Vermont Legislature SmartTranscripts:

[Jill Abrams (Office of the Vermont Attorney General)]: Wow. It must be brutal in here when it's Thursday and hot.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: So it's such a new time. Okay.

[Rep. Theresa Wood (Chair)]: Zero. Thank you. Objective date. Okay, folks. So we are back live. Welcome to House Human Services. We are going to be taking up 8,660, a bill that left our domain here many weeks ago, which is an act relating to fiscal year twenty twenty seven opioid abatement special fund appropriation. So have with us Jill Abrams from the Attorney General's office. And the reason that we have Jill, other than it's very nice to meet you As well. Is there have been some questions to come up during June down in the Senate, the deliberations, and the acceptable uses of the funds according to the settlement agreement. And so the AG's office is the entity that negotiated as part of the negotiating part of the settlement agreement. And there have been some, perhaps I don't know if disagreement or that might be too strong of a word, but some questions back and forth between the health department and the attorney general's office and Legis Council. And so we thought, Okay, because six sixty has a lot of changes from the Senate. We want to make sure that if we agree or disagree or whatever actions that we take, that our ultimate action is going to be consistent with the settlement agreement. So we've asked Jill to be here to make sure that we are clear about the settlement agreement and any actions that we take. And you might recall, we had a bunch of prevention stuff that we wanted to go to a different fund, which we'll talk about when we see the bill language back. So welcome, Jill. I think we should just do a quick round of introductions because this is your first time in our committee. I'm Theresa Wood. I'm from Waterbury, and I also serve Bolton's BUILDESCOR and Huntington.

[Rep. Daniel Noyes (Clerk)]: Hi. Good afternoon. I'm Daniel Noyes. I represent Wilkie, Hyde Park, Johnson, and Belvedere.

[Rep. Eric Maguire]: Hi. Good afternoon. Eric Maguire. I represent Washington City. I'm a Colchester for his age.

[Rep. Zon Eastes]: Hi. My name is Zon Eastes. I live in Guilford, and I also live in Vernon.

[Rep. Esme Cole]: Hi there, I'm Esme Cole of Hartford.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Hi, I'm Rey Garofano, I represent Essex and Essex Dodgers.

[Jill Abrams (Office of the Vermont Attorney General)]: So nice to meet you all.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Thank you. And we keep going all the

[Rep. Theresa Wood (Chair)]: way around the outside of the room, nobody gets away.

[Jill Abrams (Office of the Vermont Attorney General)]: All right, we're sitting here in the choir for the city's assistant. David Mickenburg. Know each other. Nice.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: And Sheila. I'm

[Rep. Theresa Wood (Chair)]: sorry, I didn't see you, blind Eric.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: And

[Rep. Theresa Wood (Chair)]: Rep Steady and Rep. McGill, you want to introduce yourselves.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Rep. Steady, East Milton Westford.

[Rep. Theresa Wood (Chair)]: And I think Representative McGill was having problems with her. Oh, there she goes.

[Rep. Jubilee McGill]: Yeah, sorry. I was getting off my phone and now on my computer. Hi, I'm Rep Jubilee McGill, and I represent Breedport, Middlebury, New Haven, Weybridge.

[Rep. Theresa Wood (Chair)]: Nice to meet you. Thank you. Now the floor is yours, Jill.

[Jill Abrams (Office of the Vermont Attorney General)]: Okay. Well, I'm not exactly sure where to start, so maybe I'll give sort of two minutes of background about the reason that we entered into the settlement and what the settlement is intended to provide for, because I think that might just be I'll be fast. So the states and the various opioid defendants, and you all know we settled with lots of different companies, all had the same goal in mind, which was to remediate the opioid crisis. And so folks wanted to make sure that the money that came from the settlement went for that goal. And folks also recognized that opioid abuse doesn't generally exist in a vacuum. There are often co occurring other health problems, other kinds of substance abuse, mental health problems, homelessness, whatever the range of issues may be. So we set out to create a document which is an exhibit to every single opioid settlement, which people have come to refer to as Exhibit E, because it's Exhibit E to every single opioid And I gave a link to Laurie. And I apologize, I guess you didn't have it before now. Oh, Okay. So Exhibit E has two parts, Schedule A, which is referred to as core strategies, and Exhibit B, which is approved uses and a little inside baseball. The exhibits were switched. It should have been in the reverse order. So Exhibit B is the one that we really focus on because it refers to approved uses.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: And you'll see in the introduction that it says the goal to support treatment of OUD and co occurring substance abuse disorder or mental health conditions through evidence based or evidenced informed programs or strategies that may include but are not limited to the following. And the reason for that language is that

[Jill Abrams (Office of the Vermont Attorney General)]: among the states that were party to these settlement agreements were places like Vermont, where we already were grappling with the opioid crisis and had some pretty good structures in place. But there were lots of other states around the country that literally had no infrastructure. And so if we just left that first paragraph in Vermont, we we would have been okay with it. But in other places where they had no idea where to start, they said, could you please give us some examples? And so the purpose of the following pages is to give examples of ways that the money could be used, but it's certainly not restricted to those. We, as a group, those of us who put together exhibit e, consulted experts who included John Brooklyn from Vermont and folks from BDH because our Department of Health was recognized as one of the national experts. So thank you, Sheila and your colleagues. And what was important to the group, and as it was explained to us by the folks that we talked with, the words evidence based or evidence informed is simply a way of saying forward thinking, we don't know in ten years what the opportunities will be to help address opioid use disorder or the co occurring problems. We assume that there'll be lots of new things that come along. And so we just want to make sure that those things meet the current scientific research criteria. So that's the reason for those works. The most important thing from the state's perspective, and again, the reason that it has this prefatory language, is flexibility, because the opioid crisis may look different in Vermont than it does in West Virginia. The way it occurs, who it happens to, does mental health come first and opioid use disorder come second, all of those different variables differ in parts of our state and from state to state. So it really was conceived to be a way to address OUD and the co occurring problems. So that's kind of the backdrop. And I don't know if there are some specific questions that I should be answering. I'm just not exactly sure what you'd like me to talk about, but I'm happy to address whatever I can.

[Rep. Theresa Wood (Chair)]: Well, think that, I guess one of the things, Katie has joined us now, so that might be helpful. One of the things that came up is, I hear you say that what we were looking for was as much flexibility as possible. But it seems also that there are limits to that flexibility in some cases. And I guess I'm just trying to we're trying to make sure that what we appropriate from these funds meets the settlement requirements. And that seemed to come into question a little bit. And not having reviewed this part since we first passed the bill, I don't know, maybe five or six years ago now. I'm not exactly sure where those things that were coming into question that we were wanting. Mean, because I look at these things and I see some of the things that maybe I thought were in question, but I see them listed here as appropriate uses, like prevention, for instance. I'll use that. We have another whole fund for prevention, which is why we wanted those funds to be over there. But that seemed to be one of the things that came up as a question mark. Katie, do you have any additional insight into that whole conversation we were having back a week or so ago?

[Rep. Esme Cole]: Sure, I think that some of the questions had to do with substance use disorder that wasn't opioid use disorder and the extent some of the funds to be used just generally for substance use disorder. And then some of the items that were removed from the opioid abatement special fund, now they're in the substance use prevention fund, the extent to which those could be funded with opioid vaping special funds. So some examples from that list are supporting the creation of a low barrier drop in teen center to provide food activities, positive adult role models, peer counselors, prevention recovery programming, and direct connection to treatments. Youth engagement and education and expand prevention, clinical staffing and youth programming space in response to community needs. Community based therapy and housing, crisis, medical recovery and employment supports. Let's see, stipends for partners to deliver medicine safety education to elementary age use? I think those are some of the ones

[Jill Abrams (Office of the Vermont Attorney General)]: you've Yeah, so I know this seems very broad, but it really is flexibility. If I look at Do we have the exhibits? I can just read out. If you look, for example, at E. So I would say yes to all of those things.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: And

[Jill Abrams (Office of the Vermont Attorney General)]: so here's an example. I'm not sure if it totally tracks with the example you gave, but it was the youth, I think you said drop in center. So this might be So just looking at the examples, and again, all these pages, there's a lot of stuff in here and there, all examples. On E6, list C says connect people who need help to the help they need. So that says provide connections to care for people who have or are at risk of developing OUD and any co occurring SUD, MH condition conditions. So, again, the conception really was, and I won't name the state, but in another settlement many years ago, the tobacco settlement, there was a state that took a chunk of its money and built a bridge with it. And so people were appalled. Around the country, people were just appalled. And so that was the first example that came up when we started creating this document, was to make sure that people are directing the funds to the right place. And so that's why it's so broad. It's not to say that every single one of these things are your only choices, but that you're aiming at the population who is most likely to be touched by opioid use disorder and recognizing that it's really hard, someone has a difficult family situation or homelessness or mental health problems. I'm not a scientist or a person who's expert in treatment, but just from what I know from this case in creating this document, what we were told was there are lots of different pressures on people that lead to opioid use disorder. And some of those pressures are a child who's living in a home with parents who have some sort of substance abuse problem, or someone who is homeless or someone who doesn't know anything about drugs. It's kind of intended to be really flexible. So the idea that if some of the money goes to a program that is funding an array of problems that are related, that that would be okay. And it's really hard to say exactly a list of specific things. But I don't know, does that answer the question? It's a tough question to answer specifically, but it's way better to think, I think, big picture. So there's one eighty eighty five. Yes, sorry. On page E12, number 10, and this is under yeah, number 10. So it says So for example, is school based or youth focused programs or strategies that have been demonstrated effectiveness in preventing drug misuse and seem likely to be effective in preventing the uptake and use of opioids. So again, if you look at a kid who may be in a situation that is going to have a problem and might lead to opioid use, that's a way to use the money. So somebody who is at risk for opioids or a co occurring condition. Number 11 has to do with programs or curricula that address mental health needs of people who might then become exposed to the possibility of opioid misuse disorder. And it says, or other drugs. Or other drugs, yes. So there are a lot of places in here that say and or substance abuse disorder or mental health. I think the experts who helped us create this helped us create it with a mindset that all of these things tend to be related, and it's very, very hard to tease one out from the other. And you never know. It's sort

[Rep. Theresa Wood (Chair)]: of like which one comes first. Right. And I think that one of the things that I want to call people's attention to is the lead in at the beginning of Schedule B, which is evidence based or evidence informed. Okay, those are scientific terms. And I just am calling attention to those two things because while there's quite a long laundry list and there's lots of flexibility with that, not everything that some of us might think of in some of these areas are evidence based or evidence informed. And I think that's why we went to folks like BDH and the similar organizations around the country in different states. And we asked them what language should we put in, because we were hearing about

[Jill Abrams (Office of the Vermont Attorney General)]: franchise is the wrong word, but there were these treatment centers around the country started popping up that you would pay a lot of money for, and it wasn't really clear that they had a specific plan. You couldn't really tell what the basis of their treatment was. And so what the experts said is this is a common term, and it will remain a common term. So maybe someone will come up with something that sounds very strange today, but in ten years or however long it takes, there'll be enough experience with it to show that this is demonstrated to be affecting us. So it was really to rule out the

[Rep. Theresa Wood (Chair)]: sort of one off, super experimental, perky. I'm bringing it up because I'm not sure that I don't know. I have never sat in on one of the advisory committee's meetings. I don't know to what extent they have that discussion and that. So I'm just calling it out. The other thing I just wanna ask a a quick question. So I'm seeing the way I'm understanding this is that everything in in schedule b is allowable, but the priorities are those things that are in schedule a, the way I'm reading it. Yeah. So and again, for a state like Vermont, I think we've probably ticked off. I mean, Sheila knows better than I do, but I think we've already done all those things. And again, in other states where they had no structure, they never tried to approach the problem, hadn't done anything, and just had no way to know where to begin. Amy, did you have something else you wanted to ask?

[Rep. Esme Cole]: Oh, I was curious about the lead in in Schedule B II, as it reads, Support treatment of opioid use disorder and any co occurring substance use disorder and mental health conditions. So it sort of reads as though that a substance use disorder or mental health treatment that was going to be covered with opioid abatement monkeys would have to be co occurring with an opioid use disorder.

[Jill Abrams (Office of the Vermont Attorney General)]: Yeah, and I think that was probably imperfect drafting. It probably would have been better to say and or, I think, or had a comma. I think the idea was to group those things together because often in real life, they're grouped together. But I don't think it means necessarily, it's so specific to a program. So if you had a program that says, this is strictly mental health, that would be questionable. But if you have a program that says mental health, because some people may be exposed to these other things, like

[Rep. Theresa Wood (Chair)]: one that I read off before, then it would

[Jill Abrams (Office of the Vermont Attorney General)]: be included.

[Rep. Theresa Wood (Chair)]: This is more informational.

[Rep. Esme Cole]: In statute, there's language that says that the fund has to be used exclusively for opioid use disorder recovery prevention treatment. I was just looking at the patients and they just approved an amendment that would track this language in B and co occurring substance use disorder and co occurring mental health. So if the committee's intent is to use the money broader, and you might be interested in ripping that when we spend some time with it.

[Rep. Theresa Wood (Chair)]: Okay, thank you. Okay, do you have anything else, Jill?

[Jill Abrams (Office of the Vermont Attorney General)]: Unless you have other questions.

[Rep. Theresa Wood (Chair)]: I think we're good. Thank you so much for being here. Of Appreciate it. And for people who weren't here when we created the statute, this is the first time you're probably seeing this list of things. So it's helpful background for people. Yes, go ahead, I think one other thing.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: I'm embarrass her. So just for those of us who don't know, Jill Abrams is instrumental in Vermont having this money and getting this money

[Rep. Golrang “Rey” Garofano (Vice Chair)]: and retiring in June.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: And I just want to thank her for all being critical to me even get to have this conversation. Wow.

[Jill Abrams (Office of the Vermont Attorney General)]: So she did. It's been a long time.

[Rep. Theresa Wood (Chair)]: Thank you. Thank you, Jill, and best wishes to you. Okay, Nolan, you're up next.

[Rep. Daniel Noyes (Clerk)]: I also want to thank Jill. She's always been super responsive whenever I have questions. Thank you.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: I have some for you too. All

[Rep. Daniel Noyes (Clerk)]: right, for the record, Noel and I will have the joint fiscal office. I think rather than go over the bill, I'm gonna give out my sheet, updated sheet. This is kinda give you it's a side by side. The chair has one.

[Rep. Theresa Wood (Chair)]: I understand you updated it. Yeah. Yeah.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: So I'll take a new one.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Oh, I'm sorry. Oh, Right,

[Nolan Langweil (Joint Fiscal Office)]: thought what I would do is instead just walk me through the sheet, and then Katie can walk me through the bill. As you've seen this before, I just have the BDH recommendation, the OSAC, what the House did, the Senate Health and Welfare did, and I added another column about SAC and the reason, I'll explain that in a second. So I'm just gonna flag the differences, which are highlighted in red. So the first difference, and by the way, these numbers on the side do not match the section numbers. They're just listed for this, but the section numbers are different. The other sheet does, but this one's not section so just confused. The first one is the recovery centers. The Senate Health and Welfare decided to put, they put $800,000 in for the recovery centers. And of course, since those were funded in the past, those are all in the far right column, just to reorient you with the sheet that just shows the previous. If they were in the bill, either version of the bill, and they were previously funded, I flagged that on the far right. The second piece is the Opioid Recover Employment Program. That's the hireability. Sorry,

[Rep. Theresa Wood (Chair)]: before you move to that, I think there are 800,000 in 26 for recovery centers?

[Nolan Langweil (Joint Fiscal Office)]: I don't think I have a 26. Well, maybe I missed that. Okay. Oh, it's on the prevention front. That's why I missed it.

[Rep. Theresa Wood (Chair)]: Oh, it's in the prevention That's

[Nolan Langweil (Joint Fiscal Office)]: why I missed it. Thank you. Okay.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Eric?

[Rep. Eric Maguire]: Is that $800,000 for the recovery centers, the request that they made for $1,600,000 and we only funded $800,000

[Nolan Langweil (Joint Fiscal Office)]: You didn't fund anything from the

[Rep. Eric Maguire]: request we made, recovery centers from the 1.6, we funded 800,000 into our recommended suggestions.

[Rep. Theresa Wood (Chair)]: In '26. The House did not recommend anything for recovery centers, either in the budget or in this bill.

[Rep. Eric Maguire]: No, that's what I'm saying. Yeah. You're just saying it was in the recommendations from OECD. Yeah, it was in recommendations, but we had a fund.

[Rep. Theresa Wood (Chair)]: It wasn't in the recommendations.

[Rep. Eric Maguire]: 1,600,000 was requested. Requested. Not write OSAC didn't recommend No. There was no the 1.6 no. This was not for 1.6 requested to OSAC.

[Rep. Theresa Wood (Chair)]: Right. I'm just I was just trying to to to track. We didn't recommend funding because BDH didn't recommend it and OSAC did not recommend it. So we did not recommend it either.

[Rep. Eric Maguire]: No. Never came recommend. Yeah. Alright.

[Rep. Theresa Wood (Chair)]: But they requested it from OSAC. And that's why it did not appear in the house budget because nobody prior to us in terms of the recommendations along the line had recommended it.

[Nolan Langweil (Joint Fiscal Office)]: I saw this was important to one of the senate members who really wanted this on the committee. That's why I was asking.

[Rep. Theresa Wood (Chair)]: Let's move on to 6B.

[Nolan Langweil (Joint Fiscal Office)]: 6B, hireability. So if you recall, there was $875,000 in the gov rec and in the house budget, the Senate in trying to put together a construct for funding primary care, who's looking for places to come up with a budget neutral solution. Anyway, long story short, they recommended putting us back into the opioid abatement fund for one more year with an acknowledgement of the fact that this committee and BDH have talked about how when programs in the fund show proven success, they should become base. So they have intent language sort of acknowledging that and intent that this should be based next year, just not this year. So this money would go back into the opioid abatement fund. It's not actually in this bill, but I have it on the sheet because it's a balance sheet. And then you have, they added in the 1.1 for the OPCs. And then there was some movement around recovery beds. They did 600 for the recovery beds and then 600 for the opioid disorder residential treatment beds at the American Addiction Society level 3.1. And then they decided to fund the public safety enhancement teams with $287,000 And then in the end, I think you, so many of you have heard about what had happened. This committee had recommended that these four items, Elevate, Greater Falls, Interxion and Winooski, be funded with substance misuse. In the end, at the time, we were told there wasn't any money left in the fund. It goes over to the Senate and we hear now that there actually would be somewhat enough money to fund it. So the Senate is putting it back to your recommendation of using the substance misuse fund. And so that would happen on this bill, so as you recommended. And those are the big changes. So everything in red are the changes. Then there are some language changes too that Katie will flag when she walks through the bell.

[Rep. Theresa Wood (Chair)]: Okay, go ahead, questions. Go ahead, Eric.

[Rep. Eric Maguire]: That is why I was getting to the, because act 113, 2024, dollars 1,060,000, their recovery services. Dollars 1,000,060, what fund were they, which one is it? That was in the So

[Rep. Daniel Noyes (Clerk)]: if you look at the top of that, you'll see an act 113. That was in the budget bill, but it still came out of the fund. So what I did was I tried to flag all the previous appropriations from the funds regardless of what bill. So you can see Act 16 was an opioid bill, 113 was a budget bill, 178 was an opioid bill, etcetera. So this is, I was trying to track any of the appropriations that were in any of the versions of the bill that passed, tried to track if they

[Rep. Golrang “Rey” Garofano (Vice Chair)]: had been funded in the past and aware. But don't have 26 on here.

[Rep. Daniel Noyes (Clerk)]: I I don't have 26 on here, I guess not. Isn't that what Act 16 was? Act 16, I think I just missed 800,000.

[Rep. Eric Maguire]: I don't know. That's 25, but it was for '26. Yeah, so I think I

[Rep. Daniel Noyes (Clerk)]: just missed 800.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Which one is it then?

[Rep. Eric Maguire]: Act

[Rep. Daniel Noyes (Clerk)]: 16 is fiscal year 2020

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Oh,

[Rep. Theresa Wood (Chair)]: it's 2026.

[Rep. Daniel Noyes (Clerk)]: Think Yeah, the year

[Rep. Golrang “Rey” Garofano (Vice Chair)]: it's the year that it passed. And what did the Okay, so we

[Rep. Daniel Noyes (Clerk)]: think I'm just missing a recovery center appropriation, But but this is all the funding, all the spending.

[Rep. Eric Maguire]: And how much in Act 16, it was recovery center?

[Rep. Daniel Noyes (Clerk)]: I don't know. I didn't see it there, but I'm being told, getting a head shake that it was. And so I think this one that I missed because this is one of the things that they added, and I didn't go and cross reference after the fact to see if it So was embedded I think that's where it was just an oversight on my part. You guys are always kissing my ears.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: It's our job.

[Rep. Theresa Wood (Chair)]: Are there questions for Nolan? I it's, and maybe we'll ask Katie these, I don't know, the 7A, do you have any other further information on 7A? No, there

[Rep. Daniel Noyes (Clerk)]: was an earlier version, Katie, correct me if I'm wrong, there was 900,000 and then there was a 300,000 for

[Rep. Eric Maguire]: That's right, there were these two levels of three point one and three point

[Rep. Daniel Noyes (Clerk)]: one. That's what they did. So you could see 7B, it was $903,100. And then at one point, I think they were combined them to 1,200,000. And then the Senate said, no, no, no, let's do six hundred and six hundred. And they added in the 7A, and I don't know the story behind that. I'll let maybe

[Rep. Esme Cole]: So your numbers don't line

[Rep. Theresa Wood (Chair)]: up for me. Are we in such

[Rep. Golrang “Rey” Garofano (Vice Chair)]: a good six week on

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: the system?

[Rep. Daniel Noyes (Clerk)]: These numbers don't line up.

[Rep. Theresa Wood (Chair)]: We're under new funding.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: If we're talking about recovery, think

[Rep. Esme Cole]: it left here 900, 300. It was combined for quite a while in functional care as 1.2. And then right before they voted it out, they switched, they made this change to be six hundred and six hundred, with the second 600 to the Department of Health for Opioid Use Disorder Residential Treatment Beds at American Society of Addiction Medicine Level three fifty one.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: And I think that is based on our request for some of the applicants.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Okay. I mean, much.

[Rep. Theresa Wood (Chair)]: Well, I mean, the health department asked us for some flexibility in recognizing that, yes, we were going to be looking at 3.1 and above. Any other questions for Nolan? He's got

[Rep. Golrang “Rey” Garofano (Vice Chair)]: to be off. Is

[Rep. Theresa Wood (Chair)]: there any other questions for Nolan before he's done? Okay. All right, Katie, thank you. I think I'm just wondering what I guess it would make sense for you to go through what the Senate so far has done. And then for us to hear from the health department about their thoughts about what the Senate has done so far. Not that they thought our bill was tremendous, but maybe

[Rep. Golrang “Rey” Garofano (Vice Chair)]: they did. I don't know.

[Rep. Theresa Wood (Chair)]: Maybe they like the Senate version better. I don't know. We'll find out.

[Rep. Esme Cole]: And

[Rep. Theresa Wood (Chair)]: just, committee members, be aware It has left appropriations now, but there could still be a floor amendment or something when it gets to the floor. So it's just got that caveat on it. So

[Jonathan (Office of Legislative Counsel)]: thank you, Katie. Okay. Jonathan, Office of Legislative Counsel. It's nice to see everyone. So what you have on your web page is a highlighted version. There are different colors of highlighting that is sort of meaningless for your purposes. It was meaningful to Senate Health and Welfare before they voted it out. But I worked really hard to try to retain the highlighting throughout their process to make it easier for you to see what their changes worked. So we've added some reader assistance headings. And then I'll scroll down. What we were just talking about was the Subdivision 6, which is the 600,000, and then a Subdivision B with another 600,000 for residential treatment beds at American Society of Addiction Medicine level three point one. And then we have some renumbering of the list. We have 800,000 to the Department of Health for distribution to recovery centers, $2.87 to the Department of Public Safety for providing, sorry, to provide funding for expanding public safety enhancement teams, harm reduction and strategic community intervention efforts. Katie, I'm

[Rep. Theresa Wood (Chair)]: sorry to interrupt, can we go back to, maybe it's just the time of day and my low sugar, to the recovery residences. So we sent it over nine and three? Yes. We believe so. Okay, that's what he's got on here. And I'm recalling this well, I'll wait till Sheila comes up, I guess. I'm recalling them asking for these amounts to be combined. Sheila, would you like to comment?

[Jonathan (Office of Legislative Counsel)]: I can say more if

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: I don't have up there. But they combined them and sent out health and welfare first to be the 1.2, which Then is what we had they split it. I want to be really clear that what's up there, 600 is for recovery residents is SBS. The new 600 is for recovery, is for treatment. It's not for recovery residents. Is a substance use treatment,

[Rep. Daniel Noyes (Clerk)]: which is

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: very different than what we were talking about previously. I can go into more detail there, but I wanted to just say that. And then lastly, the way it's worded right now is not doable. We cannot do what it says.

[Rep. Theresa Wood (Chair)]: Okay, so we'll get to you when you do that. All right.

[Jonathan (Office of Legislative Counsel)]: Okay. So we are in Subdivision 10800000 for the Department of Health for distribution to recovery centers. Subdivision 11287000 to the Department of Public Safety to provide funding for expanding the Public Safety Enhancement Team's harm reduction and strategic community intervention efforts. In Subdivision 121.1 to the Department of Health for the purpose of awarding grants to Burlington to establish an overdose prevention center, provided, however, that the department shall not distribute funding till the location for the overdose prevention center has been procured by lease or purchase. The overdose prevention center is being fit up for its intended use and the overdose prevention center is currently or will imminently become operational. And then we have language that we had in previous acts that it's the intent of the General Assembly to continue to appropriate funds annually from the Opioid Abatement Special Fund through at least fiscal year 2028 for the purpose of awarding grants to Burlington for the operation of the Overdose Prevention Center unless and until the Special Fund does not have sufficient monies to fund this expenditure. Last year said 2027 should have funding through 2027, and this year, says through 2028. No changes to section two. Nothing to section three right now, but there is an amendment that affects Section three. Section four, the Opioid Settlement Advisory Committee shall not accept funding proposals from the Opioid Abatement Special Fund for fiscal years twenty eight unless a proposal was previously identified in statute as intended for annual funding. That's highlighted, that's actually your original language. They had another idea, they went in a different direction and then came back to your language. So the blue is more closely aligned with what you sent out. And then there's this new language, if funds are available after making fiscal year twenty eight appropriations, recommendations for previously funded programs and initiatives, the Opioid Settlement Advisory Committee shall identify specific areas of focus and shall make funding recommendations within those areas based on needs assessments and statewide data rather than requesting new proposals.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Sounds like a Department of Health request.

[Jonathan (Office of Legislative Counsel)]: Section five, this is new. This is quarterly reporting. So this requires the Department of Health to submit to the General Assembly quarterly reports regarding expenditures from the Opioid Abatement Special Fund. Specifically, the report shall identify funds appropriated from the Special Fund that remain unobligated or unspent or both, and shall include an explanation as to why the funds have not been fully distributed. Reports due on 10/01/2026 and 07/01/2027 shall be submitted to the Joint Fiscal Committee. Reports due on 01/01/2027 and 04/01/2027 shall be submitted to the policy committees and approves. The department shall post reports required to go into this section on its website. Section six is reversion, so that hasn't changed. And then there's this new section seven that has taken some of the appropriations that had been in the list of the opioid abatement special fund appropriations and moved them down to the section seven coming out of the Substance Misuse Prevention Special Fund. So these are not new appropriations to the bill, but they're new to which fund they're coming out of. Section eight is language in the Substance Misuse Prevention Special Fund, the existing language in the green books. It's adding a new subsection that says, As part of its annual budget presentation, the Department shall report to the House Committees on Appropriations, Human Services, Health and Welfare on its specific spending proposal from the Substance Misuse Prevention Special Fund for the coming year. The report shall include an estimate of the monies in the special fund anticipated to remain unallocated at the end of the fiscal year. Effective date, reader assistance heading, and then changing the title. You actually had this title when it left your committee. And it's relating to fiscal year 2027, Opioid Abatement Special Fund and Substance Misuse Prevention special fund appropriations. So that's what came out of Senate Health and Welfare. Just Senate appropes just approved an amendment. I can show it to you if you would like to see it.

[Rep. Theresa Wood (Chair)]: Would that be easiest?

[Jonathan (Office of Legislative Counsel)]: Okay. Instances of amendment. First, it strikes section three of the bill and then puts a new section three in. Your subsection C that you amended hasn't changed. What's new is subsection E, changing presentation to recommendations, because this is all about the recommendations of the committee. The first subdivision one is about recommendations from the advisory committee. Subdivision two is about recommendations from the health department when they're not aligned. So this is just adding in language that asks the advisory committee to develop recommendations in consultation with the Office of the Attorney General. Same concept in subdivision two, if the department does not agree with the recommendations of the advisory committee, it may separately submit its own recommendations developed in consultation with the Office of the Attorney General to the General Assembly. So that's sort of what is happening now in practice, that if the advisory committee and the health department, if their recommendations aren't aligned, they submit those recommendations separately. And then the second instance of amendment is the one I was referring to earlier. So this is the language that's currently in statute. Let's see. The special fund, it must be utilized exclusively for opioid prevention, intervention, treatment recovery and harm reduction services. So that's what's currently in statute. And then picking up on the language in Appendix E, adding co occurring mental health conditions and co occurring substance use disorders. So if you would like that broader, then this will have to be changed when it comes to you. Or if you're happy as it is, then you're good. But that's where that language came from. And that's it.

[Rep. Theresa Wood (Chair)]: Okay. So we're not going to debate any of these changes right now because we're going to wait until the Senate passes it. But do you have any questions for Katie on understanding language that she just went through. Go ahead.

[Rep. Eric Maguire]: The general question with that language you had up at the very end there, would I be understanding this correctly is that we can, as a state, decide to distribute funds more narrowly than in the agreement, but we can't be any broader than what's in the agreement.

[Rep. Esme Cole]: It can't be any broader than

[Rep. Eric Maguire]: what's The in the Senate's proposal to narrow from what we're currently doing.

[Rep. Esme Cole]: Well, right now, technically, you only have authority to do opioid prevention, intervention, recovery, and harm reduction services. It's limited to opioid use disorder. Okay. And the Appendix E, that lead in language that I read from, allows for co occurring mental health conditions and co occurring substance use disorders to also receive funding. So this language, this change that Senate approves just voted on would allow for funding for those purposes, tracking that Appendix eight.

[Rep. Eric Maguire]: Okay. Respect to the prevention, it's just who viewing.

[Rep. Theresa Wood (Chair)]: Thanks, Katie. Appreciate it. So folks, just so you know where we're headed with this, we will wait to see what the Senate passes and if there's any further amendments to the bill. So appropriations, it will be unnoticed tomorrow in the Senate. If they get to their full calendar, they might get to it on Thursday. Who knows? Yeah, doubtful. We probably won't get it back till next week is my guess. So we will need to act quickly on this. And so I'm urging you to be thinking about all the changes here. So now we're going to hear from the health department about what they think about the Senate proposed changes.

[Rep. Eric Maguire]: It just sounds a wonderful question. Is this a situation where we can either concur with the Senate or not concur?

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: We're not going to concur with

[Rep. Eric Maguire]: the Senate. I mean, no, I mean, a committee of conference is The probably the

[Rep. Theresa Wood (Chair)]: timing is quite tight. So yeah, we will, if we do not concur, then we'll ask for a committee of conference.

[Rep. Eric Maguire]: Yeah, okay, thank you. And just what that possibility charges would be name then.

[Rep. Theresa Wood (Chair)]: Yes, and if we get to that point, if for some reason people think that we don't need to do anything and we can concur, that would be one thing. If people have thoughts about what the Senate did, we'll go to a committee conference and I will likely ask for representative from the House Appropriations Committee to be on that committee conference because the budget will be in this discussion and some of this impacts the budget. So they will I've already talked to the chair there, and she's agreed to that, pending the speaker's approval, of course. So welcome, interim deputy commissioner or acting. I'm not sure what it is. So how many titles are going to have? I say that with all affection.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Hello. Thank you for having me. I'm currently the interim deputy commissioner in the health department. Don't worry, I will be back to my previous role, hopefully, in the coming months. All good. You do a

[Rep. Theresa Wood (Chair)]: good job wherever you are there. Thank you.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: If it's Okay, I'll just run through our response to the Senate version, try to clarify a couple of things. And I do want to start with the thing that's my biggest concern, which is around what Katie has brought up around limitation. So that is not how the legislature or the health department has interpreted the use of the fund to date. Whether right or wrong, I am not a lawyer. Of all of my roles, that is one that I do not hold. So I won't question that. But I think what Jill presented earlier is how we have interpreted it, which is that it is for opioid use, but it is also for substance use, prevention, treatment, recovery, intervention, harm reduction. I cannot. We at the health department, if we truly limit it to only opioid and co occurring with opioid, then I can offer you health services, naloxone distribution. Maybe those two things. I don't know how to do it for everything else. Everything else we do. The point of what we're doing is working on prevention, intervention, treatment, recovery across substances. It is integrated with mental health. So when you think about recovery centers, they don't quiz you when you walk in the door. Like, Okay, I'm going to bill. I've got a line item bill you. So how do you come in? So I'm just, In terms of responding to the Senate version, I'm telling you, I need your help. I can't implement what is here on paper if it's limited to only opioids. And I guess

[Rep. Theresa Wood (Chair)]: the way I'm reading and understanding what the Senate did was they actually broadened it. They only did say opioids before. So why do you disagree with that?

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: I need it broader. I see. If we Exactly. Okay.

[Rep. Theresa Wood (Chair)]: Well, and it's very helpful to have the AG's office go review that, because I remember when we did the bill. I would say that I felt like, at least at that time, and Dan was there too. Think we're the only- Are you here? Yeah, you were here too. Yeah.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: We were very

[Rep. Theresa Wood (Chair)]: told that we had to be very narrow in the legislation about the use of the fund. And in reading the attachment that the AG's office just gave to us, I think that it's prouder than that. So, alright, so we'll take a look at that.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Thank you.

[Rep. Eric Maguire]: Can I ask a clarifying question? So would you say that we, as a state, are currently acting more broadly in current statutory language, but within the agreement? Okay. We need you would are you recommending that our reality statute catch up with our reality?

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Please. Okay.

[Rep. Theresa Wood (Chair)]: Okay. Now what can you tell us about these treatment

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Alright. Go through the list here. All right, let's do treatment beds first. So the state very recently worked with Valley Vista, who had closed their Brijen site, to reopen their Brijen site with level 3.1 residential treatment. So this is treatment. It is not recovery housing. It is paid for by Medicaid and insurance. And we really dearly needed more. And we almost doubled our capacity when Virgins opened. And it's possible that we will need more in the future. We have two positions here. While we might need more in the future, we need just a minute to let that Virgin site open and see what the actual demand is. And secondly, if we use OSAC money to fund ongoing treatment pressures, that is highly problematic long term. That was going to

[Rep. Theresa Wood (Chair)]: be my question, I guess. So it's a Medicaid insurance service. What we fund here are things that are not generally allowable with those services. So that troubles me, not the existence of it or the need to potentially expand it. And other than through Medicaid and whatever other arrangements we reached with Valley Vista, we didn't give them any extra money to develop this. And so it's a business decision and a funding decision and a capacity decision about whether we need more 3.1 beds. Judge would probably say yes. And I guess what I would okay, that's all I needed to know. I mean, I think that we are not opposed to the

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: concept of potentially needing more in the future. And we are actively currently exploring what that need might look like and what it could look like in the future. The second thing I will say about this is we asked for $1,200,000 And we asked for that, and I came in and I asked for flexibility. And I'm coming back to you, and I'm saying I know a lot more now about rural health transformation funding. And we need that $1,200,000 in recovery housing specifically so that we can leverage and use the Rural Health Transformation Program money. Because that money cannot be used for anything bricks and mortar or renovations that are larger or any of those other pieces. So if we are going to be able to take advantage of that funding for Vermonters, we need that $1,200,000 in here on recovery housing specifically, not on treatment. So I'm asking you, please, to re put it back into 1,200,000 for recovery housing. You guys had had it broken out in the nine and three, and the three was just specific regions. So again, not opposed to those regions. Happy to work with those regions. Really asking for the flexibility in that 1.2 bucket so that we can assess. So if the need is, assess where there's opportunity to develop this important resource for Vermonters. So please, please restore that. Get rid of the treatment for now. Put that 1.2 back together for the recovery beds. Overdose Prevention Center. Understand.

[Rep. Theresa Wood (Chair)]: I was gonna say

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: it was very agreeable. You're gonna have to

[Rep. Eric Maguire]: Take it.

[Jill Abrams (Office of the Vermont Attorney General)]: Take it. Easy. Interim deputy title does it all.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Overdose Prevention Center. We said this in our recommendation, we'll say it again. We don't think they need more this time. We don't think they need more at this time. They have a lot of carryforward.

[Rep. Theresa Wood (Chair)]: We're gonna be hearing from them Yep.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: That's really all there is to say there. Recovery centers. Recovery centers. So we do not recommend 800,000 for recovery centers out of this funding source. I know they got 800,000 last year out of SNPF. This is a new request for an additional 800,000. I would love from Nolan to get a full picture. And we are actually asking right now to put a report in to our technical bill, which you guys passed last year. So don't worry if you don't remember that bill. Is down in Center Health and Welfare. We want to do a full report with the recovery centers in partnership of all their financials across departments and the Department of Health so that we all have a much stronger understanding of their budgets and their budget needs and their ongoing budget pressures. Last year, that was supposed to be one time money. Is this one time money? It also should not necessarily be their base funding. We did not recommend this, and we do not recommend it at this time, not because we don't support recovery centers. We 100% support recovery centers. But we need to have a much firmer grasp on their overall budget across the agency. They get money from DOC. They are getting money in this bill already. You'll see up on the peer recovery services through DOC. That's 1,250,000 out of this fund for recovery services through the DOC. So that is our position on So that money actually I

[Rep. Theresa Wood (Chair)]: I guess I'm not sure I need that. That money actually goes to recovery centers, the DOC money?

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Yep. Four. Number four.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: That's awesome. We totally support that program. Yeah. I I just sort of

[Rep. Theresa Wood (Chair)]: was thinking it was somehow different. So a question on the reporting and the other sort of language things that were added downstairs. The financial reporting is fine. We're happy to

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: do that. We're trying to work on how we best communicate with you all around what is or isn't in a fund and what the pressures are. And tried to do that a little bit with this fund earlier this year with you all, and and totally open to that. That's fine. And I think

[Rep. Theresa Wood (Chair)]: we recognize there's been delays in getting money out as Thai this language is appearing to be.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Yes. And I think that some of the bigger projects are really getting caught up. And so you will start to see some more true ups, which will make it easier to know what the pressures are and which

[Rep. Theresa Wood (Chair)]: way is up. Anything else you want to comment on?

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Yes. Sorry. Number nine, PSET. We do support the inclusion of that. And another really big important one is the prevention money. So here's another fund that has a lot of different moving pieces and pressures on it. We did just like the chair said, we came in. We said there's not money. Went downstairs. They said, well, now it can't be funded here. It can be funded here, etcetera, etcetera. These four prevention projects look like really great projects. We did not recommend them. We, the health department, did not recommend them in our set of recommendations. Right now, using the Substance Misuse Prevention Fund, we are working closely with Vermont communities using data, needs based analysis, and community input to figure out how those communities need and want spend that money to do evidence based and evidence informed prevention. That money in '27, using that system, is fully booked. That said, we do appear to have interest or carry forward from '26. So we could use one time money to fund these projects this year. But prevention, I wanna remind you all, is not a one time expense. Prevention takes years to build. It is such an important system for our state. We cannot do one offs. And so they will come back and ask for money again. And I will not have money in the future for these projects. So I just want to really highlight, it's not about the projects themselves. It is not about and I apologize about the care forward versus not care forward. That is on us. But we don't have ongoing funding for it out of this fund. So I am very worried about the ongoing need for these projects. If we start them up, it's very wasteful when we start up projects and then stop funding them. I think we recognize that, and that's part

[Rep. Theresa Wood (Chair)]: of the reason for the pause next year on funding of anything new. That's for OSAC. Those prevention funds? They're out

[Rep. Golrang “Rey” Garofano (Vice Chair)]: of the prevention fund.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Thank you. Yes, I appreciate the pause.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: We

[Rep. Theresa Wood (Chair)]: had a big presentation from the health department and the PL or

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Vermont prevention lead organizations, the VPLS. Yep.

[Rep. Theresa Wood (Chair)]: You never know where the L comes before the P or vice versa. And so I am sure that that is all good work. We are also interested in them really reaching out to other entities that they might not necessarily have considered in the past. And we're not guaranteeing any funding to any of these four organizations on an ongoing basis, but we are encouraging those lead organizations and the health department to look broader than just what has been sort of the focus. And we talked about older Vermonters and prevention and adults and prevention and had a good dialogue with people.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: That's So There was also they released a needs assessment just a week ago or this week that was a statewide needs assessment as required by one of the federal grants, but it was for all of our prevention work. And I think that can also be I can share that with the committee. It can also just exactly like you're saying. Where are the holes that we're still really seeing? And where do each region need to lean into? Where does the state need to lean into? So yes, I definitely I want to be really open to feedback on how that process works, just a deep ask that we work through the process and not on more one off projects so that we ensure effectiveness of the money.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: I would also wonder, and I don't know where this fits in, but as you know, each municipality also gets funding. From OSAC. Yep. Or OSAC. From the big settlement. So where does that play in to all of this work as you're standing up these regional needs assessment, how do we incorporate what those municipalities are doing? So just putting that on your radar, because right now it's a big gap and this unknown of what each town is doing with them. Some are doing a better job at transparency than others, but there is funding out there that nobody really knows what's happening to it.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Yeah, for folks watching online, that's the other funding source, that's the OSAP. But these could be

[Rep. Golrang “Rey” Garofano (Vice Chair)]: allowable uses for those funds. A lot of people can then have them save

[Rep. Theresa Wood (Chair)]: fund when they could be done with a local fund.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Yeah, and we don't control that, but we can inform that.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Right, yeah. It should be part of the of And we could ask for

[Rep. Theresa Wood (Chair)]: a recording of that. I'm sure the Vermont has done Somewhere. Vermont City has done that. Okay, Sheila, thank you very much. Any last questions for Sheila? Okay, we're gonna see her back.

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Last thing, we want the hireability money back in the base budget, because that is part of our weaning off of the Yeah.

[Rep. Theresa Wood (Chair)]: Thanks for listening. Thank you. Thank you. Appreciate it. Okay, folks. I want people to be able to get downstairs to the unveiling

[Rep. Eric Maguire]: of

[Rep. Theresa Wood (Chair)]: the new portrait. So we will take up the two resolutions tomorrow at some point, we'll fit them in. And we have 46. We have oh, yeah. We have to do that now, actually. That is Yeah. Sorry. Briefly.

[Jill Abrams (Office of the Vermont Attorney General)]: We could request. Do

[Rep. Theresa Wood (Chair)]: we have you back tomorrow at any time? In the afternoon with House, Inspections and Institutions. Okay, that's something different. Okay, I just don't want to I'm sure they won't get started right in time. So let's go with the forty six.

[Rep. Esme Cole]: Okay. I don't have a highlighted copy. I have my own hard copy, but not an electronic one. So if you have the draft online

[Rep. Golrang “Rey” Garofano (Vice Chair)]: We do.

[Jonathan (Office of Legislative Counsel)]: Okay. I will start sharing, but my computer is about to die. So we'll see how that goes.

[Rep. Theresa Wood (Chair)]: That's okay. We can look at it and have it.

[Jonathan (Office of Legislative Counsel)]: So the changes were in Section two. This is the rare disease advisory council. Two, subsection B is the membership of the Advisory Council. Subdivision B1A, the appointing authority changed, and it's now being appointed. The two individuals with rare disease, at least one of whom is an older Vermonter, is now being appointed by the Commissioner of Health. I think many of these previously were appointed either by the Pro Tem or the Speaker. Subdivision two, also being appointed by the commissioner of health. Subdivision f, being appointed by the commissioner of health. Page three uh-oh. Our pages probably don't line up. Subdivision I, the appointment of a pharmacist practicing in Vermont, appointed by the Vermont Pharmacists Association, is a change. And J, the appointment by the Commissioner of Health, is a change. And then there's a new subsection K, subdivision K, any other persons deemed necessary by the Commissioner of Health. And then subdivision two is new language that members of the advisory council shall be appointed for staggered five year terms. Any midterm vacancy shall be filled by the appointing authority for the remainder of the unexpired term. Terms shall begin on January 1 of the year of the appointment and conclude on December 31 of the last year of the member's term. Members serve multiple terms, either consecutively or intermittently. Instead of shall, in Subdivision 3, the advisory council may

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Okay, I'm just gonna close this. And

[Jonathan (Office of Legislative Counsel)]: then subdivision C3. New language and consultation is the new language with experts on rare diseases, comma, develop new language and provide policy recommendations that, and subdivision A, identify conditions, new language, for the Department of Health to consider as part of appropriate screening guidance and recommendations. And then that brings us to subsection D, a new sentence that the department shall maintain a web page on its website that contains notices of upcoming meetings, meeting minutes, public comments and reports. That was moved from elsewhere in the draft. Subsection F, subdivision three, there is an added cross reference to the Vermont Open Meeting Law. That is new. And then all of section three is new. So long COVID resources for primary care providers and patients. On or before 01/01/2027, the Department of Health shall collaborate with the University of Vermont Medical Center, the Vermont Medical Society, and patients with lived experience of long COVID to first identify existing evidence informed standards, best practices and training for primary care providers regarding long COVID and distribute these resources through the department's website and to primary care providers. And secondly, in collaboration with Dale, identify support services and other resources for long COVID that include a range of peer supports and community based programs, such as long COVID support groups through the University, Vermont Medical Center, the Vermont Center for Independent Living and or another entity, and strategies to support patients who are homebound or at risk of becoming homebound. Then, subsection B here, on or before 02/01/2027, Department of Health in collaboration with Dale is to present recommendations to the policy committees on providing long term disability supports to individuals experiencing long COVID. And then we have a definition of long COVID. So that is the new language. Thank

[Rep. Theresa Wood (Chair)]: you, Katie. So members, we're not going to consider this. We can do that tomorrow before the floor when we can have any kind of discussion that people want. So that was sort of the fastest

[Rep. Esme Cole]: set of the run through that we did.

[Rep. Theresa Wood (Chair)]: We'll do this before floor tomorrow so that Dan can perform. Oh, it's you. You. He said it was him. I was going with Penn at it.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: Oh, was it you?

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Not him, but I

[Rep. Theresa Wood (Chair)]: don't know. We'll figure

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: out who it is. Good job about it. Well, we'll do it.

[Rep. Theresa Wood (Chair)]: I'll Yeah. Take the picture.

[Rep. Golrang “Rey” Garofano (Vice Chair)]: I'll do it.

[Rep. Theresa Wood (Chair)]: It was Ray?

[Sheila (Interim Deputy Commissioner, Vermont Department of Health)]: Yeah. I know. That's if you wanted to

[Rep. Golrang “Rey” Garofano (Vice Chair)]: mark that. LA1. Introduce them. Oh, that's why. Yeah. That's why I'm thinking. I report this.

[Rep. Daniel Noyes (Clerk)]: Yeah, okay, cool.

[Rep. Theresa Wood (Chair)]: Okay. Thank you, Katie. Appreciate And we'll see you back tomorrow. Or not here, but downstairs. Yeah. Okay, folks. So we're going to log off here and enjoy your evening. The torture unveiling is downstairs, and we'll see you back here tomorrow at 9AM.