Vermont Legislature SmartTranscripts:

[Virginia "Ginny" Lyons (Chair)]: And I'm gonna have her introduce herself when we get into our live meeting. So we are live. This is Senate Health and Welfare. It is January 6. It's the first day of our session and we're back together as a committee. Actually, we're back here with three members who were here last year and two new members and we're gonna take some time to meet our two new members in just a minute. We also have a new committee assistant. Calissa, I'm gonna have you introduce yourself first. So Calissa's role is to help me put the agenda together, identify witnesses who we would all like to have, includes you, for our bills, for testimony, and generally keep us running smoothly. So she work for each of you, but she works for me. However, there are times when you absolutely need help and she's here for that. We try to be as flexible as we can. And I'll have her talk more about things later on. But first, before we do that, let's just go around the table. Introduce yourself. I know we've done this before, but it's helpful to introduce yourselves. And I'm going to introduce Nolan in just a minute. Just to say a couple words about your background and what you do and from there I think at this point I'm not asking you to identify specific goals for being on the committee. Take a little time to think about that. You could do that tomorrow and the next day. So we'll have some times where we sort out in the agenda and identify things we'd like to work on. And some of that will depend on what goes up on the wall with the bills that we have in committee. We already have a number here. Okay. So, I'm going to start with Senator Cummings and as a third, introduce your speaker. Okay. I'm Ann Cummings, and I am the dean of the senate, which means I don't know enough to go home when I'm ahead. I chair finance. I have chaired finance for a number of years. This year I am very interested in health insurance.

[Ann Cummings (Member)]: Finance committee regulates insurance. So the impact of the loss of credit on the insurance pool, on people's ability to access healthcare, working, I think, with this committee very closely as we work on that one. And we're also we know we're gonna have some issues with provider tax and the money we've gotten and put back into the system. So, it's going to be a interesting year. I'll let Senator Gulick go next.

[Martine Larocque Gulick (Vice Chair)]: Thank you, Senator Lyons. My name is Martine Larocque Gulick. I live in Burlington. I am vice chair of this committee and I'm on finance in the afternoon with Senator Cummings. My first term, I served on the education committee as vice chair. I was a high school teacher for many years. I was a librarian. I'm still on the Burlington School Board. I'm in my eighth year doing that. So I think I know quite a

[Virginia "Ginny" Lyons (Chair)]: bit about education, although in terms of policy, it's almost as complicated as health care, I would say.

[Martine Larocque Gulick (Vice Chair)]: It's right up there. I was co chair of the redistricting committee, that got a lot of attention, and very proud of the work that we did and the report that we submitted. I hope if you

[Virginia "Ginny" Lyons (Chair)]: have time, you can peruse it

[Martine Larocque Gulick (Vice Chair)]: a little bit, because it is gonna be a huge issue this session, as you well know. But I'm really happy to be here, and nice to meet you both, and happy to have Calista here as well. And I'm thrilled to be Vice Chair of Senate of the

[Virginia "Ginny" Lyons (Chair)]: I'm glad you're Vice Chair of the Senate of Orleans. Morning. I need all the help I can get. I'm going to start with John over here, Worley, and just a little bit about yourself.

[John Morley III (Member)]: Sure. Born in the Northeast Kingdom, lived there my entire life, worked for the Village of Orleans as a municipal manager for over thirty three years managing now. And we have an electric utility, we have a water department, wastewater department, street department, fire department, and we also manage an ambulance department, which actually does a lot of transfers for ABM. I've been on certain boards, NVDA, the Association, I'm on the VESA Board of Directors, Mountain House Supply Authority. Active in my community, and I've always enjoyed My entire life's basically been donated, trying to help solve problems and work with people. So I'm getting a little bit older and we're trying to put forth some succession planning at home, and I think this is a good opportunity. You have an individual shadowing me now, although they're not down here, so they're starting to do more and more on their own. But I've always enjoyed municipal. I haven't done a policy for quite a while. I was on appropriations and done with numbers and I deal with budgets and things like that back home. I started out on commerce and that was a lot of policy when

[John Morley III (Member)]: I

[John Morley III (Member)]: was standing here in the House of Representatives. So it's gonna take me a little while. Very, very complicated issues here.

[John Morley III (Member)]: I hear a lot about it by

[John Morley III (Member)]: the phone, sees such that the chair here has a lot of bills just that they came through as we took a look as Lieutenant Governor read them. So there's going to be a lot of stuff happening it looks like to me and I know it's complicated. I'll do the best job I can. I'll learn as fast as I can and I can add that to you folks.

[Virginia "Ginny" Lyons (Chair)]: So the one thing that you have to read is that black and white bumper sticker over

[John Morley III (Member)]: there? Yeah, see it. I've already looked at it.

[Virginia "Ginny" Lyons (Chair)]: Now just as soon as we think we got it solved. Always more complicated. Thank you, John. So, I understand that you're John, and when we're doing our work here, and I will make every effort to call you as Senator Morley, and Senator Cummings and Senator Gulick, We try to keep it at that level when we're in committing them. To distinguish the two Johns, this is Jay. Jay, why don't you introduce yourself? Sure.

[John "Jay" Benson (Member)]: So all this started for me about a little over a week ago. I asked if I had any interest to serve, and by last Friday I found myself to be a senator. So, big change, I was retired. I spent my career as a civil engineer. I was the 2018 Vermont Engineer of the Year. I worked on all kinds of projects across New England, primarily in Vermont, but as far West as New Mexico and as far South as The Virgin Islands. I have worked on a wide variety of different kinds of projects. I have served and am still serving on my town's select board. I've been there for sixteen years and gave them as chair. Let's see. What else did oh, I served on our local fire department for thirty five years, twenty eight years as chief. We did a lot of things to help people across the state. We went up when the big ice storm hit the islands.

[Virginia "Ginny" Lyons (Chair)]: Oh, yeah.

[John "Jay" Benson (Member)]: We were up there, going around in total darkness, and helping different people with their homes in flooded basements and so forth. As far as healthcare is concerned, I've been on the user side. I have not been on the policy side, but we all need a vibrant healthcare system and an affordable healthcare system than access. I I worked extensively in the fire department, of course, with EMS services, and we all know that time is critical. So when we look at healthcare and we look at some of the smaller hospitals and providers and trying to stay alive, that is critical, in my opinion, for services to our communities. Remember, we were approached on our board with EMS services. The town had been part of the development of White River Valley Ambulance Service. But Brookfield, if you know anything about it, has set up both sort of three different sections of town, and for White River to get to the West Brookfield area was quite a haul, and people approached us about services, and we eventually split the town where Barrie Town now provides half of the town, White River the other, and of course I saw a little bit of the victory and I just said, time out. This is not about who gets what territory, it is about service and rapidness of the ability to serve the people in our town. And we'll talk about pricing and arrangements afterwards, but it's service number one.

[Virginia "Ginny" Lyons (Chair)]: Good, good, good decision. Yeah, thank you, thank you both. As you're talking about EMS, I mean, you both mentioned it, and that's a key part of our healthcare transformation in the rural parts of the state. We're all in the rural parts of the state, but really more most importantly in places of geographical geographic isolation where people need quick access. So I'm glad you're particularly appreciative of that that you're both here and it sounds like we're going to have a good time sorting out what we do in this room. I'm Ginny Lyons, I chair the committee. I've been in the Senate for a while, I've chaired Senate Natural Resources as well. You and I worked together when you were in the House. It's kind of neat. So, I will go through some of the bills that I introduced that you mentioned earlier were on request, some by the administration, some by the Green Mountain Care Board and others to get the discussion going in here. There are too many bills for us to do complete due diligence on each one, but what we can do is to look for common ground within and some common topics in the bills as we go forward and try to sort out how to pull things together. We've done that before. So some of the bills that are listed as we look at what we have in this room, on the left side of that court board are bills that we looked at last session and we're here. Some of them have been put into or pieces of them that we felt were critical were put into bills that are over on the right side of the court board and those are the bills that have passed out of committee. We were pretty successful last year in our goal of working on reducing cost and improving access and quality to healthcare. We're also charged in here with working on welfare issues so LIHEAP that you might be familiar with or SNAP or some of the other substance use disorder recovery housing for folks to take care of them when they're addicted to various substances. Food security, those things, they all land here and so we have a lot on our plates literally. I'll do my best as we begin the year. I'm gonna introduce Nolan over here. Nolan Linewolf. Wanna say a couple of words? My

[Nolan Langweil (Joint Fiscal Office)]: name is Nolan Linewolf. I'm with the Joint Fiscal Office or you folks, I know Senator Morley does this, but we are the budgetary arm, like the Congressional Budget Office of Brooklyn for Vermont. They'll also have been engaged with you later. They're the lawyers. We joke around. They're the words and the numbers. So I'm involved with any legislation that deals with health and human services. I'm a discipline guy. So I'm in this committee, I'll be in the House committees, I'll be in appropriations, I'll be in finance, I go over the bills are. But the other thing that I would extend to the new senators is one of the important part of my job is to help bring people up to speak. And I have a lot of like Medicaid 101, healthcare system 101 that I have to sit down with you individually or together or whatever to kind of help build your baseline of knowledge. You can send that invite anytime you want to. I can give you a contact, give us a time in a meeting, we can do weekly, we can avoid big things, but just putting it out there that you guys want to sit down with, we can help get you.

[Virginia "Ginny" Lyons (Chair)]: And I will say, take him up on the author because he's a wealth of information.

[Nolan Langweil (Joint Fiscal Office)]: And

[Virginia "Ginny" Lyons (Chair)]: we're lucky to have him. Well, aren't you? So, we'll see. He knows he said that. I remember I said that. We are lucky. We are very fortunate in the staff that we have and you will meet Katie McLennan and Jen Carvey. They will be our two principal lawyers who come in and help us go through the language of the bills to make sure our legislation is constitutional ultimately and understood. So, just a quick bit of housekeeping stuff. We meet at 09:00 in this committee. Some committees start earlier. My goal is that we are all here at nine and we can begin work at nine. If we start showing up too late, I put myself in this bucket, but if we start showing up too late, we'll start earlier just so we make it on time. But 09:00 is good. If we get to the crossover time when bills have to get to the house, which is that February, March, all of our bills have to be out of our committee. All the bills we're gonna pass this year have to be out of our committee and over to the house. So if we need a little more time, it's crunchy then, it's very crunch time, very close, We might start earlier, but basically 09:00 and that doesn't go for Tuesday. Tuesday I'll announce our time on the floor or you'll know ahead of time and every other day is 09:00. And please respect that. Also respect the committee process in here. The chair will retain control of the discussion. If you want to make a comment or ask a question just raise your hand. The whole point of having witnesses is to hear what they have to say. So if you have a question of clarity you don't understand, then we'll interrupt and we'll ask them if they want to be interrupted when they're giving their testimony, but basically we're here to listen to what they have to say. And then hopefully there'll be some time for question and answer to try to save that. So we have a defined amount of time for folks and then we give them a little bit of time at the end for a couple of questions. And we can always invite people back. Sometimes we'll have little conversations around the room and that's helpful so we can listen to the advocates who are here, who have an interest, and help us understand the differences of opinion or the collaborative process. That's where we are with that one. Remember, raise your hand to speak. I

[Martine Larocque Gulick (Vice Chair)]: actually have something I wanted to say. Do you mind if I interject something? Please.

[Virginia "Ginny" Lyons (Chair)]: The healthcare landscape is so

[Martine Larocque Gulick (Vice Chair)]: full of acronyms and they So be don't hesitate to ask for clarification about an acronym. We do it all

[Virginia "Ginny" Lyons (Chair)]: the time and it's just really important

[Martine Larocque Gulick (Vice Chair)]: to know what we're talking about.

[Virginia "Ginny" Lyons (Chair)]: Yeah, as we could say diva, but we could say, what's diva? Do we have a philosophy? We do somewhere. Somewhere they'll try to get that. Our legislature made up a long list of all the acronyms. We'll have to look for that. Thank you for bringing that up. We'll do that. So don't forget to raise your hand. You see it's effective. And then we'll listen to our witnesses. The one thing I ask of you is I know that we're all passionate about these topics. There are some topics that really resonate. Try to avoid speeches. Okay, it's okay to ask a question and then when we get to putting the bills together we know where we stand we're gonna vote yes or no but we don't need to speech cry in here. When we're in here, we're just human beings trying to solve a problem. We're not one political party or another or another. We are just here to fix problems that we hear about from our constituents. And we know they're plenty. The other thing is, I think did you each get you've got this. Good. An iPad. We tend to be electronic in here, going through all of our bills and things but we also are hybrid because there are times when you want a printed copy of testimony or a PowerPoint or a bill. We're not fully electronic. We try to avoid cutting trees as much as possible. So if you have a need for a printed copy of something like a witness testimony, we can have Gulick at that or if it's something that you can print out in the legislative branch. I mean that's really it for us. Will start talking about all the work that's being done right now. The administration is working really hard on the Rural Health Care Transformation grant that they are getting. But that's a new grant and that's a newly developed concept. The administration is also working on Act 167, Act 51, Act 68, the whole transformation of healthcare in Vermont that we've been looking at in here and that they're doing amazing work with hospitals trying to build hospital financial sustainability. Last year we worked very hard to ensure solvency for Blue Cross and Blue Shield and as Senator Cummings knows we still have, we all know, we still have insurance issues that will confront us. So tomorrow I'm going to ask us to be ready to identify an area of interest for you, I mean, as much as you can. I have priorities and my priorities will sit right out front. Will not apologize for that. They will be at the top of the list and we're all gonna suffer because of that and but everyone else out in the outside in world, out of this building, is working hard on our healthcare transformation that we have passed through legislation and that we are trying to ensure will help Vermonters. And at some point we'll have folks in to talk about that a little bit. The Green Mountain Cure Board is working really hard on looking at how to reduce hospital costs and maintain our insurance rates at a level that we can afford. So there's a lot going on. Senator Cummings.

[Ann Cummings (Member)]: I wasn't here. We did transformation. We had two new members last year. We had two new members this year. I think it would be really helpful to do, highlight bullets, but just a really quick presentation on what does hospital transformation mean, taking us to? Okay. I find that helpful, and I'm pretty sure you keep if you hear, what was it, four or five years ago, then everybody knows what it is. 01/1967 was which year? 2022. Yeah it's been about it's been a year. Right and '51 was 2023 and then '68 was last year. But we've got all this work going on, so we will. That's a good idea. I'll get Jen in to sort of The last report I got was on opioid deaths in the emergency room and I can see where that's a healthcare issue, but I couldn't see how it related to hospital transformation. Yeah, no.

[Virginia "Ginny" Lyons (Chair)]: So, we will look at reports with Katie and Jen tomorrow and start looking at some of the information that's coming to us from the work that we've done. And we'll be putting exactly what you've asked for as soon as Friday. And then next week, probably Wednesday, we'll look at the Rural Health Transformation Grant and we'll try to juxtapose those two. We'll also be looking at what the federal government thinks it's doing to Medicaid and to other areas of health care. Probably look at some of that on Friday with the health care advocate so that we have a lot of those we're building, we're building where we are, but we're also helping you build your understanding and we'll do it the best we can. We can't go back and do it as thoroughly perhaps as we have in the past but I agree we need to have some place to plant your feet. And please let me know. Yeah. Let me know what you need to know. I don't know if you. Go ahead. I'm just going to add that we could make the Oliver Wyman report available. I know it's long and it's it's you know chock full of information but it's a good thing to reference sometimes and to take a look at and to get a big picture of Right and that involved out of Act 167. So we'll see how that goes. We'll try and get it. Yeah, that's a good reminder. Yeah, we can get that on our reports page. Melissa, you can get that. And there's the Health Reform Oversight Committee has met a couple of times since the end of last session and the Health Reform Oversight Committee consists of money chairs, health care and welfare in the House and Senate and trying to keep an eye on the work that's happening. Is the work getting done? Is the healthcare transformation plan actually happening boots on the ground? Are we getting action? It's called HROP. You hear HROP, that's what it is. That's an acronym. And GMBC, that's an acronym. We'll have a quiz.

[Nolan Langweil (Joint Fiscal Office)]: About 35%.

[Virginia "Ginny" Lyons (Chair)]: Premium care board. Yes. That's right. A DFR, Department of Financial Regulation. They look at insurance, regulate insurance. Banking. Banking and insurance. We don't feel care about that. I know. I do. I do. You see this year? Well, you know, I don't think the. We're gonna have a lot of time to talk about a lot of things. Let me know where you feel huge gaps as we hear from folks. Say, oh, I need no more. We'll try to figure out how to help with that. And I personally am happy to sit down and chat with you at any time to talk about the bills we're looking at or the issues that are important. And I will just highlight that at the top of my list this year is to keep an eye of oversight on the work that we are doing in this state and also the information and the changes that are coming to us from the federal government. That's my oversight name of those two. And then primary care. Primary care is at the bottom of my list for our next steps to get there. And there's a lot that everyone wants to do, just amazing, is good. It's good. Not chatted enough. Right, same? Yeah. I

[John "Jay" Benson (Member)]: say for myself, I don't know enough.

[Virginia "Ginny" Lyons (Chair)]: To know what you don't know. Correct. Now I ask the right students. Right?

[John "Jay" Benson (Member)]: Yep. I mean, I look at that list, and I go, that's an awful, overwhelming list for a group of five people to figure out in four months.

[Virginia "Ginny" Lyons (Chair)]: Four months? We'll do it. Just so you know, the bills on the left side, with the exception of two of them, I think it's 157 and $2.37 of which the two are, the optometrist bill and the psychologist's prescription bill. We will pull those off of that side, the ones that are left over from last year. I don't know that there are too many others left over from last year that we'll look at, that we've really looked at those and done our work on them and then the new bills have come in and we'll try to sort out and I agree it's a lot and you learn a lot. If you go through one bill it really is kind of neat you know It's like going through a blueprint. You learn a lot. Okay. Senator, go ahead. I was just gonna say, my first year here, was down housing, economic development, general, and we did electric restructuring.

[Ann Cummings (Member)]: I knew nothing. But I was coming out of being mayor of Montpelier, and my motto that year was, I've learned municipal sludge. I can learn this. Yeah. You just don't expect yourself to know it all, but you have learned things, and given patients your work.

[Virginia "Ginny" Lyons (Chair)]: Well, is. I mean, Vermont is such a local control place. It's such a local place. We all bring our local experiences, you know, from school board and select board and our local community organizations. Those are the things that are important and the people we work for or our constituents. That's what's important in making our decisions. Sometimes we get stuck with language that just doesn't fit, but it ultimately is done. So try and make those connections. One of those. What am I forgetting? Oh, Melissa. We need a new clerk. Can you explain what the clerk is? Sure. So a clerk will have actually, a record of actions on film. I believe they give that to us at the at the office. So the clerk's work begins with what I did for our new clerk whoever that may be. When we had bills introduced the clerk we just got, he saw the bills that were in, usually the copies of the originals. These are all the bills that were introduced today for our committee. And the clerk brings a gown and gives them to Gulick who puts them in a secure location. And then when we vote on bills the clerk is responsible for doing exactly what Melissa said that is calling the rule and collecting the votes and then helping folks report the votes upstairs. We get more to that as we so think about if you would like to be clerk and we'll we'll nominate and elect a clerk one day this week. We'll have probably day or tomorrow. Do you want to explain it's an honorary that usually goes to the newest veteran? There's no I think I'll flip a coin here, John. I think probably that's what we're looking at. Now you have experience. So Oh, horrible. I mean,

[John Morley III (Member)]: you wanna educate me.

[Virginia "Ginny" Lyons (Chair)]: Yeah. We wanna the same. Right. Sam loves at work. He left. Alright. Well, we're gonna go offline.