Vermont Legislature SmartTranscripts:

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay, we're live. It is Thursday, February 10. This is Senate Health and Welfare Committee, and we're looking at three bills that we've been working on, and we're starting to do some markup on each one today. I will say that H545, the Immunization Recommendation Bill does have a section in it that relates to the jurisdiction of judiciary. So, I've asked Senator Hashim for his committee to take a look at the liability sections of those of section of that bill, and then he'll get back to us about what is needed or not needed there. So we will probably will not vote on 05:45 today, but we will be looking to vote on that bill very quickly during the week as soon as judiciary gets back to me. So Katie, let me come up in the morning. We've got three of your bills to go through. Okay. We may go a little bit faster than the agenda indicates, so that would be good.

[Katie McLennan (Office of Legislative Counsel)]: Hey, good morning. Ginny Lyons, office of Legislative Council. Last time we met on H545, we looked at an amendment. It had three instances of amendment from OPR. You asked that those be integrated in a strike all amendment, so that's what I have for you today. Okay, so here is your strike all amendment. It's 2.1. I'm gonna use 1.1 to point to where the changes were. So the first instance of amendment, or the first instance of amendment that we looked at last time was in section three. So I'm gonna scroll down in section three.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: So why do we do this? When we go through the bill, look at where the amendments are, and then go through the bill and watch it. Okay. Okay.

[Katie McLennan (Office of Legislative Counsel)]: Do you want me to just go through the whole bill and No, amendments first. Okay. So in section three, here we go, we're striking out subsection B and putting in a new subsection B. So, the effect of that is that this membership of the Civilization Council had the House version that was sent over had the Executive Director of the Board of Nursing and Executive Director of the Board of Pharmacy as members and OPRS that they be removed because there is also a practicing pharmacist, a practicing APRN, and I guess they didn't feel like they needed both. So that is one of the instances of amendment. The second instance of amendment is in section seven of the bill. Page. My page 13. I guess we're all working on the same document right now. So this is the pharmacy technicians. And this section sort of completely replaces what the house sent over. A lot of what is happening here is reorganization, but what's being added is this language in subdivision two that lists the authorities for a pharmacy technician to give an immunization. So that is the change there. And then in the section 13, yes, 13, you'll see we have the word deleted. So, I'll scroll down here so you can see that. This would have been the corresponding pharmacy, here it is, 13, deleted. So you're deleting a whole section from the House version of the bill. This would have had the pharmacy tech

[Andrew (Agency of Education, Director of Educator Program Approvals)]: statute go back to the way it currently is. However, OPR asked that the changes that were made in section seven be ongoing changes, so we've

[Katie McLennan (Office of Legislative Counsel)]: just deleted that section. So there are no changes to that section that take effect as of 07/01/2031.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: So all the pharmacy section stays as they are? Yep. Well, pharmacy tech. Pharmacy tech.

[Katie McLennan (Office of Legislative Counsel)]: Yes, physical info section authentic to pharmacy. Right, you're right. Yeah. So those are the three changes in this amendment. But you have the district law, so you have the whole bill.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay. Okay, why don't we do this? Why don't we go through the bill that we have in front of us and that will show us all of the everything. The bill, underlying bill, and our amendment. Okay. It's a strike call. Questions committee before the vote.

[Lauren Layman (General Counsel, Vermont Department of Health)]: My question was why do I hear music? Don't know if coming from outside.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Somebody's celebrating. We're protesting some healing. Oh. Oh, the whole The whole today is when the kids are here.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Uh-huh.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: The tobacco. Oh, that's really cool. Yeah, okay. They should have announced it. Okay. And I can tell you that, sorry. That's what I do. Alright.

[Katie McLennan (Office of Legislative Counsel)]: So, the first half of the bill, if you remember, takes effect on passage, and the changes in those sections will be in effect through 07/01/2031. So this first section is amendments to existing statute. One of the biggest changes in the bill is the change of immunizations to recommended immunizations, which very specifically means recommendations coming from the Vermont Commissioner of Health and not from the CDC. This section details the existing immunization program administered by the Department of Health. It covers how immunizations are purchased, where they are purchased from. This section, one of the changes is it gives the department authority to purchase immunizations, not only from the CDC, but from other vendors. And we also have language about an immunization funding advisory committee. This is an existing committee. The House did make changes to this section, but most of the changes are structural and less substantive as to who is on that committee, but more changes as to how the appointments are made.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: So the Funding Advisory Committee is an existing committee. Correct. Next.

[Katie McLennan (Office of Legislative Counsel)]: Okay, so next is section two. This is the new section, this is all new language of the bill. This language takes effect on passage and it sunsets, it goes away as of 07/01/2031. What's happening in this section is this is where the commissioner has sort of the authority for what is part of the commissioner's recommendations for immunizations, and that is what in the list here, A1 is. This is all the specific authority that the commissioner has and the types of recommendations that the commissioner would make about ages that immunizations are given, the number and the dosing. And then in subsection B, this is the language that dictates how the commissioner is to make that decision, who the commissioner is to consult So the commissioner, we know, is required to consult with the Vermont Immunization Advisory Council, which is an existing council. And the commissioner also has to consider various recommendations of various professional committees, including the CDC. So the commissioner has to look at the recommendations of the CDC, American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, the American College of Physicians, and any other organizations that the Commissioner may deem necessary.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: Just one question. I don't think we talked about this in the previous reviews. Why was that date picked as sunsets?

[Katie McLennan (Office of Legislative Counsel)]: That's a good question. It'd probably be a better question for human services to answer how they landed on that particular date. I can't remember specifically what the conversation was in committee, and I'm not always in the committee room, but they were looking ahead couple of years, knowing that the change under this administration may not be in effect six years from now.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Does the Department of Health and I ask, can you help us with that answer? What was the original date in the bill?

[Jessica Chittenden (Vermont Department of Health)]: Jessica Chittenden, Department of Health, that was not a recommendation that the department had made. That was something that House Human Services added to the bill. I

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: would echo. So essentially the end of the similar version was something that Human Services decided. Yes. I'll talk with Fred.

[Katie McLennan (Office of Legislative Counsel)]: Yeah, the bill was introduced, didn't have a sunset date. I mean, are there

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: questions about that? If you

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: have a question about that date, we should probably look at it again. I I was just wondering what the basis was. Right? Why that five years, I suppose eight years versus three years. I

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: wouldn't be surprised if this wasn't if there's a change in administration in DC to give them time and then to give us time because we're not here full time. Yeah. And it could be related not just to the federal administration, but to Stacy's. Yeah. Okay. Good question, Sandra? Okay.

[Katie McLennan (Office of Legislative Counsel)]: So moving through section two, subsection C is our language that provides immunity from liability for healthcare professionals who prescribe, dispense, or administer immunizations in accordance with the commissioner's guidelines or recommendations. Subsection D allows the commissioner to issue a standing order for the administration of recommended immunizations, assuming that the practitioner is acting within their scope of practice. Subsection E authorizes or directs the department to display information pertaining to recommended immunizations and other relevant information on its website, including how to access recommended immunizations. And then in subdivision two, this is a requirement that if the department, if there are documents produced by the department and there is a discrepancy between what the advisory council and the commissioner have recommended, that the department know on those documents that there was a discrepancy between those recommendations. And then we have some

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: cross

[Katie McLennan (Office of Legislative Counsel)]: references. Section three is amending existing law. This is amending the Vermont Immunization Advisory Council. There are changes to the membership of this advisory council. Specifically, there's a representative from independent schools who is removed, or the House is adding the Department of Health Immunization Program Manager two individuals who are professors, researchers, or physicians, or any combination of these individuals with expertise in infectious disease and human immunizations, adding a family or internal medicine physician, adding an APRN, and a practicing pharmacist. And then subsection C is the authority of this council, and you'll see on lines thirteen and fourteen, what's being added to the authority and responsibilities of this group is including advice regarding recommended immunizations. And then in subdivision two, this is saying that the Secretary of Education or the Secretary's designee and the representative of public schools are not to vote on advice regarding recommended immunizations. So that is outside of what they could vote on. This subsection C goes back to the way it is in current law as of 07/01/2031. Subsection B does not. So B is retained as is moving forward. Subsection C does revert back to the way it is in time law.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Can you say those letters? More slowly.

[Katie McLennan (Office of Legislative Counsel)]: B versus C. Yeah. So B is membership. Yeah. A membership would be retained moving forward, John. C is the duties of this group. That would revert back to the way it is in an existing law. Okay, got it. There's language about how the council is to operate, And then we move on to section four. Section four and five, if you remember, have to do with insurance coverage. This existing language says that there is no cost sharing for members when the immunization is recommended by the CDC. So, the change is that there'd be no cost sharing when the immunization is recommended by the Commissioner of Health. So from the consumer side, there wouldn't be an impact when there's a change in who is recommending the immunization. So those two sections do revert back. That's five and six. And then at the top of page 12, we get sections six and seven. These are our sections on pharmacists and pharmacy techs. So this is the prescribing authority for pharmacists in section six. There is a list of what the pharmacist may prescribe, order, or administer, and on the list at the top of page 13 is recommended immunizations as defined in 18 BSA eleven thirty, that's where our definition is, and that replaces as recommended by the CDC. And then we have language in Roman numeral eight that the pharmacist can prescribe and administer for patients five years, maybe older, influenza immunization, COVID-nineteen immunization, and subsequent formulations, combination products consistent with the recommendations established in accordance with this.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: Just one clarification to you, I can't remember, I know the physicians are immune, Are the pharmacists also immune? I just can't remember the section.

[Katie McLennan (Office of Legislative Counsel)]: Yeah, the, I believe so. Let me go back and make a look the language. Yeah, a healthcare professional. A healthcare professional is It covers the pharmacy. Yep.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Okay.

[Katie McLennan (Office of Legislative Counsel)]: We were at pharmacist. Section seven is the pharmacy technicians, and if you remember, this is where our amendment is. This directs that pharmacy technicians shall only administer immunizations when a licensed pharmacist who is trained and immunized is present and able to assist with the immunizations needed, pursuant to a valid prescription by a practitioner, a standing order made by the commissioner, or a protocol approved by the commissioner under the previous pharmacy session. So pursuant to section six of this bill. And then we have matching language about to patients 18 years of age or older and five years of age or older seeking influenza, COVID, and subsequent formulations or combination products. So, some reorganization and then that list of authorities. And that stays after 07/01/2031. This section stays as is. So that's the halfway point in the bill, and this is where the timeframe swaps, and now we're looking at language that is effective as of 07/01/2031, meaning this is language that's being put back into place. And as we've talked about previously, not every section goes back in exactly the way it is now. Some of the changes that were made are retained. For example, this definition of immunization, it no longer references recommendations made by the commissioner, it goes back to referencing the CDC, but you would be retaining this language that an immunization means a vaccine or other immunizing agent that provides protection against a particular disease.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And so for clarity, this is what the House put in Change. Mhmm. Yes. COVID is a non vaccination. Only COVID is is technically a vaccine. It's an immunization. Yeah, definitely. MRNA.

[Katie McLennan (Office of Legislative Counsel)]: Most of this section, the change you're seeing is replacing the term, you mean recommended immunization with immunization to reflect the change you've made in your definition. So that's mostly what you're seeing. This strike through is to rewrite the section as it is currently, including removing the language that you could purchase from another vendor. And then we have the Immunization Funding Advisory Committee, and I'll just flag that we have these ellipses here. That means that the changes made and how the appointments are made for that particular committee, there are changes in that section. Those are all being retained. They're not being changed in this amendment. Then we skip to section nine, section eleven thirty one, this is the Vermont Immunization Advisory Council, and a similar thing is happening here, where subsection B would be on page 19, line three, there are ellipses. So that is significant because that means you are making a decision to keep the membership changes that you have made, that will be effect on passage. You're keeping those past 07/01/2031. But what you are changing is the duties section, subsection C, to revert back to the way it is now. So this committee after 07/01/2031 would no longer have authority to make recommendations to the Commissioner about recommended immunizations. That would go back to the status quo. On page 20, we have sections ten and eleven. Again, are the two insurance provisions and they go back exactly the way they are now. Section 12 is our pharmacist's language. And again, that goes back the way it is now. If you scroll down, I'm on page 22, lines 15 through 19. This removes language about recommended immunizations and goes back to the language about referencing CDC recommended immunizations. So that is going back to the status quo, and as we've already discussed, on page 23, line 13, and now set, or line four, I'm sorry, section 13, and now says deleted because there had been a pharmacy section there meant to go back to the way it is. OPR is asking that the language not go back to the way it is, but to keep the changes that are in section seven, and that is why that section of the bill is deleted, because they no longer need it to change as of 07/01/2031.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: That's our amendment. What? Is that

[Katie McLennan (Office of Legislative Counsel)]: our amendment? That was proposed to you by OPR. Yes. I'll integrate it into

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: your agenda.

[Katie McLennan (Office of Legislative Counsel)]: Section 14 is a repeal. If you remember when I, at the very beginning of this walkthrough, section two, I said this is all new language. Because it's all new language, there's nothing for it to go back to, so we're just eliminating it. So this one sentence just eliminates that section altogether as of 07/01/2031. And then we've talked a lot about the effective dates. We have half first half taking effect on passage, second half of the middle of July one, two thousand thirty one.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay. So 2031 is five years away and there's nothing in here that suggests any kind of report to our committee or the Human Services Committee regarding whether or not the repeals should take place in 2031. I'm just wondering if there should be something in here about updates. Up that doesn't have to be reports, but updates. Assign request. It's between now and during one. Yeah. Do we need that? Is it just it's a It opens our If we want an update, we just ask for it to come in and give an update. Yeah. We don't need to put it in the last page. Okay. Then it becomes a report. Yeah. You know what? Trying to get rid of that. I'm working on that. I don't want 15 pages. Okay. Okay. So thank you Katie. This is good and that was helpful going through. And while we go through it the less complicated it feels about the repeal here and there. I will check with Brett Wood regarding the date that's a big budget for the Senate. Right. Committee how are we on this bill before we move on? We're good with this? Yeah. Yeah. Okay.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Alright. I

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: guess I'm stupid as I raised the question the other day of whether or not there should be notice if in fact a recommended to, know, a vaccine, right, or vaccine drops off that protective process of the federal penises. Not that we need to do anything, but it'd just be good that somebody knows that that process would no longer apply to that particular vaccine.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I've shared that, but then listening to the testimony, it isn't a process. It's where the money comes from. I forgot who the testimony was from, but in all cases, you have to hire a lawyer, you have to prove harm, you have to prove cause and effect, you have to do But there is a difference. Well it's the money comes from a fund if it's on the list, but you have to sue and go to court.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: Correct, but my understanding is if you have XYZ symptoms as a result of this vaccine that the amount of compensation is already pre established and it's a much less arduous process to basically get compensation, then if in fact it's not on that list, because then your only recourse is to sue directly the pharmacy will come in. And that's all different.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Is that what you said John? No. No. No. We're looking at the liabilities. We're looking at the liability section. Remember But is it that but that's what we're talking about is the liability section.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: Or you're talking about the liability to the state?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: To the providers. So Oh, okay. There is a yeah. Yeah. So Let's see what There are some vaccines that currently the CDC has dropped off the list, like COVID and flu. Right.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: But we try to test the motive that they're still in that program. No, they're out of that program.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Right, they're off the list, John Morley.

[Lauren Layman (General Counsel, Vermont Department of Health)]: Lauren Lehman, Department of Health, General Counsel. COVID was never on that list. It has a special liability protection under something called

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: the PREP Act, and I'm

[Lauren Layman (General Counsel, Vermont Department of Health)]: not sure about the flu vaccine.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I think, you know, I don't want to

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: I don't want to complicate it.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: No, no, no, I understand. The conversation we're having is a good conversation. It does and it does not relate to what this bill is doing. So what this bill is doing is to try to maintain the data informed, science based decision making about immunizations. Right now, that has been changed at the federal level. And so the Department of Health and the Commissioner of Health have asked to ensure Vermont has that data and information in making decisions and with the advisory council about immunizations in Vermont. So not about individual vaccines and it's not about recourse. If you think that you have been affected negatively by a vaccine, people, The cause and effect relationships are things that need to be determined scientifically before you can say it's actually happened. So we're trying to ensure that any immunization that's given is given effectively with the science base to do it. And I think that's what the bill does here. To Senator Benson's question, it's all transparent when an immunization is removed from the list, right? So it seems like there will be notification in terms of it all.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: That's all I just looked at.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Yeah, No, it is. Oh, I see. Okay. Yeah, yeah. Thank you, Senator. Yeah, It was simple. It's like a concussive. Okay. All right, so this is where we are with the bill and as soon as we hear back from judiciary and I'll get the answer from the ref Wood, We'll bring that back into committee and we'll take some time. One day during the week, I'll make sure Calista gets it on the agenda if we can get it on the agenda sooner, may not be until Friday, but we'll try and do that for a vote and we'll let Senator Morley know about this. Okay, any other discussion, questions? It's all good. Every time, as I said on Friday, every time you bring up the word vaccine, you bring up a slew of issues that people care about. That's okay. Alright. So, let's move to autopsy before it's. Going to. And then we're gonna go to kids. So kids would be fun.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Oh,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: representative Bert. I did not know you were here. I didn't you didn't notice on me, but we got you on that left. It wasn't a good.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: My apologies.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: So so please come up.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: I I look

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Now that everyone's

[Rep. Wyatt (Vermont House of Representatives)]: like still look like a farmer more so than than a politician, so you wouldn't recognize me anymore.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I recognize you as.

[Rep. Wyatt (Vermont House of Representatives)]: Yeah. I gotta I

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: understand that you testified in the house and you've offered a proposal to them as well.

[Rep. Wyatt (Vermont House of Representatives)]: Yes. I did.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And you offered a floor that's wheeled in the hall.

[Katie McLennan (Office of Legislative Counsel)]: Yeah. Hello. We're back. We're back. We have them all. Thank

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: you. Yeah.

[Rep. Wyatt (Vermont House of Representatives)]: I've tried not to say. So,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Representative Wyatt Thank you. Ginny Lyons, Chittenden, District. And Senator Morley. Here's the Hawaii. Yeah.

[Rep. Wyatt (Vermont House of Representatives)]: For the record, Denver, thanks for having us one. There's a couple questions, and it looks like it's right along the lines of what you were asking of Senator Benson. Just trying to make sure that this bill will make sure that there's compensation to individuals who are harmed as a result of immunizations that are administered according to this particular program. And I know there is transparency, it sounds like you're discussing, but I don't think there's any harm in making sure there's language in the bill that would prevent such an issue from occurring, God forbid that there was immunizations that were ever administered that no one could receive compensation for except for going and having to get a lawsuit in against a pharmaceutical company. So I think there's I would argue that there's no harm in making sure that there's language in the bill to do that. Maybe that's a job for Senate judiciary, but I think that's something to keep on the radar. I have yeah. At the top of this document, question number two, I have, does this program encourage greater trust in the system? I know that the intention is greater. Think that makes complete sense. I'm a little weary of when we're granting community through the program itself,

[Andrew (Agency of Education, Director of Educator Program Approvals)]: that we just want to

[Rep. Wyatt (Vermont House of Representatives)]: make sure that we're also linking that with a system that's rooted in trust and transparency. That's why I offered the amendment that I did on the floor, That's on the second page on the backside. I can read it if you like. I have it in green parentheses here, and it's just about making sure that it's clear that the patients who are using immunizations administered understand the risks and harms, and they are aware too that there is a, basically that, I'll just say, you know, there's the immunity that's offered to those that are administering it, making sure the patient's aware that they're potentially taking a risk for themselves or a child that wasn't there. The other part that I have down here is alternative language, or this would be, I have it, let's see here, I wish I could go back to the section that was in here, statute that you looked at this morning. But if you go below you know you know the part where it gives immunity to The blood pressure. The professional sort of administering it. Shortly below that, it if you look at number E2, which would be the third paragraph up on the bottom, any documents produced by the department of the recommended immunization shall include a disclosure as the recommended immunizations differ from the recommendations of the Vermont Immunization Advisory Council? That's currently in the document you looked at in slide. Would suggest that it be a little bit more clear, and I gave an alternative to that. Any documents produced by the department about the recommended immunizations shall include a disclosure as the recommended immunizations differ from the recommendations given in section two eighteen BSA eleven thirty A. Two. That's a more comprehensive list. That's the CDC, and that's already in the document you were looking at this morning. It's just a longer list. And state whether adverse events from such immunizations are eligible for compensation under the federal National Vaccine Injury Compensation Program is the recommendation to purchase from federal guidelines. So that would address concern, I think you had Senator Benson, that there'd be clarity that if for some reason there is a gap in compensation for individuals who are receiving these immunizations, it's a known, it's a stated fact by the department and that they at least are aware of the situation so that we can do something with that. We don't want to have any of our citizens not have a process for compensation. And then under that I added the Commissioner shall, to the extent prior to civil, align state immunization recommendations of those of the Centers for Disease Control and Prevention Programs, and shall annually report to the Senate Committee on Health and Welfare where alignment is not feasible and propose alternative state remedies for affected individuals. So that's where I just wanted to make sure that those potential gaps in compensation are covered in the language, and I think that's really important since we're standing up in the program where it's no longer the federal department that's responsible for this, but our own, and making sure there's no path to be honest. Okay.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Senator, don't wanna do anything to delay this bill. To me, what I think second section's probably not necessary, but put something on that paper they give you before you get a flu shot, which ninety nine percent of us probably don't read. Seems a fair disclosure. Could you check with how's held them well? I can see where floor amendment and something that at this point in the process people might be reluctant to. But could you check and see if that might be a game changer for them? I'll look at what they have to say. Also know that the Department of Health might comment on that. And so after we've asked questions of Representative Firth, we can turn to the department to Any answer that questions? So you understand, of course, that there is informed consent for all vaccines at both of the state and federal level. And you presented this to House Human Services?

[Rep. Wyatt (Vermont House of Representatives)]: I did.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And they did not accept the recommendation?

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: They did not. It was

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And then you presented it from the floor?

[Rep. Wyatt (Vermont House of Representatives)]: I I withdrew my amendment on the floor. Okay. Based on what college matters.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Oh. I'll send you the instructions. Alright. Thank you.

[Rep. Wyatt (Vermont House of Representatives)]: I didn't address them, I did address, my amendment did not say anything about the alternative language that I just read to you at the bottom of the citation. Which is more of that line to Senator Benson's line make sure that there aren't any gaps in compensation.

[Katie McLennan (Office of Legislative Counsel)]: Let me

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: ask you this. As I look at the language at the bottom of the page, looking at number three in particular, you're suggesting that the CDC then is the standard for making decisions.

[Rep. Wyatt (Vermont House of Representatives)]: I think I am suggesting it is the standard. It's not, obviously the idea of this program is to

[Andrew (Agency of Education, Director of Educator Program Approvals)]: not be people in

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: that Okay, so that

[Rep. Wyatt (Vermont House of Representatives)]: But it's asking why are we, you, what are you saying

[Andrew (Agency of Education, Director of Educator Program Approvals)]: for emergency?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: You're saying CDC is a standard, I get that. Then you're saying to inform people about injury automatically through the National Vaccine Injury Compensation Program, which also I think is opening for folks to identify who may have questions. Thank you.

[Rep. Wyatt (Vermont House of Representatives)]: I would, if you don't mind making one more statement, even though we might not agree with what the CDC is doing currently, who knows what four years from now will look like. And we're also investing a lot of trust in our own department of health, which I think is wordy, but we don't know who will be there in the future. Understood. So, guardrails.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I guess what we're putting our trust in is information, science based information.

[Rep. Wyatt (Vermont House of Representatives)]: Yes. Agree, fully 100%.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: That we can agree.

[Rep. Wyatt (Vermont House of Representatives)]: In full agreement, 100% side space.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: You know, it's really difficult.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: And information being transparent.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Yeah, so we always try to be transparent in this room. And I think our Department of Health is similarly open and careful. Otherwise they wouldn't have brought us this bill. Thank you for your time.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Thank you.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Appreciate it. So the question's been raised and we have three minutes. Would the Department of Health like to respond, please, to this?

[Lauren Layman (General Counsel, Vermont Department of Health)]: Thank you. Lauren Layman for Department of Health General Counsel. A couple of things I just wanna point out. These treatments are incredibly rare. Based on federal government data, about one in a million vaccines administered every year end up with compensation. And usually it's not always the amount requested. So very rare that these events occur. I think as has been noted in this room, it's not in VDH's control what the federal government does. If they remove a vaccine from VICP, we wish that they would keep these vaccines in the VICP. We wish that that was driven by scientifically based, scientifically sound, evidence based decisions. And right now it is. It hasn't changed. There's been other areas where our recommendations have changed and we have not been had access, transparent access to the science and the data behind it, and we are concerned that that might happen with this compensation program as well. That's out of our control. What's in our control is trying to maintain access by putting pieces of that system in place. We cannot recreate an entire BIC here on the state level. It's just not possible. And so we are trying to preserve access, as has been noted, by ensuring that healthcare providers are not held liable very narrowly for following those scientifically sound evidence based recommendations. Whether other forms of recourse for individuals are removed, that is up to the federal government. The federal government is choosing to remove that avenue, not the State Department of Health. We want that route to be available. If they choose to remove it, we're gonna try to preserve what we can from that system. The statement issued given to people when they get a vaccine, that's issued by the federal government as well. And that is a mandatory handout. And that's what includes the information on how to seek compensation from the BICP. Yes.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: Quick question on that. So, if in fact there is a differential between our recommendation and states versus the federal, on that sheet that the will the person getting the vaccine know that there is a difference?

[Lauren Layman (General Counsel, Vermont Department of Health)]: They, they should discuss it first or last, there wouldn't be a VMS is my guess, there wouldn't even be a vaccine information VICP, because they're no longer passing out information about that vaccine, it's saving. And if they did, they would probably say in that sheet, this is no longer covered by a VICP. Or they might say it's only covered under the circumstances in which we recommend it, for the hep B vaccine, for example. So it would come out, that statement would come out with the ACIP recommendations in it, the CDC recommendations, sorry. And then the state recommendations would, we haven't operationalized it yet, but I can imagine there will be some discussion about how to inform folks of what the Vermont schedule is and how it's recommended. Also wanna emphasize, it's not just Department of Health. We have really, this bill really bolsters and builds up the vaccine advisory committee to include experts in this field, immunologists, vaccine experts, MDs, APRNs. It's really a scientific, people who are in clinical practice, are scientific research, to advise our commissioner on how to proceed. We would never claim knowledge nor would we want to take on that risk of, for all of Vermonters, our goal is to protect public health. And so there would, you know, we're seeking that reassurance, that guidance, that scientifically sound, transparent knowledge. So that's what I have to say today. I think we can't build perfect system on the state level. We're trying, as the federal government changes in ways that we can anticipate to provide safety net here at the state level, both for access and for individuals receiving these vaccines. It's a very rare occurrence of vaccine injuries. We've also got ninety five percent promoters receiving vaccines. Just had measles detected here and we do not feel earlier this week. We're trying to protect public health.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Can you get us a couple paragraphs about what you've just presented so we have it in our testimony. It's not something that we're fluent in and you are. That would be really helpful. In particular on the VICP and the compensation and how it might change or change your mind. Yes. Some of the way. Okay. If the feds remove measles altogether, they'll walk. You know, they're not recommending measles. So, tells you what could happen with the measles that's in your brain. I'm assuming that we will have a sheet that says this is what can happen if you have a billion to one, you get a reaction. Maybe this could happen if you have measles. I think what Senator Benson and Senator Burke are saying is Representing the representative. She just got the notes. At the bottom, there be a paragraph that says, you know, this if if you do have a serious reaction, that this isn't covered under the, immunization compensation?

[Lauren Layman (General Counsel, Vermont Department of Health)]: I think where we have concerns about that is what the role of your doctor is. If you go in and get a strep test and get antibiotics and you have a reaction to the antibiotics, emphylaxis or something, know, a reaction. The doctor hasn't given you the phone number of a medical malpractice attorney. The doctors are not out there to advise on liability. They don't have that knowledge or how to pursue compensation for an injury. I think we'd also be concerned, it would be unnecessarily alarming, to say, Hey, you're taking this vaccine, but there's no compensation. That said, I do agree that they would have to go through, here are all the foreseeable risks of taking this vaccine. Okay. Beyond the red, you know, this might cause a sore arm tomorrow, a fever, nausea. Like, go through the things you should be looking at to make sure, hey, something's wrong here. There's a risk to this. To acknowledge there is a very small risk. Maybe hope ideally also what the risks of disease are. And so that folks can make that risk informed decision about it. So that's where I would say, doctors stay in their lane, they talk about the risks, the medical risks, the physical risks, all of that. And then, you know, we have the VIF statement or the vaccine information statement for whatever the federal government decides to do. And then there's, you know, a tort system in the state. You go to a lawyer just to say if you are injured in any other medical practice, treatment, diagnosis.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: That was my understanding, the discussion we had last week, is that if measles is covered, if it's on the federal list, I still have to hire a lawyer. I still have to go to court. Yeah I mean I have to go was wording I got was it was still long and expensive to get there and if it's not covered I still have to go through a long expensive process which may well cost me more than the reimbursement I'm getting. The difference is the source of the reimbursement if I sue pharma, it's gonna come from them. If I sue and it's covered under the compensation fund, the money comes from them, but the

[Lauren Layman (General Counsel, Vermont Department of Health)]: essential process of getting to the money is the same. It is a different court system, and so Senator Benson's point, there are some injuries that we don't prove causation, but it can still take years to get to that point where your petitions take you out and by the experts then sent to the panel and, you know, going through that through a chronic process. It's an alternative inventory system.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay. Thank you. And just a little Yes, absolutely. I know, CIS is federal. They decide what goes on and what comes off and the information that is given out to patients, so there is transparency and there is a link on that sheet, so patients ought to be able to access it. Thank you so much. Something for us. Yes, absolutely. Okay, good. Good. All right, good. So we'll keep moving on that one. And as I said, we'll come back to that one as soon as we hear back from judiciary. All right, so.

[Katie McLennan (Office of Legislative Counsel)]: Hello again, Katie McLennan, Office of Legislative Counsel. So we're looking at the autopsy report bill. I will go through, I have an amendment prepared that I worked on, and it's been run by health department, judge zone A, the health department wanted state's attorneys added, so now it's been run by the state's attorney. But just this morning, the state's attorney asked for another change, and I haven't heard back from them yet about what the exact wording is, so I thought this was maybe the final product, but I think there will be a few additional words out of you.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: You said you ran by the judge.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Yep.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: He had a lot of good things to say.

[Katie McLennan (Office of Legislative Counsel)]: Yeah. His feedback was great. Seemed like such a simple And just

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: FYI, I sent a little note to the chair of judiciary to look at this bill as well. Golly, no. It's got a probate court in it.

[Katie McLennan (Office of Legislative Counsel)]: Okay. So, just to refresh your memory, this bill has to do with how to access an autopsy report if you're not somebody who has permission to do so under HIPAA. So, if you remember the underlying bill, subsection A was the existing law, and then this added subdivisions B1 and B2. Subdivision B1 pretty much restates the status quo. The status quo isn't currently in statute, but the current status quo is that if it's authorized, if it's an authorized disclosure under HIPAA, then the autopsy report can be disclosed to the person. So that is not the language that was under discussion. Yeah, that was causing confusion. So, this subdivision B is the process that's being put in place for a petitioner to petition the court. Some of the feedback from Judge Chittenden was making sure that there was an opportunity for the office of the medical examiner to respond, and also to set out a standard for what is meant by good cause. Also to allow the judge to redact some of the information in their autopsy report that best meets the definition of good cause. So that's what we're looking at right now. Yellow of course is the language that's new since the last time you've seen it. But now it would read, an individual was not authorized to receive the autopsy report pursuant to subdivision one of the subsection B, meaning they can't receive it under HIPAA. They may petition the probate division of the Superior Court for a copy of the autopsy report. The petition shall contain an affidavit attesting to the petitioner's relationship to the decedent and the reason the petitioner is seeking the autopsy report. The petitioner shall notify the office of the chief medical examiner and the state's attorney of the county in which the death occurred within five days after filing the petition. The office and the state's attorney shall have an opportunity to respond within ten days after notice. If the Superior Court finds that the petitioner has demonstrated good cause for the petitioner to obtain the autopsy report, and shall order the office of the chief medical examiner provide a copy for the petitioner in whole or part and may place restrictions on the petitioner's dissemination of the copy provided. So it could be that the petitioner, the court authorizes the petitioner to see it, but not distribute it. So, you may have it, petitioner, but you may not share it with the newspaper, distribute it to other family members or what

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: have you. Do they have a process of well, I'm gonna let judiciary deal with that issue, but do they have a way of keeping people from disseminating disseminating, or is it a matter of reading it once? I mean, so yeah. I think once I send it to the gossip column, it's out there. You can't

[Katie McLennan (Office of Legislative Counsel)]: they probably be in contention with the board. Yep. Right.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And so and if the person I could see all kinds of little tricks from that and stuff. So if the person who legally can receive it disseminates it, then how do you know it was, you know

[Lauren Layman (General Counsel, Vermont Department of Health)]: Why would someone disseminate this? You

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: want to get back to the epic son-in-law boyfriend. Right? Okay. Left. Okay. Wow. She was pregnant with somebody. Right. Yeah. Okay. This is family.

[Katie McLennan (Office of Legislative Counsel)]: Right. Okay. So, term, good cause, is highlighted. Superior Court finds the petitioner demonstrated good cause, and then we have a definition of what good cause is. So, this is what Judge Ginny was mentioning, like what is the guidance for the court in making this decision? So, determining good cause, the superior court shall consider the relationship of the petitioner to the decedent and the decedent's family, whether the disclosure is necessary for the public evaluation of governmental performance, the seriousness of intrusion into the decedent and the decedent's family's privacy, whether the disclosure is by the least intrusive means available, including whether and to what degree redaction of some portions of the autopsy report is appropriate, and the availability of similar information in other public records regardless of form.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: What is the definition of family here just because it seems as though there are family members who currently are not? Not defined here. So this language comes from?

[Katie McLennan (Office of Legislative Counsel)]: Where is the It's mostly from Wyoming state, but not entirely. Did

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Judge Szony approve this language?

[Katie McLennan (Office of Legislative Counsel)]: I sent it to him and he said that that addressed his concern. Okay.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And then what about the Department of Health?

[Katie McLennan (Office of Legislative Counsel)]: They have seen it and they were comfortable with it. It's the state's attorney that I've been going back with and forth with most recently. The email I got this morning is that they would like a standard. I think what they want is something like by a preponderance of the evidence or by clear and convincing evidence that the petitioner has demonstrated good cause,

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: but they haven't gotten back to me. I was

[Katie McLennan (Office of Legislative Counsel)]: hoping that I could put it all together before you saw it, but

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I haven't. Is that Taylor Lueder, Stubant, you were thinking?

[Katie McLennan (Office of Legislative Counsel)]: I initially emailed him, but he referred me to Kim McManus. Yeah, Kim McManus. Yeah. Okay. So, she and I have been going back and forth, I think, assuming that everybody else is okay with what the language suggested, that this is hopefully getting pretty close.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: We're pretty close. Okay. And then regardless of what we have in here, they'll have to look at it next door. I mean, here's the thing I'm thinking about. There aren't gonna be a lot of these cases. We've heard one that's pretty significant. We've only heard one side of one case. But she She might have been the mother-in-law from hell and her daughter. We have only heard her side, and it is very sympathetic. Yes. But we're changing the law. For every, she could find out her daughter was pregnant and say, see, she alright. I get it. We get it. That's why, that's exactly why the courts and the state's attorney need to be invoked. We can't bring in the other person on the other side there and resolve their problem. That's what I was going to say. So get it. Okay. Okay. Okay, so let's, why don't you keep us posted. Okay. And as soon as we hear back from the state's attorneys and Kim gets to you, then I

[Katie McLennan (Office of Legislative Counsel)]: will run it by the health department and judge zoning one last time. Yeah, we'll run it by

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: that time that we can look at it and similarly, we'll bring it right back here and see if we can get the closure on it. Maybe we can get to a vote by the end of the week. Again, it'll depend on what I know that when I talked with Senator Khashim, he said they're extremely busy in there this week. So we'll just see how quickly we can move it as soon as they have a chance to take a look. Okay. They they put off. You know, I'm feeling like it's crossover with all the way the way things are gone. It's gets good. Yeah. Thank you. You're welcome. Okay, so we don't have the two folks scheduled for testimony until 11:30, But I'm thinking if we

[Katie McLennan (Office of Legislative Counsel)]: Yep, that'd be very helpful.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Yep, let's skip into it. We can go into 206, and then when they come in, we'll be ready for their testimony on 02/2006. And this is the licensure bill, and I asked folks from CDD and the DCF to come in and education to come in and talk about sort of the oversight and regulation of the licensure process where we But there's always been some amount of tension about who regulates these folks. So the Secretary of State has brought us a suggestion, I think, that can make a lot of sense as long as it's costly. So we'll have those folks in at 11:30, but in the meantime, Katie, if we can go through the. I was in the halls when they were doing speech and language pathologist? Do you remember? I was in education. Oh, I know. And Yeah. It's it's not comfortable. It's not comfortable. It's uncomfortable. Yeah. I mean, what was just discomfort. You are the issue is you are a licensed speech and language pathologist. But you're working in the public schools. Therefore, we have the same deal with nurses. Do you need to have a license or something from the board of education or whoever licensed teachers? Do you have to get to licenses? Like, who is in charge? And that gets tied to who gets paid the money for your licensure. And it was cancer at night. So we did get some really good We've got good stuff in here, I think. And then the one the one area, again, there's Northern Lights coming in today. The CCB folks, are they coming in today? Or are they coming in another day? No. They're in is it gonna be tomorrow? Or another. They're coming in tomorrow. So we also the other issue that we're dealing with on that is, remember the grandmother in clause, where we have someone at the, we heard from folks who have been in childcare for twenty five, thirty years of trying to find a pathway to them that's not the full blown education. You have to go back to college. Yeah. She's 60. Age of 45. But everybody wants something. Yeah. Right, so. Might have to step out in a few minutes, but let's start going through,

[Katie McLennan (Office of Legislative Counsel)]: but if I do, tell your center. Okay. This is our licensing bill for early childhood educators. Do we have anything changed?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Not yet. Yet. Okay.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: No.

[Katie McLennan (Office of Legislative Counsel)]: So the first section is a section of existing law that's in Title III that lists all of the professions that OPR regulates. So the First Amendment is just adding, at the top of page two, early childhood educators to the list. Next, in section two, we're creating an early childhood educator chapter in title 26. Title 26 is our professional regulation chapter. We're adding this chapter in two parts, because the board, the creation of the board, is necessary to adopt rules for the licensure program before the licensure program itself takes effect. So, section two, there's the creation of the chapter, and the creation of the board, and you're laying out the board's authority. In the next section, you add in the rest of the chapter to take effect at a later date. So, we have in section two, a new section 6,211, the creation of the board of early childhood educators. It says that the board is to consist of nine members appointed for five year terms by the governor. Two will be public members, two each of individuals licensed as an early childhood educator one, two, and three, and one family child care provider. All of these individuals are Vermont residents. The members who are early childhood educators shall have been in active practice in Vermont for not less than the preceding three years and shall be active in practice during their incumbency. The public members are to be individuals who have no financial interest, personally or through a spouse, parent, child, or sibling, and activity is regulated under the chapter. So, if you are the spouse of somebody who runs an early childhood program, you wouldn't be able to be a board member overseeing the licensure of early childhood educators.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: Is there a board present by any that oversees the licensure of the actual facilities themselves?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: We know.

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: How were they licensed?

[Katie McLennan (Office of Legislative Counsel)]: They're licensed through the Department for Children and Families Child Development Division, the CDD. So there are rules that govern their practice. I know CDD is scheduled to testify, so you'll hear more from them, but it's not a board structure.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: They do, oh, sorry. They know they have to go through fire, Virginia. Yeah, they have to get,

[Katie McLennan (Office of Legislative Counsel)]: they have to either be licensed

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: or registered. I'm curious

[Andrew (Agency of Education, Director of Educator Program Approvals)]: if there was a way

[Sen. John Benson (Member, Senate Health and Welfare Committee)]: of not duplicating and creating a whole new board if one already existed that you couldn't share.

[Katie McLennan (Office of Legislative Counsel)]: Yeah, don't think it's the board structure. The CDD does either a license or a registration depending on the size of the program. Let's see. Appointments are not made without, shall be made without regard to clinical affiliation on the basis of integrity and demonstrated ability. Language about vacancies, they're filled in the same manner as initial appointments, the form at first shall not serve more than two consecutive terms, so a maximum of ten years. Then we have procedures that govern the Board. Annually, it elects a Chair, Vice Chair, Secretary. The meetings have to be warned and conducted in accordance with the open meeting law. Majority of the members constitute a quorum, and the business is transacted by a majority vote of the members voting, unless otherwise provided. Powers and duties of the board. The board has to adopt rules. Those are rules that are necessary for the performance of its duties in accordance with the chapter, including activities that must be completed by an applicant in order to fulfill the educational experiential requirements established under this chapter. So, if there are any specificity to the experiences or education of potential applicants, that has to be dealt with in the board's rules. The board is responsible for providing general information to applicants for licensure. They have to, the responsibility of explaining appeal procedures to licensees and applicants, and complaint procedures to the public. And they are to use the administrative and legal services provided by OPR. The board can conduct hearings and exercise its authority as provided in Title III. That brings us to section three. Again, we're in this new chapter that we've created. This section takes effect at a later date, and this builds in the rest of the chapter. So first we have a sub chapter that's general provisions, but we just looked at with the board that will become I think sub chapter two, which is specific for the board. So we have definitions of who an early childhood educator is, maybe we'll go over that one. Means an individual providing care and educational instruction to children for birth through eight years of age and a program regulated by CDD, including planning and implementing intentional developmentally appropriate learning experiences that promote the physical health and social, emotional, linguistic and cognitive growth of children. Establishing and maintaining a safe, caring, inclusive, and healthy learning environment. Observing, documenting, and assessing children's learning and development. Developing reciprocal culturally responsive relationships with families and communities. Engaging in reflective practice and continuous learning. So that's what the ECE is. And then as you remember, we have the ECE one, two, three, and then the family childcare provider. Do you want me to, how much detail? Do you wanna go through ECE one, two, three with qualifications and responsibilities? Yes, a little bit, I

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: think, because that's one of the areas we're gonna have to be

[Katie McLennan (Office of Legislative Counsel)]: Sure, I'm happy to. So, ECE one is a person who practices in early childhood education as an assistant educator in a program, and they're working under the supervision of an ECE two or three, or a teacher who is licensed by AOE under Title 16, and that teacher would have to have endorsements in early childhood education, early childhood special education, or elementary education. Then we have our ECE two, is the person who practices early childhood education as the lead or primary educator in a program. They can supervise the ECE one and they receive guidance from the ECE three. Then we have the ECE three. This is a person who is the lead or primary educator in a program. They supervise the practice of the ECE one. They provide guidance to individuals licensed as an ECE two.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Then the family child care provider is the person So, to stop there for just a minute and try to place someone who's been working for twenty five years, thirty years in a setting without the degree And based on experience and outcomes, might fall under two or possibly even three. So we could be homeless if I was to say that. Anyway, that's kind of a place. And

[Katie McLennan (Office of Legislative Counsel)]: then when we get to eligibility qualifications on page eight, if we revisit each of these, that's where the education and experiential specifications are listed there. Good.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: We have it for his family.

[Katie McLennan (Office of Legislative Counsel)]: So, have our, oh yep, the family, thank you. The individual who provides developmentally appropriate care education supervision of children, birth through eight years of age, and is authorized by CDD to operate a family childcare home. So this is the person who's either licensed or registered to provide child care services in their home the CDD. This keeps them in the CDD? This doesn't change that. It wouldn't change it. They would still have to have a licensor registration from the CD. We have definitions of guidance and supervision because if you recall from our definitions, some folks receive guidance, some folks receive supervision, so this distinguishes what is meant by those, whether it's direct or indirect consultative support or on-site direct oversight. Program means a program regulated by the CDD. Okay, prohibitions. An individual cannot hold themselves out as an early childhood educator in the state unless the individual is licensed under this chapter or exempt from this chapter. And then, in subsection B, an individual is not to use in connection with the individual's name. Letters, words are indignant indicating that the individual is an early childhood educator unless they are licensed under this chapter or exempt from this chapter. Our exemptions, we already know a teacher who is licensed under Title 16 with endorsements in either early childhood education, early childhood special education, or an elementary education endorsement, or an individual who provides care in an after school program that is regulated by CDD or another childcare program that is exempt from regulation by CDD. And the chapter is not construed to alter or amend the requirements and quality funded pre K, so that program would still remain intact and unaffected by this licensure requirement. This chapter is not to be construed to limit or restrict in any manner the right of a practitioner of another profession or occupation from carrying on in the usual manner any of the functions incidental to that profession or occupation. Then, as I said before, this is where our subchapter two would be located that is adopted. We have the ellipses to show that that language will appear here unchanged. So, it was adopted previously and this is where it will be located. We skip over that subchapter to subchapter three. This is what we were just referencing, the eligibility and qualifications. Be eligible for licensure under this chapter, the applicant shall obtain the APID majority, achieve a high school diploma, a GED certificate, or an approved equivalent credential, and completed field experience in early childhood education as required by rule. An applicant shall meet the following educational requirements for each of the following license types. First, an early educator one shall have received a certificate from an approved credential program in early childhood education that requires a minimum of one hundred and twenty hours of training and instruction. Two, so EC2 shall have received an associate's degree in an early childhood education program or related field requiring a minimum of 60 college credits or in any unrelated field in a minimum of 21 approved college credits in the core childhood education competency areas identified by rule. And then an ECE three is to have a bachelor's degree from an approved program, an early childhood education or a related field requiring a minimum of 120 college credits or any unrelated fields, and a minimum of 21 approved college credits in the four competency areas identified by rule. And then, a family child care provider shall be qualified for licensure if authorized by the CDD to operate a family childcare home and is in good standing division as of 01/01/2029, and the board is not to accept a family child care provider application after 01/01/2029. So, if a person is already working in a licensed or registered family child care home as of that date, then they are qualifying on the basis of that previous approval. But after that date, they would have to obtain a license in one of the other categories. Subsection C, approved educational programs may offer college credits based upon assessment of the individual's competencies acquired through experience working in the profession. So, experiential work previously could count towards the person's degree. In addition to the requirements of A and B, applicants shall pass any exam that may be required by rule. So, this at least opens the door but does not require an exam. License renewal. License must be renewed every two years upon application, payment of a fee, failure to comply with provision of the section, result in suspension of the license. A license that has lapsed shall be reinstated upon payment of the fee and a late renewal penalty except a family child care provider shall not be renewed after a lapse of two or more years. So, if that person is qualifying on the basis of having a family child care program and their license lapse, they would have to rejoin under the ECE one, two, or three categories. This authorizes the board to adopt rules for the protection of public health to assure the board that the applicant whose license has lapsed more than five years is professionally qualified before reinstatement can occur. And then in subsection C, in addition to the provisions of A, an applicant for renewal shall have satisfactorily completed continuing education that's required by the board, and the board may require by rule not more than twenty four hours of approved continuing education as a condition of renewal. Then in section six thousand two twenty three, this is the fees section. So you'll see that there are different fees, both for initial licensure and for biennial renewal, and they differ for ECE one, two, and three, and family child care provider. And then we have language about unprofessional conduct. Is conduct prohibited in Title III or by other statutes relating to early childhood education, whether that conduct is by a licensee applicant or an individual who later becomes an applicant? It means conduct that results in a licensee applicant or an individual who later becomes an applicant being placed on the child protection registry, or conduct that is not in accordance with the professional standards of early childhood educators published by MACI. And then we have a variance language. So the board can issue a transitional ECE two or three license to a teacher or director of a program who does not meet the educational and experiential licensure in this chapter. Transitional licenses are to be valid for a two year period and shall be renewed by the board or an otherwise qualified applicant for an additional two year period with satisfactory supporting documentation that the person has ongoing work to meet the qualifications. At the conclusion of three two year transitional license period, the board at its discretion may issue a final two year transitional license. So that's eight years of transitional license for ECD two and three, if they're working to come into compliance with those sections. And then we have disclosure by licensees. So this is language that we've been over before, but it's required disclosures to help families understand who oversees various requirements in the field of early childhood education. So, information has to be displayed about all available license types regulated by the OPR pursuant to this chapter. Secondly, a description of OPR's regulatory authority over licenses and programs regulated by CDD and how to make plates. A description of the Agency of Education's regulatory authority over teachers providing pre K services, universal pre K services, and how to make complaints. And then lastly, a description of the CDD's regulatory authority over the programs and how to make complaints. In section four, this is repeal of the transitional license. That's the eight So year transitional this would be repealed after that eight years has expired. Section five, this is the appropriation. So, this is a one year appropriation, but you have legislative intent language for fiscal year '28. So, in '27, there are two positions authorized and an appropriation of 262,000, and then in fiscal year twenty eight, there is legislative intent language for three new positions, and an appropriation of 628,000. And then there's this language in subsection C that it's the intent of the general assembly in fiscal year twenty eight that 1,400,000.0 be distributed from CCFAP to the Office of Professional Regulation for the initial licensure application fees and initial renewal fees for the sort of first licensing round. Maybe we should say instead of that coming from CCFAP that it would come from the child care contribution special fund. That's

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: part of Are you on section five?

[Katie McLennan (Office of Legislative Counsel)]: I No, have to on section six.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: All right, let's go back to section five on page thirteen fourteen. Thank you. Don't like to do this to this, Okay. This is gonna be a problem when it goes to appropriations, I just wanna tell you. And we're gonna have to have a discussion after we've heard from everyone. Put this on the list for a conversation about funding, because it's significant, it's a significant pause. Okay.

[Katie McLennan (Office of Legislative Counsel)]: We've sort of already gone through some of the effective dates as we walked through it, but we have the language around adding to the list of professional regulations that OPR regulates, establishing the board, and then the licensure, the appropriation. Those all take effect July '26, this July. And then section three, it sets out the rest of the program. Section four, which is the repeal of the transitional license. Those take effect 07/01/1928, two years later. That's it. Thank

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: you. That was really good. We got our heads back into it quickly. All right. So, have two folks here testifying, unless there's a question for Katie. And I'm gonna ask you who are sitting in this chair, young woman, you could move over that chair, please. Our staff is our framework. Okay. All right. So, we have Janet McGulick from CDD here and Doctor. Proton. So, why don't we start with Janet? Okay. And so we're looking at a couple things. Well, we're looking at more than a couple things in this bill. So why don't you I know you sent us testimony. Yep. And we can follow along. You have first kind of the baseline of child care licensing, and then you've got

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Yeah, I'll try to be efficient.

[Katie McLennan (Office of Legislative Counsel)]: And great communication. Thank you.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Okay. Okay. Let me get in. I just got into the, so it takes me a second to

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: just Are you gonna put something on the screen?

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: I think so. Think that will make it easier for the web if that's easier for you guys.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I always love it when we got kids stuff in here because we have nice pictures. There you go.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Okay, so hi there, Janet McLaughlin, I am the Deputy Commissioner within the Department of Children and Families that oversees the Child

[Katie McLennan (Office of Legislative Counsel)]: Development Division.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: CDD oversees children's integrated services, which is sports for children and families who might be at home visiting, early intervention, some of those really important services for young children. We oversee all things childcare, so childcare licensing, childcare financial assistance, quality and capacity, and we also partner with the education on universal kindergarten. So, in thinking about S206,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I just wanted

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: to provide some additional information for you guys to consider as you are reviewing the bill and thinking about what's needed. Just as a background, wanna make sure just about these resources that hear right, that we do Child Home Tuition does regulate all regulate childcare programs in Vermont, and it's a mix of center based childcare programs, registered and licensed family childcare homes, and after school programs. And this bill does not specifically exempts after school program staff, but is really focused on the center based and the family childcare homes. And obviously it impacts the entire state, for the map. And our childcare licensing regulations, they do cover all facilities that are serving people who are caring for children for more than two families other than their own need to be registered and licensed with the state. It's all about the foundation of health and safety for young kids, and they're driven by federal and state statutes and best standards for the American Academy of Pediatrics. So there is a lot laid out in child care licensing regulations already. And so within child care licensing, I just want to be clear on what it is that we do right now related to individuals. So we do approve and monitor everybody who is working within a regulated child care program. So we know who they are, we know what programs they're associated with, we check their background checks, we check their qualifications, and we approve individuals to work in specific roles based on the standards that are laid out in child care licensing regulations. And we contract with Northern Lights at the Community College of Vermont to verify qualifications, ongoing professional development hours, and required trainings to inform whether or not people are approved for work within specific positions, and to maintain compliance with state and federal standards. And so I just want to be super clear that this bill really will change, require major changes for CDD in terms of our role and approach related to staffing for early childcare education positions. Like, saying that as a fact, not as, like, a, you know, positive or negative, just just making And, sure that that's you know, I as I was getting my my brain around this bill, I was trying to think of, like, who is this universe of folks who are really impacted by this bill? And so, again, it could be the 7,000 folks that are working within early childhood education and regulated childcare settings right now. And so there is about 4,500 people that are working in direct child serving roles in community based or what's also sometimes called as private center based childcare programs. There's also about 800 people working within family childcare programs. And then there's about 1,700 people that are working within public school operated center based child care programs. Because for universal pre kindergarten, we do, to ensure the foundational health and safety for threes and fours, young children, we do have joint oversight, and they are public schools are operated are licensed as center based child care preschool programs. One of the things I did talk actually with OPR about at 6PM last night was making sure that the bill is clear on whether or not you want to include public school operated center based programs or exempt them from these from these rules. And I I think the license the language probably needs to be needs to be a little clearer there. I think the intention is to exempt them, but I'm not sure the language is there right now. And then related to I know there's been a lot of discussion on this bill about how does this interact with the AOE educator licenses for with early childhood education and early childhood special education endorsement. So this red circle is my attempt to to make that clear to Paul Trine because being a because there are people that work in all of these contexts and also that all of these regulated childcare contexts that have AOE educator's license and people who don't work in in CD regular beds. So this is this is sort of saying, like, this group of people crosses about across all of those different segments. So and those people are also gonna be exempt from this bill. Right? So there's gonna be a small there's people who run family childcare programs that hold AOE educator's license. There's people that work in community based programs who hold AOE educator's license. And, obviously, there's people that work in public schools that hold AOE educator's license. And then there's also the people that are working in kindergarten and above who have those license and other people that are in nonspeaking roles. And all of those people can still just go through the AOE process and not through the throughout bed. But I think for me, when I was talking internally with my team and we were trying to get this done, this visual was helpful for us in terms of understanding what are we talking about, who's really gonna be impacted, what are the numbers. And I think it's really important to recognize that this bill is about those people who are not in the red circle, who are in family child care, and not in the red circle who are in community based programs. And that is who is gonna be impacted by this bill. It really doesn't has limited overlap with folks that are working within an a regulated context.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: It's a good visual. Thank you. I

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: had to drive it a few times before I could figure out how to get it out.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: That's like, this is like Katie McClenn's Venn diagram.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Okay. So just just wanted to make sure, again, we're, like, all working with the same context on this. So then when my team, as we're looking at the bill, we we noted three major really major changes. And, again, it really depends on your perspective, some of these things about whether or you think that's a pro or a con. But three major fundamental concerns, and then I have a couple other small things. So one is related to decision making. So this bill really, it changes the decision making on who is qualified to work within Regulated Child Care Program, from a CVD led rule making process to an OPR supported oversight board.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And I can remember going through the rules for this stuff, so it's not simple. No. No. Agree. Took time.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: It is, it is. Right. Well, the part of why the rules are a little longer is because they are trying to create a lot of flexibility for people to have multiple pathways to be able to qualify for these positions, right? The downside of all that flexibility is complexity, so it's, you know, we have to balance those things. But we would, CDD does notice, obviously this does, this switch would align with the processes for teachers and for other professions. It does ensure that those decisions around qualifications are made by those around, based on the composition of that board, I think it would ensure they're made by people with relevant credentials. It does leverage OPR's expertise and their system that they have for professional licensing, and it also does limit CD, it would limit CDD's role in terms of setting the rules, granting variances, and responding to concerns. And again, that's just, you know, that's the question of moving into a different entity and thinking about what the administration, know, when it is we want to have a

[Katie McLennan (Office of Legislative Counsel)]: lot of flexibility, when it

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: is we want things really set. Question, are we missing a transition piece in here that allows for CDD to inform work of OPR, if that were to flip over?

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: We have had multiple conversations with OPR. I think that the, because of the way that it is a transitional license, if this does, with the transition process, I think we would, over time, we would have to probably layer in the OPR recognition streams, which would make it longer for a short period of time, and then we would, as we hit the end of the transition period, we would have to update our regulations and phase out some of the alternative pathways that we have identified. Because those, some of those alternative pathways would be in the OPR process of figuring out what those would be. But yes, that would all be work that we would have to do in tight coordination with OPR during the transition period. Yeah. And there's really specific, like, our rules talk about, I don't know, they talk about age a little bit differently. They talk about years of experience a little bit differently. And so we would have to, again, that's like all stuff that we would be negotiating with. Like, in talking with with OPR, they have

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: indicated that, you know, we should be, you know,

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: actively working with them and with the board as they were work developing the rules and helping make sure things are aligned. But I'm glad you can push them in perspective of like, it's gonna be a lot of

[Katie McLennan (Office of Legislative Counsel)]: work for

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: a CBD's perspective, and I don't know that that's necessarily been reflected in what's developed so far. I get it. Okay. The next is point, major point, is around transparency and accountability. And I think CDD does agree that this bill would make qualifications for these folks who

[Lauren Layman (General Counsel, Vermont Department of Health)]: are caring for some of

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: our youngest and most vulnerable children clear and public in a way that child care licensing does not allow. Sometimes right now, because what we do is hold programs responsible for the most part, it's not as clear when there's unprofessional conduct that doesn't necessarily rise to the level of a child abuse and neglect substantiation. It's, we have ways that we might be able to prohibit someone, but it's not quite as public and as transparent a process as what probably would be available through the process that OPR does, and we can see that it could be helpful from that perspective. It would provide some consistent standards for higher education and career tech centers. We also recognize that this can be, could be confused with AOE credentialing, right, that's come up a bunch, and I have a little bit more information on that, so does Andrew on that. And then this other piece, right, is this gonna require CDD to revise the child licensing regulations to align with the scope of practice and qualifications,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: which as you guys know is doable

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: and also not the easiest left to do.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Yeah, it's not all OPR that's doing the work should all of this happen, it's also on your shoulders. Yes. Understood, yeah.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: And then relative to increased qualifications, I'm sure you guys, we see on our side too, like we were debating, right, the trick of this, because it can be a little counterintuitive to feel like, oh, we're gonna increase qualifications and somehow that's gonna increase the workforce, like, if that's what we're trying to do. But we recognize that we'd absolutely recognize this proposal does align with the evidence on quality early childhood education and child development with the national best practices. It aligns with the national pre kindergarten standards put out by NIER. It aligns with early childhood educator competencies that we've adopted as a state and use in our, in the workforce development work that CDD supports. So, it definitely does align with those more closely. Can see that when we get to a place where there is a more consistent professional standard, that that could allow CDD to pare back some of our regulations that we have right now, because right now we kind of spell everything out, because we can't then, it's less, we don't necessarily can't point people to a very specific professional standard, that we know that they've been a standard of training, that we know is consistent across all entities. So we spell everything out in great detail, which is why people, the licensing regulations are really long. But we also know this will require additional post secondary work for some people who are in the field or considering entering, and it might deter some people from entering or growing in the field. This is the part where all of us, don't know, may support, there's also evidence that would show it would support retention and reduce turnover, right, when you have people who are qualified for their jobs. We we have we do have really robust workforce development efforts at CDD right now, and it builds from those, but we would probably need to grow those, right, and develop them, refine them to specifically address this, which is, again, just pointing out, who work for CBD. And, again, it's this part for all of us, right, because we know it's difficult to really predict whether or not, and it'll be different for different people, but it feels like a burden or a support. Additional things that I will just raise is related to early childhood, the name of the license of early childhood educator and ECU radiation. That's been raised by a lot of people. It does feel like an alternative title of early childhood education professional, and maybe an abbreviation of ECU or something like that could be a reasonable way to address this issue. So here's a

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: question I have for you, and I'll ask Andrew as well, but right now folks are graduating with a degree in early childhood education, and that's been going on for fifty years, sixty years, And don't know how so now we wanna change it because we don't like the word educator. I'll just leave that right there and we can talk about that.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Yeah, I think it still includes early childhood education in it, and Andrew can talk to you about the very specifics I think what underserved concerns are. The other thing we would note is that the current proposal doesn't include the option of transitional licensors for those entering the field after the initial period, and there might be some career changers, or you think about within, again, within the K-twelve education context, there are provisional licenses available. This doesn't provide that after the bill goes forward, and so that's something, I think, to consider. And again, I already made the point that

[Katie McLennan (Office of Legislative Counsel)]: we report a lot of

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: work for CDD, and the final thing I'll just offer too is that, I know Katie just mentioned it, but it missed childcare financial assistance as the funding source, which is not a funding stream, it's a program, and so we need to decide if you guys want it to be general fund, special fund, which again is on track this year to be 99% spent on Child Care Financial Assistance, so there's not a lot of money in special, there's no extra money in special fund. So, that is what I wanted to just make sure you guys had as information as we say.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay. You've given us stuff to think about. It It doesn't sound like you're totally averse to the changes. There's some good things and some difficult things. Right. And trying to put those things together. I guess that ends up being here on God's whole life. But don't go away. And you've also sent us

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: the report. Yeah. Yes. I also included our most recent early childhood education after school workforce report, which does compare 2022, December 2022 to December 2024, and looks at the qualifications of educators, of which we're seeing great, we see some really great things in there. It's also not 100% of the workforce that we have verified credentials on, but it really should be for almost all the teachers and directors, so it's really good. I've got

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: some question, I'll add to that too, but it's helpful. Do you know why other states don't already have something like this? Yeah.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: So, other, so let's see. This is a new approach, right, being organized by all of the national zero to five organizations, recognizing that over the years, right, we have not come up with a way to consistently recognize the value of early childhood educators. And so, I think Vermont is just early in that process, the unifying framework and the National Commission were both established, and the report was released in March 2020. Vermont is one of the first, but there's many states, I think there's multiple states considering that. Other states have started in different places. Other states have aligned their, made sure that their high school to community college to state university pathways align perfectly with EC one hundred three in terms of the trainings that they're providing. And so, we don't have that same consistent approach here in Vermont, so that wasn't the place to start in Vermont. Other places do do this in different ways. I mean, California calls that, you know, it does have they call them, like, people have to get, like, a childcare permit. It's all the way they word it there. So people have things in different in different ways. It's just not all exactly the same words, but the the that part of the problem that everybody's trying to solve, with Vermont is at the tip of the spear on this.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay? Okay, so we'd better listen to Andrew because I don't have a I know. Thank you for being here, both of you. Great. Good morning.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: I'm Ann Cummings for the record. I'm Agency of Education's director of our Ed Program Approvals Division. To me, it's a couple different things, but one of my primary responsibilities is overseeing educator licensing and preparation.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I did print out my testimony if anyone would like it. Can you send it electronically?

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Yeah, we did as well.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Oh, okay.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: I was scheduled last week and then I got

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: I've got a refresher. It's on there? Oh, there it is, got it. Recommended language. Yeah,

[Andrew (Agency of Education, Director of Educator Program Approvals)]: so I think it's, this conversation is very technical, nuanced, but at the end of the day, it's fairly simple, right? The use of the word educator is, in this context, ultimately is gonna make some compliance headaches for my team. I think what we can think about it is demonstrating a little e educator and big e educator, right? Can get it

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Kids and big kids. Well, yeah, we got it.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: There's that, the more formal use of the term versus an of the use of the term. You can get a degree in education, lots of different types of degrees in education that do not lead to vice chair. There are additional national requirements needed for one of those education degrees in order to become a vice nurse educator. So within the testimony, what I really did is I wanted to try to find a really tangible, specific example of issues that can be created from this. This is not the only issue. I know a lot of the public school membership organizations like the NEA, the School Board Association, Principal's Association spoke about this last year. Not sure if they're attempting to hear from them, but there are implications with the collective bargaining agreements and the use of the word licensing as well. But for our purposes, my office, one of the most important parts of my job is to make sure that any of the qualifications for licensed educators are meeting the national definitions and the national qualifications. The early childhood educator level one, two, and three do not meet those qualifications, right? There needs to be a minimum of a bachelor's degree in a specific educator preparation program, with student teaching, testing requirements, other pieces that simply are not existing within these designations. What can happen, and I've spoken to other states, as well as members of the executive team at this association, NASTP, They're responsible for the interstate reciprocity agreement, allows a licensed teacher to move from one state to another, teach there. It allows a graduate from UVM or one of our other institutions to go to another state and earn a license in that state. The use of licensed educator in this context really may put us out of compliance. I don't want to say that it will, right, on the record, you just never want to say you're out of compliance on the record. But in my conversations with other states and the national directors, they really had a lot of concerns over this bill specifically, and the use of licensed educator in this context. Because as a member of jurisdiction, which we from all are, we need to ensure that all of our rules and regulations around licensed educators are meeting those qualifications. So I have in there a testimony some specific citations from that. I have a link, yeah, the electronic one is linked to the actual agreement, if you are interested in it. And that's really kind of the root of it, you know, I think on that like human sense, these folks are absolutely educators, you know. Anyone working with kids is an educator. When we're talking about what the statutory definitions of being an educator, that's where we can get some of these compliance issues, like, back. And I think that's about it. I mean, that's as simple as we can make it on that. And again, this is a specific example that my team has to work with on the national standards. There's lots of local implications around this language that can come out of this model.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Got it, so I know. We've been making lists too. I understand your concern that it could run into some federal or national standard requirement. Right. We get that. The folks who go through early childhood education programs come out as EOE, maybe we just say that you're licensed through early childhood education. That EOE stands for ECE. Sorry. Yes. ECE. ECE stands for early childhood education, period. And I'm licensed in early childhood education. I'm a professional in early childhood education. Don't have to call myself an educator even though you just said, I know, everyone else knows, you're an educator. We'll think about this. This kind of gets to the Brampton Aggians and really, know, that book. Anyway, we don't need to be there for this. So, Senator Gulick, you have a question? Yes, so ECEP. ECEP. Right the needle. Andrew, I don't know if you can answer this or if you want to answer it, but we are getting a lot of emails from people in the field and I'm finding them actually really helpful and kind of finding them. But one of the things that I've heard in one of the emails was that the ECE3 license seems to be kind of redundant with the AOT teaching license.

[Janet McLaughlin (Deputy Commissioner, DCF Child Development Division)]: Is there, do you see?

[Andrew (Agency of Education, Director of Educator Program Approvals)]: I think that there can be overlap, right? Like on, as far as like regulation, folks over at AOPA have done a really good job of separating kind of 16 in their title, don't remember exactly. But ultimately, you know, that ECE three is really what we based our license on. Our standards are based off of what the national organization recommends for ECE three. We did add some specific special education in addition to that, but ultimately in some cases, it would be the same. Someone who goes through the full VTS program that is phenomenal, it's really amazing what the work that has been done in the VC community, right? And we've been looking at that as a model as we think about the partnerships and such. So for someone getting that VC who goes through that full program, right, BTSU is approved all through the national, it's nationally recognized, right? So if somebody who competes, all of those requirements were its licensure, would qualify for both our license, as well as this proposed CC3, right? But then there are other opportunities for folks to get the proposed ECE3 that would not qualify. That creates additional confusion and concern where some ECE3s would qualify and others wouldn't. Right. And also, you know, our licenses, we also use doubles, so right now there is an ECE1 and an ECE2 level of license. So we would have the continuum be ECE one, ECE two, ECE three, ECE one, ECE two. Our level one license is a program graduate, someone who's completed the full state or nationally accredited organization. Level two is after three years of teaching in Vermont. So there's an additional area for confusion, right? So someone who holds one of ours, and needs to be level one license, is very qualified, they can access UPK, but with this new use of language there could be confusion, folks may think, hey, they don't have that, they have, I believe it's a high school diploma for that qualification.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Yeah, So so the question I have for you is the work that you're doing with OPR to sort of straighten this out, should the bill go forward with OPR having oversight over licensure, how are you working with them? And obviously there's a transition period in here, and the definitions and this understanding of who's doing what. So have you been working with OPR? We've had been invited to some conversations over the years on this,

[Andrew (Agency of Education, Director of Educator Program Approvals)]: and we've maintained that we're concerned about this language for several years now.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: But have you talked with them recently so that we can resolve this? We're gonna resolve this pretty soon.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Right, yeah. I mean, they are very intentional in the use of ECD, as you heard during the testimony, and I can understand why, but, you know, trying to promote and elevate the profession. You know, I feel bad saying it at the end of the day, like, there's a clear line in this national agreement we have with other states of what the requirements are. And so

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Understood. I understand that. I'm trying to understand how you are resolving this issue. We understand the problem.

[Rep. Wyatt (Vermont House of Representatives)]: Yeah.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: The problem's been out there. They've been beating us us over the head now for a long time. Mhmm. So now we're and and trust me. This isn't the first year. This is the tenth year this has been going on. And for me, just so you know, you talk about elevating the profession, these folks are elevated. They receive an exceptional education in neurobiology. They understand behavioral modification and they know how to use it. And when I talk with some folks who our educators in our schools, they say we don't do that, but our little ones do it. So here's my question. My plea for you is to work closely with OPR so that we can get to a place where this bill is going to go forward very soon. You see, on our thing it says Marco. That means we're making changes now that will go forward to the House. Just so you know.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Absolutely. I mean

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: And I get what you're saying. I totally get it. Know what your problem is.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Yeah.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: But we need to resolve these issues.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Right. And and I guess the way I phrase it, you know, is we've had a lot of conversations and and there are a number of concerns, we've decided to limit it to this one specific topic. Okay. We've made a number of compromises at the agency specific to move this along.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Good. That's good. I mean, no, and I get it. And we've seen that. So thank you. And thank you for your work and thank you for your time. And I know that you and CDD have conversations that has to keep going. We need transitional language. We need transitional funds. I hear that. And right now it's a whole bunch of money that's going into OPR, and it sounds like everybody needs to have some support somewhere. That's gonna be an interesting conversation down the hall. Great.

[Andrew (Agency of Education, Director of Educator Program Approvals)]: Any other questions for me? Yeah.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare Committee)]: Okay. Perfect. Alright, we are going to go offline and we're going to call it a day.