 Good morning. Welcome to House of Women Operations. I'm 15-ish, I'm 10-ish, 3-15, March 15th. We're going over amended draft of H-270 with Ledge Council. That's our miscellaneous cannabis bill. And I realize, Michelle, thank you for waiting. I know you're on the 10 o'clock, so I won't waste any time. Thanks. I'm going to just go right into the draft. Okay. Andrea, can you let me share my screen? No, I'm fine with that. Yeah. Okay. Yes. Okay. Great. So I'm just going to go over the, the language that's new from the, from the bill is introduced. And I've highlighted the language for you and that should be on the committee webpage as well. I'm going to go over the first section. Sorry. It's a little disconcerting for all this rolling here, but. We're going to go down to, and there's a number of kind of just technical amendments that I've made for it because you've added a new type of license for the propagation cultivator. So there's a lot of places in here that are highlighted that I'm just trying to make it, you know, jive with the, with the addition of the new license. And then you can see the definition of cannabis establishment now includes propagation cultivator. You now have a definition that applies to all the chapters with respect to the cannabis establishment regulation for cannabis propagation cultivator, and that means a person licensed by the board to cultivate cannabis clones, immature plants and mature plants in accordance with the provisions of the chapter. So moving on to section four on rulemaking. There's a few things there. The first is just a technical. And then moving down to a change to subdivision five with regard to rules, concerning retailers. And I think the board can speak to this. They asked for this change in response to some comments from Department of Health. They wanted this small change on lines 20 and 21 around the, the requirement that rules that the board adopts with regard to retailers having to do with facility inspection requirements and procedures that it just be that those inspections have to occur at least annually. Then now at the top of page six, you have new provisions for rulemaking for those new propagator licensees. So you see there's they need to have requirements for proper verification of age of customers. They have to have rules around pesticides or classes of pesticides that can be used by those propagators. There has to be standards for indoor cultivation of cannabis procedures and standards for testing cannabis. There have to be labeling requirements. And regulation of visits to the establishment. And then facility inspection requirements and procedures. And these are specific just to the propagators, but there is just so you know a very long list of rules that are required with regard to all of the cannabis establishment. So if you don't see it here, if you look back up into the existing law with regard to subdivision one, it lists all the things that all there have to be rules for all the different types of licensees. Okay. No, thank you. You actually just answered the question. My first question. So section five. This is new and this is addressing the issue of records requests and what's public and what isn't. And so this is repealing the existing statute or provision with regard to, to records and what is. The law is called the law of law, which is its own new section. So you'll see subsection a is stating the purpose of the section, which is to protect the reputation security practices and trade secret, secrets of licensees from undue public disclosure while securing the public's right to know of government licensing actions relevant to the public health and safety and welfare. Subsection B is just clarifying that all meetings of the board and the public are exempt from public inspection. Subsection C starts to identify the records that are exempt from public inspection. Subdivision C one. This is what is already in current law, which is records related to the licensee security safety transportation or trade secrets, including information that's provided according to their operating plan. And then the second one is records relating to investigations or subsection D. And so we'll take a look at that. So subsection D relates to complaints or investigations of licensees. So you'll see with the lead in language, if a complaint or investigation results in a formal action to either suspend or revoke condition, reprimand worn fine or otherwise penalize a licensee based on non-compliance. The case record as defined by three VSA 809 E is to be public. And I'm just going to, I'm going to stop sharing. I'm just going to show you what the case record. Is. So you see looking at title three, you'll see subsection E there. So the case record includes the list that you see there. I don't necessarily need to read them out to you, but I can, if you want me to, I can send the link to Andrea. If you want to have that for the record. Yeah, please send the link. It would be a useful context. Sure. So subdivision two is that the board is to prepare an aggregated list of all closed investigations into misconduct or non-compliance from whatever source. And the information contained in the list is to be a public record. The list has to contain the date, nature and outcome of each of the complaints, but it isn't to contain the identity of the licensee unless a formal action resulted as a pursuant to the investigation. And then subsection E you'll be very familiar with, which is just our standard language that we add in there. To make it clear that it continues in effect and isn't repealed. Through operation of the provision for, for public records law. So moving on to page nine, section seven. This is just a clear, some clarifying language to make sure it's clear that cultivators when they're going about their business that they can purchase and sell seeds and immature plants, not only to other licensed cultivators, but also to a propagation cultivator. Online 13. That's just a technical that I added. So that's a, that's a follow up on that. And then similarly on subdivision a three, we want to clarify that the propagation cultivator licensee whether required to test, transport, to sell cannabis seeds that meet the federal definition of hemp, that they can do that to a licensed cultivator or a retailer or to the public. We'll start is a section 12. And this is on the fee schedule. for manufacturers for tier one manufacturers that that that fee be changed from 10,000 to 50,000 per year in cannabis products so that's so they have a fee of $750 and this is just changing the threshold for that $750 for that for having to pay that $750. Understood. Pardon. No, thank you. I just saying thank you. Sure. And then, and then there's a new fee that's added for the propagation cultivators and so that would be $500 annually. 10 is just a technical and I think that might be it but I just need to run. So there's one more here and and I hope this is okay with y'all I added this one and you had already changed bumped out the date for the auditor's account. A year because you'll see the language that struck online 10 it was supposed to be do this November and it's bumping it out to 2024. And so rather than just keep the November 15 date, I change it to the first just to make sure that based on once you receive the report that you have plenty of time to be able to kind of take in that report. Talk about it think about it and in order to get me to your drafting deadline so if you want to do some type of drafting related to whatever the auditor comes back with that you'd have plenty of time to be able to meet the the introduction deadlines. Okay. And that's it. Okay. Does anybody in the room have any questions for Michelle right now reporting. Yes, thank you. What again was the big bump from 10 to 50,000 again forgot what we said that to Michelle. That's the threshold for when somebody has to is paying the fee let me pull that language back up sorry. It was paid. It's basically raising like a sales threshold. Yes, exactly. Yeah. So instead of being able to tell 10 they can go to 50. Right. So, so if you're a manufacturer. You're producing products without using solvent base extraction. Not more than right now it's 10,000 per year. Then it's a fee of $750. And I think this is again this is something that was requested by the board so I believe when pepper test advice he can talk to you about their reasonings behind that. Okay. All right. Thank you. Thank you for the time I'm sorry we started a little late and I know you're pressed so. No worries. The chair just arrived so I don't know if he has anything to add to the conversation at the moment. Thanks for your work on this Michelle really appreciate that. I think that we I've heard that the human services committee. They did. We're calling us to drive through trying to get rid of drive by they didn't drive through of this bill yesterday. The chair indicated she'd send me written feedback for us today based on their conversation, but I think I gave Michelle heads up about this that they may have a couple tweaks that we'll look at this afternoon probably so trying to keep this train moving but incorporate the feedback that we've got from our colleagues upstairs so we may see Michelle again later this afternoon. Yeah, I'll join you a little later this morning once I'm done with my other obligations. Okay, great. That's perfect. Thank you so much. Thanks. All right. So, we believe have an updated order here. Okay, so bring are you ready to take the hot seat. Thank you. Really appreciate you being here today. I apologize for me being late committee. We obviously have kind of a tough drive in especially from as far away as in all this stuff. About 60% longer drives and I'm used to bring thanks for being here. Thank you for having me so for the record been here. Executive director of the Vermont cannabis control board here to talk about draft 1.2 of each 270 the miscellaneous cannabis. I thought what might make the most sense just to go through the new the changes the highlighted yellow portions that Michelle just went through unless you want me to start over and I think that's great if you can take us through and give us the perspective on rationale for those changes that be great. Sure thing. So the initial changes that are found in section three, just the addition of the propagation cultivator language. This is the request of the board to add this additional license type of a cannabis propagation cultivator and that assures that the board is able to give licenses to folks who just want to grow some canopy to grow young seedlings. And that will ensure that the regulated market has a source of safe and tested baby plants. And so we no longer have to rely on the illicit market for for seedlings. So that is the rationale for the cannabis propagation cultivation license happy to talk more about that if you'd like. The change that's on the bottom of page five. This is in section for the rulemaking section. We heard some feedback from attorney Englander from the Department of Health that we need a statutory requirement that these cannabis established retail establishments will be inspected annually if we want to eliminate the sort of overlapping between the cannabis control board and the Department of liquor and lottery for inspecting retail establishments that sell paraphernalia. So this is addressed in the sort of as introduced version of the bill, but we got some feedback that we don't have anything in statute that requires that we inspect our retail establishments annually, although we do. So this would just add that add language that would actually require the board to inspect these retail establishments annually and that will satisfy the requirement for the Department of Health. Is that clear enough. Okay, I'll move on to page six. And this is the language about the rules concerning the propagation license type. So for every license type, the legislation sets forth a series of sort of criteria that the board needs to develop rules around the criteria that are set forth here on page six about propagators are very similar to the requirements in rule or the requirements in statute for rulemaking around cultivation licenses. So, similar pesticides what pesticides are going to be used. How are we going to require that the license type check identification to verify age standards for cultivation. What are the testing standards and the labeling requirements and how are, how are visits to the establishments going to be monitored are you allowed to bring visitors, and then facility inspection requirements so it's quite a similar set of requirements for us to develop rulemaking around as what we had to do for cultivation licenses. Is there any particular any particular rulemaking or differences in the sort of inspection regime for the propagation cultivation license versus the cultivator license it seems like it's a pretty similar to languages kind of. Yes, a cut and paste for the most part but are there any differences we should be aware of. There are no I think that this is essentially a cut and paste from from the rulemaking requirements for cultivation licenses. I think that the board's sort of vision of this is that we will try to make these rules as like we're going to make them as an onerous as possible for people to be able to get into do propagation licenses while still maintaining the integrity of like the testing requirements and labeling and age verification and things like that. But to the extent that these people are growing plants that are not going to go into flower. So there may be less value associated with the young plants as opposed to the more mature plants. The security requirements and things like that will probably be less onerous and cultivation full the full cultivation license type. So I think there are. And I'm so I should have done like a comparison. I think there are some directives to the board to make security requirements by rule for the cultivation cultivation license types. And maybe that's not here. That may be one difference between the two. Okay, I'll move on to section five. As Michelle noted, this language that struck on page seven is the existing language about what records are exempt from public inspection under public records act. And most of this language is just dropped down into the following section. So the new section that governs what records are confidential. And subsection a they're starting online 15 is new. So the legislature tends to do some explanatory language about why it is exempting records from the public records from inspection. That's the language that's found there to protect reputation security practices trade secrets of licensees from undue public disclosure, while, you know, balancing the right of the public to to know what is going on. And then we move into public health safety and welfare. So, as a question. Just curious, curious, is that customary for other, like, are there other industries that that has done for is that. Yes, yes. So this, my understanding is that what is what is laid out in this section is pretty similar to what exists for the agency of agriculture for their kind of inspections and investigations with respect to the people that they regulate. So, I think we are seeing quite a bit of similarity between the two. Thanks. It might be a good question when attorney child comes back later if you want to circle back to that and just ask her if this is kind of standard language for other similarly regulated industries. So, top of page eight, that's out the records that are exempt from public inspection. And as Michelle noted that that records related to licensee security safety transportation or trade secrets, including information provided an operating plan is existing language. And then what we've added here is records related to investigation, except is provided in the in the next subsection. And the request that this is sort of a request from the board because as we begin to do our investigations of complaints. We are trying to balance what makes sense to keep confidential what information makes sense for us to keep confidential and what is important for disclosure to the public. And that this language, I think really does try to walk that balancing line to be sure that we can withhold information that would compromise our investigations compromise the security and safety of our licensees, but also be as transparent as possible about what what is happening that would impact public health or safety. And, you know, I think a good example of this is the investigation that we recently did with respect to the Holland cannabis contamination. The board as soon as we received the complaint and had verification of that complaint. We issued a public consumer safety notice that more in the public about the contamination event. And then as we did the investigation we are we are keeping the results of the test, the test results, confidential until the investigation is complete. And then all of that will be made public. Okay, if there are no other questions about that I'll move on to page nine. And I think again these are technical amendments here to just include language about the propagation cultivation license. So, propagation cultivator license, I think there's a change there at the bottom of page nine that would allow propagation cultivators to test transport cell cannabis to a license cultivator or retailer or to the public. And the next change is page 12 yet there was a question about this about the manufacturing tier one we have those three tiers and manufacturers tier one is is only allowed to process and manufacture using non solvent based extraction methods. And it was originally designed to be a very accessible license type, which is why it's only 750 and the board capped the amount of income that that license type could bring in at $10,000 and we received quite a bit of public feedback from folks that were interested in this license types that $10,000 was not sufficient. And that 50,000 would be a more representative cap on where, where they would wind up with this type of license. So we are responding to that and raising cap to 50,000 manufacturing tier two has the same can do the same types of extractions just doesn't have the doesn't have the total income cap. So, next change on the same page sets the annual licensing fee for propagation cultivators at $500. And this is again designed to be an accessible license type that we really set our proposing that fee in comparison with some of our other fees that we have recommended for the tier one outdoor cultivation license type cost $750. This would be, you know, step down from that would be the least expensive license type. Next change I think is a technical amendment. I do have one additional request a little tweak that I am the board is requesting on page 16. I can follow up with Michelle about this. Page 16 and this is the caregiver section. And it's relevant to the new language that would remove the fingerprints for the background requirement and instead require the check of the child protection registry and vulnerable adult registry. There was if you look at page 16 section C starting on line five. There's existing language that requires the board to adopt rules and set out standards for determining whether a caregiver should be denied place on the caregiver registry. If because of their their criminal history record or the applicant applicant status on either registry and his or her criminal history record was struck there. And it was pointed out to us that it makes sense that the board should be able to make these determinations about whether a caregiver should get a card. Also, based on their criminal history, history record and not just their status on the registry. Otherwise, why would we be requiring a criminal history record check at all. So just so I just want to know what to ask legislative council. So your recommendation is that we just after the applicants include criminal history record and order status. Actually even simpler is just to unstrike his or her criminal history record. So we're removing that we do. Yes, your language so I just want to make sure it reads right so we're going to keep criminal history and with the gender on that's line five of 16. That's right. That's line seven seven seven into eight. I'm happy to follow. Oh yeah it starts the clause starts it online five so it's correct. I think we're all saying the same thing. Yeah, yeah, just want to make sure we don't. So let's remove that strike. Okay. Great. That makes a lot of sense. 4% super sorry. Make my notes here. Mr. Vice chair now I remember what my issue was. Are we looking inside or outside for that history. It's the I believe that the language just sets out our Vermont criminal history record check. That kind of was my problem somebody that popped across the border to start to do this we have no history on that. So let me just verify and connect to Vermont criminal history record check right. So, I, you know, I think that's a consideration for the committee whether a person who is. The state lines to commit a crime and then coming back if that's a if that's a genuine concern of the committee, you know, I would just reiterate what I think we mentioned. The first time we were here is that really the vast majority of these caregivers are family members that are providing care to a to a 6th child or a 6th spouse. So I think that there it doesn't appear to be a real industry like for caregivers. It really seems to be like either close, close friends or family that are providing the service. Sure, it's in its youth, I suppose, but as creep everywhere. Yeah. And under this under this language, somebody could get out of jail in the morning and Albany and come over to apply for a Bennington caregiver situation and probably pass the background check in Vermont. Well, you know, I think that the what the board has really been focused on in our criminal history record checks are the types of crimes that would would indicate that the person was a threat to the safety of the person that they are supposed to care for. So, you know, for the, for example, the criminal history record checks that we do in the adult use licensing. The board set out rules that indicated that if a person had committed the types of crimes that indicated that they were probably participating in the illicit cannabis market that that wouldn't necessarily preclude them from joining the regulated market. So I imagine with respect to the rules around caregivers we would be similarly positioned to really try and look carefully at what what would actually impact. What types of crimes would actually indicate that the person would not be an appropriate caregiver and whether or not. You know, if the committee feels strongly that we should be doing a full 50 state background check on these folks and we could leave the FBI fingerprint supported background check there. I think we were really just trying to reduce the administrative burden on these folks that are really primarily parents and and friends of people who are pretty safe. Can I just ask because I think I think what the word caregiver implies a lot of kind of power and responsibility. And I think it might help if you could just remind us we talked about this a couple weeks ago. What, what is the power that a caregiver has in this context. What are they actually allowed to do on behalf of the person who's on the registry grow plants for them. If many of our patients, you know, are too sick to engage in the cultivation of cannabis so they're allowed to grow plants for them. They're also allowed to go to the dispensary and pick up medication for the patient. That's pretty, it's a pretty limited set of set of things are allowed. Yeah, I would also administer the question maybe what's the potential of what they can do. Once you get into a situation where you're trusting and dependent upon somebody that has intended to grow outside the boundaries of maybe this particular relationship into other ones. I would be more comfortable if we recognized that somebody that came into the state with less than a year's worth of history here. Went through a different procedure not necessarily somebody who's been a family member or involved in an intimate circle with the individual but when you start dealing with people. You know, have no history it's pretty hard to assess what their history has been. So you're saying like a residency threshold. Yeah. Just like a different screening process depending on how long you've been a state resident. I just want to try. Your sins. How many people who are requiring care. Elderly I guess is a question I would have that's your focus like what percentage of the. Patient population utilizing a caregiver or elderly. I don't know if that's any data that the board has. We can, you know, I hate to sound like a pessimist or something but one person is too many because we didn't do something. Yes, I guess what I'm what is kind of zooming back so designation as a caregiver allows that adult to. Sort of ride on and facilitate the, the patients medical privileges of being a medical registry. There's there's nothing that would stop an adult now that we have the adult use retail market from. Going and purchasing cannabis and giving that to somebody else if they're. If they if their desire was to do something criminal right so what we're doing what we're saying here is that we're lowering the threshold a bit for those folks who have a caregiver relationship and just making it easier. For people to facilitate the purchase or the growth for folks who are on the medical registry. And so I'm, I still am trying to get at it. I think there is the desire to the it is reasonable to have a certain level of. Background check but I'm also wondering like, sort of what what we're trying to prevent. I think if there's a. If there's a specific suggestion, given the amount of testimony we want to take today and the latest that we're at that we either that this is a real deal breaker and we need to keep the more stringent 50 state background check or that we have that we have a bifurcated system and I guess. That's a that's a path to alleviate representing Cooper's concern for us to say for folks who have lived in Vermont for more than a year, this is sufficient. But for those who haven't got a recent residency in Vermont, we'd like them to go to the full check. If that's something that would sort of square the circle. We could, you know, I'm thinking about how we would administer that, we could certainly ask if we were depending on how the legislature wanted this language to look. We may have to do some sort of investigation ourselves and the person has lived in Vermont for the last year has lived in other places because if it were just if we just ask them. My concern is we're through this instrument or creating a state sanctioned sort of thing. Make sure it's sanctioned is protected as much as possible. And I recognize that it's outside the realm of the actual relationship that we're sanctioning possible. Try to try to figure out a way to expeditiously address your concern. My brain is. Yeah, it's moving on. I guess for me it would be helpful to have some clarity around the access that these characters have to their, the people they're taking care of like are they is it like a delivery driver, or are they in their homes, you know, like with access to their, you know, their whole life thing or is it a variety, I guess. I think that it is it does represent a variety of relationships. The, we don't specify in rule like what the nature of that relationship has to be. I think that for some people they go and pick up their medicine and they bring it back and they help administer it in their home. And for other people it may be more of a delivery type service somebody who is no longer able to drive, for example. I do think there's a it represents a variety of different like factual situations. So we have some more testimony from caregivers and folks who are involved in Canada's patient care coming right up. So let's keep thinking about this a little bit and we can come back to it later this morning and that testimony committee discussion. That makes sense. So that is the last thing that I have, except for the change of date for the auditor report, which I think you already decided on. So I don't think that's a full change. Great. Well, Brian, thank you for being with us. And I hope you'll stick around and hear what other folks have to say in case we need the board's response to some of the further testimony in the committee discussion. Yes, I will say it. Thank you. So we have a number of folks who are going to be giving us some testimony this morning. I've invited people who requested to testify and have many different perspectives. Some are represented patients caregivers who are involved in therapeutic use of cannabis. There's a couple of folks will be testifying that are representing cultivators of different types. And I've asked folks to try to keep their testimony. Within the bounds of 10 or 15 minutes, if possible, because of our tight timeline and also to stay focused on the topics that we're considering in each 270. I know there are a lot of different cannabis policies being discussed in the public elsewhere in the building. And also over week, I've committed to continue to have room for and be open to more expansive policy conversations after crossover, especially in the context of bills that may or may not come over from the Senate. But for now I'm trying to stay focused on each 270 so I just wanted to frame up some of our further testimony that way. I'm going to put a little bit of gentle bumpers on some of the conversation, if we kind of your way off topic. But I want to invite Amelia Grace from the Green Mountain Patients Alliance. Amelia, are you there on zoom. I am. Great. Well thanks for being with us today and be willing to testify and so yeah please. Absolutely. Let me just pull up my prepared testimony. All right. Good morning everybody I hope you made it into work safely. Thank you chair McCarthy for inviting me to speak today. My name is Amelia Macy and I'm a patient and advocate and the co founder of Green Mountain Patients Alliance. I speak specifically to the medical policies addressed in bill age 270 as they pertain to the patient experience. I'd like to start with a little bit of background on myself. In 1999 at the age of four, I was diagnosed with an incurable condition called the Ehlers-Danlos syndrome. It's a chronic tissue disorder that causes thin skin that bruises and tears easily joints that are loose and spontaneously dislocate as well as comorbidities that affect my organs immune systems. On top of that, I've crowns disease. And I deal with, you know, the mental effects of a lifetime of medical related trauma. The next point I'd like to touch on is the proposed language to expand the qualifying conditions to receive a medical card. As it's currently written patients who are diagnosed with one of the approved conditions or with a disease or medical condition or its treatment that is chronic debilitating and produces the symptoms of Caxia wasting syndrome chronic pain severe nausea or seizures I would propose that rather than continue with a list of conditions that patients will have to appeal to have updated with their own. We moved to a symptom based qualification system. Vermont already recognizes four symptoms as qualifiers, but replacing the existing conditions with the symptoms we recognize cannabis is used to relieve will expand registry access to thousands of currently unregistered patients. For example, cannabis has been known to relieve anxiety depression and panic attacks in patients with post traumatic stress disorder, but those three symptoms are not qualifiers on their own, even though the state recognizes the value of that relief and PTSD. My suggestion is that Vermont look into why certain conditions qualify for medical cards, and how each of those conditions share symptoms with numerous other diseases that could be relieved with cannabis. Moving to a symptom based model would not only increase access to the registry, but it would also give healthcare providers clearer guidelines to verify that their patients are finding tangible relief through cannabis. When I was approved for my card at the age of 19 in 2014, it was under the symptom of chronic pain, because Ehlers-Danlos syndrome something that is both incredibly painful and degenerative is not on the conditions list. In H270, you seek to add ulcerative colitis and IBS to the conditions list, which I absolutely believe deserve to qualify for a card. However, Crohn's already qualifies for a card and shares a majority of symptoms with both UC and IBS. Under a symptom based model, all chronic GI disorders would qualify without needing to go through the process of individually approving every single one. Also in H270, you seek to exclude chronic pain from the annual renewal exemption. I would just remind you that many conditions not listed as qualifying, including mine, have chronic pain as a symptom, and excluding those folks punishes them for needing to settle on the closest qualifier possible. Meaning they might have an incurable or long term condition, but because their condition is not listed, they then have to fall back on chronic pain. So that excluding them doesn't really make sense there. Moving on to the proposed plant count increase, I firmly believe that we need to do away with numerical immature plant caps and replace that with a canopy allowance of 250 square feet for immature plants. Removing the number of immature plants someone can have also places a limit on the number of mothers, clones and seedlings someone can have at once. This means that folks will have less genetic diversity in their own grow and will take a lot longer to find cultivar and terpene combinations that do the best job of relieving their symptoms. In short, limiting genetic diversity also limits symptom relief potential. Immature plants is also not enough for many patients who make their own concentrate and edibles with the flower those plants produce. I would recommend increasing this number to 12 mature plants and a square footage canopy allowance for immature plants rather than a set number. Regarding the caregiver amendments. I believe that caregivers should be able to serve multiple patients, but patients also need to have multiple caregivers. There are many examples where this would apply and Green Mountain Patients Alliance is currently recommending a system where caregivers may care for three patients. Patients may have three caregivers, and both can circumstantially apply for more on a case by case basis with approval from the CCB. Patients who are minors will automatically need multiple registered caregivers to relieve parents of the burden of a single family member being the only one in the house who can administer cannabis 24-7. Increasingly amount of caregivers that a patient can have also protects that patient in the instance that one of their caregivers experiences crop failure, especially in the outdoor season in Vermont. And that would ensure that the patient still has medicine should that occur. I'd also like to touch on representative Hooper's concerns about the background check. There really isn't any incentive in Vermont to become a caregiver. There is no money involved. Nobody's getting paid for this. It is largely done out of charity so that patients can afford their medicine. And while I understand the concern that somebody could come in from out of state and get a caregiver card fairly quickly, from that point on there really is no benefit to that person. It just it doesn't really make sense to think that somebody could be trying to take advantage of a system where there's there's no benefit to them monetarily. Medical cannabis reform should be patient centered throughout the history of Vermont's medical program. The state has failed to take into account patients lived experiences. I've been navigating the healthcare system advocating for myself and educating doctors about my condition for 23 years. Longer than a lot of healthcare professionals have even been practicing my firsthand experience and the experiences of thousands of Vermont patients should hold just as much weight as the opinions of doctors and their lobbyists. I'm no longer a registered patient on the Vermont medical cannabis registry. The program did not evolve in a way that supported my needs. But that does not stop me from being a patient and finding relief through cannabis. There are thousands and I have to stress thousands of unregistered patients in our state who either do not qualify for the program or do not see value in what it offers. And we can make real tangible changes to this program that will make life better for the most vulnerable people in our community. But in order to do that, those changes need to vastly increase access to the registry. And once registered needs to address the individual needs of each patient via caregivers who can provide the one on one care that a dispensary simply can't. So in summary, I'm asking you to do three things today. One, adopt a symptom based qualification model for obtaining a medical card rather than condition based. Two, increase the patient and caregiver plant count to 12 mature plants with a square footage canopy allowance of 250 square feet per immature plants. And three, allow caregivers to care for three patients for patients to have three caregivers and allow both to circumstantially apply for more on a case by case basis with approval from the CCB. Thank you for your time. If you have any questions, feel free to ask. Thank you very much for your testimony. So I wanted to my first question and then I'll go to the committee is that what what I heard from some of our colleagues outside of the room yesterday who have looked at the conditions versus symptoms is that there was a sense that the falling back on the broader symptom based language that's in what's, you know, in current statute paragraph C, a disease or medical condition, or it's treatment that is chronic debilitating etc. That that that symptom based catch all in that paragraph sort of alleviated the need to continue to list out more conditions and I'm wondering if you could. I don't have that perspective, but I heard that perspective from a couple of other members outside of the room yesterday. So I'm wondering if you feel like, and it sounds like you do that, that we still don't have a broad enough symptom based set of qualifications even though we do sort of approach that in an existing statute. There are many symptoms that are unique to certain conditions. But there are also symptoms that aren't listed that share amongst a bunch of the conditions that are listed. For example insomnia, anxiety depression like I said before panic attacks. And with respect to ulcerative colitis and IBS and Crohn's there are gastrointestinal symptoms that all of those share that are also shared with dozens of other diseases. And so, you know, I don't I don't think I need to explain to you all that over the last 10 years, we've only added two conditions to the list. And both times it's because a patient has had to take the initiative to come in and appeal for their condition to be added. And if we keep doing this like this it's going to take us years, years to actually have an amount of conditions that covers even the majority of patients in Vermont, whereas if we switch to a symptom based model, we can expand that access so much faster. Any other questions for me. Well, thank you so much for your testimony, Amelia. I appreciate you joining us today. No problem. Next, we're going to hear from Jesse Lynn Dolan. Just when are you there. Yes, thank you so much. How you doing today. I'm doing great. Thanks for joining us. Absolutely. So thank you so much for having me I want to thank chair McCarthy for allowing me to speak and be here today. For the record, my name is Jesse Lynn Dolan and I'm here on several fronts. I'm a registered nurse specializing in addiction mental health and chronic pain. I was formerly the nurse director at London patient and outpatient as well as the school nurse at so where through Northwest counseling services. I'm the former director of the American Cannabis Nurses Association. I'm the current president of the American Nurses Association here in Vermont for all nurses. I'm a co founder of the Vermont Cannabis Nurses Association with Amelia. I'm a co founder of the Green Mountain Patients Alliance, which is part of the Vermont Cannabis Equity Coalition with the racial justice Alliance Vermont Growers Association, rural Vermont and NOFA. We were collaboratively together on all our recommendations and requests. I'm a nurse. I'm a chronic patient myself for chronic pain, having had over three dozen surgeries as a child, and I ironically have the same genetic connective disorder, ailer danlos that Amelia mentioned, as well as being a sexual abuse survivor with PTSD. Without cannabis as medicine, I would be on it on disability and half a dozen or more addictive and debilitating pharmaceuticals. I've been a cannabis caregiver for another nurse in cancer remission for years. So I'm here to speak to you today about the many needs for patients and caregivers in our medical program and how together hopefully we can support these positive changes with bill h 270. I did submit my testimony and I want to continue with that but I do want to address one thing that we were speaking here today off the cuff. This is an exception of being that's being spoken to about caregivers. I'm the representative speaking I think is has some misunderstanding and misinformation and is a bit biased. I want to I want you guys to remember that nobody becomes a caregiver to grow illegally and then sell to the black market. If they wanted to do that they wouldn't sign paperwork with the state of Vermont allowing someone to come in and audit or search their property at any time. I want to recognize that caregivers myself as a caregiver we care and patients do and can benefit from caregivers and the testimony I'm here hearing today is a little disheartening and almost feels like it's being criminalized. So if we could leave some time to address this at the end of my testimony or the end of today I would really appreciate that because I am a bit saddened by the assumptions that are being made of the concerns around caregivers and would love to continue address that but I do want to finish the rest of my prepared testimony I have for you. I wanted to start by applauding you for adding several new medical conditions to the current list of conditions that are allowing medical cards to be signed for as a medical professional. I'm in support of changing from a disease based quality qualification system to a symptom based. I would ask you to please consider trusting medical professionals and allowing them to make the determination as to who is appropriate to recommend for medical cannabis. Just like we do with providers who provide suboxone to the correct people rather than them only being able to if the patient's disease is already listed as allowable for legislation so please consider changing to a symptom based system and again I do thank you for the additions you've added. Thank you for also looking to remove the mandate for patients with PTSD to need two signatures as a nurse and a patient with PTSD. I know all too well that traditional therapy is not the answer for everyone that not everyone can even find a therapist right now and not every therapist has education with cannabis. So that that extra signature is just another barrier for treatment. I'll ask you to please work with the CCB so that patients with chronic diseases do not need to apply for their medical card annually. My genetic disorder the same one Amelia has is never going away unfortunately yet I have to reapply every year. And for the chronically ill this is an undue burden. I'd like to speak to increasing the plant count limitation so I'd like to share a quick personal story several years ago I immediately needed a lumpectomy for a concerning breast lump and only had two days to prepare for surgery. I needed concentrated cannabis oil and after surgery for the pain. So to make enough of my own concentrated medicine to not need opioids after surgery. I needed about half a pound of cannabis flower with equates to one if not two entire indoor harvests and a minimum of three or four months of my growing time. So two plants is not enough cannabis for people who need higher doses of cannabis like surgery. I think it's important for you to understand the quantity of cannabis needed to treat certain conditions and make certain products such as concentrated oil and how one surgery literally utilized a quarter of my annual cannabis medicine. It was made even worse when due to being rushed and nervous before surgery. I ended up burning my own medicine even with the experience I have wasting half a pound of cannabis and didn't have more cannabis to replace it because of that two plant limit patients and caregivers need more than two plants when growing and making their own medicine for so many reasons. Outdoor grows which are much more common easier and more affordable or only allow allotted one harvest a year one harvest with two plants is not very supportive and helpful for patients and more people grow outside as inside. If you if you only harvest a few ounces per plant a few times a year or once outdoors two plants can be detrimental if the plants aren't clean or healthy enough people need to be able to destroy them knowing they have others knowing they're allowed more than two. We need to help make cannabis medicine affordable and growing your own is one way to do so but two plants isn't even close to enough. Having been a cultivating caregiver for another nurse for a long time because she couldn't cultivate herself because her husband was in the military here in Vermont. I understand the trials and tribulations are growing a cultivator needs some wiggle room to destroy destroy a plant if it's not as healthy or clean as a patient needs growing isn't as easy as everyone thinks and has a big learning curve for many. There can be pests and disease that attack the plant. So rather than trying to save or salvage the plant material which we see all too often caregivers need to know they can destroy that crop and start over to ensure cleanliness and safety for the patient. If caregivers could have the assurance that patients have access through a higher plant count and even better another cultivating caregiver on the team. We could help ensure that level of comfort and again safety for the patient. So we need to increase the amount of caregivers per patient. We need caregivers to be allowed to support more than one patient as well. I'd ask you why not. We need to put patients first before prohibition and before biases and stigmas as a nurse. As a nurse I want you to consider what having one or even only 2 caregivers means and how that is a setup for burnout. The burden placed on that one caregiver 24 7 52 weeks a year usually family is the one that has to be that caregiver and also pick up the work slack and the other responsibilities of their ill family member. This is actually inhumane as baby boomers will need more care. We desperately need this to happen to avoid burnout and secondary trauma amongst family and caregivers. So please remember that not that many people don't use cannabis or end up back on their pharmaceuticals and opioids because they can't afford cannabis cannabis is not affordable for patients and cultivating caregivers can help bridge that gap. Excuse me. So please increase the plant count to 12 flowering the caregiver count to 3 and patient count to 3. Please also join us in asking the CCB to work on a price management system for patients at the dispensary to make cannabis more affordable and accessible. So in summary for today ask you to please consider adopting a system based qualification model of support and support the removal of the second sign off needed for PTSD. I ask you to remove the necessity that patients with chronic diseases reapply annual and increase the patient and caregiver plant count to 12 mature plans with unlimited vegetation or the great idea Amelia just gave you with a 250 foot square foot cat. Allow caregivers to care for 3 patients for patients to have 3 caregivers with CCB discretion for more. Lastly and when I feel so passionately about is to allow patients access to shop at adult use retail shops without paying extra taxation patients drive from Newport to Burlington and would rather shop and support local. There's no reason patients should not have access to adult use without paying exorbitant taxes. Many adult use retailers are shouldering the cost for patients by covering their taxes and shouldn't have to please please allow patients to shop at adult use retail without exorbitant taxation. This could be an enormous support for our patients and I'd ask you to discuss this with me and other patients more so please include our testimony. Health care providers patients caregivers yesterday I believe medical was taken up without grassroots patients or caregiver voices. So please consider allowing us to speak and to listen to our words as well as looking to have a medical professional on the medical program team with the CCB. Thank you for your time and please feel free to ask me any questions or if there is more time I would love to address the concerns around caregivers even more so. Thank you so much. Questions for just one representative waters evidence. Thank you. I am wondering. I don't know if you can answer this question or not. But Amelia said that often I help care provider will or or she referenced something about how a health care provider will just use chronic pain is like a catch off for you know conditions that are mentioned in the law. And I was wondering if you have any idea or concept of how often this occurs or or if it's like a prevalent thing amongst health care providers to just kind of use that as a reason when they fit whatever the symptoms are into a different box that's that's not legally allowed. Absolutely I do feel that is what I you know what is happening what I've heard from both patients and caregivers that if they do medicinally feel that cannabis is a safe and good option for them that they have to find you know the way to make it work. So check off the right check box putting in the right diagnostic instead of saying yep this would benefit the symptoms that you're having and we know you're using cannabis are ready to support those symptoms. So I do think we see that. I think it's also great and important for you guys to know unfortunately the truth of reality is that cannabis education is not in nursing school it's not in medical professional schools and here in the state of Vermont we don't have any mandated education regarding that. So we are also looking to you know help educate and have our health care professionals understand and work a little bit more as far as educating themselves to be more supportive for our patients here in the state to So thank you that's a great question but yes unfortunately I think it is being lumped into chronic pain a little bit too much and we if we could expand that I think we would see some positive feedback from providers and patients. Just the way that the bill is currently drafted. I wanted to sort of segue into a little bit of the conversation we were having and your testimony about caregivers. Is that additional caregivers shall be at the discretion of the board so you know where it says a patient who is under 18 years of age can have to get caregivers I'm assuming that that that just covers patients who are minors can have at the discretion of the board more caregivers but we've limited that for adults. I would ask you not to limit that to pediatrics at all when you think about a time frame of a 40 hour work week you need multiple caregivers to be caring for that patient if they need round the clock care or as Bryn mentioned sometimes it's somebody helping a patient administer their own medicine. So if we have one caregiver playing that role 24 7 as I mentioned we are looking for burnout. We have a lot of people moving into that baby boomer and that elderly needing support phase of life. And if it's one caregiver and they're only available 40 hours a week that patient isn't getting what they need. If we're expecting that caregiver toward 27 you know 24 7 7 days a week again we are setting them up for failure which is then a detriment to the patient themselves to have a caregiver who is literally burning out and as we as I've mentioned as we age and get to this stage where we have a lot of baby boomers who want to use cannabis instead of opioids and other harsh chemicals if we don't have a support system with caregivers readily available instead of burning out. We are not doing our job protecting and supporting our patients. Other questions for just one representative. Hi. I'm just curious if you can kind of give us a sense of like what that looks like on a day to day basis for a caregiver. Just thinking about like dosages and how long. It would last like what that looks like. It's a great question. Thank you. So it really depends on the form of cannabis medicine they're using when you think of using edibles that is the medicine that lasts the longest in your system. So hopefully four to eight hours cannabis medicine can work for an edible to be effective if it's a disease process such as spastic pain or you know IBS something that comes on quickly. Usually most people would administer either vaping or smoking to have that work consistently. That's often a product people would administer every one to two maybe even three hours as needed. If we have a patient that needs a caregiver because they can't physically do that the work of getting that medicine ready for themselves. We are leaving patients every two to three hours to figure out how to administer their own medication rather than having someone available to help them. So essentially the way I look at this is I've mentioned I've been a school nurse before 40 hours a week I'm there with that child who's taking care of that child whether it's a child again or an elderly person because we are we do know elderly folks need the support to use cannabis medicine instead of other pharmaceuticals if that is their option. They have a we have three shifts a day seven days a week when you look at a nursing staff and shifting right that is what a caregiver is it is essentially someone helping to support their person their patient their family with medical support that should be seven days a week three people a day in shifts unless we want to expect one caregiver to do all of that work the same caregiver that likely also needs a job to be able to afford their patient to access to this medicine and for them to continue to have their other supports in place. So when we look at dosing we it really is unfortunately but fortunately because there are a lot of options based on which medication they're using but even if they are using the most long active cannabis medicine. They would need someone to administer that at least four times or more a day and just asking one person to do that is asking someone to work full time around the clock without a day off ever. Thank you so much for being with us this morning just Lynn I really appreciate you bringing the perspective of a medical professional who is working with cannabis because that's an important one I think to have in this conversation so very much appreciate your testimony. I think we're in the bill moving in the direction on a couple of those those pieces and probably not going to satisfy all the requests that both you and Amelia have brought up before crossover today. But I think as we think about the evolution of the medical cannabis market, alongside the nascent retail market, we're going to have to continue to be in dialogue with you to make sure that we're serving patients well. I mean I think we're obviously we're trying to solve in each 270 some of the immediate concerns that you brought up, but I don't think our work is going to stop there so I want to say that for folks who are not going to be satisfied by what this bill gets across that we're not done these conversations. So I really appreciate both you and Amelia bring that perspective. Oh thank you for having us and we appreciate your openness to have conversations again in the future. All right. So, next, we're going to be hearing from Jesse Lucas. Would you like to take the hot seat since you're here in person thanks for joining us today for your patients with us starting late and the snow and the craziness that weather. Good morning. Thank you chair McCarthy for inviting me down to be able to speak today, and all the fellow members of this community for hearing us on our testimony this morning regarding h2 70. For the record my name is Jesse Lucas, I am the corner of various ventures I also own own a small organic certified farm in Charlotte called GMG farms on our farm we produce vegetables throughout the four seasons along with herbs flowers berries other agricultural plants which include certified organic hemp flower. I've done this for several years and in 2002 we obtained a social equity outdoor cannabis cultivation license from the state of Vermont to grow cannabis with a higher THC than a normal hemp license would allow. This is the only one difference between having cannabis that's found in the used market. This one, the percentage of this one cannabinoid in this plant that makes that one difference everything else is the same the smell the look. They grow the same dry cure package all the same way this leads me to my dilemma as a farmer currently. I work all season to grow our cannabis flower on my farm in the ground with sunlight next to all my other plans which I can sell to the public myself, but yet I am handcuffed to sell my cannabis flower to a third party who has no obligation to even purchase what I have to offer. I would like to be able to sell our cannabis flower and products from our farm, like any other farm that is able to offer these produce their produce meat or other agricultural products at their location. We have this ability to do it now with everything else that we sell please allow us to advocate for our own cannabis flower and not be a limited to a third party. Regarding the propagation license is defined in age 270 which I've been invited to speak here. The market is still in its infancy and current structures slanted towards the intermediaries. Now is the time to balance out this intermediary heavy structure by expanding allowances for producers cultivators and manufacturers. Now is not the time to introduce yet another license which further risks pushing the market into another intermediary dominated one. Cultivators are likely the group most interested in selling seeds and living plants that should not be asked to spend more time and money on another license, when we can simply allow them to sell their products, and a safe and regulated manner, which we already do with all of our other products. And we are allowed to sell clones. We are allowed to sell seeds to other cultivators. We just can't do it to the public. So I have an issue with this. I guess, you know, I, you know, there's a gray area for us cultivators where it comes to selling seeds and living plants. Some licenses are doing this now some are not lawmakers are here to remove uncertainty from the market. In January, 2022, the federal government abandoned the source rule for sourcing cannabis seeds and living plants, and will instead use the THC threshold as defined in the farm bill. The propagation license as a fine age to 70 will only serve to reinforce this great area, such that if an active cultivators without this propagation license will likely continue to sell seeds and living plants directly to the public, as it is occurring now, is very important to explicitly allow licensed cultivators to sell seeds, living plants to the public, not only because it is the most healthy option for licensees and the state market, but it also to eliminate this gray area and remove the uncertainty currently being cast over us growers. We are farmers. We grow plants. Plants are agriculture. We are an agricultural state. I have a farm in an agricultural town that currently says I need a special conditional use permit to grow a plant in the ground on my farm. Let's change all these mistakes. Let's allow cannabis to be under the umbrella of agriculture. Let's embrace this new crop and work to educate the public together. I'm here today because I care about what I put into my body. I care because I have lost confidence in some of our systems that say they're looking out for my best interests. I produce organic soil grown agricultural crops. Can we please allow cannabis to be considered the same. I would love to hear any questions from you. Thank you for maybe speak today. Thanks for being with us. So just within the function of the H 270 with the words on the on the on the page. So we're saying right now, like with your cultivation license, the ability to sell starts essentially, which the property is in license for that. Now, we have a couple of questions here. If it's actively occurring with people who currently have cultivation license is that just not understanding the structure of their license? Sure, there could be some confusion there. Okay, so that's like more of an education. Yeah, there's a lot of education. Yeah, we're still in the infancy of all of this. And that's a lot of education to take place. So I agree. Yeah. And then within the issues that you're talking about at the town level. I mean, that's not something that we were necessarily addressing here. Now, I'm definitely aware of it. I'm from Virginia. I'm in a budding district to you. So I certainly heard about a lot of this stuff. I've worked within the conversations. This is my first year in the committee of jurisdiction for cannabis control. This is something I've been in discussion with my entire life. So I'm not for that concept. So ultimately with that property, you know, with that with that municipal conversation. I just unfortunately don't think of that something we have time to address here we've been having conversations with other folks so I just want to let you know that that's not something that's being glossed over. It's definitely an active conversation you're discussing this week. And then with the propagation conversation. So essentially like what does your vision of how you could sell to the public off of your property look like because I'm trying to get a firm understanding of that for people. Sure. I mean, we have, we sell plants already we sell vegetables. We are currently looking at being able to build, you know, a small farmers market on not farmers market a farm stand essentially to be able to sell all of these from, but on a municipal sort of running into sort of this backup against we have this one plant that sort of is not defined. And it's causing a lot of confusion. And as a cultivator to be able to sell plants to the public. I think that's in our interest and the public's interest is less hands touching everything. It's also coming directly from us. I guess we're giving the healthiest plants, the healthiest sort of thing to offer, and we already do that. I guess I just don't understand why we can't. But in your mind, you would only be selling the starts you would only be selling you would not be selling like to like flower package ready to go. I would love to be able to do that. Also not. No, well, I know I'm here talking about propagation license as well as invited to sort of come in. Of course, I would like to be able to do that. Not a product and whatnot. I just wanted to make sure I was honing in specifically that we're speaking to the same question trying to keep it focused. Yes. Okay. So what I will definitely do is when we have a brand or a chair pepper backup is talking to them a little bit about where the board is right now with what current cultivator licenses really allow because you've introduced for me a little bit of what I'm seeing as a need for some clarity on can you sell season starts with a current cultivator license and it seems like something maybe some cultivator licensees are doing that and some are saying now that's I don't think that that's really allowed and there's some uncertainty or confusion there. I think that's a great question to ask. Okay. Great. Any other questions for Jesse. Thank you. Next up, I have Maggie lens, who I think is here on behalf of a client who's a cultivator Maggie welcome to the House of military affairs I think this might be your first time in this year. Yep, I think so it's nice to see everyone I will be there in person but I'm running late so I'm here on zoom. Hi chair McCarthy representative by wrong. I'm Maggie lens I work with Lee and I am public affairs and I'm here on behalf of Satori cannabis Satori cannabis is a company that is located in Middlebury. They recently remediated and fitted 116,000 square foot building. It used to be the old Connors home building. So they have their tier five cultivation license they have their tier three manufacturing license and they have their wholesale license. The reason I am here is because while we support the idea of a propagation license and completely agree with the witness that came right before me that is a gray area right now and it's confusing. We would like the size of the propagation license to be increased to 3500 minimum, or, you know, could allow the cannabis control board to to set that amount at a later time. Right now you know the canopy is made up of the mother which is breeding stock and it generates no revenue. Since Vermont is filled with many small growers Satori is projecting that they will sell starts and clones to 50 small growers and then they're hoping to increase that to 100. And they have, you know, because of the, because of the makeup of Vermont and all the small growers, they have to keep quite a lot of variety and genetics on hand. And that is going to be about 2500 square feet for mothers and they're estimating about 1000 for clones. Yeah, the nursery licenses they generate less revenue per square foot, then flower cultivators obviously and, like I said they need to keep a really large area of canopy that has a bunch of genetic stock in it. That's in vegetative state so the clones are cut from this mom stock and then the canopy area of the mother does not generate revenue. So, it's something that we see as an agricultural commodity and therefore we would ask that you take the 2500 and increase it to at least 3500. And that's pretty much it. Do you help me understand the, the, the sort of the reason why that I'm just trying to understand the, the, so is it just that the idea of being able to have more to just do more volume. Is that the logic behind that. Yeah, I mean it's because they are going to need so many they're going they're hoping to work with a lot of small growers right so there's so there's going to be just so many different kinds of variety, and having 2500. They run the numbers it's just not enough canopy for their purposes to create enough genetics and variety for the demand in the state. Any other questions for Maggie. That was a pretty clear ask will ask for some feedback from other folks on that. So, thank you for being with us committee. I want to say, I believe Eric is is on zoom. And I had scheduled a 15 minute break now but I think it might make more sense to get Eric's testimony in the perspective of a caregiver, then take a break and come back if that's okay with the committee going for one more. So Eric if you're ready. I'm wondering if you wouldn't mind testifying a little earlier where we're running pretty efficiently this morning. Yes, can you hear me. Yes, thank you so much for being with us today. Thank you for having me. So my name is Eric St. Croix I was a caregiver to a child who had cancer, and this bill on the side of medical seems to address just about every challenge we had, which was playing counts for one, and only one caregiver only one patient. And the whole issue with that was already remediated and older bills, because we weren't allowed to go to the dispensary and grow so that was a challenge. We had to get a bunch of our medicine from friends like I see when people like that not just particular but kind of a community of that, and that was already taking care of an old bills, but there were parents having custom issues at the time. And you were only allowed one extra caregiver, and primary caregiver, so to where the parents were in a situation that they couldn't grow. And both administer medicine so they had to lose their caregiver, and this directly addresses that with the ability to add more caregivers. Also, the list of qualifications. So that's a different story that doesn't really lead into our scenario, particularly, but consideration is that if a doctor is able to prescribe the medicine to somebody shouldn't that more be the determination that not so much the qualification but the fact that if a doctor determines that either there's anxiety that needs and so cannabis could be a better alternative to that. There's a situation where the doctor thinks he needs to be medicated through say opioids and cannabis would be potentially better alternative to that. Based on qualifications, but more so whether or not a doctor is already willing to describe the medicine. Plant counts was a pretty big detriment because with two plate counts to plants for the amount you have to grow for cancer. They kind of agreed upon protocols are a pound a month. And with two plants you're going to maybe have a pound in about three to four months with cancer that can be kind of too long. So the plant counts with more allow not to have more big plans, but to not grow your plants so big and have a short grow. One of the nice parts of that is you need less intense lighting for that because you're not like four feet. Eric, I just wanted to say seems like every once in a while your voice is kind of fading out. I don't know if you can step a little closer to your microphone or your phone so we can hear you a little better. Okay, is that better. Yes, that sounds very clear. Thanks. Okay, so going from that to what's happening with the dispensaries if we're losing dispensaries if they're having a hard time keeping up. That's opening up more room for the need for caregivers. There's a benefit to the patient in that in the price per pound and growing compared to purchasing when you grow cannabis small scale the average price to grow it is $300 a pound that's $18.75 an ounce at a dispensary you're getting three to 400 an ounce. So on that plant count getting your pounds quicker getting a cheaper. There's a huge benefit in being able to do that with more plants with not going to a dispensary so the more of us. There are to be able to do that the more it's going to help the people who are sick to get medicine. I'm going to read from a few things here. I don't think the caregiver issues right now are really have the fears that that we think they could because all of the states around us have looser regulations on their caregiver systems and even on some of their recreational growth so to come to Vermont and known as being a little bit of a struggle of a state to do something devious with that I don't really see happening and you guys pretty much hash this out every year so if there is some kind of hey we need to tighten that back up. It's not so far out that there's been a big detriment because of it. So it'd be nice to consider that on these things too. The people before me said most caregivers are helping a family member saving money growing them a alternative and not having a side hustle kind of business out of this thing. I think that pretty much speaks to most of it one person had mentioned that having a different scenario for people who move into the state. I have a friend who's from Pennsylvania and moved into the state because of our medical system because her daughter was on Pennsylvania medical system. She was going to college and they picked Vermont due to its ability for her to get into the medical system easy enough moved here just for her college and that would have been quite a challenge if she was treated differently somebody in Vermont at the time. I think that's more the kind of people that we're seeing having to get into the system and navigate it more so than somebody who's coming here to set up some sort of devious scam. I think for the most part that takes care of my experience we had a hard time because the plant counts. Having more would have allowed us to throw it quicker. And like Jesse Lynn said if there's an issue with the plant which we never had issues but but you have the ability to get rid of that and compensate rather than just start over. Let's see. Eric, could I maybe ask you. Most of the committee is new we've had a lot of turnover in the house. This year, and some of us have been working on canvas policy for a couple or a few years. Some of us is really new. I'm just beginning that you are the caregiver for a child and I'm just wondering if you'd be willing to kind of contextualize just a little bit of maybe just tell us a little bit more about your story and sort of how you came to have the perspective of the inconvenience of the plant counts and and that in a little bit more context for us so we can kind of understanding who is absolutely like you say I've done this for a few years where I had my little bit to what everybody else has said. And so I forget that part so basically because of my proximity, and I had had a friend from California send straight CBD products to me a couple times for issues I had with me and my dog. So I had just after the 2014 farm bill kind of been fascinated by the hemp and CBD, and had a friend send me some for a few things. My niece ends up at two and a half years old with a cancer diagnosis in the middle of the night. And we start looking into cannabis and cancer, and that was kind of our first wow. I'm just going through Google and seeing what's coming up on that so mom decided she wanted to do that. She was down in Randolph, I was in stow at the time and the only dispensary this deal with it was Burlington CBD. And so that put me right between them moms dealing with all of the hospital stuff so she couldn't really run back and forth so that just by chance put me as her caregiver because I said hey I'm willing to do whatever you need. So, from there we started getting product made from the dispensary, but as I pointed out the price of it was was pretty through the roof and growing it was a way more viable option but early on, you couldn't do both so as we stopped using the dispensary we had to find a network of people that didn't have access to cannabis until we got to where we had a harvest and that that took a while with two plans it was not easy to get to a product for that process of being her caregiver and stuff was interrupted when when dad and the lawyer realized that he was administering cannabis illegally to a minor. So, they said there's only two caregiver cards allowed dads got to get the second one so he can administer. And now you're back to only being able to buy from the dispensary. There was a direct negative effect due to us not being able to have a third caregiver, which would have just been still the same one caregiver in the respective growing or procuring however medicine for her. It just allowed two different people at different times to administer it so you could have that come up with in laws who are taking care of a kid. grandparents, any scenario where kids with two different adults at any time who aren't the grower or our medicine procure. A few times I have gone over her story. It's nice to let everybody know that it ended well and she this may will be at six months with clear scans on her cancer. She's nine and a half years old now. No noticeable cognitive decline at all. We haven't grown anything since we stopped giving her medicine. You know, that scenario of going out and shopping for another person I can be a caregiver for or, you know, hey, this is a scenario I can make some money off of my experience and the people have come across and this are all truthfully in that scenario where they're very happy to help somebody and get them savings and get the medicine. Thank you for expanding and sharing a little bit about your story. So glad to hear that it is going well. I hope that those scans stay clear. Anybody on the committee have questions for Eric. Really great to hear a caregiver perspective and I really appreciate you taking the time and being with us this morning Eric. I represent for her. I hope I don't have to see you guys next year but I do it's always great to feel like I'm making a little bit of a difference in there giving you some perspective, some real perspective to go by. Thanks for being with us today. Thank you. So I've been told English is not my primary language. But clarify what both Jesse Lynn and well pretty much everybody seemed to say. My problem is not the caregivers interaction with their client and the business of administering. It is that through our process of giving them an authorization to operate under a particular state blessing that we need to make sure that they are as pristine as possible and somebody that we've had a relationship with in the state of Vermont for a long time. Maybe that's suffice but somebody that comes in from out of state is a blank card for us and I know with my elderly and Eric talked about people who require a lot of care. So you become dependent you develop a relationship. My aunt has people sign her or write out her rent checks for her. Just because you know the meals on wheels. She knows. So that potential to get off that cannabis rolling into something else is my flag that goes up when we talk about elderly protection. I hope that clarifies. So I can't be any worse than the black and white movie thing. So I think what I'd like to suggest represent Cooper is that we go ahead and take the break. I promise we come back conversation up at 11. If you could hold with me and chair pepper and see if we can come up with a suggestion to bring back to the committee to try to alleviate your concerns. Because I want to make sure that we don't even on a dress. But I also think we kind of need to find a path quickly if we're going to try to make some change on that particular section. So let's take a break. All right. Welcome back to the second installment house government operations and military affairs committee this morning. We are picking up our conversation on each 270. And it's kind of a control board chair pepper here with us. So thanks for joining us. I know we both face travel childcare. There's snowy Vermont morning issues this morning. So appreciate you being here. My pleasure for the record James pepper chair the Vermont cannabis control board and I apologize. I wasn't here this morning really are twin boys were upstairs running around and their childcare center. There was a wire down that caused the fire and my wife actually had to pick them up in the woods yesterday because they wouldn't let anyone drive to the. I was complaining about. Well so I you know I bring kind of filled me in on some of the testimony that everyone heard I did catch kind of the second half of the morning session. And you know I think she explained some of the rationale behind the new drafts the amendments to the as introduced version and I'm here to answer any lingering questions that the committee may have. I can talk about any aspect of the bill or address some of the testimony that you've heard this morning. So I have a few things. So I'll maybe just that are in response to the testimony we heard so I want to quickly say that we talked about huddling before we broke and representative Hooper have brought up some concern about going to the in state background check systems and it sounded like there's some openness that if we touch council maybe come back this afternoon with looking at if somebody can't demonstrate at least a year residency that they would kind of default to the federal background check and finger printing. And if that would be OK with the CCP. Yes absolutely. You know we have 223 caregivers currently as of today and they're currently subject to this fingerprint supported background check. And you know we're trying to make it easier for them because again the vast vast majority of these people are you know children that are growing for their parents are picking up from medical dispensary. There's one there's one location in the state that allows the kid finger electronic fingerprint supported background checks that have a very quick turnaround. Everyone else has to kind of go through a little bit more onerous process. Just again given the kind of authorization that they actually have it seems a little bit unnecessary. We want we want these caregivers to be able to provide for these ailing people. But it's a very legitimate concern that we also are kind of granting them a license to operate in a way. And you know almost all regulator professions have some kind of background check procedure. So I think this is a nice balance to kind of feel that we don't know people that haven't a long history in Vermont. Maybe we do the 50 state people that have a long history in Vermont. You know we do the Vermont background check and check the two registries. Representative Cooper of course. Thank you Mr. Chair and Mr. Pepper for that consideration. Absolutely. Any civil will pick that back up when we have some language to look at but any lingering questions about the caregiver background check changes. Okay, we'll circle back to that once we have a little bit of new language. The next thing I had on my list from this morning. Was the question about the with a propagation cultivator license. It sounded like the 2,500 square feet was the number that was proposed by the canvas control board. Her a rep from, you know, pretty large licensee currently that they'd like to have additional canopy. Is there a specific sort of reason for 2,500 or is it the desire to just not have kind of infinite clones be able to be Yes, I mean a 2,500 square feet by way of context to be a tier two cultivator in Vermont. You know, we had most states have an uncapped nursery license. You know, the thought is is if you are, if you specialize in clones, you know we want a clean clean source material for this industry. And if one's going to specialize in this aspect of it, why cap them, you know, but, you know, and so we actually proposed last year a nursery license propagation license their synonyms. And it did not have a cap, and there was some concern that, you know, we might see a massive massive operation that just specialized in this. And, you know, I think that the board heard that concern and coming back saying 2,500 is that the right number I mean, you know, essentially these people are going to be supplying the entire industry. And so 2,500 means that there's going to have to be many of them to get to kind of supply the entire industry. And so, you know, it's really just a policy decision there there wasn't much of a rationale behind the cannabis boards 2,500. We didn't we heard the concern from the legislature and didn't want to make it unlimited or uncapped. I appreciate your willingness to kind of jump all over the place based on things we heard this morning. So, there's flexibility for the number of caregivers right now or discretion that we're putting in the bill for the number of caregivers for a patient who is 18 years or younger, as I read it right. Is there any reason not to, to give the campus control board that discretion for other patients. So, I mean, I think you heard probably from Jesse Lynn today. You know, because she certainly is kind of articulate her concerns with the board that you know some people need around the clock coverage 24 seven and to limit the number of caregivers. You know, without any sort of discretion for the board or someone's particular circumstances, you know, has led to just people having to operate illicitly people having to kind of break the law around caregiving. You know, I think you heard it even from Eric St. Croix, he, you know, because both mother and father or divorce were separated living in different parts of the state both needed to administer the medicine. And neither of them knew how to cultivate. And so they had to engage for the third party. He was operating illegally. And, you know, it's a position that people don't like to be in, but they're going to do what's necessary. I don't like that discretion, but again, you know, I can't, can't speak to future cannabis boards. I'm not going to be at this in this job further. And I would like to be able to, you know, listen to a person circumstances and determine what the appropriate number of caregivers are, but it's a trust exercise between the cannabis board and the legislature. And it's always been one to one, one patient, one caregiver, you know, because of this story actually they changed it for people under 18 to two. And, you know, even in that situation it wasn't enough. So my next question comes out of Mr. Lucas's testimony, which has to do with this ambiguity around current folks who have a cultivation license. The board's position that they're allowed to sell seeds and starts sort of currently off there. But my understanding is they can only sell the other licensees, but it sounded like there's some sort of ambiguity or question about that. So I was wondering if you heard those comments and could maybe respond or clear that up. I walked in halfway through. We have the position that cultivators can sell to other licensees, not to the general public. This has been complicated by the DA. You know, they, there's a law firm that really push the DA on whether seeds, specifically seeds should be considered the purposes of the controlled substance act. And they, there's a DEA determination letter it's called that says seeds are hemp. Schedule one tomato seed and a cannabis each shall be treated equally in the eyes of the law. And so we can't really stop a cultivator from selling a seed. When it comes to clones, I do not believe that there's the same determination from although the same law firm and others advocates are trying to get the data kind of make a ruling on clones. But, you know, we. So what we've said is, you know, clones can be sold within the supply chain but they have to, they can only be sold to the general public through retailers. So in order to be sold by cultivators, I just would caution that we have about 250 cultivators in the state. This would be people coming on to the cultivation farms to purchase them or coming to a farm stand to purchase them. So we have very strict controls over our retail licensees including point of sale systems inventory tracking age verification advertising, and it could potentially create a resource issue at the board to follow us and we had 250 retail locations for clones. So that's just the concern that the board has with kind of opening the door at this point to what essentially be farm gate sales. Yeah, I have heard significant. You know, we heard testimony from associations or Lucas today a real desire for there to be able to be sick sale from license cultivators to on farm. But that is a question that deserves some more discussion. I don't think we're going to be able to resolve it in the context of the bill, because I know they're significant, significant concerns you bring up just some of them. This question of, you know, what we, how we define cannabis especially either before or if the plants ever going to have enough THC to be intoxicating in any way is a question that I think we're going to continue to wrestle with as we deal with these policies over the years. But I think we're not going to address that in each 270. Yeah, I mean, the idea that we've been just trying to put some structure to is maybe having a limited set of over 21 farmers markets, you know, a limited maybe a pilot program where we would allow just the farmers market that could take place in a place that's not visible to the public could have direct could have a number of stands of cultivators that would allow this kind of direct to market access which the cultivators desperately need, you know, if they're going to be successful. Just to allow people onto the farm at this point is would just I think require more staffing from at the board level just to make sure that the same, some of the same protections that we have on the retail stores could apply here and again this is a very high value crop at a specific time so a largely cash industry. And so, you know, trying to balance all of these public safety is challenging it just takes, you know, just take some thoughtfulness and some resources behind it to make sure it's working well. I think I've dominated the chair sign here. Other other questions for chair pepper. Is this anything in the room? We're wide open pepper is, you know, I think he's he's pretty familiar with everything that's in the bill so I'm willing to let it be a little free ranging if you want to go first. Yeah, sure. Again, I apologize for being late this morning so the question I've got and I received a number of emails from doctors as well as just, I guess, individuals that are following this bill and one of the concerns that they have a big concern is that the additional qualifying medical conditions and I'm just curious as to where where are they all originated from and whether there's any actual background of harm that could be attributed to adding these who who initially crafted these these additional qualifying conditions. The ones that are in current law I think there's a, there's some board I think that creates them I think that medical society could explain that a little bit better. But you know I sit on this cannabis regulator regulators association we don't take any industry money is literally just people around the country that are, you know, on cannabis boards and their supporting staff that are kind of talking about emerging cannabis. And I sit on the medical marijuana medical cannabis subcommittee. You know, I have real concerns at the medical program is kind of heading in a direction that might not be sustainable. So, the chair of that committee is the chair of the medical cannabis board for Minnesota. I just asked, how do you go about adding qualifying conditions to your program because some, some people have anxiety some people have. And personally, I think Pennsylvania a number of states have you're going to prescribe an opiate then you can also prescribe a medical card, or you automatically get access to a medical card. Some people have acute pain, some people have whatever doctor thinks is appropriate. You know there's, you know there's a wide array of qualifying conditions out there. And some Minnesota, they have a petition based process that I should say their medical program is housed within the Department of Health. It's a petition based process so when a, you know, once a condition, like multiple sclerosis or something like that gets 500 signatures some some number of signatures, and it triggers a review by a medical medical research team at the Department of Health, and they put together, they look at all of the kind of pre clinical studies the clinical studies the observational studies that have been conducted in the United States and those are usually pretty limited, but also internationally. They kind of break down the components of what the kind of symptoms of the condition are, and they look for has cannabis been effective treatment for any of those conditions. And then they make a recommendation back to the Medical Cannabis Board and the Commissioner of Health, and then they vote on whether or not they should include it and they've denied things like anxiety in the past they've denied a lot of conditions. But the conditions that I was requesting in this bill would square our list with Minnesota I mean I don't presume that we should. I don't think we have the resources to kind of do what Minnesota does. Certainly not kind of in our Department of Health. But I thought that we could just piggyback off of what they've done and I submitted all of the white papers that they produce Minnesota has produced for all these conditions they're under my name. And the last time I testified of these two weeks ago. That being said, you know, the research is limited, you know, it is very limited and I know that the Department of Health got these white papers yesterday and they didn't have a chance to review them in time for the hearing that we had in human services yesterday. Thanks for that. You just mentioned something that I didn't know existed the National Cannabis Control Board. Yeah, right like the AAA still federally frowned upon. Anybody reporting that the feds have stuck their nose in a little bit and said hey, what are you doing or you're pushing us too far and if they did where would they come. Um, well, it's very complicated history with the federal federal government. I could I could review some of my notes from no, I'd say the, I'd say the, you know, the cold memoranda which kind of bless states moving to legalize adult use candidates was drafted and released and it's just guidance it's not policy it's just policy. It can be overturned and it has been overturned was released in 2013 and that kind of allowed states to proceed with adult use medical. Colorado is Washington, Oregon, followed very closely behind Alaska as well. When Attorney General Jeff sessions rescinded that number in 2018. And so, you know, everyone kind of didn't know what to do, you know, are the are these kind of DDA rates going to resume. That didn't happen. You know, as you know, this is a 30 billion dollar industry like it's kind of hard to put the brakes on it just overnight. And, and, you know, there's been some movement federally last year, President Biden signed the first standalone cannabis piece of legislation. It was a pretty narrow and its scope it was allowed for greater access to research licenses for federally backed institutions possess some research candidates. President Biden pardoned simple possession for people with federal charges. If there's talk of this in this regular association that there's going to be a new coal memoranda coming out soon because it sounds me like safe banking probably isn't going to pass this year. And so they we need a kind of new baseline that gives credit unions, especially this what they need the kind of roadmap to banking Canada's funds of safe banking. Okay, thank you. Any other questions for chair pepper at this point. So, I have have had a request for us to have the Vermont medical societies representative had has asked me to invite a doctor from Colorado into testifier so I'm wondering maybe a chair pepper you'd be willing to stick around while you're here doctor I think it's regarding each 270 then we'll kind of pick this back up before we break for lunch minutes early because I know a number of us are attending the early childhood day lunch and the plan would be assuming that for is not super long for us to come back and hopefully look at a draft that incorporates some of the feedback that we've heard this morning. I'm trying to address representative Cooper's idea about the caregiver residency kind of having another pathway there and then a couple of the other more minor changes I think so. I'll invite Dr Stout to join us on zoom here. Welcome to the House Committee on DevOps and military affairs. Good morning. Thank you very much. I really appreciate being allowed to give some testimony. I am, I am Libby Stout. I am a board certified. I'm sorry, my internet is not the best so I might have to stop my video but I am a board certified addiction psychiatrist in Colorado and I have been, I have given talks and I have testified in Vermont before mainly on several occasions just to help people understand the significant consequences we've seen in Colorado from our fairly unregulated market and I, looking at your H270 bill, I have some very serious concerns that some of the things in that bill are going to significantly increase your public health harms. And I just think it's really important to recognize that. First of all, I would speak to the issue about the post traumatic stress disorder situation post traumatic stress disorder is a very treatable illness or disorder, extremely treatable. There has not been a single study that is a well designed, well represented demonstrating that cannabis helps PTSD or resolves PTSD or treats PTSD. In fact, most of the studies have shown definitively that it makes people worse. There was a brand new study just recently published on data from the National Health and Resilience Study and veterans between 2019 and 2020 and looking at over 4,000 veterans and they found basically that frequent cannabis use actually worsens PTSD symptoms. Other studies have shown that yes it definitely makes people worse. Some studies have shown that yes temporarily it works in the fact that yes it numbs people and it you know it can take away the symptoms of post traumatic stress disorder. When it's used acutely, but that requires somebody to use it regularly on a regular basis like daily sometimes multiple times a day, then then sets them up for cannabis use disorder, psychotic symptoms, cannabis hyperemesis syndrome. And so this is why this has not been really beneficial. There actually was this review article that looked at all of the peer reviewed studies and randomized controlled trials in humans from 1974 to 2020. And they found that while low dose of THC and their low dose was 7.5 milligrams that could potentiate fear memory extinction. And so it then could decrease anxiety and people with PTSD without any psychotic effects. However, they found that when they got into stuff that was greater than 10% or greater than 10 milligrams, but that did not facilitate fear memory extinction and it increased anxiety and increased psychotic symptoms. So that that then speaks to your idea about expanding the amount of THC available in a package. And that, I mean, I have been so happy with Vermont to date because they're like the first state to actually put some stricter regulations on these things and have a potency cap. And I just want to be really clear and I've been doing this in all our previous testimony and anyone talks about potency. I just want to be very clear for the committee because it's easy because that's being discussed elsewhere in the building to get confused and we have a lot of new folks to this on our committee. There is no change in each 270 about potency limits or serving size limits. The one change we're talking about that you did reference that and I appreciate your caution and concern on is the amount of servings we're allowing or the total amount of THC that we're allowing in a container potentially going from 50 milligrams to 100 milligrams. But I just want to be super clear for the committee that they understand the testimony that we're not we're not talking about changing the potency of any of those approved products today. Okay, okay. And I appreciate that I understand that. So basically it's expanding the amount that's available in a package. And that is concerning and the fact that the more somebody uses the more problematic it's going to be. And we've had these significant increases nationwide in young children getting hold of these things. Even in places like Canada where they have really good packaging you know and it's it's supposed to be not available to the kids. They've had like 800% increase in kids in the in the emergency room having to be admitted to hospitals. And so the less amount that's in the package, the better in these regards, there's also studies now showing that there's this in almost the 2000% increase in older people ending up in emergency rooms or hospitalizations because of the high doses of THC that people are using. And, and, and there, I just saw a webinar on somebody who was a cannabis researcher and treats people with cannabis. And she was even saying that what they need is the low dose THC, not these high dose products. And, and so a biggest, you know, concern I would have for your population is you already have this huge use of THC by those 1824 where their brains are still developing and they have this this really significant impact that I don't think they're aware of because you know the, the publicity has been oh this is great this is safe this is good for you there's nothing wrong with it. And so kids are using it and so that would be my biggest concern. Yeah, Dr. stuff I'm just you're bringing up some some data that you know we've we've seen data that we're all familiar with with the youth first behavior survey. Yeah, it's so and so I'm, I'm just trying to understand a couple of the different points that you're bringing up about the high use and also my understanding and we've had significant pressure on us and the cannabis control board to loosen our advertising laws. And we've been reluctant to do that because we don't want, and we've taken great strides to keep this and packaging standards to keep our cannabis market, not, you know, being marketed to minor so I'm just wondering maybe just in our Vermont based context I know you're you're speaking with the Colorado perspective but if. But if you're talking about Vermont specific youth youth use data. As you're referencing studies and instead of saying like a study a person could you please actually like share the information with us I have no data to look at to see who compiled it analyze it, or funded the studies please. Right, well, and actually, I know that you heard really good testimony yesterday from the Vermont Medical Society people. So they're basically saying that Vermont has the highest rate, one of the highest rates, and that 41% of 18 to 25 year olds have used cannabis in the past 30 days that's in Vermont. That's, I think, highly significant that's almost half of the kids of that age group. And, and so I think that that's very significant information. And yeah I could give you the, the references for the, the PTSD studies I've given, I could send that in an email. I'd be happy to do that. And maybe the YouTube speaker you were citing as well. Pardon, you cited a presentation on YouTube or online. If we could see that as well. Any of the points that you referenced in your testimony as applicable to this. Okay, one of your information gathering I would love it if you could share that with us. Okay, I actually have a little brief little slide show just on post traumatic stress disorder, and that has the references in the slide so I could send that to you. That would be wonderful. Questions for doctors. Well, thank you for being with us today. We, I think you, we, we have a variety of perspectives about specifically this container size question that that you bring up, and of course concerns about I'm sure that we're not marketing to minors. Are there other questions for Dr. Stout. Thank you and thank you for for testifying today. Just curious, you say you're in Colorado, what are you seeing, of course, you've been at it 10 years now. What are you seeing as the number of people that may be reaching out to you or others for for help in that regard usage of cannabis. Well, I'd have to say that the biggest problem has been with cannabis induced psychosis that we are seeing significant increases in that and it is totally related to the increased amount of THC that people are using. And the frequency of their use. You know, so we have we have young people that are smoking dabs, you know that the very high concentration stuff or vaping stuff that's like 60% 70% that is really creating havoc with their mental health. And so I think that's the biggest thing that we have been seeing. And so that makes it the most concerning. And that's why we were successful in getting our bill passed back in 21, which limited the availability of medical marijuana for 18 to 20 year olds back before that bill. We had 18 to 20 year olds that could get 40, 40 grams of concentrate daily, which is insane right now they could, they can get two grams concentrate but that's still an amazing amount of THC. Because if you look at the research for medicinal cannabis like like we have these drugs like we have marinol we have. Well it's drannabinol marinol and the FDA and that's pure THC so it's 100% THC. But the recommendation is that people not take more than 10 milligrams twice a day. If you look at what an 18 to 20 year old can get in Colorado, if they buy a bag of shatter, which is 80% THC, then there's 800 milligrams in that one gram bag. And then they can buy two of them so that's 1600 milligrams of THC that they can buy and use. And, and then there's thinking that it's medicine, and it is not medicine. I mean that is not medicine. And so, most of the people that are advocating the use of that I believe are doing the right thing in terms of using medicinal cannabis are talking about using concentrations well below 10 milligrams and and not using these huge amounts. And so if you have a package of 50 milligrams, then there's five doses in there, but if you expand that to 100, then there's 10 doses in there. And so that just expands the risk for these things. So you keep referencing 18 to 21 year olds in Colorado. What is the legal age to purchase cannabis products retail in Colorado retail is 21. Okay, so it sounds like there's a consumption issue with that youth demographic you have a compliance issue, not necessarily a product issue. Yeah, except that their brains are still developing until they're 25. So I mean it's still, it's still a public health problem. Yeah, but you keep referencing an age range where they're actually not even legally 11. And we're speaking to a controlled environment, not an uncontrolled environment within this committee's conversation. Okay, but this is also, I mean, they can do it if they've got a medical card, and it's very easy to get a medical card I don't know how easy it is in in Vermont. We're one of the strictest states. Yeah, we we We've limited our our potency caps and also have a stricter regime, which so we're, we're balancing, we're balancing the desire to have actually our medical program be more open. No, again, I just like to say, regardless of whether or not those limits are in this village 270. I know the Senate has considered and as I don't know if they've taken testimony or not it's going to drop off the radar a little bit but looking at increasing that THC cap from 60% further basically talking about how there's still a concern that the illicit they're going to get it through the illicit market anyway and of course we want to we want to have it be a a good protected product. You know, to even go further and I've received information from the Moio County Valley Health folks that were just in New York State, you can have all the regulations you want, but whether or not it's followed whether it's in Colorado New York, there's the stipulations where they were just down in New York here, where it's on the streets that was it was being sold to them on Times Square, solicited for sale on Times Square. You know, these are all things that are that are against the law down there and it's basically they're saying to that law enforcement isn't even going to attempt to enforce some of the regulations and you know they even talked here about talking with law enforcement in regards to a lot of the regulations and so on and saying that the only thing that they're really able to to enforce is underage use so there is a there is concern, at least in my point and from what I've heard from other states so but again I appreciate you even talking about the effects of increased dosages of THC. Representative Nugent. Is it fair to say and this might not be the perfect question for you so feel free to let me know but that part of the issue at least with the package size is kind of like the overton window. I don't know if you're familiar with that term but like what becomes possible. It's like, if you have. I don't know, like drinking a gallon of water sounds extreme right now but if someone has like a half gallon of water other. Table every day that might make the gallon of water seem less extreme but it still might have in that case actually might not be a great thing for you. It's kind of like what you're saying about like package size, it's kind of like, it's a psychological thing in terms of like what's okay person. Exactly, I think that's a very good point. That's why I was kind of thrilled that you have the limit at 50, where we don't have that limiting Colorado, but now you're trying to expand it to what we have in Colorado. And yes, I think it does make people think, well that. It's true for all addictive drugs you know everybody starts by thinking well if a little is good a lot must be better. And, and so, you know, especially when it's, it's couched as medicine. People are going to say well then 100 must be fine. You know, 50 is good but hundreds better. Thank you for being with us today. We're going to pick this conversation back up this afternoon. And I want to have a chance to confer with legislative council a little bit about some of the changes that I think we're going to ask to see when we return from the floor. Any kind of final questions for Dr. Stout from the committee. Dr. Stout, you just said addictive. How is this stuff in general, it's not my world I don't know it at all, really. So I speak from a lot of level of not knowing but is this an addictive thing that can get worse and worse and worse and snowball I'm hearing that from you and again it's not my world so I'm asking out of ignorance I mean because that's concerning to me as I'm hearing that from you as I. I've got problems with things in general in this in this country in this world that you know are we adding to it I don't know I just ask them that as a general question. Yes, this is turning out to be one of the most addictive drugs we have my entire career I have spent dealing with tobacco and I try and convince programs to be tobacco free because nicotine is the most addictive drug we have. Sure, I am now seeing that these higher potency products. Can I just really, I'm sorry to interrupt you, but what's tricky for me about what I'm hearing from you say is your you immediately went to talking about high potency products and we have we have limits on the potency of our products here. I'm representing Morgan asked you about, you know, is cannabis addictive. When you talk about high potency products I think maybe you're, you're conflating to kind of separate concerns that's all I just want to make sure the committee is clear about what you're testifying on. Okay. The drug itself is addicted. Yes, very addicted. And when people use more of it, then they tend to develop cannabis use disorder. So if they were just using a 10 milligram piece, once in a while, they're not going to have an addiction problem. But if they're using it every day all day long 10 milligram so they're using. So you have 100 milligram package and they're using 10 doses every day. So they are going to develop cannabis use disorder. Yes. And then that will create the problems that we're seeing with people using frequently using regularly these doses. This is, you know, and that's where you start getting into the psychotic symptoms the cannabis hyperemesis syndrome symptoms, because they're using regularly. And then they think, and this has been well studied also in medical marijuana patients that when they stop using they have significant withdrawal. And that's how you know it's an addictive substance because when you use it daily regularly, and you stop similar to any other addictive drug. You have withdrawal symptoms and so many people equate that with oh it's my symptoms are coming back they don't realize that it's really the withdrawal symptoms. The withdrawal to marijuana is irritability anxiety, anger, massive cravings for cannabis and problems sleeping problems eating, because these are all things that the cannabis did for them. But then now they're in withdrawal so that's why we're seeing more and more people with increased anxiety issues, because of their marijuana use. It initially works. That's just like any other addictive drug. But then once you become dependent on it and yes there is a physiological dependence is not just psychological. Then you're in withdrawal, and then you have to manage that withdrawal and the normal way is to use again. Yeah, I did. So you were talking about the difference between high potency and low potency and I apologize for having to be out of the room. Is there a definition of high and low in terms of milligrams of THC. Well, yes, I mean there, there are more and more people trying to equate this. So the FDA came out well not the FDA some people working with that came out with like a recommended dose would be five milligrams like that's a single dose. Some places say maybe 10 milligrams, but then again like I'm saying if you use that just occasionally like you're using ibuprofen for a headache and you just use it occasionally. That is not going to be a problem. But even with drugs like ibuprofen if somebody uses it all day long every day and they quit they have. Down headaches just because of the drug use. And so your body becomes habituated to it. And so the it can be, you know, high potency is used to determine you know how much is in the product, you know percentage wise, but there is still this 20 milligram thing that you have to look at. And, and that's why I keep equating it back to Merinol or dronabinol, which is the FDA says shouldn't be more than 20 milligrams a day, because when you get past 20 milligrams a day of pure THC, you are seeing the problems with the psychotic symptoms, the anxiety, the depression, those kind of things. So, you know, the ideal dose nobody really knows. But again, what I said was most people I know working with people with AR1 are using things like one to one balance of CBD to THC and they may have like five milligrams of THC and an equivalent amount of CBD. And those people are not having problems like I'm talking about. It's when you get into using higher doses of it more regularly that you get into problems. Okay, so I just have one comment and that is that it seems like I mean we're trying to in this bill raise the threshold, raise the amount of milligrams in a dose that's for sale. No, that's not true. Okay, so let me just let me just finish please. So I really need the health care committee to look at this dosage piece. Human Services has traditionally looked at therapeutic use and didn't did it drive through yesterday. We might have talked about this when you were. No, you said Human Services did but I'm saying health care. Well, so this is a public health. So that's absolutely true. I will just say, we are not going to, I am not putting on the table for debate the jurisdictional appropriateness of our committees, which committee is going to take up which bills. I'm also in our lap, I've allowed the committee who's worked on that particular piece to do a drive through and they're offering us official feedback about that later today so, and I'm really trying to be as expansive and allow the biggest variety of perspectives in this conversation to appreciate Dr. Sal coming on short notice and providing her testimony before we break. I just want to go back to the conversation that we had as a committee a couple weeks ago, which was that there's we we have in this committee. And this question about the amount of servings that could be in a single container and right now, a person could buy multiple 50 milligram containers, and the practical thing the only thing that we're changing here is to say you could buy 20 gummies that only have five milligrams of THC each we're still keeping that cap, but you could buy 20 of them in a single container if we passed that section of this bill, instead of just 10. And we, you know, we looked at what the containers look like it's a jar. The suggestion isn't that somebody sit down in one sitting and consume that entire jar. No more than it would be that you would drink an entire handle of vodka and one sitting right. That's the analogy here with other controlled substances is we allow for monitors to purchase much more in one package of alcohol, for instance, then we would ever suggest would be safe or reasonable for a person to consume in one sitting. And this bill only says that somebody could buy a single package that contains more servants in it. That's the only change that we're making in age 270 around the container so I just, I keep coming back to this because Dr. Sal and other folks in their testimony have brought up questions about potency they talked about things like dabs and shatter. We're not addressing any of that in age 270. And I've been really trying to keep our, our discussion here as a committee focused on what's actually real. So, great stuff. Thanks for being with us. We are going to adjourn and go off live so we can all make it across the street. We're back. Thanks to legislative it here. And thanks for everybody's patience to pick up our work on each 270 children child is here with the latest and greatest. So, Michelle, could you walk us through. Sure. So for the record Michelle child's office of legislative council and as the chair mentioned we're working off draft 2.1. And would you like me to just show you the changes from the last draft. I didn't know if you wanted to start to go through the section by section or no just do the changes. Yeah, let's start the changes and then we'll discuss anything we need to discuss and then we'll do a last job through. So if you'll turn to page nine. Section eight on the propagation cultivator license. So you'll see I have the highlighted language on line 15. So this is basically telling what someone who obtains a propagation license from the board can do and this previous amount was 2,500 square feet and that's been changed to 3,500 square feet of cannabis clones immature plants or mature plants. Next change is on page 13. And it's also section 13 and so we're moving on to the medical cannabis registry and this is in the definition section for qualifying medical condition. So recall the bill is introduced had a list of a number of medical conditions that would then qualify someone to be able to make application for their registry and all of them have been eliminated in this draft with the exception of PTSD. And you'll note that on you'll see the struck language on line 16 through 18. Currently PTSD is a recognized qualifying medical condition but only if the applicant is undergoing psychotherapy or counseling with a license mental health provider. So that requirement is taken out and it's just added back up to subdivision eight a and then the final change. This is on the caregiver section with regard to the medical registry, and it's just a technical one. And that is is the if you'll see at the bottom page 15 and subsection C. It talks about rulemaking and there was a just a, if you look at the top of page 16. I intended to strike just his or her and kind of reword that a little bit because as you know we use gender neutral language as best we can. But I just need to restructure it and get in the words criminal history record on there because they are checking the Vermont conviction record as well as the registries. That's it. Any questions about the changes. I can give a little bit of context and then I might ask. Chair pepper if he wants to weigh in we had. Looked at. So we heard from. One of the multiple licensees in Middlebury that they would like that cap to go from 2,500 to 3,500. I think the idea with the cap on the propagation recall that this is like about the. And that when I asked pepper about it earlier, it's one of those things of life. It's, it's a little bit arbitrary. I'm just trying to find some cat because there wasn't. Especially in ways it means when this was previously came up about not just having infinite numbers of. I thought we would take that recommendation. The board's not close to that major change. Change on the criminal history record that technical change reflects what brand had brought up for us earlier. So we made sure that we. And struck all of. I think we were trying to get rid of gender language in that one section in the caregiver section. And I think we were able in the qualifying medical condition in section 13. To capture the recommendations that we got in the email from the human services committee chair. They had some concern after their drive through with the bill. And I think that's about enumerating more conditions without taking further testimony and doing some more research themselves. But I think they consider the post dramatic stress. Disorder conversation. Previously, and we're comfortable with the canvas control board's recommendation around striking the, the need for 2 signatures and refer to Madagascar earlier from. The patient perspective about. Asking us not to require a second signature. So. But we removed all of the other and newly enumerated conditions in this draft. Other questions. Lots folks had. We walk through. Thank you. So, with the PTSD, is there still some. Requirement that that be taken or provided with care with a. Position or is that completely not necessary anymore? So return childs, I think all the enumerated conditions need a sign off their order. Note to the effect that the. Person on the registry has 1 of the qualifying conditions. Correct. And just as a little refresher is that all it is, is it's a medical verification form from your healthcare provider that. You have 1 of those conditions. It's not. There's no kind of the healthcare provider isn't agreeing to treat you with cannabis or they're not prescribing cannabis or anything like that. They're just verifying that you meet the statutory definition that you have that condition. So they do have like, but they do have someone that they're having that they have care from. You know, regularly or in some capacity, they have to have an established patient healthcare provider relationship with that person. So it could be a position could be a physician's assistant and our and somebody that's listed under there that can sign that medical verification form that knows you that's done an examination has a relationship with you. And has diagnosed you with that qualifying condition. And then they are just a testing to that. And then they're submitting that documentation to the board. I should maybe know the answer to this, but I don't remember, I guess, but under the propagation cultivators license. That's the test transport. Cannabis plans. Licensed cultivators. Out of state. Right. You can't. Everything's in state. So federally illegal cannot be doing business with folks outside of Vermont. It's only with other licensed cannabis establishments. And then my next question is, if for some reason it could happen, I guess that they produce more of that product, whatever it might be, then what they can sell what what happens to the stuff that they can't sell. I think that probably be a good question for pepper in terms of what they do around compliance with their license and how they might address like, you know, an oversupply of a product and what and how long they can keep it what they have to do to for because there's procedures that for destroying product things like that and how they have to handle it and there's a whole chain of command that they have to follow in terms of record keeping so I think you can probably address that. Would it make sense to maybe get that question and any others answered from pepper and then we'll do a walk through the job through the whole bill. That's okay. Whatever you want. Ever would you mind switching it up with Michelle and taking the hot seat for us. Your feedback on these changes. For the record James pepper chair the Vermont cannabis control board. And again I'm happy to talk about these changes any other changes I know that there's probably going to be a final walk through. I'm happy to just stick around for that as well. Yeah, I mean, very supportive of this bill in general. I think these changes actually do make the bill better. I mean I know we had asked for additional qualifying conditions. Those that's a policy decision you don't want them or the other if the legislature doesn't want them that's fine. The change the propagation license is, you know, again just in line with keeping things small, keeping this local. You know, it was 2500. That would have been a tier two out of five. I think that's in respect to our other cultivator licenses. Now it's kind of in between a tier two and three, but it's still small and by the way just to be clear these are micro licenses compared to our neighbors and every other state you know I don't think, you know our small cultivator tier one doesn't even register as a craft cultivation it and most of states. So I'm certainly, certainly supportive of the change and the, is there was there anything else in the bill that you wanted to point me to. There's that one technical change that Brandon asked us to make at the top of his city. Yes, so I think I can honestly I think that was just a mistake and it was caught by a human services committee you know essentially. Moving from a 50 state criminal background check to a Vermont background check, and then it authorized to make rules around what sort of, what sort of condition what sort of convictions should be disqualifying or what about you know what things from the industry should disqualify person from being able to be a caregiver, and for some reason that language around the criminal background check got struck as well so essentially would have run a background check without any ability to kind of disqualify someone if we found a conviction that would should be disqualifying. So that is just unstriking the body's current law, allowing us to use the results of the background check to disqualify someone. You know it's, we would come up with rules around it what sort of convictions, you know I would assume that it would be very similar with what we do with, you know, probably our other licensees like anything that implicates some of these cold issues around embezzlement fraud, like felony embezzlement, felony fraud, you know maybe felony gun convictions or domestic violence issues, because certain of the list of crimes we just know we don't allow them to get any kind of license in this industry. Any questions for Chair Pepper? One once, going twice. I know you put a lot of work into the bill and trying to present us with some suggestions for how we can kind of do some mid early course corrections with the new retail market and also around some of the medical cannabis policy. So I appreciate the communication and your ability to be in here so much time because I know you all are really busy as things emerge so. Well, I would say the same, the same to everyone here I know you all are very busy and I know that, you know, not many people ran on a platform of fixing the cannabis market. Well, maybe some but very rapidly evolving industry licensees in other states try and get ahead of the regulators they try and find, you know, play in the joints of areas that aren't as clear and so we just need to continuously update this market and and update the statutes and some of them so we can try our best to stay ahead of some of these issues. There's actually a lot more coming your way I imagine around hemp drive products and they're grown from legally, you know, federally legally grown hemp but are psychoactive and intoxicating and are kind of exist in a gray area. So, there's more to come unfortunately or fortunately. I'm happy to stay for the final walkthrough and come back in the chair before you guys take any action. Thanks so much so unless there are any other questions for pepper from the committee I'll invite Michelle back and we'll walk through the whole thing and understand what's in what's out. Anything else we need to work on before we move this bill along. Good. I just wasn't sure whether or not pepper wanted to address representative Hinckley's issue about what if somebody has too many plants how do they address that. Sarah and James pepper. We have very strict inventory tracking requirements and people have to update their inventory anytime any change happens to their to their inventory or two weeks or you know whichever comes first. You know, with a propagation license, you may have a fear that, you know, it's, it's immature plant becomes mature all of a sudden you're cultivator you're not a propagator anymore. And so we would require destruction of that if, if that were to happen and you know destroying cannabis plants we have a process for that. Okay, so I'm going to just go section by section, and I'll just keep moving along unless you stop me. Yeah, we can do a job because we've looked at this a couple of times and anybody in the committee wants us to stop and has a question about a piece. Definitely just get your hand up all try to keep standing room. Thanks. Okay, so page one section one. This is the repeal of the advisory committee. Page three section two. This is repealing the sunset of the cannabis control board member there was in the original bill in 2020, there was a sunset put out in the future for for the board, and you're repealing that sunset. Section three, looking at the bottom of the page is just slightly tweaking the definition of advertisement and I think you heard from Brent here about why they felt as though it would be more legally defensible to have this small language tweet. Page four bottom of the page subdivision eight just changing making that small change including propagation cultivators within the definition of cannabis establishment so that they would because you're adding a new licensee top of page five, the new definition of a cannabis propagation cultivator. Section four. There's a couple different changes in here you'll see the first one being that in subdivision a three online 11 so right now. Packages of cannabis products cannot contain more than 50 milligrams of THC. I think the chair did a great job explaining that earlier today about it's not a. There are limits on how much you can buy but this is just talking about per packaging so this isn't the overall amount this is just how much you can have an each package and that's being changed from 50 milligrams of THC to 100 milligrams of THC. In the bill but since you brought it up and can you remind the committee what the total purchase cap is on THC. It's an ounce and there's a there's a formula for how they, how they figure that all out if you're getting different types of equivalent to an ounce of flour. Right, right, because that's what you're allowed to possess under the legalization law that you pass prior to the current establishment of commercial system. Thank you. So, next change is a bottom of page five and subdivision five and this is concerning retailers and we talked about that this morning this was a small tweak that doh asked for ask the CCB for around annual inspections for retailers. Page six subdivision eight you'll see the requirements for the rules for the new propagator licenses. Bottom of page six section five starts and this is the section that currently you see the language that struck at the top of page seven is the language around public records access to records. That struck in favor of the addition of the new language and section six on the bottom of page seven. And that continues on through page eight. The question that we did have on come up earlier this morning on section six with the public records was whether this language is similar to public records protections for other similarly regulated industries. I wouldn't know that. This is the only industry that I have any involvement and usually I'm all family law and occasional crimes which is how I wound up here. I think we will be occasional. I think what we'll be doing later on, as we get into some bills that deal more with the public records act is looking at more of this it strikes me that this is similar to other public records act exemptions that we've seen and passed by any different we're striking a balance between what does the public reason we need to know versus sort of trade secrets and protected intellectual property and that kind of thing. So we can definitely kind of return to this thinking representative had that question before. Right. And as you know Tucker is our expert or in house expert on this and anything there's having to do with public records and things like that. We always all the attorneys in our office we always run all the stuff by him to make sure that it seems consistent and doesn't seem kind of way out there in comparison to what we have elsewhere in statute. Or at least he'll flag it for us if it is. Page nine section seven. This is the tweak to the cultivator licenses so just adding in that they can be purchasing and selling with a propagate propagation cultivator. And then the new edition of the language on subdivision three section eight is your new propagation cultivator license. And then section nine is the tweak to the wholesaler license right now that they can only be doing business with certain other licenses and this allows them to be doing business with any of the other licenses. That same kind of change is made in section 10 to the product manufacturers. And it and again and 11 with regard to their retail licenses page 11 bottom of the page section 12 and this is on the fee schedule. And you can see it starts out talking about manufacturers at the bottom there and the talking about manufacturer tier one. And the threshold there for this license is that they would be producing products right now since not more than $10,000 and this upset to not more than $50,000. In section seven you have the new $500 fee for a propagation cultivator. Moving on to page 13 section 13 you have the what we just talked about the changes to the qualifying medical condition. So page 14 looking at line 18 section 954 and caregivers we just talked about that about the little technical tweak there. You also have in this section the change so that a caregiver can serve to up to two patients at a time instead of just one. And then in line for registration fees is this is a change so that if you have a qualifying medical condition of chronic pain, then you have to do the annual annual registration but if you have kind of an intractable disease that is not going to be changing from year to year so if you have MS you don't have to necessarily go through and read redo that every year and have your doctor fill out the same form saying yes they still have MS. So page on page 15. And this is the tweak to the caregiver background checks language. So instead of doing the national data, national criminal history check it's a name and date of birth Vermont criminal conviction check also checking the child protection registry as well as the vulnerable adult protection registry. Section 17 section 14 on the fees. So this is changing the fee for dispensaries is that you'll see that currently there's a $20,000 registration fee for the first year of operation and that's being decreased $10,000 section 15. And carries on over to page 18 is just a clarification that the section doesn't apply to the retail sale of tobacco paraphernalia by a cannabis establishment. So if cannabis establishment is selling up a pipe or a bad or something like that that that tax that's that has been established for for tobacco for folks who have a tobacco license then you don't have to get a tobacco license in order to sell a pipe if you're already licensed by the government or to sell cannabis and cannabis products. Section 16. This is the establishment of the three new positions and the $850,000 appropriation. That was also in the BA, which I understand went to the governor yesterday or the day before. So there to understand from the clerk's office so my understanding and maybe you would know this or we can double check with the clerk is. I'm going to keep this in here just in case something happens with the BA. So, assuming that the BA that signed I may, we may look at a for amendment or the Appropriations Committee is going to look at this bill obviously and they could suggest an amendment so I want to keep it in here for now just in case something happens with the BA in between now and a few days from now and the deadline runs out but I want to make sure we're balance the spenders on this appropriation. Lots more stops for this bill and opportunities to take out that section it's easy. And then final pages page 19 section 17 and this is just bumping out the date for when the auditor of accounts is to report to you on the structure of the canvas control board and whether that initial structure of setting it up with three members and as an independent executive board executive branch entities still makes sense. And then the whole bill takes effect on July 1 of this year. You've heard a lot about this bill. Any further questions about the bill questions about the words on page. What's in it. There's technical pieces. Well, I want to open it up for committee discussion so you can feel free to stick around or if you want to get out of the hot seat. There may be a question or two that comes out of our committee discussion but then what is that. You know I've always got something to say. So I have some questions about specifically removing those conditions like we were talking about earlier and then human services. Her yesterday. Do we have to do it? No, that's such a great question here. Just respect to them and their hard work, of course. But I just I'm wondering because I knew here how that works and I might disagree with that recommendation, which is why I'm asking. So, I obviously was the co-sponsor along with representative Byron of the original version of this bill and personally was comfortable with taking the recommendations from campus control board. I think there's a difference of opinion about the way that we approach the future of the medical program. And my guiding principle with this particular package and I think we heard heard this from chair pepper several times along the way it was that this is the package that should be the kind of like the tweaks things that are not, you know, huge, major policy changes. And so when the the feedback that I was hearing from folks who were in the room and human services yesterday was that there was strong opposition to adding more enumerated conditions to the registry and qualifications and qualifying medical conditions. And I want to continue to have a conversation about the health of and the future of our medical system. I want to make sure that patients have access to the types of products that they might not be able to get at the retail adult use market. There's a disagreement. And I think strategically for for us and the other policy in this committee, the best thing to do right now is to say, Hey, we hear you do you want to take some more testimony on these things before we make this policy change. Let's have that conversation another day. I'm kind of inclined to share your opinion that we should keep those those in there and we shouldn't do that expansion. I don't know that now is the right time to do it. So in asking attorney child to do this latest draft, I said, take the recommendation for now of the human services committee, but it's, you know, it's the committee's bill now so I'm happy to have folks say, No, we should say thanks for your work but we want to keep those conditions in there. I think it's exactly the right time to have that conversation because we have kind of two versions of that section and we could go back but I think we may hear on the floor, a lot more pushback against our bill. If we voted out with those conditions. One of the note that was very particularly of laying that out sort of like on how the bill will progress and whatnot and one of the things I heard from members who I spoke to individually from the human services committee was they just didn't have enough time to take testimony on it. And that's why the vote looked the way it did. So I want to be respectful of their desire to do a little bit more homework on it. So in my opinion this conversation is, it's not over we just removed this section now that they can continue to like dig in and mine in on the subject matter that's been going through their committee as this legalization medical cannabis has evolved over the time on 15 years. I think it was 2004. Yeah, so adopted it. So I, you know, I was not enthused with the language, but I also want to be respectful of our colleagues desire to do their homework. It just seems fairly arbitrary. Yes. Once again, I'm just saying that's what it seems to me but I'm saying we had, I guess, maybe some context and maybe sharp ever can offer this, or maybe you guys know. Why were those particular conditions included in the first place and where did the where did the information come from that that led the creators of the bill or everybody who voted on her wrote it. I guess I'm asking because if we have all this testimony or this information that testimony from Minnesota and those papers and everything if that's what led us to include those first conditions in the in the first iteration of it. Why wouldn't that be sufficient of it dense or reason or kind of a logical next step as far as this is based on the testimony in my understanding isn't correct if I'm wrong but based on the testimony that they took yesterday and is limited and did not provide them enough to like make an answer to say. You were cautious. Sure. But why were the first why were, why was like, for instance, crumbs disease and all sort of clients are basically the same thing. I mean, not but they're close. So why was crumbs in that first one. I actually share your question. Yeah, so I asked that question earlier and I think you can check up and correct me but again, there appears to be in particular Minnesota that had studies done on these and that rather than having our health department. Take an extensive to my effort to go through these. Those particular. Yeah, but like so crumbs already included. It's part of it's part of the law right now. So, yeah, so when you look at the why was that included in the first place. That's the thing I don't understand. Well, actually, so there's a combination of things actually the way this has been put together has been iterative over the almost 20 years that that we've had, you know, some version of the medical program in Vermont and a lot of the pieces that are in there. Some of it predates my involvement in the legislature has been about patient advocacy. Some of it's been about there being, you know, some actual study or some medical professional being able to come in and say, yeah, there is evidence that this is helpful. Well, the challenge that we have around the whole medical program, and how we qualify people for it or not, is that because cannabis has been a schedule one drug at the federal level, there's not a ton of great data like we don't have federal, you know, huge population level studies of what the benefit versus risks are of the therapeutic use of cannabis. So, I mean, I invite chair pepper if he wants to weigh in on this discussion because it is it's really challenging for us as policymakers who are, you know, we're all citizen legislators to go, you know, which condition is the opinion and which ones out and who which doctors opinion, do we use on it and so I'm sympathetic toward the testimony we heard earlier that we should base this more on, you know, symptoms and a physician saying, you know, this person has a condition but I know that's not where some of our colleagues are both inside and outside of this room so I'm trying to find the way to thread the needle. Do you want to respond to that and then I'll go to represent hang this question. Sure. And it's James pepper chair that came as control board. I mean I would agree with everything that was said and this program certainly predates my involvement with the legislature as well. And it has been a ball it has evolved over time I mean I think it was very limited at first terminal conditions. It's usually advocacy I know PTSD. It was, you know, a number of people coming in witnesses with PTSD. Canvas has really helped helped me. And I think really the problem that we ran into is that, you know, I don't think I did enough of my homework with the health and human or the human services committee to and you know we have a very close working relationship with the Department of Health. And I think, had they been able to weigh in yesterday I think the decision may have gone the other way, which, you know, if they have the time to do this I think I'll continue to kind of push for these and have you know this bill has a long way to go as Michelle said, There's still plenty of time left in this legislative session to kind of have these conversations with the Department of Health with the medical society and other committees to just and bring in, you know, the chair of the Minnesota board to kind of just say, you know, just give that the other committee some assurance that they did a lot of due diligence in order to come up with their list and you know, I think that's what was missing. And that's why, you know, things didn't kind of go, they didn't support the Canvas Board's recommendation. I'll just say one more thing. It just on the same thing. It just seems like especially in light of the testimony we heard earlier from Jesse Lynn, was that your name? Yeah, and I asked the question because I have heard that a lot of times physicians will just or healthcare providers will just want everything kind of throw it into the chronic pain category because that's something that they know will get you to get somebody that medical card that they need but I don't think that's reflective of what actual needs are being met with the medical program. And stop. I think you're making good points. Don't and I don't want anybody on the committee to feel shy about saying. I have never. This is bad stuff. You don't have to apologize for speaking your mind. Represent Pango. Thanks for being with me. Sure. And nor have I. That was a perfect handle. On the opposite end of that spectrum. This discussion that we're having here. And at the risk of sounding like I'm trying to debate what committee of jurisdiction this should be in this whole medical conversation in my opinion should not be in this committee at all, because we are not the healthcare experts in this building. So on that note, I find this bill to be very expansive of a program that we obviously have not done our due diligence for. I mean, just hearing now. Oh, we, we should have had more time or we could have had more time or we needed more time with the Department of Health. Those types of comments to me make me feel that this is not ready for prime time. So that is where I'm at with this. I find it really difficult to pass something that I know very little about. And that we need more opinions on. Thank you. Thank you. Thank you. Give it a little history of the medical marijuana or cannabis for symptom control. It was called when we first did it. I was on human services committee. When we passed that first bill. And it wasn't healthcare committee was human services. As an any committee, we rely on the experts to come to us and we make the judgments. Some of the testimony that really convinced me that this was a good thing. For instance, we heard from a veteran of the Gulf War. Who was shot in the back and still had a bullet next to his spine. And the only thing he said that touched the pain was medical cannabis. He said he didn't get high on it, but it leveled the pain out so he could function. We heard from other people who had her were using it for epilepsy. And I don't remember what it extensive testimony to initiate this, this bill. So I just want to share that bit because I hear what what you're saying. About the healthcare committee, but I don't think that would be the committee of jurisdiction. It could be us. It could be human services. But whoever it is, I think we have to make the decisions after we get our testimony and we've heard. I think enough testimony for us to move forward on this. I think it's challenged for us to make those decisions no matter what. And I'm ready to move forward with this. And I think this is the place for us to be able to think we've taken a lot of testimony here. And I think I'm one of the people that wants to move cautiously on this, but I also think we're doing our due diligence to move slowly. And I think the Libra over here keeps balancing things out. And we've heard people say we're going too slow and others were going too fast. And I think we're falling in the middle here. So I think I agree with that. We're coming to a good place. I had representative troopers question. No, no, no. Attorney Charles, if you had to. No, I was just going to give you a little more context because Mike and I work together on there, but if I can wait, there's no. Representative Cooper Burlington, you had your hand up next. I'm going to change subject. You wanted to go with this. Well, I was just going to say pepper said at best we're going to keep updating this policy every session so you'll get another shake. And I did want to I did want to respond to represent and go and just say. Yes, we we right now. We're we're we're yes. I really understand that this is tricky because there are folks who would prefer that we not have the state involved in a medical or an adult use retail canvas market. And on one side, and then we have now that we have both of those programs markets set up. There are folks who are saying, open them up, do a lot more. And we heard folks who are really urging us to go a lot farther and put many more things in this bill that would, you know, expand access to use that would expand the market but do many things that are not in this bill. And I think the fact that we heard that no one is quite satisfied with what's in this bill means that we probably did do it representing where we're saying and how to thread the needle down the middle. A lot of us have been working on this canvas policy for a number of years. It is really challenging. And I, I, I appreciate both sides of that perspective. I've tried to walk a line in the middle and make sure we do hear from voices that don't agree with me don't agree with positions on any side of the kind of spectrum of the debate but these are really challenging questions no doubt about it. So represent Hanko. Thank you. I just want to make something really crystal clear I am not opposed to the medical registry program at all. I just don't feel that we're the people to be legislating the medical side of it. I was the time is probably passed by just wanted to when you're talking about the history or had some questions is that when the program was originally adopted it was so there had been a study committee, but just say a study committee that recommended it took a couple years for it to pass and when it was originally adopted in 2004 the only conditions that were qualifying were cancer, HIV and AIDS, and MS, and, and you had to have been diagnosed with those with with one of those conditions and have essentially exhausted all other treatments. So they had the medical provider had to say oh they've done this and they've done that and they still have not gotten relief from that and so they so it was quite restrictive at the beginning and then over the years it's just gradually changed a little bit so you know I've been here for 25 years I've been doing this these laws all the drug loss since then so every year I draft bills where somebody saying okay how about Crohn's there's you know 17 states that allow Crohn's as a qualifying condition and here's the studies for that and then there's those for that and so it's just gradually been expanded over over time and changed you know slightly but it's it's it has been very incremental over the last 20 years. President Hooper-Prem. The record is just the last time I was. Following up on a comment that somebody made, is there a reason either in license or tax statute that an individual with a card could not go into a retail establishment and buy tax free. So there's a number of our retailers are actually saying I will pay the tax for you there I think it's a legislative decision that has to be made. What's that? You think it's what? A legislative decision that would have to be made for a person with a medical card to get a tax waiver at an adult recreational store. The card is numbered? The card is numbered yes. I can go to an auto parts store and buy one thing and pay a tax and buy another thing not based on a business. Just seems customer friendly to be able to allow people to use the outlet that they. So that's a policy that's one of those big bucket of asks that was was in the list from some advocates on different, you know, from different stakeholders and this whole cannabis discussion that, you know, I think deserves a conversation in the future. The idea that if you have a medical card that you maybe could use a adult use retail having to go to medical dispensary. But I think one of the reasons why we're not driving there right now is that we're concerned about the health of the medical dispensary system to hand making too many changes too fast with these two parallel systems where you can get cannabis and I would suppose the product offers somewhat different. It is and in fact, you know, one of the things that we did in our rules is said if you are a medical dispensary that wants to play and both the WC and the medical that you need to maintain a minimum three month supply for all of your patients. I think that the patients really are held harmless because there are products that are available on the medical side that just either because of there's no profit there's no market for them on the adult like high very high CBD very low THC products or things that have certain people don't want on them on the adult side but are very therapeutic for people with PTSD or something along those lines and and there's always the high THC solid constant well so you know we said if you're going to have both and so far I think all the one of the companies is playing in both the authorities their main they're holding the patients harmless currently by maintaining those products that really if you're a for profit corporation might not stock you know you wouldn't really have it on your I don't think this will be the last time we will think about the interplay between markets. I don't think this project is going to go away. Sure. I guess I'd first like to start off saying how much I appreciate your efforts and keeping a lid on this program it's it's you know I've seen him over the years and it over the years. I haven't supported the initiative in the past and will be in regards to some of these changes. I know that the cannabis control board has abilities to hold the line or hold whether it's yours retail you name it task and they've done it with a light touch at first and I can understand that you know it's a fledgling because that's the word right in the industry but I hope that down the road for sure that they tighten up because again I think the other states that I've heard and her testimony from and so on they're always pushing the envelope the industry is always pushing the envelope and you do have to keep ahead of it and when I again read things from you know the memorial valley health group that's in constant discussions with law enforcement and law enforcement says that the only thing that they can enforce is underage use and none of the other issues of public and public consumption and and so on, you know it sounds like there's a judicial system issue there as well but again coming back to whether it's Colorado or it's New York with the illegal activities that are that are going on that are being stifled as a concern. And I and I just I you know represented my wiki talked about an individual with pain that had helped when this initially was considered there was a young mom who came out from my belief Boulder Colorado on her own. And she told the horse or is a person who got involved with dabbing and was it an institution in Texas. Her family couldn't go to a movie theater anymore and Boulder without, you know, the smell of marijuana. There was shootings down the street from from her home in regards to the illicit market and the cartels that were still, if not as much maybe more in the area so those sorts of things really have a concern to me and I've got to hand it to you to now that you're you're doing as good a job as you can but I think I think it's going to have to be stepped up a little bit on some of the enforcement. Yeah, I just take your point and I would just say we recently publicized because the case is now closed agreement has been signed a very serious violation that we initiated you know someone. You know we may be taking a kind of education first approach for unintentional actions I mean this these are brand new regulations for everyone but there's certain things that people should know better you know there's certain things that just crossed the line between unintentional and intentional mistake to kind of flagrant violations you know one was a person across day lines went down to New York and sold cannabis and posted the thing that Facebook or social media and that person got a $20,000 fine and a six week suspension and now we're we're bouncing the needs of the people that we've asked to come in and to this market, they've never been subject to this level of regulation before or any regulation before. There's a lot of people that want that are trying very hard to be compliant and then there's people that are not. We're trying to take the education first approach with the former and you know, we are cracking down on the ladder but it's it's good, you know, people are challenging board, you know they're challenging our advertising restrictions are trying to see how we respond very much like raising a child, which by the way I have to go. I really apologize that I have to go pick up my son from childcare, 330 and watching the clock tick down. They charge by the minute. So, you know, I can call in if you'd like but I really do need to. I think we have pretty much wrapped our work up on this bill. So I chair pepper I really appreciate the time you're going to us today I know it was a really tough childcare day and you know the childcare care folks I believe your wife's involved in that kind of case in point so please go get your kids. Thank you. Thank you. Thank you for again, you know, feel free to stop me in the halls or call me or any questions that you have. So I think that's one of the most important points, you know, close by. I'm trying to close it. I did everything everyone was saying actually I think that there's a lot of good points. I just want to share one perspective which for me. I think there's not enough evidence to show XYZ harms a lot of times. But then on the other hand, he I don't see us holding that same standard for when we're saying some things like safe or okay for XYZ conditions as often. And so that's where I'm kind of concerned because I think, you know, in terms of perspective, that's what I see as like my role is to absolutely sure something is safe or something. I don't feel like I should say that. So I'm struggling on this because I don't think it's, you know, I think there's some good things in there and a lot of hard work was done. Dispill still has some miles to go and what we're always balancing out with any of the controlled substances and you know reason this is this was in GovOps and that we now have you know the DLL and so there's sort of a nexus here that's in this committee now with with these illegal substances that the state has involved in regulating and it's always this balance between we know that there are these activities that are happening that people consume alcohol that people gamble that people use cannabis recreationally. And the spectrum that we all where we all fall on the line of should the state prohibit activity, should it control and regulate that activity, should it just allow people to do what they want to do and let the chips fall where they may, we're all going to fall on different places on that spectrum. Your particular public health perspective is really valuable here, and I, it challenges me in my feeling of being a little bit more of like a harm reduction slash libertarian person, when it comes to some of these behaviors is to say what is our role. And it's it's about the framing for this is it about, and, and then the question is, if our job here is to try to keep the public safe. I think having a reasonable healthy retail market, I was convinced over the last few years to work on cannabis in this committee and and outside of here with local questions about this stuff. That we would be better off having people have a well regulated well functioning retail market that, you know, had consumer protections. And this bill doesn't make any big use changes to that. What I think is there are some pretty significant tweaks to the policy, a new type of licensee, for instance, I think is, is not going to transform the market but it's definitely a tweak. But I, but I think that thing of how do we make the keep the public safe with this particular thing. I don't know if we can ever be, if we ever can get to the place where we're like, absolutely sure. We're just as cautious as as we do this and we'll keep checking back in. All right, I think we'd beat this one. I'd like to make a motion to vote out of your most studious government operations committee age 278 insulators. So that'll be draft number 2.1 at the time stamp of 117 p.m. I wonder if we could see a clean copy of the bill without the mean without without the highlights with that. Well, there's a lot that struck. Does that stay in the bill the struck. He said he removed all the okay. Yeah, the only thing I so I just went out and there's there's three places that are highlighted and those are the changes from the previous version. And I just took out the highlighting. So, and I'm going to send a clean copy over to Andrea right now, if you want to say it, but the only difference would be that I'm removing the yellow highlights. But the struck language, you know, all of that is just, you know, the repeal. Yeah, it is a messy looking first section. I totally agree. I think we have to keep it. We have to keep that in there in order to do repeal right of the advisory. Michelle, we would have to keep the correct. Yes. Yeah. I mean, there's other ways we can get around that, but you want people to be able to see what you're getting rid of. Representative Roecki, do you want to see a version without the highlights before we move? Okay. All right. Any further discussion? The clerk will call. Yes. Yes. No. No. Yeah. Yeah. Yes. Representative Watters Evans. Yes. Yes. Representative Nugent. No. Representative Pinkley. No. Representative McCarthy. Yes. Thank you all. I will be reporting this bill. I think that does wraps up our work on this bill. Yeah. So the, the really appreciate everybody's work on this. I know it was today, especially was a lot of talking about canvas policy. So we can hopefully put that aside and switch it over to. Here's to other things. The last thing that we agenda today and I think we're, we've got to give attorney and deadline. So we're going to take a 15 minute break and then come back at 345. All right. Welcome back to the late afternoon session of the house gov ops and military affairs committee. We are resuming our work here to pick up a bill that we took a little testimony on yesterday, each 178, which is an act relating to commissioning department of corrections personnel as notaries public. I think Devlin is here and then could you take us on a quick just breeze back through this bill so we just get back up to where we were yesterday. So the amendments to existing law are very minor. I guess I should just start by saying that this bill proposes to add persons employed by the Vermont Department of Corrections to the list of persons who can be commissioned as notaries public to perform notarial acts within the scope of their official duties and exempted from all regular requirements for notaries public. The pertinent languages really in section one section two is just effective dates. Section one immense title 26 PSA section 5305 specifically, which is sorry so exemptions specifically subsection a and one. Sorry. Where are we here. Subdivision B sorry halfway through page two, and you'll see that there is an enumeration of law enforcement related employees and the new language starting in line 12 would read subdivision be law persons employed as law enforcement officers certified under 20 PSA chapter 151 who are non certified constables, or who have been employed by a Vermont law enforcement agency, the Department of Public Safety, the fish of fish, sorry, the Department of Public Safety of motor vehicles of liquor and lottery, new language of corrections, or of children and families, the office of the defender general, the office of the attorney general or a state's attorney or sheriff. The other modified language at the top of pay through page three is degenerate amendments replacing he or she with the person and equivalent later on that sentence. The rest of it has been kept into provide context. The only other thing I think I should mention is that section to the effective date as it's act taking effect upon passage. Any questions. This bill. It's a tough one. Just the opposite in terms of complexity I think from the bill we just discussed so. But I think it will be helpful from what we heard and not cause any challenges from OPR and I actually think one of the best things that came out of our discussion yesterday is that Deputy Secretary Hibbert and Commissioner demo hopefully will be able to reduce the number of documents that even need to be notarized so that might be the functionally one of the best things that comes out of this. So there's really much to talk about here. So it's entertaining a motion to move the H178 as introduced so. Hooper has moved that we report favorably each 178. Is there any further discussion. Who feels like they would be willing to give a pithy floor report on this one. I mean that just really got her. Very well dated ask. You're valid here. Yeah. Appreciate that represent water. The shorter the bill the more willing I am. You want to be prepared for a thorough interrogation no matter how long or short the bill is or appears to be. Great. Well thank you so much for that. If there's no further discussion. I'll invite the clerk to call the roll. And for our. Yes. Yes. Yes. Yes. Yes. Yes. Yeah. Thank you all very much for your diligent and hard work on both of our bills today even though one was long and one was short. So, Tim, thanks for joining us and for your work as always. That concludes our business for today.