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[Rep. Theresa Wood (Chair)]: Where's mine? Relax. Okay, we're back. This is age six sixty conference committee. Just actually, listen, we've looked through the proposal and we agree with everything. We have just one concern. And that is around the $1,200,000 that for the recovery and the AM beds, medical beds and the level three at the addiction medical. Here's our concern. We could put 1,200,000 in or we could split it and put 6 and six or whatever way of splitting it. Our concern is that the money go for some development of each type of Okay. That one more one isn't left out because all the money's given over here. Mhmm. Like, tomorrow, they don't. So that's our concern, and we're kind of wordsmithing around a little bit using the $1,200,000 that you have in. And, obviously, the way we have it, so many wordsmith, but it doesn't have the money related. So we're at that's our conundrums. I'm wondering
[Rep. Anne B. Donahue (Ranking Member)]: so in testimony from the health department, they, given the increase in that level three point one already on the treatment side of things, they did not present to us a increased need at this point in time for that. So you might have heard something different from Do I Yeah.
[Rep. Theresa Wood (Chair)]: What do we have in
[Rep. Daniel Noyes (Clerk)]: terms of
[Rep. Theresa Wood (Chair)]: level three point one addiction?
[Rep. Anne B. Donahue (Ranking Member)]: So, we certainly heard from Judge Reyce, I never know whether it's Rice. Rice, that of course was before the beds that opened up in Virginia's. Right.
[Rep. Theresa Wood (Chair)]: That's what they think. Right.
[Rep. Anne B. Donahue (Ranking Member)]: Did you hear from Valley Vista or
[Rep. Theresa Wood (Chair)]: We did informally. We did not have formal testimony, but we did hear from Valley Vista, and that this would be helpful for them.
[Rep. Daniel Noyes (Clerk)]: In recovery, Chad B. J. And surrounding house would be
[Rep. Anne B. Donahue (Ranking Member)]: the other three things. And so, do you have a alternate proposal that could leave it at the 1.2, but guarantees that there's some resources to We've been trying to find that language.
[Rep. Theresa Wood (Chair)]: If you want to help us with it, that'd be great. Otherwise, having the split of six and six is one way to do it. The other way, Katie, what was the other language that we had thought about? Here it is. We talked about 1.2 to the Department of Health for both the creation of new recovery beds and for opioid use disorder, SAN beds. There was mention of equitable distribution, but the struggle there was what exactly does equitable distribution mean? Certainly
[Rep. Anne B. Donahue (Ranking Member)]: it was our intent that it would cover both, that they would just decide, well, we're going spend it all on recovery residences. So, we can strengthen the language that indicates That it's for
[Rep. Theresa Wood (Chair)]: would work. If the intent is to cover both, that's powerful. That's legislative intent. And then have language that says, That's got and. Uh-huh. Yes.
[Rep. Anne B. Donahue (Ranking Member)]: Right. The Paramount for a decree of the copy. How did you say both, Katie?
[Rep. Theresa Wood (Chair)]: 1.2 to the Department of Health for both the creation of new recovery in our beds and for OBD residential beds.
[Rep. Anne B. Donahue (Ranking Member)]: I would be able to, I think I should confirm with my comperese, but Would
[Rep. Theresa Wood (Chair)]: you be able to do that? No. No. Yeah. Fair enough? Yes.
[Rep. Anne B. Donahue (Ranking Member)]: I think you're okay with that.
[Rep. Theresa Wood (Chair)]: That's my only question. Okay. What was your answer?
[Rep. Anne B. Donahue (Ranking Member)]: Our our initial yes. We'll be
[Rep. Theresa Wood (Chair)]: We're okay with that. If we inserted code. I'm gonna put the Department of Health on as well. Sorry.
[Shannon Livingston (Vermont Department of Health)]: Shannon Livingston, Health Department. So I think that the for the committee's consideration is what those funds are for for three point one. So we did just double our 3.1 capacity when we opened the Regence facility with Valley Vista, which is awesome and was needed and is exciting. We're still watching those census numbers to see how it adjusts out. Beside that, the language, if we
[Rep. Theresa Wood (Chair)]: have that language in there, would the Department of Health support funding for both of those?
[Shannon Livingston (Vermont Department of Health)]: I think it depends on what you mean. So Chad at at Serenity House, right, like, they need some capital improvements. They need some things that are problems that are not expanding, necessarily expanding beds. If the committee is looking at expanding beds, right, I don't know if it would be enough, number one. And number two, when we opened for Jen's back up with Valley Vista, that was a facility that we had budgeted for already. Right? They closed they closed the facility, and it was in our budget to provide that level of treatment. If we continue to expand 3.1 beds, I just want to caution the committee that that has a lot of other costs associated with it. It's not just here's the money to open it, which is what this money would be. It's then a match to treat the individuals there with Medicaid, and then it's also room and board, which we cannot fund with Medicaid, and we have to fund out of dental fund or a block grant. With the department not opposed to potentially expanding 3.1 treatment, that is something that might need to happen. The two things that we need to do first is watch what's happening right now with the full census and just get our feet under us and see what the demand is. And then we would need to come back, most likely, with what the full budget impact of ongoing room and board, ongoing Medicaid rates are. And so I think it depends. If if the committee's intent is that we support this really critical services and that we do some of the work that maybe is not funded by Medicaid, like facility. I
[Rep. Theresa Wood (Chair)]: know hear that. That the facility question is being debated in institutions. That's not what we're suggesting. We're talking about VATS and treatment. And I think if we have this language in here with the intent, we also have an opportunity through the BAA process to look at this. Now there's a strong there are folks who would like to have the funding go forward for both sets of beds. Can I ask
[Rep. Anne B. Donahue (Ranking Member)]: you a question? Yeah. So, has been the census at the in because the program is that's relatively recent, that expansion there. Yeah. What has been the census there?
[Shannon Livingston (Vermont Department of Health)]: They filled right up. They filled right up. Mhmm. Which was awesome. That was what we were asking. It was the need that we had as a state. And, you know, we're still working with them on system flow and some of the processes. And, also, there was pent up need for individuals. So it's not that again, I don't I do not want the community to walk away with the idea that we might not need more. It is very possible that we do and will. And I might be back six months begging you for more. But I think it's it just it needs a little time.
[Rep. Anne B. Donahue (Ranking Member)]: I hear what you're saying, though, that, you know, you can spend money on development, but if you don't have operating funds, then it's not gonna it's not money well spent. So I I guess I'm also questioning so at Serenity House, is that is that the 3.1?
[Shannon Livingston (Vermont Department of Health)]: No. That's the 3.5. That's Chad. That's Recovery House. Okay. Even though it's treatment.
[Rep. Anne B. Donahue (Ranking Member)]: What is Chad's three point one? Grace House and Okay. McGill And what's the occupancy at those?
[Shannon Livingston (Vermont Department of Health)]: They run around 60 to 70% sold.
[Rep. Anne B. Donahue (Ranking Member)]: So, the reason I asked is because they had testified this was a different need, when we were talking about the recovery bed bill that we had that you sent up, they serve as a receiving when people have an issue and they need to get back into treatment for a short period of time and then transition back. He'd said, we've never had to turn anybody away. So that to me indicated that they had some level of openings there and capacity. So, I guess then if we still have open capacity, I'm willing to keep that at both. But if we have open capacity, what is driving the need to invest in more beds right now when we
[Rep. Theresa Wood (Chair)]: haven't identified Perhaps the fact that Virginia's is 100%
[Rep. Anne B. Donahue (Ranking Member)]: full. Right, Virginia's not. Yeah, don't. And they're both in the same county.
[Rep. Theresa Wood (Chair)]: I They're don't both in Addison.
[Rep. Anne B. Donahue (Ranking Member)]: They're both in Addison. So
[Rep. Daniel Noyes (Clerk)]: I was
[Rep. Theresa Wood (Chair)]: in Addison. I thought it was in Okay.
[Rep. Anne B. Donahue (Ranking Member)]: Yeah. He has one of the places in Addison County, doesn't he? No. Both in Maryland. No, they're both in Maryland? Okay. The ones in Maryland wanted for a status and so
[Rep. Theresa Wood (Chair)]: he Well, short of splitting the money up, I think having language that says that both and is important.
[Rep. Anne B. Donahue (Ranking Member)]: We've conferred and we're okay with both and. I just think we need to understand that it's a caveat. The department is saying that there's additional costs associated with this. Understood. We need to understand that. Operating costs are not here.
[Rep. Theresa Wood (Chair)]: Well, and one of the problems with the opioid fund is that we don't want to have operating costs embedded in the fund because it is supposed to be getting the beds in place or the infrastructure. Yes, I understand. Yeah, I hear I'll just reiterate, I like the construct that we've had, and I would like to stick with that. Let us think about it. Let about that part. Let us think about that, and then we'll come back again.
[Rep. Daniel Noyes (Clerk)]: May I add something just briefly? What I'm hearing, it sounds like they're looking for assistance to strengthen their existing infrastructure and capacity than necessarily expand. It's just to give that support as to me in regards to storm and thinking about next thing I'm reading.
[Rep. Anne B. Donahue (Ranking Member)]: Yeah. And I guess I just want I do want to share that, you know, we've come on board with your hireability. We've come on board with your public safety. We've come on board with what fit your language. And I think that the
[Rep. Theresa Wood (Chair)]: We will consider that.
[Rep. Anne B. Donahue (Ranking Member)]: Yeah. I think that the department's in the best place to determine We're not doing that. Yeah. No. I understand. I understand. I'm just pointing out the places where we've stepped over the line to the senate. That's all. We appreciate it. Alright. Appreciate it. So when we have your next steps, madam chair?
[Rep. Theresa Wood (Chair)]: I have accomplished committee on a thought about that perhaps and I've got a concept. I'm I'm just yell out for this and I've heard of you guys are gonna be on for work.
[Rep. Anne B. Donahue (Ranking Member)]: At three. Yeah. Something like.
[Rep. Theresa Wood (Chair)]: It's a hot place.
[Rep. Anne B. Donahue (Ranking Member)]: I am about to ask tomorrow at nine. We'll finish up.
[Rep. Theresa Wood (Chair)]: So do you think by 09:45 we could meet, or should we meet at 08:30?
[Rep. Anne B. Donahue (Ranking Member)]: 08:30. That's good. So I'm not available at 08:30.
[Rep. Theresa Wood (Chair)]: You're not available. You could meet without me if you're just finalizing a draft. Yeah. Okay. What I guess preference preferentially, we could be that I'm just asking if you'll be talking about sort of meaner things tomorrow. No. I'm worried about that conference thing. Yeah. Going on. Because we cried for fall.
[Rep. Anne B. Donahue (Ranking Member)]: You guys wanna converse some more and then we'll step out and then we can come back in. We could try that.
[Rep. Theresa Wood (Chair)]: Let's try that. Let's go off.
[Rep. Anne B. Donahue (Ranking Member)]: It's alright. It's
[Rep. Theresa Wood (Chair)]: a pressure. Well,
[Rep. Anne B. Donahue (Ranking Member)]: I just I'm getting pressure from upstairs. I know.