Doug Bishop (Member)]: Can I ask you a question on that 500? Has the department been able to identify a potential partner at this point? Presumably they're outside of Chittenden County if this language

[Eric Maguire (Member)]: is seeking to broaden it.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Well, Jessica Chittenden, our Department of Health, we have been engaging with potential vendors for this and we don't need to cast as wide as that is thinking on for this because they intend to operate it in Chittenden County, but they need a larger geographic operations as well. I think this gives us the most flexibility trying to go through another vendor for this project.

[Doug Bishop (Member)]: It doesn't change the department's understanding of the need. Correct. Okay.

[Theresa Wood (Chair)]: Rossetti, do you have a question?

[Brenda Steady (Member)]: I do. I'm just curious. How can we, as a committee, commit money when we don't even know where it's going? That's kinda, like, not responsible.

[Theresa Wood (Chair)]: Well, they typically put a RFP out and get different vendors. The state has a process to allocate the money to the organizations that apply for the funding. So that's pretty normal standard process for money that we appropriate.

[Brenda Steady (Member)]: And no, but are we being asked to vote on this without knowing today?

[Theresa Wood (Chair)]: No one, go ahead.

[Brenda Steady (Member)]: No vote today, not till we know.

[Theresa Wood (Chair)]: No one is answering your question, Brenda. Okay.

[Nolan Langweil (Joint Fiscal Office analyst)]: The record, no man will join this blog, which we very often will appropriate money to a department or an agency, say please find a vendor, please find a contractor. We don't generally get involved in that level of contracting. We can often use sometimes we often know or hope or be specific because it's going to power or this or that, but generally we don't, where the legislature gets more involved is in the oversight.

[Brenda Steady (Member)]: Now I can see why we have issues. Thank you.

[Theresa Wood (Chair)]: Welcome. Zon, did you have something? No. Go ahead, Anne.

[Anne B. Donahue (Ranking Member)]: No. I was just gonna add to that, but but we are appropriating it for a very specific purpose. So we're not just sending it out for for whatever. It's it is being appropriated to a department that then has to has to spend it on what we what we are directing. So it's going to a department that has to that has to supervise it. It's not just going out to an unknown entity.

[Theresa Wood (Chair)]: And then the on page six, I'm sorry. You guys talked about this, but I I just wanna make sure The 1,000,000 reversion, for community based stabilization beds. What was the reason for that?

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Sure, Justice Chittenden with the Department of Health, in FY26, the department received base funding for the engagement beds or stabilization beds, as it was referred to in this language. So given that we receive the base funding, we don't need the additional funding from the special fund to support that. And we have the re engagement beds up and running, I think, as of July year. Go ahead, Anne.

[Anne B. Donahue (Ranking Member)]: I'm not sure how to articulate that. Is there a reason for having it in one or the other, the base fund versus out of this fund? Is there an advantage?

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Yes, in the base fund it will continue and we won't have to use special fund money every year to support that. So for these projects that are working and aren't necessary, it is preferable to have that in base funding. And as you've heard, I think, in testimony to this committee on the opioid abatement special fund, These funds are limited over time, and so this is part of also the Department and Administration's approach to finding sustainable funding for these important projects versus continuing to fund them out of the special fund.

[Theresa Wood (Chair)]: It makes it

[Anne B. Donahue (Ranking Member)]: sustainable. Makes it sustainable. Right, yeah. It makes me wonder when we're in a year where we are highly fiscally stressed, maybe using a special fund is the right way to keep something going and then getting it back to the base when our capacity base is greater so that we can preserve base funding for things that otherwise would be eliminated. That's where the question was coming from.

[Theresa Wood (Chair)]: Any other questions for the department on the reversions?

[Eric Maguire (Member)]: Okay,

[Theresa Wood (Chair)]: so I will also put out that we have had a request for the overdose prevention site, which was not part of the application process to the OSAC. So this was not in any recommendations that we receive. And long the story long is that we funded the OPC several years ago and have appropriated $1,100,000 for the last two years. And they were a little bit stalled in getting going. So they have now partnered with a community organization, and work has begun and are now asking for some either language or money to be appropriated because they're anticipating opening in 2026 and spending that $2,200,000 And they have concerns that they will not have operating money when they open if they are left out of recommendations for '27. So just gonna put that out for discussion for folks to think about, and that's what we'll see.

[Doug Bishop (Member)]: Thank you. I guess, personally, I'd like to see one pager, whatever it may be from them to set forth the expenditures of the $2,000,000,000 2,200,000,000.0 How much of that is in fact gone? How much of it may be left within this year before we take another crack at this a year from now?

[Theresa Wood (Chair)]: That's good, Michelle received. And

[Doug Bishop (Member)]: then I guess, yeah, the budget for the balance until we're at this again next year.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Yeah, so I have both

[Theresa Wood (Chair)]: of those things. I don't know if I have them electronically yet. Aidan, do I have them electronically?

[Nolan Langweil (Joint Fiscal Office analyst)]: Not the spreadsheet. The memo you have electronically, not the spreadsheet.

[Theresa Wood (Chair)]: Okay, so I will send the memo to the committee and I can pass this around for folks and then maybe Aidan, if we can get this electronically? No? Maybe. We would have

[Nolan Langweil (Joint Fiscal Office analyst)]: to talk about it. Okay.

[Anne B. Donahue (Ranking Member)]: We just make copies? I

[Doug Bishop (Member)]: guess high level, it seems like we'll be making a decision unless we make fairly significant cuts in what's been proposed to us by the department or the advisory council. We would be making a decision to be depleting the balance by including it at this point. It's just an observation, not at this point of opinion one way or the other, but that would be the reality.

[Nolan Langweil (Joint Fiscal Office analyst)]: Thank you. Any

[Theresa Wood (Chair)]: other considerations? I agree. I feel like part of the conversation has been others might remember differently when you were here, Dan, when we passed this. And Jubilee, you were here as well. I think the legislative intent was not for Burlington to purchase a building. We had envisioned that they would lease the building. It turns out, and this makes perfect sense, that it is really difficult to lease space for this purpose. So they have spent a lot of time, insurance is difficult, landlords just aren't agreeable. So the organization has now identified a building that they can purchase. And I think all in, it's going to be about 1,000,000 for the building and what's needed to renovate it to get it to be viable for this purpose. Rep Steady, go ahead.

[Brenda Steady (Member)]: I agree with, Rep Bishop on this one. And we I are you going to decrease somebody else to do this? Like, that would be the right way because they've already presented it with the dollar figure. And if they purchase the building, is it gonna be in the state's name? Because when this isn't gonna last forever because most of the other states have already stopped it. Who's gonna own that building? Burlington on the taxpayer dollars?

[Theresa Wood (Chair)]: Oh, good point.

[Brenda Steady (Member)]: Yeah. So we would have to see what the lease of the building says. If it says something that the money from the sale of the that the building has to be sold. If this doesn't if this program is no longer going to be in effect, if the building is sold and the money goes back to us, the state. So there would be a lot of homework to do on that one if they purchase the building with our taxpayer dollars.

[Theresa Wood (Chair)]: All good, Plains. Thanks, Thank you. So we're going to have to do more work on this piece. Another option is to, and I don't know how this would work, we put language that would maybe authorize them to have more money if they needed it?

[Katie McLean (Legislative Counsel)]: It sounds like a budget adjustment, kind of.

[Nolan Langweil (Joint Fiscal Office analyst)]: Yeah, I think you've either given the money or you don't. And if you give them the money, the health department wouldn't, or whoever, these appropriates health department, health department give you the money until it first, so it can be part of their contracting, I guess. And if they don't buy the building then the VAU could put it back in. I guess my point is I don't think we need to get into that level of detail in words. So

[Theresa Wood (Chair)]: this is obviously very late evolving. This is just starting to gain to our attention like the last couple of days.

[Doug Bishop (Member)]: But the thing is that this

[Eric Maguire (Member)]: is what happened last year. Last year, you know, last minute it was

[Anne B. Donahue (Ranking Member)]: I think we told them last year, don't, not last minute.

[Theresa Wood (Chair)]: And I don't remember, did we include it in our recommendations last year or did?

[Eric Maguire (Member)]: It was just the things. I believe appropriations.

[Theresa Wood (Chair)]: Appropriations brought them back up

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: to $1,100,000

[Nolan Langweil (Joint Fiscal Office analyst)]: So

[Theresa Wood (Chair)]: they've received the full funding for the last two years.

[Eric Maguire (Member)]: And what's been expenditure moment through that? Is it still at the It's memo. In

[Anne B. Donahue (Ranking Member)]: Expenditures today, right, there we go. Looks like they

[Eric Maguire (Member)]: They have a total award of 2,200,000.0, of which they've spent 781,000. They've given some of that to the sub recipient.

[Anne B. Donahue (Ranking Member)]: Obligated funds left, 1.4. 4,000,000.

[Eric Maguire (Member)]: And they're estimating that the cost, if they were to purchase, they said, I hear a million dollars.

[Nolan Langweil (Joint Fiscal Office analyst)]: Yeah. They kinda looks like

[Eric Maguire (Member)]: I don't see that.

[Theresa Wood (Chair)]: It's, $600,000 for the building and then Or what another 4 or 500,000 to kinda put it out before the purchase.

[Doug Bishop (Member)]: Go. What's in their original budget for space?

[Theresa Wood (Chair)]: Well, their full allocation is a 1.1 annually. That's for operations and lease and training and staff, everything. I mean, I had a chance to look at this a little bit before you guys quickly, but some of the money that is budgeted that they already have looks like it could be operations money.

[Anne B. Donahue (Ranking Member)]: Yes, go ahead.

[Nolan Langweil (Joint Fiscal Office analyst)]: My recommendation to the committee would be rather than debate it now, get asked the OPCs, or we can do it ourselves, break down their ask by one time and ongoing one time. Because everything's one time. But there's real one time, depending on what their ongoing one time is. Because if they're going continue to be funded year after year on this, what happens when the money comes out? How do have to sustain them and they own a bill? So think about, that's how I would think about it, is what's the one time and what's the both the one time? And then think about it in a whole, like figure out each other, not just in an hourglass of one year.

[Theresa Wood (Chair)]: I like that recommendation.

[Nolan Langweil (Joint Fiscal Office analyst)]: So I don't know if we want to ask them to put together something. We are asking them to put together like what's your one time for, you know, what's your ongoing yearly anticipated asks, and then we'll know next year what they're going be asking for.

[Theresa Wood (Chair)]: That's a good plan. Yeah. Thank you, Donahue.

[Anne B. Donahue (Ranking Member)]: Go ahead, Todd.

[Todd Nielsen (Member)]: Why can't we buy this building with the opioid fund money?

[Theresa Wood (Chair)]: I'm sorry

[Todd Nielsen (Member)]: why can't we buy this building with the opioid fund money?

[Theresa Wood (Chair)]: Well that's what's being proposed this is all talking about everything we're talking about right now is opioid settlement money So that's what is being proposed. We're not using general fund dollars for this.

[Todd Nielsen (Member)]: That'd be good if you fall apart, money can go back into the cover.

[Theresa Wood (Chair)]: Well, that's a question.

[Anne B. Donahue (Ranking Member)]: We refer to that. Yes.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: We could it could be reverted.

[Doug Bishop (Member)]: Vice chairman?

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Yes.

[Doug Bishop (Member)]: If I could confirm my understanding is when the legislature first passed this bill or language related to putting this into one fund, there were four primary focuses for how the money would be spent, one of which was the center. The Burlington Center, was one of four things that were selected in my

[Katie McLean (Legislative Counsel)]: Are you thinking about last year's opioid bill, where the first four items said that it was the intention to continue funding those items? Is that what you're thinking about?

[Doug Bishop (Member)]: It may be. Was that something new as of last year?

[Theresa Wood (Chair)]: Yeah.

[Doug Bishop (Member)]: Was developed over time. So we are not necessarily

[Katie McLean (Legislative Counsel)]: Yeah. You're not bound. I think it was intent language. It's the same language that is in B, 1B, 2B, right? Or not

[Eric Maguire (Member)]: 2B. So

[Nolan Langweil (Joint Fiscal Office analyst)]: if I can jump in, right, Christian? That Brazil always is one time funding? Right. And so they had an intent because they wanted to remind themselves, yourselves,

[Eric Maguire (Member)]: of what your priorities

[Theresa Wood (Chair)]: So I have another

[Doug Bishop (Member)]: I'm sorry, you reference again where you're directing me in

[Katie McLean (Legislative Counsel)]: Yeah, so if you look at section one, Subdivision 1B, there's this language that says it's the intent of the General Assembly that these physicians shall be funded annually. In last year's or Opioid Abandon Special Fund Bill, the first four subdivisions had language like the that says it's our intent to continue funding these these specific purposes. So I'm wondering if that is what you're thinking Among

[Doug Bishop (Member)]: those four was this site. Can

[Theresa Wood (Chair)]: Say that? I don't remember it

[Anne B. Donahue (Ranking Member)]: being there.

[Doug Bishop (Member)]: For some reason, I thought recovery residences. There were four things including the cover edsons, and I thought one of the four was

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Let's see. Alright.

[Anne B. Donahue (Ranking Member)]: Because we didn't know if it was actually gonna be

[Doug Bishop (Member)]: I see.

[Eric Maguire (Member)]: We we didn't have any plans at last year.

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: Right. We didn't

[Anne B. Donahue (Ranking Member)]: know if it was gonna get there or not. We was very uncertain even last year. And now, I mean, they're going through with aspects of it, not with the original at this phase. Right?

[Doug Bishop (Member)]: Well, they needed to do certain activities on-site before doing the safe injections. Right. That's what I think. And so

[Anne B. Donahue (Ranking Member)]: this You're is we're not doing the safe injection site piece of it yet.

[Doug Bishop (Member)]: That's I that's

[Anne B. Donahue (Ranking Member)]: what I'm share

[Doug Bishop (Member)]: with us.

[Katie McLean (Legislative Counsel)]: Go ahead, Katie. Last year's Act 16, you have the 1.1 to the Department of Health for the purpose of awarding grants to the City of Burlington for establishing overdose prevention, etcetera. Then in that corresponding subdivision B, it is the intent of the General Assembly to continue to appropriate funds from the Opioid Abatement Settlement Fund through fiscal year twenty eight for the purpose of awarding grants to the city of Burlington for the operation of the Overdose Prevention Center unless and until the special fund does not have sufficient monies to fund this expenditure.

[Theresa Wood (Chair)]: So 03/28. So I have another clarifying question. I think in the original legislation, didn't we call the OPC a pilot?

[Eric Maguire (Member)]: I

[Theresa Wood (Chair)]: remember. I would have to pull

[Katie McLean (Legislative Counsel)]: that up. That would be the first year that any money was appropriated from it. So let me take that.

[Theresa Wood (Chair)]: I just remember us talking about a pilot program. So that's my other question, is if we're buying a building, how does that kind of jive with a pilot program that may not

[Eric Maguire (Member)]: reach? And that language, to say one more thing, that language from last year probably explains why they didn't expect that vacation because the intent is there, and so they vote.

[Anne B. Donahue (Ranking Member)]: Yeah. But we do that.

[Theresa Wood (Chair)]: Yeah. But other other things that were in that intent language, people apply. They they apply.

[Eric Maguire (Member)]: Others did. Right. Just suggesting that perhaps, you

[Nolan Langweil (Joint Fiscal Office analyst)]: know, Yeah,

[Anne B. Donahue (Ranking Member)]: that could be an explanation. Believe

[Eric Maguire (Member)]: that was the language in Acts 73 from 20 to 31 that it was languaged as a pilot. Right, so we should, we could go back and take

[Theresa Wood (Chair)]: a at that.

[Nolan Langweil (Joint Fiscal Office analyst)]: Think we fund

[Theresa Wood (Chair)]: Act 01/1978.

[Eric Maguire (Member)]: That was close. 01/1978, in which year

[Nolan Langweil (Joint Fiscal Office analyst)]: Yeah, was Act It's '22. '22?

[Doug Bishop (Member)]: I would think that we '23. We fund That

[Theresa Wood (Chair)]: was the first year.

[Doug Bishop (Member)]: Shorts with us. Hope that they'll be successful. I would assume. So I guess one of the points I'm driving at and asking the questions that I am about what language have we included in the past about our intentions? Again, that's intense, bound by it. But if it was part of the

[Nolan Langweil (Joint Fiscal Office analyst)]: act, I think,

[Doug Bishop (Member)]: A, it requires special scrutiny. If we had expressed a past intent, we should be giving it fair airing. Doesn't mean we're going to include the funds. But also recognizing, I think this was probably most controversial part of the bill. So again, it requires more attention than we can give to it today for sure.

[Theresa Wood (Chair)]: So we need to hear more from Burlington and the partner organization about the details that Nolan so elegantly put out. Thank you, Nolan. Do folks have, are folks okay with the reversions? Can we put that to bed?

[Doug Bishop (Member)]: Yes. Yes.

[Theresa Wood (Chair)]: Anne might have it. Okay. I think we're okay with the reversions. So we need to continue work on determining the discrepancies and programs and discrepancies and the amounts.

[Doug Bishop (Member)]: Can I ask a question about one of the asks? Yes. Thank you. The department included 250,000 for emergency shelters, line four on Nolan's chart, sustained services to meet needed guests and emergency shelters for transportation. I'm trying to determine whether there's any interplay with DCF's housing initiative, as they've called it in the budget book, and regarding OEO, HUB funding, or substance use recovery sheltering options, and there's 1,200,000.0 there. I'm just not sure if they're talking about the same shelters, or these are a broader set of shelters that they need the $250,000 for to ensure services are provided.

[Theresa Wood (Chair)]: Can we get some clarity from DCF on that question?

[Doug Bishop (Member)]: It says that it's administered via MOU with VDH and OEO, with VDH information on

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: that. I'll defer to DCF.

[Nolan Langweil (Joint Fiscal Office analyst)]: The other thing to keep in mind, if you look at the notes, it said funds would only be used for services and supplies that are otherwise built for Medicaid funded other state sources, so it's probably helping to supplement what they're doing over there, in areas where they are just falling short of taking the money.

[Theresa Wood (Chair)]: We have a couple of minutes left. Can we just go through the spreadsheet, at least the ones where the recommendation from OSAC and the health department were the same, say, whether we agree with that recommendation or not. So the first one is outreach and engagement staff at all preferred providers. That's 455,000. It's an existing initiative, and that is being recommended by both entities. It looks okay with that. Yes. So Katie, that one's a check. Okay. So I think that's the only thing that

[Eric Maguire (Member)]: It's number seven. In the Arnold sheet.

[Theresa Wood (Chair)]: Okay, so prevent program VDH. So one thing to keep in mind is the five on top have been existing programs and everything to pass number six is new funding. So these are probably new programs. And given that this is one time funding and limited time and amounts, keep that in mind, right? So like what happens in a few years when we run out of money? Can these programs sustain their operations without the support of opioid settlement money? Go ahead.

[Eric Maguire (Member)]: Yeah. And and along with what you're saying right there, there was didn't we have a conversation earlier about this notion that perhaps we might wanna consider at this point funding only the ongoing projects and not actually starting new ones just in keeping in mind what the how the the sustainability of the fund itself. So that's just something else to keep in mind. We we haven't even had that conversation about what we think about that idea, trying to persist or extend the life of the fund overall as opposed to just spending the money.

[Doug Bishop (Member)]: An observation I would share just the way I've been thinking about it is that the department, BDH and partners have sketched out I think a vision for recovery residences that includes the funds here, the funds that we're spending with GF, funds that we're looking to spend from the rural health transformation. So I have an inclination as I look at the differing amounts and the categories to go with VDH recommendations with respect to recovery residences only because I think they have built it into a larger strategy and they have a more complete window into those goals than perhaps the advisory council had access to. Things have been evolving with World Health Transformation funds and vision in particular that the advisory council didn't have.

[Eric Maguire (Member)]: Just the picture. So

[Theresa Wood (Chair)]: are you specifically talking about number two on the

[Doug Bishop (Member)]: Well, I think it's a grouping of two, three

[Theresa Wood (Chair)]: And five. So five, they didn't make any recommendations there.

[Doug Bishop (Member)]: They didn't make a recommendation, but where the amounts differ, two, three Two, six. And I think 14, they spoke to in their letter follow-up. Again, about a vision that they have, and it's not to leave out those communities, but it's part of a bigger vision. So that's just a viewpoint that may help move some of these. I'll I'll say that we did reference number five, the scholarships. I don't know that what we received yesterday spoke specifically to that request,

[Eric Maguire (Member)]: whether the department spoke to that request or not.

[Theresa Wood (Chair)]: So some of the testimony we heard this morning referenced that.

[Doug Bishop (Member)]: It did. It did. Some of that moving.

[Theresa Wood (Chair)]: What's that?

[Doug Bishop (Member)]: I said, and I found that persuasive. That's why I hold that one aside a little bit from what

[Eric Maguire (Member)]: I said. Also the notion that if the, I don't know the right acronym, but the new money that we're finding, if it's available in some ways for this, wouldn't it just, and we don't have clarity about that yet. We have probable, Doug suggesting probable insight. There's insight probably, but it seems like we're moving too fast on this in a certain way. There are ways we could use that money now for the next five years.

[Anne B. Donahue (Ranking Member)]: Just bunch of rural health

[Eric Maguire (Member)]: Yeah, seems like you want to be able to use that money now and maybe let this money either use it for slightly different purposes or not use it at all.

[Theresa Wood (Chair)]: Well, health department made some recommendations around, which I sent to everybody about shifting and

[Eric Maguire (Member)]: Well, I'm sorry

[Nolan Langweil (Joint Fiscal Office analyst)]: for that.

[Theresa Wood (Chair)]: No, no, that's okay. That's another piece of the conversation. Was

[Doug Bishop (Member)]: that you or was that were you referencing Theresa's email yesterday afternoon at one? Yeah.

[Nolan Langweil (Joint Fiscal Office analyst)]: Yeah. And

[Doug Bishop (Member)]: in that, it actually does suggest that we do not follow post tax recommendation with respect to the scholarships because they thought they would use rural health transformation dollars. I think the timeline for using those funds may be a little bit later. That may be one that we consider splitting to get through the first half of the fiscal year.

[Theresa Wood (Chair)]: How do folks feel about Doug's rep opinion about the recovery residences and the grouping of so I'm in agreement with taking recommendations for number two, three.

[Anne B. Donahue (Ranking Member)]: Are the numbers

[Theresa Wood (Chair)]: Yeah, same at the spreadsheet. Yeah. So number three is peer recovery services and corrections. Yeah, so the health department is recommending a slightly higher amount than OSAC did. Same with number two, the department is recommending a lower amount than OSAC did, and an agreement that we follow the department's recommendation.

[Anne B. Donahue (Ranking Member)]: Okay, I thought we were talking about residents, the recovery residences and that's recovery services. Yeah, well, you're bundling them together, that's fine.

[Theresa Wood (Chair)]: Okay, yeah, all the support for the recovery residences. So we are good with number two with the health department's recommendations.

[Jubilee McGill (Member)]: I'm not good with that. Based on the testimony we heard this morning, we really heard that this would harm our recovery residences and their ability to build out. They were asking us to go with a full recommendation is by the committee. And I just, yeah, I think that deserves more of a conversation. And I, yeah, sorry, I'm very sorry, but so having trouble articulating, but that that is one. I'm fine with number three, but number two, the reduction in funds to support recovery residences is just not something I would agree with.

[Theresa Wood (Chair)]: We can put it in because it's moving elsewhere versus not moving elsewhere. This is just the department is recommending a lower I amount of

[Doug Bishop (Member)]: guess in the context, Jubilee, I was putting it in the context of additional funds that weren't necessarily part of the conversation within the abatement special funds, and that is rural health transformation and an increase to base this year, that I do think the VDH and the state share the goals of expanding the residences that the advisory council has with respect to putting the 1.75. So I guess I'm not feeling as concerned as I think I'm hearing from you that it's not going to allow the building out of additional assets.

[Jubilee McGill (Member)]: I think we've run into that same thing you raised though, of the rollout of those funds, and are we blocking progress in the meantime? I don't know. I would like to have a chance to connect with the recovery partners and hear from them, I guess. So I just don't feel like I can vote on this this one. And if I did, it's to not support it right now.

[Nolan Langweil (Joint Fiscal Office analyst)]: About thirds. Yes.

[Theresa Wood (Chair)]: Go on, go ahead. Brenda, I see your hand. I'll get to you.

[Nolan Langweil (Joint Fiscal Office analyst)]: I just want to just flag that being what we're talking about the existing program, I would also refer you to the sheet in the age report that talks about unobligated versus obligated. So for recovery residences, there's still another 140,000 that has not been obligated. So there is money potentially still sitting there. So we think about how much more money you're going to give them, think about also there's still money that I have appropriate for this that hasn't gone to this process. So there's that money. The other option you have is you don't have to go with either recommendation, you can pick a number at the minute.

[Anne B. Donahue (Ranking Member)]: So I'm just refreshing my memory on the letter and I mean we're grappling around with how is this recovery housing being addressed in different funds. And what the Department of Health is saying is it won't be ready by the end of the week, but they a They are going to present a full budget for RHD recovery housing to the committee. It just won't be ready by the end of this week, which is our timeline But they are planning to present that whole vision of how this all fills in, unfortunately, we don't have it yet. Brenda, go ahead.

[Brenda Steady (Member)]: I have to head out because it takes me over an hour to get there from Milton, but I just wanted to give my 2¢. When you mentioned the the new request, my past practice as a select board member, school board member, these places will still want to exist, and I have a feeling they'll be coming asking for property tax, the taxpayer moneys in the future. So I'd be very careful about voting for those because I've seen it happen in school systems. That's why we're in the mess we're in with grants and then they keep the people, the money from COVID. They kept the people, and now we're all struggling paying our taxes. So I'm heading out, and I wanted to just put in my 2¢, and I'll see you guys in a minute in an hour. Okay,

[Theresa Wood (Chair)]: be careful.

[Brenda Steady (Member)]: Thank you.

[Theresa Wood (Chair)]: All right, it is noon. Katie, thank you. I appreciate you being here. We can go off live and we'll pick this up, I don't know when next, but soon. And

[Jessica Chittenden (Health Policy Director, Vermont Department of Health)]: we have a

[Theresa Wood (Chair)]: joint