Vermont Legislature SmartTranscripts:

[Theresa Wood (Chair)]: Okay, good morning folks. We're going to take a change of topic six sixty, which is the opioid settlement bill. Lori, And do we have a new draft? It's on our website. It there? It's there. It's there. Do you? Oh, miss Katie? Oh, no. It's nothing. I didn't know who it was. Okay. So refresh if you have it open, and open up Friday and open up six sixty draft 4.1.

[Anne B. Donahue (Ranking Member)]: 660 draft 4.1.

[Daniel Noyes (Clerk)]: See. Nolan,

[Theresa Wood (Chair)]: before we move, so there's been some discussion back and forth with the health department about the syringe services, which on our great spreadsheet that you put together has down at the bottom, the contingency management syringe services and OPC as to be funded, but not this year. There seems to be some ongoing issues that the communication between the syringe service providers and the health department about access to that current eight fifty. And so what I've asked Katie to do is to include eight fifty in here, and because there is funding to do it, and it is one of the four areas that we said that we would fund on an ongoing basis. If that number needs to be adjusted as it moves downstairs, then it can be adjusted. But I don't have specific information from the health department to say what portion of eight fifty it might be. So we're gonna go with what the last year's funding was. And representative Maguire and representative Eastes have met with the health department. They've asked about this particular issue.

[Eric Maguire (Member)]: Maybe the two of you want to share anything that you might have learned or if it still left you with more questions, which is sort of what I understood. Still processing it, but it has left me with more questions. In a nutshell, it seems that there has been a significant amount of this money not yet allocated to the services. Therefore, the decision was made to not use this $8.50 because there was already a significant amount of funding left over in that bucket. Thing is, though, that money is is obligated and allocated to the things. They just haven't received it, and those adjustments have not been made in the grants yet, which still leads well, why would we not have access to the upcoming funding? So I am in 100 support of putting this in there. That way, they do have access. The reasoning behind why it has not been made available is still unknown to me.

[Theresa Wood (Chair)]: Do you have anything to add to that?

[Anne B. Donahue (Ranking Member)]: Other than the I think our decision last year to not fund it or not include it is was not indicative of what the money was available. It just didn't get out of the house.

[Eric Maguire (Member)]: And so, yeah. So

[Daniel Noyes (Clerk)]: Katie, could you walk us

[Theresa Wood (Chair)]: through draft 4.1, please?

[Katie McLinn (Legislative Counsel)]: We have a draft 4.1 on the website. You'll see it has a watermark that says draft. The editors are looking and preparing a clean draft now. Section one is your appropriations. In fiscal year '27, the following sums appropriated from the Opioid Abatement Special Fund. In Subdivision 1, you have 455,000 to the Department of Health 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 in settings such as police barracks, shelters, social service organizations and elsewhere. And then B, you have the intent language. This is the same language that was in Act 16 last year, an Office of Appropriation. Subdivision two, dollars 1,600,000.0 to the Department of Health for recovery residency certified by VTAR. And then you have the intent language again that it would be funded annually at not less than the fiscal '27 level. Subdivision three is $850,000 to the Department of Health for Syringe Services. It's the intent of the General Assembly that this will be funded annually, not less than fiscal year 'twenty seven levels. That was supposed to be the injection site I pulled from the wrong section. I'll have to go back. I'm sorry. I'll keep going and then I'll go back and correct it. 1,100,000.0 to the Department of Corrections to provide peer recovery center coaches in Vermont correctional facilities and in probation and parole offices to provide group and individual coaching and reentry support, which will not be used to cover administrative expenses. Can I ask you question?

[Theresa Wood (Chair)]: I'm sorry, I don't understand what you said. You have to go back and fix. This was supposed to

[Katie McLinn (Legislative Counsel)]: be the I pulled from Act 16 too quickly. This was supposed to be the injection. And I pulled syringe services. They were both $8.50, I guess. But the injection said It is syringe services. Did it not specifically say injection? I have to go back. Is that what you wanted, syringe services? I thought you wanted injection.

[Theresa Wood (Chair)]: Are you talking about OPC? Yeah. No.

[Katie McLinn (Legislative Counsel)]: Is is syringe. I did it correctly.

[Theresa Wood (Chair)]: I was like, I don't know what you're gonna change because it looks okay to me.

[Katie McLinn (Legislative Counsel)]: Okay. Good. I'm sorry. I was reading it, then I like, oh, I pulled the wrong thing.

[Theresa Wood (Chair)]: You're not putting the OPC in there.

[Katie McLinn (Legislative Counsel)]: Thank you. Sorry to create confusion. That was my fault.

[Theresa Wood (Chair)]: No worries.

[Katie McLinn (Legislative Counsel)]: We're on Subdivision 41.1 to DOC to provide peer recovery center coaches in Vermont, correctional facilities and in probation and parole offices. Right group, we just did this one group, and individual coaching and reentry support, which will not be used to cover administrative expenses. Subdivision 5250000 to the Department for Children and Families, 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 six is 1.2 to the Department of Health for the creation of new recovery residents beds at NAR level three or higher in geographically diverse regions of the state? Yeah, if

[Golrang “Rey” Garofano (Vice Chair)]: I'm remembering wrong, that's fine, but I thought we were combining from another area, is where the geographically diverse. Wanted the specific. You wanted the specific, okay.

[Theresa Wood (Chair)]: No, yeah, we wanted the specific Brattleboro Mid Bear Addison.

[Golrang “Rey” Garofano (Vice Chair)]: Well, maybe, but that's not what I was raising. I thought that we didn't want to lock because it was combining too, but we didn't want to lock in 100% of that money to have to be level three or higher.

[Anne B. Donahue (Ranking Member)]: I remember too. Yes. I'm gonna say the same thing.

[Katie McLinn (Legislative Counsel)]: Yes. That's accurate. So just strike level three or higher? Yes. And then bring in the towns from the other that were listed previously?

[Theresa Wood (Chair)]: Oh, no. No. No. Because we actually are wanting specific this is to create that level that's with insufficient beds in the state. Yes.

[Anne B. Donahue (Ranking Member)]: Yeah.

[Theresa Wood (Chair)]: So we we want at least 1,000,000 or 900,000 of that to go towards creation of that Right. Level three. But But higher. Right? Still for

[Eric Maguire (Member)]: They've already got a significant amount of allocations in regards to those recovery beds. That that number, I would recommend level three or higher remains because that is directly specified to a a level of of service that is rather not as adequately funded as the other That's not

[Golrang “Rey” Garofano (Vice Chair)]: the committee says. The committee said 900,000 for the level three and 300,000 for the broader new recovery residences in that list of geographic areas. The department just asked us to combine these. So

[Theresa Wood (Chair)]: the reason they have 1,200,000.0 is because they combined

[Katie McLinn (Legislative Counsel)]: The 900 and the three Okay.

[Eric Maguire (Member)]: Okay. So

[Theresa Wood (Chair)]: we're meeting their same recommendation. Mhmm. So we want at least 900 of it to go to the level three

[Katie McLinn (Legislative Counsel)]: Yes. Or higher at least or a third 900. So I expect to

[Theresa Wood (Chair)]: Eric, I wanna make sure you're on the committee there. But

[Eric Maguire (Member)]: Yeah. 900,000 to level three or higher, and then the 300 For those geographic lists. Okay,

[Katie McLinn (Legislative Counsel)]: I'll make that change.

[Theresa Wood (Chair)]: When we add the towns, can add or other identified areas, so it's not just, know, don't get blocked.

[Katie McLinn (Legislative Counsel)]: Seven to 248,000 to the Department of Health for the pre hospital Vermont EMS Buprenorphine Treatment Prevent Program to expand training for emergency services providers on carrying and administering buprenorphine after administering naloxone. Subdivision eight, five thousand to the Department of Health to subsidize room and board for individuals in Rutland Mental Health Services Transitional Housing Program. Subdivision 9237646, to the Department of Health for distribution to the Springfield Project Action, public safety enhancement team coordinator positions in Bennington, Springfield, Brattleboro, Saint Jay, and Central Vermont for the purpose of providing administrative support, meaning facilitation, data tracking, outreach, slide over those for now. Section five is a new section since you've last seen it. This is a permanent amendment in the Opioid Settlement Advisory Committee charge. This subsection C lists the powers and the duties of the advisory committee. And then there's a sentence added towards the end that says each funding proposal considered by the Advisory Council shall include a sustainability plan from the applicant to ensure consideration of future expenses and available resources.

[Theresa Wood (Chair)]: So I just have a question about that because we actually I guess that's a broad enough is that a committee, if that has broad enough intent for what we were looking for? Because some of the things that are funded this year are ongoing services. And so I guess I'm just trying to make it clear, you know, because we did hear feedback that people were surprised they weren't getting funded a second year, and it was obviously not a one year project.

[Zon Eastes (Member)]: So I guess I would Perhaps we add a clause at the end just clarifying that that this is considerations for future expenses and available resources absent or outside of opioid settlement abatement funds.

[Theresa Wood (Chair)]: Well, and it doesn't have to be each funding. It's it's each funding proposal that is ongoing in nature or something like that. Some of them are one time. Some of them are, like, start up, you know, resources and

[Anne B. Donahue (Ranking Member)]: just start off

[Eric Maguire (Member)]: with ongoing funding proposals.

[Theresa Wood (Chair)]: Funding proposals that are ongoing. That do not include the opioid settlement fund. Ongoing sustainability plan can't be more money for you. Are we done with that

[Golrang “Rey” Garofano (Vice Chair)]: sentence? Go ahead. So in this section with my deep apologies for forgetting to raise this until now, but I feel I've been very negligent in my duties in connection with the Health Equity Committee and the subgroup that's ongoing from it. And that is the reminder of our principles on the wall there and bringing them to every bill and looking at, is it relevant here and should we include some? Would like to include where we have the list of who needs to be involved or give input to the committee to add after substance misuse, oversight and prevention council. I'm sorry, it would be bottom of page six, top of page to add the Health Equity Commission. Not

[Theresa Wood (Chair)]: sure that's their name, but

[Golrang “Rey” Garofano (Vice Chair)]: I know know what you're

[Theresa Wood (Chair)]: Yeah,

[Katie McLinn (Legislative Counsel)]: know where it is.

[Theresa Wood (Chair)]: You might have any problems with that? No. Okay. Thank you.

[Daniel Noyes (Clerk)]: Yeah. Thank you. Yeah. Good. I guess.

[Katie McLinn (Legislative Counsel)]: Yeah. A new Section six fiscal year twenty twenty eight proposal suspension. The Opioid Settlement Advisory Council shall not accept new funding proposals from the Special Fund for fiscal year twenty eight, but instead shall review the outcomes of programs and initiatives previously funded through the Opioid Abatement Special Fund to assess effectiveness and long term sustainability where applicable?

[Theresa Wood (Chair)]: The only thing that I would add here is an exception for those four areas that we've said would have annual funding.

[Anne B. Donahue (Ranking Member)]: And so that sorry, but that makes me wonder up at the top of the and maybe I'm just not thinking correctly, but we have a b section under two of them talking about continuing forward, and then we don't have it any longer under the third and fourth.

[Theresa Wood (Chair)]: Can you can you give us a page

[Zon Eastes (Member)]: and line reference?

[Anne B. Donahue (Ranking Member)]: For instance, it's the b section that's inserted at the top of page two is the intent of the general assembly to fund annually. We have that for the first two, number two a and three a, but we don't have that same language of four a four and five, and I don't know whether we should. Four being on line eight. Line

[Theresa Wood (Chair)]: eight. So the outreach and case management staff. Yep. It has that language. The recovery residences has the language. The syringe services has the language. And the only one that doesn't there's only four, and the fourth one is Overdose Prevention Center, and we're not doing that this year.

[Anne B. Donahue (Ranking Member)]: I see. Okay.

[Eric Maguire (Member)]: There we go. There we go.

[Daniel Noyes (Clerk)]: Well, we're just looking

[Theresa Wood (Chair)]: It may go back to us. We're looking for four. Yeah. The fourth one is the OPC.

[Anne B. Donahue (Ranking Member)]: Thank you.

[Zon Eastes (Member)]: While we're there, two of the references say not less than fiscal year 2027 level, but one b, page one, is not It said shall be funded annually. I don't know

[Eric Maguire (Member)]: if that's intentional or not. It's just a difference of the same. Yeah. I actually like the more general language, Katie. The one

[Katie McLinn (Legislative Counsel)]: on page nine. Let's strike I'll strike out

[Daniel Noyes (Clerk)]: the reference.

[Theresa Wood (Chair)]: No. Name of the others. Yeah. They're beautiful.

[Golrang “Rey” Garofano (Vice Chair)]: Thank you. Yep. Thanks, Nawan.

[Zon Eastes (Member)]: And then a question. This proposal suspension I'm wondering if I'm missing something. We have that they're gonna suspend getting new proposals. Does that render moot our language above that we just talked about that that make sure there's a sustainability plan? Because they're not receiving new

[Golrang “Rey” Garofano (Vice Chair)]: Oh, for each funding proposal.

[Theresa Wood (Chair)]: No. But when they do, they have to have one with plan. That's just for f y twenty eight.

[Eric Maguire (Member)]: Looking

[Golrang “Rey” Garofano (Vice Chair)]: at Oh, that line would use in statute, whereas the This

[Theresa Wood (Chair)]: is gonna be in the in the yellow the white pages or whatever. Session law.

[Golrang “Rey” Garofano (Vice Chair)]: Okay. So the fiscal year only is

[Zon Eastes (Member)]: Section six is white book, the other

[Eric Maguire (Member)]: is green book. Right. Thank you.

[Theresa Wood (Chair)]: And we just we just amended that to say except for those four areas that we've committed to funding. Right. Okay. Yeah, go ahead.

[Eric Maguire (Member)]: I would assume anything, the opioid, the council committee, we will be responsible for establishing protocols and procedures in regards to how we will measure outcomes and programs. We'd be responsible for putting those mechanisms together, correct? Yeah, we've tried language last year.

[Theresa Wood (Chair)]: People didn't really pick up

[Zon Eastes (Member)]: on it.

[Eric Maguire (Member)]: Yeah, because I do remember the push to where we wanted to get some level of whether they are responsible for providing a report after six months that ended after one year, and all that did not. But it's like, what are the outcome measures?

[Theresa Wood (Chair)]: So are they, you know, is it, if it's around prevention, it's one thing, if it's around establishment, you know, I think it's different things. Alright. But yes, that way it would be it's not intended for us to do it.

[Eric Maguire (Member)]: Intended for yep. Yeah. Yeah.

[Esme Cole (Member)]: Go ahead. I'm just gonna raise my hesitancy. I know we discussed kinda putting these extra projects, these prevention ones over in the budget, and then now I'm just reading it. And the tight budget year, I don't know if you've heard any feedback from the departments on using those funds. Now I'm just concerned that we might see those really important projects, a lot of them that do speak at equity and that prevention aspect, which we don't see in these other ones, that they may disappear the final budget.

[Theresa Wood (Chair)]: Is it possible, Katie, to put it in both places? So to direct those projects be funded through prevention funds, but include them in here and also have a split language in the budget. I know it's not normally done that way.

[Katie McLinn (Legislative Counsel)]: That will work out fine if it doesn't get changed anywhere, it sort of is, know, duplicative in both places. But if it you know, if a number is changed in one of the bills, then

[Golrang “Rey” Garofano (Vice Chair)]: Maybe change it both.

[Theresa Wood (Chair)]: Yeah. I don't normally like to do it, but I understand what's being said, that people just don't see it. They're concerned about it. And we would be directive in this bill as opposed to appropriation. We'll hear whether appropriations will think it's a good idea or not. They'll give us feedback when they amend our bill. So if we could include it, that would be good.

[Daniel Noyes (Clerk)]: I'm going to say I'm sorry, but I wasn't here for this discussion for the pilot program for wound care. Will that be something that they're going to expect to be paid for after the ultra low funding cycle? It's on page It's the first time I must have missed it. Page four, number 14. Line 14. It's a pilot program and these ones aren't going to last forever. I don't want to see it pulled over for the general budget. Page four what? I'm sorry. Page

[Theresa Wood (Chair)]: four. Line 14.

[Daniel Noyes (Clerk)]: Could there be wording in there?

[Zon Eastes (Member)]: That's actually a reversion. That's money

[Katie McLinn (Legislative Counsel)]: that they're giving I like those.

[Theresa Wood (Chair)]: Right, if you look on your spreadsheet, the lines below the red, that's money they're giving back.

[Daniel Noyes (Clerk)]: Okay, thank you.

[Theresa Wood (Chair)]: You're welcome. Okay, any other questions or comments on this draft? Gayda will go work her magic, it'll go through editing, and then what we'll do is we'll vote on it this afternoon after our witnesses are here.

[Eric Maguire (Member)]: Okay. Do

[Theresa Wood (Chair)]: you need anything else, Katie? No. Okay. All right. So you're off until one and please, you know, back here at one and we have a couple witnesses and then we'll vote on this. Then that would be the end of our committee meeting Did for

[Golrang “Rey” Garofano (Vice Chair)]: you guys talk about the

[Eric Maguire (Member)]: question to let

[Theresa Wood (Chair)]: No, Laurie we didn't talk about that. But a reminder to let Laurie know, because she is the master scheduler and she has to work her magic. And remember, Monday is a holiday. So she will need to- She's unusual. She will need to send out emails as many as possible today so they see them. Okay? Can you copy? Yeah. Would you copy, Ray and I, with whatever you sent to Laurie? That'd be great just to have an idea of