Vermont Legislature SmartTranscripts:

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You're alive. Alright. Here we are. Senate Health and Welfare, we're back. So okay. Jen, what draft are we on here?

[Katie McLennan (Office of Legislative Counsel)]: So, Jen Kirby, legislative counsel. I think what maybe made sense for the moment is for me to put up the language, but not send it. I have it edited, being edited right now. I have the, I just sent it to the advocates because I just finished it. Madam Chair, your direction yesterday was very helpful, and everyone came together.

[Jen Kirby (Office of Legislative Counsel)]: They've been great and very responsive, and we've been emailing back and forth because I had some questions about the language, and they got right back me and that's what I've

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: been incorporating Excellent. Into this. So is your I understand.

[Jen Kirby (Office of Legislative Counsel)]: So I will have it posted Okay.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: As soon as we Go through it.

[Jen Kirby (Office of Legislative Counsel)]: As soon as, yes, as soon as I get it back from editing, I think.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Good. So it was my understanding that everyone had come together on this.

[Jen Kirby (Office of Legislative Counsel)]: I think that is accurate. Okay. That's what we Yes.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I've always let them speak for themselves, I've let them know that you are taking the And pill what I will say is, if everyone's come together, that's terrific. But by holding us up so we have to do this on another day has meant that it's held us behind on $5.83 and on other bills. And gee whiz, I surely hope we can get to a $2.38 out because that or $9.38, excuse me. As if we have we need the time for that bill. That's how many millions of dollars has been held up because of this one little thing where people could not act responsibly and send information to our legislator and the CERN. Okay. Alright, I will put

[Jen Kirby (Office of Legislative Counsel)]: the language up. So this is, and I've sort of formatted it so it could be dropped into your amendment. This would add in a new section 10, adding to our executive health care services with a new subsection H. Starts out with definitions. First we have HIV prevention drug, is any pre exposure prophylaxis drug or post exposure prophylaxis drug, including oral and long acting injectable formulations that is approved by the FDA, FDA has already spelled out earlier in the statute, for HIV prevention or that is otherwise authorized for HIV prevention pursuant to FDA labeling or federal clinical guidelines. And as a definition of supportive health services, comes up in the Medicaid context later in this subsection, is any health service that is necessary to monitor a patient to ensure the safe and effective ongoing use of an HIV prevention drug, and includes an office visit, lab testing, testing for a sexually transmitted infection, medication self management and adherence counseling, patient education and counseling by the patient's healthcare provider regarding the appropriate use of the HIV prevention drug. Doesn't belong here. Any other health services that are components of comprehensive HIV prevention drug services as determined by the patient's healthcare provider. Then we have the two coverage pieces. Sub division two is health insurance. A health insurance plan shall provide coverage for HIV free exposure prophylaxis drugs as recommended by the US Preventive Services Task Force as of 08/22/2023, so tying it to a date certain when we know what was recommended. This coverage must be provided without any deductible, coinsurance, copayment, or other cost sharing requirement, except to the extent that the coverage would disqualify a high deductible health plan from eligibility for a health savings account under federal law. This is some fairly standard language we put in any time we're dictating first dollar coverage in order to ensure that we don't inadvertently disqualify a high deductible health plan from eligibility for a health savings account, because federal law dictates which services are available for first dollar coverage. And then there's requirement around Medicaid, requiring Medicaid and any other public healthcare assistance program offered or administered by the state or by any subdivision or instrumentality of the state, except for any program funded in whole or in part by federal grants that include prohibitions on coverage of HIV prevention drugs. Getting back to the beginning of that is Medicaid, shall provide coverage of HIV prevention drugs and supported health services, that was that definition, and shall not require any cost sharing, including co payments. They shall provide coverage without requiring prior authorization or any other protocol that may restrict or delay dispensing for at least one FDA approved drug in each category of pre exposure and post exposure prophylaxis drugs, and not deny coverage based on the type of healthcare professional issuing the prescription for any HIV prevention drug for which Medicaid does not require prior authorization. B, provided the healthcare professional is acting within the professional's authorized scope of practice and is enrolled as a participating provider in Vermont Medicaid. That's reflecting the potential admission in OPR bill, assuming that's still in there, for pharmacists prescribing HIV prevention drugs. If it's not, it doesn't do any harm, but that's my understanding of the intent. And then we were looking at effective dates and having certain things take effect on passage, and the bill as it came to you was effective 07/01/2026, but I don't believe there's any actual reason that it needs to wait until 2026. And I floated that very quickly by, I think, to Mary Blog is in the waiting room. One of my burden. I think everybody, at least in this group, which is mostly Veeva is affected, was okay. So rather than you

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: say, and ask for the whole bill? Yes, I

[Jen Kirby (Office of Legislative Counsel)]: don't think there's anything in here that needs to wait until July 1, so there's currently no money in the bill, for example, that would require the bill to wait until July 1. So rather than carving out certain things as effective on passage and others July 1, seemed to make sense to just say on passage and you may wanna just confirm that with Alex. The other amendment piece that we had looked at yesterday was around the GLP-one drugs. And I did, and I believe Nolan is on Zoom as well, I know he was able to check-in with GFR. And to do that work, they would need a small appropriation somewhere between, I think the estimate was 10 to $25,000 for actuarial work because they have to contract that work out. We do not have actuaries staff in this state. So that may need a different effective date if you're appropriating.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well, here's my suggestion on that one. Let's hold that one out and we'll see what happens during the budget conference process. Right now, the money's not in the budget and I know what will happen to it. I know what will happen to us. So let's just be patient for that. And I can see Alex is also smiling. So

[Jen Kirby (Office of Legislative Counsel)]: manager, does that mean you want to include the language and try to put the money in or that you would not include the language

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: If we include the language without the money, we can include the language without the money. But if we include the money, I think that the whole bill will probably find a collision force down the hallways. So if we include the language I know. Know. Cover cover up one of ours. Nolan. Speak up. Look at Nolan smiling. I could tell he's really excited about this. For

[Nolan Langweil (Joint Fiscal Office)]: the record, Nolan Langwell, joint fiscal office. I am not a fan of knowingly not appropriating money when you know money needs to be appropriated. And regardless, it will have a fiscal note and it will probably go to appropriations either way.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So here's my suggestion. Let's not put it into the bill at this time, but I will carry that language with me and we'll see what can happen somewhere.

[Nolan Langweil (Joint Fiscal Office)]: Sorry to be bearer of bad news.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Pardon me, I didn't hear you.

[Nolan Langweil (Joint Fiscal Office)]: Sorry to be the bearer of bad news.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: No, that's just fine. The realism is not a bad thing.

[Jen Kirby (Office of Legislative Counsel)]: We won't save that language in a separate document in case we're coming Okay. Back to

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you, Nolan. He left. He's busy. Everybody's busy. Okay, committee, this language then has been through the mill. We have agreement from the interested parties. I think it could have happened a long time ago, but I won't dwell on that. I won't beat a dead horse with that one.

[Alex McCracken (Director of Communications and Legislative Affairs, DVHA)]: Madam Chair, may I make a quick comment?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Please, Alex. Thank you.

[Alex McCracken (Director of Communications and Legislative Affairs, DVHA)]: Thank you. For the record, Alex McCracken, sheher pronouns, Director of communications and legislative affairs for DIVA. I just wanna make a quick note of appreciation both for the committee's patience and for the incredible amount of work that's gone into this language from all the various stakeholders. It has been a big lift with a lot of different sticking points, but I'm glad we could arrive at language that all parties can live with, and Diva is happy to see this move forward. So thank you. It's much appreciated.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you very much. We appreciate those comments. It's good to hear that what's happened is acceptable to the department. This is your bill, so want to make sure that it fits the department's needs. Okay. So, Jen, we're gonna have a proposal of amendment. You It won't be it will not be a strike off. It is not a strike off. That's a good thing.

[Jen Kirby (Office of Legislative Counsel)]: And I'm just updating the header,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: and I will put it up. Okay. It's free and void.

[Jen Kirby (Office of Legislative Counsel)]: And I was able to incorporate a couple of edits from our fast working editor.

[Sen. John Morley III (Member)]: So, ma'am, Diva Blue Cross Blue Shield Advocates. Advocates. DFR. DFR. Everyone's

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Oops. Sorry. Is my understanding. It's called the psychic dysphoria.

[Sen. John Morley III (Member)]: Have a looking around. Alex, you good?

[Alex McCracken (Director of Communications and Legislative Affairs, DVHA)]: We have all reviewed the language and all signaled that it is

[Jen Kirby (Office of Legislative Counsel)]: language that we can look at.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Oh, there's Mary. Look at Mary. Oh, terrific. Okay. She's sitting on top of Mount Philo. Gang's all here. Oh, this is wonderful. Courtney's happy. Courtney's Mary's happy. Is happy.

[Jen Kirby (Office of Legislative Counsel)]: So here, it's your full amendment. So you have the first instance of amendment is that change, or adding in the language about a 340B covered entity, and keeping the struct subsection D, the second instance of amendment is changing that 2026 date relating to OPR's duties with respect to dualist to 2027. And the third instance of amendment is what we just looked at, which is now striking out section 10 and putting in pen and 11. And so we have the only changes made by the editors were suggesting supportive health service in the singular here, and then when we talk about supportive health services, it refers to everything on this list.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And that was really it.

[Sen. John Morley III (Member)]: And effective dates to the

[Jen Kirby (Office of Legislative Counsel)]: Yes, and then the effective date, yes, has changed to the act.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: We'll take the effective message. Okay. Should I make the motion? Yeah. You went motion. You have a good option.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Idea. Yeah.

[Jen Kirby (Office of Legislative Counsel)]: I'll leave it up to the courtesy, and then I will send it to.

[Sen. John Morley III (Member)]: This is draft one.

[Jen Kirby (Office of Legislative Counsel)]: This is draft 3.1. Wait.

[Sen. Martine Larocque Gulick (Vice Chair)]: John, you gotta read. Good motion.

[Sen. John Morley III (Member)]: I get a I get a lot

[Unidentified committee member (senator)]: of paperwork.

[Sen. John Morley III (Member)]: Give the date.

[Katie McLennan (Office of Legislative Counsel)]: Five one day.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I've been made it.

[Sen. Martine Larocque Gulick (Vice Chair)]: I move that the Senate of the Rockford Committee vote favorably out of committee draft 3.1 of age six eleven on 05/01/2026.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So this is the first of two, right? You have to

[Katie McLennan (Office of Legislative Counsel)]: go through the amendment. So

[Sen. John Morley III (Member)]: we're on the amendment. Yeah.

[Chris Dubey (President, Professional Firefighters of Vermont)]: Are you ready?

[Sen. Martine Larocque Gulick (Vice Chair)]: I am. Let's see if you get my name right.

[Sen. John Morley III (Member)]: Representative Benson. Yes. Senator Cummings. Yes. Senator Gulick.

[Sen. Martine Larocque Gulick (Vice Chair)]: Yes.

[Sen. John Morley III (Member)]: Senator Morley? Yes. Senator Lyons? Yes. Statement.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Now I'll move to vote favorably. Draft

[Sen. Martine Larocque Gulick (Vice Chair)]: 3.1 to the whole senate, page six eleven on 05/01/2026.

[Sen. John Morley III (Member)]: Senator Benson. Yes. Senator Cummings.

[Sen. Ann Cummings (Member)]: Yes.

[Sen. John Morley III (Member)]: Senator Gulick.

[Sen. Martine Larocque Gulick (Vice Chair)]: Yes.

[Sen. John Morley III (Member)]: Senator Gulick. Morley. Yes. Senator Lyons. Yes.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: I hear zero there.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That's wonderful. Thank you. That was hard work. Not our hard work. Well, was our hard work, just motivating people is always difficult. So now I'm looking for a reporter and honestly I'm gonna say this, given that I will probably be conferencing the budget, it's gonna be difficult for me to pick up too many other things, and I'm looking at $9.38 going forward. So I'm looking at hell here. I'm gonna be doing the tax bills, Thank you.

[Sen. John Morley III (Member)]: I'm doing $6.57.

[Sen. Martine Larocque Gulick (Vice Chair)]: I'll do it if no one else. And it's probably gonna be

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: a while. It's going to. Right? No. I don't. It's not going

[Sen. John Morley III (Member)]: to. Any money.

[Katie McLennan (Office of Legislative Counsel)]: Yeah. I know. But do you know secretary of the? Maybe because it uses the word Medicaid, but I think it's notifying.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Senator Benson, any interest in this one? I've got one. You've got one. How many of you got? I've got two. She's got two. Jeez. You get out. What do you have? She's got

[Sen. John Morley III (Member)]: $6.57, and I'll trade with you if you wanna do it.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah. No. That's that's an. Why don't you take it and you guys can sort it out. So

[Sen. John Morley III (Member)]: who was reporting?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Senator Gulick. You guys are making great progress with that meeting. Thank you very much. You can also say Barron. Okay. Alright. Okay. Yes, you're right. I want to say that we deserve some time with a bill that is

[Sen. Martine Larocque Gulick (Vice Chair)]: less

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: confounding and much better, and that's H two seventy. So, we've been through this bill with Katie, and Katie, do you want to give us, and we could have Lieutenant McDonough who could come up because you're going to testify, but before we do that, Katie, just give us the broad picture of the bill that we have been through. Sure. I think it's one we all really appreciate.

[Katie McLennan (Office of Legislative Counsel)]: Okay, Katie McLennan, Office of Louisiana State

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: of the Council.

[Katie McLennan (Office of Legislative Counsel)]: We did a walkthrough of this bill. This is the emergency provider wellness bill, and

[Marissa Silvestri (Student, Winooski High School; NAMI Vermont Youth Advocate)]: this

[Katie McLennan (Office of Legislative Counsel)]: provides confidentiality for a peer to peer session after a traumatic event may have occurred, and all of the communications that are made as part of that peer to peer session between emergency providers would be confidential, and also there's confidentiality protections for disclosures between members of the

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: staff of the program who may need to communicate about such. And remember this is a follow-up bill to a bill that we did a few years ago that we worked with then Commissioner Baker of Department of Corrections and a huge group of folks who came in. It was more than two, I was here. You were here. I was a doctor. Right. So it's a few more years. Yeah. Called five, six. And it was a powerful set of testimony. And then to have the whole group get together and continue to meet is outstanding. So we're glad you're here on this bill, and why don't you give us your testimony? Well,

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Caroline, thank you for having me here today, the rest of the family's community. Greatly appreciate this opportunity. My name is Mark McDonough. I up a couple ranks. I'm a battalion chief in the Burlington's department now, and I manage peer support program in Burlington and was part of the crew that created it back in 2018. I'm also the vice chair of the Vermont Emergency Service Provider Wellness Commission and have been working with the team there on the commission for two years now on this bill. It was brought to our attention a little bit late in last year's session. We still pushed for it and were able to get it in the House Health Care Committee and Chair Black has been an incredible supporter and advocate for us in that. Understandably, with all the challenges the state's going through, just didn't quite make it out of committee last year, but she picked it right up right away this year. We're grateful for that and appreciative of you continuing that here. So this bill is really a fantastic example of why the commission exists. We we are given nine different tasks that we have to evaluate every every year for us to look at. One of them is certainly looking at, are there pieces of legislation we should be bringing forward and really advocating for? This one is such a for us. The culture surrounding mental health in first responders has seen dramatic improvement in my time. I started as a volunteer firefighter in ENT when I was 18 and I'm now 46. So I've been doing this for a couple of years. I worked as a volunteer firefighter, a career ENT. I've now been a career firefighter for twenty years, volunteered ski patrol for twenty five years. So my life has pretty much been in first response, and and I've seen very firsthand the challenges that being a first responder brings to folks' lives. And I've seen very personally how it's destroyed people's lives because services weren't available. The evolution of peer support programs has been foundational change in First Response Community. And the biggest reason why is that it has very little barrier to access that service. You're not calling and making an appointment with a clinician who, as we all know, are extremely overwhelmed right now. Finding a clinician gets our culture and our profession, finding clinicians that are trauma informed and educated in treatment modalities that are appropriate for our needs. Peer supporters get it because they live it, right? And so that ability to rapidly access a fellow peer, have a conversation with them, and bring down your stress levels, which is really the primary function of peer support conversation, is just to listen and help bring their stress levels down to more healthy, manageable area. It's really critical. The biggest thing to make sure that our members are willing to take that risk and have those conversations is trust and trusting that those conversations stay confidential. Peer support teams that have any credibility have their own policies. The conversations stay confidential as does ours. The challenge is that agencies could attempt to go in force those those peer support team members to divulge information that's had. We currently have no protection of that. We're bringing this forward. It is not a new concept. Many of the New England states, if not all the New England states, already have legislation of some type that provides peer support, confidentiality, primarily in the law enforcement realm. So this would be really wonderful for Vermont to be doing if all first responders is the language currently states in this. And it's also something that we're seeing across the country in all colors of states. So we have very conservative states that have those laws in place. It's very local states as well. So just just the commission representing this as the commission, I I'm certain saying we are fully in support of it as as it stands, and would greatly appreciate your support as well. You know, on a personal level as a peer to leader, it would be incredible.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. That's great. Are there is there anything that you would like to change in the bill as it currently stands?

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: No. We were You hard to

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I know you worked hard to get it to where it is.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: I told the language, and and we're we're very updated. There were some minor changes that the house committee made, and

[Sen. John Morley III (Member)]: and we were comfortable with.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay. I have a close note here. Go ahead.

[Sen. John Morley III (Member)]: Under section

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: one don't have an option. Oh, this got this. Under

[Unidentified committee member (senator)]: G, could you

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: What page are you on? Page two. Two.

[Sen. John Morley III (Member)]: Yeah. G, I'm currently working as a medical health professional in a crisis setting. Would it be better just to leave it right there? Because then you go through and you're trying to figure out all of the ones in there. And then your last sentence says, or any other professional that provides mental health services. So I was just wondering if you just did that in g.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: So I would I would look to pledge counsel for a little support on this. This was an amendment that the house committee made and representative I hope I'm saying the same right. Seventh Seventh or something around that.

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

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: This

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: will be a Katie clarification. Yeah. That's good. Go ahead. Madam Chair. I

[Sen. Martine Larocque Gulick (Vice Chair)]: don't know why I'm not this isn't clicking for me, but why would an organization want to get information about what you do? Just one example.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Think a good example is if a member is struggling with drug or alcohol addiction and they come to a peer support team member to support in that, and the entity is pursuing disciplinary actions or moving towards termination with an employee, they might wanna gather information about what those conversation events that they can show cause. Yeah. Okay. Thank you. That'll be controversial. Right. That's the biggest thing. And that's why an agency would primarily wanna get this information, so dealing with a personnel issue. Yeah. Thanks.

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

[Sen. John Morley III (Member)]: So just out of disclosure, I've spent thirty five years on volunteer department by deputy chief down to Lebanon. So what what, interaction in the development did you have with the volunteer fire departments? Because that's the majority of the departments. Yeah.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: So we have representation on the commission from volunteer firefighters, and we certainly look for their feedback when they do come to the meetings and and provide that. I don't want to lie and say that they had, you know, in-depth representation or input from the volunteer fire service. We did. That being said, to the best of my knowledge, there is no peer team that exists in a volunteer fire department organization. They rely, and I know this firsthand because I've helped support them through critical incidents, they rely on the current statewide entity that exists through EAP first and the secure peer support team. That's who helps that whenever can see people start in turn.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Other questions? Thank you for being here.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Thank you for asking. That's great. Appreciate the opportunity. You.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: All right. Good. And Chris Dupi is here. Morning. Good to see you again. Yeah. It's been a year, So

[Chris Dubey (President, Professional Firefighters of Vermont)]: for the record, my name

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: is Chris Dubey. I'm the president of professional firefighters of Vermont. I've served in that capacity for the last five years. I've been in front of

[Chris Dubey (President, Professional Firefighters of Vermont)]: this committee before in the last year.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: We've been been talking back for admitting

[Chris Dubey (President, Professional Firefighters of Vermont)]: PFAS. Yeah. Recognize it does. It's dangerous. I know it irritated some people, but it's the right move, definitely. It was funny now. So I'm here today to speak in support of H-two 70. Retired about a year and a half ago from the Milwaukee Fire Department for thirty two and a half years. When I got in, we never talked about mental health as part of a job. We wanted to accept it. Think that's, like echoing Chief McDonough's remarks, we've come a long ways. I look at this bill as being a forward looking, proactive approach that people say, Well, why? It's not an issue. Why are bringing it up

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: now? Unfortunately, the fire service,

[Chris Dubey (President, Professional Firefighters of Vermont)]: a lot of what we do is reenact it. All the fire codes, I'll use an example, they're not forward looking. They're based on an incident that happened in the past. So it is our chance to get ahead of that and break down, like I said, one of the barriers out there to getting our members the treatment, or not even the treatment, just the launching point where you can speak to somebody and get it off their chest. Similar states around us are doing it. It's happening across the country. If you just got bad from spring and state eventual meeting, obviously, I'm Victoria, Canada. Obvious, there's like six or eight other states from coast to coast that are seeing this as an issue. I'll echo chief McDonald of Marxist. One of the biggest concerns we have is that our members may not access these services because they're worried there's gonna affect their job. They may get suspended. They may ultimately lose their job, and that's not the intent of this program. So the IFF's program, we model it after that on the PFDD side. So we have a hotline that members can call, and you're on the team. You have to go through the IFF's two day training on it to get that certification. Once you get that, put your number onto the call list. I don't even know who calls it. Just call us 8, I forget the number, 833, whatever it is, and it rings to all the members' phones. Whoever picks it up, picks it up. The one concern I had on the initial bill, which I believe has gotten corrected, was it only addressed issues that happen on the job? So it's gonna be job related. I think they added in and personal. And the reason I think that's important is because we have a fair amount of our members that could be going through stress at home. Whites could be having a complicated pregnancy. Loved one may have an illness where they're dying again. They're stressing them out, and they want somebody to call. Our hotline doesn't get used a tremendous amount, but it does get used. It comes and goes. And I think by having us build and taking down that barrier, it'll allow more of our members to access it without the fear of saying, Hey, the chief's gonna wanna know what's going on and I could be suspended for a month or he may do this to me, that's not the intent of this. Like I said, the intent is to get the help that our members need to get into in retirement. I could go on and on on this, I'll leave it at that. I'm happy to take any questions, and I appreciate your support on this. I think with the revisions that were made in the House, I think it addresses any concerns we have. And like I say, I look at this as being a forward looking, proactive approach to correct an issue before it gets

[Unidentified committee member (senator)]: to that where we have

[Chris Dubey (President, Professional Firefighters of Vermont)]: to fight to keep an individual on the job.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. That's great. Questions for Chris?

[Unidentified committee member (senator)]: Thank you.

[Chris Dubey (President, Professional Firefighters of Vermont)]: Simple. Thank you for your time, I appreciate it.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You're welcome. Yeah, it's not simple. It's complicated, but it's important.

[Chris Dubey (President, Professional Firefighters of Vermont)]: Oh, you're right. We want those barriers taken down. We all deal with them. We all

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: deal in different ways, but

[Chris Dubey (President, Professional Firefighters of Vermont)]: I don't want the members to have that fear that, hey, if I go and I call Mark, the the chief or

[Unidentified committee member (senator)]: the town manager, I don't

[Chris Dubey (President, Professional Firefighters of Vermont)]: know what's going on, and I could potentially lose my job. That's why I hate that. Can't get you. So he can retire and live a

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: good life. Alright. Thank you. Alright. Committee. That is two seventy. Katie, do you mind coming up for a minute on this one and then we'll move on to eight seventeen. I think the question that Senator Morley raised regarding the listing of the health professionals is one. What page is up? Page two.

[Unidentified committee member (senator)]: It just seems, seems

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So your question of why don't you ask Katie your question? Why is it

[Chris Dubey (President, Professional Firefighters of Vermont)]: Yeah. So

[Sen. John Morley III (Member)]: at the beginning of Gi, currently working as a mental health professional in crisis setting, who's licensed, certified, roster respectively to provide mental health services position pursuant to. And then you go down through psychologists. There's psychotherapists in there. There's psychoanalysts in there. There's mental health counselors in there. There's social workers in there. There's drug abuse counselors in there. So you've got all those things in there, and then the very last sentence is, or any other professional that provides mental health services. Mhmm. I was just wondering if we if if we could make it all inclusive and say under g currently working as a mental health professional in a crisis setting. Mhmm. No. I I don't know if that makes sense or No.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That's a question. We'll we'll listen to what happened in the house.

[Katie McLennan (Office of Legislative Counsel)]: Katie McLennan, Office of Legislative Counsel. Good morning.

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

[Katie McLennan (Office of Legislative Counsel)]: So I think the reason that they're all laid up there is because a mental health professional is not a defined term, just as it stands alone. So when I say a mental health professional, what are we talking about? And so I think that's why the specificity was added. So we're listing all of the professions who could be considered a mental health professional.

[Sen. John Morley III (Member)]: So then why do ask the professional that provides mental health services?

[Katie McLennan (Office of Legislative Counsel)]: Yeah. It's just to catch all. And she knows that. I didn't hear what you're saying. But that's why they were listed initially. Well, I'm your goober. Yeah.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well, will be there's offered protection then for those who are licensed and certified and then anybody else who provides mental health services. But we're in the process of defining how mental health services are delivered in another bill, which might have an effect on this.

[Katie McLennan (Office of Legislative Counsel)]: I continue to hear from OTR that they're wanting to do a consolidation of the many mental health professions, and I suspect that will land on your table in the next year or two. So if you are uncomfortable with listing all of the professions, an alternative would be to say something currently working as a mental health professional in a crisis setting, licensed, certified, rostered under title 26 chapters, and then just list the chapters and not list all the professions. That could be a way to shorten it a little bit.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Although, if you only list title 26, you're missing I would probably still include the catchall. Yeah. You'd have to have the catchall, but then you'd be missing the the PAs and the MDs.

[Katie McLennan (Office of Legislative Counsel)]: Well, for example, you know who that would oh, that's a bad example. But there might be, for example better example. Peer peer support providers. A few, two years ago, you passed a bill that allowed a certification, but that's voluntary. So not everybody has to get that certification. So they wouldn't be captured through a certification. They wouldn't be captured by being regulated under 26, but they arguably are still providing mental health services unregulated so

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: that catch all would catch those folks. That's what I'm thinking is peer support in a small volunteer department. It might just be someone

[Sen. John Morley III (Member)]: Someone else that talks. Yes.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Talks to people.

[Sen. John Morley III (Member)]: Yes.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And may may just be really good.

[Chris Dubey (President, Professional Firefighters of Vermont)]: Yeah.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: But good listener. Yeah. Yeah. And they do a lot of good.

[Chris Dubey (President, Professional Firefighters of Vermont)]: So would they be considered even

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Give them that protection.

[Sen. John Morley III (Member)]: So they're a mental health professional.

[Sen. Martine Larocque Gulick (Vice Chair)]: They're not a mental

[Sen. John Morley III (Member)]: health professional.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Is that in the file?

[Katie McLennan (Office of Legislative Counsel)]: A mental health professional, not entitled to I mean, this is your professional

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: No. Implies credentials. I'm just thinking, Lauren, you go to court

[Sen. John Morley III (Member)]: I don't wanna get subbed this. If if if it there's a reason, I guess, the house amended this. It's changed.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Brian Chittenden, I think, represented

[Sen. John Morley III (Member)]: this. Why.

[Katie McLennan (Office of Legislative Counsel)]: This whole subdivision wasn't in there before. So mental health providers working in a crisis setting wouldn't have been picked at all and the bill is introduced. So this would capture, I'm sure the folks behind me have a better example, but my example is law enforcement is called to address a mental health call and some type of mental health provider is riding alongside them and is maybe one of the people also to respond to that mental health crisis.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Looking at the mobile crisis unit. Yeah. That's sort of what I'm thinking of. Yeah.

[Sen. John Morley III (Member)]: That doesn't happen a lot. It's just not telling you that as far as the public's here fighting departments are concerned.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: This is also police. Yeah. It's all first responders. I think some of the most powerful testimony we heard was from a lobbyist. Who is an EMT first responder on weekends, which none of us knew. And she said, you'd go out on a call, and you would see your neighbors essentially in some of the most horrendous situations. And she said, at least if you're a firefighter or policeman, you go back to the station with people. She said, I come back to the State House and no one knows what happened to me over the weekend. So it's a lot this whole thing was a lot broader than people that respond in emergency situations. You may have medical training, but you don't necessarily have counseling. And First volunteer is

[Sen. John Morley III (Member)]: possible to go right back to the job. That's right. You can't go back to the station. Crew will go back to the station and put things away.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: But

[Sen. John Morley III (Member)]: And, yeah, it is listed in here. Mean, there are a lot of the corrections and a lot

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: of different things. I'm all for it. I I'm just Yeah.

[Sen. John Morley III (Member)]: You you just couldn't kinda caught me with a g. So

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well yeah. Stance with that. Yeah. Yeah. Okay. This like yeah. There was a fire in Chittenden County, Briar Bent Fire. Everybody responded. Local volunteers, professionals from Burlington, police, sheriffs, and they were taking dead children out of the zoos. And It was like like that. Yeah. And it came out that if you were a Burlington firefighter or police officer, you're a unionized professional, you had access to mental health services. Maybe it would have been required, but there it's generally contracted. If you want it, it's there. The volunteers that showed up that did nothing, and I think it was somebody from the Burlington Fire Department that was on scene and just kind of counseling these he'd both move this, and that's what the volunteers are the ones that and now the ballet in in Vermont Yeah. Have nothing. Right? I'm just Back to engineering the next day. You

[Sen. John Morley III (Member)]: know? Basically, ours Yeah. Together like I told you about the one where Jared had boy died out.

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

[Sen. John Morley III (Member)]: And Yeah. That was tough when a lot of us and everybody sat around and talked about it and talked it through.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah. Same same things and and granddad when your family died from a dryer. He said it was a.

[Sen. John Morley III (Member)]: Two employees of animal services too.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah. Oh, yeah. Okay. This is not good. Okay. This is

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: We don't need go down. It's good thing.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: It's just nursing enough. You know you know what I said before. My said that there is distress in our lives and eustress, and sometimes the good things can cause us to want to have peer support. Too many parties. So we don't want to go down. I do not know. I know my sister does first responding another state, know see, I get phone calls, so it's needed. It's all needed.

[Sen. John Morley III (Member)]: Spending too much money. Oh. Bill making machines. Yeah.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: This is an important bill. I don't see that we need to make any changes. We could

[Sen. John Morley III (Member)]: So as to the

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

[Sen. Martine Larocque Gulick (Vice Chair)]: Yeah. By the house So just be

[Unidentified committee member (senator)]: able to

[Sen. Martine Larocque Gulick (Vice Chair)]: asked favorably out of the Health and Welfare Committee, eight to seven B, an act relating to confidentiality, peer support sessions for emergency service providers.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: You guys will.

[Sen. Martine Larocque Gulick (Vice Chair)]: First, yeah. We know who's reporting as well.

[Sen. John Morley III (Member)]: Yeah. Senator Benson. Yes. Are you ready? I'm sorry. I

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: didn't. Sure. Go for it. Senator Clerk, if you're honest.

[Sen. John Morley III (Member)]: Senator Cummings?

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

[Sen. John Morley III (Member)]: Senator Gulick? Yes. Senator Worley? Yes. Senator Orleans? Yes. Was it easier to get this passed to the house or the senate?

[Chris Dubey (President, Professional Firefighters of Vermont)]: It's always easier in the senate.

[Katie McLennan (Office of Legislative Counsel)]: Was talking about wanna

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: just ask Mark one question. Maybe Chris can answer this. But so we've had this sort of going on since 2018. It was pre pandemic It was when this all started in our state. Did other states start at the same time? Was it kind of like happening across the country?

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Confidentiality and good support?

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

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: No, many of those laws are

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: recently Recently, yeah. So it's just becoming part of the system, people understanding the need for support services.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Yeah, I mean the need for a significant increase in cultural shift in mental health and first responders has certainly been a long time coming. Nineeleven being the major That's true. That's true. It was what? 2016 that we had kind of the moment, at least personally, the moment in in Vermont. Yeah. Where we're like, what's this peer support thing? And it was 2018 that we created our program pretty much in step with professional firefighters in law. And then with the work of of commissioner Baker

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

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Creating the the statewide peer support team with 60 peers throughout the state now covering all facets of first response with really the the primary focus being volunteer because we know they don't have those resources. And that's the commission's focus is really of equity. Right? And and seeing the privilege that we have at Burlington, from on state police have an outstanding and robust program. But it shouldn't just be the fake entities. It should be knowing that they're our neighbors and they're volunteering their time as as EMTs and firefighters, many of our very small law enforcement agencies don't have the resources. And so we really focus on and making sure everybody has these these accesses through this statewide peer

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. That's helpful. I'm gonna have to move on quick

[Chris Dubey (President, Professional Firefighters of Vermont)]: Real quick. Quick.

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

[Unidentified committee member (senator)]: for the support on this. And just so you know, I'm looking there's couple of

[Chris Dubey (President, Professional Firefighters of Vermont)]: you have been no disrespect, here for a few years, remember, we were the first state in the country to get PTSD and behavioral health presumptions. The fact that other states mirrored that. I think Brad Reed, I remember Brad as That being the president of

[Unidentified committee member (senator)]: was one of the first things

[Chris Dubey (President, Professional Firefighters of Vermont)]: he spearheaded. He got it moving. And it's great that we're keeping that momentum going to get it to the next level.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: We're with you. Thank you. That'll be first Thank next level.

[Sen. John Morley III (Member)]: The brand new station. And

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

[Sen. John Morley III (Member)]: Pretty nice.

[Unidentified committee member (senator)]: Oh, cool.

[Sen. John Morley III (Member)]: Take a look.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: I was just down in Hanover the other day, and I'll go over the other side and see him. She would leave the. Right over there.

[Sen. John Morley III (Member)]: Yeah. Yeah. Thank you. Orleans fire department. You ever heard of the?

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Thank you, chair. Thank you, everybody else.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. Appreciate it. Thank you.

[Unidentified committee member (senator)]: Yeah. Put

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: those down for it. We just got them. Okay. No. We're not breaking. We are moving on to 08:17 and we have two students who are here from the University School District to testify on page eight seventeen. Remember that's the Katie before we go into it. We're on HH 17. I remember it. And Okay. Calm down, folks. Calm down, folks. Katie, can you please give us an overview of what is HH17 and then we've got two students who have been waiting very patiently to give testimony on the bill.

[Katie McLennan (Office of Legislative Counsel)]: Sure, I'll give just a few sentences. Katie McLennan, Office of Legislative Counsel. The bill really does have two programmatic pieces. One is mental health training for adults in the schools. So teachers and staff. The second piece is a peer to peer programming piece. It doesn't appropriate any money for that purpose and it requires DMH to provide written guidance as requested for either of those two programmatic pieces.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: We've already received testimony.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: This is our tip. We've had a little bit of testimony from the sponsor and sponsored with your daughter. If you recall during the pandemic I identified $3,000,000 to put into a grants program between AOE and Department of Mental Health and also a report that came out of that And this bill has come out of that report that was issued in, I think it was December or January 2025. So this is a evolution of the work that started because of the significant pressures on mental health during the pandemic, especially for students in school. So I'm going to turn it over to Marissa who is here on Zoom. Thank you for being here and so state your name for the record and offer us your testimony.

[Marissa Silvestri (Student, Winooski High School; NAMI Vermont Youth Advocate)]: My name is Marissa Silvestri. I'm a senior at Winooski High School. I'm a member of NAMI Vermont, part of America's largest grassroots mental health organization, the National Alliance on Mental Illness. As someone who lives with severe depression and anxiety, I'd like to share my story with you and ask for your support of peer to peer support in schools as well as staff education. Beginning in my seventh grade year, I struggled extremely with severe depression and there have been moments where I've experienced suicidal thoughts. I started doing very bad in school and I distanced myself from all my friends and that left me feeling very vulnerable. My physical education teacher was like my best friend and she realized that I showed signs of depression. She encouraged me to go to my mom and tell her everything that's been going on with me. From there, EE teacher helped my mom find connections through to school to get me help. In a couple of months, I'd go see a doctor for a depression screening and I was introduced to a therapist through my school. Today, I'm more at peace than I ever imagined I would have been. I've built back up my relationships with the people that I love and I have so much support surrounding me that I don't feel the need to go through my feelings alone. Now I'm focused on making sure other young people get the same help and care that I received when I needed it most. Many young people experience mental health challenges just like mine, but not everyone is lucky enough to have a trusted adult. Many schools don't offer resources that help with mental illness and may even suggest that you look elsewhere, but every person deserves to get help when needed without trouble. Staff education and peer to peer support can help make a difference for many young children and teenagers and help get them the right support and care that is needed for them. Students may feel more comfortable talking about their issues with other young people who are going through the same thing. This means that educators will know what to look for in their students and

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: what to best help them, as

[Marissa Silvestri (Student, Winooski High School; NAMI Vermont Youth Advocate)]: well as students will have a safe space to talk about any feelings and strengthen connections that they might have. And listening to my story, can I count on you to support Bill age eight seventeen and act relating to mental health literacy and peer to peer support in schools and help give young people the help that they need?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you, Marissa. We're glad you have gotten where you are. It's terrific. You've been through a lot, so we appreciate your sharing your personal history with us very much.

[Marissa Silvestri (Student, Winooski High School; NAMI Vermont Youth Advocate)]: If

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: you can send your testimony in to us, that's very helpful. Terrific. Yeah. Thank you.

[Marissa Silvestri (Student, Winooski High School; NAMI Vermont Youth Advocate)]: Thank you.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Questions, Marissa. Good. And so do you have plans after your senior year?

[Marissa Silvestri (Student, Winooski High School; NAMI Vermont Youth Advocate)]: I do have plans. I plan to go to CCV to just take some courses and then I'm going to do a radiological science program at Vermont State University.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Excellent, thanks. Good luck. Good luck with that. Alright. And we're gonna hear from your schoolmate, and I'm gonna try and say this correctly. Jafari? Yeah. Got it. Manugu?

[Unidentified committee member (senator)]: Yeah.

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

[Katie McLennan (Office of Legislative Counsel)]: you for being here. Alright.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You know what I want to do that I failed to do when Marisa was classifying? That's introduce ourselves. So we'll start over here with Senator Morley so you know who's here.

[Sen. John Morley III (Member)]: John Morley from Morley's District. That's The United States. John from the Orange

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Ginny Lyons from Chittenden Southeast District. I'm Senator Martine Larocque Gulick. I'm York. Senator, actually. Nice

[Sen. Martine Larocque Gulick (Vice Chair)]: to meet you both. I live in Burlington.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Ann Cummings, I'm from right here,

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: So I'm Chippari, and I'm kind of right about the aged child, age 17. Here's my testimony. So hello, I'm Jafar. I'm from Munozki. I'm a member of NAMI Vermont, part of America's largest grass girls mental health and police, the mental alliance, mental illness. But I'm not just a foreigner. I'm a student. I'm an athlete. I'm an older brother and a young brother. I am a son, and most importantly, I am a friend. But there was at a time when I forgot all those aspects of who I am, but fortunately, I had a friend, I had a young brother, I had an older brother, I had a parent, but who reminded me that was not any of those prior teachers before she was teaching. It's actually same as Lorisa, same teacher as Lorisa. Love it.

[Katie McLennan (Office of Legislative Counsel)]: At

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: the peak of my hardest years, my hardest year of high school, my first year of high school, when I was coming back from home from soccer practice, I would heard my parents talking about a past due rent, how it could not be paid off because my mother had just been fired from her job, and we were going to get kicked out of our house with no time to find a new one, so we died. You can only imagine how that would affect a 15 year old. I stopped playing soccer. I skipped practice every time I got him, and class time changed into classroom time because I was in my feelings. You could notice the change for the highly social curious team. I was not talking, I was not asking questions, and some teachers at some times noticed, and some did not act, and some did ask, Are you okay? In the middle of class. I can only imagine all of you, oh my god, sorry.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I was okay. Can only

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: imagine all of you wouldn't want to share the same thing, same information, that I wanted to share so badly with someone, but not with everybody. The one person who helped me was a teacher who decided to call me out of class and asked me the same question, Are you okay? Just in a different environment where I felt safer. I strongly believe that Bill 17 would provide that safe environment for all students, not just me, who just got licensed, who have a teacher who felt like they could handle that situation. We can all agree that life should not be based on lives, so why should mental health? Well, one of the most important part of this bill for me in 17 is the students and peer to peer support. I've always thought of my friends as part of my away from home family, brothers and sisters, and teachers and trusted adults like parents. My dad once said at a parents and parents conference, or what people call teachers and parents conference,

[Sen. John Morley III (Member)]: sorry, conference, quote,

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: Teachers are fathers and mothers of our child when they are at school. Now imagine knowing your child is dealing with something, but not having the ability to help one, unable to identify there is a problem until it's too late. We all know that our siblings, in this case, our friends can be a little bit of tattle tales, and that's what we need for them. The more people that have the ability to identify that your child is dealing with something, the more chances of you knowing it's not being unnoticed until it's too late. Too late could look a lot of ways. It could look like smoking, it could look like vaping, it could look like even more. This bill would make it so students, children, don't have to look for someone who looks like they cares to get some help. Teachers will get the ability to identify and help also their peers and friends. I ask you to care for a life, a dream, a hope of a 15 year old who could have been smoking to relieve mental pains and down the road even more, because I've seen friends come down the road because they do not have someone to remind them that they are students and older and younger brother or sister, most importantly, they frighten me. Thank you.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. Any questions? Any questions for Jafari?

[Sen. John Morley III (Member)]: Thank you, very testable. I've got one question for you. In that relationship of of peer support, were your parents involved, or were you keeping them? Were they at all involved in in those discussions or understanding of the help you were seeking? No. Not gonna lie. No. Because at that time,

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: I was young a lot. I see my parents are struggling. Right? So I'm like, oh, no. I can't bring this up to them. Right? Yeah. So I go to school. I'm like, oh, how am I gonna do with this? I have no way of dealing with it. So I go when it's time to go to class, I'm like, oh, oh my gosh, I'm feeling so bad. I'm doing this. Let me go to a bathroom. Right? That's where the bathroom time comes in. I go into the bathroom, spend a lot of time, get on my phone, try getting that little dopamine. Right? As people call it, get that little happiness on my phone, right? Missing plastic. Mean, that could also, you know, after that little dopamine, hitting that dopamine with phones, you could notice, oh my gosh, I feel good when I'm escaping this, and that's when you might go to other peers and find other ways to escape, like smoking, vaping, or maybe even going even farther down like drugs, or maybe just trying to complete escape, which means, yeah, I don't want to say it because it's very severe, but that's what happened. It's all of us ability, and I really, really, really would hope you guys not, you know, see how important life is, and that it should not be paid based on luck. And that we should try to, like, you know, minimize that little, that, that luck needed, just a little bit of luck needed by, you know, get the support we need, get the help, and

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: not put additional law over there. Thank you. That's great. Thank you. Thank you for sharing with us. I know it's easier the older you get, but it's never easy. Never ever. And we appreciate that. Thank you.

[Nolan Langweil (Joint Fiscal Office)]: Appreciate it.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And so wait. What year are you?

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: I I made 2000, like, in birth or when I'm

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: black. What, junior, senior?

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: I'm a junior.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You're a junior, so you're looking forward to senior year.

[Nolan Langweil (Joint Fiscal Office)]: Looking forward.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: And is soccer in your future? Soccer? Yeah.

[Jafari Manugu (Student, Winooski High School; NAMI Vermont Youth Advocate)]: Stalker is definitely part of my future. Love soccer.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Oh, good. Well, we're glad you love it too.

[Sen. Martine Larocque Gulick (Vice Chair)]: Yeah. I I just wanna say thank you, Jafari. Thank you, Marissa. And, also, thank you to your incredible teacher. I think she deserves praise for all that she's done for the students at Winooski. And she may have been teacher of the year,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: if I recall correctly. Yes.

[Sen. Martine Larocque Gulick (Vice Chair)]: Yes. Yeah. Maybe. I don't know.

[Katie McLennan (Office of Legislative Counsel)]: No? Okay. But anyway, thank you. She

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: is incredible. Thank you. Terrific. Thank you so much. We're we're good. We're very good.

[Unidentified committee member (senator)]: Thank you.

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

[Unidentified committee member (senator)]: I really appreciate it.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Did you wanna introduce yourself at all?

[Katie McLennan (Office of Legislative Counsel)]: Sure, My just a few name's Laurie Emerson, I'm the Executive Director of the National Alliance on Mental Illness of Vermont, And I just wanna thank you for having the students come and share their personal testimony with you. We've been working with them through the Youth Mental Health Advocacy cohort. And they prepared this testimony in support of this bill and really felt compelled to come in here and share their story with you to make change, to make a difference. And we're hoping that you will be passing eight seventeen. And thank you

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: so much for everything you do. Well thank you and thanks for your work. I know it's a lot of work and it's not easy, but what you're doing now with youth and the state is so critical. We all, we get it, we understand. And it's so important. Very pleased that we have that engagement from youth. This is what

[Laurie Emerson (Executive Director, NAMI Vermont)]: we need to keep promoting.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. Thank Thanks for coming in.

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: A question about the bill?

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

[Sen. John Morley III (Member)]: some of the, I think I understand, some of the teachers are gonna get training on new mental health professionals during probably these not-

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Katie, you wanna come up with that? Sure. Yeah. What's what's happening?

[Sen. John Morley III (Member)]: I think I understand it, but-

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah, no. Let me just quickly understand. Okay.

[Katie McLennan (Office of Legislative Counsel)]: They're in the. So I'll skip ahead in subsections b and c because B and C are each sort of unique standalone programmatic pieces. So this first piece is focused on the adults in the school. To the extent funds are available, public school may apply to DMH or a designee for a grant to provide mental health literacy to educators and school personnel. The training excludes topics related to working with youth in an educational setting. And then specifically, we have information about mental health conditions and symptoms, understanding common youth mental health and substance use challenges, reducing stigma and promoting supportive school environments, strengthening protective factors and help seeking behaviors, recognizing risk factors and warning signs, responding to students with empathy and appropriate boundaries, information about mental health treatments, accessing mental health resources throughout the state. And then in two, you have language. This doesn't mean that there's a specific curriculum that needs

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: to be used. This is just a general guidance about what the programmatic piece would entail. Okay. But just apply to the Department of Mental Health.

[Alex McCracken (Director of Communications and Legislative Affairs, DVHA)]: Right.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: This isn't an existing program. They would have to stand up the program.

[Katie McLennan (Office of Legislative Counsel)]: I think that this is a little bit unclear. It's a little ambiguous. I mean, we have that language to the extent funds permit, but there are no or to the extent funds are available, but there are

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: no funding being appropriated for that. A lot of that. So Suzanne said the funds would have to be there to stand up approach.

[Sen. John Morley III (Member)]: To get the grant money.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Yeah, that's very similar to what we did with ARRIS money. We had $3,000,000 between AOE and DMH, and then they established a grants program. The first part of that was to put money in for, you know, no, it's itching to talk. We put money in for teacher education and staff education, and that also put Okay. So this doesn't have any money. So I think is Ormond is up from DMH and Claire, you're here. Laurel, did you wanna comment on this question?

[Laurel Omland (Department of Mental Health)]: Sure, I can comment on that and a couple of other pieces. It's it is correct that, we don't have funding that can be dedicated to this. I believe the House initially talked about things like block grant funding, but that can't be used for prevention activities as much as I would love to be able to do that. So we are very much behind the concept of providing this training in schools, and we've sought discretionary federal funding for things like project aware, but that's very focused in a certain in certain districts. The other component to this is we would encourage the removal of the term oversight, which is on page two, line 19, to provide oversight for any entity that's, seeking to establish these, I think, is a quite an additional, expectation versus what I understood was, written guidance on what could these training programs entail, what are the ones that are available, as well as the peer to peer supports. One other comment I would make is we are in support of this without, word strike and recognizing that, agency of education isn't named or involved in this. And so we very much would want to do this in partnership with the agency of education. And I know that they had submitted some testimony as well, some written testimony. So we we, as the Department of Mental Health, we don't have authority over schools. There's not a a compelling of folks to to participate in this. What we have heard is that schools and districts, especially the smaller ones, are challenged to continue to pursue grant opportunities to access this type of programming. And I think where it's been successful was when funds were able to be put out to an entity to provide the training and then schools could sign up for it without additional burden on them to seek funding to cover it. One thing that we also support in the Agency of Education's testimony is their proposal to postpone the granting part of this given that there aren't funds and to have Department of Mental Health and Agency of Education work on a report to identify what are the current programs and activities that do exist in Vermont and what

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: are some other options that could

[Laurel Omland (Department of Mental Health)]: be considered. So gathering some data to help inform the direction

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: of this. Thank you for reminding us about the AOE testimony. I do recall that, and it is helpful because it will build a collaboration that's absolutely needed in order for this to go forward.

[Nolan Langweil (Joint Fiscal Office)]: Alright.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So we'll have to we'll have to look at how we might want to modify the bill. The word oversight is problematic. I don't I don't know how to mental health provides oversight. Any school that

[Nolan Langweil (Joint Fiscal Office)]: does this.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Unless the committee wants to leave, provide oversight in, I would suggest guidance. Would it be the Center of Mental Health collaboration for these WLP? Yeah, I think that throughout here, we're gonna have to see a collaborative process with AOE and mental health. If I can search out We're setting people out with some more or less training. We're not just talking teachers. Mhmm. We're talking students. Mhmm. We have the potential to do great good. We also have the potential to do great harm if it's not done properly. And I just hope we take the time to make sure that we do it. I'm especially concerned about peers and AI and So so I think yeah. And I say so I think the other suggestion that oral has made is on some time for development of grant process to the extent funds are available. That's always part of it. And I wonder, and we'll have to bring Nolan up, a couple questions from Nolan on this regarding funding. Those two things. One, eliminating oversight, three things, eliminating oversight, integrating AOE with DMH, and then having some time for establishing a grants process. There's language in here about guidance, so that would also give time for development of any guidance materials. Would thank Laurel. Is that also appropriate?

[Laurel Omland (Department of Mental Health)]: So that would be helpful. I think that is doable.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: It is?

[Laurel Omland (Department of Mental Health)]: To develop guidance, yes.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, that's good to know because it's in here. You don't automatically have what you need to hand out for a peer to peer mental health program. Having information developed appropriately would cover the concerns that I think Senator Cummings has just brought up.

[Laurel Omland (Department of Mental Health)]: Yes, and I think part of that guidance, I know again in AOE's testimony they talked about wanting clarification that it's not a clinical peer to peer program. And I think that was clear in the bill as it's currently written that this is peer to peer support. It's not clinical support. And so the requirement for clinical oversight isn't necessary, but, there are programs that exist around the country that, have shown evidence around the effectiveness of student peer to peer supports that are facilitated or guided by an adult who's been trained, but they don't need to have a clinical background, for example. And it really is about providing those initial connections, like we just heard from the two students' testimonies, that then might lead to some ideas about what additional supports are available in schools or outside of school for those clinical supports. But the peer to peer student programming isn't a clinical service.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Thank you. Senator Benson, you had

[Sen. John Morley III (Member)]: a question. Yes, I just have one concern, I understand it's kind of a dread sword because there's no requirement for any notification in here to the parents of the student. On some aspects, that could be part of what the problem is. But, you know, we are administering care to a child who is underage, and I am concerned that there's no provision in there to notify parents that that's going on. I think that's one of the strengths of the little person going to write it. Well, it were your child, would you want your child without your notification?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I did at one point request that my future children not be assigned to a teacher because things that were being said. Correct me if I'm wrong, but schools do have policies on these things when peer to peer programs are established. I don't know that we can dive too deeply into micromanaging what schools are doing, but that would seem to me that there would have to be some universal process that goes on. I know that we have peer to peer programs in our schools, I mean all of us do, on mentoring students younger for academic support, and this could be just emotional listening or mental health supports. And Laurel, do you want to comment on this sort of area?

[Laurel Omland (Department of Mental Health)]: I think your comments are spot on and I am not the expert on school policy, that would be an area for agency of education or schools to also get involved. I think some programs, some of the model programs that are available out there that support student peer to peer supports in this area might have a recommendation on is it a universal informing of parents, is it a, know, etc. Again, it's not a clinical service. So I don't believe that there's like a release that's needed in that sense. But that's about all I could speak to.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: If it's

[Katie McLennan (Office of Legislative Counsel)]: helpful information as you're working, thinking through this issue, I realize that professional services are very different than peer to peer services, but there is a Vermont statute that allows, I think, children 14 years of age and older to consent to outpatient mental health services without parental consent. And if you're curious, I can send that. The second question, not a comment, is time. You said more time per grant process. Does that mean bumping out the effective date? And if so, what would that look like?

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Bumping out the effective date, and Laurel I'd have to lean on you for this understanding that AOE will be involved and you'll be communicating with them. What would be your suggestion for timing on that?

[Laurel Omland (Department of Mental Health)]: Think the request was to bump it out a year.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: You said a year. A year. Okay. Would a half a year be sufficient?

[Laurel Omland (Department of Mental Health)]: Again, there's not identified funding behind this.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, I got you. Understood. Okay, we'll do that. We can do that.

[Katie McLennan (Office of Legislative Counsel)]: Yes, we don't. Yeah, we have

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: seven employees. No, you're absolutely right. Okay. A year. A year. Okay. Got it. I'm sure the house will have something to say about the things that we're saying. So But, Nolan, do you wanna just speak to this bill? Think Sure. In the fiscal note.

[Nolan Langweil (Joint Fiscal Office)]: For the record, no language on fiscal note. Think everything that I would say has already been said. I just haven't said it.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Well, it's important for you to say it because you're a professional.

[Nolan Langweil (Joint Fiscal Office)]: Well, that's fine.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: I'm not a professional.

[Nolan Langweil (Joint Fiscal Office)]: I came because I just wanted to flag two things, are exactly the things you covered. First is that says to the extent funds are available, but there's no funds available. And then two, I think taking out the word oversight actually helps reduce it. Because I said, I mentioned in my fiscal note, they're required to provide oversight and guidance, but it doesn't identify or appropriate any resources for them to support the program. So I think we heard Laurel take out the word oversight. It takes off the burden of the work that they would have to do outside of guidance, which is probably not heavy versus oversight. Oversight to me is regulatory. That's involvement. That's constant. I would just say that those are the two flags. Think removing the word oversight does remove that burden off of DMH, and they can correct me if it's around. Then two, I think your second piece about giving them time to identify funding and I reporting think that sort of helps resolve the flags that I raised in fiscal note.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: So let me ask you a question. I know we've had a huge discussion in this room about the substance abuse prevention fund. And frankly, some of this work might be funded through that fund.

[Nolan Langweil (Joint Fiscal Office)]: I think what you can do in your language is say and they're identifying grants, they can also identify existing funding, state funding sources. Yeah, I understand. For the appropriateness of whether, so they can look at any other state's fund and see if it's appropriate use of the funds, and they can make pledge recommendations around those. So you're not getting into the fund balances and whether it's All that stuff. Let them figure it out.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Katie, I missed that piece of me doing the things at once. It was

[Nolan Langweil (Joint Fiscal Office)]: just that when they're looking for funding sources and grants, they could also look at the appropriateness of any existing special funds. Okay. You just leave it vague, and they can just look and say, yes, you know. Okay. Well,

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: good. Think that what we're doing here will really improve the bill and make it more action oriented. I'd be able to actually do something to be good. I think the bill was aspirational. It was very aspirational.

[Nolan Langweil (Joint Fiscal Office)]: But I think that this puts a little bit, and I think that they knew that and they wanted to move it forward anyway.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: That's why they sent it to us. They knew that it was, know.

[Nolan Langweil (Joint Fiscal Office)]: They're adding a little bit more fuel in

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: the tank. Okay, good. That's all I gotta say.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: Okay, so the fistula will be slightly different? Yeah. Yeah, okay. Laurel, any final comments from Department of Mental Health?

[Laurel Omland (Department of Mental Health)]: No, I appreciate the focus on this. I very much appreciate the testimony that we heard earlier from the students, and I agree it is a good direction for us to be headed as a state. So thank you for the clarifications.

[Sen. Virginia "Ginny" Lyons (Chair, Senate Health and Welfare)]: All right, terrific. All right, so committee will move forward with this bill. I'm thinking that it will have to be look at language and then possible vote Tuesday whenever we can get it, whenever Katie's I don't know busy Katie is. I mentioned we've got 09:38. So we have two other bills to look at this morning with Katie. Do you wanna take a three minute break? Yeah.

[Sen. Martine Larocque Gulick (Vice Chair)]: This is something feel was horrible. I'm

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

[Battalion Chief Mark McDonough (Burlington Fire Department; Vice Chair, VT Emergency Service Provider Wellness Commission)]: Oh. I'm just