 with us this afternoon. Thanks for having me. Always fun to come up here. You say it like you need it. Well, I'm particularly a big fan of the Friday donuts and pastries. I'll just be honest. See you this Wednesday. See you this Wednesday. You missed the reenactment of that Friday. There's no floor show this week. Actually, we're kind of in tune with that as well. We'll give you the opportunity to participate if you'd like to bring some. I believe they're cream filled. We are going to say, you guys might be happy with what I grabbed on the way in. Give us a chance to be critical. Give you a chance, huh? We all go to that gas station. So there's a couple of different perspectives from which I think we can benefit from Damien's wisdom. And that is understanding what the state of Vermont has in place for regulation of alcohol. And then I think the other perspective that we might pick his brain a bit about is, how did Vermont come out of the prohibition era and into a regulated sale of alcohol? Of course, those parallels won't be direct because we're in a very different time. But I think worthwhile knowing, understanding what that process looks like so that we can think about ways that this may or may not look similar. Yeah, so for the record, Damien Leonard, Legislative Council, before I get into this overview, maybe I'll do a little bit of history on our alcohol laws and prohibition. So Vermont actually had prohibition twice, once in the late 19th century. And then again, when there was national prohibition, both times it was not a successful program, as you may know. The initial time prohibition was a statewide law, but let's say the compliance with the law was spotty at best and Towns essentially set their own policies. The second time around, as you know, national prohibition, again, compliance was spotty with lots of corruption and organized crime that grew up around that. What came out of that was our Title VII basically came almost entirely in the structure we've got now, grew out of prohibition. And it was a movement that, there were kind of two models that came out of it. And one of them was this control state model with the idea that the state could help promote temperance by controlling the supply of alcohol. So the idea and temperance to keep in mind here, the original meaning of temperance was sort of moderate consumption, not total prohibition on consumption, although that's where the temperance movement got was prohibition. So this idea was basically a pushback against that, say a prohibition was a massive failure, so we need to moderate the consumption of alcohol. Once the best way to do that, it's to get the state involved in controlling the supply of hard liquor. And so that's where we came out in 1934 when we passed Act number one of the special session that year, which was to legalize the sale of alcohol in Vermont. So what they created was the liquor control board, which was sort of an island from state government. The idea being that it would be insulated from the political temper of the moment because you have people who are appointed and then they appoint the commissioner of liquor control who works for them to control sort of the sale and regulation of alcohol within the state. So you don't have a governor coming in and just putting in a political body. And you don't have policy at the department changing with the political times as one party changes over to the other. So the idea was that you get some isolation there to get away from some of the corruption that was seen as a potential. The other thing that came out of it was this idea that the state would have this dual role, the department of liquor control and the board would have this dual role of promoting the sale in order to bring an income to the state, but also promoting temperance. So how do you promote the sale and balance that against moderate consumption? And one of the ways the state does that is by controlling the number of outlets and also controlling the price. So the price of any hard liquor you buy in the state right now is at a price set by the liquor control board which is now the board of liquor and laundry. And I'm going to use those terms interchangeably because I'm still adjusting to the new name. But the idea was that they set the price, they control the supply, they control where you can buy it. And since that time, the idea at that time was that this would control it. Since that time, studies have shown that you have lower liquor consumption when you reduce the outlets with hard liquor. So that part is at least played out. And then we've also found here in Vermont that it's a significant source of income for the state and it's a reliable one. So the other piece that the board controls is of course licensing all of the different pieces in here. Now one of the issues here with marijuana, the parallels that we can't have is because marijuana is a controlled substance at the federal level and it's a prohibited substance. The state ownership of that at some point is potentially problematic and I would leave, let Michelle discuss those issues with you more because she's far more knowledgeable about that. But that's a big difference between alcohol and marijuana. So this control state model doesn't apply as much but the regulatory model might be something you're interested in. So, and that's something to keep in mind though as you're evaluating these because it's not an apples to apples sort of comparison. There are some significant differences between the substances here. Once even just getting away from the time that they've been used within society and how marijuana is just kind of more recently coming to the legal market versus alcohol having been legal on the state for over 90 years now or 80 years. So, 85, there we go. But anyway, so the board of liquor and lottery is a five member board. They're appointed by the governor. They serve for three year terms that are staggered and you can have no more than two consecutive terms. The idea being that you don't wanna have the board become sort of entrenched, splurotic, non-responsive to things. You wanna allow for some fresh faces on the board. The board of liquor and lottery meets one to two times per month. They have jurisdiction over alcohol, tobacco and the state lottery. So again, versus any sort of control system or regulatory body you might envision for marijuana, this is different because they've got a wider jurisdiction. But they do licensing for all stages of alcohol production and as well as tobacco sales and lottery sales. They adopt the rules necessary to carry out the laws. They enforce those laws. They oversee the opening of state liquor agencies and they oversee the operation of the state lottery. What I'm gonna focus on here for you is just the retail sales aspect and the licensing aspect. So the licensing process for retail alcohol sales is interesting in Vermont because it's a local state sort of partnership. So the board will review all the licenses for retail sales and these are what we call first and second class licenses. To put it more simply, a first class license is a restaurant. A second class license is a retail store. So the three-panning is a first class license. Yankee Wine and Spirits is a second class license. So before you even get to the board though, you have to apply to the local control commissioners which is your town select board or your city council depending on where you live in the state or if you're one of the few Vermonters who lives in a gore, it's the administrator of the gore. So once you get local approval and they're directed to sort of administer the liquor laws locally and they can impose conditions based on local ordinances around noise and other sorts of nuisances that might crop up. So if there's restrictions on noise after a certain hour, they can impose that restriction on the licensees. But after you receive local approval, your application gets forwarded to the board that then reviews the application against the liquor laws as well as looking at corporate documents, trade name, your lease, your rental agreement or your deed to make sure you have control of the property. Your rooms and meals tax number, they wanna make sure you're actually legitimate business operating within the constraints of the law. They look for your federal tax number, your lodging number if you're a hotel, your health license if you're operating a restaurant, compliance with the training requirements. So you gotta train your servers on sales here so that they're making sure that they're not serving people who are intoxicated, they're checking IDs, et cetera. And then they also look to make sure you're actually updating on your taxes and your unemployment insurance contributions. And then licensing is on an annual basis on the April 30th of every year. So that's kind of a summary of the retail process. The process for all the other licenses is just a state process. So if you're a manufacturer, that's just through the state. If you're a wholesale distributor, that's just through the state. And then if you're getting a license or a permit for, for example, a festival or something like that, you may have to get a separate local permit, but you're gonna get your permit for the actual service of alcohol through the state. The only exception to this is catering licenses, which have a local state approval aspect. So that's kind of a 30,000 foot view of the process. It might be better if I just start answering sort of specific questions that have come up because I don't know where you're at from your consideration of the marijuana bill at this point. So in that context. Jim? So I have a couple of questions. First of all, I understand you're between the control state having the state line for spirits and then the regulatory state for beer and wine. Is there anything that would prevent the state from being a control state for marijuana if we want to put down that app? Not grow it maybe, but buy it. I mean, we don't grow it. We don't manufacture our own liquor we buy from surveyors. So the concern that I would have about that is that the Federal Controlled Substances Act prohibits the possession of marijuana. Okay. Now, that's not currently, the enforcement of that is currently a lot of folks. Yeah, you put a state in a really weird position there. Okay, so renewing licenses. You mentioned the towns initially grant the license and it goes up to the DLC and then they do their magic and approval license after that. Retail licenses are renewed first at the town and then at the state level every year. This has been a, that's an ongoing sort of thing. So what grounds can a town not? So a town cannot renew a license if you're either out of compliance with the liquor law or if you violate one of the conditions of your license. So the conditions of your license become, essentially if you're in violation of your license conditions, that could be a reason to suspend or revoke the license. That it's a speak license at that point or state. Right, typically revocation is something that's handled at the, although the law, I believe, allows municipalities to do it, that's typically something that the board does. The municipalities will refer it up to the board and they'll go around. I'm thinking there was, I want to say, a case in Rutland recently where a bar just had a bad record of fights breaking out and the town, the city said, you're done, they didn't renew the license. I'm wondering if there are any instances in retail stores where it's not on-premise consumption that towns have said, why don't we do your license? I'm not aware of any off the top of my head that might be a better question for the department. But I mean, it's conceivable to me that if you had a retail outlet that had multiple violations for selling to minors or something like that, that the town might decide not to renew the license or that they might have a proceeding before the board for suspension or replication of their license. There's multiple violations spelled out anywhere. I mean, if a store sold to a minor, there's a violation of their conditions of a license, but that's one violation. I wouldn't think most towns would, but could they not renew because there was a violation? Let me pull up the statute for you here and I'll just bring this over there. And while you're doing that, you've been multi-cast. To my best. If a town decided for whatever reason they wanted to become a dry town, what happens to the existing bars, restaurants, orders, stores that are in that town after the town takes over? So I think about it. I don't know that it's ever happened, but I wondered what would happen. Yeah, I'm not sure that it has. If it did, it was probably closer to the repealed prohibition, because I think towns have generally been going the other way at this point, but you can't get a license if you're in a dry town. So I think at that point, that license would last when the term ran out. But that's an interesting question. It's not one I've thought about before. So I'm going to pull up the penalty for sailor furnishing the miners. So you'll notice here what we're looking at is, so a person who violates subsection A, which is sailor furnished alcoholic beverages or knowingly-enabled consumption, is subject to a penalty of $500 to $2,000 in imprisonment for up to two years or both. So it's pretty stiff. And then there is a provision here that for, if it occurs during a compliance check, which is when they send in someone underage intentionally, then you're assessed just a civil penalty and on the second violation, the civil penalty is between $100 and $500. And you're only subject to criminal violations if it occurs within a year of the first violation. And then as far as the license revocation there, and this is actually up for, let's see if I can find the right term there. Here we go. So there's a penalty for the person who does the selling, which could include a jail term. And then the license here, if you're in violation of the title, the conditions pursuant to which the license was granted or any rule prescribed by the board, they have the power to suspend or revoke. And then the revocation, you have to have the hearing before the board of liquor and lottery. So I need to just correct what I said earlier. They need to go to board of liquor and lottery, but they can be suspended by the municipality. And then there's always the renewal. So you can do the non-renewal at that point. Typically, I think you have to have multiple violations before they do a revocation or you have to have a really serious violation. But this is something where the department's really the better entity to testify on this. But I think typically the groups you see getting a revocation are, it's a licensee that is, they got penalized once, they didn't learn their lesson, they got penalized again. And on the second or third time through the system, the board says, this is enough. Okay, so one last question, then I'll be quiet. There's been some discussion about keeping it local. Given per shot at local entities, Vermont entities for these licenses. And it seems to me, we've come to a liquor license. It used to be, it had to have a majority of your board if you were a corporation residence. So then I thought that was changed at some point. Yeah, the majority of Vermont residents, I think was probably taken out back in the mid, trying to think, it might have been the mid 2000s when the grand home decision came down. So one of the things you're dealing with here again, and this is a difference between alcohol and marijuana is for purposes of alcohol, you're dealing with a substance that's in interstate commerce. With marijuana, it's not in legal interstate commerce. There may be marijuana that's transported in violation of federal law and interstate. But so the restriction to, having allowing just residents to obtain a license has run into problems in other states where they have that restriction. In fact, there's a Tennessee case that just went up to the Supreme Court where they restrict, they required you to be a resident of the state for a certain period of time before you could get a license. In that case, that law is being challenged and I expect it to be struck down as a violation of the Norman Commerce Clause. The, in Vermont right now, our restriction, I'm just gonna pull this up here. So the definition as a person, you have to be a citizen or a lawful permanent resident of the United States or have a majority of your owners or members. If you're an LLC, these citizens are lawful permanent residents of the United States. And this is actually proposed to change this year to pass the house already and is pending in the Senate to allow individuals who are here on an E2 non-immigrant investor visa to be, to allow them to get ownership as well. You'll notice that the EB-5 has been kept out because of the problems with that program, but the E2 is the non-immigrant counterpart to that visa. It requires a smaller investment but we do have business owners in Vermont who are here on that visa and are operating businesses where they would like to sell alcohol that cannot right now because they're either in compliance with the state statute and out of compliance with their immigration requirements or they're in compliance with their visa requirements and out of compliance with elected law. So, but right now you have to be a lawful permanent resident or citizen of the U.S. Other questions? Questions? Just a comment and then a question. So addressing Jim's things, there's only two grounds that the select board acting as the Labor Control Commission can deny a license or suspend a license for. One is what Damien already pointed out, but there can be local ordinances that regulate entertainment or public licenses that they can also deny or suspend a license for. Thank you. Yeah, and that's one of the things that they can condition that license onto. So there have been instances in some of the municipalities where that violation has been a violation of the local ordinance and then that's actually, there were a couple cases that went to our state Supreme Court several years back that challenged some of the local authority and the local authority was kind of, the Supreme Court's mapped it out pretty clearly. That's pretty restrictive. Yeah, it is pretty restrictive, but there it still exists. So my question is, I mean, you talked about how limiting the number of state liquor stores limits consumption. Do you know or where we go to find out how the board of liquor and lottery determines how many stores should be in the state in their geographical diversity, I guess? So that's a multi-part answer. And I can give you, tell you what I know about it. And then of course the board or the commissioners can always fill in additional details. So they look at things like population density, distance to the nearest other liquor agency. So they don't want to oversaturate any one market. But they do want to provide people reasonable access and they also want to do it in a way that's going to be generated reasonable return for the state. Since the state owns the liquor on the shelves, the person who operates the location is just the agent for the state and they get a sales commission. So they look at things like that. So that's why you might see, for example, I think Burlington has four liquor agencies, but other towns may not have one and they have to go to the neighboring town for a liquor agency and it's based a little bit on population density. And then trying to make sure no one has to drive beyond a certain amount of time to get to one. The other limiter for the department and the board right now is the warehouse and the IT system. So we are currently at 80 agencies and my understanding is that until we get a newer, more modern warehouse with a modern IT system, we cannot expand beyond the agent 80 because we're both at capacity for warehouse space and we're also at capacity for what the IT system can handle as far as processing shipments and so forth. So that is why they're currently working through the capital bill to try to get a new warehouse and headquarters put together so that they can modernize that. If you've seen the liquor warehouse, it is amazing what the department does with what they have. It's a very antiquated building. It's not in great shape and they have squeezed, as far as I can tell, it seems like they've squeezed every available square inch out of that building. A few years back when the, I think it was during interim commissioner Giffin's time, as representative Gardner, you might have still been with the department that I can't remember but they had a consultant come in to figure out how to squeeze additional capacity out and they were able to stretch the life of the building by a couple more years by rearranging where the racks were and how they arranged inventory but I mean it's literally at that point where they're just, they're moving things around but the racking is outdated. It doesn't serve the latest sort of picking equipment. It doesn't serve the latest loading equipment so it slows down every step of the process. So the drivers are not able to unload as quickly as they might want to. They're not able to load the trucks as quickly as they would want to and so that's kind of the bottleneck right now. So I don't know how many agencies they might add if they could but at this point they were at 78 when I started here in 2014 that had gone to 80 in the last few years and I don't think they're going to add any more until they get a new space so it's interesting. J.P. Bob and Jim. I got an answer. Bob? So that's a good answer to the basically box on the end of Flickr when we started Lottery there was that kind of box too because we didn't want to promote gambling for the book and then eventually that caveat went to the win so you can have two sellers right next door to each other as we do in Burlington a lot. This is the same sort of situation we don't want to really be promoting. Marijuana use that much is there a reason why Lottery control went out the window on that? You're only here to 2014 maybe I'm asking the wrong question. Yeah, I don't know the history on the changes around Lottery and it's worth noting too that this is just for the retail outlets for hard alcohol. You can still get, you could still have multiple restaurants right next door to each other that can sell spirits. That's a third class license which you can get in addition to your first class but the, so it is just the outlets for taking spirits for consumption off the premises that they've limited and I don't know the history behind the Lottery there and without, I don't know enough about the marijuana bill to know how the provisions in there might match up or not to what's currently on the books. I know that there is, you know that sort of process of the third class licenses for restaurants are more expensive which limits them to some extent and there's additional liability too so that does make people choose here but you can still have, for example on Church Street in Burlington you have several outlets at the bottom of Church Street there that have a first and a third class license or several restaurants, excuse me. Jim, and then how? Was there any, to the back of the regulated market which is really what this is, is there anything that would, one, do you use beer and wine as an example of limiting the number of license? I ask that because, you know, in Massachusetts for example, they used to have a same ownership but so it used to be, you could only own three licenses and then eventually they changed it, it might be 10 now or something, but they limit it. I don't know that they limit the location but maybe they do. Could we do something like that if it were litter, I mean that beer. So I'm not aware of anything that would prohibit it and in fact for fortified wine permits which is a permit for a retail outlet to sell higher alcohol wine which would normally only be available through a state-like agency, those are limited to 150 statewide. So we've done it with respect to that and then there are limits on the number of sort of short term special event permits that an entity can get per year depending on the type of permit. So I think right now the special event permit which is actually one of the names of the permits is limited to two a week and these are sort of for the pop-up of the manufacturer so that they can serve their product and sell you bottles of it from a location like this is different than like a farmer's market, it's sort of they'd pop up at another special event and it's a limited space. We do limit it. Right, so medical marijuana is limited right now. I don't see any reason why you couldn't limit the number. The one thing that you would probably want to be conscious of is that it's being down on a basis that's not somehow discriminatory. So, or would have people say there's an equal treatment issue or something like that. So in terms of the licensees, are the applicants all given equal consideration on applying or would a corporation be more favorable than an individual? Is there more stable? Well I think with the licensees they're all on equal footing when they apply. The basic is you pay your fee and you submit your application. A corporation may have some advantages in being able to draw on greater resources in terms of putting its application together and getting the necessary insurance and so forth but I don't think that they're given any sort of benefit when they're actually being considered. So it's nothing that an individual who had similar resources or an LLC that had similar resources would be on exactly the same footing. So I think if there's nothing there that's not that is inherent in someone being a corporate entity that couldn't be there for an individual with significant resources if you have a well-resourced corporation. We also have to remember that a lot of sole proprietors form a corporation for liability reasons and they're going to function much the same as an unincorporated sole proprietor in terms of the resources they can bring to bear so the application process might be difficult for them because they can't hire a counsel or a consultant to help them through it or they don't have those extra resources to throw at the issue but at the same time when they get in front of the local control board and the liquor control board as long as their application is thorough and just checks all the requirements and so forth they should be on equal footing. I want to get away from the liquor and alcohol terms. Okay. This part of the question. So are there different licenses required to sell, say whiskey, wine and beer? Yes. So beer and wine are sold under the same license. Whiskey and other hard alcohol requires if you're going to sell it for consumption off the premises you need to either be a state liquor agency if you're going to sell all kinds of alcohol from 16% and above or if you're just selling wines that are 16% or above you need to have a fortified wine permit. But otherwise beer and wine is the same, is grouped together. For manufacturing we group things as beer, wine and fortified wine or spirits and fortified wine. There's three different manufacturing, some sets of the manufacturing license and so if I wanted to manufacture beer and whiskey I'd need two separate licenses there not to mention my federal approvals which are pretty significant if you're doing spirits. So that's, does that answer your question? Part of that. Okay. Two parts. The second part is so, and that's what I thought you probably were going to say, but is that why you guys use two terms, liquor and alcohol? Like at the very top of your overview it says port of liquor and lottery and alcohol. So my question is, is that why you use liquor and alcohol? Within my outline, if I just go back to that for a second. Thank you. That's why I went back there. Yes. It's fishing for accomplices. So the board of liquor or just the liquor reference department of liquor control, department of liquor and lottery is to me it's an antiquated term. When we did the modernization we've switched almost everything over to alcoholic beverages. And the reason for that is liquor in most people's minds refers to higher alcohol products. And so it was confusing to people when you'd say department of liquor control but they also control beer, control wine. They control industrial alcohol and scientific alcohol. So you're grain alcohols, methanol, that sort of thing that you're not going to be selling for human consumption but you might be using to degrease a machine shop or something like that. They control permits for that as well. So that was why we've gone over to alcohol licensing to be more clear about that. So liquor is really just an old fashioned term that's stuck around because it's been in the title. Spirits, we continue to use just to refer to the higher alcohol beverages again to try to get away from any confusion over what liquor is referring to. And so that's kind of where we're at but basically the way I think of it is beer and wine and then spirits and fortified wines if I'm thinking about it or hard alcohol and everything else. So yeah. I'm very happy to hear that. Yeah, thank you. Questions for Dan here? What's this? Tax on. Great, thank you. Please let me know if you have other questions and I'm happy to, if you have questions for Michelle, I'm happy to just provide her with whatever I can. So I hope this was helpful to you. I think it was. So great. Thank you for your time. Michelle. I was just wondering if, just based on some of the questions there, but it might be helpful if I just give you a quick just a little reminder overview of what there is for licensing in this 54. And so there's the five types of licenses under which there can be several tiers within each type of license and that's determined by the board. The bill doesn't set a certain cap on the number of licenses. So previous legislation has said, oh, you can have, you know, 42 retails and you can have this or that. It doesn't set that. It's to be determined by the board. One, an applicant can only have, can have no more than one of each type of license. So you couldn't have. So I think somebody was talking about can somebody have, you know, four different retail outlets they could not under this 54. They would only be able to have one of each. And then the way that it works in terms of the initial application period is the way that it rolls out is that they first open the period for application for cultivators and I think testing labs and then that's a 30 day application period that opens for the initial application period and then that closes. The board can open it up in the later time but the idea was to do a kind of a staggered rollout for the application starting first with the grow operations and then ending with the last votes with the retailers applying for it. And so there's not, so they may initially be saying, well, we're just gonna take this, whoever applies in this 30 day period and process and we're gonna determine how many, whether we're gonna have a cap or not and then they can open it up later. And we regard to having a lot of stores congregated in one particular location. One of the, if you recall, there's a list of priorities and things that the board is supposed to consider and adopting rules for selection of applicants and one of the things that they're to consider is the geographic distribution of the applicants. So the staggered licensing plan is in recognition of the fact that once you have cultivators licensed online, you've got basically eight months before they're gonna have the product. Right, this is kind of, this was a piece that's been in a number of bills for a few years now and we had consulted with Washington State when it had gotten its program off the ground and that was one of the recommendations they made is they had a problem in that they kind of licensed folks off at the same time and so they had retailers with no product. And so they said, you know, kind of start out with your grow facilities, getting your product going, then the product manufacturers and the testers and the distributors and then your retailers come on last and that provides, it also allows you a way to be able to manage the kind of onslaught of a lot of applications coming in at the beginning and they had also recommended the 30 day window initially because they said you just get kind of crushed at the initial point there and so it doesn't mean that the window doesn't open later but for the initial offering you kind of start to roll it out and then manage it. Questions for Michelle, that anything else that you would like to be reminded of with respect to S54? And then also just on that, David did touch on it, but about the control model, you know, and we can talk about it later if you want but there's a difference when you're doing the analysis, the constitutional analysis with the controlled substances act between whether or not the state is regulating the market or whether or not they're in possession actually and distributing the campus and there's a good understanding in terms of what your risk is with regard to the fact that you're concerned about your violation of the controlled substances act. Okay. So in regards to liquor, two years back, Maine, which was very similar to Vermont, is a control state for liquor claim. They decided they, while they wanted to control it, they outsourced their wholesale distribution as opposed to Vermont, Vermont is the wholesaler of experience. But we select and have a wholesaler to keep the state out of it, but yet we control, you know, one wholesaler for the whole state. I'm not saying I want to go down that path, I'm just asking. I don't know, I mean, I think what I would say is that the closer you are to being involved in possession and distribution of a Schedule I rather than regulating other people doing it, you kind of climb the ladder of, you know, that's a concern, but we would be regulating it. If you're regulating one, as opposed to 50. Maybe. Just, whatever, I think we just have to explore things to simplify it, and again, I'm not a fan of Monopoly as well. Maybe, whatever, just sometimes these thoughts pop up. We can keep the tires as many times as we want to. So, committee, we have Dr. Levine in the chair, is anybody dying to go drink the water or stretch or shall we take a gamble that we're gonna get out of here early, if I was starting early? Thank you so much for your flexibility today. No problem. Welcome to the committee. We are doing our best to work our way through the bill proposals in S54, and would love to hear your perspective. I suspect that you might make reference to a bill that's currently across the hallway there in terms of your view on prevention activities. Thank you. So, Commissioner Mark Levine, Department of Health. Thanks for inviting me. So, these are links to reports, which I am not going to exhaustively detail in my testimony today, but you may find them quite useful because they're very timely. So, the health impact assessment was produced by the Department of Health a couple years ago and subsequently updated. And it and a document from the National Academy of Science and Generic Medicine really details what is, from an evidence-based standpoint, known or not known about the impacts of cannabis on human beings. And a whole host of health and mental health and productivity and life kind of speeders, if you will. Sully focused on cannabis. Yes, solely focused. And then the Governor's Commission on Marijuana, obviously we had an Education and Prevention Subcommittee which I chaired, which utilized data from the previous documents I referred to and came out with a set of recommendations, some of which we'll talk about in a little bit here today. And that's fairly brief reading as well. So, I would start out by saying from a public health standpoint, we already have a public health problem with regard to marijuana use. And it's particularly focused on the youngest of the homeowners. The whole reason the Governor appointed the Commission and the subcommittee was to focus on that population. We have Youth Risk Behavior Survey data. That's a survey that's administered to youth every other year and has incredibly high response rate. And we have years of data to compare. So it's a very valid tool. And the most concerning part of the recent data was that there was an increase in current use of marijuana among youth from the past two years. We're waiting for the next set of data to see if that truly makes a trend. But the trend had been stable or downward for a long time and now it was suddenly going up. When you put that usage rate together with the perception of harm that youth have for the substance, it's very concerning. Our youth are not fools. They know two thirds of them say that if they maintained a tobacco smoking habit, that would not be good for their health. When you ask them that about alcohol and cannabis, only in the 30% did they say that that's not necessarily good for their health. And likely even worse with respect to taking. Yeah, the question wasn't asked because the vaping epidemic is so new. Oh, please ask. I have a senior high school. We've had conversations about it. Yes. So I suspect, well, we're trying to bend the curve on that one, but I suspect you're right. The perception of the harm of it would be long. But it's in the news a lot now. So I'm not going to repeat the whole impact assessment, but I do want to highlight some of the important impacts specifically on youth, because these are things that we definitely know. So it can have an adverse impact on academic performance. It can have an adverse impact on long-term IQ potential. There's definitive evidence, and now there's increasing concern and evidence in the literature that the linkage between novel use of cannabis, THC, I should say probably in this regard, and a developing brain and psychosis are quite tightly linked. So not that adults cannot become psychotic, but at the same time it's more the developing brain from teenage years through age 25 that are impacted in that way. And I have very personal experience of my own practice and can vouch for that. And I dare say any physician would be able to. Youth have a more significant propensity towards dependence about three times that of adults. Early we start, and more likely that will develop. There's an association with depression and anxiety and heavy use. We know from the motor vehicle experiences in the literature and in other states that there's an increased risk of crashes and fatal crashes. And we know for adults that there can be impacts, again, not dependence, but also on economic productivity, how they work a good job, how much motivation they have, and other psychosocial outcomes. And if pregnant women should use it, and unfortunately they do in Vermont, it can be associated with a lower birth rate for the infant. When we talk about prevention and substance misuse, our common mantra these days is that we don't silo substances. Substance misuse prevention works across substances and we don't need to necessarily design a specific intervention for every single thing that human beings can take into their bodies. And we stand by that still. It turns out, but let's say Vermont does decide to commercialize the sale of marijuana products. We would state that there needs to be comprehensive and sustainable prevention efforts to protect youth. And evidence-based strategies that we use in the health department for prevention only work when they are comprehensive and sustained. Can't be a one-time affair. And right now, as you know, across the state, there's very little funding for prevention. There is some federal money for prevention. Much of it is, I'll use the word restricted in a focused... Silo. Pardon? Siloed was the service you gave me a few minutes ago. Yeah. So this time, as we talk here, is a prime opportunity to begin to discuss how to focus funds from the state, specifically on these activities. Commercializing marijuana usually implies that there will be an impact from industry that will focus on perhaps vulnerable people. So the heaviest users or the youngest users. They have a lot to lose over a long period of time. They can use over a long period of time. And those are the people we have the same public health concerns about. So as a physician and as a commissioner of health, I'm clearly focused on prevention. And my department is charged with protecting and promoting the health of overmodels. That's our mission statement. Prior to legalization, our health department obviously had a lot to say about just the legalization issue and how that would impact our youth. And I can say a lot of the same with regard to a legalized product and now having a regulated market. I'm trying to turn that off, sorry. Yeah, so the main lesson that we've learned from states that have already been through what we're going through right now is that they would have loved to have prevention money up front. They felt that their prevention money came way too late. And when I'm talking like just a little too late, it was a couple of years too late. Obviously they did set up their structures to provide revenue that would then be dedicated towards prevention, but not having it at the outset put them behind the eight ball very, very quickly. And it takes a department of health and others who are partnering with the department a fair amount of time to set up these programs. It's not like you just snap your finger and all of a sudden you have a total parking program operational. The counterparts we have in other states estimated the amount up front would be five to $10 million. So their advice obviously was to have some kind of funding up front built into the entire legislation and protect young brains when the market actually opens rather than after the fact when these young brains may have already been impacted. So I want you to keep that in mind. S54, as it's currently structured, does not include funding or requirements for prevention efforts. And I testified to that in the Senate Judiciary Committee as well. The fact that the bill would move forward then with a commercial market is aimed at Vermont's youth without any of the valuable protections that can be provided is very concerning for me. Especially when we have a good track record in prevention and know that the types of programming that we can develop and set up and that are evidence-based and that should be comprehensive and sustained, they actually work and the rate of use can decrease. So clearly I would be offering my sage wisdom in saying that S54 needs to include funding for evidence-based, comprehensive and sustainable community prevention efforts. And I went so far in the Judiciary Committee and I'll do it here as well, saying that it's not only unacceptable and irresponsible, but it's unconscionable to develop a legal marketplace for marijuana without establishing a dedicated revenue stream for education and prevention to protect public health and to protect public safety. I have a few other items I'd like to just sort of add into my talk here that are very specific and focused. I know there's been some conversation about modifying the bill in some way with regards to medical marijuana and making changes to perhaps the indications or requirements that would be out there for using medical marijuana. And the bottom line is there's nothing in the medical literature regarding new conditions that are suddenly medical marijuana is the cure, is the treatment beyond the conditions we already have, some of which I will add or not in this case. So I would certainly not think that there'd be any room for any other conditions that perhaps some of them might be advocating for. Second thing has to do with edibles. The education and prevention subcommittee was very specific and direct regarding their lack of enthusiasm for regulating edibles. When you look at states like Colorado where kids have gotten into trouble, when you look at volume of emergency room visits for pediatric populations, there's some very recent literature I just read two weeks ago that further substantiates this. There's not an insignificant amount of visits to hospitals for adverse events related to marijuana. And then within that group, there's a fairly significant group that are edibles and kid related. So we obviously have a strong sentiment against edibles period. The overall marijuana commission could not make a decision. It came down as a really split vote. So the report reflected the fact that we weren't saying no to edibles, but we weren't saying yes to edibles either. It was really divided. Also with regard to edibles, there's a clarification I should make with regarding to food licensing. The Department of Health regulates licenses in a food establishment's restaurants. Not included in something like that is actually selling marijuana products within those food establishments. It's envisioned, we would hope, that if edibles were on the market, they would continue to be sold in dispensaries. And like CBD products, not like CBD products, which are kind of now everywhere you look in society, even though there's not a lot of evidence for your benefit. But for the actual licensing of establishments to sell edibles, that's not the business that the Department of Health will be in or should be in. I just wanted to add that level of clarification. On the topic? Yes. So if someone was making edibles, would the Health Department have some real sight of the facility that's being used to manufacture those products at that point? No? No. Jim? No, maybe I misheard, but I thought we went to the medical facility and we went through the kitchen and they talked about the inspected and regulated the Health Department. They have invited the Health Department and been told we don't regulate these kind of facilities. So why would you say that? That's not our business. It's a food production facility. And we don't potentially expect the refood production to sell it. What's your license? We license the restaurant. Hi, everyone. Shayna Livingston from the Health Department just to jump in here a little bit. So the Health Department is looking to clarify. So right now, as envisioned in this bill and in front of you, edibles, if they are to be allowed, would be only sold through dispensaries. On top of that, the board, however it is defined, would then simply confer with the Health Department about what health oversight and regulations would be appropriate if they are producing edibles. And that board would have to staff and oversee that and go and do those inspections themselves. So we would be happy to provide technical assistance with the food safety aspects of that and how they would implement it. But the Health Department and our licensing technicians would not be the ones going out and inspecting that. So we are looking to clarify that in the bill that's currently drafted. In what way? So Michelle, I'll talk here unfortunately, but I did actually talk to her about it a little bit before. I'd have to share it if you'd like to. Yes. Not have to. I mean, you could also stand. We don't like to having people look down at us. Bloom. So I would have to work with her with if the committee is interested, and I would work with her to figure out the best way to crack that. Her interpretation of the bill that's currently drafted is that indeed that is the case. And that tax has actually, in Senate Finance, went in and made some similar clarifications around what is considered food and what is not considered food. And that the Health Department is here to ask that we be able to offer that similar kind of clarification in relation to our licensing. I'd be happy to take a look at that. Okay, great. So you want to license? No. No, you don't want to license. We do not want. The Health Department does not take legal decisions as a good idea, we do not want to license. We would be happy to provide any regulatory agency with how to enforce food safety regulations if they wanted to adopt them. Jim, did that answer all your questions? And then you had your hand up for a minute. No, I have other questions, but we went over them. I'll go back. I'm sorry. No, no, no. That's fine. It's on top. It's okay. Yeah, I'm just trying to stay on this topic. Sure, I totally agree with that answer, but that's okay, but we can have disagreements. J.P.? I guess I'm not clear on why. I've heard a couple of times that the Department of Health does not want to regulate this, but I'm not clear on why. Sure, so it's not our area of expertise, right? Like, we don't have regulations or limits on how much THC and how to test that food and how to make sure that that is done safely. That's not something that we are able to do. We want to ensure we have seen issues with CBD products as they are currently being sold in establishments that we do license. And so we want to make very clear, again, I don't think this is, I think it's as clear in the intent that the edibles, if they are to be utilized, it would only be sold out of dispensaries, but we want to make that crystal clear that if you have a license from us to sell food, that an edible product with THC, and it is not considered food, and that that's not to be sold in establishments with our license. And again, there are standardized FDA food safety, preparation safety guidelines, and those can be implemented and monitored by any regulatory body that, you know, adopts them as rules. And we are happy to assist the cannabis, can't remember what's called the cannabis board, with how to do that. But we do not want our staff going and doing those tools. That's not what they're trained to do. So you're suggesting that you would be happy to share, for instance, the roughly 100 point inspection form that you use when you come to my commercial kitchen, and license my kitchen, and you point out the fact that that floor tile is cracked and needs to be replaced. And, you know, this is an opportunity for a hazard here and this needs to be fixed. So you're suggesting that you would rather give that to another entity and have them do those inspections than to have you come into a kitchen where a cookie with cannabis infusion is being made. Correct. Or have it be part of whatever other license that the board is having these places here. So in the event that the cannabis control board were to look at the landscape around Vermont and say, we really don't want to recreate the wheel here, we want the Department of Health to inspect the food safety aspect of it and we'll leave the agency of agriculture in their testing lab or whoever it is that ends up doing the testing of the concentrate of cannabis. Would you be capable of doing that? So we would oppose that, we would also be, we are currently at 50% staff of what we're supposed to be according to FDA for restaurant and food license. That's why I don't see you often. I don't see you often. Sure. I don't like to be there more often. And so we would need a significant amount of staff and we would request a significant amount of staff to do that, so it might be prohibitive in terms of the cost. Other questions? Al and then Nassau. So Dr. Levine, I really appreciate your advocacy and your support for education prevention in regards to the cannabis. And I also am concerned as well. So say if the bill goes through without any meaningful or sustainable education prevention resources and tomorrow the market opens. What's it look like in three years for our young brains out there? Yeah, so we'd be really concerned about the only thing, I don't want to give you the idea there's no prevention activities going on right now. The scale and magnitude and sustained program we envision requires those resources. So yes, there'll be some messaging campaigns that youth will see on their own social media, which is fine, but certainly not the makings of a comprehensive prevention program, because messaging is sort of a necessary but never sufficient kind of ingredient. What it really requires is usually regional programs of prevention that are tailored to the communities in that specific region that involve a lot of community input, parental input and experts, if you will, input. You've heard probably talk about things like the Iceland model since they were just visiting the state house last week. Some models of that sort that go over frankly years to decades, but that still when they begin have a very comprehensive portfolio of prevention activities that involve the community level and the school kind of current. That usually requires people who full-time work in those activities to carry out these programs. So I think it would be very challenging to suddenly have cannabis on the market without especially with the perception of harm that data that I showed you and expect that we wouldn't be behind the eight balls on the start and perhaps for many years. Now some more on Jim. One is when you talk about not the inspecting help or who inspects the pharmacies and make sure that the pharmacies are passing the stuff in the state or is it just to get the product of someone who's selling? Probably. It's a little out of my scope, but I can say that it's not apples and apples what you're talking about because we're talking about the actual drug being integrated into a food substance as opposed to vitamin B and gummy bear. We're talking about the actual psycho-mattive drug in a few seconds. And the other question, I agree with you but you gotta be out ahead of it. I thought we did a good job on teaching our young man to smoke, but as you see, there's always another side that's always trying to get up in front of this, okay? So I think it has to be ongoing. It's not a, as you say, we need an initial prompt, but I think we can't drop the ball if we do that. I completely agree. Initial, robust effort and then sustained it. A little while ago, I think you were talking about your investigation with what other states were doing in terms of medication prevention and the number of five to $10 million came up. Was that specifically a Vermont number or is that what some of these other states were talking about? Okay, so we perhaps could scale that to size because whichever states you were talking about are bigger than Vermont. Yeah, like Washington and Colorado, you know. I don't think there are any that are smaller than Vermont, yeah. Right, so we could, that was just my thought. Can we scale that to a Vermont effort, some sort of capital adjustment? Yeah, I mean, we have scaled it, if you will, to a $68 million number, because... Yeah, right, I guess I'm thinking my good friends don't know ways to mean to committee what they're going to do. So what do you want to think when they hear $68 million and replace that with 10 million? No, I hear you. Find that. So when you're talking about some of the school-based activities, they usually require what's joined like a substance abuse professional in the school. And we have that in about one-third of Vermont schools now. So just the cost of that scaling up is real money because that's two-thirds of the schools in Vermont. And this regional approach to prevention that I've been discussing still requires the millions of dollars, whether you're a state that's shaped like Colorado or shaped like Vermont, you still have regions that all have the unique flavors that can lead that kind of structural support to carry out the program. So it's not quite so easy to say we could scale it down. Both geographically, it's difficult to scale it down, but I understand where you're coming. Sure, we can't find $25,000 extra for anything. Right, let me know these days. And I understand why. Thank you. Jim? So I appreciate your advocacy, as was mentioned before, about wanting to do an education program. Can you give us some meat on the bones with that? I mean, what is it? I mean, $6 to $8 million, but I'm not gonna help us all because we don't have $6 to $8 million to put into this. I do agree it's gotta be part and parcel to whatever we do, if we do anything. Even if we do nothing, it should be there. So we need some structure, you know? This is what it looks like. Ideally, you get this, but you could do a good effort with why. So that would be very helpful. The other question I have related to all of that is, in the states that have gone, ahead of us that have gone to a retail market, after been any change in youth access that we can measure, or anybody that's measured. Maybe that's not possible. And so youth access, meaning? Younger than 21. Younger than 21. Right. I'm not sure about the data on that. Probably too early, but since we legalized it last July, have there been any change in Vermont access or youth? Youth? I mean it's still illegal, in either case. Right, because youth can get a hold of things anyway. Right. So we're counting on the next survey, and I should get us that data for it. And what do you do with that? This year, 2009. I just, No, I'm okay. Sometimes, you know. No, you want data too. Doing it at home, where we sort of put it in this, out of sight, out of mind, but we could have made it worse, as opposed to a regulated retail market. I'm not saying we did, but we could have. Yeah, I understand where you're coming from, because at home, youth have access to whatever there is at home. Try it. So can't argue against that. Okay, so finally, what I heard you say is, you don't like animals. And it was an education for me to go to, in this century, last week, week before. In that, what hit home to me is, there's a delay. So you might have a brownie, and you don't feel anything, so you might have a second brownie. So that made me think, well maybe, First problem is eating a whole brownie. Never eat a whole brownie. Maybe that's not a good idea. On the other hand, it's sort of like if I have a drink, I feel it pretty quickly. So I know I'm not, maybe not to have that second drink. So I am concerned about that. But on the other hand, unless people around this room know things, I don't know, I'm a little naive about some of this. You smoke it, or you vape it, right? It's quicker than. It's quicker, but I'm not sure that's the type of behavior you want to say, vaping or smoking is okay. So you say we're focusing people on the more unhealthy ways to adjust the product because we're forbidding them from doing it. I'm just curious in your thoughts on that, obviously, we've made a lot of progress on reducing smoking. We still have ways to go. No, so you're? So I'm just, I don't want to say it's okay to smoke now. Right. So the one point I'll start out by saying is we're talking about the concentration of THC and whatever root we're using and whatever product we're using. And THC is a psychoactive ingredient and a cannabis of 2,000 teens compared to 20 or more years before is a whole different product. Okay. It is far more potent so that no matter what root, the potency factor is increased over what anybody might remember from the past few years. So we should have the health department regulate that. Well, we won't go there. While you were inspecting the kitchen. We're not doing it now with the homegrown. We regulate numbers of plants. I get off. Do you often just? No, I'm good with that. So, but the reason I'm going to protect youth is because youth can more readily pick up something that's edible, perhaps knowing what's in it or perhaps not knowing what's in it. And it packs a potent punch. And if you don't know on the first round because you didn't give it enough time and you're still hungry, that's why I want to have a second time. It also looks just like my problem at dinner is I eat my food very fast. Yes. I'm still hungry. So the other thing is... It's gotten to my brain that I'm really hungry. We would assume within the legislation and some of it's been covered in prior legislation it would be safeguards built in so that if edibles were permissible it would not be child friendly, so to speak. So the types of products, light candy and recognizable products that are the same in every way except they happen to have THC in it. We would assume that there would be restrictions and regulations regarding that point of sale, et cetera, et cetera, et cetera. And in the document I referred to from my committee we have a whole list of those kinds of safeguards. We are to the meet on the bones in prevention programs. Without getting into the weeds, we have messaging campaigns, we have school-based prevention activities, some of which involve the actual people who are connecting with students, advising them, counseling them, but also responding to them as trusted mentors if you will when they have problems. We've seen with the SAPs in the schools to date that those relationships actually form very nicely and are worth expanding. Plus there's curriculum in schools. Within the communities, models like the Iceland models do take time to develop, but they involve important ingredients and these ingredients may sound intuitive but they actually take time to develop. One of the ingredients is actually talking to the youth themselves about the things that they want to be doing or can't do because they're not available in their community. We talk about the so-called third space which is the after-school component. The most dangerous time being between 3 and 6 p.m., 3 and 7 p.m., depending on what hours you want to use because they're not in school, they're not exactly with family and at home, and whatever happens in that space happens. It's a very productive and constructive thing that can happen in that space and we're actually starting to fund some of that in a very preliminary way across the state to really make sure that it's not just sports either. Sports is a big component but it's all kinds of other activities. Countries like Finland call them hobbies. Iceland, they have a lot of leadership activities. They empower youth. They have a lot of activities that youth can become proficient at something good and feel like they're a contributing part of their community. Another important component is parental activation, if you will. Parents have to really buy into this as much as their kids and support their kids in these activities and in this kind of a structure. And then there's a community activation piece that has to happen where communities actually all envision the kind of community they want to live in and that they want their kids to grow up in and provide the support for actually making that actualization. So there's a lot of very, I would call it intense work but work that everybody actually wants to do and recognizes this good work to keep youth out of trouble, keep them feeling empowered in many ways, having a voice, but also having them feel like they're a contributing part of the community because the other part of our youth risk behavior survey data shows that unfortunately high levels of youth don't feel connected in the community, feel socially isolated and that leads to depression, suicidal ideations, things of that sort. In addition to that, if you further look at it from a whole population standpoint there are segments of the population that have it even worse than what I've described. So if we look at socioeconomically disadvantaged people, if we look at LGBTQ community, we look at racial, you pick your parameter, you will inevitably find that they score worse on some of these adverse circumstances than I've mentioned. So we have to be very focused sometimes on how we do our prevention because there's an actual part of our population that would benefit so much more than anyone else and we don't want them to be forgotten. So I have spent a great deal of time in my life working with young people first as a teacher and as a coach and as a mom and I know that the most effective approach to keeping kids on healthy behaviors and on a healthy trajectory is the relationship that they have with an adult, a trusted adult in their life and is the combination of real, accurate information that says this is not a healthy behavior and full and open access to a variety of things that are healthy. And that's where I fear we are going to fall on our faces because we don't do a good enough job when I look at what has happened in my community in the last 10 years in terms of the narrowing of options for kids to be involved in after school activities there's no longer an afternoon bus so kids in a rural community unless they have a mom or a dad come down into town to pick them up can't participate in the play they can't do the after school club they can't go on the snowboarding trip or the ski trip that gets home at 5 o'clock they can't participate in sports these are all really resource intensive supports that are really critical to keeping kids involved, connected and active in ways that will be vastly more effective than simply having substance abuse professional in every building saying don't do it. So I want to work with the Department of Health and the administration to make sure that we're putting forward our best mutual efforts at how we achieve the kind of substance abuse prevention push and pull that we need to unfortunately the frustrating thing is we're referring to all of these model countries who have actually figured it out and know how to do it and these are all the big bad socialist countries that take all of your money away from you and thou shalt not because we're Americans and we do it better sorry to be glib about it but they're making an investment they're making a conscious investment and they're young people because they've seen the ill effects of leaving kids to kind of float and test with whatever they have access to that looks like fun how are we going to what are you proposing to show us as a citizen legislature that we can support and how we move us along that model so you know I appreciate everything you just said and when we talk about how to shave the five to ten million dollars it's really hard when you hear stuff like this because it takes resources we actually have a country in the southwestern corner the southeastern corner no country in the southeastern corner of Vermont it's called Deerfield Baptist so when you talk about Finland when you talk about Iceland how did they start they looked at their data kind of data we retired and said we are alarmed at the rate of our kids using X, Y and Z substances not only that they're out to four in the morning in the case of Iceland because it's daylight there half the year at four in the morning and they're just doing bad things and they learned that from their parents who did the same we need to make a change in that so models like that be going that way well Deerfield Valley had the same beginning too they had an infusion of fund monies from the health department and elsewhere for a regional as we call it a regional prevention partnership and invested it in much the same way that these other countries did and had the exact same curve now this is over 10 to 20 years this isn't over three months to six months over 10 to 20 years they have the same curve except the numbers are a little different Iceland and Finland have achieved much better numbers than we have in Vermont but the fact is we have come down substantially and we can show you this data and it's very compelling data when you can say if they can do it down there why can't we do it elsewhere and throughout the state because of the opioid epidemic we have coalitions developing on their own like the Chittin County Opioid Alliance Project Vision in Rutland PITR in Newport now I mean I can go on and on they're all over the state they're not all over the state and they don't have this kind of money and this kind of vision right now they have a vision for how they want their community to look because they don't want needles on the street and they don't want to have people who are succumbing to overdoses from opioids so they have a good reason to have their coalition drawn together but they're at the point where they want prevention too and just like you're speaking it does cost resources but if the evidence is based behind it can be shown and people are convinced as I know they will be that the programming we talk about works it changes the equation the way I see it because we're dealing with opioids now when the threshold is dealing with cannabis we still have alcohol which we should never forget about because it's still on number one I have high schoolers we're dealing with cannabis so we're dealing with all these things and tomorrow we could be dealing with stimulant drugs so it has to be a program that works for all the reasons you stated that engage youth engage parents and communities in ways that will just know that the outcome is going to be better and we don't have to worry about the new kid on the block that's the drug of concern it's any substance at all so you helped me state that well I appreciate it a model for tobacco use many years ago to reduce youth rates of smoking and is it possible that some of the ingredients that went into that formula that seemed to work pretty well could be translated into prevention programs for cannabis I know that along with some print which really wasn't used that much but there were clever inexpensive TV ads from LVX grants were given to communities where they presented their ideas for their community to reduce cannabis for tobacco at that time and and then people would review that and say we're going to pick these these are the best and those communities would receive some funds from the health department and you even had youth come to the state capital who were in organized groups to help the adults help youth campaign against tobacco so all of that some of that's happening and you don't know it because again it's on social media and you don't see but if I had to tell you I've had to ask you I should never put a legislator on the spot but I'm going to what do you think the most successful part of an anti-tobacco campaign for one has been in terms of what was implemented was it the things you talked about or is it something that I'm going to mention probably something you're going to mention so there's two things I'm going to mention sorry because for tobacco the CDC and other on gust bodies says there's a tripod a tripod type kind of one is messaging campaigns the second is interfering with people's ability to smoke comfortably in a sense so laws that passed for secondhand smoke restricting where you can raising prices and then the third part is taxation and I know there's been some discussion about the level of taxation in trying to find that sweet spot where you can fund all these wonderful programs make some money perhaps as a state but also where the black market or grey market or whatever you want to call it won't be as potent an adversary to do with so I know that there's been numbers thrown around in many circles but certainly the commission the marijuana commission I believe recommended the 20% excise tax and the 6% sales tax 26% tax which is the number that does fund the kinds of things we're talking about so if we learn from big tobacco we always say that alcohol, cannabis you name the industry, they learn from big tobacco because they have a very strong flavor if we learn from our experience from that in big tobacco it should be to realize that these taxation routes and these access routes are really prime areas to focus on I'm worried that if your pack of American spirits had to go up against you know somebody's home grow that they were selling on the black market that are tobacco tax revenue would plummet very quickly so I think we need to obviously the committee downstairs is going to do a lot of work on the taxation level but one of the one of the fundamental areas of focus I think needs to be in how do we in moving out of prohibition how do we try to bring the black market not snuff it out I don't think we're going to snuff it out I think we're going to have to figure out if we can bring it in and taxation rates we're going to have some influence on that John and then Jim I have two questions I believe it's very important that prevention be looked at very carefully unfortunately in this bill the bill is currently drafted barely or doesn't pay for the cannabis control board let alone for a prevention manner methods or anything like that do you have any thoughts about how we can fund a prevention program either through the budget the general fund or through a different mechanism taxation mechanism or licensing mechanism so that we can put in place prevention at the beginning not halfway through the process early on it's probably outside my scope of influence in state government to as a health commissioner but are there models out there taxation funding through taxation taxation is the model unfortunately but did any state have a tax system set up so that there was prevention right from the beginning and what I heard you say is that did not happen so that those models at least what other states have done today did not lead to a I do know that in the initial this won't provide $5 million I know that in the initial licensing issues that all happen up front there's a fair amount of administrative stuff that has to happen up front before you start selling your product there is opportunity for some of those revenues to be utilized in new ways so a lot of those revenues is supposed to go to pay for the administrative infrastructure that's required to run this operation from the state perspective but one could actually divert it to this kind of activity knowing that the state will still get what it needs eventually over time if they don't get it the moment that happens am I clear about that? yeah but I mean it would be good to hear solutions for financing because at the end of the day there's likely to be a lot of revenue through the retail sale of cannabis so how can we get to the point that we can have prevention at the front end and not in the middle or at the back end for instance the board is set up and S54 contemplates borrowing against anticipated receipts in order to fund the activities of setting up the regulatory structure of the board salaries their executive director any contracting they might need to do for technical expertise in how to regulate this very new industry conceivably within the agency of human services you could propose a similar structure that would maybe at least get the groundwork the network of these regional programs that you think will be very valuable in youth prevention and you know I mean I heard secretary go bay at the press conference the other day say very clearly there's no money to do this unless we have tax and regulate so how can we come together you know endorse a plan and a concept and put it into motion you know I do want to stress I think that this other states have really seen this thing of their playing catch-up and that's a huge problem but I think what you've hopefully what you've heard from the commissioner is the model that we can cite here in Vermont is your build-up model that is a decades long program what we're here saying is exactly what the chairs said that this needs to be for substance use prevention across the board doesn't have to be substance specific has to be sustained so we can do these comprehensive programs in order to do that what we're saying is we need a dedicated revenue stream that is going to continue to come in that's not the federal grants that come and go and up and down and have all these streams attached to them and that when we look at S-54 as it's currently drafted it does not have any language saying we need that tax revenue and like you said there will be tax revenue we'll go to that long term and that as a public health model is the most important thing that we can tell you we can go on and on about all the different ways in which we can do prevention et cetera et cetera but none of it matters unless it is funded and right now in S-54 it's not funded and there's no way to guarantee that funding will go to prevention work and that as a public health agency that is the most concerning I wanted to shift to the second question which goes to the taxation issue I know high taxes tend to lead to less consumption of various products but if you look at the Senate I can't take this inside as my own but if you look at the Senate fiscal note you actually see revenue increasing even though we're taxing marijuana because usage is increasing but the price is dropping so is the current taxation model that's proposed in S-54 the correct taxation model which is 16 yeah 16 plus 2% auction tax I think even if we went up to 21 you're going to see the same results because the price of the product is going to be dropping dramatically so you're right I know that it's your correct I think what's happened is the price has gone down the revenues have still gone up and I think one of the things that we're doing right now the House has done and the Senate is looking at this tax and these cigarettes what level that would be appropriate at and I don't have an exact interview on that but that might need to be adjusted I think the chair's point with the black market is you're not going to know what's going to happen in California like it's thriving or a gray market what do we call it so I think that that's definitely a piece that that's going to be in the middle but in terms of excise taxes like the commissioners said you're looking at them to drive the price up to the point where some kid is not going to be able to afford or not going to want to afford to start and that people are going to want to use less of a small tool that we can't I'm not sure we are going to put right now to tell you a tax rate that would work because I'm not sure we know what the prices are going to be I think we showed you when I came in here about the E6 the graph that shows that each time a new tax was placed on tobacco products there was a subsequent fall in adult and youth usage quite nicely correlated so higher taxes do have the impact we want but all we can tell you is from a public health standpoint using public health data you keep increasing the tax you keep decreasing the number of individuals so sort of going back to my first question and maybe I just missed this and reviewed the governor's advisory commission of reporting on marijuana but how does the governor fund prevention and his recommendations from the beginning or is that money coming from I totally speak for him but I don't believe he actually spoke to me so he didn't have a solution either he only spoke to the issues of prevention and driver impairment needing to be told to what he was saying thank you can I go back to an issue before that can I just ask Warren first did you have a question on this topic yeah I wanted to talk to Warren first John and the doctor tobacco is very different than cannabis we have a thriving black market for cannabis we don't have a thriving black market for tobacco unless you want to drive to the aquasizony mohawk reservation so when you raise the tax on tobacco it's no surprise that consumption drops but if we raise the tax on cannabis past some point the black market simply thrives so it's very different in that regard I think you can't make a really strong correlation between the two because it's so different I understand we are coming from but I would ask that that doesn't necessarily dictate that we start to run no we may not be as high as a vision but should not be so low that you've taken care of the black market but usage is just widespread so the sweet spot is what's hard to find it's a little bit of a blind spot at this moment honestly building a plan while flying it so Jim and then Marcia and is that I see a hand over here somewhere Bob Jim so two issues initially you mentioned the impact it was having on developing brain age 22 suggesting the age B-25 oh if I was going to come out with a naive but informed public health your king for the day yes but we understand that it's 21 so my second question is maybe you folks know something that you can read into this that I can but food manufacturing facilities are clearly under the purview of the health market food manufacturer includes bakeries so it begs the question why aren't you inspecting them or lysing them the only exemption is maple yes well and we didn't want you you know adding a license to all of our sugar shacks but I mean it's clear there's no exemption because they were telling you those open rafters they're going to drop something into your I know I know I'm sorry I just can't I can't let go now before me so I'm sorry yeah no this committee is contemplating entirely new market so we so the FDA I want to go back to your question a little bit the FDA regulates drugs so they inspect the drug manufacturers they inspect the drug we don't do that the health department is not involved in inspecting drugs we don't do any of that work and that's not something that we can say oh yeah that's safe for human consumption we don't want to be I understand a little bit and that's not well we are asking for this new statute to be clear that that's not a part of what we do that's what we're at are clear that it is part of what we do that's what we're at showing money as we can barely visit the chairs you know I'm going to say that to all of you guys oh don't worry I'll see you after that I'm not asking she's not talking about that it's fine it gives a fair amount of anxiety when I text message from my employees that say health inspector is here today and I say oh good I hope you were ready Jim does that answer your question for the moment I will let them talk about it you'll talk around I'm sorry I just I got a cue going but Rob is it on this topic yeah sort of I think I know it is I'll keep it on this topic and then we're going to go to Marsha I just want to talk about your place it's part of the issue the fact that you inspecting there would be there in an official capacity and doesn't that don't you run a fowl of some federal issues as far as you know it is condoning the federal level of parts of it doesn't that put the state employees in a tough position yeah that's all we would have to have our lawyers fully fed back because right now we're operating under the hope that we would be exempted that would be a thing to investigate I think it's the other we can get more out of that we're trying to throw a lifeline that's okay we'll take it this would be a collaborative relationship Marsha I know I'm sorry just be happy thank you well question, comment we're going to make an entrance so going back to the tax issue in the mid 1990s Vermont increased its tax on spirits buying quite a lot up to a 25% retail tax and the sales dropped to less than half of what they had been before and everyone went right next door to New Hampshire so people find alternate markets and some of these products where they can get the same thing for a certain price but I understand where you're coming from on the tobacco that did work well every time the price went up we would get people to report just do that to New Hampshire as well that'd be great it's like it can go right across the board yeah frankly we're worried about that with the e-cigarette issue because we have one of the pieces of legislation you're entertaining is the tobacco 21 and New York just did that yesterday and the governor will sign it because the governor proposed it in the first place the legislature said being so sure of the sign Massachusetts has already done that New Hampshire doesn't show any signs of doing that but again the case we made was that only 1 to 2% of sales of these tobacco products are going to 18 to 20 year olds so it's not going to decimate a border merchant by not selling cigarettes to 18 to 20 year olds in terms of they've lost all their business to New Hampshire because that's a very small piece of the market it'd be interesting when all the brownies and cookies come up with a seminar because the eggs were bad and somebody says who's looking down that's fair but more to my original point I signed it to be sad that we're looking at trying to find a funding source for education and prevention for a problem that the attorney general just filled us in this morning is and has been existing for a long time so at this point the horse is out of the barn running across the field with the saddle trying to get a free ride it's just really sort of weird that's why it takes a decade to show a difference but again if I can do a parallel to the opioid crisis we have an entire generation of people that are afflicted and we're dealing with that and we've got robust treatment and recovery systems etc etc etc we've got proper strategy as you name it we now are turning our attention towards we don't want connection so as a society that's sort of the kind of things that are harder to do but the things that we have to do otherwise problems perpetuate them there's more to the chair's conversation about doing things that need to be done rather than until they should have been done any other questions for Dr. Rubin or do you have anything else that you would like to leave us with no I think we've covered pretty much everything I will say the senate health and welfare committee did ask the same question but then they tried to answer it themselves they have to hook a lot easier they tried to answer it themselves and know how challenging it could be but at the same time did feel sort of they are the health committee's part of it they really felt a commitment towards pursuing this for them because they agreed it couldn't be ignored and I think my point to you today is just that to have a bill that doesn't even think about it to talk about it explicit about the word even just doesn't seem responsible so in the few years that I've been in this building working on really earnest really life or death you know access to healthcare and health and watching really good policy move into the juggernaut of the money committee and go up onto the wall and spend the rest of the biennium there there's only there's two components that have the greatest chance of getting a default yes on any initiative and I know that you know what these components are and I'm just going to say it for the benefit of the committee and the folks around the room it has to be in the governor's budget in January and it has to have the strong support of the policy committee that is the only kind of program that gets a default yes to the 11 members around the table and the appropriations committee room and so my hope is I think you're sensing that we have a lot of interest in supporting what looks like an appropriate youth prevention and public health outreach program so we've got our yes thank you thanks for being here