 Senator Clarkson is here to take us through the Senate version of age 68, which we almost passed that crossover, our version of it, before we learned that they were almost ready to do it. And then we had received testimony. We were not going to be making any changes off of what was introduced. But we were told that Senator by Michael Churnick, the attorney on this, when he first introduced the bill to us, that the language in the Senate bill was the most up to date. And was the proper version of the bill. So Senator Clarkson is here to introduce the bill to us. Well, I don't want to be redundant to work that you've already done. But it was really exciting to actually get this bill passed out of the Senate because they have been fairly resistant for a while. But I think lots of things have changed. And I was one of the sponsors of this bill along with Debbie Ingram. And thank you for your work on it. So this will give you a great foundation to then pick it up midstream. Because we probably, given your time, we, anyway. So as you know, for the last three years with two different governors, we have proclaimed the second mundane October as Indigenous People Day, Indigenous People's Day in Vermont. And I then read from the proclamation, which I'm not sure everybody had known that we had two Vermont governors that had already done this. We're not alone, as you know, in considering making this change from the recognition of Columbus Day to Indigenous People's Day on the second Monday in October. And since 1992, over 60 cities and towns nationwide have taken this step from Berkeley, California to three towns in Vermont. I think Met Marlboro, Brattleboro, and Cardford. Several other states, Oregon, North Carolina, and Iowa, also had an annual governor's proclamation. And you've heard this because you've already taken up this bill. I think our legislature has explored this change for a number of years. I think you've gotten it through to the Senate before. I think you've passed it before. Am I not correct? Or it's been introduced many times. It's been introduced, and I don't know that we've actually passed it. Because I know Diana introduced it a couple of years ago. Anyway, this year just seemed to be different as we worked to dismantle implicit bias and systemic racism in Vermont. This year, we really need to focus on holidays, aligning our holidays with our values. And I think we just felt this was the year. And it was the year definitely in Senate government operations. So that was wonderful. And I feel that in making this change, we're completing history, not erasing history. And we listened to very compelling testimony on this and encouraging us to look at this holiday differently. That it needs to be for the living. That it recognizes the dignity of our indigenous people living here now. And all indigenous people, not just the Avanaki and our Native American populations, but all our migrant workers, all the indigenous people who are here in Vermont at the moment. Our refugees are all sorts of people. And so we have done this fairly short bill. It has four sections, which you'll find. I'm sure you'll go through them with Michael. I'm sure you've listened to the history of Columbus. This is not to negate all of what Columbus may or may not have done. There is, you know, it's a fairly controversial history. And the setting of Columbus Day was made in many ways to appease certain populations. And that was only done in the first recognition, as you know, was in Colorado in 1907, I think. It's not, it hasn't been forever. Even when it was made a federal holiday in 1937, which you may have already heard of. And it was moved in 1971 to Monday to make it a three-day holiday. So the, we heard from a wonderful chap who's the commissioner, who's one of the commissioners on the Native American affairs, Rich Holshu, who was really compelling and was a really terrific person to testify in our committee. And he was a very persuasive person. So if you take this up, and which I assume you will take this up, given the work you've already done on it, I'd encourage you to hear from him, because his testimony was wonderful. And if you want to just read part of it that moved us, particularly as it talks about Columbus and this new thought. Rich said, I do not support the idea of removing from our histories those events or persons that we, with hindsight, now find less palatable or honorable. We need to know these things. This is the value of learning the lessons of history. By exploring a more complete narrative with the inclusion of all the voices involved, we can listen, understand, and resolve to do better. We now know that Columbus was not the idealistic, magnanimous, inspirational figure we were told years ago. He is not the one to be set on a pedestal and honored for his great and often fictional accomplishments. The heroic myth was created in service to a set of divisive ideologies of separation and entitlement, which left those outside its walls denied, dispossessed, and or dead. Not to be ignored is the fact that a version of these attitudes has played out all over the planet with the indigenous people of each place at the receiving end of exploitation, disenfranchisement, and dismissal, often paying the ultimate price. This is the more complete story that we should learn and understand. And then work to honor and celebrate the resilience of the human spirit, its creativity, persistence, and adaptability. There is much to be done and undone in order to provide for the future generations and the world they will inherit. And we were moved and persuaded and voted unanimously in our committee to vote this out, and it had a very strong vote. I think we had a unanimous vote in the Senate as well. So I, we, you know, I'll just leave you with Obama's quote that I did. As Obama did in his last proclamation of Columbus Day, he said, as we mark this rich history, we must also acknowledge the pain and suffering reflected in the stories of Native Americans who had long resided on this land prior to the arrival of European newcomers. As we reflect on the adventurers throughout history who charted new courses and sought new heights, let us remember the communities who suffered and let us pay tribute to our heritage and embrace the multiculturalism that defines the American experience. So with that, I give you S68, and I hope you will have a good and throw and full conversation, and we hope to see you back in the Senate. Okay, well, we, again, we, as we did hear from... You heard from Rich. Yeah, no, we, we were not aware that the bill was moving through the Senate at the same time that it was moving through the House. So, right through our committee. That was one of the bills we hadn't chatted about. Yes, so we did hear from, we did hear from many of the same... Did you get Obama in as your witness? No, we had, we had Michelle. So, no, but thank you for, thank you for passing it through. Thank you for coming to introduce it. And, you know, we already look kindly on the bill. You are on the journey. So thank you, and thank you for giving me time. And now back to Govons. See you. Thank you for joining us. I just an email away from you, be back. All right, thank you. Bye. Thanks a billion. Michael, I wish I read this. Did you catch your breath, Michael? Michael, there was no, I had read it was 2.15 and as Ron was saying, it was 15 minutes after the floor and I still saw the 2.15 on my calendar, but I don't wanna know. I think we did this last time too, so. So when we were here last on this, well, when you first introduced this bill, you had told us that this bill was our version, the House version of the bill was slightly different than the Senate version, and the Senate version was the most recent version. And I'm assuming that's what passed. Right, but I, the difference, as I explained the last time I was here, which seems a long time ago now, it must have been at least about six weeks ago, there was a House version and the Senate version. When I did the Senate version, the changes had no impact whatsoever on the indigenous people, native American substance. It doesn't, the holiday change that's provided for in section two, the findings from section one are exactly the same down to the comma, semi-colonial spacing. Ditto section two on legal holidays, which creates indigenous people's day, is exactly the same. What's different is section three, which is a technical cleanup for business days, entitled eight, and the way that I set it up in the Senate now reflects the way the legal holidays are set up in the House, as opposed to the slightly different way I initially had it in the House. The way the Senate passed is the version that is the way it technically should be, and more importantly, minus the indigenous people's line, which obviously is not in the technical corrections bill. It's a formatting we use this year to switch it in the technical corrections bill so that notwithstanding whatever happens to this bill, that the title eight, this section of title eight, 11201, assuming the technical corrections bill passes the Senate, which it appears likely it will, will now read the same way as the legal holidays in the House. So it's primarily a technical matter, but this is the version that corresponds to all of that. Okay. And just, Sean, if you could scroll back up. So just to be clear, indigenous people's day would be the second Monday of October. It doesn't have a numerical assignation, is that right? That is correct. The same is, right, it's the same, it's number and title, it's section two, it's number nine, it's the same as Columbus Day. All I did was to strike the words Columbus Day and insert the words indigenous people's day. But other than that, it's exactly the same place. And Ditto in the section eight that I mentioned to you, number 10, it's now number 10, that works a little bit, the numbers work a little bit differently on section eight, just as an FYI and being full disclosure. In title eight, rather, section three, is because New Year's Day is listed as number two, that's a structural, because it's an introductory clause, but it's the same thing. Okay, and just to be clear, these are holidays, not paid holidays. Correct, these are observant states, if you like, there. We also have observant states such as PLW Day, MIA Day, but this will be officially noted as a state holiday, maybe for a governor's speech or something of that nature. But the state employees, day off days, which is what everybody's driving at all the time, those are decided exclusively based upon the negotiations between the Vermont State Employees Association and the administration, whoever is the administration in a particular time. So it has no impact on whether state employees are the day off, because as I mentioned to you some weeks ago, state employees have not had Columbus day off at all, since early in the 2000s, near the end of the dean administration, the VSEA and the administration came to an agreement to give up what was called a flex holiday, which is what Columbus Day was, in exchange for making Barney the King Day a full state holiday, employees paid off. And that's been the case now for about 16, 17 years. And so again, the difference between an observance day and that, so PLW MIA Day is not listed on here, but so observant days can be anything? We have, we have PLW MIA Day, there's Aberdey, there's Juneteenth dealing with slavery in June. The difference between that and this is, it might be considered as somewhat, shall I say, higher bragging rights statutorily, because it's on the official list of holidays. But again, it has no impact in terms of state employees having the day off. And I want to emphasize that. Okay, no, that's, no, I just, I had not heard the differential between, we've been talking about how Indigenous People's Days has been established in the last several years, just simply by resolution or by. Governance proclamation. Governance proclamation. Executive order. The one other thing I tend to say by that is on any of these days, whether it being something that's going on the list or whether it's a Juneteenth or Aberdey or PLW MIA Day, permanent establishment of that day can only happen through a statute in the green books, what this would do. The General Assembly can adopt a resolution year after year. The Governor can issue a proclamation in executive order, but that's for that year. So for example, when you have the various resolutions in the House designating this as Cancer Week or Heart Month or whatever it is, that's a one-time thing just for that year. But there is a pecking order between, between an executive order, observance day, state holiday, paid state holiday. Yeah, I think that's fair to say. And, okay, that's fair to say. That's as far as we're going now. Yeah. I'm not here advocating anything, but I'm just making a neutral comment that one could say there's a pecking order. No, absolutely. That's just, again, I had not heard the differentiation between a state holiday and an observance day, so I appreciate that. Although you will not find the term observance day anywhere in the Green books. I just used that term to try and distinguish those that are and aren't on the list. So where, so then where does, where will I find PLWMIA today? In Title I, there are other days being on the list. In Title I, it's a few, this is the 371. If you open up the Green books, it might be 371. This is 371, this might be 372, 373, 374. We've added, so there are some additional sections that provide for those non-listed holidays. Okay. But they were in the Green books. We've got a few sections of this. Okay, great. Questions for Michael? Thank you. Now, are you anticipating any sort of markup today that, or would you say? No, we have a markup schedule for tomorrow. And in pending conversation, we may, you know, we'll discuss the bill in greater detail, I think, tomorrow. Okay. At 11.15, I believe we're on for. Right. Okay. All right. I mean, I, you know, again, when we were close to passing this before crossover, we weren't anticipating making any changes. Okay, I just wanted to be sure because I'm about to go back. If you don't need my services right now in terms of potential lighting. I think we're all set. Thank you. I will be here at 11.15 tomorrow morning unless I've been informed otherwise. Great. Thank you. Thanks. Thank you. Yes, sir. All right, welcome back. We are on the record for S111, which we, while we scheduled this last week, it was in anticipation that we were to receive the bill, which we did in fact receive today. So Damien, if you could just tell us a little bit about the bill from your perspective and then walk us through. Sure, thank you for the record. Damien Leonard, Legislative Council. So I'm going to let the other witnesses talk more about the underlying issue. I think they have a lot more to add on this than I do. The bottom line is that our members of the National Guard, as well as soldiers, airmen, and other members of the US Armed Forces from Vermont were exposed to toxic smoke from burn pits while serving in the Middle East and Afghanistan from about 1990 through the present. And the US Department of Veterans Affairs has set up a burn pit and airborne hazards registry to track the health effects on these individuals. And this is the first step towards figuring out whether there should be a presumption that certain conditions were caused by exposure to the burn pits. The problem right now is that there are not a lot of Vermonters who have signed up. So between June 2014 and January 2018, only 394 Vermonters out of probably more than 10,000 who were exposed had signed up. So what this is designed to do is to increase publicity and knowledge about both the public health issue and also about the registry. So the first section, section two, would have the Department of Health and Consultation with the Adjutant Inspector General and the Department of Veterans Affairs develop written educational materials to provide information about health effects that are associated with chemicals identified at the open burn pits during overseas military deployments, including symptoms associated with exposure to open burn pits, information regarding how to participate in the Department of Veterans Affairs Registry, infuriate information regarding eligibility requirements for participation, contact information for the registry and contact information for the Environmental Health Coordinator at the VA, and then Honor before July 1, 2019, making that information available on the Department of Health and Office of Veterans Affairs websites, and then in cooperation with the appropriate licensing boards and professional membership organizations, ensuring that the information is made available to all licensed healthcare providers in Vermont by that date, and then Honor before July 1, 2019, and the Commissioner of Health and the Adjutant General in coordination with any available and interested federal or state agency would develop a pamphlet and other written information material for veterans and members of the Guard regarding the same information, and then section three covers communication of that material, so the Adjutant Inspector General, the Executive Director of the Vermont Office of Veterans Affairs, again, with any available and interested federal or state agency would collaborate to contact all members of the Vermont Guard and all known veterans and members of the US Armed Forces that reside in Vermont. Who may be eligible to participate in the Airborne Hazards and Open Burn Hit Registry, and in particular, they would endeavor to contact anyone who served in operation and during freedom, Operation Iraqi Freedom, Operation New Dawn, in Djibouti, Africa, Honor after September 11th, in Afghanistan, Honor after September 11th, in Operation Desert Shield or Desert Storm, and in the Southwest Asia Theater of Operations, Honor after August 2nd, 1990, so Southwest Asia Theater of Operations is the catch-all for the Arabian Peninsula, Qatar, Saudi Arabia, Kuwait, et cetera. And the members who are contacted would be encouraged to join the registry and provided with contact information and a copy of the pamphlet. And then section four directs the Aged Stem General to encourage, because we cannot require the federal government to take action, but to encourage the federal government to enhance and simplify the registration process by providing for identification verification for the required access permissions to be available at community-based outpatient clinics throughout Vermont. Right now, if you can't get your identity verified online, you have to go to White River Junction to the VA facility, which as you may imagine is quite difficult for some veterans living in Vermont. For the creation of a paper registration option, right now you have the option of printing out your online registration, but to the best of our knowledge, there's not current VA paper form that you can mail in and submit, so again, this could present a difficulty. When you're talking about something which is supposed to take a minimum of 40 minutes for you to fill out, if you have a slow internet connection at your house, that can extend the time required to log on. testimony in the Senate talked about log-on times or times to fill out the online registration that took in excess of two hours, so we're talking about something that can be quite lengthy and if you're having to deal with a slow internet connection on top of that, having the paper form that you can fill out at your leisure may be an easier option for folks. And the creation of a process for deceased veterans, family members to participate in the registry on behalf of the deceased veteran. And then additionally requesting that the periodic health assessment for members of the National Guard determine if the Guard member was deployed to a location that would make him or her eligible and whether the Guard member was exposed and then if they're identified, pursuant to that periodic health assessment as having been potentially exposed to burn pits, automatically registering them to participate in this registry. Again, the goal here is to expand the number of people who are participating in hopes of speeding up this process at the federal level for recognizing the health effects that are already being identified in relation to these burn pits. And the effective data is on passage to allow for all of this action to happen. That's all I have. Do we know, I'm sorry, I was late, Daniel, but do we know if there's been some data collection regarding what symptoms are consistent presently with exposure? So we heard in the Senate when they were talking to us, yeah, the Senate here, Senate government operations heard from a former doctor at the VA who actually had recently resigned because she was, in her own words, running into difficulties because she was advocating too much for the patients. But she described a number of health effects, several of the other witnesses have described various cancers that are associated with us along with respiratory problems and other things. But I really think that that's probably better testimony from the witnesses who can give you first-hand descriptions of what they and their loved ones have experienced. And we started with Daniel here from the Center of the White Limited as well. Okay, yeah. I mean, one of the reasons I ask is because once symptoms of dioxin poisoning came to light that the VA's response was not adequate in testing that poisoning. There was one method of testing that poisoning that veterans didn't actually receive so that when it came to it, it was just kind of a gathering of information without any definitive conclusions of these men and women are suffering from this. And I think it prolonged the compensation or the recognition, I should say, that this was a true and accurate ailment that veterans were suffering. Yeah, I think that some of the testimony we heard in the Senate indicated that there are a number of health effects that have been documented with members of the Armed Forces and veterans who are exposed to this. But to date, the Department of Veterans Affairs and DOD are not acknowledging that those are necessarily linked to the burn pits. And again, this is testimony that the veterans themselves and their loved ones can provide you with much better detail on. Sorry, no, no, that's okay, and then we'll, so yes, are you, are we all, so I've walked you through the bill. I really, at this point, don't have anything to add that can't be said better by a different witness. Right, so let's see that Senator White joined us. Let's have her start with the committee's experience with the bill, I mean, I've already got like 600 questions in my head, so let's see if it expands after this, or thanks, David, you're welcome. I didn't look behind me, I didn't look behind you. Welcome, Senator, how are you? I'm fine, thank you, thank you for asking me up here. I'm Jeanette White, Senator from Wyndham County. Let me just give you a little bit, the witnesses you're gonna hear from are much better qualified to speak to this issue than I am, but I'm going to just give you a little bit of information. I had no idea that this was an issue, as I think most of Vermont probably didn't, including a lot of returning members of the service. So in December, I was having breakfast with my sheriff, and he happens to have been a guard member, and he was a friend of Mike Hestens, and he said, this is an issue, and it's going to be facing many more of us, and we need to do something about it. Is there anything you can do? Well, I said the DOD and the VA, and there isn't anything I can do. So I brought it here and worked with the pro tem and the governor, and we came up with this bill. And the, I have to tell you, I've been involved in a lot of issues here that have advocates on every side, opposition from every side, passionate issues, but I've never been involved with one that has made me so angry and so sad, because I was angry that we heard what we heard that wasn't happening, and I was sad because of what was happening to the people. So I'm going to let them talk to you about the conditions, the, what the DOD and the VA are doing and aren't doing and how we need to do it, but our main purpose here was to, a couple things, to create awareness among the general population, but also among the veterans who are returning to get them to sign up for the registry. And we recognize that signing up for the registry is not necessary. It isn't going to, it isn't connected to their benefits. We know that, but if people can sign up for the registry and we can get, let me back up a minute. We know that Vietnam was a long time ago, and it took the Veterans Administration working with this organization called the Institute of Medicine. It took them years and years and years and many deaths before they started acknowledging what are called the presumptive illnesses that are connected to Agent Orange. So we did not want the same thing to happen here. We wanted to make people aware, get them signed up, and hopefully began the awareness sooner so that the VA could start creating a list of presumptive illnesses. Just let me tell you some of the illnesses that the Institute of Medicine already connected, but they said they're associated, but they couldn't kind of officially say they're connected. Neurological effects, liver toxicity and reduced liver function, cancer, stomach, respiratory skin, leukemia and others. Respiratory toxicity and morbidity, kidney toxicity and reduced kidney function, blood effects, anemia and changes in various cell types, cardiovascular toxicity and morbidity, reproductive and developmental topic. And that's just the ones they've identified so far. And I will let people explain to you what the burn pits are when I started explaining it on the floor of the Senate. People were stunned, three football fields in size and they, in one base alone, they estimated that they were throwing in and burning about 100 to 200 tons a day. Tons a day. They throw in the disabled vehicles, the tires, animals, human excrement, body parts, old ammunition, whatever they need to get rid of and then they just dump a lot of accelerant on it and burn and burn and burn. And when it runs, the fire dwindles down, they shove it together or more accelerant on it and burn it again. That's what people are dealing with. And so we felt that we needed to get people signed up for the registries early. We need to make awareness. We need to get people involved in this. And that's about all I'm going to say because your witnesses are much better here, but I will tell you, get out your tissue boxes. Because this is an issue that I consider myself not a very emotional person and I couldn't report it on the floor. So, but the one thing I will say is that everybody involved in the implementation of this bill, the medical society, the Guard, the Department of Health, the Vermont Veterans Administration, everybody is supportive and willing to do their part in getting this done. So I think that you're, I see you have two very capable and good witnesses here today. I don't know if you're both testifying, but so I don't know if you have any questions. I just want to make one comment. This is the Agent Orange newsletter. 50 years later, we're identifying illnesses and disease that the men are suffering from. 50 years later. Yes. We had some Vietnam vets came in who were dying from Agent Orange and heard from them. And yeah, and we did a roll call vote and it was 30. And we're very, I have to say I'm proud of our state government, our National Guard and everybody who has really stepped up and said this is an issue we need to deal with and we need to deal with it quickly. We can't sit around, which is why we put the effective date upon passage because we want to start it right away. And we put the letters that are to go out by July 1st. And we've heard from the Department of Health and from the Veterans Administration and the National Guard that indeed can happen by July 1st. So you'll hear more. Did you take testimony from someone in, you mentioned that a doctor quit because she was told that she cared too much about the patients. So did you take testimony from that? I don't even know how to phrase this, right? I'm sorry, Senator. Just like, from the person who could have told her that, I mean, you know, I mean, we're all Americans and we all support our veterans and we all support our troops and our guard and the service. We, and I'm just, as I was, as a child hearing about, as a teenager hearing about the beginnings of the Agent Orange situation, I'm just, I mean, as you said, tissues, anger. I mean, it's already floating up in me and I'm just curious to know, did you, you said everyone who testified supported this, but what about the people who are denying that this is happening or denying this to the veterans? Well, as a little tiny committee in the little tiny state of Vermont state legislature, we didn't seem to have much influence over the Department of Defense, nor did we have much influence over the Federal Veterans Administration. The Office of Vermont, the Vermont Office of Veterans Affairs, I believe is what the official name is, is very supportive. The Federal Veterans Administration chose not to respond to our requests for testimony. They, and one of the things that we heard from the doctor and from other people was that the DOD is the one that's doing this, right? So they're the ones that are perpetuating this practice. The Veterans Administration is the one that pays for it in the end. And there's a huge disconnect there between the two. We did not ever expect to hear actually from the, while we were hoping that we might from the Federal Veterans Administration, but we didn't, they chose not to come. We did have a letter here from somebody in the Veterans Administration and he pointed out some errors in the bill, such as contradictory information on health effects and he tried to justify why that wasn't true. And then at the end he says, you mentioned that someone from the VA will be talking to the state legislature. It would be very good to make sure that person has some of the facts outlined in this email. But no one chose, we sent him a note asking him if he would care to come visit us and never heard back from him. So no, everybody that we heard from was supportive, but the two main players here that we don't seem to have a lot of control over, we did not hear from. So they, and we are, we wanted to put in there that they had to allow people to show their IDs at the VA clinics around the state instead of having to drive to White River, but we knew we couldn't tell them they had to do that so we're suggesting that they do it. And our three federal delegation, people were in there and they all spoke to us and they're all supportive and they all actually have bills introduced that would speed up some of this and add additional money to places where they needed in order to speed this up. So they are with us and they are doing whatever they can, our federal delegation. So. And did you take testimony on anyone that would be able to tell us about planning the burn kits about how we managed to have such an extended buildup and we as American citizens had no idea that this is how we did waste disposal when we were talking about how long it would set up. Was this something, did you take any testimony on who set this up? Was this something that private contractors set up? Is this something that the US government set up? Well, I think both. And we, I think that they've probably been using burn pits longer than 2003 in this, in these theaters. This is what we're concerned about right now. But I don't know how they dealt with, how the military dealt with waste in 1967 or in 1972. I don't know how they dealt with it then. But we do know that in, since 2003 and you can, if you, I can give you some of the handouts we were given by our federal delegation. And in 2000, I don't remember what the year was, General Petraeus warned the military that this was a problem. He pointed it out and oh yes, they began in 2003 and he warned the military that it was doing harm to our guards, people and our soldiers at that point. And our federal delegation wrote a letter saying, how come 10 years later we're still doing this? We do know that there were at least three incinerators built in different places to burn the waste instead of using the open pits. And but we, as I said, we kept, banging our heads on the wall saying, why does the Department of Defense do this? We wouldn't let that happen in this country. We can't, you can't even have a 50 gallon drum down town here and burn your trash in. And yet we're allowing this. And they identified over 51 toxins in the atmosphere and in the sand, so. It was because it was the easiest and the quickest solution. And probably the cheapest and unthought of. But unfortunately it's not gonna be the cheapest if we can get some care for our veterans. And we did, I mean, I'm not, you, the testimony you will hear is very compelling and I'll just leave it at that. I appreciate you coming up here, it's been a pleasure. Just so I understand, it goes back to 1990, but I think it says when they served up to 1990. Well there are four, five theaters that are designated by the, we didn't come up with those. Those are designated by the DOD or Veterans Administration. I don't know how they do that, but those are the ones that are defined. And because in those arenas, the burn pits were used. In all of those, from 1990 on. Yes, in those particular cases. And just to be clear, what this bill is seeking to do, what this bill acknowledges that the federal government for all of its anger that will come out, they formed this burn pit registry some five years ago. And what the records are showing is that Vermonters don't know enough about it, it regards people, and we don't have that many other kinds of veterans in this state that would have served during that time. But what this bill is promoting is, at its base level, is to get information to National Guards members who served overseas during this timeframe who may have been exposed to this. That's what, that's the biggest laughing. The government at the very least has set up a registry. Yes. And this registry will help perhaps down the line for folks, but it just shows, it'll also show that this many people actually served there and Vermont's being underrepresented. Well, it isn't just Vermont. Everywhere in the nation is underrepresented. They're not signing up for this. And I should say, it isn't just Guards members, it's any active service member who served there. And what we've heard, and I'm sure Mrs. Heston will tell you this, that people from across the country have the same concerns, and they're calling her and saying, what can we do? We know that you're doing something, what can we do? And we have, let's see, the last time we took the testimony on this would have been a week and a half ago, I guess, and we had already increased the registrations by 10% in Vermont. So the hope is that getting people to register will both speed up the process of the Institute of Medicine defining the presumptive illnesses that are connected to the burn pits. It will also, perhaps, although we don't know, have influenced some of the benefits that people can get. But it will also, we hope, cause some kind of a groundswell. As citizens, there's very little we can do about the DOD or the VA, right? But if we can get people from around the country, if we can get people from Texas, I think June heard that people from Texas have called, if we can get people in Texas and in Arizona and North Dakota and all over to start calling and saying, this is an issue, we need to do something about it and getting their federal delegations concerned about it and doing something, maybe we can make a difference for some people. Yes, representant of the department. First of all, I'd like to say that tomorrow is going to be the fifth anniversary of my husband's death and he was a Vietnam veteran. So I know all about it, you do know. I have a niece that's served in the Middle East and ended up getting a medical discharge. I don't know if she was exposed to these burn pits or not, but I'm going to find out and I can assure you why we're gonna have a conversation about it. And I just don't understand, I don't understand, this is, we need to take care of our veterans and why aren't they told upon discharge if you have these symptoms reported to your... Or if you served in these places. Well, and then served in those places. And one of the reasons for involving the medical profession here is because the medical profession are the people that see their patients and if we can give them information about how, so every medical provider in Vermont will get this communicator, whatever you want to call it, if it's a, what to look for, ask your patient if they're a veteran. If they're a veteran, did they serve in these places? If they served there, get them registered. Give them information on how to get registered. So I also would like to say I wish that my husband had the doctor that testified in front of your committee because he did not and he had a doctor that really cared for his patients. Maybe, you know, who knows? Yeah. But thank you. I'm just wanting to know, do you know if there are any other states that have taken similar action or are all working on it? I mean, is there any, a network? Is there... I think that Mrs. Heston can talk to you about that because she is involved with a network of, I don't even remember TAP, whatever that stands for. It's a network of veterans and veterans, spouses and survivors. I think she can talk to you about that. I don't know right now about any other state that's actually doing it. I know that there are some states that have asked for a copies of the legislation so that they're thinking about it, but that, I don't know. It would, we could, I guess, find out from NCSL, maybe, if there are any other states that have. Are there, I don't know. Yeah, we can take that point before we can try to come. Mrs. Heston's up next. I just have one quick question. Sorry, if someone wanted to sign up now, is there an avenue for them to take? Yes. In fact, I just wrote a piece for our paper, the other day, and at the end of it, I put the adjutant general's number and email and I put Bob Burke's email and telephone number and said they will be very helpful in helping you to sign up, because yes, they will. And the guard, yeah, I'm sure they'll give it to you. And the guard has said that they've talked about doing something like on drill weekends of having people sign up and there is Laura Cibalia, the representative Cibalia, and I are going to have an awareness sign-up day in our area and we're encouraging other legislators to do the same kind of thing and have it at some place that has access to computers and people there that can help people sign up. Thank you. Thank you very much. Thank you. Thank you for taking this up. Thank you very much. Well, let's just introduce ourselves to the representative, I'm Stephen Steele. I'm from Matt Byron, Bridgette and Sarah. I'm Zod, Farmer's. Representative Lisa Hingo from Berkshire. Representative Mary-Helga Nash was one. John Collette from Zod, Berlin. Tony Walts from Harri City. Mary Howard from Rutland City. Chip Croyado from Standard. Thank you very much and thank you for inviting me to be here today. And I want to thank Senator White for giving me permission to be emotional. You always have permission. Yeah, thank you. My husband, Brigadier General Michael Heston, died on November 14th, 2018, after almost a two-year battle with a rare form of pancreatic cancer. I've been asked to testify today regarding S111 bill known as the Burn Pit Registry Bill. Mike's diagnosis took 10 months and approximately 25 to 30 visits to many doctors and specialists. A familiar story among veterans. During this time, we knew toxic exposure due to the Burn Pits during his deployments in Afghanistan were an issue because the Burn Pit Registry was established. Mike always said, you only create a registry when you know there is a problem. As the Deputy Adjutant General for the state of Vermont, he communicated to his staff that all soldiers and airmen who were exposed to these Burn Pits while deployed were to register on the Burn Pit Registry. The problem is the registry is difficult to access and when you are able to access it, the process takes a great deal of time. It asks irrelevant questions and it appears like the objective is to find ways for the government not to be responsible for any health concerns. Many soldiers give up trying and 40% who begin the registry do not complete it. This needs to be rectified. Systems need to be put into place to ensure our service members are able to register. Mike did take the time to register as soon as it was available. Two years later, Mike started having extreme back pain followed by significant weight loss. Although we let Mike's doctors know of his three deployments, we did not think to mention his exposure because there was little visibility on this issue at that time. And of course you want to believe that it can't happen to you, particularly since he was told by a doctor at UVM. We don't know what it is, but it's not cancer. It was not until Mike was diagnosed that Dan Farber Cancer Institute in Boston in January 2017 that San Juan sent me an article about Amy Muller, a young woman who served in the Minnesota National Guard and deployed to Iraq. She died at age 36, nine months after being diagnosed with stage three pancreatic cancer. That's when I started doing my own research on burn pits and discovered many veterans were being diagnosed with rare illnesses and cancer. We started talking to Mike's oncologist about Mike's exposure to toxins from the burn pits overseas. Dr. Abrams, like most of the US population, had no idea what we were talking about. That's when testing was done to determine if his exposure was responsible for his cancer. Dr. Abrams writes in a letter dated May 3rd, 2017, quote, as a medical oncologist specializing in gastrointestinal cancer with the Dana Farber Cancer Institute and a faculty member with the Harvard Medical School. I'm a national recognized expert in the care and treatment of epidemiology and epidemiology of pancreatic cancer. It is generally believed that roughly 30% of all pancreatic cancer cases are likely attributable to environmental, parentheses, carcinogenic exposure, end quote. He later said, states regarding Mike, I've conducted a detailed review of one, his diagnostic and therapeutic course, two, the timeline of General Heston's multiple tours of duty to Afghanistan, and three, the environmental exposure profiles for both Kabul and Bagram, sites of his year long deployments. General Heston has none of the genetic, medical, dietary, or behavioral risk factors commonly associated with pancreatic cancer. Based on the prolonged carcinogenic exposure, metals, chemicals, and smoke from burn pits, sustained over the course of General Heston's deployments and the timing of those deployments, relative to the onset and diagnosis of his pancreatic cancer. It is my professional opinion, more likely than not, that General Heston's pancreatic cancer is due to his prolonged environmental exposure sustained over the course of his deployments to Afghanistan. This letter was the evidence we provided for Mike's application for service-connected disability. This process took almost a year, and in January of 2018, we received a letter from the Department of the Army rejecting Mike's claim for service-related disability. It states, there have been studies conducted in Afghanistan and Iraq regarding air quality and toxic, toxin exposure. They indicate an increased risk of developing various conditions. However, the study stopped short of saying that exposure to smoke fumes from the burn pits directly causes various medical conditions. The studies also state that more research is needed, end quote. More research is not needed. The evidence is clear. The rate of cancer among service members is significantly higher than the general public. It is also understood that open air burn pits would not be allowed in the U.S. under OSHA regulation. Open burning of residential, commercial, institutional, and industrial solid waste is prohibited under 40 CFR part 257-3.7A. So why is it our military members who are working for the United States government are not provided the same safety standards while serving overseas as are required here in the U.S.? The letter from the Department of the Army also states, quote, effective for April 2017, soldiers will have up to 180 days following the completion of their qualified duty to request consideration for a line of duty determination, absent special circumstances. LOD was not initiated until 6 June 2017, end quote. Why is it that military personnel, the less than 1% of our population that make the decision to serve this country are not afforded more time to determine the effects of war? The James Zidroga 9-11 Victim Compensation Fund Reauthorization Act, section 402, is reauthorizing the September 11th Victim Compensation Fund of 2001 and extends the deadline for application to 2020. Do our service members not deserve the same? Mike Dye did receive a service-connected disability from the VA, and we feel fortunate for that because only 20% of all applications for service-connected disability are being approved. The benefits are significantly less with a VA disability, but it is something. Unfortunately, many who deserve this are not getting it. When I asked our veterans' affairs officers how many people in Vermont have received this disability due to a cancer diagnosis, they said one, Mike. I was then told that they were surprised that Mike got it. They said that the letter from Dr. Abrams was the most compelling letter they had seen. My response was, that seems like an easy fix. I since learned that another veteran who received a VA service-connected disability, Wesley Platt, and his mom is here, who's been diagnosed with stage four colon cancer, told me he went to Dana-Farber Institute for a second opinion and by chance saw Dr. Abrams, Mike's doctor, who at this point was well-versed in the issues of our veterans' exposure to burn pits. So he wrote a letter for Wesley as well. This legislation will provide the education the medical community needs to understand the significance and write a quote, compelling letter, to help these service members. Many of you know Mike, Brigadier General Michael Heston, and his service to the state and his country. He served as a Vermont State Trooper for 26 years and 33 years of military service, including Marine Corps reserves and the Vermont Army National Guard. He stepped up every time he was asked to and he proudly served this country, including three deployments to Afghanistan, totaling three years away from his family. He was a soldier's soldier. That service cost him his life and it cost others their lives, like Wayne Carroll, who passed away with pancreatic cancer in May of 2017, and Mike Cram, who passed away in December of 2017. And Jess Solis, in October of 2016, both died of prostate cancer along with many others. Still, others have reached out to me letting me know of their illnesses and their inability to get the medical community to take notice. Mike was more than a soldier. He was an amazing husband and father. Family was very important to him and he would always reinforce the importance of family with his troops. Not only did Mike's service cost him his life, it cost him the opportunity to see his son graduate with his MBA this year. It cost him that beautiful moment of walking down the aisle with his daughter on her wedding day. It cost him the enjoyment of retirement that he worked so hard for. The journey we planned together is now just the difficult memory. The immense heartbreak can't be changed for me or our family or for the many other families who've lost their battles, but you can make a difference for others. Education of the service members, the medical community, and the awareness of the public will lead to earlier diagnosis and hopefully to better care for those veterans who do get sick. It will also bring awareness to the fact that our veterans need to be taken care of. Let's not wait decades to acknowledge that the burnt pits are this war's Agent Orange. Vermont has led the way so many times and I'm proud to call myself a Vermonter, particularly when we stand up and do the right thing. Brigadier General Michael Heston passed away on November 14th, 2018 due to his exposure to toxins from burnt pits. He was not the first to die and unfortunately he will not be the last to die because we have work to do to raise this awareness. Please let me be the last widow to talk about what we are not doing for our service members, our veterans, and their families. Thank you. Like well on this committee, I know we celebrated his career last May which seems so little in the face of this particular circumstance. Thank you. And I don't know what questions I could possibly ask you right now. Someone asked a question about has anything been done? There was a class action lawsuit against KBR, which is one of the contractors that was responsible for operating the burnt pits and that was rejected by the U.S. Supreme Court stating that they took their direction from the military so they were not responsible, which tells me that our government is. And the DOD takes no responsibility? Currently they take no responsibility. They're saying that there needs to be more evidence that there is a connection, which is confusing to me since we have an OSHA regulation that spans that here in this country. So I'm thinking we have evidence somewhere we wouldn't have an OSHA regulation. No, I think, and it's my question earlier about who arranged these, was it a private contractor or was it the military or as that relationship is both? I think what we saw from Agent Orange is that once you take, once you admit guilt or take responsibility, it costs a lot of money. Yes. Which is as it should be. Yes. And so this delay doesn't strike me as being out of line with past actions, but just out of line with how we think veterans should be treated. Right. The burnt pit registry, I went through this with someone recently and I do believe that people need to register because I do believe decisions will be made based on how many are registered, not just who's in there and what their health concerns are. But as you go through the burnt pit registry, it asks how many hours a day you feel you're exposed and how many days a week. But then it asks questions like, have you ever had a job that exposed you to desk? Have you ever had another job that exposed you to a specialist? Have you ever had a job that exposed you to carcinogens? And so for me, I'm thinking, well, why would you ask that? And okay, so there's a history, so they can't say that it was their exposure to burn pits. How much do you drink? I'm not sure how that's relevant to this question about exposure to burn pits. So it is, so when I went through with a current service member, his question to me after was, is this gonna affect my career because I've killed this after. So that is the question. And the answer has been, well, there is no connection between the DOD and the burnt pit registry. Although when you go in for the first time, your deployment dates are at the top. So there is some connection on that. It has to happen though. I think people need to register because I think they're going to make decisions based on the number of people who go in and register. And I think that if people stand by waiting, hoping nothing's gonna happen to them, that might be a mistake. So it occurs to me that possibly, I mean, awareness certainly has a huge heart to play in this, but we're calling the anger that comes as a result of the notion that you are poisoned and may die as a result of actions by your government. That anger is difficult to overcome. So not only awareness, but to overcome and approach veterans to overcome this anger, to put it aside and to act in our own best interest may be another issue that we need to face. That is true. In your talks with our federal delegation, have they expressed any willingness to interact with their own members to see what can be done in other states regarding this? Is there any push that you move to actually act on the federal level? They are acting on the federal level. They are trying to institute legislations that will address this. And one of the pieces of evidence that were given at the Senate Committee was a document they had asked the Department of Veterans Affairs to do a study on the effectiveness of the registry. And they came back saying that it isn't, it's collecting data, but a lot of it is irrelevant and that the National Institute, National Academy of Engineering Medicine and something else has stated that really what needs to be done is money needs to be put into epidemiological studies. And because that this data isn't necessarily it's self reported data and it probably isn't as relevant as them doing these epidemiological studies of what people are experiencing for health concerns because it is the gamut. It's all different kinds of cancers, rare cancers, things they haven't seen before. It's a lot of respiratory illnesses. And I think there are things that probably haven't even come up yet that will come up as a result of exposure. And there was a 27 page document sent from the Department of Veterans Affairs to all of the regional VA's in 2010 stating the exposure, what the exposure from burn pits, like what toxins they could be exposed to, what it could result in, that was in 2010. And they're still looking for evidence. So I'm confused by now. Thank you. I feel like a lot of the questions that I have are gonna be for the guard for Edge in general and I in terms of Mike's work to try to get more people signed up. So I'll refrain from asking you that. But I, again, I'm very sorry. Thank you. You know, Tommy. I have a quick question. I was just wondering if you can help a veteran's organizations like the leach and then you can get these veterans signed up. Maybe they could do something. And there are meetings happening now to figure out the best way to reach out to the 10,000 or so who served for the Vermont Guard. And I think they're looking at all kinds of options to do that. And I have been, I was called in January from a person at TAPS, which is the Trigegy Assistance Program for Survivors in Washington DC. It's a nonprofit that works with spouses and families who have lost a military member either in combat or to suicide or to illness. And they are ramping up staff to focus on burn pit exposure and have asked me to testify at a congressional hearing in DC in September. They're also initiating a survey to kind of get more data to present at that congressional hearing. And I think other states are now looking at legislation. And I've gotten calls, since this legislation was proposed, I've gotten calls from a number of media outlets, but one was NBC Boston and they did a story on the burn pits and Mike, they profiled Mike and they have 13 or 14 affiliates across the country. And I'm pretty sure one in California and one in Texas picked it up because I heard that someone saw the stories in those states. So this awareness is making people ask questions and people need to ask questions because we need answers. Thank you very much. And we have your testimony by the end of our time with this bill and it will have the same information. We do believe you are. We still have folks to hear from today from the Agents down tonight and Bob Burke who's here. And we do have the federal delegation and others that are scheduled for tomorrow as well. So thank you. Thank you. Thank you so much. We call you to turn on the light. Please send me on phone. Can you dial it first, please take a minute? Please turn it off. Of course it's not, it's just us. Thank you. Hello, General Mike. This is the General Housing Military Affairs Committee. Good, we're just adjusting, gotta adjust the volume. Okay, still got it? Yep. Can you hear us? I can. General Knight, welcome back. We have heard testimony so far this afternoon from Damien Leonard, walked us through the bill and we've heard from Senator White and from June Heston. And if we just like you to share your thoughts on S111 and we'll probably have a few questions for you. That sounds good, sir. I appreciate the opportunity. And I think the first thing that I mentioned to Senator White was thank you to the legislature for taking this bill up. Does that mean you're you? I think it's him. Okay. We think it's you, but no, it's not. How does that? All right, try again. I just want to thank the legislature for taking this bill up. I think it's a wonderful endeavor and I'm gonna do everything I can to support it to fruition. Just at some points of clarification, you certainly have heard from June. Just going through and not to be redundant. I apologize for not being able to be there today. But like at a page two of eight, line three, it's good that we've identified what's being purported. Most of the irritation is temporary. It dissolves once the exposure is gone. Don't agree with it. I'm glad that was captured. And June will probably tell you that our process is to support a line of duty injury is 180 days. And we all know that some of these ailments don't develop in 180 days. They may develop over years. That was captured. On page three of eight, line 10. And Senator White was there for this testimony from Dr. O'Mara. That's very important. Line 10 is important to everybody for a monitor. The hazard may have been exposed to burn pitch to participate in the registry. My question that came up and I don't have an answer yet is an understanding that this is just a registry. I don't know what happens with the information. I don't know where it goes. I don't know what it informs or who is informed. What happens with it? So getting back up to line eight, where I think we're gonna make immediate improvement is to that number of 394 monitors joining the registry. That'll take some doing. I haven't logged back in to even see if my registration is still valid. It took me a week. It took some folks as long as three weeks to get in. So maybe that process has improved. I've also, I think it was Wesley Black testified that he was actually dropped out of the burn pit registry. Unbeknownst to him and had to re-register. So, educational materials, excuse me. Again, on page three, line 15, to develop written educational materials providing information about health effects. I think that is outstanding. I'm happy to see that there. One thing that I don't see, and I don't know if it's, we can certainly make the information and publish it as part of that educational process. On page four, line four, information regarding the eligibility requirement for participation in the registry. Including deployment locations and dates. I think there's an opportunity for us here when we're talking with our deployed veterans who've been exposed to burn pits to include a recommendation to provide a medical release from their primary care provider to the VA. Because we simply don't know what we don't know. We don't know how many veterans we have here. We don't know how many we have coming in to Vermont. And as I testified to before, when we separate somebody from the service, either Air or Army, all we would have is a known address. We lose track of them. And my concern is they lose track of us. And we might be the best mechanism for them to seek treatment and certainly have the opportunity to relate that back to the VA and earn any benefits or tie in a duty-related condition that comes back to deployment. So that would tie into a line 15 and making sure the information is made available to all licensed healthcare providers. And that's again on page four. And maybe that would be part of that information going to them to ensure that their patient, if identifying as a veteran, signs that medical release and the information can get back to the veterans administration. On line 15, page five, I'm in communication with service members. I have some concern. It's nothing I don't think we can overcome. It's basically the resources to do this. I think the best way we can't be so fightin' this, I believe that the committee understands that. I have resources here. It's a very busy organization, but I think we make the time to do it. But we're not doing it by ourselves. I spoke briefly with Bob Burke today. I think it's the whole of government, whole of Vermont approach that helps us get at this. And O'June, at least was engaging with WCAX for a public service announcement. So we use the media, social media, our veterans affairs, VA, town clerks, DMV. I just, I mean, everything available. And that ties into any available and interested federal estate agency. So I think that's probably the best way to get at it. We won't get everybody, but at least we can make the effort. And I think the results would be reflected in how many boats, for instance, we get registered into the burnt it, burnt it registered. The other piece that I've identified was page seven, I made a way back to the bill again. Page seven, line four, the creation of a paper registration option. I just had a question and this is probably not the committee that's for us to figure out is on the back end of that. We have the paper registration option. Who entered the information with the VA or with the burnt it registry. So we're bandwidth limited like anybody else here based on firewalls and all that, which is probably part of the reason we're getting kicked out of the registry. And I don't know what the time required at this point would be for an individual to register outside of our system. The other piece, let's see, what I did, I do know, and I will confirm this with Major Lewandowski, he's with our Medevac Company overseas right now. The in line 15 requested any member of the National Guard who during his or her periodic health assessment and identified we will continue doing that. We can add that to our soldier readiness checks that are done annually. But I also know that in speaking with some folks who have been deployed more recently that that registry, if there's burnt it, there is occurring during deployment or post deployment when they're preparing to come out of theater. But I think this is a wonderful bill. I'm very happy to see it. I'm very happy to do everything we can to get to the end state of getting more folks registered and get them the health care that they need and get any benefits that they may have coming with them from deployment related conditions. And June probably testified to some of the subtleties that are in here. The hazards are certainly identified. The airborne hazards identified. And what I think I haven't heard discussed and what comes with this is whether it's Afghanistan, Iraq, Kuwait, it doesn't matter. You have a burnt it, which results in airborne hazards. But that airborne hazard also becomes a soot and then falls down into this talcum cot or fine dust that we deal with. And that's stirred up by the wind, it's stirred up by track vehicles, wheel vehicles. And again, it becomes airborne. And it's not just what you breathe. You're ingesting it. And it's probably redundant to the committee if you've heard it before, I apologize. But as an example, we had come back from Ramadi, Iraq and four or five days post deployment in Camp Shelby, Mississippi. I could take a baby white and wipe my face and it would still come away brown. I can blow my nose and it will come away brown. It's in you. You've assimilated it into your body. So this comes back to look, I'm not a doctor. I am certainly not a research physician. But I know what goes in the burnt it has now been ingested by our service members. And that's why I would come back to saying this bill is a great initiative and thank you for doing it. Thank you, General. Do you have your notes on changes? I know Damien's here taking notes as well, but do you have those changes that you can email to us? Thank you, sir. Okay, I have a question about in June's testimony she talked about Mike Heston before he was ill was asking or trying to get members of the guard who served during those places to get onto the registry. My impression of the guard is always that you guys have so much information about so many different things. Why is it so hard to track the folks who were deployed over there at this point in time? It seems like at least you have a list to start with. And if it is as many as 10,000 people, how can we get to as many as we can find and keep narrowing that list down? Well, sir, we're gonna do that and that will fall to the deputy chief of staff and personnel. And that's a data poll. We can do that digitally. I know Bob Burke can do that through the veterans affairs. They've got folks there and we're certainly happy to send folks down there to do the actual manual poll of any DD 214, the discharge documentation that shows locations of service. So I think it's probably more time than anything, but it's something that we can do. I don't think it's as monumental a task as we think. We'll at least take a shot at it and we'll certainly have a better sense of where we are with numbers. My concern is less finding them and probably more finding them after they're separated from the service. We can find the information that I do believe, but tracking them down if they left the state or if they've moved and left no forwarding address, that will follow some other mechanisms to try to get to them and make sure they do what we're asking them to do. Representative Kamash. Colonel Knight, I'm just wondering, since you have, since there is available data, if a service person is going to the VA for any sort of medical treatment, even if they've moved out of state, can that information be available somewhere so that it could be gathered? You mean the medical information if? Yes, in terms of a location, in terms of locating and finding of a veteran once they have separated from service. I understand the difficulties that could pose, but when they would show up to a veteran's, for medical attention, even if they have moved out of state wherever they are, wouldn't that information be fed into, as far as their location, be fed into some kind of data bank? I mean, because they have to produce identification of who they are. I mean, I'm not at all well-versed with the procedure, but I'm just thinking wherever, because even, so my question is, could the data that comes from an office visit with the VA from a service man who is no longer active, has been separated from the service, but did serve in one of those theaters during those periods of time, since they have a location at that point when they are seeking medical treatment, would that information not become available? Yes, ma'am, it could be. And I would often defer to my medical professionals because they have a habitual relationship with the VA. The caveat to that is there's a number of folks that simply don't use the VA system. We'll find some through that mechanism, but there are folks that will go to their primary care provider and perhaps not share that they're a veteran. So that's probably a concern, and I'm not quite sure how to get at that yet, other than as discussed with his public service announcements or a mailing to wherever that person is. So we could find some, I believe, through the VA system and a linkage with our medical personnel who have access to the systems that the VA may use. Part of this bill discusses that educating healthcare providers, doesn't it? Yes, sir. To recognize symptoms or to ask whether they're a veteran. Let me go back, I don't recall seeing it, it may be in here, but again, that will be part of any mailing or any communication with our providers, certainly within the tricare network. Anything reaching out to all medical providers to different forums, medical professional associations with a lot of different ways to get at it. But I think that's part of the educations, maybe simply asking that question, how you've been a Detroit veteran and where and when. Any further questions for General Nett right now? No, thank you for this base information, General, I appreciate it, it's hard to, this is all very emotional and anger inducing, I'm not sure how to process it best. Well, I think doing something and certainly doing more is better than where we've been. And I appreciate, again, the efforts of the legislature to get this on the front burner. And I certainly appreciate you and Heston and West Black for their impassioned perspective on this. I'm just gonna make a difference and we're gonna do everything we can to make that happen. Well, I appreciate your support of this and your desire to get our guards, people, the best help they can get on it, especially on something like this. This is incredibly troubling. Yes, sir. All right, we'll be back in a second, thank you. All right, thank you again. Yeah, thank you, General. Thank you. Robert, Bert, Bob, you're up. Should I have done this all in eight hours and just wanted to answer your question? Do we need us to take a break yet? I think we're gonna work right through until 4.30, that's okay. For the record, Robert Burke, Director, Vermont Office of Ethics and Players. So I stand in support of S111, worked with Senator White, Morgan Wood-June and the Adjutant General's Office on the letter directed towards veterans. And I talked to Senator White earlier to get some clarification on the letter that the Commissioner of Health was to collaborate with the Adjutant General on. So actually I had a good meeting on Monday from a representative from General Knight's Office and the Associate Director of the VA Medical Center down in my room junction. We've met on Monday for collaboration on gaining the correct information, the most accurate information and putting that in format best to go out to town halls and VFW posts and Legion posts and through our email serve and to the all Vermont National Guard email trail so that it's fairly concise, tells what you need to do, what you should do and here's how to do it. I do, and Mr. Sestin has expressed this, we don't really know what happens to the Burm Pit Registry. So I spent from April of 2007 to April of 2008 on the same base that General S did. I knew about the Burm Pit Registry and it went inside of the asymptomatic, disinterested, whatever. So as a result of starting in with the Senate, I said, okay, I'll be my own guinea pig, I'll go on and I'll do the Burm Pit Registry. I have a E-benefits account, so it was very easy for me to get on and get access to the registry. It took me about an hour and 10 minutes. I did it from across the street, so my connection was fairly good. If I did it from Cabot, it probably would have taken four hours. But probably half of that time was waiting for it to kind of cycle through, bounce back to wherever the server is and then come back and say, okay, he's ready to go to the next session. So that was really about going through the questions just fairly quick. Yes, it does pull your, where you serve, so it's got a link into DoD information somewhere, but mine was wrong. I spent in total 10 and a half, 11 months on the ground in Afghanistan. It only had me there for three months. And it had me in Kuwait for, you know, when I'd go to the airfield to get something and it had me in Qatar and that was true. I was in Bahrain twice for at least 10 or 12 days, a couple of times. It didn't have that on there. I was able to edit that at the time. And then last Friday, I went for a screening. They took a blood, they took chest x-rays, a number of other things. But again, I have no idea what's gonna happen with the results of that. You know, it does not meet the level of an epidemiological study. It will not be accepted by any research institute as qualifying, you know, medical information. That's my opinion. So again, the more people, the more focused, the more attention, the more money that's gonna be put toward it. But did I waste five hours of my time? I hope not. The list, the long list and the long list of symptoms or of other diseases, where is that available? There is no list for currently, for burn pit. I mean, it's really based on anecdotal people talking about what's going on with them after returning. So there must be something within this database because they do ask some questions about, you know, have you had respiratory issues? Have you had, and so I don't know, you know, I think that I'm hoping that they're looking for that and that if, you know, Mike registered before he was diagnosed with pancreatic cancer, so it's not in there, that he died as a result of pancreatic cancer. It's in the VA system because it has to be, but it's not in the database that they're collecting. You're the first person who mentioned a screening as a result of filling out the registry. So are through those 394 registrants, have they been screened also medical screening? I don't know. So were you told that you needed to go have a screening for the minister? No, it's the last question. Do you request a screening? Oh, okay. Yes, no. So 40%, don't even get to that last question out of frustration or timeout and like I kicked off the server and then, you know, of the 60% were actually completed. I don't have the data on how many actually then went and completed. It doesn't say, it doesn't ever come up and say, based on your answers you really don't qualify for first screening. And it does ask some bizarre questions. How much do you drink? A lot, looks like I have to do a little bit. Yeah. You know, do you like hobbies? Do you like welding, woodworking? Now I understand because overarching is airborne hazards and open burn pit, right? There's a lot of airborne hazards. Diesel generator smoke. Yes, woodworking, any number of things, welding, certainly. But again, what's, is it that qualifier? How much do you smoke? When did you start smoking? When did you quit? How much did you smoke? You know, so overall I can understand but are they trying to section people out by doing that or just understand other issues that may pertain? So it kind of makes you think that it's this medical study but then it's like, I'm not really sure. Representative. In the last question survey, would you like to screen, is that then available through the hospital like a rejunction or any? Yes, any VA hospital. But could then those, if you requested those hospitals, how many people have been screened? Is that possible for us to have our own database in the moment? I'm gonna go out on a limb and assume that they would know how many burn pit screenings they've done on an annual basis. I'm surely environmental health officer could answer that question. And before I forget, oh, you were talking about data from the VA. So I retired in 2012. I had good insurance. I made too much money. I'm not eligible to go. I spent 28 years in retirement. I'm not eligible to use the VA. Well, sorry. I would be eligible under like category nine, which means I would never get an appointment at the VA. Because you make too much money. Correct. That's a great time to approve that. And I'm not a prisoner of war. I don't have a peripheral heart and I'm not a medal of honor when they're category one, two, three, four. Benefits are allowed to veterans, but they are prioritized. Correct, yeah. So based on income. I try and say, I am eligible. I just would never gain access to that benefit. Well, I think you're eligible but would never qualify. No, eligible and qualified, but just would never. Not prioritized. Would not be prioritized for those services. So you'd have to wait five years? So when they filter through. Yeah. Yeah. On being facetious. No. Yeah, exactly. Yeah. Make $100,000 a year to be back here. Right. And it has to do with capacity. And that's an assumption that you would get healthcare elsewhere. Fill out that form. No, it's income. It's assumed that if you have X income, you can afford health insurance. Right. Yeah, right. Representative Mosh. Weirdest. Do you know where the registry emanates from? What agency and who puts it? Is there a person at the other end of this? That's a different question. The man behind the curtain? Yes. The people behind the registry that has been created. I mean, is there someone that you can ultimately reach out and touch? So to speak. Good idea. So the TAPS is now working with an advisor from Veterans Affairs to talk about the registry. So there is someone that they're reaching out to because the registry is cumbersome and people aren't necessarily completing it, but it is under the Department of Veterans Affairs. And there's a tie-in link to the National Institute for War-related illness. Yes. Which is another piece of the pie on top of. Yes, the bureaucracy's talking to us. Is that what? The Institute for War-related injuries really kind of then just focuses on that where VA provides healthcare and they provide benefits and they run cemeteries, whereas it's more like an NIH National Institute for Health. It's kind of more, okay, this is our little box to operate in. That's my understanding. Is that a term? So do we know of any discussions that are taking place to streamline this registry to make it more friendly, to make it easier to use? I mean, if we're going to reach out to veterans that seems like the first place it is, I mean, sitting on a computer for three hours to try and fill out a form is really a concern. I mean, it's really difficult. I agree. I do know, I have been told by somebody at the VA that a paper copy does exist. Okay, so then what happens? Not about the two hours. There's not that many questions. There really aren't, no, there's not that many questions. I mean, if you did three deployments and you were in eight different locations, it's gonna ask you 90% of the same questions for every location. So you're gonna, there's, you know, for each place driver, remember how many hours a day you were outside, you were exposed to, and I made the point during the exam that you didn't have to be outside. It was blowing through buildings. It was blowing through tents. It was, you know, if you didn't, you know, brush it off every day, it was all over everything. So then what I'm not clear about having got a good answer is what happens to that paper copy? Does that get handed in? And then somebody has to, some administrative person has to then sit there. And then how do they qualify? You saying, I spent a year in bag gap. Gotta go find you 214. Probably gonna go as far as to find your orders to get, you know, the number of days you were there and what exact base you were on, et cetera, et cetera. So it's a lot more complicated than just saying, hey, go and fill out the registry. Yes, I do encourage everybody to do that and I am in support of this, but it's, it can require some bulk hand holding. My question is, is there an acknowledgement by the VA that would suggest, yes, we need to work on this. We need to make it more friendly in order to enlarge the registry so that we're reaching veterans who could be poisoned? That's my question. I did not have an answer bottle. Right, I've not spoken to somebody at that level I know that our associate director of the Medical Center, White River Junction is supportive of it, is supportive of us encouraging more people to participate in the registry. But again, it's a registry and what am I registering for? Just got to know. Do you think there's a better way of doing this? I mean, I think it should be done, I think it should have been done post-deployment. You spend three days, five days, eight days, depending on what the aircraft cycle is, sitting in Kuwait, it should have been done there. Should have been, we didn't know about the connection between Agent Orange and, oh by the way, Agent Yellow and Agent Purple and it would just so happen that the chemical formula that they called Agent Orange was one that got picked but there was a formulation, Agent Red and Purple and Yellow that was sprayed on bases in the U.S. and our service officers were making connections to people who were exposed in the U.S. of those chemicals. So it's a lot bigger than that. It's really hard to listen to constantly like feel like the enemy is us when it comes to this. I mean, it's really, I mean, we take a note to the Constitution just like a lot of people do and I'm just, sorry, I'm showing, I'm wearing my heart on my sleeve here right now. This is just really hard to hear. I mean, we know it from back history about Agent Orange, about everything, about the fact that the United States has a really hard time with how it treats its veterans. Since 1776, this isn't new. It's just hard, this is hard testimony to hear and to hear and I'm sure when I'm less worked up I'll have a coach in questions to ask. Representative Howard. It's hard enough to get a veteran to contact VA to think, you know, there might be something wrong with me. It's a pride thing. It's really difficult, trust me and I know. However, they go out of this website and it takes forever. It's not worth it, it's just a registry. It's not worth it. Right, and so 40% drop out because they say, what's been this for me? Well, okay, for you maybe nothing, but as a population of veterans that served in those regions and maybe experienced health, it's really important because that's what's gonna drive investment in epidemiological studies that then will lead to presumptives, which then can lead to it being easier for people to gain benefits. We're back here, we're not even moving towards those steps. It's an awareness. Correct. Well, and we hear so much from you, how difficult it is just to get people to use their benefits. I mean, every January, February, we work. I'm an offender. Yeah. You know, I'm a veteran, I'm an offender. I, first time I went to the VA. I just have a question. Sure. If we know we've deployed these people, these persons, why is it so difficult for them to want the vet to fill out the cumbersome form when they could just say, we know that you were here, here, and here, this is what we're thinking we see, this is what could probably happen, contact us. Why can't it just be that simple, as opposed to somebody registering online, spending more hours of time getting frustrated and then saying, I don't want anything to do with it and it won't be open to it? So, for, let me explain to you how we have our records across the street. So we get Department of Defense Form 214, they're just charged. And we get multiples of them every day for Vermonters, National Guard, people who are moving into the state, people who originally lived here, basically anybody that says, this is what I want my home of record to be. And so we get a copy from the services and we file them alphabetically. Not by time and service, not where you served. We file pieces of paper. There's no way to search for, if you'd call me and say, can you look in your record and see if you have a G214 for Wesley Black? Okay, I can go and look at it. And it could say that he was awarded the Iraq Service Medal. I know that he served somewhere in Iraq during that three year, five year, 25 year period. Okay, he got out of the service back in 2006. This was his address back then. That's as much as I know if you give me a name. But I can't, there's no magical digital database that I can type into and say, give me all of the modules that served between 1990 and April 10th of 2019. I understand what you're saying, but working in the healthcare field, we have care everywhere down in Boston. And all it takes is one press at the button to say yes, and we can gather information from all the other hospitals that this particular patient may have been seeing at because it's an electronic medical record. So as long as I have their one permission, they're signed off on it, I have access to that information. I just don't see why the VA wants to make it the veteran's job to go through that cumbersome process to get to where they recognize that they were part of the burn pit. Well, the VA never knew that I was spent a year in Afghanistan until- Well, they didn't know basically he had colon cancer for over a year. Right, but I'm saying I never had any contact with the VA until the last Friday. So I'm not in their system on their radar. Am I not being clear enough? I just think it's- No, I think you are. I think this is- Is it bureaucracy? Yes, well, whatever it is. I mean, I think it turns into a philosophical question because it sounds so simple, but in, and I think what we're experiencing is that the VA for whatever reasons, and I won't ascribe any reasons whatsoever, they're not, they haven't been anxious to work on this problem. And like Agent Orange, they are not making it easy. I mean, I have an assumption, as I said earlier, that the military should know everything about everybody who ever walked through their door. And it sounds like they might, but they don't or they don't use it in this way or whatever. And so I just, I mean, I'm with you on the questions and I just want to actually move to, I want to be able to get to you in a minute. But I- Hard-working, but I'll be quick. But I just, this is, again, we've experienced this with veterans' issues, I can't remember a time that it's been this direct. And again, I only served here for 10 years, so I only got here for the deployment, the second deployment. But it's clear that this is something that if the states, if we don't do something, the goal is to get the ball rolling or to get it going down a hill and so that's all I can say. I'd like to just move to Jess, if I can. To Jess. Oh, yes, I'm sorry. But we know where to, as always, we know where to find you. Right across the street, we can send you a signal box. Open the window. Open the blinds. And thank you for sitting with us. Thank you. No, thank you for taking up the bill and thank you for hearing from me. I'm Jess Barnard, I'm the Executive Director of the Vermont Medical Society. I've been in this committee this session yet, so we're a voluntary membership association for physicians, physician assistants, and medical students across the state in primary care and specialty care. And my testimony will probably be pretty short. I just want to say that the Medical Society supports the bill, absolutely supports addressing and improving veterans' health. We have a fairly small role in the bill. Really, we're being asked as a member. There's been some language change. Our organization was actually named initially when the bill was introduced, but we actually suggested that it be expanded to all health professionals, not just physicians. And so now it lists that the Department of Health will share their information with both licensing boards. So that would include the Board of Medical Practice and the Office of Professional Regulation, which regulates a lot of health professionals, physicians, nurses, others, and then also work with membership associations like the Vermont Medical Society. There's also, there's a nursing association. There are other associations that represent other health professionals for us to help share that information with our members. So speaking on behalf of our association, working with physicians and physician assistants, we're certainly happy, anxious, to share the information created by the Department of Health with our members on our website, through emails, through newsletters. That sort of, we have channels of communication with our members that we really want to share the information. I think it is, over the past year or so, I think the issue has gained some publicity in the press, but I still don't think it's very widely known or understood, either in the public or among health professionals. So we see our role also as helping just make sure physicians are aware of that. So speaking less probably for VA physicians, but community physicians who do see a lot of veterans make sure they know about the issue, know about the resources available. So that's all I have prepared. Happy to answer any further questions. So one of the issues that came up in Agent Orange was that the VA was not willing or able, willing, I would stick with, to do an assessment that was more involved than they wanted to do. Dioxin, lodges, and abdominal fat. And in order to detect it, biopsies needed to be done of abdominal fat for each individual who may have been exposed. That never happened. So how many diagnosis did we miss as a result of that? And how many people suffered as a result of that? So if there can be a collaboration and you can be part of it, or as your agency can be part of that collaboration that can include the Veterans Administration and all the healthcare providers in the state, maybe we will be able to come to a situation in which we could overcome that. We can actually diagnose conditions that are related in a definitive way and say, yes, this happened. Yes, this is part of what we need to look at and address. That would be my hope. I don't disagree with that. And I think more, I think better epidemiological research. There's association and then there's causation. So it's really hard to parse out what just you happen to be in one area. You also happen to develop a cancer versus do we really have the strength of evidence to prove that it's causation and what's the range of symptoms? What are the range of conditions? Epidemiological research is tricky. It usually does involve a lot of people over time really creating this evidence base. So I think physicians would certainly love to have more hard evidence. What to look for? What are the symptoms? But I think we also shouldn't necessarily wait to move forward. This is a step in the right direction. And I think that the registry is a step in the right direction. So until we have the definitive science, let's keep moving forward and educating. So at least we're asking the questions and maybe can catch some diagnoses earlier if not have all the evidence wrapped up. Some of that does take a lot of time. I'm sure some of the conditions caused by this type of exposure may not even develop for 10 or 20 more years. So, and it takes, you know, big studies like that take funding. So I certainly, it sounds like you're hearing from the congressional delegation tomorrow. I'd certainly encourage more funding for real hard research to look at these issues so that we can develop that knowledge set base. Yeah, thank you. Thank you. Thank you. And it's on our left. That's for today's morina. I appreciate all the work that you are doing and listening to us. But I have Wesley, who was the oldest of my two sons. My husband was in the first Gulf War. Wesley was in Iraq and Afghanistan and our youngest son was in Afghanistan with him. So potentially I look at daily being a widow and jobless because they have all been exposed to what these horrible chemicals were doing. And Wesley is the father of a three-year-old son. He is beautiful. And when I, I don't mean to be kind of emotional, but when I watch him, when you're around, I think, oh, he's just like Wesley was. He just, and my heart breaks. It breaks. And I think, I know, I know that because I'm a nurse, I know the cycle of life. I know what it is. But I also know that exposure to toxins that I sent him over there, he was, it didn't have to happen. He is dying. We've been lucky, we've had two years with him. He's dying. So it's just, it's heartbreaking. And I thank you for your time. I do. I do, but you know, I seriously just love, love being with my family because I realize that I have them on borrowed time. And it's sad. It's heartbreaking, but thank you for listening to me. Thank you for coming in and listening. Thank you all of you. Thank you for your sacrifice and your service. I guess my question is, we're leading into the conversations with the congressional delegation. You mentioned resources, idea of what we should be talking about. I'm not sure. I don't have a number in mind, but maybe others in the room or the delegation themselves might have ideas. I think they testified on this. I mean, it's clear that the regard, I mean, there's so many pieces. So, you know, why have a registry if people drop out and can't, you know, can't finish it? Yeah. I mean, never mind why have a registry at all, except if something's wrong. I mean, there's so many bars to cross just with a simple thing of telling someone, oh yeah, there's registry and it's going to take you five hours. There were some pretty specific recommendations from the study of the registry that would be extremely helpful if they were back. I think they were really specific. I've read that, I don't have it with me. I have it. From the National Academy of Sciences, of Engineering and Medicine, and it says that, you know, based on the fact that it's self-reported data and probably not as valid as data could be, that they're recommending the studies on epidemiology of the different illnesses. So, and from what Catherine Long from Senator Lee's office said, $5 million has been put towards rectifying the registry, I believe. So, they are taking some action, but I think, you know, just putting it out there, this registry needs to be a registry and that they don't ask all these health questions because if they go to the VA for an appointment, they're going to be asked those same questions. If they're currently still in the military, 80% of those questions are asked on their periodic health review. So, it's duplicative information. They don't need to ask those questions. It should say, is your deployment information correct? Where are you exposed and where? I don't think that you have to, you should have to put it on every single deployment. Some people have deployed multiple times, particularly if they're active duty military. I think it should just be that information. All the other questions could be asked when they go for their health assessment if they choose to go for a health assessment. I think when it asks the question, you know, do you use the internet? How would you want us to contact you? Do you use the internet? They don't ask for your email address. They don't ask for your mailing address. So, it's great that you are putting out there that you want to communicate with these people but then you have to find out how to communicate with them. So I think that's what it should be. And then the rest of that, if they go for their assessment and are they having current medical issues? But that's what it should be. Because the rest of the information is not relevant. Right, because as you mentioned, if you went and pulled Mike's registry, Mike's fine. Mike's alive and Mike's fine. So then I would venture to say that there needs to be some kind of connection between that registry and what happens to people after they fill out that registry. Which is unfortunately nothing that we can do, right? You can't tell the federal government what to do. But if getting more Vermonters onto the list, aware of the list and onto the, they can do the patients to get through it anyway, at least, like I said, I mean, it's literally the least we can do, right? It's just to start the ball rolling. And from what Bob said, they are counted even if they don't complete it. So we just need them counted. People need to put their information in there so that they're counted as exposed. Speaking to Representative Byron's comment and question though, is that something that the federal delegation could work on doing is making a connection between the registry and what happens to folks after they fill it out? Well, the VA, I mean, my reading on the VA right now is that while we've always heard that our local VA hospital has been one of the better ones, nevertheless, it's part of a system that is, I mean, I just read a terrible article about the privatization of the VA yesterday, because it's 180 billion dollars, whatever it is, whatever size organization it is, it's become, I can't say, I can envision something like this being a privatized thing. I don't have any evidence of that, but I can see that this is one of those things that someone would pitch a contract for to be cynical about it. But it's a tough, it's a really, I throw my hands up with stuff like this. It would be nice to be able to say that we trust the system and that it's working. And there's not a lot of evidence of it in many different places, in many different ways. So, I know that, I mean, Senator Sanders was on, was the chair of the subcommittee some years ago on Veterans Affairs, and at that time, for the few years that he was on that subcommittee, the elements of it improved, but he's not there. Certainly not in the same position, so. So I think our hearts has, yes, and we just have to keep a pilot light on to say that the more work we do, that it will make a difference. Let's stop here for today, and we'll pick up tomorrow. We will, tomorrow is another full day. Minimum wage in the morning, and then we'll talk about Indigenous Peoples Day again before lunch. And then after the floor, which I didn't look at the calendar, I'm assuming it's a short day. Tomorrow is well on the floor. It's a little longer than several bills from the Senate. Okay. We've got a bill introduction from an S83, which is, per percent of Christie introduced the House version of it about working for an employer following the settlement of a discrimination claim. It's the dark in my door legislation that was part of, it's an extension of what we passed last year with the second harassment bill. And then we will be back for the second half of the afternoon on this issue again with Pat Cram, with Wesley Black, with Catherine Long, and other members of the federal delegation. Thank you, everybody. Thank you. Thank you. Thank you.