 So, we're on YouTube again, and this is the House Healthcare Committee. It's Friday, March 12th, about 12.30 after taking a break. We've been in the process of reviewing final markup on House Bill 210, which is the bill that addresses health disparities and working toward health equity. We have invited Susanna Davis, who is the Director of Racial Equity for the State of Vermont, to join us and who is an integral part of the proposal that's in front of us, or she and her office. And so, Susanna, we haven't had a chance to chat, but what I wanted to say was simply that we appreciated your input in our committee on a number of occasions now, but we have crafted a proposal that I believe is consistent with what we last talked about, and in fact works with your office and your position to help move forward the idea of establishing an office of health equity. And I think I've sent to you the most recent draft. Have you had a chance, did you receive that, and have you had a chance to see that? I'm hoping. It is very likely that I did receive it, but unfortunately, I didn't see it. I am losing the battle, I can see in box. Oh, yeah. We can appreciate that greatly. Yeah, I've just done quick search for you, and I don't see anything unread, but it might have come from somewhere else. Okay, well then, oh dear, my apologies. Come from Katie or from Colleen, if you're looking for an inbox name. It should have come from me. Yesterday afternoon. Got it. I think I see that. Yep, I do. Apologies for not getting to that before today. Well, believe me, we're, we're all operating in a similar sphere of. Many things coming at us and deadlines ahead of us, right ahead of us. So, let's go ahead, Ian. I was just going to suggest that Katie would be the quickest to be able to point to exactly the section of the bill that is most relevant. I would welcome Katie for you to do that and that would help orient both Susanna to the bill where it's involving her and her office. Sure. Do you want me to put it up on the screen or just direct you to where the language is. We're looking in section three of the bill. And that, let's see, my document has been marked up by today's changes, but around page. 14. Section 252 health equity advisory commission. I think it might like to leave it to Susanna, you and Katie to walk through and identify the key places. And let us listen while you're getting the opportunity to. I think it's important that we reoriented this to what we had talked about or what this bill now proposes. So I think another key part is under the powers and duties of the commission. But Katie, you can help guide us. Sure. So in. So in section, take the lead on that, whatever works best for you, Susanna. I've just gotten up to see, to subsea now. Powers and duties. Okay. Okay. So, does it help if I kind of give you an overview as you read through? Yeah, please. Okay. So. C1. Looks at kind of the short-term duties. Of the commission with regard to providing recommendations and guidance for setting up an office of health equity. Making recommendations on structure, and then there are specifics that require recommendations, including whether the office will be independent, how it will be staffed, the population served in issues addressed, duties of the office, how grant funds will be managed and distributed and the time frame and necessary steps to establish the office. From there in subdivision to it's the duty of the commission to provide invite advice and make recommendations to the office once it's established. And there's a list of what the commission would provide advice on to the office once there is an office. And then subdivisions three, four and five in this subsection A would be ongoing responsibilities of the commission. So and three and four were in the bill as introduced. So you probably had read through those at one point, but reviewing monitoring and advising all state agencies regarding the impact of current and emerging state policies, procedures, practices, laws and rules. And then in four identifying and examining the limitations and problems associated with existing laws, rules, programs and services related to the health status of the communities identified. And then there's a new responsibility in five, which is providing advice and recommendations on cultural competency and anti-racism within the healthcare system through training and continuing education requirements. This has assistance and subsection D assistance for the commission coming from the agency of administration. And this has an annual reporting requirement. The committee has contemplated language here that the recommendations of the advisory commission would be based on data collected and analyzed pursuant to the next section. It has your position executive director of racial equity calling the first meeting of the commission to occur on or before September 1, September 1, 2021. And then I think the other language has remained the same in this section. And then there's also language in section 253 data responsive to the health equity inquiry. And the language here talks about each state entity that's collecting health-related data to collect disaggregated data by race, ethnicity, gender, identity, age, primary language, socioeconomic status, disability, and sexual orientation. And it also says that data related to race and ethnicity is to show you separate collection categories disaggregated beyond the categories of nonwhite and white. And this is to be based on recommendations made by the executive director of racial equity and consultation with the advisory commission. And then I'm going to skip down to section four. This is existing law that lays out the duties of the executive director of racial equity. And this adds a new subdivision four that says that another duty of the executive director is temporarily overseeing and chairing the health equity advisory commission until an office of health equity is established. And then in section five of the bill, this is a one-time report that the health equity advisory commission is going to do by October 1st of 2022 with regard to making recommendations for improving cultural competency and anti-racism and Vermont's health care system through initial training, continuing education, education requirements and investments. And then in section six, it's a two-part section, but in this fiscal year, $180,000 is appropriated to the agency of administration from the general fund for use by the executive director of racial equity and carrying out the provisions of this act. And then in subsection B, there's legislation language that a similar appropriation will need to be made in future fiscal years until the office of health equity is established. And that's it for the bill. The last section is effective date. Thank you very much for that. It was very, very useful. And looking through it for the most part, it looks very comprehensive. I'm wondering if the herdium section can be updated. I recognize that there had been a change from the bill as introduced that raises the cap on per diem from three meetings annually. Actually, it does more than that. It calls for more than three meetings and raises the cap on per diem for those meetings to six meetings annually. And I'm wondering if we can just make that something to the effect of for as many meetings as the stated funding permit. I feel strongly that asking people, especially the listed people, the 28 listed people, many of whom are people of color and are leaders in the community who are often asked to do this kind of labor for little or no remuneration. And I feel strongly that giving every opportunity that we can to fairly compensate for this work might be as simple as saying until the money runs out or something like that. Thank you for flagging that. That's actually on my list of something that I wanted us to still tend to, because we had talked about, and I think you actually had used the phrase process equity, which made a big impact on my thinking. And when I didn't realize until quite looking at it again, that the number had been changed, but it still had a stated number of meetings. And I would personally support some language to the effect. Some, some find some other language that allows for the commission to determine within the funds appropriated to determine how often to me. And. Thank you. So I think, I think we shouldn't have that. I have lots of circles around that right now. So. I think that that's an important change. Are you chairing? No representative. A representative Goldman has a question for. Susanna. Okay. First, I want to ask Susanna before we take any questions as to whether you have other. Thoughts or suggestions based on. The opportunity that you've just had to review this, but. I don't know. I don't know. Knowing there may be others. I'm going to say for, for right now, no, I'm happy to take a representative question. Just while I let this. Yeah. That sounds good. Representative Goldman then represent Gina. We talked about remuneration for, well, no, we didn't talk about it, but we talked about creating work groups within the commission and remuneration for people doing work group. Commitments. And I would like to include that in some way. So I don't know if it has to be specific or not. Yeah. Thank you for that. That was kind of, that was going along with, with that thinking was, are the six meetings just of the larger group or of the sub committees included. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Is it six per person manually? And, and if we have to bring in outside experts or what have you, you know, how does all that factor in? So those are. Those are certainly open questions that I think are worth considering here. Thank you for raising that. Can I ask my question now? It looks like Bill might have froze. No, I was just, I was just wanting to step in and say that I'm supposed to present at one o'clock to the appropriations committee on the financial end of this. And I wanted to just share what my thinking was. I had some conversation with Susanna at a previous point in time, but, but to suggest that the. That there be a consulting that, that there be funds for hiring a temporary, not a permanent position, but temporary either person or persons or a consulting group or some, somebody to assist under the direction of Susanna. And was thinking in terms of tying that to. I'd say to four. 140,000 dollars at that level. Perhaps then an additional. 10 to $20,000 of administrative and other expenses that would be used to perhaps bring in. Other expert consultants, et cetera. And then another $20,000 for per diem. For, for per diem use within the. But I would see that as both within the commission, as well as the work group. And then we haven't, it's not all calculated out exactly to a dollar specific dollar amount, but I think. I'm going to make that recommendation to the appropriations committee within the range of under $80,000. Hopefully that can accommodate some of what's being, what we're talking about here. Can I ask my question now? And they will, they will have other questions that I probably won't have all the answers to. Yeah. Sure. I don't know again, Suzanne. I don't know if that's, I mean, that I think that's pretty consistent with what we, we had talked about somewhat previously. Yeah. Okay. Brian. So I just, you know, you mentioned in your testimony today. That. Very, it's very common for. You know, you know, when we impacted people, especially by Poc to be asked to do extra work and not compensated. And I feel like. In your role that's happened where we hired, you know, we hired a, um, a director of racial equity and then gave a massive amount of work to that position. Um, Uh, and we, there's, there is talk of expanding. The work of the director and giving the director an office and more support. Um, I just wanted to, um, provide it to hand a piece of that work to the office of racial equity director, you know, to set this up. And I guess I just want before we move forward with it, I haven't heard you express any objection. Um, I just wanted to give you a chance to weigh in on that specifically and just make sure that if you, if. If we're going to give the position of the director of racial equity, this work that we're also giving the proper support. I don't know if there's anything you need to say or want to say about that, but I wanted to make sure I asked before I voted on this. Thank you, representative. Um, the work has to be done. And I'm here. So. We got to get it done. I mean. It is a lot. I don't pretend, um, I don't pretend that one person or three people can, uh, necessarily balance everything that needs. To be done in and for Vermont. But, um, one thing that I, one thing that I can say I'm relieved about this year and seeing the aftermath of the pandemic is that oftentimes when we face crises or budget shortfall, one of the first things to get cut is equity work. And, uh, I think this year I'm very pleased to say that we have a legislature and an executive administration that has demonstrated the opposite that we're looking to expand this equity work. Um, we're looking to expand this equity work because we can't recover unless we're recovering equity. And so it's not an ancillary part. It's a necessary part. So, uh, all that said, I, I, um, and grateful for the trust that you all are putting in, in the racial equity office for this work. And, um, we're going to do the best that we can. I'm sorry if that was a strange non answer, but. I just want to make sure that we're, I just want to make sure that we're working from you that you are, you're, you're welcoming the work and you see it as part of the overall goal of your office. And I guess the only thing I would encourage is that when you need the financial help. Um, don't be afraid to ask because we will advocate for it. I can't speak for everyone, but I would advocate for it, you know, because I want to make sure that we're properly funding the work too. Can I, can I step in and say, and I speaking, I'm just going to say I just want to make sure that we're doing the right thing because when we sent our budget recommendations to the appropriations committee, we said, uh, we said, we wanted to fund this temporary work that at the time had a place, save her in about a hundred thousand dollars, but we also said that that was contingent on the full funding of the two additional positions in your office. That if we, if the, that. Your office cannot take this on from our point of view, committee had to do in order for us to be able to consider taking this next step and asking you to take on this additional transitional responsibility. So we as a committee, and I will reiterate that in the appropriations committee today as well, that the funding of those two additional permanent positions is a necessary prerequisite to moving forward with our proposal for this Office of Health Equity transition work. So I welcome any further thoughts. And I'll just, maybe I'll just cut to the chase. I think you've said this, Susanna, but it's like when we were going over this yesterday, the question was raised, has the Office of Racial Equity agreed that if we are successful in this, that they are interested and willing to take this on? I said, well, let's have that straight up discussion because it had been referred to and implied in some ways when you visited well as previously, but today is that I hear you saying, I believe I hear you saying that you would support taking on this additional work, presuming that your office has the other support that's intended as well. Yes, and if I may, I might just add one thing to that that I've hesitated to say until now, but it's Friday and it's getting cold. I would say yes, I would welcome the opportunity, but I would ask the committee and the legislature and I guess the state in general to be prepared slash understanding in the event that the time limit might need to shift. Yeah. I think we are ready for the stage where we want to get it right. More than we just want to get it done fast. And I respect that the rulemaking process generally does rely heavily on deadlines and timelines, but I would also just put a note in here that it's very possible that we may ask for those to shift. And I'm going to thank you all in advance for the understanding and the flexibility in that. I appreciate you saying that. And we haven't had this particular discussion, but that would be consistent, I believe with the intent of our committee to have the work done right and not just to meet an artificial deadline, but we would be trusting on the collective judgment of your office and the commission members to advise us as to what the practical implications of that are so that we could work together on that. Thank you. Okay, well, actually the timing is actually fortuitous because I'm being asked to come to appropriations in a few minutes. You don't get to eat, but the rest of us want a lunch break. Well, that's good for everybody, I suppose. But actually my question was whether I was, yeah, okay, well, I think that's the place for us to stop right now then. And so I will, maybe, Susanna, could you stay on video just for a minute and let me check in with you as others are leaving to get their lunch and I'm welcoming you to go get your lunch. But I'd like to just touch base with you a minute more before I leave the screen, if I can. Could we just verify one more coming back? Two-thirty. Two-thirty. Come back at two-thirty. Thank you. Okay, great. Thank you for all your work this morning. And I want to actually, before you go, I want to thank Representative Donahue for stepping in and helping to facilitate the committee this morning. I really appreciate that, Representative Donahue. And that was greatly appreciated by me. Okay, I'm going to crop your quick email just so you know it's coming. Great. Oh, let me say, so we need to integrate language in that compensation section on page 18 or whatever that number is that revises. Page 19. Item H, I believe. Compensation. Yeah, H, yeah. We must not forget that in order to be consistent with what our conversation just has taken place with Susanna as the director of racial equity. Okay.