 I'm going to suggest that we actually start with something that's actually oh and then Jennifer added a new section in this new sub chapter and it's Dr. Dinosaur like coverage legislative intent and it says that in establishing Dr. Dinosaur like coverage for children and pregnant individuals who are not eligible for the Dr. Dinosaur program because of their immigration status it is the intent of the general assembly that the hospital medical dental and prescription drug benefits and eligibility criteria for the coverage that set forth in that next section should align to the greatest extent practicable with the benefits and eligibility criteria of the Dr. Dinosaur program so this is stating intent that you're looking to provide with Dr. Dinosaur and this new program so that then when we go into this new setting the language up with the Vermont Medicaid state plan. The extent that applicable funds are appropriated in the fiscal year 2022 budget as when it's in the language. The budget as proposed by the Senate. Right. Okay so questions. Let's are there questions. Members of Fusion. Yes thank you chair. I hate to beat a dead horse because I talked about it before. The confidentiality statement when it says you can do everything except give these data to the United States government. Is it the is it the law to give it to the government. What's the relationship just so I'm clear. The reason that the language that I put the language in like that is because in the in this this languages is kind of piggybacking on the existing language in section 1902 of chapter 19 of title 33 and that language says specifically includes the federal government as a as a recipient of the information because it's a federal state partnership program Medicaid. So this is saying those same confidentiality provisions apply except for that part about making information available dollars program. Right. So is it is it useful to remind us that this is being paid for with strictly Vermont funds not with any federal match or right. This is outside of the Medicaid program and that was why Diva had those concerns about your status that that would be an issue. I guess that's the best way I can. Consideration and it was my understanding that it was important to some folks to have language in here to provide that comfort and reassurance to applicant and it's using state only dollars. There isn't a clear need for that information to be provided to the federal government. Thing be turned over. I mean they would just sign up and and they were going to go their merry way. Do you think. Well if I piggyback on this same language about section 1902 a applying that language says and I can maybe it would be helpful to put the language up. I can show you. I'm just wondering if there's immigration language in law that requires the state to to give that information to the federal government. I guess that's the best way to describe it. Here it is here I guess. Well so this is what I was this is just this is the 1902 a language and so it says all applications submitted and records created under the authority of this chapter concerning any applicant for a recipient of Medicaid are confidential and shall be made only available only to persons authorized by the agency the state or the United States for purposes directly related to plan administration. Well there's no plan admin there's no federal plan administration of this state only benefit. So so I mean we don't we don't necessarily put specific language about not providing information to the federal government in all state programs that don't have a federal component but I think because of the issues around this one about immigration status there was particular concern about the confidentiality of that information. Okay all right thank you. Can can I just ask again because I think one of the questions that was raised as well was we had provided I believe some similar type or some or something along the same lines to give some comfort around the stimulus dollars that were extended as well as to the DMV. The DMV was the result of a settlement I checked in with my colleague who does transportation and the withholding of specific exclusion of information from being shared with the federal government is not in statute around the non-resident driver's licenses it was the result of a litigation and a settlement between migrant justice and the DMV. Air office how how are they you know registered how are they taken in. Will they get reimbursed is that part of where you're going I mean what do you because it's like how would how would someone access this program. I don't know I just I don't know what the questions are and I don't know how how is an individual supposed to respond to those questions you know it's kind of embarrassing to be honest with you I would think for that person to be right there at the front desk everybody's looking and listening you know and in fact it might even restrict the individual from going to see their their doctor you know so I'm just throwing that out there I realize there's probably no good answer to it but it just just seems kind of funny to me. Can I weigh in on that a little bit? Well if you like yes. I'm just you know I mean anytime anybody walks into a healthcare facility area any more than it currently already is at least now there's an option for this select I mean right now they're already dealing with that issue of they're going to ask me what I have for insurance and I don't have anything so here's another question does diva provide a card for these individuals that are undocumented or will in the future when we get the word out to the you know the various farms and other establishments? I believe diva indicated that they would get a green mountain care card just like any other person under vermont medicaid everybody gets the same card they may be under different programs but they all get a little card with the mountain on it and the name and your id number but it would clearly not be a medicaid card. Right it's the term it's the umbrella term for the programs the health programs administered by the department of vermont health access so I think my understanding is the same as representative blacks that they would get that same card the patient experience of their card would not be different it's the back end of which funds are used to pay claims that would be different. So how does an undocumented worker get one of these green mountain cards? Do we have there's an outreach provision in the bill? I know that. Is that part of this? Yes that was the language in there requires the grants for outreach to organizations to provide outreach and information both for the opportunity to get coverage during this kind of transition year FY 2022 but also after so that there would be information about potentially how to sign up or what the process is or where to go. So as soon as they arrive at the primary care physician they'll already have this green card to provide? Potentially or if they don't I think you know representative black is saying and I think we've heard this from others too that that that's the kind of thing that the providers would also be made aware of so that they could connect a patient with that with the enroll application and enrollment which they do now for medicaid as well if they were not covered. Okay. Representative Peterson? You're muted. Yeah if Leslie wants to go I think she was before me or no okay. Well I was just gonna say let me just say that I think you covered the issue I think there are two ways into the program the first is this outreach program through the communities then people will get their cards and then we'll feel safe going to get care and then the second way was they will arrive for care and as representative black says then people within the medical offices will recognize that they are eligible for this program and be sure they get it so it's going to come from both places. Does that make sense? Yeah. Yeah make that summarize it yeah okay. All right thank you. Representative Peterson? Yeah yes and and again I want to and I don't know who can help me here but I want to understand if I can the population where we're giving this to and I excuse my ignorance here but when migrant workers say come here to work are they are there some who have a card I've heard of green cards I don't even know what it is but do they have a a card or something that tells someone that they are legal to be in the country or state is that is that what these folks are supposed to show anybody or is it does no one check at all and they just come in and and they do the work they're supposed to do do we know that or do we even care about it? Can I suggest we step back from that question because I think the question is for whom is this program available right and this program is available to those who are here because of their immigration status are not eligible for Medicaid am I correct? That's right and that may be people who are here both. It's different it's different statuses they're not just describing and that's actually why diva suggested not using the language of undocumented immigrants because there are some people who are here with you know what you would call documents who are here under a particular visa program for agricultural workers but Medicaid still does not consider that group eligible for Medicaid so there are people in different different statuses but what they have in common is that they are ineligible for Medicaid because of their immigration status whatever that is. Okay so there it could be a mix of a lot of different levels of whatever okay and so my other question would be and just opposing it if the federal government was looking for someone who was wanted say and and they went to us and asked you know have you seen so-and-so he's wanted in other states would our information on what we're doing here be provided to the to the feds in a case like that or no? I don't think solely on that right I don't think solely on the basis of we're looking for somebody do you know this person I think you know there there is I suppose potential if there was a subpoena for information that they could be required to turn it over although I'm not familiar enough with the circumstances under which that would occur to know whether our confidentiality provision would be strong enough to prevent that or not. Okay thank you. Other questions so let me let me try out where I think we are and where we need to be before we take any formal action it seems to me that so what what we're doing is reviewing in anticipation of action by the Senate which has not happened yet but what we have done at this point is to brief ourselves on what we anticipate are the most likely changes to the bill that we sent to the Senate so what we will need to do so I don't anticipate I'm not I'm not asking for any funding for us to take any action here today but what we will do is for this bill and for several others that are in a similar situation we will return to putting these back on our action calendar if you will for our committee at some point we are right now and I think that sets us in good stead for thinking about it more efficiently when it comes back officially from the Senate and that's the goal this afternoon to do that with a number of these bills.