Vermont Legislature SmartTranscripts:

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Alright, we're back. This is Senate Health and Welfare, and we're joined by Senate Judiciary on a bill of joint interest S-one 193. We do have folks in the room who can testify, and I think before we do that, because our questions about we you do wanna hear from WellPath. Maybe we'll start with that. Okay. I'm gonna kick you out again. That sounds perfect. With apologies. No problem. Karen, did you wanna say anything before we move into

[Katie (Office of Legislative Counsel)]: the Well No, I'm here

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: more just to answer questions. I think I think that is to

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: go to Well Path. Right, so Well is on the screen. Robin, thanks for being here. And do you have anything to say in the beginning or are you looking to respond to questions?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: You know, I could give an overburden view of WellPath and who I am if that's a good place to start.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. Why don't we do that?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Okay, absolutely. So pleasure to meet you guys. My name is Doctor. Robin Hodges. I am the Senior Vice President of Mental Health for WellPath. I'm a psychologist by training, and I've been with WellPath about twenty years, working between DOCs and jails. And I spent about ten of those twenty years in the main DOC, so right next door to Vermont. I just wanted to give kind of a brief overview of WellPath for those who may not know who WellPath is. So we're a correctional healthcare company. We have about forty two years of experience in corrections. We provide services to 37 states across the country. We have about 300 partner facilities. We have about 8,000 plus employees. We serve roughly 148,000, patients a day. So around 8,000,000 contact patient encounters annually, somewhere around there. And we organize our services for WellPath kind of around what we call our five P's. So it's kind of our framework for excellence. So our top priority is patients. Patients are always first for us. Our people, so our team members. A lot of folks think because we're a Tennessee based company, when we come into other states, we're bringing busloads of individuals. That is not accurate. We hire the folks who are in states. So for Vermont, we have hired and who are working in your facilities today, your neighbors, family members. We work with the community, and we hire folks in the community. And then our partners are critical. We have transparent collaboration with our partners. We're aligning our goals together, our processes. We have proven systems. We have continuous improvements. We do a lot of CQI work, a lot of peer reviews, and our performance is critical. So measurable results, ensuring we have our accreditations. We, as a company, have never missed any accreditations. We've never failed any. We have quite a few what they call triple crown facilities out there, and we're accountable. So all that to say, we really sort of align our people, partners, processes around exceptional care for our patients to deliver really good outstanding performance. I'm So going to bring it down just to match what do we do in Vermont. And I never like to assume that folks know what Vermont DOC looks like because it's got such a unique system. It's a unified system. So you have sentenced and unsentenced individuals. Traditionally, folks who would be housed in a jail or in a DOC, they're all mixed together across six facilities, which creates a really nice, population in the state. We, as WellPath, have been the healthcare vendor since 2023. We were the healthcare vendor from 2010 to 2015 as well. And our scope of services is all healthcare. So medical, mental health, substance use, dental, etcetera. We manage all of the healthcare needs for the individuals who are currently incarcerated today in the state of Vermont. And then just a little bit about competency restoration, which is the whole reason I was asked to be here today. WellPASS got a long history of doing competency restoration. We are actually one of the very first private partners in California to partner with the Department of State Hospitals there to develop jail based competency programs. And so we've got a long history of not only that,

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: but operating in other states. And so we have a lot of experience coming in and working around whatever your statutes are. So I know you guys are kind of in process of that creation, but lots of different states have lots of different statutes when it comes to competency restoration. We're very fluid. We can work with most any statutes out there, and we

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: do today. They all vary in how they're delivered. I'm very familiar with Maine where we do competency restoration. But essentially what we do is once your statutes are really formed, we come in, develop your program, coordinate with your district attorneys, DMH, behavioral health, your courts, etcetera. And Then we really sort of create an integrated program around psychiatric stabilization, legal psychoeducation, and assessment. Some states, their statutes depend. Sometimes they want the treating psychologist to do the evaluations, and sometimes they'll have an independent evaluator come in to do it. All states do it differently. It just kind of depends on where Vermont lands. And then obviously, the whole reason WellPath got involved in competency restoration is the wait times for individuals in the jails for so long waiting on a state hospital bed that developing competency restoration reduced those weights for state hospital beds and also reduced the length of time folks were waiting to get to their court proceedings. With that, I will take any questions. Hopefully that was helpful.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah, no, thank you very much. That is helpful and I think in particular to those folks who are less familiar with the work that you've been doing within our Department of Corrections. So I do have a couple of questions. We are looking at S-one hundred ninety three. It does place folks with mental illness or substance use disorder squarely into DOC and our concern obviously here in health and welfare is that anyone who is placed in a facility who has a significant mental health issue, we'll start with that one. I know there's more work that's been done on substance use disorder than on mental health, but that anyone who has a mental health disorder is receiving the ongoing clinical care that they require. So in terms of the diagnostic procedures, some of the diagnoses will definitely be made outside of Wellpass purview, but then some of the treatment orders will be made outside of your border, outside, excuse me, your purview. These folks will need ongoing consistent care. Can you talk a little bit about how someone who has a I don't want to start with competency restoration. We've had a lot of discussion on that, but I'm speaking more from the perspective of bringing someone into a better state, a mental health state, and helping them achieve some level of capacity. So, I shouldn't use that word. Mental health status. You know, so someone who might require ongoing counseling, and you talked about wait times. That's a concerning phrase. So could you talk a little bit about how your organization deals and will deal in Vermont providing mental health care for someone who has committed a significant crime and is in the care of DOC?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Absolutely. Likely we're already caring for these individuals today. We have significant amount of individuals who are in custody in the Vermont DOC who do have mental illness. I'm not sure if folks are aware, we have mental health units there. So we have both a kind of residential level and acute level mental health unit. You have staff assigned. All of our staff are licensed and credentialed individuals.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I get that. I think I'm talking more about the timing and the number of counseling events that can occur. And if you have someone who's committed an egregious crime that is now being moved into this secure forensic facility, that's what we're talking about. So how are they being cared for?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: So you're talking future state or current state?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Both. I think mostly future state.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Okay, all right. So future state for us is that we would obviously be working with them on a regular daily basis. So generally in different competency restoration programs, there may be a required treatment number that you're engaging with them daily. Perhaps that's a group daily, perhaps that's individual care. Some statutes are clear about that, others are not. But generally, for competency restoration, you're engaging with them daily through the milieu, through education, through medication compliance, because you'll have your nurses involved, psychiatry, mental health clinicians in general. And so you're caring for them much in the way that you would care for them in a state hospital. So there's the milieu going on, folks providing the treatment. Which is what happens currently today, is that individuals are cared for, they're seen regularly, depending on what their level of need is, depends on everyone gets an individual treatment plan, So depending on what that plan looks like depends on what their treatment needs look like. So if they're in an acute mental health unit, they're being seen daily. If they have a stable mental health disorder, they're living in general population, they might be seen once a month, every other week. It just really depends on what the individual needs.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Doctor. Cummings, you have a question? I don't know if it's a question or just the goal of this care, competency rehabilitation, I think we understand. Like, go to trial. Okay. They go to trial, they're found know, innocent by reason of insanity or mental incompetence. So they get sent to this facility or to the jail, wherever. We got in trouble with our state hospital and we couldn't recreate it because Medicare Medicaid won't pay for just maintenance. And so is the goal to cure that mental illness and restore people to competency or if the goal is just to keep them stable enough so they can live in a population because last time I was on judiciary, which was quite a few years ago, there was concern about people in the correction system who had spent years in solitary confinement. They go to solitary, they come out, they do whatever they did, they got them sent back, they'd be back for x amount of time, they'd come out, it was just a revolving door. Is this is the treatment we're talking about trying to make it so that people don't get caught in that kind of cycle, Or are we just having them seen by mental health clinicians to say they were, you know, are we trying to cure them or make them better or are we just having them seen by a clinician to say we saw, you know, they got seen by three clinicians today but nothing how do we yeah, how is it monitored? How do we know what we're paying for? Was it judged?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Yeah, so what you're looking for is not necessarily the box check of

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: they've

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: been seeing, yeah. Okay, If I can back up just a little bit, so how I sort of see this progression. Obviously, we've not had any specific discussions around how confidence restoration may look in Vermont. I'm going to just talk specifically about what information I have about other states and other programs to help answer your question. But essentially, when we have someone who is for competency restoration, so they've been deemed incompetent to stand trial, Our goal is restoration, which is obviously the psycholegal aspect that may involve medication, but it also involves mill use. On how we set up the program for Vermont, that can look like risk needs responsivity treatment, as well as a lot of folks bringing good life. So it's not checking the box. It's actually working with people, problem solving, learning coping skills, learning about their mental health illness to better manage it. So our first task in that competency restoration is getting that individual to the point where they're competent to stand trial or they're not. If they're found competent, keeping them competent through their court process. And then obviously depending on what happens there depends on where they go. If they're confident, they come to us for DOC because they're competent to stand trial. They're not going to get Is it NCR or NGRI for Vermont?

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

[Committee Clerk/Assistant (name not stated)]: Okay. I

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: should know that, but every state operates so different. So if they're found NGRI, both are, regardless of where they come, if they're coming for NGRI or they're coming to live their time with us, it's all about getting them to the least restrictive point of care. So doing enough treatment to get them, if they're NCR or NGRI, getting them to the point where they could be reviewed for release into the community. So you're going to be treating them for their mental health issues, getting them stable. However, that's sort of going to look for Vermont if there's opportunities for them to visit the community, however it looks. If they're found competent and they're committed to us and the DOC, then they're still getting mental health treatment, Depending on how they're functioning will depend on where they live in our facilities, but they're still getting different types of group treatment, individual treatment. We're definitely not box checkers. So we have a great team in Vermont currently, led by our great regional psychiatrist, regional mental health director, medical director in general. And they are constantly looking at charts, reviewing cases. Vermont is a very small state, and so you have the luxury of having folks who are really oversighting and involved in those individual care pieces. And even at times, I'm involved in some of the care going on in Vermont because it's so collaborative.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So you're involved, are you involved in person?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Sometimes I've seen, I'm licensed in Vermont, and so I have seen an individual in person when I've been there. A lot of times it's more remote. I don't live in Vermont but I am licensed there.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, and then I'll ask one more question because there's a hand up in judiciary and I want to get to that. How many providers do we have, psychological counselors, mental health counselors do we have available on our state for the number of folks who require services?

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: You know what, I'm not going to guess. I oversee way too many states to give you a guess. Is that something I can send to you via HALE so I give you an exact number? I know roughly, but I don't want to misinform.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: No, that's okay. That would be helpful. It's something that we've been, you know, I get concerned about. When you say we're a small state, we also have workforce shortages that are significant within the general public as well as others. Absolutely. And then I have other questions. I have a lot of other questions. Judiciary is here. They haven't had an opportunity to meet with Wellpass, so I'm going to turn it to it looks like Senator Vahowski has her hand up. I don't know which hand is up in judiciary, but I'm going to judiciary to ask your question.

[Committee Clerk/Assistant (name not stated)]: Thank you. Yes, Senator Rehovsky has a question.

[Senator Tanya Vyhovsky (Senate Judiciary)]: I have a few. I'm wondering why the

[Katie (Office of Legislative Counsel)]: contract with LilPath ended in 2015.

[Senator Tanya Vyhovsky (Senate Judiciary)]: I don't have an answer for that. I mean, in correctional healthcare business, there's a lot of different companies out there and contracts have to go out to bid X amount of years. So every time we get a contract, we're only locked in for X amount of time, ten years, five years, whatever it looks like. And then it goes back out to bid and sometimes folks may have a lower bid. It really depends. I don't know specifically why in 2015, Vermont chose a different vendor.

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

[Senator Tanya Vyhovsky (Senate Judiciary)]: the current contract with WellPath? I believe, and this will be another one I'll have to get back to you on it, I think it's either a seven or ten

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

[Senator Tanya Vyhovsky (Senate Judiciary)]: In your professional opinion, is prison a trauma informed place for people to receive mental health care? You know, I think over the years, prison has gotten so much better about training folks in trauma informed care. I could say probably when I first started in my career, we didn't really talk that much about trauma. We thought about just women in particular. I think we do a much better job in more recent years training people on trauma informed, having folks understand that this is just not about women. All of our clinicians are required to take trauma informed care CEs. We offer that through our program. So they're trained for trauma informed. But the actual prison structure, the concrete walls, the lack of lighting, the locked facility, the armed guards, is that trauma informed? I mean, it's not ideal, but unfortunately it is the environment in which we exist in. So we try to make it as trauma informed as possible. Sometimes we paint so it looks less like a prison and more like a welcoming environment. We've done a little work at Chittenden over the years to make it a little more friendly. Mean, prison is prison, right? And so you can do some things, but you can't change other things. Other systems have changed how officers are dressed. So rather than having kind of that traditional looking uniform, they'll put on a polo shirt. So over the years, different systems have done things to try to compensate for things that we can't change like the structure of the building, the doors, things like that. Okay. And I know that there are about 1,500 lawsuits pending alleging negligence abuse medical malpractice under staffing. And there's at least one in Vermont, but how many lawsuits against WellPath are currently pending in Vermont? I do not

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

[Senator Tanya Vyhovsky (Senate Judiciary)]: know the status of the Chapter 11 bankruptcy filing? That we are done with. We've emerged from bankruptcy, and we've been out, I think, almost a year at this point, We're in great fiscal shape at this point. That took, I want to say, approximately six months for us to get through bankruptcy and emerge on the other end.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, thank you. No problem. Any other questions from judiciary? No, no, thank you. Okay, thank you. The folks around the table here in health and welfare questions, I know our concerns go very much along the lines of the questions that Senator Bahowski was asking around having trauma informed care and having a venue, an environment that is conducive to improvement and mental wellness. So I think you're hearing concerns that we have, and it's basic to the bill, of course. We're not changing what the work the judiciary has done on the bill with respect to DOC. I know that institutions is also looking at the bill, and we're trying to find the best place and the best care that we can find for folks regardless of the crime that they've committed. So I'm gonna ask Karen Barber if you can respond to any of the questions that have been asked regarding contracting and length of time. I know we looked at it in Justice Oversight.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: I'm happy to speak to it.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Please, yeah, that would be good.

[Phillip Semmer (Director of Communications, Vermont Department of Corrections)]: For the record, my name is Phillip Semmer. I'm the Director of Communications for DOC. Like Doctor. Hodges stated, the contract with WellPath started 07/01/2023. It is a three year contract, so it's set to end 07/01/2026 with the option for I think one or two year extensions, but

[Committee Clerk/Assistant (name not stated)]: I can't confirm that exact number.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah, because as the discussion was going on, it was my thought that we're moving into a new world, so there will need to be some contract changes to provide support for the folks who are not currently under that contract.

[Phillip Semmer (Director of Communications, Vermont Department of Corrections)]: Yes, and one thing I would just note is that contract amendments are not just limited to the period in which your contract is being extended. We have made certain contract amendments throughout our contract thus far with WellPath for other emerging needs of care.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, thank you. That's good. Was there any other question that was asked that wasn't answered that you can help us with? I don't have

[Phillip Semmer (Director of Communications, Vermont Department of Corrections)]: the exact number of mental health care providers throughout the state in our six correctional facilities, but we can work with WellPath to send that to the committee.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That would be really helpful. I mean, it's a great concern. If it ends up that we've got patients who are receiving only telehealth visits, that's problematic because the one on one contact is critical for care and employment. Understood, and appreciate the sensitivity as well around staffing challenges that persist

[Phillip Semmer (Director of Communications, Vermont Department of Corrections)]: throughout the state to include for healthcare providers and correctional officers.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Oh, I know. It's a challenge for all of us. Right, other questions. Senator Cummings, I'm just trying to clarify. This bill would set up a separate forensic facility in which we would house and separate is at this point an undefined term, but it would be in some way removed from the general just criminal population and it would house people who had been found either not guilty by reason of mental illness or incompetent in the stand trial by reason. So they would be in a separate facility. We are not talking about housing people who had mental illness but had not come in contact with the court system here.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: I see Katie also looking around, so I'll let you speak. I'm happy to speak to the infrastructure piece of it, and then let you take the rest. Yeah. Let's let Legislature Even the Office of Legislature Council. Sorry, I

[Katie (Office of Legislative Counsel)]: was concerned because I see nodding on the screen. So, there's nothing in the statute that says it has to be separate. The language in the, and shouldn't say statute, it's in the draft. The forensic facility definition means a locked facility or placement. But it doesn't say anything about that it has to be a separate standalone building or a separate unit. Those pieces could be added, but they're not there right now. So if there is an intent that's not reflected in the language, we should make sure that that language is updated.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So what are we changing from the present system? Right now, if you're in either of those categories, you are either in a corrections facility or you are up here at Berlin at the State Hospital, or you're in a community facility. It could be in a community facility. With 27% care. Yeah. But it's this would put people in community facilities in a locked facility. Karen, we wanna help out.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: Yeah. So for the record, Karen Barbara, general counsel, the department of mental health. So as we've talked about it, like, this is a gap in the system. So these are individuals that do not fit into the DMH system in terms of they're not eligible to be hospitalized, so they are not in our hospitals. They could be in corrections. That is generally time limited based on kind of their unique every criminal case is different. There is no other secure setting in Vermont outside of either DMH or DOC. So if they don't fit into those systems, they could be in the community. It doesn't necessarily mean they're in a community placement. They could just be in the community without supervision or a structure around them, because those don't necessarily exist right now. So what we're attempting to do is for this very small narrow population. So I think it's important to remember that we're only talking about folks that have been accused of committing the

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: How many people are we talking about? It's three

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: to five a year. Just a handful of people we're talking about. This is not anyone who is coming in through the civil system, and this absolutely does not mean that if someone has a mental health need and the community doesn't commit or you alleged to commit a very serious crime and help with that bail, that they would in any way be an abrogance system. They would go through the normal mental health system. This is just for that narrow set of folks that are accused of committing very serious crimes where there's not a secure setting for them currently.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay. Other questions? All right, haven't sec, Senator Lyons.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: Please go. Yeah, absolutely. It was my understanding from the testimony and judiciary that the plan is to use a wing at one of our prisons. So it will not be separate facility.

[Committee Clerk/Assistant (name not stated)]: Is there

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

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: for- It's not, mean, know, I think Haley said that she would talk about the infrastructure plan, it

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: would be great if we could do that.

[Committee Clerk/Assistant (name not stated)]: I

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: was basically going to reiterate what Katie said, which was that it establishes the authority. There is not an existing forensic infrastructure outside of the correct infrastructure that the state is on.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So right now, these people would be in with the general criminal population or perhaps given the severity of the actions their mental illness causes them to take, These would be the people that are in solitary confinement, or abortion at the time?

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: No. There are many details that need to be worked out, so we haven't designated exactly where that housing would be yet. But I mean, right now, currently,

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: these people are incompetent to stand trial. They go to jail and get treatment until they are found competent, or they stay in jail on sentence, or they've been found not guilty by reason of insanity but committed to the correction system because they're a danger to the public, or do they get committed to the state hospital because they're a danger, or do they just or

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: they could just get put out in the street? They could just get put out. Yeah. If they don't meet our criteria, then they would come into our custody, and as I said, that's the gap. There is no other system for them to go into. Once you're found not guilty by reason of insanity, you cannot currently under statute, you cannot remain in the corrections. This would allow someone who continues to have clinical needs and be a danger to public safety to remain committed until there was evidence the court found that they could be placed back into the community, that that's the less restrictive setting and that they are no longer a danger to others. But that does not exist now.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So the court has no option but to turn them back out until they do something else? Correct.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: Unless they need hospital level care and then they could be in the hospital, but again our hospitals are acute care systems, so someone only remains in the hospital until their mental health need is not acute.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Like CVH and there's state mental health hospital.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: So they are all licensed and run exactly the same, and just because someone is found not competent does not mean they're at PBCH. They could be at any one of our facilities across the state.

[Committee Clerk/Assistant (name not stated)]: Every hospital runs exactly the same. Okay.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And there's no alarm facility. So they could walk out of any of those facilities anytime they want. Inpatient units for involuntarily committed

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: folks are locked.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: They also would not be able to stress off our hospitals?

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: No, because these are folks that would not be in our hospitals. They are folks that are not eligible for our hospital system. Anyone who remains, who needs to be in a hospital, will continue to go in a hospital. The idea is not at all

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: to divert people I'm from a physically healthy, but I'm mentally ill. And I have done violence to someone or something, probably someone. Found not guilty by the reason of insanity. Right now, you're telling me that the only option a judge has is just turn me loose or they could commit me to a voluntary hospital.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: If you meet that criteria. So there's two options, right? So if mental illness is the issue, but again remember this isn't just about mental illness. I know this is the only thing we focused on today, but we're also talking about substance use. We're talking about intellectual and developmental disabilities. We're talking about TDI and dementia. None of those things can be treated in the hospital. But if it is a pure mental illness, then you could be committed to the custody of the Department of Mental Health, and there are two ways that could happen. If you need hospital level of care, can go to the hospital, but if you do not, then you would be put on an outpatient order in the community. So those are not secure settings, And so the gap, again, we're trying to fill is not just those with mental illness with everyone, but the only secure, real secure option is if you meet that hospital level of care. Otherwise, unless you meet River Valley requirements, you're

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You said hospital level of care. I think a hospital level of care is I am physically sick. Not my body is just fine. I can walk around. I eat. I breathe. I'm doing fine physically. My mind, on the other hand, has some problems. Are those what do you mean when you say hospital level of care? Sure. So all of

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: our hospitals in Vermont are CMS certified and Joint Commission accredited. So that means that there are clinical criteria to be admitted to a psychiatric hospital. So just like you, maybe you broke your leg, but that doesn't mean you need to be inpatient, right? It could be that you need a lower level of outpatient care. It's the same with mental health. So what CMS is looking at is, do you have an acute mental illness? Can you receive active treatment? And is there no less restrictive alternative than to be in the hospital? So just like any other thing, if you could be served in an outpatient, you need to be served in an outpatient. And so only an admitting physician can make that decision. Those are clinical decisions. So a court cannot admit someone to a hospital. DMH cannot require our own hospital to take someone, only a physician can make that clinical determination because it is a clinical So

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: who would go to these this new forensic facility? Would be a person who was mentally ill enough not to be competent to be found guilty, but not ill enough to require a hospital level of intervention?

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: So again, it's enough people are found incompetent and insane for lots of reasons other than mental illness. It could be mental illness. It

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: could It be someone who could also be substance abuse. It could be developmental delay. So it's someone who doesn't

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: belong in the DMH system in a hospital. So either that means that they do have a mental illness but they don't need an inpatient level of care, they can be treated on an outpatient basis. And as you heard, Corrections is already giving people an outpatient level of care just like a DA would, right? Those are kind of outpatient levels of care, substance use, all of the other things. So the goal is to not, specifically in the language, not include people who should read hospital level care. So if they need to be in the hospital, they should absolutely be

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: in the hospital and the goals for them to be there. But again, our

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: hospital, unlike the old Vermont State Hospital, which had lost its accreditation and certification at the end, people cannot remain in the hospital once they're no longer acute. And so it is not we don't have long stays, we're an acute care system. So just because even if someone were to go into the hospital initially, it doesn't mean that they would stay there. So this could be a discharge option if they no longer met that need, but still remain a public safety risk. And again, we're only talking about folks accused of committing allegedly. This

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: might be someone who started out with some developmental delays and then bribe their brain on drugs

[Katie (Office of Legislative Counsel)]: and

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: wasn't gonna get cured in a hospital setting, but was too much of a risk to be set loose on the general public.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: The idea is that we are targeting individuals that are public, that have both clinical needs and public safety risks, and so the current system, because it's solely clinically based, doesn't have an option for that, and so we're really focused on how do we address both public safety and

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So health I think to offer clarity, we do have examples in the state, recent examples in the state where someone has been released into the community and has caused horrible signs. And so we're trying to resolve that issue, but the best way to resolve it. So this is a proposal to solve that problem. So I'm going to go to Senator Benson and we're going to have to move on very quickly, but this is gonna help me.

[Senator John Benson (Member, Senate Health and Welfare)]: Just because I understand it when you're making your your program making a decision about an individual being admitted to a hospital, that individual risk of, getting a, offense, is not part of the process. It's it's their mental condition, not whether they're a danger to the public or not in making the decision to admit them to It's the

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: a little more nuanced than that, so it's danger to self or others due to mental illness, but but people can and do remain dangerous for reasons other than mental illness or could have their mental illness treated to the point where they no longer need hospitalization, but that doesn't mean they couldn't be dangerous for other reasons. We see a lot of, especially for substance use, someone has, you know, their mental illness is treated, but if they use substances, it may cause them to be, you know, engage in dangerous behavior. So we do look at danger to some or others, but it's only in the context of mental illness. Does that Yeah.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, thank So here's what we're gonna do. We're not making any decisions right now. I know that Claire Neal has sent some language that the agency has looked at relative to this bill based on conversations about we need to do the right thing, trauma informed and so on. Katie has a suggestion as well. So we need to look at this again. We'll do it next Tuesday when we're outside of the umbrella of crossover week. Katie, do you want to show, look at your language now or how do we wanna do that? It's up to you.

[Katie (Office of Legislative Counsel)]: I I don't think my language is, you know, perfect. I guess it might be just worth thinking through how the instruction I got or the concern I heard from this committee is wanting to make sure that any placement was clinically appropriate and the providers were clinically appropriate. My first thought when I heard that was to put that as part of the definition of forensic facility in the bill. So, I was sort of starting to work in embedding those provisions within the definition of forensic facility. What you received from the departments is they're looking at rulemaking and to having the clinical, I guess, protections for lack of a better word, be within a rulemaking process. So that's a policy decision at where you want to place those type of

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: As you're talking, I think it makes sense to have it in both places. Okay. So, go ahead. No, have one more. Yeah, go ahead.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: Food for thought. So, we

[Katie (Office of Legislative Counsel)]: have been sort of emailing while you're having this discussion because what is in the bill right now is emergency rule making and what was sent from the agency is not emergency rulemaking, but the effective date of the forensic facility is July. I was thinking, so we need to be operating without rules, and it sounds like there might need to be a change in the effective dates because the intention is not to operate without rules and the department wants time to put the rules in place. So that might be part of an amendment that you're looking at is to bump out the effective date to give time for a goal making process. Okay, we'll have to think about that. And then

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I asked Calista to put the agency's language up and you've given your comment about the definition going in there. So we'll think about that over the weekend and then at the emergency rule making piece. The other piece is ensuring that the contract with WellPath reflects the needs that we have in the state for these folks, understood. We've even been talking about people who have committed a violent crime and didn't have a place to be, but there were also people in this bill included with TBI, SUD and you did mention IDD so it could be I don't know what role Act two forty eight is going play I mean, or the the folks who have developmental issues. I have no idea what the interest I know. I knew that. So anyway, so there's a lot here that is specific by population. So different groups needing different levels of services. And we may want to reference that somehow in the course as well. And does one place fit all?

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: I'm happy to work with Katie if that

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: is helpful. No, definitely we're going have you work with Katie. But my concern continues to be, know, we've talked about this in the past, we're trying to narrow this a little bit just to look at the folks who have committed a violent crime with mental illness, but I'm hearing from the agency that it covers everyone. We don't wanna go back to covers everyone because then we have the Schaller method to take care of people with developmental disorders. That's the only way to help them. We don't have a lot of people in this state who could take care of them. So I'm concerned that we're broadening the intent of the bill here. So I'm looking for, I'm asking a question for you.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: So the intent of the bill was to address I

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I put the bill in, so I'm

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: gonna You're you take the intent. Our understanding and and talking with the state's attorneys and what we are hoping to address, what we see as the gap in the system is for individuals who have been found incompetent for any reason. And again, people are routinely found incompetent for reasons other than mental illness. So if you limit it just to mental illness, you're not actually addressing the gaps of the system. And a lot of some of the bigger cases you're seeing, they're not in the hospital because they don't belong in the hospital, right? So the goal is to address the gaps, you have to think about more of the mental illness. This is not purely a mental illness issue. Our goal is to is that very small gap, again, only talking about individuals that are accused of committing the most serious crimes, but for whatever reason that they have been found incompetent or for whatever reason they have been found insane, having a secure location where they can receive treatment and public safety can be a factor in their their length of stay in that secure setting is what we are trying to address. My understanding was that the goal was to address that. And so it can't just be focused on mental illness because then you don't actually solve the gap.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And it also can't be just anyone who goes into a facility who has substance use disorder or anyone who happens to have a developmental disorder who's had a minor, right. Correct, we are

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: not talking about misdemeanors, we're not even talking about all felonies, We're only talking about very specific felonies that carry all acceptance. We are only talking about the most serious crimes.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: The judiciary's left. Okay. That's all right. Okay, good. Thank you for that. So there will be something that Katie and you folks can work out, and we'll be coming back to this. Here's the problem. The bill was voted out yesterday. It's on notice today. It's up for action on Tuesday. We'll have to pass over it or we'll have something for third reading of. That's a process I have to work out. And but the latest that we can do anything with this amendment is Wednesday morning. So we're gonna try and get to it. We're gonna try and get to it on Tuesday. If we can't, we'll have Wednesday morning to finish it off. So that that's how I'm gonna present that to my colleagues in issue. Thank you for your time. And, Robin, thank you for being here. Appreciate that. My pleasure. Go ahead. We're good.

[Dr. Robin Hodges (Senior Vice President of Mental Health, WellPath)]: I was just going to say my pleasure. Thanks for having me today. I appreciate it.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: All right, good. Thank you. So we're going to move on to two other bills. One is Michelle Child, but one is Katie's. So while Katie is here, we'd like to move on to S-twenty six. Sure. Thank you. Thank you. Since it's been years.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: Yes, we've done it for about a decade. So, yes.

[Katie (Office of Legislative Counsel)]: Michelle is here. Am, sorry.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: No, no, don't waste the week. We just finished one bill that was Katie's, and I didn't know when we should go on to the other bill that Katie had, or what's your time frame?

[Katie (Office of Legislative Counsel)]: Can I just do like a super quick swap? He has to do an email so this works. Go ahead.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Is that the one yesterday? Yeah, Bill's on that

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: here. Sorry.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Gonna spicy debate on the house floor arrangements. That's what I understand. So we have two thirty nine. Graph 2.1.

[Michelle Childs (Office of Legislative Counsel)]: Welcome. Thank you. Alright. So for the record, Chittenden, Office of Legislative Counsel, and we're gonna look at the latest changes to S-two 39. I that it shouldn't.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Senator Gulick is not able to stay on Zoom with us this morning, and so this is for this is she and Senator Vaaskey introduce her to someone, make sure that she's okay with this.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Can be with you till noon, so I'm I'm eight till 11:30. I'm just in the car.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Apologize. I thought you said 11:00, so good. Glad you're here.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: I'll be listening.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: All right, that's terrific. Having a little trouble.

[Michelle Childs (Office of Legislative Counsel)]: We move from different places in the building, it disconnects in

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: that storage. Going from bill to bill, we've got the same problems in here.

[Michelle Childs (Office of Legislative Counsel)]: Here we've got it. So, we are looking at version 2.1 of the committee amendment with respect to the child abuse and neglect reporting working group. So, I've highlighted the changes in yellow, and I'm just gonna walk you through the changes. Okay, so for the first changes in subsection A, and I just added the word mandatory reporting, so you would ask that it'd just be clear that we're talking about the mandatory reporting focus. Subsection B are the folks who are on the committee. And you'll see there's a change at the top of page two. Previously you had person, one member from the Department for Children and Families appointed by the Commissioner, and the recommendation I think was for it to be two members, and those folks to be from the Family Services Division, so we changed that. Then there's a new subsection C. And so you recall, the testimony from DCF last time was that there'd be certain stakeholders that are kind of part of the process, and so typically what we do is just to kind of identify them as, and of course the working group can be consulting with whoever is helpful for them, and sometimes it's helpful to specifically identify some folks who are stakeholders. So those are just the list of folks who were recommended by DCF, as well as recommendation from Senator Viejoski for the Disability Rights Vermont to be on there as well.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So there's actually a total of nine people on the working group.

[Michelle Childs (Office of Legislative Counsel)]: On the working group. That is good. Nine people on the working group. So subsection D is your reporting requirement to January. So, there's some new language that I put under the reporting and this is based on your discussions at your last committee hearing. So, the first one is any recommendation should remain consistent with capta and then talks a little bit about what CAPTA is. The second one is to promote efficiency and avoid repetitive work, that the group is to leverage the work of the Children's Justice Task Force and the Vermont Citizens Advisory Board, which is something that's required by CAMTA. And then subdivision three is that the working group is to consider best practices from other states in developing its recommendations. Subsection E is that the working group is to have the administrative, technical, and legal assistance of DCF. And then a few little housekeeping things under that subsection is that they are to convene their first meeting on or before August 15. They're to elect a chair at their first meeting, and five members shall be a quorum for purposes of voting to say. And that's it.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Good. Senator Gulick, your comments on the draft.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: I think it looks great. Thank you so much, Michelle.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Questions committee? Comments? Okay. I would entertain a motion on draft number 2.1 of S-two 39 as presented. Is there anyone up on the screen who wants to do a motion?

[Committee Clerk/Assistant (name not stated)]: I'll move the

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: this bill move forward. Sorry. Okay.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So you're you're moving that S two thirty nine draft 2.1 be voted on favorably and sent to the full Senate? Thank

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: you, Chair Lyons. That is my motion. Yes.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Alright. So is it a different draft? It's 2.1. Okay. We got it. She made a great motion. Discussion?

[Committee Clerk/Assistant (name not stated)]: Good. Okay. Okay. Senator Benson? Yes. Senator Cummings? Yes. Senator Gulick?

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Yes.

[Committee Clerk/Assistant (name not stated)]: Senator Morley? Yes. Senator Lyons? Yes.

[Senator John Benson (Member, Senate Health and Welfare)]: I zero zero.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Is there anyone who would like to present the bill?

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: I'm happy to.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I thought that would happen. Good. Thank you, Senator, appreciate it. I know you're busy with other bills next week, but this is a good one for you to do and I appreciate it. All right, Thank you, Michelle. Thank you so much,

[Michelle Childs (Office of Legislative Counsel)]: and anybody please reach out if you have questions, or Senator Gulick, if I can help in any way with your preparation for the floor. Thank you. Good luck on the floor. So we're

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: gonna move on to S26. Okay. This is great. So S26, Katie, remind us where we are and we'll see that. Under documents, open my

[Committee Clerk/Assistant (name not stated)]: list. We go.

[Katie (Office of Legislative Counsel)]: This is your bill on prohibiting certain artificial food dyes, additives, and food sold or provided at schools. Shouldn't say sold necessarily. The last time we met, we realized that the bill had, the amendments had changed the bill and the title of the bill, specific to dyes, no longer reflected what was in the bill. So, you asked me to update the title of the section. So it's now prohibiting certain substances and foods and beverages served or sold at school. Also, last time we met, there was a list of 12 items and number eight and number 12 on your previous list have been removed. So now you have a list of 10 dyes or additives that are prohibited from failure being served at school. And those are your only two changes. What's this draft 4.1?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay. We've reached out to the school folks. First, made changes so that the agency will ensure compliance and will be responsible for the administrative oversight for this. And the two school folks that we heard from said that they still felt it was going be really difficult for them to do. Then we also heard that the additives that are in here are being removed fairly quickly and they're not sold in other countries as we know, like some European countries, Canada. Foods without these things are available. We also heard from the beverage industry, I think we all live, that these dye some of the dyes that are in there and some of the additives are really important to the flavor of the beverages, but I'm not sure that the sodas and things that are sold that would contain those are actually sold, are part of the school fluent programs. So I'm less concerned about that. So I mean that's where we are with this one and it's really a policy choice to keep it going or say, just let it happen naturally out there. My only question is I remember when we heard from the schools

[Senator John Benson (Member, Senate Health and Welfare)]: that they had looked at the original list and said that really wouldn't affect their program, but they hadn't, at that time, looked at the additional items. I just wanna know if I have a current back, whether they actually looked at them or are they in their school program currently? Is that an issue or not an issue for them in terms of their program? I don't think it's worth it. Go ahead. I'm just

[Katie (Office of Legislative Counsel)]: thinking that there were a series of written testimony

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: that came to the committee Yes. We have. From from schools.

[Katie (Office of Legislative Counsel)]: And I didn't memorize them.

[Senator John Benson (Member, Senate Health and Welfare)]: Yeah. That's why I just had

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: We have it. We'll look at it. I think we just the the schools did look at the changes that we made because we added in the second list when we also reached out to Rosie Cooper so I'm feeling that these are also okay. We will hear, oh, look forward. I we have some comments on earlier dates. We'll make sure to get all the comments up so that goes.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Senator Lyons, can I ask a question, please?

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

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Did I hear you say that even with the new language proposed by the AOE that the folks in the field still think it's going to be an onerous process for them?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That's what they said. They said they weren't sure that they could they thought it was going to happen organically, that these substances were being removed and that we should just let it play out, that it would be overly burdensome for them. I don't think that word was overly. I'll make sure we have that testimony. It should be posted because we all got it.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: So they think it's gonna happen organically but this is gonna add paperwork for them to deal with. Is that right?

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well, the paperwork will be at the Agency of Education. We've removed that burden from them. Katie, help with the answer for that.

[Katie (Office of Legislative Counsel)]: Sure, hello. The language that was added builds on an existing compliance structure that the agency of education was already following. That by reviewing school menus and product labels, I'm not sure what their timeframe is, but they're already required to do that. And this adds to that existing process that they would have to be looking for these items when they're reviewing the school menus and product labels.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: The school doesn't have to do them.

[Katie (Office of Legislative Counsel)]: The school doesn't, the agency does. The agency does that review. That's the enforcement. The school would, you know, to make sure they're in compliance with the voucher, they have to be checking them, but the enforcement is at the agency.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And when they find out they're not in compliance, if they don't read the fine print, then the agency says you're not in compliance. I'm assuming the agency can also say, Here are alternatives, because that's what they're doing now, and you've heard alternatives out there.

[Senator John Benson (Member, Senate Health and Welfare)]: Right. Right. Right. I remember for the first group, they didn't feel that was a problem. Right. And then already most of it was out there for It was just that's the my earlier question about this. That

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: went to Rosie Krumovich, my understanding. So I was part of the process.

[Senator John Benson (Member, Senate Health and Welfare)]: I'm not sure where. Oh,

[Committee Clerk/Assistant (name not stated)]: okay. I

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: think I'm gonna be a no, just FYI. As much as I support the thinking behind it, I'm not comfortable adding administrative burden to schools when we're probably going to be cutting their budgets.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, let's offer some clarity. Katie, please. The role of the agency will be to look at the foods the schools are offering.

[Katie (Office of Legislative Counsel)]: They're doing the formal compliance review.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So the agency is doing the compliance review. If they find that a school is offering foods, this takes effect in a year, July 2027. Doesn't take effect right away. But if the agency finds that a school is offering foods that contains one or more of these products additives, then the agency will say this food contains this toxin, this chemical, this is the alternative that you could put on your menu. So between now and 2027 we may see a reduction in a lot of these things because that's happening. I don't feel, I know it's uncomfortable when we tell students to do things. I know that. But I really don't feel uncomfortable about this. I think there's a process here that protects the individual school food. I mean, this point I am concerned that the AOE doesn't even have the capacity

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: to do that little task because they are so overburdened, understaffed, and they just have a lot of issues right now. So I'm torn also.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well yeah. But AOE has testified they can do this. So I I'm I'm not gonna go behind the scenes on that one. If we need to put more staffing, put more staffing. Rosie Krueger's on it. Yeah. So Senator Morley. I

[Committee Clerk/Assistant (name not stated)]: thought I heard that, I think it's from Burlington.

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

[Committee Clerk/Assistant (name not stated)]: That they're doing this now anyways. So they they don't wanna be giving to be getting products with these dyes and that AOE could, their oversight say, hey. Look. You're doing this. Can you try something else? And I'm sure that they would. I don't see a or yeah. Anyone saying, yeah. Well, we should be supplying more of these to our students. So I just I'm not positive that a bill is necessary right now. I I may be completely wrong. It's just

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well, these chemicals are not chemicals that AOE is looking at. This would add chemicals that they look at. And they do have significant effect on development. Okay. Yeah. They affect all of us. I'm looking at it right there.

[Committee Clerk/Assistant (name not stated)]: Yeah. But So that's

[Senator John Benson (Member, Senate Health and Welfare)]: I think to your point, we're hearing that they are disappearing out of the food chain without any regulation. All in Europe.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Because Europe is out. But they're not out locked here. So supply and demand, some manufacturers may be removing them because but some may have plants that feed to market in The US, and maybe some schools are serving Fruit Loops, which I believe is one that's come under scrutiny. Florence Yeah. Beautifully attractive bright colors, which are better than light brown, supposedly. I think I don't think this is Ferguson. I've had issues with that was the federal government doing supply and saying you couldn't serve pickles or ketchup because there was too much sugar in it, and a football player got the same serving amount as a 90 cheerleader, that felt intrusive. Draconian. Yeah. But this one,

[Committee Clerk/Assistant (name not stated)]: I'm not having. Oh, missed something then. So the schools

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: do want this. Don't wanna have to go through all the labels and figure out if the state says, look, this product, you know, next time they do your review, do you know down here in that tiny print it says this chemical, and that's on the list and you can't do that anymore, it gives the alternatives, then I don't yeah. I don't think that's if they had to go through everything they served to try and find two more minute traces or if we told them it couldn't contain more than point 025%, that might be it. But as long as the state is safe, and they're not gonna say you have to take it out, they used to they've been doing this.

[Committee Clerk/Assistant (name not stated)]: I know, miss Gloria. Yeah. Right.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So we're just telling them to do it with a few more chemicals. And the agency will be providing the oversight for schools. Schools don't have to provide the oversight for these chemicals. The agency will look and see and say these foods have these chemicals and these are the replacement products that you can get. So I'm not, I feel good about this one. This is nothing like what we've been through with some of the chemical discussions that we do have in town. I don't like that. So yeah, about protecting kids. And it's not gonna happen organically unless there are states actually push the federal government to push our manufacturers. Only so much goodwill out there. Part of it is, right now the European market, which is much larger than the market in The United States, and add Canada to it, is doing all this. So the products are available, period. They know how to put stuff together without these dollars. I can't say it becomes 50 per stage. I

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: like that.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So anyway, there's a discussion. I did get a note from, I think posted a message from, was it the superintendents? Yes. Yes, they're positive on this, very supportive of it. So it's not like schools are not supportive of it.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Okay, I will support the bill, but I can tell you all that the AOE is struggling to support schools in many, many ways right now. So I concerned that they will be able to do what we're asking them to do here just because there have been other failures in other areas. But Senator Lyons, I hear your point and I will support the bill.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you, Senator, for that comment. And we'll move forward with a vote if we can get a motion and then come what may, know there's a lot of work between here and the end of the day on this one. But I also hear you Senator Gulick and maybe we can work with when education comes into appropriations, we're asking them about staffing needs. Because it is an ongoing problem, you're right. It has been for years. Can I get a motion on this bill? I'll move it. Is it draft four point one?

[Committee Clerk/Assistant (name not stated)]: Four point one.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That's what I'm asking. All right, favorably to the Senate. Okay, we've had a big discussion, so is there any further discussion? Alright. Senator Clark. I'm keeping you busy today.

[Committee Clerk/Assistant (name not stated)]: You are. I don't know what this one is. Senator Benson.

[Senator John Benson (Member, Senate Health and Welfare)]: Yes.

[Committee Clerk/Assistant (name not stated)]: Senator Cummings. Yes. Senator Gulick.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Yes.

[Senator John Benson (Member, Senate Health and Welfare)]: Senator Morley.

[Senator John Morley III (Member, Senate Health and Welfare)]: Yes. Senator Lyons. Yes. What?

[Senator John Benson (Member, Senate Health and Welfare)]: Yeah. So you're glad it's 500. K.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That's good. I think this will be good. It really will. Alright. Well, we'll sort it out.

[Senator John Benson (Member, Senate Health and Welfare)]: The last comment, I think they feel much more comfortable. Thank you.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you, Chittenden. So who

[Committee Clerk/Assistant (name not stated)]: wants

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: to report this bill?

[Committee Clerk/Assistant (name not stated)]: I have

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: three bills. Who wants to report this one bill?

[Committee Clerk/Assistant (name not stated)]: Are you good? Yeah. I'm good. I will record it, though.

[Karen Barber (General Counsel, Vermont Department of Mental Health)]: Oh, okay.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: I I will if nobody else wants to.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Martine's got it. That's good. I like that. And you know about the school issue and school stuff, and we'll work on that.

[Committee Clerk/Assistant (name not stated)]: Agree. Okay. Thanks.

[Senator Martine Larocque Gulick (Vice Chair, Senate Health and Welfare)]: Oh, but I can't bring it up because I'm not there.

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Also, I'll bring it up for you Can on your I sign it on your behalf?

[Committee Clerk/Assistant (name not stated)]: Yes. Okay. All

[Senator Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: right. Oh boy. We have done our work. I know the S-one94 is sitting out there. I'm okay, Amy. We're gonna work on that. I understand. It'll be a different way of putting And that appreciate your work on it. Right, we are calling it a wrap. Thank you for everything. Gulick Sue? Yes.