 Good afternoon, everyone. With just three or four weeks left in the legislative session and the Senate Appropriations Committee finishing up their version of the budget and possibly voting on their bill on Friday, I wanted to take a moment to pick up on some of what we've talked about over the last few weeks. Every year, I put forward a balanced budget with initiatives that I think will be beneficial for Vermont. As I often say, I know I don't have all the answers, or every good idea no one does. I've also said the legislature will have some worthwhile ideas of their own. That's part of the process. And as a reminder, I've been on both sides of this, as governor and as a member of the Senate. There's always some back and forth, and typically we find a path forward. Although this year is somewhat unusual with an unprecedented amount of federal funding and record budget surpluses, the underlying concept is still the same. At the beginning of the year, I proposed the legislature a budget that included major tax relief, and historic investments in housing, combat and climate change, broadband, cell service, water and sewer infrastructure, economic development, and more. Members have basically agreed conceptually, but we have a lot of details to work through, like how much we invest and where the money comes from. Now, I know I'm never going to get everything I asked for, and the legislature has vetoed their fair share of my ideas over the years by not even taking them up, but there are some significant differences in the House budget that, as I've said, need to be addressed before I can support the bill, such as investments in housing and economic development that don't include poison pills, along with other things I want to see included, like more money for prevention, and tax relief that helps seniors, nurses, childcare providers, military retirees, and low-income working families. And by the way, after seeing today's inflation numbers, tax relief is more important than ever. I brought up these concerns before at these briefings, not because I want conflict, but because I want to be clear about what I believe is needed to make sure Vermonters get the most of this budget. And I know legislators care, too. I heard in Senate appropriations yesterday they are concerned about creating cliffs by finding new programs with one-time money that will be difficult to address in the future. And I couldn't agree more. I think I've shown that I'm perfectly willing to veto legislation, including budgets and things that might sound good on paper, but when you dig deeper, it'll cause more harm than good. And I certainly won't hesitate to do it again, if I think it's necessary. But it's not something I want to have happen. I would rather work forward, work together, to find a path forward. My team and I are always ready to have conversations to find those paths. But it's important to remember, voters across the entire state, in all 14 counties, elected me to represent them in this process. And I get a vote, too. The reason I feel so strongly about how we end this session is because we have an opportunity to set Vermont on a transformational path to a better, stronger future. We simply can't squander it, and we only have a few more weeks to get this right. So as the rubber meets the road with the German approaching and legislation now moving, I want Vermonters and legislators to know I'm still at the table, ready to do what I think is right. So we take full advantage of this once in a lifetime opportunity. With that, I'll turn it over to Dr. Levine. Thank you and good morning, everyone. It's afternoon now, I guess. My comments today, I'll start with the BA2 variant, since that's driving a slight uptick in COVID cases right now. We continue to monitor our data very closely. However, this is not unexpected with this subvariant, which is even more transmissible than the original Omicron variant. As this first graph illustrates, we are in a very different time compared to our original Omicron experience. We've had a 29% increase in our seven-day average of numbers of cases. You can now see a very slight uptick in that plateaued area of the graph. But again, it's actually an order of magnitude different than the original Omicron. The good news is, so far hospitalizations have increased slightly as well, as you can see on this graph. But it's again, nothing like it was at the peak of the original Omicron. We remain very focused on hospitalizations because it means most people who are getting infected are not experiencing severe disease, or as the next slide shows, ending up in the ICU. Today there were a half a dozen people in an ICU. And talking about the hospitalizations, you may be aware that our neighboring state, New Hampshire, is now listing their hospitalizations in a very different way. Only listing hospitalizations where the patients received medications appropriate for COVID, as a way of identifying those who are in the hospital because of COVID, not just with COVID churning up as a positive test. We are still characterizing hospitalizations as anybody who has an association with COVID, whether because of COVID or with COVID, is still counted. But the hospitals give us on a weekly basis a report. And this week their report was that 40% of those in the hospital labeled as COVID were there because of COVID, just to put that in perspective. And then finally, of course, this is of the most lagging indicator deaths. And we continue to track this very closely. I can show you the dramatic drop-off in the month of March compared to the preceding three months. And now we have in the first dozen days of the month here two deaths in the month of April. We'll be keeping close eyes on all this data over these ensuing weeks. Though I do want to remind people, BA2 has been with us for quite a number of weeks yet. So a little unclear on how long it will stay. The protection of the vaccines and the relatively milder nature of BA2 for most people are hopeful signs that we can weather serious impacts to Vermonters and our healthcare system from this latest version of the virus. But we know that the virus is not going away. Just like you might get a cold or any respiratory infection, you can still get it. At last note, it was noted that up to 50% of Americans may have had Omicron or a previous version. But with the right tools, the virus does not need to upend our lives. You can protect yourself and others by being up-to-date on vaccines, getting tested if you have symptoms, or if you're a close contact and you're not up-to-date on vaccine, staying home if you're sick, knowing about treatment options if you're at higher risk, and taking any additional precautions like wearing a high quality mask based on your own personal risk because there will still be the possibility of clusters in indoor environments as a number of high profile cases on Broadway and in Washington, DC have illustrated last week. But based upon our current local and regional data, there is no need for any new mitigation strategies at this time here in Vermont. On the testing front, I want to remind Vermonters that if you're using antigen tests, be sure to use both tests in the kit at least 24 hours apart. That's why they come two to a kit. And if you test negative, but you are still concerned that you could have COVID, our test sites also offer take home lamp tests. While lamp aren't PCR, they should be considered a PCR equivalent because they are nucleic acid amplification tests and they provide a quick result as well so that you can then help protect others from further spread quickly. And thank you to those who are reporting their take home test results by visiting our website. Indeed, last week we had a record number of test results reported over 1,000. I've also been getting plenty of questions about second booster shots since the CDC updated its recommendations to allow certain people to get one. Before I go any further, I first want to emphasize it is the first booster, the so-called third shot, that is actually the most important. There's good evidence that the first booster is indeed protecting people from serious outcomes. This is why being up to date includes getting your booster if you're age 12 or older. So if you haven't even gotten your first booster shot, I urge you to do so, especially if you're at higher risk. Now for this second booster or fourth shot, the CDC and FDA are allowing people age 50 and older to get a second booster, as well as immunocompromised people age 12 and older, or if you got two shots of Johnson and Johnson. The difference with the wording around the second booster is you may get it, but not everyone should get it. I believe it will be more beneficial for people age 65 or older or people age 50 to 65 with underlying medical conditions. If you're under age 50, it should be a consideration if you're immunocompromised or if the only vaccine you've received to date is two doses of Johnson and Johnson. Now people who are eligible can choose whether to receive this dose based on their own personal risks, a family member who's at higher risk or their own comfort level. The second booster is safe and we support for monitor's decisions in whether getting this dose makes sense for them at this time. If you're uncertain about your risk or about getting a second booster, please talk to your healthcare provider. And finally, and I've spoken here many times about the impact of the pandemic on many other aspects of our lives and our health. And unfortunately, the data continues to show its negative effects on substance use. Our latest data recently released shows the number of opioid related fatal overdoses in 2021 increased 33% from 158 deaths in 2020 to 210 in 2021. Now of course the pandemic is just a contributing factor. The involvement of fentanyl as a major factor in these deaths is also very evident and increasing, increasing from 88 to now 93%, which is alarming as it can be deadly even in small doses. Fentanyl even factors prominently in white powders advertised as stimulant drugs like cocaine. Now we're incredibly saddened to see this increase, especially because it comes on the heels of a significant decrease in deaths pre-pandemic in 2019. And we continue and have redoubled our efforts to promote harm reduction and to connect Vermonters with help and treatment. We encourage people who are using any substance, including cocaine, methamphetamine, pills, opioids, as well as their loved ones to have Narcan, know how to use it and know the signs of opioid overdose. Even when Narcan is used, it's become even more important to call 911 for a full assessment following an overdose as we continue to see other substances such as xylazine which is an animal anesthetic agent involved in opioid overdose related deaths. This is because naloxone may not be as effective in fully reversing the opioid overdose when other substances like xylazine is present mixed with fentanyl. For more information on harm reduction strategies and where to find free Narcan kits, visit NoVermont, K-N-O-W-O-D-Vermont.com. And for people interested in learning about what harm reduction treatment and recovery services are available in Vermont, visit our Vermont help link.org website. The isolation caused by the pandemic coupled with the stigma surrounding substance use disorder may have prevented people from getting the help they needed. But we want people with this disorder to know they are not alone. There is help available and recovery is possible. Turn it back to the government. Thank you, Dr. Levine. We'll now open it up to questions. I spoke to the pro tem yesterday. I spoke to the speaker last week. So we try and meet every week and we've agreed that we should do that through the end of the session. So we're in communication there. Some of my team have been of course in contact with the appropriations chairs and other chairs of jurisdiction of some of the bills that we have concerns about. So we're talking. We're trying to articulate our position and trying to make a difference so that we don't have to, so that I don't have to veto bills at the end of the session like to at least make it known what our issues are and then find a path forward if possible. If so, what's different about this version than the other two bills you didn't support? Yeah, it's different than the first two bills and we're at a different time now. And I think that again, I will sign this one if there's nothing technical or wrong with the bill, but it's come a long ways. And so I think we've gone through a court case and it's basically codifying the results of that. So I think it's fine. It'll be used as precedent in the future regardless of whether this bill passes, but I think it's fine the way it is. So the settlement had something to do with it? The St. Joe Bain settlement? Sure. I mean, we got through a lot of that settlement period and I think that the Attorney General represented us well during that point in time. So again, we're in a much different place than we were four or five years ago. Any position in Philadelphia to read St. Joe Bain? I haven't followed that, to be honest with you. Obviously, every jurisdiction is going to have to make decisions about what they do, but we're in pretty good shape here in Vermont right now as Commissioner Levine had articulated and showed by the graphs, but you might have more on that situation. I ask only because the metrics are strikingly similar to Vermont's in terms of the curves that they're looking at and the percent positivity, the other case counts. Yeah, when you read between the lines in terms of what their city health commissioner commented upon, two points, number one, they had a much greater than 50% increase over one week so they were concerned that they were seeing the beginning of an ascent that they were uncomfortable with and they were uncomfortable with it because of point number two, which was they felt that they were disproportionate inequities around their city that they had already seen as part of this two year pandemic and that those populations at highest risk, they didn't want to have subjected yet to another surge in cases and if they could prevent that, they felt that the density of population and who's in their population would benefit. Do you think it was a sound analysis that resulted in a sound updating guidance? Well, I think it's a very cautionary thing. So, you know, time will tell. I don't know the appetite of people in Philadelphia for getting more stringent again with mitigation strategies. If they're like people around the rest of the country, you know, you observe it yourself, walking around, even here in Vermont, most people are kind of not in the place where they wanna hunker down again, so to speak. But I'm not here to criticize what they did in Philadelphia. They are a much densely populated urban setting with a much more diverse population than we have in Vermont and I can respect their reasoning. I don't think we're gonna see a cascade of that happening around the country, though. And I have a question for you, Dr. Levine. That's unusual, right? The vaccination rates in Philadelphia are the same as Vermont. I mean, do they have a... That's a great question. Pennsylvania in general, the vaccination rate is respectable, but not as good as Vermont. I don't know about Philadelphia specifically. To follow up on that, the New York Times, as you might have seen, has Vermont rated as having the highest rate of spread in the country right now. We're already hearing anecdotally about disruptions in schools. At what point does the state's posture go from a word, we're keeping an eye on it to we're somewhat concerned about it? Yeah. I'm not sure what that statistic is, the rate of spread, how do they... The reported case counts, maybe? Yeah, the report, which not all states report the same as Vermont, I don't believe. Right. I can tell you that we've had discrepancies in the data before based on the data that they scrape versus what we have in our own database. So that's one concern. We'll look at what the CDC community levels look like later this week when they get put out on their weekly basis, but at last look, all of Vermont was green except for four counties that were yellow. So we'll have to watch how that goes. But again, you try to predict based on where your curve is going, what is happening. And we're looking very carefully at that slope of that curve, which is drastically different than where it was not too many weeks ago when we were in full stage of Omicron. But we're also, again, though I understand cases are disruptive, we're again focusing as much as possible on the serious outcomes, which is also what the CDC community levels do. So we certainly don't want to see those take off. So we will keep a very close eye on that. Dr. Levine, perhaps for you and Secretary franchise on the line, are there any discussions right now about changing the guidance for schools if there are worries about clusters forming like the cluster we've seen pop up like in New York City, say or something like that? Yeah, so when clusters form, the best thing that can happen is people have identified early and taken the right strategies to isolate themselves and not allow the cluster to continue on. That would be in any setting. And that's where we tell people to use their judgment if they feel comfortable going into a sporting event or into a concert or what have you versus if they don't feel comfortable based on the level of transmission they're seeing around them. And the schools, I'll let Secretary French respond, but there's been no plans to change the strategy of looking at the community the school is in more than focusing all the attention on the school itself. Secretary French? Yeah, I would echo, I was just looking at one of my emails this morning from a superintendent in the Northeast Kingdom giving me a heads up that one of their elementary schools was gonna close and just some of the circumstances around that I think are less sort of of the issues. So we have cases among their kitchen staff, so meaning it was going to affect their operations relative to student meals, again, an operational impact. They were having a dance to involve a lot of students at the elementary and middle schools over the weekend. And also the AAU basketball was starting up. So just the point that I think each school's you'll look at the circumstances on a community by community basis, but just underscore the fact that schools aren't isolated from their communities and all these activities that are related and are around schools often contribute to their disposition relative to the virus. So schools aren't necessarily a special environment in that regard, but I'm also hopeful we are seeing some cases increase, but we're also coming up on to April vacation here next week and the weather's getting warmer. So I'm optimistic that schools will be able to manage next couple of weeks pretty well. And Calvin, just to follow up on your question with one other piece. I think if you really start looking through all the news media, you're gonna be hard pressed to find someone who actually predict for you which way things are going and what the modeling shows. You haven't even heard the word modeling for a while because people, you know, frankly, we've said this before. We learn from this virus every day. And though we've learned a heck of a lot in the two years, we've experienced it two years plus. Very few people feel they know what is it going to really happen with BA2 in a very definitive way. We can make very educated guesses and try to do the best we can, which we will continue to do. But you're not seeing a lot of people going out on a limb and saying, oh, this will be over tomorrow or this is gonna flare up and in a month we're gonna be in a disaster. They're saying very little about that and just respecting the data and following it closely. Thank you. Pretty dire concerns about the expiration of pandemic era of federal nutrition assistance programs despite the fact that spiking the ban we saw with the course of the pandemic has not waned. And I'm wondering broadly what you think the state's obligation is to backfill some of the federal revenue on which local nutrition programs have been relying on to meet increased demand. Are you talking about in schools or just in general? In general. We can talk about universal preschool meals. The food bank has a $6 million request in for FY23 that was not in the House budget. I'd love to know what you think about either of those but just broadly, conceptually, what role do you think the state has in making sure there's local. We've invested a lot of money in entities like the food bank throughout the pandemic. And so we, again, wanna make sure that people are fed and make sure that they have shelter and all the basic needs. So we'll continue to do that in the best manner possible. I think what we're going to see possibly sooner rather than later is more in terms of inflation than pandemic, right? I mean, the inflation is really taking over when we saw the numbers today impacts like everyday Vermonters, workforce, as well as those who are living paycheck to paycheck week to week. So that's why I think it's important for us to get this budget, right? For instance, we're giving tax relief to people who need it for the broadest section possible. And that's why I feel my tax proposal is better than the house tax proposal because it helps a broader cross-section of Vermont from all extremes to seniors, to those, what childcare needs and so forth. So again, we'll do what's best and what's right and we'll continue to take care of Vermont or of a compassionate state and we'll continue to do that. But do you think we need to be directly more public state, public dollars towards nutrition assistance program? Well, again, it depends again. I'll defer to the agency of human services to do whatever we think is best. And we'll continue to have these conversations with legislators on this, but to view just one segment of all the things that we do, I think we have to look at this more holistically. And I think we're doing that to be perfectly honest with you. Governor, just like on that message on that note about inflation, what message do you have to everyday Vermonters that are dealing with these higher prices? Yeah, I mean, we're not the only ones, obviously, feeling the burden here in Vermont. It's across the country, but also across the world. I saw in France where it's really overwhelming their economy and whether it's the war and Putin's war in Ukraine or just the supply and demand as a result of the pandemic or the labor demographics we're facing here in the state. It's all this perfect or imperfect storm that's really affecting the cost of living. We had a problem before this and this has just exacerbated that. So that's why I'm so focused on making the right investments in the budgets and all the money we're receiving, the federal funds we're receiving so that we can be better in the future. We can't just use it for one-time needs and then face this very real issue 12 months from now. It has to be strategic. I have to look at these as investments with the one-time money because the one-time money isn't going to get us over this. So again, we're doing all we can. Hopefully the price of fuel is coming down. Hopefully that'll get down further because I think that really impacts more than we know because of the price of food and all the costs of goods because everything has to be trucked and transported. So we're doing what we can but we can't control inflation but we can control what we do. We certainly can't raise taxes on people during this time because that would impact them further. So we can do what we can to not increase inflation but again, this is a global problem. Yeah, I was gonna say just another story is just the New York Governor was arrested. Was curious if you had any comments or reactions to that? They had their share of problems in New York over the last couple of decades. It seems like both Lieutenant Governors and Governors have had their share of issues. So it's unfortunate. I don't know the circumstances and I'm thankful we don't have that here in Vermont. So lawmakers are calling on you to denounce remarks made by the chair of the Burlington Republican Party related to legislation dealing with transgender. Yeah, I always really, I saw that actually a tweet by Senator Rahm and if you look at the story that it's attached to, I did condemn him. So I don't know what the story, I don't understand it myself. I was bewildered. I'm sure if you read the story, you'll see that I condemn those remarks. Governor, has the decision been made yet to run again for Governor? Not by me, no. But over the weekend, NBC5 aired an interview with you and it wasn't on camera, but for the tools for it that better that we can't go home for people in Montpelier. Well, there needs to be an adult in the room. Can you expound on that? What did you do with that? Well, there needs to be someone who is in the control tower, making sure that they were looking out after the entire state. Sometimes that doesn't happen when we have so much money coming into the state. I mean, there is a feeding frenzy and I think it got to some legislators that especially the chair of Senate appropriations. And again, it looks like a lot of money, but it gets spent very quickly. So someone, and as a group of us, I think they have to look at this from a 40,000 foot view and we can't do everything that everyone wants us to do. And so my comment really is that you need to look at this from a wider perspective and as someone who is elected on a statewide basis and not individually by a county or by a certain district with a much smaller contingency, I think it's incumbent upon the governor to do just that. I mean, a governor, like on an engine, a governor is like a rev limiter, right? To make sure that the engine doesn't over rev and self-destruct. And that's what the governor has to do here as well is make sure that we're doing the right things to make sure that we don't do harm to ourselves. Being the legislative leader is on a regular basis to hash out budget disagreements. And then you're also saying publicly threatened to veto it. And then you say, you know, there needs to be an adult. Would you say, qualify that as a civil relationship? It's very civil. And this isn't personal. I mean, we see the personal attacks. I mean, you can see them against me on social media and from others. I mean, they're personal attacks, but I've never, I've not done anything personally. It's just we have a difference in a philosophical, political slant, but it's never personal. I like the speaker. I like the pro tem. I like a lot of the legislators. If you go to one of our coffee hours, you'll see people from both sides of the aisle. And we have great conversations. Doesn't mean that we have to agree. I mean, that's what a democracy is about, right? Having civil disagreement, respectful disagreements. And I've always, always had those, always. But it's nothing. I wouldn't say, what I'm saying here to you today is nothing that I haven't said to them. So I don't, I don't see that as being disrespectful or uncivil. Have you said, you know, there's only to them 30s of you in the courtroom? I mean, that was taken maybe, that was something I said after the camera. I mean, I talked about that, but that's not a, I didn't take that as derogatory. And if somebody is taking it differently then I apologize for that, but it wasn't meant to be disrespectful. I think they would say that they, they have to assume those roles in their own positions within the legislature at times. I mean, we can't, we can't satisfy everyone. Dr. Levine's opening comments about the overdose crisis. House Bill 728 puts forward a number of harm reduction solutions and potentially sets up a four task force to look into creating safe consumption sites for drugs. What, what do you make of that? Well, again, we put together a package that had a lot of prevention dollars associated with it because we, we see the need. We've always talked about prevention, recovery, retreat treatment and enforcement as a way to combat the, this epidemic. So we, they've decided not to move forward with our package. We're not done yet. We would like to see some of those provisions included, but safe injection sites in particular, I haven't, I've said publicly, that's not something that I'm interested in, but, but again, there are New York City, I think is doing it. There's some urban cities with lots of population that are trying it, but I don't know, I don't think that's the answer for Vermont. We, we unfortunately, we've seen a turn since the pandemic, we felt like we were on the right path, but fentanyl has really changed that. And it's, it's not just us here in Vermont. This is again, across the country. Other states are facing the same thing that we are and it's, it's overdose deaths as well as suicide deaths are up, even deaths on our highway, highways are up. It seems like this risky type behavior has changed things, but fentanyl has really changed the game a lot. Dr. Levine? Yeah, I think their bill refers to a, like a work group study. So that's, you know, certainly not the same as erecting a facility and staffing it. So hopefully that means they're sort of on the same page as the health department, which is we need more compelling data to really make that a core strategy for Vermont. As the governor said, it's exclusively been in urban settings, whether you're in Sydney, Australia or Vancouver, British Columbia or now New York city is the only ones in our country. And, you know, people would have to drive back and forth in Vermont to get to such a facility and God forbid they were under the influence of medications during those times that would be a significant problem. There's no question that people do not die within the facility. God forbid that would be a failure of the whole concept of an overdose prevention site. So knowing that is not the same as the level of people, of the rate of dying from an opioid overdose changes because you have those sites. It just means while you're in the walls of that site you will not die from an overdose because you're being observed. We've looked at heat level analyses around Vancouver and it turns out that though people aren't dying in the Vancouver site, they are dying in the neighborhood at similar rates to what was happening without the site. It's also an important concept of connection to treatment, making sure that this overdose prevention site is a site that can eventually get persons who are willing to get treated and not again have to live their life under the influence of those drugs. And the bottom line is that has not been shown very much as an outcome measure that would make us say that's a really good thing and we should embrace that. So a lot of issues, and I did wanna pick up on the governor's use of the word prevention too because certainly this is a way of preventing death from a harm reduction standpoint, but some of the proposals that were forwarded as part of the governor's initiative are actually true primary prevention in terms of again work with our youth and with prevention coalitions around the state. And these ultimately are the things that are going to help us the most in all of substance misuse, not just opioids. If the opioid religion gets decreased within 500 meters of the safe injection site itself, but not outside that zone, then why wouldn't you read that as a triumph of the safe injection site and parts nearby? Yeah, no, it is a triumph of the safe injection site, but if you think about it, an individual who has the level of addiction to an opioid that makes them want to actually be observed in the safe injection site is probably injecting three, four, five, maybe more times a day. So are they going to be living at the site in 24 seven? And that's their whole existence? No, because that's not what happens. But at the same time, the injection that was observed was done safely, but what about the other injections that are occurring? And if the density of overuse of opioids in the neighborhood of that site is sufficiently high and you're not actually making a difference for the overall death rate in the area, I'm not sure that's a win. It's just a very, you know, there are many other strategies that also cost millions of dollars that can be very helpful in opioid overdose prevention and death prevention. So I would like to see more evidence that this specific strategy does the same thing. Believe me, I'd love to try everything under the sun to try to prevent more opioid overdose deaths, but we do want to make sure they all are ones that are very evidence-based and can be successful. That we had going into the pandemic, the Hubbins Code Program, very effective and a national example. Has the state gone away from that? Is it abandoned? No, actually, Hubbins Spoke continued to flourish if I could use that term during the pandemic and there are now more people connected to treatment through the Hubbins Spoke Program than there were pre-pandemic. And there were a lot of clever strategies, many facilitated by the federal government actually, to help us keep people within treatment. So if you were at a hub, which is more complex addiction specialty center, with addiction specialists at it, many people getting methadone at that site, there was an opportunity to have to go there less often and have more so-called take-home doses which continues to this day. If you were at a spoke, meaning perhaps your primary care physician and getting buprenorphine, there were opportunities to get a prescription of a longer duration so you wouldn't have to continue to go back and be exposed in a healthcare facility to other people, et cetera, during the pandemic. And that was facilitated by federal payers as well. And telehealth became, of course, not only important for all kinds of healthcare but also for substance use healthcare. So a lot of things happened. Hubbins Spoke's system is continuing to thrive and busier than ever. Strengthening of the system or changes to be made? Yes, there are actually lots of things in the hopper with regard to potential changes in the system, not the least of which involves more adequately and expansively treating mental health issues which so often co-occur with the primary substance use issue. Colin Flanders, seven days. Hi, thanks. I'd like to continue on this topic. Governor, I'm curious if you could outline for us the main differences between the way that you would like to spend the substance use prevention money in your budget versus the house's proposed budget. I understand that this is one of the big issues that your secretary of administration has raised recently. Do you tell us sort of what the differences are and why yours is a better idea? Yeah, well, again, from my perspective, it's focusing on the initiatives that we've been working on for a number of years, prevention, treatment, recovery, and also enforcement. So those are the, that's the primary focus for us and we've, prevention being key and I'm not sure that the house bill does that and that's my primary concern. Dr. Levine can elaborate. And I'll provide the caveat that this is legislation in process, you know, things just crossed over, Senate is addressing things, so nothing should be considered final by any means. There is a significant amount of overlap. Governor's proposal did have money for recovery built in and specifically recovery housing to try to keep any success made in the treatment arena continuing through the person's life into their future, which is really critical. The legislatures focus a little more on treatment and aspects of the treatment system that we felt perhaps were already in play and didn't need to be refined in any other way. And then the bigger focus on, again, these prevention coalitions and prevention activities for our youth to make sure that we have an equitable statewide opportunity for any youth to benefit from these kinds of programs and from their communities to benefit from these kinds of programs, which currently the federal funding does not allow us to be as equitable in every arena all the time just because of the on-off nature of much of that federal funding. It sounds like from what I'm gathering that some of the differences between addressing more upstream prevention efforts or more downstream prevention efforts and I'm curious given the recent news that last year was the worst year for overdue system, I just want to get your reaction. Like why wouldn't it make sense to focus more on downstream given that we just had the worst year? I think the way the House Budget Writing Committee chair put it is that if your house is on fire and you need to put your house, you put the fire out before you get started. Can you talk a little bit about that? Sure, I mean, if you look at the main reasons why things probably got worse. Besides fentanyl, which we acknowledge is in everything now, it was to some degree related to the isolation encouraging part of a pandemic. Indeed, we all suffered from isolation, but if you already have a preexisting substance misuse disorder, you probably will suffer more related to all of the stress of the disorder and the stress of the isolation that you're now encountering. When you're isolated, you're not injecting with others, so if you do have an overdose, who's there to observe you and rescue you? That was a very big part of the issue. You're also probably going to be subject to a different dealer and a different line of powders that you're perhaps not accustomed to because that supply chain was another supply chain that was disrupted during the pandemic, so often people did not know what they had and perhaps were not as suspicious, if you will. So there's a lot of reasons that I don't think legislation is going to fix. I think getting out of the pandemic is going to fix, and there's a lot of preexisting infrastructure with regard to our ability to provide rapid access to medications for opioid overuse disorders in emergency departments at all of our syringe service programs around the state, and these are very effective strategies that can now work much more better in a less pandemic-driven environment. A lot of it seems to be chalked up to behavioral changes versus gaps in our treatment. Do you think that our treatment program or the statewide treatment, common spoke model, you think it's adequate right now, we don't really need to increase or change the way we're doing things? No, I do think there's always opportunities for improvement in the program. However, access to the program has not been the big issue and we continue to not have waiting lists, we continue to have more people getting treatment than ever before. So again, there's 37 or more states that can also say that the pandemic was harsh on their state with regard to these kinds of statistics. So we're not alone in this and we all need to sort of rally back and try to get back on track where we were and look for improvements. Thank you. Tom Davis, Compass Vermont. Thanks, Jason. Governor, good news, no questions today. Another gold star. Thank you. Tim McQuiston for my business magazine. Hi, Governor. Dr. Levain had answered this question via email to me, but I thought a few were going to be said publicly also, are there any medical conditions that would prevent someone from who is otherwise eligible from getting vaccinated? The only condition would be if you had a very serious reaction to the vaccine. So that would generally be in the anaphylaxis realm. But in terms of a medical condition, it's very rare for a physician to tell their patient no matter what they have underlying as conditions that they should not get the vaccine. And I think the track record of the vaccine supports that it's done well across a very broad population. And I think that's what's really expressed today. Thank you, Ed. Guy Page from Montbelly Chronicle. Thank you, Guy. It worked. County Courier, Hanco, Beachy Digger. Hi, can you hear me? I'm starting a little work here. No, we can hear you just fine, Erin. Okay, great. I think that this question is for Commissioner Levain. Looking at the budget report put out by the agency administration, which covers the kind of different recommended funding levels for different agencies. It appears that the budget request for the department of health response to the COVID pandemic is going from about 62 million in fiscal year 21 to about 25 million for upcoming fiscal year 23. And I was wondering, why is there such a significant shift? I know that there's been some changes with you guys do things, but is there anything specifically that you are dropping that is responsible for that not quite 40 million dollar decrease? Some of that might have to do with the federal money flowing through. I think a lot of it does. I don't know if Commissioner Greshin is on or Secretary Clouser. Talking about the healthcare stabilization response. You know, I'm now 100% sure this is the PPMB and I'm going through the department of health different categories under COVID-19 response. They have FY21 actual expense, FY22 estimated expense, which doesn't actually have anything in it. And then FY23 budget request for governor's recommendation. And that's where I'm getting the 25 million dollars. There was a request for 25 million dollars of additional money in the healthcare stabilization fund. But I think it might make sense for us to take this offline and we can get some additional details and I'll work with the department of health to get you that specific information. Okay, all right, thank you very much. I think that's about it for me. Thank you. And we'll go back to Greg Lamarro, the County Courier. Greg, I can see you on there and it says you're unmuted, but we can't hear you. Looks like you just muted yourself. One more try. Maybe he could text the question to you. We got you now. We just heard some sound come through. All right, Governor, can you hear me now? We can. All right. Governor, I've noticed the influx in campaign-style lawn science cropping up around the region, advertising opportunities for employment at Northwest Directional Center. Obviously, they're in the safe boat that many employers are in, having a hard time finding employees, but in the past, V-TRANS has had a policy that signs of this nature would be picked up by V-TRANS employees if they were positioned in the right-of-way and state highway. However, it doesn't seem that this is happening with the Northwest Directional Center advertising signs. So at least it seems like a double standard, but especially in a year when we can expect to see an influx in campaign-style signs coming down the road here. Yeah. And that's not to mention that it's kind of borderline violating a billboard law. So I'm wondering if there's been any directive from upper management and state government to tell V-TRANS workers to leave the state-sponsored signs alone, or if this is just something that happens to be. I would hope that it's the latter, because there certainly hasn't been anything from the fifth floor telling the V-TRANS and not to pick up signs. If they're in the right-of-way, they need to be picked up. And I don't know if Secretary Flynn is on today. No. We can, well, I'll have Secretary Flynn call you, but I don't, I would hope that's not the case. There should be no double standard. We should adhere to the same rules and regulations that everyday Vermonters have to. That's it. Thank you all very much. See you next week.