Vermont Legislature SmartTranscripts:

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, so this is Senate Health and Welfare. It is still March 10 and we are looking at S26 with Legg Council. Katie, why don't you walk us through this? I know there have been recommendations from folks on this and we had our, after we met with Rosie Krueger and met with the school food folks, we suggested some changes. Why don't we just go through what you have here?

[Katie (Office of Legislative Counsel)]: Sure. Katie with the Office of Legislative Council, you've got 2.1. Changes are highlighted in yellow. Just to refresh your memory, this is the bill about artificial dyes in school meals. So we have a new section that's being created describing the types of school meals that this language would impact. Then you have a list of substances that would not be allowed in the school meals. The new language here is adding some new substances. You have a list here, subdivisions seven through 12 of new substances that would be on the prohibited list. In subsection B,

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: you

[Katie (Office of Legislative Counsel)]: have some language that this provision doesn't apply to beverages or food that's sold away from the school campus or half hour after the school day until midnight. And then the new language is language that I have run by Rosie Krueger at the Agency of Education. And this is that the agency shall ensure compliance with this section by reviewing school menus and product labels for school meals and competitive foods that are submitted by schools to the agency as part of existing federal administrative review requirements. So this is having the agency look at the school meals and the product labels, but they're not doing it as an extra additional step. They're building this process into an existing review process that they already have to do.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And that's it for That takes the administrative burden off of the schools.

[Katie (Office of Legislative Counsel)]: And you have an effective date, 07/01/2027, monthly. Okay.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And I guess the time Oh, and you have

[Katie (Office of Legislative Counsel)]: a new title. Controllating to prohibiting certain substances and foods and beverages served at school because it's not just artificial dyes. That makes me think maybe we should change the heading of this section too. Artificial dyes and, what should

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I say here, Other substances. So we have a new, we have a new phone.

[Katie (Office of Legislative Counsel)]: Yeah, so I can update

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: the title but that's each script nurse. Okay, thank you. And I know, Anna, you wanna testify and Bill Driscoll wanna to say something. You both want to come up here, you want do it from where you are, it's your choice. So we'll start with Anna's and join the table. Yeah. Great.

[Anna (Vermont Public Interest Research Group - VPIRG)]: Well good morning, what happens with the community and supervising environmental damage with BPIRG. As you remember, and I testified, was still at the very beginning of its discussion, so I'm happy to return and provide our perspective on version 2.1. First, I just want to, you know, praise your work on this bill. We're a generous part of this initiative. We've heard, along with many other witnesses that you've heard from, believe that children should be safeguarded from the health impacts of synthetic dyes and chemical additives, harmful additives in our food, especially in schools, which is why S-twenty six matters. Vermont is fortunate to be a state where we prioritize feeding our children whole foods made from scratch and sourced locally when possible. As you've heard, a lot of these chemicals are already on their way out or out of our school systems. Our values show up in our schools

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: and this bill reflects those values.

[Anna (Vermont Public Interest Research Group - VPIRG)]: If we are supportive of the chemicals and additives addressed in version 2.1, which I believe are the same as the previous draft of 1.1, While we would ultimately like to see a concept like this expanded to include additional chemicals and additives and possibly include a statewide ban similar to laws passed in West Virginia and California. We understand time constraints that we're working under and other meeting obstacles currently at play. Even still, this bill is really a strong and meaningful move forward to protecting our most vulnerable population in a really critical environment at this point in their lives. As for our recommendations, we agree with previous witnesses that when it comes to initiatives like this, it's important to ensure that we're not placing additional administrative burden on schools, which is why I was really about to wake up this morning and find the changes proposed by the Agency of Education or incorporated into the newest draft. As you know, Rosie Krueger from AOE recommended the committee align the bill's compliance mechanism, of which there were previously none, to align with the federally required administrative review already conducted by their child nutrition programs. From our understanding, newly incorporated compliance provisions rely on documents that schools already submit for this administrative review process and include information related to school menus and product ingredients for both school meals and food sold to students during the school day to comply with the Smart Snacks program, which covers the same food products impacted by this legislation. So, you think it makes sense that AOE to use these documents schools are already submitting to verify compliance for this legislation. That's really what I have for you guys today. We're supportive of the new version of the bill. Of course, we'd love to see a streamlined process that minimizes any additional burden on schools, which already face significant administrative demands. The agency's recommendations offer a clear and practical path forward. We think this bill's in a really good spot. I encourage you all to continue moving forward. I'm happy to take questions. If you have questions about specific operational details about how these provisions work, I would recommend reaching out to Mercy. I heard testimony about this, it was pretty clear. Thanks.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Good. Thank you. Don't go away. Sure, I'll be right back. We may get to a conversation. And I'm looking at the rest of

[Katie (Office of Legislative Counsel)]: the room here, and if you want to

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: make comments after Bill, address the office's comments, I'll do.

[Bill Driscoll (Associated Industries of Vermont)]: Thank you, Madam Chair. I'm with Associated Leadership Industries. I'm on this slide. We had found something to talk to you guys about before Columbus Circle. Search volume in March. I apologize I'm kind of new to this bill in large part because food industry, the manufacturers didn't have any particular concerns, and the bill has introduced. I mean, it's pretty pariah anticipation that a lot of this is probably gonna be done at the federal level very soon. With the new additions to the list of chemicals that are asked about, there were flags raised about two of them, and the most significant concerns, I think, were with what's known as TBHQ, which is number 12 on the list. I'm not gonna try to pronounce fully.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Tetrabutyl hydroquinones. Yeah. That one?

[Bill Driscoll (Associated Industries of Vermont)]: Yeah. Okay. And then also some concerns about number eight. The two related hydroxycholium. Yes. Both of those are are actually fairly widely used, so there's gonna be some supply concerns. I don't have data on that. Unfortunately, I guess, I'm not trying to get that. And then with regard to safety, PBHQ, I believe, is still considered safe in not only The United States, but also Europe as well. And, yeah, so there's a question there whether there's the need to ban that at this time, in addition to supply concerns. The VHD, that is restricted in Europe, although it's allowed under regulations in The United States and other major international markets. There is an active FDA review of a number of chemicals that include VHT, so it is under review by the FDA. And I think the census, given its role in the marketplace, certainly prefer to let that FDA process work its way out and see what a determination will be made for DHT. For CVH2, there's less of a even less of a concern on that one. So it's really just a request to to not include those two chemicals at this time.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Okay, thank you. So,

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: want make sure I have your comment accurately. So you said number 12? Eight and twelve. But they were both allowed in Europe at this time? No. No. 12 is allowed.

[Bill Driscoll (Associated Industries of Vermont)]: 12 is allowed. It's quite understanding that 12 is allowed, and eight is prohibited in Europe, but not The US or other, like Canada and Australia. They have restrictions, obviously, in terms of but they're not necessarily bad. And to the extent that there's time you need, I'll certainly try to give you more specific information on that.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Go ahead. Any questions for Bill? I'm still here. You're still here. Right. So is there anyone else who'd like to just comment briefly on S-twenty six at this point? Anna, do you want to comment back based on what you've heard? I'm happy to have that Yeah, guess Dialogue.

[Anna (Vermont Public Interest Research Group - VPIRG)]: I guess I would just say that these chemicals, age 12, isn't a concern that we heard from ARB in their testimony. They looked over the chemicals conversion 1.1 and said they shouldn't

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: have a compliance issue, so I just want to highlight that. AOE's comment was that these are already being vetted out and it goes until 27, there's time for some FDA work. So we'll have to think about that as a committee and what we wanna do with those two chemicals based on that test.

[Bill Driscoll (Associated Industries of Vermont)]: We'll be getting geared back to the

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: school. I've asked Calista to reach out to them. And we'll do that, and then we'll come back to 26, so you can get that love of the phrase fixed. I already did it. You did it. Okay, that's good. We're good. So I'm gonna close out our conversation on twenty sixth and we'll come back to it.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: If you wanna vote

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: on this bill and get it out, I feel that with the date being out there, it may be less problematic on the two chemicals that Bill Driscoll has brought up and what we've heard from AOE, particularly since it's just schools, it's not an outright ban across the board.

[Eric Fitzpatrick (Office of Legislative Counsel)]: So we can go with that. Just going on, remember another chair, a lot of

[Senator John Morley III (Member, Orleans District)]: this was being done and looked at anyways, right, as I recall?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: A lot I'm sorry.

[Senator John Morley III (Member, Orleans District)]: The schools were already looking at a lot of this stuff. Yes. Yes. They are. Anyways, and working on it.

[Eric Fitzpatrick (Office of Legislative Counsel)]: They just didn't wanna get burned and have more regulations on them,

[Senator John Morley III (Member, Orleans District)]: so then it's looking like it's going to AOE is what I'm understanding. Yes.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You got it. So it goes through the regular process that they currently have through the AOE.

[Bill Driscoll (Associated Industries of Vermont)]: Right. Just to clarify, what I remember is they had looked at the original list, said most of those weren't in their food. It was not an issue. But they had not looked at the additional in detail that they would get back to us on

[Eric Fitzpatrick (Office of Legislative Counsel)]: that. Exactly.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And they are getting back to us. So we've asked the schools to get them back. And Rosie Krueger will be on it, in fact, with us. Not moving until we hear back from them. Got it. Okay. Anyone else? Okay. We're good. So, Katie, thank you on that one. So, we're going to move on to S-one 193. This is not a bill that we have in our committee. It is a bill that is in the judiciary committee and it's a bill that we spent a whole lot of time on last session, so those of us were in the building last year, remember this one that I don't know about. Remember this one, so Eric, I think what would be helpful is Eric and Katie, how do you want to divide? Sure. Yeah. And Karen,

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: are you gonna comment? Yeah. Yeah. I'm happy to answer any questions.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay. That's great. Thank you. I didn't mean to look at you when we were talking about

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: Oh, no worries.

[Eric Fitzpatrick (Office of Legislative Counsel)]: I was

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: like, I didn't know. It does have mental health implications. That's true. Welcome. Thank you.

[Katie (Office of Legislative Counsel)]: It's good to see you.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Good to see you too.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Our two new folks. I

[Eric Fitzpatrick (Office of Legislative Counsel)]: we've met briefly, but not in Why don't

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: we go ahead and introduce?

[Senator John Morley III (Member, Orleans District)]: John Morley from Orleans District.

[Bill Driscoll (Associated Industries of Vermont)]: Me too. John Benson from the Orange District. Nice meeting you.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Eric Fitzpatrick with the Office of Legislative Counsel. I haven't been in here this year much. I haven't been in many times in previous years.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Missed you.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Oh, thank you very much. Same here. Well, I'm glad to be back to to walk the committee through a bill that has spent a lot of time in the senate judiciary committee this year, but as the chair mentioned, has been worked on a lot in this committee in prior years. S one ninety three is an act relating to establishing a forensic facility for certain criminal justice involved persons. This is one of those bills where it's helpful for a minute or two without before you look at the language to understand what the state of the current law is and what the proposal is to change that that you have in S one ninety three. So, I'm sure this committee is very familiar with it. Under current law, if a person is as a result of a mental illness, is found by a court to be dangerous to themselves or others, Now the legal term for that is person in need of treatment, but the gist of it is dangerous to themselves or other people to result of a mental illness or other condition. Currently, a person found by a court to have those circumstances would be committed to the Department of Mental Health for treatment. So, and that goes through two possible processes, two possible courts that that person could end up in Department of Mental Health custody. One is a civil process in the family division of the Superior Court. Now that would be a place where a person files a petition in the court. The court finds the person is dangerous to themselves or others as result of mental illness, they would be committed to the Charter Mental Health Retreat. That's one avenue. The other avenue is through the criminal justice route, criminal division, and that's what we call forensic cases. Forensic cases coming from the criminal court. Now that happens when a person could be found either not guilty by reason of insanity for a crime or incompetent to stand trial. Those are two different things. The competency to stand trial has to do with the person's mental state at the time of the trial, whereas not guilty by reason of insanity has to do with the person's mental state at the time they committed the offense. They're two different things, but either way, if in the criminal court, the court finds that the person is one of those two things, we call them not guilty verbiage means any NGRI, it's quicker to say, or in common, then the court has to have a hearing. And the court has a hearing after making the finding where they have to have the same question about that we just talked about in the civil division. Are they dangerous to themselves or others as a result of the mental illness? And if they say yes, they find yes, then that person gets committed to the Department of Mental Health as well for these same types of proceedings that ultimately end the family. So that is the current status of the law. You have these two avenues where a person can be subject to Department of Mental Health custody on account of their mental health status, either related to a crime, forensic case, not, just your standard family division civil case. So what does S-ninety three propose to do? The proposal is to carve out a piece of those criminal division cases, those forensic cases. In other words, they're cut there right now. They go into the family division. They go into the civil process from the criminal court. The proposal is that for a certain subset of those forensic cases, those criminal ones, they wouldn't go to Department of Home. They would go to the Department of Corrections for purposes of this forensic facility. That's the big picture. And what sort of grouping of cases get carved up? For the most part, it's it's a small number, but it's cases with a lifetime sentence, potential life imprisonment sentence. And there's about about 15 or 16 offenses in Vermont and the entirety of Krumovacov that have this potential lifetime mass, we call them. So if you have a potential lifetime mass, and you're then found either not guilty of burgeons and sanity, or incompetent to stand trial is a couple of other factors I mentioned, then you wouldn't go to the Department of Mental Health for treatment. You would go to this forensic facility in the Department of Corrections for treatment there. That's the big picture of what's going on. And we can talk more specifically about the processes and how they work as far as the person going one route or the other. As I said, competency to stand trial and non guilty verbs in the sand are two different things. So processes are slightly different. The criteria for the person getting to the forensic facility are a little bit different, and we can talk about those. But I just figured I'd pause there for a second to see if there's any questions about the big picture before we talk about the details.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Right now you go to the custody of the Department of Mental Health. Correct. Not just the Department of Mental Health to review. If you're a danger to yourself or others, we don't, We have a very small state hospital. What happens? I mean, if you're in danger, what what does the Department of Mental Health do with you?

[Eric Fitzpatrick (Office of Legislative Counsel)]: That's a good question for other people. That's not No,

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I don't know. Don't don't Do you want

[Eric Fitzpatrick (Office of Legislative Counsel)]: to take

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: the detainee now or do you want to pull it off?

[Katie (Office of Legislative Counsel)]: Sure, I'll answer it too. Under the statute, if somebody is meeting the clinical definition of a person in need of treatment, the court would order them either to an order of hospitalization or an order of non hospitalization. So, there are two options. Hospitalization may be on what you think of as a hospital unit. If it's an order of non hospitalization, they could be in the community and have certain criteria like taking certain medications, having to meet with certain clinicians, a designated agency, for example, or they could be on an order of non hospitalization to a specific facility that's not a hospital facility. So we have a secure residential recovery facility in the state. So somebody could be under an order of non hospitalization and be in the custody of the commissioner of mental health at that secure facility. Was that the Kent City? Used to be in Middlesex Since moved.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay.

[Katie (Office of Legislative Counsel)]: And I know. Happy for, you know, out of the penguin if I rehabbed it or anything. Railroad.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Go ahead.

[Senator John Morley III (Member, Orleans District)]: We don't have the bill, right?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: No. And we probably will not have the bill. It would probably we wouldn't have the time, but we could call to have the bill in and then have to get it out by Friday. So as as long as the bill is still viable on the floor, we can look at it. And we can always sort it in here.

[Eric Fitzpatrick (Office of Legislative Counsel)]: It's

[Senator John Morley III (Member, Orleans District)]: Oh, I guess my question to to Eric would be, I don't know why we call me a forensic facility. I don't understand that. Is this under corrections?

[Eric Fitzpatrick (Office of Legislative Counsel)]: Forensics generally refers to related to criminal proceedings. So that's why these are not cases, criminal cases, as opposed to the so that facility would only be for people who are coming in as a result of criminal proceedings.

[Senator John Morley III (Member, Orleans District)]: Okay. My guess is it's it's what maybe driving this are a number of beds potentially, and maybe also cost.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Would you like guess? Why don't we move forward to Karen Barbara from

[Katie (Office of Legislative Counsel)]: For

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: the record, Karen Barbara, General Counsel, the Department of Mental Health. Just to clarify, this is not an alternative to DMH. So if you qualify to be in DMH custody on an order of hospitalization in our facilities, you would go there. You would continue to go there. There's a specific carve out in this bill. The gap we're trying to address is that you can be found incompetent for many reasons other than mental illness. It could be substance use, it could be developmental or intellectual disabilities, could be a TBI, could be dementia. Those folks do not qualify to come into our system because they do not have a mental illness that requires hospitalization, which is the criteria. So we are not creating an alternative to DMH. What we're trying to fill is the gap. So everyone who's going here can't go to DMH. And that's a gap in our system. Right? We do have folks that due to public safety issues who still need clinical help, not necessarily mental health help or not mental health to the point where it needs hospitalization, they still need a secure facility. And so that's the gap we're trying to address here. So it has nothing to do with number of beds or anything like that. It's really that these are folks that don't fit into our system and we're trying to find an alternative. Does that help?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah. Okay. So but it fills a gap for those who are incompetent to stand trial but also have committed one of these deaths. Sixteen year forensic incompetent. So this might be a gentleman many years ago. We had to deal with him uphillard who had a traumatic brain injury. He couldn't stand trial. But he had this thing about beating up old waves. Oh, that's took out the surrounding police department. He definitely had issues, but it was loose on on the street.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: There is other than DMH, there really or correction, there are no secure facilities for individuals. And so what this is attempting to address is those individuals who are accused of committing the most serious crimes and where there is no secure location option for them. So it creates that pathway.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: It was vigilant de action. He stopped eating up all the fees. So, it required from But decision making at the judicial level will require some special knowledge and information. So Eric, why don't you go ahead? I have a feeling we're gonna have to come back to this bill later in the week, but why don't we go ahead?

[Eric Fitzpatrick (Office of Legislative Counsel)]: Yeah, sure. So, as I mentioned, there's a difference between competency and not guilty by reason of insanity and the way the bill is structured, it sort of divides those categories out. So the first one you see on page one has to do with competency. So, since two things are different, one

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: of So, just to clarify, we're going through the entire bill. One Up to you. Yeah, well, it would be nice to know what is in the whole bill, and then there's the yellow markup section that we're supposed to comment on.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Yeah. I didn't see any yellow markup section.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Oh, okay. I have it on mine. It's what the

[Eric Fitzpatrick (Office of Legislative Counsel)]: I sent the revised version this morning we didn't yellow markups in it. Okay.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Is it draft 4.1?

[Eric Fitzpatrick (Office of Legislative Counsel)]: Yes, but it's clean.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: All right, let's go through it then. You wanna put it up?

[Katie (Office of Legislative Counsel)]: I can do it, I'm glad. Yeah, okay.

[Eric Fitzpatrick (Office of Legislative Counsel)]: So, yeah, the, the difference between the treatment that a person gets in the forensics facility depends upon whether they're been found in competent stent trial or not guilty by reason of insanity. And the reason for that is competency is a fluid thing. So as I said, that's due to your defendant's mindset at the time of the trial. They can't participate in it. They can't understand the charges against them. They can't participate in their own defense, but that can change with treatment. So, that person, when they're in, this is section one of the bill, you see the title of section one, competency restoration services within forensic facility. That's because the person's competency can be regained. And if that's the case, then they can be tried for the crime that they were found incompetent on some period of time ago, whenever that was. So, that's what happens when that person is in the forensic facility. They get what's called competency restoration services. So, during the entire period that they're there, they're going be getting services supervised by DOC to try and restore them to competency. Just before we that's the big picture. You see on page one there, though, and I mentioned the criteria. Well, how does a person get into the forensic facility? You see there's four criteria. The four we just talked about. Number four, line 20, they've been found out confident. So we're talking about that group right now, found in confident. One, two, and three. First one I mentioned, charged with a life offense. Yeah. That's number one. So it has to be one of those sixteen, seventeen offenses. If they are held without bail, then they would also be I'm wondering if that might be a typo there. But, yeah, that's right. If they're held without bail, then they would also qualify. But if they're not held without bail, that's subdivision B, then they would only go in if their release would create a substantial risk of bodily injury to another person. You'll see that phrase repeated a lot throughout this, throughout the bill. And lastly is the one that Karen mentioned, number three, they're not currently receiving treatment through an order of hospitalization, and that's that civil commitment process that we talked about. So that's what had to be established for the person to be sent to the parental facility on the basis of lack of confidence. So what happens when they're there? Then you turn to page two to see a reevaluation happens. That's the line three, I believe, a bit. So every six months, they're going be reevaluated. And as I mentioned, competency is fluid, could be restored. So they check-in every six months. Or, when the forensic facility's clinical director thinks that, well, they might have regained competency. So in either event, the court's going to look at it again, decide whether they've and

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: regain competency. So in the case of Vermont, that would be WellPath's Clinical Services Director. That's what I've heard in testimony. Exactly. WellPath provides medical, services for DOC, folks with DOC. That's the private corrections in each of our institutions. Correctional institutions. They do physical, and that's what they do then. Took testimony on that at the Joint Justice Oversight Committee this summer and fall. Yeah. I just wanted to make sure Katie can help us with that. I'm I'm up here.

[Eric Fitzpatrick (Office of Legislative Counsel)]: There's another concept, we were just talking about restoration of competency, right? Because that is something that the person is receiving services for, their competency restored. As I said, these evaluations take place every six months, and subdivision two there says, of parties can request that the evaluation include an opinion on whether the person's competency can be restored, because sometimes the clinician might decide that this isn't going to happen, This particular person's competency can be restored. That's the case. If the court finds by clear and convincing evidence that they can't be restored to competency, then the person's commitment is continued under these restrictive conditions possible, unless the court finds that they could be released without causing the substantial risk of harm to somebody. If that's the case, they release them with conditions. And those conditions apply. I'm turning over to page three now.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So the piece I think that's important for us though before you go there is, unless Katie's gonna go through this, the prescribed regimen of medical, psychiatric, psychological treatment.

[Katie (Office of Legislative Counsel)]: Yeah, I mean the bill doesn't go into much more detail besides the fact that as a condition of release, clinical director sort of put together this treatment plan. There is language later on about the possibility of receiving a voluntary medication when somebody is being held for competency restoration services. Okay.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Sorry, keep going. I don't know if

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: you wanna open that. Did you wanna open that one up? Over

[Eric Fitzpatrick (Office of Legislative Counsel)]: on page three, subsection C, person remains at the facility until their competency is restored or until there's a final disposition of the criminal charges. Subsection D, while they're there, they receive competency restoration services. They must be provided while they're there. And then you see kind of what you were just getting at center lines starting on line 12. Service shall include any appropriate combination of medication, education, accommodations, etc. Subsection E also just talks about the blogger there, or as part of the discharge plan, get competency restoration services until they're restored or until the criminal charges are disposed of. Over on page four, so if they are released, right, it says, because we were just saying that if they're not a danger, even if their competency isn't going to be restored, could still be released under these conditions. If that's the case, the commissioner, that means commissioner corrections, actively monitors them. And if they determine that the person has become incompetent, well then they're immediately returned to the facility. Basically, the court has to hold a hearing, it's, and I'm on line 12, state's turn has to establish by clear and convincing evidence that the person's not competent anymore. In that case they're readmitted. So essentially, it's a mechanism for the department to essentially monitor the person's compliance, and if they become not competent again, to readmit. Final page four, over on top of page five, am going to defer to Katie on this, because this is the involuntary medication piece, and it provides some standards as to when involuntary medication can be administered that I think are consistent with the United States Supreme Court decision.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So this is a little

[Katie (Office of Legislative Counsel)]: bit different from the involuntary medication that you have seen a court process for in relation to the,

[Bill Driscoll (Associated Industries of Vermont)]: order

[Katie (Office of Legislative Counsel)]: of hospitalization that hinges on whether or not the person has capacity to make a decision and if they do have capacity that overrides whatever court may order. So, this is linked specifically to competency restoration services, and there's a Supreme Court case that has ruled on involuntary medication specific to competency restoration services. So, this list of four, the standard that the court has to look at to determine whether involuntary medication could be ordered for competency restoration purposes has been lifted almost directly from that Supreme Court case.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, right. I know this has always been extremely controversial. When was that court case?

[Katie (Office of Legislative Counsel)]: Oh gosh, it's not as old as I would have thought. I think it was in the 2000s.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Was in the 2000s. I'd have to pull it. Okay, that's good.

[Eric Fitzpatrick (Office of Legislative Counsel)]: All right, so that's the end of the competency piece, other than that we're in section two, this is related competency, it's actually an entirely separate issue. This has to do, and it may not be something that this committee is interested in, I can describe it for a second if you want.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Just describe it, think. I think the other parts are more in our area.

[Eric Fitzpatrick (Office of Legislative Counsel)]: Right. Right. Yeah. This has to do with, if a person is found incompetent to stand trial, and their case has been in act for a long period of time, has to be a period of time that's equivalent to the maximum sentence for the crime, then the court can dismiss As simple as that. So in other words, the case will just wind around for a long time and think because they were bound and competent, court has the option to dismiss it. That's basically it.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Right. So these are judiciary.

[Eric Fitzpatrick (Office of Legislative Counsel)]: I think it's in many ways having to do the core battle. Right. These cases are hanging around without moving. That's way to clean things up. All right. So now we move on, page six. This is the other group of people. This is the not guilty by reason of insanity group. And these procedures are very similar to what we just talked about for the incompetency group. One of the primary differences is that this person is not looking to have any sort of competency restored because their mental health status was established at the time of the offense. So that can't be changed later on. It was what it was at the time of the offense. If they were unable to understand the nature of their conduct or unable to conform their conduct to the to what the law requires, and the court finds that they were therefore not guilty by reason of insanity for a lifetime offense, then they would go to the forensic facility I mean, this language, but they wouldn't be there for restoration facilities, because there isn't, it's not a competency issue. There, the difference is they would be there, if look over, skip for a second over on page, to page seven, subsection C, you'll see person stays at the frenic facility until the court finds that they're no longer suffering from this qualifying condition, I'm on line 16, that upon the person's release would create a substantial risk of bodily injury to another person. As I mentioned, that's a standard that's used throughout the building. So, basically the court, the person stays there, you look a little bit further down, subsection D, Commissioner of Corrections shall provide adequate care, individualized treatment at the facility, the persons who are there. Again, not talking about competency restoration, but that's not the issue right now. So they get treatment, and they stay there until they can demonstrate to the court or until the court finds that they no longer have this condition that would cause substantial risk of injuring somebody if they're released. That's the idea. Are periodically can be re evaluated, so it's not like they're there without the court looking in at their condition again. They can petition once a year to have the court look at their condition again to see if they can still create this risk as a result of what their conditions are. Or similar to what we just looked at in competency, if the clinical services director has the opinions that, oh, this person could be released without being a risk again, that they also have to petition the court to look at this again. And that is the big picture about I mean, there are more details, but that is that's how the process works in the big picture. There has to be an after the person, through this not guilty by reason of insanity route, ends up in the forensic facility, there has to be a hearing within the first forty days to determine whether or not the person that creates this risk has a result of the qualifying condition. So you have that initial hearing, initial ruling by the court. And then after that, as I said, the person can ask again every year, or the clinical services director has to ask if they reach the conclusion that the person would no longer be dangerous, such a result of a condition, qualifying condition. That's the big picture for the process. I think there's a, again, the rest, there's other processes similar to what we just talked about for the competency situation. A person can be released on conditions, but then pulled back in if the commissioner finds that there could be a wager again. And when

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: you say commissioner, you're referring to the commissioner of Corrections. Exactly. And that would be based on a recommendation from

[Eric Fitzpatrick (Office of Legislative Counsel)]: The clinical director. The clinical director. Exactly. So I'm skipping right over to page 10, because as you mentioned, Lyons, the facility, you'll see this is page 10, line, starting on line 10, line 11. What is the forensic facility? It's a locked facility replacement that the Department of Corrections provides. So they're the DOC that's supervising this. For secure evaluation, treatment, and care of persons involved in legal systems who do not require hospitalization level of care and is required for the custody control, correctional treatment, rehabilitation of persons transferred, and these are the two sections we just talked about, either because of competency, same trial, or not guilty of every second. And I can't mention qualifying condition. What does that mean? You'll see any condition whether mental, congenital or traumatic, however acquired or developed, or any other circumstance that resulted in the person being determined either incompetent to state trial or guilty verdict said in the same way. So the condition has a connection between the lack of competency and the NGRI finding with the person's mental health condition. So, when you look at subsection B, page 11, requires the Commissioner of Corrections to establish and operate this locked, secure, forensic facility for the evaluation, treatment, and care of the people we just described. You see line 10, as you were just mentioning, center lines, everything, all these services there are overseen by a clinical services director. Records related to this are generally confidential, that's subsection C. There are a couple of exceptions to that, like parties in the criminal case can see it, and so can the person's healthcare provider if the person consents. Over on page 12, the person, persons who are, remember I was mentioning they have these opportunities to file a petition, right? They can have the court review their status at the facility. They have an entitlement to legal representation for that purpose. You'll see that in lines three and four, page 12, Vermont Legal Aid. And Legal Aid, you may recall, handles many of those cases in the civil existing system that I was talking about at the very beginning. So they are, at least from the forensic case, the ones that come from the criminal division legally gets involved, and stay involved. Subsection E, we mentioned this, is the Commission of Corrections that oversees this, but there's a requirement that the Commission of Corrections regularly consult with the Commission of Mental Health for purposes of all of these things. And there's a rule making requirement as well, and you'll see that on page 11, a couple of different places. So that the operation of the facility and related duties can be covered by rules that the Department of Corrections proposed as well. And the last couple of things have to do with the rules of evidence, a very specific criminal justice provision that the rules of evidence aren't going to apply strictly in these competency restoration proceedings, and other regarding conditional release from the forensic facility that we were talking about, and the person sometimes rules that conditions.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. I agree Jeff went over our time, but I think it's worthwhile doing that. Yeah. Appreciate your time. We do need to hear from the Department of Mental Health regarding this and also we

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: need

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: to come back to this bill. So we'll schedule it in with, I hope, understanding from the Department of Mental Health what we are. Do you know, where is the bill now in judiciary? Have they passed it out as yet?

[Eric Fitzpatrick (Office of Legislative Counsel)]: No, I think they might do that

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: tomorrow morning. Okay, so there will be time for us when it goes up on notice and we'll have time to look at the bill. I have a lot of questions and I do have some comments. For example, saying clinical services director is one thing, but having someone who has a psychiatric background or experience with mental health. Medicine is critically important here, and then the rules also need to reflect that. I don't know that it does that right here with the language, so we'll have to hear from DMH Katie's bottom line on some of this. Anyway, so the committee will come back to this. This is a big one. It is one that we have spent a huge amount of time on, So, and for me, it feels like going home to, going back and going through it all again, but for you, it's probably new territory, so we'll take a little punch out of it.

[Eric Fitzpatrick (Office of Legislative Counsel)]: One last little thing. It just also happens to be that Senate institutions are looking at it, it's after them as well. Yes. Of the impact on the Department of Corrections.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Absolutely. And I have talked with Senator Harrison about that, so that's a good thing. It's nice we're all working together on it. I think it almost even said All right.

[Eric Fitzpatrick (Office of Legislative Counsel)]: We Fire and greedy.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And he's on corrections. That's a good link. That's important. That is gonna be critical, Senator.

[Eric Fitzpatrick (Office of Legislative Counsel)]: I might bore you though because you're gonna hear me say the same thing.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Hey, you know what, redundancy is great because you've So, learned a Katie, we're gonna need you to come back in at some point. Happy to come back in. Okay. So, we will go off live, and DMH, we need your comments here. I have lots of questions for you. I might ask them off