Vermont Legislature SmartTranscripts:

[Sen. Virginia “Ginny” Lyons (Chair)]: Where's mine? You're last. We're back. Is age six sixty conference committee. Just actually, listen, we've looked through the proposal and we agree with everything. We have just one concern. And that is around the $1,200,000 that's for the recovery and the AM beds, medical beds, and the level three, and the addiction medical. We've here's our concern. We could put 1,200,000 in or we could split it and put 6 and six or whatever way of splitting it. Concern is that the money go for some development of each type of Okay. One or one isn't left out because all the money's given over here. Mhmm. Like, tomorrow, we don't want it. So that's our concern, and we're kind of wordsmithing around a little bit using the $1,200,000 that you have in. And, obviously, the way we have it, so many wordsmith, but it doesn't have the one of the latest, you might want to see it. So we're at that's our conundrums. So I'm wondering

[Unidentified House conferee]: so in testimony from the health department, they, given the increase in that level 3.1 already on the treatment side of things, they did not present to us a increased need at this point in time for that. So you might have heard something different from Do I have Yeah.

[Sen. Virginia “Ginny” Lyons (Chair)]: What do we have in terms of level 3.1 addiction bans?

[Unidentified House conferee]: So, we certainly heard from Judge Rice. I never know whether it's Rice. That, of course, was before the the beds that opened up in Virginia's. Right.

[Sen. Virginia “Ginny” Lyons (Chair)]: That's what we think about it. Right.

[Unidentified House conferee]: Did you hear from Valley Vista or

[Sen. Virginia “Ginny” Lyons (Chair)]: We did informally. We did not have formal testimony, but we did hear from Valley Vista, and that this would be helpful for them.

[Unidentified legislator (possibly Sen. Martine Larocque Gulick)]: In recovery, Chad B. J. And surrounding house would be

[Sen. Virginia “Ginny” Lyons (Chair)]: the other three things. And surrounding houses. And

[Unidentified House conferee]: so, do you have a alternate proposal that could leave it at the 1.2, but guarantees that there's some resources to

[Sen. Virginia “Ginny” Lyons (Chair)]: We've been trying to find that language. If you wanna help us with it, that'd be great. Otherwise, the split of six and six is one way to do it. The other way, Katie, what was the other language that we had thought about? There it is. We talked about 1.2 to the Department of Health for both the creation of new recovery beds and for opioid use disorder, SAN beds. There was a mention of equitable distribution, but the struggle there was what exactly does equitable distribution mean? Certainly

[Unidentified House conferee]: it was our intent that it would cover both, that they would just decide, well, we're going to spend it all on recovery residences. So, we can strengthen the language that indicates That it's for

[Sen. Virginia “Ginny” Lyons (Chair)]: would work. If the intent is to cover both, that's powerful. That's legislative intent. And then, have language that says, in. That's an end. Uh-huh. Yep.

[Unidentified House conferee]: Right. To the for a decree of. How did you say both, 1.2

[Sen. Virginia “Ginny” Lyons (Chair)]: to the Department of Health for both the creation of new recovery in our beds and for OBD residential beds.

[Unidentified House conferee]: I would be able to, I I should confirm with my comperese, but Comperese, would you

[Sen. Virginia “Ginny” Lyons (Chair)]: be able to do that? No. Yeah. I think we're okay with that. That's my only question. Okay. What was your answer?

[Unidentified House conferee]: Our answer. Yes. We'll be

[Sen. Virginia “Ginny” Lyons (Chair)]: We're okay with that. If we insert your code. I'm gonna put the Department of Health on as well.

[Unidentified House conferee]: Janet Livingston, Health Department. So I think

[Janet Livingston, Vermont Department of Health]: that for the committee's consideration is what those funds are for for 3.1. So we did just double our 3.1 capacity when

[Sen. Virginia “Ginny” Lyons (Chair)]: we opened the Virginia Gems facility with Valley Vista, which is awesome and was needed and is exciting. We're still watching those census numbers to see how it adjusts out. Beside that, the language, if we have that language in there, would the Department of Health support funding for both of those?

[Janet Livingston, Vermont Department of Health]: I think it depends on what you mean. So Chad at Serenity House, right, like, they need some capital improvements. They need some things that are problems that are not expanding necessarily expanding beds. If the committee is looking at expanding beds, right, I don't know if it would be enough, number one. And number two, when we opened Virginia's back up with Valley Vista, that was a facility that we had budgeted for already. Right? They closed they closed the facility, and it was in our budget to provide that level of treatment. If we continue to expand 3.1 beds, right, I just want to caution the committee that that has a lot of other costs associated with it. It's not just here's the money to open it, which is what this money would be. It's then the match to treat the individuals there with Medicaid, and then it's also room and forth, which we cannot fund with Medicaid, and we have to fund out of dental fund or a block grant. So, when the department is not opposed to potentially expanding 3.1 treatment, that is something that might need to happen. The two things that we need to do first is watch what's happening right now with the full census and just get our feet under us and see what the demand is. And then we would need to come back, most likely, with what the full budget impact of ongoing room and board, ongoing Medicaid rates are. And so I think it depends. If if the committee's intent is that we support this really critical services and that we do some of the work that maybe is not funded by Medicaid, like facility.

[Sen. Virginia “Ginny” Lyons (Chair)]: I you. Know that the facility question is being debated in institutions. That's not what we're suggesting. We're talking about VATS and treatment. And I think if we have this language in here with the intent, we also have an opportunity through the BAA process to look at this. Right now there's a strong there are folks who would like to have the funding go forward for both sets of beds. Can I

[Unidentified House conferee]: ask a question? Yeah. So, what has been the census at the, because the program is that's relatively recent, that expansion there. Yeah. What has been the census there?

[Janet Livingston, Vermont Department of Health]: They right up. They filled right up Mhmm. Which was awesome. That was what we were asking. It was the need that we had as a state. And, you know, we're still working with them on system flow and some other processes. And also, there was pent up need for individuals. So it's not that again, I don't I do not want the community to walk away with the idea that we might not need more. It is very possible that we do and will. And I might be back six months begging you for But I think it's it just it needs a little time.

[Unidentified House conferee]: I hear what you're saying, though, that, you know, you can spend money on development, but if you don't have operating funds, then it's not gonna it's not money well spent. So I I guess I'm also questioning so at Serenity House, is that is that the 3.1?

[Janet Livingston, Vermont Department of Health]: Nope. That's the 3.5. That's Chad. That's Recovery House. Okay. Even though it's treatment.

[Unidentified House conferee]: What is Chad's three point one? Grace House and Okay. McGee And are what's the occupancy at those?

[Janet Livingston, Vermont Department of Health]: The they run around 60 to 70% full.

[Unidentified House conferee]: So the reason I asked is because they had testified, this was a different need, but when we were talking about the recovery bed bill that we had that you sent up. They serve as a receiving when people have an issue and they need to get back into treatment for a short period of time and then transition back. He'd said, we never had to turn anybody away. So that to me indicated that they had some level of openings So there and I guess then if we still have open capacity. I'm willing to keep that at both. But if we have open capacity, what is driving the need to invest in more beds right now when we

[Sen. Virginia “Ginny” Lyons (Chair)]: haven't identified Perhaps the fact that Virginia's is

[Unidentified House conferee]: 100% full. Right, Virginia's not. Yeah, they don't. And they're both in the same county. Both in Addison. I thought it was in Raleigh. Okay. Yeah. He has one of the places in Addison County, doesn't he? No. No, they're both in Raleigh? Okay. The ones in Raleigh, one in Raleigh. So,

[Sen. Virginia “Ginny” Lyons (Chair)]: Well, short of splitting the money up, I think having language that says that bothand is important.

[Unidentified House conferee]: We've conferred and we're okay with both and. I just think we need to understand that it's a caveat. The department is saying that there's additional costs associated with this. Understood. We need to understand that. Operating costs are

[Sen. Virginia “Ginny” Lyons (Chair)]: not here. Well, and one of the problems with the opioid fund is that we don't want to have operating costs embedded in the fund because it is supposed to be getting the beds in place or the infrastructure. Yes, I understand. Yeah, I hear you. Senator Gulick? I'll just reiterate, I like the construct that we had, and I would like to stick with that. I want to think about it. Let's think about that part. Let us think about that, and then we'll come back again. Good number.

[Unidentified legislator (possibly Sen. Martine Larocque Gulick)]: May I add something just briefly? What I'm hearing, it sounds like they were looking for assistance to just strengthen their existing infrastructure and capacity than necessarily expand. It's just to get that support, actually, in regards to stories and

[Sen. Virginia “Ginny” Lyons (Chair)]: then what makes me motivated. Yeah.

[Unidentified House conferee]: I guess I just want I do want to share that, you know, we've come on board with your hireability. We've come on board with your public safety. We've come on board with quite a of your language. And I think that the

[Sen. Virginia “Ginny” Lyons (Chair)]: We will consider that.

[Unidentified House conferee]: Yeah. I think that the department's in the best place to determine We're not doing that. Yeah. No. I understand. I understand. I'm just pointing out the places where we've stepped over the line to the senate. That's all. We appreciate it. Alright. So when we have your next steps, madam chair?

[Sen. Virginia “Ginny” Lyons (Chair)]: I have accomplished committee on a thought on the morning but perhaps and I've got a concept. I'm I'm busy all afternoon and I've heard of you guys. Don't know. I'm so worried. At three. Yeah. Something like. Is that

[Unidentified House conferee]: I am about to

[Sen. Virginia “Ginny” Lyons (Chair)]: finish tomorrow

[Unidentified House conferee]: at nine. Finish up.

[Sen. Virginia “Ginny” Lyons (Chair)]: So do you think by 09:45 we could meet, or should we meet at 08:30?

[Unidentified House conferee]: 08:30.

[Sen. Virginia “Ginny” Lyons (Chair)]: That's good. So I'm not available at 08:30. You're not available. You could meet without me if you're just finalizing a draft. Okay. What if I guess preference preferentially, we could be that I'm just asking if we'll be talking about sort of meatier things tomorrow. No. I'm worried about that conference thing. Yeah. Going on. Because we tried for fall.

[Unidentified House conferee]: You guys wanna converse some more and then we'll step out and then we can come back in?

[Sen. Virginia “Ginny” Lyons (Chair)]: We could try that. Let's try that. Let's go off. It's alright. If If I sit too hard, I'll put pressure on these.

[Unidentified House conferee]: Well, I just I'm getting pressure from upstairs. I don't know.