Vermont Legislature SmartTranscripts:

[Christopher Mattos (Committee Clerk/Assistant)]: We are live. Alright.

[Senator Nader Hashim (Chair)]: We are back in senate judiciary. We have the defender general with us since February 25. Ten minutes, and then we gotta shift gears to one ninety '3. But I

[Matthew Valerio (Vermont Defender General)]: just just wanted to get perspective on 02/2003. This isn't a big concern to the defendant general's office one way or the other. I think every time you anytime you tinker with DUI, you tinker with thousands of cases, not necessarily in the public defense system because we don't get them as much. The, you know, the DUI DUI ones usually resolve for fines. So they don't end up in the public defense system. And what this as I understand it, and you can explain this to me while you're getting at. And it's good to get certainty about what exactly when the twenty twenty year window closes on a DWI two. And you chose in the bill to have it be, I think, the incident that gave rise to the first and second charges. Right? The incident, so long

[Senator Nader Hashim (Chair)]: as there's a subsequent conviction tied to that incident.

[Matthew Valerio (Vermont Defender General)]: Right. The only thing that I wonder about and, honestly, I don't care. I think you might be making it harder on the state's attorneys. Not that I need to argue their side. But when you're doing that second charge, it's really easy to go in if you're the state's attorney and say, well, when was the last conviction? Because that's right in the record. But it's hard to figure out that that that conviction may be, for an instance, that occurred two, three, four, six, however long, you know, sometimes as much as a year earlier depending upon what. And how do you research, like, you're the state's attorney, how do you find out when the incident was as opposed to the conviction? It's really all I'm saying is it's really easy to go to the record and see when the conviction is and and say, was it twenty years until whatever the next conviction is? But it might be hard as a matter of charging to figure out without going back into the actual documents to figure out where the when where the incident was. Am I reading this wrong? So I don't I honestly, I don't care. But it's but I think that if you go conviction to conviction, it it makes it easy

[Senator Philip Baruth (Member)]: to do because you you have two definitive dates that are on the record.

[Matthew Valerio (Vermont Defender General)]: To get beyond the conviction, you have to dig into the facts of whatever happened to figure out when when that was. Am I wrong about this?

[Susan Aronoff, Vermont Developmental Disabilities Council]: I mean,

[Senator Tanya Vyhovsky (Member)]: I guess I'm just a little curate like, is that wouldn't that be filed with the charges when it happened?

[Matthew Valerio (Vermont Defender General)]: But you have to see in the information and affidavit. Like, you know, it's not in it's not in yes. It is. But you can when you do a when somebody runs a record check to see, oh, has it been twenty years since the last conviction, you can see that easily. It just pops up. If you're trying to find out when the incident was that gave rise to the conviction, now you've gotta go behind the record to try to figure, you know, to see what's there.

[Senator Nader Hashim (Chair)]: I thought there's usually the charging date on the the '29 c triple I document. I thought

[Matthew Valerio (Vermont Defender General)]: what you said well, I thought what you meant with this is that you were looking at the incident.

[Senator Nader Hashim (Chair)]: Wouldn't that Yeah. So long as the incident is within the twenty years. Yeah.

[Matthew Valerio (Vermont Defender General)]: Well, that's right. Yeah. But you don't know what the incident is because charges may come later I mean, will come later than the incident. So if you're looking at what the incident is, it's something other than the charge date. Oh, that's why I got them. Like I said, I don't really care. But I'm just to make it simple for everybody, it it might be easier to just go conviction to conviction. But I you know, like I said, I don't really have a huge Yeah.

[Senator Nader Hashim (Chair)]: I I think, though, the the challenge with that, as far as I'm understanding, is if you're going conviction to conviction and the conviction happens several years after the initial charge, then the question is where does that twenty year block of time, where where do those incidents fall within that twenty year block of time to determine whether or not it's a second or third offense?

[Matthew Valerio (Vermont Defender General)]: Well, if you're just if you're just counting from conviction to conviction.

[Senator Philip Baruth (Member)]: I

[Matthew Valerio (Vermont Defender General)]: mean, I'm

[Susan Aronoff, Vermont Developmental Disabilities Council]: not trying to Yeah. I mean, I think

[Christopher Mattos (Committee Clerk/Assistant)]: the Department of State's Attorneys and Sheriffs is

[Susan Aronoff, Vermont Developmental Disabilities Council]: asking for this change. So I

[Senator Tanya Vyhovsky (Member)]: think I would defer to them. And I also, I think a perfect world, people have access to really quick resolution of these things. But that's

[Susan Aronoff, Vermont Developmental Disabilities Council]: not the world we're in. And I

[Susan Aronoff, Vermont Developmental Disabilities Council]: have concerns if someone's sitting for two years, they've done

[Susan Aronoff, Vermont Developmental Disabilities Council]: like it should be when it happens, not after they've done treatment. I ask it from a

[Senator Tanya Vyhovsky (Member)]: fairness standpoint. But

[Christopher Mattos (Committee Clerk/Assistant)]: sort of circling back to

[Senator Tanya Vyhovsky (Member)]: the underlying question, it was

[Christopher Mattos (Committee Clerk/Assistant)]: the Department of State's attorneys that came

[Susan Aronoff, Vermont Developmental Disabilities Council]: in and asked

[Senator Nader Hashim (Chair)]: us to

[Susan Aronoff, Vermont Developmental Disabilities Council]: do this?

[Matthew Valerio (Vermont Defender General)]: They if they're asking, I I wonder what the now I'm wondering what's going on. But maybe they haven't thought about it that way. But most cannot find those, to be honest. I don't care either way. I think it's gonna give I think the incident might be good for defenders, you know, from a you know? When I was in private practice, I did about a 100 DUIs a year when I was in private practice all over the state. And so this is like a an issue that's sort of near and dear to my heart even though I haven't done one in twenty five years. But like I said, I don't really care. If they if for some reason they want it, then fine. Doesn't matter to me. I just don't seem seems like it might be more difficult for But, hey, whatever. Sorry about this.

[Senator Nader Hashim (Chair)]: No. I was

[Senator Nader Hashim (Chair)]: just gonna say can if you in my head, if you go conviction to conviction, if you're starting to get if you're within a couple of months or something and you wanna delay that second conviction till you get then outside the twenty years. Yeah. You know? Yeah. I more time for

[Matthew Valerio (Vermont Defender General)]: this. Yeah. Try it. You can do that. Although the other thing that happens is you can delay the you know, say you have the first one, you have an incident. Now you you do some things, you know, maybe you do treatment, you do whatever it is, and your con your first conviction isn't for eighteen months, two years after the incident, your suspension just you know, and your condition you've got conditions of release for two years. The bottom line is you're actually extending to twenty two years your your impact. Right. Right. So, you know, it's on however would you Right. You know, it it like I said, it's not the the only interesting thing about DUI, time we every time we tinker with it and when I was in private practice, I was doing these. I wanted when you guys do this stuff. Because oh, because it's like it was a good good moneymaker for private counsel who did a lot of DUIs. Just the litigation around tinkering was always profit.

[Senator Nader Hashim (Chair)]: Sergeant Morrison. I

[Senator Philip Baruth (Member)]: do have a question for you. Yeah. If it's appropriate. I heard testimony from the state attorney general office. I see you're the lead sponsor on this bill. What would you like to support this? Is this something that someone approached you on? Or what are

[Senator Nader Hashim (Chair)]: you talking about? A modest request, I think. A modest request from my state's attorney.

[Senator Philip Baruth (Member)]: From your state's attorney. Okay. And

[Senator Nader Hashim (Chair)]: it seems like a small change. It it is it seems like the more we talk about it, the more complicated it gets. But and I understand. I understand it. It's just

[Senator Philip Baruth (Member)]: What was the reasoning from your state's attorney for this request?

[Senator Nader Hashim (Chair)]: What I've described in terms of the yeah. It's it's unclear, And there's also the issue of going beyond that twenty year timeline inadvertently or in such a way that it's kind of contradictory to what the original law probably intended?

[Matthew Valerio (Vermont Defender General)]: I would definitely agree it needs to be clarified. I agree with the state's attorney on that. And I probably in the in the real world, it's more fair to go incident to incident. It's just more difficult to determine when, you know, twenty years later, nineteen years later, whatever it is, when the actual incident occurred as opposed to when the conviction occurred. But I don't care. Yeah. One question.

[Senator Tanya Vyhovsky (Member)]: Oh, I just I quick statement. I I appreciate that it might be easier, but I think there's enough unfairness baked into our system.

[Susan Aronoff, Vermont Developmental Disabilities Council]: I would really advocate that

[Senator Tanya Vyhovsky (Member)]: we go with the more fair, even if it is a little bit more work. I don't want to bake more unfairness into our already unfair justice system.

[Senator Nader Hashim (Chair)]: Thanks for coming in.

[Susan Aronoff, Vermont Developmental Disabilities Council]: Hi. Good morning. For the record, my name is Susan Aronoff, and I do the policy work for the Vermont Developmental Disabilities Council. And if the committee would just allow me a couple of minutes to explain because I'm just hardly I don't think I've ever been before the Senate Judiciary Committee. So who am I, and what am I doing here? And why do I have a dot gov address? So the Vermont Developmental Disabilities Council is a state agency. We are located in the agency of human services in a separate county office.

[Christopher Mattos (Committee Clerk/Assistant)]: The

[Susan Aronoff, Vermont Developmental Disabilities Council]: All 50 states and six territories have developmental Developmental disabilities Disabilities councils. Council We were created by federal law. Our council happens to be entirely federally funded. On disability advocacy day, you might have received a copy of our platform in your mailboxes. I have a couple of them to Our platform is created by a governor appointed board, the majority of which has to be people with disabilities and their family members. Our executive director is employed by that board, and I work for her. Executive director, Kersten Murphy, happens to be the chair of our National Association of All of the Developmental Disabilities Council. So when we talk about what's going on with Medicaid or home and community based services or things like that at a federal level, we're kind of tied in what's happening. And when we talk about the criminalization of people with disabilities, particularly people who are unhoused and have disabilities, particularly people with autism who might be on registries, our little network here in Vermont is really tied in to what's happening nationally. The of the state state of of recommended budget or what the good people at AHS are proposing in order to get our federal funding. As I referred to in our in my briefing testimony, we have a current memorandum of understanding. It's updated all the time with the current, secretary of do to council adopts even if they're different from the AHS positions. And I always have to say that. Sorry, it takes so long before I speak publicly because it won't surprise you. Spoiler alert. The Vermont Developmental Disabilities Council, every time we have it considered again this session in fairness, but the last session and every other session when we've considered a forensic facility, another institution for people with disability is in Vermont. The position of our council has been opposed to it. And I don't want you to think this is just me to our composition, so I wanna explain some of why why we're opposed. And after I finish my prepared comments, what I really wanna focus this committee's attention on today is the new language you're considering that you're thinking of as a fix to the mental disease and defect. My apologies to anyone listening. I use words like mental disease and defect. Those are the words of record. They are very offensive to the people I serve. So any words that I use about mental illness, psychiatric disabilities, incompetence, ability to be restored for the record, I'm using the language of this building. Some of those words, like whole departments were called Department of Mental Retardation. That r word is insulting and offensive. Mental disease and defect, it's insulting and offensive. I understand the desire to fix that, and I applaud it. The conditions language, well intended, doesn't get us there, and I'll explain why. Okay. A little another piece about my background so you understand where I'm coming from. Explain where the different disabilities comes from. The reason why I took senator Mahosky's nudge to testify today is I have I rarely have the lived experience that anyone in this building cares about. I bring the people in who are the parents of the people with disabilities or the people with disabilities. I rarely have a lived experience that matters. This is an exception. I've worked as an attorney representing low income adults with psychiatric disabilities for more than twenty years. I did a lot of that work, some of that work in the home. I did a lot of that work, fifteen years in the good state of Connecticut. My office was based at Connecticut Valley Hospital, which is home to the Whiting Forensic Institute. And prior to the atrocities at Woodside, I used to share all the atrocities at the Whiting Forensic Institute as examples of what in 2017 can go wrong at a forensic institute that was as well in doubt. The Psychiatric Security Review Board in Connecticut does not mess around to protect the public safety of the good people of Connecticut. So when they say and they I served on the committees and studied this issue in the state, and they used to bring in the people from Connecticut to talk about their successes, their zero recidivism rate. Well, guess what? After 2017, when they had 30 people arrested, now serving time for the abuse of those patients that boasting and looking to Connecticut as a model. While I was in Connecticut, I taught mental health law at a master's level at the University of New Haven to master's students who were mostly going into public safety, police. This was a famous school for forensic studies. And every year for final exams and midterm exams, I would ask the students to bring me definitions of things like mental disease and defect and to construct as a team the best pill in the blank commitment statute for someone with a psychiatric disability, the best competency evaluation. And why? Because every all 50 states, we all do it differently. We define who's in and who's out differently. We give them their rights differently. So I will just submit that if the state wants to do this the right way, there are examples out there of how you would define a competency restoration program and who's in. And the wise doctor, testified yesterday, she, I think, was trying to alert you that a category of people you have to consider are the people who are gonna be found not competent. So imagine someone with an intellectual or developmental disability. In Vermont, we still use the IQ score, so apologies to my colleagues. I'm gonna use the IQ score. So with an IQ that would qualify them for developmental services in this state, there there is no competency restoration program in this country, in the planet, that will change their IQ. There's no medication that will make a person who's not competent to stay on trial because of an intellectual developmental disability Confident. So you, by this definition, can include people who are not confident and not restorable. And the new change would be to have them only reviewed annually. And the idea of taking disabilities who cannot be restored and holding them indefinitely and not just holding them indefinitely anywhere. Public safety, you might have to hold people indefinitely. The good people of Connecticut who are gonna be holding sex offenders indefinitely, they're building gated communities, actual houses with TVs and real normal houses. If you're concerned about public safety and I I just wanna say something about the crime victims. Absolutely. The system is not working. We do not have public safety. We have people who who are out in public who are people in need of treatment. I do not deny those facts at all. Those are facts on the ground. God bless the memory of the late senator Sears. There was a real problem he was trying to fix. I think he would be the first one to say, do not put people with disabilities in prison. I spent the last couple of years trying to convince him of his life, trying to convince him that our DOC facilities has as much of an obligation, affirmative obligation to meet the Americans with Disability Act needs of people with disabilities who happen to be in their facilities as anyone else. Because there are people with disabilities who end up in DOC facilities and they do have a right to reasonable accommodations. But I want to say based on my experience as an attorney serving people with disabilities in a forensic facility that operated very much like a prison, you can have a disability like blindness. You do not get a cane in a forensic facility. It's too dangerous. My client was given literally a pink pool noodle that people laughed at. He did not know it was pink. My client who was blind in the forensic facility had to rely on the goodness of his fellow, I'll say, inmates to escort him around because there was no staff available during his waking hours to provide what the ADA would have insisted he was providing. One of my favorite cases was trying to get him a service animal when he was moved to a lower secure facility because his service dog you know, this is not service dogs. If they're not in use for a couple months, they revert to pets, and you gotta start over. Well, imagine being someone in a secure facility who wants to start stuff. But they'll go. Like, they came and legitimately checked out the environment at the Connecticut Valley Hospital where this guy was living to see if they could train him on-site with his dog. And they concluded a couple of things. They concluded the campus itself, which is very much like the Waterbury State Hospital campus, was an unsafe environment for the dog. It did not have cross. It did not have sidewalks. It didn't have crosswalks. The dog would have been endangered there. Just imagine what that says about the patients. Likewise, most significantly, the good people of Fidelco did not think the living environment No carpeting, no roof, all these various things. But the living environment that you take for granted when you work in an institutional setting, literally and I have this in writing the living environment would not be suitable service animals. So what does that say about the living environment we're suggesting to put people with disabilities indefinitely if they're not confident, not restorable? The state wants to design a competency restoration program. I would submit, like, 40 something other states have them, and they know whose competency can be restored and how. And someone with a brain injury, no. There you know at the gate whether or not they're confident whether or not so what does competency mean? This is judiciary committee. You probably already know. The ability to communicate with your attorney. The ability to know truth from fiction, the ability to know who the judge is and the other people in the courtroom. So you might teach someone by rote, even someone with an IQ that would qualify them for services, who the attorney is. But to meaningfully talk to your attorney, that's very hard even with medication. Other group I wanna talk about having represented them for years, people with with psychiatric disabilities, we would have to restore to competency with psychiatric medication. There is a percentage of people, and I would suggest you bring doctor Raven back to ask her about these people. For whom? There are no known medications that work out. These treatments are called treatment refractory. And, again, I'm not suggesting that in the interest of public safety, you do nothing and send them back to their communities. But if you know you're gonna be bullying someone in six months, a year, six years, twenty years, a prison would not be a suitable environment. Likewise, for therapeutic purposes, the people whose competency you're restoring, another question for doctor. Someone is committed of pain is acting and then restored to competency and they gain any insight into the vaccine might have committed. They need intensive therapeutic supports. I bet those times are through that process. And I would submit. You're not gonna find that in a DOC setting. So I've heard some of the committee discussion here about does it really matter in the end? Are they if they're in a hospital, they're they're in prison? I would say for so many reasons, but especially for the sake of the people, living experience. We are gonna be putting through this process to do it in the most humane setting where they can have the greatest amount of dignity and quality of life afforded to them, whatever conditions they are living with, whatever crimes they have been accused of. I think that Dick Sears, senator Sears, would have been the first to say that the people that he was concerned about would not be treated in a DOC committee at a facility. I remember how angry she was when there was one person receiving developmental disability services residing in a DOC facility. And he walked in for out. Mhmm. That's true. And I don't think that that that I've probably taken up more time than I can go through in my comments. Oh. Oh. The most important thing. Sorry. Of my comments. So I submitted electronically. And because I'm old at my paper, I'm gonna submit, basically, the story of grace. This is the story of what happened at Woodside in this state, in this century, in our time, with our current leadership. And to take away what happened, and I was really humbly assert if you haven't read it, even if you've read it. I hadn't read it in a while. And I, like, didn't really get through it this morning with breakfast, but Winters, now deputy commissioner, but when he was commissioner of DCF, the day after he has this amazing investigative piece about what happened at Woodside, when that came out, he said a couple really serious things. And these are the things that I wanted to leave you with because I it's not too late to fix this bill to address these issues. It's the issue of oversight. It's really different if you're prison than if you're in a hospital. Which legal advocates do you have a right to? If you're in a psychiatric facility in Vermont, you have the right twenty four seven to the services of disability rights Vermont. Who do you have? Thank you. Defender general Mario when you're in a prison, and what will they be able to do for you? And who who's gonna have your back? Is it gonna be the conditions that CMS, the Center for Medicare and Medicare Services sets for how people in treatment should be treated? The right to fresh air, the right to exercise, all kinds of humane and dignified treatment rights that come in the hospital certificate of participation process are totally absent for correctional facilities. So think about the rights individual oversight. But especially with the agency of human services I've worked there. I've worked at Dale for a couple of years. They like to pride themselves on this mantra sometimes, an agency of one. Well, that could be great if only true from a policy perspective, but it could be effective, collective impact, all of that. But when you're talking about the same facility, determining who goes in and who goes out, and also operating and also providing oversight. That is exactly what Chris was worried about after experience with what happened with Woodside. And his big takeaway was there must be transparent over years. Judges said, Okay, so many people in power look the other way. I know you guys weren't in these seats then. But as a judiciary committee, I think you would want to reacquaint yourselves with what happened and then bring those eyes to bear and how can we prevent this from happening from people who might not even be able to speak. Certain people with intellectual developmental disabilities, some of the ones that I bring to the building as my guests, they use facilitated communication, augmented communication. How is that gonna work in an inpatient setting? But who's going to cut up their food and feed them in a feeding tube and change their adult papers? How is that how you have Connecticut address the needs that he spoke. There's a certain subset of people who end up not confident to stand trial because they participated in a murder attempted suicide. They say attempted suicide because one of my clients, David, was in such a situation. I did notice by murder and attempted suicide, was then using a wheelchair and was in a diapers and all the other things I described. And the state of Connecticut was trying to care for him with their normal staff in the forensic facility, and it wasn't going very well. So the state of Connecticut opened a nursing home, a secure nursing home, which I understand Vermont now partnered with the same organization Because the needs of our imprisoned population, they are aging just with the rest of us. And there's a lot being done. Commend you to the work of a social worker named Mashkin who's written extensively on this topic. So how do you care for people who are aging compassionately in prison settings? Well, one answer is you don't. You put those same people in a more compassionate setting more appropriate to their needs. Maybe they all get in suite bathroom. Just whatever an elder might need, aging behind bars, a person with a disability might need who's not competent to stay on trial and not be able to even reason to stand but has a very serious and the law has to do, have to be met, supporting us 20 fourseven. So I'm going to spare you my written comments. Areas that I think you you would really wanna focus on the definition of who's in and who's out because this wide open door of any condition, however, required aside from being a little grammatically wobbly. It just means you're capturing a net really wide to bring into a facility for restoration or to be held for indefinitely. A large group of people who you will know at the gate are not capable of being restored, and there is no time being.

[Senator Philip Baruth (Member)]: Susan, thank you. Am I right that you're talking about that phrase that's been substituted throughout qualifying conditions? Yes. What so that was, as I saw it, an attempt to get rid of the language that you found offensive. Yes. So you don't like either of those. What might you suggest in their place?

[Susan Aronoff, Vermont Developmental Disabilities Council]: Yes. I think I would go to the what problem are you trying to solve. So if the issue is competency restoration, I would include a definition of people in the definition of people whose competency can be resorted at a minimum. And and that would exclude people with certain dimensions, people with certain brain injuries, people with certain and not all necessarily intellectual developmental disabilities. And the other thing is in other states, there is much another large populations. I get that. Larger state agencies. But there are much higher walls maintained between, well, first of all, between correctional facilities and treatment facilities. Treat us as I've been right about that, but also between people with different types of disabilities. And whatever I might think about that, in certain states people with intellectual and developmental disabilities are not allowed by definition to be admitted into these psychiatric facilities and for some people it was their get out into a different than some of these with a board rich service system. So I would consider the wisdom mixing populations. That said, I just want to say for all people, just to understand the horror, I think this community knows, far more likely to be victims of crimes ever than perpetrators of crimes, and particularly people who have been labeled psychiatric diagnoses and particularly people who are not verbal, communicated, or who have autism. So many are have been the victims of crimes and especially in these facilities, not just in Connecticut at the White and Transit facility, our good friends in New Hampshire are struggling with lawsuits that the people who were held and abused in their state of mind disabilities.

[Senator Nader Hashim (Chair)]: So thank you. I think one thing I just wanted to make sure is clarified here is that I don't know that necessarily casts as big of a net as folks may think that it does because this would apply to individuals who are charged with life offenses are being held without bail. So they'd be in the jail already, but not going through any sort of competency restoration program. But I think the challenging piece that you've raised, which I'm trying to figure out how to navigate as well, is if somebody is unlikely to be restored to competency, then what happens to them? I think that could apply to instances where the rare instance where somebody isn't held without bail but also charged with a life offense. And there's a finding of no competency. And so I'm wondering if adding in language on page three, somewhere around line 14, that if somebody is unlikely to be found competent and they're not already being held without bail, that the court shall consider less restrictive means, like the Berlin Psychiatric Hospital?

[Susan Aronoff, Vermont Developmental Disabilities Council]: So to address the first question of who would this apply for apply to, so one thing that I don't think I've heard the committee discuss very much is the sense of the parallel Act two forty eight process. Does that come up in the Yes. No. Okay. So in my written comments, I just want to say that way back in the way back machine in 2010, discussion of perhaps having a forensic disability for people with intellectual developmental disabilities was raised and studied. Secure programs in communities. So what you're saying about Berlin, I would even show that. So I worked with a gentleman who had been held in the waiting facility in 4 Point Bedford Street 247 for more than a year in violation of every CMS rule in existence at the time. When CMS came to the hospital and found them out of compliance, this gentleman was flown across the country to California where he lived in the community in a house, but he had three on one staffing. And, yes, his house had a secure room for the staff. They had protocols they would follow around taking this gentleman into the community, but I visited him in the community. I have pictures of him and I listening to music in the Barnes and Noble. So I would say that even people who are would would fit that definition of charged with a crime that, you know, can still be safely can still live safely in the community. The community's safety protected if Vermont had rules and tools to do that. I think Was that another question?

[Senator Nader Hashim (Chair)]: I I think the distinction, though, is that if somebody is found to not be safe with their community, if they're released to their community, that's that's the

[Susan Aronoff, Vermont Developmental Disabilities Council]: issue. Right. So that's what I'm saying. There are people who might have been appropriate under the definitions to be admitted into a forensic facility. But what the holding of the Supreme Court case in Olmsted said was where the state is providing services. So sometimes when you think about people with disabilities, we think about I know you guys are kind of thinking about all this from the state's power for public safety and how you protect the safety of the public. The state has a person with disabilities in its control, the state is the guardian, the caretaker, service provider, that person, they're doing it either in the local apprentice, the police and parents that do need to care, to take care of someone who cannot take care of themselves. That was the most humane reason ever created for our institutions for anything the state does. The other of our parents' patriarch is a more controlling entity, which everyone you're gonna root into, whether you're gonna take care of people in the community, or force them into treatment in the community, I would submit you would have the right and the duty to do both. But I would say that states had and have found ways to keep the public safe and to not keep people behind bars and get them at home. Those are not the the two options.

[Senator Nader Hashim (Chair)]: I think the

[Susan Aronoff, Vermont Developmental Disabilities Council]: other I mean, the client that I had who had three on one staffing, he did not have three on one staffing forever. So a good behavioral modification program will work on reducing that over time so that that person has a chance for community and. When I met him in his twenties, he's gone on to do so many other things after having spent a year. You put 23 staff out on comp. It was not a good boy.

[Senator Nader Hashim (Chair)]: The other piece that I had brought up at the beginning of this entire bill is also making sure that if this were to be a forensic facility that's in a DOC facility, that any individuals who fall into these categories are separate and apart from the general population. I don't know if it's actually

[Susan Aronoff, Vermont Developmental Disabilities Council]: Okay. Can I just say one quick thing about that? Separate and apart thing. I meant to. One woman I represented was the only woman on her unit at the White King Forensic Department. What that meant effectively for her, and she was a young black woman, again, a civil patient in the forensic department, same people you're talking about here. What that meant was she was essentially in isolation and solitary. They actually ended up moving a woman from the other part of the hospital that was not a friend of the hospital over to the more reserved like a jail. You go in and navigate and can't bring a pen for maximum security, so she wouldn't be the only woman. So, yes, separating people from a population is great as long as it doesn't further further inflict My former agency brought a really successful sex discrimination case for the failure of the state of Connecticut at that time to provide effective services for the women. Senator Miles. Yeah. I'm just

[Senator Tanya Vyhovsky (Member)]: wondering if you have concerns around the effectiveness of treatment and restoration if the staff is armed guards and surround you can have a separate wing in a jail,

[Susan Aronoff, Vermont Developmental Disabilities Council]: but the setting is still a jail.

[Senator Tanya Vyhovsky (Member)]: I'm wondering if that concerns you about the treatment capacity. Yes.

[Susan Aronoff, Vermont Developmental Disabilities Council]: Yes and yes. So in general, I think that the draft does a good job of capturing the state of the Supreme Court law on who states can involuntarily medicate. The state has an interest in restoring some of the confidence. I think that that's well captured. I think where and how the state chooses to exercise that awesome power is really significant, both on communicating with the state thinks that the person whose rights they're able to violate their bodily autonomy, they're able to violate with drugs that upon first dose can cause permanent irreversible side effects. I think and doctor would be an expert on this, not me. I think that when she said that competency restoration has been more successful in inpatient settings than in the community because of issues like housing and food and the other things get in the way of compliance, I would ask her to consider some of the studies that have been done on people when those needs are met. And in particular, the recidivism rate in Connecticut for sex offenders when they're under community supervision, and they check-in every day and they express feeling like they matter and work and have opportunities, their participation rate in treatment remarkable. And, again, for defer this kind of to doctor on that. But I think that any treatment is gonna be more successful when the person treated is as engaged

[Senator Nader Hashim (Chair)]: was gonna interject with a quick note for my committee

[Susan Aronoff, Vermont Developmental Disabilities Council]: assistant. Yes.

[Senator Nader Hashim (Chair)]: Could you ask Senate Health and Welfare to look at the qualifying condition language, please? I do think that is one that falls into their wheelhouse.

[Susan Aronoff, Vermont Developmental Disabilities Council]: Better resourced in order to do that. And one thing that I saw very done very successfully in Connecticut is that the provider is similar to our designated specialized services agencies. They were that it made it possible for the agencies to serve them the way they needed to be served. Three on one staffing is so much cheap. I'm not pretending it is. It's a lot less expensive than an inpatient bed indefinitely and

[Senator Nader Hashim (Chair)]: I made a note actually because we haven't heard. I haven't actually have we gotten any witnesses from WellPath? WellPath, the medical providers for DOC. My

[Susan Aronoff, Vermont Developmental Disabilities Council]: I just wanna make another comment because I think that this could be fixed in the directive is the area of oversight that a client's a patient's right to sue for rights violations sometimes really depends on if they're being provided provided services by a state contractor or by a state agency or by a hospital or by a prison. How much rate of health care does someone have? So I would just encourage the eyes on, what kind of rights did people have, and to take commissioners' work Winter's works hard and provide for independent outside of the HS eyes on.

[Senator Nader Hashim (Chair)]: And what would you I mean, if if you were if you were the drafter, what would you say oversight looks like specifically? As in who would be on such a oversight committee or council?

[Susan Aronoff, Vermont Developmental Disabilities Council]: Yeah. I think to me and, the story about what happened at Woodside is so instructive. Even the attorney general's office, TJ Neumann, knew what was happening at Woodside while it was happening. So I would have to think outside. Because ordinarily, I'd like to say, oh, the attorney some outside of AHS. But I don't I think it would actually have to be outside of the wrong statement. The defender general might have an opinion. I just wanna say in terms of resolving the issues at Woodside, there was no office more instrumental in writing those wrongs than the office of the defendant judge.

[Senator Nader Hashim (Chair)]: Anything anything else for our witness? Questions or comments?

[Susan Aronoff, Vermont Developmental Disabilities Council]: Thank you.

[Senator Nader Hashim (Chair)]: Thank you for your time.

[Christopher Mattos (Committee Clerk/Assistant)]: Right. Yeah. Okay.

[Senator Nader Hashim (Chair)]: Alright. So, Mark, do you mind if we take about a seven minute break back at 11:20. Is that what Absolutely. Yeah. Great. We can we can go off and be back at 11:20.