 Good morning, and thank you for coming. And by the way, I just want to say who's here, Dr. John Brooklyn, Medical Director at the Howard Center Clinic. Simone Rowschmeyer, did I make sure? Who is the Executive Director of Vermont Cares Network, and 13 years there, UVM grad from Rhode Island. We're glad to have you here. And our special, special, special guest is Misty Lemon, who's a patient and has been helped by the program. I want to start by just saying what we all know. The opioid epidemic in this country has just been brutal, been brutal, and it's been aggravated by COVID. Any one of us could find ourselves in the grip of opioids. And the folks who have been in that grip, there's many reasons that they found themselves in that predicament. In some cases, it was pain medication that was prescribed, and there's a whole separate story about the pharma industry and what they did. In other cases, it was a personal issue, but it's a personal issue of the kind that every single one of us can have. We lost somebody, we have a setback, something that happens in a lot of our lives. And to get a little bit of relief from that, a person takes an opioid, and then the powerful addictive qualities take over. And I think what I've seen, and this has been gratifying to me in Congress, is that this can happen anywhere to anybody at any time. And despite all of the battles in Congress about the conflicts that we have, whether you represent a red state or a blue state, all of us represent folks who need and want help. And what I've seen in Congress is there has been a bipartisan approach to try to get relief and help out to the communities so that organizations like this, the Howard Center, can be there for folks. Today we've got MISTI here, but it can be folks all across the country who are good, good people who want to have a good life and want to have love in their life. They want to be able to take care of themselves. They want to take care of the people they love. And of course, COVID, I think, made it much, much tougher because it was an isolating couple of years for us. So when you need that little help and you're more isolated, and all of those insecurities take over, it'll make it tougher for you to get the help and the support you need. And it's helping support that, oftentimes, we get just in the ordinary course of our daily life. Having contact with other people, trusted friends, where you can have a little discussion and they can kind of bring you back to your self-confidence. You don't have that with the isolation of COVID. And what we've seen, of course, in Vermont and around the country is that the opioid epidemic expanded a lot during COVID. So we can't let up our commitment to try to help individuals and help in organizations that are helping individuals. In Congress, we now have the opportunity as members of Congress to select projects and advocate to fund projects that we believe would be good for our community. It's called Congressionally Directed Spending. Every one of the grants that I advocate is public. You're entitled to judge it on the merits, whether you agree with me or disagree with me. So total disclosure. Well, one of the projects that I advocated and has been written into the budget is the $1.15 million program to expand the Wheels and Waves program. And what it does is provide another option to get medically assisted assistance, buprenorphine, for folks who are trying to get through the opioid crisis. You know what? It's practical. Because what it does is take advantage of telemedicine, something I've been working on for years, where instead of the person who needs to help having to get in a car and come here, they can do telehealth from where they are and have the monitoring that is required in order to have the medically assisted dosage. And it's a combination of the technology of telehealth and then the technology of these wheels where the daily dose is contained. And that can't be... And then in the observation of the provider, the patient is able to take that dose at home without the inconvenience. And really it's more than inconvenience. Oftentimes the prohibitively difficult process of getting in the car and coming up here for all kinds of reasons. So what we're doing is just something that's practical. You're saying, hey, there's a way to do this where you can do it at home and you can do it safely. And we have the security, which everyone knows is essential to make certain that the medication is not being used improperly. So what we have been able to secure is this grant of $1.15 million. It's going to facilitate the Howard Center of Vermont Cares doing the work for many of our citizens who we revere, who we support, who are trying their very best to be able to get the medical assisted treatment that has proven to be so effective. So that's what this is about. And I just want to also, we're going to hear from Dr. Brooklyn, acknowledge the incredible work that our providers have provided. You know, sometimes people say, Peter, it's a hard job in Congress and in some ways it is all a conflict. But you want to know where the hard job is? It's right here. You know, our job is to try to appropriate the funds to make it possible for people back home to do the work that needs to be done. Doing the work that needs to be done, that's day in and day out and it's tough. And Dr. Brooklyn, you have done such an incredible job with the hub and spoke system that you helped devise and it's really effective and it's working and being adopted around the country. Simone, you've been on this for 13 years and then I'll say a special few words about Mr. Before She Speaks. But I'm very happy to have played this small role in getting this $1.15 million to do something that is totally practical, that is proven to be effective and it's going to be good for our citizens in Vermont who are going through that really, really challenging effort of getting clean and getting off of these addictive drugs. So thank you so much. I want to thank the Howard Center for hosting us and now I want to turn it over to Dr. Brooklyn, the medical director of the Howard Center, Chittenden Clinic. Thank you, Dr. Brooklyn. Thank you. Appreciate those kind words. Just briefly, the project that we are going to be talking about was first done here at the Chittenden Clinic. I actually have a device I'm going to show you in a moment but the idea was basically to help people not have to come to the clinic every day and we know throughout the state of Vermont there are people who live 40, 50 miles away and can you imagine every day getting up, putting on your clothes, getting in the car, driving 40 minutes to get your dose of medicine, turn around, go back home, parent, work, whatever the case may be. And so with this program we were able to give, we originally had 50 people and then another 50, 60 people that we gave these devices to and I'll show you in a moment what it looks like. Basically when we give people methadone we usually give it to them in a liquid form but there's a device that is sold commercially as a pill reminder for people to take their medication daily and so it's got a little beeper and what we do is we fill it with these are aspirins, these are not methadone we fill it with pills for each day's dose and then we close it and then because we're concerned about safety we put it in this steel box we've actually had somebody drive their car over it by mistake without any damage we lock it and then we send it with the person home so the very next day the person would then the alarm would be they would take it, the pills would come out and then they'd set them on a countertop and then they take their smartphone which has an app and they hover the smartphone over the pills so we can know what they are and then they put their phone up and then while the phone is up they hit a button and it records them taking their medication at home so they take their medication they drink some water, they speak and that's it, about one minute they hit send they send the video to the clinic they do the video later in the day to make sure the person's been compliant with their treatment so all of that takes away that 40-50 minute journey we actually had a couple people who had to be at work at 5 o'clock in the morning what time's the clinic go? 6 we had videos at 3 o'clock 4 o'clock in the morning people taking their medicine and off they go it kept them in treatment for a year and a half until they decided to have regular take-homes but the point being that this really saves a tremendous amount of time we actually demonstrated that of the people that we gave these to about 75% before they got the wheel we're working or taking care of family going to school and then at the end we had 95% of people now engaged in some kind of pro-social activity we had an average of 5.5 hours a week of travel time saved we had I think Simone you've got the number something like $72 on average a week saved in transportation costs including Medicaid dollars because sometimes it's up to $30 a day to transport somebody so we believe very highly that this is going to make a big difference throughout the state especially really rural areas so excited about it thank you so much we're going to hopefully move forward with it in a very positive way for many Vermonters who can't stay in treatment just to explain how people can't get into that because that was a question I have too so because it turns every day this is locked and it's a steel box so you really the wheel doesn't advance until the next day so if we set it for 7 o'clock in the morning the next day 7 o'clock in the morning will come it'll beep medicine it doesn't move again to the following day thank you very much now Simone thank you for your work taking my aspirin and moving away some of us could use aspirin right now thank you and thank you Congressman Welch for all of your hard work and Dr. Brooklyn for creating this really it's really quite incredible for Montcare for Montcare partners is a network of 16 community-based agencies that are designated by the state to provide mental health substance use disorder and intellectual and developmental disability services and supports all of our agencies believe that Vermonters have a fundamental right to live healthy and safe lives in their communities and their local services this program does just that it brings medication assisted treatment into people's homes and enables them to not have to leave work to go get services enables transportation time savings and cost reduces carbon emissions at the same time and added benefit and reduces the stress of having to find child care and we plan with these dollars to spread the program statewide to other hubs around the state and hope to have at least 50 people per hub signed up so approximately 400 people for the year and the funds will support the dispensers as well as the video application smartphones if necessary staffing at the hubs technical assistance for implementation we do really want to make sure that we are taking a good look at how this is working over the next year in the hopes that we can expand it even further it really is fundamental and as you were saying the timing now people are stressed we're all stressed and the more we can do to relieve people and to enable them to get the services they need in an easy manner the better so we're really excited about the opportunity you know the program saves lives and while Howard Center is the only hub that's a member of Vermont Care Partners we just felt it was important for Vermont to be able to expand this program so really looking forward to working with the hubs aid up as a partner Howard Center your office and with Dr. Brooklyn on expanding this program so thank you yeah thank you thank you very much a very special person we have here is Misty Lemon Misty is a patient and you know what it is so cool that you're willing to come and share your experience so you can help other folks who have been through what you've been through so we are really really especially grateful that you're here thank you so much I just want to say that coming into the program when it came coming into the program when I actually got into the telehealth system I was debating on leaving the program because I did work early in the morning and they were literally telling me that they were going to write me up if I was going to be late so it came at the perfect time and it was easy it was easy to do it saved time it saved a lot of time because you know I didn't say in 40 minutes but I used to walk here from Shelburne Road and back so sometimes it's longer than 40 minutes if you can't afford the bus or a taxi or you know whatever it may be but it was the best program this place gave me my life back and it not just gave me my life back but it saved my life so this program has done more for me than ever so thank you you're doing good thank you thank you Misty any questions so Misty when you had a wheel or you had I had the app how hard was it for you to learn it was very easy I came here they showed me how to use it and I went home and used it at night I never had a problem not once you know get it done make it simple and get it done Misty that's fantastic you didn't have to walk here from Shelburne Road you could keep your job just think what would happen if the price of getting your medication the trip you had to take was losing your job and for most of us the job we have is a major support system for us so this allows enhance the support get the medical assistance that is really helpful and you keep your job which is really helpful so that's a wonderful story Misty about how this works and we want more people to be able to get the benefit of it just like you did so no questions we're around but thank you all very much