Vermont Legislature SmartTranscripts:

[Speaker 0]: Yeah. You're live. We are back live. And this is Senate Health and Welfare. We're moving on to S210. We had a short introduction to it. I'm gonna ask Judy if you don't mind. Can we close that door? Oh, okay. A short intro to remind us of what is in the bill and then we have a witness who would like to speak about lived experience and then Judge Zonay from Superior of March this year.

[Katie McLean, Office of Legislative Counsel]: Katie McLean, Office of Legislative Counsel. This is S210, which is a bill that pertains to how to access law town state reports. We already looked at this in a bit of detail, but just remind you, we're creating a new subsection in an existing section on autopsy reports. The first paragraph is meant to sort of maintain the status quo, which is that if HIPAA allows the disclosure of an autopsy report, that it can be distributed or disclosed. Subdivision two creates a process by which a person could petition a court for access to an autopsy report, and then the court would make a decision. And again, we have sort of this loose standard in line 16, that if the Superior Court finds the petitioner has demonstrated a legitimate reason for the petitioner to obtain the autopsy report, then it would be disclosed. So that is left to create a lot of room for the court to decide what is a legitimate reason.

[Speaker 0]: So, that's it. And then when we talk with Judge Zonay, we'll also consider how this gets reviewed in the admitting and score. Okay, thank you. So we have a witness who wishes to Why don't you come right on up and have a seat? And we're not going to ask you your name, but we appreciate your being here and providing your testimony on the bill. And we heard from Senator Party earlier and know that she's helped you get here and make a We understand it's a difficult decision for you to be here and to provide your testimony so why don't you go ahead and read what you have for us? If that's okay, I'm gonna read pretty much. And before you do that, we're gonna introduce ourselves because you may not know all the senators that

[Sen. John Morley III, Member]: are here. John Morley, Orleans, Steve, John Benson from Orange.

[Speaker 0]: Cummings, Ginny Lyons, Chittenden, Ann Cummings, Washington Ann Cummings, Cummings. So I appreciate you inviting me to speak today regarding a bill as we can. This bill is related to my personal experience and the lack of access to the autopsy results. We lost our daughter unexpectedly at 40 years old in November 2024, a little over a year ago. Through this experience, I met with Senator Harvey and Paintsmere Collective previously living in States Of Benbury in the 2025 to share my experience. This bill is a result of that being made. I appreciate being burned. With the sudden unexpected death of our daughter at age 40, the state police were called to do an investigation for an untimely death. At that time, my daughter was recently split from her partner at 14 years. Due to domestic issues in this relationship, they will report to authorities by our daughter during the fourteen years of that relationship, there was no documentation of the difficulties. Other than her asking her to evacuate the premises a few short months prior, the world did not know of her struggle. They were not married. There were two twin, 13 year old children resulting from this relationship. Currently, as the law stands, autopsy results are given to the legal guardian of the minor children. At the time of the death, that was not determined due to an absence of his name on the birth certificate. Her ex partner had to file for legal guardian of the two children through the court system. From the time I found our daughter, met with investigators, communicated with medical examiner's office, and dealt with the initial shock and loss, never did it occur to me that I, as her mother, would not have access to her report. Prior to the autopsy results and the final report, the medical examiner's office was communicating with me regularly. After parentage was legally determined, they were no longer able to speak with me regarding questions, progress, or access to the results. Blah blah blah. My daughter signed on her HIPAA papers dating back to a car accident we were in many years ago, allowing me to have conversations with her and and see her records from then to the time of her death. She trusted me with that role and information. I encountered an unfortunate understanding that her privacy and wishes were not honored for Nipah after her passing. I believe that anyone asking for a relationship to end, married or unmarried, has a right to privacy. Her fear and anxiety for years kept her from stepping forward and having any legal documentation. That was the unfortunate hurdle that could not be overcome. I believe that there are many more women and families affected by this issue than just our development. Just a brief history and context of this situation. We have not had contact or allowed to have contact with the grandchildren since the end of another step. We live a mile away from us, who got moved out of state six months later, but do all goodbye to their friends, they'll goodbye to their family, their mothers, family, their community. No ability to go back into the house on their belongings or clothes, mementos of their mothers, their ability to participate in celebration of life, picking out photos, nothing since then. That's the context of what we're talking about. Many, many conversations throughout many weeks and months with the medical examiner's office after their passing, we waited for the results of her autopsy. I bagged them when they became available. I felt deep pain, trauma, grief, anger, frustration. The medical examiner's office felt our pain and understood the lack of fairness in the situation, but their hands were tied, bound by the current law. Her next of kin, the children, had the right to go to record. And her ex partner had the right as legal guardian to view her personal records. Far beyond what any underage child would need to read or know, he had a right to those for privacy to finally put that hold in. The children should have had access to the results, preferably held with the safe until they are engaged. So information does not possibly get changed as the narrative can be and as we have experienced from this individual who chartered all the way through death. Letting the children know that their loved one passed from natural causes, a cardiac event, an overdose, or a head trauma, or those of underage is sufficient. That is what they need to know in the aftermath of their loved one's passing. Not all the detailed information at all from others bodily systems. The impossibility of information being changed and translated at will by the legal guardian who was their abuser is solely left to this individual as he chooses to relay the information to the underage veteran, however he chooses to. To give her records to someone who did not treat her well, who was not signed on her HIPAA forms when she had asked to leave the relationship is to meet a real invasion of her privacy after him. As her mother, I was unable to get the results of her dad. It took many, many conversations with the medical examiner's office, as well as the state social worker assigned to our family, to convince him to hand them over to me. One of his replies at one point was, I'll think about it. After much warm and concentrated efforts by many parties, he agreed to hand over the results. They took her as part in full control of any access to those results, resulting in a lot of emotional pain and uncertainty for our entire family. And they gave full control to someone who should not have had that much power. Protecting the children and their right to the information is absolutely worthy of protecting them. Perhaps another way it can be found to be done. So this bill can prevent this immense trauma for others by giving people and the immediate family the possibility of access to this important information without having to beg for them, or honor HIPAA forms signed to protect mom's privacy. Continue that regular privacy after that, that would be really appreciated. It would eliminate a gatekeeper information when there are family concerns and thoughts, allowing a mother, a father, a sister, or daughter, permission to have access for a loved one's report. Given the tragic and complex family dynamics after our families on time of death, having an avenue to the probate court to request a copy of our daughter's box office reform would have enabled us a safer and less dramatic way to get information and move forward with a small bit of clarity and peace

[Sen. John Morley III, Member]: after the death. Thank you for your

[Speaker 0]: time and attention to this bill, or anyone in the future that would benefit from your care for consideration. My goal with this is it moves through the process of to prevent this from happening again to another loved one. Protect the children's rights and their information. Protecting any loved ones' rights now by taking into account the many hidden, undocumented domestic situations that exist today. Thank you. Yeah, this is very helpful for our understanding of the bill and so we'll continue to take testimony and look at it, make sure that we can, it's got all the I's dotted and the T's crossed. There's many layers there. There are multiple layers in there. We're focused on one. Because peace would be Right. Can't eliminate the whole spectrum. So much. Yes, understood. Trauma distress. And it would be terrific if you would send your testimony to Callista electronically so that we have a record of it. We should read it. As you said, you know, anonymously, it's a volume we have done. Questions? Very

[Sen. John Morley III, Member]: sorry for your loss. Thank you. It's times three. Thank

[Speaker 0]: you all. Thank you. Thanks for coming in. You're lucky that it wasn't yesterday. Not a friend. Not a come. But we appreciate your driving over and everything. Thank you. Thank you very much. Thank you for waiting. Thank you, senators. Really appreciate that. Yeah, good. Thank you. Okay, is Jed Chittenden online? He is in the booth. He is. Good morning. Good morning. No, I had an ulterior motive in inviting both you and Terri Porzons, and we have a little competition going on in here because Melissa made some Black Forest chocolates cookies, and we were gonna do a comparative analysis with chocolate chip, but that's not happening. Maybe another We

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: will work on that, I'll let Terry So

[Speaker 0]: thank you for being here on S2Tech.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: My pleasure.

[Speaker 0]: Why don't you just go right ahead with me?

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: Sure. So Tom Zone, Chief Superior Judge. It's a pleasure to be here this morning. I've had a chance to look at s two ten, and I also just obviously had an opportunity to listen to the witness who testified. It's unclear to me if the intent under S210 would be to have her be able to, as the mother of an adult child, able to receive the autopsy report under subsection B on page two or subsection B1 or subsection B2. So let me go through the way it would seemingly work. The new addition under B1, what that does is it provides that makes it clear that under Vermont law, the personal representative has the ability to seek a copy of the autopsy report. It goes a step further. What it also says is that the debt and the decident's air at law. And it defines that under by chapter one chapter 42 of title 14. An error at law is the individual or individuals who are entitled to take a portion of an estate when the decedent dies without a will. That is they die intestate. Under Vermont law, title 14 section three eleven talks about if someone is married and they die and that they have a their spouse would take the estate. If they have children with the spouse, the spouse takes the estate. If they have children not with that spouse, then the spouse and the children would split it. And then you jump to to 14 VSA section three fourteen. And what that says is the balance of the intestate estate not passing to the decedent's surviving spouse passes to their descendants by right of representation, and that's the children and then the grandchildren. What happens if there's no spouse, or no children is it then goes to the parents equally of the decedent. If there are no parents, it goes to the siblings and the descendants of any deceased siblings. And so, I point this out because the way the bill is structured under B one, it doesn't include all of those individuals. And this is a policy decision for the legislature and I wanna be clear, I'm not giving a judicial determination, but if for instance, in a case where there is a decedent and they have children, as I just noted under section three fourteen, the parents would not in that hierarchy would not be an error at law. It would stop at the children. And so in that circumstance for the individual who just testified, as, she pointed out, the children would be the ones to get the report, even if they're minors, that's the way it would be, but because they would be the heirs at law, it stops there. So it would not seemingly allow the parent to also get it. That is a policy decision. And I would note that in some jurisdictions, for instance, Wyoming, they don't necessarily follow the statute and say heir at law. What they say is a surviving spouse, surviving parent, an adult child, personal representative, legal representative, or a legal guardian, and they spell out who can get it. And so that's something you may wish to consider if the intent is to say that in all circumstances, you wish to have a parent such as the witness who just testified, able to obtain that information. You may wish to consider spelling out who can get it instead of just saying you're going to rely on air at law. And I would note

[Speaker 0]: keep going. This is very helpful.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: And that would be under Wyoming statutes. I believe it's section seven-four-one 105 entitled confidentiality of reports. Now their statutory framework is a little different, but I point that out because I think if that's the policy you're trying to have that a parent doesn't have to submit and do something, you may want to specifically name them because, if they don't get there in the hierarchy, they wouldn't get it under B1. Unless there's any questions on B1 I'm going to move on to B2.

[Speaker 0]: Please go ahead. Questions first on B1? This is clear. Okay, B-two. This is great.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: B-two. So what B-two does is it says if you don't qualify under B-one, anyone may petition the probate division for a copy of the autopsy report. I would be remiss if I didn't say we don't know how many of these cases we're going to get and so this could be a significant number and if it is that that could be a resource issue for the probate courts. But leaving that aside. The petition has to contain an affidavit attesting to the petitioner's relationship to the decedent and the reason they're seeking the report. There's a notification to the office of the medical examiner And then it says if the superior court finds that the petitioner has demonstrated a legitimate reason to obtain it, it shall order the medical examiner to do that. There are no limitations as to who can seek that. There are no provisions that allow anyone to object. For instance, if a family member or if the special administrator of the estate did not feel that it was appropriate for someone to get it, that they did not have a legitimate interest, The bill does not provide an opportunity for the special administrator to file an objection. The bill does not even provide an opportunity for that person to be notified. So please understand that what could happen here is someone files an action with the probate court saying we want an autopsy report. There may be sitting in the probate court's files and docket an estate with a special administrator for the decident who was a subject to that autopsy report but they don't come together under this statute. So that special administrator may never know that someone was seeking it. And so that's a concern that if you, if that's a policy decision, if you would like someone to have the ability to object and say, no, this is not a legitimate reason, you may wish to consider adding a provision that has to have notice upon the special administrator executor in addition to the chief medical examiner and affording them an opportunity to respond. I would say the more concerning issue is that it uses the undefined term legitimate reason. There is no criteria, no factors, or any examples of what constitutes a legitimate reason. Is it for legal claims, medical issues, academic research, media investigation, or someone who is just curious? This provides no guidance to the courts, provides for inconsistent outcomes amongst the courts because judges would look at it differently and courts have to fill the gap and decide well what is a legitimate interest. I'm sure if we went around the room today, we all may have a different idea of what's a legitimate interest. There's no balancing test either. For instance, where it says that the application has to have an affidavit of why and their relationship, well there's nothing that says the relationship makes any impact on whether it's legitimate interest or not. If you had a newspaper from California that says, well we're deciding we're going to, we want to post the autopsy of the week, we're going to pick a state and just start posting autopsy reports. We think it's a reportable legitimate interest. Some people might think, well, that's public knowledge. That's legitimate. Others may say, well, no, wait a minute. It's infringing on privacy interests. There may be law enforcement concerns, there's public interest concerns, there may be sensitive contents. And so the concern that I have with this is that it gives the courts no guidance as to what should we be looking at. Are we balancing privacy interests with public interest? Are we balancing law enforcement concerns with sensitivity of contents? How do we balance those interests? There's also no no nothing about redactions or scope. The way the statute is phrased, if we find, if the court finds a legitimate interest, it says it shall order to provide a copy to the petitioner. It doesn't have any prevent and that's when it uses language like that, it means the entire report. It doesn't provide anything about redactions, it doesn't provide anything about partial disclosure if the court finds that sections one and five should be redacted for whatever reason and so you may wish to consider that. It doesn't have any ability, it doesn't say anything about the court ordering further restrictions on dissemination. So if you find it that one person can have it, it doesn't say they can't disseminate it further. It doesn't, again, doesn't provide anything other than an all or nothing determination with no real standard to apply. So I would phrase it as it's procedurally structured, but substantively undefined in many ways under that section. Other states have provided, and again, they're not, it's not apples to apples or oranges to oranges, but I think there's enough of a comparison where others, some states have used the phrase good cause for obtaining a copy. Florida, for instance, under statute section 406.135, subsection B it looks like, says in determining good cause, the court shall consider whether such disclosure is necessary for the public evaluation of government performance, governmental performance, the seriousness of the intrusion into the family's right to privacy and whether such a disclosure is the least intrusive means available and the availability of similar information in other public records regardless of form. Wyoming also has a very similar if not almost identical definition for what constitutes good cause and so those are my comments and I'm happy to answer any questions.

[Speaker 0]: This is really very helpful and greatly appreciate it. And what would be very helpful as well is to have you send your testimony into Callisto so we have a record of it.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: I have to comment on that Senator. It goes from here to here. There's nothing written. Just some handwritten think scrawled out

[Speaker 0]: that our Lich Council may be reaching out to you for some of the references to Wyoming and Florida and so on so that we can fix the language in here and make sure that we're not upsetting the apple cart. Yeah, so the other piece is obviously going ahead. Judiciary may want to take a look at this and you may hear from that committee as well. Overall, if the goal is to allow for a parent or a sibling or a child or someone who wasn't heir at law to be included in accessing the autopsy. I'm hearing you say that Wyoming's actually fixed the problem in a way that this bill does not.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: They specifically identify individuals who can receive information that would otherwise be non disclosable to the public.

[Speaker 0]: Yes, okay, that's helpful. And then in two, in the second B2, clarifying good cause, which is something that the court is familiar with, I mean, if that were even if that were changed, the question I have for you from your position is what administrative burden would this change would these changes provide? I mean, would there be additional we don't know how many of these applications are going be, but there would be some administrative something that would happen.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: There would be the we would first have the filing, then depending on how the bill is structured, if there is going to be any opportunity for someone to oppose it, that could lead to additional filings. I think that even if it doesn't say the court may have a hearing, a court I believe always has the ability if it thinks a hearing is necessary to consider a request to conduct hearings, so that would take additional time. Then the court would issue orders. But again, we don't know how many of these are out there, but it does have the potential and I would suggest to add court time and staff time, but I would suggest that the potential for court time, the more particular that the bill is as to what the court has to apply for standards or factors, you will reduce the disputes. Because right now, just saying legitimate interest, it's wide open.

[Speaker 0]: Got it. Senator Morley had a question. Yeah.

[Sen. John Morley III, Member]: So, if if we fixed B one and listed the individuals, Would you need me to?

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: That's a policy decision. The question for the committee and the legislature is who do you want to have access? If for instance your intent is to make sure that the individual who testified before me today, someone in her position, a mother who has tragically lost a child, an adult child, will always have the ability to get that, you wouldn't need B2 because if you put something in B1, you would provide the opportunity for that status, a parent to get it. Absolutely. So you would not need the B2.

[Speaker 0]: I think Ledge Palsall has a comment or question.

[Katie McLean, Office of Legislative Counsel]: I just wanted to clarify, thank you, Judge Sonay. That was very helpful. And I very much appreciate the feedback on the good cause because I absolutely agree that it needs some boundaries. The piece that I feel concerned about is how we're classifying B1. My instructions were to work with the health department. The health department feels extremely strongly that under HIPAA we cannot add additional folks beyond what they would be able to obtain in a state settlement. When I I have a reading of HIPAA where I feel like I may have a different opinion, But as

[Sen. John Morley III, Member]: it was my

[Katie McLean, Office of Legislative Counsel]: responsibility to work with them, that language in B1 was not meant to expand it to parents or this parent. It was meant to maintain the status quo under HIPAA. There is clear language under HIPAA that says if a state creates this judicial process, then the autopsy report can be released. So it was meant to create that, one was meant to create this, maintain the status quo. Two was meant to create this judicial process that the health department and I both agree is a legitimate avenue under. Doesn't mean we can't have more conversations, but you might want to have the health department. Oh we will. The

[Speaker 0]: health department's on our list. Okay.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: I understand what you are saying and I do not, I won't weigh in on the legal issue between what I think you are your view and the health department. I understand that there are those who believe that HIPAA provides affirmative rights for access and there are those who believe that HIPAA provides the prohibitions for access and disclosure, but that HIPAA does not define state law as to the access. And so those are legal issues that there are sometimes disagreements on. I I cannot wade into that and give an opinion but I I I do know that there are those who view it differently. Which explains why Legg Council and the Health Department might not be necessarily see it the same way right away.

[Speaker 0]: So we will this is the shortest bill that we have and it just opened up the biggest, nothing like a little bill, a simple bill. Judge, thank you so much

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: My pleasure.

[Speaker 0]: Taking the time to evaluate this, and now we have two sides of a coin as we bring in the Department of Health and try to sort out where we will go with this bill.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: My pleasure and if Ms. McGlynn has any questions absolutely feel free to give me an email or give me a call.

[Speaker 0]: Thank you very much.

[Hon. Thomas G. "Tom" Zonay, Chief Superior Judge, Vermont Judiciary]: Thank you have a great day everyone take care.

[Sen. John Morley III, Member]: All right. Wow.

[Speaker 0]: We're on to a simpler bill. No? There are no simpler bills. It's a little more complicated than that. And we are, we're gonna move to 157. We've got some folks to testify. Jeff Faroe, who we didn't have last night, Zigar, the Department of Health is available, hopefully can get a little bit, but we may not get to them right away. So, we've been through this bill a couple of times, so I think we'll go with that. But this is the bill on recovery resident certification. Do you want to give a quick comment on? Pardon me?

[Sen. John Morley III, Member]: I'm happy. I'm good.

[Katie McLean, Office of Legislative Counsel]: Sorry. No, that's okay. Do you want me to

[Speaker 0]: jump up and give a little overview?

[Sen. John Morley III, Member]: Real quick. Sure. Yeah. That's how to help.

[Speaker 0]: No, was just running out of your water. Just

[Sen. John Morley III, Member]: drink your water. Okay.

[Speaker 0]: Dana Ginny Lyons,

[Katie McLean, Office of Legislative Counsel]: the Legislative Council. You're looking at the Recovery Residence Bill. I won't go through this again, but just to give you sort of the high level, we have section one, which is the certification. It's a voluntary certification and you have language sort of listing what recovery residence would have to do to be certified. The second section of the bill amends an existing section of law, and in that existing section of law, it talks a bit about what is necessary for a recovery, what sort of boxes have to be checked before a recovery residence could exit a person. And that language is expanded upon in this draft. We've already put that language. So very high level that is what this bill accomplishes.

[Speaker 0]: That's good. Okay. And with that testimony on it, also know that department, AHS to the Department of Health has recommendations on the language that we'll look at and we heard from folks earlier. So we'll move on to testimony from Jeff Moreau. And Jeff, thank you for being here.

[Jeff Moreau, Executive Director, Vermont Alliance for Recovery Residences (VTAR)]: Thank you, Senator Lyons. I'm Jeff Moreau. I'm the executive director of the Vermont Alliance for Recovery Residences. It looks like we might be tight for time with a number of people that are testifying today, so I will not read my testimony today unless you would like me to, but I have submitted that and I know that it's been uploaded for your review. Just a few very quick high level comments. I just want to thank the legislature for your incredible dedication to recovery. And you do so much for the recovery centers and for treatment and the support that you have given to recovery housing, which is separate from treatment has made all the difference in the world. And I'll point to one thing that the health department was able to help us with through your funding and support, And that is these reengagement beds that are available at Serenity House and Valley Vista. And what they do is they provide the ultimate safety net for us when an individual is asked to leave a recovery residence for a variety of reasons. So we're very excited about that. We've been talking about it for five or six years. And the fact that it's come into play is incredibly powerful. The second thing I wanted to offer to you today is that we have tested over the last two years, the concept of this bill, working with certified recovery residences in Vermont. And I'm really proud of the work that they have done to support individuals when they have a recurrence or they have a mental health challenge or violent or threatening situations in the home. And so just real quickly, I noted what the process looks like in those cases. And first and foremost, the bill only applies to those residences that are certified and meet these additional standards around exiting an individual. They will review with the resident the program rules, rights, social standards, and they will work with that individual to develop a self directed plan of where they would go if they're asked to leave. And again, that could be for return to use or those violent or threatening situations. And in the case that the plan cannot be executed, the residences are now, in addition to some that have created a stabilization space right in their own entity, They are now partnering with Serenity House and Valley Vista. And then, of course, we also have the Crisis Bets that you've developed as well. So we have a really good system in place, and this bill codifies that work and makes it permanent. And again, just to emphasize that it's only for certified residences that meet these standards. I know that you are very interested in what makes up certification and how that works and what the carrot and stick is, but we wanna make sure that this remains voluntary and that only those organizations that meet these rigorous standards can benefit from the exemption of this bill, can benefit from state funding, And so there's a lot of reasons for them to become certified. But with that said, there are some programs that will not meet the certification standards. If we force it on them, it's really going to put us in a difficult space. And I'll give you two examples of why we wouldn't want to do that. The first is some homes have a complete abstinence based philosophy. And what that means is they will not accept individuals who receive medically assisted treatment. And I think most everybody in this room would see that as something that is discriminatory and that we don't wanna permit. And certainly our work with the health department would discourage us from certifying a home, that operates under those standard. Is that a, valid choice for people? Absolutely. And they can continue to do their thing. They many of these programs will also have a zero tolerance policy, which goes back to that immediate removal and really doesn't incorporate all the work that we've done over the last couple of years. And frankly has given the recovery resident system a bit of a black eye because we don't operate that way, but these particular homes do. So I think it's important to offer that as well. Again, I just want to thank you for your hard work and commitment to this. I know that we have representatives from the health department today and Chad Viche from Serenity House, who can tell you a little more about the support that his program's offering. And then I think we'd like to chat with you about the strike call amendment that the department has brought forward. There's a couple tweaks that Vifor has identified that I think are worth conversation with you. But generally, we're so excited about this bill and we're really pleased to be coming under the health department and working much more closely. We've always had a good relationship and we've always worked well together, but this really brings our work together in a more meaningful way, in a more coordinated way. So thank you very much.

[Speaker 0]: Thank you. And just to of reiterate what you have said, that there are benefits, there can be benefits and incentives for a certification that don't mandate it across the board, allow for that to happen as folks understand the benefits.

[Jeff Moreau, Executive Director, Vermont Alliance for Recovery Residences (VTAR)]: Thank you for your consideration of that.

[Speaker 0]: Well, no, that's what you said. I'm just trying to affirm that is what you said. That's helpful. It's good. Okay. Questions for Jack? I'm sure we'll be seeing you again.

[Jeff Moreau, Executive Director, Vermont Alliance for Recovery Residences (VTAR)]: I look forward to it.

[Speaker 0]: Okay, good. So, Hannah's here from the Foundation for Recovery. Okay. I'm as excited about this bill as everybody else. It's a great step for everybody. Absolutely. Good

[Janice Gale, Director of Community Relations, Vermont Foundation of Recovery]: morning Chair Lyons and members of the committee. My name is Janice Gale and I'm Director of Community Relations for Vermont Foundation of Recovery. BPOR operates 10 certified recovery residences across Vermont, serving individuals in early recovery as they transition from substance use to stable independent living. All of our homes are certified by Vermont Alliance for Recovery Residences, or VTAR, as we just heard from Jeff, and adhere to the National NAR standards. I'm here today to speak in support of S-one 157, to explain why the language in this bill is important for safety, recovery integrity, and policy alignment for Certified Recovery Residences. Certified Recovery Residences operate as structured recovery programs, not as traditional rental housing. These homes are built on accountability, peer support, and clearly defined expectations that protect both the individual in recovery and the collective recovery environment of the home. S-one 157 recognizes this distinction and provides clarity so these homes can function as intended. Each year as part of our certification and recertification process, B4 is required to submit extensive documentation demonstrating compliance with national standards. This includes, but is not limited to, our mission and vision statements, proof of legal entity status and insurance, membership agreements, member applications, grievance procedures, medication and drug testing practices, relapse planning protocols, health and safety practices, personnel policies, background check policies, member rights and responsibilities, exit and transfer policies, substance use policy, prohibited items policies, good neighbor policies, and assigned attestations and codes of ethics. In addition to written policies, our recertification process includes annual safety inspections and recovery home walkthroughs. As part of this process, the Executive Director of VTAR also speaks directly to members of the recovery home. These reviews ensure that homes remain safe, well maintained, and in compliance with certification standards, and that policies are being implemented consistently in practice, not just on paper. This is not a light or informal process. Certification requires transparency, documentation, and ongoing oversight. These policies are reviewed annually, enforced consistently, and designed to ensure safety, fairness, and dignity for everyone living in the home. They also ensure that recovery residences are accountable to the communities in which they operate. What S-one 157 does is align Vermont's statutory framework with its existing well regulated system. It acknowledges that recovered residences already operate under a comprehensive policy structure that governs entry, participation, accountability, and exit when necessary to protect the recovery environment. It is important to be clear that this bill does not remove protections or eliminate accountability. Landlord tenant law continues to apply. What S-one 157 does is clarify how certified recovery residences can uphold their policies in limited circumstances, circumstances, where where a person's behavior may jeopardize the safety or recovery of others in the home. Without this clarity, operators are placed in an impossible situation, forced to choose between maintaining a safe recovery environment and navigating processes that were never designed for recovery housing. When a relapse occurs, recovery residences do not act in isolation. Members are able to return to inpatient treatment when clinically appropriate, and V4 works closely with treatment providers such as Recovery House, Serenity House, and Valley Vista to ensure continuity of care. When a member returns to treatment, V4 may hold that individual's recovery home bed, allowing them to stabilize in treatment without losing their place in recovery housing. This coordination ensures that relapse is treated as a health issue, not a housing failure. The goal is always safety, stabilization, and connection to appropriate group supports while protecting the recovery environment for all members of the home. S-one 157 allows certified recovery residences to continue doing what they are already required to do: operate responsibly, transparently, and in alignment with nationally recognized standards, while protecting the integrity of recovery homes as part of Vermont's substance use system of care. There are two edits that we would like to see made to this bill. In section three B one, we see a need to add sections four thousand four hundred sixty and four thousand four hundred and sixty four to the notwithstanding language. By adding 4,460, an operator can enter the home freely, which is sometimes important and necessary for safety reasons. Adding section 4,464 protects operators from lawsuits when an individual is asked to leave, which aligns with the intent of this bill. In section three. B. D, we have concerns around the use of provided or arranged for alternative housing. When an individual is putting the health and safety of the home at risk, it is already standard practice to adhere to the resident's personal safety net plan, which we require every resident to have in order to enter the home. Plan A is always the individual safety plan. If that option is no longer available, Plan B involves connecting an individual to a re engagement bed at Valley Vista Serenity House or the Mental Health and Substance Use Crisis beds at our designated agencies. It is standard practice to rely on these options and operators do everything in our power to ensure that an individual's needs are met and individuals still have free will. Operators cannot be responsible if an individual refuses to utilize their personal safety net plan or a reengagement bed. People in early recovery live complex lives, and it does happen where an individual refuses the services offered to them. In these cases, operators cannot be held responsible to override the free will of an individual. Thank you for your time and for your thoughtful consideration of this legislation and I'm happy to answer any questions. Thank you.

[Sen. John Morley III, Member]: I don't want landlord tenant audits recurs in the field and I just saw it again.

[Speaker 0]: Which what? What's the question? Landlord tenant law. Oh, we're gonna get to that. Right. Addiction. So eviction for someone who behaves inappropriately or violates code of ethics. Yep. Does things within the recovery residence that don't fit with their agreement. It's controversial. Oh,

[Sen. John Morley III, Member]: good. We

[Speaker 0]: worked on it last year or year before. Forgot. Yeah. Two years ago. Yeah. Two years ago. So, and we need to be back at it. Thank you. You're welcome. It's great. Yeah. And thanks for the recommendations. Senator. Do residents pay rent for their members? They pay pay a membership fee. They pay a membership fee. Yeah. Okay. On a monthly basis? On a weekly basis. On a weekly basis. Yes. Okay. That's

[Sen. John Morley III, Member]: The

[Speaker 0]: term free will is used to be to my understanding your testimony. I don't know a lot about substance use disorder, but it seems though it affects if you will. And so I'm just curious as to the interplay between the disease and Regal as it's brought up in this past week.

[Katie McLean, Office of Legislative Counsel]: Well, can't hold someone and tell them they need to do this or that. We have to recommend and connect them to resources. Or we can't, you know, hold them and cage them in a room or a a cannot let them go anywhere. We have to let them operate as they will.

[Speaker 0]: Thank you. Good. Okay. Is Chad? Chad Bigger, Dion, Yes, I see. Alright, there he is. Oh, there you are. My goodness. Do a great work, but thanks. Thank you so much. Especially for your comments on language and as we hear from the Department of Health and then we do markup on the bill this would be fine. You. Thank

[Chad Vige, CEO, Recovery House, Inc.]: you Madam Chair. Thank you committee members for having me. Also, thank you to Jeff and Candace on your testimony. Know, I'm here to express support for this bill and to offer the lens of a treatment provider and how we interact with recovery residences. And hopefully this will be helpful in understanding some connection points. So my name is Chad Vige, I am the CEO of Recovery House Inc. Despite its name, we do not operate recovery residences, however we do operate inpatient residential substance use treatment at a few different levels. The one that has been referenced so far today is Serenity House, which is our highest level of care. We also operate McGee House and Grace House, which are our longer term lower levels of care, And I bring those up because we have a really intricate interaction point with recovery residences at all of our levels of care. We're referring to recovery residences and oftentimes recovery residences are referring to us. This is a beautiful partnership of the continuing care system that we have established between treatment and recovery, and it's an important transition point, and I think oftentimes people are lost in transition points in our systems of care, whatever system we have decided. But we've worked to create safety nets in that transition point. As mentioned before by Jeff and by Candace, we operate what are called engagement beds and these beds are designed to catch people If someone no longer meets criteria for treatment and there's a gap before they can get to a recovery residence, we might put them in an engagement bed to bridge that gap. On the other side of it, if someone needs to be exited from a recovery residence swiftly or not, we're there to catch them and we have made plans with recovered residences in these instances where they will either return back to the recovery residence if it's appropriate, or we will refer them to a higher level of care, whether it's Serenity House or Valley Vista. This safety net has been critical in helping not only the individual but the remaining residents in those operators facilities. Candice spoke to the importance of exiting members who are posing a risk to the house. I understand and support the need to address those individuals swiftly because those at risk individuals pose risk to other humans that we're caring for. However, creating the safety net of engagement beds has allowed these operators to do so in a way that is protective not only of the house but of the individual who is struggling in the moment. So this is an infrastructure that we've been working on for several years and it's become more widely known over the past year and we'll continue to operate these engagement beds to help our recovery residents partners moving forward. In addition to that, I think it's important to kind of speak to two other items that were brought up. Am also supportive of the partnership between VDH and VTAR and certifying these recovery residences. And I'm also supportive of the recommended changes that Candace proposed with Vifor to the language of the bill. The other piece that I wanted to talk about was the idea of free will as that was a question that was brought up and that is at the center most point of providing person based care, person centered care, right, the right to autonomy and choice is a very important thing and I've seen operators provide choices in the safety planning process when being exited and the choices include a safe environment that has been pre selected by the resident and it also includes engagement beds that we offer and Valley Vista offers, and unfortunately that autonomy has led some individuals to choose neither option and return to unhealthy unsafe environments. We don't want to remove an individual's right to autonomy, that free will is really important, but on our end being able to provide those multiple options is a critical piece and that infrastructure I think is going to ensure that we have operators who are doing the very best to center that person and provide excellent services. That was all I had for today.

[Speaker 0]: That's a lot. Thank you. Thanks for taking the time and if you could send your comments in to Calista we can we'll put it up on our webpage that'd be great.

[Chad Vige, CEO, Recovery House, Inc.]: Will do.

[Speaker 0]: And I know that we'll as we set a time for markup it'll be important for everyone to be in the room so we can have that conversation as we go through the bill. And I'm going to turn to the Department of Health. We've got about ten minutes so this is not bad time.

[Jessica Chittenden, Policy Director, Vermont Department of Health]: Would it be helpful for me to bring up the language that we submitted last week during our testimony? Well, for the opportunity to come back to talk to you again about this important bill. My name is Jessica Chittenden. I'm the policy director for the Department of Health, and I've had Ann Cummings Truter, the division director for the Division of Substance Use Programs of the Department of Health, to answer any additional questions. But I just wanted to recap some of the testimony we provided last week with a clear picture for you all about the changes that we're proposing. So the first treatise, we have added a different section one and two in our markup version of the bill, and this would replace section one of the proposed S-one 157. And we have in section one, a definition of recovery residence that aligns with the current definition in Act 163. And then instead of provisions in section one of S-one 157 that provide a detailed certification process for recovery residences, the department is recommending that we receive authority under 18 BSA 4,806 in existing statute that has been used previously to oversee other alcohol and drug treatment services. And so we would just recommend adding the recovery residences to this list, so that would allow the department to have the ability to establish rules for certification and oversight of the recovery residences. And we think that this would be helpful because it would be more flexible. It would allow us to engage in a rulemaking process with other stakeholders of recovered residents' communities to really establish the details of the process. And it allows us to adapt it over time without having to come back to all of the other legislative changes. Section three is the landlord tenant law exclusion. And most of this in our markup preserves the language in sections two and three of s one fifty seven with some only minor modifications. And I tried to highlight things in yellow, but some of this is language that is proposed to be added in S-one 157. So this first one you see, and the second one here on this page, is really a non substantive change to what was trying to be accomplished by 157, but just modifying the language of it. Same with these provisions in CNC, that it's really not substantive changes, just trying to tweak the language. The two substantive changes in this section are this deletion of section two Here in this language, noting a relapse of a substance use disorder shall not be deemed the cause of the resident's own homelessness for purposes of obtaining emergency housing. And this is being proposed by our DCF colleagues, and they would be happy to come in and talk to you more about this or answer any questions you have. But the concern with this language is that it seems to refer to only one element of the General Assistance Emergency Housing Program eligibility, and that piece is no longer part of the determination process. They do not evaluate the cause of your own homelessness. So, even with this provision, as it is in place in the current law, individuals still had to meet other program requirements, such as homelessness status and income resource eligibility to be eligible for the General Assistance Emergency Housing Program, and the language as it's written in current statute, it did not guarantee access to the program. It just provided the interpretation of the one component of prior eligibility, which is no longer part of the process. So, that is the reason for that change. And The other piece here, and I think I heard other folks mention it already, the proposed change we have ensures that this exclusion applies only to certified recovery residences, and not to all recovery residences, and the markup you see here is consistent with what is in current statute to address that. What you will not see in our markup is similar provisions about data collection and reporting requirements that are in section one of S 157 in proposed paragraph F. And last week, when we were providing testimony to the committee, We

[Speaker 0]: It's just that little cricket, it's bad. That's it. Hopefully you found me. We have a cricket in the world.

[Jessica Chittenden, Policy Director, Vermont Department of Health]: It's a robotic cricket.

[Speaker 0]: You don't have to have backdoor. As

[Jessica Chittenden, Policy Director, Vermont Department of Health]: we talked to you all last week, while we agree that systematic data collection and reporting is really important for both the department and recovery residence organizations, we think that we do not need specific statutory requirements to ensure that that is accomplished. We're one of the few states that already collects this outcome information. We use grant agreements to require state funded recovery residence organizations to collect data, and if we get the authority to oversee recovery resident certification processes, we would all also be able to establish those requirements and pools, and work with VTAR to ensure that data collection is harmonized. We also would be able to ensure that we could adapt the measures that we're being asked to collect over time as conditions change, and to have that flexibility to balance state priorities and administrative burden on the recovery residences. So, happy to answer any questions, but those are the key changes and the language that we're proposing for you on.

[Speaker 0]: So, and we don't have it on our page? We do.

[Katie McLean, Office of Legislative Counsel]: Oh, we do. Yes. Okay.

[Speaker 0]: I have it at last. Can type it, and I know that page has it, so I have to refresh. I don't know it's in page.

[Katie McLean, Office of Legislative Counsel]: Oh, and I just wanted to acknowledge that the changes that Candice spoke about earlier are not inconsistent with the changes that we're proposing, and we are currently engaged in conversation with them to identify

[Speaker 0]: solutions to those concerns as well. Okay, that's good. Good to know. Because I think the next time we look at this bill, unless there's someone else who's dying to testify, who would like to testify, we're gonna come in and we'll do a markup with lecture council. So we're at that stage with this meeting. See exactly what you're wanting which we'll see something separate. Thank you. Yes, ma'am. Are the recovered residences in agreement with all of the language? Yeah. It's something. Right? It's yeah. It's less restrictive. My language. We're just getting started with this. This is good. Not with this bill, but with the concept of a systemic recovery residency with. If we started out, we left there how many years ago? That's good. Okay, Emily, did you have any other comments to make? All right, good. Well, that's it, committee. That's just the delay. One minute early, that's great. We're at a wrap, we've had a big day and you know, we've got a new stage with these bills where we can start talking about how we want to mark them up. This one in particular, so we'll get these on the agenda, and we'll have a little block of time to talk about language and how to get ready to report it and whatever else. That's good. And then tomorrow tomorrow before we begin, I have some process things I wanna talk about further the dates coming up. So we'll