 We had the preparedness at 2.45 and I see David Hurley. He has joined us. So We're gonna have In case just for your information the reason David Hurley is here is probably not terribly obvious since he's the director of the medical board but we put some language in the preparedness bill that affected the medical board and their ability to function in in an emergency. So when we get to that then we'll see if he's still in agreement or if he has additional things for us to consider. So that's why he's with us. So I don't know Tucker and Amron. How do you propose doing this? I'll just turn it over to you and you can do a nice little walk-through for us. That's what we plan on doing a nice little walk-through. So for the record Tucker Anderson with the office of legislative council, would you prefer a high-level overview where we focus in on some of the details that you put into the bill during the COVID response? Or would you prefer a meticulous and thorough walk-through of each section? Committee, what do you think? I think at this point a high level. Okay, that seems to be the consensus. Okay So to refresh everyone's recollection, this language was originally contained in S-354 as it passed out of this committee and eventually the senate. When this bill reached the house towards the end of the September return session the house took these provisions out and replaced it with a COVID emergency provision allowing Australian ballot voting at the annual meeting. So S-354 turned into the temporary authority provisions that municipalities used to convert to Australian ballot for the 2021 annual meetings. I will walk through the first I believe six or seven sections of the bill that deal with open meeting law, municipal quasi-judicial proceedings, municipal utilities and water utilities in general, and the transfer of certain municipal funds in the case of a declared state of emergency, which is really just a repeal of an existing prohibition. And then I will hand it off to Amron and try to coordinate my scrolling abilities with her excellent walk-through abilities. The first the first section of the bill codifies the temporary open meeting law provisions that the general assembly passed in response to COVID-19 to bring everyone back to what happened starting in the spring. First, the general assembly temporarily authorized any public body in the state to hold a fully electronic meeting without designating a physical meeting location. The open meeting law does require, when you don't have that temporary authority, that a public body designated physical location where either a member of the body or a staff member is present and where the public can access and participate in the electronic meeting. That was suspended because of the close personal contact prohibitions that came out in the spring. Then the general assembly went on to allow electronic posting of notices and agendas and some other minor alterations to essentially allow fully electronic meetings. In the codification that is in front of you, you are setting up the automatic trigger for all of those provisions to happen again. This section starts by defining what an affected public body is. An affected public body is anybody whose regular meeting location is located in an area affected by a hazard and they cannot meet in a physical meeting location due to a declared state of emergency. Last year, a lot of questions came up about what a hazard is. Hazard is defined here as an all hazards as that term is defined in Title 20. To bring everyone back to the discussions that happened in the fall, an all hazard covers natural disasters, public health emergencies, nuclear war, insurrection, and other significant events such as chemical spills. Let your imagination run wild about what a significant event requiring a declared state of emergency might be. These first sections allow during a declared- Madam Chair, may I ask a question? I don't know if you can see me. This does not let, let's say there was a severe ice storm and a town had to make, the select board had to make a decision, but nobody could get to Town Hall. It wasn't necessarily, there wouldn't necessarily be a declared state of emergency in that particular town. How could a town use this when it isn't a state, you know, isn't statewide? The answer is they could not. The answer is that this section and the bill is, it was introduced by the committee last session, doesn't address that issue. This is really only about when the governor declares a state of emergency for the whole state or region of the state, perhaps a particular municipality. In the event that there is some sort of localized significant event and the governor has not declared a state of emergency, the answer would be that the municipality would likely cancel their meeting and post a notice for a future meeting potentially in a different location. Or there are other provisions that allow, for example, you can cancel your regular meeting and announce an emergency meeting in its place, have an electronic meeting with a designated physical meeting location that is elsewhere, but that you have made a press release about so the public is aware of where they have to go. I think the hope of this was not to deal with every, every emergency that might happen in one town and not someplace else, but more, more regional or statewide ones and ones that would really prohibit meeting. If there's an ice storm in Brookfield and nobody can get to their meeting, my guess is they'll cancel their meeting. They're not going to that night set up for a remote meeting. If the ice storm remains for three weeks, perhaps the governor declares a state of emergency in Brookfield. It doesn't have to be statewide. I hear you, but I could also see something that would require an emergency meeting that there might be a hazard that would occur an emergency in a community or in a region where it hadn't yet been declared an emergency, but they had to meet to make decisions about something important that was pressing. Anyway, I can see, anyway, I just, this is great. And I know we did this last year. I just, as we have thought further about it, I just am trying to think as flexibly, giving towns as much flexibility as possible. Well, we should definitely, as we go through this, Bill Moore, we'll hear from the league about whether they have some suggestions about that. Yeah. Okay. All right. Tucker? Subsection B allows during this declared state of emergency, first for the public body to meet without designating the physical meeting location, it suspends the requirement that a staff member or a member of the public body be present. And it allows the public body to place their notices in electronic locations in lieu of designated physical locations. And remember, that is a specific requirement for municipal public bodies. So municipal public bodies under the open meeting law have to post their notices in two physical locations in the municipality. So there are some requirements if the affected public body is going to meet electronically. First, the body is required to use technology that permits the attendance and participation of the public through electronic or other means. This is a change that was made from the temporary COVID bills, which only required that the technology permit attendance. The request was that the technology should also allow participation of the members of the public who are attending. Whenever feasible, the public should be able to access by telephone. And finally, and this is another change from the temporary COVID open meeting law provisions that are in play right now, they're required to post information that enables the public to directly access and participate in meetings electronically. And they shall include this information in the published agenda for each meeting. So if this were codified and move forward, the requirement would be if you're holding an electronic meeting, part of your agenda, you have to provide direct access to the public so that they can participate in the meeting electronically. And the discussions that you all had around this was posting, for example, the Zoom link that would allow the public to access the Zoom meeting. Unless unusual circumstances make it impossible for them to do so, each municipality and school board shall record any electronic meeting that is held. So can I go back one second here? I'm thinking about this, and I know we'll get more into detail about it. But in terms of Allison's question, we at one point, we have a paper mill right downtown Potney, right in the smack dab in the center of the village. And we, a couple of years ago, had a huge chemical spill and chemical fire there. And so no one was allowed into the village proper. It was all closed off. If the select board had been having, if they had had to have a meeting to deal with something as a result of that fire, they couldn't have gotten to town hall. Could they then post an emergency meeting and have had it at the central school, which is outside of the village proper? And somebody would have been there. I mean, there are ways of dealing with those kinds of emergencies right now, right? So the answer is that they could hold an emergency meeting where they put in the notice for that meeting the specific issues that they're going to be dealing with, which may be a response to this particular emergency. And they could designate a physical meeting location where public access is possible. Okay, great. That's what I thought. Thank you. Last piece that the public body of municipality is required under these provisions to continue to post notices and agendas near the municipal clerk's office and then to provide each notice or agenda to the newspapers of general circulation for the municipality. And in case any of you are unfamiliar, each municipality has to designate the newspapers of general circulation within the town where certain notices must be posted. So we'll move on to two sections about quasi-judicial proceedings. The reader assistance heading says municipal quasi-judicial proceedings, but there is one state-level quasi-judicial proceeding that you all worked on and that is included here. So the first section amends the Title 32 provisions around inspections pursuant to a grand list appeal of a property. To bring you all back to the work that you did, this issue was around in-person inspections of property. The Listers, the Board of Civil Authority, whoever's performing this sort of inspection was required to perform an in-person inspection of the property if requested by the property owner. And the issue that came up during COVID again was that these municipal officers did not want to be in and around the homes of individuals who are requesting this appeal. So the provisions would suspend during the state of emergency the requirement for an in-person appeal and would provide the property owner with the right to request an inspection through electronic means. So first, the municipality would suspend its in-person inspections. The property owner would then have the opportunity to say, no, I want an inspection, perform it through electronic means. And then the property owner would have to facilitate that and the two parties would carry on. This same opportunity is given to hearing officers who perform the next level of appellate inspection. Section four, dealing with the temporary moratoria on water service disconnections. This is an issue that you just discussed. It affected municipalities primarily because it prevented any utility provider for water or sewer services from shutting off those services during the declared state of emergency. The provisions that you put together here are a bit different. It maintains that any provider of these services shall not disconnect services during the declared state of emergency, provided that first the state of emergency is declared in response to an all hazard that will cause financial hardship and the inability of rate payers to pay for water or sewer services. This is one area that the committee focused on. They did not want to apply this to all hazards that could come up or all states of emergency. It would only be those that will cause financial hardship and the inability to pay. And two, that the all hazard does not require the water or sewer service provider to disconnect services in order to protect the health and safety of the public. So you didn't want to create a situation where there's a declared state of emergency and the water has to be cut off because there's contamination in the water. You didn't want to set up a moratorium on water service disconnections that would get people sick. The other addition that you made beyond what is in play right now with the temporary moratorium that's in place is that this provision states that a rate payer shall remain obligated for any amounts due to a water or sewer service provider that is subject to the section. And you put in a 90-day window for the rate payer to make those payments. Section five, you took some pieces of the temporary authority for municipal deadline extension. And here you add them to the Title 20 declared state of emergency chapter. This states that during state of emergency, municipal corporation may extend any statutory deadline applicable to municipal corporations provided that the deadline does not relate to a licensed permit program or plan that is issued or administered by the state or the federal government. And they may extend or waive deadlines applicable to those licenses permits applications what have you that are issued by the municipal corporation. So you looked at the window of authority that municipal corporations have around deadlines and certain licenses permits and programs. If there is a declared state of emergency in the future, municipalities would have the authority temporarily to extend deadlines and to continue the effectiveness of licenses, permits and plans up to 90 days after the date that the emergency ends. So the final piece here is a repeal of the statute related to town highway funds to bring you all back to the discussions that you had under current law 19 vsa section 312 town highway funds have to be kept separate and segregated segregated from general funds. There's to be no co mingling of funds at all. You granted on co mingling. You granted temporary authority during the year 2020. So we're already past the point of the effectiveness of that temporary authority for municipalities to move town highway funds to their general fund or to move general funds to their highway funds. You weren't sure where the gaps were going to be during the co vid response. Under that temporary authority, all of the money had to be paid back and the funds had to be made whole by the end of 2021. Here, you're just repealing that prohibition. This is not contingent on a declared state of emergency. This would be a permanent change. Moving forward, you are lifting the requirement that those funds be segregated, which brings me to the last point in my portion of the discussion. That particular section that repeal has a different effective date, which requires some explanation. That repeal is going to take effect July 1st, 2021. And the idea of having that as the effective date separate from the other parts that will take effect on passage was that July 1st for most municipalities is the start of the next fiscal year. And I'll bring you back and hand this off to Amron. Thank you, Tucker. For the record, Amron Aberjaley, Office of Legislative Council. I'm going to be walking through some of the sections of this bill that cover professional regulation before moving on to one last section on reserve funds for the sheriffs. So section seven here. And I will note that this actually, it says three VSA section 138. It's actually going to be 139. There will be a 138 that was already adopted last year in the OPR bill that will become effective on July 1st. So we're going to update this to say section 139. And the first few provisions we have in here about professional regulation are about extension of licenses and practicing without a license for a temporary period of time. So once again, this is only during a declared state of emergency. The director, the director, and in this case, we're talking about the director of the Office of Professional Regulation may extend up to 90 days at a time, the expiration dates of current licenses to practice the profession attached to the Office of Professional Regulation. And the director could also waive any associated fees for license renewal that would otherwise apply. Moving on to page 10. This provision, once again, around the Office of Professional Regulation, during a state of emergency, the director may authorize a healthcare professional who practices a profession attached to the office, who holds a valid license certificate or registration to provide healthcare services, to be deemed a licensed, certified, or registered to provide healthcare services to a patient located in Vermont. And this would be either using telehealth or as part of a staff of a licensed facility. And there are some parameters on here on, I guess I would say safeguards, which is that the healthcare professional must be licensed, certified or registered in good standing in whichever jurisdiction that they are presently licensed. They have to not be subject to any professional disciplinary proceedings and any other US jurisdiction. And they cannot be affirmatively barred from practice in Vermont for reasons of fraud or abuse, patient care or public safety. Moving on to page 11. A healthcare professional who's deemed to be authorized under this section will need to submit their name, contact information, and the location or locations where they will be practicing. Anyone who delivers healthcare services under pursuant to this section shall be deemed to consent to and be subject to the regulatory jurisdiction of the office of professional regulation. And the authority to practice under this section is going to remain in effect until the termination of the declared state of emergency and assuming or and provided that the healthcare professional remains licensed, certified or registered in good standing. I unfortunately was not here with you all last year so I don't have as much of the history as Tucker does on his sections. So I will have to circle back if you have any questions about the history of how we ended up here unless someone has fresh recollections of what happened last year that prompted these. I'm assuming that well let me just say should I stop here for questions or continue? I can't see if there are any questions so if somebody has a question if they would just pipe up but I will say that these came the ones around health and licensing came either through OPR the director of OPR or from the medical board the executive director of the medical board so that's that's where they were vetted. So does anybody have a question about this section? No. I don't hear any. Thank you. Moving down then to the bottom of page 11 into section 9. This provision governs inactive healthcare professionals being able to practice. This once again is only during a declared state of emergency and this authorization must be done in consultation with the commissioner of health. The director of OPR may authorize a former healthcare professional who practices a profession attached to OPR who left active practice not more than three years earlier with the individuals Vermont license certificate or registration in good standing to provide healthcare services to a patient located in Vermont using telehealth or as part of the staff of a licensed facility. Once again they would need to submit or have submitted on their behalf their name contact information and the location at which they will be practicing to the office of professional regulation. Moving down onto page 12. The returning healthcare professional is only authorized to provide healthcare services without a license for not more than 30 days and it must be pending their application for a temporary license and again the 30 days is limited to the extent that the director determines whether to issue that individual a temporary license. That is to say that if a professional applies for a temporary license and on day 20 is denied such a license they would not be able to continue practicing for those additional 10 days to reach the 30 days which it is whichever comes first the 30 days or the director's determination on their temporary license and the director may issue a temporary license at no charge and may also impose limitations on the professional scope of practice as the director deems appropriate. Any healthcare professional who returns to the healthcare workforce pursuant to this section is going to be subject to the regulatory jurisdiction of OPR. Moving down to section 10. So once again during a state of emergency if the director finds that a board attached to the office cannot reasonably safely convene a quorum to transact its business and if authorized by the secretary of state the director may exercise the full powers and authorities of the board including disciplinary authority. The signature of the director shall have the same force and effect as if voted by the board. Moving down to page 13. And then a record of the actions of the director taken pursuant to this authority shall be published conspicuously on the website of the board on whose behalf the director took the action. Moving down to section 11. During a state of emergency the director may issue such orders governing regulated professional activities and practices as as may be necessary to protect the public health safety and welfare. If the director finds that a professional practice by a person licensed or required to be licensed by the office is exploitative, deceptive, or detrimental to the public health safety or welfare the director may issue an order to cease and desist from the applicable activity. And it's worth noting that the director must have reasonable efforts to publicize or serve the order on the affected persons and that a violation of the order shall subject the person or persons to professional discipline which may be a basis for injection by the superior court and shall be deemed a violation of section 127 of this sub chapter which is the sub chapter on unauthorized practice. Moving on to page 14. We are now shifting into sort of companion sections to these prior sections but in this case rather than the office of professional regulation we're talking about regulation through the board of medical practice. So this first section section 12 gives the executive director of the board of medical practice the authority to exercise the full powers and authority of the board if it's not safe for the board to reasonably convene a quorum to transact business. The signature of the executive director shall have the same force and effect as a voted act of the board and once again a record of the actions of the executive director shall be published conspicuously on the board's website. Moving into section 13. This is a sort of companion section too earlier which would authorize the executive director when authorized by the commissioner of health to authorize a health care professional who practices a profession regulated by the board of medical practice. So long as the person holds a valid license certificate or registration to provide those health services to a patient located in Vermont using telehealth or as part of the staff of a licensed facility similar to above you have the same sort of parameters here such as the professional must be in good standing in the other US jurisdiction where they are licensed or registered or certified. They cannot be subject to any professional disciplinary proceedings in any US jurisdiction and they cannot be affirmatively barred from practice in Vermont. Once again the health care professional who is authorized under this section must submit to the board their name contact information and the location at which they will be practicing and a health care professional who delivers health care services in Vermont pursuant to this section shall be deemed to consent to and be subject to the regulatory jurisdiction of the board of medical practice. Moving on to page 16. The authority to practice under this section shall remain in effect until the termination of the declared state of emergency provided that the health care professional remains licensed certified or registered in good standing. Section 14 is again a companion section from above this time again for the board of medical practice when authorized by the commissioner of health the executive director may authorize a former health care professional who practice a profession regulated by the board of medical practice and who left active practice not more than three years earlier against the same time limit as you saw above with the individual's Vermont license certificate or registration in good standing may provide health care services to a patient located in Vermont again using telehealth or as part of a license staff of a licensed facility. Once again they have to submit or have submit on their behalf their name contact information and location where they will be practicing to the board of medical practice. Once again they are only authorized to practice without a license for not more than 30 days pending their application for a temporary license or until the executive director determines whether to issue the individual a temporary license whichever comes first. The executive director may issue a temporary license to such a returning health care professional at no charge and may impose limitations on the professional's scope of practice and that is at the executive director's discretion and the former health care professional who returns to the health care workforce under this section shall be subject to the regulatory jurisdiction of the board. I realize I went through that second half a little quickly but these sections are relatively similar to the first portion again the difference being that these are professions governed by the board of medical practice versus OPR. So before I move on to the emergency share of funding are there any questions on those sections? I don't see any hands okay I'll keep going then. So our last section section 15 is about emergency share of funding and during a declared state of emergency that affects a county in order to support the emergency needs of that county's sheriff due to the emergency the county's operations reserve funds and capital reserve funds which are described in a previous section of title 24 may be allowed to be used for the emergency needs of the sheriff subject to the approval of the assistant judges. You do have a definition in here as to what emergency needs are which in this case means the needs to respond to the emergency and includes hiring deputies dispatchers and other personnel and purchasing equipment and supplies. Moving on to our last page the funding of these emergency needs under the subsection shall be in addition to the support of the sheriff's department set forth in section 73 of title 24 which sort of lays out the basics of what support the sheriff's office will have. There's then a section on reimbursement so if a sheriff receives county reserve funds for emergency needs they are required to apply to any applicable resources for emergency relief such as the federal emergency management agency FEMA that are known to the sheriff for any allowable reimbursement within 30 days of receiving any such allowable reimbursement the sheriff's shall provide those funds to the county in order to reimburse the county for the funds that were allocated under this subsection and it's important to note that a sheriff shall only be responsible for reimbursing the county an amount equal to the allowable reimbursement the sheriff received under subdivision one of this subsection in other words the sheriff shall only be responsible for providing to the county what they are allowed to be reimbursed by the resources for emergency relief such as FEMA. Then there's a sunset for this authority the authority for a sheriff to obtain funding for emergency needs under subsection a shall sunset two weeks after the day the governor terminates the declared state of emergency and this the sections that I just covered will also take effect upon passage senator I think you are on mute I can't hear you you're right I was I was I was complimenting you oh thank you I'm sorry I missed it well done so committee I think that what we'll do is just I would like there might be other things we want to put in here and this has not been introduced as a draft yet I mean it's we have the request in but it might end up being a committee bill so we can take time to put other things in it if we want what I'd like to do right now is hear from David Hurley he about the board of medical practice section and if that has changed in any way or if you still feel comfortable with it thank you senator white and hello and can you turn up your speaker a little bit oh David we can hardly hear you is that any better no no not measureably oh there the better now oh no I think that was senator color more I'm sorry let me um I gotta change the microphone and while David's finding that uh button to increase his volume of madam chair may we take a leg break a body break as soon yes I think that what we'll do is um when we after we've heard from David we will then um unless there are any other questions about this up to this point then I think what we'll reschedule this and hear from OPR and the sheriffs and VLCT about it and if there are other issues that we want to add to it and then we'll take a little break and then hear from emergency management systems does that work okay all right David is that better now perfect okay good so thank you and I was just saying hello and happy new year I haven't seen you yet in this new year thank you thank you for inviting me to give you some feedback on this draft um and I apologize I only had a few minutes to look at it I got it this afternoon and was in another meeting but um and you know it is exactly the same as what we passed last year yeah I mean and it um it looks good on um I having had a chance to to um look it over again it's really just some some technical um changes that I might mention um and that is on page um 16 of 18 at the top of the the page where it says uh in in paragraph D where it says the authority to practice under the sections shall remain in effect until the termination of the cleared state of emergency and provided the healthcare professional remains licensed certified or registered in good standing I think it might be improved by changing it to say something to the effect of remains licensed certified or registered in at least one jurisdiction and in good standing in all jurisdictions we're still licensed so because people you know we have a lot of our licensees are licensed in multiple states and they may they may let a license drop and really you know but what we care about is they have at least one state where they are licensed and they're not in bad standing anywhere you know haven't had something come up so um and really that's that's the only um technical issue I had with it um and I just wanted to say thank you uh generally going back to the provisions about being able to hold um remote meetings during an emergency that's been critical for us to continue operations and um it's it's working I think we haven't had any complaints from the public we've had contested hearings um we've we've you know everything from uh small committee meetings that are mostly executive session to to contested hearings on on charges and it's it's worth just fine great that's good to hear thank you any questions for David I think um Emron we might want to run that change that David just made you run it by um Lauren Hibbert also to see if that makes more sense to put in their section also that makes sense I will make a note thank you thank you so much David for joining us well thank you for having me all right good to hear that the open meeting and the change those changes were helpful to you also great great great it's good to see you good to you all all right let us hear about um EMS what worked what didn't work what do we need to do where do we go from here um and I believe that um I don't know if you all yet have met um Emron I believe you are um our contact on this issue is that right um or is it Tucker which I'm ashamed to say I don't know what we're taking up right now emergency management uh yes I believe that would be me okay so for those of you who haven't yet met Emron Emron is our new Betsy Ann Rask so you will soon meet the people here who are here to talk to us about emergency management systems what worked what didn't work what they need us to do now um it's an issue we've been trying to address for the last few years and I think have made some some progress and I understand that Dan you have um this uh time constraint and so we'll turn it over to you thank you very much and we have a new committee member here I'm sorry I didn't um acknowledge that right away for those of you who don't know Senator Keisha Rom is now with us from Chittenden County okay all right well thank you Madam Chair and uh Senator it's Senator Rom it's very nice to meet you um I'm Dan Betsy and I am formerly the EMS chief for the Department of Health in August I was promoted to director of emergency preparedness so uh I'm going to be ceding this roll over to a gentleman named William Moran uh he'll be with you I'm sure at some point along the journey uh but uh I'll I'll I'll do my best today to uh to fill his shoes um I first wanted to say thank you very much because uh the efforts that you all put forth uh last year really were greatly successful uh and just to give you the highlights um the the major success was around tuition uh voucher systems that we put into play uh as most of you remember uh you gave us a pot of money for both paramedics and for uh everyone else so EMTs advanced EMTs uh and emergency medical responders uh we had overwhelming success in both of those pools we put uh we completely filled all of our resources so we used all the all the funding um we put 39 new paramedics into uh the paramedic programs that are associated with Vermont EMS that is probably double what we normally would do in a given year uh and uh that's really remarkable and I would say that if we had uh twice as much money we would have put twice as many students in uh under those circumstances because we were turning people away by the time we were were finished um we have more work to do in that including uh trying to get a handle on the cost of paramedic programs and VTC and working with them and they've been great partners in this uh but uh overwhelming success on the on the paramedic side and that's going to lead us to a heck of a lot more advanced life support providers uh roaming the streets of Vermont here in another few months so uh really great um in the other room I'm not sure I'd use the term roaming the streets but I know yeah sorry a little too colloquial there um uh in the other pot of money uh we put uh 313 additional providers uh into class seats uh and these are all remember these are all active providers in Vermont uh so so in order to be eligible for tuition voucher you had to be um uh approved by a service chief so these aren't just students at Middlebury and UVM taking a class because they want to go to a PA school or a medical school these are our folks who are actively on a roster we put 313 uh into programs and again we used up all the funding so who knows where it would have gone if we had more um and just to put that in perspective on a given year uh I'll take you back our last three years in the last three years we put on average in a year about 400 new licenses every year um and to get to that number we have to train about 600 so so again that 600 number accounts for the students that are moving out of state and don't really ever intend to be in an ambulance so in and remember we had this we received this money in August with a November deadline to finish it so in three months we put nearly half as many people as we ordinarily would in a full year into our EMS system so that is really a remarkable feat and um what it demonstrates to me at least is that we do have a financial barrier to bringing people into this system uh and you know when I when I think about how we plan ahead and what are the things that we need to be looking forward to what what what it makes me realize is if we intend to keep a volunteer EMS system at least in partially uh of volunteer nature we've got to think about what that financial barrier is because clearly there's people who want to come in who if given the financial resources to do it we'll enter our system so uh but that's for future planning but I do want to say thank you because this has been a great boon and and also keep in mind we did this during a global pandemic when two-thirds of our educational programming were shut down there were no for for the entire period of enrollment there was no classes going on at UVM there were no classes going on at Middlebury and those account for almost half of our students in a given year so you know this is really something uh that that has been facilitated through your efforts and uh uh it's been it's been great it really has been a terrific boon um we've also made significant progress with some of the other elements uh we've had some some great uh meetings moving forward looking at um uh competency and portfolio based testing I think we will have a meaningful plan in place here very soon uh you'll hear from Pat uh a little bit later today um there's a very high likelihood that we'll have a pilot project with his program coming up again I don't want to put him on the spot because there's still some work to do but we've got we've got a good concept in mind and I think it's uh something that will will be an innovative way to get people into our system coming up and then we still get a lot of work to do we've still got to work on how to sort out the other levels of instructor we still got to work out how to sort out the the new emergency responder level of Vermont first responder level um and that's uh that's a challenge right we're we're juggling a lot of a lot of uh there's a lot of balls in the air at the department of health right now but but again we've got good contributions from the um from the advisory committee we've got good contributions good people working on it so I think we're going to be in very good shape uh come time to report back to you great that that is fantastic that is great and as we go forward I would love for you all to think about what as we look at new cares money coming in to look at what might be a reasonable amount to to vote to the training aspect so um and you don't have to have any answers today but I do know that um the uh the appropriations committee is asking us to to look at that and I think it would be very helpful if we had some real numbers and then this great information here to back up those yeah those numbers well senator I think I think we certainly have a model that will inform us on this and I think we we've certainly been looking at a lot of the data behind it um and I'm happy to share any and all of that information um so so I think I think we've got good fodder for conversation at least around this good senator Clarkson so thank you Dan that is that's it you know it's just great to know when things worked and that money was well used and uh I'm glad you didn't return any of it um I'm glad you used it all um I guess I would uh uh wonder going forward I am hoping we will be able to uh appropriate significant money from the state with any stimulus bill that comes from the Biden-Harris uh 1.9 trillion they've talked about I would assume that there would be some EMS kinds of money that we could direct to booting up and really getting uh the EMS systems booted up you know staffed up fully in the state or at least partially staffed up so I'm hopeful I'm living in hope that we can continue this work with a big money injection I have I did write um a note to uh VTC to the president and asked her about the tuition difference and why why there would be such an amazing tuition difference and what and she did respond to me but I um I'm going to ask her to come in the next time we get more into detail on in this area about why there's such a discrepancy between it and the amount at GCC because um that's Greenfield Community College for those of you don't live on the border um so she we will ask her to come in and and talk to us about why that difference exists President Mullen's been a really excellent partner in this uh so I want I want to thank her as well um she's been creative and and we had to go through several degrees of administrative machinations to to find a way to appropriately fund these paramedics that are going through she's been a terrific partner I think she's anxious to answer that question as well and and we're anxious to help her navigate this is also so whatever resources we can bring to bear including you know numerous connections to other college systems and other programs in other states we're happy to help however we can yep yeah thank you any more questions for Dan Senator Polina it could just remind me about what the cost is per student I forget I remember I don't remember there was a big difference between GCC and VTC but remind me what the caught what we're talking about per student yeah so it's been it's been about probably a year Drudy have better information than I do yeah and there are two different programs to the provider one and the paramedic one right yeah I do have some um data about the cost of all of the paramedic programs in New England that I did um after Senator White has kind of sent me a request for some research so I do have that for you I don't know if you want those numbers now or you want me to wait until later to present that well maybe just um I think Anthony Senator Polina's question was we talked about the tremendous difference between GCC and VTC and if you just throw that up then we can get more into the I just don't I just don't remember the numbers I'm curious so uh Greenfield Community College is a certificate program a 20 month program with a total cost of $9,000 that's cost and fees and VTC is also a 20 month certificate program and the total cost and fees is between 32 and 34,000 pretty big difference oh my thank you Senator Rom um I don't know if this is off top off topic but I thought it was appropriate for Dan um I've just been following uh some language at the federal level about trying to make grants and supports available for mobile vaccine units to make sure we get out to our transportation barrier folks um and I just wondered if you all are following that I know there's certain temperature requirements and things like that but I wondered if you've been seeing if that's something we can put together for places like the northeast kingdom yeah senator we're not only following it we're leading the way um EMS in Vermont has showed a tremendous burden throughout the pandemic it started with testing uh and we've supported our mobile testing efforts since the beginning and we are about to kick off uh what will be really an unprecedented effort using EMS in Vermont to reach vulnerable populations in fact uh I'll make a specific note of drew and rescue Inc they're partnering right now with windham county home health uh to reach uh homebound folks and they're ready to kick that off next week I haven't heard of any other state in the union that's as aggressive and ready to go as we are in this field um we know that there's going to be a tremendous need for a lot of different vulnerable populations uh we've talked to stakeholders from uh houseless citizens to assisted living centers to uh migrant workers we've been we've been chatting with lots of people um of course it's mitigated by vaccine supply so we're going to start off slow and build capacity as we go on but uh to answer your question absolutely and uh EMS will will will lead the way in that regard thank you and I just will say um two things here and then we can go to drew I will say for senator roms um information here that we probably have the most incredible EMS system in the country and they have been they have responded well even before the pandemic hit they were they responded and took care of our citizens in really incredible ways and since the pandemic has hit we we should be very proud of them in all areas of of their response and then I would like to just before we go to drew ask dan how he likes his new job and would he just much prefer to be back with us and EMS well uh I'll let you know when I actually do my real job it's still been doing this pandemic response you know 12 hours a day for the last year um but you know it was a great opportunity for me and and and since my division oversees EMS you'll still uh see my hand in the mix I'm not ready to fully give it up yet um but uh it's going to be a different a different uh a different gig okay good well I didn't expect you to answer whether you really wanted to be back but are you replacing the woman who runs emergency uh response now no I think you're talking about director bornham and over yeah emergency management I'm replacing chris bell uh who was division director of the the division of emergency response preparedness and injury prevention okay well thank you for joining us and I know that you have some time time constraints and so we'll probably be leaving us at some point but we appreciate it and we will be continuing this conversation because we want to make sure that we're doing everything and not just in response to um money or the pandemic but if there are other things that we need to that we need to be addressing for our EMS system we will we will be continuing the conversation so yeah and and thank you all again you've been tremendous partners in this effort and uh uh we really appreciate it well I can tell you um and drew has uh for the last four years been um I was going to say a pain in my side but I won't say that he has been persistent in um in his needs so thank you the nicest thing anybody's ever said to me thanks Drew Dan Dan good luck as you transition a good luck all right Drew would you like to yeah so uh you know Dan got to steal the thunder there a little bit and talk about kind of the success that we've had with implementation too of kind of our education program I guess I'll just kind of add a little bit to that you know we talked really in the spring which seems like you know several years ago at this point but about the the reduction in total transports that had an effect on the kind of the financial status of a lot of ambulance services because remember we are only paid to uh to move people we're not actually paid to deliver health care currently something I think we should we should probably talk about the future but as a result of that transport lost there was a significant concern about ambulance services that we're not going to be able to stay viable and as part of the CARES appropriation there was a um 900,000 dollar um ambulance stabilization grant that did go out so with the help of the Agency Human Services and the some federal funding um we're we're doing pretty well in Vermont we have not lost ambulance services as a result of of lost revenue this year which is certainly a better position than I thought we were going to be in uh in March in that kind of lost revenue assistance we got through the ambulance stabilization grant was was a huge help we did have like Dan said some significant uh success in standing up a completely new style of EMS program so for many years 50 years EMS education has been in person and it's been you know a typical kind of two night a week schedule it's um kind of had this very historical existence and given the the pandemic and given the need to shut down education programs in the spring in the spring to prevent the spread of COVID we needed to come up with something completely new so not only did we kind of get that done during the pandemic but we kind of redesigned it and in the fall we kicked off hybrid programs around the state which are allowing us to reach people that we weren't able to reach before last year when we were I was testifying with this committee we talked about some pilot programs that we had run in our region down here in southern Vermont um looking at expanding our access to education for the volunteers in the smaller communities through um technology and you know as as we sit here on zoom today we're certainly understanding some of the advantages though I'm not sure they're all advantages but some of the advantages in our ability to reach people that we couldn't reach before so we did get um overwhelming response to the the voucher program we have a lot of data and a lot of information a lot of education on what we can do with EMS education programs that have financial support when you you know asked about what can we what has worked I would say that what we did has certainly worked when you asked about what we need to think about doing especially as we look at maybe additional COVID funds is to continue to build a sustainable system so this year we managed to stand up some programs we've learned a lot but I don't know that we've built sustainability into the program we hopefully at the end of these classes which again we got started much later than our typical um kind of class schedule we're going to have some new people in our workforce but we're still going to be short um usually we have spring classes and fall classes that's kind of the typical EMS pattern we didn't do that we kind of started late fall so these classes are going to be ending over the next couple months um so we've learned a lot from those classes but what we need to be thinking about as we kind of work forward through what funds might be available is how to get additional people into this workforce and build a sustainable education model so kind of going down that path we made I think some some huge steps in that direction last year in legislation by addressing the instructor coordinator the advisory committee and through the education council that was created has four working groups now that are taking on those topics of EMS instructor coordinator credentials portfolio based testing the development of the Vermont responder which is uh is going to be a level that'll help bring people in into the EMS system and increase our overall workforce group do you want to just explain what that level is to uh senator ron because she was not aware of that yes this is a a new level of uh licensure that we're going to be offering in Vermont which will allow people that have uh the skills to provide least life-saving interventions for example a in a lot of areas it would be a fireman or a a police officer that has first aid CPR bleeding control and market administration training to be part of the EMS system and be able to be respond to those calls so for our smaller services volunteers that have limited availability for training this is a way that they can get the life-saving skills they need to help in their community so we have some areas I can say right here in you know in our area window county where the entire first response workforce is now falling on one or two people um that responsibility is huge and by adding these Vermont responders they'll be able to in some cases increase their workforce by tenfold by bringing out a lot more a lot more hands so it's pretty exciting especially to our first responders that are they're trying to get this work done so and Dan kind of touched on some of the other interesting things that have happened to EMS over the last you know six or seven months we've been plugged in to some of the pandemic related challenges everything from initially setting up testing sites and working with the regional health departments to health offices to do their testing to in-home testing for homebound people we've been involved in transportation of a non-medically necessary COVID positive or COVID suspected patients so that we can help to eliminate the associated risk of putting them into housing units like homeless shelters so for example in our area if a if there's a potential exposure of a homeless person those people are transported by EMS to a shelter where they can be monitored and weighed out their quarantine periods so we've taken on all kinds of roles so far and the most recent role that EMS is going to be undertaking is this this massive effort of vaccinating the entire public a role that EMS is you know excited to participate in and I know we have services around the state that are are working to you know put their plans together and we'll be supporting the health department in that in that realm down here in in our area we're working with Dan and his office as well as the visiting nurses and we're going to be starting home visits next week for those people that are unable to get to vaccine clinics so that we can get some of the most vulnerable people in our community vaccinated as quickly as we can. Senator Clarkson. Drew it's great to see you so does that mean that's a partnering that's a big partnering effort with our long-term care facilities our our senior centers that to identify that population for you and you must be partnering with a huge group of organizations to do that. Yeah the collaboration that's happening right now in the kind of the healthcare arena is is amazing. We've seen for many years silos in different kind of sectors of of healthcare as well as different sectors of emergency services and if the pandemic's done anything it's really kind of torn down those those silos and everybody's really pushing forward to kind of the end goal of getting people vaccinated so yeah these are huge partnerships and the cooperation has been excellent the working with the health department has been super easy and certainly other than you know Dan's daily call to tell us that he needs us to pull just a little bit more a little bit more weight which we're glad to do you know it's been a pretty stressful but seamless pandemic for EMS. So I'm I'm just going to throw this out that that was very interesting that you talked about tearing down the silos because this morning right before this we heard from VLCT and one of the positive things that they said came out of this pandemic was the tearing down of silos that they felt that there was better communication between state agencies and between state agencies and them and the ability to communicate and respond so that is something that we really really need to keep in our heads as we go forward about the systems changes that we need to look at. Yeah okay Senator Rom did you have a question? Yeah kind of along the same lines I'm just hearing about this extra level of training which sounded like it was related to opioid issues etc. I've just been following for a while experiences in places like Lisbon, Portugal and West Virginia where they have mobile medication assisted treatment and that helps you know people drive by on their way to work or something if it's more convenient for them or you know go somewhere where there's you know there's a high population of people who need that service. Is that something that you all have given any thought which might be an interesting way to sort of study the partnerships that are needed to be made for the vaccine although different age groups and sort of transition to having mobile MAT available to people? I think that I'm gonna let Drew respond but I think that the MAT probably is more in the jurisdiction of the health committee and through the Department of Health other programs rather than EMS but I'll let Drew respond to that. So I believe we're going to be moving into the area of mobile vaccination so as we work our way through the kind of the vaccine process I can definitely see mobile distribution sites being set up around in some of those areas as a way to reach more of the public. Dan is the expert on how that's going to happen but I think you'll see those vaccine clinics moving to locations where people are. I mean it might be that Senator Romney might be that the lessons learned from how we do the mobile vaccine units could be applied to other areas of health delivery but that wouldn't be through the EMS system. If it's going to be permanent it shouldn't be through the EMS system is my feeling but Dan you just muted yourself. Sorry about that. So we actually have looked at MAT. New Jersey is a good example of EMS using it. When we applied their model to our system the challenge in New Jersey was that it wasn't available in lots of places. Here in Vermont we had such good access in the emergency rooms that it wasn't a significant I'm not saying there isn't a need but there wasn't as much of a need comparatively so at that point we kind of said maybe we should leave it over there because it's a challenge on the EMS side as well but I think what if anything this pandemic has demonstrated is how good a public health partner EMS is and how important their role is beyond the traditional movement of a patient from one place to another and I think that has really told us that everything should be on the table. Well one of the things that we've talked about is that when the emergency management system was first put into place it really was thought of as a as transportation it was a transport system and it wasn't part of our healthcare consciousness and that we've been working really hard in this committee and with health and welfare to try to change that that kind of culture so that EMS really is seen as a healthcare provider and and to that end we need to look at what they can do what they can deliver how they get reimbursed for their the use of their medicines how they get reimbursed for actually serving people and going there instead of just for transporting so we'll have Corey Gustafson and some other people come in and talk to us about how we might begin to look at at the reimbursement part of it anyway. Sorry Drew go. Well that's actually the other thing that is when we knew it in this committee certainly has we've had this discussion the other thing we we made very clearly in the pandemic is quite how fragile the system is so it took about three weeks of reduced call volume before the financial viability of our EMS system was in question so as we you know we've talked for quite a few years about how EMS is struggling because of the way that we're reimbursed in the low reimbursement amounts it was it was very apparent when you started operating in the in the red just a couple weeks into the pandemic so as we kind of move forward away from the the pandemic and we look at the need for EMS and the need for a trained and sustainable workforce we do know that you know 25 percent of EMS responders are going to be leaving EMS in the next year that's what our data says we've surveyed our workforce we know that a large percentage of those are leaving EMS as a result of the wages in EMS so what we're asking of our EMS providers is huge just to put it into perspective the EMTs that we are going to be sending to people's homes to vaccinate observe for life-threatening complications on a daily basis make between 13 and 15 dollars an hour that's something that you know moving forward we're going to need to address yeah and if the reimbursement rate was different and how you were reimbursed and what you were reimbursed for it would help in that so senator Clarkson so on the workforce development issue I'm just curious Drew we've discussed this for years that the number of people you train you invest in them and then they leave for various reasons I'd like to know if some of them if we can look at EMS as part of the ladder into healthcare professionals I mean is it you know nurses have a very well-defined ladder in workforce development do we could we better employ EMS as part of a ladder of a bigger system and instead of looking at as a detriment to EMS but really looking at as a workforce development partner with then the next certificate program and the next training and maybe getting them to medical school that's that's one question and I have another one I could speak to that with my you know my personal experience here in our workforce is definitely that EMS providers quite often are stepping their way into other healthcare careers it's a way to see if you are interested in the healthcare environment and you know this year alone we've lost two providers to PA school we've lost three providers to emergency room positions although they're still working at their EMS level they're working in a hospital-based type system I've trained and I like to point out that I've trained five doctors that I now get the pleasure of working for so it's it is definitely a career ladder well and that's great and the question I think we have for EMS is then how do we better use that to then let them evangelize the value of so that we make it more of a feed so that it feeds you so that we help make them be you know advocates for coming in and beginning using that as an entry point for the healthcare system do you see what I mean I mean how can we better employ them to help us so I think there's there's a couple different things that are kind of playing out and one is people are moving from EMS to other healthcare careers because of the level of reimbursement so a paramedic makes roughly half of what a nurse makes but the scope of practice and the expectations are no different when I come to your house or you're suffering a heart attack I think your expectations are pretty high yeah well I hope your expectations are pretty high but yet the the reimbursement is is so low on the the way that we reimburse and the calls that do get reimbursed that it's very difficult to pay that livable wage to those professionals so they do move on to other careers right I've got that and we've talked about that um I guess another one of my questions is where are the volunteers I mean because when we talk about if you are a real mesh a volunteer system a volunteer system and a paid professional system and you're right is paid professionals this is very low earnings and challenged reimbursements which we hope will get improved where are the I mean what do the volunteers get do they get paid per call or do they not get paid at all there are some services that do uh stipend their volunteers um you know small amount for travel expenses and um and other kind of costs most of them don't receive any compensation and those people that are true volunteers in EMS system are what we worked so hard last year at trying to come up with ways to support through the new first responder through the access to um education um we the cost associated with becoming an EMT at a thousand dollars a student uh was in many cases being paid by the volunteer themselves so most of our kind of legislative effort last year was targeted towards that volunteer support right people access the Margaret's the Margaret Lagas is I think I think that I would just throw in a thought here that um while we it would be nice to have people be able to see it as a a career ladder a career ladder we also don't want to keep the EMS providers so underpaid that they have to go through for a career there we need to keep good people in our EMS system we need to pay them to stay there not to not to look elsewhere because they can't afford to remain there and there many of them are doing much the same the same things in their new jobs but they're being paid better so we we really need to look at how we keep people in our EMS system and if that's I am sure it's more than just pay but that's a huge one yeah no it agreed so um Drew do you have more that you want to tell us today um the only other thing I'll you know just you know from the experience and we're still facing this hesitation of people going to the hospital so just as a piece of information early on in the pandemic we told everybody that the entire public that if you're not dying do not go to the hospital which is it's interesting to see what happens when you you know tell people not to go to the hospital they actually listened we had people that were actively having strokes and heart attacks that are like I don't want to go to the hospital they told us not to go unless we're actually dying and they really did take that public message very seriously so we've seen our number of people that are expecting EMS to come to their homes take care of them and leave them at home for follow-up later increase actually in our areas double since the beginning of the pandemic which is kind of an interesting piece of of data for us um that that people are still calling EMS but are really hesitant to go to the the hospital so we're seeing more of that home treatment and um and then then following up later with their their local primary cares I don't know that I have anything specific as we as you guys go through your session I'll be glad to answer questions or I can provide you with the data that we have I do apologize our legislative report from the advisory committee it's going to be a little bit late we will get to as soon as I can tidy up the last draft I don't know if Jim has anything else specific he wants to throw in there but I would like to say thank you for the work that you guys did last year we would definitely not be in as good a position as we are this year without that workforce development money and the ambulance stabilization if we didn't have the ability to pay for those 300 students which we desperately need in our system right now I'm not sure where we'd be as far as as far as workforce goes this year so that was a huge help thank you Jim did you have anything you wanted to throw in you've you've had some very eloquent speakers they're telling you how it is I want to review a few things on behalf of the Vermont Animal Association the service which is again very much thank you thank you for the past year services that you've done for us looking into this there's nothing that is completely fixed nothing that has been miraculously changed but without your help I think we'd be in much much bigger trouble I'm very proud of the EMS system that we have the people are working very hard the EMS people are helping in everything they can and they want to and I'm so proud of them but your help has been tremendous to us when they talk about numbers I just want to say this problem is not solved this number of personnel that we need to get into and not to take anything away the numbers you got for us to get into paramedic school and to get into EMT school those numbers are are still going to be very hard on us right now and into the future so when like Dan said they have 313 people added through this course in EMTs or 36 paramedics it's going to be probably another three four months before even all those can get certified in the in the EMT and it's really going to be a probably another year and a half two years before the paramedics become online this is a very big help but it's a problem we need to really look into the future if we can use some of the COVID funding to help again this year that'd be wonderful that's my main thing is we need to have personnel and you've touched everything from we have to pay them to keep them there's so much but without your help we would be in a lot worse shape only thank you thank you I do have two two questions um or two areas that we addressed and I don't quite remember how we in the end left them but one was the um the requirement that the green mountain care board look at the EMS system when they do their ATRAP their health resource allocation plan and I wondered if if that has happened or if they have done it this year and if they have contacted you to get information and then the other area is the um we were seeing some potential pressure put on the system by um those private ambulance services who were specializing in hospital to hospital transports um and we tried to deal with that around cherry picking and telling saying that if an ambulance service was going to serve in an area or be licensed in an area they had they couldn't do that they had to serve the entire population and I wonder if you can comment on those two areas and if there's been any anything as a result of that me okay I'll call it either any of the three of you just on the uh green board mountain board they have not contacted us that I know of yet and I'm sure that everybody we're very busy but we're so thankful that we're able to go into that and look forward but not as of yet and on the the transport of the uh patients it's a problem hospital to hospital but we don't have a method that keeps them out as of yet from the past but it's all determined about how we can make the system work for everyone within the local means as much as possible I don't think there's a permanent answer from the past on that didn't we put something in there that said that if they're going to be licensed that they have to they can't cherry pick I thought we put that in that was in the legislation um and those um it was a requirement for the health department to implement that as part of uh rule so I'm assuming at this point with everything going on the rule has not been updated yet okay and it is a non-discrimination requirement that needs to be added to the licensure which will um would prevent amulet services from for example only taking um private insurance so if if I'm only willing to go to the hospital and pick you up if you have insurance um I think that's a terrible a terrible system so um I can tell you from you know our perspective and I'm sure Jim is the same way we take uh very good care of the patients that are in our system that are in our hospitals and any patient that shows up at one of our two hospitals that needs a higher level of care whether they have insurance or they don't have insurance we will make every single effort possible to get them to whatever care they need and as long as I think what you guys did is you kind of leveled the playing field and made that the standard across the board so I think that will be helpful once the rules are in place okay Dan is that the case that it just hasn't happened yet because of everything else I think you're muted yeah I apologize um uh so so I don't know the answer to your question uh and I wanted to go back and double check I don't believe it has we've had discussions about rules and the reason I'm hesitating is I can't remember if the interpretation was that it already existed when we had the capability or if it was something we needed to do I'd like to go back and look though uh to be sure I don't want to give you a half answer here okay thanks um yeah I would like to hear some follow-up on that and and I don't know where the Green Mountain Care Board is in uh terms of their new ATRAP but if they are working on it and they haven't contacted you then we need to um slap their fingers so um and I understand that Shayla has taken a new position also so will not be with us is that am I right about that Dan you do like to mute yourself yeah I'm sorry my dog is eating his dinner literally two feet away from me and it's kind of loud so uh oh um anyhow uh yeah so Shayla's been fully dedicated to the response uh I think she's been moved in sort of a different direction I don't know if if that will change as things change here but she certainly has her hand in things as well so I don't think you've seen the last of her oh good thanks so in terms of your dog eating his dinner we had a somebody testifying to us the other day and she we could hear this little shrieking in the background and her dog was eating her two-year-old daughter's mac and cheese so at least your dog is eating his own dinner yeah well he's yeah um anybody else have any questions for uh Dan or Jim or Drew nope it's always good to see everybody though and as we go forward and we have more like any legislation or anything that we need to to do amaran will be working with us and um she'll be might be coming to you for more background information on some of the issues okay um so I I see that Quinn is still with us and I just wondered if you wanted to weigh in at all on the EMS issue and how in relation to the towns because I know in some towns the EMS system is part of the municipal system sorry I was on on a call so I don't I don't know exactly what you want to talk about so I no I just wondered we were just talking about the EMS system and I know that in some towns the EMS system is actually part of the municipal government right and it and if you had we heard here um some of the positives and negatives and where we need to go from here and I just didn't know if you had anything else that you wanted to throw in or if you wanted to wait till the next time we took it off I'll wait I just know that I think the the nonprofits the ones that are haven't been associated with municipalities just had a little bit more trouble than than we did because we had direct aid to municipalities um so there was just that extra step that um was arnerous on on those folks um which is unfortunate so I think we were in a little bit better shape at the municipal level okay um senator Clarkson yeah I'm just curious Gwen if you could when you come back if you could bring us data about what percent of the EMS uh teams uh are municipal versus uh nonprofits and Drew probably has that too obviously but it would be great if if we could get a better set I mean you probably have given this to us in the past but I'm not remembering um so what percent are municipal what percent are standalone what percent are volunteer what percent are professional I think that would help us understand the full universe and I'm sure you but I don't have it sort of I don't yeah thank you Drew maybe or Dan but I think with the disc like with the different districts don't they have an inventory of each agency and then you can glean from that yeah that's why yeah um we're about to prepare for you something called the stakeholders guide okay if we if we ever get a moment where we can concentrate on something other than COVID-19 it's it's ready to go uh and um the challenge has just been that our so everyone in our communications team is pulled in a thousand directions but that does contain a lot of that and uh I think it would be exactly what you're looking for so I would simply say stand by it's coming hopefully as soon as we can kind of divert some resources away we'll have a presentation for you all thank you give me if you give me one second Dan I'm looking at the draft I'll give you the number okay maybe well you're looking for that can I ask if this isn't directly related to COVID or where you need to go moving forward but it seems to me that one of the first things we did um directly related to EMS in this committee was when we um reassigned or the district there there was and there was a a lot of opposition to it and we did it anyway um and I just wondered if that has worked out I can't Brian do you remember Sarah Callum or do you remember exactly what it was we did no but I remember the I remember the discussion about that yeah Drew will remember because he's the one that brought it to us I hope I can't remember the resolution well we changed the some for some reason the membership on the advisory council had uh did not have a representative from each district and um and we changed that and I don't remember how we changed it and I just wonder if the change whatever we did was a valuable change yeah so I can't speak to that um the big change was uh to the EMS advisory uh committee so you restructured that committee and uh changed the membership um and also changed how the um how the the chair of that committee was chosen it used to be that committee was run by the EMS office um and then up until COVID um part of that change was that the EMS um advisory committee had to move from district to district so that it was accessible to all of the um end of the stakeholders all the EMS groups around the state obviously uh with with COVID this year um that meeting has been virtual for almost a year like everything else but um I would say um that the change has been beneficial we have um pretty widespread participation in most of our meetings I would say that you know we're probably 80 plus percent participation with people coming to those meetings um the reports and the information that you've been getting from the last three years has been a direct result of the change so I think you're probably seeing more um more accurate more available information on the EMS system that you do before so but that being said I do chair that committee so I may have a little bit of bias just as a point of privilege as someone who sits on a lot of these reports like committees or study groups or whatever at the um it's a very high functioning advisory commission it's um and I you can thank Drew for that he really does a really good job of you know getting everyone um energized and involved so um yeah good job Drew all right so he's in a pain in the side of more than me is that what you're saying in the best way possible though in the best way yes that I meant that too we I just forgot this is going out to anybody who's listening so I do believe we're live on YouTube any more questions or comments or concerns or anything and I think we'll we'll we'll follow this up oh the one thing when you are thinking about what um in terms of training money that you might need from new cares money around the training and the education programs I know that um Dan you said that uh getting the instructor level and the first response level um programs up was it was a lot of work and the because everybody everybody is so busy dealing with this other stuff it would it be helpful to have an additional person as a point person to do just that uh so the answer is yes um uh what we were really hoping for is we'd have a is to fill our training administrator position all right which we're interviewing for this week again and and you guys know the saga of our our trials and tribulations with filling that position um I think if that doesn't work out uh and that person cannot be the point person on on most of those projects then absolutely um and maybe there is some room for a second person in there to to to help us shepherd some of these um we'd have to talk about it but uh yeah it certainly makes sense well it is um it is unfortunate that you're you and the the police academy also are having such a hard time um recruiting and hiring and getting people here and I've heard some of it is because it is it's a we're so small that there's no kind of ladder for them so people from the outside are saying why would it come to Vermont it's just a dead-end job but I will throw this out that we had um applications for the cannabis control board and there are three positions and there were 94 applicants so maybe you could recruit some of them guess i'm in the wrong line of work I think so when you do your interviews if any of them are EMT cinema away okay we'll do any other questions or concerns or anything all right well thank you very much and thank you for the the good work all of you it's it's an amazing system we have I believe here here thank you thank you thank you madam chair so committee remember we're not meeting tomorrow our hearts are broken well in in judiciary we're going to do a good time earned good time and you've earned good time here so you get to get the day off and um Tuesday uh just to let you know Tuesday we're going to be uh gail do you want to join us again do we want to go off live do we want to go off live no we can stay on so that people can hear what we're going to be doing next week in case they have um interest so Tuesday I believe that the first thing we're doing is gail do you want to help me out here uh yeah let me look at my notes I have too many pieces of paper we are starting after the budget address we're talking about the public records of juveniles all right and that will be our whole afternoon on Tuesday and then Wednesday Wednesday we are talking about the governor's executive order with DPS oh and the beginning of the reports from the council yep and then we'll be talking about the criminal justice council yep Thursday is elections yes so if anybody has the list for me i got to get you ryan you better get them to me or ryan already got me his she did you are a whiz it's about before the weekend what you said this get it to before the weekend if at all possible i can get them so i've got them from the secretary of state from the town clerks from ryan i know v perk is about to send some in i've contacted the campaign for vermont and i don't know who else will have lists that they want to put in but if vlct or any of you or any of your constituents or groups this isn't my list no this is the list of things that you want to see changed in our elections laws and then i'm going to make the list over the weekend and i'll get it out to you and i'm going to try and put them together in kind of categories of things that some are purely administrative issues and some are more philosophical issues and put them together in a list and identify who it was that suggested that change if it was the secretary of state and the league of women voters and v perk and senator clerks and all agree or it comes from all of their lists then i'll put that on there so that you can see where where they come from unless you would prefer not to see where they came from well i have a little list but if i could have some you know benefit of the doubt from the chair that if i put something on the list that you've talked about ad nauseam and isn't going anywhere that you just let me know when we take it off the list like for example ballot selfies you know which comes up a lot well that what i'd like to do is get everything on the list and then we'll go through the list and see some things we may say that's a really nice idea but i don't think we can do it or maybe i'll just make the list and not put where they came from that's what i'm going to do that would help me because i don't want to notice myself okay that's what i'll do i'll just make the list put it in categories kind of and then um and then and then we'll look at the list and we can deal with them as they come up and some of them maybe we don't want to deal with at all some of them we may say this is a nice idea but we don't have time to do it before march and i know for example um re-looking at the whole way we do public financing might come up as on a list so that's a pretty big issue that's not just can people take a ballot selfie i mean so there's different levels of them here but let's get them all out okay does that make sense yes yes just that mine okay and then we'll start taking testimony on the on the kind of categories and i'd like to so if we can have the list done by thursday then we can line up some people to start looking at the um presenting their their positions on different ones okay perfect okay and there won't be a bill there we do have one bill right one elections bill yeah we can use that as a vehicle or we can create a committee bill oh i know we'll have more elections bills also so i know kasha um this is this is just something i want to put out in a way that if it can't happen that's fine i've told them i would make them a little video instead but uh vermont law school next friday afternoon is having their race and the law symposium and they've asked me to speak around three three thirty and i said i'll try but if i can't make it and i know the day before i will make a video so um would you rather i just made a video or do you think there's a chance that it will work out next friday to legal um we haven't done the schedule yet for friday but i i really hate to see us end at three o'clock on fridays i mean i i and i know i am i'm the reason we're not meeting this friday so i shouldn't say that but um we'll see let's see where we okay let's see where gail do we have anything so thursday we have elections and then we also have beth pierce talking about the potential retirement changes that she's proposing and then we don't have anything on friday yet do we uh nothing on the schedule we tried to move uh the treasurer to friday and she's not available okay well we'll do her like at three fifteen or so on friday i mean on thursday on thursday okay all right thank you anything else oh thanks bye have a nice weekend