 All right we'll get started. Good afternoon everyone. Thank you for being here today as we highlight the PACT Act and how this new law will provide generations of veterans and their survivors with the VA care and benefits they've earned. It's good to be joined by the Executive Director of the White River Junction VA, Becky Rhodes, General Knight, members of the Veterans Advisory Council and legislators to help raise awareness of the PACT Act. Director Rhodes will go into more specifics about the act itself and who qualifies but in short the law is meant to help veterans who were exposed to burn pits and other toxins while serving our country. I want to thank our congressional delegation for their work on this bill but most importantly I want to acknowledge June Heston who is here with us today for her efforts on behalf of our veterans at both the state and federal level making sure they get the care they deserve. As you know June was a strong advocate in 2019 when we enacted a first in the nation burn pit registry and she didn't stop there. She and other advocates kept pushing to get the PACT Act signed into law and it wouldn't have happened without her so I thank her for that. Those who serve our country give so much for all of us. They put their lives on the line to keep us safe here at home. I think we can all agree the least we can do as a country is to ensure that once they return they get the care they need. The PACT Act is designed to help protect veterans against things we don't see. When we think of sacrifice I often think about people like my dad. As many of you know he served in World War II as a tank operator and came home a double amputee. The VA was there for my dad and people like him who came back with visible physical injuries as a result of their service but the PACT Act makes sure that those who were exposed to chemicals that caused cancer and other hidden illnesses get care as well. That's why it's important for veterans to learn more about these benefits and places where they might have been exposed to burn pits and other chemicals that cause serious health problems later in life like cancer. So it's important to identify them as early as possible. As you'll hear next from Director Rhodes there are time limits for some to enroll so please don't wait and if you have questions we're here to help. So with that I'd like to turn over to Director Rhodes. Thank you Governor Scott for inviting us here and for supporting our military community. As Governor Scott mentioned the Sergeant First Class Heath Robinson honoring our promise to address comprehensive toxic acts the PACT Act of 2022 is a new law. It expands VA healthcare and benefits for all veterans exposed to toxic substances and burn pits. It's one of the largest health and benefit expansions in American history. The PACT Act expands and extends eligibility for VA healthcare for veterans with toxic exposures and veterans from the Vietnam era the Gulf War era including Desert Storm and post 9-11 era. This law recognizes that toxic exposure is a cost of war and allows us in VA to address the full range of issues that impact toxic exposed veterans. We want to reach as many veterans and service members as possible and encourage them to enroll for VA healthcare. For those veterans and service members that already receive their healthcare through the VA we want to make sure they know about the expanded benefits that are available under the PACT Act. As of last week VA had received over 260,000 PACT related claims and performed over one million toxic exposure screenings from around the country. We want to make sure that Vermont veterans and service members know what is available to them and what they are eligible for. On Saturday, February 25th, the Vermont National Guard and Governor Scott have made it possible for us to hold a VA claim assistance and toxic exposure screening clinic at Camp Johnson in Colchester. We will have staff on hand to process benefit claims, perform toxic exposure screenings and answer any questions. Today we will sign a letter that outlines the importance of the PACT Act and invites the military community to attend this event. General Knight, once again, thank you for hosting us at Camp Johnson and Governor Scott. Thank you for prioritizing Vermont veterans and service members today and into the future. I'm going to turn it over to General Knight. Thank you, Dr. General Knight. I have people come in. Do you like to? So Governor Scott, thank you, sir, for your ongoing support of our veterans and certainly exemplified by what we're doing here today. Dr. Rhodes, thank you for being here as the lead representative for what in my view is probably the best VA clinic in the United States. We've got it pretty good here. Look, the PACT Act is important. We've been pretty diligent as a guard getting the word out, starting with the burn pit registry. It's passed into law here, working with all interested agencies to get the word out to our veterans and that we've grown that number by three times. And that's important for the VA so they can continue providing services to our veterans as well as continue their data analysis and research required to continue this process. PACT Act is going to be important. Obviously, the most frustrating thing for me is knowing the challenge it takes to reach the veterans that we need to reach when they separate from the service. We can reach the ones that we know of. When they retire, they leave Vermont. They go elsewhere and we simply lose track of them. They certainly don't report back to us. So that's why this event is very important. We'll push it out on all of our social media and reach as many veterans as we can to get in here, get their screening, enroll in the VA healthcare system. And the governor's absolutely right. These are invisible wounds. And what's happening today, what's true today, may not be tomorrow. So it's important to reach all of our veterans. But thanks everybody for being here. And a special thanks to our congressional delegation for working so diligently to get this done. Thanks. All right, we'll open up to questions at this point. Question about the capacity to serve health care to some of these volunteers who have been exposed. What has been done or what is being done within Vermont's medical community to meet that need? Because you said 200,000, that's pretty significant. Any Director Rhoads? The 200,000 that's across the country. And those are claims. So it's important to note, we talked about the burn pit registry. Registering on the burn pit registry is separate from filing claim through the Vermont, the Veterans Benefits Association. So administration. So if you need, if you are on the burn pit registry, there is that's a separate and different thing from filing a claim. So a claim for benefits is the thing that then allows us to provide health care. So through the benefits arm. So that's where all of those claims are coming. That's the new sort of part one is the VBA claims part two is the delivery of health care. We are certainly primed and ready in White River Junction and across the country to handle what's coming in. As we've talked about some of these are invisible and some of them are over time. And so there may not be a presentation today. But at least we can monitor track and be aware of warning signs for the future for health care. We may need to provide that maybe isn't isn't needed today. Do we have a sense of how many Vermont veterans may have participated in these conflicts and may be eligible for these benefits? So if you go back over the past two decades and all the combined deployments between the air and Army National Guard here in Vermont, that number is easily in the thousands. We can certainly get you a more refined number. But again, that's the ones we know of when they separate from the service, either as a first term member, they could do their six year commitment and depart the service. Or if they retire, we will lose track of them. It's also important to note this isn't confined to the Middle East. I believe that Agent Orange is also included in this on this list. So for those who served in Vietnam, as well, do you want to just So I'm going to kind of follow up on your question. So I'm Bob Burke, Director of Veterans Affairs for the state. So it's similar to the governor's challenge to reduce veteran suicide, right? For private providers, it's asked the question. Have you ever served? Right? Not we in the military, are you a veteran? Right? Very simple. Have you ever served? Right? And then start breaking it down from there, right? Peel the onion back and find out. Oh, yeah, I did serve. Oh, did you serve? Where did you serve? I served in an area, you know, XYZ. And so it's informing and educating private providers that those are some questions and and some things that you need to dig into. You talked about the screening. Are you talking about a medical screening that's looking for apologies? Or are you talking about screening to get a sense of whether or not they might have been in a place where they could have the letter. So it's a screening. It can be done. The initial screening and there are triggers in the initial screening that prompt more thorough physical and other a much deeper dive in if you screen essentially screen positive for answering some of the some of the questions. So that's what's happening. We have two licensed independent providers perverted performing those screenings right now for anyone that wants them and have been doing that this fall and then any of those that prompt sort of a yes trigger to that is a more in-depth investigation into more questions and can generate other tests and other follow up based on their responses. Would a medical intervention have to wait until somebody is showing symptoms consistent with exposure or other things that can be done on the medical side in advance of that to either minimize the chance that those symptoms show up or I'm definitely not a medical doctor. So I don't have expertise in that particular area. But my understanding is all of this is that the because of things like the burn prep registry. We know warning signs all the research that happens within VA. We know groups of symptoms that may be indicative of acts that prompt other treatment. And again those private providers sending people to the VA for the toxic exposure screening so that they're in our system and you have providers and physicians that are familiar with what we're talking about here. They do it all the time every day. So getting them into the VA system is important to help get that get that health care. But it's not that you have to wait until you know just like preventative health care. That's what we're trying to do all the time so that we don't end up with a bad outcome. How are the outcomes for people that do get early treatment. I don't know the I'm not sure I can speak on you know specific things very independent based on what what was the exposure. When are they coming to us. Is it early. Is it is it late. But I think that would be a very individual question based on the individual person their exposure is their general medical history etc. With that process being said the numbers that have been mentioned how prepared is the VA to handle the influx of claims. Right now we have a representative from VBA here that primary influx is to VBA for claims. Once someone gets a service connection through that process that's when they would transition that to the Veterans Health Administration and VA hospitals. We've seen again with our number exactly that we've done toxic exposure screenings in the last three months is 1700 which is way more than we'd ever done if you look at that you know annualize that way more than we've done in the past. But the transition from claim to health care that's the bolus that hasn't hit us yet that's in the VA claims process right now. Absolutely that's our anticipated when we're trying to staff all the clinics appropriately both on the side of folks that are trying to get into the system so on the eligibility side registering for VA care. We don't want their first experience to be that we don't call them back we don't answer the phone. We want people to come to the VA we want to see them for their health care on the back side of the claims or if they're just interested in getting into the VA system on the front end. I think probably the most important thing is Becky said we've got a very good system here in Vermont. The bigger concern for me I will come back to it again because it is important is is getting the word out to those veterans who have been deployed in areas where may be of concern for exposure to toxins. My big concern is once somebody separates from the service as I said we don't have track of them but they also may not connect an ailment with exposure to burn pits and the further the distance between the two events. And again it comes back with the governor said it's invisible now. If you do the screening you're far more likely and I say there's not being a doctor by any stretch but you're far more likely to find something early and be able to get the treatment once you're enrolled in the VA system. I think we probably all know someone who's served and done tours multiple tours in the Middle East in particular. I think about Mike Cram for instance I went to visit him with General Heston about a week before Mike Cram passed away. Had we had this registry before then maybe that this would have been identified with people like Mike Cram. Not long after that General Heston passed away due to cancer. Same issue there. So trying to get this registry so that we know who they are where they are so they're getting screened is really a matter of life and death at times. So I think this is very important. I also had a cousin who was in Vietnam lived in Barrie and he passed away due to cancer and I'm sure we're all sure that it was due to Agent Orange and but it was never proven. That wasn't viable at that point in time but today again having this registry will give everyone an opportunity to at least get on this registry so we know who they are where they are can get them the help that they deserve from service to their country. Any other questions on this topic? We have a number of veterans here in the room. We have a number of active duty here as well. Maybe you want to ask them about their thoughts on the production of the tax on military pensions? All those in favor? Budget and fiscal issues. The house wants to spend 20 million dollars to extend hotel and hotel program as it is until July 1st. I said they want more time to put in a plan for what's going to happen to those folks when they leave those units. We have a plan that we put forth so we have a plan for that and some that we've been talking about some will be in the budget itself but trying to get them into permanent housing is important. I'm also a little concerned about that. I think it's 86 or 87 million in total. Very pleased by the way with them including our initiatives in that budget adjustment but I'm concerned about the 86, 87 million dollars more they added and where that's going to come from because obviously we have a budget that includes a lot of money and I just want to make sure that we continue to focus on the fundamentals and what can help us get through the next few years as we see the economy turn downward I believe. So you pose to spending an additional 20 million dollars? I don't know that it's needed I think it should be something we discuss but I think we have a plan in place right now. They fenced off as Representative Landford said the 9 million the US for for the site beds down south but they said they're not ready to appropriate that money until they can learn more about sure what it is the hospital. That makes sense. Right. Yes. Governor the federal government is ending its nation like emergency declaration. I think that's in May. Is that yeah I believe I heard that last night they made that declaration so I think it's just a sign of where we are at this point in time. We've been through a lot over the last two or three years and COVID is still among us but but it isn't at the emergency level so I think it's it's probably appropriate. So you would agree with this? Yeah. Yeah. My understanding is that this could have implications for insurance coverage of vaccines and testing. Are you concerned about that? Well well again I mean this is going to be as common as the flu as time goes on. I mean we've gone through this emergency. The vaccine we have is viable and it'll become just like we do with the normal flu. I believe that you'll have to have a COVID booster on a yearly basis of some sort. So I think again this is appropriate and we've been through this for a while and it's just going to become part of our everyday challenges. The rolling back of the emergency also means rolling back some regulations surrounding telehealth especially. In a rural state like Vermont what would you think that could happen? Well telehealth has become very central to what we do and I think it's been been viable. We'll see where we're at with that and what we need to supplement that but I think it's become effective. And in terms of I don't know if I described as rolling back but you know the emergency has has been subsiding for quite some time. We're not seeing anyone attesting to the degree we had like a year or two ago. In fact it's almost non-existent at this point in time. So again we need to get back to somewhat normal and this will be part of normal. Do you think that the states should have some sort of role and we'll do the gap to have coverage of vaccines in the testing? Well again we'll we'll see what happens on a on a federal level. We'd already have assistance for flu shots and so forth. So again it's covered under under regular insurance. So I would I would say that it's going to be included in some capacity in the future. Also this week the House and Senate are continuing testimony on abortion shield law. I know last week you said principle or in theory it would be something that you'd eventually support. Have you gotten a chance to look at the bill? I haven't looked at the bill and I know it's being worked on but I feel the same way from what I've heard over the last week or so. I'm generally in favor but details matter. So this is 37. It includes a provision in that basically to have statute on consumer protection as leading and do harm to the public health etc. What's your take on that? I think we're getting too far in the weeds from my expertise so I would want to confer with my my team to see what they think about this and what the ramifications are of this as well before I jump into the to the fray. Well in in concept I would say the more we can do as a region the better. I'm not sure again the ramifications of that and I'd want to talk to my health care team to see if this is a good for Vermont or not. Yeah interestingly enough I did speak to the cabinet this morning we had our weekly cabinet meeting and I brought that up and advocated it's going to be a you know this we've been spoiled in some respects this winter. I believe I heard that we haven't had a one day below zero in January that's going to come to an end by the end of the week. Thankfully it's a short period of time we're going to have this extreme weather but I've asked them to check in with their their folks and their agencies and departments to make sure that we're doing everything we can to protect the most vulnerable and advocating for anything we can do to protect your pets and so forth. Any advice we can do to get through that to two to three days? And lastly a lot of the folks from the CUDs in the state that have helped expand broadband and are continuing to do so many of them started construction and already have. What is your take on all the work that they've done? Obviously there's a resolution in the house that they just recognize them and all their work. Yeah we've got to you know I appreciate every all the effort from them a lot of them are just community groups volunteers and so forth so I very much appreciate that but we have a long ways to go and we need to be able to to measure that with metrics to see how we're doing and I'm not sure where we're at with that either so I think again we've advocated and we've been able to as a group with a legislature put a lot of money towards this appropriately so and we'll just have to make sure that we follow through to make sure that we're getting everything we need out of this so that we are connected in the future for our economy and the rural parts of our state as well. And I guess last but not least on that Governor what do you think the monitor's expectations should be of connecting the last month right? We heard this morning we're about halfway through getting everybody we're about halfway there and it's going to take substantial investment. The last last mile is always the most difficult I remember having these conversations in the debates and the gubernatorial debate a few years ago and I'd said you know it's nothing's free and it's going to take hundreds of millions of dollars to accomplish this and that was back in those you know 2017 dollars so it's gotten more expensive today so I said it's like four or five hundred miles of million dollars and we're going to need some help on the federal end to accomplish this. So we got the help from the feds on this using these federal dollars and the legislature worked with us to to make sure that we appropriated that in the right way and they had a lot of great ideas as well and so I have a feeling that we're going to get to a point where we still aren't to the last mile because it's it's just very expensive very difficult to do but at that point who knows what the technology will bring forth and maybe they'll be maybe they'll perfect more satellite provisions for broadband to connect but time will tell we've we've still got a few years to go before we get to that point. We've got a couple folks on the phone. We'll start with Ed Barber, Newport Daily Express. Ed Barber? We can. Give me a question. It involves the auto industry with this massive transformation over new electric vehicles as the administration taking steps to provide education for first responders to know how to handle a burden of battery or extract a person from a car without being electrocuted and there's there going to be any changing in career centers for students taking time over the last few years to clarify themselves with batteries. I'll take the last part first. We've been working with our CTEs throughout the state and trying to develop programs to get ready for this involvement to two electric vehicles and obviously I've been an advocate for this change in this this new frontier so to speak and we're going to learn a lot along the way. In terms of firefighters, yes, I mean there is a lot of talk about that and there will be more as we move forward on how to safely put out any fires that might develop and in terms of electrocution, I'm not sure that there are going to be any more dangerous than an average vehicle that are in some ways electrified now so I don't think that will be any different. What was the other part of the question, Ed? The career centers, it's not just about reading a book, it's got to be some money invested to get an EV vehicle on site for the students to get their hands on it. We have been trying to promote that obviously with the supply chain issues. It's been difficult to get as many vehicles as we need to meet the demand but that will come soon enough with ships and so forth as well with batteries themselves. And that's going to be a challenge for us as a country. Where do we get the materials for the batteries and are we going to build them ourselves or are we going to rely on other countries to supply them? I would much rather have them on our own soil and make sure that we're producing them here but that's going to be a national discussion I believe. Thank you very much. Wilson Ring, DAP. Hi, Governor. Just a follow-up on the discussion you were having earlier about the end of the COVID emergency. There aren't any emergency restrictions left over here. Are there? I don't think so but I know what I'm saying. I know everything. And then secondly, how do you think, almost three years since the start of the emergency, how do you think we'll launch a response once we know a few others? I don't know if there's any restriction to this point. We ended our state of emergency over a year ago, maybe a year and a half ago. So that's been quite some time. In terms of our response, I think we did as well as could be expected through the help of many Vermonters and their attitude and trying to take the politics out of it. And so we got through it successfully. Certainly with the appropriations from Congress, with Senator Leahy, Senator Sanders and Congress from Welch, they brought our share more than our share in some respects to Vermont in terms of relief dollars. And that's going to be essential that we continue to make sure that we're investing that money into the future and get us through this last inflationary period. So I think we did well in terms of in relationship and in comparison to other states and very proud of what we accomplished together in doing so.